Transcript Educational-Programme-Depression

WPA Educational Programme on
Depressive Disorders
Volume One: Fundamentals
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Patients with moderate depressive episode:
• May also have considerable difficulty maintaining
personal and vocational roles functions;
• Some symptoms may be quite severe but on the whole
fewer in number and less intense than severe episodes.
• Must fulfill general criteria for a depressive episode, have
two of three typical symptoms and have four additional
symptoms as outlined in ICD-10 Classification of Mental
Disorders.
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Epidemiologic Findings:
• Several large epidemiological studies have been
conducted.
• One of the earliest by National Institute of Mental Health
(NIMH) Epidemiologic Catchment Area (ECA) found:
– 9.5% of the US population over 18 years of age was afflicted by a
mood disorder in any one year period (Regier et al. 1993)
• More recent studies in other population groups, using
similar ascertainment tools have provided additional
results.
– Lifetime prevalence approaches 17-18%
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Impact of Depressive Illnesses
• Impact of depression on society is well-documented
(Desjarlais et al. 1995)
• The Global Burden of Disease study found depression
was the fourth most burdensome of all medical conditions
throughout the world in 1990;
• And predicted it would rise to second by 2020 (Murray
and Lopez 1996)
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Impact of Depressive Illnesses
• Disability Adjusted Life Years (DALY) is a metric,
introduced in 1998 by the Harvard School of Public
Health in collaboration with the World Bank and World
Health organization.
• DALY represents the sum of years of life lost due to
premature mortality (YLL) in the population and years lost
due to disability for incident cases of the health condition.
• Neurospsychiatric disorders accounted for about 28% of
total DALYs lost due to non-communicable diseases in
2005.
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The Three Phases of Treatment
for Depression
• Depressive disorders are often recurrent.
• Therefore, treatment is generally viewed in three phases:
acute, continuation, and maintenance (or prophylaxis)
phases.
• Demarcations between the different phases is often
somewhat blurred.
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