Trends in the prevalence of depression and anxiety disorders among Canadian working-age adults between 2000 and 2016.

Abstract

Understanding the prevalence of major depressive episodes (MDEs) and anxiety disorders at the population level among different labour force segments is critical to assessing and planning equitable mental health policies for Canadians adults. This study quantified prevalence trends of annually reported MDEs, anxiety disorders, and comorbid MDEs and anxiety disorders among working-age Canadians by labour force status, between 2000 and 2016. This study used multiple cycles of the Canadian Community Health Survey. MDE prevalence was assessed using variants of the Composite International Diagnostic Interview and the Patient Health Questionnaire-9. Anxiety disorder prevalence captured the presence of an anxiety disorder diagnosed by a healthcare professional. Prevalence estimates were calculated in each survey cycle for three labour force groups: employed, unemployed and not participating in the labour force. A meta-analytic framework stratified by labour force status estimated prevalence trends. Between 2000 and 2016, MDE prevalence remained statistically stable over time at 5.4% (95% confidence interval [CI]: 4.7% to 6.0%), 11.7% (95% CI: 10.4% to 13.0%) and 9.8% (95% CI: 8.5% to 11.2%) among participants who were employed, unemployed, and not participating in the labour force, respectively. Anxiety prevalence ranged from 4.6% to 10.8%, and increased over time (employed: β=0.26%/year, 95% CI: 0.08% to 0.45%; unemployed: β=0.34%/year, 95% CI: -0.10% to 0.78%; not participating in the labour force: β=0.55%/year, 95% CI: 0.15% to 0.95%). Stable comorbid MDE and anxiety prevalence ranged from 1.2% to 4.1% between 2003 and 2016. Trends suggest that MDE prevalence has remained stable among all labour force groups since 2000, while anxiety disorder prevalence has modestly increased since 2003. Disorder prevalence increased as labour force attachment decreased across all outcomes studied.