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Depression

Depressions

Depression is a type of mood disorder characterized by low mood and state of aversion. Individuals living with this condition often exhibit signs of sadness, helplessness, irritability, anxiousness and restlessness.


Presentation

Individuals affected with depression usually experience several bouts of depressive episodes. The symptoms almost occur every day and gradually begin interfering with the daily activities of the individual. The following are the signs and symptoms exhibited [6]:

  • Too little sleep or excessive sleeping
  • Loss of appetite accompanied by weight loss in some, while increase in appetite and weight gain in others
  • Low level of mood characterized by loss of interest in normal activities
  • Lack of energy, fatigue and difficulty in carrying out simple tasks
  • Angry outbursts and feeling of irritation and frustration
  • Poor concentration and inability to make decisions
  • Feeling of worthlessness that causes suicidal thoughts and suicidal attempts
  • Unexplained physical ailments such as back ache and headache
Pain
  • Depressive disorders may constitute a risk factor for vulvodynia and occur as a secondary condition to pain.[ncbi.nlm.nih.gov]
  • Pain, IL-6, and Pittsburgh Sleep Quality index values were all significantly higher in SLE patients compared with the healthy control group (P[ncbi.nlm.nih.gov]
  • Additionally, migraineurs with comorbid depression had different developmental trajectories in the right thalamus and fusiform, which were associated with recognizing, transmitting, controlling and remembering pain and emotion.[ncbi.nlm.nih.gov]
  • You're in pain. Depression and pain share some of the same biological pathways and neurotransmitters. About 75% of people with depression suffer recurring or chronic pain, research shows.[prevention.com]
  • QoL in patients after KTx showed a good level for everyday life functioning, and 2. general health assessment, physical functioning, pain, sleep quality, occupational status, vitality, social activity, staff support, and quality of care were major factors[ncbi.nlm.nih.gov]
Fatigue
  • OBJECTIVE: Fatigue after acquired brain injury may be related to the subcortico-frontal attention network. Depression is also strongly related to fatigue.[ncbi.nlm.nih.gov]
  • Unfortunately, people who have chronic fatigue syndrome may become depressed. And while depression doesn’t cause chronic fatigue syndrome, it can certainly cause increased fatigue.[healthline.com]
  • A variety of psychological assessments were used to evaluate depression, anxiety, sleep, fatigue, and relationship status. Clinical values were obtained from medical records.[ncbi.nlm.nih.gov]
  • RESULTS: A quick and complete abrogation of the depression ensued along with improvement of migraine headaches, insomnia, and chronic fatigue.[ncbi.nlm.nih.gov]
  • […] treating it as an emotional problem and/or mental illness such as depression, physicians - including cardiologists - should be aware of these conditions when examining patients with multiple and incapacitating complaints including palpitations and general fatigue[ncbi.nlm.nih.gov]
Weight Loss
  • Physical health was determined based on information regarding falls and weight loss and an assessment of each patient's general medical condition. The treating physician evaluated current suicidality in a comprehensive and standardized way.[ncbi.nlm.nih.gov]
  • Changes in Activity or Energy Level Physical Changes Caused by Depression Unexplained aches and pains Weight loss or gain Decreased or increased appetite Psychomotor agitation or retardation Emotional Pain of Depression Prolonged sadness Unexplained,[verywell.com]
  • How often have you been bothered that you have poor appetite, weight loss, or overeating over the last two weeks? NOT AT ALL SEVERAL DAYS MORE THAN HALF THE DAYS NEARLY EVERY DAY 5.[depression.org.nz]
  • loss or gain Uncontrollable crying Headache Stomach ache Digestive problems Problems with sexual function Thoughts of death or suicide Attempting suicide If you or someone you know is demonstrating any of the following warning signs, contact a primary[my.clevelandclinic.org]
  • Loss Wellbutrin Widow Widower Xanax Zoloft[depression.supportgroups.com]
Weight Gain
  • Winter depression, typically accompanied by social withdrawal, increased sleep, and weight gain, predictably returns every year in seasonal affective disorder.[nimh.nih.gov]
  • Depression in women Women are more likely to experience depression symptoms such as pronounced feelings of guilt, excessive sleeping, overeating, and weight gain.[helpguide.org]
  • It is characterized by weeks of such symptoms as low or sad mood, diminished interest in activities that used to be pleasurable, weight gain or loss, fatigue, inappropriate guilt, difficulty concentrating, and recurrent thoughts of death.[nutritionfacts.org]
  • gain headaches upset stomach.[au.reachout.com]
  • The following are the signs and symptoms exhibited: Too little sleep or excessive sleeping Loss of appetite accompanied by weight loss in some, while increase in appetite and weight gain in others Low level of mood characterized by loss of interest in[symptoma.com]
