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Conclusion

  • Tullio GiraldiEmail author
Chapter
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Abstract

This chapter concludes the discussion of the epidemic of depression and the prescription of antidepressants , which still grows, including in children and teenagers, in spite of the suicidality ascertained in antidepressants. In the USA, screening of every citizen with the current diagnostic criteria has even been proposed. Guidelines for the treatment of depression were made in Great Britain by the National Institute for Health and Care Excellence , which led to the national programme Improving Access to Psychological Therapy. Psychological support is the first treatment option provided, and antidepressants are used only when needed as a second-step option. Various psychotherapies are employed, including mindfulness integrated into cognitive behavioural therapy . The results obtained are better in some respects than those of pharmacotherapy, are cost effective and avoid stigma and a passive adaptation of the patients, stimulating their active attitude towards a fully reacquired participation in social and working life.

References

  1. AIFA. (2016). Rapporto sull’uso dei farmaci in Italia. Rapporto nazionale 2015. http://www.agenziafarmaco.gov.it/sites/default/files/Rapporto_OsMed_2015__AIFA.pdf. Accessed 4 Jan 2017.
  2. Bachmanna, C. J., Aagaard, L., Burcu, M., et al. (2016). Trends and patterns of antidepressant use in children and adolescents from five western countries, 2005–2012. European Neuropsychopharmacology, 26, 411–419.CrossRefGoogle Scholar
  3. Barth, J., Munder, T., Gerger, H., et al. (2013). Comparative efficacy of seven psychotherapeutic interventions for patients with depression: A network meta-analysis. PLoS Medicine, 10(5), e1001454. doi: 10.1371/journal.pmed.1001454.CrossRefPubMedPubMedCentralGoogle Scholar
  4. Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1987). Cognitive therapy of depression. New York: Guilford Press.Google Scholar
  5. Benson, H. (1975). The relaxation response. New York: Avon Books.Google Scholar
  6. Blackford Newman, K. (2016). The pill that steals lives. London: John Blake.Google Scholar
  7. Blech, J. (2006). Inventing disease and pushing dills. London: Routledge.Google Scholar
  8. Brewer, J. A., Mallik, S., Babuscio, T. A., et al. (2011). Mindfulness training for smoking cessation: Results from a randomized controlled trial. Drug Alcohol Dependence, 119(1–2), 72–80.CrossRefPubMedPubMedCentralGoogle Scholar
  9. Bunting, M. (2014). Why we will come to see mindfulness as mandatory. http://www.theguardian.com/commentisfree/2014/may/06/mindfulness-hospitals-schools. Accessed 16 Apr 2015.
  10. Connolly Gibbons, M. B., Gallop, R., Thompson, D., et al. (2016). Comparative effectiveness of cognitive therapy and dynamic psychotherapy for major depressive disorder in a community mental health setting: A randomized clinical noninferiority trial. Journal of the American Medical Association Psychiatry, 73(9), 904–911.PubMedGoogle Scholar
  11. Cosgrove, L., & Krimsky, S. (2012). A comparison of DSM-IV and DSM-5 panel members’ financial associations with industry: A pernicious problem persists. PLoS Medicine, 9(3), e1001190. doi: 10.1371/journal.pmed.1001190.CrossRefPubMedPubMedCentralGoogle Scholar
  12. Cosgrove, L., Krimsky, S., Vijayaraghavan, M., et al. (2006). Financial ties between DSM-IV panel members and the pharmaceutical industry. Psychotherapy and Psychosomatics, 75(3), 154–160.CrossRefPubMedGoogle Scholar
  13. Cuijpers, P. (2016). Are all psychotherapies equally effective in the treatment of adult depression? The lack of statistical power of comparative outcome studies. Evidence-Based Mental Health, 19(2), 39–42.CrossRefPubMedGoogle Scholar
  14. Editorial Nature. (2014). What lies beneath. A focus on specific biological targets rather than constellations of symptoms heralds a more scientific approach to the treatment of neuropsychiatric disorders. Nature, 507(273). doi: 10.1038/507273a.
  15. Elliott, C. (2010). White Coat, Black Hat. Boston: Beacon Press.Google Scholar
  16. Frances, A. (2013). Saving Normal: An Insider’s Revolt Against Out-Of-Control Psychiatric Diagnosis, Dsm-5, Big Pharma, and the Medicalization of Ordinary Life. New York: William Morrow, an imprint of HarperCollins publishers.Google Scholar
  17. Frances, A. (2016, January 26). Screen everyone for depression? Good intention, very bad idea. New Scientist. Comment. https://www.newscientist.com/article/2075249-screen-everyone-for-depression-good-intention-very-bad-idea/. Accessed 4 Jan 2017.
  18. GAO. U.S. Government Accountability Office. (2009). Human subjects research: Undercover tests show the Institutional Review Board system is vulnerable to unethical manipulation. http://www.gao.gov/new.items/d09448t.pdf. Accessed 11 Apr 2015.
