Pharmacological Treatments for Unipolar Depression

2015 ◽  
Author(s):  
Stefania Prendes-Alvarez ◽  
Alan F. Schatzberg ◽  
Charles B. Nemeroff
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Age Of Onset ◽  
Treatment Options ◽  
Unipolar Depression ◽  
The United States ◽  
Major Depressive ◽  
Medical Disorders ◽  
Increased Risk ◽  
Dsm Iv

Major depressive disorder is a chronic syndrome associated with high mortality (secondary to suicide and increased risk for heart disease, stroke, and other serious diseases). It is one of the most common medical disorders affecting adults in the world today. In the United States, the lifetime prevalence of major depression is 16.7% for adults. The average age of onset is 32 years, and women are 70% more likely to develop depression than men. Neither the core requisite symptoms for the diagnosis of a major depressive episode nor the required duration of at least 2 weeks has changed from DSM-IV to DSM-5. This chapter discusses the main issues surrounding the treatment of major depressive disorder, such as suicidality and goals of treatment, and provides information about all treatment options approved by the U.S. Food & Drug Administration. Drugs are categorized by their mechanisms of action.

scholarly journals Lifetime prevalence and inter-cohort variation in DSM-IV disorders in metropolitan China

2006 ◽  
Vol 37 (1) ◽  
pp. 61-71 ◽  
Author(s):  
SING LEE ◽  
ADLEY TSANG ◽  
MING-YUAN ZHANG ◽  
YUE-QIN HUANG ◽  
YAN-LING HE ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Mental Disorders ◽  
Depressive Disorder ◽  
Age Of Onset ◽  
Lifetime Risk ◽  
Lifetime Prevalence ◽  
Major Depressive ◽  
Cross Sectional ◽  
Dsm Iv ◽  
Prospective Longitudinal

Background. This is the first study to examine variation across cohorts in lifetime risk of DSM-IV mental disorders in metropolitan China.Method. Face-to-face household interviews of 2633 adults in Beijing and 2568 adults in Shanghai were conducted from November 2001 to February 2002 using a multi-stage household probability sampling method. The Chinese World Mental Health (WMH) Survey Initiative version of the WHO Composite International Diagnostic Interview (WMH-CIDI) was used for assessment.Results. Lifetime prevalence of any disorder was 13·2%. Alcohol abuse (4·7%), major depressive disorder (3·5%), and specific phobia (2·6%) were the most common disorders. The median age of onset was later for mood (43 years) than anxiety (17 years) and substance use (25 years) disorders. Compared to observed lifetime prevalence, the projected lifetime risk as of age 75 years increased by 106% for major depressive disorder (7·2%), and was uniformly higher for all disorders. Relative odds of any lifetime disorder were 4·7 in the most recent cohorts (ages 18–34) compared to the eldest cohorts (ages [ges ]65).Conclusions. The findings of this cross-sectional study tally with the view that rapid socioeconomic changes may bring about increasing incidence of mental disorders in China. However, prospective longitudinal studies are needed to confirm if the increase is real. Because of the huge size of the Chinese population, any increase in projected lifetime risk of mental disorders represents an enormous increase in the number of affected individuals.

scholarly journals Reduced immunity to measles in adults with major depressive disorder

2018 ◽  
Vol 49 (2) ◽  
pp. 243-249 ◽  
Author(s):  
Bart N. Ford ◽  
Robert H. Yolken ◽  
Faith B. Dickerson ◽  
T. Kent Teague ◽  
Michael R. Irwin ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Age Of Onset ◽  
Solid Phase ◽  
Childhood Vaccination ◽  
Adult Onset ◽  
Major Depressive ◽  
Increased Risk ◽  
The Usa ◽  
Childhood Vaccines

AbstractBackgroundDepression can impair the immunogenicity of vaccine administration in adults. Whereas many vaccinations are administered in childhood, it is not known whether adolescent or adult onset depression is associated with impairments in the maintenance of protection of childhood vaccines. This study tested the hypothesis that individuals with adolescent or adult onset mood disorders would display compromised immunity to measles, a target of childhood vaccination.MethodsIgG antibodies to measles were quantified using a solid phase immunoassay in volunteers with bipolar disorder (BD, n = 64, mean age of onset = 16.6 ± 5.6), currently depressed individuals with major depressive disorder (cMDD, n = 85, mean age of onset = 17.9 ± 7.0), remitted individuals with a history of MDD (rMDD, n = 82, mean age of onset = 19.2 ± 8.6), and non-depressed comparison controls (HC, n = 202), all born after the introduction of the measles vaccine in the USA in 1963.ResultsRelative to HC, both the cMDD group (p = 0.021, adjusted odds ratios (OR) = 0.47, confidence interval (CI) = 0.24–0.90), and the rMDD group (p = 0.038, adjusted OR = 0.50, CI = 0.26–0.97) were less likely to test seropositive for measles. Compared with unmedicated MDD participants, currently medicated MDD participants had a longer lifetime duration of illness and were less likely to test seropositive for measles.ConclusionsIndividuals with adolescent or adult onset MDD are less likely to test seropositive for measles. Because lower IgG titers are associated with increased risk of measles infection, MDD may increase the risk and severity of infection possibly because of impaired maintenance of vaccine-related protection from measles.