Crying
  • I didn’t know why I was going to cry, but I knew that if anybody spoke to me or looked at me too closely the tears would fly out of my eyes and the sobs would fly out of my throat and I’d cry for a week.[goodreads.com]
  • Activity or Energy Level Physical Changes Caused by Depression Unexplained aches and pains Weight loss or gain Decreased or increased appetite Psychomotor agitation or retardation Emotional Pain of Depression Prolonged sadness Unexplained, uncontrollable crying[verywell.com]
  • Sometimes it feels like a black hole but sometimes it feels like I need to cry and scream and kick and shout. Sometimes I go quiet and lock myself in my room and sometimes I have to be doing something at all times of the day to distract myself.[mind.org.uk]
  • […] hopeless Feeling worthless Sleeping too much or too little Loss of enjoyment from things that were once pleasurable Loss of energy Difficulty concentrating, thinking, or making decisions Changes in appetite that lead to weight loss or gain Uncontrollable crying[my.clevelandclinic.org]
  • Research also suggests that babies born to women with depression are more likely to be irritable and may cry more than babies born to moms who aren't depressed.[babycenter.com]
Overeating
  • High-dose intravenous treatment with methylprednisolone over 5 days and oral dose reduction over 3 weeks led to the sustained improvement of clinical symptoms.[ncbi.nlm.nih.gov]
  • A decrease in depressive symptom severity was observed for the individual with MCI, which was sustained over 12 months of follow-up. Neither the husband nor wife experienced an incident episode of major depression over the course of the study.[ncbi.nlm.nih.gov]
  • The latter had been evaluated multiple times in the general practice over several years; each time it was considered to be a symptom of depression.[ncbi.nlm.nih.gov]
  • Her anorexia symptoms have been developing over 1.5 years. The body mass index (BMI) at admission was 12.21 kg/m².[ncbi.nlm.nih.gov]
  • How often have you been bothered that you have poor appetite, weight loss, or overeating over the last two weeks? NOT AT ALL SEVERAL DAYS MORE THAN HALF THE DAYS NEARLY EVERY DAY 5.[depression.org.nz]
Loss of Appetite
  • Symptoms Individuals with depression exhibit signs of sadness, lack of interest in various activities, loss of appetite or sudden increase in food cravings, lack of sleep, poor concentration, lack of energy and fatigue.[symptoma.com]
  • Symptoms: Sadness and or irritability Loss of interest or pleasure in everyday activities Loss of appetite—or increase in appetite Sleep disturbances—either insomnia or excessive sleeping Agitation or slowing in behavior Fatigue Feelings of worthlessness[nationalmssociety.org]
  • Even the loss of appetite often seen in depression could be viewed as promoting analysis because chewing and other oral activity interferes with the brain’s ability to process information.[scientificamerican.com]
  • Symptoms of depression may be different or less obvious in older adults, such as: Memory difficulties or personality changes Physical aches or pain Fatigue, loss of appetite, sleep problems or loss of interest in sex — not caused by a medical condition[mayoclinic.org]
Bulimia
  • Arthritis Asperger Syndrome Asthma Ativan Autism Back Pain Bedwetting Binge Eating Bipolar Birth Defects Bisexuality Bladder Cancer Body Dysmorphic Disorder Bone Cancer Borderline Personality Disorder Brain Cancer Brain Injury Breast Cancer Breastfeeding Bulimia[depression.supportgroups.com]
  • Eating disorders such as anorexia and bulimia may accompany depression. In this situation the eating disorder is usually the main target of treatment.[patient.info]
Increased Appetite
  • Changes in Activity or Energy Level Physical Changes Caused by Depression Unexplained aches and pains Weight loss or gain Decreased or increased appetite Psychomotor agitation or retardation Emotional Pain of Depression Prolonged sadness Unexplained,[verywell.com]
  • Other symptoms of atypical depression include weight gain, increased appetite, sleeping excessively, a heavy feeling in the arms and legs, and sensitivity to rejection.[helpguide.org]
Tinnitus
  • Single Dads Single Moms Single Parents Singles Skin Cancer Skin Picking Sleep Apnea Sleep Walking Smoking Social Anxiety Social Security Spina Bifida Stress Stroke Stuttering Suboxone Sugar Addiction Suicide Surgery Teen Testicular Cancer Thyroid Cancer Tinnitus[depression.supportgroups.com]
Anxiety Disorder
  • Aim: To develop a visual screening tool for depression and anxiety disorders that is applicable across cultures and levels of education.[ncbi.nlm.nih.gov]
  • Using rating scales such as the 9-item Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder 7-item scale (GAD-7), and Mood Disorder Questionnaire (MDQ) can help clinicians recognize suboptimal response and make treatment adjustments such[ncbi.nlm.nih.gov]
  • Abstract A 59-year-old woman on daily peritoneal dialysis for end-stage renal failure received care at an outpatient psychiatric clinic for her diagnoses that include major depressive disorder, generalised anxiety disorder and insomnia disorder.[ncbi.nlm.nih.gov]
