A recent study in the Journal of the American College of Radiology suggests that self-referral in medical imaging may be a significant contributing factor in diagnostic imaging growth. Self-referred imaging is identified as physicians (or non-physicians) who are not radiologists directing their patients to their own on-site imaging services or the referral of patients to outside facilities in which the referring physicians have financial interest.
In the current political and economic climate, there is a desire to reduce health care costs; diagnostic imaging expenditure is one area of particular interest.
Researchers identified the relative risk of physicians' referring patients for imaging to facilities in which the physicians have financial interest (self-referrers) compared with physicians' referring patients for imaging to facilities in which they have no financial interest (radiologist referrers).
"This meta-analysis of the available medical literature estimates that non-radiologist self-referrers of medical imaging are approximately 2.48 times more likely to order imaging than clinicians with no financial interest in imaging, which translates to an increased imaging utilization rate of 59.7 percent," said Ramsey K. Kilani, MD, lead author of the study.
"The utilization fraction of imaging attributable to self-referral in our study was calculated as 59.7 percent. According to the 2008 GAO report, $14.1 billion was spent on diagnostic imaging in 2006; of this amount, 64 percent ($9.0 billion) was to physician offices. Of that $9.0 billion, 68 percent went to non-radiologists. Using the 59.7 percent utilization fraction attributable to self-referral, a theoretical associated cost was calculated at $3.6 billion," said Kilani.
"The cost of this excess imaging to Medicare Part B is likely to be in the billions of dollars annually, on the basis of the best available data. This level of spending on potentially unnecessary medical imaging is concerning in light of the growing emphasis on reducing health care expenditures," he said.
*Source: American College of Radiology
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02 July 2011
Foods with baked milk may help build tolerance in children with dairy allergies
Introducing increasing amounts of foods that contain baked milk into the diets of children who have milk allergies helped a majority of them outgrow their allergies, according to a study conducted at Mount Sinai School of Medicine's Jaffe Food Allergy Institute. The data are reported in the May 23 issue of the Journal of Allergy and Clinical Immunology. Researchers studied 88 children, ages 2 to 17 years old, who were diagnosed with milk allergy, evaluating their tolerance to foods containing baked milk, such as muffins, waffles and cookies. The high temperatures used in baking cause the proteins in milk to break down, reducing the allergenicity.
Over the course of five years, researchers used a series of food challenges to introduce the children to foods that had progressively less-heated forms of milk. At the end of the study period, 47 percent of the children in the experimental group could tolerate unheated milk products, such as skim milk, yogurt and ice cream, compared to only 22 percent in a control group, indicating that controlled, increased exposure to baked milk products accelerates the rate at which children outgrow their milk allergies.
"This study shows that many children with allergies do not need to completely avoid all milk products," said Anna Nowak-Wegrzyn, MD, co-author of the study, and an Associate Professor of Pediatrics, Allergy and Immunology at Mount Sinai School of Medicine. "It's also an encouraging sign that through careful medical supervision, children can grow out of their allergies much quicker."
In the study's first food challenge, children were given a plain muffin or waffle containing baked milk. Sixty five of the 88 children, approximately 75 percent, experienced no allergic reactions. Parents of those children were given specific guidelines on how to incorporate baked milk products such as muffins, cookies and cakes into their child's daily diet. The children who reacted to the muffin continued avoiding foods containing milk.
After a period of six to 12 months, the 65 children who passed the initial muffin food challenge returned to the clinic for the second food challenge and were given cheese pizza. Baked cheese is cooked at a lower temperature than baked goods and contains higher amount of milk protein. Seventy-eight percent of the children in this group experienced no allergic reactions and were told to incorporate baked cheese into their diets. Children who reacted to the baked cheese continued eating muffins and returned after a period of six to 12 months to be re-challenged with pizza. If they showed no allergic reactions, they moved on in the study.
After an average of three years, the study participants who showed no reaction to baked cheese returned for the final food challenge, and were given foods with unheated milk such as skim milk, yogurt and ice cream. Of the 65 children who passed the initial muffin challenge, 60 percent could tolerate unheated milk.
"While we need to continue our research to determine how to best apply these results to the clinical setting, these data are an exciting step towards our ultimate goal of finding curative therapies for food allergies," said Dr. Nowak.
