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MMW Fortschritte Der Medizin Jun 2024
Topics: Humans; Depressive Disorder; Diabetes Mellitus, Type 2
PubMed: 38806899
DOI: 10.1007/s15006-024-4001-5 -
The Psychiatric Clinics of North America Jun 2023Major depressive disorder is a substantial public health challenge impacting at least 3 million adolescents annually in the United States. Depressive symptoms do not... (Review)
Review
Major depressive disorder is a substantial public health challenge impacting at least 3 million adolescents annually in the United States. Depressive symptoms do not improve in approximately 30% of adolescents who receive evidence-based treatments. Treatment-resistant depression in adolescents is broadly defined as a depressive disorder that does not respond to a 2-month course of an antidepressant medication at a dose equivalent of 40 mg of fluoxetine daily or 8 to 16 sessions of a cognitive behavioral or interpersonal therapy. This article reviews historical work, recent literature on classification, current evidence-based approaches, and emerging interventional research.
Topics: Humans; Child; Adolescent; Depressive Disorder, Treatment-Resistant; Depressive Disorder, Major; Antidepressive Agents; Diagnosis, Differential; Treatment Outcome; Transcranial Magnetic Stimulation; Psychotherapy
PubMed: 37149350
DOI: 10.1016/j.psc.2023.02.007 -
Psychopathology 2020Since the introduction of DSM-III anhedonia has become a core depressive criterion and is defined as the loss of interest or pleasure. Although the origin of the word... (Review)
Review
Since the introduction of DSM-III anhedonia has become a core depressive criterion and is defined as the loss of interest or pleasure. Although the origin of the word goes back to the end of the 19th century and numerous anhedonic symptoms are described in classic texts on depression, this centrality in the diagnosis of depression is only recent. Anhedonia is best described as a symptom complex with unclear boundaries cutting across the tripartite model of the mind (affect, volition, and cognition). Popular concepts of anhedonia pertain to the pleasure cycle and positive affectivity. These concepts partially overlap and are often mixed up, but clearly stem from different theoretical backgrounds: the affective science of reward processing versus more general, dimensional modelling of affect. The former concept seems more suitable to understand anhedonic emotions, the latter more suitable to understand anhedonic mood or trait. This narrative review covers the history of "anhedonia," the different anhedonic phenomena, and psychopathological concepts. An attempt is made to go beyond a merely descriptive psychopathology. Neurobiological and psychological insights shed a light on how symptoms are made and interconnected; these insights possibly call for a new psychopathological language.
Topics: Adult; Anhedonia; Depressive Disorder; Female; Humans; Male
PubMed: 32668436
DOI: 10.1159/000508773 -
International Journal of Molecular... Jan 2021Sleep problems are frequently associated with the principal diagnostic criteria for many mental disorders. Alterations in the sleep of depressive patients are of high... (Review)
Review
Sleep problems are frequently associated with the principal diagnostic criteria for many mental disorders. Alterations in the sleep of depressive patients are of high clinical significance because continuous sleep problems raise the chance of relapse, recurrence, or suicide, as well as the need for augmenting medications. Most antidepressants have been proven to influence the sleep architecture. While some classes of antidepressants improve sleep, others may cause sleep impairment. The successful treatment of depressive disorder also requires an understanding of the effects of antidepressants on sleep. This article briefly reviews the physiology of sleep and the typical alterations in the sleep architecture in depressive patients and updates the different effects of the majority of antidepressants including novel drugs in clinical practice on sleep. The summary of the updated scientific findings of the relationship between depression and sleep disturbances could be clinically beneficial in choosing the best medication for depressive patients with concurrent sleep disorders.
Topics: Animals; Antidepressive Agents; Depressive Disorder; Humans; Sleep; Sleep Wake Disorders
PubMed: 33572767
DOI: 10.3390/ijms22031333 -
Psychopharmacology Bulletin Aug 2023Transcranial magnetic stimulation (TMS) is effective in the management of treatment resistant major depressive disorder (MDD) and has recently become widely available.... (Review)
Review
BACKGROUND
Transcranial magnetic stimulation (TMS) is effective in the management of treatment resistant major depressive disorder (MDD) and has recently become widely available. Our aim was to explore the literature for evidence of the mechanism of action.
