The FDA has issued a "black box" warning about the use of all antidepressants in the pediatric population due to a 1.8-fold increase in suicidality on drug compared to placebo. Yet these medications can be an effective tool in treating depression. How should parents and patients be educated, considering this information?
"Pseudodementia" needs a third look. Always a "soft" diagnosis, it has never had objective, explicit diagnostic criteria or a spot in an official nomenclature.
Multiple studies show that diabetes approximately doubles the risk of comorbid depression. Furthermore, major depressive disorder is a risk factor for the subsequent development of type 2 diabetes mellitus. Treatments for depression in the setting of diabetes must be evaluated for their effects on blood glucose levels, propensity for weight gain, possible concomitant use for diabetic neuropathy and potential drug interactions.
Comorbid substance use disorders may complicate treatment for both the hepatologist and psychiatrist. Comprehensive assessment of psychiatric illness and psychopharmacological management may be critical.
Three recently published studies uncovered some answers to the genetic underpinnings of depression. Familial vulnerability was shown to increase with each generation affected by depression. Two genetic variants pointed in opposite directions: one showed an increase risk of depression and the other predicted responsiveness to antidepressants.
The prevalence of major depression following stroke ranges from 10% to 40%. Other psychiatric disorders, including anxiety disorders, apathy and cognitive impairment are also common. Psychiatrists need to be on the lookout for symptoms not just immediately poststroke, but up to six months after the event.
It has been well established that there is a high incidence of depression in conjunction with Alzheimer's disease and other forms of dementia. What are the best assessment and diagnostic methods, and which treatments will produce the best results?
The relationship between depression and epilepsy is bidirectional as not only are patients with epilepsy at higher risk of developing depression but patients with depression have a three- to sevenfold higher risk of developing epilepsy. Several studies have found that the presence of depression in patients with intractable epilepsy was a stronger predictor of poor quality of life than the frequency and severity of seizures. The principles of managing depression in epilepsy are reviewed in this article.
The postpartum period represents a time of increased vulnerability for women, though postpartum disorders are often under-recognized and undertreated.
Given that a substantial minority of patients don't respond to monotherapy, clinicians may have to consider combined or augmentation therapy. According to the research, which drugs are most effective, and in which combinations?
Three studies over the past three years show that individuals over age 65 who are suffering from depression may still not be receiving the treatment they need. Is integrating treatment into primary care the answer?
After reading this article, you will be familiar with:The function of the hypothalamic-pituitary-adrenalaxis and the significance of cortisolin the etiology of depression.
According to a large international study, BD-II mixed depression can easily be misdiagnosed as major depressive disorder. Proper assessment and treatment of mixed depression in BD-II could have a positive impact on outcomes in bipolar disorder.
A recent survey of 1,200 Australians found that many respondents did not understand how best to help people with depression.
Depression and dementia or Alzheimer's disease often go together. The presence of dementia may also increase the odds of depression. What can clinicians do to treat these two often comorbid conditions?
Mood and well-being are believed to be regulated by mechanisms of estrogen and progesterone. How effective are they in the treatment of major and minor depression?
Can PET scans show differences in suicide risk among depressed patients? What are the risk factors for high-lethality suicide attempts versus low-lethality attempts?
Zubenko and colleagues recently released results from the first genome-wide linkage survey for genetic loci that influence the development of unipolar mood disorders in 81 families identified by individuals with recurrent, early-onset, major depressive disorder. The survey found 19 loci that appear to influence vulnerability to depressive disorders.
"Can a Depressed Parent be A Good Parent? You Bet!" This campaign, launched by the Children's Hospital in Boston and Screening for Mental Health, Inc. aims to raise awareness of parental depression and encourage parents to openly talk about their illness with their children.
The use of alternative treatments--like acupuncture, homeopathy, herbs, dietary supplements--for postpartum depression is becoming widespread. Dr. Hendrick discusses the benefits and risks of these alternative treatments and research that is being done to ensure their safety for new mothers
Rather than looking at the biological basis for depression, it may be more useful to look at the patient's worldview and how that may have primed them for depression. Examining events that took place in the patient's past lead to a solution to their current depression.
More women than men are diagnosed with depression. Yet, men who are troubled by depression are also more likely to die, even when suicide is removed from the factors of consideration. Vascular depression, hyperintensities within the brain, physiological changes and late-life onset provide both insight and more questions into the nature of depression and this enigmatic paradox.
Our perceptions about antidepressant efficacy have been inflated by the "file drawer" effect: the selective publication of positive studies and suppression of negative ones.
Psychiatrists, neurologists, primary care physicians, physician assistants, psychologists, psychiatric nurses, social workers and other mental health care professionals. Continuing education credit is available for most specialties. To determine if this article meets the requirements of your specialty, please contact your state licensing board.
A case history illustrates the need to consider psychosocial approaches to treating postpartum depression.
