Latin American consensus recommendations for the management and treatment of patients with treatment-resistant depression (TRD).

Unlabelled: Despite the abundance of literature on treatment-resistant depression (TRD), there is no universally accepted definition of TRD, and available treatment pathways for the management of TRD vary across the Latin American region, highlighting the need for a uniform definition and treatment principles to optimize the management of TRD in Latin America.

Methods: Following a thematic literature review and pre-meeting survey, a Latin America expert panel comprising 14 psychiatrists with clinical experience in managing patients with TRD convened and utilized the RAND/UCLA appropriateness method to develop consensus-based recommendations on the appropriate definition of TRD and principles for its management.

Results: The expert panel agreed that 'treatment-resistant depression' (TRD) is defined as 'failure of two drug treatments of adequate doses, for 4-8 weeks duration with adequate adherence, during a major depressive episode'.

Effect of Low-Dose Statins in Addition to Standard Therapy on Brain Perfusion and Neurocognitive Performance in Patients with Major Depressive Disorder.

Introduction: Major depressive disorder (MDD) is a prevalent condition which has a well-known association with ischemic cardiomyopathy, probably explained by an inflammatory mediator mechanism. Statins, besides reducing cholesterol production, have pleiotropic effects including anti-inflammatory activity. The goal was to evaluate the effect of statins as an addition to standard therapy on mood status, brain perfusion, and neurocognitive performance in MDD.

Regional Brain Perfusion Is Associated with Endothelial Dysfunction Markers in Major Depressive Disorder.

Background: Major depressive disorder (MDD) is an important independent risk factor for cardiovascular disease. Cumulative data suggest that depressive patients exhibit derangement in regional cerebral blood flow (rCBF), although underlying mechanisms remain mostly unknown. Endothelial dysfunction (ED), defined as different forms of abnormal endothelial activity, plays a key role in the pathogenesis of vascular disease.

Effectiveness of Sleep Deprivation in Treating Acute Bipolar Depression as Augmentation Strategy: A Systematic Review and Meta-Analysis.

Background: Bipolar disorder is a disabling disease characterized by the recurrence of mood episodes. Successful strategies for the acute treatment of bipolar depression are still a matter of controversy. Total sleep deprivation (TSD) has shown acute antidepressant effect; however, the prompt relapse of depressive symptoms after sleep recovery has been reported.

Current challenges and future perspectives of the role of governments in the psychiatric/mental health systems of Latin America.

The practices and systems of mental health in Latin America and the Caribbean are heterogeneous and are connected to dissociation between national macro systems and the complex quotidian that occurs in the daily attention of mental pathologies. The health care experiences in mental health are diverse and go back to the 1960s; these took a boost with the Caracas Declaration of 1990. The Health Care Reform has had several stages, lately focused in the strength that derives from a growing psychiatric epidemiology "base".

[Trends in benzodiazepine use in primary care patients].

Background: Benzodiazepine use is associated to a risk of abuse of dependency. In Chile benzodiazepine abuse is a public health issue. In an attempt to overcome this problem, several restrictions in their prescription were implemented by the health authority.