Addressing the Global Burden of Depression

Depression is a leading debilitating psychiatric disorder, and its burden on human capital and survival is significant. Scientific, cultural, and economic understanding of depression has increased over the past decades, and effective therapeutic modalities have emerged to help reduce the global burden of the disorder.

Despite greater understanding and the increased availability of potentially effective treatments, global governmental and clinical bodies have yet to address the burden of depression. A team of international mental health clinicians described the recent development of a Lancet-World Psychiatric Association Commission, an effort to address depression’s burden, as well as various preventive measures. An overview of this commission and its associated report was published in a comment article in the Lancet.¹

In an effort to address the global burden of depression, The Lancet and the World Psychiatric Association are collaborating to develop a clinical commission on depression. Experts in the fields of economics, neuroscience, public health, psychology, primary care, psychiatry, and epidemiology comprise the commission’s leadership.

According to preliminary findings, the commission has identified key messages that will outline the report and its recommendations. First, the commission’s report will describe the burden of depression and its impact on society and global development at large. Second, prevention and treatments of depression, both established and being investigated, will be described. The lack of effective strategies and reasons for addressing depression’s global burden will also be explored in the report. Finally, theories for reducing the burden of depression and strategies for tackling knowledge gaps in identifying effective, applicable interventions will be reported.

While a hybrid model that defines clinical stages of depression has been proposed to facilitate early treatment, the commentary authors also suggest appropriate staged models of care are needed to stratify and personalize therapy.² These models may be enhanced if complemented by treatment regimens that support young people, women and girls at risk for perinatal depression, and patients with depression that appears to be resistant to therapy.

“Investment in research is needed for the discovery of new forms of intervention and specific subtypes of depression and their markers, along with research and service investments in more targeted interventions and precision psychiatry,” the commentary authors wrote. “Timely intervention can save future generations and enable people to fulfil their potential and contribute to society.”

Disclosures

The authors of the commentary reported no financial conflicts of interest.

References

1. Herrman H, Kieling C, McGorry P, et al. Reducing the global burden of depression: a
Lancet-World Psychiatric Association Commission. Lancet. 2019;393:e42-e43.

2. McGorry P, Nelson B. Why we need a transdiagnostic staging approach to emerging psychopathology, early diagnosis, and treatment. JAMA Psychiatry. 2016;73:191-192.