Depression is the fourth leading cause of global burden of mental ill health. According to WHO it will be the second most common form of disability by 2020 after ischemic heart disease. Depression is a major cause of suicide. Nearly 1 million people die of suicide, annually. Incidence of major depressive disorder is 1 in 20 people during their entire life time. It is more common in women than men.
Depression affect compliance, immune functioning, quality of life and it will lead to unhealthy behaviours in patients. Due to depression patient experience a variety of somatic illness. Less than one half of depressed patients are identified and adequately treated by primary care physician. It is a common condition and is treatable. Hence identification of this syndrome is important.
Risk factors for depression are
- Gender-common in females.
- Genetic/biological vulnerability.
- Stress/environmental/life events especially loss events such as bereavement.
- Physical illness especially chronic and painful illness.
- Drugs.
- Chronic and excessive alcohol intake.
- Difficulties in interpersonal relationship.
- Lack of social support with no confiding relationship.
Pathways to depression
Broadly depression can be classified as two major groups.
- “Major” depression – Pharmacologically treated.
- “Minor” depression – Treated mainly by psychological approaches.
