RIYADH – According to the World Health Organization (WHO), depression is a common mental health disorder, affecting more than 350 million people of all ages worldwide. 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), Riyadh has recently hosted a national mental health forum supported by the Ministry of Health where psychiatrists and experts provided a profound insight into 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 with the rest of the world - almost 7 percent. This figure is especially alarming 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. The World Mental Health Day in 2012 (celebrated every Oct. 10 annually) under the theme “Depression: A Global Crisis", strived to eradicate the stigma associated with major MDD and other mental health disorders, and promoted discussion on investments in prevention, promotion and treatment services, to reduce burden. As an example demonstrating the regional burden of depression, a recent study published in the Journal of Clinical Psychiatry highlighted a large gap in the Middle East region between the number of people needing and actually receiving treatment for depression. Furthermore, the WHO noted 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. 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. “Almost 1 in 10 of those who live in the Middle East is suffering from MDD. For those individuals, studies show that functional impairment with work, school, family and social life is likely present, and rises with the severity of their depression. For that reason, it is critical to identify MDD, and offer treatment and proper management to patients as early as possible," said Dr Suhail Abdul Hamid Khan, General Manager, Jeddah. The study included some of the Middle East countries namely, Egypt which ranked first in disability-adjusted life years with 622,000 DALYs, followed by Saudi Arabia 201,000 DALYs, Syria 156,000 DALYs, UAE 39,000 DALYs and finally Lebanon 37,000 DALYs lost form depression. A recently published analysis showed that there is also a link between MDD treatment and improvement in functional impairment. Analysis suggests that there is a significant relationship between measures of depression symptom severity and 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 improvement of care in patients with depression. Hence, it is important that patients consult their doctor so they can be properly diagnosed and ensure their condition is managed effectively. Current leading guidelines from the American Psychiatric Association (APA) and 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, pharmacological properties of the medication (e.g., actions on cytochrome P450 enzymes, other drug interactions). Offering an additional first-line therapy for depression, new treatment options launched in Saudi Arabia have proven to be more of greater efficacy and safety for depression 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 – and simplified dosing. – SG
