Depresión What Is

8/18/2019 Depresión What Is

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DepressionWhat is Depression?

Depression is a serious medical illness; it’s not something that you have made up in your head. It’s more than just

feeling "down in the dumps" or "blue" for a few days. It’s feeling "down" and "low" and "hopeless" for weeks at atime. more>>

Signs & Symptoms

• ersistent sad! anious! or "empty" mood• #eelings of hopelessness! pessimism• #eelings of guilt! worthlessness! helplessness• $oss of interest or pleasure in hobbies and activities that were once enjoyed more>>

Treatment

% variety of treatments including medications and short&term psychotherapies have proven effective for depression.more>>

Getting Help: Locate Services$ocate mental health services in your area! affordable healthcare! 'I() clinical trials! and listings of professionalsand organi*ations. more>>

Related Information

• Information about coping with traumatic events • +ccurrence in,

• -hildren and adolescents • +lder adults • omen

• (en • +ccurrence with other serious illnesses, Depression may coeist with other serious illnesses! such as heart

disease! stroke! )I/0%ID1! diabetes! and arkinson2s disease.• Information about medications • Depression Information from '$(2s (edlinelus! in 3nglish and 1panish • 1ome mental illnesses also carry an increased risk for suicide.

Depression Research at the ational Instit!te

of "ental HealthDepressive disorders affect approimately 45 million %merican adults. 6he suffering endured by people withdepression and the lives lost to suicide attest to the great burden of this disorder on individuals! families! and society.Improved recognition! treatment! and prevention of depression are critical public health priorities. 6he 'ationalInstitute of (ental )ealth 7'I()8! the world’s leading mental health biomedical organi*ation! conducts andsupports research on the causes! diagnosis! prevention! and treatment of depression.3vidence from neuroscience! genetics! and clinical investigation demonstrate that depression is a disorder of the

brain. (odern brain imaging technologies are revealing that in depression! neural circuits responsible for theregulation of moods! thinking! sleep! appetite! and behavior fail to function properly! and that critical

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neurotransmitters9chemicals used by nerve cells to communicate9are out of balance. :enetics research indicatesthat vulnerability to depression results from the influence of multiple genes acting together with environmentalfactors. 1tudies of brain chemistry and of mechanisms of action of antidepressant medications continue to inform thedevelopment of new and better treatments.In the past decade! there have been significant advances in our ability to investigate brain function at multiple levels.

'I() is collaborating with various scientific disciplines to effectively utili*e the tools of molecular and cellular biology! genetics! epidemiology! and cognitive and behavioral science to gain a more thorough and comprehensiveunderstanding of the factors that influence brain function and behavior! including mental illness. 6his collaborationreflects the Institute’s increasing focus on "translational research!" whereby basic and clinical scientists are involvedin joint efforts to translate discoveries and knowledge into clinically relevant uestions and targets of researchopportunity. 6ranslational research holds great promise for disentangling the comple causes of depression and other mental disorders and for advancing the development of more effective treatments.

Symptoms and Types of Depression1ymptoms of depression include a persistent sad mood; loss of interest or pleasure in activities that were onceenjoyed; significant change in appetite or body weight; difficulty sleeping or oversleeping; physical slowing oragitation; loss of energy; feelings of worthlessness or inappropriate guilt; difficulty thinking or concentrating; and

recurrent thoughts of death or suicide. % diagnosis of major depressive disorder 7or unipolar major depression8 ismade if an individual has five or more of these symptoms during the same


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Research on Treatments for Depression

"edication

1tudies on the mechanisms of action of antidepressant medication comprise an important area of 'I() depressionresearch. 3isting antidepressant drugs are known to influence the functioning of certain neurotransmitters in the brain! primarily serotonin and norepinephrine! known as monoamines. +lder medications9tricyclic antidepressants76-%s8 and monoamine oidase inhibitors 7(%+Is89affect the activity of both of these neurotransmitterssimultaneously. 6heir disadvantage is that they can be difficult to tolerate due to side effects or! in the case of(%+Is! dietary restrictions. 'ewer medications! such as the selective serotonin reuptake inhibitors 711AIs8! havefewer side effects than the older drugs! making it easier for patients to adhere to treatment. oth generations ofmedications are effective in relieving depression! although some people will respond to one type of drug! but notanother.%ntidepressant medications take several weeks to be clinically effective even though they begin to alter brainchemistry with the very first dose. Aesearch now indicates that antidepressant effects result from slow&onsetadaptive changes within the brain cells! or neurons. #urther! it appears that activation of chemical messenger

