Depression

A compact, practical guide to diagnosis, assessment, and empirically supported treatments of depression by one of the world's leading experts - for students and busy practitioners alike.

Based on years lived with disability, the World Health Organization ranks depression as the fourth largest global disease burden. Depression is one of the most frequent problems seen in psychotherapy. This book takes the reader through the central issues of diagnosis and treatment of depression. It begins with definitions and a readable explanation of the intricacies of depression diagnoses. Instruments for assessing depression as a diagnosis and as a dimension are described with their primary uses. Major theories are presented with their conceptions of depression and the implications of the conceptions for treatment. Today's empirically supported treatments for depression tend to be complex packages with sequences of different interventions. This book identifies the basic and common components of therapy for depression, i.e., the basic competencies that will allow professionals to treat most cases of depression. The book is aimed at students and professionals, giving them a comprehensive and up-to-date overview of psychopathology, assessment, and treatment of depression.

Contenu

1 Description ... 1 1.1 Terminology... 1 1.2 Definitions ... 1 1.3 Epidemiology... 8 1.3.1 Age Cohort... 8 1.3.2 Gender... 10 1.3.3 Summary... 13 1.4 Course and Prognosis... 13 1.5 Differential Diagnosis... 15 1.6 Comorbidities... 16 1.7 Diagnostic Procedures and Documentation... 17 1.7.1 Diagnostic Interviews: Semistructured and Structured ... 18 1.7.2 Clinician Rating Scales... 19 1.7.3 Scales Measuring Constructs Related to Depression... 21 1.7.4 Depression Scales... 25 1.7.5 Inventories with Depression Scales... 27 1.7.6 Behavioral Measures ... 30 2 Theories and Models of the Disorder ... 33 2.1 Biological Models... 33 2.1.1 Genetics ... 33 2.1.2 Monoamine Hypotheses ... 34 2.1.3 Neuroendocrine Models... 36 2.1.4 Brain-Derived Neurotrophic Factor... 36 2.1.5 Biological Rhythms ... 37 2.2 Psychodynamic Models ... 37 2.3 Behavioral Models... 38 2.4 Interpersonal and Social Skill Models... 39 2.5 Interpersonal Psychotherapy... 40 2.6 Learned Helplessness ... 41 2.7 The Cognitive Therapy Model... 42 2.8 Self-Management ... 43 2.9 Concluding Comments... 44 3 Diagnosis and Treatment Indications ... 45 3.1 Dimensions and Subtypes of Depression... 45 3.2 Personality Factors as Treatment Indicators... 46 3.3 Life Events and Stress ... 49 4 Treatment ... 51 4.1 Methods of Treatment ... 51 4.1.1 Therapy Packages ... 51 4.1.2 Education About Depression ... 52 4.1.3 Behavioral Activation... 54 vi Advances in Psychotherapy: Depression 4.1.4 Scheduling as an Intervention ... 55 4.1.5 Continuous Assessment ... 55 4.1.6 Skill Training ... 56 4.1.7 Problem Solving... 56 4.1.8 Interpersonal Psychotherapy... 57 4.1.9 Countering Helplessness... 58 4.1.10 Cognitive Techniques... 59 4.1.11 Mindfulness ... 61 4.1.12 Goal Setting ... 62 4.1.13 Self-Reinforcement/Self-Talk... 63 4.1.14 Assets List... 63 4.1.15 Other Psychotherapy Components... 64 4.1.16 Medications ... 65 4.2 Mechanisms of Action ... 66 4.3 Efficacy and Prognosis ... 68 4.3.1 Efficacy... 68 4.3.2 Prognosis and Relapse ... 70 4.4 Variations and Combinations of Treatments ... 70 4.4.1 Applications to Different Populations ... 70 4.4.2 Treatment Formats... 71 4.4.3 Sequencing with Medication ... 71 4.5 Problems in Carrying Out the Treatments... 72 4.6 Multicultural Issues ... 73 5 Further Reading ... 74 6 References ... 78