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How does mental health impact public health? In 2001, the WHO recognized depressive disorders as the leading cause of disability worldwide. But most Americans who meet diagnostic criteria for major depression are untreated or undertreated. Luckily, recent advances have finally made it possible for the field of public health to address mental health in the population. Public Health Perspectives on Depressive Disorders fills a gap by identifying the tools and strategies of public health practice and by exploring their application to twenty-first-century public mental health policy and practice. By looking at depressive disorders through a public health lens, this book highlights the centrality of mental health to public health. Linking the available research on depressive illness at the population level with public mental health policy and practice, expert contributors set a research agenda that will help make mental health a central part of public health science and practice. This book is an invaluable resource for researchers and practitioners to develop, facilitate, and conduct pilot and feasibility studies of promising preventive and treatment interventions that might mitigate the progression toward major depression and other mental disorders among populations at risk. The first part of the book underscores the public health significance of depressive illness by focusing on the evidence provided by recent approaches to nosology, epidemiology, illness burden, and impact on overall health. The second part looks at the social and environmental influences on depressive disorders that are critical to future efforts to prevent illness and to promote mentally healthy communities. The third and longest part addresses the vulnerability of diverse groups to depressive illness and underscore best practices to mitigate risk while improving both the preventive and therapeutic armamentaria.
The World Health Organization states that depression is the leading cause of disability worldwide, and predicts that by 2030 the epidemic of depression raging across the world will be the single biggest contributor to the overall burden of disease of all health conditions. Yet this gloomy picture masks a number of paradoxes concerning the diagnosis and cultural interpretation of depression that appear to challenge the claimed prevalence rates on which it is based. This book’s essays by some of the world’s leading researchers and scholars on depression explores these anomalies in detail from multidisciplinary and multicultural perspectives, and in doing so reshapes the debate on the nature of depression that is currently under way in the US and abroad. At the book’s core is the exploration from the multiple perspectives of a key dilemma: is the epidemic of depression real or is it just apparent? In particular, could it be the result of criteria laid down in the official American classification system of mental disorders, the DSM, interacting with cultural changes to reshape our view of melancholy, pathologizing what were formerly normal symptoms of grief or intense sadness? The debate over the DSM's conception of depression has an international relevance, with the WHO’s upcoming revisions to its International Classification of Diseases requiring coordination with the DSM. This collection of perspectives has an unprecedented international dimension, as scholars from Europe and around the world join US academics to explore a central and controversial element of contemporary psychiatric diagnosis - and one that has enormous practical implications for the future of mental health care and how we view our emotions. The book’s accessible essays will make it useful to scholars, practitioners, and students across a wide range of disciplines.
This book reviews all aspects of major depressive disorder (MDD), casting light on its neurobiological underpinnings and describing the most recent advances in management. The book is divided into four sections, the first of which discusses MDD from a network science perspective, highlighting the alterations in functional and structural connectivity and presenting insights achieved through resting state functional MRI and the development of neuroimaging-based biomarkers. The second section examines important diagnostic and neurobiological issues, while the third considers the currently available specific treatments for MDD, including biofeedback, neurofeedback, cognitive behavioral therapy, acceptance and commitment therapy, neuromodulation therapy, psychodynamic therapy, and complementary and alternative medicine. A concluding section is devoted to promising emerging treatments, from novel psychopharmacological therapies through to virtual reality treatment, immunotherapy, biomarker-guided tailored therapy, and more. Written by leading experts from across the world, the book will be an excellent source of information for both researchers and practitioners.
This volume focuses on one of the most prevalent and devastating psychiatric disorders, depression. The contributors apply a developmental analysis to the etiology, course, and sequelae of depression across the lifespan. The effects of depression on multiple domains of functioning, including socio-emotional, social cognitive, and psychobiological, are explored. In addition to the impact of the disorder on the depressed individual, its role on the developmental process in offspring of depressed parents and for families having a depressed member are examined and reviewed. Contributors: BARRY NURCOMBE, PAUL F. COLLINS, RICHARD A. DEPUE, JEFFREY F. COHN, SUSAN B. CAMPBELL, KARLEN LYONS-RUTH, PAMELA M. COLE, CAROLYN ZAHN-WAXLER, JAMES C. COYNE, GERALDINE DOWNEY, JULIE BOERGER, CONSTANCE HAMMEN, E. MARK CUMMINGS, PATRICK R. DAVIES, DONNA T. ROSE, LYN Y. ABRAMSON, JULES R. BEMPORAD and STEVEN J. ROMANO.
