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Australasian Psychiatry : Bulletin of... Jun 2020An incorrect false positive diagnosis of melancholia can lead to inappropriate treatment and illness prolongation. This paper therefore seeks to introduce the concept of... (Review)
Review
OBJECTIVE
An incorrect false positive diagnosis of melancholia can lead to inappropriate treatment and illness prolongation. This paper therefore seeks to introduce the concept of 'pseudo-melancholia' to capture such instances and provide clinical examples of contributing at-risk scenarios.
METHODS
The author draws on clinical experience to provide exemplars of circumstances most risking a false positive diagnosis of melancholia.
RESULTS
Pseudo-melancholia can result from invalid measures of melancholia and from several functional and organic conditions presenting with suggested melancholic features.
CONCLUSIONS
Recognising high-risk pseudo-melancholia scenarios has the potential to advance a change in diagnostic formulation, provide a more diagnosis-specific intervention and so avert a secondary diagnosis of 'treatment resistant depression'.
Topics: Depressive Disorder; Depressive Disorder, Treatment-Resistant; Diagnosis, Differential; Diagnostic Errors; Humans
PubMed: 32157900
DOI: 10.1177/1039856220908167 -
Annual Review of Psychology Jan 2020Depression remains one of the most prevalent psychiatric disorders, with many patients not responding adequately to available treatments. Chronic or early-life stress is... (Review)
Review
Depression remains one of the most prevalent psychiatric disorders, with many patients not responding adequately to available treatments. Chronic or early-life stress is one of the key risk factors for depression. In addition, a growing body of data implicates chronic inflammation as a major player in depression pathogenesis. More recently, the gut microbiota has emerged as an important regulator of brain and behavior and also has been linked to depression. However, how this holy trinity of risk factors interact to maintain physiological homeostasis in the brain and body is not fully understood. In this review, we integrate the available data from animal and human studies on these three factors in the etiology and progression of depression. We also focus on the processes by which this microbiota-immune-stress matrix may influence centrally mediated events and on possible therapeutic interventions to correct imbalances in this triune.
Topics: Animals; Depressive Disorder; Gastrointestinal Microbiome; Humans; Inflammation; Stress, Psychological
PubMed: 31567042
DOI: 10.1146/annurev-psych-122216-011613 -
The New England Journal of Medicine Sep 2014
Review
Topics: Age Factors; Aged; Antidepressive Agents; Depressive Disorder; Female; Humans; Practice Guidelines as Topic; Psychotherapy; Selective Serotonin Reuptake Inhibitors
PubMed: 25251617
DOI: 10.1056/NEJMcp1402180 -
Zeitschrift Fur Kinder- Und... Nov 2019Depressive symptoms have long been associated with abnormalities in neural processing of reward. However, no review has yet consolidated evidence of such deficits in... (Review)
Review
Depressive symptoms have long been associated with abnormalities in neural processing of reward. However, no review has yet consolidated evidence of such deficits in adolescent depression, integrating findings across neuroimaging modalities, such as functional magnetic resonance imaging (fMRI) and electroencephalography (EEG). The current review found consistent evidence of reduced striatal responses in anticipation and upon receipt of rewards, and blunted feedback-related negativity (FRN) potentials associated with depression in adolescence, consistent with the adult literature. Furthermore, while these occurred in currently depressed adolescents, they were also found to be predictive of the onset of depressive symptoms in longitudinal studies with community-based adolescent samples. This paper makes recommendations for future work to continue to elucidate this relationship, a greater understanding of which may lead to more targeted and efficacious treatments for depression in adolescence.
Topics: Adolescent; Depression; Depressive Disorder; Electroencephalography; Humans; Magnetic Resonance Imaging; Neuroimaging; Reward
PubMed: 30957688
DOI: 10.1024/1422-4917/a000663 -
Current Neuropharmacology 2021Multiple studies on the pathomechanisms of depressive disorder and antidepressants have been reported. However, literature involving scientometric analysis of depressive...
Multiple studies on the pathomechanisms of depressive disorder and antidepressants have been reported. However, literature involving scientometric analysis of depressive disorder is sparse. Here, we use scientometric analysis and a historical review to highlight recent research on depression. We use the former to examine research on depressive disorders from 1998 to 2018. The latter is used to identify the most frequent keywords in keyword analysis, as well as explore hotspots and depression trends. Scientometric analysis uncovered field distribution, knowledge structure, research topic evolution, and topics emergence as main explorations in depressive disorder. Induction factor, comorbidity, pathogenesis, therapy and animal models of depression help illustrate occurrence, development and treatment of depressive disorder. Scientometric analysis found 231,270 research papers on depression, a 4-fold increase over the last 20 years. These findings offer a vigorous roadmap for further studies in this field.
Topics: Animals; Antidepressive Agents; Bibliometrics; Depressive Disorder; Publications
PubMed: 32888272
DOI: 10.2174/1570159X18666200905151333 -
Acta Psychiatrica Scandinavica May 2018To provide an update on the evidence base for the nature of the relationship between negative symptoms and depressive features in people with schizophrenia, and propose...
OBJECTIVE
To provide an update on the evidence base for the nature of the relationship between negative symptoms and depressive features in people with schizophrenia, and propose new models that reflect their complex relationship.