  • After referral, the patient was diagnosed with severe obstructive sleep apnoea (OSA), comorbid to a depressive and anxiety disorder.[ncbi.nlm.nih.gov]
  • This includes serious adult psychiatric illnesses such as major depressive disorder, anxiety disorders, and substance abuse.[ncbi.nlm.nih.gov]
Feeling of Worthlessness
  • […] of worthlessness Loss of self-esteem Despair Hopelessness Helplessness Difficult Moods Associated with Depression Irritability Anger Worry/anxiety Pessimism Indifference Self-critical Changes in Thought Patterns due to Depression Inability to concentrate[verywell.com]
  • […] of worthlessness, hopelessness or guilt Persistent physical symptoms such as headaches, digestive problems or chronic pain that do not respond to routine treatment Substance abuse problems Thoughts of suicide or suicide attempts[halfofus.com]
  • […] of worthlessness or guilt having thoughts of self-harm or suicide feeling hopeless and helpless difficulty remembering things.[au.reachout.com]
  • […] of worthlessness or hopelessness, or inappropriate or excessive guilt Recurrent thoughts of death, suicide plans or a suicide attempt Treating depression Getting appropriate treatment for depression can significantly improve quality of life.[alz.org]
  • […] of worthlessness that causes suicidal thoughts and suicidal attempts Unexplained physical ailments such as back ache and headache A combination of tests would help in diagnosis of depression.[symptoma.com]
Low Self-Esteem
  • For example, depression is not loneliness, it's not low self-esteem, and it's not being sad or distressed for good reasons. Those are all important and serious issues too, and they should be discussed, but this is not the place.[reddit.com]
  • Adding psychological treatment to medication may be helpful for managing negative thoughts and low self-esteem and finding better coping strategies.[cancer.net]
  • Depression is more than just sadness Symptoms are wide-ranging and typically include: Social isolation Anxiety Low motivation Low energy levels Low self-esteem Lack of interest in activities – even the ones you used to love How Neurocore’s depression[neurocorecenters.com]
  • Factors that seem to increase the risk of developing or triggering depression include: Certain personality traits, such as low self-esteem and being too dependent, self-critical or pessimistic Traumatic or stressful events, such as physical or sexual[mayoclinic.org]
Social Isolation
  • Although the criteria are similar to general diagnostic standards for major depression, they reduce emphasis on verbal expression and include irritability and social isolation.[alz.org]
  • The desire for social isolation, for instance, helps the depressed person avoid situations that would require thinking about other things.[scientificamerican.com]
  • Depression is more than just sadness Symptoms are wide-ranging and typically include: Social isolation Anxiety Low motivation Low energy levels Low self-esteem Lack of interest in activities – even the ones you used to love How Neurocore’s depression[neurocorecenters.com]
  • Because social isolation is a serious problem for some older people, the study also examined social behavior and found that people who don't use hearing aids are considerably less likely to participate in social activities.[audiology.org]
  • According to the Mayo Clinic, these include alcohol or drug abuse, anxiety, social isolation and relationship conflicts, work or school difficulties, or suicide.[livescience.com]
Delusion
  • Psychotic depression occurs when a person has severe depression plus some form of psychosis, such as having disturbing false fixed beliefs (delusions) or hearing or seeing upsetting things that others cannot hear or see (hallucinations).[nimh.nih.gov]
  • Sometimes depressive episodes can get so severe that hallucinations or delusions are present, the person becomes catatonic, or they feel stuck in bed. This is known as Psychotic Depression. Postpartum Depression occurs after giving birth.[psycom.net]
  • Symptoms of severe mania may include agitation, confusion, hallucinations, or delusions. Schizophrenia that does not respond to medication. Living with depression The most important part of living with depression is not giving up.[familydoctor.org]
  • Psychotic Depression: This type of depression occurs when a person has severe depression plus some form of psychosis, such as having disturbing false fixed beliefs (delusions) or hearing or seeing upsetting things that others cannot hear or see (hallucinations[nimh.nih.gov]
  • Some people with severe depression also develop delusions and/or hallucinations. These are called psychotic symptoms. A delusion is a false belief that a person has, and most people from the same culture would agree that it is wrong.[patient.info]
Headache
  • RESULTS: A quick and complete abrogation of the depression ensued along with improvement of migraine headaches, insomnia, and chronic fatigue.[ncbi.nlm.nih.gov]
  • This case provides a valuable contribution toward understanding HaNDL pathophysiology and in doing so may also yield broader implications regarding neurophysiological principles of CSD. 2016 American Headache Society.[ncbi.nlm.nih.gov]
