Abstract
Purpose
In many western countries during the recent years, people have witnessed the deterioration of their economies and the emergence of related phenomena such as loss of property, unemployment and social disruption. These phenomena have also been associated with increasing levels of demoralization and the developing of major depressive episodes (MDE). Greece in the years 2008 and mainly in 2009 started facing a sharp economic decline. The purpose of this study was to explore the consequences of this condition and the ways are reflected in the prevalence of MDE during these two critical years.
Method
Two nationwide cross-sectional telephone surveys were carried out in 2008 and 2009 with representative samples of 2,197 and 2,192 respondents, respectively. The interview comprised the SCID I module of MDE and an Index of Personal Economic Distress (IPED).
Results
The 1-month prevalence of MDE in 2009 was found to be 6.8%, compared to corresponding rates of 3.3% in 2008. Respondents facing serious economic hardship (with higher scores in IPED) were mostly at risk for developing an MDE.
Conclusions
The findings of both studies underline the significance of the risk involved in developing MDE when individuals have been exposed in extreme and stressful economic situations.
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References
Boyd JH, Weissman MM (1981) Epidemiology of affective disorders. A reexamination and future directions. Arch Gen Psychiatry 38:1039–1046
Bebbington PE (1988) The social epidemiology of clinical depression. In: Henderson AS, Burrows GD (eds) Handbook of social psychiatry. Elsevier, Amsterdam, pp 87–102
Young MA, Fogg LF, Scheftner WA, Keller MB, Fawcet JA (1990) Sex differences in the lifetime prevalence of depression. J Affect Disord 18:187–192
Weissman MM, Bland RC, Canino GJ, Faravelli C, Greenwald S, Hwu HG, Joyce PR, Karam EG, Lee CK, Lellouch Lepine JP, Newman SC, Rubio-Stipec M, Wells JE, Wickramaratne PJ, Wittchen H, Yeh EK (1996) Cross-national epidemiology of major depression and bipolar disorders. JAMA 276:293–299
Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, Wittchen HO, Kendler KS (1994) Lifetime and 12 month prevalence of DSM III R psychiatric disorders in the United States: results from the National Comorbidity Survey. Arch Gen Psychiatry 51:8–19
Blazer DG, Kessler RC, McGonacle KA, Swartz MS (1994) The prevalence and distribution of major depression in a national community sample: The National Comorbidity Survey. Am J Psychiatry 151:979–986
Horwarth E, Weissman WW (1995) Epidemiology of depression and anxiety disorders. In: Tsuang MT, Tolen M, Zahner GE (eds) Textbook in psychiatric epidemiology. Wiley, New York, pp 317–344
Katschnig H, Angermeyer MC (1997) Quality of life in depression. In: Katsching H, Freeman H, Sartorius N (eds) Quality of life in mental disorders. Wiley, Chichester, pp 31–45
Ayso-Mateos JL, Varquez-Barquero JL, Dowrick C, Lethinen V, Dalgard OS, Casey P, Wilkison C, Lasa L, Page H, Dunn G, Wilkinson G, ODIN group (2001) Depressive disorders in Europe: prevalence figures from the ODIN study. Br J Psychiatry 179:308–316
Andrade L, Caraveo-Anduaga JJ, Berglund P, Bijl RV, Vollebergh RDG, Dragomireka E, Martin Keller RK, Kessler RC, Kawakami M, Kilic C, Offord D, Ustun TB, Wittchen HU (2003) The epidemiology of major depressive episodes: results from the International Consortium of Psychiatric Epidemiology (ICPE) Surveys. Int J Methods Psychiatr Res 12:3–21
Jonas B, Brody D, Rope M, Narrow O (2003) Prevalence of mood disorders in a national sample of young American adults. Soc Psychiatry Psychiatr Epidemiol 38:618–624
Wilhem K, Mitchell P, Slade T, Brownhill S, Andrews G (2003) Prevalence and correlates of DSM IV major depression in an Australian national survey. J Affect Disord 75:155–162
Alonso J, Angermeyer MC, Bernert S, Bruffaerts R, Brugha TS, Bryson H, Girolamo G, Graaf R, Demyttenaere K, Gasquet I, Haro JM, Kats SJ, Kessler RC, Kovess V, Lepine JP, Ormel J, Polidori G, Russo LJ, Vilagut G, Almansa J, Rbabzadeh-Bouchez S, Autonell J, Bernal M, Buist-Bouwmann MA, Codony M, Domingo-Salvany A, Ferrer M, Joo SS, Martinez-Alonso M, Matschinger H, Mazzi F, Morgan Z, Morosini P, Palacin C, Romera B, Taub N, Vollebergh RDG (2004) Prevalence of mental disorders in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatr Scand 109:21–27
Marcus SM, Young EA, Kerber KB, Kornstein S, Farabaugh AH, Mitchell J, Wisniewski SR, Balasubramani GK, Trivedi MH, Rush AJ (2005) Gender differences in depression: findings from the STAR*D study. J Affect Dis 87:141–150
