Seven-Year Outcome of Two Cases of Depression in Elderly High-Altitude Residents in Ladakh, India

Abstract

Studies have reported a positive association between suicide rate and altitude, suggesting a relationship between hypoxia and depression. Previously we reported that a high frequency of depression is not universal at high altitudes and that the prevalence of depression in Ladakh was low. This study aimed to analyze the clinical course of residents diagnosed with depression during our previous health checkup. The participants were two residents diagnosed with depression during our health checkup of 114 residents in Domkhar, Ladakh in 2009. Their 7-year outcome was analyzed through home visits. The Geriatric Depression Scale-15 as an index of depression, the Religious Commitment Inventory-10 as an index of religious devotion, and the Multidimensional Scale of Perceived Social Support as an index of social support were administered. The two residents diagnosed with depression achieved spontaneous remission without treatment. Both residents had strong religious devotion and were satisfied with their relationship with other residents. They reported that praying, listening to a priest’s lecture, and visiting a religious facility made them feel better. The results suggest that social support and religious beliefs may not only protect against the development of depression but also have a positive effect on the clinical course of depression in high-altitude communities.