“ nine years of depression, and i'm very satisfied with the results of today.” a rehab biographer on depression by a blogger named “near” from the community of bean petals received thousands of praises. “doctors say i've been stable in recent years, not re-emerged, well controlled, and i've had a strong desire for healing, and i've worked with them, so i've always been better.”
It is exactly one year before the launch of the work programme for the exploration of specialized services for the prevention and treatment of depression (hereinafter referred to as the programme) by the national commission for health and welfare on 11 september 2020. Studies from the epidemiological survey of mental illness conducted in 2019 show that the lifetime prevalence of depression in our country is as high as 6. 9 per cent, and that figure is still rising。
Data from the world health organization (who) also show that more than 54 million people in china suffer from depression, accounting for 4. 2 per cent of the total population, equivalent to four out of every 100 people in rio. Every year in china, the cost of absence from work, medical care and other expenses due to depression amounts to about rmb 49. 4 billion。
“and that the burden of depression does not lie exclusively in the cost of medicines, and that the greater part is due to the economic loss of working capacity due to illness, which may even result in mental disability, which strikes the entire family severely.” in an interview with wang yong, the chief physician of the shanghai mental health centre, indicated that their number of outpatients was increasing every year and that children's clinics often had to work overtime to see 19 points。
Diagnosis is difficult and has a high rate of relapse
At this time, the number of people suffering from depression is increasing and further rejuvenation。
The programme provides for the screening of high school and higher education students, pregnant women, elderly persons, etc., for depression, especially the establishment of mental health records for students in high schools and institutions of higher learning, with a focus on students with abnormal results。
Rue lin, a member of the chinese academy of sciences and director of the beijing university's sixth hospital, has publicly stated that the incidence of depression in our country's adult population is about 7 per cent, and that it is already among the most common diseases; in the united states, the incidence of depression is between 10 and 15 per cent。
What is the basis for the diagnosis of depression? Journalists have learned that there are standard diagnostic criteria for mental disorders such as depression, and that at present doctors ' diagnosis is based mainly on the international classification of diseases (icd-10) and the fifth edition of the united states manual for the diagnostic and statistics of mental disorders (dsm-5), with an updated version of icd-11 coming into operation。
“however, at the present time, mental disorders such as depression are based mainly on a symmetrical diagnosis and there are no reliable biological diagnostic criteria.” wang yong said to the first financial journalist, “there are clearer biological indicators (e. G. Blood sugar, blood pressure, etc.) for internal diseases, but the mechanisms for the occurrence of mental diseases are complex and it is difficult to find biological markers that match the disease at this time.”
In terms of the mechanism (cause) of depression, it is now recognized that there are a number of hypotheses, which form the basis of a range of treatments。
Wang yong told reporters that the most important hypothesis was that the disease was caused by single-amine neurotransmitters, and that most antidepressants also functioned as a result of depression associated with neurotransmitters and receptor abnormalities, such as 5-ht, detoxin (ne), dopamine (da)。
“other hypotheses of the mechanisms for the onset of depression include biological rhythm disorders, neuroendocrine disorders, multigenetic genes, etc., which interact with psycho-social factors, leading to a reduction in brain neuroplasticity and the death of nervous cells, and ultimately to depression. As a result, frequent rollovers and long cell phones can lead to endocrine and biological disruptions, causing anxiety and depression. Thus, physical treatments such as phototherapy, biological feedback, electro-stimulation and magnetic stimulation, based on drug treatment, tend to yield better results.” wang yong said。
Despite some cure rates, high rates of relapse into depression cannot be ignored. A forward-looking study from the united states showed that the cumulative relapse rate for people with post-rehabilitation depression was as high as 85 per cent in 15 years, including 380 cases。
Why is depression so difficult to cure? This includes a combination of factors such as a single antidepressants mechanism, slow functioning (on average, about two weeks), a high level of stigma and poor drug dependence。
Wang yong also stated that depression is now one of the highest burdened by families in all cases. In the case of outpatient patients with moderate depression above 16 to 17 dollars per day, the cost of medication is approximately 20 dollars per day, and the burden is approximately 600 dollars per month; if some supplementary drugs, such as tranquillizers, are added, it is about 1,000 dollars per month. With a medical settlement, the patient spends between $400 and $500 per month. If hospitalization is required, the cost is $20,000 to $30,000 per month, and if medical insurance is in place, the self-funded portion is $6000 to $7,000。
Drug research and development dilemmas remaining
In response to the growing number of people suffering from depression, the national commission for health and human rights (cndh) issued a programme to increase the incidence of depression by 50 per cent by 2022。
Are existing antidepressants sufficient? As of 2020, there were 435 listed antidepressants (disaggregated by atc) in the country and 385 have been included in the national list of essential health insurance medicines, according to the lilacs database。
Wang yong told the first financial journalist that “using the commonly used hydrochloric acid curlin, a 50 milligram of hydrochloric acid curry tablets is now included in the national drug belt procurement policy, and the imported drug pfizer zoloft is about $5. 00, and the domestic drug-carrying is about $1. 2. 00, which is a substantial drop over the previous period”
“on the other hand, medications such as amphetamine, hydrobromo acid, and sulphuric acid are relatively few clinical applications because of the patient's own expense.”
