Prevalence of Self-reported Lifetime Physician-diagnosed Depression in Tunisia: Results of a National Study

Introduction/Objective Depression is a disabling mental health disorder affecting over 300 million people worldwide. In Tunisia, population-level data on its prevalence and determinants remain limited. Our study aimed to estimate the prevalence of depression in the Tunisian population and identify associated socio-demographic and clinical factors. Methods Data were drawn from the mental health component of the Tunisian Health Examination Survey (2016), a nationally representative study conducted among 9,209 individuals aged ≥15 years. Self-reported, physician-diagnosed lifetime depression was the main outcome. Associations with socio-demographic characteristics and clinical conditions, including rheumatoid arthritis, diabetes, and menopause, were examined. Results The study population comprised 4360 men (49.2%) and 4849 women (51.8%), with a mean age of 41.4±17.4 years. The prevalence of self-reported lifetime depression was 4.7%. Multivariate analysis identified female sex (OR=1.53, 95% CI [1.11–2.10]) and age groups 30–64 years (OR=1.81, 95% CI [1.20–2.73]) and ≥65 years (OR=1.82, 95% CI [1.06–3.14]) as factors significantly associated with higher prevalence. Conversely, marriage (OR=0.59, 95% CI [0.42–0.84]) and the absence of rheumatoid arthritis (OR=0.48, 95% CI [0.38–0.60]) were associated with a lower prevalence of the disorder. Discussion The findings indicate that self-reported depression in Tunisia is significantly influenced by gender and aging, consistent with global epidemiological trends. The strong association with physical comorbidities, particularly rheumatoid arthritis, underscores the necessity of integrated mental health screening for patients with chronic illnesses. Furthermore, the protective association of marriage suggests that social and family cohesion remain vital factors in the Tunisian sociocultural context. Conclusion Depression in Tunisia is shaped by gender, aging, and physical comorbidities. Targeted prevention and integrated screening strategies are needed, especially for vulnerable demographic and clinical groups.