pathways within neurons! and changes in the way that genes in brain cells are epressed! are the critical eventsunderlying long&term adaptations in neuronal function relevant to antidepressant drug action. % current challenge isto understand the mechanisms that mediate! within cells! the long&term changes in neuronal function produced byantidepressants and other psychotropic drugs and to understand how these mechanisms are altered in the presence of illness.Bnowing how and where in the brain antidepressants work can aid the development of more targeted and potentmedications that may help reduce the time between first dose and clinical response. #urther! clarifying themechanisms of action can reveal how different drugs produce side effects and can guide the design of new! moretolerable! treatments.%s one route toward learning about the distinct biological processes that go awry in different forms of depression!

'I() researchers are investigating the differential effectiveness of various antidepressant medications in peoplewith particular subtypes of depression. #or eample! this research has revealed that people with atypical depression,a subtype characteri*ed by reactivity of mood 7mood brightens in response to positive events8 and at least two othersymptoms 7weight gain or increased appetite! oversleeping! intense fatigue! or rejection sensitivity8! respond betterto treatment with (%+Is! and perhaps with 11AIs than with 6-%s.

(any patients and clinicians find that combinations of different drugs work most effectively for treating depression!either by enhancing the therapeutic action or reducing side effects. %lthough combination strategies are used often inclinical practice! there is little research evidence available to guide psychiatrists in prescribing appropriatecombination treatment. 'I() is in the process of revitali*ing and epanding its program of clinical research! andcombination therapy will be but one of numerous treatment interventions to be eplored and developed.=ntreated depression often has an accelerating course! in which episodes become more freuent and severe overtime. Aesearchers are now considering whether early intervention with medications and maintenance treatmentduring well periods will prevent recurrence of episodes.

%sychotherapy

$ike the process of learning! which involves the formation of new connections between nerve cells in the brain!

psychotherapy works by changing the way the brain functions. 'I() research has shown that certain types of psychotherapy! particularly cognitive&behavioral therapy 7-68 and interpersonal therapy 7I68! can help relievedepression. -6 helps patients change the negative styles of thinking and behaving often associated withdepression. I6 focuses on working through disturbed personal relationships that may contribute to depression.Aesearch on children and adolescents with depression supports -6 as a useful initial treatment! but antidepressantmedication is indicated for those with severe! recurrent! or psychotic depression. 1tudies of adults have shown thatwhile psychotherapy alone is rarely sufficient to treat moderate to severe depression! it may provide additional relief in combination with antidepressant medication. In one recent 'I()&funded study! older adults with recurrent majordepression who received I6 in combination with an antidepressant medication during a C&year period were muchless likely to eperience a recurrence of illness than those who received medication only or therapy only. #or mild


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depression! however! a recent analysis of multiple studies indicated that combination treatment is not significantlymore effective than -6 or I6 alone.reliminary evidence from an ongoing 'I()&supported study indicates that I6 may hold promise in the treatmentof dysthymia.

lectroconv!lsive Therapy '(T)3lectroconvulsive therapy 73-68 remains one of the most effective yet most stigmati*ed treatments for depression.3ighty to ninety percent of people with severe depression improve dramatically with 3-6. 3-6 involves producinga sei*ure in the brain of a patient under general anesthesia by applying electrical stimulation to the brain throughelectrodes placed on the scalp. Aepeated treatments are necessary to achieve the most complete antidepressantresponse. (emory loss and other cognitive problems are common! yet typically short&lived side effects of 3-6.%lthough some people report lasting difficulties! modern advances in 3-6 techniue have greatly reduced the sideeffects of this treatment compared to earlier decades. 'I() research on 3-6 has found that the dose of electricityapplied and the placement of electrodes 7unilateral or bilateral8 can influence the degree of depression relief and theseverity of side effects.% current research uestion is how best to maintain the benefits of 3-6 over time. %lthough 3-6 can be veryeffective for relieving acute depression! there is a high rate of relapse when the treatments are discontinued. 'I()is currently sponsoring two multicenter studies on 3-6 follow&up treatment strategies. +ne study is comparingdifferent medication treatments! and the other study is comparing maintenance medication to maintenance 3-6.Aesults from these studies will help guide and improve follow&up treatment plans for patients who respond well to3-6.

