Abstract:
:Effective treatment of severe or chronic unipolar depression requires the combination of pharmacological and psychotherapeutic interventions, and demands a theoretical paradigm integrating biological and psychosocial aspects of depression. Supported by recent research, we propose in our article a biopsychosocial diathesis-stress model of depression. Its basic aim is psychoeducational: to provide therapists, patients, and their environment a constructive conceptual framework to understand depressive complaints, vulnerability, and stress. The core of the model consists of the concept of psychobiological vulnerability, which is determined by risk factors-of a biogenetic, psychological, somatic, and societal nature-and by protective factors. Life events with an idiosyncratic, stress-inducing value interact with this vulnerability, triggering severe or chronic distress that affects the individual's resilience and leads to symptoms of depression. The pathogenesis of depression is symbolized by a negative downward loop, in which interactions among symptoms, vulnerability, and stressors drive the patient toward a depressive condition. Moreover, experiencing recurrent depression influences psychobiological vulnerability, the occurrence of stressors, and tremendously increases the risk of further relapse. The model stresses the self-evident integration of biological and psychological therapeutic interventions that need to focus on symptom reduction and on relapse prevention. Moreover, it offers the patient and therapist a psychoeducational context in which the individual's vulnerability and depressive symptoms can be treated. Finally, applications of the depression model as a therapeutic approach to severe depression in the phases of remoralization, symptom reduction, and relapse prevention are presented.
journal_name
Depress Anxietyjournal_title
Depression and anxietyauthors
Schotte CK,Van Den Bossche B,De Doncker D,Claes S,Cosyns Pdoi
10.1002/da.20177subject
Has Abstractpub_date
2006-01-01 00:00:00pages
312-24issue
5eissn
1091-4269issn
1520-6394journal_volume
23pub_type
杂志文章,评审abstract:BACKGROUND:Processes of phasic fear responses to threatening stimuli are thought to be distinct from sustained, anticipatory anxiety toward an unpredicted, potential threat. There is evidence for dissociable neural correlates of phasic fear and sustained anxiety. Whereas increased amygdala activity has been associated ...
journal_title:Depression and anxiety
pub_type: 杂志文章
doi:10.1002/da.22382
更新日期:2015-09-01 00:00:00
abstract::This study seeks to determine how panic disorder patients with anxiety and depression comorbidity differ from panic disorder patients without comorbidity at the time of presentation for treatment. One-hundred seventy-one panic disorder patients presenting for their initial assessment and treatment at the Payne Whitney...
journal_title:Depression and anxiety
pub_type: 杂志文章
doi:10.1002/1520-6394(2000)12:2<78::AID-DA3>3.0.CO;2-5
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Panic disorder (PD) is highly comorbid with major depressive disorder (MDD) with potential impact on patient-reported outcomes of quality of life (QOL), functioning, and depressive symptom severity. METHODS:Using data from the sequenced treatment alternatives to relieve depression (STAR*D) trial, we compare...
journal_title:Depression and anxiety
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1002/da.22152
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:Evidence-based treatments for post-traumatic stress disorder (PTSD) have poor uptake and remission rates, suggesting that alternative treatments are needed. Morning bright light may be an effective treatment for PTSD given its established effects on mood and sleep, however, there are no published trials. ME...
journal_title:Depression and anxiety
pub_type: 杂志文章,随机对照试验
doi:10.1002/da.22897
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Parental mental disorders have been shown to predict offspring's mental health problems. We examined whether pathways from parental mental disorders to offspring's psychiatric work disability in early adulthood are mediated through offspring's mental disorders and social disadvantage in adolescence. METHODS...
journal_title:Depression and anxiety
pub_type: 杂志文章
doi:10.1002/da.22847
更新日期:2019-04-01 00:00:00
abstract::Age at onset is an important dimension in the classification of mood disorders. Recent findings on early-onset (EO) versus late-onset (LO) unipolar chronic depressions support this subtyping. The aim of the present study was to determine clinical differences between EO and LO bipolar II chronic depression and to suppo...
journal_title:Depression and anxiety
pub_type: 杂志文章
doi:10.1002/1520-6394(2001)13:1<45::aid-da7>3.0.co;2-4
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Investigations of gene-environment interaction (GxE) in depression have implicated a polymorphism in the promoter region of the serotonin transporter gene (5-HTTLPR) as a moderator of the stress-depression relationship. However, recent evidence for 5-HTTLPR GxE in depression has been inconsistent. This study...
