الفهرس | Only 14 pages are availabe for public view |
Abstract Depression has been known to present in different severities: mild, moderate, severe and dysthymia.Research has revealed that there is a category of unspecified depression which is quite prevalent in both primary care clinics and psychiatric outpatient clinics. The category of unspecified depression includes patients having less than the five symptoms of depression for less than two weeks duration and patients who complain of depressive symptoms,but do not complain of depressed mood or anhedonia neverthless,these symptoms are enough to impair one’s functional capacity (Kendler and Gardner, I998.) Unspecified depression is found to be comparable in demographics and clinical characteristics to specified depressive disorders. Unspecified depression is found to be associated with family dysfunction as compared to healthy subjects but with a lesser degree than specified depression subjects. It appears that unipolar depression is presenting in different degrees of severity along a spectrum.Unspecified depression may be constructed as the mildest form along a spectrum followed by dysthymia,then mild,moderate and severe depression, Judd et al,(1997). Serious impairment can indeed result from even mild symptoms of depression in absence of depressed mood or anhedonia.The high prevalence of unspecified depression,the significant psychosocial ’’’lfI/ ConcCusion 1=============== 111 impairment associated with it make unspecified depression a matter for serious consideration by clinicians and researchers. The research leading to the discovery of unspecified deprssion and its establishment as a clinically significant illness may lead to a revised concept of unipolar depression as ”a single illness” having various degrees of symptomatology falling along a spectrum. Depressive symptoms should not be necessarily viewed as static ,but mobile,changing over the course of time.This revision in concept may give rise to significant implication for treatment of specified depression. Currently, researchers recognize that the goal of treatment should be to reach a complete a symptomatic status as opposed to reduction of symptoms to subsyndromal level. Otherwise,symptoms may well recur, simply leading to specified deprssive disorder(Sadek ,N &Bona J,2000) . In summary we have demonstrated rates of unspecified depression in Egyptian primary care clinics and in psychiatric outpatient clinics that are comparable to those reported from western countries and Japan.Our study was unique in the inclusion of both specified and unspecified depressive disorders. In addition,we have demonstrated that both the depressive disorders result in significant functional impairment. A major concern is the lack of specific diagnoses and appropriate therapy for these disorders in primary care setting.Improved diagnoses and therapy, however,may not ------- IConcCuslon 1============= 112 be forthcoming without a shift in cultural attitudes towards mental illness. Our findings can be summarized as follows: (I) A large proportion of subjects from the general population manifest depressive syndromes of sufficient severity to affect their personal and family life, yet they do not meet conventional criteria for any of specified depressive disorders. (2) Unspecified depression constitutes a valid diagnostic subtype of depressive disorder, evidence from clinical features, delimitation from other conditions and social and personal dysfunctioning demonstrates that unspecified depression cannot be distinguished from specified depressive disorders, yet it is significantly distinct from a normal control group. |