ABSTRACT

The 12-month prevalence of major depressive disorder varies widely cross nationally from 0.3% to 10.2%. The incidence rate for major depression is higher among those with comorbid anxiety. Risk factors for increased prevalence of major depression and anxiety disorders include female gender, not being elderly, an inverse relationship with social economic status, having life events, and perceived stigma and non-racial discrimination. Those who are married have a lower rate of major depression, and being divorced has the strongest association with having an anxiety disorder. Two-thirds of those with major depression also have another psychiatric disorder. The onset of depression is usually later than the comorbid psychiatric disorders. There is an association between physical disorders and major depression and anxiety disorders. However, only a modest association was noted between major depression, anxiety disorders and obesity. The findings from psychiatric epidemiological surveys provide a mixed picture for an association between physical activity and major depression. Recovery from anxiety disorders but not major depression is associated with physical exercise. Ten percent to 17% of those with major depression have a chronic course. The reasons that depressive disorders and anxiety disorders account for a high percentage of the global burden of disease is its high prevalence, young age of onset, and chronicity. The health care team frequently does not recognize major depression and anxiety disorders, and when they are recognized they are not always managed appropriately. Therefore, there is a wide treatment gap.