J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Original Article

Volume 10, Number 3, March 2018, pages 202-209

A Brief Survey of Public Knowledge and Stigma Towards Depression

**Table 1.** Characteristics of Study Participants (n = 1,085)
IQR: interquartile range; SD: standard deviation; HL: health literacy. ^aMissing values were omitted when calculating percentages.
Age, median, IQR (range)	55; 37 - 66; 18 - 91
Sex, n (%)^a
Male	368 (34.1%)
Female	711 (65.9%)
Employed, n (%)^a	552 (51.4%)
Educational background, n (%)^a
Nine years of compulsory education or less	180 (17.2%)
Twelve years of upper secondary education	541 (51.6%)
Post-secondary or short-cycle tertiary education	233 (22.2%)
Tertiary education at bachelor’s level or above	94 (9.0%)
Medical condition, n (%)^a
Regularly visit an outpatient clinic	480 (46.0%)
History of depression	37 (3.8%)
Health literacy score, median, IQR (range)
Total health literacy score	3.40; 2.80 - 4.00; 1 - 5
Communicative health literacy score	3.67; 2.67 - 4.00; 1 - 5
Critical health literacy score	3.50; 2.50 - 4.00; 1 - 5

Table 1. Characteristics of Study Participants (n = 1,085)

IQR: interquartile range; SD: standard deviation; HL: health literacy. ^aMissing values were omitted when calculating percentages.

Age, median, IQR (range)

55; 37 - 66; 18 - 91

Sex, n (%)^a

Male

368 (34.1%)

Female

711 (65.9%)

Employed, n (%)^a

552 (51.4%)

Educational background, n (%)^a

Nine years of compulsory education or less

180 (17.2%)

Twelve years of upper secondary education

541 (51.6%)

Post-secondary or short-cycle tertiary education

233 (22.2%)

Tertiary education at bachelor’s level or above

94 (9.0%)

Medical condition, n (%)^a

Regularly visit an outpatient clinic

480 (46.0%)

History of depression

37 (3.8%)

Health literacy score, median, IQR (range)

Total health literacy score

3.40; 2.80 - 4.00; 1 - 5

Communicative health literacy score

3.67; 2.67 - 4.00; 1 - 5

Critical health literacy score

3.50; 2.50 - 4.00; 1 - 5

**Table 2.** Percentages of Appropriate Beliefs Regarding Depression
	Misunderstanding about the behavior of depressed people^a	Belief about the necessity of rest^b	Belief about the effectiveness of pharmacotherapy^c	Stigma about the cause of depression^d
^aAppropriate responses: “strongly disagree” and “disagree” to “it is not necessary to worry about depression in a person behaving brightly”. ^bAppropriate responses: “strongly agree” and “agree” to “rest is important for treating depression”. ^cAppropriate responses: “strongly agree” and “agree” to “medicine is effective for treating depression”. ^dAppropriate responses: “strongly disagree” and “disagree” to “a weak personality causes depression”.

Total	70.8%	768/1,085		75.6%	820/1,085		58.9%	639/1,085		54.5%	591/1,085
Age group
Younger (18 - 54 years)	83.5%	451/540	< 0.001	81.1%	438/540	< 0.001	55.6%	300/540	0.03	65.7%	355/540	< 0.001
Older (≥ 55 years)	58.2%	317/545		70.1%	382/545		62.2%	339/545		43.3%	236/545
Sex
Male	58.2%	214/368	< 0.001	68.8%	253/368	< 0.001	54.9%	202/368	0.07	45.1%	166/368	< 0.001
Female	77.5%	551/711		79.0%	562/711		60.6%	431/711		59.5%	423/711
Employment status
Employed	76.6%	423/552	< 0.001	73.6%	406/552	0.14	55.4%	306/552	0.03	57.1%	315/552	0.08
Unemployed	64.9%	339/522		77.4%	404/522		62.1%	324/522		51.7%	270/522
Educational background
Nine years of compulsory education or less	53.9%	97/180	< 0.001	68.3%	123/180	0.03	52.2%	94/180	0.24	37.8%	68/180	< 0.001
Twelve years of upper secondary education	71.9%	389/541		76.5%	414/541		58.8%	318/541		55.3%	299/541
Post-secondary or short-cycle tertiary education	81.1%	189/233		77.7%	181/233		61.8%	144/233		64.4%	150/233
Tertiary education at bachelor’s level or above	78.7%	74/94		83.0%	78/94		60.6%	57/94		63.8%	60/94
Medical condition
Regularly visit an outpatient clinic, yes	64.0%	307/480	< 0.001	76.3%	366/480	0.47	61.0%	293/480	0.15	49.6%	238/480	0.001
no	77.8%	438/563		75.5%	425/563		56.7 %	319/563		59.5%	335/563
History of depression, yes	89.2%	33/37	0.01	86.5%	32/37	0.15	67.6%	25/37	0.26	70.3%	26/37	0.06
no	70.5%	668/947		76.3%	723/947		58.2%	551/947		54.6%	517/947
Health literacy score
Total health literacy, higher	73.2%	443/605	0.047	78.8%	477/605	0.005	63.0%	381/605	0.002	56.7%	343/605	0.10
Total health literacy, lower	67.7%	325/480		71.5%	343/480		53.8%	258/480		51.7%	248/480
Communicative health literacy, higher	74.2%	420/566	0.01	80.0%	453/566	<0.001	63.6%	360/566	0.001	57.4%	325/566	0.04
Communicative health literacy, lower	67.1%	348/519		70.7%	367/519		53.8%	279/519		51.3%	266/519
Critical health literacy, higher	71.8%	404/563	0.46	77.6%	437/563	0.1	63.4%	357/563	0.002	56.0%	315/563	0.31
Critical health literacy, lower	69.7%	364/522		73.4%	383/522		54.0%	282/522		52.9%	276/522

