Disability and comorbidity among major depressive disorder and double depression in African-American adults.

BACKGROUND: Few studies have examined differences in disability and comorbity among major depressive disorder (MDD), dysthymia, and double depression in African-Americans (AA).

METHODS: A secondary analysis was performed on AA in the National Survey of American Life. Interviews occurred 2001-2003. A four stage national area probability sampling was performed. DSM-IV-TR diagnoses were obtained with a modified version of the World Health Organization's expanded version of the Composite International Diagnostic Interview. Disability was measured by interview with the World Health Organization's Disability Assessment Schedule II.

RESULTS: Compared to non-depressed AA, AA endorsing MDD (t=19.0, p=0.0001) and double depression (t=18.7, p=0.0001) reported more global disability; AA endorsing MDD (t=8.5, p=0.0063) reported more disability in the getting around domain; AA endorsing MDD (t=19.1, p=0.0001) and double depression (t=12.1, p=0.0014) reported more disability in the life activities domain. AA who endorsed double depression reported similar disability and comorbidities with AA who endorsed MDD. Few AA endorsed dysthymia.

LIMITATIONS: This was a cross-sectional study subject to recall bias. The NSAL did not measure minor depression.

CONCLUSIONS: The current study supports the idea of deleting distinct chronic subtypes of depression and consolidating them into a single category termed chronic depression.