Major Depressive Disorders

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Summary by Maurice M. Ohayon, MD, DSc, PhD

Reference to cite: Ohayon MM, Priest RG, Guilleminault C, Caulet M. The prevalence of depressive disorders in the United Kingdom. Biol Psychiatry 1999; 45:300-7.

Variations in prevalence estimates are due partly to the time frame used (previous year or previous month basis) and to the diagnostic instruments employed (DIS, UM-CIDI, CIS-R).

Major Depressive Disorder is one of the most common of mental disorders.

It is the second most common cause of disability in industrial countries.

In our studies, the point prevalence of a DSM-IV Major Depressive Episode (4.3%) is comparable to the one-month prevalence reported in the National Comorbidity Survey (NCS) (4.9%).

When we excluded the individuals with substance abuse or dependence, bipolar disorders or non-affective psychosis,

• the prevalence of a Major Depressive Episode dropped to 2.4%, which is close to the 2.2% of the Epidemiological Catchment Area (ECA) rate

• and close also to the 2.1% rate of “pure episode” of Major Depression reported in the NCS study.

More Information

Medical & Psychiatric Correlates
Smoking is positively related to difficulties in initiating sleep and estimated sleep latency.

Although often reported in clinical studies, the association between the use of antihypertensive drugs and insomnia was seldom reported in epidemiological studies.
On sleep patterns, alcohol at bedtime accelerates the sleep onset, increases the amount of slow-wave sleep, decreases the amount of REM sleep and causes sleep disruption in the second half of the sleep period.
About four out of 10 insomnia subjects medicate themselves with over-the-counter medications or alcohol.
Other medications, such as serotonergic reuptake inhibitors (SSRIs), some neuroleptics, some antiparkinsonians and amphetamines may all provoke insomnia among patients using these kinds of medications. Hypnotics and anxiolytics may cause insomnia

Morning Headaches

Waking up with a headache is traditionally associated with sleep disorders

Hypertension

Obstructive Sleep Apnea Syndrome is an independent risk factor (odds ratio: 9.7) for hypertension. Snoring and breathing pauses during sleep appeared to be non-significant predictive factors.

Chronic Pain

Depression, Pain and Sleep
Surprisingly, few studies have attempted to determine if a comorbid medical condition in individuals with chronic painful physical disease increased the likelihood of having a major depressive disorder

Depression with Psychotic Features

There are little data regarding the prevalence of associated psychotic features in subjects with major depressive disorders in the general population

Sleep Apnea and Depression
Some clinical studies have attempted to determine whether depression limits the recognition and treatment of breathing-related sleep disorders, or if breathing-related sleep disorders play a role in the etiology or course of depressive disorder

The STANFORD JOURNAL of SLEEP EPIDEMIOLOGY