Document Detail


Global Burden of Disease estimates of depression--how reliable is the epidemiological evidence?
MedLine Citation:
PMID:  21205775     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To re-assess the quality of the epidemiological studies used to estimate the global burden of depression 2000, as published in the GBDep study.
DESIGN: Primary and secondary data sources used in the global burden of depression estimate were identified and assigned to country of origin. Each source was assessed with respect to completeness and representativeness for national/regional estimates and against the inclusion criteria used by the scientific team estimating GBDep.
SETTING: Not applicable.
PARTICIPANTS: Not applicable.
MAIN OUTCOME MEASURES: Not applicable.
RESULTS: First, National estimates: The 28 scientific sources cited in the GBDep study related to 40 of the 191 WHO member countries. The EURO region had studies relating to 15 of 52 countries whereas AFRO region had studies for only three of 46 countries. Only six of the 40 countries had data drawn from a nationally representative population: the three AFRO country studies were based on a single village or town and, likewise, SEARO region had no nationally representative data; second, GBDep criteria: GBDep inclusion criteria required study sample size of more than 1000 people; 19 (45%) of the 42 studies did not meet this criterion. Sixteen (44%) of 36 studies did not meet the requirement that studies show a clear sample frame and method. GBD estimates rely on estimates of incidence; only two of the 42 country studies provided incidence data (Canada and Norway), the remaining 34 studies were prevalence studies. Duration of depression is based on three studies conducted in the USA and Holland.
CONCLUSIONS: Most studies exhibit significant shortcomings and limitations with respect to study design and analysis and compliance with GBDep inclusion criteria. Poor quality data limit the interpretation and validity of global burden of depression estimates. The uncritical application of these estimates to international healthcare policy-making could divert scarce resources from other public healthcare priorities.
Authors:
Petra Brhlikova; Allyson M Pollock; Rachel Manners
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the Royal Society of Medicine     Volume:  104     ISSN:  1758-1095     ISO Abbreviation:  J R Soc Med     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-05     Completed Date:  2011-02-03     Revised Date:  2011-07-28    
Medline Journal Info:
Nlm Unique ID:  7802879     Medline TA:  J R Soc Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  25-34     Citation Subset:  IM    
Affiliation:
University of Edinburgh, UK. petra.brhlikova@ed.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Depression / epidemiology*
Depressive Disorder / epidemiology*
Epidemiologic Methods*
Humans
Incidence
Prevalence
Reproducibility of Results
Research Design / standards*
World Health*
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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