Hostname: page-component-76fb5796d-skm99 Total loading time: 0 Render date: 2024-04-26T08:22:42.078Z Has data issue: false hasContentIssue false
  • English
  • Français

Comparison of the estimated prevalence of mood and/or anxiety disorders in Canada between self-report and administrative data

Published online by Cambridge University Press:  17 June 2015

S. O'Donnell ,
S. Vanderloo ,
L. McRae ,
J. Onysko ,
S. B. Patten  and
L. Pelletier
S. O'Donnell*
Affiliation:
Centre for Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, Ontario, Canada
S. Vanderloo
Affiliation:
Centre for Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, Ontario, Canada
L. McRae
Affiliation:
Centre for Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, Ontario, Canada
J. Onysko
Affiliation:
Centre for Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, Ontario, Canada
S. B. Patten
Affiliation:
Department of Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
L. Pelletier
Affiliation:
Centre for Chronic Disease Prevention, Public Health Agency of Canada, Ottawa, Ontario, Canada
*
*Address for correspondence: S. O'Donnell, Centre for Chronic Disease Prevention, Public Health Agency of Canada, 785 Carling Avenue, AL: 6806A, Ottawa, Ontario K1A 0K9, Canada. (Email: siobhan.odonnell@phac-aspc.gc.ca)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background.

To compare trends in the estimated prevalence of mood and/or anxiety disorders identified from two data sources (self-report and administrative). Reviewing, synthesising and interpreting data from these two sources will help identify potential factors that underlie the observed estimates and inform public health action.

Method.

We used self-reported, diagnosed mood and/or anxiety disorder cases from the Canadian Community Health Survey (CCHS) across a 5-year span (from 2003 to 2009) to estimate the prevalence among the Canadian population aged ≥15 years. We also estimated the prevalence of mood and/or anxiety disorders using the Canadian Chronic Disease Surveillance System (CCDSS), which identified cases using ICD-9/-10-CA codes from physician billing claims and hospital discharge records during the same time period. The prevalence rates for mood and/or anxiety disorders were compared across the CCHS and CCDSS by age and sex for all available years of data from 2003 to 2009. Summary rates were age-standardised to the Canadian population as of 1 October 1991.

Results.

In 2009, the prevalence of mood and/or anxiety disorders was 9.4% using self-reported data v. 11.3% using administrative data. Prevalence rates obtained from administrative data were consistently higher than those from self-report for both men and women. However, due to an increase in the prevalence of self-reported cases, these differences decreased over time (rate ratios for both sexes: 1.6–1.2). Prevalence estimates were consistently higher among females compared with males irrespective of data source. While differences in the prevalence estimates between the two data sources were evident across all age groups, the reduction of these differences was greater among adolescent, young and middle-aged adults compared with those 70 years and older.

Conclusions.

The overall narrowing of differences over time reflects a convergence of information regarding the prevalence of mood and/or anxiety disorders trends between self-report and administrative data sources. While the administrative data-based prevalences remained relatively stable, the self-reported prevalences increased over time. These observations may reflect positive societal changes in the perceptions of mental health (declining stigma) and/or increasing mental health literacy. Additional research using non-ecological data is required to further our understanding of the observed findings and trends, including a data linkage exercise permitting a comparison of prevalence estimates and population characteristics from these two data sources both separately and merged.

