Major Depressive Disorder

The authors focus on the epidemiology of postpartum psychosis, its clinical presentation, etiology, treatment, and strategies to prevent its recurrence.

A look into longer-term clinical and psychosocial outcomes of depressive disorder in early adulthood, as well as clinical and demographic variables associated with recurrence and lack of remission.

Information from studies on adolescents with psychosis and a review of the evidence about the risk of suicide and suicidal behavior in this patient population.

We know so little about community grieving. What is normal and what is not? Perhaps the tragedy in Newtown needs a careful analysis over time.

Demographic shifts and rising life expectancies will lead to an epidemic of chronic neuropsychiatric disease, and societal and public health costs will be enormous. Deep brain stimulation--a procedure that interfaces directly with the neural elements that drive pathological behavior--could be useful.

Mood switching is not uncommon and it is much more prevalent in depressed juveniles than in depressed adults, and there is a large apparent excess of antidepressant-associated switching over reported spontaneous diagnostic changes to bipolar disorder. Details here.

There have been considerable advances in the research on and clinical use of neurostimulation for psychiatric disorders, especially mood disorders and MDD. Three of the most recognized are reviewed here. An experimental new treatment-- trigeminal nerve stimulation-- is also briefly discussed.

Learning to talk openly with patients about their suicidal ruminations poses more of an emotional than intellectual challenge.

In a PsychCongress presentation on perinatal mood disorders, Marlene Freeman, MD, stressed that treatment is essential for women with mood disorders-but whether to treat becomes complicated during a women’s reproductive years.

It is hard for mental health professionals to discuss completed suicides. Legal fears, confidentiality concerns, shame, and stigma are formidable obstacles. But talk we must, for talking-and listening-is a key to prevention and treatment.

Lack of communication is often a key factor in mass murder, according Phillip Resnick, MD. Although HIPAA is important, the safety of the individual and the public should outweigh privacy issues, and “risk to human life always trumps confidentiality.”

Most persons who use CAM modalities to self-treat a mental health problem take prescription antidepressants concurrently. Combined use can result in serious supplement-drug interactions.

Most people look forward to their morning jolt from coffee, but could that cup of Joe be doing more than keeping us alert? According to researchers from Harvard University, java may indeed have another benefit-that of reducing suicide risk.

Older Latinos with depression report higher levels of impairment and are more persistently ill than non-Hispanic white older adults, yet they have lower rates of guideline-concordant treatment. Cognitive and problem-solving psychosocial modalities are emerging as key treatment considerations for older Latinos.

A risk to benefit ratio of treatment must be established to determine the optimal treatment for perimenopausal depression. Untreated depression during the perimenopause exacerbates heart disease, diabetes, and osteoporosis. Details about management options here.

Is depression a systemic disorder of oneself and the brain’s intrinsic activity?

For many patients with depression, full symptom remission remains elusive despite multiple trials of antidepressants. This article focuses on psychopharmacological and related interventions.

The diagnosis and management of unipolar depression remain challenging. The articles in this Special Report remind us of the wide knowledge base that is needed in the management of the depressed patient and of the multiple conceptual levels that must be integrated in the care of our patients.

Nonpharmacological interventions-such as mind-body interventions-can improve a partial response to antidepressants via stress reduction, improved physical functioning, increased socialization, and reduced risks of polypharmacy.

This article highlights several features of medical and social importance that are somewhat unique to the Somali refugee community in the US.

What is the relationship between common illnesses and depression? And why is the relationship so strong? What can clinicians do now to manage both the medical illness and the depression?

CBT has become rooted as proven dogma in the treatment of depression despite large problems remaining in methodology of CBT clinical trials and the logic behind how CBT works. This article will describe the major methodologic problems in the clinical trials of CBT.

Obesity is one of the most common physical health problems in individuals with psychiatric conditions and contributes to excess medical morbidity and mortality. Several classes of psychotropic medications, particularly atypical antipsychotics, cause weight gain. While these issues pose challenges to optimal health, the good news is that there are solutions and emerging strategies.

This article highlights evidence-based treatment with herbs and nutrients with good tolerability and potential benefit when integrated into psychiatric practices.

The major challenges for epigenetic therapies are target specificity of the drugs-an issue that is also true for most of the currently used drugs in medicine, especially in psychiatry.