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Prevalence Rates of Major Depressive Disorders

The Effects of Varying the Diagnostic Criteria in an Older Primary Care Population

From the Departments of Psychiatry and Medicine, Indiana University School of Medicine, and Regenstrief Institute for Health Care, Indiana University, Indianapolis, IN. Address correspondence to Hugh C. Hendrie, M.B. Ch.B., Chairman, Department of Psychiatry, Indiana University School of Medicine, 541 Clinical Drive, Room 298, Indianapolis, IN 46202–5111.

Patients age 60 years and older (N = 3,767) were screened for depression using the Center for Epidemiological Studies Depression Scale (CES-D). A random sample of patients scoring 16 on the CES-D (n = 44) and of patients scoring < 16 (n = 81) were recruited to complete a structured psychiatric interview. The estimated prevalence of major depressive disorder (MDD), using a clinically derived diagnosis with the "etiological" method, was 1.78%. When a computer-generated algorithm for MDD using the "inclusive" method for counting somatic symptoms was applied, the estimated prevalence for MDD rose to 5.84%. All subjects with MDD diagnosed by any method had significantly higher scores on the Sickness Impact Profile (SIP), compared with nondepressed subjects.

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