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Depression May Be World's Most Disabling Disease

Global study finds it takes bigger toll than other chronic conditions

FRIDAY, Sept. 7 (HealthDay News) -- When compared with other chronic diseases, depression may well be the most disabling disease in the world, a new global study finds.

People with chronic physical diseases such as angina, arthritis, asthma and diabetes also fare far worse if they also suffer from depression, the team of international researchers found.

"Being sad is bad for your health," according to lead researcher Dr. Somnath Chatterji, from the World Health Organization (WHO) in Geneva, Switzerland.

But all too often, he said, depression doesn't get the serious attention paid to physical ailments.

"Treatment of mental health conditions such as depression are a necessity, not a luxury. Mental health conditions such as depression must be treated on a par with physical health conditions," Chatterji said.

In the study, published in the Sept. 8 issue of The Lancet, Chatterji's team perused data on more than 245,000 people from 60 countries participating in WHO's World Health Survey.

They found that 3.2 percent of people had experienced a depressive episode in the past year. For people with angina, the rate was 4.5 percent; for people with arthritis, it was 4.1 percent; for those with asthma, it was 3.3 percent; and for people with diabetes, it was 2 percent.

Moreover, between 9 percent and 23 percent of people had depression in addition to suffering from one or more of these conditions. That's significantly higher than the likelihood of having depression without having a chronic disease, Chatterji's group noted.

After the researchers had accounted for socioeconomic factors and health conditions, they confirmed that depression had the biggest effect on worsening health compared with the other four major chronic illnesses. In different countries, people with depression plus one or more chronic diseases were in the worst health of all the disease states studied, Chatterji's team reported.

"Compared to the chronic physical illnesses of angina, arthritis, asthma and diabetes, depression produces the most decline in health," Chatterji said. "Having depression over and above a physical illness significantly worsens health even further," he said.

Depression needs to be recognized and treated as an urgent public health priority, Chatterji said. "Persons with physical illnesses should also be examined for depression and treated appropriately. Primary care providers must learn to recognize and manage concurrent physical illnesses and depression to reduce disease burden and improve population health," he added.

One expert hailed the findings.

"It is encouraging to see that results that we have been seeing from our country, from studies in the United States about the devastating effects of comorbid depression with other chronic illnesses, are replicable internationally," said David L. Shern, the president and CEO of the nonprofit advocacy group Mental Health America.

Depression is a huge public health issue, Shern said. "Continuing to have these inane debates about whether we should have insurance coverage for mental health care, in the light of data like these, is just silly," he said.

The study also highlights the need for integrated care and screening for depression, Shern said. "Practitioners need to be educated to look for depression, and consumers need to push their doctors to be aware of their depression," he said.

Depression is treatable, Shern noted. "That's one of the big stories of the last 20 years -- the development of pharmacological treatments that have broad scale effectiveness," he said. "There are psychosocial treatments, for people who don't want to take medication, that are just as effective," he said. "Combining the two is the preferred regimen."

More information

For more on depression, visit the U.S. National Institute of Mental Health.

SOURCES: Somnath Chatterji, M.D., World Health Organization, Geneva, Switzerland; David L. Shern, Ph.D., president and CEO, Mental Health America, Alexandria, Va.; Sept. 8, 2007, The Lancet

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