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Post by Admin on Aug 17, 2015 19:08:38 GMT -4
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Post by Michael Fuselli on Aug 17, 2015 23:59:46 GMT -4
Depression is a condition that is still not completely understood and can be hard to fully define. Today, some experts still feel that even the new DSM-V is too vague in its definition of depression because completely opposite symptoms can get the same categorical score and fall under the same diagnosis. It becomes difficult to treat because not only can we not truly define it, we are still not sure of the exact etiology. It was widely believed for many years that depression was predominantly caused by low levels of serotonin leading to a lot of time and money being pushed into the development of antidepressant drugs like SSRIs. But these drugs have proved to only be significantly helpful in major depression and not very beneficial in mild to moderate depression. New ways of thinking about depression are focusing on treating the specific symptoms and focus on the genes, neural circuits, physical response, and self-reported behavior associated with each symptom. It is hoped that by introducing this alternative avenue that maybe there will be some advancement in knowledge and treatment of depression and other mental disorders.
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Katherine Marshall Lugo
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Post by Katherine Marshall Lugo on Aug 18, 2015 18:31:11 GMT -4
Depression is a sensitive subject and hence makes it hard to define. Depression is a strong component of many if not all mental illness. The article states “one size fits all treatment doesn’t exist”. When treating depression you have to treat every person individually and not as group. I do agree that using SSRI as a first line treatment is correct but treating symptoms in addition to that might help stabilizing patients. With new studies and treatments depression has been changed from category with the new edition of DSM and will most likely be changed again when the newest edition comes out because medicine is constantly changing. I do agree that depression has more to do with severity of symptoms than quantity of symptoms.
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Post by Anjani Singh on Aug 18, 2015 23:57:13 GMT -4
It seems that depression is a rather ambiguous topic to most and is not clearly defined by even the psychiatry community. Everyone who struggles with depression is not created equal. As the article noted, not all have anhedonia, so not all treatments treat all the symptoms. The one treatment viewpoint for depression is not only ineffective, but only makes life harder for the physician in the future when the medication does not help. Treatments like SSRIs have been used for a long time now and have been proven to help severe depression, but maybe treating symptom by symptoms is a more effective way to go about relieving patients of their depressive suffering. The article states that the DSM 5 definition is still vague, but it is at least taking the viewpoint of not only the patient, but others who see them too, which would probably make the diagnosis a bit clearer because there’s an objective look at the “disease” as well. It’s an ongoing struggle to define it, but as the article said, we know more about it now than we used to and I’m sure we’ll only know more down the road.
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Post by Mario F Vigil on Aug 19, 2015 11:17:34 GMT -4
A depression diagnosis is often difficult to make and is even more difficult to try to define it because clinical depression can manifest in many different ways. Perhaps we don’t need a new definition of depression. The DSM-V counseled the diagnosis of clinical depression by identifying at least 4 of the 8 most common symptoms. Most professionals agree that depression is a condition in which a person feels discouraged, sad, hopeless, unmotivated, or disinterested in life in general. The big dilemma is how we can help a person that presents with these symptoms. There are many tools proven to help patients with clinical depression such as cognitive therapy, SSRI, SNRI, and other medications. However, as mentioned on this article one specific approach alone usually doesn’t solve the problem of all these depressed patients.
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Post by Munit Singh on Aug 19, 2015 11:50:43 GMT -4
Defining a mental illness can certainly be a challenging task considering the symptoms are all subjective and do not have a medical laboratory basis. The DSM V criteria for major depression requires at least 5 out of the 8 possible symptoms of depression. Many of these symptoms overlap with other psychiatric conditions.
The article mentions the use of the Research Domain Criteria, which is a system that is based on specific symptoms and treating the specific symptom rather than a cluster of symptoms. I think this idea is interesting, however, it may also create further issues, such as using multiple medications that may cause side effects that present as other psychiatric illnesses.
Like medicine as a whole, the definition of depression requires continued surveillance for a proper diagnostic criteria and treatment.
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Post by Vivian Ariyo on Aug 19, 2015 14:22:21 GMT -4
Depression is a topic that is hard to define in a truth sense because it is a component of all mental iilness. Patients experiencing depression have both positive and negative symptoms that can also be interwoven sometimes which make it difficult to deal with as a patient and also difficult to treat. The way most physicians are dealing with treating this, is to treat with any presenting symptoms when they show up in the office. Everyone of us have situations that get us depressed sometimes but patients dealing with a major depression as an ailment can be difficult to deal with. It is a component of some other mental illness that I personally feel more research has to be done to be able to properly define depression.
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Post by Daman Pannu on Aug 19, 2015 22:57:52 GMT -4
I most agree with the article that people with depression can sometimes present with opposite symptoms, some patients can present with hypersomnia while others may present with trouble sleeping. Therefore, we should be grouping people with similar symptoms together when conducting clinical trials so that we can find subgroups with which a new drug would work, without having patients with opposite symptoms confounding the results. I’m hesitant though, if trying to treat similar symptoms across patients with multiple different diagnosis will yield results. I am curious whether a person’s personality traits has any effect on which symptoms a person with depression will present with and if that could explain the differences with one patient having hypersomnia while the other is struggling to fall asleep.
