Prevalence and potential determinants of subthreshold and major depression in the general population of Qatar

Abstract

Background There is a paucity of epidemiological studies of depression in war-free Arab countries. This study estimated the prevalence and potential determinants of Subthreshold (SUBDE) and Major Depressive Episode (MDE) in migrants and non-migrants typical of Qatar and neighboring Gulf countries.

Methods A telephone survey of a probability-based sample of 2,424 participants was conducted in February 2017. The sample was divided based on nationality and income: Low-Income Migrants (LIMs), High Income Migrants (HIMs), and non-migrants or Qatari Nationals (QNs). Participants completed the nine-item Physician Health Questionnaire (PHQ-9). Ethnicity, sociodemographics, health- and work-related information was collected. Bivariate and multinomial logistic regression analyses were used.

Results Overall prevalence of any depression ranged between 4.2% (95% CI: 3.3–5.3) and 6.6% (95% CI: 5.4–7.9) for a cut-off of 12 and 10, respectively. The diagnostic algorithm for SUBDE and MDE resulted in estimates of 5.5% (95% CI: 4.4–6.8) and 3.6% (95% CI: 2.8–4.5), respectively. SUBDE, but not MDE rates, were significantly increased in LIMs (OR=2.96, p = 0.004) and HIMs (OR = 2.00, p = 0.014) compared with non-migrants. Arab ethnicity was significantly associated with SUBDE: relative to South Asians (OR = 3.77, p < 0.001) and other ethnicities (OR = 3.61, p = 0.029). Arab ethnicity was significantly associated with MDE: relative to South Asians (OR = 10.42, p < 0.001) and South East Asians (OR = 3.54, p = 0.007).

Limitations Clinical diagnostic interviews for depression were not included.

Conclusion Using the PHQ-9, depression prevalence in Qatar was comparable to general population estimates from Western countries. Migrant status and ethnicity were associated with SUBDE and MDE with implications for early screening and community intervention.