Parents concordant for major depressive disorder and the effect of psychopathology in offspring

2001 ◽  
Vol 31 (7) ◽  
pp. 1211-1222 ◽  
Author(s):  
Y. NOMURA ◽  
V. WARNER ◽  
P. WICKRAMARATNE
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Psychiatric Disorders ◽  
Age Of Onset ◽  
Female Offspring ◽  
Major Depressive ◽  
Increased Risk ◽  
Clear Dose Response ◽  
Affected Parent ◽  
Parental Mating

Background. Concordance for major depressive disorder (MDD) between parents could happen for different reasons. Regardless of the origin and the frequency of the concordance, the effect on offspring of having two parents affected with MDD may be serious. The sex of the affected parent and offspring may also be a important risk factor for MDD in offspring.Methods. We examined the increased risk of psychopathology among offspring of the four parental mating groups: both parents affected with MDD (N = 53); only mother affected (N = 31); only father affected (N = 65); and, neither parents affected (N = 33). Parents and offspring were assessed by direct interview, conducted blind and independently of each other.Results. Among the four parental mating groups, offspring of both parents affected had the highest risk of MDD, anxiety disorder and alcohol dependence, and the earliest age of onset for MDD. There were two exceptions: the highest risk of conduct disorder and of drug dependence was in the groups where only the father was affected and where only the mother was affected, respectively. Mother's MDD was a stronger predictor of MDD in male compared to female offspring. Father's MDD was a stronger predictor of MDD in female compared to male offspring.Conclusion. Having two parents with MDD increases the risk of psychiatric disorders in offspring. A clear dose–response relationship between the number of affected parents and psychiatric disorders in offspring was observed. The sex of the affected parent and of the offspring is important in determining the risk to offspring. For an examination of the risk to psychopathology in offspring, diagnosis status of both parents should be considered.

scholarly journals Pharmacogenomics of antidepressants for major depressive disorder

2012 ◽  
Vol 1 (9) ◽  
pp. 222-224 ◽  
Author(s):  
Joel Martin ◽  
Kelly C. Lee
Keyword(s):  
United States ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Treatment Options ◽  
The United States ◽  
Primary Treatment ◽  
Major Depressive ◽  
Current Guidelines

Major depressive disorder (MDD) is a common disorder, affecting approximately 10% of adults in the United States each year. The primary treatment options for moderate to severe MDD are antidepressant medications, mainly selective serotonin reuptake inhibitors (SSRIs). Current guidelines recommend an initial trial of 4–8 weeks to determine if a medication is effective for a patient. Through the use of pharmacogenomics, it may be possible to predict whether patients will respond to and tolerate SSRIs. This article discusses several genes and alleles that may play a role in a patient's response to SSRIs.

scholarly journals The overlap of genetic susceptibility to schizophrenia and cardiometabolic disease can be used to identify metabolically different groups of individuals

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Rona J. Strawbridge ◽  
Keira J. A. Johnston ◽  
Mark E. S. Bailey ◽  
Damiano Baldassarre ◽  
Breda Cullen ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
European Ancestry ◽  
Cardiometabolic Disease ◽  
Metabolic Profiles ◽  
Genome Wide Association Studies ◽  
Uk Biobank ◽  
Major Depressive ◽  
Increased Risk

AbstractUnderstanding why individuals with severe mental illness (Schizophrenia, Bipolar Disorder and Major Depressive Disorder) have increased risk of cardiometabolic disease (including obesity, type 2 diabetes and cardiovascular disease), and identifying those at highest risk of cardiometabolic disease are important priority areas for researchers. For individuals with European ancestry we explored whether genetic variation could identify sub-groups with different metabolic profiles. Loci associated with schizophrenia, bipolar disorder and major depressive disorder from previous genome-wide association studies and loci that were also implicated in cardiometabolic processes and diseases were selected. In the IMPROVE study (a high cardiovascular risk sample) and UK Biobank (general population sample) multidimensional scaling was applied to genetic variants implicated in both psychiatric and cardiometabolic disorders. Visual inspection of the resulting plots used to identify distinct clusters. Differences between these clusters were assessed using chi-squared and Kruskall-Wallis tests. In IMPROVE, genetic loci associated with both schizophrenia and cardiometabolic disease (but not bipolar disorder or major depressive disorder) identified three groups of individuals with distinct metabolic profiles. This grouping was replicated within UK Biobank, with somewhat less distinction between metabolic profiles. This work focused on individuals of European ancestry and is unlikely to apply to more genetically diverse populations. Overall, this study provides proof of concept that common biology underlying mental and physical illness may help to stratify subsets of individuals with different cardiometabolic profiles.

