ABSTRACT
According to the DSM IV-TR, 10-25% of women and 5-12% of men will experience an episode of major depression, and 1-2% will experience bipolar disorder at some point in their lives. Kessler and colleagues (2003) recently conducted an epidemiology study of depression in 9,090 adults from 48 states and reported the lifetime prevalence ofmajor depressionwas 16.2% (women) and 6.6% (men) within the last 12 months. The majority of subjects described their level of impairment during depression as severe, and over 70% of cases involved at least one additional psychiatric disorder. Symptoms of depression typically develop over time and, untreated, can last 4 months or longer (APA, 2000). Kessler et al. reported the average duration of depression is 16weeks. In themajority of cases, depression remitswithin a fewmonths although some (5-10%) continue for 2 ormore years.According toGreenberg et al. (2003), the economic burden of depression is also increasing as reflected in costs associated with depression in the
workplace, mortality costs from depression-related suicides, and direct costs. They reported that as the treatment rate of depression increased by nearly 50% between 1990-2000, the associated costs rose from $77.4 billion in 1990 to $83.1 billion in 2000. Papakostas and colleagues (2004) recently reported that adults suffering from major depression are more likely to report a poorer quality of life. Studies exploring the effectiveness of treatment in improving quality of life are lacking. According to the DSM IV-TR, cultural differences exist in the experience and communication of symptoms of depression. In some cultures, depression may be experienced largely in physical complaints rather than emotions. Fava (2003), for example, reported that approximately 76% of patients with depression report various somatic symptoms such as stomachaches, headaches, and back pain. Oquendo et al. (2001) recently reported that the 1-year prevalence rates for major depression were 3.6% for whites, 3.5% for blacks, 2.8% forMexican Americans, 2.5% for CubanAmericans, and 6.9% for Puerto Ricans. Suicide rates were highest in white males. Depression often co-occurs with other disorders such as anxiety, attention, and behavior disorders in childhood and adolescence (DSM IV-TR, APA, 2000) and anxiety and substance use disorders in adulthood (Zimmerman, Chelminski, & McDermut, 2002).
