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Depression in the Mideast reaches alarming levels

JEDDAH: Depression is a common mental health disorder, affecting more than 350 million people of all ages worldwide, according to the World Health Organization (WHO). In 2001, the WHO identified depression as the fourth leading cause of disability and premature death in the world. It is projected to become the leading cause of burden of disease by 2030.
Addressing the growing unmet need for developing better understanding of psychiatric diseases including major depressive disorder (MDD) in Saudi Arabia, the capital city, Riyadh recently hosted a national mental health forum supported by the Ministry of Health in which psychiatrists and experts provided profound insight into the proper management of MMD, consultancy guidelines and treatment options.
A new study found that the Middle East, including Saudi Arabia has a very high rate of major depression compared to the rest of the world — almost 7 percent. This figure is especially concerning due to a recent link found between depression and patients’ functional impairment. As the severity of depression increases, so does the level of impairment in social, familial and work role functioning.
As an example demonstrating the regional burden of depression, a recent study published in the Journal of Clinical Psychiatry highlighted the large gap in the Middle East region between the number of people needing and actually receiving treatment for depression. Furthermore, the World Health Organization notes more than 75 percent of people with depression in developing countries are inadequately treated, with mental health one of the most neglected, yet essential, development issues in achieving the United Nations’ Millennium Development Goals one and five.
Demonstrating the local burden, in Saudi Arabia, more than 201,000 disability-adjusted life years (DALYs) are lost from depression in a year. DALYs is a measure of overall disease burden, expressed as the number of years of potential life lost due to premature death and the years of productive life lost due to disability.
The study included a ranking of some of the countries in the Middle East most profoundly burdened with depression. Egypt ranked first in terms of DALYs with a staggering figure of 622,000, followed by Saudi Arabia with 201,000 DALYs, Syria 156,000 DALYs, UAE 39,000 DALYs and finally Lebanon 37,000 DALYs lost form depression.
A recently published analysis shows there is also a link between MDD treatment and improvement in functional impairment. The analysis suggests that there is a significant relationship between measures of depression symptom severity, functional impairment and emotional well being. Healthcare providers are increasingly using scales, such as Sheehan Disability Scale (SDS), to measure disability and impairment to improve MDD treatment management, which has led to the improvement in the health care of patients with depression. Thus, it is important that patients consult their doctor so they can be properly diagnosed and ensure their condition is managed effectively.
“Almost 1 in 10 of those who live in the Middle East suffer from MDD. For those individuals, studies show that functional impairment with work, school, family and social life is likely also present, and rises with the severity of their depression. For that reason, it is critical to identify MDD, and offer treatment to patients as early as possible.” said Dr. Suhail Abdul Hamid Khan.
Current leading guidelines from the American Psychiatric Association (APA) and the Canadian Network for Mood and Anxiety Treatments (CANMAT) recommend selective serotonin reuptake inhibitors (SSRIs), serotonin and noradrenaline reuptake inhibitors (SNRIs), as a first-line treatment for depression. According to the APA, “The initial selection of an antidepressant medication will largely be based on the anticipated side effects, the safety or tolerability of these side effects for the individual patient, and the pharmacological properties of the medication.”
New treatment options launched in Saudi Arabia for depression have proven to be of great efficiency and safety for patients. Based on clinical research, the newly approved treatments can offer favorable tolerability – meaning discontinuation rates on the drug were similar to a placebo in the trial.

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