Risk and Protective Factors in Elderly Depression

The elderly are exposed to many putative risk factors, which contribute to the high prevalence of depressive symptoms in this age group. Risk factors are epidemiological inferences that can help define individuals as at higher relative risk for developing certain illnesses. Understanding their role is critical for disease prevention and treatment planning. Depression in late life may be associated with structural and functional abnormalities within the brain. To date, however, it has not been...

Flaws of Current Diagnosis of Depression

Stefanis and Stefanis provide an excellent survey of current depression diagnosis. Equally, it clearly reveals what I see as the failings of that system, which I will briefly discuss. Syndromal vagueness. One and the same diagnostic construct covers a variety of syndromes. The reason is that, for a particular diagnosis, a fixed set of symptoms is not required, just the presence of x out of a list of y symptoms, no matter which ones. Moreover, lists of symptoms to choose from for the various...

References

MusselmanD., DeBattista C., Nathan K., Kilts C., Schatzberg A., NemeroffC. (1998) Biology of mood disorders. In Textbook of Psychopharmacology (Ed. D. Kupfer), pp. 549-588, American Psychiatric Press, Washington, DC. 2. Biederman J., Faraone S.V., Mick E., Lelon E. (1995) Psychiatric comorbidity among referred juveniles with major depression fact or artifact J. Am. Acad. Child Adolesc. Psychiatry, 34 579-590. 3. Nierenberg A.A., Alpert J.E., Pava J., Rosenbaum J.F., Fava M. (1998) Course and...

Recurrent Brief Depression RBD

According to ICD-10, to make the diagnosis of RBD, depression should have occurred about once a month over the past year, and each episode should have lasted less than 2 weeks (typically 2-3 days with complete recovery), not having occurred only in relation to menstrual cycle and otherwise fulfilling the symptom criteria for a mild, moderate or severe depressive episode. The risk for manic episode is low and thus it may not fall into the rapid-cycling form of bipolar disorder 2, 60, 61 . It has...

Info

Grant I., Patterson T.L., Yager J. (1988) Social supports in relation to physical health and symptoms of depression in the elderly. Am. J. Psychiatry, 145 1254-1258. 95. Forsell Y., Winblad B. (1998) Major depression in a population of demented and nondemented older people prevalence and correlates. J. Am. Geriatr. Soc., 46 27-30. 96. Parmelee P.A., Katz I.R., Lawton M.P. (1989) Depression among institutionalized aged assessment and prevalence estimation. J. Gerontol., 44 M22-M29. 97. Ames...

Depressive Disorders In Children

Depressive Disorders in Children and Adolescents A Review 233 4.1 Towards an Understanding of Early Onset 4.2 Depression In Youth Trends in Diagnosis 269 4.3 Depressive Disorders in Childhood and Adolescence State of the Art 271 4.4 ''At least in the form seen in adults.'' A Commentary on Major Depressive Disorder 4.5 The ''Atypicality'' of Depression in Youth 276 4.6 How the Study of Early Onset Depression Challenges Us to Produce a New Paradigm for Understanding Mood Disorders 278 4.7 Adult...

Antidepressants

During the last two decades, a number of different research strategies, including investigations in postmortem tissue, neuroendocrine studies, and neuroimaging studies, have refined our understanding of the underlying biological correlates of depression. During the same period a large number of agents with different pharmacological profiles have been developed which exert antidepressant actions. Antidepressants play a major role in the treatment of major depression. Per Bech has described the...

Depression and its Treatment a General Health Problem

Depressive disorders are amongst the most common health problems in any community. They are usually underrecognized, underdiagnosed and undertreated. The selective serotonin reuptake inhibitors (SSRIs) are actually not selective, as they act on the six subtypes of serotonin receptors. Although they may have the same efficacy in treating depressive disorders, however, the diversity of their chemical structure may imply different clinical profiles, side effects and targeted symptoms. It seems...

Some Unsolved Problems in Childhood Depression A Clinicians View

Richard Harrington's article starts with the statement that, until recently, it was widely believed that depressive disorders were rare in young people. This statement has to be changed by recent studies that have demonstrated not only the occurrence of depressive states in children and adolescents, 1Department of Child and Adolescent Psychiatry, Philipps-University, D-35033 Marburg, Germany but also increasing rates with age. A review of the literature of psychiatric and behavioural disorders...

Combinations Between Antidepressants

The synergistic benefits of serotonin and noradrenaline reuptake inhibitors in the acute treatment of major depression were first noticed by Nelson et al in 1991 178 , in an open trial in which fluoxetine and desipramine were combined. In this trial fluoxetine raised the blood levels of desipramine. The combination of phenelzine or isocarboxazide with amitriptyline is safe 179 , while combinations of MAOIs with clomipramine or SSRIs or venlafaxine can have a fatal outcome. The combination of...

Underdiagnosis of Depression Its Impact on the Community

The proper diagnosis of depression is of paramount importance, not only because of the high prevalence of this condition in different patient 1Institute of Psychiatry, Ain Shams University, 3 Shawarby Street, Kasr El Nil, Cairo, Egypt populations, but also because it is associated with poor physical and social functioning and significant impairment of everyday activities as well as an increased number of disability days. Mental disorders present a greater burden globally than cerebrovascular...

Depression in the Elderly is Underdiagnosed Etiology is Multifactorial

As is evident from the review by Chiu et al, depression in the elderly is a great problem. In Sweden, where there is a large number of elderly people, statistics show that around 50 of all depressed people are 65 years old or more. Depression in the elderly is thus not a narrow field, and efforts must be made to offer this group of people good treatment. There is clearly underdiagnosis and undertreatment of elderly depressed patients. The problem is to identify the patients. Elderly depressed...

F39 Diagnostic Criteria

Unspecified mood (affective) disorder criteria. As an affective experience of sadness, it is common to all humans as a symptom, it is present in several mental and physical illnesses and, as a syndrome, it is associated with specific mental and physical disorders. The prototype of the syndromal entity of depressive disorders is the depressive episode (DE) in ICD-10 and the corresponding major depressive episode (MD) in DSM-IV. In both systems, it serves as the qualifying yardstick for all the...

Normal Sadness

Depressed mood as an essential ingredient of pathological (morbid) depression has its equivalent in the emotional response of practically all normal individuals when faced with losses, rejections and the adversities and vicissitudes of life. Sadness, disappointment, downness, gloominess, discouragement, unhappiness, and even despair, are universal human experiences how different are these normal emotions from the clinically meaningful mood changes of a depressed patient Is there a line...