Depression can have a devastating impact on the lives of those affected, their families and societies more broadly. It is associated with numerous negative outcomes throughout a person’s life, including poorer academic performance, reduced earnings, chronic illness, diminished quality of life and a higher chance of death.12 It is the leading cause of suicide3, contributing to up to 60% of all suicides worldwide.4 Up to 15% of people with untreated depression may die by suicide.5 Stigma associated with depression may exacerbate suffering and prevent people from seeking and receiving quality care for their illness.6 7 8 Depression also places a significant socioeconomic toll on European countries.
The depression scorecards aim to support the assessment of national-level performance in key aspects of policy, delivery and care for people with depression. The framework that underpins the scorecard was developed based on an international literature review and consultation with an expert advisory group.
A fifth area of focus – financing for depression care – cuts across these four domains. The scorecard framework was applied initially to four countries: Belgium, France, Italy and Romania. The project continued in CEB region, focusing on the state of depression care in Slovakia, Czech Republic, Hungary, Slovenia, Croatia, Serbia, Bulgaria, Estonia, Latvia and Lithuania.
The national-level findings were based on in-depth literature review and interviews with leading national experts in depression, and summarised in individual scorecard reports.
During a depressive episode, a person experiences depressed mood (feeling sad, irritable, empty) or a loss of pleasure or interest in activities. Several other symptoms are also present, which may include poor concentration, feelings of excessive guilt or low self-worth, hopelessness about the future, thoughts about dying or suicide11, disrupted sleep, changes in appetite or weight, and feeling especially tired or low in energy.
During a depressive episode, the person experiences significant difficulty in personal, family, social, educational, occupational, and/or other important areas of functioning.
A depressive episode can be categorized as mild, moderate, or severe depending on the number and severity of symptoms, as well as the impact on the individual’s functioning.12 Although most patients suffering from depressive disorders respond to different types of treatment, up to 1/3 of the patients are suffering from treatment resistant depression13. They don´t respond well to medication and treatment, and can pose an increased challenge to the healthcare systems.
Read more about Depression patterns, contributing factors, diagnosis and treatment.Read more
In the region of Central and Eastern Europe and the Baltics, the research was carried out independently by local research and communication agencies:
Depression scorecards research, website design and development
1. Linder A, Gerdtham U-G, Trygg N, et al. 2019. Inequalities in the economic consequences of depression and anxiety in Europe: a systematic scoping review. Eur J Public Health 30(4): 767-77
2. Cuijpers P, Vogelzangs N, Twisk J, et al. 2014. Comprehensive Meta-Analysis of Excess Mortality in Depression in the General Community Versus Patients With Specific Illnesses. Am J Psychiatry 171(4): 453-62
3. World Health Organization Europe. Depression. Available from: https://www.euro.who.int/en/health-topics/noncommunicable-diseases/mental-health/areas-of-work/depression [Accessed 11/06/20]
4. Ng CWM, How CH, Ng YP. 2017. Depression in primary care: assessing suicide risk. Singapore Med J 58(2): 72-77
5. Centre for Suicide Prevention. 2015. Depression and suicide prevention: resource toolkit. Calgary: CSP
6. Sabbe B. 2020. Interview with Pooja Krishnaswamy at The Health Policy Partnership [Video conference call]. 06/11/20
7. Muller R. 2020. Interview with Pooja Krishnaswamy at The Health Policy Partnership [Video conference call]. 20/11/20
8. Tavormina MG, Tavormina R, Nemoianni E, et al. 2015. A questionnaire to assess social stigma. Psychiatr Danub 27 (Suppl 1): S328-31
9. World Health Organization: https://www.who.int/news-room/fact-sheets/detail/depression
10. The Lancet. 2022. Ensuring care for people with depression. The Lancet, 399(10328), 885
11. World Health Organization Europe. Depression. Available from: https://www.euro.who.int/en/health-topics/noncommunicable-diseases/mental-health/areas-of-work/depression [Accessed 11/06/20]
13. Kubitz N, Mehra M et al (2013) Characterization of treatment resistant depression episodes in a cohort of patients from a US commercial claims database. PLoS One. 8(10): e76882.2013