Discrimination reported by people with major depressive disorder

摘要

Antonio Lasalvia and colleagues (Jan 5; p 55)1 did a multisite international study to assess the global pattern of experienced and anticipated discrimination. One of the most interesting findings of the paper is that lower education was associated with less stigma. The correlation stood out at a trend-level significance even in the multivariate analysis. Previous studies had left the relation between education level and stigma equivocal.23 But findings from this global venture, representative of varied economic and cultural backgrounds, adds evidence to that of another well designed international study3 which showed that higher education means greater perceived stigma. On a speculative note, the reason could be that lower educational status translates might give some indication as to the likely classification of lower, middle, and higher level gait disorders.3 Additionally, nursing homes could use the interRAI minimum dataset for resident assessment,4 as occurs in some Canadian provinces and European countries. This dataset includes a simple assessment of gait disturbance. Robinovitch and colleagues are also probably overly pessimistic about the use of simple screening tests for gait and balance problems in nursing-home residents. For example, the timed get-up-and-go test has been usefully adapted to the stand-and-walk test for this population,5 and should help to discourage nihilism about the assessment and treatment of gait and balance disorders as an important aspect of falls prevention in nursing homes.