• Title/Summary/Keyword: Treatment for Depression

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Cytokines and Depression (사이토카인과 우울증)

  • Kim, Yong-Ku
    • Korean Journal of Biological Psychiatry
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    • v.15 no.3
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    • pp.175-185
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    • 2008
  • Accumulating evidence has suggested the existence of reciprocal communication between immune, endocrine, and neurotransmitter system. Cytokine hypothesis of depression implies that increased pro-inflammatory cytokine such as -1, IL-6, IL-12, TNF-${\alpha}$, and IFN-${\gamma}$ in major depression, acting neuromodulators, play a key role in the mediation of behavioral, neuroendocrine, and neurochemical disturbances in depression. Concerning the relation between cytokines and serotonin metabolism, pro-inflammatory cytokines have profound effects on the metabolism of brain serotonin through the enzyme indoleamine-2,3-dioxygenase(IDO) that metabolizes tryptophan, the precursor of 5-HT to neurodegenerative quinolinate and neuroprotective kynurenate. The neurodegeneration process is reinforced by the neurotoxic effect of the hypercortisolemia during depression. From this perspective, it is possible that efficacy of antidepressants in the treatment of depression may, at least in part, rely on downregulation of pro-inflammatory cytokine synthesis. So, the use of cytokine synthesis inhibitors or cytokine antagonists may be a new treatment approach in depression. However, at present the question whether cytokines play a causal role in the onset of depression or are mere epiphenomena sustaining depressive symptoms remains to be elucidated. Nevertheless, cytokine hypothesis has created new perspectives in the study of psychological and pathophysiological mechanism that are associated with major depression, as well as the prospect for developing a new generation antidepressants.

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Paradigm Shift in the Study of Treatment Resistant Depression (치료저항성 우울증의 연구에서 패러다임의 전환)

  • Kim, Yong-Ku
    • Korean Journal of Biological Psychiatry
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    • v.23 no.2
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    • pp.37-40
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    • 2016
  • Treatment-resistant depression (TRD) is a major public health problem. It is estimated that about 30% of patients with major depressive disorder do not show substantial clinical improvement to somatic or psychosocial treatment. Most of studies for TRD have focused on the subjects already known as TRD. Patients with unipolar depressive episodes that do not respond satisfactorily to numerous sequential treatment regimens were included in the TRD studies. Such post hoc experimental design can be regarded only as consequences of having TRD, rather than as causal risk factors for it. Although informative, data derived from such studies often do not allow a distinction to be made between cause and effect. So, we should shift paradigm toward examining the risk for developing TRD in untreated depressed patients. To deal with this problem, untreated depressed patients should be enrolled in the study to identify biological markers for treatment resistance. The peripheral or central biological markers should be explored before starting treatment. Subsequent systematic administration of treatments with appropriate monitoring in the subjects can determine the risk for developing treatment resistance in untreated individuals. Such information could give a cue to improve the initial diagnosis and provide more effective treatment for TRD.

The Cytokine-mediated Link Between Depression and Cachexia in Cancer Patients (암환자의 우울증과 카켁시아 간 시토카인 매개 연결)

  • Lim, Woo Taek
    • Journal of Korean Physical Therapy Science
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    • v.26 no.3
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    • pp.44-56
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    • 2019
  • Despite the advances in medical technology, there are limited therapeutic interventions for cancer. Currently, the main goal of treatment is to remove a tumor completely. However, recent studies have shown that mortality is highly influenced by symptoms such as depression and cachexia, not solely by cancer itself. Depression is caused by psychological stress, and cachexia involves extreme weight loss with skeletal muscle atrophy, which are widely observed in patients with cancer. Although those two appear completely different from each other, they have a common etiology: cytokines. The production of cytokines can lead to depression and cachexia, and it contributes greatly to the increase in mortality rate. A better understanding of depression and cachexia in patients with cancer will help establish efficient treatment strategies.

