Depression in the Youth and Adolescent



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Chapter 6.15: Depression in Young People and the Elderly


Priority Medicines for Europe and the World


"A Public Health Approach to Innovation"

Background Paper


Depression in Young People and the Elderly
By Eduardo Sabaté
7 October 2004



Table of Contents




Summary 4

1. Introduction 5

Definition and Classifications 5

Natural History 6

Depression in Young People 6

Depression in the Elderly 6

2. Epidemiology and Burden of Depression 7

Epidemiology of Depression in the General Population 7

Epidemiology of Depression in Youth 9

Epidemiology of Depression in the Elderly 10

Epidemiology of Depression as a Comorbidity 10

Economic Impact of Depression 11



3. Control Strategy 11

Antidepressants in Young People 14

Antidepressants in the Elderly 14

Side-Effects of Antidepressants 15



4. Major Problems and Challenges for Disease Control: Why Does the Disease Burden Persist? 19

5. Past and Current Research into Pharmaceutical Interventions with Antidepressants 20

6. What Are the Opportunities for Research into New Pharmaceutical Interventions? 25

7. Gaps Between Current Research and Potential Research Issues that Could Make a Difference 25

8. Conclusions 25

9. References: 26


Annex

Abbreviations Used in this Report

5HT: 5-hydroxytryptamine

AD: Alzheimer disease

ADHD: attention deficit with hyperactivity disorder

CRF: corticotropin-releasing factor

CT: computerized tomography

CVD: cardiovascular disease

DALY: disability-adjusted life year

EU10: European union new accession countries

EU15: European union countries

EU25: Expanded European union

ECT: electroconvulsive therapy

FDA: United States’ Food and Drug Administration

fMRI: functional magnetic resonance imaging

GABA: gamma-aminobutyric acid

GDP: gross domestic product

GnRH: gonadotropin releasing hormone

GP: general practitioner

Obs & Gyn: obstetrics and gynaecology

HMO: health management organization

IHD: ischaemic heart disease

IP: interpersonal psychotherapy
CM-IPT: clinician-managed interpersonal psychotherapy

MAO: monoamine oxidase

MAOI: monoamine oxidase inhibitors

MRI: magnetic resonance imaging

NK: neurokinin

NMDA: N-methyl-D-aspartate

PD: Parkinson disease

PET: positron emission tomography

PTSD: post-traumatic stress disorder

PUFA: polyunsaturated fatty acids

RCT: randomized clinical trial

SNSRI: serotonin and noradrenaline-selective reuptake inhibitor

SSRI: serotonin-selective reuptake inhibitor

TCA: tricyclic antidepressant

TMS: transcranial magnetic stimulation

YLD: years lived with disability






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