journal_title:Depression and anxiety
pub_type: 杂志文章
doi:10.1002/da.20715
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:Major depressive disorder (MDD) has been associated with changes in mean telomere length and mitochondrial DNA (mtDNA) copy number. This study investigates if clinical features of MDD differentially impact these molecular markers. METHODS:Data from a large, clinically ascertained sample of Han Chinese women...
journal_title:Depression and anxiety
pub_type: 杂志文章
doi:10.1002/da.22517
更新日期:2016-11-01 00:00:00
abstract::This study examined the validity of the Assessment of Depression Inventory (ADI), a 39-item measure of depression with three embedded validity scales, using inpatient participants. The ADI Depression (Dep) and Feigning (Fg) scales were compared to the corresponding scales of a widely used multiscale instrument, the Pe...
journal_title:Depression and anxiety
pub_type: 杂志文章
doi:10.1002/da.20183
更新日期:2006-01-01 00:00:00
abstract::Pediatric psychopharmacology is hindered by the relative lack of controlled, empirical clinical trials [Shatzberg and Nemeroff, 1998: Washington, D.C.: The American Psychiatric Press, Inc. p 301-306]. Psychiatric disorders in children and adolescents carry considerable morbidity, impede development, and carry a signif...
journal_title:Depression and anxiety
pub_type: 杂志文章,评审
doi:10.1002/1520-6394(2000)12:1+<85::AID-DA12>3.0.CO;2
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Treatment utilization/costs and work performance for persons with major depressive disorder (MDD) by severity of illness is not well documented. METHODS:Using National Comorbidity Survey-Replication (2001-2002) data, US workforce respondents (n=4,465) were classified by clinical severity (not clinically dep...
journal_title:Depression and anxiety
pub_type: 杂志文章
doi:10.1002/da.20580
更新日期:2010-01-01 00:00:00
abstract::There are no reports of a child taking a selective serotonin reuptake inhibitor and an atypical anti-psychotic being successfully tapered from these medications after completion of cognitive-behavioral therapy (CBT) for obsessive-compulsive disorder. With this in mind, we report the case of an 8.5-year-old male who wa...
journal_title:Depression and anxiety
pub_type: 信件
doi:10.1002/da.20448
更新日期:2009-01-01 00:00:00
abstract::Functional impairment might amplify suicide risk in later life. A positive view of the future may reduce this risk. We tested the hypothesis that hopelessness and positive future orientation moderate the association between functional status and suicide ideation in a sample of 136 patients, 55 years of age or older, i...
journal_title:Depression and anxiety
pub_type: 杂志文章
doi:10.1002/da.20224
更新日期:2007-01-01 00:00:00
abstract::Experimental evidence suggests that panic disorder is characterized by abnormalities in the balance system function and that these abnormalities might be related to the severity of agoraphobic avoidance. Since the balance system can be modulated by the serotonergic system, we investigated the effect of a 6-week treatm...
journal_title:Depression and anxiety
pub_type: 临床试验,杂志文章
doi:10.1002/da.10092
更新日期:2003-01-01 00:00:00
abstract::There is an urgent need for more rapidly effective pharmacotherapies for major depressive disorder and bipolar disorder (BP) that are efficacious and tolerable for depressed patients who respond poorly to conventional treatments. Multiple controlled trials have now demonstrated a rapid, nonsustained antidepressive res...
journal_title:Depression and anxiety
pub_type: 杂志文章,评审
doi:10.1002/da.22505
更新日期:2016-08-01 00:00:00
abstract::This study was designed to investigate the efficacy of the antidepressant fluvoxamine in the treatment of combat-related post-traumatic stress disorder (PTSD). Fifteen veterans with combat-related PTSD and no other psychiatric diagnosis except depression were recruited to participate in a 14-week open-label study of f...
journal_title:Depression and anxiety
pub_type: 临床试验,杂志文章
doi:10.1002/da.1082
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:Brain-derived neurotrophic factor (BDNF) may have an important role in the pathophysiology of depression. Previous studies indicate that serum BDNF levels were lower in patients with depression and increased after treatment with antidepressants. However, results of studies on serum BDNF levels in remitted pa...
journal_title:Depression and anxiety
pub_type: 杂志文章
doi:10.1002/da.21933
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:Although losses are important consequences of disasters, few epidemiological studies of disasters have assessed complicated grief (CG) and none assessed CG associated with losses other than death of loved one. METHODS:Data come from the baseline survey of the Hurricane Katrina Community Advisory Group, a re...
journal_title:Depression and anxiety
pub_type: 杂志文章
doi:10.1002/da.20865
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVES:This article describes a computer-assisted cognitive behavioral therapy (CBT) program designed to support the delivery of evidenced-based CBT for the four most commonly occurring anxiety disorders (panic disorder, posttraumatic stress disorder, generalized anxiety disorder, and social anxiety disorder) in pr...
