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Our topic

• Depression: a major public health problem
• Suicidality
• Diagnostic and therapeutic deficits

Depression a major public health problem
Depressive disorders (6-month prevalence of about 7 % in the European Society [Lépine et al., 1997]) are characterised by a recurrent, often chronic course. They can impair the quality of life more than any other disease, often leading to suicidality. Up to 15 per cent of the patients suffering from severe major depression commit suicide. High suicidality is regarded to be an important indicator for the under-diagnosis and under-treatment of depression. Considering the facts, it is not surprising that a recent WHO-Study (Murray & Lopez, 2001) identified depression to be heading the list of disorders responsible for the global burden of disease in industrial countries.

  
Fig. 1: WHO Study „Global Burden of Disease”, Murray & Lopez 2001   
© Kompetenznetz Depression

Suicidality
More than 90% of suicides occur in the context of a psychiatric disorder, depression being by far the most important one. Annually, more than 58,000 persons in the countries of the European Union commit suicide. Suicide rates per country range from 5,92 per 100,000 in Italy up to 25 per 100,000 in Slovenia (WHO-data, 2001-2003).

Fig. 2: WHO Data “European suicide rates”, 2005

Europe-wide, dying from suicide accounts for the second highest risk of death for young men and the third highest risk for young women. About 14% of all suicides occur in the age range of 15–24 (Report on the state of young people’s health in the EU, EC Working Paper). Compared to the number of suicide deaths, the number of suicide attempts is assumed to be much higher. Estimates for the younger aged range from 20 to 30 suicide attempts on every suicide. Given this situation, interventions aiming at the prevention of suicidality and, thereby, especially focusing on children, adolescents and young people are urgently needed.

Diagnostic and therapeutic deficits
Although effective treatments (antidepressants, psychotherapy) are available only about 10% of the depressed patients receive an optimal care. The reasons for the under-diagnosis and under-treatment of depression range from deficits at the primary care level (e.g. lack of knowledge concerning diagnosis and treatment of depression, underestimation of the severity of the disorder) to the public attitude (e.g. “crisis during adolescence are normal”, “depression is not a real disorder”) and the depressed person himself (e.g. lack of energy to seek help, compliance problems, fear of stigmatisation). The EAAD project addresses the severe diagnostic and therapeutic deficits concerning depression and suicidality by establishing multi-faceted community based intervention programmes targeting the topic in several European regions.

Last update: 19.03.2010