Prevalence and variability of depressive symptoms in Europe: update using representative data from the second and third waves of the European Health Interview Survey (EHIS-2 and EHIS-3)

Jorge Arias-de la Torre; Gemma Vilagut; Amy Ronaldson; Ioannis Bakolis; Alex Dregan; Vicente Martín; Gonzalo Martinez-Alés; Antonio J. Molina; Antoni Serrano-Blanco; Jose M. Valderas; Maria Carmen Viana; Jordi Alonso

doi:10.1016/S2468-2667(23)00220-7

Prevalence and variability of depressive symptoms in Europe: update using representative data from the second and third waves of the European Health Interview Survey (EHIS-2 and EHIS-3)

Jorge Arias-de la Torre^*, Gemma Vilagut, Amy Ronaldson, Ioannis Bakolis, Alex Dregan, Vicente Martín, Gonzalo Martinez-Alés, Antonio J. Molina, Antoni Serrano-Blanco, Jose M. Valderas, Maria Carmen Viana, Jordi Alonso

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

15 Citations (Scopus)

Abstract

Background: Assessing the prevalence of clinically relevant depressive symptoms and their possible variation by country and over time could be a valuable resource to inform the development of public health policies and preventive resources to reduce mental health burden. We aimed to assess cross-national differences in the point prevalence of clinically relevant depressive symptoms in Europe in 2018–20, and to evaluate point prevalence differences between countries and over time between 2013–15 and 2018–20. Methods: In this population-based study, data from participants in the second and third waves of the European Health Interview Survey (EHIS-2 from 2013 to 2015 and EHIS-3 from 2018 to 2020) from 30 European countries were used (n=542 580). From the total sample, 283 692 participants belonging to EHIS-3 were included in the study (52·4% women and 47·5% men). The non-response in EHIS-3 ranged by country, from 12% to 78%. Point prevalence of clinically relevant depressive symptoms was evaluated using a cutoff score of 10 or more for the 8-item version of the Patient Health Questionnaire. Crude prevalence ratios and adjusted prevalence ratios (aPRs) were obtained to assess differences in the prevalence between countries and over time within countries. Findings: The point prevalence of clinically relevant depressive symptoms in Europe in 2018–20 was 6·54% (95% CI 6·34–6·73), ranging across countries from 1·85% (1·53–2·17) in Greece to 10·72% (10·04–11·40) in Sweden. Compared with the other European countries, those with the lowest aPRs were Greece, Serbia, and Cyprus and those with the highest aPRs were Belgium, Slovenia, and Croatia. A small but significant increase in the prevalence between EHIS-2 and EHIS-3 was observed (aPR 1·11 [1·07–1·14]). A wide variability over time in the point prevalence within countries was observed, ranging from an aPR of 0·63 (0·54–0·74) in Hungary to 1·88 (1·53–2·31) in Slovenia. Interpretation: This study, based on large and representative datasets and a valid and reliable screening tool for the assessment of depression, indicates that the point prevalence of clinically relevant depressive symptoms in Europe from 2013 to 2020 remains relatively stable, with wide variability between countries. These findings could be considered a baseline for monitoring the prevalence of clinically relevant depressive symptoms in Europe, and could inform policy for the development of preventive strategies for depression both at a country and European level. Funding: Center for Biomedical Research in Epidemiology and Public Health Network and AGAUR.

Original language	English
Pages (from-to)	e889-e898
Journal	The Lancet Public Health
Volume	8
Issue number	11
DOIs	https://doi.org/10.1016/S2468-2667(23)00220-7
Publication status	Published - Nov 2023

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Arias-de la Torre, J., Vilagut, G., Ronaldson, A., Bakolis, I., Dregan, A., Martín, V., Martinez-Alés, G., Molina, A. J., Serrano-Blanco, A., Valderas, J. M., Viana, M. C., & Alonso, J. (2023). Prevalence and variability of depressive symptoms in Europe: update using representative data from the second and third waves of the European Health Interview Survey (EHIS-2 and EHIS-3). The Lancet Public Health, 8(11), e889-e898. https://doi.org/10.1016/S2468-2667(23)00220-7

@article{a65496d4a1ca4a3da3f0b55bbfe6fd7f,

title = "Prevalence and variability of depressive symptoms in Europe: update using representative data from the second and third waves of the European Health Interview Survey (EHIS-2 and EHIS-3)",

