Major Depressive Disorder

Dear Mrs. -- You have asked me about the cause of your mood disorder, and whether it is due to a "chemical imbalance."

Psychotherapy outcomes and the mechanisms of change that are related to its effects have traditionally been investigated on the psychological and social levels, by measuring changes in symptoms, psychological abilities, personality, or social functioning.

Newly developed blood tests for schizophrenia and for depression designed to augment current diagnostic approaches have attracted increased attention at recent major scientific meetings.

Polypharmacy has become so ubiquitous that more accidental overdoses are now caused by prescription drugs than by street drugs. The question naturally arises whether this almost routine use of multiple psychotropic medications make sense?

This article addresses the epidemiology, diagnosis, and treatment of mild TBI among combat veterans, with a particular focus on blast injury and the presence of comorbid posttraumatic stress disorder (PTSD).

For women with metastatic or recurrent breast cancer, reductions in depression symptoms over the first year of a randomized controlled trial predicted longer survival times.

The majority of the literature focuses on prenatal and postnatal depression in mothers, and little attention has been given to the incidence of prenatal and postpartum depression in fathers.

There should be no quarrel over the reality of severe CFS as an instantiation of genuine disease, just as schizophrenia and major depression constitute real disease.

Depression and alcoholism treatment requires the proper use of medication and psychosocial interventions, as well as a solid doctor-patient relationship and a commitment to treat both disorders.

In this Special Report, Helen M. Pettinati, PhD, and William D. Dundon, PhD, discuss prevalence, assessment, clinical features, and treatment issues with respect to individuals with co-occurring major depression and alcohol dependence.

I just received a very important email from Dr Dayle Jones who chairs the DSM-5 Task Force of the American Counseling Association (ACA). The ACA has provided a much needed wake-up call for the American Psychiatric Association.

In a decade-long study of antipsychotic prescribing for hospitalized children and adolescents, researchers found that antipsychotics were used in 44.3% of patients and were often prescribed for behavioral disorders, PTSD, and other anxiety disorders as well as psychotic disorders.

A large-scale, systematic depression screening of adults with cardiovascular disease (CVD) conducted by Kaiser Permanente in Southern California produced some unexpected result. Even those with negative depression screens benefitted.

If ketamine is able to turn off a patient’s depression, even for one day, you have accomplished something important, whether or not you can maintain it. This is because you have at least given the patient hope . . . that in itself is very significant from a therapeutic perspective.

Deliberate self-harm (DSH) is a behavior in which a person commits an act with the purpose of physically harming himself or herself with or without a real intent of suicide.

The evidence-based approach to bipolar depression symptoms includes treatment with lithium, conventional unimodal antidepressants, lamotrigine, or divalproex.

Whenever a suicide happens in the New Asylums, a palpable, muted dread descends over the institution. It stays there in full force for weeks and months afterwards, sometimes longer. After that, it is added as another sedimentary layer to the strata and culture of the particular institution. Before things get too deeply buried, it is important to excavate.

Digital technology is a valuable tool, but if it dazzles us with its speed and control, there is the risk that we may forget the old way of connecting.

Mixed depression is defined as a major depressive episode (MDE) with concurrent manic or hypomanic symptoms that are insufficient in number for a patient to meet the criteria for mixed hypomania.

Mixed states constitute a wondrously variegated universe of psychopathology. These states are characterized by the intrusion of features characteristic of depression into states of hypomania or mania and the converse. Mixed states assume a myriad of forms that as a family may be among the most commonly encountered states of affective illness.

The title of Gardiner Harris’s front-page story in the March 6 New York Times was blunt: “Talk Doesn’t Pay, So Psychiatry Turns Instead to Drug Therapy.” For those of us who see our profession as a humanistic calling, this piece is likely to provoke a mixture of sadness and anger.

Dr McIntyre discusses bipolar disorder and several studies in medical comorbidity in general and more specifically neurological comorbidity.

The efficacy of psychodynamic psychotherapy is supported by empirical evidence. Patients have reported residual therapeutic gains following treatment.

Charles Moser, PhD, MD, has forwarded an interesting suggestion to solve the problem of weak diagnoses that have received a free ride through previous revisions of DSM. His is a middle way intended to steer between the contrasting risks of continuing questionable diagnoses and the risks of eliminating them.

Major mood disorders have been associated with increased suicidal behavior. This is especially true in patients with a mixed, manic-depressive, or dysphoric-agitated state.