Chinanews client, Beijing, September 16 (Reporter Zhang Ni) According to epidemiological survey data, the number of depression patients in the country may be close to 100 million. The high incidence of depression patients has attracted the attention of the whole society in recent years.
Recently, the National Health Commission announced in the "Working Plan for Exploring Special Services for the Prevention and Treatment of Depression" that various high schools and colleges and universities will incorporate depression screening into the content of student health examinations.
Are we ready to deal with such a heavy and special disease?
Data map: Nanjing volunteers "seeking hugs" on the streets, calling for care for patients with depression.
Photo by Yang Bo
Expert: Depression patients or close to 100 million people nationwide
According to a report from the World Health Organization: The worst consequence of depression is suicidal behavior, which is currently the second leading cause of death among people aged 15-29.
In China, the situation is not optimistic.
In an online forum that young people like to browse, there are more than 660,000 discussions about depression alone.
"According to epidemiological survey data, the lifetime prevalence rate of depression in China is 6.9%, and the prevalence rate within one year is 3.6%. Studies have estimated that nearly 100 million people suffer from depression in the country." Party Secretary of Beijing Huilongguan Hospital Yang Fude revealed in an interview with reporters.
For frontline clinicians, the intuitive experience is even more obvious.
"Take the data of our hospital's psychiatric department as an example. At present, more than half of the patients who come to see a doctor are depressed. In recent years, it has been obvious that the number of people visiting is increasing, and patients of all ages are increasing. "Qu Shan, deputy chief physician of the psychiatric department of Peking University People's Hospital, told reporters.
Qu Shan said that in recent years, the number of patients in the department has increased. The main reason is that people are more aware that this is a disease.
"In the past, people felt that they couldn't think about it, they were weak-willed, and they could just overcome it with their own strength. Now, many people realize that this is a disease and choose to seek medical treatment."
This status quo has also attracted national attention.
The "Healthy China Action (2019-2030)" issued by the National Health Commission puts forward such a goal: By 2022 and 2030, the treatment rate of depression will increase by 30% and 80% on the existing basis.
Not long ago, the "Working Plan for Exploring Special Services for the Prevention and Treatment of Depression" was also announced, which stated that by 2022, the public's awareness rate of depression prevention and treatment knowledge will reach 80%, and the student's awareness rate of prevention and treatment knowledge will reach 85%.
On the existing basis, the medical treatment rate for depression is increased by 50%, the treatment rate is increased by 30%, and the annual recurrence rate is reduced by 30%.
Data map: Psychological counselor talking with patients.
Photo by Lu Ming
People, why are they depressed?
Depression is an affective mental disorder and often occurs with anxiety.
The clinical manifestations are "three lows"-low mood, decreased interest, and lack of motivation, which last at least 2 weeks.
However, ordinary people still know little about the cause of this disease.
"At present, the research on the etiology of this disease is clearly related to genes and environment." Qu Shan explained.
Experts say that from the pathological process, if people’s subjective thoughts are unpleasant or can’t think about for a long time, neurotransmitter disorders will occur in the brain, people are always suffering, depressed, and neurological substances, electrical activities, and brain functions in the brain are active. The area will change, which creates a physical change.
From the etiological point of view, depression is also genetically related. Those who have a family history of depression have a much higher risk of depression than others.
At the same time, from the perspective of age distribution, the incidence of depression also has three peak periods.
Generally, the initial age of onset of depression is between 20 and 30 years old. This is the first peak period, and the disease is very easy to relapse. The second peak of onset is in menopause, about 50-60 years old, and the third The peak period of incidence is after entering old age.
"When people are young, there are many protective factors, so they are not easy to get sick. After entering the society, they begin to face some pressure and shocks. These shocks will induce susceptibility genes under certain circumstances and eventually lead to disease."
Qu Shan explained that from clinical experience, ordinary students will face various problems after entering the workplace, such as employment, dating, marriage, childbirth, etc. In this process, there are more "critical events" encountered, so Will become the age group with a high incidence of initial depression.
