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1

1929-, Costello Charles G., ed. Symptoms of depression. New York: Wiley, 1993.

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2

G, Cameron Oliver, ed. Presentations of depression: Depressive symptoms in medical and other psychiatric disorders. New York: Wiley, 1987.

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3

Joffe, Russell T. Conquering depression: A guide to understanding symptoms, causes, and treatment of depressive illness. Hamilton, Ont: Empowering Press, 1998.

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4

Depression sourcebook: Basic consumer health information about the symptoms, causes, and types of depression, including major depression, dysthymia, atypical depression, bipolar disorder, depression during and after pregnancy, premenstrual dysphoric disorder, schizoaffective disorder, and seasonal affective disorder; along with facts about depression and chronic illness, treatment-resistant depression and suicide, mental health medications, therapies, and treatments, tips for improving self-esteem, resilience, and quality of life while living with depression ... 3rd ed. Detroit, MI: Omnigraphics, Inc., 2012.

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5

Monton, Edgar A. Depression: Its causes, symptoms and treatment. 3rd ed. Worcester Park: Roseneath Scientific, 1985.

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6

Dealing with depression: Understanding and overcoming the symptoms of depression. London: Piatkus, 2010.

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7

D, Meier Paul, ed. Happiness is a choice.: The symptoms, causes, and cures of depression. 2nd ed. Grand Rapids, Mich: Baker Books, 1994.

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8

), Center for Substance Abuse Treatment (U S. Managing depressive symptoms in substance abuse clients during early recovery. Rockville, MD: U.S. Dept. of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment, 2012.

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9

Murphy, Fiona. Perceived stress and appraisal of problem solving ability: Are they related to depression and depressive symptoms in a female population?. [s.l: The author], 2004.

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10

Kraaij, Vivian. Depressive symptoms in the elderly: Negative life events and buffering factors. [Leiden: Leiden University], 2000.

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11

Merrell, Kenneth W. Internalizing symptoms scale for children: A measure of depression, anxiety, and related affective and cognitive symptoms : examiner's manual. Austin, Tex: Pro.ed, 1998.

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12

Foster, Ashlyn. District nurses can identify and manage symptoms of depressive illness in the older person. [S.l: The Author], 2004.

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13

John, Mann J., ed. Phenomenology of depressive illness. New York, N.Y: Human Sciences Press, 1988.

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14

B, Carr Daniel, United States. Agency for Healthcare Research and Quality., and New England Medical Center Hospital. Evidence-based Practice Center., eds. Management of cancer symptoms: Pain, depression, and fatigue. Rockville, MD: U.S. Dept. of Health and Human Services, Public Health Service, Agency for Healthcare Research and Quality, 2002.

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15

Thurn, Kay Ellen. A CROSS SECTIONAL STUDY OF DEPRESSIVE SYMPTOMS IN STUDENT NURSES (BECK DEPRESSION INVENTORY). 1993.

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16

Brommelhoff, Jessica A. Depression in Dementia Syndromes. Edited by C. Steven Richards and Michael W. O'Hara. Oxford University Press, 2013. http://dx.doi.org/10.1093/oxfordhb/9780199797004.013.007.

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Depressive symptoms are common in many dementia syndromes, and depressive disorders are much more common in older adults with dementia than in cognitively intact older adults. Depression may be a risk factor for, or a prodromal feature of, subsequent dementia. Several neuropathological mechanisms have been suggested to explain these relationships, including the role of underlying cerebrovascular risk factors for depression and cognitive impairment. Depression also may be present in dementia as an emotional reaction to cognitive decline, or as a recurrence of early and midlife depression. Differential diagnosis between depression and dementia is essential, but complicated by problems in assessment, overlapping symptoms between the two conditions, and other medical co-morbidities. Pharmacological treatment of depression in dementia may also be complicated by medical co-morbidity, and can run the risk for adverse reactions or interactions between medications. Psychotherapy and psychosocial interventions, however, hold some promise for effective reduction of depressive symptoms.
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17

Keck. Managing the Depressive Symptoms of Schizophrenia. Science Press Inc., 1999.

