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Depression Among World's Worst Illnesses

By Jennifer Macey

Depression is not only emotionally debilitating - a new study has found it's more physically damaging than many chronic diseases.

Researchers from the World Health Organisation (WHO) have studied data from 250,000 people in 60 countries.

One finding from the study is that people who suffer depression on top of a disease such as angina, asthma, arthritis or diabetes fare worse than if they only had the physical condition.

Experts say better treatment for depression would greatly improve people's overall health.

Gavin Andrews from St Vincent's Hospital wrote an article accompanying the WHO study, published in the latest Lancet medical journal.

"We'd always thought that depression was the most disabling condition in the world but we'd had no hard evidence," he said.

"But a quarter of a million people in 60 countries, carefully diagnosed and measured, has to say to us, it's now official, depression is awful."

WHO researchers have found that people suffering a chronic disease are more likely to develop a mental illness, and it's the depression that makes these patients feel worse.

"Whenever you had depression plus one of the other disorders you were more disabled than if you had any two physical disorders," Professor Andrews said.

The study identified high levels of co-morbidity, or patients suffering both depression and a chronic disease.

University of Queensland psychiatry professor Harvey Whiteford says depressed patients are less able to manage their physical ailments.

"The patient's less likely to adhere to the treatment regime, they might be less likely to visit the doctor, they will have more difficulty in returning to work or participating in a rehabilitation program, because the depression takes away some of the motivation, energy, concentration, that you need to participate in those programs," he said.


Professor Whiteford says the problem is compounded because doctors often fail to identify depression in patients suffering other diseases.

"Because it's stigmatised, because we've often attributed the symptoms of the depression, such as fatigue or poor concentration, to the physical health problem," he said.

"It can be that we haven't been perhaps attuned enough to look for other things that are going on once the doctor has made the diagnoses of a physical health problem such as asthma, diabetes, arthritis."

WHO researchers say wider treatment for depression would improve people's overall health.

But Professor Andrews says in Australia less than 30 per cent of depression patients receive good treatment, with anti-depressants and cognitive behaviour therapy.

This is compared to 80 per cent of arthritis patients and 90 per cent of asthma patients who receive good standards of care, he says.

"The cost of treating depression properly, for every $10 you spend on them you get another day in the work force, you get a depression-free day," he said.

"In health care terms, that's a bargain."
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