Positive activity interventions (PAIs) offer a safe, low-cost, and self-administered approach to managing depression and may offer hope to individuals with depressive disorders who do not respond or have access to adequate medical therapy, according to a comprehensive review article in The Journal of Alternative and Complementary Medicine, a peer-reviewed journal published by Mary Ann Liebert, Inc.

More than 100 million people worldwide suffer from depression, and an estimated 70-90% either do not receive sufficient medical treatment, do not respond to therapy, or do not have access to quality care. As a result, there is an immense unmet need for alternative, economical, and effective strategies for treating major and minor depression.

Kristin Layous, Joseph Chancellor, and Sonja Lyubomirsky, PhD, University of California, Riverside, and Lihong Wang, MD, PhD, and P. Murali Doraiswamy, MBBS, Duke University (Durham, NC), reviewed the medical literature covering the effectiveness of PAIs in treating depression. PAIs, such as counting one’s blessings, practicing optimism, performing acts of kindness, and using one’s unique strengths, “teach patients ways to increase their positive cognitions, emotions, and behaviors without professional help,” explain the authors.

They discuss the views of PAIs presented in the literature, propose models for how PAIs might relieve depression and describe how it might be possible to translate the potential benefits of PAIs into clinical treatments for patients with depressive disorders. The authors also propose goals for future research on PAIs.

“This is ground-breaking work of global significance. It applies in all cultures at all times but especially in our pharmaceutically dominated culture of dependence. Because it is in many ways common sense, it is all the more important to have scientific validation and more low cost highly effective means to help people submerged in the sea of depression,” says Journal Editor Kim A. Jobst, MA, DM, MRCP, MFHom.

Source: “Delivering Happiness: Translating Positive Psychology Intervention Research for Treating Major and Minor Depressive Disorders”

Older people taking new generation antidepressants are at more risk of dying or suffering from a range of serious health conditions including stroke, falls, fractures and epilepsy, a study involving researchers at The University of Nottingham has found.

The research, published on bmj.com,with a full report due on www.hta.ac.uk discovered that selective serotonin reuptake inhibitors (SSRIs) are more strongly associated with an increased risk of several adverse outcomes in people over the age of 65 with depression compared with older tricyclic antidepressants (TCAs).

The authors say the risks and benefits of different antidepressants should be carefully considered when prescribing these drugs to elderly patients and have called for further research to investigate the findings.

Dr Carol Coupland, Associate Professor in Medical Statistics in The University of Nottingham’s Division of Primary Care said: “We’ve found some evidence from our study that the older tricyclic antidepressants may be associated with lower risks of several adverse outcomes compared with newer antidepressants in older people diagnosed as having depression.

“This was an unexpected finding, and so further research using other data sources is needed to confirm these findings as well as provide more evidence on the benefits of different antidepressants in this group of people.”

Depression is a common condition in older people and antidepressants — particularly SSRIs — are widely used. However, very little is known about the safety of these drugs in older people.

The team of researchers from the Universities of Nottingham and East Anglia set out to investigate the potential link between antidepressant treatment and the risk of a number of potentially life-threatening outcomes in older people.
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Depression affects 121 million people worldwide. In can affect a person’s ability to work, form relationships, and destroy their quality of life. At its most severe depression can lead to suicide and is responsible for 850,000 deaths every year. New research published in BioMed Central’s open access journal BMC Medicine compares social conditions with depression in 18 countries across the world.

In conjunction with the World Health Organization World Mental Health (WMH) Survey Initiative, researchers from 20 centers collaborated to investigate the prevalence of depression around the globe. To be classified as having had a Major Depressive Episode (MDE) a person was additionally required to fulfill five out of nine criteria including sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy and poor concentration.

Based on detailed interviews with over 89,000 people, the results showed that 15% of the population from high-income countries (compared to 11% for low/middle-income countries) were likely to get depression over their lifetime with 5.5% having had depression in the last year. MDE were elevated in high-income countries (28% compared to 20%) and were especially high (over 30%) in France, the Netherlands, and America. The country with the lowest incidence was China at 12% but, in contrast, MDE were very common in India (at almost 36%).

Some aspects were cross cultural – women were twice as likely to suffer depression as men and the loss of a partner, whether from death, divorce or separation, was a main contributing factor. However the contribution of age varied from country to country. Age of onset of depression was almost two years earlier in low income countries and, while the amount of difficulty a person had with aspects of their life increased with depression and how recent their last attack was, it was more apparent in people from high income countries.

Prof Evelyn Bromet from State University of New York at Stony Brook said, “This is the first study which uses a standardized method to compare depression and MDE across countries and cultures. We have shown that depression is a significant public-health concern across all regions of the world and is strongly linked to social conditions. Understanding the patterns and causes of depression can help global initiatives in reducing the impact of depression on individual lives and in reducing the burden to society.”

Source: Cross-National Epidemiology of DSM-IV Major Depressive Episode
Evelyn Bromet, Laura Helena Andrade, Irving Hwang, Nancy A Sampson, Jordi Alonso, Giovanni de Girolamo, Ron de Graaf, Koen Demyttenaere, Chiyi Hu, Noboro Iwata, Aimee N Karam, Jagdish Kaur, Stanislav Kostyuchenko, Jean-Pierre Lepine, Daphna Levinson, Herbert Matschinger, Maria Elena Medina Mora, Mark Oakley Browne, Jose Posada-Villa, Maria Carmen Viana, David R Williams and Ronald C Kessler BioMed Central Limited