Depression a Big Factor in Poor Health
World Health Organization Finds Depression Often Goes Untreated
Sept. 6, 2007 -- Depression has a greater impact on overall health than
arthritis, diabetes, angina, and asthma, but it all too often goes unrecognized
and untreated, a report from the World Health Organization (WHO) suggests.
Based on interviews with almost 250,000 people living in 60 countries, WHO
researchers found depression to be a greater predictor of poor health in
patients with these chronic conditions than having one or more chronic medical
conditions without depression.
People who had arthritis, diabetes, angina, or asthma were more likely to
suffer from depression than people without these conditions.
And consistent across different countries and cultures, people with
depression plus one or more of the chronic diseases included in the study had
the worst overall health scores.
The findings, which appear in the Sept. 8 issue of The Lancet,
illustrate the urgency of identifying and treating depression in patients with
other chronic health problems and in the population as a whole, the WHO
"We have to recognize that mental health is not a luxury. It is a
necessity for good overall health," researcher Somnath Chatterji, MD, tells
"Health care providers are so focused on the physical health of their
patients that they often miss the signs of depression. But treating depression
can have a big impact on overall health."
Depression Screening in New York City
Lloyd I. Sederer, MD, knows all too well the importance of identifying and
treating depression in patients who see doctors for other health issues. When
he was mental health commissioner in New York City, Sederer implemented a
routine depression screening program now used in the city's municipal
Prior to seeing their doctor, patients fill out a nine-question mental
health survey. Their answers are scored numerically, with a high score
suggestive of depression.
"When you go to the doctor they weigh you, take your blood pressure, and
you get other tests that result in numbers," Sederer tells WebMD.
"Patients and doctors understand numbers, so being able to talk about
depression in numbers is important."
Sederer says as few as one in eight depressed people receive care for their
condition that is considered minimally adequate.
"If this was cancer or tuberculosis or diabetes and one in eight people
were getting minimally adequate care, the public wouldn't stand for it,"
says Sederer, who now serves as medical director for the New York State Office
of Mental Health.
The hope, he adds, is that routine depression screening will become the norm
in New York City and across the country once doctors become convinced that the
self-reported test has value.
"Twenty one million adults in the United States suffer from depression
and half a million depressed people between the ages of 18 to 55 kill
themselves every year," he says. "This is a big problem."
Depression and Disease Connected
Mental health researcher Gavin Andrews, MD, says doctors must recognize the
integral nature of mental and physical ailments in their patients.
"They should put as much energy into screening and treating depression
as they put into treating angina, diabetes, arthritis, or any other chronic
condition," he tells WebMD.
Andrews is a professor of psychiatry at the University of New South Wales in
In an editorial accompanying the WHO report, he noted that less than 30% of
patients in Australia receive adequate treatment for depression, compared to
90% of patients with asthma and 80% of patients with arthritis.
"Treatment for depression should at least be on a par with that for
other chronic diseases," he wrote.