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CMAG

Notes

8

Incidence of Depression and Other Illnesses

The management of depressed primary care patients can be complicated by the fact that these patients may lack insight into the cause of their symptoms and report only the somatic manifestations of their disorder to their physicians. Primary care patients may also be reluctant to accept a diagnosis of depression or referral to a mental health specialist. Primary care physicians may feel they lack the time or the training to adequately address their patients’ depressive disorders.23

According to the WHO World Health Survey, depression is an important global public health problem due to both its relatively high lifetime prevalence and the significant disability that it causes. In 2002, depression accounted for 4.5% of the worldwide total burden of disease. Without treatment, depression has the tendency to assume a chronic course, to recur, and to be associated with increasing disability over time. WHO’s World Health Survey collected data on health and health-related outcomes. This survey was given only to adults. The prevalence of depression was estimated using criteria in the International Statistical Classification of Diseases and Related Health Problems, tenth revision (ICD-10). The prevalence of four chronic physical diseases—angina, arthritis, asthma and diabetes – was also estimated.24

Figure 124 Results of World Health Survey 2003

Mean Health Score by Disease Status, World Health Survey 2003

Without depression

100

With depression

Mean Health Score (0-100)

80

60

40

20

0

No chronic condition

Depression

Asthma

Angina

Arthritis

Diabetes

Chronic Disease

Figure 1 shows the World Health Survey results from individuals with depression and another chronic condition. The results indicate that those with depression and a chronic condition had much lower mean health scores than those with only a chronic condition. While the analysis does not tell us whether individuals are more depressed because they have a co-existing chronic

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