Seasonal Affective Disorder: (SAD)

Wed, 5 Mar 2008 12:06 GMT

In terms of diagnosis, seasonal affective disorder is not really a separate mood disorder from major depression or bipolar disorder. Instead, "seasonal pattern" is a specifier used as additional diagnostic information to describe the regular pattern of the depressive episode associated with major depression or bipolar disorder. For instance, a person could receive the following diagnosis: Major Depressive Disorder, Recurrent Episode, Moderate, With Seasonal Pattern However, since people often refer to this type of depression as "Seasonal Affective Disorder" or "SAD" we will use that terminology here. SAD is a condition that affects a person during specific times or seasons of the year. Typically the depressive symptoms of this condition begin during fall or winter, and end when spring arrives. At other months during the year a person's mood will be normal, or at least will not meet criteria for clinical depression. Those who have SAD may notice that in the winter months they have a lack of energy or feel sluggish, they sleep more than usual, they overeat and gain weight, and they may have a craving for carbohydrates. Of those who have SAD, 60%-90% are women. Rates of SAD are higher in those who live at higher latitudes. It also occurs more frequently in younger people and often begins in a person's twenties.

Diagnosis of a Seasonal Pattern Specific:

This specifier may describe the depressive episode in major depression or bipolar disorder.

A. A person has experienced a regular pattern of depressive episodes that begin at specific time of the year (e.g., fall or winter), and which are not related to specific yearly stressors such as school/college or seasonal unemployment.

B. The depression also ends or changes at a specific time of the year (e.g., spring).

C. The pattern has occurred for the most recent two years with no other symptoms outside of the pattern.

D. A person has had more seasonal depressions than non-seasonal depressions in his/her lifetime.

Only Severly Depressed Benefit From Anti-Depressants

Tue, 4 Mar 2008 11:45 GMT

This is news in the field of research that anti-depressants work only on the severely depressed people which means that the people who are less depressed can not rely on anti-depressants any more. But then what is the option for them if not anti-depressants? While popular antidepressants such as Prozac are widely prescribed for people with varying degrees of depression, the drugs are only effective for those with the most severe depression, a new study suggests."Although patients get better when they take antidepressants, they also get better when they take a placebo, and the difference in improvement is not very great," lead researcher Irving Kirsch, a professor of psychology at the University of Hull in Great Britain, said in a prepared statement. "This means that depressed people can improve without chemical treatments," he added. In the study, Kirsch and his colleagues collected data on 35 clinical trials of antidepressant drugs whose results had been submitted to the U.S. Food and Drug Administration. The antidepressants included in the trials were fluoxetine (Prozac), venlafaxine (Effexor), nefazodone (Serzone), and paroxetine (Seroxat/Paxil). An analysis of the data showed that patients taking antidepressants fared no better than patients receiving a placebo. This appeared to be the case whether the patients were mildly or moderately depressed.The drugs only seemed to benefit a small group of patients -- those with the severest depression when the study began. Based on these results, there appears to be little reason to prescribe these antidepressants to anyone but the most severely depressed patients, the study authors concluded. Dr. Nada Stotland, president-elect of the American Psychiatric Association, said she wasn't surprised that the study found that not every antidepressant works for every patient. Many people who are depressed don't respond to the first antidepressant they try. It can take up to an average of three different antidepressants until one works for a particular patient, she said. "Medication helps some, but not all, people with depression," Stotland said in a prepared statement. "For people with mild to moderate depression, psychotherapy can work as well as medication. Studies have shown that between 70 and 80 percent of people can and do get better with a combination of treatment approaches, which will often include individual therapy, family therapy and/or medication. "Therefore, testing any single antidepressant on a group of depressed individuals will show that many of them do not improve," Stotland added. "There is a small group of depressed individuals who do not respond to any antidepressant." The new study highlights the fact that treatment for depression needs to be tailored to an individual, and that the most effective treatment will often include multiple approaches, Stotland said. The study results also suggest that more long-term follow-up trials are needed to determine which patients are most likely to benefit from specific therapies. "Some of the most exciting research in progress at the present time concerns our attempt to match the antidepressant to the patient from the outset; we may be able to perform laboratory tests or identify clinical factors that let us know in advance which antidepressant will work for each person," Stotland said. "That will be an enormous advance for the millions of people suffering from this very painful and potentially disabling disease." In a prepared statement released late Tuesday, Pharmaceutical Research and Manufacturers of America (PhRMA) Senior Vice President Ken Johnson said, "It is true that pharmaceutical products, such as antidepressants, can result in a differential response among different patients. It is for this reason that a variety of therapeutic options is important in health care -- so that each patient can receive the most effective treatment for his or her needs. "Because of this, America's pharmaceutical research companies are dedicated to continuing their research into and development of potential new medicines to treat depression as well as the other disease that affect patients worldwide."