Effects of Banhahubak-tang(Banxiahoupotang) on patients with poststroke depression (중풍후우울증에 대한 반하후박탕의 유효성 및 적응증 평가)

  • Jung, Jae-Han;Choi, Chang-Min;Hong, Jin-Woo;Kim, Tae-Hun;Rhe, Jun-Woo;Lee, Cha-Ro;Bahn, Geon-Ho;Jung, Woo-Sang;Moon, Sang-Kwan;Bae, Hyung-Sup;Na, Byong-Jo
    • The Journal of Internal Korean Medicine
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    • v.26 no.3
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    • pp.563-574
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    • 2005
  • Objectives : Poststroke depression is a frequent and specific entity that impaires the rehabilliation and functional recovery of patients with hemiplegia. The author evaluated the effect of Banhahubak-tang(Banxiahoupotang) in patients with poststroke depression. Methods : 38 patients suffering from poststroke depression(determined by Diagnostic and Statistical Manual of Mental Disorders, revised. 3rd edition. and Beck Depression Inventory[BDI] cutoff $point{\geqq}10$) in Kyunghee Oriental hospital were randomized into two groups; treatment group(n=19) and control group(n=19). The treatment group was prescribed with Banhahubak-tang(Banxiahoupotang) three times a day fur a week. Control troop was prescribed with other herbal medicines used for stroke Patients three times a day for a week. Patients were evaluated by use of BDI scale, Modified Barthel Index, Depression of Ki score, Yin syndrome score, and Yang syndrome score. Among 38 patients, 24 patients got BDI scores above 21, which is the cut-off score for depression in Korean. The same procedures and assessments described above were applied. Results : Treatment group did not significantly improve compared with control group. Results yielded only slight significance (P=0.086). Especially. patients with poststroke depression as yin syndrome improved more significantly on BDI than those classified as yang syndrome. When BDI cutoff point for depression was defined as being ${\geq}\;21$, treatment group did not significantly improve compared with control group(P=0.114). However, patients with poststroke depression classified as yin syndrome were also significantly improved on BDI than those classified as yang syndrome. Conclusions : This study suggests that Banhahubak-tang(Banxiahoupotang) is significantly effective in patients with poststroke depression classified as yin syndrome.

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Research on Depression in Married Immigrant Women: Trends in Korea (여성결혼이민자의 우울에 관한 연구 동향)

  • Byun, Seong Won
    • Journal of Korean Academy of Rural Health Nursing
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    • v.6 no.2
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    • pp.69-77
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    • 2011
  • Purpose: This study was done to identify the current status of research on depression in married immigrant women and to suggest directions for future nursing research. Method: Sixteen articles for the period between 2001 and 2010 were selected by key words such as "Married Immigrant Women" and "Depression" from the databases (RISS4U et al). Results: Twelve of the research reports were related to correlations and 4 were related to interventions. Depression level was measured using BDI or CES-D. Depression levels were as follows: 20-30% reported major depression and less than 10%, severe depression. Factors which influenced depression included: socio-demographic factors, and family, economic, psychological and situational characteristics. Psychological treatment prevailed in the intervention research, for example, art therapy, and horticultural therapy. In 2 papers significant improvement in the state of depression among participants in the intervention group were reported. Conclusion: The next phase of nursing research related to married immigrant women is to reconsider the importance of the concept of depression to reexamine research methods and directions.

Mammalian Target of Rapamycin Signaling Pathways and Depression (Mammalian Target of Rapamycin 신호전달체계와 우울증)

  • Lee, Jung Goo;Seo, Mi Kyong;Park, Sung Woo;Kim, Young Hoon
    • Korean Journal of Biological Psychiatry
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    • v.23 no.1
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    • pp.18-23
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    • 2016
  • Depression is a complicated psychiatric illness with severe consequences. Despite recent advanced achievements of molecular neurobiology, pathophysiology of depression has not been well elucidated. Among new findings of pathophysiology of depression, the possible fast antidepressant effect by N-methyl-D-asparate receptor antagonist, such as ketamine, is regarded as a promising treatment target of depression. Ketamine stimulates the mammalian target of rapamycin (mTOR) signaling pathway and activation of mTOR signaling pathway may be a key mechanism of the antidepressant effect of ketamine. Thus, this review describes the role of mTOR signaling in the pathophysiology of depression and developing a new treatment target of depression.

Trends of Tuina Therapy on Depression and Its Efficacy -based on CNKI-

  • Kwon, Chan-Young;Choi, Eun-Ji;Kim, Jong-Woo;Chung, Sun-Young
    • Journal of Oriental Neuropsychiatry
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    • v.26 no.3
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    • pp.251-266
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    • 2015
  • Objectives: The purpose of this study is to investigate the research about using tuina therapy for depression and to determine its efficacy. Methods: All relevant articles were searched in the China National Knowledge Infrastructure using the terms 'tuina' and 'depression'. Results: Forty-one studies were selected, 34 randomized controlled trials (RCTs) and 7 prospective studies. The Chinese Classification of Mental Disorders and Hamilton Depression Rating Scale were used most frequently as diagnostic criteria and an assessment tool, respectively. Conduction exercise therapy was used in all studies; in contrast, Zheng Xing exercise therapy was used in only 1 study of depression patients with neck vertebrae disease. In 9 RCTs that showed scores of more than 2 points on a modified Jadad scale, tuina therapy had significant antidepressant efficacy compared with conventional treatment. However, more high-quality studies are required. Conclusions: Tuina therapy has a valid therapeutic effect on depression according to studies published in China; if evidence accumulates from high-quality studies, it can be considered a non-pharmacologic treatment for depression in Korean medicine, as well.

