# Epidemiology of depression

The epidemiology of depression has been studied across the world. Depression is a major cause of morbidity and mortality worldwide, as the epidemiology has shown. Lifetime prevalence estimates vary widely, from 3% in Japan to 17% in India. Epidemiological data shows higher rates of depression in the Middle East, North Africa, South Asia and the United States than in other regions and countries. For most countries among the 10 studied, the number of people who experience depression during their lifetimes falls within an 8–12% range.
In North America, the probability of having a major depressive episode within any year-long period is 3–5% for males and 8–10% for females.

## Demographic dynamics

Population studies have consistently shown major depression to be about twice as common in women as in men, although it is not yet clear why this is so. The relative increase in occurrence is related to pubertal development rather than chronological age, reaches adult ratios between the ages of 15 and 18, and appears associated with psychosocial more than hormonal factors.
People are most likely to suffer their first depressive episode between the ages of 30 and 40, and there is a second, smaller peak of incidence between ages 50 and 60. The risk of major depression is increased with neurological conditions such as stroke, Parkinson's disease, or multiple sclerosis and during the first year after childbirth. The risk of major depression has also been related to environmental stressors faced by population groups such as war combatants or physicians in training.
It is also more common after cardiovascular illnesses, and is related to a poor outcome of cardiovascular diseases. Studies conflict on the prevalence of depression in the elderly, but most data suggest there is a reduction in this age group. Depressive disorders are more common in urban than in rural populations and, in general, the prevalence is higher in groups with adverse socio-economic factors (for example in homeless people).
Data on the relative prevalence of major depression among different ethnic groups have reached no clear consensus. However, the only known study to have covered dysthymia in the US specifically found it to be more common in African and Mexican Americans than in European Americans.
Projections indicate that depression may be the second leading cause of life lost after heart disease by 2020.
In 2016, a study, published by JAMA Psychiatry, and written by Charlotte Wessel Skovlund, found an association between hormonal contraception and depression.

## By country and category

Age-standardised disability-adjusted life year (DALY) rates per 10,000 inhabitants in 2017.
