The following case studies and articles were prepared by Professor Gordon Parker and published in Medical Observer. They are reproduced here with the kind permission of Medical Observer.

• Monitoring lithium levels (19 September 2008) [PDF, 93KB] - Lithium revolutionised the management of bipolar disorder, but close monitoring of this medication is required.
• Sadness or sickness? (22 August 2008) [PDF, 90KB] - A new book provides another challenge to the current thinking on depression.
• The argument for unhappiness (25 July 2008) [PDF, 92KB] - Is there an upside to feeling down?
• The pursuit of happiness (20 June 2008) [PDF, 88KB] - Is the positive psychology movement more style than substance?
• Fall in young male suicide (30 May 2008) [PDF, 173KB] - Why has the suicide rate among young men dropped?
• Trials may not reflect real life (4 April 2008) [PDF, 78KB] - Are antidepressant drugs really any better than placebo?
• Persistent depression (29 February 2008) [PDF, 68KB] - Rethinking the management of treatment resistant depression.
• Selecting psychotherapy (1 February 2008) [PDF, 72KB] - If seeking a psychotherapy for a mood disorder, is there a preferred 'type'?
• 'Tis not the jolly season for all (December 2007) [PDF, 88KB] - Spring evokes a vision of new energy, while Christmas is portrayed as a happy and convivial season. But there is a darker side to the picture.
• Chocolate a mood stabiliser? (19 October 2007) [PDF, 91KB]- Why some people crave chocolate when depressed.
• The blues is the new black (21 September 2007) [PDF, 88KB]- The defining and redefining of depression.
• Which antidepressant? (24 August 2007) [PDF, 66KB] - Working out the right antidepressant for the right patient.
• Prescriptive psychiatry (27 July 2007) [PDF, 78KB] -The non-prescriptive approach may not always be the best.
• Getting back in control (29 June 2007) [PDF, 86KB] - Once there was manic depressive illness, requiring hospitalisation and lithium clinic follow-up. Now there are several bipolar subtypes, and management is more pluralistic.

Case Studies

OBJECTIVE

This series is designed to illustrate two key issues that underpin the Institute's approach to the mood disorders. Firstly, rather than viewing depression as an 'it', we argue that there are multiple types and patterns, commonly reflecting quite differing causes. The case study series presents common diagnostic subtypes and patterns and highlights how it is just as important to address the cause of the depression as well as treat the depression itself.

• A late-life crisis (1 June 2007) [PDF, 50KB] - Just as 60 is now the new 50, mid-life crises are being taken up by a more elderly cohort.
• A compulsion to shop (4 May 2007) [PDF, 64KB] - Compulsive buying disorder is a diagnosis that pathologises the 'shop til you drop' philosophy of many.
• The provocative patient (6 April 2007) [PDF, 56KB]- Treating a patient who feels he's been let down by all.
• Bypassing the rule of parsimony (9 March 2007) [PDF, 73KB]- The clinical world does not always reflect the theory.
• Late-onset melancholia (9 February 2007) [PDF, 69KB]- Melancholic depression with a vascular cause creates management difficulties.
• Depression and anxiety: the difference (8 December 2006) [PDF, 55KB] - A middle-aged woman seeks to overcome the incapacitation effects of anxiety.
• Too nice for their own good (3 November 2006) [PDF, 55KB]- Why being too nice can be a marker of high risk for depression.
• A patchwork of problems (13 October 2006) [PDF, 87KB]- What is driving a middle-aged mother's frustration and irritability?
• Retirement blues (15 September 2006) [PDF, 77KB]- Is retirement a cause of depression?
• Constant craving (18 August 2006) [PDF, 59KB]- Does craving chocolate signal a particular type of depression?
• Mind over matter (21 July 2006) [PDF, 70KB]- Inappropriate therapy unmasks severe underlying anxiety and guilt.
• The depression she had to have (23 June 2006) [PDF, 95KB] - Depression characterised by 'anxious worrying' is particularly responsive to SSRIs.
• The years should not condemn (26 May 2006) [PDF, 62KB] - Childhood trauma has a long-term and devastating impact for an elderly woman.
• A fortunate escape (28 April 2006) [PDF, 66KB] - A farmer's despair is not as obvious as it seems.
• On keys and locks (31 March 2006) [PDF, 66KB] - A woman's depression after surgery is linked to childhood events.
• Battling an emotional roller coaster (3 March 2006) [PDF, 82KB] - A successful female lawyer’s fluctuating moods leave her private life in a state of chaos and dysfunction.
• Hidden obsessions (3 February 2006) [PDF, 78KB] - Deeper investigation uncovers the complex cause of a woman’s chronic depression.
• The vulnerable, silent type (9 December 2005) [PDF, 73KB] - The suicide attempt of an apparently well-adjusted young man perplexes his family.
• Analysing psychosis (11 November 2005) [PDF, 82KB]- The psychosis was obvious and profound, but what was the underlying diagnosis - Schizophrenia or Bipolar I Disorder?
• Highs and lows of mood disorder (30 September 2005) [PDF, 81KB]- A young woman presents with an eight-year history of debilitating depressive episodes - Bipolar II Disorder is diagnosed.
• Persistent melancholia (2 September 2005) [PDF, 76KB]- Once again a perfectionistic patient suffers depression - but this time melancholia is the diagnosis.
• Paralysed by perfection (5 August 2005) [PDF, 80KB]- A 52-year-old school teacher presents with treatment-resistant depression, with perfectionism having put the patient at risk to a non-melancholic depression.
• Introduction to the series (8 July 2005) [PDF, 82KB]- the need for a ‘horses for courses’ approach in diagnosing and managing mood disorders, with cause often shaping treatment options (and an unusual case history – where antidepressants caused depression to worsen).