Global burden of depression: the intersection of culture and medicine (original) (raw)
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VIPSIG_Depression_around_the_world.pdf
As a mental health community we are proud to mark World Health Day, 7th April 2017, which this year has a theme of depression and suicide. This is the first time that there has been mental health theme on World Health Day since 2001. We commemorate this day with stories of depression from over 30 countries around the world. We know that depression is one of the most disabling conditions in global health – currently the third most disabling condition globally and predicted to be the leading and most disabling condition throughout the world by 2030. Depression is universal, taking no account of class, religion, or ethnic group. It spares neither the rich, nor the poor. It is the silent illness causing untold misery. It leads to effects on whole families, children's health and wellbeing. In terms of mental health interventions, if there is just one thing we can do, it should be to diagnose and treat depression. Treatment of depression is cost-effective and cheap, with a huge dividend in well-being for the affected and their families. In these stories we see a range of views of depression, but the same themes come up again and again – barriers to treatment, stigma, missed diagnosis and opportunities to pick up depression are universal in low-, middle- and high-income countries. The countries have been selected through our professional and personal connections and don’t represent any agenda. The views expressed belong to the individual authors.
Global burden of depressive disorders: the issue of duration
The British Journal of Psychiatry, 2002
Comparing age at onset of major depression and other Comparing age at onset of major depression and other psychiatric disorders by birth cohorts in five US psychiatric disorders by birth cohorts in five US community populations. community populations. Archives of General Psychiatry Archives of General Psychiatry, , 48 48, 789^795. , 789^795. Costello, C. G. (1990) Costello, C. G. (1990) The similarities and dissimilarities The similarities and dissimilarities between community and clinic cases of depression. between community and clinic cases of depression.
Global burden of depressive disorders in the year 2000
The British Journal of Psychiatry, 2004
Background The initial Global Burden of Disease study found that depression was the fourth leading cause of disease burden, accounting for 3.7% of total disability adjusted life years (DALYs) in the world in 1990. Aims To present the new estimates of depression burden for the year 2000. Method DALYs for depressive disorders in each world region were calculated, based on new estimates of mortality, prevalence, incidence, average age at onset, duration and disability severity. Results Depression is the fourth leading cause of disease burden, accounting for 4.4% of total DALYs in the year 2000, and it causes the largest amount of non-fatal burden, accounting for almost 12% of all total years lived with disability worldwide. Conclusions These data on the burden of depression worldwide represent a major public health problem that affects patients and society.
Background: Depressive disorders were a leading cause of burden in the Global Burden of Disease (GBD) 1990 and 2000 studies. Here, we analyze the burden of depressive disorders in GBD 2010 and present severity proportions, burden by country, region, age, sex, and year, as well as burden of depressive disorders as a risk factor for suicide and ischemic heart disease.
Depression: cost-of-illness studies in the international literature, a review
The Journal of Mental Health Policy and Economics, 2000
Background: Depression is one of the most ancient and common diseases of the human race and its burden on society is really impressive. This stems both from the epidemiological spread (lifetime prevalence rate, up to 30 years of age, was estimated as greater than 14.4% by Angst et al.) and from the economic burden on healthcare systems and society, but also as it pertains to patient well-being. Aims of the study: The scope of this review was to examine studies published in the international literature to describe and compare the social costs of depression in various countries. Methods: A bibliographic search was performed on international medical literature databases (Medline, Embase), where all studies published after 1970 were selected. Studies were carefully evaluated and only those that provided cost data were included in the comparative analysis; this latter phase was conducted using a newly developed evaluation chart. Results: 110 abstracts were firstly selected; 46 of them underwent a subsequent full paper reading, thus providing seven papers, which were the subject of the in-depth comparative analysis: three studies investigated the cost of depression in the USA, three studies in the UK and one study was related to Italy. All the studies examined highlight the relevant economic burden of depression; in 1990, including both direct and indirect costs, it accounted for US$ 43.7 billion in the US (US$ 65 billion, at 1998 prices) according to Greenberg and colleagues, whilst direct costs accounted for £417 million in the UK (or US$ 962.5 million, at 1998 prices), according to Kind and Sorensen. Within direct costs, the major cost driver was indeed hospitalization, which represented something in between 43 and 75% of the average per patient cost; conversely, drug cost accounted for only 2% to 11% in five out of seven studies. Discussion: Indeed, our review suggests that at the direct cost level, in both the United States and the United Kingdom, the burden of depression is remarkable, and this is confirmed by a recent report issued by the Pharmaceutical Research and Manufacturers Association (PhRMA) where prevalence and cost of disease were compared for several major chronic diseases, including Alzheimer, asthma, cancer, depression, osteoporosis, hypertension, schizophrenia and others: in this comparison, depression is one of the most significant diseases, ranked third by prevalence and sixth in terms of economic burden. Moreover, in terms of the average cost per patient, depression imposes a societal burden that is larger than other chronic conditions such as hypertension, rheumatoid arthritis, asthma and osteoporosis. The application of economic methods to the epidemiological and clinical field is a relatively recent development, as evidenced by the finding that, out of the seven studies examined, three refer to the US environment, three to the UK and one to Italy, while nothing was available about the cost of depression for large countries such as France, Germany, Spain, Japan and others. Implication for health care provision and use: The high incidence of hospitalization, and the finding that drug cost represents only a minor component of the total direct cost of the disease, suggests that room is still available for disease management strategies that, while effectively managing the patient's clinical profile, could also improve health economic efficiency. Implication for health policies: Disease management strategies, with particular emphasis on education, should be targeted not only at patients and medical professionals but also at health decision makers in order 'to encourage effective prevention and treatment of depressive illness'. Implications for further research: Cost of illness studies are a very useful tool allowing cost data comparisons across countries and diseases: for this reason, we suggest that further research is needed especially in some western European countries to assess the true economic burden of depression on societies. Copyright
The Epidemiology of Depression Across Cultures
Annual Review of Public Health, 2013
Epidemiological data are reviewed on the prevalence, course, socio-demographic correlates, and societal costs of major depression throughout the world. Major depression is estimated in these surveys to be a commonly occurring disorder. Although estimates of lifetime prevalence and course vary substantially across countries for reasons that could involve both substantive and methodological processes, the cross-national data are clear in documenting meaningful lifetime prevalence with wide variation in age-of-onset and high risk of lifelong chronic-recurrent persistence. A number of sociodemographic correlates of major depression are found consistently across countries, and cross-national data also document associations with numerous adverse outcomes, including difficulties in role transitions (e.g., low education, high teen childbearing, marital disruption, unstable employment), reduced role functioning (e.g., low marital quality, low work performance, low earnings), elevated risk of...