METHOD
We examined our own accumulating TMS library, the reference lists of all available papers and used a search engine to collect information. We collated and examined this information under relevant heading.
RESULTS
TMS produces a large number of physiological changes including site of stimulation neurochemical, brain wave and blood flow effects, and distant structure effects including neurotransmitter effects and volume increase. TMS also corrects generalized and local functional connectivity (FC) abnormalities which are a feature of MDD.
CONCLUSION
TMS produces a range of physiological changes. It is unclear which of these underpin its antidepressant. It is likely more than one work synergistically to this end-almost certainly the capacity to correct MDD induced FC abnormalities makes a strong antidepressant contribution.
Topics: Humans; Depressive Disorder, Major; Transcranial Magnetic Stimulation; Depressive Disorder, Treatment-Resistant
PubMed: 37601083
DOI: No ID Found -
Expert Review of Neurotherapeutics Feb 2020: Post-stroke depression (PSD) is a common clinical problem affecting approximately one-third of stroke survivors. PSD is associated with poor functional outcome and... (Review)
Review
: Post-stroke depression (PSD) is a common clinical problem affecting approximately one-third of stroke survivors. PSD is associated with poor functional outcome and higher morbidity and mortality rates. Currently, uncertainty remains regarding optimal pharmacological strategies for its prevention and treatment.: This article reviews the state of the current literature on pharmacologic intervention strategies for PSD, providing a summary of the most recent evidence to support pharmacological treatment in PSD.: Experimental and clinical research have increased our knowledge on PSD, although unanswered questions still remain regarding the best time to begin treatment, the effect of the antidepressants in areas other than emotion, or their capability to reduce mortality in stroke patients, among others.Currently, though numerous trials and meta-analyses suggest that antidepressants are effective in treating PSD and guidelines recommend their use for PSD, in the daily clinical practice, only a minority of patients are properly assessed and treated. Therefore, though further evidence is needed to clarify the real role of antidepressants in patients with stroke, physicians and other healthcare professionals must be familiar with the pharmacological treatment of PSD, in order to improve the outcome and increase the quality of life of this vulnerable group of patients.
Topics: Antidepressive Agents; Depressive Disorder; Humans; Stroke
PubMed: 31860359
DOI: 10.1080/14737175.2020.1707666 -
American Journal of Psychotherapy Mar 2020This review details the history of the development of interpersonal psychotherapy (IPT), beginning at Yale University when Dr. Gerald Klerman led a maintenance study of... (Review)
Review
This review details the history of the development of interpersonal psychotherapy (IPT), beginning at Yale University when Dr. Gerald Klerman led a maintenance study of the treatment of depression. The trial aimed to mimic clinical practice and, therefore, included psychotherapy. This review describes the first IPT clinical trial, subsequent trials, and numerous IPT adaptations for different age groups, formats (group, telephone, computer), disorders, and educational levels of mental health trainees. As of 2017, at least 133 clinical trials of IPT had been carried out worldwide. This review also describes challenges associated with training clinicians to deliver evidence-based psychotherapy. It concludes with a discussion of future directions for IPT, which include expanding training to community health workers and testing IPT in low- and middle-income countries.
Topics: Depression; Depressive Disorder; Humans; Interpersonal Psychotherapy; Interpersonal Relations; Treatment Outcome
PubMed: 31752510
DOI: 10.1176/appi.psychotherapy.20190032 -
Zeitschrift Fur Gerontologie Und... Mar 2023Due to their frequency, complications, and sequelae, depressive disorders are of great significance to patients, their environment, and society. They are considered the... (Review)
Review
BACKGROUND
Due to their frequency, complications, and sequelae, depressive disorders are of great significance to patients, their environment, and society. They are considered the most frequent form of mental disturbances in old age. The use of antidepressant drugs (AD) represents a cornerstone of the treatment, which is always multidimensional.
