Current subjects on depression

EDITORIAL

Current subjects on depression

Depressive disorder contains several of the main characteristics of a priority in Public Health. It is prevalent, highly incapacitating and, in general, relatively easy to diagnose and treat.

Paradoxically, depression – as all other mental disorders – receive, in Brazil and in the developing world, resources, which are not only insufficient, but also frequently wrong, originated in the absence of public health policies, or, sometimes, of highly ideologically biased policies that lack scientific evidence to support their efficacy.¹

In the last years, the Revista Brasileira de Psiquiatria (RBP) has published articles about specific subjects involving depression.^2-4 However, due to the clinical importance of the subject, RBP's editors chose to elect the subject "Depression" as the focus of this supplement. Its conception was based on the idea of focusing subjects which could be useful for the clinical psychiatrists.

Evidently, this supplement is not aimed to exhaust the different perspectives about the subject. Rather, it has sought much more to select themes that may be useful for the clinical practice and/or to challenge and question the diagnosis and treatment of depressive disorders.

The supplement "Depression: Current subjects" comprises five articles written by international and national authorities on the subject's treatment and research.

The first article, called "Major depression invites major concerns", has as its first author professor Gordon Parker. Besides being an important researcher in the field, he is a "thinker" of Contemporary Psychiatry. His consistent and well-grounded questionings make us reflect about Psychiatry's directions. In the study, he summarizes in a very didactic and concise way his ideas and critiques about the problems involved in the concept of major depression and its repercussions in the clinical practice and research.

In the second article, "Revision of the guidelines of the Brazilian Medical Association for the treatment of depression (Complete version)", a group of national authors representing different institutions in the country reviews the guidelines developed by the Brazilian Psychiatric Association for the Brazilian Medical Association. The original document of 2003, published in RBP, was updated according to the same path of the first one, that is, it has utilized guidelines developed in other countries and adapted to the Brazilian clinical reality.

In the third article, "Which are the recent clinical findings regarding the association between depression and suicide", authors from Brazilian and Canadian centers have accomplished an interesting update about the relationship between suicide and depression, regarding what the recent research has to offer to clinicians.

In the fourth article, "Electroconvulsive therapy in major depression: current aspects", authors from two Brazilian centers with tradition in the use of electroconvulsive therapy perform a review about the subject. Electroconvulsive therapy, although being the oldest biological treatment available, is still challenging prejudice and has shown, in light of contemporary research, an unquestionable efficacy in the treatment of major depression with new and intriguing mechanisms possibly involved.

Lastly, a group of researchers from a Canadian center presents an interesting review, called "Transcranial direct current stimulation: a promising alternative for the treatment of major depression?". In this article, it is accomplished a description of a technique recently applied in Psychiatry, but due to its simplicity and low cost it may become an interesting therapeutic resource in developing countries.

We hope that the supplement "Depression: current subjects" may fulfill its function, by providing the best scientific information as to enable mental health professionals to review and update concepts, stimulating the search for excellence in their clinical practice.

Marcelo P. Fleck

Medical School, Universidade Federal do Rio Grande do Sul

(UFRGS), Porto Alegre (RS), Brazil

References

• 1. Lancet Global Mental Health Group, Chisholm D, Flisher AJ, Lund C, Patel V, Saxena S, Thornicroft G, Tomlinson M. Scale up services for mental disorders: a call for action. Lancet 2007;370(9594):1241-52.
• 2. Mello AF, Juruena MF, Pariante CM, Tyrka AR, Price LH, Carpenter LL, Del Porto JA. Depression and stress: is there an endophen otype? Rev Bras Psiquiatr. 2007;29(Suppl 1):S13-8.
• 3. Tamayo JM, Rovner J, Muñoz R. The importance of detection and treatment of somatic symptoms in Latin American patients with major depression. Rev Bras Psiquiatr. 2007;29(2):182-7.
• 4. Cigognini MA, Furlanetto LM. Diagnosis and pharmacological treatment of depressive disorders in a general hospital. Rev Bras Psiquiatr. 2006;28(2):97-103.

Publication Dates

• Publication in this collection
  17 June 2009
• Date of issue
  May 2009