Studies have revealed that at any point in time, about 6 percent of the population will have a significant depression and only 20 to 25 percent of these people ever seek help. Given those statistics it’s no surprise that the World Health Organization (WHO) named depression the number one cause of disability in the world, in terms of years lived with disability (YLDs).
According to Ricardo Muñoz, PhD, in the department of psychiatry at UCSF and director of the UCSF/SFGH Internet World Health Research Center, the health care system should be providing access to depression intervention programs.
In his recent article, “Major Depression Can Be Prevented,” which appears in a special section of the May-June 2012 issue of the American Psychologist, Muñoz and co-authors provide a road map for what needs to be accomplished in the next 10 years to make headway against depression.
Previous studies suggest that 22 percent to 38 percent of major depressive episodes could be prevented with currently available interventions, according to Muñoz.
Facts from the World Health Organization (WHO)
- Depression is common, affecting about 121 million people worldwide.
- Depression is among the leading causes of disability worldwide.
- Depression can be reliably diagnosed and treated in primary care.
- Fewer than 25 percent of those affected have access to effective treatments.
Muñoz and co-authors William Beardslee, MD, professor of child psychiatry at Harvard Medical School and Yan Leykin, PhD, assistant adjunct professor in the department of psychiatry at UCSF, are calling their article a “call to action for the health care system.” The article builds on a 2009 Institute of Medicine report on prevention of mental, emotional and behavioral disorders, which provided evidence that mental disorders can be prevented.
“Very few people are aware that depression can be prevented, including professionals in the field, and there are very few preventive services,” said Muñoz in a press release from UCSF.
“The healthcare system is set up to pay providers for treatment. It has not been set up to pay providers for prevention of mental disorders,” said Muñoz. “Without financial incentives for prevention, few professionals will engage in preventive interventions. It’s a major structural obstacle.”
Muñoz and his co-authors advocate teaching people mood management skills, shown to be effective for the treatment of depression. “Why wait until people are seriously depressed to teach them these skills?” said Muñoz. “If we can teach these skills earlier, serious depression can be prevented and we could reduce unnecessary suffering significantly.”
In addition to cognitive-behavioral or interpersonal psychotherapy methods, one of the “nontraditional” mood management interventions mentioned in the article is an internet-based program using cognitive-behavioral tools. At six months the intervention was found to reduce relapse in the experimental group to 10.5 percent of the participants, versus 37.8 percent in the control group.
The article offers a set of guidelines to help decrease the number of people affected by depression, which includes identifying high-risk individuals and ultimately striving to reduce new cases of depression by half. Those at high risk include: (1) people who have already had a major depressive episode – the likelihood of having a repeat episode is increased and can lead to chronic or recurrent depression; (2) recognizing that depression may be a family illness – parents who have had depressive episodes should consider the needs of their children; and (3) stressful life events often trigger depression -therefore, managing stress in an effective way through mood management techniques can be beneficial.
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