Table 2. Percentages of Appropriate Beliefs Regarding Depression

Misunderstanding about the behavior of depressed people^a

Belief about the necessity of rest^b

Belief about the effectiveness of pharmacotherapy^c

Stigma about the cause of depression^d

^aAppropriate responses: “strongly disagree” and “disagree” to “it is not necessary to worry about depression in a person behaving brightly”. ^bAppropriate responses: “strongly agree” and “agree” to “rest is important for treating depression”. ^cAppropriate responses: “strongly agree” and “agree” to “medicine is effective for treating depression”. ^dAppropriate responses: “strongly disagree” and “disagree” to “a weak personality causes depression”.

Total

70.8%

768/1,085

75.6%

820/1,085

58.9%

639/1,085

54.5%

591/1,085

Age group

Younger (18 - 54 years)

83.5%

451/540

< 0.001

81.1%

438/540

< 0.001

55.6%

300/540

0.03

65.7%

355/540

< 0.001

Older (≥ 55 years)

58.2%

317/545

70.1%

382/545

62.2%

339/545

43.3%

236/545

Sex

Male

58.2%

214/368

< 0.001

68.8%

253/368

< 0.001

54.9%

202/368

0.07

45.1%

166/368

< 0.001

Female

77.5%

551/711

79.0%

562/711

60.6%

431/711

59.5%

423/711

Employment status

Employed

76.6%

423/552

< 0.001

73.6%

406/552

0.14

55.4%

306/552

0.03

57.1%

315/552

0.08

Unemployed

64.9%

339/522

77.4%

404/522

62.1%

324/522

51.7%

270/522

Educational background

Nine years of compulsory education or less

53.9%

97/180

< 0.001

68.3%

123/180

0.03

52.2%

94/180

0.24

37.8%

68/180

< 0.001

Twelve years of upper secondary education

71.9%

389/541

76.5%

414/541

58.8%

318/541

55.3%

299/541

Post-secondary or short-cycle tertiary education

81.1%

189/233

77.7%

181/233

61.8%

144/233

64.4%

150/233

Tertiary education at bachelor’s level or above

78.7%

74/94

83.0%

78/94

60.6%

57/94

63.8%

60/94

Medical condition

Regularly visit an outpatient clinic, yes

64.0%

307/480

< 0.001

76.3%

366/480

0.47

61.0%

293/480

0.15

49.6%

238/480

0.001

77.8%

438/563

75.5%

425/563

56.7 %

319/563

59.5%

335/563

History of depression, yes

89.2%

33/37

0.01

86.5%

32/37

0.15

67.6%

25/37

0.26

70.3%

26/37

0.06

70.5%

668/947

76.3%

723/947

58.2%

551/947

54.6%

517/947

Health literacy score

Total health literacy, higher

73.2%

443/605

0.047

78.8%

477/605

0.005

63.0%

381/605

0.002

56.7%

343/605

0.10

Total health literacy, lower

67.7%

325/480

71.5%

343/480

53.8%

258/480

51.7%

248/480

Communicative health literacy, higher

74.2%

420/566

0.01

80.0%

453/566

<0.001

63.6%

360/566

0.001

57.4%

325/566

0.04

Communicative health literacy, lower

67.1%

348/519

70.7%

367/519

53.8%

279/519

51.3%

266/519

Critical health literacy, higher

71.8%

404/563

0.46

77.6%

437/563

0.1

63.4%

357/563

0.002

56.0%

315/563

0.31

Critical health literacy, lower

69.7%

364/522

73.4%

383/522

54.0%

282/522

52.9%

276/522

**Table 3.** Factors Independently Associated with Appropriate Beliefs Regarding Depression
	Misunderstanding about the behavior of depressed people^a	Belief about the necessity of rest^b	Belief about the effectiveness of pharmacotherapy^c	Stigma about the cause of depression^d
