John F. Greden

Leon Grunhaus

The range of severity in depressive disorders is great -- Severe Depressive Disorders is the first book published that provides an in-depth look at the most severe end of the spectrum. The book is oriented toward the care of patients who require specific attention, careful treatment, and detailed prognostic assessment. Improved understanding, knowledge, and treatment approaches of depressive disorders are stressed throughout. Severe Depressive Disorders contains a distinguished list of contributors who present original concepts in the causes of, and treatment for patients with, severe depressive mood disorders.

Severe Depressive Disorders

Michelle B. Riba

Melvin G. McInnis

This unique book presents the treatment "roadmap" implemented by the University of Michigan Comprehensive Depression Center's Treatment Resistant Depression Program, step-by-step guidance that has long eluded clinicians, patients, and their families. Writing across discipline, modality, lifespan, and patient demographics, the authors have compiled the most current thinking on TRD and distilled it into a highly readable, imminently practical, and brilliantly organized source of hope. The authors believe that early intervention is critical, and they advocate strategies for renewed focus on identifying youths who are at risk or already symptomatic. Similarly, they devote chapters to special populations such as pregnant women, older people, and those with comorbidities. Perhaps most useful to patients and their families, the book has a strong self-care orientation, emphasizing the importance of exercise, nutrition, and healthy sleep guidelines. Patients who are actively engaged in managing their disease often have better outcomes. Treatment Resistant Depression is frequently a lifetime diagnosis. The book acknowledges that fact and offers a systematic course of treatment grounded in evidence-based research that is current and comprehensive. Treatment Resistant Depression: A Roadmap for Effective Care offers a new way of conceptualizing an old enemy, and should prove to be an indispensable weapon in the battle.

A Roadmap for Effective Care

Treatment Resistant Depression

Based on powerful epidemiological data such as numbers afflicted, mortality rates from suicide, personal and familial consequences, and skyrocketing fiscal costs, major depressive disorder (MDD) has the sad and ignominious distinction of being a leader among disabling disorders worldwide. With lifetime prevalence risks of 13% for men and 21% for women, the magnitude of this crisis cannot be understated. This hard-hitting volume focuses on recurrences -- perhaps most important among the many factors (others include extreme underdiagnosis and undertreatment, genetic vulnerability, frequent recurrences, severe stigma and poor adherence with maintenance treatment, and brain tissue degenerative changes associated with recurrences and chronic depression) that contribute to MDD's high morbidity. Following an introduction by the editor detailing the overwhelming personal and societal burden created by MDD, the distinguished authors of this volume emphasize five critical topics: The lifetime impact of gender on recurrent MDD in women, emphasizing the clinical features, treatment, and prevention strategies of the illness during three key periods of hormone transition (adolescence, childbearing years, and middle life) and including recommendations on where future research should focus. Treatment strategies for chronic and recurrent depression to help prevent acute episodes from developing into long-term depression, specifically addressing the continuing question of whether pharmacotherapy and psychotherapy combinations are superior to either alone. Prevention of recurrences in bipolar patients, updating the demonstrated benefits of several new anticonvulsant mood stabilizers and integrative treatment approaches and suggesting that treatment success depends on a multifaceted approach that combines old and new pharmacotherapy. Potential applications of new somatic treatment strategies involving minimally invasive brain stimulation that have greatly reduced the stigma but done little to advance the diagnosis and treatment of neuropsychiatric illnesses, with exciting data suggesting the efficacy of vagal nerve stimulation (VNS) and repetitive transcranial magnetic stimulation (TMS). A "call to arms" with updated recommendations on how to ensure demonstrable, lasting progress in preventing recurrences of depression, which -- along with other chronic diseases such as diabetes, heart disease, and schizophrenia -- progresses throughout life unless actively treated. This highly informative volume, clearly written and exceptionally well referenced, is a "must-read" for every clinician, including specialists in depression and clinical neurosciences, primary care physicians and mental health clinicians interested in learning more about how to successfully treat what remains one of our most recalcitrant, debilitating illnesses.

Treatment of Recurrent Depression

Sagar V. Parikh

This book offers a guide to better understanding models of workplace mental health, as well as best practices for mental health professionals, employee assistance groups, employers and employees alike. The cost of depression at the workplace is staggering, both in terms of absenteeism and productivity loss while at work, and in terms of human and family suffering. Depression is highly prevalent and affects employees’ concentration, decision-making skills and memory, contributing to accidents and quality issues. Analyses indicate that the returns on investment for workplace mental health programs are significant, with employers reporting lower productivity-related financial losses and less need staff turnover due to mental health conditions. The book also addresses substance use and misuse, and ways to address such problems.

John F. Greden

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