Unipolar Major Depression

Presentation about epidemiology of Unipolar Major Depression in the world taking special focus to National Mental Health Program of India.

1. UNIPOLAR MAJOR DEPRESSION SIR MICHAEL MARMOT GROUP 1

2. GROUP CONTRIBUTIONS SIR MICHAEL MARMOT GROUP 2

3. ABRAHAM LINCOLN SIR MICHAEL MARMOT GROUP 3

4. WHAT IS UNIPOLAR MAJOR DEPRESSION ? Unipolar Major Depression is a mental disorder characterized by pervasive and persistent low mood that is accompanied by low self esteem and by a loss of interest of pleasure in enjoyable activities. (3) MANIFESTATIONS Affects daily life for weeks or longer Interferes with social life - Family and relationships - work and school life - Sleeping and eating habits Implications on general health SIR MICHAEL MARMOT GROUP 4

5. SIR MICHAEL MARMOT GROUP 5 HISTORY Hippocrates – described Melancholia with mental and physical symptoms. (3) Sigmund Freud – Mourning and Melancholy CLASSIFICATION DSM-I, 1952 AND DSM-II, 1968. (3) ICD – 10 By WHO

6. SIR MICHAEL MARMOT GROUP 6 RISK FACTORS SYMPTOMS Restlessness and Irritation Loss of Interest Abnormal Appetite Insomnia and Hypersomnia

7. SIR MICHAEL MARMOT GROUP 7 More common in urban than rural population. (3) 8.2% - global YLDs in 2010, making it the 2nd leading cause of global disability. 11th leading cause of global burden (or DALYs) in 2010. (6)

8. SIR MICHAEL MARMOT GROUP 8 GOLBAL BURDEN OF UNIPOLAR DEPRESSION Global Rank of MDD (Acc. To WHO) (5) Year Rank Cause DALYs (000s) % DALYs DALYs per 100,000 population 2000 11 Unipolar depressive disorders 64,300 2.2 1050 2010 9 Unipolar depressive disorders 76,500 2.8 1081 GHE Estimates 2014 : DALYs by Age and Sex (Acc. To WHO) (5) Age group Sex 0-27 days 1-59 months 5-14 years 15-29 years 30-49 years 50-59 years 60-69 years 70+ years Total Male 1,731 3,084,015 8,598,453 10,379,302 3,783,804 2,012,581 1,288,466 29,148,352 Female 2,759 4,796,559 13,222,569 16,511,919 6,321,185 3,600,032 2,896,867 47,351,890

9. SIR MICHAEL MARMOT GROUP 9 COMPARISON OF DALYs Globally, Prevalence of MDD more in women than men (2012)

10. SIR MICHAEL MARMOT GROUP 10 Unipolar Depressive Disorders World Map (6)

11. SIR MICHAEL MARMOT GROUP 11 GBD OF DEPRESSION IN INDIA Global Health Estimates – DALYs – By sex and age groups (2012). (5)

12. SIR MICHAEL MARMOT GROUP 12 GBD OF DEPRESSION IN INDIA Global Health Estimates – DALYs in year 2000 and 2012. (5) 18% increase from year 2000 to 2012 of depressive disorder.

13. SIR MICHAEL MARMOT GROUP 13

14. SIR MICHAEL MARMOT GROUP 14 NATIONAL MENTAL HEALTH PROGRAMME Started in 1982 Re - Strategized in 2003

15. SIR MICHAEL MARMOT GROUP 15 NATIONAL MENTAL HEALTH PROGRAMME HOSPITAL BASED APPROACH COMMUNITY BASED APPROACH 10 th 5 Year plan (2002-07) DMHP-Country wise Strengthening Central & State Mental Health Authorities Increased Psychiatry content in Medical curriculum Research & Training 11 th 5 Year plan (2007-12) DMHP with added components Modernization of state run hospitals Up gradation of psychiatric wing IEC Man power development 12 th 5 Year plan (2012-17) Integration of different components of NMHP to that of NRHM

16. SIR MICHAEL MARMOT GROUP 16

17. SIR MICHAEL MARMOT GROUP 17 S. No. Resources Present Status (2011) Required Status 1 Psychiatrist 3000 11,500 2 Clinical Psychologist 500 17,250 3 Psychiatrist Social Workers 400 23,000 4 Psychiatrist Nurses 900 9,000 5 Number of Beds 300 30,000 7% of population suffers from mental disorders Point Prevalence - 10 to 20 per 1000 of the population <1 Psychiatrist for every FOUR lakh population. MANPOWER RESOURCE IN INDIA

18. SIR MICHAEL MARMOT GROUP 18

19. SIR MICHAEL MARMOT GROUP 19

20. SIR MICHAEL MARMOT GROUP 20 TREATMENT

21. SIR MICHAEL MARMOT GROUP 21 S. No. Low Resourced Setting High Resourced Setting 1 Routine screening for detection High-risk or routine screening with confirmation of diagnosis by skilled clinician 2 Psycho-education Psycho-education 3 Generic antidepressants Choice of antidepressants 4 Problem-solving treatment Choice of brief psychological treatments  CONCLUSION Mass awareness through education and promotion. Removal of Social taboos and stigmas (FAITH-HEALERS) People with illness should be joined to mainstream. PACKAGE CARE FOR DEPRESSION .

22. SIR MICHAEL MARMOT GROUP 22 Sir Isaac Newton John Stuart Mill Abraham Lincoln Robin Williams Mike Tyson

23. SIR MICHAEL MARMOT GROUP 23 IMPORTANT FACTS World Mental Health Day – 10 th October Theme for 2014 – “Living with Schizophrenia”

24. SIR MICHAEL MARMOT GROUP 24 REFERENCES The Hindu Newspaper - http://tinyurl.com/pzby9ow National Crime Records Bureau – Suicides in India, 2013 Wikipedia - http://tinyurl.com/lealaug http://obad.ca/information_depression#criteria WHO Data on Global Health Estimates. GBD Data on Depressive Disorder Medscape - http://www.medscape.com/viewarticle/813896 WHO - http://www.who.int/mental_health/mhgap/en/ WHO - http://www.who.int/mental_health/maternal-child/en/ MOHFW - http://tinyurl.com/qgvu6ev

25. SIR MICHAEL MARMOT GROUP 25 “Depression begins with disappointment. When disappointment festers in our soul, it leads to discouragement .” - Joyce Meyer