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Hospitalizations for depressive disorders in Ecuador: An eight-year nationwide analysis of trends and demographic insights

Abstract:

Background: Sociodemographic characteristics and limited mental health care access may contribute to higher depression rates in low- and middle-income countries. This study aimed to analyze nationwide depressive disorder hospitalizations in Ecuador. Methods: We assessed the sociodemographic characteristics, severity, recurrence, and duration of hospitalizations for depressive disorders. The dataset used is publicly available on the Ecuadorian National Institute of Statistics and Censuses website. Multivariable multinomial logistic regression was performed to calculate adjusted relative risk ratios (aRRR). Results: 14,586 hospitalizations were analyzed during 2015–2022. There was a significant increase in depressive disorders hospitalizations, from 9.41 cases per 100,000 inhabitants in 2015 to 13.9 in 2022. Females accounted for 65.7 % of hospital admissions. Depressive disorder hospitalizations had a mean age of 33.43 years. Severe depressive disorders without psychotic symptoms had the highest average hospitalization rate during 2015–2022 with 3.53 cases per 100,000 inhabitants. Individuals aged 20–29 years (aRRR 1.68, 95 % CI 1.27–2.22) and those aged 30–39 years (aRRR 1.81, 95 % CI 1.32–2.47) had higher probabilities of hospitalization for severe depressive disorder without psychotic symptoms. Patients with severe depression with or without psychotic symptoms were more likely of being hospitalized for seven or more days. Ethnic minorities were less likely to be hospitalized for severe depressive disorder without psychotic symptoms. Conclusion: These findings highlight the increasing rates of depressive disorders in low- and middle-income countries such as Ecuador and emphasize the necessity for public health strategies focused on vulnerable groups.