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3 results

  • 11 - Molecular imaging of major depression

  • from Section II - Mood Disorders
    • By Julia Sacher, PET Centre Centre for Addiction and Mental Health Toronto, ON, Canada, Gwenn S. Smith, Department of Psychiatry and Behavioral Sciences The Johns Hopkins University School of Medicine Baltimore, MD, USA
  • Edited by Martha E. Shenton, Bruce I. Turetsky, University of Pennsylvania
  • Book:
    Understanding Neuropsychiatric Disorders
    Published online:
    10 January 2011
    Print publication:
    09 December 2010, pp 170-196

  • Summary

    The primary focus of radiochemistry development for positron emission tomography (PET) and single photon emission computed tomography (SPECT) has been dopamine and serotonin neurotransmission. This chapter reviews the PET and SPECT neurochemical brain imaging studies to understand the neurochemical mechanisms underling depression and the response to treatment. It examines the clinical and methodological aspects involved in the design, analysis and interpretation of neurochemical imaging studies. The chapter overviews the studies on neurochemical imaging in depressive illness. While the majority of studies have focused on unipolar depression, the chapter discusses the available data on other depression subtypes. The serotonin and dopamine systems have been the major focus of in-vivo neurochemical imaging studies in depression, as well as other conditions including schizophrenia and anxiety disorders. The chapter also reviews the available neurochemical imaging data for other neurotransmitter systems, and highlights active areas of radiotracer development for other potentially important neurochemical targets.

  • 4 - Estrogen and depressive illness in women

  • from Part II - Biological basis
  • Edited by Jay D. Amsterdam, University of Pennsylvania, Mady Hornig, University of California, Irvine, Andrew A. Nierenberg
  • Book:
    Treatment-Resistant Mood Disorders
    Published online:
    25 March 2010
    Print publication:
    28 June 2001, pp 80-95

  • Summary

    One of the most consistent findings in the epidemiology of mental disorders is the higher prevalence of depressive illness in women than in men. This chapter reviews neurological effects of estrogen that have been elucidated since the 1980s so as to provide a scientific basis for possible biological mechanisms of action of this sex steroid on affective states. Estrogen induces RNA and protein synthesis via genomic mechanisms, which, in turn, cause changes in levels of specific gene products, such as neurotransmitter synthesizing enzymes. The chapter discusses the clinical studies of estrogenic effects on mood in non-clinical and in clinical populations with regard to the therapeutic use of estrogen in depressive disorders in women. Although there have been few systematic investigations of the use of estrogen in treatment-resistant depression, several controlled studies and case reports serve to provide some evidence of its effects.

  • Medical audit in an elderly depressed cohort

  • Peter Donnelly
  • Journal:
    Irish Journal of Psychological Medicine / Volume 9 / Issue 1 / May 1992
    Published online by Cambridge University Press:
    13 June 2014, pp. 62-66
    Print publication:
    May 1992

  • Medical audit was carried out to evaluate drug therapy in a cohort of depressed patients admitted to a functional ward for the elderly. A retrospective case note study was carried out in 61 consecutive admissions with a diagnosis of depression. Seventeen of the 41 patients (41%) with a diagnosis of Manic Depressive Psychosis were not taking antidepressant medication on admission. Of the 11 patients who received Electroconvulsive Therapy seven (64%) did so under Section 3 of the Mental Health Act. Four of the 41 patients (10%) with a diagnosis of Manic Depressive Psychosis were not on prophylactic antidepressants or lithium on discharge. Seventeen of the patients (28%) were taking benzodiazepine hypnotics on admission, and 14 of these were discharged on the same type and dosage. There were no patients on more than one type of antidepressant or antipsychotic at any one time. These findings reflect deficiencies in the general practice and specialist treatment of depressive illness in an elderly cohort. The need for on-going audit in this at risk group is emphasized.