TY - JOUR
T1 - Epidemiological overview of major depressive disorder in Scandinavia using nationwide registers
AU - Pasman, Joëlle A
AU - Meijsen, Joeri J
AU - Haram, Marit
AU - Kowalec, Kaarina
AU - Harder, Arvid
AU - Xiong, Ying
AU - Nguyen, Thuy-Dung
AU - Jangmo, Andreas
AU - Shorter, John R
AU - Bergstedt, Jacob
AU - Das, Urmi
AU - Zetterberg, Richard
AU - Tate, Ashley
AU - Lichtenstein, Paul
AU - Larsson, Henrik
AU - Odsbu, Ingvild
AU - Werge, Thomas
AU - Reichborn-Kjennerud, Ted
AU - Andreassen, Ole A
AU - Sullivan, Patrick F
AU - Buil, Alfonso
AU - Tesli, Martin
AU - Lu, Yi
N1 - © 2023 The Authors.
PY - 2023/6
Y1 - 2023/6
N2 - BACKGROUND: Major depressive disorder (MDD) is a common psychiatric disorder associated with a high disease burden. This study gives a comprehensive overview of the prevalence, outcomes, treatment, and genetic epidemiology of MDD within and across the Scandinavian countries.METHODS: This study has aimed to assess and compare across Norway, Denmark, and Sweden 1) the prevalence and trajectories of MDD and comorbidity, 2) outcomes and treatment, and 3) heritability (Denmark and Sweden only). The analyses leveraged data on 272,944 MDD cases (and 6.2 million non-cases) from Norway, Sweden, and Denmark in specialist care in national longitudinal health registers covering 1975-2013. Relying on harmonized public data global comparisons of socioeconomic and health metrics were performed to assess to what extent findings are generalizable.FINDINGS: MDD ranked among the most prevalent psychiatric disorders. For many cases, the disorder trajectory was severe, with varying proportions experiencing recurrence, developing comorbid disorders, requiring inpatient treatment, or dying of suicide. Important country differences in specialist care prevalence and treatment were observed. Heritability estimates were moderate (35-48%). In terms of socioeconomic and health indices, the Scandinavian nations were comparable to one another and grouped with other Western nations.INTERPRETATION: The Scandinavian countries were similar with regards to MDD epidemiological measures, but we show that differences in health care organization need to be taken into consideration when comparing countries. This study demonstrates the utility of using comprehensive population-wide registry data, outlining possibilities for other applications. The findings will be of use to policy makers for developing better prevention and intervention strategies.FUNDING: Swedish Research Council (Vetenskapsrådet, award D0886501 to PFS), US National Institutes of Mental HealthR01 MH123724 (to PFS), European Union's Horizon 2020 Research and Innovation Program (847776 and 964874, to OA) and European Research Council grant (grant agreement ID 101042183, to YL).
AB - BACKGROUND: Major depressive disorder (MDD) is a common psychiatric disorder associated with a high disease burden. This study gives a comprehensive overview of the prevalence, outcomes, treatment, and genetic epidemiology of MDD within and across the Scandinavian countries.METHODS: This study has aimed to assess and compare across Norway, Denmark, and Sweden 1) the prevalence and trajectories of MDD and comorbidity, 2) outcomes and treatment, and 3) heritability (Denmark and Sweden only). The analyses leveraged data on 272,944 MDD cases (and 6.2 million non-cases) from Norway, Sweden, and Denmark in specialist care in national longitudinal health registers covering 1975-2013. Relying on harmonized public data global comparisons of socioeconomic and health metrics were performed to assess to what extent findings are generalizable.FINDINGS: MDD ranked among the most prevalent psychiatric disorders. For many cases, the disorder trajectory was severe, with varying proportions experiencing recurrence, developing comorbid disorders, requiring inpatient treatment, or dying of suicide. Important country differences in specialist care prevalence and treatment were observed. Heritability estimates were moderate (35-48%). In terms of socioeconomic and health indices, the Scandinavian nations were comparable to one another and grouped with other Western nations.INTERPRETATION: The Scandinavian countries were similar with regards to MDD epidemiological measures, but we show that differences in health care organization need to be taken into consideration when comparing countries. This study demonstrates the utility of using comprehensive population-wide registry data, outlining possibilities for other applications. The findings will be of use to policy makers for developing better prevention and intervention strategies.FUNDING: Swedish Research Council (Vetenskapsrådet, award D0886501 to PFS), US National Institutes of Mental HealthR01 MH123724 (to PFS), European Union's Horizon 2020 Research and Innovation Program (847776 and 964874, to OA) and European Research Council grant (grant agreement ID 101042183, to YL).
KW - Electronic health records
KW - Epidemiology
KW - Heritability
KW - Major depressive disorder
KW - National patient register
UR - http://www.scopus.com/inward/record.url?scp=85157978635&partnerID=8YFLogxK
U2 - 10.1016/j.lanepe.2023.100621
DO - 10.1016/j.lanepe.2023.100621
M3 - Journal article
C2 - 37265784
SN - 2666-7762
VL - 29
JO - The Lancet regional health. Europe
JF - The Lancet regional health. Europe
M1 - 100621
ER -