Depression in the Italian community: epidemiology and socio-economic implications

A survey on the 6-month prevalence of depression in the Italian community was performed using the modified-Mini-international Neuropsychiatric Interview (MINI) administered with a computer-prompted interview to a panel of 5566 individuals, which aimed to validate the results of a previous similar survey and evaluate the socio-economic consequences of the illness. Prevalence of major depression and minor depression accounted for 10.8% and 3.3% of the cases, respectively, thus confirming the previous results (8.0% and 2.9%, respectively). Major depression was 1.4-fold more prevalent in females compared to males, while minor depression was 2.6-fold more prevalent in males, thus confirming the previous results (1.3% and 1.6%, respectively). The majority of subjects of all MINI depression categories, including major depression (62.7% versus 83.9% of the minor depression and 82.3% of the depressive symptoms subjects), did not consult any healthcare professional with respect to their symptoms. Among the major depression subjects undergoing medical consultation, 34.2% of were not prescribed any therapy or intervention, while only 36.8% reportedly started a drug therapy (22.3% with an antidepressant). More than twice as many major depression subjects had at least three physician visits and drug therapies and more than three-fold as many had at least four instrumental examinations in the preceding 6 months compared to no depression subjects. Loss of work or global activity longer than 1 week was reported by approximately four-fold as many major depression subjects compared to no depression subjects. These results provide evidence for a higher frequency of under-recognition of depression as a medical illness in Italy compared to other European countries, while confirming the evidence from other countries on the small proportion of subjects with disabling symptoms who receive treatment, particularly specific treatment with antidepressants, and on the direct relationship between the impairment induced by the depressive symptoms and global healthcare resources use, as well as of work and activity days lost. (C) 2004 Lippincott Williams Wilkins.