Comorbidity of major depressive episode and chronic physical conditions in Spain, a country with low prevalence of depression

Objectives: The objectives were to describe the comorbidity between 12-month major depressive episode (MDE) and chronic physical condition (CPC) in Spain, a Latin country with relatively low prevalence of depression.

Methods: The European Study of Epidemiology of Mental Disorders (ESEMeD)-Spain is a cross-sectional, general-population, household survey representative of the Spanish noninstitutionalized adult population (N=5473). The Composite International Diagnostic Interview was used for assessing mental disorders. CPCs were assessed among a subsample (N=2121) with a standardized checklist. Logistic regression analysis was performed. ESEMeD-Spain is part of the World Health Organization World Mental Health Surveys.

Results: Among those with CPC, the prevalence of MDE was 5.9%, and the odds ratio (OR) of comorbid MDE was 2.2 compared with those without CPC. The strongest association with MDE was for respiratory disorders (OR up to 7.8). Having an MDE increased notably the odds of disability among those with a CPC (ORs ranged from 3.6 to 23.0). The likelihood of receiving treatment for the MDE was similar irrespective of having or not comorbid CPC.

Conclusions: Results show intense associations among MDE and CPC. Compared to other developed countries, higher likehoods of comorbidity and more severe impacts on disability are found in specific comorbid conditions. These findings highlight the need to improve the treatment of MDE in those with a CPC in Spain.