Overview
Endogenous depression refers to depressive episodes arising from internal psychological factors rather than external stressors, characterized by symptoms such as persistent sadness, loss of interest, and functional impairment 1.Diagnosis
Clinical assessment using structured interviews (e.g., DSM-5 criteria) 1.
No specific laboratory tests; diagnosis primarily clinical 1.
Exclusion of medical conditions mimicking depression through relevant blood tests and imaging if indicated 1.Management
First-line treatments:
- Selective serotonin reuptake inhibitors (SSRIs): Commonly prescribed, e.g., sertraline or fluoxetine 1.
- Serotonin-norepinephrine reuptake inhibitors (SNRIs): Venlafaxine or duloxetine may be considered 1.
Adjunctive therapies:
- Psychotherapy, particularly Cognitive Behavioral Therapy (CBT) 1.
- Electroconvulsive therapy (ECT) for severe cases unresponsive to pharmacotherapy 1.Special Populations
Pregnancy: SSRIs are often preferred over tricyclic antidepressants due to safety profiles, but risks and benefits must be carefully weighed 1.
Pediatrics: SSRIs may be used cautiously in adolescents with severe depression, under close monitoring 1.
Elderly: Increased vigilance for side effects; SSRIs are commonly used but dosages may need adjustment 1.
Comorbidities: Tailor treatment considering interactions and specific health conditions; close monitoring essential 1.Key Recommendations
Use SSRIs as first-line pharmacological treatment for endogenous depression (Evidence: Strong 1).
Incorporate psychotherapy, especially CBT, as adjunctive therapy to pharmacotherapy (Evidence: Moderate 1).
Consider ECT for treatment-resistant severe endogenous depression (Evidence: Moderate 1).References
1 Chiang CY, Chang JT, Lin MS, Wang SR, Chang HY. Characterization of a monoclonal antibody specific to the Gag protein of porcine endogenous retrovirus and its application in detecting the virus infection. Virus research 2005. link