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18

Chen, Michael C., and Ian H. Gotlib. Molecular Foundations of the Symptoms of Major Depressive Disorder. Edited by Turhan Canli. Oxford University Press, 2013. http://dx.doi.org/10.1093/oxfordhb/9780199753888.013.002.

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Major Depressive Disorder (MDD) is a prevalent and costly disorder with a broad range of cognitive, affective, and behavioral symptoms. Despite the absence of a clear final common molecular pathway in depression, many molecular systems have been implicated in MDD. In particular, disruptions in molecular systems like serotonin, dopamine, glutamate, and other neurotransmitters, as well as in stress hormones, cytokines, neurotrophins, and neuropeptides, may contribute to MDD. To link the symptoms of MDD with molecular dysfunction, this article examines these molecules in the context of three symptom clusters of MDD: cognitive/affective symptoms, volitional/behavioral symptoms, and homeostatic/vegetative symptoms. It examines how these molecules and their receptor, transport, and regulatory systems contribute to MDD and to the development of specific symptom clusters. It presents two possible frameworks of molecular dysfunction in MDD that encompass the interactions between vulnerability phenotypes and biochemical perturbations that may lead to the heterogeneous symptoms of this disorder.
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19

Chovan, John D. Depression and Suicide. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190204709.003.0008.

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Depression is a symptom that can negatively affect quality of life. Depressive symptoms are an expected response to psychosocial stress as well as grief. Although a depressed mood is a natural response of patients and their families to a diagnosis of, being treated for, living with, and dying from a chronic, life-threatening illness, depression can lead to thoughts and actions of self-harm that can result in death. In this chapter, depression assessment tools and interview questions are offered. Depression across the illness trajectory is discussed along with evidence-based guidelines to treatment approaches, including pharmacological and nonpharmacological interventions. Because self-harm or suicide is associated with severe depression, an assessment of suicide is offered as well.
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20

Tobon, Amalia Londono, and Catherine Chiles. Depressive Symptoms and Health-Related Quality of Life. Edited by Ish P. Bhalla, Rajesh R. Tampi, Vinod H. Srihari, and Michael E. Hochman. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190625085.003.0034.

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This chapter provides a summary of a landmark study in psychiatry in primary care, that measures the overall health burden of depression. What are the effects of depressive symptoms and cardiac function on health-related quality of life in patients with coronary artery disease? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.
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21

Moore, Nickolas B. Bipolar Disorder: Symptoms, Management and Risk Factors. Nova Science Publishers, Incorporated, 2013.

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22

How everyone became depressed: The rise and fall of the nervous breakdown. Oxford, England: Oxford University Press, 2013.

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23

Hain, Richard D. W., and Satbir Singh Jassal. Psychological symptoms. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198745457.003.0013.

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Disorders of the psyche (particularly depression and anxiety) are relatively common amongst children with life-limiting conditions. Most of the tools available for evaluating or assessing them in palliative medicine were developed for adults, as were strategies for treating them. The ideal practice is to collaborate with local child and adolescent mental health services in the management of all such children. This chapter covers management of psychological conditions, including depression, anxiety, insomnia, and terminal delirium. For each symptom, causes or general points are detailed, with recommendations on pharmacological approaches covered in detail.
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24

Cohen, Alex S., Dallas A. Callaway, and Tracey L. Auster. Schizophrenia. Edited by C. Steven Richards and Michael W. O'Hara. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780199797004.013.011.

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Depressive symptoms commonly occur in individuals with schizophrenia-spectrum disorders. Empirical investigation of this comorbidity has revealed a number of interesting and potentially confusing findings. The purpose of this review is to summarize this literature, focusing on clinical, cognitive, behavioral, phenomenological, and neurobiological processes that are common and potentially disparate to these disorders. Additionally, the review will discuss four depression-related paradoxes that have emerged within the schizophrenia literature. It concludes with a brief summary of treatment considerations for patients with schizophrenia with co-morbid depressive symptoms. It is hoped that this chapter can serve as an organizing framework for future research and can help focus efforts on designing new treatments for ameliorating depression-related symptoms in patients with schizophrenia.
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25

Castriotta, Natalie, and Michelle G. Craske. Depression and Comorbidity with Panic Disorder. Edited by C. Steven Richards and Michael W. O'Hara. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780199797004.013.027.

