Department of Psychiatry, Forensic Psychiatry Fellowship Program, University of Missouri School of Medicine, Columbia, MO.
Sumandeep Vidyapeeth University, Gujarat, India.
Ann Glob Health. 2014 Mar-Apr;80(2):89-95. doi: 10.1016/j.aogh.2014.04.001.
Clinical depression is a major leading cause of morbidity and mortality but it is oftentimes overlooked and undertreated. The negative perception and lack of understanding of this condition prevents millions of people from seeking appropriate and on-time medical help, leading to distress and increased burden for affected people and their families. The implementation of public education campaigns and training of non-psychiatric health professionals on mental health and clinical depression has been neglected in several countries, including India, which is the second most populous country in the world with a population of more than 1.2 billion people, almost one-fifth of the world's population.
This study sought to explore the knowledge and attitudes toward the diagnosis and treatment of clinical depression in nonpsychiatric health care providers in Vadodara, Gujarat, India.
A cross-sectional survey was conducted over a 4-week period In Gujarat, India among resident physicians and community health workers about their knowledge and views on clinical depression.
We found considerable stigma and misinformation about depression especially among health care workers in India. Most of the community health workers had a great deal of difficulty when defining clinical depression, and a large majority said that they never heard about depression or its definition and although the overwhelming majority of respondents did not believe that clinical depression results from a punishment from God (82% disagreed or strongly disagreed with this belief) or evil spirits (77.5%), a much smaller proportion disagreed with the assertions that depression was either solely due to difficult circumstances (38.2%) or that sufferers only had themselves to blame (47.2%). Meanwhile, only 32.6% disagreed with the position that clinical depression is a sign of weakness and 39.4% disagreed with the statement that suicide was a sign of weakness.
Our findings underscore the considerable public health priority facing India's policymakers and planners to better educate more non-psychiatric physicians and community health workers to identify, understand, and respond to early signs of mental illnesses, especially clinical depression.
临床抑郁症是导致发病率和死亡率的主要原因之一，但它经常被忽视和治疗不足。人们对这种疾病的负面看法和缺乏了解，导致数以百万计的人无法寻求适当和及时的医疗帮助，给患者及其家属带来痛苦和负担。包括印度在内的一些国家忽视了针对公众的教育活动和对非精神科卫生专业人员进行心理健康和临床抑郁症方面的培训。印度是世界上人口第二多的国家，拥有超过 12 亿人口，几乎占世界人口的五分之一。
本研究旨在探讨印度古吉拉特邦瓦多达拉的非精神科卫生保健提供者对临床抑郁症的诊断和治疗的知识和态度。
在印度古吉拉特邦，对住院医师和社区卫生工作者进行了为期 4 周的横断面调查，了解他们对临床抑郁症的知识和看法。
我们发现，尤其是在印度的卫生保健工作者中，对抑郁症存在相当大的污名化和误解。大多数社区卫生工作者在定义临床抑郁症方面存在很大困难，绝大多数人表示他们从未听说过抑郁症或其定义，尽管绝大多数受访者不认为临床抑郁症是上帝惩罚（82%不同意或强烈不同意这种信念）或邪灵（77.5%）的结果，但较小比例的人不同意以下说法，即抑郁症仅仅是由于困难的环境（38.2%）或患者只能责怪自己（47.2%）。同时，只有 32.6%不同意临床抑郁症是软弱的表现的说法，39.4%不同意自杀是软弱的表现的说法。
我们的研究结果强调了印度政策制定者和规划者面临的相当大的公共卫生优先事项，需要更好地教育更多的非精神科医生和社区卫生工作者，以识别、理解和应对精神疾病，特别是临床抑郁症的早期迹象。
