Depression and anxiety.

Comorbid depression and anxiety disorders occur in up to 25% of general practice patients. About 85% of patients with depression have significant anxiety, and 90% of patients with anxiety disorder have depression. Symptomatology may initially seem vague and non-specific.

Bipolar disorder: diagnostic issues.

Bipolar disorders are cyclical mood disorders with clinical features including distinct sustained periods of mood elevation. Briefer (4 days or more), mild episodes of mood elevation define bipolar II disorder; lengthier (7 days or more), more severe episodes (or those requiring hospitalisation), with or without psychotic features, define bipolar I disorder. Depressive periods are more common and lengthier than manic or hypomanic states, and are the main cause of disability.

Seizure threshold determination for electroconvulsive therapy: stimulus dose titration versus age-based estimations.

Objective: This study compared electroconvulsive therapy (ECT) seizure threshold determined by stimulus dose titration with age-based estimations.

Method: Patients with major depressive disorder had their initial seizure thresholds determined by stimulus dose titration and the results compared with age-based estimations. There are no significant differences in thresholds determined by these methods.

Dual action antidepressants and some important considerations.

Objective: To review controlled studies of long-term treatment and their side-effects with newer dual action antidepressants following an acute episode of major depression.

Method: A literature review (MedLine) was undertaken and references were selected for their relevance and methodology in describing their contribution to the examination of our objective.

Result And Conclusion: Three dual action antidepressants are identified: venlafaxine, mirtazapine and milnacipran.