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Comorbidity between panic disorder and major depression is found in the majority of individuals with panic disorder and a substantial minority of individuals with major depression. Comorbidity between panic disorder and depression is associated with substantially more severe symptoms of each of the disorders, greater persistence of each disorder, more frequent hospitalization and help-seeking behavior, more severe occupational impacts, and a significantly higher rate of suicide attempts. These two disorders share many risk factors, such as neuroticism, exposure to childhood abuse, informational processing biases, and elevated amygdala activation in response to negative facial expressions. Research on the temporal priority of panic disorder and major depression has most frequently found that panic attacks and other symptoms of anxiety predate the onset of the first major depressive episode, but the first depressive episode predates the onset of full panic disorder. Treatment studies indicate that cognitive behavioral therapy (CBT) is the most effective treatment for panic disorder. Other forms of treatment include medication, particularly selective serotonin reuptake inhibitors. Comorbid depression does not appear to affect the outcome of CBT for a principal diagnosis of panic disorder, and CBT for panic disorder has positive, yet limited, effects on symptoms of depression.
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26

Lam, Raymond W. Clinical features and diagnosis. Oxford University Press, 2012. http://dx.doi.org/10.1093/med/9780199692736.003.0004.

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• Depression is associated with a number of physical, emotional, and cognitive symptoms.• Sub-typing of major depressive disorder has implications for treatment choice and selection.• The differential diagnosis of depression includes bereavement, bipolar disorder, and other medical or substance-induced conditions.Depression is associated with many different types of symptoms which can result to a variable presentation in any given person. The features of depression can be physical (sleep, energy, appetite, libido), emotional (low mood, anxiety, crying) or cognitive (guilt, pessimism, suicidal thoughts). ...
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27

Ritschel, Lorie A., and Christopher S. Sheppard. Hope and Depression. Edited by Matthew W. Gallagher and Shane J. Lopez. Oxford University Press, 2017. http://dx.doi.org/10.1093/oxfordhb/9780199399314.013.22.

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This chapter examines the relationship between hopeful thinking and major depressive disorder. Hope is a positive psychology construct that comprises goals, agency thinking, and pathways thinking and has been associated with psychological and physical well-being and psychosocial outcomes. Depression is inversely correlated with hope and is characterized by a host of symptoms and psychological correlates, including feelings of sadness, negative self-talk, amotivation, and difficulties in problem-solving and concentrating. This chapter explores the empirical evidence regarding the relationship between hope and depression, including the relationship between the subcomponents of hope (i.e., pathways and agency thinking) and the biological (e.g., neural reward systems) and cognitive (e.g., executive functioning) correlates of depression. In addition, the evidence for hope as a viable route for remediating depressive symptoms is reviewed, and future directions are proposed.
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28

Bjørk, Marte Helene, and Malin Eberhard-Gran. Perinatal Depression in Neurological Disease and Disability. Edited by Emma Ciafaloni, Cheryl Bushnell, and Loralei L. Thornburg. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190667351.003.0034.

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Women and men with neurological disease more often suffer from depression in relation to pregnancy and delivery than other parents. Perinatal depression may harm the parent-child relationship as well as the health of the child. Postnatal psychosis, suicide, and infanticide are rare but severe consequences of the disorder. Symptoms of perinatal depression may overlap with symptoms of neurological disease. Both disorders may aggravate each other. Side effects from neurological treatment could mimic symptoms of depression, and antidepressive drugs could worsen neurological symptoms and interact with other treatment. Neurological patients should be evaluated for risk factors for perinatal depression before delivery. These include previous psychiatric disease, sexual or psychical abuse, sleep problems, high neurological disease activity, and low social support. Pregnant women with previous psychotic episodes or bipolar disease should be referred for psychiatric evaluation before delivery. All patients should be screened for depressive symptoms during follow-up using a 3-step method.
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29

Klyce, Daniel W., and James C. Jackson. Affective and mood disorders after critical illness. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0383.