Genetics ResearchAesearch on the genetics of depression and other mental illnesses is a priority of 'I() and constitutes a criticalcomponent of the Institute’s multi&level research effort. Aesearchers are increasingly certain that genes play animportant role in vulnerability to depression and other severe mental disorders.In recent years! the search for a single! defective gene responsible for each mental illness has given way to theunderstanding that multiple gene variants! acting together with yet unknown environmental risk factors or

developmental events! account for the epression of psychiatric disorders. Identification of these genes! each ofwhich contributes only a small effect! has proven etremely difficult.)owever! new technologies! which continue to be developed and refined! are beginning to allow researchers toassociate genetic variations with disease. In the net decade! two large&scale projects that involve identifying andseuencing all human genes and gene variants will be completed and are epected to yield valuable insights into thecauses of mental disorders and the development of better treatments. In addition! 'I() is currently solicitingresearchers to contribute to the development of a large&scale database of genetic information that will facilitateefforts to identify susceptibility genes for depression and other mental disorders.

Stress and Depressionsychosocial and environmental stressors are known risk factors for depression. 'I() research has shown that

stress in the form of loss! especially death of close family members or friends! can trigger depression in vulnerableindividuals. :enetics research indicates that environmental stressors interact with depression vulnerability genes toincrease the risk of developing depressive illness. 1tressful life events may contribute to recurrent episodes ofdepression in some individuals! while in others depression recurrences may develop without identifiable triggers.+ther 'I() research indicates that stressors in the form of social isolation or early&life deprivation may lead to

permanent changes in brain function that increase susceptibility to depressive symptoms.


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*rain ImagingAecent advances in brain imaging technologies are allowing scientists to eamine the brain in living people withmore clarity than ever before. #unctional magnetic resonance imaging 7f(AI8! a safe! noninvasive method for

viewing brain structure and function simultaneously! is one new techniue that 'I() researchers are using to studythe brains of individuals with and without mental disorders. 6his techniue will enable scientists to evaluate theeffects of a variety of treatments on the brain and to associate these effects with clinical outcome.rain imaging findings may help direct the search for microscopic abnormalities in brain structure and functionresponsible for mental disorders. =ltimately! imaging technologies may serve as tools for early diagnosis andsubtyping of depression and other mental disorders! thus advancing the development of new treatments andevaluation of their effects.

Hormonal #$normalities6he hormonal system that regulates the body’s response to stress! the hypothalamic&pituitary&adrenal 7)%8 ais! isoveractive in many patients with depression! and 'I() researchers are investigating whether this phenomenon

contributes to the development of the illness.6he hypothalamus! the brain region responsible for managing hormone release from glands throughout the body!increases production of a substance called corticotropin releasing factor 7-A#8 when a threat to physical or

psychological well&being is detected. 3levated levels and effects of -A# lead to increased hormone secretion by the pituitary and adrenal glands which prepares the body for defensive action. 6he body’s responses include reducedappetite! decreased se drive! and heightened alertness. 'I() research suggests that persistent overactivation of thishormonal system may lay the groundwork for depression. 6he elevated -A# levels detectable in depressed patientsare reduced by treatment with antidepressant drugs or 3-6! and this reduction corresponds to improvement indepressive symptoms.

'I() scientists are investigating how and whether the hormonal research findings fit together with the discoveriesfrom genetics research and monoamine studies.

(o+occ!rrence of Depression and #n,iety Disorders 'I() research has revealed that depression often co&eists with aniety disorders 7panic disorder! obsessive&compulsive disorder! post&traumatic stress disorder! social phobia! or generali*ed aniety disorder8. In such cases! itis important that depression and each co&occurring illness be diagnosed and treated.1everal studies have shown an increased risk of suicide attempts in people with co&occurring depression and panicdisorder9the aniety disorder characteri*ed by unepected and repeated episodes of intense fear and physicalsymptoms! including chest pain! di**iness! and shortness of breath.Aates of depression are especially high in people with post&traumatic stress disorder 761D8! a debilitating conditionthat can occur after eposure to a terrifying event or ordeal in which grave physical harm occurred or wasthreatened. In one study supported by 'I()! more than @ percent of patients with 61D had depression whenevaluated both at 4 month and months following the traumatic event.

(o+occ!rrence of Depression and -ther IllnessesDepression freuently co&occurs with a variety of other physical illnesses! including heart disease! stroke! cancer!and diabetes! and also can increase the risk for subseuent physical illness! disability! and premature death.Depression in the contet of physical illness! however! is often unrecogni*ed and untreated. #urthermore! depressioncan impair the ability to seek and stay on treatment for other medical illnesses. 'I() research suggests that earlydiagnosis and treatment of depression in patients with other physical illnesses may help improve overall healthoutcome.


