10月10日の「世界メンタルヘルスデー」に合せて、WHOがうつ病に関する発表を行った。

　それによると、（以下意訳）うつ病は全てのコミュニティー、全ての年代の、推計3億5千万人に影響を与えており、疾患による世界的な負担を与えている。

うつ病のための効果的な治療法が知られているが、殆どの国で治療にアクセスする（治療を行う）あたり問題があり、幾つかの国では治療を受ける必要がある人の10％未満しか治療を受けていない。



WHOのメディア向けの頁があり、ニュースの殆どはこの文章を略して報道しているようだが、各報道機関によって微妙な差がある。。

日本語での「報道の差を比較」するために、日本語各社のネット版ニュースをKwoutし、最後にWHOのメディア向け文章全文を掲載してみる。

自分の見たマスメディアの中では、NHKが最も正確に報道している様に思う。


産経は「共同通信」の記事の様だ。


読売は独自の記事の様だ。


日経の記事は「ジュネーブ＝共同」とあるが、産経とは異なるな。


時事も微妙に異なる印象。


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【以下WHO ‘World Mental Health Day: Depression, the Most Common Mental Disorder’
　（http://new.paho.org/hq/index.php?option=com_content&view=article&id=7305%3Adia-mundial-de-la-salud-mental-la-depresion-es-el-trastorno-mental-mas-frecuente-&catid=740%3Anews-press-releases&Itemid=1926&lang=en）より】

Press Releases

World Mental Health Day: Depression, the Most Common Mental Disorder

Depression affects 350 million people in the world. In Latin America and the Caribbean, 5% of the adult population has depression, but six of out of every ten do not receive treatment

Washington, D.C., 9 October 2012 (PAHO/WHO).- Depression affects more people than any other mental disorder and is also one of the world’s leading causes of disability. Although it is a treatable disease, six out of every ten people who have depression in Latin America and the Caribbean do not seek or do not receive the treatment they need.

On World Mental Health Day, which is held annually on the 10th of October, the Pan American Health Organization/World Health Organization (PAHO/WHO) joins with the World Federation for Mental Health (WFMH) to increase awareness about this disorder that affects more than 350 million people of all ages around the world.

In Latin America and the Caribbean, depression affects 5% of the adult population. “This is a disorder that can strike anyone at some point in their life, and for which they need to receive psychological and social care and support,” according to the PAHO/WHO Principal Adviser on Mental Health, Jorge Rodriguez.

In addition to influencing the ill person, depression also affects their family and community around them. In the worst cases, it can lead to suicide. Each year, almost 1 million people kill themselves in the world, of which around 63,000 are in the Americas. “In human terms, it represents suffering and in economic terms it involves considerable costs to families and to governments,” said Rodriguez.

“Depression: A Global Crisis” is the theme chosen for this year, to advocate for recognizing the disease and addressing it. Because of the stigma suffered by people with depression, many sufferers hide it or do not talk about it and even avoid treatment. WHO prepared a campaign that includes pamphlets and a video on “the black dog of depression,” to call attention to this public health problem.

Between 60% and 65% of ill people do not receive care. The lack of appropriate services; of trained health professionals, especially in primary care; and the social stigma associated with mental disorders are some of the barriers to access to appropriate care, in addition to the need for boosting capacity for the identification and early treatment of depression. In the region, it is calculated that less than 2% of the health budget is allocated to mental health, and of this, 67% is spent on mental hospitals.

Depression is more common in women than in men. Between two and four of every ten mothers in developing countries suffer from depression during pregnancy or after childbirth.

This disease has a good prognosis if it is treated in time and appropriately. Depression can be mild, moderate, or severe, and is caused by a complex interaction of social, psychological, and biological factors. However, “we must abandon the idea that all depression needs pharmaceutical treatment. Mild and even some moderate cases can be resolved, basically, with social and family support, brief psychotherapy, or other types of psychosocial interventions that can be provided by primary health care physicians or by community organizations that provide support for people,” explained Rodriguez.

From 16 to 18 October of this year, PAHO will sponsor a Regional Mental Health Conference in Panama, where a variety subjects will be discussed, including the assessment of mental health systems in the countries of Latin America and the Caribbean, and the first draft of the Global Plan of Action on Mental Health that will be presented at the World Health Assembly in 2013. Participants will include professionals in the field of mental health and other stakeholders from various countries, including representatives from academic institutions, PAHO/WHO collaborating centers, nongovernmental organizations, and representatives from consumer and family member movements.

The World Federation for Mental Health initiated World Mental Health Day in 1992, which is celebrating its 20th anniversary in 2012.