Brain Images Reveal Effects Of Anti-Depressants

Fri, 29 Feb 2008 15:10 GMT

When one is depressed he/she cannot understand or comprehend anything that is said to that person the reason being that he/she is so depressed that nothing feels like to be done by this particular person the only thing needed by this individual at this point of depression is to remain alone and not to talk to anyone but this effects the family at a large level being in a close knit family the others cannot let their dear one be on its own at any cost, the result is anti-depressants which are given to the person in need of them with the hope that these anti-depressants will help him/her in getting out of depression. But medically brain images have shown that there are after effects of these medicines on the brain. The experiences of millions of people have proved that antidepressants work, but only with the advent of sophisticated imaging technology have scientists begun to learn exactly how the medications affect brain structures and circuits to bring relief from depression. Researchers at the University of Wisconsin-Madison and UW Medical School recently added important new information to the growing body of knowledge. For the first time, they used functional magnetic resonance imaging (fMRI)--technology that provides a view of the brain as it is working--to see what changes occur over time during antidepressant treatment while patients experience negative and positive emotions. The study appears in the January issue of the American Journal of Psychiatry. UW psychology professor Richard Davidson, Ph.D., psychiatry department chair Ned Kalin, MD, research associate William Irwin and research assistant Michael Anderle were the authors. The researchers found that when they gave the antidepressant venlafaxine (Effexor(r)) to a small group of clinically depressed patients, the drug produced robust alterations in the anterior cingulate. This area of the brain has to do with focused attention and also becomes activated when people face conflicts. Unexpectedly, the changes were observed in just two weeks. "Conducting repeated brain scans in these patients allowed us to see for the first time how quickly antidepressants work on brain mechanisms," said Davidson, who also is director of the W. M. Keck Laboratory for Functional Brain Imaging and Behavior, where imaging for the study took place. He noted that the findings were surprising because patients don't usually begin noticing mood improvements until after they have been taking antidepressants for three to five weeks. The researchers also found that while the depressed patients displayed lower overall activity in the anterior cingulate than non-depressed controls, those depressed patients who showed relatively more activity before treatment responded better to the medication than those with lower pre-treatment activity. This kind of information may be extremely useful to clinicians someday, Kalin said. "We expect that physicians in the future will be able to predict which patients will be the best candidates for antidepressants simply by looking at brain scans that reveal this type of pertinent information," said Kalin, who also is director of the HealthEmotions Research Institute, where scientists concentrate on uncovering the scientific basis of linkages between emotions and health. One third of all patients treated with antidepressants do not respond to them, and of those that do, only about 50 percent get completely better, he added. Virtually all previous studies analyzing brain activity in depressed people used PET (positron emission tomography) and SPECT (single photon emission computed tomography) technology. With these imaging systems scientists were not able to obtain pictures with the same resolution as that which is now obtainable with fMRI, which provides a "working snapshot" of the brain. The Wisconsin team used fMRI's capability to capture brain activity as it occurred to record subjects' reactions as they viewed pictures designed to stimulate negative and positive emotions. "We believe that we can uncover the best indicators of treatment changes when we present research subjects these emotion challenges," said Davidson. "The pictures activate the individual circuits that underlie different kinds of emotional responses." UW emotions researchers have been using fMRIs with emotion-challenging pictures for several years in an effort to understand normal and abnormal brain responses to a range of emotions. They theorize that in depressed people, reactions to negative emotions are similar to, but more exaggerated than, reactions that non-depressed people have, and that the reactions may be more difficult to turn off. "We all experience some sadness from time to time, but in depression, the responses may be sustained and out of context," said psychiatrist Kalin.

Substance Induced Mood Disorder

Wed, 27 Feb 2008 14:56 GMT

Depression may be caused or precipitated by the use or abuse of substances such as drugs, alcohol, medications, or exposure to toxins. A mental health professional or physician must determine whether the mood disorder occurs as a result of the substance or just happens to occur at the same time by coincidence. If it develops as a result of the use of or exposure to the substance then this diagnosis may be appropriate. To make a diagnosis of a substance-induced mood disorder, the disturbance can only occur while a person is intoxicated, going through withdrawal, or within four weeks of either.

Diagnosis of Substance-Induced Mood Disorder

Summarized from the Diagnostic and Statistical Manual of Mental Disorders- Fourth Edition

A. A person has significant disturbance in mood that includes either (or both):
Depressed mood or significantly reduced level of interest or pleasure in most or all activities.
Mood that is euphoric, heightened, or irritable.

B. The person's symptoms develop during (or within four weeks of) intoxication or withdrawal, or are caused by medication use.