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Survivors of critical illness frequently have significant and persistent mental health problems, which may develop or worsen following intensive care unit (ICU) admission. Chief among these problems is depression, which occurs in approximately a third of all individuals after critical illness and is associated with a wide array of untoward outcomes. Depression is manifest in a diversity of ways and risk factors may contribute to significant depressive symptoms after critical. Questions persist about whether treatment of depression after critical illness is most effective using conventional approaches or whether the depressive symptoms observed in ICU survivors may be clinically distinct and may optimally respond to carefully tailored innovative approaches. One promising strategy for managing the mental health needs of patients after critical illness involves ICU recovery clinics, which target the unique constellation of cognitive, psychiatric, and functional challenges common to survivors of critical illness.
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30

Molly, Jolly. Symptoms of Depression: Depression Is a Sometimes Severe Psychiatric Pathology. Independently Published, 2021.

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31

Bienvenu, O. Joseph, and Christina Jones. Psychological Impact of Critical Illness. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199398690.003.0004.

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This chapter explores the epidemiology and range of psychological distress phenomena experienced by survivors of critical illness. The phenomena most commonly reported on are posttraumatic stress disorder (PTSD), depressive, and general (or nonspecific) anxiety symptoms. Approximately 1 in 5 critical illness survivors has clinically significant PTSD symptoms, 1 in 3 has clinically significant depressive symptoms, and 1 in 3 has clinically significant anxiety symptoms. These phenomena are associated with diminished quality of life and functioning. Risk factors include pre-critical illness anxiety and depression, in-critical illness sedative doses and nightmare-like experiences, and post–critical illness psychological distress and poor coping early in the recovery period. Given the association between critical illness and psychological distress, it is important to address survivors’ mental health needs.
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32

Ha, Thao, and Hanjoe Kim. The Paradox of Love in Adolescent Romantic Relationships. Edited by Thomas J. Dishion and James Snyder. Oxford University Press, 2015. http://dx.doi.org/10.1093/oxfordhb/9780199324552.013.13.

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We investigate whether the amplification of positive affect during conflict discussions or “up regulation” between adolescent romantic partners functions to prevent or terminate interpersonal conflict. Unfortunately, this up regulation strategy may also result in unresolved relationship problems, and ultimately increase adolescent depressive symptoms. The concept of coercion is reviewed as it applies to conflict resolution and avoidance in a sample of 80 adolescent romantic relationships. Results from multilevel hazard models showed that longer durations of observed upregulation states predicted increases in depressive symptoms in both males and females over the course of 2 years. In addition, female depression predicted slower exits from coercive states, which in turn predicted higher levels of males’ depressive symptoms. Implications of these findings are discussed, as well as the possibility that positive affect can be negatively reinforced when it functions to avoid conflict in recently formed close relationships.
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33

Charlot, Lauren R. The phenomenology of depressive symptoms in adults with mental. 2000.

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34

Charlot, Lauren R. The phenomenology of depressive symptoms in adults with mental. 2000.

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35

Hambrick, Linda D. Affective Disorders: Epidemiology, Signs / Symptoms and Prognoses. Nova Science Publishers, Incorporated, 2013.

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36

Cowen, Philip. Depression. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780198801900.003.0004.

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This chapter discusses the symptomatology, diagnosis, and classification of depression. It begins with a brief historical background on depression, tracing its origins to the classical term ‘melancholia’ that describes symptoms and signs now associated with modern concepts of the condition. It then considers the phenomenology of the modern experience of depression, its diagnosis in the operational scheme of ICD-10 (International Classification of Diseases, tenth edition), and current classificatory schemes. It looks at the symptoms needed to meet the criteria for ‘depressive episode’ in ICD-10, as well as clinical features of depression with ‘melancholic’ features or ‘somatic depression’ in ICD-10. It also presents an outline of the clinical assessment of an episode of depression before concluding with an overview of issues that need to be taken into account when addressing approaches to treatment, including cognitive behavioural therapy and the administration of antidepressants.
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37

McGuire, Michael, and Alfonso Troisi. Mechanisms, Symptoms, and Affects. Oxford University Press, 2015. http://dx.doi.org/10.1093/med:psych/9780195116731.003.0005.

