Major depressive disorder function

O Classic views as to the cause of major depressive disorder focus on the monoamine neurotransmitters norepinephrine (NE), serotonin (5-HT), and to a lesser extent, dopamine (DA) in terms of both synaptic concentrations and receptor functioning. 

Hudson, Christopher G., Socioeconomic Status and Mental Illness Tests of the Social Causation and Selection Hypotheses , American Journal of Orthopsychiatry 75, no. 1 (2005) 3-18 The Humble Humbug , The Lancet 2 (1954) 321 Hunter, Aimee M., Andrew F. Leuchter, Melinda L. Morgan and Ian A. Cook, Changes in Brain Function (Quantitative EEG Cordance) During Placebo Lead-in and Treatment Outcomes in Clinical Trials for Major Depression , American Journal of Psychiatry 163, no. 8 (2006) 1426-32 Hyland, Michael E., Do Person Variables Exist in Different Ways , American Psychologist 40 (1985) 1003-10 Hypericum Depression Trial Study Group, Effect of Hypericum Perforatum (St John s Wort) in Major Depressive Disorder A Randomized Controlled Trial , Journal of the American Medical Association 287 (2002) 1807-14... 

The classic symptoms of depression are listed in Table 12.1, which is based on DSM-IV criteria. For a diagnosis of major depressive disorder, most of these symptoms must be present, including the first two (APA, 2000). These symptoms should be of sufficient intensity and chronic duration (at least 2 weeks) to cause clinically significant distress and impairment in social or economic functioning. However, they should not be a result of another psychiatric or somatic illness, nor of drug misuse or bereavement. For a diagnosis of mania, the symptoms are a mirror image of those for depression (Table... 

The positive symptoms are the most responsive to antipsychotic medications, such as chlorpromazine or halo-peridol. Initially, these drugs were thought to be specific for schizophrenia. However, psychosis is not unique to schizophrenia, and frequently occurs in bipolar disorder and in severe major depressive disorder in which paranoid delusions and auditory hallucinations are not uncommon (see Ch. 55). Furthermore, in spite of early hopes based on the efficacy of antipsychotic drugs in treating the positive symptoms, few patients are restored to their previous level of function with the typical antipsychotic medications [2]. 

Yu YW, Tsai SJ, Chen TJ, Lin CH, Hong CJ (2002) Association study of the serotonin transporter promoter polymorphism and symptomatology and antidepressant response in major depressive disorders. Mol Psychiatry 7 1115-1119 Zanardi R, Benedetti F, Di Bella D, Catalano M, Smeraldi E (2000) Efficacy of paroxetine in depression is influenced by a functional polymorphism within the promoter of the serotonin transporter gene. J Clin Psychopharmacol 20 105-107 Zanardi R, Serretti A, Rossini D, et al (2001) Factors affecting fluvoxamine antidepressant activity influence of pindolol and 5-HTTLPR in delusional and nondelusional depression. Biol Psychiatry 50 323-330... 

Bakish D, Hooper CL, Filteau MJ, et al A double-blind placebo-controlled trial comparing fluvoxamine and imipramine in the treatment of panic disorder with or without agoraphobia. Psychopharmacol Bull 32 135-141, 1996 Bakish D, Hooper CL, Thorton MD, et al Fast onset an open study of the treatment of major depressive disorder with nefazodone and pindolol combination therapy. Int Clin Psychopharmacol 12 91-97, 1997 Baldwin DS Depression and sexual function. J Psychopharmacol 10 (suppl l) 30-34, 1996... 

Treatment of cerebral stroke patients with selective serotonin reuptake inhibitor antidepressant showed difference in improvement with respect to laterality. The post-stroke major depressive disorder improved much more in right stroke subjects in comparison with the left stroke ones (Spalletta el al., 2003). In case of unilateral brain injury due to stroke or parkinsonism, the intact hemisphere plays an important role in recovery and compensation for the lost motor function (Schallert el al., 2003). A well-selected homeopathic potency may facilitate recovery by acting on the intact hemisphere. It has been demonstrated that the brain can asymmetrically... 

Papakostas GI, Petersen T, Mischoulon D, et al. Serum cholesterol and serotonergic function in major depressive disorder. Psychiatry Res 2003 118 137-145. 

Volkcrs AC, Tulen JH, van den Broek WW, Bruyn JA, Passchier J, Pepplinkhuizen L (2004) Effects of imipramine, fluvoxamine and depressive mood on autonomic cardiac functioning in major depressive disorder. Pharmacopsychiatry 37 18-25... 

In 33 patients with chronic hepatitis C, of whom 10 developed major depressive disorders during interferon alfa treatment, there was no relation between changes in thyroid function and the development of depression... 

Though most persons who do not have bipolar disorder may consider the manic episodes to be beneficial and a positive experience, given the increased energy and euphoric mood, many patients with bipolar disorder find manic episodes to be very unpleasant, characterized by high levels of irritability and anxiety. Bipolar disorder, like major depressive disorder, is an episodic, recurrent convvdition, and in between episodes, the bipolar person may have function and behavior that appear completely normal. 

Major depressive disorder is a disorder of mood in which the individual experiences one or more major depressive episodes without a history of manic, mixed, or hypomanic episodes. A major depressive episode is defined by the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders, 4th ed.. Text Revision (DSM-IV-TR), published by the American Psychiatric Association. Depression is associated with significant functional disability, morbidity, and mortality. 

Bipolar disorder is one of the leading causes of chronic disability worldwide and shares characteristics of both major depressive disorder and schizophrenia. ° Bipolar disorder is primarily treated in the public mental health sector, and a majority of patients receive lifelong disabihty coverage because of compromised functioning. The total cost to society for bipolar disorder is enormous and is exceeded only by the costs for treating individuals with schizophrenia. It is estimated that the total economic impact of bipolar disorder in the United States is approximately 45 billion. ... 

Few studies have prospectively documented the degree of functional impairment before or after specific treatments or have evaluated the pharmacoeconomic differences in treatments for premenstrual and perimenopausal disorders. Data on the economic burden (i.e., health care utilization, related costs, and the loss of productivity) from different menstrual-related disorders are still lacking. Several PMDD studies have reported greater improvement in psychosocial functioning and work capacity with SRls compared with placebo. In all studies, the degree of functional impairment was substantial at baseline and similar to that seen in studies of major depression. The functional improvement correlated with the improvement in premenstrual symptoms and was evident by the second cycle of treatment. 

Major depressive disorders have been postulated to arise from a functional deficiency in brain NE and/or 5HT (amine hypothesis of depression). This notion is largely based on the acute actions of antidepressant drugs (which may t NE and/or 5HT actions) and the fact that reser-pine (which depletes brain amines) causes depression. However, no antidepressant takes effect rapidly, and some drugs do not appear to have significant effects on brain amines. 

Paroxetine is a selective serotonin reuptake inhibitor that blocks reuptake of serotonin, enhancing serotonergic function. It is used to treat panic disorder or social anxiety disorder (except Pexeva), as defined in the DSM-IV major depressive disorder, as defined in DSM-111 (immediate release) orDSM-lV (controlled release). Immediate release only for obsessive-compulsive disorder (OCD) generalized anxiety disorder (GAD) (except Pexeva) posttraumatic stress disorder (PTSD), as defined in the DSM-IV (except Pexeva). 

Amine hypothesis of mood The hypothesis that major depressive disorders result from a functional deficiency of norepinephrine or serotonin at synapses in the central nervous system... 

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