The purpose of this study was to assess medical residents’ knowledge of symptom criteria and subtypes of major depressive episode and their accuracy in diagnosing major depressive disorders and classifying episode severity and subtype according to criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Thirty-five third-year internal medicine residents completed a self-administered, written instrument containing 2 open-ended questions and 21 hypothetical scenarios. The sensitivity for recognizing major depressive disorder was 64%, and the specificity was 69%. The sensitivity for classifying severity was 86% for mild, 66% for moderate, 71% for severe, and 66% for severe with psychosis. Misclassification of severity was most commonly to a less severe class. For scenarios with a diagnosable subtype of a major depressive disorder, the sensitivity for classification was 34% for atypical, 51% for catatonic, 74% for melancholic, 100% for postpartum, and 94% for seasonal depression. When asked to enumerate the criteria symptoms for depression, 80% or more of the residents listed sad mood, loss of interest, weight change, and sleep disturbances; 14 to 21 (40%-60%) listed thoughts of death and worthlessness; other criteria were listed by 7 to 11 (20%-31%). When asked to list the episode subtypes, none was listed by more than 3 (9%) residents, although 13 (37%) residents volunteered psychotic as a subtype. Residents frequently failed to recognize the presence or absence of major depressive disorder and often misclassified episode severity and subtype on scenarios. Few could spontaneously list the episode subtypes. Methods must be developed to improve the recognition and classification of major depressive episodes to better direct treatment.

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WASHINGTON (AP) – The U.S. is declaring a public health emergency to deal with the emerging new swine flu.

The precautionary step doesn’t signal a greater threat to Americans. But it allows the federal and state governments easier access to flu tests and medications.

Homeland Security Secretary Janet Napilotano says roughly 12 million doses of the drug Tamiflu are being released from a federal stockpile so that states can get it if needed.

Travelers entering the U.S. from areas with confirmed swine flu cases will be asked about any illness they may have.

Passengers won’t be barred from getting into the United States. But they could be referred for further testing.

Napolitano characterized the step as more “passive surveillance,” saying airline workers certainly could tell people they shouldn’t fly if ill.

Napilotano said at a White House news conference Sunday that the emergency declaration is standard operating procedure, one was recently declare for the inauguration and for flooding.

Tamiflu (Oseltamivir Phosphate) – is an oral anti-viral drug for the treatment of uncomplicated influenza in patients one year and older whose flu symptoms have not lasted more than two days. This product is approved to treat Type A and B influenza; however, the majority of patients included in the studies were infected with type A, the most common in the U.S. Efficacy of Tamiflu in the treatment of influenza in subjects with chronic cardiac disease and/or respiratory disease has not been established.

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What does it mean to be vulnerable to a mental disorder such as major depression? While 20% of women and 12% of men can provide first-hand knowledge about this ubiquitous disorder, it may be assumed that even more people are vulnerable to depression. Treatments, whether psychopharmacological or psychotherapeutic, may be effective; however, the challenge to the field is to identify individuals who may need more than a universal intervention (e.g., building children’s self-esteem) to prevent episodes and the recurrence of episodes. Ingram and colleagues have set out to define and review this area from a fundamentally psychological perspective, while being mindful of other factors (e.g., genetic, neurochemical, social/interpersonal, economic and political). Buy Imitrex online

Cognitive vulnerability refers to “an internal and stable feature of the person that predisposes him or her to the development of psycho-pathology under specified conditions such as the occurrence of stressful life events”. The internal and stable feature is cognitive, meaning a broad metaconstruct composed of mental structure propositions, operations and products related to perception, thinking and memory. These authors wisely choose to be all-inclusive and go to great pains to put these constructs in the context of cognitive models (e.g., information-processing, social-cognitive and behavioural-cognitive). They also acknowledge that there is relatively little that is unique across other related psychopathological domains such as anxiety, schizophrenia and depression, at the level of these broad constructs. The authors are, after all, concerned with how people perceive, think about (whether consciously or not), and remember, themselves and their lives. The book serves as an excellent primer for those readers curious about the concepts of cognitive psychology and models in this field, while remaining close to the experimental literature of depressive disorders. …..Click here to read more

What does it mean to be vulnerable to a mental disorder such as major depression? While 20% of women and 12% of men1 can provide first-hand knowledge about this ubiquitous disorder, it may be assumed that even more people are vulnerable to depression. Treatments, whether psychopharmacological or psychotherapeutic, may be effective; however, the challenge to the field is to identify individuals who may need more than a universal intervention (e.g., building children’s self-esteem) to prevent episodes and the recurrence of episodes. Ingram and colleagues have set out to define and review this area from a fundamentally psychological perspective, while being mindful of other factors (e.g., genetic, neurochemical, social / interpersonal, economic and political).

