The Devil in the Details: Public Health and Depression

[摘要] Mental disorders have been increasingly portrayed by the World Health Organization (WHO) and health researchers as a growing burden to global public health (1–5). Just the sheer economic impact of mental disorders is significant; it is expected to cost almost a third of the projected US$47 trillion incurred by all non-communicable diseases by 2030 (6). American and European research indicated in 2005 that 26–27% of the adult population suffers from a diagnosable mental disorder, representing over 57 million Americans and almost 83 million Europeans (7, 8). The European research was later revised in 2011 to 38% (approximately 160 million Europeans) by including mental diagnoses usually not analyzed in these kinds of studies, such as insomnia and alcoholism (9). In Sweden as well as other countries, milder mental symptoms are now being frequently reported as common occurrences (10, 11), especially among youth and the elderly (12, 13). These milder symptoms are increasingly becoming highlighted as important; research (for example, Swedish and American) have suggested that early mental ill health can predict more severe mental illness and mental disorders (such as major depression) later in life (14–16) and even premature death (17). It is, therefore, often argued that early signs of mental ill health need to be acknowledged and treated to prevent the onset of mental disorders (14–16, 18–21).

[学科分类] 卫生学

[关键词] depression;medicalization;mental disorders;overdiagnosis;overtreatment;public health