Depression in women

Article Abstract:

Depression is the most commonly reported psychiatric disorder. Most Western studies demonstrate that twice as many females as males are treated for this disorder. Several explanations for this gender-difference have been advanced: (1) men and women have equal depressive tendencies, but women tend to seek more help; (2) depression may have a genetic or hormonal basis; (3) women's social roles lead to more depression; and (4) distress is directed into depression in females and expressed differently by males. Studies have shown that the female-to-male ratio among depressives is not an artifact of help-seeking behavior, since women with psychiatric disorders have not been shown to consult doctors significantly more than men. Twin studies have demonstrated a genetic element in mood disorders, although it is still unclear to what degree environmental and familial factors influence the development of depression. Mild depression has been found to be common among married women of childbearing age. Social explanations of depression usually concern life-events, social support and women's social roles. Several community studies have found that both sexes experience the same number and kinds of life-events but that women react to stressors with higher symptom intensity. Social vulnerability studies have found that stress among women is related to the absence of a confidant, the presence of young children in the home, lower social class, not working outside the home, and the early loss of a mother. Other social explanations center on societal roles which foster dependency and helplessness in women. Married women have been shown to have high rates of many mental illnesses. Single women have much lower rates. The ratio is reversed for men, for whom marriage appears to be protective. Since men have higher suicide rates than women, it is safe to assume that they do become severely depressed. Women may be more prepared to admit or recognize depression in themselves, since several studies have shown that women are more willing than men to acknowledge both positive and negative feelings. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Women, Demographic aspects

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Neuroendocrine challenge studies in puerperal psychoses: dexamethasone suppression and TRH stimulation

Article Abstract:

The incidence of post-partum (post-childbirth) psychiatric illness, such as psychotic depression, is increasing, but the reasons for this are unknown. While there have been a wide range of psychological studies to classify post-partum psychiatric disorders, there has been relatively little attention directed toward the biological abnormalities in post-partum psychosis. Often, it is difficult to find enough cases to do a meaningful study. In the present investigation, neuroendocrine tests were performed on mothers with post-partum psychoses, and the results were compared with normal post-partum controls. Specifically, subjects underwent a dexamethasone suppression test (DST), which has been shown to detect the nonsuppression of cortisol production in patients with psychiatric disorders, and thyroid-stimulating hormone (TSH) tests, which often show a blunted TSH response to thyrotropin-releasing hormone (TRH) in patients with psychiatric disorders. Of the 11 psychotic patients, nine underwent the TRH stimulation test, and eight received the DST (some patients received both). There was one matched control for each test done on a psychotic patient; therefore, there were 17 matched controls. As expected, post-partum psychotic patients had elevated cortisol levels detected by the DST and blunted TSH response with the TRH test. Controls showed normal results. This is the first study to show blunted TSH response to TRH as a feature of post-partum disorders. Because the sample size was small, interpretation of the data needs to be cautious. A broader conclusion is that neuroendocrine abnormalities are more frequent in post-partum psychotic patients than in normal post-partum controls. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Dexamethasone, Thyrotropin releasing factor, Thyrotropin releasing hormone, Puerperal psychoses

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Treatment of depression: the relevance of research for clinical practice

Article Abstract:

Models of depression overlap and include a variety of theories encompassing biological, psychological, sociological, genetic, chemical, and existential phenomena. Most studies evaluating treatment outcome have used designs in which patients are assessed, participate in a treatment regimen, and are reassessed so that pre-and post-treatment data can be compared for statistical significance. However, this type of design cannot assess cause and effect because a number of factors other than the treatment regimen may confound results. For instance, recovery may be spontaneous or due to the support and concern of the experimental staff. In placebo-controlled experiments, usually 20 to 30 percent of recoveries are directly attributable to the antidepressant being tested. Electroconvulsive therapy (ECT) was originally used to treat schizophrenia, but has proven to be more useful in treating severe depression and depressive psychosis. No studies have found that drug treatments are more effective than ECT for these two disorders. The major classes of antidepressant drugs are monoamine oxidase inhibitors and tricyclics; studies indicate they are almost equivalent in terms of efficacy. Since tricyclics (which prevent the reuptake of serotonin and norepinephrine) cause fewer side effects, they are more commonly prescribed, and have proven to be very effective for a wide spectrum of depressive and anxiety disorders. Studies indicate that psychotherapy is helpful for depression in areas of social adjustment and interpersonal relationships. Cognitive therapy has proven to be more effective than psychoanalytic psychotherapy for treating depressive symptoms and reducing relapse rates. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Evaluation, Drug therapy, Antidepressants, Electroconvulsive therapy, Electroshock, Psychotherapy

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