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Acta Psychiatrica Scandinavica.... 2007There is a general clinical impression that depression differs qualitatively from non-depressive conditions, and that it can be identified as a categorical entity. In... (Review)
Review
OBJECTIVE
There is a general clinical impression that depression differs qualitatively from non-depressive conditions, and that it can be identified as a categorical entity. In contrast, epidemiological studies support the view that depression is dynamic in nature and develops on a continuous scale. The present article reviews selected epidemiological studies of depressive subtypes.
METHOD
A selective review.
RESULTS
Prior studies have found no clear differences in clinical presentation or long-term outcome between patients with melancholic and with neurotic/reactive depression. In addition, recent studies suggest that there is no clear demarcation between mild, moderate, and severe depression, pointing toward a continuity rather than categories of illness. For the individual patient, depressive symptoms seem to change over time, fulfilling criteria for major depression, minor depression, dysthymia, and subsyndromal states; the association between stressful life events and depression appears to diminish with the number of depressive episodes. Finally, recent genetic findings are congruent with a model indicating that the majority of depressions develop in the interplay between genes and stressful experiences, whereas 'reactive' depressions and 'endogenous' depressions apparently exist at a lower prevalence.
CONCLUSION
Further longitudinal, analytical, and genetic epidemiologic studies are needed to reveal which conditions are mild and transient, and which may be precursors of more severe and substantial illness such as melancholia.
Topics: Depression; Depressive Disorder; Depressive Disorder, Major; Diagnosis, Differential; Dysthymic Disorder; Humans; Severity of Illness Index
PubMed: 17280574
DOI: 10.1111/j.1600-0447.2007.00966.x -
American Family Physician May 2004Depression in elderly persons is widespread, often undiagnosed, and usually untreated. The current system of care is fragmented and inadequate, and staff at residential... (Review)
Review
Depression in elderly persons is widespread, often undiagnosed, and usually untreated. The current system of care is fragmented and inadequate, and staff at residential and other facilities often are ill-equipped to recognize and treat patients with depression. Because there is no reliable diagnostic test, a careful clinical evaluation is essential. Depressive illness in later life should be treated with antidepressants that are appropriate for use in geriatric patients. A comprehensive, multidisciplinary approach, including consideration of electroconvulsive treatment in some cases, is important. The overall long-term prognosis for elderly depressed patients is good.
Topics: Aged; Antidepressive Agents; Comorbidity; Depression; Depressive Disorder; Electroconvulsive Therapy; Female; Geriatric Assessment; Humans; Male; Psychological Techniques; Psychological Tests
PubMed: 15168957
DOI: No ID Found -
Epilepsy & Behavior : E&B Dec 2003Depressive disorders (DDs) are frequent psychiatric comorbidities of neurological disorders like multiple sclerosis, stroke, dementia, migraine, Parkinson's disease, and... (Review)
Review
Depressive disorders (DDs) are frequent psychiatric comorbidities of neurological disorders like multiple sclerosis, stroke, dementia, migraine, Parkinson's disease, and epilepsy. The clinical manifestations of DDs in these neurological disorders are identical to those of idiopathic mood disorders. In epilepsy, however, DDs can frequently also present with clinical characteristics that differ from those of idiopathic depression and fail to meet the criteria included in the Diagnostic and Statistical Manual of Psychiatric Disorders-Fourth Edition. Despite their multifaceted clinical expressions and their relatively high prevalence in epilepsy, DDs very often go unrecognized and untreated. The aim of this article is to review some of the more relevant aspects of DDs in epilepsy, to highlight their various clinical expressions, and their impact on the quality of life of patients with epilepsy, and to review the basic principles of treatment.
Topics: Depression; Depressive Disorder; Epilepsy; Humans; Quality of Life
PubMed: 14654423
DOI: 10.1016/j.yebeh.2003.10.004 -
Zeitschrift Fur Gerontologie Und... May 2024
Topics: Humans; Aged; Aged, 80 and over; Male; Female; Germany; Depressive Disorder; Depression
PubMed: 38717489
DOI: 10.1007/s00391-024-02306-3 -
The New England Journal of Medicine May 2024
Topics: Humans; Depression; Depressive Disorder; Mass Screening; Prevalence; Primary Health Care; Suicide
PubMed: 38692291
DOI: 10.1056/NEJMp2310179 -
Journal of Affective Disorders Oct 2013Depressive disorders are disabling conditions striking at all ages. In adults, subthreshold depression (SD) is viewed as being on a continuum with major depressive... (Review)
Review
BACKGROUND
Depressive disorders are disabling conditions striking at all ages. In adults, subthreshold depression (SD) is viewed as being on a continuum with major depressive disorder (MDD). Whether this holds for children and adolescents, is still unclear. We performed the first systematic review of SD in subjects below 18 years, in order to explore if childhood SD and MDD share causal pathways, phenomenology and outcomes, supporting a dimensional view.
METHODS
A critical systematic review in accordance with preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. A review protocol was developed a priori, and all reports were assessed by two reviewers.
RESULTS
The literature search generated 941 eligible references and 24 studies were included. Although diagnostic criteria for SD showed great variability, similarities for SD and MDD were striking. Both were common conditions with similar risk factor patterns. Clinical characteristics in both groups were depressed mood, suicidal ideation and high comorbidity. Outcomes were almost equally poor, with increased psychiatric morbidity and health service use. SD intervention studies showed promising results.
LIMITATIONS
Reports with data on SD not reported in keywords or abstract may have been missed by the search strategy.