**Source: The Mount Sinai Hospital / Mount Sinai School of Medicine
Over the course of five years, researchers used a series of food challenges to introduce the children to foods that had progressively less-heated forms of milk. At the end of the study period, 47 percent of the children in the experimental group could tolerate unheated milk products, such as skim milk, yogurt and ice cream, compared to only 22 percent in a control group, indicating that controlled, increased exposure to baked milk products accelerates the rate at which children outgrow their milk allergies.
"This study shows that many children with allergies do not need to completely avoid all milk products," said Anna Nowak-Wegrzyn, MD, co-author of the study, and an Associate Professor of Pediatrics, Allergy and Immunology at Mount Sinai School of Medicine. "It's also an encouraging sign that through careful medical supervision, children can grow out of their allergies much quicker."
In the study's first food challenge, children were given a plain muffin or waffle containing baked milk. Sixty five of the 88 children, approximately 75 percent, experienced no allergic reactions. Parents of those children were given specific guidelines on how to incorporate baked milk products such as muffins, cookies and cakes into their child's daily diet. The children who reacted to the muffin continued avoiding foods containing milk.
After a period of six to 12 months, the 65 children who passed the initial muffin food challenge returned to the clinic for the second food challenge and were given cheese pizza. Baked cheese is cooked at a lower temperature than baked goods and contains higher amount of milk protein. Seventy-eight percent of the children in this group experienced no allergic reactions and were told to incorporate baked cheese into their diets. Children who reacted to the baked cheese continued eating muffins and returned after a period of six to 12 months to be re-challenged with pizza. If they showed no allergic reactions, they moved on in the study.
After an average of three years, the study participants who showed no reaction to baked cheese returned for the final food challenge, and were given foods with unheated milk such as skim milk, yogurt and ice cream. Of the 65 children who passed the initial muffin challenge, 60 percent could tolerate unheated milk.
"While we need to continue our research to determine how to best apply these results to the clinical setting, these data are an exciting step towards our ultimate goal of finding curative therapies for food allergies," said Dr. Nowak.
**Source: The Mount Sinai Hospital / Mount Sinai School of Medicine
Delayed access to tertiary care associated with higher death rate from type of pulmonary fibrosis
Idiopathic pulmonary fibrosis (IPF)―scarring and thickening of the lungs from unknown causes―is the predominant condition leading to lung transplantation nationwide. Columbia University Medical Center researchers confirmed that delayed access to a tertiary care center for IPF is associated with a higher risk of death. The findings were published online in the American Journal of Respiratory and Critical Care Medicine on June 30, 2011.
A group led by Columbia researcher David J. Lederer followed 129 IPF patients at an academic medical center. They looked at the length of time from the onset of shortness of breath to the first visit to the center. A longer delay was associated with increased risk of death, independent of age, gender, socioeconomic status, lung capacity, disease severity, type of health insurance, or education. The researchers also found no association between the length of delay and the likelihood of the patient's receiving a lung transplant.
IPF leads to respiratory failure and death, usually within three years. It is a relatively rare disease, which afflicts 100,000�,000 Americans, almost all over the age of 50. Characterized by shortness of breath upon exertion, it is often misdiagnosed, especially in people with other ailments.
A delay in making a correct diagnosis can lead to ineffective, or even harmful, treatments. For example, doctors sometimes still treat IPF with steroids, because the disease was originally thought to have an inflammatory component. Now scientists know that steroids are counterproductive. A delay in diagnosis can also delay evaluation for a lung transplant. Although research is underway on potential drug therapies, currently lung transplantation is the only effective treatment.
"The initial symptoms of IPF are subtle, and accurate diagnosis may not be feasible for community-based pulmonologists," explains Lederer, Herbert Irving Assistant Professor of Clinical Medicine and co-director of the New York-Presbyterian Hospital Interstitial Lung Disease Program and Lung Transplant Program.
For that reason, earlier access would be aided by improved methods of early detection. But until then, the recognition, or even suspicion, of IPF should prompt referral to a tertiary care center.
**Source: Columbia University Medical Center
A group led by Columbia researcher David J. Lederer followed 129 IPF patients at an academic medical center. They looked at the length of time from the onset of shortness of breath to the first visit to the center. A longer delay was associated with increased risk of death, independent of age, gender, socioeconomic status, lung capacity, disease severity, type of health insurance, or education. The researchers also found no association between the length of delay and the likelihood of the patient's receiving a lung transplant.
IPF leads to respiratory failure and death, usually within three years. It is a relatively rare disease, which afflicts 100,000�,000 Americans, almost all over the age of 50. Characterized by shortness of breath upon exertion, it is often misdiagnosed, especially in people with other ailments.