| Category | 1990 | 2017 | Absolute change | Relative change |
| Afghanistan | 439.81 | 443.57 | +3.75 | <1% |
| Albania | 306.48 | 308.44 | +1.96 | <1% |
| Algeria | 454.02 | 455.36 | +1.34 | <1% |
| American Samoa | 299.00 | 301.44 | +2.43 | <1% |
| Andean Latin America | 395.14 | 395.61 | +0.47 | <1% |
| Andorra | 462.69 | 466.65 | +3.96 | <1% |
| Angola | 300.38 | 307.07 | +6.68 | +2% |
| Antigua and Barbuda | 423.69 | 423.07 | –0.63 | >–1% |
| Argentina | 554.67 | 555.27 | +0.60 | <1% |
| Armenia | 235.57 | 235.64 | +0.07 | <1% |
| Australasia | 588.29 | 588.66 | +0.36 | <1% |
| Australia | 564.71 | 564.13 | –0.58 | >–1% |
| Austria | 473.10 | 470.30 | –2.81 | >–1% |
| Azerbaijan | 237.12 | 235.03 | –2.09 | >–1% |
| Bahamas | 426.25 | 425.91 | –0.34 | >–1% |
| Bahrain | 428.36 | 426.75 | –1.61 | >–1% |
| Bangladesh | 390.09 | 399.43 | +9.34 | +2% |
| Barbados | 427.13 | 425.42 | –1.71 | >–1% |
| Belarus | 262.09 | 261.92 | –0.16 | >–1% |
| Belgium | 454.81 | 453.91 | –0.90 | >–1% |
| Belize | 417.94 | 421.10 | +3.16 | <1% |
| Benin | 270.23 | 272.67 | +2.43 | <1% |
| Bermuda | 425.79 | 426.62 | +0.83 | <1% |
| Bhutan | 348.85 | 351.02 | +2.17 | <1% |
| Bolivia | 393.70 | 393.43 | –0.27 | >–1% |
| Bosnia and Herzegovina | 308.44 | 307.51 | –0.92 | >–1% |
| Botswana | 321.91 | 319.57 | –2.34 | >–1% |
| Brazil | 513.45 | 554.75 | +41.30 | +8% |
| Brunei | 315.25 | 318.63 | +3.37 | +1% |
| Bulgaria | 325.36 | 325.40 | +0.04 | <1% |
| Burkina Faso | 269.71 | 273.79 | +4.07 | +2% |
| Burundi | 340.21 | 335.02 | –5.19 | –2% |
| Cambodia | 306.36 | 306.09 | –0.26 | >–1% |
| Cameroon | 269.81 | 271.78 | +1.97 | <1% |
| Canada | 484.22 | 450.76 | –33.46 | –7% |
| Cape Verde | 278.10 | 274.58 | –3.52 | –1% |
| Caribbean | 422.38 | 421.72 | –0.66 | >–1% |
| Central African Republic | 300.76 | 303.45 | +2.69 | <1% |
| Central Asia | 235.74 | 234.85 | –0.89 | >–1% |
| Central Europe | 307.09 | 306.99 | –0.09 | >–1% |
| Central Europe, Eastern Europe, and Central Asia | 271.76 | 268.25 | –3.51 | –1% |
| Central Latin America | 264.02 | 270.29 | +6.27 | +2% |
| Central Sub-Saharan Africa | 300.88 | 304.43 | +3.55 | +1% |
| Chad | 270.61 | 269.81 | -0.80 | >–1% |
| Chile | 553.66 | 550.58 | –3.08 | >–1% |
| China | 289.57 | 275.39 | –14.18 | –5% |
| Colombia | 244.81 | 230.00 | –14.81 | –6% |
| Comoros | 334.19 | 339.17 | +4.98 | +1% |
| Congo | 303.07 | 304.40 | +1.33 | <1% |
| Costa Rica | 264.62 | 267.24 | +2.62 | <1% |
| Côte d'Ivoire | 266.99 | 269.37 | +2.38 | <1% |
| Croatia | 310.58 | 309.13 | –1.45 | >–1% |
| Cuba | 421.37 | 421.70 | +0.33 | <1% |
| Cyprus | 470.31 | 472.29 | +1.98 | <1% |
| Czechia | 309.12 | 307.16 | –1.96 | >–1% |
| Democratic Republic of Congo | 300.71 | 303.61 | +2.90 | <1% |
| Denmark | 470.42 | 469.49 | –0.93 | >–1% |