CONCLUSION
A dimensional view of depressive disorders is also supported in children and adolescents, suggesting SD to be a precursor to MDD. Although SD is a somewhat milder condition than MDD, it has severe outcomes with psychopathology and impairment. There is a need of identifying cost-efficient and longlasting interventions in order to prevent development of early SD into MDD.
Topics: Adolescent; Child; Child, Preschool; Depression; Depressive Disorder; Depressive Disorder, Major; Humans; Prevalence
PubMed: 23856281
DOI: 10.1016/j.jad.2013.06.010 -
CMAJ : Canadian Medical Association... Jun 1990The overall prevalence of depression is from 3.5% to 27%. The burden of suffering is high and includes death through suicide. In most cases treatment is effective, but... (Review)
Review
The overall prevalence of depression is from 3.5% to 27%. The burden of suffering is high and includes death through suicide. In most cases treatment is effective, but important episodes of depression are being missed. To determine whether a brief, systematic assessment for the early detection of depression should be part of the periodic health examination we searched MEDLINE and the Science Citation Index for randomized controlled trials that evaluated the effectiveness of early detection of depression with a questionnaire. Seven instruments met our quality criteria; the Beck Depression Inventory, the Center for Epidemiologic Studies Depression Scale, the Zung Self-Assessment Depression Scale, the General Health Questionnaire, the Hopkins Symptom Checklist, the Mental Health Inventory and the Hospital Anxiety and Depression Scale. The four randomized controlled trials failed to provide adequate evidence of the benefit of routine screening. Early detection is difficult because of depression's natural history, the role of symptoms, the cultural diversity of Canada and how detection instruments have been developed. Depression deserves careful attention from primary care physicians; however, further research and development is required before the widespread routine use of any detection test can be recommended.
Topics: Adult; Depression; Depressive Disorder; Female; Humans; Male; Middle Aged; Personality Tests; Physicians, Family; Time Factors
PubMed: 2188720
DOI: No ID Found -
Clinical Excellence For Nurse... May 1999Elderly depression is a common problem seen in primary care in the United States. Unfortunately, primary care practitioners often do not recognize or diagnosis... (Review)
Review
Elderly depression is a common problem seen in primary care in the United States. Unfortunately, primary care practitioners often do not recognize or diagnosis depression in the older population. There are serious negative consequences for the elder whose depression remains untreated. Depression in the elderly has a unique presentation, different from that in the younger population. This article presents information on assessment and differential diagnosis of the depressed elder. The clinical interview is the key piece in the assessment process. Laboratory screening is one part of the diagnostic process that can detect physiologic changes related to depression. An overview of the Agency for Health Care Policy and Research guidelines on diagnosing depression in primary care is presented.
Topics: Aged; Depression; Depressive Disorder; Diagnosis, Differential; Geriatric Assessment; Humans; Interview, Psychological; Nurse Practitioners; Nursing Assessment; Practice Guidelines as Topic; Primary Health Care; Risk Factors
PubMed: 10646410
DOI: No ID Found -
Psychopharmacology 1992Though the concept of Major Depression was generated by clinicians using depressed inpatients as models, a polydiagnostic study in 600 psychiatric inpatients with... (Review)
Review
Though the concept of Major Depression was generated by clinicians using depressed inpatients as models, a polydiagnostic study in 600 psychiatric inpatients with heterogenous psychological disturbances revealed that all six competing operational definitions of Major Depression (including DSM-III-R and ICD-10) were too restrictive to serve as a general concept of depression. Another polydiagnostic study in 500 primary care outpatients showed that more than two-thirds of all non-chronic depressed cases were below the severity threshold of Major Depression: these patients are classified as Depression Not Otherwise Specified (NOS) by DSM-III-R. Loosening of the over-restrictive time criteria would broaden the concept of Major Depression so as to meet the requirements of a general concept of depression, while the definition of Minor Depression below the threshold of Major Depression would add to a reduction of cases of NOS Depression by more than 80%. For the evaluation of antidepressant drugs in outpatient samples, we propose that patients with these modified definitions of Major and Minor Depression be included, provided they meet a minimum severity criterion of 13 or more points on the Hamilton Depression Scale; four-fifths of the modified Major Depression group and one-third of the Minor Depression group do in fact meet this criterion.
Topics: Depression; Depressive Disorder; Diagnosis, Differential; Humans
PubMed: 1546147
DOI: 10.1007/BF02246241 -
Revista de Enfermeria (Barcelona, Spain) Apr 2000To review the recent advances made in evaluation and treatment procedures in cases of depression and their repercussions in nursing care. The growing efficiency of... (Review)
Review
OBJECTIVES
To review the recent advances made in evaluation and treatment procedures in cases of depression and their repercussions in nursing care. The growing efficiency of antidepressive medication, together with the importance given to community awareness of the upheavals which affect mental health, have modified the role nursing plays in evaluation of patients suffering depressive episodes. In this changing context, the therapeutic relationship between nurse and patient has developed into one of the pillars which sustain a correct and long-lasting stability in the depressed patient's state of mind.
SOURCES
Primary source information on treatment methods by nurses handling depressed patients published from 1995 through 1999 and identified in the Medline data base. In a second article, these same authors will evaluate the intervention and the follow-up procedures carried out by nurses caring for patients suffering from depression.
Topics: Antidepressive Agents; Depression; Depressive Disorder; Humans; Nurse-Patient Relations; Nursing Assessment; Psychiatric Nursing
PubMed: 10909355
DOI: No ID Found