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6he results of a recent 'I()&supported study provide the strongest evidence to date that depression increases therisk of having a future heart attack. %nalysis of data from a large&scale survey revealed that individuals with ahistory of major depression were more than four times as likely to suffer a heart attack over a 4


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remains much to be learned about brain development during the early years of life before treatments for depressionin young people will be as successful as they are in older people. 'I() is pursuing brain&imaging research inchildren and adolescents to gather information about normal brain development and what goes wrong in mentalillness.Depression in children and adolescents is associated with an increased risk of suicidal behaviors. +ver the lastseveral decades! the suicide rate in young people has increased dramatically. In 455G! the most recent year for whichstatistics are available! suicide was the third leading cause of death in 4F&


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#lternative Treatments6here is high public interest in herbal remedies for various medical conditions including depression. %mong theherbals is hypericum! or 1t. Hohn’s wort! promoted as having antidepressant effects. %dverse drug interactions have

been reported between 1t. Hohn2s wort and drugs used to treat )I/ infections as well as those used to reduce the riskof organ transplant rejection. In general! preparations of 1t. Hohn2s wort vary significantly. 'o adeuate studies have been done to determine the antidepressant efficacy of the herbal. -onseuently! the 'I() has co&sponsored the firstlarge&scale! multi&site! controlled study of 1t. Hohn’s wort as a potential treatment for depression. Aesults from thisstudy are epected in


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theory! biological markers would reveal the specific depression profile of each patient andwould allow psychiatrists to select treatments known to be most effective for each profile.%lthough such data&driven interventions can only be imagined today! 'I() already isinvesting in multiple research strategies to lay the groundwork for tomorrow’s discoveries.

The *road I"H Research %rogramIn addition to studying depression! 'I() supports and conducts a broad based! multidisciplinary program ofscientific inuiry aimed at improving the diagnosis! prevention! and treatment of other mental disorders. 6heseconditions include bipolar disorder! clinical depression! and schi*ophrenia.Increasingly! the public as well as health care professionals are recogni*ing these disorders as real and treatablemedical illnesses of the brain. 1till! more research is needed to eamine in greater depth the relationships amonggenetic! behavioral! developmental! social and other factors to find the causes of these illnesses. 'I() is meetingthis need through a series of research initiatives.

I"H H!man Genetics Initiative

6his project has compiled the world2s largest registry of families affected by schi*ophrenia! bipolar disorder! and %l*heimer2s disease. 1cientists are able to eamine the genetic materialof these family members with the aim of pinpointing genes involved in the diseases.

H!man *rain %ro/ect

6his multi&agency effort is using state&of&the&art computer science technologies to organi*ethe immense amount of data being generated through neuroscience and related disciplines!and to make this information readily accessible for simultaneous study by interestedresearchers.

%revention Research Initiative

revention efforts seek to understand the development and epression of mental illnessthroughout life so that appropriate interventions can be found and applied at multiple pointsduring the course of illness. Aecent advances in biomedical! behavioral! and cognitivesciences have led 'I() to formulate a new plan that marries these sciences to preventionefforts.

hile the definition of prevention will broaden! the aims of research will become more precise and targeted.

"ore Than 01222 Grants and (ontractsIn total! 'I() supports more than

the nation and overseas. It also conducts basic research and clinical studies involving 5!@@@ patient visits per year atits own facilities on the 'ational Institutes of )ealth campus in ethesda! (D! and elsewhere. 'I() research

projects focus on,• basic research on behavior! emotion! and cognition to provide a knowledge base for a better understanding

of mental illnesses• basic sciences! including cellular and molecular biology! developmental neurobiology! neurochemistry!

neurogenetics! and neuropharmacology! to provide essential information about the anatomical and chemical basis of brain function and brain disorders


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• neuroscience and behavioral aspects of acuired immune deficiency syndrome 7%ID18 and behavioralstrategies to reduce the spread of )I/ 7human immunodeficiency virus8

• interventions to treat! prevent! and reduce the freuency of mental disorders and their disablingconseuences

• mental health services research! including mental health economics and improved methods of servicesdelivery

• comorbidity among mental disorders and with substance abuse and other medical conditions! such asdepression and heart disease

• the prevalence of mental disorders• risk factors for mental disorders• differences in mental health and mental illness among special populations• children and adolescents who suffer from or who are at risk for serious mental disorders and learning

disabilities• psychotherapies and pharmacotherapies for specific disorders

%t the beginning of the


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=na esperan*a contra la depresiLnSegn e,pertos $rit5nicos1 insertar !n marcapasos en el cere$ro de !npaciente podr;a


