Preface

This book is about depression, a malady which has tethered to almost every disease condition and metastasized in every section and every phase of life. It discriminates none, remains silent but in due course of time, manifests in a very loud manner. Despite the fact that it is associated significantly to some of the dreaded diseases, it is often considered as an artefact of age or of concomitant health problem and usually not considered amenable to intervention by health practitioners and general physicians. In the last couple of years, researchers have heralded various risk factors that can contribute to depression and documented their preventive measures, but every time, it appears that it is more complex than what we know so far.

The present eBook, “Depression: A Silent Culprit in Health and Disease” is aimed to consolidate state of the art knowledge from scholars of high repute who have contributed immensely in the field of depression. This treatise tries to bring comprehensive review of latest technological advances in understanding and diagnosing depression, its genetic causes and concerns along with post-stroke consequences which impinge substantially upon health and disease.

In the first chapter, “Depression: It Matters!” author Ana Maria Sanchez Peralta has familiarized about the neurotransmitters, which are present in central nervous system and serve as chemical messengers that transmit signal across synapse from one neuron to another. Imbalance of these endogenous chemicals triggers depression and extent of their imbalance decides severity of depression. She has elaborately discussed various forms of anti-depressants and their adverse effects, withdrawal aftermaths and contraindications. Therapies to treat depression vary according to its presence in different diseases, information given regarding this in the chapter is noteworthy and justifies that it matters.

Apropos to every query submitted, a musical event is organized in the hall of brain, where central nervous system plays melodious concert and millions of neurons dance to perform synchronized ballet. This symphonized answer can be understood by a rhythmic wave named P300, musicality of which has been interrogated in the second chapter by Prakash et al. This chapter engrosses the attention that neurophysiological examination of P300 wave can comprehend the different layers of depression and putforth that application of P300 wave in clinical settings has tremendous potential in diagnostic and prognostic modalities in major depressive disorder.

Third chapter emphasizes that many stroke survivors undergo depression which can be exacerbated by advancing age and if remains untreated, may lead to adverse outcomes and even mortality. In order to understand the age specific depression after stroke and its preventive measures, authors have pointed out several molecular and cellular mechanisms that can contribute to it, while ageing. Some screening instruments and therapeutic strategies for post-stroke depression have also been discussed, which help us to control depression, which otherwise has formidable impact after ischemic stroke in ageing brain.

Fourth chapter emerges from the query that whether gene and genome wide association studies precisely infer genetic contributions for the risk of depression in post genomic era. Albeit, this chapter by Singh et al. revolves around the genetic, epigenetic and pharmacogenetic concerns of depression, but persuades to realize that the concept of ‘Personal Medicine’ proposed by scientists, by which every person will be treated according to the genes one carries, appears to be a distant dream.

Gianluca Serafini and co-workers have browsed seventy published research papers to uncover the utility of diffusion tensor imaging techniques for understanding brain white matter abnormalities in relation to pathophysiology of major depressive disorder and suicidal behavior. They have deduced that microstructural white matter abnormalities located in neural circuits are critically involved in emotional processes and mood regulation, which may result in enhanced vulnerability to psychiatric morbidity contributing to functional impairments. This review chapter offers an indepth understanding of the current knowledge and applicability of diffusion tensor imaging techniques in major depression and suicidal ideation.

I am deeply indebted to Ms. Shallu Khullar for her extended help in style editing of the book. I extend my heartfelt gratitude to Ms. Humaira Hashmi, In-charge eBook department and editorial manager publications, Ms. Maria Baig, Manager Publications and especially Mr. Mahmood Alam, Director Publications, Bentham Science Publishers for their kind support, encouragement and help.