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Validity of the Concept of Minor Depression in a Developing Country Setting

Fekadu, Abebaw MD, MSc, MRCPsych*†; O’Donovan, Michael C. PhD, FRCPsych; Alem, Atalay MD, PhD§; Kebede, Derege MD, ScD; Church, Steve BM, BS, MRCPsych; Johns, Louise MA, DPhil, DClinPsych*; Medhin, Girmay MSc; Prince, Martin MD, MSc, MRCPsych*; Shibre, Teshome MD, PhD§

The Journal of Nervous and Mental Disease: January 2008 - Volume 196 - Issue 1 - p 22-28
doi: 10.1097/NMD.0b013e31815fa4d4
Original Article

Evidence for validity of the diagnostic construct of minor depressive disorder comes primarily from reports on subthreshold depressive states rather than minor depressive disorder per se. We report on the prevalence, impact, and sociodemographic correlates of minor depressive disorder in a developing country setting as further validation of this diagnostic construct. Diagnostic assessment of 1714 adults of an island population in Ethiopia was carried out using the Composite International Diagnostic Interview. The lifetime prevalence of minor depressive disorder was 20.5% (95% confidence interval 18.6, 22.5%). One-third of cases had sought help and expressed suicidal ideation. Being divorced/widowed, middle-aged, and having somatic pain were independently associated with having minor depressive disorder. Only being divorced/widowed was a shared risk factor for both minor depressive disorder and bereavement. Minor depressive disorder seems to be a useful and valid diagnostic construct with particular clinical significance in this and, possibly, similar developing country settings.

*Section of Epidemiology, Health Services Research Department, Institute of Psychiatry, King’s College London, UK; †Maudsley Hospital, South London and Maudsley NHS Trust, London, UK; ‡Department of Psychological Medicine, School of Medicine, Cardiff University, Cardiff, UK; and Departments of §Psychiatry, ∥Community Health, and ¶Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.

Supported by the Stanley Medical Research Institute.

Send reprint requests to Dr Abebaw Fekadu, Section of Epidemiology, Health Services Research Department, Institute of Psychiatry, King’s College London, PO Box 60, DeCrespigny Park, London, SE5 8AF, UK. E-mail:

© 2008 Lippincott Williams & Wilkins, Inc.