Journal of Depression and Anxiety - Volume 4, Issue 4, 2001
Volume 4, Issue 4, 2001
Author C.P. SzaboSource: Journal of Depression and Anxiety 4 (2001)More Less
Extracted from text ... EDITORIAL Antidepressants in the treatment of eating disorders Psychiatric treatment takes place within a conceptual framework that should seek to address the patient as a whole i e a biopsychosocial approach ' The realm of biology in treatment approaches has been in the ascendency, potentially to the detnment of psychosocial aspects, in recent times 2 Eating disorders (anorexia nervosa, bulimia nervosa, eating disorder not otherwise specified e g binge eating disorder)3 constitute a group of psychiatric conditions whose treatment has encompassed predominantly psychosocial interventions4 Research into the biological underpinnings of eating disorders appears to have told us more about the ..
Source: Journal of Depression and Anxiety 4, pp 4 –11 (2001)More Less
A retrospective study of patients with classic conversion symptoms was undertaken to determine if underlying primary psychiatric disorders could be identified. There were 53 patients, 40 females and 13 males age 17 to 67 years (mean =36 years). All patients presented with sensorimotor disturbances or seizures for which no organic etiology could be determined. Stable neurologic deficits or seizures had been present for 6 months or more in all but 6 patients. All patients underwent detailed neurological examination, a semistructured mental status examination and a battery of neurodiagnostic investigations. The mental state of 41 patients admitted to hospital was further explored by daily onetoone interviews, narcoanalysis and art therapy. Psychiatric diagnoses were made from the initial and uncovered psychopathology using DSMIHR criteria. Forty two patients (79%) had depression. Eighty three per cent of these met criteria for major depressive episode. Five (9%) had no depressive symptoms but had other psychiatric disorders. In the remaining 6 (11%) no primary psychiatric disorder could be identified. However, in this group, only one patient had no secondary gain and was adequately studied. Therefore, in patients in whom there was no secondary gain and who were adequately studied, an underlying psychiatric disorder was identified in 47 out of 48 patients (98%).
Depression and coronary artery disease Part 2 : Biopsychosocial approach to management of Myocardial Infarction : review articleAuthor M.E. SmithSource: Journal of Depression and Anxiety 4, pp 12 –21 (2001)More Less
The association between depression and coronary artery disease has implications for the management of myocardial infarction. There is an important role for antidepressant medication and newer antidepressants have made this a much safer option. In the wider biopsychosocial approach, however, successful rehabilitation is more likely to be achieved if patients with relevant psychological and social problems are identified and offered additional support and treatment.
Author G. SchutzSource: Journal of Depression and Anxiety 4, pp 22 –26 (2001)More Less
Despite major advances in the understanding and treatment of schizophrenia, it remains an incompletely understood and often debilitating illness. The classic dopaminergic model of schizophrenia has given way to a more complex picture. Numerous studies have in recent years been examining the potential role of nondopaminergic systems in the pathophysiology of this illness. Several of these studies have focussed on the noradrenergic system, which is known to have wideranging effects in the brain. Within this context research into noradrenaline (NA) and schizophrenia will be reviewed. Furthermore, the potential benefits of pharmacotherapy involving noradrenergic pathways in the treatment of schizophrenia, including several of the newer antidepressants will be explored.
Author U. SubramaneySource: Journal of Depression and Anxiety 4, pp 27 –38 (2001)More Less
Antidepressants have been in use since the 1950's, when an antituberculous drug was accidentally found to have mood elevating properties. Since then, many antidepressants have become available. This has paralleled the increasing knowledge and insights into the aetiology of depression. Neurotransmitters implicated in the aetiology of depression include serotonin, noradrenaline, dopamine, gamma amino butyric acid (GABA) and acetylcholine. Antidepressants may be classified into the first generation antidepressants, which include the tricyclic antidepressants (TCA's) and the monoamine oxidase inhibitors (MAOI's); the selective serotonin reuptake inhibitors (SSRI's); noradrenergic reuptake inhibitors (NRI's) and other drugs which are basically modifications of the SSRI's. These drugs are all discussed in terms of their mode of action, and side effect profile. Other drugs which may be used as antidepressants, as well as future therapeutic targets in depression are discussed.