Recurrent brief depression revisited

Abstract

Recurrent Brief Depressive Disorder (RBD) is a well-defined and prevalent mood disorder with an increased risk of suicidal behavior and significant clinical impairment in the community and general practice. Occurring at least monthly with depressive episodes lasting only a few days defines recurrent Brief Depressive Disorder. The lifetime co-occurrence of both RBD and Major Depressive Disorder (MDD), called Combined Depression (CD), substantially increases the risk for attempted suicide, even more than that known for 'pure' MDD. The diagnostic criteria for RBD found in the ICD-10 and DSM-IV are helpful in research and clinical routine as well as several methodological issues, which make clinical diagnostic and drug response evaluation of RBD very different from MDD. Formal differences in the course of RBD and MDD require different designs for drug treatment studies. Denials of disorder, specific methodological requirements, and highly selected patient samples have probably been responsible for false negative results in double blind, placebo-controlled treatment studies. Although several authors reported successful treatment of RBD with different compounds in about 60 patients, it is still not possible to deduce a treatment algorithm for RBD to date. Obviously future treatment studies without the limitations of previous studies are clearly required for RBD. Results of ongoing studies will soon provide the first data on the biological underpinnings of RBD.

Amygdala responses to emotional faces in twins discordant or concordant for the risk for anxiety and depression

“…A replicated association has been found between amygdala reactivity to emotional stimuli and a polymorphism in the serotonin transporter gene (Hariri et al, 2002Pezawas et al, 2005), and other genes in the serotonergic pathway also seem to influence amygdala reactivity (Brown et al, 2005;Buckholtz et al, 2007;Dannlowski et al, 2007;Iidaka et al, 2005). tioning.…”

Lamotrigine in the treatment of recurrent brief depression

“…Hamilton Depression Rating Scale) when used in the conventional weekly manner with fixed follow-up intervals may not be optimal as they only capture symptoms present within the week before, and may not accurately portray the variable course of RBD that can occur even within a single week. Other factors include the lack of study designs with appropriate statistical sensitivity and longer periods of observations (Pezawas et al, 2005). Despite the recognition of RBD in the DSM-IV, the level of acceptance for this diagnosis in North America appears to be limited.…”

“…Contradictory results have been attributed to differences in the design, statistical analysis and types of subject included (e.g. comorbidity) (Stamenkovic et al, 2001;Pezawas et al, 2005). Corominas et al (1998) have proposed that agents which help prevent repeated depressive episodes in bipolar disorder might also be useful in RBD.…”

Antidepressant Prescribing and Suicides in Emilia-Romagna Region (Italy) from 1999 to 2008: An Ecological Study

“…There is some evidence that treating more depressed patients with AD might prevent suicide [3]. However, some concerns have been raised over the fact that AD use, mainly Selective Serotonin Reuptake Inhibitors (SSRI) may increase the risk of suicide [4]. Ecological studies showed some evidence that more widespread AD use corresponds to a decrease in suicide rates [1], although this finding is disputed [5].…”