How does mental health impact public health? In 2001, the WHO recognized depressive disorders as the leading cause of disability worldwide. But most Americans who meet diagnostic criteria for major depression are untreated or undertreated. Luckily, recent advances have finally made it possible for the field of public health to address mental health in the population. Public Health Perspectives on Depressive Disorders fills a gap by identifying the tools and strategies of public health practice and by exploring their application to twenty-first-century public mental health policy and practice. By looking at depressive disorders through a public health lens, this book highlights the centrality of mental health to public health. Linking the available research on depressive illness at the population level with public mental health policy and practice, expert contributors set a research agenda that will help make mental health a central part of public health science and practice. This book is an invaluable resource for researchers and practitioners to develop, facilitate, and conduct pilot and feasibility studies of promising preventive and treatment interventions that might mitigate the progression toward major depression and other mental disorders among populations at risk. The first part of the book underscores the public health significance of depressive illness by focusing on the evidence provided by recent approaches to nosology, epidemiology, illness burden, and impact on overall health. The second part looks at the social and environmental influences on depressive disorders that are critical to future efforts to prevent illness and to promote mentally healthy communities. The third and longest part addresses the vulnerability of diverse groups to depressive illness and underscore best practices to mitigate risk while improving both the preventive and therapeutic armamentaria.
Depression is a widespread condition affecting approximately 7.5 million parents in the U.S. each year and may be putting at least 15 million children at risk for adverse health outcomes. Based on evidentiary studies, major depression in either parent can interfere with parenting quality and increase the risk of children developing mental, behavioral and social problems. Depression in Parents, Parenting, and Children highlights disparities in the prevalence, identification, treatment, and prevention of parental depression among different sociodemographic populations. It also outlines strategies for effective intervention and identifies the need for a more interdisciplinary approach that takes biological, psychological, behavioral, interpersonal, and social contexts into consideration. A major challenge to the effective management of parental depression is developing a treatment and prevention strategy that can be introduced within a two-generation framework, conducive for parents and their children. Thus far, both the federal and state response to the problem has been fragmented, poorly funded, and lacking proper oversight. This study examines options for widespread implementation of best practices as well as strategies that can be effective in diverse service settings for diverse populations of children and their families. The delivery of adequate screening and successful detection and treatment of a depressive illness and prevention of its effects on parenting and the health of children is a formidable challenge to modern health care systems. This study offers seven solid recommendations designed to increase awareness about and remove barriers to care for both the depressed adult and prevention of effects in the child. The report will be of particular interest to federal health officers, mental and behavioral health providers in diverse parts of health care delivery systems, health policy staff, state legislators, and the general public.
Depressive Realism argues that people with mild-to-moderate depression have a more accurate perception of reality than non-depressives. Depressive realism is a worldview of human existence that is essentially negative, and which challenges assumptions about the value of life and the institutions claiming to answer life’s problems. Drawing from central observations from various disciplines, this book argues that a radical honesty about human suffering might initiate wholly new ways of thinking, in everyday life and in clinical practice for mental health, as well as in academia. Divided into sections that reflect depressive realism as a worldview spanning all academic disciplines, chapters provide examples from psychology, psychotherapy, philosophy and more to suggest ways in which depressive realism can critique each discipline and academia overall. This book challenges the tacit hegemony of contemporary positive thinking, as well as the standard assumption in cognitive behavioural therapy that depressed individuals must have cognitive distortions. It also appeals to the utility of depressive realism for its insights, its pursuit of truth, as well its emphasis on the importance of learning from negativity and failure. Arguments against depressive realism are also explored. This book makes an important contribution to our understanding of depressive realism within an interdisciplinary context. It will be of key interest to academics, researchers and postgraduates in the fields of psychology, mental health, psychotherapy, history and philosophy. It will also be of great interest to psychologists, psychotherapists and counsellors.
This volume is the second in a series on depressive illness. The first volume, entitled Phenomenology of Depressive Illness, is de voted to a description of depressive illness from many vantage points including that of the patient as well as the psychiatrist. Epidemiological, nosological, and developmental aspects are included together with specific descriptions of major subtypes of depressive illness. It is only after an illness is fully described that an attempt should be made to generate models with ex planatory and predictive properties. This second volume is that next step. The major models of depressive illness are described. The limited progress that has been made in integrating these models is discussed, but with further knowledge, this will change. Each model has different advantages and may apply more directly to different subtypes of depressive illness. Such refinements also await the results of future studies. However, the heuristic and clinical usefulness of the models described is considerable and will inform the reader about the current state of knowledge regarding the etiology and pathogenesis of de pressive illness and directions of future research. J. John Mann, M.D. New York vii ACKNOWLEDGMENTS This volume would not have been possible without the support of my wife and children who permitted me the time to work on it. Ms. Renee Azima-Heller assisted greatly in the organi zation of the material for the book. A career scientist award from the Irma T. HirschI Trust provided support for this work.
In this publication a comprehensive overview of the state of the art and future perspectives is given in the fields of basic research, diagnosis, therapy, suicide and relapse prevention, and psychiatric care regarding patients with affective disorders. Presented are decisive new developments which have been milestones in basic research or diagnosis, pharmacotherapy and psychotherapy of affective disorders. The contributions of renowned experts in the field include quantitative brain morphology and developments in genetics and neurochemistry. Special attention has been given to neuropharmacology, pharmacogenetics, electrophysiology, structural and functional neuroimaging of affective disorders as well as new therapeutic options in the field of psychotherapy. Moreover, important clinical issues such as modern aspects of preventing relapse, suicide and postnatal depression in mothers are discussed. Psychiatrists, psychotherapists, neurobiologists and students who participate in the treatment of patients with affective diseases will find this book valuable reading.
