Environmental factors causing depression in Sri Lanka

[NEW DELHI] Depression is influenced more by environmental factors than genetics, according to a study conducted in Sri Lanka, a country devastated by a long civil war (1983-2009) and the 2004 Indian Ocean tsunami, resulting in hundreds thousands of deaths and massive damage. economic losses.

More than half of the differences in depression symptoms among the 3,948 people studied could be explained by environmental rather than genetic influences, said Helena Zavos, study author and senior lecturer in the psychology department at King’s College. of London, UK.

“These environmental influences weren’t shared among family members — for example, stressful life events,” Zavos said.

“We found that people who reported more symptoms of depression reported a lower level of health-related quality of life…This underscores the importance of considering the mental health and well-being of people with depression. chronic physical health problems.”

Helena Zavos, King’s College London

Published on March 30 in PLoS One, the study noted that parts of the Sri Lankan population were disproportionately affected, either socio-economically or emotionally, by the civil war and the tsunami. Such pervasive experiences could lead to environmental variability and explain why the heritability of health-related quality of life (HRQOL) traits was found to be insignificant, according to the study.

The US Centers for Disease Control and Prevention defines HRQoL as the perceived physical and mental health over time of an individual or group. An individual’s HRQoL is intimately linked to the number of depressive symptoms a person reports and its measurement can help calculate the burden of preventable disease and disability.

“We found that people who reported more symptoms of depression reported lower health-related quality of life,” Zavos said. “This underscores the importance of considering the mental health and well-being of people with chronic physical health conditions.”

“The shared environment (eg, tradition, extended family members, elders) may be a protective factor against depression in Sri Lanka,” said Ramdas Ransing, faculty of psychiatry at BKL Walawalkar Rural Medical College. in Maharashtra, India.

Ransing also suggested that such a shared environment “could be a protective factor against depression. [among women] in Sri Lanka”.

Depression is linked to adverse environmental factors such as onset of illness or death of the significant other, said Soumitra Shankar Datta, Senior Consultant Psychiatrist at Tata Medical Center, Kolkata.

“The study shows that depression is associated with quality of life across multiple domains such as general health, fatigue, social functioning, and others,” Datta explained.

According to the World Health Organization (WHO), more than 75% of people in low- and middle-income countries receive no treatment for mental disorders, although these disorders – which include depression – receive recognized and beneficial treatments. . Depression affects nearly 280 million people worldwide and can, in the worst case, lead to suicide.

Depressive symptoms listed by the WHO include poor concentration, feelings of guilt, low self-esteem, hopelessness about the future, thoughts of death, disturbed sleep, loss of pleasure or interest in activities lasting at least two weeks.

The study results suggest modest associations between the severity of depressive symptoms and lower physical and psychological functioning, primarily due to overlapping gene and environmental impacts.

“Poverty, lack of opportunity, social adversity are common among people with depression and are very significant for most low- and middle-income countries, including Sri Lanka where the study was conducted,” Datta said. “The results will help clinicians individualize the treatment approach based on each person’s reality.”

The authors stated that because mental health problems carry social stigma in Sri Lanka, they cannot rule out the possibility of response bias in the questionnaires given to the subjects.

This piece was produced by the Asia and Pacific office of SciDev.Net.