Recurrent brief depression revisited

Department of General Psychiatry, Medical University of Vienna, Vienna, Austria.
International Review of Psychiatry (Impact Factor: 1.8). 03/2005; 17(1):63-70. DOI: 10.1080/00207390500064650
Source: PubMed


Recurrent Brief Depressive Disorder (RBD) is a well-defined and prevalent mood disorder with an increased risk of suicidal behavior and significant clinical impairment in the community and general practice. Occurring at least monthly with depressive episodes lasting only a few days defines recurrent Brief Depressive Disorder. The lifetime co-occurrence of both RBD and Major Depressive Disorder (MDD), called Combined Depression (CD), substantially increases the risk for attempted suicide, even more than that known for 'pure' MDD. The diagnostic criteria for RBD found in the ICD-10 and DSM-IV are helpful in research and clinical routine as well as several methodological issues, which make clinical diagnostic and drug response evaluation of RBD very different from MDD. Formal differences in the course of RBD and MDD require different designs for drug treatment studies. Denials of disorder, specific methodological requirements, and highly selected patient samples have probably been responsible for false negative results in double blind, placebo-controlled treatment studies. Although several authors reported successful treatment of RBD with different compounds in about 60 patients, it is still not possible to deduce a treatment algorithm for RBD to date. Obviously future treatment studies without the limitations of previous studies are clearly required for RBD. Results of ongoing studies will soon provide the first data on the biological underpinnings of RBD.

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    • "Both models show that during the first six months the recovery from depression in a large majority of subjects progresses at a high and (nearly) constant probability whereas they deviate at later time intervals [37]. Another example of fast mood transitions is covered by the diagnosis recurrent brief depression referring to depressive episodes occurring at least once a month and lasting for only a few days [38]. This condition was recognized in more than 30% of the patients in the general practice [39]. "
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    • "RBD was found to be similar to major depressive disorder (MDD) on most of the indicators of validity except the duration of the depressive episodes. This suggests that RBD constitutes a valid subtype of affective disorder (Angst and Dobler-Mikola, 1985; Angst and Gamma, 2002; Angst and Hochstrasser, 1994; Angst et al., 1990a, 1990b; Pezawas et al., 2005). "
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    • "Functional imaging studies of brain correlates of anxiety and depression have converged on the amygdala, a structure crucial for emotional processing (Canli et al., 2005; Davidson et al., 2003; Drevets, 2001; Fu et al., 2004; Kumari et al., 2003; Lawrence et al., 2004; Rauch et al., 2000; Shin et al., 2005; Siegle et al., 2001; Stein et al., 2002; Surguladze et al., 2005; Thomas et al., 2001; Wright et al., 2003). A replicated association has been found between amygdala reactivity to emotional stimuli and a polymorphism in the serotonin transporter gene (Hariri et al., 2002, 2005; Pezawas et al., 2005), and other genes in the serotonergic pathway also seem to influence amygdala reactivity (Brown et al., 2005; Buckholtz et al., 2007; Dannlowski et al., 2007; Iidaka et al., 2005). tioning. "
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