by Dr Alexandr Sapunov, Consultant Psychiatrist, Springfield Hospital, London, UK
According to the WHO about 350 million people, or 5% of the world population, suffered from depressions in 2012.
In the same year, about 6.7 million people were reported to have mental health problems including depressions and anxiety disorders in Russia, also according to the WHO. However, little is known about how many of these 6.7 million people suffered from depression since Russian official statistics (ROSSTAT) provides almost no insight.
As far as Russian mental health professionals’ opinion is concerned, they largely agree that the WHO statistics is way too conservative. According to Stanislav Poltorak, who is the leading researcher at the St. Petersburg V.M Bekhterev Psychoneurological Research Institute, depressions may affect as much as 25% of Russian population, whereas the majority of practicing psychotherapists assume that 20% is more or less accurate estimation based on their clinical experience. According to Vladislav Plotnikov, the researcher at the International Centre for Economics, Management and Health Policy of the Higher School of Economics, the real percentage of the population suffering from depression and anxiety disorders varies between 10% and 20%.
The difference of opinions can be partially attributed to widespread negative attitude towards psychiatry among Russian population. People are afraid of being labelled as ‘crazy’ or ‘mad’. For the male population seeking help for mental health issues is largely associated with being ‘wimpy’ and ‘weak’ which is not in line with the cultural perception of being male. That is why the so-called ‘masked depression’ and untreated depressive conditions are very common in Russia. It comes as no surprise that sales of antidepressants did not exceed $ 0.03 billion during the first 10 months of 2016 (as per Russian Association of Pharmacy Chains) in contrast to the US where sales reached $ 9.6 billion in 2016. On top of that it was reported that sales of antidepressants in Russia fell by 0.5% during this period, compared to a previous year. Interestingly, prices for these products were going up more slowly than for any other drugs in Russia. It is important to notice, however, that antidepressants are not included in the list of drugs covered by social funds and costs associated with the purchase of antidepressants are entirely on the patient’s shoulders.
Despite limited information about the incidence and structure of depressions in Russia there are some ways to look into it. The WHO suggests that 60% of suicides committed can be connected to depressions. In accordance with ROSSTAT data, suicides were the main cause of death due to external factors (i.e. not related to the physical health directly) in 2015 in Russia. There were overall 24982 deaths registered from suicide and this number is higher than the number of deaths due to accidents on all means of transport combined. During this year the suicide rate amounted to 17.1 per per 100,000 people in Russia which ranks the country among those with the highest rates. For comparison, the UK suicide rate was 10.9 deaths per 100,000 people in 2015 (as per the Office for National Statistics report).
Comprehensive studies in this field are much needed in order to understand the structure of depressions, the risk factors unique for Russian society, as well as to offer a standard of care.
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