Wealth does not equal mental health?

July 27, 2011

According to a new cross-national survey published in BMC Medicine, people living in wealthier counties are more likely to have experienced a depressive episode than those living in low and middle-income countries.

89,000 people in 18 countries were surveyed for major depressive episodes using a standardized set of questions. Approximately 15 percent of those living in 10 high-income nations reported having at least one depressive episode in their lifetime, The Huffington Post reports. For lower-income countries, the incidence was 11 percent.

No matter the location, it was found that women are almost twice as likely to experience depression. In wealthier countries, low-income respondents have double the risk of experiencing a depressive episode.

According to the research team:

“On one level, it seems counterintuitive that people in high-income countries should experience more stress than those in low- to middle-income countries. However, it has been suggested that depression is to some extent an illness of affluence.”

The countries found to have the highest prevalence of a depressive episode are:

  1. France– 21 %
  2. United States– 19.2 %
  3. Brazil– 18.4 %

The countries found to have the lowest incidence are:

  1. Mexico– 8 %
  2. India– 9 %
  3. South Africa– 9.8%

Lead study author Dr. Evelyn Bromet, a professor of psychiatry at State University of New York at Stony Brook, says the fact that the same interview was used in all 18 countries is a potential weakness of the study. The standardized questions may not capture depression as well in low-income countries where mental health is not as widely discussed and where citizens may be less likely to open up to a foreign interviewer.

To see the full list, click here.

Antidepressants may alter personality

December 9, 2009

New research finds that antidepressants may alter personality, making those who suffer from depression more extraverted and less neurotic. Tony Tang, PhD, lead study author and adjunct psychology professor at Northwestern University, says changes in these personality traits could help prevent future relapses of depression.

According to HealthDay, relapsing after receiving treatment for depression has been found to be a major problem for sufferers. Approximately two-thirds of patients relapse after stopping medication, while almost half of patients suffer a relapse while they are still in the process of being treated.

It has been thought that patient personality changes were the result of antidepressants improving mood. However, Science News reports that this new research suggests that SSRIs (selective serotonin reuptake inhibitors) have an independent effect on these personality traits which in turn helps to ease depression.

The study, published in the Archives of General Psychiatry, consisted of 240 adults with severe depressive disorders. The participants were divided intro three groups – 120 took Paxil (paroxetine), sixty received cognitive therapy, and the other sixty took a placebo. Personalities were assessed before, during and after the treatment had been completed.

Health.com reports that the level of extraversion reported by the Paxil group was 3.5 times greater than the other two groups, and the reduction in neuroticism was seven times greater.

Lead researcher Tang says:

“People’s personalities actually do change and quite substantially when they go through these antidepressant treatments…In the past, we tended to dismiss the personality changes as a side effect or something not very important. But our study suggests it’s actually very important to treatment outcomes.”

Antidepressant use doubles in America

August 5, 2009

A new study finds that the use of antidepressants has almost doubled among people in the U.S. between the years 1996 and 2005 – increasing from 5.84 percent to 10.12 percent. That translates to a grand total of 27 million people.

In order to conduct this study, the authors Dr. Mark Olfson and Dr. Steven C. Marcus examined the Medical Expenditure Panel Surveys completed in 1996 and 2005 by the U.S. Agency for Healthcare Research and Quality. The surveys help to provide estimates about healthcare costs and consisted of approximately 50,000 people age  six and over.

After examining the data, the research team noticed that this significant increase did not hold true for African Americans (3.61 percent in 1996 to 4.51 percent in 2005) or Hispanics (3.72 percent in 1996 to 5.21 percent in 2005). They also found that the number of people taking part in therapy decreased from 31.5 percent to 19.87 percent, while the patients prescribed antipsychotic medications rose from 5.46 percent to 8.86 percent.

Dr. Mark Olfson tells HealthDay:

“The reasons [for the growth] are unclear but they may include the introduction of new antidepressants over the last 10 to 12 years or so and a broadening in the clinical indications of antidepressant treatment. Years ago, these drugs were largely focused on depression. Today, more different conditions are treated with antidepressants… There’s also been an increase in direct-to-consumer advertising and a lessening of the stigma associated with seeking mental health care.”

The study authors found a considerable increase in direct-to-consumer advertising, from $32 million in 1996 to $122 million in 2005. This is evident through the influx of television advertisements for antidepressants shown in recent years. (Does anyone else find the recent commercial with the woman and her wind up toy slightly creepy?)

Now that antidepressants are the most prescribed category of drugs in the U.S., Olfson expresses concern that these prescriptions might be taken too casually. He emphasizes to WebMD that the decision to take an antidepressant is between the physician and the patient and should be taken seriously in order to determine the best treatment plan.

The study is published in the Archives of General Psychiatry and more information on depression can be found here.


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