Depression and Altitude: Cross-Sectional Community-Based Study Among Elderly High-Altitude Residents in the Himalayan Regions

• Published in: Culture, medicine and psychiatry Vol. 40; no. 1; pp. 1 - 11
• Main Authors: Ishikawa, Motonao, Yamanaka, Gaku, Yamamoto, Naomune, Nakaoka, Takashi, Okumiya, Kiyohito, Matsubayashi, Kozo, Otsuka, Kuniaki, Sakura, Hiroshi
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.03.2016; Springer Nature B.V
• Subjects: Aged; Aged, 80 and over; Altitude; Altitudes; Anthropology; China - epidemiology; Clinical Psychology; Cross-Sectional Studies; Cultural factors; Depressive Disorder - epidemiology; Environmental aspects; Epidemiology; Ethnicity; Female; Females; Geriatrics; Himalaya Mountains; Humans; Hypoxia; Hypoxia - psychology; India - epidemiology; Internal medicine; Male; Medicine; Melatonin; Mental depression; Mental disorders; Mental Health; Middle Aged; Older people; Original Paper; Physicians; Population; Primary care; Psychiatric Status Rating Scales; Psychiatry; Public Health; Questionnaires; Residence Characteristics; Social Sciences; Sociocultural factors; Sociology; Studies; Suicides & suicide attempts; Surveys and Questionnaires; Asia; United States > US; China; India; High altitude; Depression; Hypoxia; Ladakhi; Tibetan
• ISSN: 0165-005X; 1573-076X
• DOI: 10.1007/s11013-015-9462-7

Suicide rates are higher at high altitudes, and some hypothesize that hypoxia is the cause. There may be a significant correlation between rates of depression and altitude, but little data exist outside the United States. The purpose of the present study is to conduct a survey of depression among the elderly highlanders in Asia. We enrolled 114 persons aged 60 years or older (mean, 69.2 ± 6.7 years; women, 58.8 %) in Domkhar (altitude, 3800 m), Ladakh, India and 173 ethnic Tibetans (mean, 66.5 ± 6.1 years; women, 61.3 %) in Yushu (altitude, 3700 m), Qinghai Province, China. The two-item Patient Health Questionnaire (PHQ-2) and the geriatric depression scale were administered. A psychiatrist interviewed the subjects who had a positive score on the PHQ-2. The results of the interview with the residents conducted by the specialist showed that two cases (1.8 %) from Domkhar and four (2.3 %) from Qinghai had depression. Despite the high altitude, the probability of depression was low in elderly highlander in Ladakh and Qinghai. Our finding seems to indicate that cultural factors such as religious outlook and social/family relationship inhibit the development of depression.