Health-related quality of life-based definition of remission from depression among primary care patients.

Background: Depression undermines health-related quality of life (HRQoL). Remission is the central aim of all treatments for depression, but the degree of remission necessary for depressive patients' HRQoL to correspond to the normal range of the general population remains unknown.

Methods: The Vantaa Primary Care Depression Study prospectively followed-up a screening-based cohort of depressive primary care patients for 5 years.

Pharmacological and psychosocial treatment of depression in primary care: Low intensity and poor adherence and continuity.

Background: Primary health care bears the main responsibility for treating depression in most countries. However, few studies have comprehensively investigated provision of pharmacological and psychosocial treatments, their continuity, or patient attitudes and adherence to treatment in primary care.

Methods: In the Vantaa Primary Care Depression Study, 1111 consecutive primary care patients in the City of Vantaa, Finland, were screened for depression with Prime-MD, and 137 were diagnosed with DSM-IV depressive disorders via SCID-I/P and SCID-II interviews.

[Recognition of mood disorders].

A mood disorder involves lowering or elevation or mood and usually also somatic symptoms associated with anxiety, substance abuse problems or a personality disorder. In addition to diagnoses, the stage and degree of severity of the disorder and the patients' own motivation influence the treatability of the patients. The expectations and hopes of the patients are associated with their life and medical history, social situations and increasingly heterogenous cultural backgrounds.

Temperament and character traits predict future burden of depression.

Background: Personality traits are associated with depressive symptoms and psychiatric disorders. Evidence for their value in predicting accumulation of future dysphoric episodes or clinical depression in long-term follow-up is limited, however.

Methods: Within a 15-year longitudinal study of a general-population cohort (N=751), depressive symptoms were measured at four time points using Beck׳s Depression Inventory.

Borderline personality disorder among primary care depressive patients: a five-year study.

Background: Studies of depressive disorders with concurrent borderline personality disorder (BPD) in primary health care are scarce and methodologically weak. Limited epidemiological evidence suggests BPD may be common among users of primary care services. Prevalence, characteristics and outcome of primary care depressive patients with co-morbid BPD are unknown.

P2RX7 gene is associated consistently with mood disorders and predicts clinical outcome in three clinical cohorts.

We investigated the effect of nine candidate genes on risk for mood disorders, hypothesizing that predisposing gene variants not only elevate the risk for mood disorders but also result in clinically significant differences in the clinical course of mood disorders. We genotyped 178 DSM-IV bipolar I and II and 272 major depressive disorder patients from three independent clinical cohorts carefully diagnosed with semistructured interviews and prospectively followed up with life charts for a median of 60 (range 6-83) months. Healthy control subjects (n = 1322) were obtained from the population-based national Health 2000 Study.

Differences in neuroticism and extraversion between patients with bipolar I or II and general population subjects or major depressive disorder patients.

Background: Whether levels of neuroticism or extraversion differ between patients with bipolar disorder (BD), major depressive disorder (MDD) and subjects from the general population, or between BD I and BD II patients, remains unclear.

Methods: BD patients (n=191) from the Jorvi Bipolar Study, and MDD patients (n=358) from both the Vantaa Depression Study and the Vantaa Primary Care Depression Study cohorts, were interviewed at baseline and at 18 months. A general population comparison group (n=347) was surveyed by mail.

[Update on current care guidelines. Depression, current care guideline].

The treatment of depression is based on careful diagnostic evaluation. In the acute phase of treatment, brief psychotherapies (cognitive, interpersonal, psychodynamic or problem-solving) are effective in cases of mild to moderate depression. Antidepressants are also effective, their importance increasing alongside the level of severity.

Major depressive disorder and white matter abnormalities: a diffusion tensor imaging study with tract-based spatial statistics.

Background: A few diffusion tensor imaging (DTI) studies have shown abnormalities in areas of white matter tracts involved in mood regulation in geriatric depressive patients, using a region-of-interest technique. A voxel-based morphometry DTI study of young depressive patients reported similar results. In this study, we explored the structure of the white matter of the whole brain with DTI in middle-aged major depressive disorder (MDD) patients, using novel tract-based spatial statistics.

Do characteristics of patients with major depressive disorder differ between primary and psychiatric care?

Background: Despite the need for rational allocation of resources and cooperation between different treatment settings, clinical differences in patients with major depressive disorder (MDD) between primary and psychiatric care remain obscure. We investigated these differences in representative patient populations from primary care versus secondary level psychiatric care in the city of Vantaa, Finland.

Method: We compared MDD patients from primary care in the Vantaa Primary Care Depression Study (PC-VDS) (n=79) with psychiatric out-patients (n=223) and in-patients (n=46) in the Vantaa Depression Study (VDS).

Depressive disorders in primary care: recurrent, chronic, and co-morbid.

Background: Preceding longitudinal course and current somatic and psychiatric co-morbidity of depression have been little investigated in primary care.

Method: Consecutive patients (n = 1111) in primary care in the city of Vantaa, Finland, were screened for depression with the PRIME-MD, and positive cases interviewed by telephone. Cases with current depressive symptoms were diagnosed face-to-face with the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I/P).