Treatment of depressive disorders may involve psychopharmacology, psychotherapy, or both. Studies have shown that for mild depression, psychotherapy was more effective than placebo. For major depressive disorder (illness), psychopharmacologic treatment was more effective than psychotherapy alone. The most effective treatment with better long-term outcomes has been achieved with psychopharmacologic treatment combined with psychotherapy. Treatment of a depressive disorder must begin with a comprehensive evaluation ... Read More

Depressive disorder untreated can last 7 to 14 months and longer than 2 years. In the elderly, a pathological grieving process that has progressed to an episode of depressive illness may last 5 years or longer. Studies of the outcome of depressive episodes among psychiatric patients have shown rates of relapse that ranged from 5% to 52%. Some 15% to 67% of patients with depressive ... Read More

The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) enumerates a total of nine criteria for the diagnosis of major depressive disorder; two are required and another five of the remaining seven are necessary to make the diagnosis. Studies summarized in the first section of this article have reported on the presence of four types of depressive disorders in the elderly. These ... Read More

Major depressive disorder occurs throughout the life cycle. Longitudinal data suggest a changing pattern in the age of onset in the United States. In more recent birth cohorts, the rates of major depression were higher and the age of onset was younger. The lifetime prevalence rates for major depression per 100 population were determined in five US cities by the Epidemiologic Catchment Area Survey (ECA). ... Read More

The following is the question and answer session from the Depression and Psychosis: Improving Outcomes. The presenters were Richard G. Petty, M.D., and Jack M. Gorman, M.D. Question: What's the latest on quetiapine and slit lamp examinations? Dr. Petty: As many of you will know, quetiapine was associated with the development of cataracts in dogs during the clinical studies and there have also been case reports of humans getting cataracts. My own ... Read More

(Country: Canada) Psychiatric Problems in Children Tranquillizers have been used to a moderate degree in the treatment of similar psychiatric conditions in children, as in the anxiety reactions and the associated somatic symptoms. They are also of value in childhood schizophrenia. Promethazine has been a particularly helpful drug with very minimal side effects. Promazine and thioridazine have proved to have a similar function. Children who have such problems as speech defects, enuresis, ... Read More

(Country: Canada) Miscellaneous Group The drugs in the miscellaneous group which are most widely used are meprobamate and Librium. Meprobamate is marketed under the trade names of Equanil, Miltown and Tranquiline. It has presented minimal toxic effects but has been misused by many people prone to drug addiction. The drug is essentially an effective medication for anxiety reactions but should be avoided, or at least used with considerable caution, in individuals with character ... Read More

(Country: Canada) A healthy controversy continues to be manifested in the field of psychiatry concerning the use of drug therapy. This controversy is related to the following factors: (a) The complexity of new drugs and the multiplicity of drugs offered from month to month to the physician. (b) The difficulty in determining the effect of the drug as distinct from the psychological influence of placebo administration. (c) The pressure on the ... Read More

In clinical practices and research program we have commonly observed dual diagnoses in patients with serious disorders of alcohol or other substance abuse. One of the most frequently encountered comorbid psychologic disorders is depression. Although depression can be associated with alcohol or substance abuse as an antecedent or a consequence most of the current literature on cocaine appears to focus on depression as a consequence. Clearly, depression is a known and ... Read More

Special problems The early detection of depression is much more complex and challenging than the detection of other conditions seen in the primary care physician's office. Perhaps the most significant reason for this is how the natural history of depression differs from that of most conditions for which there are effective measures for prevention or early detection. The successful early detection of diseases or of ... Read More