Informtion on Depression
July 1, 2003
Depression
I have had numerous requests for information on depression during these past 5 years. Newly published medical articles warrant a fresh look at this condition.
There is an unjustifiable stigma associated with this condition. Due to this negative association, most individuals who have this disorder do not seek medical attention, or do not adhere to the pharmacological treatment modalities. This has a significant negative impact upon every facet of their lives.
As has been presented within the earlier articles, a majority of Americans will exhibit symptoms associated with this disorder in their lifetime. Many of these individuals can respond very well to the demands in their personal, professional and social lives, while under medication.
In a recent article by Kessler et al. (2003. JAMA), it was reported that 1 out of every 6 people in the United States suffers from lifetime major depressive disorder (MDD). Those demonstrating symptoms for one calendar year represented another 1 in 14. Collectively, this equates to almost 1 out of every 4 Americans are effected by this disease. This survey was conducted in the 48 contiguous States, and enlisted information from 9090 people.
Within the breakdown of the 12 month cases, virtually all were clinically significant using the Quick Inventory of Depressive Symptomatology Self Report (QIDS-RS). Further sub fraction indicated that 10.4% were mild, 38.6% moderate, 38% severe, and 12.9% very severe. The average episode duration was approximately 16 weeks.
Almost 60% of these12-month cases had severe or very severe role-impairment implications. This exacerbates the condition as it undermines much of the inner-self stability needed to function within society.
Of these patients, 78.5% had co-morbid disorders. This indicates a compounding effect upon both the treatment modules and functional difficulties.
The disturbing news was that only 51.6% of these people received medical treatment. After further review, only 21.7% were reported to have been adequately treated.
In a companion article (2003. JAMA), by Stewart et al., the labor costs, per depression, were calculated. This was defined as Lost Productive Work Time (LPT).
The average lost time, per week, was estimated at 5.6 hours. This was 4 times larger than previously projected.
The total figure was determined to be $44 billion, per year. This equates to $31 billion more than is associated with workers not diagnosed with depression.
About 81% of all the costs were defined as reduced performance at work. Those with MDD accounted for 48% of these losses.
Less that 30% of the workers interviewed stated they used
antidepressants. Almost half of these individuals reported only “moderate” treatment effectiveness when following the prescription.
In Conclusion: The disturbing information contained within this article, should be viewed through the aforementioned social and professional implications. It is known that less than half of all those demonstrating symptoms of this condition ever seek professional assistance. The Kessler et al. article reported that only 22 percent of these patients receive adequate medical treatment.
The treatment of this condition can best be described as a “trial and error” method. It takes most medications from one week to10 days to demonstrate a pronounced effect upon the symptoms. Even if a pharmacological agent is found to be effective, this may not remain consistent, therefore demanding that the patient returns to the trial and error methodology. This may account for the “moderate”
classification for those few adhering to the medicinal treatments.
It is also obvious that the loss of production time and dollars is significant. Adequate interaction and intervention must be aggressively pursued to reduce these figures.
If the estimation of 1 in every 4 Americans is affected by depression, termination from employment is an illogical option. For the corporate entities to realize a reduction in LPT, they must pursue an aggressive program for providing these men and women, clinically appropriate avenues.
In many cases, depression can be modified successfully with the inclusion of cardiovascular exercise. This would translate into daily walking, cycling, jogging, etc. The cost of implementing this program is minimal, and the results are significant.
If you have any questions, please feel free to contact me.
Dr. Jack W. Chisum
Depression
I have had numerous requests for information on depression during these past 5 years. Newly published medical articles warrant a fresh look at this condition.
There is an unjustifiable stigma associated with this condition. Due to this negative association, most individuals who have this disorder do not seek medical attention, or do not adhere to the pharmacological treatment modalities. This has a significant negative impact upon every facet of their lives.
As has been presented within the earlier articles, a majority of Americans will exhibit symptoms associated with this disorder in their lifetime. Many of these individuals can respond very well to the demands in their personal, professional and social lives, while under medication.
In a recent article by Kessler et al. (2003. JAMA), it was reported that 1 out of every 6 people in the United States suffers from lifetime major depressive disorder (MDD). Those demonstrating symptoms for one calendar year represented another 1 in 14. Collectively, this equates to almost 1 out of every 4 Americans are effected by this disease. This survey was conducted in the 48 contiguous States, and enlisted information from 9090 people.
Within the breakdown of the 12 month cases, virtually all were clinically significant using the Quick Inventory of Depressive Symptomatology Self Report (QIDS-RS). Further sub fraction indicated that 10.4% were mild, 38.6% moderate, 38% severe, and 12.9% very severe. The average episode duration was approximately 16 weeks.
Almost 60% of these12-month cases had severe or very severe role-impairment implications. This exacerbates the condition as it undermines much of the inner-self stability needed to function within society.
Of these patients, 78.5% had co-morbid disorders. This indicates a compounding effect upon both the treatment modules and functional difficulties.
The disturbing news was that only 51.6% of these people received medical treatment. After further review, only 21.7% were reported to have been adequately treated.
In a companion article (2003. JAMA), by Stewart et al., the labor costs, per depression, were calculated. This was defined as Lost Productive Work Time (LPT).
The average lost time, per week, was estimated at 5.6 hours. This was 4 times larger than previously projected.
The total figure was determined to be $44 billion, per year. This equates to $31 billion more than is associated with workers not diagnosed with depression.
About 81% of all the costs were defined as reduced performance at work. Those with MDD accounted for 48% of these losses.
Less that 30% of the workers interviewed stated they used
antidepressants. Almost half of these individuals reported only “moderate” treatment effectiveness when following the prescription.
In Conclusion: The disturbing information contained within this article, should be viewed through the aforementioned social and professional implications. It is known that less than half of all those demonstrating symptoms of this condition ever seek professional assistance. The Kessler et al. article reported that only 22 percent of these patients receive adequate medical treatment.
The treatment of this condition can best be described as a “trial and error” method. It takes most medications from one week to10 days to demonstrate a pronounced effect upon the symptoms. Even if a pharmacological agent is found to be effective, this may not remain consistent, therefore demanding that the patient returns to the trial and error methodology. This may account for the “moderate”
classification for those few adhering to the medicinal treatments.
It is also obvious that the loss of production time and dollars is significant. Adequate interaction and intervention must be aggressively pursued to reduce these figures.
If the estimation of 1 in every 4 Americans is affected by depression, termination from employment is an illogical option. For the corporate entities to realize a reduction in LPT, they must pursue an aggressive program for providing these men and women, clinically appropriate avenues.
In many cases, depression can be modified successfully with the inclusion of cardiovascular exercise. This would translate into daily walking, cycling, jogging, etc. The cost of implementing this program is minimal, and the results are significant.
If you have any questions, please feel free to contact me.
Dr. Jack W. Chisum