Abstract
BackgroundPrevalence rates of minor and major depression vary from 0.7 to 6.8 (minor) and 3.8 to 10.9 (major) for the general population. Twenty-two percent of older, long-term unemployed people suffer from major depression. However, the prevalence rate of minor depression (depression on a subthreshold level with less than 5, but more than 1 depression symptom) in this population is unknown. The first aim of this study is to identify that prevalence rate, because we already know that minor depression increases the risk of developing a major depression and this in turn reduces the chances of reemployment what increases social and individual costs at the same time. The second aim is to find out whether there are symptoms that distinguish the different groups “no depression”, “minor depression” and “major depression” in this population. In contrast to the general population, the most frequent symptoms within major and minor depression in older, long-term unemployed people are unknown so far.MethodsA total of 234 long-term unemployed people (response rate 59%) were included in a study within a project of the Department of Psychiatry and Psychotherapy at the University of Leipzig and an unemployment agency. Based on the results of the Patient Health Questionnaire, the participants were classified as non depressive, minor depressive or major depressive. Descriptive statistics and chi-square tests were performed to identify whether there are symptoms stated by the participants that are more frequent than others, and if the classified groups differ in this regard.ResultsFifty percent had no depression, 15.6% had a minor depression and 34.4% were suffering from major depression. Difficulty with concentration is the symptom that differentiated the last two groups the most. Fatigue, depressed mood and anhedonia were the symptoms that distinguished participants with minor depression the most from participants with no depression. Main limitations are: The sample was determined by programme conditions, e.g. not all potentially available people participated. The sample may therefore not be representative for the general long-term unemployed. Due to limited resources the PHQ 9 was used instead of a clinical interview to assess minor and major depression.ConclusionsResults indicate that minor depression in older, long-term unemployed persons is significant, as, almost 16% of the participants were affected in the study. Especially when fatigue is present for a period of more than 2 weeks, people should be informed about the option to consult a primary care physician or professionals from the unemployment agency in order to prevent the possible onset of major depression.
Highlights
Prevalence rates of minor and major depression vary from 0.7 to 6.8 and 3.8 to 10.9 for the general population
Cuijpers and van Straten reported in their meta-analytic review [13] that subjects with minor depression carry a high risk of developing major depressive disorder
Prevalence rates of minor depression are only known for the general population: in 2006, Martin and colleagues reported a rate of 5.4% for minor depression
Summary
Prevalence rates of minor and major depression vary from 0.7 to 6.8 (minor) and 3.8 to 10.9 (major) for the general population. In contrast to the general population, the most frequent symptoms within major and minor depression in older, long-term unemployed people are unknown so far. Called minor depression, defined as “depressed affect and at least one of the other eight symptoms of a major depressive episode” (DSM V), is a prevalent disorder associated with impairment of quality of life and functional disability [24] or even suicidality [42]. Other terms for this disorder are subsyndromal, subthreshold, or subclinical depression. These authors found the Patient Health Questionnaire [32] being a useful tool to identify major and minor depression in the general population
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