THE CASE FOR DEPRESSION PREVENTION IN WOMEN

Depression is currently a major public health problem for women worldwide. Epidemiological data indicate that lifetime prevalence rates of major depressive disorder (MDD) in the United States are 1.7 to 2.7 times greater for women than for men (Burt & Stein, 2002), and rates of MDD have been found to be approximately twice as high among women as men across a range of cultures and countries (Bebbington et al., 1998; Weissman et al., 1996). The negative impact of depression on women is far-reaching. The 2000 census figures estimate the U.S. population at 281,421,906, of whom 143,368,343 (50.9%) are female (U.S. Census Bureau, 2004). Nationally representative data indicate that women have a 21.3% lifetime prevalence of major depressive episodes (MDE; Burt & Stein, 2002), suggesting that over 30 million females will have at least one episode during their lives in the U.S. alone.

Depression produces significant impairments, causing dysfunction that equals or exceeds chronic physical illness (Hays, Wells, Sherbourne, Rogers, & Spritzer, 1995). In addition, researchers underestimate the negative impact of depression when they look only at its direct effects without attending to the concept of attributable risk (Muñoz, 2001), that is, the empirically documented contribution of depression to major causes of preventable death, such as smoking, poor diet and exercise, substance use, firearms, risky sexual behavior, and car accidents (see, e.g., McGinnis & Foege, 1993). Similarly, depression has been linked with higher risk for serious medical conditions.