Depression

Course Outline

Based on years lived with disability, the World Health Organization ranks depression as the fourth largest global disease burden. Depression is one of the most frequent problems seen in psychotherapy. This book takes the reader through the central issues of diagnosis and treatment of depression. It begins with definitions and a readable explanation of the intricacies of depression diagnoses. Instruments for assessing depression as a diagnosis and as a dimension are described with their primary uses.

Major theories are presented with their conceptions of depression and the implications of the conceptions for treatment. Today’s empirically supported treatments for depression tend to be complex packages with sequences of different interventions. This book identifies the basic and common components of therapy for depression, i.e., the basic competencies that will allow professionals to treat most cases of depression. The book is aimed at students and professionals, giving them a comprehensive and up-to-date overview of psychopathology, assessment, and treatment of depression.

About the Authors

Lynn P. Rehm, PhD,ABPP., obtained his doctorate in Clinical Psychology from the University of Wisconsin Madison. He has been on the faculties of the Neuropsychiatric Institute at UCLA and the University of Pittsburgh in Psychology and Psychiatry. He recently retired from the Department of Psychology at the University of Houston after 30 years as Professor. His research and clinical interests center around the psychopathology and treatment of depression. He has published widely on his self-management treatment program for depression and on psychotherapy for depression generally. Dr. Rehm continues to be active professionally and is currently President of the Division of Clinical and Community Psychology of the International Association of Applied Psychology.

Learning Objectives

After completing this course you’ll be able to:

1. Discuss the history of the word depression.
2. Describe a major depressive disorder.
3. Describe catatonic features.
4. List atypical features of depression.
5. Compare dysthymia and cyclothymia.
6. Describe the ICD-10 and the ICD-10-CM.
7. Discuss the research of Osgood and Russell.
8. Discuss depression, in relation to age and the first episode.
9. Compare depression among men and women.
10. Describe the concept of sociotropy and autonomy according to Beck.
11. State why women have a greater risk for depression according to Susan Nolen-Hoeksema.
12. Discuss the course of minor depression disorder.
13. Discuss MDD, generalized anxiety disorder, and manic episode.
14. Compare clinician rating scales.
15. Describe briefly the ten rating scales used to assess depression.
16. Describe the six depression scales.
17. Describe the five inventories with depression scales.
18. Discuss the role of genetics regarding the occurrence of depression.
19. Compare the tricyclic antidepressants, serotonin reuptake inhibitors, and the selective serotonin and norepinephrine reuptake inhibitors.
20. Discuss the role of cortisol in depressed individuals.
21. Compare dependency depression and dominant-goal depression.
22. Compare the behavior models and interpersonal and social skill models.
23. Discuss the research of learned helplessness by Seligman.
24. Compare the cognitive therapy model by Beck and the integrative theory by Rehm.
25. Discuss various personality factors and appropriate therapy.
26. Discuss the research by Nemeroff et al. (2003) regarding childhood trauma.
27. Discuss the educational aspects of therapy.
28. Describe the cognitive techniques originated by Beck (1972).
29. List the elements of goal setting.
30. Discuss the three theoretical mechanisms of action.
31. Discuss prognosis and relapse prevention of depression according to Vittengl,Clark, Dunn, and Jarrett, 2007.
32. Discuss lack of compliance with therapy.

Course Contents

1 Description
1.1   Terminology
1.2   Definitions
1.3   Epidemiology
1.3.1     Age Cohort
1.3.2     Gender
1.3.3     Summary
1.4   Course and Prognosis
1.5   Differential Diagnosis
1.6   Comorbidities
1.7   Diagnostic Procedures and Documentation
1.7.1     Diagnostic Interviews: Semistructured and Structured.
1.7.2     Clinician Rating Scales
1.7.3     Scales Measuring Constructs Related to Depression
1.7.4     Depression Scales
1.7.5     Inventories with Depression Scales
1.7.6     Behavioral Measures
2 Theories and Models of the Disorder
2.1   Biological Models
2.1.1     Genetics
2.1.2     Monoamine Hypotheses
2.1.3     Neuroendocrine Models
2.1.4     Brain-Derived Neurotrophic Factor
2.1.5     Biological Rhythms
2.2   Psychodynamic Models
2.3   Behavioral Models
2.4   Interpersonal and Social Skill Models
2.5   Interpersonal Psychotherapy
2.6   Learned Helplessness
2.7   The Cognitive Therapy Model
2.8   Self-Management
2.9   Concluding Comments
3 Diagnosis and Treatment Indications
3.1   Dimensions and Subtypes of Depression
3.2   Personality Factors as Treatment Indicators
3.3   Life Events and Stress
4 Treatment
4.1   Methods of Treatment
4.1.1     Therapy Packages
4.1.2     Education About Depression
4.1.3     Behavioral Activation
4.1.4     Scheduling as an Intervention
4.1.5     Continuous Assessment
4.1.6     Skill Training
4.1.7     Problem Solving
4.1.8     Interpersonal Psychotherapy
4.1.9     Countering Helplessness
4.1.10     Cognitive Techniques
4.1.11     Mindfulness
4.1.12     Goal Setting
4.1.13     Self-Reinforcement/Self-Talk
4.1.14     Assets List
4.1.15     Other Psychotherapy Components.
4.1.16     Medications
4.2   Mechanisms of Action
4.3   Efficacy and Prognosis
4.3.1     Efficacy.
4.3.2     Prognosis and Relapse
4.4   Variations and Combinations of Treatments
4.4.1     Applications to Different Populations
4.4.2     Treatment Formats
4.4.3     Sequencing with Medication
4.5   Problems in Carrying Out the Treatments
4.6   Multicultural Issues
5 Further Reading
6 References

FROM THE REVIEWS

A concise how-to-do’ book, authoritative and user friendly at the same time. From professional clinician to student this is a practical resource book, at each stage referring the reader to relevant studies and their findings while taking him through the central issues of diagnosis and treatment of depression. Depression is the fourth largest global disease based on years lived. [. . .] This book will undoubtedly provide assistance in its diagnosis and treatment.” - Robert Riley in KAIROS, Slovenska revja za psihoterapijo. Vol 4 (3-4), 2010

Professor Rehm manages to cut right to the heart of the disorder and shines a light on the essence of the different approaches to its treatment. The treatise makes a real contribution to the literature for the neophyte and experienced clinician alike.” - Steven D. Hollon, PhD, Department of Psychology, Vanderbilt University, Nashville, TN

Lynn Rehm has spent most of his productive career studying and treating depression, and now, in an extremely well written and concise book, he shares the wisdom he has accumulated over the decades with us. As one of the originators of modern day psychological treatments for depression, few individuals are better positioned to guide clinicians in the difficult task of assessing and treating depression. This brief guide should be on the bookshelves of every clinician who assesses or treats depression.” - David H. Barlow PhD, ABPP, Professor of Psychology and Psychiatry, Director, Center for Anxiety and Related Disorders at Boston University, MA

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