Depression in China: On the road with Jonathan Flint

Oxford University's psychiatrist Jonathan Flint has a sixth sense for people's moods.

I met him last summer at a genetics conference in Bar Harbor, Maine. I remember the moment clearly because I had my head down and I was about to cry. He knew something was bothering me and came over to ask me what was wrong.

The truth was, I was beginning to feel like Charles Darwin (okay, well NOT quite that bad). Luckily, my sour mood lifted as quickly as the fog drifted away from the bay and made way for the sun to shine.

Today, Flint is in Dalian, China, talking to doctors about gathering patients for his large scale genetic research study. I spoke with Flint, who with his research collaborator Ken Kendler and a group of project supervisors, in a hotel room overlooking snowy, pine-covered hills with industrial buildings that obstruct the view of the sea in the valley below.

What is a meeting like?

The doctors are an amiable group. No suits. They are prone to leave the room when their mobile goes off and some are obviously just texting during the meeting. Kendler and I do a couple of short presentations, but it always takes longer than we are used to because of the need for translation. We concentrate on what's useful for them, so they will put more effort in and collect more patients.

Kendler and I commit to coming back for a week to train them about how to analyze the data they collect and how to write it up. Kendler puts up some training topics including biostatistics, but not many of them vote for this training option. I find out later that this is a new word for many of them.

What are you doing in China?

I am visiting eight hospitals to see how we can help hospital directors collect patients. My job involves eating a lot of food.

Are more people depressed because of the economy?

No, there's no evidence for that.

What's the best way to treat depression?

Treatment is still mostly antidepressants, with cognitive behavior therapy where this is available.

What are you learning about the genetic basis of psychiatric disorders?

So far, in humans it is very difficult to find genes. That is why we are here in China collecting 12,000 people for the study. The mice teach us about how genes act on behavior.

What kind of mental problems can stress cause?

Any really, I guess. But mostly environmental [factors] like losing your job. You know about that.

How are stress and depression related?

Stress increases the chance you get depressed.

How do you know if you are depressed? How big of a problem is it?

About 10-15 percent of people will have at least one episode of depression in their lifetime. And half of those will have more than one episode. The disorder is predicted by WHO to be the second biggest cause of morbidity worldwide by 2020.

Neuroticism indexes risk for depression. We think though through shared genetic determinants, what makes you neurotic in your genes also makes you likely to get depressed.

What do you do for inspiration?

Read.

What's the hardest thing you've overcome?