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

Motonao Ishikawa*, Gaku Yamanaka, Masakazu Takaoka, Ayana Sakurai, Tomoko Ogasawara, Shoko Marshall and Hiroshi Sakura

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.