  19. Goetzsche, P. (2015). Deadly psychiatry and organized denial. København: People’s Press.Google Scholar
  20. Goldacre, B. (2012). Bad medicine. How drug companies mislead doctors and harm patients. London, Fourth Estate.Google Scholar
  21. Gøtzsche, P. C., Smith, R., & Drummond, R. (2013). Deadly medicines and organised crime: How big pharma has corrupted healthcare. London: Radcliffe Publishing.Google Scholar
  22. Harvard Health Blog. (2011, October 20). Astounding increase in antidepressant use by Americans. Peter Wehrwein. Retrieved January 4, 2017, from http://www.health.harvard.edu/blog/astounding-increase-in-antidepressant-use-by-americans-201110203624.
  23. Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. Journal of Consulting and Clinical Psychology, 78(2), 69–83.CrossRefGoogle Scholar
  24. Huhn, M., Tardy, M., Spineli, L. M., et al. (2014). Efficacy of pharmacotherapy and psychotherapy for adult psychiatric disorders: A systematic overview of meta-analyses. The Journal of American Medical Association. Psychiatry, 71(6), 706–715.Google Scholar
  25. Hunot, V., Moore, T. H., Caldwell, D. M. et al. (2013). ‘Third wave’ cognitive and behavioural therapies versus other psychological therapies for depression. Cochrane Database of Systematic Reviews 2013, Issue 10. Art. No.: CD008704. doi: 10.1002/14651858.CD008704.pub2. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008704.pub2/abstract;jsessionid=4C0109A49619D5B64123E345B73AE12F.f03t03. Accessed 4, 4 Jan 2017.
  26. IAPT. (2015a). Improving access to psychological therapies. https://www.england.nhs.uk/mentalhealth/adults/iapt/. Accessed 4 Jan 2017.
  27. IAPT. (2015b). Psychological therapies; annual report on the use of IAPT services: England 2014/15. http://content.digital.nhs.uk/catalogue/PUB19098/psyc-ther-ann-rep-2014–15.pdf. Accessed 4 2017.
  28. Ilyas, S., & Moncrieff, J. (2012). Trends in prescriptions and costs of drugs for mental disorders in England, 1998–2010. The British Journal of Psychiatry, 200, 393–398.CrossRefPubMedGoogle Scholar
  29. Insel, T. (2013). Director’s blog: Transforming diagnosis. National Institute of Mental Health. http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml. Accessed 9 Apr 2015.
  30. Insel, T. (2014). Director’s blog: A new approach to clinical trials. National Institute of Mental Health. http://www.nimh.nih.gov/about/director/2014/a-new-approach-to-clinical-trials.shtml. Accessed 1 Feb 2015.
  31. JAMA. (2016). Journal of the American Medical Association, vol. 315, n. 4; Michael, E. T. Recommendations for Screening for Depression in Adults, pp. 349–350; Howard, B., Fontanarosa, P. B. & Golub, R. M. JAMA Welcomes the US Preventive Services Task Force, pp. 351–352.Google Scholar
  32. Kabat-Zinn, J. (1991). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York: Delta Trade Paperbacks.Google Scholar
  33. Kabat-Zinn, J., Wheeler, E., Light, T., et al. (1998). Influence of a mindfulness meditation-based stress reduction intervention on rates of skin clearing in patients with moderate to severe psoriasis undergoing phototherapy (UVB) and photochemotherapy (PUVA). Psychosomatic Medicine, 60(5), 625–632.CrossRefPubMedGoogle Scholar
  34. Kassirer, J. P. (2005). On the take: How medicine’s complicity with big business can endanger your health. Oxford: Oxford University Press.CrossRefGoogle Scholar
  35. Kramer, P. D. (2016). Ordinarily well: The case for antidepressants. New York: Farrar, Straus and Giroux.Google Scholar
  36. Law, J. (2006). Big pharma: How the world’s biggest drug companies control illness. London: Constable & Robinson Ltd.Google Scholar
  37. Linde, K., Sigterman, K., Kriston, L., et al. (2015a). Effectiveness of psychological treatments for depressive disorders in primary care: Systematic review and meta-analysis. Annals of Family Medicine, 13(1), 56–68.CrossRefPubMedPubMedCentralGoogle Scholar
  38. Linde, K., Kriston, L., Rücker, G., et al. (2015b). Efficacy and acceptability of pharmacological treatments for depressive disorders in primary care: Systematic review and network meta-analysis. Annals of Family Medicine, 13(1), 69–79.CrossRefPubMedPubMedCentralGoogle Scholar
  39. Moynihan, R. (2003). The making of a disease: Female sexual dysfunction. Britsh Medical Journal, 326(7379), 45–47.CrossRefGoogle Scholar
  40. Moynihan, R. (2005). The marketing of a disease: Female sexual dysfunction. Britsh Medical Journal, 330(7484), 192–194.CrossRefGoogle Scholar
  41. Moynihan, R., & Cassels, A. (2005). Selling sickness: How the world’s biggest pharmaceutical companies are turning us all into patients. Toronto: Greystone Books.Google Scholar