  • Symptoms can include Feeling sad or "empty" Loss of interest in favorite activities Overeating, or not wanting to eat at all Not being able to sleep, or sleeping too much Feeling very tired Feeling hopeless, irritable, anxious, or guilty Aches or pains, headaches[medlineplus.gov]
  • […] change in appetite and/or weight Overreaction to criticisms Feeling unable to meet expectations Difficulty concentrating, remembering details, and making decisions Feelings of worthlessness, hopelessness or guilt Persistent physical symptoms such as headaches[halfofus.com]
  • Side effects, which are usually temporary, include changes in sexual desire, digestive problems, headache, insomnia and nervousness.[livescience.com]
Insomnia
  • Although there was partial improvement in the patient's mood and anxiety symptoms with antidepressant treatment, insomnia remained a persistent complaint despite adequate trials of different sleep medications.[ncbi.nlm.nih.gov]
  • RESULTS: A quick and complete abrogation of the depression ensued along with improvement of migraine headaches, insomnia, and chronic fatigue.[ncbi.nlm.nih.gov]
  • Side effects, which are usually temporary, include changes in sexual desire, digestive problems, headache, insomnia and nervousness.[livescience.com]
  • Healthy Sex Heart Attack Heart Disease Heartburn Hepatitis C Heroin Herpes High Blood Pressure High Cholesterol Hives Hoarding Hodgkins Lymphoma Huntingtons Disease Hyperthyroidism Hypothyroidism Hysterectomy Incest Survivors Infertility Infidelity Insomnia[depression.supportgroups.com]
  • Has Many Faces Jan. 8, 2019 — Researchers have revealed that there are five types of insomnia.[sciencedaily.com]
Difficulty Concentrating
  • concentrating, remembering details, and making decisions Feelings of worthlessness, hopelessness or guilt Persistent physical symptoms such as headaches, digestive problems or chronic pain that do not respond to routine treatment Substance abuse problems[halfofus.com]
  • The major symptoms of depression include the following: Feeling extremely sad, anxious, or "empty" Feeling hopeless Feeling worthless Sleeping too much or too little Loss of enjoyment from things that were once pleasurable Loss of energy Difficulty concentrating[my.clevelandclinic.org]
  • It is characterized by weeks of such symptoms as low or sad mood, diminished interest in activities that used to be pleasurable, weight gain or loss, fatigue, inappropriate guilt, difficulty concentrating, and recurrent thoughts of death.[nutritionfacts.org]
  • If you have depression, some symptoms you might experience include: feeling down or ‘numb’ for longer than two weeks losing interest in activities that you used to enjoy feeling like you don’t get much pleasure out of things difficulty concentrating negative[au.reachout.com]
  • concentrating or making decisions Suicidal thoughts or intentions Treatments Although depressive disorder can be a devastating illness, it often responds to treatment.[nami.org]
Sleep Disturbance
  • Patients with unimpaired sleep at baseline showed greater improvements over time than those with sleep disturbances. Changes on the MCCB were not correlated with other psychometric variables.[ncbi.nlm.nih.gov]
  • People who have a history of sleep disturbances, medical illness, chronic pain, anxiety and attention-deficit hyperactivity disorder (ADHD) are more likely to develop depression.[nami.org]
  • Symptoms: Sadness and or irritability Loss of interest or pleasure in everyday activities Loss of appetite—or increase in appetite Sleep disturbances—either insomnia or excessive sleeping Agitation or slowing in behavior Fatigue Feelings of worthlessness[nationalmssociety.org]
  • disturbances, including insomnia or sleeping too much Tiredness and lack of energy, so even small tasks take extra effort Reduced appetite and weight loss or increased cravings for food and weight gain Anxiety, agitation or restlessness Slowed thinking[mayoclinic.org]
  • […] general idea of what comprises depression: Persistent feelings of sadness, hopelessness, worthlessness, or emptiness Irritability, frustration, or restlessness Loss of interest in activities or hobbies that used to be enjoyable Difficulty sleeping, sleep[psycom.net]
Personality Change
  • It is imperative to observe the changes in personality, changes in sleeping and eating habits, gaining or losing weight in a short time, isolation, and change of behavior towards life.[about-addiction.com]
  • Her personality changed — my sweet, kind child became angry, self-loathing, and withdrawn. My husband and I didn’t know what to do… My daughter no longer suffers from depression. She has literally transformed.[neurocorecenters.com]
  • Different types of psychotherapy include cognitive-behavioral therapy, which helps a person change negative thought patterns and replace them with healthier ones, as well as interpersonal therapy, which is designed to help someone understand and work[livescience.com]
  • Symptoms of depression may be different or less obvious in older adults, such as: Memory difficulties or personality changes Physical aches or pain Fatigue, loss of appetite, sleep problems or loss of interest in sex — not caused by a medical condition[mayoclinic.org]

