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

ABSTRACT 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.

  • [Show abstract] [Hide abstract]
    ABSTRACT: The hypothesis defended here is that the process of mood-normalizing transitions fails in a significant proportion of patients suffering from major depressive disorder. Such a failure is largely unrelated to the psychological content. Evidence for the hypothesis is provided by the highly variable and unpredictable time-courses of the depressive episodes. The main supporting observations are: 1) mood transitions within minutes or days have been reported during deep brain stimulation, naps after sleep deprivation and bipolar mood disorders; 2) sleep deprivation, electroconvulsive treatment and experimental drugs (e.g. ketamine) may facilitate mood transitions in major depressive disorder within hours or a few days; 3) epidemiological and clinical studies show that the time-to-recovery from major depressive disorder can be described with decay models implying very short depressive episodes; 4) lack of relationship between the length of depression and recovery episodes in recurrent depression; 5) mood fluctuations predict later therapeutic success in major depressive disorder. We discuss some recent models aimed to describe random mood transitions. The observations together suggest that the mood transitions have a wide variety of apparently unrelated causes. We suggest that the mechanism of mood transition is compromised in major depressive disorder, which has to be recognized in diagnostic systems.
    Medical Hypotheses 05/2014; · 1.15 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Recurrent brief depressive disorder (RBD) is a well-defined and significantly prevalent affective disorder with an increased risk of suicidal behaviour and significant clinical impairment in the community and general practice. RBD is characterized by depressive episodes occurring at least once a month and lasting for only few days and the lack of a successful treatment represents one of the main challenges of this disorder. We report on a 21-years-old married woman who presented with a three years history of sudden depressive episode with a twenty days recurrences lasting 7-10 days of depressive symptoms such as psychomotor retardation and mutism. The patient was treated with imipramine and fluoxetine for a while and in spite of maintaining the treatment, recurrence of depressive episodes were continued but since sodium valporate therapy was added, she has remained euthymic without any recurrence of depressive symptoms.The absence of recurrence for a year since sodium valporate treatment was started, suggest a prophylactic effect of this agent on RBD.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Recurrent brief depressive disorder is now a well-recognized type of depressive disorder. However, there is still no clear evidence base for its treatment. The efficacy of several drugs including antidepressants and mood stabilizers in this disorder has been controversial. Methodological limitations need to be considered when interpreting the results of studies on efficacy of drugs in this disorder. We report a case of recurrent brief depressive disorder that responded dramatically to paroxetine. However, there is a need for larger, methodologically sound, double-blind, placebo-controlled studies.
    Journal of pharmacology & pharmacotherapeutics. 10/2013; 4(4):288-90.

Full-text (2 Sources)

Available from
May 31, 2014