http://d.hatena.ne.jp/sumita-m/20131120/1384914970に対して、
医学用語として鬱病をいうときにはmelancholyよりもdepressionを使う方が多いのか。経済用語では不況。
nessko*1
2013/11/20 12:06 「メランコ」は、メランコリーから来ていて、鬱寄りな方々を指していたと記憶します。
対比される「シゾフレ」が、当時の言い方なら分裂寄り、私が読んだ本では、和田先生は若い世代はシゾフレが多い、として、一種の若者批判(批評?)のような形で書いていました。
http://d.hatena.ne.jp/sumita-m/20131120/1384914970#c1384916788
日本に限らず世界的に見て、増えているのは精神分裂病(統合失調症)ではなく鬱病*2ではないでしょうか。また、抗鬱剤の処方数はそれ以上に増えている。
Sarah Boseley, Mona Chalabi and Mark Rice-Oxley “Antidepressant use on the rise in rich countries, OECD finds” http://www.theguardian.com/society/2013/nov/20/antidepressant-use-rise-world-oecd
OECDによれば、豊かな先進国を中心に抗鬱剤の使用が急増している。先進国=抗鬱剤を飲む人が多い国という定義も可能なほど。勿論鬱病も増えているが、抗鬱剤の使用の伸びはそれを上回っている。その背景のひとつとして、抗鬱剤よりもカウンセリングや認知療法が有効な軽度の鬱病にも抗鬱剤が処方されていることがあるという。それから、金融危機と鬱病(抗鬱剤使用)の関係;
1988年にプロザック*3が認可されて抗鬱剤は一気に大衆化したが、そのうちに自殺誘発などの副作用の指摘などがあり、プロザックはあっけなく脱神話化されたが、それは抗鬱剤使用の長期的なトレンドには殆ど影響を与えていないという;
Data from the OECD show that in some countries doctors are writing prescriptions for more than one in 10 adults, with Iceland, Australia, Canada and the other European Nordic countries leading the way. Separate data from the US shows that more than 10% of American adults use the medication. Numbers are even rising in China, with the antidepressant market growing there by about 20% for each of the past three years, albeit from a lower base.Global rates of depression have not risen to the same extent, even though more people than ever are being diagnosed in some countries.
In its Health at a Glance report to be released on Thursday , the OECD said that rising consumption levels could be explained by the use of antidepressants in milder cases. "These extensions have raised concerns about appropriateness," it said.
It added that the financial crisis may have been a factor in more recent increases in usage, noting that in Spain and Portugal, for example, prescriptions have jumped by more than 20% over the past five years.
Most psychiatrists agree that antidepressants work for people with severe illness but are not supposed to be the first resort for those with mild depression. Counselling and talking therapies, such as CBT (cognitive behaviour therapy), are recognised as just as effective over the long term. But counselling is in short supply in many countries.
The modern antidepressants known as SSRIs (selective serotonin reuptake inhibitors), such as Prozac, took off in the 1990s and gained almost cult status with the publication of Elizabeth Wurtzel's book Prozac Nation in 1994. Doctors were happier to prescribe them because they did not have the addictive properties or side-effects of pills such as benzodiazepines. But within a few years, the bubble seemed to burst, with stories of some, particularly younger, people attempting suicide while on the drugs. Some of the companies paid large sums to settle court cases in the US and in the UK, doctors were warned in 2003 not to prescribe them to the under-18s.But the issues around the various medications do not seem to have affected the long-term upward trend. The OECD figures show Iceland to have the highest prescribing rate, at 105.8 doses a day for every 1,000 inhabitants in 2011, up from 70.9 in 2000 and 14.9 in 1989, when it first submitted figures.
Three countries have figures in the 80s in 2011 – Australia, up from 45.4 in 2000 to 88.9 in 2011; Canada, up from 75 in 2007 when it first submitted figures to 85.9 and Denmark, up from 34.8 to 85.2. The lowest rate in 2011 was in Chile, where 12.8 daily doses were prescribed for every 1,000 inhabitants. In the UK, rates have roughly doubled over the past decade to 70.7 for every 1,000 people.
Jonathan Kaiman “China starts to turn to drugs as awareness of depression spreads” http://www.theguardian.com/world/2013/nov/20/china-depression-antidepressants-drugs
中国における鬱病の現状。中国では抗鬱剤市場が年率20%\以上で伸び続けている*4。
張進「地獄帰来――我與抑鬱病抗争的日子」http://zhangjin.blog.caixin.com/archives/44873
上の『ガーディアン』の記事で言及されたジャーナリスト張進氏の鬱病体験記。
話を戻すと、鬱病と精神分裂病の対比ということでは、和田秀樹のものよりは、例えば中井久夫先生の『分裂病と人類』とかを読む方が色々な面で有益だろうとは思う。或いは、木村敏先生の『時間と自己』*5。
- 作者: 中井久夫
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- 作者: 木村敏
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*1:http://d.hatena.ne.jp/nessko/
*2:Mentioned in http://d.hatena.ne.jp/sumita-m/20060727/1154012155 http://d.hatena.ne.jp/sumita-m/20071203/1196648646 http://d.hatena.ne.jp/sumita-m/20080622/1214075188 http://d.hatena.ne.jp/sumita-m/20090312/1236788552 http://d.hatena.ne.jp/sumita-m/20090326/1238032463 http://d.hatena.ne.jp/sumita-m/20090818/1250561312 http://d.hatena.ne.jp/sumita-m/20091019/1255884330 http://d.hatena.ne.jp/sumita-m/20100212/1265948020 http://d.hatena.ne.jp/sumita-m/20100220/1266675362 http://d.hatena.ne.jp/sumita-m/20101217/1292579103 http://d.hatena.ne.jp/sumita-m/20110924/1316802079 http://d.hatena.ne.jp/sumita-m/20120519/1337449378 http://d.hatena.ne.jp/sumita-m/20120620/1340214843
*3:See eg. http://www.ssri.net/prozac.html
*4:http://www.prnewswire.com/news-releases/research-report-on-chinas-antidepressant-market-2013-2017-211159091.html
*5:Mentioned in http://d.hatena.ne.jp/sumita-m/20110603/1307042637 See eg. 水野優「木村敏『時間と自己』書評」http://yumizuno.seesaa.net/article/75677179.html