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IFMA Preventive Health Management Inc.

Institute for Medical Advancement

New York, USA

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Major Depression

Depressive disorders affect about 4-8% of the general population, causing the loss of the ability to work, to have close relationships, and to have a fulfilling life. Characteristic is a distinct loss of energy and activity, often along with somatic conditions like hypertension, circulatory problems, and sleep disturbances. Available treatments, though effective, have only modest response rates and the question of predicting treatment response in the individual patient is not answerable for any of the currently available therapeutic approaches.

Etiology of Depression

Evidence from twin, family and adoption studies suggests that there is a genetic predisposition to major depression which varies across patients and may "explain" some 25% of causality. Genetic predisposition acts nonspecifically, by elevating a subject's "vulnerability" (or "sensitivity") to environmental or endogenous challenges. Vulnerability is neither necessary nor sufficient for the development of major depression.

Low Mood and Voice

Low mood significantly reduces the dynamic expressiveness of human voices, thus greatly reducing the between-subject differences regarding speaking behavior and voice sound characteristics. Consequently, the voices of people in the state of low mood become very similar to each other ("depressive voices"). During recovery, however, speaking behavior and voice sound characteristics return to "normal" values.

Mechanisms that Maintain Health

A subject's vulnerability is complemented by resilience factors. The term "resilience" denotes all those endogenous mechanisms that support and maintain health. Strengthening resilience combined with an early detection of impending mental health problems are a much better strategy than waiting until clinical symptoms develop.

Polypharmacy in Psychiatry  

Current treatment standards in psychiatry are oriented towards polypharmacy, that is, patients receive combinations of several antidepressants, antipsychotics, mood stabilizers, anxiolytics, hypnotics, antihistamines, and anticholinergics, along with other somatic treatments. In tandem with the beneficial effects of psychopharmacological drug treatment, patients experience significant adverse reactions which appear to have become more frequent and more severe with the rise of ubiquitous polypharmacy.

More to Explore

Stassen HH, Bachmann S, Bridler R, Cattapan K, Herzig D, Schneeberger A, Seifritz E: Detailing the Effects of Polypharmacy in Psychiatry: Longitudinal Study of 320 Patients Hospitalized for Depression or Schizophrenia. Eur Arch Psychiatry Clin Neurosci. 2021, doi: 10.1007/s00406-021-01358-5 [epub ahead of print] [get the article]
Moragrega I, Bridler R, Mohr C, Possenti M, Rochat D, Sanchez Parramon J, Stassen HH: Monitoring Mental Health and the Effects of Therapeutic Interventions through Self-Assessment Voice Analyses. Res Psychother. 2021, 24(3): 250-262 [get the article]
Mohr C, Braun S, Bridler R, Chmetz F, Delfino JP, Kluckner VJ, Lott P, Schrag Y, Seifritz E, Stassen HH: Insufficient Coping Behavior under Chronic Stress and Vulnerability to Psychiatric Disorders. Psychopathology 2014; 47: 235-243
Stassen HH, Anghelescu IG, Angst J, Böker H, Lötscher K, Rujescu D, Szegedi A, Scharfetter C: Predicting Response to Psychopharmacological Treatment. Survey of Recent Results. Pharmacopsychiatry 2011; 44: 263-272
Stassen HH, Angst J, Hell D, Scharfetter C, Szegedi A: Is there a common resilience mechanism underlying antidepressant drug response? Evidence from 2848 patients. J Clin Psychiatry 2007; 68(8): 1195-1205
vSpacer Time course of recovery from depression under therapy
Time course of recovery from depression under therapy as reflected by Hamilton Depression Scores «HAMD-17» (green square points) and voice sound characteristics (red circle points) from repeated assessments at 2-day intervals along with a final assessment at study end. Recovery from depression and revitalizing of voice sound characteristics occur essentially parallel.
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