Major Depressive Disorder and Discrimination

Research published in Lancet this week, assessed the nature and severity of experienced and anticipated discrimination reported by adults with major depressive disorder worldwide.

In a cross-sectional survey, people with a diagnosis of major depressive disorder were interviewed in 39 sites (35 countries) worldwide with the discrimination and stigma scale (DISC-12). Also included in the assessment was the ability to understand and speak the main local language and age 18 years or older.

Findings

1082 people with depression completed the DISC-12. Of these:

  • 855 (79%) reported experiencing discrimination in at least one life domain
  • 405 (37%) participants had stopped themselves from initiating a close personal relationship
  • 271 (25%) from applying for work
  • 218 (20%) from applying for education or training

The researchers noted that higher levels of experienced discrimination were associated with: several lifetime depressive episodes; at least one lifetime psychiatric hospital admission; poorer levels of social functioning (widowed, separated, or divorced); unpaid employed; looking for a job and unemployed.

Experienced discrimination was also associated with lower willingness to disclose a diagnosis of depression for concealing depression vs for disclosing depression.

Interestingly, anticipated discrimination is not necessarily associated with experienced discrimination since 147 (47%) of 316 participants who anticipated discrimination in finding or keeping a job and 160 (45%) of 353 in their intimate relationships had not experienced discrimination.

The authors conclude that “discrimination related to depression acts as a barrier to social participation and successful vocational integration. Non-disclosure of depression is itself a further barrier to seeking help and to receiving effective treatment.” It is suggested that steps should be taken to reduce or prevent discrimination and stigmatization of people with depressive disorders.

The Lancet, Early Online Publication, 18 October 2012