The Association between Health-related Quality of Life and Depression on Activity Restriction in Osteoarthritis: A Cross-sectional Study

  • Lee, Do-Youn;Kim, Seong-Gil
    • The Journal of Korean Physical Therapy
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    • v.32 no.6
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    • pp.329-334
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    • 2020
  • Purpose: The purpose of this study is to provide basic evidence on the need to approach osteoarthritis patients through a psychological factors-considering rehabilitation program by understanding how activity restrictions in osteoarthritis affect health-related quality of life and depression. Methods: This study assessed 3,761 osteoarthritis patients from the Korea National Health and Nutrition Examination Survey. The subjects were divided into two categories: with and without activity restriction. Results: The prevalence of osteoarthritis in women was higher than that of men (men: 19.7%; women: 80.3%), and high BMI increased the prevalence of osteoarthritis. The EQ-5D index of subjects with activity restriction was 0.84±0.18 (points), while in those without activity restriction was 0.93±0.12, and the diagnosis of depression was 15.8%, 8.2%. There was a statistically significant difference in the odds ratio for each item in the EQ-5D. Moreover, the odds ratio for depression with activity restriction was 2.098 compared with no activity restriction. Conclusion: Activity restriction of osteoarthritis patients significantly decreases the health-related quality of life and increase the probability of depression. Therefore, early diagnosis of depression symptoms to prevent deterioration of symptoms in patients with osteoarthritis and to increase compliance with rehabilitation treatment, and to provide arbitration, including treatment that can alleviate depression.

Depression Management System for Single-Person Households In The Era of COVID-19 Pandemic (코로나 팬데믹 시대에서 1인 가구의 우울증 관리 체계 시스템)

  • Hwangbo, Je-Seong;Kim, Ho-Yoon;Lee, Won-Seok;Shin, Seung-Soo
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2022.10a
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    • pp.104-106
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    • 2022
  • Single-person households are steadily increasing every year, and unlike multi-person households, the incidence of depression is higher because they are mentally isolated. There are many causes of depression, including physical activity, family size, and stress. Less physical activity and more stress are associated with higher rates of depression. As the number of single-person households increased, and the COVID-19 outbreak in 2019 caused restrictions on physical activity due to the overlapping pandemic, the stress index increased, resulting in many depressed patients. Since many patients do not receive treatment even if they develop depression, we propose a depression management system to increase access to treatment for depression.

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Relationship between Depression and Health Care Utilization (우울과 의료이용의 관계)

  • Hyo Eun Cho;Jun Hyup Lee
    • Health Policy and Management
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    • v.34 no.1
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    • pp.68-77
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    • 2024
  • Background: Depressive disorders can be categorized into daily depression and clinical depression. The experience of depressive disorder can increase health care utilization due to decreased treatment compliance and somatization. On the other hand, the clinical depression group may also experience social prejudice associated with the illness, which can limit their access to health care utilization. In terms of the significance of health care utilization as a factor in individual and social issues, this study aims to compare the health care utilization of the clinical depression group with that of the non-depressed group and the daily depression group. Methods: The analysis utilized the inverse probability of treatment weighting based on the generalized propensity score. Results: As a result of the analysis, clinical depression and daily depression were higher among women, low-income groups, individuals with low education levels, and so forth. The clinical depression group was also higher among individuals who were not economically active, did not have private health insurance, or had multiple chronic diseases. The number of outpatient department visits in the depression group was significantly higher than in the non-depressed group. In addition, the number of outpatient department visits for the clinical depression group was significantly higher than that for the daily depression group. Outpatient medical expenses were higher in the depression group than in the non-depressed group, and there was no significant difference between the clinical depression group and the daily depression group. Conclusion: Health care utilization was higher in the depression group than the non-depressed group, it was also higher in the clinical depression group than the daily depression group.