Vol 8, No 2 - Depression in Medicine
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ear Colleagues, “Depression” is a disease which has always been problematic in medicine: • Firstly, because mood disorders provoke, are comorbid with or related to, or follow, many somatic illnesses, of which they may alter the presentation, worsen the symptoms, or mask certain features. • Secondly, because there is a large variation in types of depressive states; this variation is brought about by the presence or absence of precipitating factors, the patient's environ- ment and family history, detected or undetected comorbidities, and resistance to treatment. • Finally, depressive states are difficult to characterize: it is extremely hard to divide patients into homogeneous groups responding to the same treatment in the same manner.The diagnosis is often influenced by the complex relationship between the pre-existing per- sonality and the depressive symptomatology, and the prognosis is often based as much on the former as on the latter. We have decided, in this issue of Dialogues in Clinical Neuroscience, to have these various themes addressed by some of the shining lights in our field, and thus to present an updated view of the various approaches possible, based on current knowledge in the area, not only on a diagnostic and clinical level, but also in terms of deciding whether phar- macological treatment is appropriate, and examining the role of comorbidities. We are now living in an exciting time; we have made much progress in our knowl- edge of the causes of depression, and new ideas have been emerging, particularly in the fields of neurogenesis and neuroplasticity, and notably the implications of protein factors. Many new therapeutic possibilities are now emerging, and we finally have some hope of being able to use treatments which have no or very few side effects.This naturally opens up avenues for long-term treatment, or even, in some cases, preventive treatment which could eliminate recurrences, even in chronic conditions. We would like to thank all those who have made the publication of this issue possi- ble, especially Prof Manfred Ackenheil, the coordinating editor, and all the authors who have been willing to privilege us with their scientific opinions on the subjects proposed. Yours sincerely, Jean-Paul Macher, MD Marc-Antoine Crocq, MD E d i t o r i a l D 1 4 5