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Ask the Mental Health Expert Archives 2001-2004

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Country Ranking for Depression

Q. For the developed world, is there a ranking of countries from the highest rates of depression to the least, and is there something similar for developed versus undeveloped countries?

A. I am not aware of a ranking of depression prevalence according to developed vs. undeveloped status; however; you may want to read the article by Lepine in the Journal of Clinical Psychiatry, supplement 13, 2001 (pp. 4-10), which reports the findings of the Cross-National Study of depression and anxiety. This study examined the lifetime rates of major depression in a variety of cultures and countries, including the U.S., Canada, Puerto Rico, France, Lebanon, Taiwan, and Korea. Major depression was prevalent in all the countries sampled, but with considerable variation.

For example, the rate of major depression in Taiwan was only about 1.5%, versus 19% in Beirut, Lebanon. But this disparity may not reflect developed vs. undeveloped status alone--the author suggests that data from Lebanon were gathered during time of war, for example.

There is evidence of high rates of depression in at least some developing countries. For example, in Pakistan, the adjusted prevalence of depressive disorders was about 44% (Husain et al, Psychol Med 2000 Mar;30(2):395-402). The authors attributed this to "the high proportion of the population who experience social adversity." It also appears likely that, within a given country, rates of depression may vary from urban to rural locations; e.g., in Puerto Rico, higher rates are found in urban areas.

On the other hand, in St. Louis, Mo., rates are higher in rural samples. Most clinicians are struck by the similarities, rather than the differences, in rates of depression prevalence world-wide.

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November 2001
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