Archives for July 2009

Early in Studs Terkel's Hard Times, before the tales of Depression-era woe get rolling, we hear from a startling young man. Jerome Zerbe, a celebrity photographer for Parade magazine, not only remained stylish during the downturn, he remembered it fondly.

"The Thirties," he told Terkel, "was a glamorous, glittering moment." In Zerbe's New York City there were no bread lines, no apple salesmen, and certainly no worried faces as he partied in the Rainbow Room with Roosevelt's heirs. Central Park was a jungle of cardboard shacks, unemployment hung above 20 percent. Yet for him "there was never any sign of poverty," just a few nattering headlines in the newspaper.

Was Zerbe's experience unusual? It certainly departs from the usual Depression gloom. But it isn't unique in its distance—emotional, social, and economic—from the worst of the '30s. Every few pages, in fact, Terkel's award-winning oral history fluoresces with surprisingly positive testimony: alongside fear, hunger, and desperation, there was also "fun" in soup lines, "hope" and "excitement" in job queues, and light-hearted resilience in the face of "hard times."

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A meta-analysis of more than 50,000 patients has shown that general practitioners (GPs) have great difficulty separating those with and without depression, with substantial numbers of missed and misidentified. GPs looking for depression make more misidentifications (false positives of depression) than the number of depressions they correctly spot following an initial consultation but accuracy could improved by re-assessment of people suspected of having depression.

These are the conclusions of an article published Online First and in an upcoming edition of The Lancet, written by Dr Alex Mitchell of University of Leicester together with Dr Amol Vaze, and Dr Sanajay Rao of Leicester Partnership Trust. The study pooled 41 trials from nine countries that used robust outcome standard of a semi-structured interview to assess depression. The researchers found that GPs were able to recognize about half of people who had clinical depression and correctly reassured 80% of healthy people.

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Depressive disorders have been with mankind since the beginning of recorded history. In the Bible, King David, as well as Job, suffered from this affliction. Hippocrates referred to depression as melancholia, which literally means black bile.

Black bile, along with blood, phlegm, and yellow bile were the four humors (fluids) that described the basic medical physiology theory of that time. Depression, also referred to as clinical depression, has been portrayed in literature and the arts for hundreds of years, but what do we mean today when we refer to a depressive disorder?

In the 19th century, depression was seen as an inherited weakness of temperament. In the first half of the 20th century, Freud linked the development of depression to guilt and conflict. John Cheever, the author and a modern sufferer of depressive disorder, wrote of conflict and experiences with his parents as influencing his development of depression.

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GPs are failing to diagnose clinical depression in at least half of patients who see them because consultations are too rushed, a major study suggests.  Up to 12 per cent of patients also have depression diagnosed incorrectly on the basis of one visit to the doctor, research on more than 50,000 GP consultations found.

Researchers at the University of Leicester said that they did not want to criticise all doctors for failing to identify depression, but those operating in busy urban surgeries may not have enough time to assess patients properly during a one-off visit of only a few minutes.

The study, published today in the medical journal The Lancet, said that a family doctor practising in urban areas would be likely to see up to 100 people over two days, of whom 20 would be suffering from depression.

However, of these, he or she would correctly diagnose only ten and fail to identify the rest. Of the remaining 80 non-depressed patients, the doctor would be likely to "over-diagnose" 15 (20 per cent) and correctly reassure a further 65 (80 per cent).  The findings were based on a review of 41 studies involving one-to-one consultations between doctors and patients, to assess the signs of depression.

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General practitioners correctly identify only about half of patients with depression, and misidentifications outnumber missed cases, according to a study published online July 28 in The Lancet.Alex J. Mitchell, of Leicester General Hospital in the United Kingdom, and colleagues conducted a meta-analysis of 41 studies that included 50,371 patients.

The researchers found that general practitioners correctly diagnosed only about 50 percent of true cases of depression and treated only 15 percent of them. They also found that general practitioners correctly ruled out depression about 80 percent of the time. In every 100 unselected cases seen in primary care, they estimated that the number of false positives (15) is higher than that for either missed cases (10) or identified cases (10).

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Approximately 32 to 35 million adults in the United States have an episode of major depression sometime during their lifetime, and many of them do not respond to initial treatment.1 The results of an analysis undertaken by Fava and Davidson2 suggest that between 29% and 46% of depressed patients fail to respond fully to antidepressant treatment of adequate dose and duration; about 15% of patients fail to respond to multiple treatment trials.3 Fagiolini and Kupfer4 have suggested that patients with treatment-resistant depression (TRD) may represent a biologically unique subtype of depressed patients. Unfortunately, the chances for full recovery diminish the longer a patient remains depressed—a fact that lends a sense of urgency for appropriate therapy.5 Before discussing the effectiveness of individual agents in TRD, it is important to review recent evidence regarding the principles of using these agents to maximize the chance of a response.6-9 Some of the most salient findings from the STAR*D trial on this topic are summarized in Table 1.

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Seven in 10 people surveyed believe there is social stigma attached to depression, according to the Lundbeck Mental Health Barometer. The annual survey pointed out that this finding is higher than the 66pc who thought it was stigmatising in 2008.

It showed 74pc of women consider the condition to be stigmatising, compared to 68pc of men.  Dr Eamonn Shanahan GP said while it is encouraging to see that people are talking about depression more, there is still a long way to go to fight feelings of stigma.

One issue which will remain an issue for all women till menopause is Premenstrual syndrome or PMS. This is one sad thing that has neither any medication nor is unavoidable.  PMS is like a horn or a warning signboard of the forth coming danger.

According to Wikipedia,” PMS is a collection of physical, psychological and emotional symptoms related to a woman’s menstrual cycle.”While it may sound just another routine problem that is a part of a woman’s physical attribute, it is not that simple! In the first place it is the most repulsive phase of the month for a woman. The symptoms vary from irritation,  terrible mood swings, tension , depression, dysphoria(unhappiness) to headaches, backaches, stomach cramps leg cramps. for physical agony at least there are medicines that can be consumed and pain eased. But there is no solution as such to the other syndrome. Then there are hormonal changes that a woman goes through every month during her menses which is not a very pleasant thing either.This is may sound surprising but during menses most of the women have some or the other kind of craving for food.

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There is a reason why there are strict laws against medicines being sold only with a prescription-not only are they harmful taken without a doctor's consultation, but also usually do not take effect in the manner desired by the consumer. Incorrect or excessive dosage is potentially dangerous.

Antidepressants are medicines used for depression treatment.Antidepressants help by raising the extent ofexcitatory neurotransmitters, such as serotonin, that stimulate chemicals in the brain to stabilize mood disorders.Such medicines are helpful as they are usually safe, non-addictive and provide substantial relief as therapeutic medicines towards mental disorders. They are also commonly safe from abuse.

Some antidepressants which have shown evidence of abuse, especially those that are tricyclic and heterocyclic, i.e. antidepressants which are monoamine oxidase inhibitors (MAOIs).

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A new study suggests screening children for symptoms of depression, the most common mental health disorder in the United States, can begin a lot earlier than previously thought, as early as the second grade.

University of Washington researchers followed nearly 1,000 children from the second to the eighth grades. During the investigation they discovered five distinct patterns for the way symptoms of depression develop among adolescents.

“Some children are reporting that they don’t have as many friends, feel lonelier and are more anxious than their peers,” said James Mazza, a UW professor of educational psychology and lead author of the study.  “They are telling us that they feel different from the typical happy- go-lucky second grader.

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