摘要:

The therapy of depressions with amine precursors is based on the hypothesis of an amine deficiency in depression. A brief review of different trials with these substances is given. However, the therapeutic effects achieved were not satisfactory, although treatment with 5-HT or with amine precursors combined with lithium or MAO-inhibitors seemed to be more successful. Furthermore, the difficulties in interpreting these somewhat disappointing results is pointed out.

ISSN:0254-4962    

DOI:10.1159/000285144

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Bright white light (WL) improves depressive symptomatology in seasonal affective disorders (SAD). Different dosage regimens are effective: photoperiod extension (3, 2, or 1 hr WL at dawn and dusk); morning only (2, 1, or ½ hr); midday only (4 or 2 hr); and evening only (5 or 2 hr). Late evening WL may be deleterious. The placebo effect of WL has not yet been adequately resolved. Only SAD patients and not major depressive disorders have responded to WL. The mechanism of action of WL is unknown: however melatonin does not appear to play a major role.

ISSN:0254-4962    

DOI:10.1159/000285145

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Cognitive therapy alone without concurrent behavioral components seems to be ineffective in the treatment of depressive patients. However, the combination of cognitive and behavioral treatment procedures including social skills training is effective even in the therapy of definite endogenous depression. Three important characteristics are mentioned explaining the therapeutical effectiveness: a concrete rationale, a highly structured therapy program and feedback- and support-techniques. Effectiveness and outcome of the various treatment methods are discussed in the light of three aetiological cognitive hypotheses: the Precipitation theory, the Vulnerability theory and the ‘depression about depression’ hypothesis.

ISSN:0254-4962    

DOI:10.1159/000285146

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Current research is centered mainly on the age group between 6–12 years. The assessment in preschool age and in adolescence seems to present additional difficulties. DSM III criteria for major depression in childhood are slowly recognized internationally. Newly developed rating scales help to standardize clinical and research assessment methods. Biologic markers show deviations similar to those in depressed adults. Epidemiologic data are still not sufficient. The bridging to the development and disturbances of affect attunement between caretaker and child, to family interactions and to environmental stresses has not yet been established in a satisfactory manner.

ISSN:0254-4962    

DOI:10.1159/000285147

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

In the management of depressive states in children and adolescents a distinction should be drawn between: 1. General antidepressive treatment, as exemplified by the attitude and approach adopted by the physician and by close reference persons towards the depressive child. 2. Indirect antidepressive treatment consisting in: a) counselling of the parents or treatment for them (psychotherapy, psychotropic medication), family therapy, or admission of the child to a home; b) learning and teaching hygiene: preventing the child from becoming overtaxed as a result of his difficulty in learning and his impaired performance, recourse to conditioning procedures, demotion to a lower class at school, or transference to another school; c) initial and follow-up psychotherapy or cognitive therapeutic procedures in cases of ‘endogenous’ depression. 3. Direct antidepressive treatment (sleep deprival, phototherapy, antidepressants).

ISSN:0254-4962    

DOI:10.1159/000285148

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

The enormous socio-cultural arrangements of the last centenary led to transformations in the course of diseases. Child mortality and infectious diseases could be largely eliminated. On the other hand, there appeared new diseases because of prolongation of life, increase of population, stress and conflicts. They, therefore, are called ‘specific human diseases’ – as depressions, neurosis, psychosomatic disturbances and drug abuse. In the last years depression more and more appeared as somatically masked depression.

ISSN:0254-4962    

DOI:10.1159/000285149

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

‘Concomitant depression’ (Begleitdepression) is a term proposed by us to signify presence of somatic illness plus depressiveness at the time in one individual. – Headache patients form a main part of patients bearing concomitant depression. Depressiveness can be a sequela of headache, a causative factor of headache, as well as a modifying one. The more severe a headache syndrome is the more it tends to be associated with depressiveness. Cephalea patients are more depression-afflicted than migraine patients, women more than men, higher age group more than lower ones. We have denominated a special ‘depressive headache syndrom of higher age groups’ for its great frequency and clinical importance. Therapy has to take into account all the causative and accompanying factors at the time; thus to include antidepressant therapy (in a complex way, using drugs beside psychotherapy) together with all indicated further somatotropic headache therapy. As slogan: No either/or-therapy but a comprehensive therapy.

ISSN:0254-4962    

DOI:10.1159/000285150

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

In a naturalistic clinical trial we administered three partial sleep deprivations (PSD) within one week to a diagnostically heterogeneous sample of 30 depressed patients and applied serially three dexamethasone suppression tests (DST). We observed that this PSD treatment induced sustained clinical improvement independently from nosological attribution. Abnormal DST results prior to PSD treatment failed to predict clinical course, and normalized after beneficial response.

ISSN:0254-4962    

DOI:10.1159/000285151

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

The relationship of alcohol and depression has always been a subject of clinical and scientific interest. Though many studies have been carried out to clarify the mode of this relationship it still remains in its complexity an area for further research. The two basic ideas of a possible connection are on one hand symptomatic alcoholism with a preexisting depression and on the other hand alcoholism leading to a symptomatic depression. There is in literature a great variability of results with regard to this problem which will be discussed in view of the results of an own study on 444 chronic alcoholic patients.

ISSN:0254-4962    

DOI:10.1159/000285152

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

After the establishment of the first European depression research ward at the PUK Basle 1968 we started the Weissenau ‘depression treatment and research ward’ in 1976. Since this time there were approximately 1800 admissions of depressed inpatients. Up to this day 3 of the 9 county mental hospitals of Baden-Württemberg FRG (1984 2797 depressiv inpatients, average time of stay 49 days) established also such special treatment wards. The conceptualization of depression wards due to treatment strategies is still in the beginning and based on clinical experience up to now. Some advantages of such depression wards could be treating a homogenous group of patients, the chance for special psychotherapeutic treatment strategies (reinforcement of non-depressive behaviour, empathic understanding of underlying dynamics), reduced anxiety in dealing with suicidale and clinging patients, a better dealing with regressive tendencies, or also better conditions for research programmes. Some of the disadvantages could be an uncontrollable regression under too empathic conditions or an accumulation of severely depressed which can paralyse therapeutic activity. To realize such a psychotherapeutic and pharmacological treatment and research program it is necessary to have staff members specialized and also supervised in dealing with depressed patients.

ISSN:0254-4962    

DOI:10.1159/000285153

出版商:S. Karger AG    

年代:1986

数据来源: Karger