Thursday, May 7, 2009

Depression and Participation in Preventive Health Care Activities

Prevention plays an important role in health care. Monitoring blood pressure is a way to detect elevated blood pressure and by treating this prevent strokes and heart disease. Procedures such as mammography and Pap tests can detect cancers earlier than they would normally be detected and at a stage when they are more likely to be curable. When people are struggling with depression they may be less likely to persevere with these kinds of preventive activities. Even mild depression can affect peoples' energy and motivation, which could have an impact. Also, while depressed, it is more difficult for people to think positively - and preventive health care is all about creating a healthier future. Finally, when people are severely depressed they may not value their life as much (the most extreme such manifestation being suicidality) and therefore not take steps to safeguard it.

Because of these concerns, we have examined the impact of major depression on participation in preventive health care activities in Canadians during the late 1990s and up to 2004. The results are available here. Surprisingly, no effect was found. The most likely explanation is that even though depression might cause reduced participation, this is offset by more frequenty contact with the health system. People with depression contact the health system more often because they are seeking or receiving treatment, and perhaps for other reasons as well (e.g. a tendency of depression to magnify pain complaints).

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