DepressionPub Date : 2019-10-01DOI: 10.1093/med/9780190929565.003.0020
C. Rethorst
{"title":"Exercise as a Treatment for Depression","authors":"C. Rethorst","doi":"10.1093/med/9780190929565.003.0020","DOIUrl":"https://doi.org/10.1093/med/9780190929565.003.0020","url":null,"abstract":"Beginning with epidemiological evidence and moving to randomized controlled trials, researchers have established evidence supporting the effectiveness of exercise in the treatment of depression. This chapter will provide an overview of the benefits of exercise for patients with depression, discuss the challenges clinicians face in using exercise as a treatment in clinical practice, and provide practical advice on exercise prescription. The chapter concludes with a discussion of areas of need for future research, focusing on three areas: identifying strategies to ensure patient adherence with exercise prescriptions, identifying predictors of treatment response that will facilitate a personalized medicine approach to exercise prescription, and the use of exercise as a complementary agent with other depression treatments.","PeriodicalId":11179,"journal":{"name":"Depression","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83198879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
DepressionPub Date : 2019-10-01DOI: 10.1093/med/9780190929565.003.0006
Carly W Yasinski, Bonnie Seifert, Callan M. Coghlan, B. Rothbaum
{"title":"Anxiety Disorders","authors":"Carly W Yasinski, Bonnie Seifert, Callan M. Coghlan, B. Rothbaum","doi":"10.1093/med/9780190929565.003.0006","DOIUrl":"https://doi.org/10.1093/med/9780190929565.003.0006","url":null,"abstract":"This chapter discusses the similarities, differences, and comorbidities between depression and anxiety disorders broadly defined, including generalized anxiety disorder, social anxiety disorder, specific phobias, panic disorder, obsessive-compulsive disorder, and post-traumatic stress disorder. The high level of comorbidity between anxiety disorders and depression is explicated, and the negative consequences of this comorbidity, including higher severity, functional impairment, and worse response to treatment, are discussed. Major theoretical models for differentiating anxiety and depression, including the tripartite model, the integrative hierarchical model, and the quadripartite model, are explained. Translational research, including neurological, psychophysiological, and genetic underpinnings of the similarities and differences between anxiety and depression, is reviewed. The chapter concludes with broad treatment implications and recommendations.","PeriodicalId":11179,"journal":{"name":"Depression","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74873154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
DepressionPub Date : 2019-10-01DOI: 10.1093/MED/9780190929565.003.0003
T. Halldorsdottir, H. Hilmarsdóttir
{"title":"Genetic Risk Factors of Depression","authors":"T. Halldorsdottir, H. Hilmarsdóttir","doi":"10.1093/MED/9780190929565.003.0003","DOIUrl":"https://doi.org/10.1093/MED/9780190929565.003.0003","url":null,"abstract":"Research on the genetic underpinnings of depression has rapidly advanced in the past decade. This field of research provides a promising avenue toward improving the diagnosis of, prevention of, and treatment for this devastating disorder. The goal of this chapter is to review the main genetic and gene-by-environment interaction findings on depression. We first describe family and twin studies used to empirically study the familial aggregation of depression. Second, we provide a review of the genome-wide association studies (GWAS) published to date. Building on GWAS findings, we will discuss the use of polygenic risk scores in predicting depression. We also review the most robust candidate gene studies and gene-by-environment interaction studies. Finally, we discuss the clinical implications of the findings and promising strategies for making further progress within this field.","PeriodicalId":11179,"journal":{"name":"Depression","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73763170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
DepressionPub Date : 2019-10-01DOI: 10.1093/med/9780190929565.003.0004
Katherine Sanchez, E. P. Sánchez
