Default mode dysfunction underpins suicidal activity in mood disorders

BackgroundSuicide is a serious and not uncommon consequence of mood disorders that occurs primarily when individuals are depressed. Understanding the neurobiology of suicidal activity (thoughts or behaviors) is likely to facilitate prevention. MethodSeventy-nine adult depressed mood disorder patients (MDP), of which 25 had attempted suicide at least once, and 66 healthy controls (HC) participated in […]

Pharmacologic Treatment of Acute Major Depression and Dysthymia

This guidelines in based on an evidence report on pharmacotherapies for depression from the San Antonio Evidence-based Practice Center that was commissioned by the Agency for Healthcare Research. It reviews the evidence supporting the benefits of pharmacologic treatment, the data on the efficacy & side effects (including suicide) of “newer” compared with “older” pharmacotherapies, & […]

Self-Reported Depressive Symptoms That Differentiate Recurrent-Episode Major Depression From Dysthymic Disorders

The Beck Depression Inventory (BDI) was administered to 168 outpatients diagnosed with recurrent-episode, major-depression disorders & 99 out-patients diagnosed with dysthymic disorders. The mean ratings of 18 BDI items were comparable in both groups; the mean total-BDI score & mean number of BDI items rated were higher for the major depressive disorders than for the […]

Depression

This article describes the clinical diagnosis & treatment of depression. Types of depression & warning signs for specific populations (such as the elderly & medically ill) are presented. Suicidal ideations & behaviors are identified as warning signs for this disorder. The author stated that over two-thirds of people who died by suicide had given evidence […]

Depressive Symptoms and Signs That Differentiate Major and Atypical Depression From Dysthymic Disorder in Elderly Finns

Symptoms & signs that in terms of severity differentiate major & atypical depression from dysthymic disorder were investigated in depressed Finns aged 60 years or over. The overall symptomatology of major depression was not found to be significantly more severe than that of dysthymic disorder, although some symptoms were more severe in major depressive patients […]

Depression: Lifting the Cloud

Adolescent Suicide: Diagnosis, Psychopharmacology, and Psychotherapeutic Management (IN: Treatment Approaches With Suicidal Adolescents, edited by J K Zimmerman & G M Asnis)

Although psychopharmacological intervention can help, literature on medication managment in adolescents is limited. Noting that adult drug studies often are used in treatment decisions, this chapter discusses the use of pharmacotherapy in suicidal adolescents with affective disorders (major depression, dysthymia & atypical depression, & bipolar disorder), anxiety disorders (panic & obsessive compulsive disorders), schizophrenia, & […]

The Role of Psychosocial and Biological Variables in Separating Chronic and Non-Chronic Major Depression and Early-Late-Onset Dysthymia

Psychosocial & biological variables were examined in 180 patients to see if there are differences between the chronic & non-chronic course of major depression & the early- & late-onset types of dysthymia. One finding of the study was that significantly more patients in the chronic course depression & early-onset dysthymia groups had attempted suicide. Results […]

Parental Abuse as a Precursor to Childhood Onset Depression and Suicidality

Child guidance clinic cases were reviewed for abuse history, diagnosis, depressive symptoms & suicidality. Many depressed abused children were found to have been previously diagnosed exclusively with conduct-related versus affect disorders. The results suggested that abused children are at specific risk of developing depression & suicidality & that a subgroup of those with early-onset depression […]

Long-Term Treatment of Chronically Suicidal Patients (IN: The Psychology of Suicide: a Clinician’s Guide to Evaluation and Treatment, edited by E S Shneidman, N L Farberow, & R E Litman)

This chapter focuses on the long-term treatment of chronically suicidal patients. A follow-up study of clients who had contacted an emergency telephone service is also discussed. Psychiatric treatment is examined in the context of the psychiatrist as part of an interdisciplinary team, record keeping, & decisions to hospitalize or not. The treatment of patients with […]

