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Depression Is Not All In The Mind
September 7, 2007
Depression can do more physical damage to a person's health than several
long-term diseases, according to a study lead by Saba Moussavi of the
World Health Organisation that is the largest population-based study on
the physical effects of several illnesses.
The study analysed data from more than 245,000 people in 60 countries and
the results, published today in the Lancet, showed that depression had
more impact on sufferers than angina, arthritis, asthma, and diabetes. "On
the basis of our results, addressing the further exacerbation of
disability due to depression needs to be a priority of health systems
worldwide," wrote Dr Moussavi. "Primary care providers must be taught not
to ignore the presence of depression when patients present with a chronic
physical condition."
He said that this would only be achieved by reducing the stigma around
mental illness and alerting doctors and the public at large that
depression was a disease at least on a par with physical chronic diseases
in damaging health, being the fourth leading cause of disease burden in
2000, a measure of the number of years of full health lost due to an
illness. Projections by scientists at the Harvard School of public health
suggest that, by 2020, depression will rise to become second only to heart
disease in terms of disease burden.
On a scale of 0 to 100, with 0 indicating worst health and 100 indicating
best health, sufferers of depression had an average score of 72.9 in Dr
Moussavi's study. This compared with 80.3 for asthmatics, 79.6 for angina
sufferers, 79.3 for arthritis sufferers and 78.9 for those with diabetes.
"Our main findings show that depression impairs health state to a
substantially greater degree than the other diseases," Dr Moussavi said.
Suffering from depression along with another chronic disease produced
significantly worse health than having one or more of the chronic diseases
alone. "The need for timely diagnosis and treatment of depressive
disorders to reduce the burden on public health is imperative," added
Moussavi. "In many primary care settings patients presenting with multiple
disorders that include depression often don't get diagnosed, and if they
do often treatment is focused towards the other chronic diseases."
In an accompanying article in the Lancet, Gavin Andrews, of the University
of New South Wales, said: "In Australia less than 30% of patients receive
good treatment with antidepressants, cognitive behavioural therapy, and
proactive maintenance care. By contrast, 80% of patients with arthritis
and 90% of patients with asthma receive an acceptable standard of care."
Dr Moussavi said mental disorders often came hand-in-hand with other
chronic illnesses and would become more common as the world's population
lived longer.
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