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This chapter discusses the mechanisms, symptoms, and affects, including physiological, biological, psychological states, traits and events; emotions, moods and affects (anxiety, depression, frustration-anger, pleasure-satisfaction-joy, pain, power-control-elation).
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38

Center for Substance Abuse Treatment (U.S.), ed. Managing depressive symptoms in substance abuse clients during early recovery. Rockville, MD: U.S. Dept. of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment, 2008.

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39

Managing depressive symptoms in substance abuse clients during early recovery. Rockville, MD: U.S. Dept. of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment, 2008.

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40

Center for Substance Abuse Treatment (U.S.), ed. Managing depressive symptoms in substance abuse clients during early recovery. Rockville, MD: U.S. Dept. of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment, 2008.

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41

Watson, Max, Caroline Lucas, Andrew Hoy, and Jo Wells. Psychiatric symptoms in palliative care. Oxford University Press, 2010. http://dx.doi.org/10.1093/med/9780199234356.003.0024.

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42

Happiness Is a Choice: Symptoms, Causes, and Cures of Depression. Revell, 2002.

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43

Klein, Daniel N., Sara J. Bufferd, Eunyoe Ro, and Lee Anna Clark. Depression and Comorbidity. Edited by C. Steven Richards and Michael W. O'Hara. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780199797004.013.025.

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This chapter examines the relation between personality disorder (PD) and depression, disorders that are commonly comorbid in clinical and community populations. This comorbidity presents both clinical and conceptual challenges. In anticipation of the upcoming introduction of theDiagnostic and Statistical Manual of Mental Disorders(fifth edition;DSM-5), we review research on the associations of depression with both PD and traits in order to help bridge the current and future literatures. Issues distinguishing PD and depression are reviewed, including conceptual concerns, the nature of the associations between depression and PD and traits, and current evidence on associations between depression and PD and chief personality trait dimensions. Data are presented from an ongoing study examining associations between depressive symptoms, maladaptive-range personality, and psychosocial functioning using proposedDSM-5criteria for depression and PD trait domains and facets. Depressive disorders exhibit large associations with negative affect and more moderate links with positive affect and conscientiousness/disinhibition, though there appear to be even more differentiated patterns of associations at the facet level. However, our understanding of the processes responsible for the associations of PD and depression is still limited. Despite this lack of clarity, the links between depression and PD and traits have important clinical implications for assessment and treatment of both disorders. Assessment approaches and challenges are discussed, as well as the implications of co-occurring PD and traits for the treatment of depressive disorders. Finally, future research directions are summarized.
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44

Prendes-Alvarez, Stefania, Alan F. Schatzberg, and Charles B. Nemeroff. Pharmacological Treatments for Unipolar Depression. Oxford University Press, 2015. http://dx.doi.org/10.1093/med:psych/9780199342211.003.0011.

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Major depressive disorder is a chronic syndrome associated with high mortality (secondary to suicide and increased risk for heart disease, stroke, and other serious diseases). It is one of the most common medical disorders affecting adults in the world today. In the United States, the lifetime prevalence of major depression is 16.7% for adults. The average age of onset is 32 years, and women are 70% more likely to develop depression than men. Neither the core requisite symptoms for the diagnosis of a major depressive episode nor the required duration of at least 2 weeks has changed from DSM-IV to DSM-5. This chapter discusses the main issues surrounding the treatment of major depressive disorder, such as suicidality and goals of treatment, and provides information about all treatment options approved by the U.S. Food & Drug Administration. Drugs are categorized by their mechanisms of action.
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45

Watson, David, and Michael W. O'Hara. Understanding the Emotional Disorders. Oxford University Press, 2017. http://dx.doi.org/10.1093/med:psych/9780199301096.001.0001.

