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Psychodynamic Psychiatry 2019
Topics: Depressive Disorder; Humans; Psychotherapy, Psychodynamic
PubMed: 31107167
DOI: 10.1521/pdps.2019.47.2.127 -
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 -
The Psychoanalytic Quarterly 2024This paper explores how the film illuminates psychoanalytic understandings of melancholia and mourning. The author attempts to unwind the complicated character of...
This paper explores how the film illuminates psychoanalytic understandings of melancholia and mourning. The author attempts to unwind the complicated character of melancholia, using Freud as an initial point of orientation, then relying on a few ideas from Klein and later writers. The paper attempts to refine our understanding of the difference between absence and emptiness, especially the difference between being captured in the nothing or deadness of melancholic emptiness, on the one hand, and being alive enough to suffer the absence of a lost object, which bears a potential for mourning, on the other. The possibility of psychic tension between these states is explored. Some implications of the relationship between absence and emptiness for the mourning process are considered. The author uses the film as a resource throughout.
Topics: Humans; Motion Pictures; Grief; Depressive Disorder; Psychoanalytic Theory; Psychoanalytic Interpretation; Freudian Theory; Psychoanalytic Therapy
PubMed: 38814151
DOI: 10.1080/00332828.2024.2345047 -
The Journal of Nervous and Mental... Sep 2019The old classification of depression as reactive and endogenous, which are still observed in clinical practice, both cannot be accommodated under the current rubric of... (Review)
Review
The old classification of depression as reactive and endogenous, which are still observed in clinical practice, both cannot be accommodated under the current rubric of major depression. This is because psychiatric nosology under the Diagnostic and Statistical Manual of Mental Disorders (DSM) and its latest fifth edition (DSM-V) is still descriptive and not etiologic. The aim of this review was to revisit reactive and endogenous categories of depression from the perspective of today's understanding of etiological pathways. From an epigenetic perspective, the old dichotomy of reactive versus endogenous is interrelated through the impact of the environment (e.g., stress). This includes familial or prenatal depression, where the environmental impact is before birth, or childhood depression, where the early life stress is the precipitating factor to genetic susceptibility. In conclusion, searching for both environmental impact (e.g., stressors) and genetic predispositions in depression, even at a clinical level, could help clinicians with better therapeutic decisions.
Topics: Adjustment Disorders; Depressive Disorder, Major; History, 20th Century; Terminology as Topic
PubMed: 31464986
DOI: 10.1097/NMD.0000000000000989 -
Tidsskrift For Den Norske Laegeforening... Mar 2020
Topics: Depressive Disorder; Grief; Humans
PubMed: 32238967
DOI: 10.4045/tidsskr.19.0504 -
Psychopharmacology Oct 2019As a species, humans are vulnerable to numerous mental disorders, including depression and schizophrenia. This susceptibility may be due to the evolution of our large,... (Review)
Review
RATIONALE
As a species, humans are vulnerable to numerous mental disorders, including depression and schizophrenia. This susceptibility may be due to the evolution of our large, complex brains, or perhaps because these illnesses counterintuitively confer some adaptive advantage. Additionally, cultural and biological factors may contribute to susceptibility and variation in mental illness experience and expression. Taking a holistic perspective could strengthen our understanding of these illnesses in diverse cultural contexts.
OBJECTIVES
This paper reviews some of these potential factors and contextualizes mental disorders within a biocultural framework.
RESULTS
There is growing evidence that suggests cultural norms may influence inflammation, neurotransmitters, and neurobiology, as well as the illness experience. Specific examples include variation in schizophrenia delusions between countries, differences in links between inflammation and emotion between the United States and Japan, and differences in brain activity between Caucasian and Asian participants indicating that cultural values may moderate cognitive processes related to social cognition and interoception.
CONCLUSIONS
Research agendas that are grounded in an appreciation of biocultural diversity as it relates to psychiatric illness represent key areas for truly interdisciplinary research that can result in culturally sensitive treatments and highlight possible biological variation affecting medical treatment.
Topics: Cross-Cultural Comparison; Depressive Disorder; Humans; Japan; Mental Disorders; Schizophrenia; Schizophrenic Psychology; United States; White People
PubMed: 30721322
DOI: 10.1007/s00213-019-5178-7 -
Issues in Mental Health Nursing Jan 2020
Topics: Depressive Disorder; Humans
PubMed: 31951802
DOI: 10.1080/01612840.2019.1685345 -
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 -
The American Journal of Psychiatry Dec 2021For many decades, psychiatric treatment has been primarily guided by two major paradigms of psychopathology: a neurochemical paradigm leading to the development of... (Review)
Review
For many decades, psychiatric treatment has been primarily guided by two major paradigms of psychopathology: a neurochemical paradigm leading to the development of medications and a psychological paradigm resulting in the development of psychotherapies. A third paradigm positing that psychiatric dysfunction results from abnormal communication within a network of brain regions that regulate mood, thought, and behavior has gained increased attention over the past several years and underlies the development of multiple neuromodulation and neurostimulation therapies. This neural circuit paradigm is not new. In the late 19th and early 20th centuries, it was a common way of understanding psychiatric illness and led to several of our earliest somatic therapies. However, with the rise of effective medications and evidence-based psychotherapies, this paradigm went mostly dormant. Its recent reemergence resulted from a growing recognition that medications and psychotherapy leave many patients inadequately treated, along with technological advances that have revolutionized our ability to understand and modulate the neural circuitry involved in psychiatric disorders. In this overview, the authors review the history and current state of neuromodulation for psychiatric illness and specifically focus on these approaches as a treatment for depression, as this has been the primary indication for these interventions over time.
Topics: Brain; Depressive Disorder, Major; Electroconvulsive Therapy; Humans
PubMed: 34855452
DOI: 10.1176/appi.ajp.2021.21101034 -
Therapeutische Umschau. Revue... Aug 2021Post stroke depression Post stroke depression is a common psychiatric disorder after a cerebrovascular insult. It effects the outcome of the rehabilitation after the...
Post stroke depression Post stroke depression is a common psychiatric disorder after a cerebrovascular insult. It effects the outcome of the rehabilitation after the stroke and leads to an increased mortality. The symptomatic description of the depressive symptoms is done according to the ICD-10 criteria. The following article aims to provide an overview of the etiologic theories, diagnostic approaches, and therapeutic strategies regarding PSD.
Topics: Depression; Depressive Disorder; Humans; Stroke
PubMed: 34291664
DOI: 10.1024/0040-5930/a001274