Depression, a highly common clinical disorder, is an important and clinically relevant topic for both clinical researchers and practitioners to address, because of its prevalence, impact on the individual and society, association with other mental and physical health problems and the social contexts in which it develops. Depression ranks in Germany and central Europe as the third among the leading mental disorders and world-wide is a leading cause of disability. It is estimated that 8.3 % of the German population is depressed within a year (11.2 % women, 5.5 % men). These statistics mean that 4 million people per year are depressed in Germany alone (one year prevalence). According to the WHO, over 300 million people world-wide experience depression and in the USA the financial burden of this disorder, due to disability and work absenteeism, reaches Depression is also becoming more frequent over time and has a high risk of recidivism –particularly since its most common form, Major Depressive Disorder (DSM-5; ICD10) tends to occur in episodes. For example, 20% to 40% of people become depressed again within two years after their first depressive episode, meaning that a major aim of any therapeutic intervention should be to prevent future relapses. Depression also shows very high comorbidities with other mental and physical health conditions. Its overlap with anxiety pathology is so high that clinicians are concerned with whether the two disorder categories are indeed distinct or if they show substantial etiological overlap. Depression is also associated with heart disease and even cancer, making it a risk factor for mortality and morbidity that needs to be identified early and addressed effectively. In addition to Major Depressive Disorder, the often severe Bipolar Disorder, and the chronic form of Depression referred to as dysthymia are additional mood disorders that among them require careful differential diagnosis. They also lead to questions regarding their common or distinct etiological mechanisms. In order to gain a better understanding of Depression as a clinical disorder, one needs to look at it as a multifaceted phenomenon. Depression is a neurobehavioral condition, and one has to be up to date and have solid understanding of its biological substrate, at a genetic, neuronal, hormonal and pharmacological level. Depression is also a socio-demographic phenomenon, and one needs to examine its epidemiology, that might contain significant cues towards its clearer understanding. It is more prevalent, for example, in certain regions, climates, age groups and genders (much more prevalent in women, with age of appearance in young adulthood but also presents as a significant problem for youth and the elderly), is associated with stereotypes and stigma and can be the aftermath of crises, trauma and loss. The etiology of Depression remains under scrutiny, though recently much more knowledge is emerging from contemporary neuroimaging, genotyping and data science methods. Different neural and behavioral systems may be involved contributing to the significant heterogeneity within the disorder. Social roles, stressors, attachment patterns, family support and social networks, and individual (e.g. gender linked) vulnerabilities may contribute significantly towards increasing risk for developing depression. Different therapeutic approaches, like those stemming from the psychoanalytic/psychodynamic perspectives and those stemming from the cognitive/behavioral (2nd and 3rd wave) tradition focus on the components of etiology considered most dominant. As science progresses with clearer evidence regarding the important etiological factors and their interactions, these different perspectives, each with its own contribution, may need to take new developments into consideration, adapt and even begin to converge. These different aspects of the topic of Depression, which are central to the scientific aims of clinical scientists, but also permeate the way clinicians approach assessment, diagnosis, case formulation and treatment, become the focus of the present volume. Following a conference held at the University of Cyprus, in Nicosia, Cyprus in October 2019, which included presentations by internationally renowned experts in the field on these various aspects of Depression, the idea of extending the topics presented and discussed at the meeting into more elaborated and substantive chapters and synthesizing them into an edited volume was generated. The aim was to fill a substantive gap, with a volume that would be beneficial to a wider, interdisciplinary audience of clinicians, trainees and researchers with examine the different aspects of Depression. In this Edited volume, with contributions from prominent experts in the field, we propose to discuss the subject of conceptualizing and treating Depression and related conditions (e.g. Suicide, Bipolar Disorder) from different theoretical perspectives and after taking into consideration current research into the etiology and maintenance of this condition. Chapters on theoretical perspectives of treatment cover a wide range of approaches, that could be broadly clustered under behavioural and psychodynamic points of view. Perspectives discussed in this volume are psychodynamic therapy, 2nd waver CBT, acceptance and commitment therapy and mentalization therapy. Special topics with great relevance to treatment, include treatment in different levels of care (e.g. partial hospital setting; prevention of suicide; working with cancer patients). The book provides a unique combination of current empirical findings on etiology of depression and suicide, treatment considerations and practical recommendations, treatment in different settings and combination of different theoretical perspectives that can enrich a therapists’ repertoire of tools for understanding and approaching depression. The book describes various theoretical approaches without adhering to anyone but with an effort to highlight common underlying themes like issues of loss, self-esteem, guilt, grief and emotion regulation as these permeate the various perspectives. In this way the book presents a combination of science and practice and of various views that constitute an excellent resource of researchers, clinicians and students of mental health professions. In a final chapter the two editors, Drs. Christos Charis and Georgia Panayiotou, make an effort to impartially integrate information from the various perspectives, highlighting the utility of each approach to address specific vulnerability and etiological factors discussed in the book. In this regard, the volume stresses the idea of the need for continuous and open dialogue between perspectives, theories, levels of investigation, research areas, practitioner needs and scientific views to help make progress in treatment and address this complex and multi-faceted phenomenon in the service of patients, their carers and societies in general.