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Friday, 25 January 2013 12:00

Psychological diseases – A rise in depression and anxiety

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Psychological diseases are very common in Mauritius. However, often, people suffering from psychological diseases are not aware of it. There are also those who do not come forward for any treatment.
Dr Parmanand Jagarnath, psychiatrist at the Brown Séquard hospital, and Sabrina Puddoo, director of Friends in Hope, talk about psychological disorders on Explik Ou Cas Santé on Radio Plus.

According to the estimates of the World Health Organisation (WHO), around 40% of each country’s population will suffer from psychiatric problems during their lifetime. Moreover, the prevalence of mental diseases in each country is between 20 and 25% while worldwide, around 400 million people are affected.

Both psychiatrists admit there is an increase in cases of depression and anxiety in Mauritius. “More and more people are depressed and anxious come to us for help. We also note there are more young people nowadays, especially teenagers. They leave out on their studies and tend to isolate themselves. This is reason to worry for parents. There are also many young people who come to us because of burn-out. That is, they have an overload of work and as a result of being constantly under pressure at work, they end up becoming depressive,” explains Sabrina Puddoo.  
This trend, she explains, is due to our lifestyle which further increases our risk to depression and anxiety. They are not only linked to hereditary factors but are also associated with environmental factors like stress, family problems, pressure at work, bullying at school and competition at school level among others.

Dr Jagarnath underlines that often, patients going to hospital or health care centres regarding fatigue, body aches, migraines, muscular problems, diarrhea or shivering among others ignore that they are suffering from a psychological disease which is causing these physical problems.

After anxiety and depression, schizophrenia is the most common psychological problem in Mauritius, affecting around 10,000 to 12,000 people. The main signs of this psychosis are: the person isolate himself, have hallucinations and believes that he is being persecuted.

“Schizophrenia patient often believes that people around him want to hurt him. So much so that he can become aggressive. Unfortunately, in 15 to 20% cases, the disease becomes chronic. For other psychological problems, 50% of patients get over while others have a relapse. Very often, this is because they stop taking their medicines or if they stop working. We have noticed that a schizophrenia patient which is professionally active has less risk of relapse,” points out the psychiatrist.

“Unfortunately, these are the first persons that suffer from discrimination at work. For example, they are the first to be thrown out during crisis since they are less productive than others,” he adds.

Mental disease is not only a problem for the patient but for his surroundings as well. The family is often in distress since they do not know how to handle the situation, say Dr Jagarnath and Sabrina Puddoo. “It is imperative to set up a specialized home for patients who do not have any one to look after them. It is also important for the family to know that there are professionals who will look after the patients,” says Sabrina Puddoo.

Self-help books ‘treat depression’
Prescribing self-help books on the NHS is an effective treatment for depression, a study suggests. Patients offered books, plus sessions guiding them in how to use them, had lower levels of depression a year later than those offered usual GP care. The effect was seen in addition to the benefits of other treatments such as antidepressants, Scottish researchers report in the journal Plos One. More than 200 patients who had been diagnosed with depression by their GP took part in the study, half of whom were also on antidepressant drugs.

Some were provided with a self-help guide dealing with different aspects of depression, such as being assertive or overcoming sleep problems. Patients also had three sessions with an adviser who helped them make the most out of the books and plan what changes to make. After four months those who had been prescribed the self-help books had significantly lower levels of depression than those who received usual GP care. A year later, those in the self-help group were more likely to be keeping on top of their depression. Study leader Prof Christopher Williams, from the University of Glasgow, who also wrote the books called Overcoming Depression and Low Mood, said the guided sessions were the key to getting people engaged.

Alcohol-fuelled sleep ‘less satisfying’
A tipple before bedtime may get you off to sleep faster but it can disrupt your night’s slumber, say researchers who have reviewed the evidence. The London Sleep Centre team says studies show alcohol upsets our normal sleep cycles. While it cuts the time it takes to first nod off and sends us into a deep sleep, it also robs us of one of our most satisfying types of sleep, where dreams occur. Used too often, it can cause insomnia. Many advocate a nightcap - nursing homes and hospital wards have even been known to serve alcohol - but Dr Irshaad Ebrahim and his team advise against it. Dr Ebrahim, medical director at the London Sleep Centre and co-author of the latest review, published in the journal Alcoholism: Clinical & Experimental Research, said: “We should be very cautious about drinking on a regular basis. One or two glasses might be nice in the short term, but if you continue to use a tipple before bedtime it can cause significant problems.

If you do have a drink, it’s best to leave an hour and a half to two hours before going to bed so the alcohol is already wearing off.” He said people could become dependent on alcohol for sleep. And it could make sleep less restful and turn people into snorers. “With increasing doses, alcohol suppresses our breathing. It can turn non-snorers into snorers and snorers into people with sleep apnoea - where the breathing’s interrupted.” Alcohol reduces how much time we spend in rapid eye movement (REM) sleep - the stage of sleep where dreams generally occur. As a consequence, the sleep may feel less restful, said Dr Ebrahim.

Long-term aspirin ‘blindness link’
People who regularly take aspirin for many years, such as those with heart problems, are more likely to develop a form of blindness, researchers say. A study on 2,389 people, in the journal JAMA Internal Medicine, showed aspirin takers had twice the risk of “wet” age-related macular degeneration. The disease damages the ‘sweet spot’ in the retina, obscuring details in the centre of a patient’s field of vision. The resear-chers said there was not yet enough evidence to change aspirin use. Taking low doses of aspirin every day does reduce the risk of a stroke or heart attack in patients with cardiovascular disease. There are even suggestions it could prevent cancer. One in 10 people in the study, conducted at the University of Sydney, was taking aspirin at least once a week. On average the participants were in their mid-60s. By the end of the study, the researchers showed that 9.3% of patients taking aspirin developed wet age-related macular degeneration (AMD) compared with 3.7% of patients who did not take aspirin.

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