C. Another disorder does not better explain the mood disturbance.

D. The mood condition is not present only when a person is delerious.

E. The symptoms are a cause of great distress or difficulty in functioning at home, work, or other important areas.

Possible specifiers used to describe the mood:
With Depressive Features: A person has depressed mood, but his/her symptoms are not enough to meet criteria for a major depressive episode.
With Manic Features: A person's symptoms are primarily euphoric, heightened, or irritable.
With Mixed Features: A person has symptoms that are both depressive and manic and neither are dominant.
With Onset During Intoxication: The symptoms develop while the person is intoxicated.
With Onset During Withdrawal: The symptoms develop while the person is in withdrawal.

Indian Herb Helps In Healing Diabetes

Tue, 26 Feb 2008 13:29 GMT

where all medical science fails its at that time that people turn to healing of Indian herbs and that is why its known to many that an Indian herb helps very much in healing people with blood sugar meaning diabetes. An extract of Coccinia indica, a perennial herb that grows abundantly in India, may help people with mild type 2 diabetes control their blood sugar levels, the results of a new study suggest. In the journal Diabetes Care, researchers note that while Coccinia indica, also known as Coccinia cordifolia, has been widely used in traditional treatments of diabetes, carefully controlled studies have not been done.To examine the effects of this herb on blood sugar levels, the India-based researchers randomly assigned 60 adults with newly detected type 2 diabetes to receive Coccinia extract or placebo. The subjects were between 35 and 60 years old and were being treated with diet and lifestyle modification only. According to Dr. Rebecca Kuriyan, from the Institute of Population Health and Clinical Research in Bangalore, and colleagues, there were significant differences in blood sugar favoring Coccinia extract over placebo after 90 days of treatment. Fasting blood sugar levels at 90 days in people taking the Coccinia extract fell by an impressive 16 percent, while fasting blood sugar levels rose slightly in the placebo takers. Likewise, patients in the Coccinia extract group had an 18-percent decrease in post-meal blood sugar levels at the study's end, whereas the placebo group experienced a small increase in post-meal blood sugar levels.This study suggests that Coccinia extract has a potential blood sugar lowering action in patients with mild diabetes. Kuriyan and colleagues note however that additional studies are needed to identify the mechanisms involved.

Mood Disorder Due To A General Medical Condition

Mon, 25 Feb 2008 12:49 GMT

In order to receive this diagnosis, a mental health professional or physician must first determine that a general medical condition is present. This, of course, may already be established if a person with a medical disorder seeks treatment for problems with his or her mood. Having clinical depression is not a normal part of coping with a medical condition. In fact, the presence of clinical depression can complicate a person's recovery from a medical condition. One problem is that having a mood disorder along with a serious medical condition can increase the risk of a person attempting and completing suicide. The greatest risk of suicide is related to the more chronic, painful, and incurable illnesses such as spinal cord injury, head injury, AIDS, malignant cancer, etc.

Diagnosis of Mood Disorder Due to a General Medical Condition

C. Another disorder does not better explain the mood disturbance.

D. The mood condition is not present only when a person is delerious.

E. The symptoms are a cause of great distress or difficulty in functioning at home, work, or other important areas.

Possible specifiers used to describe the mood:
With Depressive Features: A person has depressed mood, but his/her symptoms are not enough to meet criteria for a major depressive episode.
With Major Depressive-Like Episode: A person's depressive symptoms meet criteria for a major depressive episode.
With Manic Features: A person's symptoms are primarily euphoric, heightened, or irritable.
With Mixed Features: A person has symptoms that are both depressive and manic and neither are dominant.

