[BOOK] Manic-depressive illness: bipolar disorders and recurrent depression
FK Goodwin, KR Jamison - 2007 - books.google.com
Page 1. SECOND EDITION MANIC- DEPRESSIVE ILLNESS Bipolar Disorders and Recurrent
Depression FREDERICK K. GOODWIN d- KAY REDFIELD JAMISON Page 2. ...
Cited by 102 - Related articles - All 6 versions
Available online 17 October 2006.
Major depression is associated with reduced volumes in the hippocampus and prefrontal cortex, whereas antidepressant treatments promote several forms of neuronal plasticity, including neurogenesis, synaptogenesis and neuronal maturation, in the hippocampus. Several neurotrophic factors are associated with depression or antidepressant action. Stress suppresses brain-derived neurotrophic factor (BDNF) synthesis in the hippocampus, at least partially through a sustained modification of chromatin structure. Essentially all antidepressant treatments increase BDNF synthesis and signaling in the hippocampus and prefrontal cortex. This signaling is required for the behavioral effects of antidepressant drugs in rodents, and increased BDNF levels in the hippocampus mimic the behavioral effects of antidepressants. However, injection of BDNF into the mesolimbic dopamine pathway produces an opposing depression-like response. One hypothesis emerging from these data proposes that mood disorders reflect failed function of critical neuronal networks, whereas a gradual network recovery through activity-dependent neuronal plasticity induces the antidepressant effect. Neurotrophic factors themselves do not control mood, but they act as necessary tools in the activity-dependent modulation of networks, the physiological function of which determines how a plastic change influences mood.
NFLUENTIAL PUBLICATION
Assessing and Managing Depression in the Terminally Ill Patient
Susan D. Block, M.D. for the American College of Physicians–American Society of Internal Medicine End-of-Life Care Consensus PanelPsychological distress often causes suffering in terminally ill patients and their families and poses challenges in diagnosis and treatment. Increased attention to diagnosis and treatment of depression can improve the coping mechanisms of patients and families. This paper reviews the clinical characteristics of normal grief and clinical depression and explains strategies for differential diagnosis. Although some literature discusses the psychological issues facing elderly patients and terminally ill patients with cancer, less is known about patients with end-stage pulmonary, cardiac, renal, and neurologic disease. Data on the effectiveness of interventions in terminally ill patients are lacking. Treatment recommendations in this paper represent extrapolations from existing literature and expert opinion. Diagnosing and treating depression in terminally ill patients involve unique challenges. Evidence of hopelessness, helplessness, worthlessness, guilt, and suicidal ideation are better indicators of depression in this context than neurovegetative symptoms. Although terminally ill patients often have suicidalthoughts, they are usually fleeting. Sustained suicidal ideation should prompt a comprehensive evaluation. Clinicians should have a low threshold for treating depression in terminally ill patients. Psychostimulants, because of their rapid onset of action, are useful agents and are generally well tolerated. Selective serotonin reuptake inhibitors and tricyclic antidepressants may also be used. Psychological interventions—including eliciting concerns and conveying the potential for connection, meaning, reconciliation, and closure in the dying process—can also facilitate coping.
(Reprinted with permission from the Annals of Internal Medicine 2000;132:209–218
http://focus.psychiatryonline.org/cgi/content/abstract/3/2/310
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Cognitive Therapy vs Medications in the Treatment of Moderate to Severe Depression
Arch Gen Psychiatry. 2005;62:409-416.
WHOLE ARTICLE GLORY BE!!!!
here's the source: http://archpsyc.ama-assn.org/cgi/content/full/62/4/409
SEE P. 11 this is where I left off
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