In fact, globally, there are few options for antidepressants and fewer are studied. Journalists have found that the development of depression drugs is not easy, and that a new antidepressant drug, recently approved by the united states food and drug supervisory authority (fda), dates back to 2013 and is produced by the danish linpei pharmaceuticals in the form of hbv sulphate (a pleasure)。
Why is the development of antidepressants so difficult? According to industry sources, on the one hand, due to the expiration of patents on heavy-pound antidepressants (e. G., hydrochloric acid tablets entered the country in 1998), the increase in generic drugs has led to a lack of motivation in the development of new medicines; on the other hand, the lack of human understanding of the nervous system, emotional control systems and the institutional difficulty of finding other breakthroughs in newly marketed drugs, as well as the fact that existing depressive drugs, such as long-term administration, also have some side effects, which increases the threshold for approval of new drugs and increases their input and risk。
Researchers of iqvia depression drugs told first financial reporters that clinical demand for depression drugs is objective and that there is an upward trend globally in the number of drugs being tested, but that the development of depression drugs is difficult given the delay in basic research。
Nevertheless, there are still a number of domestic pharmaceutical companies working in this area。
“for the time being, one of our new drug types, the ly 0305, has been accepted by the national drug authority's review centre, which is a three-fold re-ingestion inhibitor of 5-oxylamine/depinephrine/dopamine and has completed the third stage of clinical trials.” the relevant officials of the green leaf pharmaceutical industry told journalists in their interviews, and more than six years have elapsed since the drug was clinically tested for phase i。
On 2 august, s. T. I. A. Announced that a wholly-owned subsidiary had received a united states fda notification of consent to a new chemical drug, js1-1-01, for clinical trials for moderate severe depression treatment。
Lower the threshold for patient treatment
In fact, the country's depression patients have a number of concerns beyond treatment, and it is not only the cost that prevents their treatment。
Wang yong indicated that a significant proportion of people suffering from depression, especially middle-aged men, had a strong “disease” and knew that they were not willing to seek medical treatment and even stopped taking medication。
The lack of a cadre of skilled specialists is also a factor. Journalists have learned that the mental health specialists are understaffed in the three major general hospitals, with an average of 2 to 3 persons, and that in the psychiatric hospitals, the shanghai mental health centre, the beijing peace hospital and the winzhou conning hospital are the health institutions of greater interest to the industry。
Wang yong indicated that, for example, the city's mental health centre had more than 1 million outpatient consultations in 2019, and that the current number of outpatient consultations in 2021 had remained the same as in 2019, with the number of first-time visits increasing by 15 to 20 per cent from 2019. In addition, there is a shortage of psychiatric clinics to support depression treatment。
On 28 september 2020, the national commission for health and welfare published a circular on the publication of opinions on the strengthening and improvement of mental health services, which states that by 2022, the number of psychiatrists had increased to 45,000, to 3. 3 per 100,000; by 2025, the number of psychiatrists had increased to 56,000, to 4. 0 per 100,000。
