| Foreword | p. v |
| Preface | p. vii |
| Contributors | p. xv |
| Epidemiology, Symptomatology, and Diagnosis | p. 1 |
| Introduction | p. 1 |
| Phenomenology of Depressive States | p. 2 |
| Classification of the Depressive States | p. 4 |
| Differential Diagnosis of the Depressive States | p. 5 |
| Epidemiological Information | p. 6 |
| References | p. 7 |
| Substrates of Sadness: The Pathophysiology of Depression | p. 9 |
| Introduction | p. 9 |
| Historical Development of a Biological Approach to Depression | p. 10 |
| Clues and Challenges to Exploring the Neurobiological Basis of Depression | p. 12 |
| The Biogenic Amine Hypotheses: Signaling the Ascendancy of Biological Models of Depression | p. 14 |
| Fast-Acting Neurotransmitters: Small Molecules with Big Roles | p. 20 |
| Intracellular Signal Transduction: Taking in the Message | p. 22 |
| Neuroendocrinology: Brain-Body Interactions | p. 23 |
| Genetic Contributions: Risk and Resilience | p. 29 |
| Conclusions | p. 31 |
| References | p. 31 |
| Drug Development, Psychotherapy Development, and Clinical Use | p. 41 |
| Introduction | p. 41 |
| Pharmacotherapy | p. 41 |
| TCA and Tetracyclic Antidepressants | p. 42 |
| MAOI Antidepressants | p. 46 |
| NDRI Antidepressants | p. 48 |
| SSRIs | p. 50 |
| Trazodone | p. 53 |
| Nefazodone | p. 54 |
| Selective SNRIs | p. 55 |
| Mirtazapine | p. 58 |
| Conclusions | p. 59 |
| Psychotherapy | p. 59 |
| History of Depression-Focused Psychotherapies | p. 60 |
| Overview of Depression-Focused Psychotherapies | p. 64 |
| Conclusions | p. 71 |
| References | p. 73 |
| Treatment Outcomes with Acute Pharmacotherapy/Psychotherapy | p. 85 |
| Introduction | p. 85 |
| Acute Treatment Outcomes with Antidepressant Pharmacotherapy | p. 86 |
| Acute Treatment Outcome with Psychotherapy | p. 97 |
| Conclusions | p. 108 |
| References | p. 109 |
| Depression: Treatment Outcomes with Long-Term Maintenance | p. 123 |
| Pharmacotherapy | p. 123 |
| Predictors of Chronicity, Relapse, and Recurrence | p. 124 |
| Drug Discontinuation | p. 125 |
| Maintenance Pharmacotherapy | p. 127 |
| Studies of Long-Term Pharmacotherapy | p. 128 |
| Psychotherapy | p. 136 |
| Residual Symptoms of Unipolar Depression | p. 138 |
| Psychotherapy During Continuation and Maintenance Phases of Treatment | p. 139 |
| Efficacy of the Sequential Approach in Treating Residual Symptoms | p. 141 |
| Standard Format of Sequential Treatment Sessions | p. 143 |
| Cognitive-Behavioral Treatment of Residual Symptoms | p. 144 |
| Well-Being Therapy | p. 145 |
| Lifestyle Modification | p. 149 |
| Drug Tapering and Discontinuation | p. 149 |
| Conclusions | p. 150 |
| References | p. 150 |
| Combining Medications to Achieve Remission | p. 161 |
| Introduction | p. 161 |
| Making the Decision to Switch, Combine, or Augment an Antidepressant | p. 164 |
| Documentation During the Management of Combination Strategies | p. 167 |
| Augmentation | p. 168 |
| Antidepressant Combinations | p. 185 |
| Conclusion | p. 191 |
| References | p. 192 |
| Combining Drug Treatments to Achieve Better Tolerability and Adherence | p. 201 |
| Introduction | p. 201 |
| Adjunctive Strategies | p. 202 |
| Switching Antidepressants Owing to Intolerance | p. 206 |
| References | p. 207 |
| Depression and Genetics | p. 217 |
| Introduction | p. 217 |
| Limitations in Psychiatric Genetics | p. 217 |
| Traditional Genetic Approaches | p. 218 |
| Genetic Epidemiology | p. 219 |
| Candidate Genes | p. 222 |
| Conclusion | p. 224 |
| References | p. 224 |
| Depression, Neuroimaging and Neurophysiology | p. 229 |
| Introduction | p. 229 |
| Structural Imaging | p. 230 |
| Functional Imaging | p. 232 |
| Magnetic Resonance Spectroscopy | p. 234 |
| EEG Studies | p. 237 |
| References | p. 239 |
| Depression and Somatic Treatments | p. 245 |
| Introduction | p. 245 |
| ECT, TMS, and MST in the Treatment of Major Depression | p. 246 |
| ECT in MDD | p. 247 |
| TMS in MDD | p. 251 |
| MST in MDD | p. 253 |
| Minimally Invasive Somatic Techniques in MDD: DBS and VNS | p. 254 |
| Deep Brain Stimulation (DBS) | p. 258 |
| VNS | p. 261 |
| Conclusions | p. 268 |
| References | p. 270 |
| Medication and Psychotherapy Options and Strategies: The Future | p. 283 |
| Introduction | p. 283 |
| Combining Psychotherapy and Antidepressant Medications: Sequential Application | p. 283 |
| Conceptual Shift from Cognitive Content to Cognitive Process | p. 284 |
| Dismantling and Integrating Treatments | p. 285 |
| Interpersonal Psychotherapy | p. 286 |
| Specialized Populations | p. 286 |
| Dissemination of Evidence-Based Treatments | p. 286 |
| Psychodynamic Treatment Models: What's Next? | p. 287 |
| Balancing Effectiveness and Efficacy Research | p. 287 |
| Improving Detection of MDD | p. 288 |
| Use of Target Symptom Problem Lists and Pharmacodynamic Theory | p. 288 |
| Manualization of Psychopharmacopsychotherapy | p. 289 |
| Technology | p. 289 |
| Pharmacotherapy | p. 289 |
| Conclusions | p. 291 |
| Bibliography | p. 292 |
| Index | p. 293 |
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