| Djibouti | 327.85 | 330.88 | +3.03 | <1% |
| Dominica | 422.36 | 418.16 | –4.20 | >–1% |
| Dominican Republic | 424.23 | 420.58 | –3.65 | >–1% |
| East Asia | 290.12 | 276.32 | –13.80 | –5% |
| Eastern Europe | 262.88 | 262.56 | –0.32 | >–1% |
| Eastern Sub-Saharan Africa | 336.34 | 340.89 | +4.55 | +1% |
| Ecuador | 395.69 | 396.44 | +0.75 | <1% |
| Egypt | 398.29 | 398.86 | +0.57 | <1% |
| El Salvador | 266.25 | 270.06 | +3.81 | +1% |
| England | 395.05 | 395.14 | +0.09 | <1% |
| Equatorial Guinea | 304.76 | 303.81 | -0.94 | >–1% |
| Eritrea | 331.15 | 339.69 | +8.54 | +3% |
| Estonia | 261.91 | 261.21 | -0.70 | >–1% |
| Eswatini | 322.64 | 318.73 | –3.90 | –1% |
| Ethiopia | 347.39 | 349.31 | +1.92 | <1% |
| Fiji | 299.92 | 300.46 | +0.54 | <1% |
| Finland | 333.44 | 329.68 | –3.76 | –1% |
| France | 576.00 | 576.03 | +0.03 | <1% |
| Gabon | 303.27 | 306.57 | +3.31 | +1% |
| Gambia | 268.55 | 271.49 | +2.94 | +1% |
| Georgia | 238.24 | 235.38 | –2.87 | –1% |
| Germany | 564.54 | 565.03 | +0.48 | <1% |
| Ghana | 272.17 | 274.68 | +2.51 | <1% |
| Greece | 512.06 | 511.19 | –0.87 | >–1% |
| Greenland | 492.10 | 500.98 | +8.89 | +2% |
| Grenada | 423.74 | 417.51 | –6.23 | –1% |
| Guam | 299.44 | 301.30 | +1.86 | <1% |
| Guatemala | 263.12 | 267.56 | +4.45 | +2% |
| Guinea | 271.79 | 273.08 | +1.29 | <1% |
| Guinea-Bissau | 271.17 | 272.76 | +1.59 | <1% |
| Guyana | 418.26 | 420.11 | +1.84 | <1% |
| Haiti | 417.74 | 420.25 | +2.50 | <1% |
| High SDI | 462.62 | 463.66 | +1.04 | <1% |
| High-income | 489.63 | 494.52 | +4.89 | <1% |
| High-income Asia Pacific | 318.28 | 318.18 | –0.10 | >–1% |
| High-middle SDI | 329.26 | 342.11 | +12.86 | +4% |
| Honduras | 264.60 | 266.37 | +1.77 | <1% |
| Hungary | 308.84 | 309.31 | +0.47 | <1% |
| Iceland | 469.33 | 469.26 | –0.06 | >–1% |
| India | 309.28 | 306.76 | –2.53 | >–1% |
| Indonesia | 304.31 | 304.18 | –0.12 | >–1% |
| Iran | 689.12 | 692.26 | –6.25 | >–1% |
| Iraq | 427.22 | 430.09 | +2.87 | <1% |
| Ireland | 506.29 | 511.29 | +5.00 | <1% |
| Israel | 274.39 | 274.00 | –0.40 | >–1% |
| Italy | 512.79 | 499.21 | –13.58 | –3% |
| Jamaica | 424.62 | 422.32 | –2.30 | >–1% |
| Japan | 257.27 | 224.62 | –12.69 | >–1% |
| Jordan | 447.61 | 445.91 | –1.70 | >–1% |
| Kazakhstan | 235.88 | 236.01 | +0.13 | <1% |
| Kenya | 337.41 | 339.52 | +2.10 | <1% |
| Kiribati | 302.20 | 303.25 | +1.04 | <1% |
| Kuwait | 430.22 | 444.44 | +14.22 | +3% |
| Kyrgyzstan | 235.31 | 235.09 | –0.22 | >–1% |
| Laos | 388.45 | 390.62 | +2.17 | <1% |
| Latin America and Caribbean | 393.06 | 405.65 | +12.59 | +3% |
| Latvia | 261.95 | 261.48 | –0.46 | >–1% |
| Lebanon | 545.72 | 547.07 | +1.35 | <1% |
| Lesotho | 320.94 | 318.40 | –2.54 | >–1% |
