Prevalence, Associated Factors and Predictors of Depression among Adults in the Community of Selangor, Malaysia

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Abstract

Introduction

Depression is one of the most common mental health disorders and is an emerging public health problem. The objectives of this paper were to determine the prevalence of depression, its associated factors and the predictors of depression among adults in the community of Selangor.

Methods

A cross sectional study was conducted in three districts in Selangor, from 11th June to 30th December 2012. The sampling frame was obtained from the Department of Statistics Malaysia (DOS) in May 2012, using the National Population and Housing Census 2010. Adults aged 18 years and above, living in the selected living quarters were approached to participate in the study and requested to complete a set of questionnaires.

Results

A total of 1,556 out of 2,152 participants participated in this study, giving an overall study response rate of 61.90%. Patient Health Questionnaire 9 (PHQ-9) was used to determine the presence of depression. The prevalence of depression was 10.3%, based on the PHQ-9 cut off point of 10 and above. Based on multiple logistic regression analysis, the predictors of depression were presence of anxiety, serious problems at work, unhappy relationship with children, high perceived stress, domestic violence, unhappy relationship with spouse, low self-esteem, unhappy relationship with family, serious financial constraint and presence of chronic diseases. When reanalyzed after removing anxiety, high perceived stress and low self-esteem, additional predictors of depression were found to be serious marital problems and religiosity.

Conclusion

The prevalence of depression in this study is similar to that found in other studies. Findings from this study are being used as baseline data to develop an effective program to assist in the management of common mental health disorders in the community, in particular depression. The identification of predictors of depression in the community is important to identify the target population for the program.

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Most cited references 27

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Global burden of depressive disorders in the year 2000.

T Ustün, J Ayuso-Mateos, S Chatterji … (2004)

The initial Global Burden of Disease study found that depression was the fourth leading cause of disease burden, accounting for 3.7% of total disability adjusted life years (DALYs) in the world in 1990. To present the new estimates of depression burden for the year 2000. DALYs for depressive disorders in each world region were calculated, based on new estimates of mortality, prevalence, incidence, average age at onset, duration and disability severity. Depression is the fourth leading cause of disease burden, accounting for 4.4% of total DALYs in the year 2000, and it causes the largest amount of non-fatal burden, accounting for almost 12% of all total years lived with disability worldwide. These data on the burden of depression worldwide represent a major public health problem that affects patients and society.

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Quality-of-life impairment in depressive and anxiety disorders.

Mark Rapaport, Cathryn Clary, Rana S. Fayyad … (2005)

Previous reports demonstrating quality-of-life impairment in anxiety and affective disorders have relied upon epidemiological samples or relatively small clinical studies. Administration of the same quality-of-life scale, the Quality of Life Enjoyment and Satisfaction Questionnaire, to subjects entering multiple large-scale trials for depression and anxiety disorders allowed us to compare the impact of these disorders on quality of life. Baseline Quality of Life Enjoyment and Satisfaction Questionnaire, demographic, and clinical data from 11 treatment trials, including studies of major depressive disorder, chronic/double depression, dysthymic disorder, panic disorder, obsessive-compulsive disorder (OCD), social phobia, premenstrual dysphoric disorder, and posttraumatic stress disorder (PTSD) were analyzed. The proportion of patients with clinically severe impairment (two or more standard deviations below the community norm) in quality of life varied with different diagnoses: major depressive disorder (63%), chronic/double depression (85%), dysthymic disorder (56%), panic disorder (20%), OCD (26%), social phobia (21%), premenstrual dysphoric disorder (31%), and PTSD (59%). Regression analyses conducted for each disorder suggested that illness-specific symptom scales were significantly associated with baseline quality of life but explained only a small to modest proportion of the variance in Quality of Life Enjoyment and Satisfaction Questionnaire scores. Subjects with affective or anxiety disorders who enter clinical trials have significant quality-of-life impairment, although the degree of dysfunction varies. Diagnostic-specific symptom measures explained only a small proportion of the variance in quality of life, suggesting that an individual's perception of quality of life is an additional factor that should be part of a complete assessment.

