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National Mental Health Survey found that in India, the point prevalence
of major depressive disorder (MDD) was 2.7% and the treatment gap was
85.2%, whereas in Madhya Pradesh the point prevalence of MDD was 1.4% and
the treatment gap was 80%.
To describe the baseline prevalence of depression among adults,
association of various demographic and socioeconomic variables with
depression and estimation of contact coverage for the same.
Population-based cross-sectional survey of 3220 adults in Sehore district
of Madhya Pradesh, India. The outcome of interest was a probable
diagnosis of depression that was measured using the Patient Health
Questionnaire (PHQ-9) and the proportion of individuals with depression
(PHQ-9>9) who sought care for the same. The data were analysed using
simple and multiple log-linear regression.
Low educational attainment, unemployment and indebtedness were associated
with both moderate/severe depression (PHQ-9 score >9) and severe
depression only (PHQ-9 score >14), whereas age, caste and marital
status were associated with only moderate or severe depression. Religion,
type of house, land ownership and amount of loan taken were not
associated with either moderate/severe or only severe depression. The
contact coverage for moderate/severe depression was 13.08% (95% CI
There is an urgent need to bridge the treatment gap by targeting
individuals with social vulnerabilities and integrating evidence-based
interventions in primary care.
Matthias Fischer, Department of Anaesthesiology and Intensive Care Medicine, Klinik am Eichert, Göppingen, Germany,
Thomas Krafft, Ludwig-Maximilians-Universität München, Germany,
Luis García-Castrillo Riesgo, Universidad de Cantabria, Hospital Universitario Marqués de Valdecilla, Santander, Spain,
Freddy Lippert, Copenhagen Hospital Corporation, Copenhagen University Hospital, Denmark,
Jerry Overton, Richmond Ambulance Authority, Richmond, Virginia, USA,
Iain Robertson-Steel, West Midlands Ambulance Service NHS Trust, Dudley, W. Midlands, UK
Emergency Medical Services (EMS) constitute a unique component of health care in the prehospital setting. Prehospital EMS systems are commonly understood as the resources used for planning and providing medical care for patients who experience an unpredicted need for emergency or urgent medical care outside a hospital. The EMS system 's primary role is to provide care for patients whose lives are at immediate or imminent risk. In the beginning of organized prehospital care, most emergencies were of traumatic origin but in the last decades this has changed to include medical problems. In 2002 at the conference of the European Resuscitation Council in Florence the First Hour Quintet (FHQ) was defined, a set of five major medical problems of prehospital care on which EMS can have a significant impact on the outcome; these are:
out-of-hospital cardiac arrest (OHCA)
severe respiratory difficulties
chest pain, including acute coronary syndrome
Together these conditions areamongthe four leading causes of death in the European Union (EU). Cardiovascular problems, cancer, externalcauses,andrespiratorydiseases represent the top four leading causes of death and morbidity: 80% of all deaths are attributable to these common causes. Cardiovascular disease (CVD) is the number one cause of death in all EU countries, resulting in 4 million deaths per year inEuropeor 1.5 million in theEU,respectively.CVDalso accounts for the largest amount of years of life lost by early death in Europe and in the European Union, contributing significantly to the escalating costs of health care. Coronary HeartDisease (CHD) is the most important cause of death in the adult population, comprising 55% of all CVD deaths.