PAHO celebrates its 110th anniversary this year and is the world's oldest international public health organization. It works with all the countries of the hemisphere to improve the health and quality of life of the peoples of the Americas and serves as the WHO Regional Office for the Americas.

Mental health and depression in numbers

It is calculated that 25% of people suffer from one or more mental or behavioral disorders in their lifetime.
Mental and neurological disorders account for 14% of the global burden of disease in the world and 22% in Latin America and the Caribbean.
More than 350 million people of all ages suffer from depression in the world. In Latin America and the Caribbean, 5% of the adult population suffers from it.
From 60% to 65% of people who need care for depression in Latin America and the Caribbean do not receive it.
Each year, around 1 million people die from suicide in the world, of which some 63,000 are in the Americas.
Depression is the most common mental disorder in the world.
Among mental disorders in Latin America and the Caribbean, depression is the most common (5%), followed by anxiety disorder (3.4%), dysthymia (1.7%), obsessive-compulsive disorder (1.4%), panic disorder and non-affective psychoses (1% each), and bipolar disorder (0.8%), among others.
Between 20% and 40% of women in developing countries experience depression during pregnancy or after childbirth.
Less than 2% of the health budget in the Region is allocated to mental health, and of this, 67% is spent on mental hospitals.
Of the countries of Latin America and the Caribbean, 76.5% reported that they have a national mental health plan.

【以下略　（注；下線は我楽者による修飾）】
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【以下WHO Media centre ‘Depression is a common illness and people suffering from depression need support and treatment’（http://www.who.int/mediacentre/news/notes/2012/mental_health_day_20121009/en/index.html）より】

Depression is a common illness and people suffering from depression need support and treatment

WHO marks 20th Anniversary of World Mental Health Day

Note for the media

9 OCTOBER 2012 | GENEVA - On World Mental Health Day (10 October), WHO is calling for an end to the stigmatization of depression and other mental disorders and for better access to treatment for all people who need it.

Fighting stigma: a key to increasing access to treatment
Globally, more than 350 million people have depression, a mental disorder that prevents people from functioning well. But because of the stigma that is often still attached to depression, many fail to acknowledge that they are ill and do not seek treatment.

Depression is different from usual mood fluctuations. Depression induces a sustained feeling of sadness for two weeks or more and interferes with the ability to function at work, school or home. Effective treatments include psychosocial treatment and medication. The active involvement of depressed people and those who are close to them in addressing depression is key. The first step is to recognize the depression and reach out for support. The earlier the treatment begins, the more effective it is.

“We have some highly effective treatments for depression. Unfortunately, fewer than half of the people who have depression receive the care they need. In fact in many countries this is less than 10%,” says Dr Shekhar Saxena, Director of the Department for Mental Health and Substance Abuse. “This is why WHO is supporting countries in fighting stigma as a key activity to increasing access to treatment.”

Cultural attitudes and lack of proper understanding of the condition contribute to a reluctance to seek help for depression.

Depression common in all regions
WHO estimates suggest that depression is common in all regions of the world. A recent study supported by WHO revealed that around 5% of people in the community had depression during the last year.

Depression results from a complex interaction of social, psychological and biological factors. There is a relationship between depression and physical health, for example cardiovascular disease can lead to depression and vice versa. Up to one in five women who give birth experience post-partum depression.

In addition, circumstances such as economic pressures, unemployment, disasters, and conflict can also increase the risk of the disorder. At its worst, depression can lead to suicide. Tragically almost one million people commit suicide every year and a large proportion of them had experienced depression.

WHO response
WHO assists governments in including treatment of depression in their basic health care packages. Through WHO’s Mental Health Gap Action Programme (mhGAP), health workers in low-income countries are trained to recognize mental disorders and provide proper care, psychosocial assistance and medication to people with depression.

World Mental Health Day was initiated by the World Federation for Mental Health in 1992. The day is used by many countries and organizations to raise public awareness about mental health issues and to promote open discussion of mental disorders, and investments in prevention, promotion and treatment services.

