Depression could be Third World disease

A statistical analysis by a team led by University of Queensland researcher Alize Ferrari found North America, Western Europe and Australia have the lowest rates of major depressive disorders, while South Asia, Africa and the Middle East lead the world for incidences of major depressive disorders.

However, a separate study by her colleague Amanda Baxter and other researchers identifies anxiety disorders as a disease of affluence, with Africans far less prone to them than Euro and Anglo cultures.

The two papers are the first findings of a Bill & Melinda Gates Foundation research project at the University of Queensland led by Harvey Whiteford.

Professor Whiteford said the Gateses' motivation was to discover the effectiveness of 20 years of global health spending.

He said the increase in incidence of major depression in the developing world was a result of an improvement in basic health services.

"Better maternal health and better infectious diseases control mean people in the developing world now live into the age group where mental health disorders emerge, which is the late teens and early 20s," he said.

But traditional cultures can be better at dealing with anxiety, a sense of disquiet and foreboding out of proportion to real-world risk, thanks to strong systems of family support that encourage resilience among individuals.

However, Professor Whiteford warns the apparent lower level of anxiety in poor and conflict-ridden countries than in the West may be more apparent than real, saying Third World surveys show low levels of anxiety but higher incidences of medically unexplained complaints.

"People are just as anxious but they report it as physical symptoms," he says.

Professor Whiteford is optimistic that identifying the extent of anxiety and major depression will lead to treatments that reduce the social impact and individual burden of these illnesses.

While about 20 per cent of depression cases are genetic -- and while both it and anxiety are triggered by factors as diverse as poverty, war and domestic violence -- once the symptoms are identified medical treatment becomes possible.

The WHO funded programs in the successor states to Yugoslavia to deal with the trauma of the wars in the region a decade ago and Professor Whiteford is in contact with Libyan officials looking to address the impact of the recent conflict.

"Wars are like infectious disease. They run their course, with depression rising, and take decades to drop back," Professor Whiteford said. "Our research will show it is possible to measure the disease burden and then come up with ways to reduce it."