Depression, a highly common clinical disorder, is an important and
clinically relevant topic for both clinical researchers and
practitioners to address, because of its prevalence, impact on the
individual and society, association with other mental and physical
health problems and the social contexts in which it develops.
Depression ranks in Germany and central Europe as the third among
the leading mental disorders and world-wide is a leading cause of
disability. It is estimated that 8.3 % of the German population is
depressed within a year (11.2 % women, 5.5 % men). These statistics
mean that 4 million people per year are depressed in Germany alone
(one year prevalence). According to the WHO, over 300 million
people world-wide experience depression and in the USA the
financial burden of this disorder, due to disability and work
absenteeism, reaches Depression is also becoming more frequent over
time and has a high risk of recidivism -particularly since its most
common form, Major Depressive Disorder (DSM-5; ICD10) tends to
occur in episodes. For example, 20% to 40% of people become
depressed again within two years after their first depressive
episode, meaning that a major aim of any therapeutic intervention
should be to prevent future relapses. Depression also shows very
high comorbidities with other mental and physical health
conditions. Its overlap with anxiety pathology is so high that
clinicians are concerned with whether the two disorder categories
are indeed distinct or if they show substantial etiological
overlap. Depression is also associated with heart disease and even
cancer, making it a risk factor for mortality and morbidity that
needs to be identified early and addressed effectively. In addition
to Major Depressive Disorder, the often severe Bipolar Disorder,
and the chronic form of Depression referred to as dysthymia are
additional mood disorders that among them require careful
differential diagnosis. They also lead to questions regarding their
common or distinct etiological mechanisms. In order to gain a
better understanding of Depression as a clinical disorder, one
needs to look at it as a multifaceted phenomenon. Depression is a
neurobehavioral condition, and one has to be up to date and have
solid understanding of its biological substrate, at a genetic,
neuronal, hormonal and pharmacological level. Depression is also a
socio-demographic phenomenon, and one needs to examine its
epidemiology, that might contain significant cues towards its
clearer understanding. It is more prevalent, for example, in
certain regions, climates, age groups and genders (much more
prevalent in women, with age of appearance in young adulthood but
also presents as a significant problem for youth and the elderly),
is associated with stereotypes and stigma and can be the aftermath
of crises, trauma and loss. The etiology of Depression remains
under scrutiny, though recently much more knowledge is emerging
from contemporary neuroimaging, genotyping and data science
methods. Different neural and behavioral systems may be involved
contributing to the significant heterogeneity within the disorder.
Social roles, stressors, attachment patterns, family support and
social networks, and individual (e.g. gender linked)
vulnerabilities may contribute significantly towards increasing
risk for developing depression. Different therapeutic approaches,
like those stemming from the psychoanalytic/psychodynamic
perspectives and those stemming from the cognitive/behavioral (2nd
and 3rd wave) tradition focus on the components of etiology
considered most dominant. As science progresses with clearer
evidence regarding the important etiological factors and their
interactions, these different perspectives, each with its own
contribution, may need to take new developments into consideration,
adapt and even begin to converge. These different aspects of the
topic of Depression, which are central to the scientific aims of
clinical scientists, but also permeate the way clinicians approach
assessment, diagnosis, case formulation and treatment, become the
focus of the present volume. Following a conference held at the
University of Cyprus, in Nicosia, Cyprus in October 2019, which
included presentations by internationally renowned experts in the
field on these various aspects of Depression, the idea of extending
the topics presented and discussed at the meeting into more
elaborated and substantive chapters and synthesizing them into an
edited volume was generated. The aim was to fill a substantive gap,
with a volume that would be beneficial to a wider,
interdisciplinary audience of clinicians, trainees and researchers
with examine the different aspects of Depression. In this Edited
volume, with contributions from prominent experts in the field, we
propose to discuss the subject of conceptualizing and treating
Depression and related conditions (e.g. Suicide, Bipolar Disorder)
from different theoretical perspectives and after taking into
consideration current research into the etiology and maintenance of
this condition. Chapters on theoretical perspectives of treatment
cover a wide range of approaches, that could be broadly clustered
under behavioural and psychodynamic points of view. Perspectives
discussed in this volume are psychodynamic therapy, 2nd waver CBT,
acceptance and commitment therapy and mentalization therapy.
Special topics with great relevance to treatment, include treatment
in different levels of care (e.g. partial hospital setting;
prevention of suicide; working with cancer patients). The book
provides a unique combination of current empirical findings on
etiology of depression and suicide, treatment considerations and
practical recommendations, treatment in different settings and
combination of different theoretical perspectives that can enrich a
therapists' repertoire of tools for understanding and approaching
depression. The book describes various theoretical approaches
without adhering to anyone but with an effort to highlight common
underlying themes like issues of loss, self-esteem, guilt, grief
and emotion regulation as these permeate the various perspectives.
In this way the book presents a combination of science and practice
and of various views that constitute an excellent resource of
researchers, clinicians and students of mental health professions.
In a final chapter the two editors, Drs. Christos Charis and
Georgia Panayiotou, make an effort to impartially integrate
information from the various perspectives, highlighting the utility
of each approach to address specific vulnerability and etiological
factors discussed in the book. In this regard, the volume stresses
the idea of the need for continuous and open dialogue between
perspectives, theories, levels of investigation, research areas,
practitioner needs and scientific views to help make progress in
treatment and address this complex and multi-faceted phenomenon in
the service of patients, their carers and societies in general.
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