We only thought of a temporary peak in cases of depression due to the conditions caused by the pandemic, but even in 2023 the numbers confirm 3 million cases. Of these, 2 million mainly concern women, adolescents and adults. Furthermore, depression is often accompanied by anxiety, eating and sleep disorders. Loneliness is also now a clear risk factor for depression. Finally, there is the problem of comorbidity with metabolic and cardiovascular diseases.
Depression, drugs are not enough to feel well again by Angela Nanni 07 March 2024
The meeting
All these topics will be discussed in Milan on March 8 (Hotel Hilton), during the conference “Women and mental health, the most common disorders in the era of unpredictability”, organized by the Italian Society of NeuroPsychoPharmacology and the Onda Foundation, with the non-conditioning contribution of Viatris. Among the initiatives to dispel taboos and prejudices on mental health which, even today, do not allow us to speak freely about pathologies such as anxiety, depression and insomnia, especially among younger people, the “Non Sono Solo” campaign is also active (nonsonosolo.it ). Here you can find informative, educational and support content on mental health issues, providing the population with the basic tools to recognize the symptoms and talk to their doctor or specialist.
The Depression
“A recent study published in the Journal of Affective Disorder, which investigated the trend of psychological stress in the post-COVID-19 period, shows that the majority of the Italian population has developed good resilience capabilities – he explains Camilla Gesi, medical director of the mental health department, ASST Fatebenefratelli-Sacco of Milan – . However, there has not yet been a decrease in the number of cases of depression at a general level, which has remained constant post-Covid. Furthermore, a part of the sample showed persistent anxious and depressive symptoms, with a predisposing effect of female sex, young age, low cultural level, self-employed worker status and location in central-southern regions of Italy. Even today, some groups, including women, are at greater risk of persistent psychological distress and require targeted interventions.”
Women are the most exposed. “These data confirm that women are up to twice as likely to suffer from depression as men – he explains Emi Bondi, president of the Italian Society of Psychiatry (SIP) and director of the mental health department at the Papa Giovanni XXIII Hospital in Bergamo – . A vulnerability, that of women, certainly linked to biological factors, but also to social factors, connected to the stress linked to the work and emotional overload that they are often called upon to face, in the role of workers, and at the same time as mothers and care givers of family members. It is therefore essential to plan prevention and prevention education activities, especially in schools, and also improve the capacity for early diagnosis, intervention and treatment before the disease becomes too serious or comorbidity cases develop.”
Comorbidity
The problem is that those who are depressed risk developing other pathologies as well. “Many physical illnesses, in fact, are more frequent in patients with depression than in the general population and can influence each other – he specifies Andrea Fagiolini, full professor of psychiatry at the department of molecular medicine at the University of Siena – . For example, in patients with depression, diabetes is 5 times more frequent, ischemic coronary heart disease and joint diseases are approximately double, respiratory diseases are 4 times more frequent and, after the age of 55, mortality is approximately 4 times higher to that of the general population. There are multiple mechanisms that explain this frequent comorbidity: a common biological basis, the presence of shared risk factors, emotional stress and anxiety, linked to each of the two diseases, as well as greater difficulties in adhering to prescribed therapies. In many cases, the treatment of comorbidity requires an integrated approach that addresses both conditions through compatible treatments prescribed in synergy with colleagues dealing with the other disease. This approach avoids adding a further burden to those who are already ill, improves the prognosis of existing disease and facilitates the achievement of a better quality of life.”
Bipolar disorder
In addition to comorbidities with ‘physical’ illnesses, there are numerous psychiatric conditions that are often associated with depression. “Among these we find bipolar disorder – he explains Bernardo Dell’Osso, full professor of psychiatry and director of the Psychiatry-2 department at the ASST Fatebenefratelli Sacco in Milan – a condition diagnosed with increasing frequency (from 2 to 5% of the general population) in females. There are several reasons behind this phenomenon. The most important is greater attention by mental health professionals in recognizing mood disorders earlier. Among these, many forms of bipolar disorder type 2, longitudinally characterized by the prevalence of depressive episodes, are today diagnosed with greater attention and precocity, having previously often been misdiagnosed for “simple” depressions. A series of factors have been called into question to explain the increase in early-onset forms of bipolar disorder already in childhood and adolescence, especially in females. Among these it is necessary to mention a greater frequency of overweight and obesity, factors capable of anticipating puberty in females, with a consequent greater risk of developing mood disorders, especially in the presence of other environmental risk factors, such as the use of substances . A higher prevalence of bipolar disorder in females also presents a series of implications in terms of therapeutic management and follow-up.”
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