【以下略（注；上記文章中「下線」は我楽者による修飾）】
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またWHOの作成したうつ病についてのチラシも（2分割して）Kwoutしておく。




以下、WHOのうつ病に関する他のページへのリンク等。

・Health topics Depression（http://www.who.int/topics/depression/en/）

・Mental health　Depression（http://www.who.int/mental_health/management/depression/en/index.html）[内容は上記topics頁と同様]
上記ページより；


・Depression Fact sheet N°369 October 2012[Fact sheet on depression]
(http://www.who.int/mediacentre/factsheets/fs369/en/index.html)
上記頁より；


・Evidence-based recommendations for management of depression in non-specialized health settings
　（http://www.who.int/mental_health/mhgap/evidence/depression/en/index.html）[下記頁へのリンク]

・Question 1: Are antidepressants (Tricyclic Antidepressants (TCA) and Selective Serotonin Reuptake Inhibitors (SSRI)) better (more effective than/as safe as) than treatment as usual (placebo) in adults with depressive episode/disorder?
[Antidepressants (Tricyclic Antidepressants and Selective Serotonin Reuptake Inhibitors) in treatment of adults with depression]
　（http://www.who.int/mental_health/mhgap/evidence/depression/q1/en/index.html）

・Question 2: How long should treatment with antidepressants continue in adults with depressive episode/disorder?[Duration of antidepressant treatment]
(http://www.who.int/mental_health/mhgap/evidence/depression/q2/en/index.html)

・Question 3: Is brief, structured psychological treatment in non-specialist health care settings better (more effective than/as safe as) than treatment as usual in people with depressive episode/disorder?[Brief, structured psychological treatment]
(http://www.who.int/mental_health/mhgap/evidence/depression/q3/en/index.html)

・Question 4: Is behavioural activation better (more effective than/as safe as) than treatment as usual in adults with depressive episode/disorder?[Behavioural activation]
　（http://www.who.int/mental_health/mhgap/evidence/depression/q4/en/index.html）

・Question 5: Is relaxation training better (more effective than/as safe as) than treatment as usual in adults with depressive episode/disorder?[Relaxation training]
　（http://www.who.int/mental_health/mhgap/evidence/depression/q5/en/index.html）

・Question 6: Is advice on physical activity better (more effective than/as safe as) than treatment as usual in adults with depressive episode/disorder with inactive lifestyles?[Physical activity]
　（http://www.who.int/mental_health/mhgap/evidence/depression/q6/en/index.html）


【以下個人的想い】

自分が非常に気になったのはWHOの文章の以下の文章。

Between 60% and 65% of ill people do not receive care. The lack of appropriate services; of trained health professionals, especially in primary care; and the social stigma associated with mental disorders are some of the barriers to access to appropriate care, in addition to the need for boosting capacity for the identification and early treatment of depression.

Fighting stigma: a key to increasing access to treatment
Globally, more than 350 million people have depression, a mental disorder that prevents people from functioning well. But because of the stigma that is often still attached to depression, many fail to acknowledge that they are ill and do not seek treatment.
（中略）
Effective treatments include psychosocial treatment and medication. The active involvement of depressed people and those who are close to them in addressing depression is key. The first step is to recognize the depression and reach out for support. The earlier the treatment begins, the more effective it is.

中でも特に下記の語句が気になった。

‘ the social stigma associated with mental disorders are some of the barriers to access to appropriate care’
‘Fighting stigma: a key to increasing access to treatment’
‘But because of the stigma that is often still attached to depression, many fail to acknowledge that they are ill and do not seek treatment.’

つまり社会的にメンタル疾患が‘stigma’「恥」或いは「汚名」と考えられている事が、患者が適切な治療を受けられない障壁の一つとなっているとの記述である。

現在の日本では、うつ病は社会的に認知が広まり、自らその様に公言する人も居るほどになった。

しかし統合失調症や高次脳機能障害等、未だに社会的認知が不足しているメンタル疾患も多い。

うつ病にしても日本社会の中で徐々に認知が広まってきてはいるものの、正しい理解をせずに断片的な情報のみで解った気になりその思い込みでうつ病に関して発言する人も又、数多く存在しているの我が国の現状である。

例えば「サイエントロジー」という「精神医療」特に現在メンタル疾患の主軸である薬物療法に対して全く論理性のない「反対を唱えるカルト組織」も日本に進出してきており、「サイクバスター」と名乗る人物が（しばしばその所属を明らかにせずに）精神医療の否定を盛んに行っている。

（以下「サイクバスター氏」情報へのリンク）
・やや日刊カルト新聞
　「サイエントロジー関連団体世話役が講演予定の慶応大薬学フォーラムが中止に」
　（http://dailycult.blogspot.jp/2011/12/blog-post_21.html）
・Togetterまとめ「「精神医学は役にたたない！」「そんなことはない」」
　（http://togetter.com/li/84271）
・Togetterまとめ「サイクバスターと名乗るこの方の情報求む」
　（http://togetter.com/li/63063）
・Togetterまとめ「バルタン グッジョブ　(うつ病の薬による治療を全否定するサイクバスターの正体)」
　（http://togetter.com/li/102942）

