Clinical psychologist Professor Ieva Bite and Professor Elmārs Rancāns, head of the Department of Psychiatry and Narcology of Riga Stradiņš University told listeners the findings of the hefty 100-page report (attached to this story in Latvian, with the English-language summary reproduced below).
Previously, separate data sources and studies were available in Latvia providing information on some mental disorders, however, these studies did not cover all mental disorders, and the sample was not always representative of the general population of Latvia, said Rancāns.
After being commissioned by the Ministry of Health, the research team of Riga Stradiņš University conducted a study on the prevalence of mental disorders and suicidal behavior in Latvia from June 2019 to May 2023, finding out that clinically significant symptoms of depression are present in 6.4% of the population of Latvia, generalized anxiety in 3.9 % of the population, and alcohol use disorders in 13.1% of the population. Suicidal thoughts, self-harm and suicidal behavior affected 10.6% of people.
"The current prevalence of depression is an average of 6.4% of the population of Latvia. What does this number mean? 6.4 is a dry number, but if we recalculate it to the adult population of Latvia, it is more than 100,000 Latvian residents, who during the interview – at that particular day and hour – [had] clinical depression that needs help. That problem hasn't gone away," explained Rancāns.
One of the important findings of the study is that people often do not realize that they are depressed and do not seek help. The prevalence of various anxiety states is also common, and there are certain groups of society that are more prone to mental health disorders.
" Sometimes a very simple and basic question, how do you rate how you feel today, [shows a lot]. For someone who says, 'I feel bad', the probability that they have depression can be four or five times higher than for someone who would say 'I feel great' to such a question," said Rancāns.
People with eating disorders and people who use various intoxicating drugs or alcohol are at greater risk of experiencing depression as well as those with physical health problems.
"Often people in such cases start to self-medicate if they feel bad, with means available to them, looking for a quick solution, but it is important to recognize the basic problem – why it exists," emphasized Rancāns.
Rates of anxiety and depression rose sigificantly during the pandemic. People with a history of any mental disorder reacted much more sensitively to the change, while people with a history of suicide attempts reacted even more strongly to the pandemic.
"Undoubtedly, mental health is a very sensitive indicator of society. If the Covid-19 pandemic has subsided a little, then the war in Ukraine is the next challenge.
"For the first months, even half a year, we all dealt with crisis assistance, trying to help people find stability and help them understand how to react to what is happening in the world around them and what they cannot influence," Rancāns said.
Bite agreed, noting that there is now a huge demand for psychological help.
"Currently, mental healthcare professionals cannot provide help to the extent that it is needed. Professor Rancāns talked about 100,000 people who have depression, but we have to add to that all the other disorders, for example, post-traumatic stress disorder, which is very a significant problem in the context of war, and all anxiety disorders, and schizophrenia spectrum disorders," she explained.
Help is also needed for people with a range of different neurodevelopmental disorders.
"Undoubtedly, the situation in the field of mental health is critical. We must not forget that the number of suicides in general is higher than the number of people who die in car accidents. We have a great need for help and for the improvement of the help system," emphasized Bite.
One of the contributing factors to society's overall mental health is loneliness, which is linked to our excessive sitting at computers, use of devices and reduced social contact, which was exacerbated during the pandemic.
"Also, of course, all negative and traumatic childhood experiences. If we think about adults, what times did we grow up in? Some of us grew up in Soviet times, some of us grew up in the 90s, when there were all these huge crises, changes, economic challenges, the increase in crime and so on. The insecurity of people at that time, of course, affects the fact that both substance abuse and violence increased. Domestic violence, childhood violence, of course, is one of the factors that absolutely dramatically affects a person's mental health throughout life," explained Bite.
Another important factor affecting people's mental health, including the desire to commit suicide, is economic status, loss of job and social status. Rancāns pointed out that the highest number of suicides in Latvia is among men in the age group of 40 to 55 years. The highest number of suicide attempts reported to the emergency services is in the age group of 35 to 40 years.
"Furthermore, in that age group, in a very large percentage of the cases in which emergency services arrive to provide assistance, people are in a state of alcoholic intoxication. People use alcohol to reduce their internal discomfort, to self-medicate. But if alcohol is used for a long period of time, it becomes part of the problem. It's a downward spiral. At the same time, if a person consumes alcohol at the moment when he has suicidal thoughts, it contributes to taking this step," Rancāns explained.
