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Depressive symptoms in older people higher in European Latin countries

NOVEMBER 01, 2007

Erico Costa, lead author at the Institute of Psychiatry at King's and colleagues have published research findings in the November issue of the British Journal of Psychiatry which indicate that amongst older people. Depressive symptoms are more prevalent in the Latin countries of Europe (France, Italy and Spain).  This is as opposed to the Germanic countries (Sweden, Denmark, Germany, Austria, Switzerland and the Netherlands) and Hellenic countries like Greece.   This is particularly true of symptoms related to lack of motivation, according to a new study of over 22,000 older Europeans.

Fellow researchers on the project included: Dr Michael Dewey, Dr Robert Stewart and Professor Sube Banerjee at the Institute of Psychiatry.

The SHARE study is a European Union funded consortium survey of health and wealth in people aged 50 and over in 10 European countries: Denmark, Sweden, The Netherlands, Germany, Austria, Switzerland, France, Spain, Italy and Greece. The mental health component is coordinated by Prof. Martin Prince of the Centre for Public Mental Health at the Institute of Psychiatry, King’s College London. 

Professor Martin Prince, comments: "The extent of the difference in mental health outcomes between countries is striking. We need to do more work in the next stages of the project to replicate this finding, and understand better the underlying reasons for these differences.  Certainly this should be a matter of concern for regional policymakers.’  

The EURO-D scale, a 12-item self-report questionnaire for depression, was administered to nationally representative samples of people in each country, and the effects of age, gender, education and cognitive functioning assessed. An average of 90-minute interviews was conducted in respondents’ homes.

55 per cent of those surveyed were female, and their average age was 65 years. Two types of depressive symptoms were considered; affective suffering symptoms (for example tearfulness, guilt and suicidal feelings) and motivation symptoms (for example pessimism, loss of interest and lack of enjoyment). Affective suffering scores were higher in women than men, while older people and those with cognitive impairment (verbal fluency) scored higher on the motivation symptoms.

Depressive symptom scores were highest in France, Spain and Italy and the prevalence of probable depression was nearly two times higher than that in other regions. Age and gender distributions were similar across the 10 countries. Older people in France, Italy, Spain and Greece were less well educated than others, and performed worse on cognitive tests. However, after adjusting for these differences the high levels of depression in the three ‘latin’ countries, France, Italy and Spain still persisted.

The authors speculate that factors linked to the shared linguistic and cultural heritage may have contributed to the high levels of reported depression symptoms in latin countries. Equally, national variation in social and economic policy affecting older people (impacting perhaps on income security, social protection and income equality) may have made a contribution.
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