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Psychol Med. 2017 Sep;47(12):2107-2117. doi: 10.1017/S0033291717000551. Epub 2017 Apr 4.

Depression and physical health multimorbidity: primary data and country-wide meta-analysis of population data from 190 593 people across 43 low- and middle-income countries.

Author information

1
Physiotherapy Department, South London and Maudsley NHS Foundation Trust,Denmark Hill,London SE5 8AZ,UK.
2
KU Leuven Department of Rehabilitation Sciences,Leuven,Belgium.
3
Geriatrics Division, Department of Medicine-DIMED,University of Padova,Padova,Italy.
4
Department of Psychiatry, Social Psychiatry and Psychotherapy,Hannover Medical School,Hannover,Germany.
5
Department of Cancer and Molecular Medicine,University of Leicester,Leicester,UK.
6
Department of Psychiatry,Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine,Kaohsiung,Taiwan.
7
Department of Psychiatry,Tsyr-Huey Mental Hospital,Kaohsiung Jen-Ai's Home,Taiwan.
8
Kyambogo University,Kampala,Uganda.
9
Department of Neurosciences,University of Padova,Padova,Italy.
10
Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine,Federal University of Ceará,Fortaleza, CE 60430-040,Brazil.
11
Research and Development Unit,Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu,Dr. Antoni Pujadas, 42,Sant Boi de Llobregat,Barcelona 08830,Spain.

Abstract

BACKGROUND:

Despite the known heightened risk and burden of various somatic diseases in people with depression, very little is known about physical health multimorbidity (i.e. two or more physical health co-morbidities) in individuals with depression. This study explored physical health multimorbidity in people with clinical depression, subsyndromal depression and brief depressive episode across 43 low- and middle-income countries (LMICs).

METHOD:

Cross-sectional, community-based data on 190 593 individuals from 43 LMICs recruited via the World Health Survey were analysed. Multivariable logistic regression analysis was done to assess the association between depression and physical multimorbidity.

RESULTS:

Overall, two, three and four or more physical health conditions were present in 7.4, 2.4 and 0.9% of non-depressive individuals compared with 17.7, 9.1 and 4.9% among people with any depressive episode, respectively. Compared with those with no depression, subsyndromal depression, brief depressive episode and depressive episode were significantly associated with 2.62, 2.14 and 3.44 times higher odds for multimorbidity, respectively. A significant positive association between multimorbidity and any depression was observed across 42 of the 43 countries, with particularly high odds ratios (ORs) in China (OR 8.84), Laos (OR 5.08), Ethiopia (OR 4.99), the Philippines (OR 4.81) and Malaysia (OR 4.58). The pooled OR for multimorbidity and depression estimated by meta-analysis across 43 countries was 3.26 (95% confident interval 2.98-3.57).

CONCLUSIONS:

Our large multinational study demonstrates that physical health multimorbidity is increased across the depression spectrum. Public health interventions are required to address this global health problem.

KEYWORDS:

Depression; low- and middle-income countries; multimorbidity; physical health; psychiatry

PMID:
28374652
DOI:
10.1017/S0033291717000551
[Indexed for MEDLINE]

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