July 28, 2011

India, the most depressed nation

"Indians are the unhappiest," revealed a study sponsored by World Health Organization. It is reported that around 9 percent people in India suffers from extended period of depression within their lifetime and 36 percent suffer from Major Depressive Episode (MDE).
Sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy and poor concentration and feeling depressed are a few characteristics of MDE.

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China, on the other hand, is reported to be the country with lowest predominance (12 percent) of MDE. The average age of depression in India is 31.9 years compared to 18.8 years in China, and 22.7 years in the US.

The BMC Medicine journal published the study based on interviews of more than 89,000 people in 18 different countries by 20 different researchers and reports that nearly 121 million people are affected by depression, worldwide. In the interview, people were first screened on the basis of three questions for depression sadness/depressed mood, feelings of discouragement, and loss of interest lasting several days or longer. They were put through a questionnaire to detect MDE.

The study includes countries such as the US, China, Japan, India, Brazil, Mexico, Ukraine and Spain, Germany, Lebanon, Mexico, and South Africa.
A person had to qualify for five of the nine cardinal symptoms, including indicators in appetite, sleep, mood, lack of concentration and tendency of suicidal thoughts, to be a positive for MDE. Depression is pointed out as the second contributor to shorten the lifespan for individual in the age group of 15-44.

Countries with high income (28 percent) are reported to suffer more from lifetime MDE than low-income countries (19.8 percent). France (21 percent) and the US (19.2percent) are reported to be the highest in rates of lifetime depression. The main reason women suffer from depression as twice as men, is due to the loss of a partner, whether from death or divorce.

Dr Jitender Nagpal, psychiatrist, from VIMHANS said, "Depression can arise from day-to-day activities. However, MDE is much more serious. This is the feeling of tremendous helplessness, and worthlessness. Planned suicide is highest among those suffering from MDE. Those suffering from MDE don't have the strength to conduct day-to-day chores and become dysfunctional." Moreover, he added, "Increased stress, lonely lives and the falling apart of the social support systems like joint families is a major cause of growing depression among Indians."

The study says, "The average lifetime and 12-month prevalence estimates of MDE were 14.6percent and 5.5percent in the 10 high-income and 11.1percent and 5.9 percent in the eight low to middle-income countries. The average age of onset ascertained retrospectively was 25.7 in the high-income and 24 in low to middle-income countries. The female: male ratio was about 2:1.

But, a senior official from the Ministry of Health, cautioned that the Indian figures are highly exaggerated and do not reveal the true situation of mental health problems and said, The study funded by WHO and DGHS began in a total of 11 centres in India, including PGI in Chandigarh, NIMHANS in Bangalore, Central Institute of Psychiatry(CIP) in Ranchi, AIIMS, and JIPMER, Pondicherry, in 2001-02. The official added that AIIMS was entrusted with the task of tabulating the data for all centres, but after 2005-06, they started knocking out one centre after another, pointing out problems in sampling and interviewing methods. They sent distorted reports to Harvard, without informing the Ministry.

Depression is a significant public-health concern across all regions of the world and is linked to social conditions." said Professor Evelyn Bromet from State University of New York.

The study which finds links between social factors and depression states that the strongest demographic correlate in high-income countries was being separated from a partner, and in low- to middle-income countries, was being divorced or widowed.

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