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OPEN ACCESS PLUS
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Contents
8(4): Pp. 292 - 298
Hilarie Cash, Cosette D. Rae, Ann H. Steel and Alexander Winkler
[Open Access Plus] |
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Problematic computer use is a growing social issue which is being debated worldwide. Internet Addiction Disorder (IAD) ruins lives by causing neurological complications, psychological disturbances, and social problems. Surveys in the United States and Europe have indicated alarming prevalence rates between 1.5 and 8.2% [1]. There are several reviews addressing the definition, classification, assessment, epidemiology, and co-morbidity of IAD [2-5], and some reviews [6-8] addressing the treatment of IAD. The aim of this paper is to give a preferably brief overview of research on IAD and theoretical considerations from a practical perspective based on years of daily work with clients suffering from Internet addiction. Furthermore, with this paper we intend to bring in practical experience in the debate about the eventual inclusion of IAD in the next version of the Diagnostic and Statistical Manual of Mental Disorders (DSM).
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5(4): Pp. 287 - 297
Knut A. Hestad, Pal Aukrust, Sverre Tonseth and Solveig Klæbo Reitan
[Open Access Plus] |
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Epidemiological findings indicate a connection between depressive symptoms and changes in status of the immune system in depressed patients. This raises the possibility of causative connections. Theories on mechanisms for interactions between immune and affective systems – directly and via endocrine system – are evolving. Such hypothesized causative connections are supported by several findings. First, in depressed patients changes in the status of the immune system in vivo and ex vivo are seen. Also, depressive symptoms are seen in patients with altered immune status (physiologically, pathologically or chemically induced). Knowledge in this field may have implications regarding psychiatric follow up of physically ill people suffering from diseases caused by an altered immune system (long lasting infections, autoimmune diseases, hypersensitivity disorders) as well as disorders for which treatment and prognoses depends on the immune system (infections, cancer). Similarly, medical treatment of depressed patients may be adjusted by more specific knowledge about the interaction between neuroimmunology and depression. Important findings and the present knowledge and theories are reviewed.
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4(3): Pp. 145 - 156
Trond F. Aarre and Alv A. Dahl
[Open Access Plus] |
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Objectives: Depressive episodes and symptoms are common in bipolar disorder and are often treated with medication. The aim of this literature review is to critically examine the empirical evidence supporting the pharmacological treatment options in bipolar depression. Methods: Randomized controlled trials (RCTs) with parallel-group design of medications for bipolar depression were identified using PubMed. Reference sections were searched for publications of additional RCTs. The quality of the trials was rated. Results: We identified 35 studies. Most trials are of moderately good quality, underpowered and use active comparators of uncertain merit. Large and replicated clinical trials support the efficacy of quetiapine and the combination of olanzapine and fluoxetine. One very large trial found olanzapine alone to be efficacious. One study found lamotrigine to be superior to placebo on some outcome measures, but several negative lamotrigine trials have remained unpublished. The efficacy of lithium is supported by small trials in mixed samples. There is no convincing evidence that antidepressants are effective in bipolar depression, with the possible exception of tranylcypromine. Conclusion: Quetiapine, and olanzapine alone or in combination with fluoxetine, are well documented treatments for bipolar depression. The evidence in favour of lithium and lamotrigine is weaker. Commonly prescribed antidepressants are probably unhelpful.
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