  42. Moynihan, R., & Mintzes, B. (2010). Sex, lies and pharmaceuticals: How drug companies plan to profit from female sexual dysfunction. Toronto: Greystone Books.Google Scholar
  43. NICE: National Institute for Health and Care Excellence. (2009). Depression in adults: The treatment and management of depression in adults. https://www.nice.org.uk/guidance/cg90. Accessed 12 Apr 2015.
  44. Payer, L. (1992). Disease-mongers: How doctors, drug companies, and insurers are making you feel sick. New York: John Wiley.Google Scholar
  45. Pratt, L. A., Brody, D. J., and Qiuping, G. U. (2011, October). Antidepressant use in persons aged 12 and over: United States, 2005–2008. NCHS Data Brief, No. 76, https://www.cdc.gov/nchs/data/databriefs/db76.pdf. Accessed 4 Jan 2017.
  46. Reardon, S. (2014). NIH rethinks psychiatry trials. Nature, 507(7492), 288.Google Scholar
  47. Richards, D., Ekers, D., & McMillan, D. A. (2016). Cost and outcome of behavioural activation versus cognitive behavioural therapy for depression (COBRA): A randomised, controlled, non-inferiority trial. The Lancet, 388, 871–880.CrossRefGoogle Scholar
  48. Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. American Psychology, 65(2), 98–109.CrossRefGoogle Scholar
  49. Smith, R. (2006). The trouble with medical journals. London: The Royal Society of Medicine Press.Google Scholar
  50. Spence, R., Roberts, A., Ariti, C., & Bardsley, M. (2014). Focus on: Antidepressant prescribing. Trends in the prescribing of antidepressants in primary care. Quality Watch, The Health Foundation, Nuffield Trust. http://www.health.org.uk/sites/health/files/QualityWatch_FocusOnAndidepressantPrescribing.pdf. Accessed 4 Jan 2017.
  51. Stephenson, C. P., Karanges, E., & McGregor, I. S. (2013). Trends in the utilisation of psychotropic medications in Australia from 2000 to 2011. Australian and New Zealand Journal of Psychiatry, 47(1), 74–87. doi: 10.1177/0004867412466595.CrossRefPubMedGoogle Scholar
  52. Talking Therapies. (2011). Talking Therapies: A Four-year Plan of Action. Department of Health. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/213765/dh_123985.pdf. Accessed 12 Apr 2015.
  53. Tang, Y. Y., Tang, R., & Posner, M. I. (2013). Brief meditation training induces smoking reduction. Proceedings of the National Academy of Sciences of the United States of America, 110(34), 13971–13975.CrossRefPubMedPubMedCentralGoogle Scholar
  54. The Guardian. (2013). Peer review and scientific publishing. Nobel winner declares boycott of top science journals. http://www.theguardian.com/science/2013/dec/09/nobel-winner-boycott-science-journals. Accessed 11 Apr 2015.
  55. The Guardian. (2014, May 28). Rise in antidepressant prescriptions rates in England: Get the data. Ami Sedghi. https://www.theguardian.com/news/datablog/2014/may/28/rise-in-antidepressant-prescriptions-rates-in-england-get-the-data. Accessed 4 Jan 2017.
  56. The Guardian. (2016, July 5). Mental health. Antidepressant prescriptions in England double in a decade. James Meikle. https://www.theguardian.com/society/2016/jul/05/antidepressant-prescriptions-in-england-double-in-a-decade. Accessed 4 Jan 2017.
  57. The New York Review of Books. (2011a, June 23). The epidemic of mental illness: Why? Marcia Angell. http://www.nybooks.com/articles/2011/06/23/epidemic-mental-illness-why/. Accessed 4 Jan 2017.
  58. The New York Review of Books. (2011b, July 14). The illusions of psychiatry. Marcia Angell. http://www.nybooks.com/articles/2011/07/14/illusions-of-psychiatry/. Accessed 4 Jan 2017.
  59. Tone, A. (2009). The age of anxiety: A history of America’s turbulent affair with tranquilizers. New York: Basic Books.Google Scholar
  60. van Grieken, R. A., Kirkenier, A., Koeter, M., et al. (2014). Helpful self-management strategies to cope with enduring depression from the patients point of view: A concept map study. BMC Psychiatry, 14(331). doi: 10.1186/s12888-014-0331-7.
  61. Watters, E. (2010). Crazy like us: The globalization of the American psyche. New York: Free Press.Google Scholar
  62. Whitfield, G., & Williams, C. (2003). The evidence base for cognitive—Behavioural therapy in depression: Delivery in busy clinical settings. Advances in Psychiatric Treatment, 9, 21–30.CrossRefGoogle Scholar
  63. Williams, M., Teasdale, J., & Segal, Z., et al. (2007). The mindful way through depression: Freeing yourself from chronic unhappiness. New York: The Guilford Press.Google Scholar
  64. Wislar, J. S., Flanagin, A., & Fontanarosa, P. B., et al. (2011). Honorary and ghost authorship in high impact biomedical journals: A cross sectional survey. British Medical Journal, 343: d6128.Google Scholar

Copyright information

© The Author(s) 2017

Authors and Affiliations

  1. 1.University of TriesteTriesteItaly

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