The prevalence and impact of major depressive disorder among Chinese, Malays and Indians in an Asian multi-racial population

Abstract

Reports of rates of depression among different Asian ethnic groups within the same country using standardized assessments are rare in the extant literature. This was a household survey of 6616 adult residents of Singapore which constituted a national representative sample. Face to face interviews were conducted with the English, Chinese and Malay versions of the World Mental Health Composite International Diagnostic Interview. The response rate was 75.9%. The lifetime and 12-month prevalence estimates for MDD were 5.8% and 2.2%, respectively. MDD was significantly higher among the females, Indians, those who were divorced/separated, or widowed. The median age of onset of MDD was 26 years with the highest risk of onset in those aged 18-34 years while the age group of 65 years and above had the lowest risk of onset. Chronic physical conditions were present in approximately half of the respondents with MDD. MDD was also associated with considerable disability in terms of days of role impairment. More than half (59.6%) of those with lifetime MDD had not ever sought professional help. This was a cross-sectional household survey that excluded those who were institutionalized. Responses were self-reported and therefore subjected to recall bias. Our findings add to the body of knowledge on the differential rates of depression among different ethnic groups; the association with disability, comorbid physical conditions and the considerable proportion of untreated cases also have important clinical and policy implications.