Major depressive disorder in a population of urban, African-American young adults: prevalence, correlates, comorbidity and unmet mental health service need

Background: The U.S. Surgeon General recently highlighted the relative dearth of research on the mental health of minority populations in the U.S. The present report describes the prevalence of major depressive disorder (MDD) in an epidemiologically-defined population of 1197, predominately poor, African-American 19–22-year-olds, living in the greater Baltimore, MD metropolitan area. Method: The prevalence and correlates of MDD, its comorbidity with other mental and substance disorders, and unmet mental health service need were assessed via a structured clinical interview administered by lay interviewers. Results: Using DSM-IV criteria, the overall prevalence of lifetime MDD for the study population was 9.4%, whereas the last year and last month prevalences were 6.2 and 2.7%, respectively. Females were approximately 1.6 times more likely to report a lifetime episode of MDD than males. MDD was highly comorbid with substance disorders. Just under 10% of those who had experienced an episode of MDD within the last year reported receiving mental health specialty services within the last year. Limitations: A major limitation was the reliance on a single interview conducted by a lay interviewer as opposed to a comprehensive psychiatric assessment carried out by a highly trained clinician, integrating information on symptoms and functioning from multiple sources. Conclusions: The lifetime prevalence of MDD found in the present study suggests that it is a significant mental health problem in the African-American young adults studied, particularly amongst women. Moreover, most episodes of MDD went untreated.