What does the report say?
Though the bulk of the report on Latvia's mental health is in Latvian, the authors do provide a helpful English-language summary of their findings, which is reproduced below.
Mental health is an essential component of overall public health. In Latvia, until the study described in this report, several data sources and studies providing information on some mental disorders were available.
However, they did not cover all mental disorders, and the sample was not always representative to the general population of Latvia. Thus, between 25.11.2019 and 16.03.2020 a nationally representative “Research on the prevalence of mental disorders and suicidal behavior in the adult population of Latvia” was conducted, the purpose of which was to find out the prevalence of mental disorders and suicidal behavior in the adult population of Latvia. 2687 respondents participated in the study. The research was implemented in frame of the European Social Fund project “Complex health promotion and disease prevention measures” (identification No. 9.2.4.1/16/I/001).
The results of the study show that alcohol disorders (according to the Mini-International Neuropsychiatric Interview (hereinafter M.I.N.I.) diagnostic tool) have been found in 13.1% of respondents. Disorders are more often found in men, younger people, people living in Riga, people with a lower level of education and people with a higher income level.
Drug use disorders were found in 1.7% of respondents. At the time of the study, a major depressive episode was found in 1.8% of respondents. The lifetime prevalence of a major depressive episode is 7.1%. The indicators are higher among women, among the elderly population, among people living in Riga and among persons with a higher income level.
The Anxiety Screening (GAD-7) survey shows that generalized anxiety disorder is present in 3.9% of the study participants. Generalized anxiety disorders (according to the M.I.N.I. diagnostic tool) have been found in 0.2% of the population in the last 6 months before the interview. According to M.I.N.I. diagnostic tool panic disorder or episodic paroxysmal anxiety was found in 0.1% of respondents during the last 12 months. The point prevalence of agoraphobia in the study population is 0.4%. Last month prevalence of social phobia is 0.2%.
Obsessive-compulsive disorder (OCD) was diagnosed in 0.6% of the study population during the last month before the interview. Post-traumatic stress syndrome was found in 0.1% of respondents. Suicidal thoughts, self-harm and suicidal behavior during the last month (according to the M.I.N.I. diagnostic tool) were identified in 10.6% of respondents. Higher prevalence was found in persons with a lower level of education and low income level, as well as persons who were found to have risky alcohol consumption. Of the mentioned respondents, 13.0% were determined to have a severe risk of suicide. 4.0% of respondents admitted to attempting suicide during their lifetime.
Among respondents with suicidal behavior, 16.1% of respondents did not rule out a possible suicide attempt in the next 3 months. 8 Psychotic disorders (according to the M.I.N.I. diagnostic tool) were detected in 2.6% of respondents during the interview. The lifetime prevalence of psychotic disorders is 5.9%. Indicators decrease with increasing age. The indicators are higher in the population of Riga residents.
Delusional ideas or hallucinations (psychotic symptoms) were noted by 1.7% of the study participants during the last month. Pathological mood elevation in the form of mania or hypomania syndromes were not detected at the time point of the research. Individual symptoms of hypomania during the interview were found in 0.7% of respondents. The point prevalence of the symptoms is highest among the younger population (18–44 years). 2.7% of individuals have hypomanic symptoms during their lifetime. The prevalence of symptoms decreases with increasing age. A higher prevalence of disorders was found in persons with a lower level of education.
A manic episode during their lifetime was determined in 0.2% of respondents. No current (within past 3 months) cases of anorexia nervosa were detected during the study. Bulimia nervosa was found in 0.4% of the study population during the last 3 months.
Compulsive overeating disorder was detected in 0.4% of the population. A higher prevalence of disorders was found in persons living in Riga. Antisocial personality disorder was identified in 2.3% of the study population. Prevalence is higher among men, younger people, and people with lower levels of education.
A significantly higher proportion of respondents with a rather poor and poor self-rated health is in the group of respondents with clinically significant depressive symptoms (39.5%), with certain generalized anxiety disorders (33.3%), as well as among respondents with suicidal behavior (23.5%) or episodes of major depression at the time of the interview or within lifetime (23.9%) (compared to persons without the mentioned disorders).