OBJECTIVE
The classification, mechanism of action, efficacy and tolerability of AD are described. Furthermore, the practical treatment procedure as well as special aspects, such as treatment resistance and special features in old age are presented.
MATERIAL AND METHODS
Narrative review incorporating the most recent literature and the new edition of the national healthcare guidelines on unipolar depression.
RESULTS
In the past 20 years, a large number of so-called 2nd generation ADs have been approved worldwide with comparable efficacy but more favorable side effect profiles than conventional (tricyclic) substances. Almost all ADs act by enhancing monoaminergic, mostly serotonergic, neurotransmission. Other common features include a latency in the onset of action, moderate response rates, and potential efficacy on all core symptoms of depression. Side effects can include cardiovascular, metabolic, or sexual dysfunction, but these may significantly differ between drug classes. This enables individualized treatment taking age, individual risk factors, comorbidities and comedications into account.
CONCLUSION
With the correct interpretation of indications, knowledge of the risks, and consideration of the defined precautionary measures outlined here, treatment with AD is a safe and effective tool in the treatment of moderate and severe depression.
Topics: Humans; Selective Serotonin Reuptake Inhibitors; Antidepressive Agents; Depressive Disorder
PubMed: 36806981
DOI: 10.1007/s00391-023-02169-0 -
International Review of Psychiatry... 2020Dysthymia is a psychopathological construct historically described and often reconsidered through the centuries. Its first description is dated back to 400 b.C., when... (Review)
Review
Dysthymia is a psychopathological construct historically described and often reconsidered through the centuries. Its first description is dated back to 400 b.C., when Hippocrates proposed his theory about the 'black bile' and the melancholic temperament. The concept of dysthymia (-, 'ill', -, 'emotions') has been largely elaborated in the XIX and XX centuries by Burton, Cullen, Schneider, Kretschmer, Akiskal and other authors, and recently re-formulated in the various editions of the modern Diagnostic and Statistical Manual of Mental Disorders under different diagnostic labels: neurotic depression, dysthymic disorder, persistent depressive disorder. Beyond the nosology, dysthymia issues some other challenges, including the need for further research to characterise the peculiar pathophysiological framework of this syndrome (compared with major depressive disorder) and to better define evidences about tailored-treatment options and their effectiveness.
Topics: Depression; Depressive Disorder, Major; Depressive Disorder, Treatment-Resistant; Diagnostic and Statistical Manual of Mental Disorders; Dysthymic Disorder; Humans
PubMed: 32436408
DOI: 10.1080/09540261.2020.1765517 -
European Journal of Nuclear Medicine... May 2023Major depressive disorder is a growing and poorly understood pathology. Due to technical and ethical limitations, a significant proportion of the research on depressive... (Review)
Review
Major depressive disorder is a growing and poorly understood pathology. Due to technical and ethical limitations, a significant proportion of the research on depressive disorders cannot be performed on patients, but needs to be investigated in animal paradigms. Over the years, animal studies have provided new insight in the mechanisms underlying depression. Several of these studies have used PET imaging for the non-invasive and longitudinal investigation of the brain physiology. This review summarises the findings of preclinical PET imaging in different experimental paradigms of depression and compares these findings with observations from human studies. Preclinical PET studies in animal models of depression can be divided into three main different approaches: (a) investigation of glucose metabolism as a biomarker for regional and network involvement, (b) evaluation of the availability of different neuroreceptor populations associated with depressive phenotypes, and (c) monitoring of the inflammatory response in phenotypes of depression. This review also assesses the relevance of the use of PET imaging techniques in animal paradigms for the understanding of specific aspects of the depressive-like phenotypes, in particular whether it might contribute to achieve a more detailed characterisation of the clinical depressive phenotypes for the development of new therapies for depression.
Topics: Animals; Humans; Depressive Disorder, Major; Positron-Emission Tomography; Models, Animal; Phenotype; Brain; Disease Models, Animal
PubMed: 36642759
DOI: 10.1007/s00259-022-06073-4