Twelve-month prevalence and disability of DSM-IV bipolar disorder in an Australian general population survey

2004 ◽  
Vol 34 (5) ◽  
pp. 777-785 ◽  
Author(s):  
P. B. MITCHELL ◽  
T. SLADE ◽  
G. ANDREWS
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
National Survey ◽  
Large Scale ◽  
Well Being ◽  
Major Depressive ◽  
Co Morbidity ◽  
Dsm Iv ◽  
Days Out Of Role

Background. There have been few large-scale epidemiological studies which have examined the prevalence of bipolar disorder. The authors report 12-month prevalence data for DSM-IV bipolar disorder from the Australian National Survey of Mental Health and Well-Being.Method. The broad methodology of the Australian National Survey has been described previously. Ten thousand, six hundred and forty-one people participated. The 12-month prevalence of euphoric bipolar disorder (I and II) – similar to the euphoric-grandiose syndrome of Kessler and co-workers – was determined. Those so identified were compared with subjects with major depressive disorder and the rest of the sample, on rates of co-morbidity with anxiety and substance use disorders as well as demographic features and measures of disability and service utilization. Polychotomous logistic regression was used to study the relationship between the three samples and these dependent variables.Results. There was a 12-month prevalence of 0·5% for bipolar disorder. Compared with subjects with major depressive disorder, those with bipolar disorder were distinguished by a more equal gender ratio; a greater likelihood of being widowed, separated or divorced; higher rates of drug abuse or dependence; greater disability as measured by days out of role; increased rates of treatment with medicines; and higher lifetime rates of suicide attempts.Conclusions. This large national survey highlights the marked functional impairment caused by bipolar disorder, even when compared with major depressive disorder.

scholarly journals Validity and reliability of the Structured Clinical Interview for Mood Spectrum: Brazilian version (SCIMOODS-VB)

2011 ◽  
Vol 33 (1) ◽  
pp. 64-67 ◽  
Author(s):  
Roberto Ratzke ◽  
Doris Hupfeld Moreno ◽  
Clarice Gorenstein ◽  
Ricardo Alberto Moreno
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Intraclass Correlation ◽  
Unipolar Depression ◽  
Brazilian Portuguese ◽  
Clinical Interview ◽  
Stepwise Discriminant Analysis ◽  
Cutoff Score ◽  
Major Depressive

OBJECTIVE: The aim of this study was to translate the Structured Clinical Interview for Mood Spectrum into Brazilian Portuguese, measuring its reliability, validity, and defining scores for bipolar disorders. METHOD: Questionnaire was translated (into Brazilian Portuguese) and back-translated into English. Sample consisted of 47 subjects with bipolar disorder, 47 with major depressive disorder, 18 with schizophrenia and 22 controls. Inter-rater reliability was tested in 20 subjects with bipolar disorder and MDD. Internal consistency was measured using the Kuder Richardson formula. Forward stepwise discriminant analysis was performed. Scores were compared between groups; manic (M), depressive (D) and total (T) threshold scores were calculated through receiver operating characteristic (ROC) curves. RESULTS: Kuder Richardson coefficients were between 0.86 and 0.94. Intraclass correlation coefficient was 0.96 (CI 95 % 0.93-0.97). Subjects with bipolar disorder had higher M and T, and similar D scores, when compared to major depressive disorder (ANOVA, p < 0.001). The sub-domains that best discriminated unipolar and bipolar subjects were manic energy and manic mood. M had the best area under the curve (0.909), and values of M equal to or greater than 30 yielded 91.5% sensitivity and 74.5% specificity. CONCLUSION: Structured Clinical Interview for Mood Spectrum has good reliability and validity. Cut-off of 30 best differentiates subjects with bipolar disorder vs. unipolar depression. A cutoff score of 30 or higher in the mania sub-domain is appropriate to help make a distinction between subjects with bipolar disorder and those with unipolar depression.

Use of a Second Generation Antipsychotic among Patients Diagnosed with Major Depressive Disorder in the United States

2012 ◽  
Vol 26 (4) ◽  
pp. 235-241
Author(s):  
David A. Sclar ◽  
Linda M. Robison ◽  
Lawrence J. Cohen ◽  
Kimberly K. Laubmeier ◽  
Iftekhar D. Kalsekar ◽  
...  
Keyword(s):  
United States ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Second Generation ◽  
The United States ◽  
Major Depressive ◽  
Second Generation Antipsychotic
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