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ara el doctor ruce -ohen! psiuiatra del )ospital (c$ean de (assachusetts! afiliado a la 3scuela (dica de)arvard! este descubrimiento tiene el potencial de revolucionar los tratamientos para la depresiLn."$as ratas se comportaban como si hubiesen tomado anti&depresivos. Psta es una manera de estimular las clulasnerviosas sin necesidad de utili*ar fMrmacos"! comentL -ohen."or eso las implicancias de este descubrimiento tienen el potencial de ser muy profundas"! agregL.fecto adverso 1in embargo! el doctor illiam -arle*on &uien forma parte del euipo de investigaciLn& aNadiL ue esto puedesignificar tambin ue algunas clases de escMner pueden provocar daNos para los pacientes."$a gente cree ue cuando se le hace un escMner! solamente se le estMn tomando fotografKas del cerebro. ero enrealidad! lo ue sucede es ue el cuerpo estM siendo epuesto a un campo electromagntico"! seNalL -arle*on."3sto puede tener efectos ue aJn escapan a nuestra compresiLn"! agregL.(ientras tanto en el Aeino =nido! -osmo )allstrom! psiuiatra del -olegioAeal de siuiatrKa! seNalL ue el estudio debe ser tomado con cautela."$as ratas no son iguales a los pacientes! por eso hay ue tomar con pin*aslos estudios reali*ados con animales"! dijo )allstrom."'unca habKa escuchado ue tuviesen este efecto como tampoco escuche uenadie haya sufrido algJn daNo a raK* de ellos. $os resultados de estedescubrimiento me sorprenden! debemos continuar investigando"! concluyLel cientKfico.

(Ms niNos reciben antidepresivosInvestigadores m=dicos e,presaronpreoc!paci3n por el crecientenmero de nios 7!e est5n siendotratados con medicamentos 7!ealteran el estado de 5nimo1 como el%ro8ac1 en pa;ses e!ropeos yamericanos6 =n informe publicado este jueves en el%rchivo de 3nfermedades de la 'iNe*!una revista especiali*ada en medicinainfantil! describe un estudio reali*adoen la =niversidad de $ondres sobre las

ta*as de prescripciLn de medicamentosen nueve paKses! incluidos :ranretaNa! #rancia! -anadM! %rgentina!rasil y (ico.$os autores del informe encontraronue los mdicos en estos paKses ahoraestMn mucho mMs inclinados a recetar alos niNos medicinas contra ladepresiLn! la ansiedad! hiperactividad yotras condiciones mentales! de lo ueestaban hace cuatro aNos.$os especialistas advirtieron ue esta tendencia podrKa ser peligrosa! pues losmedicamentos en cuestiLn han sido desarrollados para adultos y pocos

estudios se han reali*ado sobre sus efectos en niNos."5s di5logo1 menos %ro8ac 3n estos cuatro aNos! donde se registrL el mayor incremento fue en el Aeino=nido con G?Q.3l menor aumento fue en -anadM donde 4CQ mMs niNos estMn recibiendomedicinas para calmar o estimular el cerebro.3n promedio! la proporciLn de prescripciLn de antidepresivos a niNosaumentL en E@Q en una dcada.

Lasratas no son ig!ales a los pacientes1por eso hay 7!e tomar con pin8aslos est!dios reali8ados con animales

-osmo )allstrom! psiuiatra del-olegio Aeal de siuiatrKa

3n 4@ aNos! el nJmero de niNostomando antidepresivos aumentoE@Q.

%or !naparte1 hay !n indicativo de !nmayor reconocimiento de lasenfermedades mentales en nios yadolescentes

Ian ong! investigador


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$a informaciLn fue recabada de una base de datos internacional 7I(1 (ID%18 la cual se nutre de una muestrarepresentativa de mdicos practicantes en cada paKs.(uchos de los pacientes fueron tratados por sKntomas del Desorden de Dficit de %tenciLn )iperactivo."or una parte! hay un indicativo de un mayor reconocimiento de las enfermedades mentales en niNos yadolescentes"! dice el doctor Ian ong! director del centro ue llevL a cabo la investigaciLn.ong cree ue aunue algunos antidepresivos no es recomendable usarlos en niNos! esta tendencia creciente se

produce por la falta de opciones mejores como la psicoterapia.