journal_title:Depression and anxiety
pub_type: 杂志文章
doi:10.1002/da.20542
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Although trauma-focused cognitive behavioral therapy (TF-CBT) is the frontline treatment for posttraumatic stress disorder (PTSD), at least one-third of patients are treatment nonresponders. This study aimed to identify neural markers of treatment response, specifically the prediction of remission of specifi...
journal_title:Depression and anxiety
pub_type: 杂志文章
doi:10.1002/da.23061
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVES:To explore the anxiolytic effects of a 4-month randomized, placebo-controlled trial of exercise and antidepressant medication in patients with major depressive disorder (MDD), and to examine the potential modifying effects of anxiety in treating depressive symptoms. MATERIALS AND METHODS:In this secondary a...
journal_title:Depression and anxiety
pub_type: 杂志文章
doi:10.1002/da.23088
更新日期:2020-08-12 00:00:00
abstract:BACKGROUND:Social anxiety disorder (SAD) is an incapacitating disorder running in families. Previous work associated social fearfulness with a failure to habituate, but the habituation response to neutral faces has, as of yet, not been investigated in patients with SAD and their family members concurrently. Here, we ex...
journal_title:Depression and anxiety
pub_type: 杂志文章
doi:10.1002/da.22962
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Previous work on gene-environment (GxE) interplay concerning anxiety has focused on the interaction of 5-HTTLPR with childhood adversities or traumatic events whereas the impact of recent stressors is understudied, as is the integration of resilience. The current study aimed to investigate the interactive ef...
journal_title:Depression and anxiety
pub_type: 杂志文章
doi:10.1002/da.23101
更新日期:2020-10-14 00:00:00
abstract::Previous studies have revealed altered structural development of the frontal lobes and prefrontal cortex (PFC) in children with symptoms of posttraumatic stress disorder (PTSD). This study is the first to provide a detailed structural analysis of the PFC in children with and without PTSD symptoms. We compared gray and...
journal_title:Depression and anxiety
pub_type: 杂志文章
doi:10.1002/da.20131
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Brain structures underlying posttraumatic stress disorder (PTSD) have been a focus of imaging studies, but associations between treatment outcome and alterations in brain structures remain largely unexamined. We longitudinally examined the relation of structural changes in the rostral anterior cingulate cort...
journal_title:Depression and anxiety
pub_type: 杂志文章
doi:10.1002/da.22471
更新日期:2016-05-01 00:00:00
abstract::Treatment-resistant depression (TRD) in adolescents is prevalent and impairing. We here review the definition, prevalence, clinical significance, risk factors, and management of TRD in adolescents. Risk factors associated with TRD include characteristics of depression (severity, level of hopelessness, and suicidal ide...
journal_title:Depression and anxiety
pub_type: 杂志文章,评审
doi:10.1002/da.20884
更新日期:2011-11-01 00:00:00
abstract::This report describes the reactivation of a posttraumatic stress disorder (PTSD) after a minor head injury in two young women who had recovered from extreme stress caused by sexual abuse during adolescence. Intrusive thoughts, images, dreams, and phobic avoidance bear a direct relationship to the specific circumstance...
journal_title:Depression and anxiety
pub_type: 杂志文章
doi:10.1002/(sici)1520-6394(1998)8:1<43::aid-da9>3.0.c
更新日期:1998-01-01 00:00:00
abstract::This study explores the psychometric properties of the Spanish adaptation of the Mood Spectrum Self-Report (MOODS-SR), an instrument designed to assess a broad range of manifestations of mood psychopathology. A total of 71 Spanish subjects participated: 49 outpatients who met criteria for a mood disorder or generalize...
journal_title:Depression and anxiety
pub_type: 杂志文章
doi:10.1002/da.20169
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Physical activity is increasingly recognized as an important modifiable factor for depression. However, the extent to which individuals with stable risk factors for depression, such as high genetic vulnerability, can benefit from the protective effects of physical activity, remains unknown. Using a longitudi...
journal_title:Depression and anxiety
pub_type: 杂志文章
doi:10.1002/da.22967
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:There is evidence that negative affect (NA) and anxiety sensitivity (AS) predict the development of anxiety disorders, particularly panic disorder (PD). The main purpose of this study was to examine whether NA and AS will also predict the clinical course of PD. METHODS:Participants were 136 individuals with...
journal_title:Depression and anxiety
pub_type: 杂志文章
doi:10.1002/da.20423
更新日期:2009-01-01 00:00:00