Trends in depression in Sri Lanka: Findings from the SLHAS 2018-2024

Abstract

Sri Lanka recently experienced the COVID-19 pandemic, political turmoil, and an economic crisis, all potentially implicating nationwide mental health. Yet, the differential impact of crises on population subgroups remained understudied. Thus, we examined the trends in depression between 2018 2024 in Sri Lanka, and investigated the disparity in depression between subgroups during this period. Data for this study are from Waves 1 (2018/2019) and 2/2x (2021/2024) of the Sri Lanka Health and Ageing Study (SLHAS) a nationally representative longitudinal study that recruited 6,668 non institutionalised adults in its first wave. Depressive symptoms were measured by the 8-item Patient Health Questionnaire (PHQ-8), with a cut-off score of 5 indicating mild depression. Linear mixed models were fitted to predict the prevalence of mild depression and adjusted mean PHQ-8 score by month, with age, sex, ethnicity, education level, sector of residence, and socioeconomic status as predictors. Marginal predictions of the mean PHQ-8 score by month were obtained by demographic subgroup by including interaction terms in the models. Preliminary results show fluctuating trends in depression over time, increasing following the economic and political crisis. Women, older individuals, and those with lower education reported higher depression. Depression symptoms in Sinhalese individuals demonstrated a stable trend, whereas the other ethnic groups displayed greater fluctuations. The gap in depression between socioeconomic subgroups narrowed during the crisis period. However, depressive symptoms in the most disadvantaged group rose the most, post-crisis, while that of the highest socioeconomic bracket remained the lowest. The findings suggest disparities in depression between demographic groups during crises in Sri Lanka. Specifically, disadvantaged groups experience more depressive symptoms after crises, indicating that focused attention is needed on these populations during such periods.