%ntidepresivos son igual de riesgososl riesgo de !na cond!cta s!icida con los n!evos antidepresivos como %ro8ac es ig!al al 7!e se corr;a con losvie/os antidepresivos1 de ac!erdo a !n est!dio llevado a ca$o por la 9niversidad de *oston1 stados 9nidos6 (uchos cientKficos se han mostrado preocupados por los efectos de estosmedicamentos! ante los reportes de pensamientos y conducta suicidas entre

personas! particularmente menores de 4? aNos! ue toman las nuevas versionesde antidepresivos.ero la investigaciLn de oston indica ue todos los antidepresivos demorancierto tiempo hasta hacer efecto.$os halla*gos de este estudio figuran en la ediciLn de esta semana de la

publicaciLn Hournal of the %merican (edical %ssociation.

6anto ro*ac 7fluoetina8 y 1erotat 7paroetina8 pertenecen a la nueva formade fMrmacos antidepresivos llamados inhibidores selectivos de la recaptaciLnde serotonina 7I1A18.$os I1A1 son recetados como una alternativa a los antiguos antidepresivosllamados triciclicos.1e considera a los triciclicos como peligrosos en sobredosis! por lo ue losI1A1 constituyen una buena opciLn para pacientes ue! segJn su mdico!

pueden ser suicidas.#dictivos $a seguridad de estas nuevas alternativas fue cuestionada por investigadoresen


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=n tercio de las vKctimas de lesiones en la cabe*a mostraron sKntomas de depresiLn en el trmino de un aNo! deacuerdo con la investigaciLn llevada a cabo por doctores de Iowa.$os pacientes con los mayores ataues de depresiLn mostraban diferencias en la estructura fKsica de sus cerebros.1e sabe muy poco acerca del mecanismo por el cual una lesiLn de cabe*a puede generar cambios en el estado deMnimo y el comportamiento.1in embargo! muchas personas ue han sufrido este tipo de incidente se vuelven irritables y agresivas! o pasan porataues de ansiedad o depresiLn cKclica.3sto confirma la importancia de recibir un tratamiento neurolLgico adecuado despus de una herida de cabe*a! dicenepertos.(omparaciones 3n el estudio de Iowa se comparL a 54 pacientes con "lesiLn traumMtica cerebral" con otros afectados de otro tipo deherida.=n CCQ del primer grupo fueron diagnosticados con "desorden depresivo mayor" durante el primer aNo.(uchos de ellos tambin presentaban sKntomas de ansiedad! y mMs de la mitad mostrL un comportamiento agresivo.% esto se aNadiL la evidencia obtenida del estudio de las historias clKnicas de 5@@ pacientes con lesiones de cabe*a!mMs de la mitad de los cuales desarrollL algJn tipo de enfermedad psiuiMtrica en el primer aNo.or otro lado! sLlo cinco de cientos de pacientes con otras condiciones mostraron algJn problema psiuiMtrico.

%ntidepresivos con etiueta negra

l go$ierno estado!nidense orden3 a los fa$ricantes de medicamentos laincl!si3n de !na advertencia en prod!ctos antidepresivos ante el peligrode 7!e provo7!en !n a!mento de las tendencias s!icidas entre los /3venes6$a %gencia de %limentos y #Mrmacos de 33.==. 7#D% por sus siglas eningls8 eigiL la colocaciLn de una etiueta negra subrayando los riesgos deluso de los fMrmacos."'o prohKben ue los niNos y adolescentes usen antidepresivos! sino uealerten del peligro de suicidio y piden a los mdicos ue euilibren este riesgocon la necesidad clKnica".=n reciente estudio comisionado por la #D% concluyL ue el dos o tres por ciento de los jLvenes tratados con antidepresivos corrKan el riesgo dedesarrollar tendencias suicidas.1egJn las investigaciones! el peligro es mayor durante la primera fase del

tratamiento.3n la advertencia se pide a los padres ue estn pendientes de observar cambios en el comportamiento de sus hijos como un empeoramiento de ladepresiLn! agitaciLn e irritabilidad.3l anuncio de la #D% se produce tras una investigaciLn de una comisiLn del-ongreso ue criticL a la agencia por su lentitud en reconocer el vKnculo entrelos antidepresivos y los pensamientos suicidas en algunos niNos yadolescentes.