METHOD
A systematic review following PRISMA guidelines. A total of 2210 articles were identified from EMBASE, PsychInfo and MEDLINE, and further two articles were hand-searched from references. Twenty-seven met inclusion criteria and were included in the review.
RESULTS
In schizophrenia, primary evidence suggests symptoms of low mood, suicidal ideation and pessimism have more specificity for depression whereas alogia and blunted affect may have more specificity as negative symptoms. Anhedonia, anergia and avolition may be common to both.
CONCLUSION
It may be possible to further distinguish depressive features from negative symptoms in schizophrenia when detailed phenomenology is considered. However, in a proposed dimensional model, these two domains continue to share certain phenomena, highlighting their close relationship.
Topics: Comorbidity; Depressive Disorder; Humans; Schizophrenia
PubMed: 29532909
DOI: 10.1111/acps.12873 -
Journal of the American Academy of... Mar 2019Depression is the most prominent mental health disorder among youth and has a profound impact with respect to morbidity and mortality if not addressed. The Treatment for... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
Depression is the most prominent mental health disorder among youth and has a profound impact with respect to morbidity and mortality if not addressed. The Treatment for Adolescent Depression Study (TADS) is one of the largest randomized controlled trials that compared the effectiveness of four treatments: cognitive-behavioral therapy (CBT); fluoxetine (FLX); combined cognitive-behavioral and fluoxetine treatment (COMB); and placebo (PBO). However, meaningful heterogeneous treatment courses are masked by these group mean comparisons of treatment impact. The present study sought to characterize the acute phase symptom trajectories of the depressed teens enrolled in TADS and to explore predictors of these trajectories, including TADS treatment condition.
METHOD
The TADS sample of 439 adolescent participants diagnosed with major depressive disorder was subjected to growth mixture modeling (GMM) to evaluate subgroups of adolescents with unique trajectories of depression symptom change.
RESULTS
Growth mixture modeling revealed three unique classes of adolescents: (1) a high-severity class with early significant improvement; (2) a high-severity class with limited symptom change; and (3) a moderate severity class with late significant improvement. Baseline predictors of class membership included treatment condition, sex, age, stage of change, depression severity, number of comorbid disorders, hopelessness, melancholia, suicidality, and cognitive distortions.
CONCLUSION
Results of this study may have implications for the selection of which treatment to use for which depressed adolescent.
CLINICAL TRIAL REGISTRATION INFORMATION
Treatment for Adolescents With Depression Study (TADS); https://clinicaltrials.gov/; NCT00006286.
Topics: Adolescent; Cognitive Behavioral Therapy; Combined Modality Therapy; Depressive Disorder, Major; Diagnostic and Statistical Manual of Mental Disorders; Female; Fluoxetine; Humans; Male; Quality of Life; Remission Induction; Selective Serotonin Reuptake Inhibitors; Severity of Illness Index; United States
PubMed: 30768414
DOI: 10.1016/j.jaac.2018.07.908 -
Perspectives in Biology and Medicine 2021Depression is a word used to describe a mood. It is also a diagnosis. The same word, depression, straddles many meanings across time and from place to place. It is at...
Depression is a word used to describe a mood. It is also a diagnosis. The same word, depression, straddles many meanings across time and from place to place. It is at once a medical illness and a universal human experience. Jonathan Sadowsky's Empire of Depression (2021) traces the evolution of the concept of depression from ancient descriptions of melancholia to modern diagnostic criteria. Writings at least as far back as Hippocrates distinguish the sadness that occurs after a loss from the more pervasive and persistent unhappiness that came to be known as melancholia and then depression. This history is more than a chronicle; it draws on a number of sources to illustrate and illuminate how depression has been variously understood and particularly how psychiatrists attempt to help people suffering from a recognizable but complex disorder.
Topics: Depression; Depressive Disorder; Humans; Psychiatry; Sadness
PubMed: 34840158
DOI: 10.1353/pbm.2021.0043 -
Fortschritte Der Neurologie-Psychiatrie Apr 2022
Topics: Depression; Depressive Disorder; Humans; Parkinson Disease
PubMed: 35443281
DOI: 10.1055/a-1683-1840 -
The Psychiatric Clinics of North America Mar 2018This article covers current research on the relationship between depression and cognitive impairment in older adults. First, it approaches the clinical assessment of... (Review)
Review
This article covers current research on the relationship between depression and cognitive impairment in older adults. First, it approaches the clinical assessment of late-life depression and comorbid cognitive impairment. Cognitive risk factors for suicide are discussed. Research is then provided on neuropsychological changes associated with depression, discussing subjective cognitive impairment, mild cognitive impairment, and dementia profiles. Additionally, literature regarding neuroimaging and biomarker findings in depressed older adults is presented. Finally, therapeutic models for treatment of late-life depression are also discussed, including psychotherapy models, holistic treatments, pharmacologic approaches, and brain-stimulation therapies.
Topics: Aged; Aging; Comorbidity; Depressive Disorder; Humans; Neurocognitive Disorders; Psychotherapy
PubMed: 29412840
DOI: 10.1016/j.psc.2017.10.009