Posts Tagged ‘depression’

ACEs and the Epidemiology of Psychophysiologic Disorders

Thursday, June 8th, 2017
A new paper (on-line only at the moment) (1) reports a prospective epidemiological study thaexamines the association between Adverse Childhood Experiences (ACEs) and the subsequent occurrence of painful medical conditions.  The role that mood and anxiety disorders play in this association is also carefully assessed.


Stress and Blurred Vision

Thursday, March 25th, 2010

For years I would teach medical residents about stress illness by telling the true story of a 16 year old girl who came to clinic with intermittent blurred vision (the full story is in my book).  I would ask them to pretend she was in the room and to try to diagnose the cause.  They would ask questions about her symptoms and “order” tests and I would give them the results.  Very few even got close to the answer though a few, to their credit, were able to look beyond physiology alone and figure out that her vision blurred when she was crying.  The crying was from severe depression brought on by regular physical abuse by her father.


Depression News (6)

Monday, February 8th, 2010

The United States Preventive Services Task Force (USPSTF) has published an update (1) of their recommendations for screening for depression in adults seen in a primary care office.  You might assume that screening for depression is always a good thing until you realize that it will help only those whose depression would not otherwise be detected by their medical clinician.  These cases of “screen-detected depression” tend to be milder than “clinician-detected depression”, they may not need treatment and they might not respond as well to medication.  In addition, about half of patients given medication for depression in primary care stop taking it in less than three months which limits the effectiveness and  increases the relapse rate of their illness.  This reduces the benefit of screening.


Depression News (5)

Friday, February 5th, 2010

Continuing the discussion from the last post, a new study has shown that anti-depressant medication (ADM) has no more benefit than a sugar pill (placebo) when depression is less than very severe (1).  What should you do if you were in that category of depression when ADM was prescribed for you and you are still taking them?


Depression News (4)

Thursday, February 4th, 2010

Continuing the discussion from the last post, a new study has shown that anti-depressant medication (ADM) has no more benefit than a sugar pill (placebo) when depression is less than very severe (1).  This evidence, though not necessarily a reason to halt prescription of ADM for patients in that category, should certainly make clinicians reconsider the risks and benefits and discuss the results of this research with their patients.


Depression News (3)

Wednesday, February 3rd, 2010

Continuing the discussion from the last post, the University of Pennsylvania study (1) concluded that anti-depressant medication (ADM) was no better than placebo (sugar pill) for people with mild, moderate or even severe depression as measured by the Hamilton Depression Rating Scale.  Only in those with very severe depression by that scale was the improvement with ADM significantly greater than the improvement with placebo.


Depression News (2)

Tuesday, February 2nd, 2010

The results from the JAMA paper (1, described in the last post) are reported using the Hamilton Depression Rating Scale.  The scale is derived from a series of questions and scores are interpreted as follows: (more…)

Depression News (1)

Monday, February 1st, 2010

In the U.S. alone, 27 million people take anti-depressant medication.  This is approximately 10% of the population of teens and adults.  With numbers like that, it is not surprising that a recent study (1) received a great deal of attention from national and local news media.


Stress Illness Brochure (4)

Thursday, December 17th, 2009

Continuing with Part 4 of the Stress Illness brochure:

III. A Disease Called Depression


Linking Stresses and Symptoms (3)

Wednesday, December 9th, 2009

It  comes as a surprise to many, that mental health conditions like Depression, the Anxiety disorders or Post-Traumatic Stress may manifest themselves predominantly as a physical illness.  As a result, people suffering from these conditions may have no idea what is causing their symptoms.  Many people with Depression, for example, don’t feel particularly depressed.  So what are the clues that point us toward these diagnoses?  I usually ask the following questions: (more…)