Depression, only 1 in 2 people receive proper diagnosis and treatment
In Italy, depression is estimated to affect 3.5 million people – Less than 50% of sufferers receive timely diagnosis and proper treatment. More than a year and a half between onset of first symptoms and decision to seek medical attention, about two years before receiving a correct diagnosis. The social cost in our country in terms of lost work hours is €4 billion a year.
Each patient with depression costs the National Health Service 5.000 euros annually.
Depression has been recognized by the World Health Organization as the leading cause of disability globally
In Italy, the prevalence of this disease is estimated at 5.5 percent, with about 3.5 million patients; in Europe, more than 35 million citizens live with depression. In addition, it is estimated that only 1 in 2 people receive proper diagnosis and treatment, that more than a year and a half passes between the appearance of the first symptoms and the decision to seek medical attention, and about two years to receive a correct diagnosis. “Depression is therefore an unavoidable issue when talking about health and in particular the health of women, who are affected twice as much as men. Our goal is to increase awareness of the disease among the population in order to overcome the stigma that is still so deeply rooted and to try to bring patients closer to appropriate diagnosis and treatment,” introduced Francesca Merzagora, President of Fondazione Onda, National Observatory on Women’s and Gender Health.
The social cost of major depression is very high
The social cost of major depression is very high and includes direct health care costs involving diagnosis, treatment, rehabilitation, care and prevention of long-term relapse that weigh on the National Health Service, amounting to about 5.000 euros per year per patient. Also very significant are the costs of not treating depression because of the implications related in particular to lost productivity, which is estimated to be 4 billion euros annually in terms of lost work hours.
The document “Depression: challenge of the century
For this reason, the document “Depression: challenge of the century – A commitment to counter it while waiting for a National Plan” containing the 10-point Manifesto “Getting out of the shadow of depression” was presented at the Chamber of Deputies as a collective call to action to promote effective targeted prevention actions, timely and facilitated access to diagnostic and treatment pathways, including through the strengthening of services in the territory and research activities aimed at identifying the most effective and innovative therapeutic measures in the pharmacological, cognitive and psychosocial fields.
The paper is sponsored by Fondazione Onda, National Observatory on Women’s and Gender Health with the sponsorship of Cittadinanzattiva, Progetto Itaca, SINPF, Italian Society of Neuropsychopharmacology, SIP, Italian Society of Psychiatry and the unconditional contribution of Janssen.
“This effort cannot disregard the role of the institutions that we are involving on this issue,” Merzagora continues. “The ‘Getting Out of the Shadow of Depression’ Manifesto is a tool that we hope can be the basis for the establishment of an interparliamentary table, led by the Hon. Rossana Boldi, in order to quickly define a national plan to combat depression by involving all stakeholders.”.
Major depression is an often undiagnosed psychiatric illness
“Major depression is a psychiatric illness that is often undiagnosed, misunderstood in its severity, and often misrecognized,” comments the Hon. Rossana Boldi, vice chair, Social Affairs Committee, Chamber of Deputies. “It compromises the working, social and emotional lives of those who suffer from it, and often, because of the stigma attached to it, they reject the diagnosis.
I believe the time has come for the institutions to take concrete charge of the problem. Three and a half million patients in Italy, two-thirds of whom are women, can no longer be neglected. It is my hope that the manifesto we are presenting today thanks to Onda, will become the basis for concrete proposals to define a National Plan for Depression, aimed at establishing definite pathways for the prevention, diagnosis and treatment of this pathology.
A plan that finally puts patients and their families at the center and is able to grasp the complexity of this pathology”.
The importance of not underestimating alarm bells
Among the Manifesto’s 10 points are the importance of not underestimating alarm bells such as transient states of sadness and turning to one’s doctor or specialist when these persist for a long time; reducing the time to diagnosis; encouraging therapeutic adherence by involving family members and caregivers in the treatment pathway; and reducing the stigma that hovers over the illness and prevents patients and those around them from seeking help through proper information and awareness.
The Italian action is in line with the content of the report “A sustainable approach to depression: moving from words to action” recently presented to the European Parliament at the initiative of a coalition of European scientific societies and family associations committed to combating depression. The report, which highlights the severity of depression in Europe and the need for greater investment at the policy-institutional level to combat it, suggests concrete recommendations on how to address this illness based on proven scientific and best-practice evidence and calls for an appropriate response from policymakers.
Claudio Mencacci, DSMD Director
“Although Italians are not the most depressed in the EU, the average in our country is high: 5.5 percent of the population suffers from major depression with a clear prevalence declined in women,” explains Claudio Mencacci, DSMD Director – Neuroscience ASST Fatebenefratelli-Sacco, Milan and President SINPF, Italian Society of Neuropsychopharmacology. “Important is to recognize it in the various stages of life where we see a crescendo, from adolescence (1.9%) to adulthood (6.5%), up to 13.1% in the over-65s. Early recognition of symptoms and implementation of appropriate treatment pathways is increasingly important”.
Alberto Siracusano, Director UOC Psychiatry and Clinical Psychology, Policlinico Tor Vergata, Rome
“In fact, depression results in serious damage to the development and maintenance of work, family, relational, emotional and social skills for sufferers and caregivers,” says Alberto Siracusano, Director UOC Psychiatry and Clinical Psychology, Policlinico Tor Vergata, Rome. “This disease also leads to a marked worsening of the quantity and quality of life both because of comorbidity with many medical conditions and because of the particularly high risk of suicide in the age groups between 20 and 34 and after 65 with more than 3.600 cases of suicide annually.”.
Giorgio Racagni, president-elect SIF, Italian Society of Pharmacology
“Pharmacological research is aimed at addressing current unmet therapeutic needs in the treatment of depression, especially with regard to cognitive and residual symptoms in patients who do not respond to traditional pharmacological treatments,” continues Giorgio Racagni, president-elect SIF, Italian Society of Pharmacology. “Loss of neuronal plasticity of specific neurotransmitters constitutes a crucial factor in the pharmacology and pathology of this disease, leading to the neurotrophic hypothesis of depression. It is on this target that the mechanism of action of the new glutamatergic drugs is based, which have recently been shown to lead to a rapid clinical response.”.
Massimo Scaccabarozzi, President Farmindustria
“Drug companies are at the forefront of the fight against depression with some 40 new molecules in development worldwide, potential progenitors of new therapeutic classes,” says Massimo Scaccabarozzi, President of Farmindustria. “In addition, among the 1.600 clinical trials on depression conducted internationally today, also with the contribution of the pharmaceutical industry, more than 1.300 use innovative approaches, such as digital technologies, identification of new therapeutic targets and new routes of administration.”.
“The companies’ commitment is therefore aimed,” Scaccabarozzi concludes, “at minimizing the impact of this disease on the population and allowing patients to lead normal daily lives.”.