Keywords

Administrative dataepidemiologymood and/or anxiety disordersprevalenceself-report datasurveillance
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 25 , Issue 4 , August 2016 , pp. 360 - 369
Copyright
Copyright © Crown Copyright. Published by Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andrews, G, Henderson, S, Hall, W (2001). Prevalence, comorbidity, disability and service utilisation. Overview of the Australian National Mental Health Survey. British Journal of Psychiatry 178, 145–153.CrossRefGoogle ScholarPubMed
Bland, RC, Newman, SC, Orn, H (1990). Health care utilization for emotional problems: results from a community survey. Canadian Journal of Psychiatry 35, 397–400.CrossRefGoogle ScholarPubMed
Canadian Institute for Health Information (2011). Health Care in Canada, 2011: A Focus on Seniors and Aging. Ottawa, ON (ISBN 978-1-55465-996-8). Retrieved 2 April 2015 from https://secure.cihi.ca/free_products/HCIC_2011_seniors_report_en.pdf.Google Scholar
Cohen, L, Manion, L (1986). Research Methods in Education. Croom Helm: London.Google Scholar
Donoghue, TA, Punch, KF (2003). Qualitative Educational Research in Action: Doing and Reflecting. Routledge Falmer: London.CrossRefGoogle Scholar
Goffman, E (1963). Stigma: Notes on the Management of Spoiled Identity. Prentice-Hall: Englewood Cliffs, NJ.Google Scholar
Hobbs, MJ, Anderson, TM, Slade, T, Andrews, G (2014). Relationship between measurement invariance and age-related differences in the prevalence of generalized anxiety disorder. Journal of Affected Disorders 152–154, 306–312.CrossRefGoogle ScholarPubMed
Institute for Health Metrics and Evaluation (IHME) (2013). GBD Profile Canada. IHME, University of Washington: Seattle, WA. Retrieved 18 September 2014 from www.healthdata.org/sites/default/files/files/country_profiles/GBD/ihme_gbd_country_report_canada.pdf Google Scholar
Jorm, AF (2000). Mental health literacy: public knowledge and beliefs about mental disorders. British Journal of Psychiatry 177, 396–401.CrossRefGoogle ScholarPubMed
Kaufman, J, Charney, D (2000). Comorbidity of mood and anxiety disorders. Depression and Anxiety 1, 69–76.3.0.CO;2-K>CrossRefGoogle Scholar
Kessler, RC, Üstün, TB (ed.) (2008). The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders. Cambridge University Press: New York, NY.Google Scholar
Kessler, RC, Aguilar-Gaxiola, S, Alonso, J, Chatterji, S, Lee, S, Ormel, J, Ustün, TB, Wang, PS (2009). The global burden of mental disorders: an update from the WHO World Mental Health (WMH) surveys. Epidemiologia e psichiatria sociale 18, 23–33.CrossRefGoogle ScholarPubMed
Kessler, RC, Birnbaum, HG, Shahly, V, Bromet, E, Hwang, I, McLaughlin, KA, Sampson, N, Andrade, LH, de Girolamo, G, Demyttenaere, K, Haro, JM, Karam, AN, Kostyuchenko, S, Kovess, V, Lara, C, Levinson, D, Matschinger, H, Nakane, Y, Browne, MO, Ormel, J, Posada-Villa, J, Sagar, R, Stein, DJ (2010). Age differences in the prevalence and co-morbidity of DSM-IV major depressive episodes: results from the WHO World Mental Health Survey Initiative. Depression and Anxiety 27, 351–364.CrossRefGoogle ScholarPubMed
King-Kallimanis, B, Gum, AM, Kohn, R (2009). Comorbidity of depressive and anxiety disorders for older Americans in the national comorbidity survey-replication. American Journal of Geriatric Psychiatry 17, 782–792.CrossRefGoogle ScholarPubMed
Kisely, S, Lin, E, Gilbert, C, Smith, M, Campbell, LA, Vasiliadis, HM (2009 a). Use of administrative data for the surveillance of mood and anxiety disorders. Australian and New Zealand Journal of Psychiatry 43, 1118–1125.CrossRefGoogle ScholarPubMed