Workup

A combination of tests would help in diagnosis of depression. The following methods would be employed for diagnosing the condition:

  • Physical examination: At the preliminary level, a thorough physical examination is carried out to check for presence of physical ailments if any; because many a time depression is linked to physical ailment. In addition, the psychologist would also ask various detailed questions concerning health of the individual [7] [8].
  • Laboratory tests: Blood tests to detect complete blood count are required to assess the presence of underlying disease conditions such as thyroid disorders.
  • Psychological examination: In this, the individual is asked in depth questions about the symptoms, thoughts and feelings. He/she are also asked to fill in a questionnaire to arrive at a definite conclusion.
  • Imaging studies: CT scan and MRI scan of the brain can be considered to evaluate underlying disease conditions which are causing depression.

Treatment

A combination of treatment regime has been proved to be effective for individuals with depression. The following methods are employed in treating depression:

  • Medications: Antidepressants such as serotonin-specific reuptake inhibitors (SSRIs), serotonin–norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants and atypical antidepressants are used for treating depressions. Amongst these classes of drugs, antidepressants containing SSRIs are considered to be safe with fewer side effects. In addition to antidepressants, individuals may also be put on antipsychotics and mood stabilizers to enhance the effect of medications.
  • Psychotherapy: This method involves interpersonal therapy, cognitive behavioral therapy and commitment therapy that helps individuals to overcome the condition through counseling [9]. 
  • Electroconvulsive therapy is a process wherein electrical currents are imparted to the brain which significantly improves the levels of neurotransmitters providing immediate relief from severe depression. It is a method of choice for those individuals for whom medication and other therapies did not work.
  • Transcranial magnetic stimulation is a process in which magnetic impulses are passed on to the brain which stimulates the nerves cells involved in mood regulation [10].

Prognosis

A high incidence of morbidity and mortality is associated with depression owing to increase in suicidal attempts amongst the depressed population. The prognosis of the condition is good with treatment as about 70 to 80% of individuals report significant reduction in symptoms of depression when given appropriate treatment. However, it has also been observed that about 50% of individuals do not respond to the initial phases of depression [5].

Etiology

The exact cause of depression is not clearly understood. However interplay of various factors has been known to play a role. The following factors can cause depression:

  • Brain chemical imbalance: Neurotransmitters are brain chemicals that are known to play a vital role in causation of depression. Imbalance in the level of neurotransmitters can trigger depressive symptoms.
  • Physical changes: Individuals with depression are thought to have certain physical changes in the brain which again are a significant factor that can help determine the causative factor.
  • Genetic factors: Certain genes are known to play foul in causation of depression as this mood disorder is thought to run in families. Individuals with family history of depression are more prone to suffer from this disorder.
  • Hormones: Hormonal changes or imbalance due to certain disease conditions can cause depression.
  • Life events: Individuals who have suffered the loss of loved ones, or have undergone physical or mental trauma during childhood are likely to develop depression in the future.
  • Drug abuse: Use of certain medications or recreational drugs can also trigger symptoms of depression [2].

