In Canada, we need to stop thinking of depression as a Cinderella disease — as deserving as its stepsisters, but neglected nonetheless.

http://www.cmaj.ca/content/early/2014/09/29/cmaj.141128.full.pdf+html

(Because of browser and firewall issues, this link may not work. The article is attached in PDF format.)

In this recently published editorial, “Depression Deserves Better Treatment,” the CMAJ weighs in on depression. It’s a big editorial in a big journal. It also is well written and worth reading.

Some important points from this piece written by Deputy Editor Kirsten Patrick:

  • Drawing on the WHO Global Burden of Disease study, the author notes that, on a global scale, “[depression’s] burden is greater than that of diabetes or tuberculosis.”
  • In the wealthy nations, “only ischemic heart disease and stroke cause more disability than unipolar depression.”
  • “If the amount of money donated to various charities is a way of gauging the relative importance attributed to medical causes, then depression goes down the list like a lead balloon: in Canada, when ranked by donation amount, not one mental health charity cracks the top-10 list.”

Patrick notes that there is evidence for effective treatments, emphasizing CBT and exercise, as well as medications. (Note that the literature supports the good work that we are doing at the AOP.)

Much to like here in the analysis. Yes to more funding and yes to more community support. But let’s not forget the efficacy of our current treatments. My one hesitation, then, is that Patrick seems to understate the effectiveness of depression treatments. I’ll leave aside her point about medications – I’ll agree to disagree – but CBT is very effective. Indeed, compared to common treatments for physical health issues (say, statins for cholesterol), our psychological interventions are strikingly good. (I wrote about this recently for The Globe and Mail.)

Still, a great editorial that puts an illness in its proper context.

The Globe and Mail piece can be found here:

http://www.theglobeandmail.com/globe-debate/mental-illness-a-depressing-failure-of-public-policy/article20073285/

Reading of the Week. Every week I pick a reading — often an article or a paper — from the world of Psychiatry.

cmaj.141128.full.pdf