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Causal relationship between stressful life events and the onset of major depression.

L M Karkowski, De Prescott, K Kendler (1999)

Stressful life events are associated with the onset of episodes of major depression. However, exposure to stressful life events is influenced by genetic factors, and these factors are correlated with those that predispose to major depression. The aim of this study was to clarify the degree to which stressful life events cause major depression. The authors assessed the occurrence of 15 classes of stressful life events and the onset of DSM-III-R major depression over a 1-year period in female twins ascertained from a population-based registry. The sample contained 24,648 person-months and 316 onsets of major depression. Stressful life events were individually rated on contextual threat and dependence (the degree to which the stressful life event could have resulted from the respondent's behavior). The nature of the relationship between stressful life events and major depression was tested by 1) discrete-time survival analysis examining the relationship between dependence and the depressogenic effect of stressful life events and 2) a co-twin control analysis. While independent stressful life events were significantly associated with onsets of depression, when level of threat was controlled, the association was significantly stronger for dependent events. The odds ratio for onset of major depression in the month of a stressful life event was 5.64 in all subjects, 4.52 within dizygotic pairs, and 3.58 within monozygotic pairs. Stressful life events have a substantial causal relationship with the onset of episodes of major depression. However, about one-third of the association between stressful life events and onsets of depression is noncausal, since individuals predisposed to major depression select themselves into high-risk environments.

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Author and article information

Contributors

Robert Stewart: Role: Editor

Journal

Journal ID (nlm-ta): PLoS One

Journal ID (iso-abbrev): PLoS ONE

Journal ID (publisher-id): plos

Journal ID (pmc): plosone

Title: PLoS ONE

Publisher: Public Library of Science (San Francisco, USA )

ISSN (Electronic): 1932-6203

Publication date Collection: 2014

Publication date (Electronic): 22 April 2014

Volume: 9

Issue: 4

Electronic Location Identifier: e95395

Affiliations

[1 ]Department of Psychiatry, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia

[2 ]Department of Community Health, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia

Institute of Psychiatry, United Kingdom

Author notes

* E-mail: sherina@ 123456upm.edu.my

Competing Interests: The authors have declared that no competing interests exist.

Conceived and designed the experiments: SMS SFKM LR. Performed the experiments: SFKM SMS. Analyzed the data: SFKM SMS. Contributed reagents/materials/analysis tools: SMS SFKM. Wrote the paper: SF SMS. Obtained funds: SMS. Review of manuscript: SMS LR FM.

Article

Publisher ID: PONE-D-14-04093

DOI: 10.1371/journal.pone.0095395

PMC ID: 3995972

PubMed ID: 24755607

SO-VID: 412c1795-52ef-4add-889c-c4307afa7aba

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

History

Date received : 29 January 2014

Date accepted : 26 March 2014

Page count

Pages: 14

Funding

This research was funded by Lembaga Promosi Kesihatan Malaysia (LPKM) under the project grant number of (4)LPKM/04/061/06/06. The project is entitled “Contributing factors of common mental health disorders in the community.” The URL of the funder's website can be accessed at http://www.mysihat.gov.my/. This research was also funded by the E-science Fund Ministry of Science and Technology Malaysia (MOSTI) under the project grant number of 06-01-04-SF1587. The project is entitled “A web-based mental health assessment and psychiatric intervention program in Malaysia.” The URL of the funder's website can be assessed at http://www.mosti.gov.my/. There was no one else (other than the named authors) involved in this study. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Prevalence, Associated Factors and Predictors of Depression among Adults in the Community of Selangor, Malaysia

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Abstract

Introduction

Methods

Results

Conclusion

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PLOS Global Public Health

Most cited references 27

Global burden of depressive disorders in the year 2000.

Quality-of-life impairment in depressive and anxiety disorders.

Causal relationship between stressful life events and the onset of major depression.

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