A delay in making a correct diagnosis can lead to ineffective, or even harmful, treatments. For example, doctors sometimes still treat IPF with steroids, because the disease was originally thought to have an inflammatory component. Now scientists know that steroids are counterproductive. A delay in diagnosis can also delay evaluation for a lung transplant. Although research is underway on potential drug therapies, currently lung transplantation is the only effective treatment.
"The initial symptoms of IPF are subtle, and accurate diagnosis may not be feasible for community-based pulmonologists," explains Lederer, Herbert Irving Assistant Professor of Clinical Medicine and co-director of the New York-Presbyterian Hospital Interstitial Lung Disease Program and Lung Transplant Program.
For that reason, earlier access would be aided by improved methods of early detection. But until then, the recognition, or even suspicion, of IPF should prompt referral to a tertiary care center.
**Source: Columbia University Medical Center
Gastric bacterium Helicobacter pylori protects against asthma
Infection with the gastric bacterium Helicobacter pylori provides reliable protection against allergy-induced asthma, immunologists from the University of Zurich have demonstrated in an animal model together with allergy specialists from the University Medical Center of the Johannes Gutenberg University Mainz. Their results published in the prestigious Journal of Clinical Investigation confirm the hypothesis recently put forward that the dramatic increase in allergic diseases in industrial societies is linked to the rapid disappearance of specific micro-organisms that populate the human body. Allergy-induced asthma has been on the increase in the industrialized world for decades and has virtually taken on epidemic proportions. The rapid rise in allergic airway disease is attributed to air pollution, smoking, the hygiene hypothesis and the widespread use of antibiotics. The hygiene hypothesis states that modern hygiene measures have led to a lack of exposure to infectious agents, which is important for the normal maturation of the immune system. In an article published in the Journal of Clinical Investigation, scientists from the University of Zurich and the University Medical Center of the Johannes Gutenberg University Mainz now reveal that the increase in asthma could be put down to the specific disappearance of the gastric bacterium Helicobacter pylori (H. pylori) from Western societies.
H. pylori is resistant to gastric acid. According to estimates, around half of the world's population might be infected with the bacteria. The affliction often has no symptoms, but under certain conditions can cause gastritis, gastric and duodenal ulcers, and stomach cancer. Consequently, H. pylori is often killed off with antibiotics as a precaution, even if the patient does not have any complaints.
Early infection with H. pylori protects against asthma
For their study, the researchers infected mice with H. pylori bacteria. If the mice were infected at the age of a few days old, they developed immunological tolerance to the bacterium and even reacted insignificantly – if at all – to strong, asthma-inducing allergens. Mice that were not infected with H. pylori until they had reached adulthood, however, had a much weaker defense. "Early infection impairs the maturation of the dendritic cells and triggers the accumulation of regulatory T-cells that are crucial for the suppression of asthma," says Anne Müller, a professor of molecular cancer research at the University of Zurich, explaining the protective mechanism.
If regulatory T-cells were transferred from infected to uninfected mice, they too enjoyed effective protection against allergy-induced asthma. However, mice that had been infected early also lost their resistance to asthma-inducing allergens if H. pylori was killed off in them with the aid of antibiotics after the sensitization phase. According to lung and allergy specialist Christian Taube, a senior physician at III. Medical Clinic of the Johannes Gutenberg University Mainz, the new results confirm the hypothesis that the increase in allergic asthma in industrial nations is linked to the widespread use of antibiotics and the subsequent disappearance of micro-organisms that permanently populate the human body: "The study of these fundamental mechanisms is extremely important for us to understand asthma and be able to develop preventative and therapeutic strategies later on."
**Source: University of Zurich
H. pylori is resistant to gastric acid. According to estimates, around half of the world's population might be infected with the bacteria. The affliction often has no symptoms, but under certain conditions can cause gastritis, gastric and duodenal ulcers, and stomach cancer. Consequently, H. pylori is often killed off with antibiotics as a precaution, even if the patient does not have any complaints.
Early infection with H. pylori protects against asthma
For their study, the researchers infected mice with H. pylori bacteria. If the mice were infected at the age of a few days old, they developed immunological tolerance to the bacterium and even reacted insignificantly – if at all – to strong, asthma-inducing allergens. Mice that were not infected with H. pylori until they had reached adulthood, however, had a much weaker defense. "Early infection impairs the maturation of the dendritic cells and triggers the accumulation of regulatory T-cells that are crucial for the suppression of asthma," says Anne Müller, a professor of molecular cancer research at the University of Zurich, explaining the protective mechanism.
