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Epidemiological overview of major depressive disorder in Scandinavia using nationwide registers
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden.
Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen, Denmark.
Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, Norway.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden; College of Pharmacy, University of Manitoba, Canada.
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2023 (English)In: The Lancet Regional Health: Europe, E-ISSN 2666-7762, Vol. 29, article id 100621Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Major depressive disorder (MDD) is a common psychiatric disorder associated with a high disease burden. This study gives a comprehensive overview of the prevalence, outcomes, treatment, and genetic epidemiology of MDD within and across the Scandinavian countries.

METHODS: This study has aimed to assess and compare across Norway, Denmark, and Sweden 1) the prevalence and trajectories of MDD and comorbidity, 2) outcomes and treatment, and 3) heritability (Denmark and Sweden only). The analyses leveraged data on 272,944 MDD cases (and 6.2 million non-cases) from Norway, Sweden, and Denmark in specialist care in national longitudinal health registers covering 1975-2013. Relying on harmonized public data global comparisons of socioeconomic and health metrics were performed to assess to what extent findings are generalizable.

FINDINGS: MDD ranked among the most prevalent psychiatric disorders. For many cases, the disorder trajectory was severe, with varying proportions experiencing recurrence, developing comorbid disorders, requiring inpatient treatment, or dying of suicide. Important country differences in specialist care prevalence and treatment were observed. Heritability estimates were moderate (35-48%). In terms of socioeconomic and health indices, the Scandinavian nations were comparable to one another and grouped with other Western nations.

INTERPRETATION: The Scandinavian countries were similar with regards to MDD epidemiological measures, but we show that differences in health care organization need to be taken into consideration when comparing countries. This study demonstrates the utility of using comprehensive population-wide registry data, outlining possibilities for other applications. The findings will be of use to policy makers for developing better prevention and intervention strategies.

Place, publisher, year, edition, pages
Elsevier, 2023. Vol. 29, article id 100621
Keywords [en]
Electronic health records, Epidemiology, Heritability, Major depressive disorder, National patient register
National Category
Psychiatry
Identifiers
URN: urn:nbn:se:oru:diva-106362DOI: 10.1016/j.lanepe.2023.100621ISI: 001029126800001PubMedID: 37265784Scopus ID: 2-s2.0-85157978635OAI: oai:DiVA.org:oru-106362DiVA, id: diva2:1773103
Funder
Swedish Research Council, D0886501EU, Horizon 2020, 847776 964874EU, European Research Council, 101042183
Note

Funding agency:

United States Department of Health & Human Services

National Institutes of Health (NIH) - USA

NIH National Institute of Mental Health (NIMH) R01 MH123724

Available from: 2023-06-22 Created: 2023-06-22 Last updated: 2023-09-05Bibliographically approved

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