In addition, after the age of 70, a variety of diseases begin to appear in the human body, such as chronic diseases such as Parkinson's, tumors, cerebrovascular disease, heart failure, etc. These diseases can also easily lead to concurrent depression.
Data map: A college student shares his experience of fighting depression.
Photo by Yang Zuiwen
How to judge "Am I depressed"?
Like any other disease, early screening and intervention for depression are particularly important for patients.
"This feature of psychiatry is very important. If you get sick 5 or 10 years later, the prognosis is estimated to be very poor." Yang Fude said in an interview.
In the "Working Plan for Exploring Special Services for the Prevention and Treatment of Depression", screening and evaluation are also listed as a key task.
The document proposes that medical and health institutions use the PHQ-9 scale to carry out depression screening, and provide the public with online and offline depression evaluations, scoring instructions, and diagnosis and treatment recommendations through the establishment of WeChat public accounts and APP clients.
Various physical examination centers include emotional state assessments in physical examination items for selection by medical examiners.
Most notably, the "Plan" also proposes that various high schools and colleges and universities include depression screening in the content of student health examinations, establish student mental health files, evaluate students’ mental health, and give priority to students with abnormal results. attention.
This also means that the early screening of depression will sink to younger students in the future.
"Assessment is an auxiliary method that can help doctors provide some clues." Qu Shan said that early screening can effectively prevent patients from having more serious consequences.
However, experts also emphasized that assessment cannot be used as a diagnostic tool, but only as a reminder.
“At present, the “golden standard” for the diagnosis of depression in the world is mental examination. It is mainly for doctors and patients to talk face-to-face, and through some outline-style questions, it is clear whether they meet some of the symptoms in the diagnosis. Instead of using simple questionnaires to confirm the diagnosis, this process is called diagnosing diseases."
Qu Shan emphasized that, unlike other diseases, the difficulty of early screening for depression is that simple screening may not be able to obtain 100% of the true information of the patient. If only relying on the assessment, some people may be in for some reason. Falsified during the evaluation and interfered with the final results.
"If there are obvious symptoms, you need to go to a professional doctor for diagnosis as soon as possible, and then determine whether you need psychological treatment, medication and other specific measures based on the severity of the symptoms." She said.
Photo by Cui Nan issued by Xinshe in the data map
Are we ready for depression?
In China, the treatment of depression faces another dilemma: on the one hand, the number of patients is large, on the other hand, there is a shortage of professional doctors in China.
Qu Shan revealed such a number in the interview-at present, there are about 40,000 psychiatrists nationwide, which is far from the number compared with some developed countries.
"Unlike psychotherapists and psychologists, the main difference between doctors and non-doctors is that professional physicians can diagnose whether patients have depression, and clarify what treatment measures the patient should take next. This is the first to diagnose and treat patients. This is the most important one."
Qu Shan said that with the diagnosis of a professional doctor, patients can go to a psychotherapist for treatment or receive medication according to the doctor's recommendation. Only by straightening out this medical treatment process can patients avoid many detours.
However, the national level has already given plans for the construction of professional teams.
The "Healthy China Action (2019-2030)" has clearly stated that by 2022 and 2030, there will be 3.3 and 4.5 psychiatric practicing (assistant) physicians per 100,000 population.
The document also clearly stated that it is necessary to establish a community rehabilitation service system for mental disorders in which mental health medical institutions, community rehabilitation institutions, social organizations, and families are connected to each other, and to establish and improve mental health education, psychological hotline services, psychological evaluation, psychological consultation, psychological treatment, and Psychiatric treatment and other cohesive psychological crisis intervention and psychological assistance service models.
In addition, the "Exploration of Specialized Services for the Prevention and Treatment of Depression" also proposes that by 2022, physicians in non-psychiatric hospitals will increase the recognition rate of depression by 50% on the existing basis, and the standardized treatment rate will increase on the existing basis. 20%.
What is certain is that in the face of such a huge crowd of patients with depression, the future is destined to have a long way to go.
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