If regulatory T-cells were transferred from infected to uninfected mice, they too enjoyed effective protection against allergy-induced asthma. However, mice that had been infected early also lost their resistance to asthma-inducing allergens if H. pylori was killed off in them with the aid of antibiotics after the sensitization phase. According to lung and allergy specialist Christian Taube, a senior physician at III. Medical Clinic of the Johannes Gutenberg University Mainz, the new results confirm the hypothesis that the increase in allergic asthma in industrial nations is linked to the widespread use of antibiotics and the subsequent disappearance of micro-organisms that permanently populate the human body: "The study of these fundamental mechanisms is extremely important for us to understand asthma and be able to develop preventative and therapeutic strategies later on."
**Source: University of Zurich
Pre-pregnancy diet affects the health of future offspring
Poor maternal diet before conception can result in offspring with reduced birth weights and increased risk of developing type II diabetes and obesity. This work, which is being presented at the Society for Experimental Biology Annual Conference in Glasgow on Saturday the 2nd of July, used an animal model to illustrate the importance of maternal diet even before pregnancy begins.
During the study mice that were fed a low protein diet for ten weeks before conception (but had a normal diet during pregnancy) gave birth to offspring that had lower birth weights, showed catch-up growth after weaning and increased insulin sensitivity.
These effects combined can lead to problems later in life. MSc researcher, Ms Anete Dudele, from the University of Aarhus, explains: "Low birth weight and catch-up growth is associated with enhanced insulin-sensitivity in young adults, this then deteriorates into insulin resistance and type II diabetes with increased age. There is also evidence that male offspring are more likely to develop obesity."
Humans and mice respond in the same way to poor diet during pregnancy; their offspring show low birth weights and increased risk of obesity, type II diabetes and cardiovascular disease. "If humans respond in the same way as mice to pre-conception diet as well then women should not only consider what they eat during pregnancy but also before pregnancy if they want to reduce the risk of their future children acquiring lifestyle diseases," says Ms. Dudele.
Cardiovascular disease is often associated with obesity and type II diabetes and future research by the team will determine whether offspring born to mothers who had poor pre-conception diets are predisposed to these types of problems as well.
**Source: Society for Experimental Biology
During the study mice that were fed a low protein diet for ten weeks before conception (but had a normal diet during pregnancy) gave birth to offspring that had lower birth weights, showed catch-up growth after weaning and increased insulin sensitivity.
These effects combined can lead to problems later in life. MSc researcher, Ms Anete Dudele, from the University of Aarhus, explains: "Low birth weight and catch-up growth is associated with enhanced insulin-sensitivity in young adults, this then deteriorates into insulin resistance and type II diabetes with increased age. There is also evidence that male offspring are more likely to develop obesity."
Humans and mice respond in the same way to poor diet during pregnancy; their offspring show low birth weights and increased risk of obesity, type II diabetes and cardiovascular disease. "If humans respond in the same way as mice to pre-conception diet as well then women should not only consider what they eat during pregnancy but also before pregnancy if they want to reduce the risk of their future children acquiring lifestyle diseases," says Ms. Dudele.
Cardiovascular disease is often associated with obesity and type II diabetes and future research by the team will determine whether offspring born to mothers who had poor pre-conception diets are predisposed to these types of problems as well.
**Source: Society for Experimental Biology
Cinco razones importantes para vacunar a los niños
Con motivo de la celebración de la Semana Europea de la Vacunación, una iniciativa de la Región Europea de la OMS, a la que este año ha querido unirse al Ministerio de Sanidad se ha resaltado la importancia de la vacunación en la prevención de ciertas enfermedades infecciosas y conmemorar los éxitos alcanzados con los programas de vacunación en la promoción de la salud de la población.
Para ello, el Ministerio de Sanidad ha difundido un documento en el que se destaca que la existencia de un calendario de vacunación infantil ha propiciado que enfermedades infecciosas frecuentes en la infancia, hoy se consideren un asunto del pasado.