Epidemiology

Depression is a common mood disorder affecting more than 20 million individuals in the US. The lifetime incidence of depression amongst men and women in the US has been estimated to be 12% and 20% respectively. Depression is a more common phenomenon amongst the women population [3].

It has also been reported that the incidence of depression is higher amongst the elderly population owing to advancing age and increase in prevalence of medical illness and institutionalization in this age group.

Sex distribution
Age distribution

Pathophysiology

The pathophysiology of depression is not clearly understood. Certain clinical trials have pointed towards disturbance in the various neurotransmitters to be a major factor. In addition, development of vascular lesions that damages the functioning of the neural networks involved with emotional regulation play a significant role in development of depression. When the brain activity of affected individuals were studied through neuroimaging tests, it was revealed that depressed mind is associated with decreased metabolic activity in neocortical structures with an increase in metabolic activity of limbic structures [4].

Prevention

Depression can seldom be prevented. However, certain steps can help avoid its onset. These include:

  • Taking help of family and friends when feeling low or sad
  • Considering medical intervention when first signs of depression appear
  • Working out various ways to keep stress at bay

Summary

Such a type of mood disorder if not treated on time can make life worse for the individual living with it. Depression requires long term treatment and individuals generally do better with medications and psychological counseling. Affected individuals exhibit symptoms of constant feeling of sadness and lack of interest in activities [1]. Depression is also termed as major depressive disorder or clinical depression.

Patient Information

Definition

Depression is a type of mood disorder characterized by constant feeling of sadness accompanied by lack of interest in life. Such a type of condition can strike individuals at any age and is more prevalent amongst the female population.

Cause

Depression is thought to occur due to interplay of various factors such as genetics, unpleasant life events, hormonal imbalance and drug abuse. Individuals with certain underlying disease condition can also fall prey to depression.

Symptoms

Individuals with depression exhibit signs of sadness, lack of interest in various activities, loss of appetite or sudden increase in food cravings, lack of sleep, poor concentration, lack of energy and fatigue.

Diagnosis

Individuals who seek medical advice are asked to fill up a questionnaire containing list of questions to better understand their condition and thought process. In addition, blood tests and imaging studies will also be required to diagnose underlying disease conditions.

Treatment

Depression is best treated through combination of medication and psychotherapy. Those who fail to respond to these modes of treatment are given electroconvulsive therapy.

References

Article

  1. Pampallona S, Bollini P, Tibaldi G, Kupelnick B, Munizza C. Combined pharmacotherapy and psychological treatment for depression: a systematic review. Arch Gen Psychiatry. Jul 2004;61(7):714-9.
  2. Richardson LP, Katzenellenbogen R. Childhood and adolescent depression: the role of primary care providers in diagnosis and treatment. CurrProblPediatrAdolesc Health Care 2005; 35:6.
  3. Klerman GL. The current age of youthful melancholia.Evidence for increase in depression among adolescents and young adults. Br J Psychiatry. Jan 1988;152:4-14.
  4. Kempton MJ, Salvador Z, Munafò MR, Geddes JR, Simmons A, Frangou S, et al. Structural neuroimaging studies in major depressive disorder. Meta-analysis and comparison with bipolar disorder. Arch Gen Psychiatry. Jul 2011;68(7):675-90.
  5. Stewart JW, McGrath PJ, Blondeau C, et al. Combination antidepressant therapy for major depressive disorder: speed and probability of remission. J Psychiatr Res 2014; 52:7.
  6. Friedman RA, Leon AC. Expanding the black box - depression, antidepressants, and the risk of suicide. N Engl J Med. Jun 7 2007;356(23):2343-6.
  7. Arroll B, Khin N, Kerse N. Screening for depression in primary care with two verbally asked questions: cross sectional study. BMJ. Nov 15 2003;327(7424):1144-6
  8. U.S. Preventive Services Task Force. Screening for Depression. May 2002. 
  9. Mufson L, Fairbanks J. Interpersonal psychotherapy for depressed adolescents: a one-year naturalistic follow-up study. J Am Acad Child Adolesc Psychiatry. Sep 1996;35(9):1145-55. 
  10. Martiny K, Lunde M, Bech P. Transcranial low voltage pulsed electromagnetic fields in patients with treatment-resistant depression. Biol Psychiatry 2010; 68:163.

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Last updated: 2017-08-09 17:51