Depression

Major depressive disorder has become psychiatry’s signature diagnosis. Depression is diagnosed in about 40% of patients who see a psychiatrist. This percentage is double that of just 20 years ago.

The FDA has cleared the first transcranial magnetic stimulation (TMS) device (Neuro-Star) for the treatment of major depressive disorder in adults who show no improvement after an adequate trial of a single antidepressant.

Late-life depression is both underrecognized and undertreated. The impact of medical comorbidity may mask depressive symptoms.

Reports of 1 in 5 military service members returning from Iraq or Afghanistan with posttraumatic stress disorder (PTSD) and/or depression and rising suicide rates have led researchers and military leaders to warn civilian psychiatric care providers of a “gathering storm”1 headed their way.

I have been invited to write a clinical article on psychotherapeutic interventions for chronic depression.

Unipolar major depressive disorder is a debilitating condition with a lifetime prevalence of 17%. Recent epidemiological evidence indicates that MDD is the fourth leading cause of disease burden and the leading cause of disability-adjusted life years.

Regular interval administration of outcome measurement tools has proved to be beneficial in improving the quality of care that we all hope to provide for our patients.

This article focuses on recent innovations in diagnostic issues, tactics, and strategy, and takes a brief look at the future.

Polypharmacy is used increasingly in the treatment of depression.1 Although it can be beneficial-and at times may even be unavoidable-it can also be overused, resulting in drug-drug interactions, accumulation of adverse effects, reduced treatment adherence, and unnecessary increases in the cost of health care.2 This article describes current trends in psychiatric polypharmacy in the treatment of depression along with ways to use polypharmacy to optimize treatment outcomes.

This review provides an overview of the efficacy, safety, and mechanisms of action in the treatment of depression.

Depression is a risk factor for cardiovascular disease and death in many ways, directly and indirectly. It is independently linked to smoking, diabetes, and obesity-all of which are risk factors for coronary heart disease (CHD).1 Depressed patients are more likely to be noncompliant with treatment recommendations, including diet, medications, and keeping appointments, and are more likely to delay presentation for treatment with an acute coronary event.2-4

The rising prevalence and dispersion of obesity in North America in the past decade is analogous to a communicable disease epidemic. Longitudinal and cross-sectional associations between major depressive disorder, schizophrenia, and obesity have been established. Existing evidence also indicates that there is an association between bipolar disorder and obesity.

The loss of a loved one is one of the most traumatic events in a person’s life. In spite of this, most people cope with the loss with minimal morbidity. Approximately 2.5 million people die in the United States every year, and each leaves behind about 5 bereaved people.

In clinical medicine, the term recovery connotes the act of regaining or returning to a normal or usual state of health. However, there is lack of consensus about the use of this term (which may indicate both a process and a state), as well as of the related word remission, which indicates a temporary abatement of symptoms. Such ambiguities also affect the concepts of relapse (the return of a disease after its apparent cessation) and recurrence (the return of symptoms after a remission).

In working with adolescents, mental health care professionals often draw on their own developmental experiences to help guide their patients; however, nonsuicidal self-injury (NSSI) is not likely to be a personal experience that psychiatrists can often draw on.

What is the effectiveness (if any) of antidepressants in bipolar depression? What is the risk of manic switching? How effective are antidepressants in preventing relapse of bipolar depression? Insights here.

As psychiatrists we need to clarify within our profession and with our patients what therapies actually treat an illness and what therapies help one learn to function better.

Patients with low back pain (LBP) face many decisions, ranging from the nature and extent of the evaluation they should undergo to determining which treatments are likely to be most effective. These choices can be confusing not only to those who are in pain but also to their health care providers.

When historians try to understand why psychiatric diagnosis abandoned validity for the sake of reliability in the years surrounding the millennium, they will rely on The Loss of Sadness: How Psychiatry Transformed Normal Sorrow Into Depressive Disorder.

Discovering the biological basis of major depressive disorder (MDD) could lead to improved medication and therapeutic treatment for patients with this condition. To date, the cause of MDD is not well understood, but researchers believe that elevated levels of the brain serotonin, 5-hydroxytryptamine (5-HT), may play a role.

The cultural and demographic profile of the United States is undergoing a rapid transformation. In many areas of the country, there is no longer an ethnic majority but a multiplicity of racial and cultural groups.

On October 20, 2007, leading researchers in the fields of mood disorders and meditation discussed the promise-and limitations-of meditation for the prevention and treatment of major depression. Participating in a day-long symposium titled "Mindfulness, Compassion, and the Treatment of Depression" was His Holiness the Dalai Lama.

Major depressive disorder (MDD) in pediatric populations represents a significant public health concern. Rates of MDD rise dramatically in adolescence, with an estimated lifetime prevalence of 15% in adolescents aged 15 to 18.

It is estimated that at least half of persons who begin antidepressant treatment will not respond to monotherapy.

Evidence for Use of Neurostimulating Techniques