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Post by Cheryl Stephens on Aug 20, 2015 9:44:55 GMT -4
From the study done at John Hopkins, I agree in that ‘depression is heterogeneous.’ Even though criteria should be met, the subtypes of depression vary so widely based off of not only symptoms but also an individual’s age, experiences, life events, genetics and environmental exposure. In this article, I find that the RDoC approach recognizes treating depression by focusing on the symptom. I like this approach but can understand that it is not a definitive answer to treating depression. I highly agree with Cuthbert in that clinical trials with depression are not individualized and therefore are not the best way to fully grasp the psychological the elements of depression. I agree that more research and undefined areas of the diagnosis of depression are still unanswered and unreached.
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Post by Anurag Prabhu on Aug 20, 2015 10:04:10 GMT -4
This week's article about the need for a better definition for depression highlights the much avoided and hidden fact that depression, even though being a huge area in our field of Psychiatry, is vague and lacks proper set of guidelines. It is true that we have come up with SIGECAPS and other terms like that but every one of us knows that there are still a lot of loopholes to be filled. The idea of treating the specific symptoms rather than the “disease” to the “disorder” per se is very thought provoking and it looks like this idea is only going to help us improve exponentially in this area which clearly needs to be worked on a lot even today after all the years of research we have put in the last century. As of today, I feel a bit relieved that at least we have some wonder drugs like Zoloft, Prozac etc which have been helping millions of people worldwide suffering from depression. As I said many times before, the next 10 years are going to be golden years for us Psychiatrists and the field of Psychiatry itself. So, we will have to keep working.
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Post by Brittany Egeh on Aug 20, 2015 11:21:16 GMT -4
The Article “Why Depression Needs a New Definition” discussed that due to the multi-factorial causes of depression, scientist have been unable to correctly define depression. Psychologist Rollo May, wrote in his book that depression is an inability to construct a future, which is a great simple definition of depression. In observation of depressed patients, it seems that they are often stuck in their thoughts of whatever may have caused their current situation and have an inability to move forward. The author of this article states that depression is not a disease, but a syndrome which is defined as a collection of signs and symptoms known to frequently appear together. Depression is usually diagnosed on a subjective report or through observation. Diagnoses are generally made based on a criterion of 4 out of 9 symptoms which makes the diagnoses. I agree with the researchers that it is difficult to completely understand the cause of depression and why it occurs in individuals, however I also believe that depression is mainly environmental.
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Post by Ravi Gudipalli on Aug 20, 2015 12:43:56 GMT -4
Everybody feels blue or sad in their life time. But for some people it will come and go away quickly and for others it won't. Depression is a common but serious illness. It interferes with daily life and causes debilitating consequences. DSM-V, published in 2013 defined depression with some symptoms and tried to diagnose people with depression with “Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful).” But I agree with psychiatrist Daniel Goldberg that DSM-V has put some entirely opposite symptoms to diagnose Depression. So may be Depression is a syndrome rather than an illness. But still we need to do a lot of research on brain and its chemical neurotransmitters in order define exactly.
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Alicia Capilla Crespillo
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Post by Alicia Capilla Crespillo on Aug 20, 2015 14:38:52 GMT -4
I agree that depression needs a new definition. Since the ancient times, the human being has been looking for answers and since then our knowledge has expanded however, it is not enough. We have created a concept called “depression” that we use to explain an overwhelming reality that many people suffer. We have tried to group different symptoms around sadness and we make a diagnosis based just on mere symptoms. The problem is that these symptoms, the ones that define depression, are also found in others mental illnesses, so by treating the symptoms of depression we may be treating other diseases that have similar symptoms. Thus, the clue for the definition of depression will be given when we can explain in detail the mechanism and just then we will be able to treat according to the cause and not only to symptoms. I strongly believe that our efforts will be rewarded. Who knows, maybe the definition of depression is closer than we think.
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Post by Stephanie Anyikude on Aug 20, 2015 15:10:31 GMT -4
The definition of Depression is evolved over the years. Initially, there were two types of depression identified: Endogenous and Reactive depression. In the 1980s, Depression was defined by a list of various symptoms and having at least 5 out of the 8 symptoms which should including Anhedonia. Today, DSM V has changed to include as a symptom subjective or objective presence of a depressed mood most time of the day. It is marvelous to know how the evolution of the definition of depression. Additionally, research has exposed that there are more factors involving depression other than decreased serotonin or "chemical imbalance."
The vast majority of researchers are still looking and/or reasserting other sectors of Depression to most accurately define this condition, so it can be best managed by Clinical psychiatrist and both heath care professionals.
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Post by Deepika Tanwar on Aug 20, 2015 15:34:26 GMT -4
The article correctly states that “unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure.” It should not be surprising, therefore, that each person that experiences depressions, experiences differently. Diagnosis and treatment of depression should not be done with a mind-set of “one-fits-all.” Even medical conditions, such as diabetes or hypertension, treatment plans are based on the individual’s specific case, so mental conditions should not be considered any different. Generalizations can be even more problematic for psychiatric patients since there is still no consensus as to what leads to these disorders, whether it is physical or environmental. The current thought process is that it is a mix, though each individual can be influenced by one more than the other depending on the circumstances.
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