Recall bias and major depression lifetime prevalence

Area of Science:

• Psychiatry
• Epidemiology
• Biostatistics

Background:

• Epidemiological studies show stable lifetime major depression prevalence across age groups, contradicting expected accumulation.
• Potential explanations include cohort effects, recall bias, and differential mortality.
• This study investigates the role of recall failure in major depression prevalence estimates.

Purpose of the Study:

• To describe the relationship between recall failure and bias in age-specific lifetime major depression prevalence.
• To evaluate how recall failure and differential mortality affect prevalence estimates.

Main Methods:

• Utilized a framework by Hill et al. relating age-specific prevalence to incidence and mortality.
• Incorporated an additional term for recall failure into the model.
• Conducted a literature review to explore the impact of plausible differential mortality rates.

Main Results:

• Low recall failure rates (2-4% annually) can explain flat or declining age-specific lifetime prevalence.
• Higher recall failure rates are needed to explain patterns in adolescents.
• Differential mortality may also contribute to observed patterns in the elderly.

Conclusions:

• Plausible recall failure rates, combined with incidence and mortality data, explain stable or declining lifetime major depression prevalence.
• Existing lifetime prevalence estimates for major depression may be underestimated.
• Inferring cohort effects from cross-sectional data requires instruments minimizing recall failure.