Kisely, S, Lin, E, Lesage, A, Gilbert, C, Smith, M, Campbell, LA, Vasiliadis, HM (2009 b). Use of administrative data for the surveillance of mental disorders in 5 provinces. Canadian Journal of Psychiatry 54, 571–575.CrossRefGoogle ScholarPubMed
Lefebvre, J, Lesage, A, Cyr, M, Toupin, J (1998). Factors related to utilization of services for mental health reasons in Montreal, Canada. Social Psychiatry and Psychiatric Epidemiology 33, 291–298.CrossRefGoogle ScholarPubMed
Lim, KL, Jacobs, P, Ohinmaa, A, Schopflocher, D, Dewa, CS (2008). A new population-based measure of the economic burden of mental illness in Canada. Chronic Diseases in Canada 28, 92–98.CrossRefGoogle ScholarPubMed
Lin, E, Goering, P, Offord, DR, Campbell, D, Boyle, MH (1996). The use of mental health services in Ontario: epidemiologic findings. Canadian Journal of Psychiatry 41, 572–577.CrossRefGoogle ScholarPubMed
McDougall, FA, Matthews, FE, Kvaal, K, Dewey, ME, Brayne, C (2007). Prevalence and symptomatology of depression in older people living in institutions in England and Wales. Age and Ageing 36, 562–568.CrossRefGoogle ScholarPubMed
Mental Health Commission of Canada (2012). Changing Directions, Changing Lives: The Mental Health Strategy for Canada. Mental Health Commission of Canada: Calgary, AB.Google Scholar
Mitchell, PB (2012). Bipolar disorder: the shift to overdiagnosis. Canadian Journal of Psychiatry 57, 659–665.CrossRefGoogle ScholarPubMed
Morrison, E, MacKinnon, NJ (2008). Workplace wellness programs in Canada: an exploration of key issues. Healthcare Management Forum 21, 26–32.CrossRefGoogle Scholar
Palin, JL, Goldner, EM, Koehoorn, M, Hertzman, C (2012). Prevalence and frequency of mental health care provided by general practitioners: differences between 2 national data sources for the same population. Canadian Journal of Psychiatry 57, 366–374.CrossRefGoogle ScholarPubMed
Patten, SB (2009). Accumulation of major depressive episodes over time in a prospective study indicates that retrospectively assessed lifetime prevalence estimates are too low. BMC Psychiatry 9. doi: 10.1186/1471-244X-9-19 CrossRefGoogle Scholar
Pearson, C, Janz, T, Ali, J (2013). Mental and Substance Use Disorders in Canada. Statistics Canada: Ottawa, ON, Catalogue no. 82-624-X.Google Scholar
Pies, R (2007). How “objective” are psychiatric diagnoses? (guess again). Psychiatry (Edgmont) 4, 18–22.Google Scholar
Public Health Agency of Canada (2010). Report from the Canadian Chronic Disease Surveillance System: Hypertension in Canada. Public Health Agency of Canada: Ottawa, ON, Catalogue no.: HP32-4/2010.Google Scholar
Public Health Agency of Canada (2013). Surveillance – Chronic Disease Surveillance System. Public Health Agency of Canada: Ottawa, ON. Retrieved 19 September 2014 from www.phac-aspc.gc.ca/surveillance-eng.php Google Scholar
Public Health Agency of Canada (2015). Report from the Canadian Chronic Disease Surveillance System: Mood and Anxiety Disorders in Canada, 2015. Public Health Agency of Canada: Ottawa, ON (submitted for publication).Google Scholar
Regier, DA, Rae, DS, Narrow, WE, Kaelber, CT, Schatzberg, AF (1998). Prevalence of anxiety disorders and their comorbidity with mood and addictive disorders. British Journal of Psychiatry Supplements 34, 24–28.CrossRefGoogle Scholar
Reid, IC (2013). Are antidepressants overprescribed? No. British Medical Journal 346, f190.CrossRefGoogle ScholarPubMed
Rost, K, Smith, R, Matthews, DB, Guise, B (1994). The deliberate misdiagnosis of major depression in primary care. Archives of Family Medicine 3, 333–337.CrossRefGoogle ScholarPubMed
