Date

5-20-2015

Document Type

Thesis

Degree Name

M.P.H.

Department

Dept. of Public Health & Preventive Medicine.

Institution

Oregon Health & Science University

Abstract

Background -- Though mood and substance use disorders account for a large majority of the years lived with disability (YLD) worldwide, there is a dearth of research regarding the epidemiology of these conditions (Whiteford, et al., 2013). In response, the global mental health community along with the World Health Organization (WHO) supports the World Mental Health Survey Initiative (WMHSI) to characterize the burden of mental and addictive disorders. This initiative also places mental health and substance use conditions firmly at the forefront of the global health agenda and addresses the tremendous disparities between demand and access to treatment (Sharan, et al., 2009). Major Depressive Disorder (MDD) and Alcohol Use Disorders (AUDs) are among the most prevalent and disabling mental health conditions worldwide and prior estimates of these conditions in Peru were based on small studies with limited populations. This secondary analysis is intended to provide insight into the sociodemographic associations of lifetime prevalence of Major Depressive Episodes and Alcohol Use Disorders (including alcohol abuse with and without dependence) in adults living in urban Peru. Methods – This analysis was based on survey data gathered by the WMHSI among 3930 adults ages 18-65 living in five Peruvian cities (Arequipa, Chiclayo, Huancayo, Iquitos, Lima). A standardized, validated survey (World Health Organization – Composite International Diagnostic Interview) carried out by trained lay interviewers captured sociodemographic characteristics and symptoms based on DSM-IV criteria for Major Depressive Episode and Alcohol Abuse with and without Dependence. Univariate and multivariate analyses examined epidemiologic patterns of these conditions. Results – The overall lifetime prevalence of Major Depressive Episode was 6.9%. Men were significantly less likely to have lifetime MDE compared to women (adjusted OR 0.63; 95% CI 0.49 – 0.83). Prevalence varied by geographic location; residents of Arequipa, Chiclayo and Iquitos were less likely to have lifetime MDE compared to respondents in Lima. Previously or never married respondents had a significantly higher odds of having lifetime MDE compared to those who were married (adjusted ORs 2.48 and 1.48, respectively). The overall lifetime prevalence of AUDs was 5.6%. Men were significantly more likely to have lifetime AUD compared to women (adjusted OR 15.6; 95% CI 9.50 – 25.59). Respondents living in Arequipa and Chiclayo had a lower lifetime odds of AUD (adjusted ORs 0.36 and 0.44, respectively). Previously married respondents had a higher lifetime odds of AUD compared to those who were married (adjusted OR 1.90; 95% CI 1.14 – 3.17). Lower educational attainment was associated with higher odds of lifetime AUD compared to those who complete university level education (including primary, some secondary and completed secondary). Conclusion – Major depression and AUDs are significant public health concerns for urban Peru. Moving forward, recognizing the epidemiological trends of these conditions by providers and policy-makers will be important in designing targeted prevention and treatment campaigns.

Identifier

doi:10.6083/M41Z434B

Included in

Public Health Commons

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