Mood Disorders

Section Editor A. John Rush, M.D.Mood Disorders Introduction

This effort was supported by the Sarah M. and Charles E. Seay Center for Basic and Applied Research in Psychiatry to the Department of Psychiatry, University of Texas Southwestern Medical Center at Dallas. The administrative support of Kenneth Z. Altshuler, M.D., Stanton Sharp Distinguished Chair and Chairman, is deeply appreciated.

The nine chapters in this section are organized according to treatment modalities. We had the choice of organizing the section according to mood disorders or according to major treatment modalities. Because each treatment modality (e.g., psychotherapy, antidepressant medications, electroconvulsive therapy) is applicable to more than one mood disorder group, we chose to present the modalities, specifying the disorder groupings for which each modality would be appropriate.

Each chapter distills the essence of the available group-based data that are often developed for the purposes of establishing the efficacy and safety of a treatment and combines these data with the clinical experiences and case reports of individual patients being treated by individual clinicians. The natural tension between available group-based data and the need to adapt and apply these data to one patient at a time is illustrated in case vignettes. We hope that clinicians reading these chapters will find both an up-to-date fund of scientific knowledge and a sense of how to use this knowledge optimally in treating individual patients.

The authors of the chapters review efficacy and safety data and then provide an empirical basis for selecting each modality. They then provide specific information on how to apply each modality, often with clinical vignettes to illustrate the general principles and particular tactics involved in employing each treatment.

We are very fortunate to have engaged extraordinarily gifted authors for each section. The section begins with chapters on antidepressant and antimanic medications (Pedro Delgado and Alan Gelenberg), depression-focused psychotherapies (Michael Thase), psychodynamic psychotherapies (Glen Gabbard), combined medication and psychotherapy (Steven Hollon and Jan Fawcett), electroconvulsive therapy (Richard Weiner and Andrew Krystal), and light therapy (Dan Oren and Norman Rosenthal).

After these individual treatments are reviewed, two additional chapters are provided in which the authors specifically address commonly encountered clinical circumstances that require adaptation of these treatments. An excellent chapter on the management of , by Jerrold Rosenbaum, Maurizio Fava, Andrew Nierenberg, and Gary Sachs, guides clinicians through recommended steps should the first treatment fail. This chapter combines both established clinical research information and substantial clinical experience to provide a course roadmap to refer to in selecting the most effective modality for subsequent treatments.