TY - JOUR
T1 - Epidemiology and symptomatology of depression in Sri Lanka: A cross-sectional population-based survey in Colombo District
AU - Ball, Harriet A.
AU - Siribaddana, Sisira H.
AU - Kovas, Yulia
AU - Glozier, Nick
AU - McGuffin, Peter
AU - Sumathipala, Athula
AU - Hotopf, Matthew
PY - 2010/6
Y1 - 2010/6
N2 - Background: It is important to understand the nature of depression in non-Western and lower-income countries, but little such research exists. This study aimed to examine the characteristic features of depression in Sri Lanka, and to identify environmental risk factors.
Methods: Depression diagnoses, symptoms and impairment were measured using the Composite International Diagnostic Interview, in a population-based sample of 6014 twins and non-twins in the Colombo region of Sri Lanka (the CoTASS sample). Socio-demographic factors and environments were assessed via questionnaires.
Results: Lifetime-ever depression was reported in 6.6% of participants, rising to 11.2% if the functional impairment criterion was excluded. The symptom profile of depression and its socio-demographic associations were very comparable to those in Western and more economically developed countries, whether functional impairment was included in the definition or not. Standard of living was independently associated with depression, especially among men at the more deprived end of the distribution. Specific associations were found with both financial wellbeing and material characteristics of the home environment.
Limitations: The observational associations identified are cross-sectional, so do not necessarily imply causal links.
Conclusions: Aside from a lower prevalence, depression is very similar in this predominantly urban Sri Lankan sample to higher-income, Western countries, and may be under-identified due to a relatively low cultural appropriateness of the assessment of impairment. Under Sri Lanka's cultural and environmental context, certain aspects of the material environment are associated with depression among certain segments of society, perhaps because of their particular link to social status and social networks. (C) 2009 Elsevier B.V. All rights reserved.
AB - Background: It is important to understand the nature of depression in non-Western and lower-income countries, but little such research exists. This study aimed to examine the characteristic features of depression in Sri Lanka, and to identify environmental risk factors.
Methods: Depression diagnoses, symptoms and impairment were measured using the Composite International Diagnostic Interview, in a population-based sample of 6014 twins and non-twins in the Colombo region of Sri Lanka (the CoTASS sample). Socio-demographic factors and environments were assessed via questionnaires.
Results: Lifetime-ever depression was reported in 6.6% of participants, rising to 11.2% if the functional impairment criterion was excluded. The symptom profile of depression and its socio-demographic associations were very comparable to those in Western and more economically developed countries, whether functional impairment was included in the definition or not. Standard of living was independently associated with depression, especially among men at the more deprived end of the distribution. Specific associations were found with both financial wellbeing and material characteristics of the home environment.
Limitations: The observational associations identified are cross-sectional, so do not necessarily imply causal links.
Conclusions: Aside from a lower prevalence, depression is very similar in this predominantly urban Sri Lankan sample to higher-income, Western countries, and may be under-identified due to a relatively low cultural appropriateness of the assessment of impairment. Under Sri Lanka's cultural and environmental context, certain aspects of the material environment are associated with depression among certain segments of society, perhaps because of their particular link to social status and social networks. (C) 2009 Elsevier B.V. All rights reserved.
U2 - 10.1016/j.jad.2009.08.014
DO - 10.1016/j.jad.2009.08.014
M3 - Article
SN - 1573-2517
VL - 123
SP - 188
EP - 196
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
IS - 1-3
ER -