Tuesday, December 20, 2011

Depression is curable

Most patients require treatment by successive stages.

Neuroimaging and brain stimulation offer new hope

         One in six people suffer from clinical depression at least once in their lives and 7% of the population suffers from this disease within the year. The extension of this psychiatric problem has to have an impact on public health similar to chronic diseases such as arthritis or diabetes. However, often overlooked or mistaken for a simple and natural sorrow.

    A comprehensive review of studies published between 2005 and 2010,  published in the journal 'The Lancet', has determined that there have been "clear progress" at this time at the research level, but still no treatment "completely satisfactory for major depression. "

      The problem is that, although the disease can be cured, most patients require subsequent treatments to try and combine therapies to find a clear improvement. One of the jobs that are reviewed, called STAR * D and defined as "the largest study ever conducted on depression outside the pharmaceutical industry" - yielded revealing results.

"The goal was remission [of disease] and not just the answer. Remission rates from first to fourth steps were disappointing with a referral (...), gained 67% after foursteps," indicate the researcher David J. Kupfer, Medical Center, University ofPittsburgh (USA) and his coauthors.

            However, the review confirms that both drugs and psychotherapy are "effective" against clinical depression, "alone or in combination." "Depression, with proper treatment, cure, and patients can lead a perfectly normal life," Dr. Jose Luis resolved Carrasco, head of the unit of Personality Disorders at the Hospital Clinico SanCarlos in Madrid.

          However, psychiatric disease risks go unnoticed, especially if it occurs incombination with a physical ailment seriously. So the above review highlights: "A crucial implication is that primary care services should not ignore the presence of depression in patients who have chronic physical disorder," insists Kupfer and his colleagues
            "It is common in chronic clinical depression the percentage is between 30% and 40%," explains Carrasco. "Not that I have a reaction of sadness, it would be normal,but are hoping that everything is over and die. This makes the treatment worse habits, consumption-inducing toxins such as alcohol and worsens the prognosis of the disease" he adds.

Cutting-edge areas

             The review of 'The Lancetalso mentions cutting-edge areas in the study and treatment of major depression. These include several investigations in the field of neurobiology,as the search for genes associated with disease-or patient response to drugs, and neuromiagen techniques that have been detected in the brain areas related to clinical depression states . "However, the degree to which the findings of neurobiological studies can help to improve clinical and functional response of people with this disease is still uncertain," the authors acknowledge.

            They emphasize, however, deep brain stimulation as a major hope for the treatment of depression. Dr. Carrasco is in agreement with this statement, but clarifies that the technique is still "green, in the sense that it is unclear where and when to encourage.It is promising but need to refine it."

           The review authors have also met with various publications around the al eged risk of suicide inhibitors derived from the reuptake of serotonin, a common treatment for depression whose security have questioned some studies. Estimate, however, that there are no conclusive data on this effect. Shows the strongest Dr. Carrasco:"Psychiatrists have very clear that the inhibitors reduce suicides. It's the opposite, patients commit suicide if you do not give medication"

The expert adds, in any case, the first two weeks of treatmentwhen the patient "does not have the antidepressant effect and feel more agitated" - require extensive monitoring, especially with teenagers. "But this has always been known," he says.


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