OR: odds ratio; CI: confidence interval; HL: health literacy.^aAppropriate responses: “strongly disagree” and “disagree” to “it is not necessary to worry about depression in a person behaving brightly”.^bAppropriate responses: “strongly agree” and “agree” to “rest is important for treating depression”.^cAppropriate responses: “strongly agree” and “agree” to “medicine is effective for treating depression”.^dAppropriate responses: “strongly disagree” and “disagree” to “a weak personality causes depression”.^eYounger age group: 18 - 54 years old. ^fHigher educational background: post-secondary, tertiary education or above (≥ 13 years).^gHigher health literacy group: total health literacy score ≥ 3.4.
Younger age group^e	2.45	1.69 - 3.53	< 0.001	1.93	1.33 - 2.80	< 0.001	0.74	0.54 - 1.02	0.06	1.99	1.45 - 2.73	< 0.001
Female	2.25	1.64 - 3.10	< 0.001	1.58	1.14 - 2.18	0.006	1.35	1.02 - 1.80	0.04	1.56	1.17 - 2.08	0.003
Employed	1.41	1.02 - 1.95	0.04	0.68	0.49 - 0.95	0.03	0.91	0.69 - 1.20	0.50	0.99	0.75 - 1.32	0.96
Higher educational background^f	1.46	1.02 - 2.09	0.04	1.07	0.76 - 1.52	0.69	1.28	0.95 - 1.71	0.10	1.35	1.00 - 1.81	0.05
Regularly visit an outpatient clinic	0.80	0.58 - 1.11	0.18	1.27	0.91 - 1.78	0.16	1.11	0.84 - 1.48	0.46	0.95	0.71 - 1.27	0.74
History of depression	3.07	1.03 - 9.19	0.04	1.52	0.57 - 4.01	0.40	1.53	0.75 - 3.13	0.25	1.62	0.77 - 3.41	0.20
Higher health literacy group^g	1.29	0.95 - 1.75	0.10	1.36	0.99 - 1.84	0.05	1.48	1.14 - 1.93	0.003	1.27	0.97 - 1.65	0.08

Table 3. Factors Independently Associated with Appropriate Beliefs Regarding Depression

Misunderstanding about the behavior of depressed people^a

Belief about the necessity of rest^b

Belief about the effectiveness of pharmacotherapy^c

Stigma about the cause of depression^d

Adjusted OR

95% CI

Adjusted OR

95% CI

Adjusted OR

95% CI

Adjusted OR

95% CI

OR: odds ratio; CI: confidence interval; HL: health literacy.^aAppropriate responses: “strongly disagree” and “disagree” to “it is not necessary to worry about depression in a person behaving brightly”.^bAppropriate responses: “strongly agree” and “agree” to “rest is important for treating depression”.^cAppropriate responses: “strongly agree” and “agree” to “medicine is effective for treating depression”.^dAppropriate responses: “strongly disagree” and “disagree” to “a weak personality causes depression”.^eYounger age group: 18 - 54 years old. ^fHigher educational background: post-secondary, tertiary education or above (≥ 13 years).^gHigher health literacy group: total health literacy score ≥ 3.4.

Younger age group^e

2.45

1.69 - 3.53

< 0.001

1.93

1.33 - 2.80

< 0.001

0.74

0.54 - 1.02

0.06

1.99

1.45 - 2.73

< 0.001

Female

2.25

1.64 - 3.10

< 0.001

1.58

1.14 - 2.18

0.006

1.35

1.02 - 1.80

0.04

1.56

1.17 - 2.08

0.003

Employed

1.41

1.02 - 1.95

0.04

0.68

0.49 - 0.95

0.03

0.91

0.69 - 1.20

0.50

0.99

0.75 - 1.32

0.96

Higher educational background^f

1.46

1.02 - 2.09

0.04

1.07

0.76 - 1.52

0.69

1.28

0.95 - 1.71

0.10

1.35

1.00 - 1.81

0.05

Regularly visit an outpatient clinic

0.80

0.58 - 1.11

0.18

1.27

0.91 - 1.78

0.16

1.11

0.84 - 1.48

0.46

0.95

0.71 - 1.27

0.74

History of depression

3.07

1.03 - 9.19

0.04

1.52

0.57 - 4.01

0.40

1.53

0.75 - 3.13

0.25

1.62

0.77 - 3.41

0.20

Higher health literacy group^g

1.29

0.95 - 1.75

0.10

1.36

0.99 - 1.84

0.05

1.48

1.14 - 1.93

0.003

1.27

0.97 - 1.65

0.08