Diagnosis and adherence to treatment are very important
Depression is a disease that affects 340 million people in the world and approximately 4 million in Spain. During the average age of life, the prevalence is two times higher in women than in men, although these data are equalized with age.
Experts point out the importance of diagnosis, since it presents various symptoms that make it difficult, and adherence to treatment as two of the fundamental challenges in addressing the problem of depression, one of those with the greatest social burden according to the WHO.
The importance of adherence to treatment
- One of the main challenges in addressing the problem of depression is achieving adequate therapeutic compliance prescribed by physicians. Spanish data indicates that more than 50% of patients do not adequately take the treatment that has been prescribed.
- This has an impact on the disease, increasing the risk of relapse and contributing to its chronicity. In the case of Spanish patients, they normally follow the treatment for an average of 4 months, when the clinical guidelines recommend that the treatment be maintained for at least 6 to 9 months.
- “At 2-4 weeks after the start of treatment, the patient will notice a significant subjective improvement,” says Dr. Javier Quintero, a member of the Madrid Community Psychiatric Society. “But it is not enough. We know that the patient must persevere in the treatment. He must follow the instructions that his doctor gives him regarding the duration of the treatment, despite the initial improvement.”
Pain as a symptom of depression
- 59% of patients with generalized anxiety report pain and this figure rises to 78% in patients with anxiety and depression. However, in many cases the painful symptoms suffered by these types of patients are not associated with said diseases (anxiety and depression). This was revealed by a national study (Gaudi Study) that was recently published in the ‘Journal of Affective Disorders1’. Despite the fact that 90% of these patients had seen their primary care physician at least once in the last three months, in 69% of cases their doctor did not associate this pain with anxiety and depression.
- The study, the first of its kind to be carried out in Spain and in which more than 80 primary care physicians have participated, analyzed a total of 7,152 patients who attended primary care for any reason, of whom more than 13% (981 ) presented generalized anxiety, confirming this disorder as the second most frequent mental illness in primary care. Also, more than half of these patients (559) had a major depressive disorder along with the anxiety disorder.
- On the other hand, the painful symptoms associated with anxiety and depression negatively impact the quality of life and the functionality of the patient. A revealing piece of information in this sense, which is also collected in the research, is that the painful symptoms of these pathologies are associated with a reduction in the work productivity of patients by 3.9 days per week.
- Regarding the social burden of depression, specialists also point out the importance of achieving complete remission in patients who have suffered a major depressive disorder in order to improve not only the depressive symptoms, but also the functional levels of the patients. A study carried out in Spain shows how patients with major depressive disorder in complete remission had three times fewer days off work than those who were in partial remission (20.1 vs. 62.8 days). Likewise, the indirect cost per patient in complete remission was also three times lower than that of patients in partial remission, over 6 months (€1,062 for €3,331).
The crisis as a trigger for depression
- “The appearance of a depressive episode is the result of two factors: the vulnerability that each person has, the personal risk, that is something with which one is born, and the vital events that each person has throughout their lives, and is suffering and overcoming” says Dr. Agüera, Psychiatrist at the Doce de Octubre University Hospital and professor of Psychiatry at the Complutense University of Madrid.
- Thus, people who have a great vulnerability, personal, family, need few events to develop a depressive episode. and those with greater genetic strength and resistance to depression may develop a more severe life event episode. “It is clear that for the most vulnerable people, an environment of economic crisis, layoffs, difficulties can cause them to have an episode when, if it had not happened, that person would still have spent the rest of their lives without developing it. As a consequence, there is an increase in consultations for depressive episodes because the current crisis environment affects, above all, the most vulnerable people”.
- In this sense, Dr. Agüera points out the impact of depression on daily life and the importance of going to a specialist and asking for help. “Depression is a disease that affects the person globally, it does not have only one symptom such as sadness, decay or the idea of death. Depression affects the functionality of that person and their ability to function daily. Therefore, it affects the work, family, relationships, and the ability to have fun and enjoy life. Antidepressant treatment restores the functionality of these people by returning them to their previous level of functioning, that is, to a normal level.”