BMJ Open (Jun 2019)

Prevalence and socioeconomic impact of depressive disorders in India: multisite population-based cross-sectional study

  • Mathew Varghese,
  • Banavaram Anniappan Arvind,
  • Gopalkrishna Gururaj,
  • Santosh Loganathan,
  • Senthil Amudhan,
  • Vivek Benegal,
  • Girish N Rao,
  • Arun Mahadeo Kokane,
  • Chavan B S,
  • Dalal P K,
  • Daya Ram,
  • Kangkan Pathak,
  • Lenin Singh R K,
  • Lokesh Kumar Singh,
  • Pradeep Kumar Saha,
  • Ramasubramanian C,
  • Ritambhara Y Mehta,
  • Shibukumar T M,
  • Sonia Pereira Deuri,
  • Mousumi Krishnatreya,
  • Vijay Gogoi,
  • Sobhana H,
  • Saumik Sengupta,
  • Indrajeet Banerjee,
  • Sameer Sharma,
  • Anjan Kumar Giri,
  • Abhay Bhaskar Kavishvar,
  • Kamlesh Rushikray Dave,
  • Naresh T Chauhan,
  • Vinod K Sinha,
  • Nishanth Goyal,
  • Jayakrishnan Thavody,
  • Anish PK,
  • Thomas Bina,
  • Abhijit P Pakhare,
  • Pankaj Mittal,
  • Sukanya Ray,
  • Rajni Chatterji,
  • Brogen Singh Akoijam,
  • Heramani Singh,
  • Gojendro,
  • Priscilla Kayina,
  • Roshan Singh L,
  • Subhash Das,
  • Sonia Puri,
  • Rohit Garg,
  • Amita Kashyap,
  • Yogesh Satija,
  • Kusum Gaur,
  • Divya Sharma,
  • Sathish R V,
  • Selvi M,
  • Krishnaraj N,
  • Singh SK,
  • Vivek Agarwal,
  • Eesha Sharma,
  • Sujit K Kar,
  • Raghunath Misra,
  • Rajashri Neogi,
  • Debasish Sinha,
  • Soumyadeep Saha,
  • Ajoy Halder,
  • Pradeep Banandur S,
  • Gautham Melur Sukumar,
  • Subbakrishna D K,
  • Thennaarasu,
  • Marimuthu P,
  • Binu Kumar B,
  • Janardhan Reddy Y c,
  • Jagadisha T,
  • Sivakumar P T,
  • Prabhat Kumar Chand,
  • Muralidharan K,
  • Senthil Reddi,
  • Naveen Kumar C,
  • Krishna Prasad M,
  • Jaisoorya T S,
  • Janardhanan C N,
  • Mahendra Prakash Sharma,
  • Suman L N,
  • Paulomi S,
  • Keshav Kumar,
  • Manjula M,
  • Poornima Bhola,
  • Roopesh B N,
  • Thomas Kishore M,
  • Veena S,
  • Aruna Rose Mary K,
  • Shobha Srinath,
  • Satish Chandra Girimaji,
  • John Vijayasagar K,
  • Sekar Kasi,
  • Muralidhar D,
  • Dhanasekara Pandian R,
  • Ameer Hamza,
  • Janardhana N,
  • Aravinda Raj E,
  • Gobinda Majhi

DOI
https://doi.org/10.1136/bmjopen-2018-027250
Journal volume & issue
Vol. 9, no. 6

Abstract

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ObjectivesThe National Mental Health Survey (NMHS) of India was undertaken with the objectives of (1) estimating the prevalence and patterns of various mental disorders in representative Indian population and (2) identifying the treatment gap, healthcare utilisation, disabilities and impact of mental disorders. This paper highlights findings pertaining to depressive disorders (DD) from the NMHS.DesignMultisite population-based cross-sectional study. Subjects were selected by multistage stratified random cluster sampling technique with random selection based on probability proportionate to size at each stage.SettingConducted across 12 states in India (representing varied cultural and geographical diversity), employing uniform, standardised and robust methodology.ParticipantsA total of 34 802 adults (>18 years) were interviewed.Main outcome measurePrevalence of depressive disorders (ICD-10 DCR) diagnosed using Mini International Neuropsychiatric Interview V.6.0.ResultsThe weighted prevalence of lifetime and current DD was 5.25% (95% CI: 5.21% to 5.29%, n=34 802) and 2.68% (95% CI: 2.65% to 2.71%, n=34 802), respectively. Prevalence was highest in the 40–59 age groups (3.6%, n=10 302), among females (3.0%, n=18 217) and those residing in cities with population >1 million (5.2%, n=4244). Age, gender, place of residence, education and household income were found to be significantly associated with current DD. Nearly two-thirds of individuals with DD reported disability of varying severity, and the treatment gap for depression in the study population was 79.1%. On an average, households spent INR1500/month (~US$ 23.0/month) towards care of persons affected with DD.ConclusionAround 23 million adults would need care for DD in India at any given time. Since productive population is affected most, DD entails considerable socioeconomic impact at individual and family levels. This is a clarion call for all the concerned stakeholders to scale up services under National Mental Health Programme in India along with integrating care for DD with other ongoing national health programmes.