Association of major depressive disorder with chronic diseases and multimorbidity in Brazilian adults, stratified by gender: 2019 National Health Survey.

Neuciani Ferreira Da Silva Sousa,Deborah Carvalho Malta,Marilisa Berti De Azevedo Barros,Celia Landmann Szwarcwald,Lhais De Paula Barbosa Medina

doi:10.1590/1980-549720210015.supl.2

Abstract

To analyze the association of major depressive disorder with chronic non-communicable diseases and multimorbidity in Brazilian adults, stratified by gender, as well as examine the interaction between gender and chronic non-communicable diseases in association with major depressive disorder. Based on a sample of 65,803 adults from the 2019 National Health Survey, we estimated the prevalence of major depressive disorder (≥10 points in the Patient Health Questionnaire) according to the presence of chronic non-communicable diseases and multimorbidity (≥2 chronic diseases). Prevalence ratios and their respective confidence intervals were calculated by Poisson regression, and multiplicative interaction terms were used to assess the role of gender in the associations. The prevalence of major depressive disorder among Brazilian adults (18-59 years) was 10.9%, with a statistically significant difference between men (6.0%) and women (15.4%) (p<0.001). Individuals with any chronic non-communicable disease and multimorbidity showed a higher prevalence of major depressive disorder, both in the general population and in each gender. However, the association of major depressive disorder with chronic non-communicable diseases tended to be stronger among men. Data also showed an interaction between the male gender and multimorbidity or specific diseases, such as arthritis or rheumatism, heart disease, and chronic kidney disease, in association with major depressive disorder. The results reveal a significant association between major depressive disorder and chronic non-communicable diseases in both genders and raise the hypothesis that the effects of multimorbidity and certain diseases may be greater on the mental health of men.

Highlights

In the world population, the proportion of individuals with depression was estimated at 4.4%, representing an increase of 18.4% between 2005 and 2015
For almost three decades (1990–2017), depressive disorders remained among the three main causes of non-fatal health loss, measured through years lived with disability (YLD)[2]
This study revealed that adults (18–59 years) with a self-reported diagnosis of any non-communicable diseases (NCDs) had a higher prevalence of Major depressive disorder (MDD) than individuals without these diseases

Summary

Introduction

The proportion of individuals with depression was estimated at 4.4%, representing an increase of 18.4% between 2005 and 2015. This percentage corresponds to more than 300 million individuals[1]. Major depressive disorder (MDD) is characterized by broad symptomatology, including depressed mood, loss of interest or pleasure, decreased energy, feelings of guilt, impotence, low self-esteem, sleep or appetite changes, and difficulty concentrating. These symptoms can become chronic or recurrent, interfering with the capacity for self-care and the maintenance of social, work, or domestic activities[3]. Women with depression usually report depressed mood, anxiety disorder, and appetite, weight, and sleep disorders, while alcohol and drug abuse is more common among depressed men[4,5,6,7]

Methods

Results

Conclusion