European Commission - Public Health: healthindicators.org

DOCUMENTATION SHEET FOR:

Indicator: 23(a). Depression: self-reported prevalence

SHORTLIST sub-division: B) Health status

Status: implementation section

Date last modification documentation sheet: 24-09-2010

PDF version of documentation sheet

Operational indicators (Excel-file)

Definition

Proportion of individuals reporting to have ever been diagnosed with chronic depression and to have been affected by this condition during the past 12 months.

Calculation

Proportion of individuals reporting to have ever been diagnosed with chronic depression and to have been affected by this condition during the past 12 months, derived from European Health Interview Survey (EHIS) questions HS.4/5/6: HS.4: Do you have or have you ever had any of the following diseases or conditions? (19. Chronic depression) (yes / no). If yes: HS.5: Was this disease/condition diagnosed by a medical doctor? (yes / no). HS.6: Have you had this disease/condition in the past 12 months? (yes / no). EHIS data will not be age standardized.

Relevant dimensions and subgroups

• Country
• Calendar year
• Sex
• Age group (15-64, 65+)
• SES (educational level. ISCED 3 aggregated groups: 0-2; 3+4; 5+6)

Preferred data type and data source

Preferred data type

HIS

Preferred data source

Eurostat (EHIS)

Data availability

BE, BG, CZ, DE, EE, EL, ES, FR, IT, CY, LV, HU, MT, AT, PL, RO, SI, SK, CH, NO and TR conducted a first wave of EHIS between 2006 and 2010. It is noted that not in all of these countries a full scale survey was carried out; in some only specific modules were applied, in others the full questionnaire was applied in a small pilot sample. It is expected that all EU Member States will conduct EHIS in the second wave, which is planned for 2014. The results of the first wave are expected to be published in two stages, 11 countries in October 2010, the remaining countries in April 2011. EHIS data are available by sex, 8 age groups (15-24/25-34/35-44/45-54/55-64/65-74/75-84/85+) and ISCED groups.

Data periodicity

EHIS will be conducted once every 5 years. The first wave took place in 2007/2010 (with some derogations in 2006) and the second wave is planned for 2014.

Rationale

High-burden disease. Because of the high frequency of mental health problems in our society and the importance of their costs in human, social and economic terms, mental health should be regarded as a public health priority. The Global Burden of Disease study reckons that mental disorders represent four of the ten leading causes of disability worldwide. Depression is a major mental condition that is amenable to intervention.

Remarks

• According to current plans, Eurostat will probably not age-standardize EHIS data. For comparability reasons ECHIM would however prefer age-standardized data.
• It has to be noted that this methodology will result in an underestimation of depression prevalence, as many people with depressive symptoms do not seek professional help and therefore they will not be diagnosed with depression. Moreover, depressive symptoms are not always recognized by physicians who are not specialised in mental disorders (e.g. GPs). Therefore epidemiological surveys using more comprehensive measurement instruments tend to find higher prevalence estimates than estimates based on registered/diagnosed cases.
• The above definition and calculation are based on the first version of the EHIS questionnaire, as used in the first EHIS wave (2007/2010). The EHIS questionnaire will be revised, hence adaptations to the EHIS question underlying this indicator may occur in the second wave (planned for 2014).
• (E)HIS-based estimates may be influenced by reporting biases and sampling related biases. Therefore they may not be an adequate reflection of the current situation in a country, and other estimates may be better for this purpose (see indicator 23b). However, as a common methodology is underlying the gathering of EHIS data, they suit well the purpose of international comparison.
• The legal basis for EHIS is regulation (EC) No 1338/2008 of the European Parliament and of the Council of 16 December 2008 on Community statistics on public health and health and safety at work. This is an umbrella regulation. Specific implementing acts will define the details of the statistics Member States have to deliver to Eurostat. An implementing act on EHIS is expected to come into force in 2014.

References

• EHIS standard questionnaire (version of 11/2006, used in first wave)
• EHIS 2007-2008 Methodology: Information from CIRCA
• Regulation (EC) No 1338/2008 of the European Parliament and of the Council of 16 December 2008 on Community statistics on public health and health and safety at work
• Murray C. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020. Cambridge M, Harvard School of Public Health (Pour le compte de l'Organisation Mondiale de la Santé et la Banque Mondiale), editors. 1996.

Work to do

Monitor EHIS/Eurostat developments