Major Depressive Disorder

Latest News


CME Content


Although light therapy is an old treatment, new therapeutic uses are being researched. What is the optimal time and strength of light treatment to best help patients with depressive disorders?

According to the World Health Organization, five of the 10 leading causes of disabilities worldwide are psychiatric conditions. More than 450 million people worldwide suffer from mental and brain disorders, and nearly 1 million people commit suicide each year. Because of this, many health care organizations and governments are forging partnerships to combat the daunting talk of providing quality health care around the globe.

Patients with anorexia nervosa often attempt to deceive health care professionals because they do not want treatment for their disorder. Thus, physicians must maintain a high index of suspicion for signs and symptoms of AN due to its potentially fatal complications.

Transcranial magnetic stimulation has been applied in a growing number of psychiatric disorders as a putative treatment. As a focal intervention that may exert lasting effects, TMS offers the hope of targeting underlying circuitry and ameliorating the effects of psychiatric disorders. The ultimate success of such an approach depends upon our knowledge of the neural circuitry involved, on how TMS exerts its effects and on how to control its application to achieve the desired effects. Current challenges in the field include determining how to enhance the efficacy of TMS in these disorders and how to identify patients for whom TMS may be efficacious.

Assessing and treating patients with suicidal behavior is not an easy task. Acts of suicide cannot be predicted; the best a psychiatrist can hope for is the ability to identify a patient's risk factors and reduce them. With the publication of a new practice guideline, it is hoped that psychiatrists will be better equipped to deal with this particularly vexing challenge.

In many preliminary studies, including one presented at the recent 2nd World Congress on Women's Mental Health, the naturally occurring steroid dehydroepiandrosterone has been shown to be an effective treatment for mild-to-moderate midlife depression. Questions remain, however, as to its mechanism of action, the risk of side effects and its interactions with medications.

With increased concern about suicidal impulses in children taking antidepressants, the FDA has decided to step in. Two committees held a meeting to discuss various plans for classifying suicidal events, along with some of the difficulties in deciding whether certain events qualify as suicide attempts.

What are some of the pitfalls of treating patients from varying cultural backgrounds, what cultural issues should psychiatrists be aware of and how can they fit varying culturally based psychiatric disorders into a proper diagnostic framework? Using case studies, Dr. Moldavsky explores the clinical implications of culture in psychiatric practice.

Psychopharmacologic management has become increasingly complex, and physicians run the risk of precipitating drug-drug interactions when certain drugs interact via the cytochrome P450 system. In addition, the P-glycoprotein transporter may play a role in certain drug-drug interactions. While physicians currently rely on Web sites and textbooks to avoid potentially morbid and lethal interactions, electronic medical records may play a crucial role in the future.

Anorexia nervosa, bulimia nervosa and binge-eating disorder remain challenging disorders for the practicing psychiatrist. While psychopharmacological agents play an important role in the overall treatment of eating disorders, current empirical evidence does not support their sole use. A recipe consisting of evidence-based psychopharmacological agents together with evidence-based psychotherapeutic approaches is usually required for a successful outcome.

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.

One of the spin-offs of the consensus statement is a study of the risk for metabolic disorders with antipsychotic use in children and adolescents. Here, the lead researcher discusses some of the group's initial findings.

For decades, personal essays on ECT highlighted pain and discomfort, a dismaying loss of memory, and an indifference of practitioners who forced the treatment on unwilling patients. The attacks on ECT by popular writers in the press and in film drowned out the voices that described its benefits. However, the public testimony has slowly changed toward a greater acceptance of ECT; it is time to hearken to the testimony of these witnesses and roll back the unethical restrictions that commit our most disadvantaged citizens to unnecessary chronic illness, prolonged hospital care and even death.

Will the most effective treatments be available for your patients? Atypical antipsychotics and antidepressants that are being marketed or developed worldwide are reviewed.