Depressive Disorders

Depression is one of the most common mental disorders. In addition to a depressed mood and a marked lack of interest the victims often suffer from other symptoms such as rapid fatigue, difficulty concentrating, social withdrawal and insomnia.

Many patients also suffer from repetitive brooding thoughts. Often the victims suffer from a diminished self-esteem and reduced self-confidence. Added symptoms are a loss of appetite, physical discomfort, lethargy, fatigue, and suicidal thoughts and suicidal behavior.

Depressive disorders belong the group of so-called affective disorders, which also includes bipolar affective disorder, cyclothymic disorder and dysthymic disorder.

In addition to major depressive disorder (MDD) there are several other manifestations of depressive disorders, such as double depression, minor depression, the recurrent brief depression and the premenstrual dysphoric disorder (PMDD), also known as premenstrual syndrome (PMS).

Psychological Tests

There are several psychological tests for the diagnosis and assessment of depressive disorders. The most important test instruments include the CES-D-Scale (Center for Epidemologic Studies Depression Scale) by the National Institute of Mental Health, the Beck Depression Inventory (BDI-II) and the Hamilton Rating Scale for Depression (HAM-D).

Risk Factors

Women are affected about twice as likely as men and have a younger average age of onset. About half of all patients report a family history of affective disorders.

Course

Depressive disorders often appear in recurrent episodes or in phases, with a high rate of recurrence in untreated individuals. Under adequate, multi-stage treatment can about 2/3 of all outpatients with major depression achieve long term remission.

Treatment

There are several therapeutic methods for the treatment of depression. Depending on the individual symptoms and severity psychotherapy and / or pharmacotherapy are recommended.

Psychotherapy

In the psychotherapeutic treatment of depressive disorders, different treatment methods are used such as psychodynamic therapy, cognitive-behavioral therapy (CBT) or interpersonal psychotherapy (IPT).

Pharmacotherapy

In the pharmacological treatment of depression mainly the so-called antidepressants are used.

Other treatment options

In addition to these therapies, there are several other treatment approaches, such as the so-called brain stimulation procedures (such as the electroconvulsive therapy, the repetitive transcranial magnetic stimulation and the vagus nerve stimulation). In addition, various complementary therapies are used, such as relaxation techniques, art therapy or regular endurance training.

Prien am Chiemsee / Rosenheim, www.Dr-Elze.de

References

Depressive Disorders: Guidelines

American Psychiatric Association - APA (2003). Practice Guideline for the assessment and treatment of patients with suicidal behaviors. Arlington: APPI.
Full text (pdf) >>
American Psychiatric Association - APA (2010). Practice Guideline for the treatment of patients with major depressive disorder. 3rd edition. Arlington: APPI.
Full text (pdf) >>
DGPPN, BÄK, KBV, AWMF, AkdÄ, BPtK, BApK, DAGSHG, DEGAM, DGPM, DGPs, DGRW (Hrsg) für die Leitliniengruppe Unipolare Depression (2015). S3-Leitlinie/Nationale VersorgungsLeitlinie Unipolare Depression. 2. Auflage. Berlin, Düsseldorf: DGPPN, ÄZQ, AWMF.
Full text (pdf) >>
National Institute for Health an Clinical Excellence - NICE (2010). Depression - The treatment and management of depression in adults. National Clinical Practice Guideline 90. London: British Psychological Society, The Royal College of Psychiatrists.
Full text >>
National Institute for Health an Clinical Excellence - NICE (2003). Guidance on the use of electroconvulsive therapy. Technology Appraisal Guideline 59. London: NICE.
Full text (pdf) >>

Dr. Sandra Elze & Dr. Michael Elze

Prien am Chiemsee / Rosenheim, www.Dr-Elze.de