$a depresiLn puede afectar el cora*Ln9na investigaci3n !niversitaria demostr3 7!e las personas 7!es!fren de depresi3n son m5s propensas a desarrollar latidos del

cora83n irreg!lares 7!e incl!so los p!eden poner en riesgo de tener!na m!erte repentina6 3l estudio reali*ado por la =niversidad 3mory en el estado de %tlanta en3stados =nidos! revelL ue mientras mMs fuerte la depresiLn! mMs grandees el riesgo.$os detalles del estudio fueron presentados durante una reuniLn del-olegio %mericano de -ardiologKa.$a investigaciLn determinL ue las personas con depresiLn eran mMs

propensas a desarrollar los sKntomas de una condiciLn conocida comovariabilidad del ritmo cardKaco decreciente.

$os antidepresivos generan preocupaciLn por sus efectoscolaterales.

$a depresiLn puede tener efectosfKsicos.


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Latidos del cora83n $a variabilidad del ritmo cardKaco mide la habilidad del cora*Ln para adaptarse a determinadas circunstancias. orejemplo! cuando la persona hace ejercicio! el cora*Ln necesita latir mMs rMpido para bombear mMs oKgeno a losmJsculos! mientras ue al dormir! no se necesita un ritmo cardKaco rMpido.=na variabilidad del ritmo cardKaco decreciente significa ue el cora*Ln tienemenos capacidad para adaptarse. 6ambin aumenta el riego de desarrollar laarritmia ue es cuando el cora*Ln late de forma irregular.$os investigadores se concentraron en F@ pares de gemelos y ninguno tenKa

problemas cardKacos.1us cora*ones fueron monitoreados durante


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3l doctor Him olton! siuiatra del hospital 1t. )eiler del sur de $ondres! dijo ue el estudio "tiene sentido"."#recuentemente tendemos a pensar ue todas estas cosas estMn en la mente. $o ue pensamos ue son efectossicolLgicos! puede tener tambin consecuencias en el cuerpo"! dijo a la -.olton afirmL ue la ansiedad es comJn en gente ue padece el desorden de estrs postraumMtico."$a ansiedad y la depresiLn tienen consecuencias en los Kndices cardKacos. uede ser ue hagan mMs vulnerable alcora*Ln a latidos irregulares y pueden incrementar los riesgos de coagulaciLn de la sangre"! afirmL olton.

La falta de s!eo genera depresi3n¡Error!Marcador no defnido.Los problemas del sueño afectan nuestra vida en general.La apnea del sueño -que produce el cese de la respiración durante el sueño poraproximadamente 10 segundos- puede tener efectos signicativos en nuestra salud mentaly física.l menos esto es lo que sugiere un estudio !ec!o por investigadores en "uebec# $anad%#que por primera ve& examinaron los efectos psicológicos de esta condición.'eg(n el estudio# las interrupciones en el sueño causan problemas en el traba)o y en lasrelaciones sociales y por ende pueden conducir a la depresión.'e estima que un *+, de personas se ven afectadas por apnea del sueño# con !asta +interrupciones de la respiración por !ora.

Fatiga Los cientícos del $entro de eumología de la niversidad de "uebec# se dedicaron aobservar pacientes con apnea del sueño durante dos años./l profesor Lacasse expresó a la $ su sorpresa ante los resultados del estudio 2fuesorprendente encontrar una gran cantidad de pacientes con depresión en nuestro grupo2.2o podría decir que la apnea causa depresión pero es probablemente un factor in3uyente2#agregó!ora# el equipo de $anad%# est% implementando un cuestionario simple# para tratar deevaluar como la apnea del sueño afecta en general la calidad de vida


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6errie (offitt! profesora del Instituto de siuiatrKa del Bing2s -ollege! dijo ala - ue se abren nuevas oportunidades para el estudio de la interacciLnentre los genes y el ambiente social.")asta ahora &manifestL (offitt& la gentica se habKa centrado mMs en elestudio de las causas de enfermedades raras o poco comunes".(offitt agregL ue ahora se podrM avan*ar en el tratamiento de la depresiLn ylos modos de prevenirla.3ntretanto! (arjorie allace! especialista en 1alud (ental! epresL, "3speroue estudios como ste permitan el desarrollo de tratamientos mMs

personali*ados y de respuestas individuales al problema de la depresiLn".

$unes!


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La asistencia a las personas que padecen de depresión debe reformarse# seg(n los expertos.La mayoría de los ;+0 millones de personas de todo el mundo que tienen problemasmentales o psicosociales reciben diagnósticos incorrectos o tratamientos inadecuados.La revista ritis!


