Global pattern of experienced and anticipated discrimination reported by people with major depressive disorder: a cross-sectional survey

Findings 1082 people with depression completed the DISC-12. Of these, 855 (79%) reported experiencing discrimination in at least one life domain. 405 (37%) participants had stopped themselves from initiating a close personal relationship, 271 (25%) from applying for work, and 218 (20%) from applying for education or training. We noted that higher levels of experienced discrimination were associated with several lifetime depressive episodes (negative binomial regression coeffi cient 0·20 [95% CI 0·09–0·32], p=0·001); at least one lifetime psychiatric hospital admission (0·29 [0·15–0·42], p=0·001); poorer levels of social functioning (widowed, separated, or divorced 0·10 [0·01–0·19], p=0·032; unpaid employed 0·34 [0·09–0·60], p=0·007; looking for a job 0·26 [0·09–0·43], p=0·002; and unemployed 0·22 [0·03–0·41], p=0·022). Experienced discrimination was also associated with lower willingness to disclose a diagnosis of depression (mean discrimination score 4·18 [SD 3·68] for concealing depression vs 2·25 [2·65] for disclosing depression; p<0·0001). Anticipated discrimination is not necessarily associated with experienced discrimination because 147 (47%) of 316 participants who anticipated discrimination in fi nding or keeping a job and 160 (45%) of 353 in their intimate relationships had not experienced discrimination. Interpretation Discrimination related to depression acts as a barrier to social participation and successful vocational integration. Non-disclosure of depression is itself a further barrier to seeking help and to receiving eff ective treatment. This fi nding suggests that new and sustained approaches are needed to prevent stigmatisation of people with depression and reduce the eff ects of stigma when it is already established.