A sensible 10-year plan for mental health

The Lancet: "As Klaus Ebmeier and colleagues describe in their Lancet Seminar today, depression affects around one in six people in the USA at some time in their lives, and may double their chance of death. These figures are similar for other developed countries and are compounded by the fact that over 50% of people with depression will become functionally impaired because of their illness.
Sadly, for many people a diagnosis of depression is made worse by the social stigma that still clings to all mental-health diagnoses, by difficulties in accessing treatment options, and by confusion about which treatments work and which may make their problems worse. The bewildering spectrum of therapeutic alternatives ranges from a conversation with a psychologist, through a confusing array of pharmacological alternatives, to more radical treatments such as deep brain stimulation. Paradoxically, some of the best drugs, serotonin reuptake inhibitors, have been associated with an increased risk of suicide, although research published this month in the American Journal of Psychiatry suggests that this effect might be less common than initially thought.
The release last week of a policy paper, The future of mental health: a vision for 2015, by a multi-agency panel in the UK, is welcome news for patients with depression and those who care for them. Bold in its outlook, the policy envisages a shift in focus from mental illness to mental wellbeing over the next 10 years. Replete with important practical suggestions, the paper also considers broader aspects of mental-health policy, including education for children about mental-health issues and the importance of ensuring that prisoners with mental-health needs receive care comparable to that deemed acceptable outside prison.
The paper's authors rightly point out that, however bold they may/.../"

Alterations in 5-HT1B Receptor Function by p11 in Depression-Like States -- Svenningsson et al. 311 (5757): 77 -- Science

Alterations in 5-HT1B Receptor Function by p11 in Depression-Like States -- Svenningsson et al. 311 (5757): 77 -- Science: "Alterations in 5-HT1B Receptor Function by p11 in Depression-Like States
Per Svenningsson,1,2 Karima Chergui,2 Ilan Rachleff,1 Marc Flajolet,1 Xiaoqun Zhang,2 Malika El Yacoubi,3 Jean-Marie Vaugeois,3 George G. Nomikos,4 Paul Greengard1*
The pathophysiology of depression remains enigmatic, although abnormalities in serotonin signaling have been implicated. We have found that the serotonin 1B receptor [5-hydroxytryptamine (5-HT1B) receptor] interacts with p11. p11 increases localization of 5-HT1B receptors at the cell surface. p11 is increased in rodent brains by antidepressants or electroconvulsive therapy, but decreased in an animal model of depression and in brain tissue from depressed patients. Overexpression of p11 increases 5-HT1B receptor function in cells and recapitulates certain behaviors seen after antidepressant treatment in mice. p11 knockout mice exhibit a depression-like phenotype and have reduced responsiveness to 5-HT1B receptor agonists and reduced behavioral reactions to an antidepressant.
1 Laboratory of Molecular and Cellular Neuroscience, The Rockefeller University, New York, NY 10021, USA.
2 Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden.
3 Unite de Neuropsychopharmacologie Experimentale�CNRS FRE2735, European Institute for Peptide Research (IFRMP 23), Faculty of Medicine and Pharmacy, Rouen F76183 Cedex, France.
4 Neuroscience Discovery Research, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN 46285, USA.
* To whom correspondence should be addressed, E-mail: greengard@rockefeller.edu "

Poverty Limits Efficacy of Treatment for Depression - CME Teaching Brief - MedPage Today

Poverty Limits Efficacy of Treatment for Depression - CME Teaching Brief - MedPage Today: "Recognize that older depressed patients living in low-income areas may have a poor response rate to pharmacologic and talk therapy for depression and are more likely to report suicidal ideation. "