abstract = "Background: Assessing the prevalence of clinically relevant depressive symptoms and their possible variation by country and over time could be a valuable resource to inform the development of public health policies and preventive resources to reduce mental health burden. We aimed to assess cross-national differences in the point prevalence of clinically relevant depressive symptoms in Europe in 2018–20, and to evaluate point prevalence differences between countries and over time between 2013–15 and 2018–20. Methods: In this population-based study, data from participants in the second and third waves of the European Health Interview Survey (EHIS-2 from 2013 to 2015 and EHIS-3 from 2018 to 2020) from 30 European countries were used (n=542 580). From the total sample, 283 692 participants belonging to EHIS-3 were included in the study (52·4% women and 47·5% men). The non-response in EHIS-3 ranged by country, from 12% to 78%. Point prevalence of clinically relevant depressive symptoms was evaluated using a cutoff score of 10 or more for the 8-item version of the Patient Health Questionnaire. Crude prevalence ratios and adjusted prevalence ratios (aPRs) were obtained to assess differences in the prevalence between countries and over time within countries. Findings: The point prevalence of clinically relevant depressive symptoms in Europe in 2018–20 was 6·54% (95% CI 6·34–6·73), ranging across countries from 1·85% (1·53–2·17) in Greece to 10·72% (10·04–11·40) in Sweden. Compared with the other European countries, those with the lowest aPRs were Greece, Serbia, and Cyprus and those with the highest aPRs were Belgium, Slovenia, and Croatia. A small but significant increase in the prevalence between EHIS-2 and EHIS-3 was observed (aPR 1·11 [1·07–1·14]). A wide variability over time in the point prevalence within countries was observed, ranging from an aPR of 0·63 (0·54–0·74) in Hungary to 1·88 (1·53–2·31) in Slovenia. Interpretation: This study, based on large and representative datasets and a valid and reliable screening tool for the assessment of depression, indicates that the point prevalence of clinically relevant depressive symptoms in Europe from 2013 to 2020 remains relatively stable, with wide variability between countries. These findings could be considered a baseline for monitoring the prevalence of clinically relevant depressive symptoms in Europe, and could inform policy for the development of preventive strategies for depression both at a country and European level. Funding: Center for Biomedical Research in Epidemiology and Public Health Network and AGAUR.",

author = "{Arias-de la Torre}, Jorge and Gemma Vilagut and Amy Ronaldson and Ioannis Bakolis and Alex Dregan and Vicente Mart{\'i}n and Gonzalo Martinez-Al{\'e}s and Molina, {Antonio J.} and Antoni Serrano-Blanco and Valderas, {Jose M.} and Viana, {Maria Carmen} and Jordi Alonso",

note = "Funding Information: The present work is partially funded by the Center for Biomedical Research in Epidemiology and Public Health Network (ESP21PI05, CB06/02/0046) and AGAUR (2021 SGR 00624). This Article represents independent research part funded by King's College London. IB is part supported by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley England National Health Service (NHS) Foundation Trust and King's College London, and part supported by the NIHR Applied Research Collaboration South London at King's College Hospital NHS Foundation Trust. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health. Publisher Copyright: {\textcopyright} 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license",

year = "2023",

month = nov,

doi = "10.1016/S2468-2667(23)00220-7",

language = "English",

volume = "8",

pages = "e889--e898",

journal = "The Lancet Public Health",

issn = "2468-2667",

publisher = "Elsevier Limited",

number = "11",

}

Arias-de la Torre, J, Vilagut, G, Ronaldson, A , Bakolis, I , Dregan, A, Martín, V, Martinez-Alés, G, Molina, AJ, Serrano-Blanco, A, Valderas, JM, Viana, MC & Alonso, J 2023, 'Prevalence and variability of depressive symptoms in Europe: update using representative data from the second and third waves of the European Health Interview Survey (EHIS-2 and EHIS-3)', The Lancet Public Health, vol. 8, no. 11, pp. e889-e898. https://doi.org/10.1016/S2468-2667(23)00220-7

Prevalence and variability of depressive symptoms in Europe: update using representative data from the second and third waves of the European Health Interview Survey (EHIS-2 and EHIS-3). / Arias-de la Torre, Jorge; Vilagut, Gemma; Ronaldson, Amy et al.
In: The Lancet Public Health, Vol. 8, No. 11, 11.2023, p. e889-e898.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Prevalence and variability of depressive symptoms in Europe

T2 - update using representative data from the second and third waves of the European Health Interview Survey (EHIS-2 and EHIS-3)

AU - Arias-de la Torre, Jorge

AU - Vilagut, Gemma

AU - Ronaldson, Amy

AU - Bakolis, Ioannis

AU - Dregan, Alex

AU - Martín, Vicente

AU - Martinez-Alés, Gonzalo

AU - Molina, Antonio J.

AU - Serrano-Blanco, Antoni

AU - Valderas, Jose M.

