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Association of major depressive disorder with chronic diseases and multimorbidity in Brazilian adults, stratified by sex: National Health Survey, 2013


  • Neuciani Ferreira da Silva Sousa Universidade Federal de Mato Grosso, Cuiabá (MT), Brasil
  • Marilisa Berti de Azevedo Barros Universidade Estadual de Campinas - Campinas (SP), Brasil
  • Lhais de Paula Barbosa Medina Universidade Estadual de Campinas - Campinas (SP), Brasil
  • Deborah Carvalho Malta Universidade Federal de Minas Gerais – Belo Horizonte (MG), Brasil
  • Celia Landmann Szwarcwald Fundação Oswaldo Cruz – Rio de Janeiro (RJ), Brasil



Depressive Disorder, Chronic Disease, Multimorbidity, Health Surveys


Objective: To analyze the association of major depressive disorder (MDD) with the presence of chronic non-communicable diseases (CNCD) and multimorbidity in Brazilian adults, stratified by sex, and to examine the interaction between sex and CNCD in association with TDM. Methods: Based on a sample of 65,803 adults from the National Health Survey of 2019, the prevalence of MDD (≥ 10 points of the PHQ-9 instrument) was estimated according to the presence of CNCD and multimrbity (≥ 2 chronic diseases). The prevalence ratios and respective confidence intervals were estimated using Poisson regression and the terms of multiplicative interaction were used to assess the role of sex in associations. Results: The prevalence of MDD among Brazilian adults (18-59 years) was estimated at 10.9%, with a statistically significant difference between men (6.0%) and women (15.4%) (p <0.001). Among individuals with any CNCD and multimorbidity, higher prevalence of MDD was observed, both in the general population and in both sexes. However, the association between TDM and NCDs tended to be stronger among men. The data also showed an interaction between male gender and multimorbidity or specific diseases such as arthritis or rheumatism, heart disease and chronic renal failure in association with MDD. Conclusion: The results show a significant association between TDM and NCD, in both sexes, and raise the hypothesis that the effect of multimorbidity and specific diseases may be greater on the mental health of men.


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