Daily Stress May Raise Women's Risk Of Cervical Cancer

Wed, 20 Feb 2008 13:55 GMT

Stress is no doubt a silent killer and it’s because of this that women who are under stress all the time are more prone to Cervical Cancer. Therefore it’s better to stay away from stress and to keep one self busy, all the time so that you can lead a long and a healthy life at least this is the least one can do for oneself in order to save yourself from Cervical Cancer. High levels of daily stress could explain why some women infected with malignancy-linked types of human papillomavirus (HPV) develop cervical cancer, a new study suggests. Scientists at Fox Chase Cancer Center in Philadelphia tested 74 women, all diagnosed with cervical dysplasia (precancerous cervical lesions), for an immune response to HPV 16, one of the strains of human papillomavirus thought to be a major cause of cervical cancer. The women also completed a questionnaire that assessed stressful life events experienced during the previous six months -- including deaths of family members, loss of a job or divorce -- as well as their perceived daily stress level over the previous month.The research, published in the February issue of Annals of Behavioral Medicine, found that slightly more than 55 percent of the women tested positive for one or more types of HPV, a sexually transmitted infection that can cause genital warts as well as cancer. "We observed that stress was associated with deficits in immune response to HPV 16," said Carolyn Y. Fang, the study's lead investigator. Most HPV infections in healthy women disappear over time without progressing to precancerous cervical lesions or cancer. "That means HPV infection alone is not sufficient to cause cervical cancer," Fang said. "Our study suggests a potential mechanism by which stress may influence cervical disease progression."We were surprised to discover no significant association between the occurrence of major stressful life events and immune response to HPV 16, possibly because of the amount of time that had passed since the event and how the women coped," she added. "However, women with higher perceived levels of daily stress were more likely to have an impaired immune response." HPV expert Dr. Kevin Ault, associate professor of gynecology and obstetrics at Emory University School of Medicine in Atlanta, said, "It is unusual to see psychology and immunology in the same study, and this is very interesting. It is clear that almost all sexually active men and women get infected by HPV but very few have cancer. We already knew that nutrition may play a role. It seems likely that immune responses to HPV are influenced by stress, too." Dr. Charles Raison, clinical director of Emory University's Mind-Body Program, said the new study adds to the growing evidence that stress can negatively influence health. "There is data that stress can put the immune system at a disadvantage in dealing with viral infections. Even daily hassles like commuting in bad traffic can impact how the body functions," he said. "If a person with HPV is feeling stressed, it is important to do something positive to reduce the stress load. Exercise is known to help, and psychiatric therapy for any depression is important, too." Fang added: "We want women to understand that stress does not cause cervical cancer, and feeling stressed out does not mean that one will develop cervical cancer. In this initial study, we observed that stress was associated with deficits in immune response to HPV. Whether stress causes these deficits, however, is unknown, and much more research will need to be done." To that end, Fang and her research team have launched a five-year randomized trial to examine whether participation in an eight-week stress reduction program can lead to enhanced HPV-specific immune responses in women diagnosed with cervical dysplasia. U.S. Centers for Disease Control and Prevention statistics show that one in four American women between the ages of 14 and 59 years is infected with HPV. Gardasil, a vaccine that protects against several cancer-causing HPV sub-types, has been approved by the U.S. Food and Drug Administration. However, the vaccine works best when given to girls before they become sexually active and is not effective in women already infected. That means the best protection against cervical cancer for sexually active women, whether or not diagnosed with HPV, is to have regular Pap tests and to develop good health habits, Ault said.

Blight of depression

Fri, 15 Feb 2008 07:37 GMT

It was heartening to read Janey Godley on the subject of depression (11 February). It can indeed strike anyone down; it can be endogenous, circumstantial or genetic. Sometimes it is a combination of all three.
Some sufferers get better with SSRIs or other medications, some however (as was my personal experience) find the iatrogenic side-effects worse than the illness. It ruins lives, relationships and health in general, physical as well as mental.

Fortunately, I am not on Incapacity Benefit and, as I recover slowly, will eventually return to work, but for those that need it, it should remain available without the government's proposed fearsome grilling. That way, indeed, madness lies.

Postnatal depression can be worse with a male baby

Thu, 14 Feb 2008 08:13 GMT

Giving birth to a boy can lead to higher levels of severe postnatal depression (PND) than having a girl, according to a study.

Claude de Tychey, of the French university Nancy 2, studied 181 women who had given birth and found that just under a third of them suffered from PND.

Nine per cent of the women in the study had severe PND and just over three quarters of those had given birth to boys.

“Postnatal depression is very common and poses a major public health problem, especially if it is not diagnosed and treated,” Professor de Tychey said. “When we launched our research, our main aim was to study the effect that gender has on PND. But the overwhelming finding of the study was the fact that gender appears to play a significant role in reduced quality of life as well as an increased chance of severe PND.”

Woman Faces Court Over NZ Hijack Attempt

Tue, 12 Feb 2008 17:39 GMT

A Somali immigrant who allegedly stabbed both pilots on a small commercial plane in a hijack attempt was ordered held in custody for psychiatric assessment when she appeared in court Saturday.
Asha Ali Abdille, 33, was represented by a court-appointed lawyer in the Christchurch District Court and entered no plea to several charges, including hijacking and the wounding of two pilots and a passenger on the flight Friday.

She faces life in prison if convicted.
Police on Friday told media Abdille became agitated 10 minutes into the flight from her regional home town of Blenheim to Christchurch on New Zealand's South Island. She entered the cockpit of the twin-propeller Jetstream and attacked the pilots with a knife while attempting to tamper with the controls, police alleged. Abdille falsely claimed two bombs were aboard the plane, police said, and demanded to be flown to Australia, well beyond the range of the aircraft. The crew and passengers overpowered and held her until the plane made a safe landing at Christchurch airport. One pilot was in stable condition in Christchurch Hospital on Saturday after surgery on an injured hand. The other pilot and a female passenger suffered minor injuries.