No more depression, but depressions, as announced the title of a recent conference organized by the Italian Society of Psychiatry (Sip). The most commonly identified forms are 8, and we will list them, but it should be said that this diagnostic subdivision is part of the path towards which psychiatry is started: getting into precision medicine by tracking the oncology footprint. Each one its drug, identified as a priori the most effective.
The new scenario was illustrated by Claudio Mencacci, chair of Sip and director of the neuroscience department of the Fatebenefratelli-Sacco Hospital in Milan. Based on five new parameters to measure depression, he said, in cure there will be no more attempts, as it is today. There will be a detailed assessment of these factors: genetic data, biomarkers, brain neuroimaging, depression typology, indications of increased probability of resistance to therapies.
MISURABLE DATA – Among these particular investigations, Mencacci, cytochrome P450, an enzyme that metabolizes drugs and which can slow or speed up the response, and the reactive C protein that may indicate the greater or lesser efficacy of individual antidepressants, has been mentioned. For psychiatry, who has always complained of not being able to have a radiographic plate or a blood test to support his diagnosis, the one that he sees is really an epochal turning point. Even doctors of the mind can prescribe data to the hand, and not just on the basis of preparation and intuition. Professor Mencacci pointed out that the reality of precision psychiatry will also have a reassuring effect on depression patients over time: if today 77 percent say confidence in the possibility of healing thanks to available treatments, in fact only 1 out of 3 really care for fear of side effects or becoming dependent.
“MORE FAITH OF A TUMOR” – Yet the evil they suffer is tremendous. A survey conducted by Onda (National Observatory on Women’s Health) on a sample of 1,000 people about the perception, experience, fears of the Italian population of depression shows that “obscure evil” is second only to tumors as an impact on quality of life. Onda’s president, Francesca Merzagora, then specified: 70 percent of patients end up isolating themselves, and 30 percent suffer from cognitive impairment problems such as difficulty making decisions, lack of attention and concentration. Additionally, it is apparent that women are more afraid of the depression of a breast cancer.
OTHERS SUBJECTS – And we come to the criteria that nowadays divide the depression into 8 types, unless we pretend to apply them rigidly.
1) Disruption of disruptive mood disorder (7-18 years) it is a youth condition characterized by chronic and severe irritability with frequent attacks on things and people.
2) Major depressive disorder Severity – mild, moderate, severe – has specific features: there may be anxiety, hypomanic symptoms, sometimes delusions of guilt and ruin, persecution ideas. Women suffer about twofold of men.
3) Persistent depressive disorder (distimia) the onset is premature and insidious, the chronical course often associated with borderline personality disorder or substance use, not characterized by true anguish, however, can produce disabilities equal to the major depressive disorder.
4) Premenstrual dysphoric disorder moodily depressed mood, irritability, dysphoria, anxiety characterize in some women the stage before the cycle and disappear at the arrival of menstruation or soon after.
5) Drug-induced depressive disorder all the symptoms of major depression appear and such symptoms persist beyond the expected duration of the drug or drug or withdrawal period.
6) Depressive disorder due to medical condition Depression is a direct consequence of another disease: stroke, Huntington’s disease, brain trauma, Parkinson’s, hypothyroidism …
7) Depressive disorder with other specification a) recurrent short depression b) short-term depressive episode c) depressive episode with insufficient symptomatology.
8) Depressive Disorder without Other Specification It is ranked when symptoms of depression, which cause clinically significant discomfort, predominate but do not fully meet the criteria for any of the depressive disorders.
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