{"title":"Environmental and Social Risk Factors in Depression","authors":"Katherine Sanchez, E. P. Sánchez","doi":"10.1093/med/9780190929565.003.0004","DOIUrl":"https://doi.org/10.1093/med/9780190929565.003.0004","url":null,"abstract":"An understanding of the social and environmental factors that contribute to risk for developing depression is important for illustrating the potential for primary prevention and identification of target groups and social contexts. The social determinants are thought to impact health indirectly through mechanisms such as stress associated with low socioeconomic status, experiences of disempowerment and violence, hopelessness, helplessness, and income insecurity. They impact health more directly through reduced access to health services for physical and mental health problems. Evidence from neurobiology and epidemiology suggests that early life stress and related adverse experiences cause enduring brain dysfunction and are a significant risk factor for the development and prevalence of a wide range of health problems throughout a person’s lifespan, including substance misuse/abuse, depression, and obesity. The practicing psychiatrist will be a better clinician by delivering evidence-based clinical care that is informed by individuals’ burden of social and environmental factors and by understanding and, in some instances, advocating for policies that can ease the burden of social determinants on populations.","PeriodicalId":11179,"journal":{"name":"Depression","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89870455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
DepressionPub Date : 2019-10-01DOI: 10.1093/med/9780190929565.003.0028
Robert S. Kinney, Radu Pop
{"title":"Primer on Depression","authors":"Robert S. Kinney, Radu Pop","doi":"10.1093/med/9780190929565.003.0028","DOIUrl":"https://doi.org/10.1093/med/9780190929565.003.0028","url":null,"abstract":"Depression is a commonly occurring illness in the general population. Existing systems for identifying and treating depression vary greatly, and the adoption of a universal, standardized method of addressing the disorder within primary care is lacking. New guidelines and recommendations by accrediting bodies have resulted in the development of some initiatives and the increased recognition of depression, yet treatments continue to rely on referrals to specialty psychiatric care providers. Given that primary care may be the only point of health care access for many individuals, this serves as an opportune setting to initiate treatment at the time that depression screening is completed. With adequate support, guidance, and a systemic approach (i.e., measurement-based care), primary care providers can be as effective as psychiatric specialty care in treating depression. This chapter providers evidence for this approach, along with direct recommendations to primary care providers.","PeriodicalId":11179,"journal":{"name":"Depression","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84142646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
DepressionPub Date : 2019-10-01DOI: 10.1093/med/9780190929565.003.0011
M. Jha
{"title":"First-Line and Combination Therapeutics for Major Depressive Disorder","authors":"M. Jha","doi":"10.1093/med/9780190929565.003.0011","DOIUrl":"https://doi.org/10.1093/med/9780190929565.003.0011","url":null,"abstract":"Major depressive disorder (MDD) affects one in five adults during their lifetime. Patients with MDD and their clinicians have a multitude of options to select for management of this chronic and/or recurrent condition. Selection of treatment modalities may be guided by the severity of illness. Nonpharmacologic treatments such as psychotherapy or exercise may be considered for those with mild symptom severity, with pharmacologic treatment reserved for those with moderate or higher symptom severity. Severe or very severe depression may warrant the combination of both pharmacologic and psychotherapeutic treatments. In patients who fail to improve adequately with one or more first-line treatments, augmentation with second-generation antipsychotics should be considered. There currently are no objective markers to guide the selection of one first-line treatment over other. Exciting ongoing research in the field of depression may inform new methods to personalize treatment selection and potentially lead to the development of mechanistically novel antidepressants.","PeriodicalId":11179,"journal":{"name":"Depression","volume":"111 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80576014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
DepressionPub Date : 2019-10-01DOI: 10.1093/med/9780190929565.003.0026
Nikita Patel, Emily B. Kroska, Z. Stowe
{"title":"Postpartum Depression","authors":"Nikita Patel, Emily B. Kroska, Z. Stowe","doi":"10.1093/med/9780190929565.003.0026","DOIUrl":"https://doi.org/10.1093/med/9780190929565.003.0026","url":null,"abstract":"Perinatal care, including the management of mental health issues, is often under the auspices of primary care providers. This chapter provides an overview of identification, diagnosis, and treatment of postpartum depression (PPD). It reviews the prevalence of PPD in the general and minority populations, related disorders, common symptoms, and genetic and psychosocial risk factors to facilitate PPD management in the primary care clinic. The most commonly employed screening scale, the Edinburgh Postnatal Depression Scale, has several advantages in the primary care setting. The potential adverse consequences of untreated PPD on the mother and her family underscore the importance of identifying and providing effective interventions, including preventive strategies, in high-risk groups. As a class, antidepressant medications have amassed a large reproductive safety literature, including considerable data in breastfeeding and women with PPD. Notably, psychosocial therapies have demonstrated equal efficacy in women with PPD and are viable treatment options.","PeriodicalId":11179,"journal":{"name":"Depression","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75992299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