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/iernes! @C de agosto de


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m%s industriali&ados o aquellos que experimentan un r%pido crecimiento económico# comoel caso de


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mantienen altos# el período 1AFA-1AAA experimentó un descenso del 1;, entre losadolescentes.'in embargo# el consumo de :xtasis presentó un incremento./n $entro m:rica# aumentaron las plantaciones de opio# al mismo tiempo que seincrementaron las conscaciones de !eroína en $olombia./n Pfrica se registró un aumento en la conscación de cannabis# !eroína y substancias

psicotrópicas en 1AAA# mientras la conscación de cocaína disminuyó./l tr%co tambi:n es un problema grave. /l 76H/ informa que la mitad del suministro mundialde resina de cannabis pasó por


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psiquiatra. /so signica que no se !a !ec!o el diagnóstico correcto. 9or ello# dice E!ompson#es dicil saber cu%ntas víctimas de la enfermedad existen realmente.29ara muc!a gente el 4/ es una enfermedad seria que les impide funcionar en formanormal durante el ;0, de su vida. Eodos los años !ay pacientes que pierden el empleodurante el invierno# porque literalmente no pueden llegar a su lugar de traba)o durantecuatro meses2# señala E!ompson.

/l 4esorden fectivo /stacional suele diagnosticarse una ve& que la persona !a padecido losmismos síntomas durante dos o m%s inviernos consecutivos./l equipo del 4r. E!omspon estudió la ecacia de la terapia de lu& y concluyó que quien sesomete a este tratamiento tiene tres veces m%s probabilidades de recuperarse de laenfermedad que quien no tiene acceso a :l.

%pril


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S%lthough several small trials suggest that antidepressants may deliver modest benefits to patients with minordepression! there is no evidence to support their use in adjustment disorder! especially when patients describe a clear event as the cause of their depression! and ehibit mild symptoms for only a short period of time!T says Dr. Aichard$. Bravit*! lead investigator on the study. Srescribing antidepressants for adjustment disorder! as presented in thestudy! is at the margin of clinical appropriateness.TIn addition to prescribing practices! the study found that those who made a reuest for medication were more likelyto receive minimally acceptable initial care 7any combination of antidepressant! mental health referral! or follow&upvisit within two weeks8. %nd physicians were more likely to consider and record a mental health diagnosis7depression ?? percent compared to GF percent and adjustment disorder F@ percent compared to 4? percent8 if theactor&patient made a reuest for medication.%lso participating in the study were Drs. Aahman %*ari! -arol 3. #ran*! (ichael 1. ilkes! $adson )inton! andeter #ranks from =niversity of -alifornia! Davis; (itchell D. #eldman from =niversity of -alifornia! 1an#rancisco; and Aonald 3pstein from =niversity of Aochester.Bravit* A$! 3pstein A! #eldman (D! #ran* -3! %*ari A! ilkes (1! )inton $! #ranks . Influence of patients’reuests for direct&to&consumer advertised antidepressants, a randomi*ed controlled trial. JAMA.


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1ince serotonin activity plays a key role in wiring the brain’s emotion processing circuitry during earlydevelopment! the researchers propose that the short variant leads to stunted coupling in the circuit! a poorlyregulated amygdala response! and impaired emotional reactivity 9 resulting in increased vulnerability to persistent

bad moods and eventually depression as life’s stresses take their toll.+ther members of the 'I() team were, Dr. haskar Bolachana! Dr. (ichael 3gan! Dr. /enakata (attay! 3milyDrabant! eth /erchinski! and Baren (uno*. Dr. %hmad )ariri! =niversity of ittsburgh! also participated in thestudy.

%reas in the cingulate 7right8 and amygdala 7left8 that differed in gray matter volume between subjects with the shortand long versions of the serotonin transporter gene. 1hort version carriers showed the greatest reductions in the redarea! which previous studies have linked to depression.

1ubjects with two copies of the long version 7$$8 of the serotonin transporter gene showed more functionalconnectivity between the amygdala 7yellow8 and the cingulate 7red! blue8! which are key components of a mood&regulating circuit.1ource, 'I() -linical rain Disorders ranch

1ee press releases,• :ene (ore 6han Doubles Aisk of Depression #ollowing $ife 1tresses • :ene (ay ias %mygdala Aesponse to #rightful #aces
http://www.nimh.nih.gov/Press/prgenestress.cfmhttp://www.nimh.nih.gov/Press/pramygdala.cfmhttp://www.nimh.nih.gov/Press/pramygdala.cfmhttp://www.nimh.nih.gov/Press/prgenestress.cfmhttp://www.nimh.nih.gov/Press/pramygdala.cfm

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