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Re: Brain Signature for Melancholia Identified » Robert_Burton_1621

Posted by ed_uk2010 on February 23, 2015, at 13:43:54

In reply to Re: Brain Signature for Melancholia Identified » ed_uk2010, posted by Robert_Burton_1621 on February 23, 2015, at 10:29:07

>One of the purposes of defining depression by reference to identifiable types (to the extent that they are distinct and identifiable) is to counter the dominant paradigm according to which "depression" is a unitary clinical entity which differs only in respect of the extent of the severity with which it is experienced. When you think about it, this is a very odd way of thinking about disease.

It is certainly a poor way of conceptualising depression. Unfortunately....

Depression, as a diagnosis, is currently a clinical syndrome and not a specific disease entity ie. the diagnosis is almost entirely symptom-based. Inevitably then, there is much variation between different people classified as suffering from depression. I can only assume that there is as much heterogeneity in the underlying causes of depression and its pathology as there is in terms of the symptoms described.

The concept of 'atypical' depression is particularly confused in the literature. All of the listed symptoms are common, and it is unclear whether the emphasis should be on reverse vegetative symptoms (oversleeping, overeating), on mood reactivity....or even personality traits.

I don't think we will be very successful at all in trying to define the subtypes of depression until we see large advances in understanding of the neurobiological aspects of depression.

 

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