Estas son las 5 razones por las que toda la población infantil debe vacunarse siguiendo las recomendaciones establecidas en el calendario oficial de vacunación:
-1) LA VACUNACION SALVA VIDAS.-
-Algunas de las enfermedades que se previenen hoy en día mediante la vacunación fueron muy temidas hace pocos años. Hace 50 años la poliomielitis causó en España 2.132 casis de parálisis permanente y 208 muertos, hoy en día ha desaparecido gracias a la gran cobertura de vacunación
-Al alcanzar altas coberturas de vacunación frente a una enfermedad se produce una importante disminución en el número de personas infectadas. Por el contrario, cuando la cobertura de vacunación disminuye, aumenta el número de personas susceptibles y el número de casos de enfermedad vuleve a aumentar
-2) LAS VACUNAS SON SEGURAS Y EFECTIVAS.-
-Las vacunas se utilizan en la población solamente tras una evaluación muy exhaustiva por parte de profesionales expertos, siguiendo protocolos internacionalmente aprobados
-3) LA VACUNACION ES UN DERECHO BASICO.-
-En España el Sistema Nacional de Salud proporciona las vacunas necesarias para todos los jóvenes, en función de su edad, de manera voluntaria y gratuita. Aun así, hay personas en España que no están adecuadamente vacunadas y continúan siendo susceptibles a enfermedades que se pueden prevenir
-4) LOS BROTES INFECCIOSOS SUPONEN UNA AMENAZA IMPORTANTE.-
-Gracias a la disponibilidad de programas de vacunación efectivos se consigue prevenir enfermedades. Muchas personas piensan que dichas enfermedades ya no suponen peligro, e incluso creen que las vacunas son más peligrosas que las infecciones que protegen
-Con el mantenimiento de altas coberturas de vacunación se mantienen controladas ciertas enfermedades infecciosas y con un esfuerzo coordinado entre los países se puede conseguir eliminar e incluso erradicar enfermedades
-5) LA VACUNACION ES UNA MEDIDA COSTE-EFECTIVA.-
-Un estudio europeo realizado en once países muestra que el coste de tratamiento de un caso de sarampión fue entre 209 y 480 euros por caso, mientras que el coste de la vacunación y el control del sarampión era entre 0´17 y 0´97 euros por persona( Carabin 2003)
-La vacunación previene muertes y discapacidad por una fracción del coste del tratamiento de la enfermedad, beneficiando tanto a las personas de manera individual como a la sociedad en su conjunto
**DOCUMENTO APOYADO POR EL OBSERVATORIO PARA EL ESTUDIO DE LAS VACUNAS DURANTE EL "I FORO DE DISCUSION 2011" CELEBRADO EN ALHAMA DE ARAGON
Para ello, el Ministerio de Sanidad ha difundido un documento en el que se destaca que la existencia de un calendario de vacunación infantil ha propiciado que enfermedades infecciosas frecuentes en la infancia, hoy se consideren un asunto del pasado.
Estas son las 5 razones por las que toda la población infantil debe vacunarse siguiendo las recomendaciones establecidas en el calendario oficial de vacunación:
-1) LA VACUNACION SALVA VIDAS.-
-Algunas de las enfermedades que se previenen hoy en día mediante la vacunación fueron muy temidas hace pocos años. Hace 50 años la poliomielitis causó en España 2.132 casis de parálisis permanente y 208 muertos, hoy en día ha desaparecido gracias a la gran cobertura de vacunación
-Al alcanzar altas coberturas de vacunación frente a una enfermedad se produce una importante disminución en el número de personas infectadas. Por el contrario, cuando la cobertura de vacunación disminuye, aumenta el número de personas susceptibles y el número de casos de enfermedad vuleve a aumentar
-2) LAS VACUNAS SON SEGURAS Y EFECTIVAS.-
-Las vacunas se utilizan en la población solamente tras una evaluación muy exhaustiva por parte de profesionales expertos, siguiendo protocolos internacionalmente aprobados
-3) LA VACUNACION ES UN DERECHO BASICO.-
-En España el Sistema Nacional de Salud proporciona las vacunas necesarias para todos los jóvenes, en función de su edad, de manera voluntaria y gratuita. Aun así, hay personas en España que no están adecuadamente vacunadas y continúan siendo susceptibles a enfermedades que se pueden prevenir
-4) LOS BROTES INFECCIOSOS SUPONEN UNA AMENAZA IMPORTANTE.-
-Gracias a la disponibilidad de programas de vacunación efectivos se consigue prevenir enfermedades. Muchas personas piensan que dichas enfermedades ya no suponen peligro, e incluso creen que las vacunas son más peligrosas que las infecciones que protegen
-Con el mantenimiento de altas coberturas de vacunación se mantienen controladas ciertas enfermedades infecciosas y con un esfuerzo coordinado entre los países se puede conseguir eliminar e incluso erradicar enfermedades
-5) LA VACUNACION ES UNA MEDIDA COSTE-EFECTIVA.-
-Un estudio europeo realizado en once países muestra que el coste de tratamiento de un caso de sarampión fue entre 209 y 480 euros por caso, mientras que el coste de la vacunación y el control del sarampión era entre 0´17 y 0´97 euros por persona( Carabin 2003)
-La vacunación previene muertes y discapacidad por una fracción del coste del tratamiento de la enfermedad, beneficiando tanto a las personas de manera individual como a la sociedad en su conjunto
**DOCUMENTO APOYADO POR EL OBSERVATORIO PARA EL ESTUDIO DE LAS VACUNAS DURANTE EL "I FORO DE DISCUSION 2011" CELEBRADO EN ALHAMA DE ARAGON
¿Qué es la depresión?