DepressionPub Date : 2019-10-01DOI: 10.1093/med/9780190929565.003.0023
R. Lam
{"title":"Chronobiological Treatments","authors":"R. Lam","doi":"10.1093/med/9780190929565.003.0023","DOIUrl":"https://doi.org/10.1093/med/9780190929565.003.0023","url":null,"abstract":"Chronobiology is the study of circadian rhythms that are present in many aspects of our daily health, from molecular to behavioral levels. Bright environmental light is known to synchronize the biological clock in the brain that regulates circadian hormonal and sleep–wake cycles. There is increasing evidence for disruption of circadian rhythms in the pathophysiology of major depressive disorder (MDD), especially in seasonal affective disorder (SAD). Chronobiological treatments that target the circadian system, including wake therapy (total sleep deprivation) and light therapy, have been studied for over four decades, with evidence supporting their efficacy in SAD and non-seasonal MDD, as well as in other psychiatric conditions. Wake and light therapies are useful additions to the clinical armamentarium for patients with MDD because of their noninvasive nature, low propensity for adverse events, rapid onset of effect, low cost, and ease of combining with other treatments for depression.","PeriodicalId":11179,"journal":{"name":"Depression","volume":"132 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80011633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
DepressionPub Date : 2019-10-01DOI: 10.1093/med/9780190929565.003.0001
M. Trivedi, T. Greer, T. Mayes
{"title":"Primer on Depression","authors":"M. Trivedi, T. Greer, T. Mayes","doi":"10.1093/med/9780190929565.003.0001","DOIUrl":"https://doi.org/10.1093/med/9780190929565.003.0001","url":null,"abstract":"Major depressive disorder (MDD) is a serious, debilitating, life-shortening illness that affects many persons of all ages and backgrounds. The point prevalence of MDD is high (2.3–3.2% in men; 4.5–9.3% in women) and the lifetime risk for MDD is 7% to 12% for men and 20% to 25% for women. MDD is a disabling disorder that costs the United States over $200 billion per year in direct and indirect costs. Depression also has detrimental effects on all aspects of social functioning (e.g., self-care, social role, and family life, including household, marital, kinship, and parental roles). While there have been several treatments that are efficacious, many individuals suffering from depression experience lifelong challenges due to the often chronic and episodic nature of the disease. Identifying strategies to find the right treatments for the right patients is critical.","PeriodicalId":11179,"journal":{"name":"Depression","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75504326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
DepressionPub Date : 2019-10-01DOI: 10.1093/med/9780190929565.003.0027
C. Cullum, C. Munro
{"title":"Depression Following Mild Traumatic Brain Injury","authors":"C. Cullum, C. Munro","doi":"10.1093/med/9780190929565.003.0027","DOIUrl":"https://doi.org/10.1093/med/9780190929565.003.0027","url":null,"abstract":"Interest in concussion and traumatic brain injury (TBI) has increased to an all-time high due to recent media attention and public awareness. Mild TBI (mTBI), or concussion, is the most common, accounting for roughly 75% to 90% of all TBIs. Although symptoms vary, typical neurobehavioral domains affected in TBI include physical, cognitive, sleep, and emotional. Whereas the vast majority of people at all ages recover well from mTBI, risk factors and mechanisms for prolonged recovery and so-called post-concussion syndrome remain poorly understood. Nevertheless, detection and treatment of symptoms are important in order to facilitate recovery, as psychological factors may complicate or exacerbate the clinical picture. Post-mTBI depressive symptoms have multifactorial determinants, reflecting a complex neurobiopsychosocial condition.","PeriodicalId":11179,"journal":{"name":"Depression","volume":"140 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80015457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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