Zimmerman F, Katon W (2005) Socioeconomic status, depression disparities, and financial strain: what lies behind the income–depression relationship? Health Econ 14:1197–1215
Andersen I, Thielen K, Nygaard E, Diderichsen F (2009) Social inequality in the prevalence of depressive disorders. J Epidemiol Commun Health 63:575–581
Roy-Byrne P, Joesh J, Wang P, Kessler R (2009) Low socioeconomic status and mental health care among respondents with anxiety and depression in the NCS-R. Psychiatr Serv 60:1190–1197
Talala K, Huurre T, Aro H, Martelin T, Prattala R (2009) Trends in socioeconomic differences in self-reported depression during the years 1979–2002 in Finland. Soc Psychiatry Psychiatr Epidemiol 44:871–879
Liwowsky I, Kramer D, Mergl R, Bramesfold A, Allgaier AK, Pöppel E, Hegerl U (2009) Screening for depression in the older long-term unemployed. Soc Psychiatry Psychiatr Epidemiol 44:622–627
Lamberg T, Virtanen P, Vahtera J, Luukkaala T, Koskenvuo M (2010) Unemployment, depressiveness and disability retirement: a follow-up study of Finnish HeSSup Population sample. Soc Psychiatry Psychiatr Epidemiol 45:259–264
Madianos M, Stefanis C (1992) Changes in the prevalence of symptoms of depression and depression across Greece. Soc Psychiatry Psychiatr Epidemiol 27:211–219
Madianos MG, Gefou-Madianou D, Stefanis C (1993) Changes in suicidal behavior among nationwide general population samples across Greece. Eur Arch Psychiatry Clin Neurosci 243:171–178
Madianos MG, Gefou-Madianou D, Stefanis C (1994) Symptoms of depression, suicidal behaviour and use of substances in Greece: a nationwide general population survey. Acta Psychiatr Scand 89:159–166
Schields MA, Wheatley J, Price S (2005) Exploring the economic and social determinants of psychological well-being and perceived social support in England. J R Stat Soc Series 168:513–538
Jacobs IA, Podobny MT, Bilusich D (2007) One mechanism underlying contrasting health-economy findings. Int J Epidemiol 36:929–931
Scutella R, Wooden M (2008) The effects of household joblessness on mental health. Soc Sci Med 67:88–100
Kessler RC, Turner JB, House JS (1989) Unemployment, reemployment and emotional functioning in a community sample. Am J Sociol Rev 54:648–657
Feather NT (1990) The psychological impact of unemployment. Springer, Berlin
Wilson SH, Walker G (1993) Unemployment and health: a review. Publ Health 107:153–162
Kessler RC (1997) The effects of stressful life events on depression. Annu Rev Psychol 48:191–214
Rahmqvist M, Carstensen J (1998) Trend of psychological distress in a Swedish population from 1989 to 1995. Scand J Soc Med 26:214–222
Murphy GC, Athanassiou JA (1999) The effect of unemployment on mental health. J Occup Organ Psychol 72:83–89
Dooley D, Prause J, Ham-Rowbottom KA (2000) Underemployment and depression: longitudinal relationship. J Health Soc Behav 41:421–437
Wittchen HU, Jacobi F (2005) Size and burden of mental disorders in Europe: a critical review and appraisal of 27 studies. Eur Neuropsychopharmacol 15:357–376
Mandal B, Roe B (2008) Job loss, retirement and mental health of older Americans. J Ment Health Policy Econ 11:167–176
Riley A, Coiro MJ, Broitman M, Colantuoni E, Hurley KM, Bandeen-Roche K, Miranda J (2009) Mental health of children of low-income depressed mothers: influences of parenting family environment and rates. Psychiatr Serv 60:329–336
Simmons L, Braun B, Charnigo R, Haveus J, Wright D (2009) Depression and poverty among rural women: a relationship of social causation or social selection. J Rural Health 24:292–298
Eurostat (2010) Report of the revision of the Greek Government deficit and debt figures. http://epp.eurostat.e.c.europa.eu/cache/ITY
Mitrakos T, Tsakloglou P (2006) Inequality and poverty in the last quarter of the 20th century. In: Petmesidou M, Mossialos E (eds) Social policy development in Greece. Ashgate Publishing, Ashgate, pp 126–143
Bank of Greece (2008) Annual reports. B.G. Printing Office, Athens
Lavrakas PJ (1993) Telephone survey methods: sampling, selection and supervision. Sage Publications, Thousand Oaks, CA
Pridemore WA, Damphousse KR, Moore RK (2005) Obtaining sensitive information from a wary population: a comparison of telephone and face-to-face surveys of welfare recipients in the United States. Soc Sci Med 61:976–984
McQueen DV (1983) Comparison of results of personal interview and telephone surveys of behaviour related to risk of AIDS: advantages of telephone surveys techniques. In: Fowler F (ed) Health survey research methods: conference proceedings. Government Printing Office, Washington, DC, pp 247–252