或いは上記のごとく「うつ病」について生半可な知識を元にした誤った解釈を公言する方が、患者の治療機会を妨げ或いは患者に苦痛を与えている事も多い様だ。

この様な方が特に家族や職場等の身近に居られる場合、患者の適切な治療が妨げられる恐れが非常に大きい自分は感じている。

特にその人物が社会的に上位にある（企業その他の社会的な集団の中で）場合、その発言は「ハラスメント」として訴訟の対象になる事もあり得るのではなかろうか。

メンタル疾患に対する正確な知識の普及と適切な治療が進み、その様な発言により苦痛を感じる患者が減ることを願って、一例を紹介しておく。

また以下の引用例は「ツイッターという公共の場において、公に発言された」ものであり、批判の為の引用の範囲内であり、誹謗中傷や名誉毀損或いはプライバシーの侵害にはあたらないと判断した。

なお＜＞内は我楽者個人の知識と経験に基づく主観と感想であり、医学或いは科学的に正しいとは限らない（我楽者の限界）のは、言うまでもあるまい。

誤り等に対してのご指摘を頂ければ感謝。

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【以下ツイッターの引用紹介】


＜メンタル疾患の苦しさ、辛さを全く理解しておられない様ですが、患者は日がな遊んでいるとでも思っておられるのでしょうか。＞


＜第二次大戦時英国首相を務めたチャーチルでさえ、うつ病に悩まされていたと言うのに、「鍛えればうつ病にならずに済む」と考えておられるようです。＞


＜通常の「落ち込み」とうつ病の違いを理解しておられないと見受けられます。＞


＜「メンタル疾患の原因（ではないかとの仮説）を理解すれば、その疾患に掛からないで済む」とは、科学的な根拠は皆無ではないでしょうか。またご自分の「気分の変調」を「うつ病」或いは「それに類する」と判断しておられるようですが、精神科医でない方に診断がつくのでしょうか。＞


＜「レセプターの変異部位を知る」事が、うつ病に対する対応に必要だと言うことでしょうか。原因が正確に解らなくとも、効果のある事が分かっているのが多くの薬の実情ではないでしょうか。またレセプター変異の話は「仮説」の域を超えていない様に思いますが、研究者のあいだで広範に同意されているのでしょうか。＞


＜患者が自分の疾患について知識を増やし、薬や疾患の経過、日常生活での注意等に詳しくなるのは当ではないでしょうか。肝臓病を患った患者は肝臓専門医に、腎臓を悪くしたら腎臓医になれというのでしょうか。そして「患者のままでいたい」とは、メンタル疾患の苦痛を全く理解していないことが解る発言であると私は感じます。＞


＜それは「言いがかり」ではなく、「精神的暴力に対する抗議」でしょう。「メンタル疾患で苦しんでいる人間に対して上記の様な言葉を発すれば相手が傷つく」という、人間のコミュニケーションとして当然の事を理解出来ないとは、驚きに値するものであると感じます。＞


＜どうやら過去にうつ病を抱える患者に対して、同様の事を述べてこられた様に見受けられます。その方々のストレスを増やして病状を悪化させていなけれよろしいのですが…。＞

▽▲▽▲▽▲▽▲▽▲▽▲▽▲▽▲▽▲▽▲▽▲▽▲▽▲▽▲▽▲▽▲▽▲▽▲▽▲▽▲

因みに上記紹介文中では「セロトニンとかのニューロトランスミッターの仕組みとかちゃんと理解できてたら、自分の状態がわかるから、自分で制御できるんじゃね？」との発言については、「専門家である精神科医」でさえも「うつ病を発症する事がある」事実から、「科学的根拠の無い、『思い込み』に過ぎない」と私は考えています。

参照；
・Forget-me-not blog　「精神科医がうつ病になった」の泉基樹のブログ-あらすじ-
　（http://ameblo.jp/forget-me-not-blog/theme-10007274653.html）
・精神科医の本音日記　「僕（精神科医）はうつ病でした。」
　（http://d.hatena.ne.jp/satochan8/20110118/1295360179）



追記；
上記で紹介した方は「HOPE-JAPAN（http://hope-japan.tv/）」或いは「CAMPFIRE（http://camp-fire.jp/projects/view/240）」というプロジェクトに関わっておられるようですが、人の苦しみに思い至ることの出来ない方が、果たして他人を救えるのだろうかとの疑念を感じるのは、私だけでしょうか…。