| Liberia | 266.73 | 267.44 | +0.71 | <1% |
| Libya | 443.86 | 449.94 | +6.08 | +1% |
| Lithuania | 261.63 | 261.43 | –0.19 | >–1% |
| Low SDI | 326.04 | 329.76 | +3.72 | +1% |
| Low-middle SDI | 332.91 | 337.68 | +4.77 | +1% |
| Luxembourg | 468.43 | 467.04 | –1.39 | >–1% |
| Madagascar | 332.44 | 336.98 | +4.53 | +1% |
| Malawi | 335.11 | 341.69 | +6.58 | +2% |
| Malaysia | 392.10 | 389.83 | –2.26 | >–1% |
| Maldives | 295.24 | 291.29 | –3.96 | –1% |
| Mali | 268.90 | 270.70 | +1.80 | <1% |
| Malta | 472.67 | 468.46 | –4.21 | >–1% |
| Marshall Islands | 299.32 | 299.31 | –0.02 | >–1% |
| Mauritania | 272.46 | 273.97 | +1.51 | <1% |
| Mauritius | 303.11 | 302.78 | –0.33 | >–1% |
| Mexico | 271.36 | 289.05 | +17.69 | +7% |
| Micronesia (country) | 299.20 | 299.84 | +0.64 | <1% |
| Middle SDI | 306.44 | 306.98 | +0.54 | <1% |
| Moldova | 260.72 | 261.03 | +0.31 | <1% |
| Mongolia | 233.62 | 234.85 | +1.23 | <1% |
| Montenegro | 309.18 | 308.71 | –0.47 | >–1% |
| Morocco | 452.71 | 453.82 | +1.11 | <1% |
| Mozambique | 336.20 | 341.61 | +5.41 | +2% |
| Myanmar | 300.93 | 307.06 | +6.13 | +2% |
| Namibia | 320.84 | 322.18 | +1.34 | <1% |
| Nepal | 348.75 | 359.13 | +10.38 | +3% |
| Netherlands | 579.45 | 578.84 | –0.62 | >–1% |
| New Zealand | 705.21 | 722.98 | +17.77 | +3% |
| Nicaragua | 264.58 | 265.73 | +1.15 | <1% |
| Niger | 271.34 | 272.82 | +1.47 | <1% |
| Nigeria | 268.96 | 272.57 | +3.61 | +1% |
| North Africa and Middle East | 448.40 | 450.80 | +2.39 | <1% |
| North America | 561.85 | 561.25 | –0.60 | >–1% |
| North Korea | 304.06 | 297.84 | –6.22 | –2% |
| North Macedonia | 308.26 | 307.40 | –0.86 | >–1% |
| Northern Ireland | 651.12 | 660.19 | +9.07 | +1% |
| Northern Mariana Islands | 296.39 | 300.91 | +4.52 | +2% |
| Norway | 673.49 | 665.89 | –7.59 | –1% |
| Oceania | 296.33 | 297.51 | +1.18 | <1% |
| Oman | 421.68 | 413.70 | –7.97 | –2% |
| Pakistan | 349.19 | 353.29 | +4.10 | +1% |
| Palestine | 455.01 | 451.42 | –3.59 | >–1% |
| Panama | 263.33 | 264.25 | +0.92 | <1% |
| Papua New Guinea | 294.77 | 296.24 | +1.48 | <1% |
| Paraguay | 553.15 | 552.96 | –0.19 | >–1% |
| Peru | 395.29 | 395.88 | +0.59 | <1% |
| Philippines | 302.25 | 302.49 | +0.24 | <1% |
| Poland | 309.40 | 309.37 | –0.04 | >–1% |
| Portugal | 472.59 | 473.61 | +1.01 | <1% |
| Puerto Rico | 427.30 | 425.85 | –1.45 | >–1% |
| Qatar | 403.81 | 391.06 | –12.75 | –3% |
| Romania | 292.12 | 292.61 | +0.49 | <1% |
| Russia | 262.99 | 262.58 | –0.42 | >–1% |
| Rwanda | 338.57 | 343.75 | +5.18 | +2% |
| Saint Lucia | 424.55 | 421.42 | –3.13 | >–1% |
| Saint Vincent and the Grenadines | 421.10 | 417.18 | –3.92 | >–1% |
| Samoa | 299.55 | 300.51 | +0.96 | <1% |
| São Tomé and Príncipe | 273.98 | 273.61 | –0.37 | >–1% |
