Depressive Disorders: Update on Diagnosis, Etiology, and Treatment

2018 ◽  
Author(s):  
Isabelle E. Bauer ◽  
Antonio L Teixeira ◽  
Marsal Sanches ◽  
Jair C. Soares

This review discusses the changes in the diagnostic criteria for depressive disorders as outlined in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), and recent findings exploring the etiology of and treatment strategies for these disorders. Depressive disorders are typically characterized by depression in the absence of a lifetime history of mania or hypomania. New developments in the DSM-5 include the recognition of new types of depressive disorders, such as disruptive mood dysregulation disorder, persistent depressive disorder, premenstrual dysphoric disorder, and the addition of catatonic features as a specifier for persistent depressive disorder. These diagnostic changes have important implications for the prognosis and treatment of this condition. A thorough understanding of both the clinical phenotype and the biosignature of these conditions is essential to provide individualized, long-term, effective treatments to affected individuals.  This review contains 1 table and 52 references Key words: brain volumes, depressive disorders, DSM-5, hormones, inflammation, neuropeptides, somatic therapy, stress

2018 ◽  
Author(s):  
Isabelle E. Bauer ◽  
Antonio L Teixeira ◽  
Marsal Sanches ◽  
Jair C. Soares

This review discusses the changes in the diagnostic criteria for depressive disorders as outlined in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), and recent findings exploring the etiology of and treatment strategies for these disorders. Depressive disorders are typically characterized by depression in the absence of a lifetime history of mania or hypomania. New developments in the DSM-5 include the recognition of new types of depressive disorders, such as disruptive mood dysregulation disorder, persistent depressive disorder, premenstrual dysphoric disorder, and the addition of catatonic features as a specifier for persistent depressive disorder. These diagnostic changes have important implications for the prognosis and treatment of this condition. A thorough understanding of both the clinical phenotype and the biosignature of these conditions is essential to provide individualized, long-term, effective treatments to affected individuals.  This review contains 1 table and 52 references Key words: brain volumes, depressive disorders, DSM-5, hormones, inflammation, neuropeptides, somatic therapy, stress


2018 ◽  
Author(s):  
Isabelle E. Bauer ◽  
Antonio L Teixeira ◽  
Marsal Sanches ◽  
Jair C. Soares

This review discusses the changes in the diagnostic criteria for depressive disorders as outlined in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), and recent findings exploring the etiology of and treatment strategies for these disorders. Depressive disorders are typically characterized by depression in the absence of a lifetime history of mania or hypomania. New developments in the DSM-5 include the recognition of new types of depressive disorders, such as disruptive mood dysregulation disorder, persistent depressive disorder, premenstrual dysphoric disorder, and the addition of catatonic features as a specifier for persistent depressive disorder. These diagnostic changes have important implications for the prognosis and treatment of this condition. A thorough understanding of both the clinical phenotype and the biosignature of these conditions is essential to provide individualized, long-term, effective treatments to affected individuals.  This review contains 6 table and 53 references Key words: brain volumes, depressive disorders, DSM-5, hormones, inflammation, neuropeptides, somatic therapy, stress


2018 ◽  
Author(s):  
Isabelle E. Bauer ◽  
Antonio L Teixeira ◽  
Marsal Sanches ◽  
Jair C. Soares

This review discusses the changes in the diagnostic criteria for depressive disorders as outlined in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), and recent findings exploring the etiology of and treatment strategies for these disorders. Depressive disorders are typically characterized by depression in the absence of a lifetime history of mania or hypomania. New developments in the DSM-5 include the recognition of new types of depressive disorders, such as disruptive mood dysregulation disorder, persistent depressive disorder, premenstrual dysphoric disorder, and the addition of catatonic features as a specifier for persistent depressive disorder. These diagnostic changes have important implications for the prognosis and treatment of this condition. A thorough understanding of both the clinical phenotype and the biosignature of these conditions is essential to provide individualized, long-term, effective treatments to affected individuals.  This review contains 1 table and 52 references Key words: brain volumes, depressive disorders, DSM-5, hormones, inflammation, neuropeptides, somatic therapy, stress


2020 ◽  
Author(s):  
Mulugeta Gobena Tadesse ◽  
Dereje Dirago Dire ◽  
Yacob Yacob Abraham