Rust, K, Rao, JNK (1996). Variance estimation for complex surveys using replication techniques. Statistical Methods in Medical Research 5, 281–310.CrossRefGoogle ScholarPubMed
Rutherford, GW, McFarland, W, Spindler, H, White, K, Patel, SV, Aberle-Grasse, J, Sabin, K, Smith, N, Taché, S, Calleja-Garcia, JM, Stoneburner, RL (2010). Public health triangulation: approach and application to synthesizing data to understand national and local HIV epidemics. BMC Public Health 10. doi: 10.1186/1471-2458-10-447.CrossRefGoogle ScholarPubMed
Simpson, KRS, Meadows, GN, Frances, AJ, Patten, SB (2012). Is mental health in the Canadian population changing over time? Canadian Journal of Psychiatry 57, 324–331.CrossRefGoogle ScholarPubMed
Spence, D (2013). Are antidepressants overprescribed? Yes. British Medical Journal 346, f191.CrossRefGoogle ScholarPubMed
Statistics Canada (2004). Canadian Community Health Survey (CCHS) 2003 Shared File (Cycle 2.1) User Guide. Statistics Canada: Ottawa, ON.Google Scholar
Statistics Canada (2006). Canadian Community Health Survey (CCHS) Cycle 3.1 (2005) Public Use Microdata File (PUMF) User Guide. Statistics Canada: Ottawa, ON.Google Scholar
Statistics Canada (2008). Canadian Community Health Survey (CCHS) – Annual Component User Guide 2007 Microdata Files. Statistics Canada: Ottawa, ON.Google Scholar
Statistics Canada (2009). Canadian Community Health Survey (CCHS) – Annual Component User Guide 2008 Microdata Files. Statistics Canada: Ottawa, ON.Google Scholar
Statistics Canada (2010). Canadian Community Health Survey (CCHS) – Annual Component User Guide 2009 Microdata Files. Statistics Canada: Ottawa, ON.Google Scholar
Statistics Canada (2013). Canadian Community Health Survey (CCHS) – Annual Component. Statistics Canada. Retrieved 8 January 2014 from www23.statcan.gc.ca/imdb/p2SV.pl?Function=getSurvey&SDDS=3226&Item_Id=144171&lang=en Google Scholar
Streiner, DL, Patten, SB, Anthony, JC, Cairney, J (2010). Has lifetime prevalence reached the end of its life? A review of the concept. International Journal of Methods in Psychiatric Research 18, 221–228.CrossRefGoogle Scholar
Stuart, H (2008). Fighting the stigma caused by mental disorders: past perspectives, present activities, and future directions. World Psychiatry 7, 185–188.CrossRefGoogle ScholarPubMed
Stuart, H, Patten, SB, Koller, M, Modgill, G, Liinamaa, T (2014). Stigma in Canada: results from a rapid response survey. Canadian Journal of Psychiatry 59(10 Suppl. 1), S27–S33.CrossRefGoogle ScholarPubMed
Townsend, L, Walkup, JT, Crystal, S, Olfson, M (2012). A systematic review of validated methods for identifying depression using administrative data. Pharmacoepidemiology and Drug Safety 21(Suppl. 1), 163–173.CrossRefGoogle ScholarPubMed
Vasiliadis, HM, Lesage, A, Adair, C, Boyer, R (2005). Service use for mental health reasons: cross-provincial differences in rates, determinants, and equity of access. Canadian Journal of Psychiatry 50, 614–619.CrossRefGoogle ScholarPubMed
Wang, J, Adair, C, Fick, G, Lai, D, Evans, B, Perry, BW, Jorm, A, Addington, D (2007). Depression literacy in Alberta: findings from a general population sample. Canadian Journal of Psychiatry 52, 442–449.CrossRefGoogle ScholarPubMed
Wang, J, Lai, D (2008). The relationship between mental health literacy, personal contacts and personal stigma against depression. Journal of Affective Disorders 110, 191–196.CrossRefGoogle ScholarPubMed
Wittchen, HU, Beesdo, K, Bittner, A, Goodwin, RD (2003). Depressive episodes – evidence for a causal role of primary anxiety disorders? European Psychiatry 18, 384–393.CrossRefGoogle ScholarPubMed