Depression underdiagnosis: Prevalence and associated factors. A population-based study.

Area of Science:

• Public Health
• Epidemiology
• Mental Health Research

Background:

• Depression is a prevalent condition with significant negative impacts, yet it is frequently underdiagnosed.
• Underdiagnosis of depression poses a substantial public health challenge, hindering timely and effective treatment.

Purpose of the Study:

• To estimate the prevalence of depression underdiagnosis in Brazil.
• To identify sociodemographic and health-related factors associated with depression underdiagnosis in a nationally representative sample.

Main Methods:

• Utilized data from 70,806 participants in the Brazilian National Survey (PNS 2019).
• Defined depression underdiagnosis using Patient Health Questionnaire-9 (PHQ-9) scores (>9) without a prior health provider diagnosis.
• Employed logistic regression to analyze associations and calculated population attributable risk fractions for key predictors.

Main Results:

• The prevalence of depression was 11.2%, with a depression underdiagnosis prevalence of 63.6%.
• Underdiagnosis was more common in males, the elderly, individuals with lower income and education, and those in the North/Central regions.
• Key factors contributing to underdiagnosis included lower income, education, fewer medical appointments, and specific demographic groups.

Conclusions:

• Depression underdiagnosis is a widespread issue in Brazil, affecting a majority of cases.
• Preventive strategies must address identified sociodemographic and health-related disparities to improve depression diagnosis rates.