Abstract Background: Premenstrual dysphoric disorder (PMDD)-is a severe and disabling form of premenstrual Syndrome affecting 3-8% of menstruating women. The disorder consists of a cluster of affective, behavioral and somatic symptoms that recur monthly during the luteal phase the menstrual cycle. Premenstrual dysphoric disorder (PMDD) was added to the list of depressive disorders in the diagnostic and statistical manual of mental disorders in 2013. The exact pathogenesis of the disorder is still unclear.Objective: To assess the prevalence of PMDD and its associated factors among students of Hawassa tabor secondary and preparatory school.Method: A cross sectional institutional based was conducted among 351 randomly selected female students of Hawassa tabor school. Data was collected by three students were facilitate the works with closed ended structured questionnaire and they was trained on how to collect the data. The collected data was entered, analyzed and cleaned by SPS.Results: prevalence of premenstrual dysphoric disorder in this study was 76.9%. Of each symptom is more than ninety present or 324 (92.3%) respondents can’t have experience unpleasant physical or emotional symptoms peculiar to the five days before the onset of menses & 27(7.7%) participants have show the symptoms. Among those 26 (7.4%) have present for the past ≥3 consecutive cycles. 46 (13.1%) have family history of such symptoms.Conclusions: These findings have implications for both women and medical providers, who should be aware that PMS symptoms are prevalent and often distressing, yet also understand that the severity of symptoms may remit over time.


Depression ◽  
2018 ◽  
pp. 23-34
Author(s):  
Raymond W. Lam

The core clinical features of depression include physical (sleep and appetite disturbances, psychomotor changes, fatigue, low energy), emotional (sadness, loss of interest, anhedonia), and cognitive (guilt, suicidal thoughts and behaviours, concentration and memory difficulties, indecisiveness) symptoms. DSM-5 classifies depressive disorders in adults as major depressive disorder (MDD), other depressive disorders, and persistent depressive disorder; the latter includes chronic MDD, unremitted MDD, and dysthymia (chronic, low-grade depressive symptoms). DSM-5 also includes specifiers, or sub-types, of MDD that have implications for prognosis and treatment choice and selection. The differential diagnosis of depression includes bereavement, bipolar disorder, and other medical or substance-induced conditions.


Author(s):  
Daniel N. Klein ◽  
Sarah R. Black

Over the past few decades, there has been increasing recognition of the problem of persistent, or chronic, depression. Chronic depressions account for up to a third of the cases of depression in the community and half the cases in clinical practice. Moreover, as reflected in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), persistent depressive disorder differs in many significant respects from nonpersistent depression. This chapter provides an overview of the current literature on persistent depression, starting with classification, epidemiology, and course. Psychosocial and neurobiological risk factors, including early adversity, genetics, personality/temperament, cognitive style, interpersonal difficulties, neural abnormalities, and chronic stress, are then reviewed. Next, we discuss psychopharmacological and psychotherapeutic interventions for acute and continuation/maintenance treatment of persistent depression. We conclude with suggestions for future research.


The field of psychiatry is rapidly evolving, specifically in the areas of psychopharmacology, psychotherapeutic strategies, and the classification of many major psychiatric disorders with the implementation of the Diagnostic and Statistical Manual of Mental Disorders: DSM-5 in 2013. A new board review textbook is imperative to address these changes in order to prepare board-eligible psychiatrists for the certification examination as well as for clinical practice in general. Additionally, the American Board of Psychiatry and Neurology is in the process of phasing in the DSM-5 criteria to the board examination, such that by 2017 the examination material will exclusively reflect the new manual. The book is aimed primarily at board-eligible psychiatrists preparing for their Initial certification in psychiatry. It will be a useful study tool for psychiatrists renewing certification as well, which in the United States is required every ten years. Furthermore the text will also be a useful reference for all psychiatrists in clinical practice to familiarize themselves with the new diagnostic classifications of DSM-5, the latest psychopharmacologic treatment strategies, and psychotherapeutic techniques.


Author(s):  
Peter Zachar ◽  
Kenneth S. Kendler

Chapter 41 discusses a kind of in vivo case study of the interactions between science and extra-scientific processes involved in the construction of nosological categories of psychiatry. The very first medical report on a cluster of symptoms, regularly affecting some women over their menstrual cycle, the so-called syndrome of premenstrual tension, appeared in 1931. The name changed with time to premenstrual syndrome, subsequently renamed as late luteal phase dysphoric disorder (LLPDD) and is currently known as premenstrual dysphoric disorder (PMDD). It was listed as a psychiatric disorder in the DSM-III, but was later moved to the section on the condition deserving further study (aka the “appendix”). In the DSM-5, PMDD returned to the main section of the manual devoted to depressive disorders as a diagnosis approved for routine clinical use. The PDD is an ideal-type condition to stimulate a controversy about its justification as a psychiatric disorder. By its nature it affects only females (here, feminist issues may arise); it is clearly linked to physiological rhythm (is it not a somatic issue?); does it exist as a distinct behavioral abnormality or is it just a variant of female experience?: does it need to be treated pharmacologically? (the issues of medicalization and “big pharma”). It provides a detailed narrative on the vicissitudes of this psychiatric nosological category, which is not only based on a careful study by interested outsiders but is crucially enriched by the insights of one of the participants of the very process of DSM construction.


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