Major Depressive Disorder

Standardized, quantifiable outcome measures exist for most major psychiatric disorders, yet they are rarely used in routine clinical practice. This article identifies the rationale for using psychiatric scales.

What to do once treatment-resistant depression is established based on risk factors and exclusion of other conditions? Insights here-and a treatment algorithm.

The discovery that a single IV infusion of low-dose (subanesthetic) ketamine exerts rapid antidepressant effects constitutes an expansion in our understanding of the neurobiology of depression and provides new avenues for drug development.

Genius and madness: does one phenomenon cause the other-or do both share a common underlying factor or mechanism? How are geniuses able to accomplish “creative fits”? The author explores both questions.

How can we get even better at customizing treatment for our patients and thereby achieve improved outcomes? How do we avoid becoming relegated to mere brokers of psychopharmacologic commodities? A few thoughts in this brief communication.

The lay press has focused a lot of attention on the use of ketamine as a potentially rapidly acting treatment for depression. But are psychiatrists really ready to offer ketamine as a treatment alternative for mood disorders? An expert weighs in.

Suicide is not being adequately addressed in terms of prevention, and part of that process is better education of mental health professionals and primary care physicians. More in this expert Q&A.

A recently published study found that certain types of stress affect the quality and quantity of men's sperm. The senior author of that study addresses the topic and provides take-away points for psychiatrists in this brief podcast.

The menopausal transition is characterized by sex hormone variability and a vulnerability to depressive symptoms and major depressive episodes. The rate of new-onset major depressive episodes is increased during the menopausal transition, as is the experience of depressive symptoms.

Chronobiology-the science of daily (circadian), monthly, tidal, and seasonal rhythms-has undergone exponential growth in the past decade, with major discoveries at the molecular and neuroanatomic level.

The “story behind the story” is not the over-prescription of antidepressants-though it happens-but the under-availability of optimal treatment.

A brief review of interesting new findings on suicidality and depression treatment in youths.

A mother recalls seeing a donation box with a photo of a little boy with leukemia in a grocery store checkout line but never one of a child with serious mental illness. How can this be if twice as many children and young people die from suicide than those who die of all cancers combined? More in this commentary.

Given the greater frequency of depression than manic episodes in bipolar disorder, what clues indicate bipolar disorder rather than unipolar depression?

Minorities remain less likely to receive diagnosis and treatment for their mental illness and more likely to die by suicide. As ethnocultural diversity within the US grows, psychiatrists are increasingly evaluating attitudes, beliefs, and behaviors of a broad spectrum of ethnocultural groups.

Most patients with psychiatric diagnoses present with sleep disturbances that can have as great an impact on health-related quality of life as the mental illness itself. Here are tips on treatment and chronotherapeutic applications for major depression and other disorders.

An update on the diagnosis, causation, and treatment of chronic depressive problems. The focus is on the recently introduced diagnostic category of persistent depressive disorder.

Most, if not all, antidepressants can cause bothersome adverse effects. These are described here along with strategies to help patients cope.

Epidemiological research has shown that the Māori people of New Zealand are approximately twice as likely to have serious psychiatric illness compared with non-Māori. Here, a child and adolescent psychiatrist describes her work in Aotearoa, New Zealand.

The authors emphasize the importance of risk and protective factors and risk prediction models; analyze the growing evidence base for preventive interventions; and describe the concept of mental health promotion.

With over 2 dozen FDA-approved antidepressants on the market, it is reasonable to ask: which antidepressants are most effective?

What treatments are effective for mild chronic depression in older patients? Are there novel antidepressant medications with fewer adverse effects than current treatments? In this podcast, experts report on the latest updates in the evaluation and treatment of depression in older adults.

Evidence has accumulated on the efficacy of transcranial direct current stimulation in major depression. The authors review its potential mechanism of action, findings from recent clinical trials, and potential role in the treatment of depressive disorders.

The removal of the so-called “bereavement exclusion” (BE) from DSM-5 was one of the most difficult and controversial decisions the DSM-5 work groups made, and many clinicians continue to find the distinction between ordinary grief and major depression confusing.

What are the psychological and physiological effects of persistent loneliness? How prevalent in the US? What role can cognitive behavioral therapy play for persistently lonely people? In this podcast, an expert offers a brief overview of this underappreciated, but often overlooked, problem.