| Saudi Arabia | 430.80 | 435.29 | +4.49 | +1% |
| Scotland | 421.09 | 419.01 | –2.08 | >–1% |
| Senegal | 271.34 | 271.99 | +0.66 | <1% |
| Serbia | 308.40 | 307.93 | –0.47 | >–1% |
| Seychelles | 305.21 | 300.90 | –4.30 | –1% |
| Sierra Leone | 271.01 | 270.96 | –0.05 | >–1% |
| Singapore | 319.22 | 326.20 | +6.98 | +2% |
| Slovakia | 309.64 | 309.22 | –0.42 | >–1% |
| Slovenia | 309.55 | 306.52 | –3.03 | >-1% |
| Solomon Islands | 296.00 | 298.91 | +2.91 | <1% |
| Somalia | 327.47 | 333.31 | +5.84 | +2% |
| South Africa | 367.94 | 365.43 | –2.51 | >–1% |
| South Asia | 320.86 | 320.95 | +0.09 | <1% |
| South Korea | 338.46 | 335.96 | –2.50 | >–1% |
| South Sudan | 317.40 | 329.08 | +11.67 | +4% |
| Southeast Asia | 291.86 | 292.91 | +1.05 | <1% |
| Southeast Asia, East Asia, and Oceania | 289.93 | 280.40 | –9.53 | –3% |
| Southern Latin America | 554.25 | 554.08 | –0.18 | >–1% |
| Southern Sub-Saharan Africa | 349.41 | 348.08 | –1.33 | >–1% |
| Spain | 444.92 | 463.69 | +18.77 | +4% |
| Sri Lanka | 301.85 | 307.85 | +6.00 | +2% |
| Sub-Saharan Africa | 307.47 | 308.98 | +1.51 | <1% |
| Sudan | 452.15 | 452.80 | +0.65 | <1% |
| Suriname | 419.61 | 421.18 | +1.57 | <1% |
| Sweden | 469.30 | 467.41 | –1.89 | >–1% |
| Switzerland | 468.85 | 468.55 | –0.30 | >–1% |
| Syria | 452.10 | 453.39 | +1.29 | <1% |
| Taiwan | 307.25 | 306.89 | –0.36 | >–1% |
| Tajikistan | 234.35 | 232.74 | –1.62 | >–1% |
| Tanzania | 335.95 | 341.24 | +5.30 | +2% |
| Thailand | 305.63 | 306.91 | +1.28 | <1% |
| Timor | 295.90 | 300.52 | +4.63 | +2% |
| Togo | 272.10 | 274.16 | +2.05 | <1% |
| Tonga | 302.76 | 302.51 | –0.25 | >–1% |
| Trinidad and Tobago | 419.97 | 419.20 | –0.77 | >–1% |
| Tropical Latin America | 514.41 | 554.73 | +40.32 | +8% |
| Tunisia | 455.67 | 459.67 | +4.00 | <1% |
| Turkey | 342.96 | 352.71 | +9.74 | +3% |
| Turkmenistan | 236.15 | 233.30 | –2.85 | –1% |
| Uganda | 317.76 | 330.35 | +12.59 | +4% |
| Ukraine | 263.10 | 262.92 | –0.18 | >–1% |
| United Arab Emirates | 390.77 | 386.30 | –4.46 | –1% |
| United Kingdom | 406.06 | 406.09 | +0.03 | <1% |
| United States | 570.31 | 573.38 | +3.06 | <1% |
| United States Virgin Islands | 428.12 | 428.10 | –0.02 | >–1% |
| Uruguay | 555.13 | 557.10 | +1.96 | <1% |
| Uzbekistan | 234.56 | 234.50 | –0.05 | >–1% |
| Vanuatu | 295.97 | 298.94 | +2.97 | +1% |
| Venezuela | 265.18 | 264.86 | –0.32 | >–1% |
| Vietnam | 192.79 | 192.17 | –0.62 | >–1% |
| Wales | 423.11 | 421.79 | –1.32 | >–1% |
| Western Europe | 502.89 | 499.26 | –3.63 | >–1% |
| Western Sub-Saharan Africa | 269.65 | 272.36 | +2.70 | +1% |
| World | 348.53 | 345.69 | –2.84 | >–1% |
| Yemen | 442.49 | 446.34 | +3.85 | <1% |
| Zambia | 334.01 | 337.31 | +3.30 | <1% |
| Zimbabwe | 286.38 | 286.72 | +0.34 | <1% |