--La depresión es un trastorno del estado del ánimo en el que éste se encuentra anormalmente bajo, existe una pérdida de interés o placer en casi todas las cosas, tristeza e irritabilidad
--Tristeza o melancolía no son sinónimos de depresión. Los períodos de tristeza o melancolía son inherentes a la experiencia humana. La tristeza es un sentimiento normal, pero puede llegar a ser patológica en función de su duración, intensidad y grado de interferencia en la conducta y la vida cotidiana de la persona
--La depresión clínica es la situación que se produce cuandoa la intensidad o duración de estos sentimientos es tan acentuada que se hace "incomprensible y parece irracional y desproporcionada respecto a las circunstancias. En estos casos, los sentimiento de tristeza y las gandas de llorar pueden no ser las manifestaciones más obvias, sino que empiezan a surgir otros síntomas psicológicos y físicos
--TIPOS DE DEPRESION.-
Los trastornos del estado de ánimo( o trastornos afectivos o del humor) comprenden tanto episodios depresivos como maníacos. Se clasifican en función de los síntomas de los pacientes y del número de episodios que aparecen a lo largo del tiempo. Los más comunes son los trastornos unipolares donde se encuentran:
-Trastorno depresivo mayor. Es lo que habitualmente llamamos "depresión". Se caracteriza por alteraciones anímicas, conductuales y somáticas. Es a menudo recurrente, se cronifica en un 25% de los casos y puede presentarse a cualquier edad, causando una gran discapacidad a los enfermos que la padecen. Cuando se repite a lo largo del tiempo recibe el nombre de trastorno depresivo mayor recurrente
-Trastorno distímico o distimia, que conlleva síntomas depresivos menos intensos pero de mayor duración
-también son trastornos del estado de ánimo los trastornos bipolares( trastorno bipolar y trastorno ciclotímico)
**Datos extraidos del dossier de LUNDBECK sobre el Seminario "Sumidos en la tristeza a cualquier edad"
--Tristeza o melancolía no son sinónimos de depresión. Los períodos de tristeza o melancolía son inherentes a la experiencia humana. La tristeza es un sentimiento normal, pero puede llegar a ser patológica en función de su duración, intensidad y grado de interferencia en la conducta y la vida cotidiana de la persona
--La depresión clínica es la situación que se produce cuandoa la intensidad o duración de estos sentimientos es tan acentuada que se hace "incomprensible y parece irracional y desproporcionada respecto a las circunstancias. En estos casos, los sentimiento de tristeza y las gandas de llorar pueden no ser las manifestaciones más obvias, sino que empiezan a surgir otros síntomas psicológicos y físicos
--TIPOS DE DEPRESION.-
Los trastornos del estado de ánimo( o trastornos afectivos o del humor) comprenden tanto episodios depresivos como maníacos. Se clasifican en función de los síntomas de los pacientes y del número de episodios que aparecen a lo largo del tiempo. Los más comunes son los trastornos unipolares donde se encuentran:
-Trastorno depresivo mayor. Es lo que habitualmente llamamos "depresión". Se caracteriza por alteraciones anímicas, conductuales y somáticas. Es a menudo recurrente, se cronifica en un 25% de los casos y puede presentarse a cualquier edad, causando una gran discapacidad a los enfermos que la padecen. Cuando se repite a lo largo del tiempo recibe el nombre de trastorno depresivo mayor recurrente
-Trastorno distímico o distimia, que conlleva síntomas depresivos menos intensos pero de mayor duración
-también son trastornos del estado de ánimo los trastornos bipolares( trastorno bipolar y trastorno ciclotímico)
**Datos extraidos del dossier de LUNDBECK sobre el Seminario "Sumidos en la tristeza a cualquier edad"
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