Handbook of Chronic Depression: Diagnosis and Therapeutic Management

Handbook of Chronic Depression: Diagnosis and Therapeutic Management

Handbook of Chronic Depression: Diagnosis and Therapeutic Management

Handbook of Chronic Depression: Diagnosis and Therapeutic Management

Excerpt

Our goal as editors of this handbook was to join with respected colleagues with complementary expertise to produce a guide to chronic depression that would be accessible, clinically relevant, and empirically based. The enthusiasm with which we have pursued this project has been fueled by the steadily emerging recognition that chronic depression is not an esoteric subtype of depression, but rather a ubiquitous clinical feature associated with significant morbidity.

Although the majority of controlled depression treatment trials extend over months (1), the burden of depressive disorders is frequently measured in years. Consistent with clinical experience, major epidemiological studies (2 -4) and observations from a number of large outcome studies over the past two decades, including the Zurich Follow-Up Study (5), the National Institute of Mental Health Collaborative Depression Study (6), and the Medical Outcomes Study (7), have helped refocus our understanding of major depressive disorder (MDD) from that of an episodic illness to that of a disorder with a strong tendency to persist and/or recur and a propensity to produce long-lasting and pervasive psychosocial and general medical consequences, indeed even when present in diminished intensity as subsyndromal symptoms.

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