Special Issue Epidemiology of Depressive Disorder Maeng Je Cho, M.D Jun Young Lee, M. D. Department of psychiatry Seoul National University College of

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1 Epidemiology of Depressive Disorder Maeng Je Cho, M.DJun Young Lee, M. D. Department of psychiatry Seoul National University College of Medicine & Hospital mjcho@plaza.snu.ac.krbenji@naver.com Abstract In Korea, the prevalence of major depression is 4 per 100 and the world prevalence is 10 per 100. Risk factors are women, younger cohort, separated and divorced, persons with family history, early parental death and disruptive childhood environment, negative stressful events and chronic stress, absence of confidant in women, and urban areas. The mean age of onset ranges from late twenties to early thirties, but the age of onset becomes earlier and the prevalence of major depression is increasing. The recurrence rate is 85% and patients experience four episodes of depression on average and major depression is ranked as the fourth disabling disease. It was proven that major depression is one of most chronic and disabling diseases. The prognosis is poorer with comorbid dysthymia. Anxiety disorder, substance dependence, and hypothyroidism are frequent comorbid conditions with depression. And coronary arterial disease and stroke are also frequent comorbidities and their mortality rates increase with depression. The diathesisstress model of depression is supported by the genetic study of depression. In conclusion, the rate of depression is rising and depression is one of the most chronic and disabling diseases. Therefore, I hope the disease be prevented through future studies. Keywords : Major depression; Dysthymia; Keywords : Epidemiology; Prevalence; Prevention 772

2 (2001, WHO) Diseases % of Total Lower respiratory infections 6.4 Perinatal conditions 6.2 HIV / AIDS 6.1 Unipolar depressive disorders 4.4 Diarrheal diseases 4.2 Ischemic heart disease 3.8 Cerebrovascular disease 3.1 Road traffic accidents 2.8 Malaria 2.7 Tuberculosis

3 100 Place MD Female Male No Age Investigator Tool Diagnosis time Korea Korea USANCS USAECA Edmonton, Canada Puerto Rico Taiwan New Zealand Nijmegen, Netherlands Camberwell, UK Canberra, Australia Santander, Spain Finland ~64 18~64 15~54 17~64 18~ Cho, et al.(2001) Lee, et al.(1990) Kessler, et al.(1988) Weissman, et al.(1988) Bland, et al.(1998) Canino, et al.(1987) Hwu, et al.(1996) Joyce, et al.(1990) Hodiamont, et al.(1987) Bebbington, et al.(1981) Henderson, et al.(1979) VazquezBarquero, et al. Lehtinen, et al.(1990) CIDI CIDI PSE PSE PSE PSE PSE DSMIV DSMIII DSMIIIR DSMIII DSMIII DSMIII DSMIII DSMIII ICD9 ICD9 ICD9 ICD9 ICD9 lifetime lifetime lifetime lifetime lifetime lifetime lifetime lifetime point point point point point MD : Major depressive disorder, DD : Dysthymic disorder, No : Case number, Dx : Diagnosis criteria 774

4 Risk factor Sex Age Socioeconomic status Marital status Family history Childhood experience Stress A confidant Residence Major depressive disorder Women Younger cohort Lower Socioeconomic status (?) Separated and divorced Persons with family history Early parental death and disruptive childhood environment Negative stressful events and chronic stress Absence of confidant in women Urban areas Adapted from Comprehensive textbook of psychiatry. 7th edition 775

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6 Single episode with antecedent dysthymia % 9 Single episode without antecedent dysthymia 22 Recurrent, with antecedent dysthymia, with full interepisode recovery 4 Recurrent, with antecedent dysthymia, without full interepisode recovery 26 Recurrent, without antecedent dysthymia, with full interepisode recovery 20 Recurrent, without antecedent dysthymia, without full interepisode recovery

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A 617 Special Issue Diabetic Retinopathy Won Ki Lee, M.D. Department of Ophthalmology The Catholic University of Korea College of Medicine Kangnam St. Mary s Hospital E mail : wklee@catholic.ac.kr Abstract R