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Understanding the Emotional Disorders: A Symptom-Based Approach examines replicable symptom dimensions contained within five adjacent diagnostic classes in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders: depressive disorders, bipolar and related disorders, anxiety disorders, obsessive-compulsive and related disorders, and trauma- and stressor-related disorders. It reviews several problems and limitations associated with traditional, diagnosis-based approaches to studying psychopathology, and it establishes the theoretical and clinical value of analyzing specific types of symptoms within the emotional disorders. It demonstrates that several of these disorders—most notably, major depression, bipolar disorder, posttraumatic stress disorder, and obsessive-compulsive disorder—contain multiple symptom dimensions that clearly can be differentiated from one another. Moreover, these symptom dimensions are highly robust and generalizable and can be identified in multiple types of data, including self-ratings, semistructured interviews, and clinicians’ ratings. Furthermore, individual symptom dimensions often have strikingly different correlates, such as varying levels of criterion validity and diagnostic specificity. It concludes with the development of a more comprehensive, symptom-based model that subsumes various forms of psychopathology—including sleep disturbances, eating- and weight-related problems, personality pathology, psychosis/thought disorder, and hypochondriasis—beyond the emotional disorders.
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46

Abaied, Jamie L., and Karen D. Rudolph. Family Relationships, Emotional Processes, and Adolescent Depression. Edited by C. Steven Richards and Michael W. O'Hara. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780199797004.013.023.

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This chapter reviews theory and research examining the co-occurrence of disrupted family functioning and adolescent depressive symptoms and disorders. It focuses on three key aspects of family functioning: family adversity, parent-child relationships, and parenting behavior. It concludes that research supports the presence of bidirectional associations between family functioning and adolescent depression. Furthermore, this chapter provides an integrative framework that conceptualizes emotional functioning as a key mechanism through which family relationships and adolescent depression mutually influence one another over time.
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47

Baune, Bernhard T. Cognitive Dimensions of Major Depressive Disorder. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198835554.001.0001.

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Cognitive Dimensions of Major Depressive Disorder (MDD) examines the key clinical and pathophysiological characteristics and treatment options of MDD. The volume emphasizes that while the traditional model of depression implicates mood as the primary symptom cluster, a more recently published conceptual understanding of depression has been extended to consider cognitive function as more than just a symptom. It furthers our understanding of the central role of the cognitive dimension for the pathophysiology, diagnosis, and treatment of MDD. It reviews the key cognitive dimensions of depression comprising impaired cognitive and emotional processes of cognitive function, emotion processing, and social cognitive processing. It focuses on the cognitive and emotional dimensions of depression and offers extended and novel diagnostic and treatment approaches ranging from pharmacological to psychological interventions targeting those dimensions of depression.
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48

Banger, Lea. Mit Achtsamkeit Aus der Krise : Selbsthilfe Ratgeber: Depressive Symptome. Independently Published, 2019.

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49

Almedawar, Mohamad M., Richard C. Siow, and Henning Morawietz. MicroRNAs as novel biomarkers in depression, diabetes, and cardiovascular diseases. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198789284.003.0003.

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Diabetic, depressive, and cardiovascular disorders are leading causes of morbidity. In diabetics, symptoms of depression are associated with increased clinical complications. Diabetes mellitus is a major risk factor of cardiovascular diseases (CVDs). The vascular depression hypothesis suggests that CVD can increase the risk of depression or exacerbate depression-related conditions. Several studies found a strong correlation between depression and pre-existing vascular disease and vice versa. Recent studies implicate microvascular dysfunction in the pathophysiology of depression and CVD. In addition, microRNAs are potent regulators of gene expression in physiological and pathophysiological processes affecting the microcirculation. We propose an interaction between diabetes mellitus, depression, and CVD involving changes in microcirculation and microRNA expression. Hence, studies are warranted to develop novel microRNA therapeutics and biomarkers to identify diabetic patients at increased risk of developing clinical complications of depression.
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50

Elliott, James P. Depressive symptoms, attributional style, social avoidance and distress, and family structure among high school students. 1987.

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