Halbrook AL, Green MC, Krosnick JA (2003) Telephone versus face-to-face interviewing of national probability samples with long questionnaires. Public Opin Quart 67:79–125
Lee S, Tsang A, Kwok K (2007) Twelve-month prevalence, correlates and treatment preference of adults with DSM IV major depressive episode in Hong Kong. J Affect Dis 98:129–136
Lepine JP, Gastpar M, Mendlewicz J, Tylee A (1997) Depression in the community: the first pan-European study DEPRES (Depression Research in European Society). Int Clin Psychopharmacol 12:19–29
Allen K, Cull A, Sharpe M (2003) Diagnosing major depression in medical outpatients: acceptability of telephone interviews. J Psychosom Res 55:385–387
Korkeila JA, Kovess V, Dalgard OS, Madianos M, Salize HJ, Lehtimnen V (2007) Piloting mental health indicators for Europe. J Ment Health 16:401–413
Ketola E, Klockars M (1999) Computer-assisted telephone interview (CATI) in primary care. Fam Pract 16:179–183
First MB, Spitzer R, Gibbon M, Williams JBW (1996) Structured clinical interview for DSM IV axis I disorders, patient edition. Biometrics Research, New York State Psychiatric Institute, New York
Madianos M, Papaghelis M, Philippakis A (1997) The reliability of SCID I in Greece in clinical and general population. Psychiatriki 8:101–108
Madianos M, Economou M, Stefanis C (1998) Long-term outcome of psychiatric disorders in the community: a 13 year follow up study in a nonclinical population. Compr Psychiatry 39:47–56
Madianos M, Papaghelis M, Joannovich J, Dafni R (2001) Psychiatric disorders in burn patients. A follow-up study. Psychother Psychosom 70:30–37
SPSS (2005) SPSS Base 14.0 User’s Guide. SPSS Inc, Chicago
Robins LN, Regier DA (1991) Psychiatric disorders in America: the Epidemiologic Catchment Area Study. Free Press, New York, NY
Kessler RC, Berglund P, Demler O, Jin R, Koretz D, Merikangas KR, Rush AJ, Walters EE, Wang PS (2003) The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA 289:3095–3105
Wakefield J, Schmitz M, First M, Horwitz A (2007) Extending the bereavement exclusion from major depression to other losses. Arch Gen Psychiatry 64:433–440
Patel V, Araya R, De Lima M, Ludermir A, Todd C (1999) Women, poverty and common mental disorders in four restructuring societies. Soc Sci Med 49(11):1461–1471
Bhugra D, Mastrogianni A (2004) Globalization and mental disorders: overview with relation to depression. Br J Psychiatry 184:10–20
Kohn R, Dohrenwend BP, Mirotznik J (1998) Epidemiological findings on selected psychiatric disorders in the general population. In: Dohrenwend BP (ed) Adversity stress and psychopathology. Oxford University Press, New York, pp 235–384
Lewis G, Bebbington P, Brugha T, Farrell M, Gill B, Jenkins R, Meltzer H (2003) Socio-economic status, standard of living, and neurotic disorder. Int Rev Psychiatry 15(1–2):91–96
Takeuchi DT, Chung RCY, Lin KM, Shen H, Kurasaki K, Chun CA, Sue S (1998) Lifetime and twelve-month prevalence rates of major depressive episodes and dysthymia among Chinese Americans in Los Angeles. Am J Psychiatry 155:1407–1414
Chen VCH, Chou JY, Lai TJ, Lee CTC (2010) Suicide and unemployment rate in Taiwan, a population-based study, 1978–2006. Soc Psychiatry Psychiatr Epidemiol 45:447–452
National Statistical Service (2009) Vital and health statistical yearbook. NSS Printing Office, Athens
European Opinion Research Group. Eurobarometer. The Mental Status of European Population 2009. Brussels http://www.europa.eu.int/comm/health/ph_determinants/life_style/mental_eyrobaro.pdf
National Statistical Service (2009) The national household survey report. NSS Printing Office, Athens
Acknowledgments
All works for this paper were carried out within University Mental Health Research Institute and the School of Health Sciences Department of Mental Health and Behavioral Sciences of Athens University. The study was supported by a research grant from the University of Athens Research Special Fund.
Conflict of interest statement
M.M. is a professor of psychiatry of Athens University.
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Madianos, M., Economou, M., Alexiou, T. et al. Depression and economic hardship across Greece in 2008 and 2009: two cross-sectional surveys nationwide. Soc Psychiatry Psychiatr Epidemiol 46, 943–952 (2011). https://doi.org/10.1007/s00127-010-0265-4
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DOI: https://doi.org/10.1007/s00127-010-0265-4