AU - Viana, Maria Carmen

AU - Alonso, Jordi

N1 - Funding Information: The present work is partially funded by the Center for Biomedical Research in Epidemiology and Public Health Network (ESP21PI05, CB06/02/0046) and AGAUR (2021 SGR 00624). This Article represents independent research part funded by King's College London. IB is part supported by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley England National Health Service (NHS) Foundation Trust and King's College London, and part supported by the NIHR Applied Research Collaboration South London at King's College Hospital NHS Foundation Trust. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health. Publisher Copyright: © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license

PY - 2023/11

Y1 - 2023/11

N2 - Background: Assessing the prevalence of clinically relevant depressive symptoms and their possible variation by country and over time could be a valuable resource to inform the development of public health policies and preventive resources to reduce mental health burden. We aimed to assess cross-national differences in the point prevalence of clinically relevant depressive symptoms in Europe in 2018–20, and to evaluate point prevalence differences between countries and over time between 2013–15 and 2018–20. Methods: In this population-based study, data from participants in the second and third waves of the European Health Interview Survey (EHIS-2 from 2013 to 2015 and EHIS-3 from 2018 to 2020) from 30 European countries were used (n=542 580). From the total sample, 283 692 participants belonging to EHIS-3 were included in the study (52·4% women and 47·5% men). The non-response in EHIS-3 ranged by country, from 12% to 78%. Point prevalence of clinically relevant depressive symptoms was evaluated using a cutoff score of 10 or more for the 8-item version of the Patient Health Questionnaire. Crude prevalence ratios and adjusted prevalence ratios (aPRs) were obtained to assess differences in the prevalence between countries and over time within countries. Findings: The point prevalence of clinically relevant depressive symptoms in Europe in 2018–20 was 6·54% (95% CI 6·34–6·73), ranging across countries from 1·85% (1·53–2·17) in Greece to 10·72% (10·04–11·40) in Sweden. Compared with the other European countries, those with the lowest aPRs were Greece, Serbia, and Cyprus and those with the highest aPRs were Belgium, Slovenia, and Croatia. A small but significant increase in the prevalence between EHIS-2 and EHIS-3 was observed (aPR 1·11 [1·07–1·14]). A wide variability over time in the point prevalence within countries was observed, ranging from an aPR of 0·63 (0·54–0·74) in Hungary to 1·88 (1·53–2·31) in Slovenia. Interpretation: This study, based on large and representative datasets and a valid and reliable screening tool for the assessment of depression, indicates that the point prevalence of clinically relevant depressive symptoms in Europe from 2013 to 2020 remains relatively stable, with wide variability between countries. These findings could be considered a baseline for monitoring the prevalence of clinically relevant depressive symptoms in Europe, and could inform policy for the development of preventive strategies for depression both at a country and European level. Funding: Center for Biomedical Research in Epidemiology and Public Health Network and AGAUR.

AB - Background: Assessing the prevalence of clinically relevant depressive symptoms and their possible variation by country and over time could be a valuable resource to inform the development of public health policies and preventive resources to reduce mental health burden. We aimed to assess cross-national differences in the point prevalence of clinically relevant depressive symptoms in Europe in 2018–20, and to evaluate point prevalence differences between countries and over time between 2013–15 and 2018–20. Methods: In this population-based study, data from participants in the second and third waves of the European Health Interview Survey (EHIS-2 from 2013 to 2015 and EHIS-3 from 2018 to 2020) from 30 European countries were used (n=542 580). From the total sample, 283 692 participants belonging to EHIS-3 were included in the study (52·4% women and 47·5% men). The non-response in EHIS-3 ranged by country, from 12% to 78%. Point prevalence of clinically relevant depressive symptoms was evaluated using a cutoff score of 10 or more for the 8-item version of the Patient Health Questionnaire. Crude prevalence ratios and adjusted prevalence ratios (aPRs) were obtained to assess differences in the prevalence between countries and over time within countries. Findings: The point prevalence of clinically relevant depressive symptoms in Europe in 2018–20 was 6·54% (95% CI 6·34–6·73), ranging across countries from 1·85% (1·53–2·17) in Greece to 10·72% (10·04–11·40) in Sweden. Compared with the other European countries, those with the lowest aPRs were Greece, Serbia, and Cyprus and those with the highest aPRs were Belgium, Slovenia, and Croatia. A small but significant increase in the prevalence between EHIS-2 and EHIS-3 was observed (aPR 1·11 [1·07–1·14]). A wide variability over time in the point prevalence within countries was observed, ranging from an aPR of 0·63 (0·54–0·74) in Hungary to 1·88 (1·53–2·31) in Slovenia. Interpretation: This study, based on large and representative datasets and a valid and reliable screening tool for the assessment of depression, indicates that the point prevalence of clinically relevant depressive symptoms in Europe from 2013 to 2020 remains relatively stable, with wide variability between countries. These findings could be considered a baseline for monitoring the prevalence of clinically relevant depressive symptoms in Europe, and could inform policy for the development of preventive strategies for depression both at a country and European level. Funding: Center for Biomedical Research in Epidemiology and Public Health Network and AGAUR.

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U2 - 10.1016/S2468-2667(23)00220-7

DO - 10.1016/S2468-2667(23)00220-7

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AN - SCOPUS:85174960677

SN - 2468-2667

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Prevalence and variability of depressive symptoms in Europe: update using representative data from the second and third waves of the European Health Interview Survey (EHIS-2 and EHIS-3)

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