The Comorbidity of Post-Traumatic Stress Disorder and Suicidality in Vietnam Veterans

Vietnam vetrans recruited from 3 sources were assessed for suicidal thinking & behaviours, & symptoms of posttraumatic stress disorder & depression. Findings support the notion that suicidal thoughts are prevalent in this group, with veterans in psychotherapy reporting a greater likelihood of such symptoms (82.6%), than veterans in the community (35.7%), or those seeking assistance […]

Suicidal Behaviors and Childhood-Onset Depressive Disorders: a Longitudinal Investigation

The subjects studied in this article were outpatient youth with depressive disorders & youth with other psychiatric disorders. 66% of them had suicidal ideation at study entry; 9% had attempted suicide. Ideation rates were stable over time; rate of attempts reached 24% by the average age of 17 years. Major depressive & dysthmic disorders were […]

Depressive Disorders in Older Medical Inpatients

Symptoms of depression that are temporary or caused by physical illness can be difficult to differentiate from those that represent a depressive disorder. Management involves accurate diagnosis & treatment of medical illness, practical interventions to resolve social stressors & emotional support. Because suicidal thoughts are frequent in older patients with concurrent major depression & chronic […]

Children’s Reaction to Loss of Parent Through Violence

Discusses 21 cases of violent parental loss. A review of the children’s medical records revealed that a majority were from lower socioeconomic families & were of preschool age. They were diagnosed as being overanxious, having dysthymic or conduct disorders & they seemed to be at greater risk developmentally if their current caretakers had conflicted feelings […]

The Outcome of Neurotic Disorders After Out-Patient & Day Hospital Care

Affective Disorders and Aggression Disorders: Evidence for a Common Biological Mechanism

Van Praag reviews recent biochemical research & concludes that most studies have found a correlation between suicidal behavior & low levels of CSF 5-HIAA; that evidence of a connection between violence & the attempt is equivocal and that the theory that low CSF 5-HIAA levels predict increased suicide risk has not yet been confirmed. The […]

The Economic Burden of Depression

The authors present estimates of direct treatment costs & indirect costs from lost productivity associated with the morbidity & mortality of depression. Data are based on epidemiologic estimates of the prevalence of major depressive illness & on the number of suicides assumed to be secondary to depression. Direct & indirect costs are estimated at $16.3 […]

Depressive Disorders in 100 Adolescents Who Attempted Suicide

Homicide and Depression

The subject of homicide & depression has received little attention by clinical psychiatry, particularly in the United States. The author bases the present study on clinical material which he claims illustrates the homicidal potential in depressed patients. Homicidal depressed patients are likely to have a personality disorder, to have suffered physical abuse in childhood, to […]

Depression in Children & Adolescents

Dr. Petti covers a wide range in the study of depression in children & adolescents. Several models of depression are presented & various studies are cited in support of these approaches. Recognition of depression at different age levels is discussed. He ends his presentation by stating that a number of apporaches have been developed, reliable […]

Neurosis and Mortality: Investigating an Association

Neurosis is not a cause of death, but at follow-up neurotic patients are found to experience increased premature mortality. Suicide & accidental death are considerably increased in this group. The increased mortality is not explained by confusion over the term depression. Those neurotic patients who subsequently die are more likely to have suffered from amore […]

Dexamethasone Suppression Test in Suicide Attempters

Recent studies reported abnormal DST results in subjects afflicted with endogenous depression who later committed suicide. The DST was administered to 37 suicide attempters diagnosed as depression by emergency room pshysicians. Subjects were 29 females & 8 males, with a mean age of 33-81. The control group consisted of 40 depressives. Results did not provide […]

Problems of the Ward Manager Seven. A Case of Acute Reactive Depression

In case history form, the author presents the problem of attempted suicide on a non-psychiatric ward: both crisis management & the recognition of pathological depression are covered in this article. Possible management solutions are outlined.(NBB)