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Medications to relieve symptoms of depression are called antidepressants. They work by altering levels of certain neurotransmitters such as serotonin, norepinephrine, and dopamine in the brain. A neurotransmitter is a brain chemical that enables messages to pass from nerve cell to nerve cell in the central nervous system. Many people with depression have low levels of one or more of these neurotransmitters and antidepressant medications help to boost levels. The most common types of antidepressant medication are:

• Selective serotonin reuptake inhibitors
• Serotonin and norepinephrine reuptake inhibitors
• Tricyclic antidepressants
• Combined reuptake inhibitors and receptor blockers
• Monoamine oxidase inhibitors
• Norepinephrine and dopamine reuptake inhibitors

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Evidence indicates that all of the available antidepressants on the market have a high efficacy rate. The only area where the drugs do differ, is in the side effects they create. Side effects have become a central consideration in the new approach to depression treatment.

Years ago, Prozac launched a revolution. It rendered depression a disorder that was finally safely treatable. The torrent of prose hailing Prozac and its chemical kin eventually made the mental illness dinner-party discourse. Today, a much quieter revolution in treatment is taking place. It, too, has its origins in Prozac drug and its siblings, the selective serotonin reuptake inhibitors.

Fifteen years of experience with reasonably safe treatments has given the mental health world a new understanding of the disorder and its true course: It’s no longer enough to merely treat depression; it’s necessary to banish it.

Increasingly, the aim of treatment is not to make patients better but to make them completely well. In the absence of full remission from an episode of depression, the disorder tends to recur. What’s more, studies now show that the longer patients remain sick, the harder it is for them to recover completely. Buy Lexapro Online

“It became very clear over the past several years that people who don’t achieve full remission are at high risk for relapse and for doing poorly,” says Jonathan Alpert, M.D., Ph.D., associate director of the depression research program at Massachusetts General Hospital in Boston. “Even if they don’t have a full relapse, they don’t do well in social and occupational function.”

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The major classes of antidepressant medication are the selective serotonin re-uptake inhibitors (SSRIs), the tricyclic antidepressants (TCAs), the monoamine oxidase inhibitors (MAOIs), and the atypical antidepressants.

SSRI medications affect levels of serotonin in the brain. For many people, these medications are the first choice. Examples of these medications are listed here. The generic name is first, with the brand name in parentheses. These drugs are best known by their brand names. …..Click here to read more

Therapy frequently includes antidepressant medication and supportive care such as psychotherapy. Other less widely used therapies, such as electroconvulsive therapy, are used in severe cases.

Therapy may be provided by your health-care provider or by a specially trained mental-health professional. …..Click here to read more

Once you are being treated for depression, you can make lifestyle changes and choices that will help you through the rough times and may prevent depression from returning:

• Try to identify and focus on activities that make you feel better. It is important to do things for yourself. Don’t isolate yourself. Take part in activities even when you may not want to. Such activity may actually make you feel better.
• Talk with your friends and family and consider joining a support group. Communicating and discussing your feelings is an integral part of your treatment and will help with your recovery.
• Try to maintain a positive outlook. Having a good attitude can be beneficial.
• Regular exercise and proper diet are essential to good health. Exercise has been found to increase the levels of the body’s own natural antidepressants called endorphins.
• Try to get enough rest and maintain a regular sleeping pattern.
• Avoid drinking alcohol or using any illicit substances.

If your symptoms indicate that you have clinical depression, your health-care provider will strongly recommend treatment. Treatment may include supportive therapy, such as changes in lifestyle and behavior, psychotherapy, complementary therapies, and may often include medication. Without treatment, your symptoms will last much longer and may never get better. In fact, they may get worse. With treatment, your chances of recovery are quite good.