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300 million people affected worldwide
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6.7% of U.S. adults affected
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More common for female (8.5%) than male (4.7%)
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Highest rate for 18-25 years old (10.3%), the rate decreases as age group increases.
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Rate in terms of race
2 or more race - 12.2%
American Indian/Alaskan Native- 8.9%
White - 7.5%
Native Hawaiian/Other Pacific Islander - 5.2%
Black - 4.9%
Hispanic - 4.8%
Asian - 4.1%
"Women are about twice as likely as men to develop depression" (Nolen-Hoeksema, 1990; Weissman et al., 1996)
1. Social Roles
2. Biological Responses
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Women are often victims of sexual assault even from their childhood.
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Makes less money than men
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Handle job, children, elderly - all at the same time.
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Lower opportunities and choices
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Girls are more interpersonally oriented
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Women are more likely to have a dysregulated HPA response (regulates cortisol) to stress
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"Some women may have depressions during periods of rapid change in levels of ovarian hormones”
Supporting study - Breslau et al. (1995)
Aim:
To analyze the role of anxiety disorders in the development of sex differences in major depression
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Procedure:
Longitudinal (3.5 years) epidemiologic study was conducted among young adults in Michigan. DSM-III-R was used as a criteria for depression.
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Results:
The lifetime prevalence of major depression was two-fold higher in females than in males. Prior anxiety disorder increased the risk for subsequent major depression in both sexes, and females were more likely to develop anxiety disorder from younger age.
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Implication:
Anxiety and depression are highly correlated. Women were more likely to get anxiety, thus higher chance for depression.
Depression is not prevalent in China, and the treatment for it is still not common. In China, patients with depressive disorder tend to focus on physiology rather than cognitive or emotional symptoms (Parker et al. 2001). Rather than depression, neurasthenia is more common, which focuses on "fatigue" rather than "illness" or "abnormality". Chinese patients who are diagnosed as mentally ill face obstacles. Li-Pac's study show that white therapist found Chinese patients less socially competent and has less capacity for inter personal relationship.
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Unlike Western society, China does not value individuality. Depressed patients who are categorised as "out-group" and "depressed" face harsh reality, where they are not accepted by the society.
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Supporting study: Lee et al. (2008)
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Aim: ​
To investigate the prevalence of depression in metropolitan China.
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Procedure:
Researchers conducted face-to-face household interviews in Beijing and Shanghai. DSM-IV criteria was used to assess whether they had major depressive disorder or not.
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Results:
1.8 and 3.6% had major depressive disorders. No significant gender difference were found. Only 22.7% of diagnosed patients with Major Depressive episode sought treatment.
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Implication:
Treatment for depression is not prevalent in China.
discussion
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It was discussed previously that both biological and social factors can play a role on prevalence of depression.
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However, it seemed that social role plays a bigger role in depression.
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Those who were socially weak (including women and minorities) had higher tendency to develop depression.
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Instead of focusing on "treatment of depression", researchers should also focus on "how to avoid those socially weak from getting depression."
depression in China
Prevalence