Changing perceptions of depression: ten-year trends from the general social survey.

OBJECTIVE: The authors examined the changes in beliefs about the causes of and appropriate treatments for major depression between 1996 and 2006 in a representative sampling of U.S. adults. METHODS: The authors compared data about depression from the mental health modules of the General Social Survey from 1996 (300 respondents) and 2006 (397 respondents), which measured perceptions of mental illness through use of vignettes. RESULTS: There was an increase in the belief that depression is attributable to biological causes, from 77% in 1996 to 88% in 2006 (risk ratio [RR]=1.14, 95% confidence interval [CI]=1.04-1.23). Attitudes toward the treatment of depression changed as well, with 60% of respondents prioritizing a biological focus for treatment in 2006 compared with 48% in 1996 (RR=1.29, CI=1.04-1.59). These changes varied modestly by sociodemographic variables and were most pronounced among male, white, and elderly populations. CONCLUSIONS: There have been changes in attitudes about the causes and treatments of depression among the American public in the past decade, with a shift toward a biological framework. A greater understanding of beliefs about depression may lead to more effective outreach and education efforts.

Endoscopic resection of a venous hemangioma of the optic nerve sheath.

We describe a case of a venous hemangioma that arose in the optic nerve sheath of the orbital apex in a 28-year-old man who presented with progressive vision loss. To the best of our knowledge, this is the first reported case of a venous hemangioma occurring at this location. A definitive diagnosis and partial excision was achieved via an endoscopic transsphenoethmoid approach with interactive, computer-assisted, frameless stereotactic surgical navigation. The intervention resulted in minimal morbidity, demonstrating yet again that this surgical approach is a safe and effective way to treat lesions of the orbital apex.

Long-term maintenance therapy for major depressive disorder with rTMS.

OBJECTIVE: There is growing evidence to support the short-term antidepressant effects of repetitive transcranial magnetic stimulation (rTMS), but few published data pertain to the maintenance treatment of patients with DSM-IV-diagnosed major depressive disorder who have responded acutely to rTMS. We describe long-term maintenance therapy for major depressive disorder with rTMS. METHOD: Repetitive transcranial magnetic stimulation was applied in 10 adults over the left prefrontal cortex at 100% of motor threshold, most often at a frequency of 10 Hz for sessions consisting of 40 trains at 5 seconds per train (2000 pulses per session), for periods ranging from 6 months to 6 years. Session frequency averaged 1 to 2 per week. The study was conducted in the TMS lab of an academic medical center. RESULTS: Seven of the 10 subjects experienced either marked or moderate benefit, which was sustained without the addition of concomitant antidepressant medication in 3 cases. There were no serious adverse events reported by any participant. The seizure rate for the 1831 reported rTMS sessions was zero. CONCLUSIONS: These data, while open label, suggest that maintenance rTMS may be a safe and effective treatment modality in some patients with unipolar depression. Further research into the long-term safety and efficacy of rTMS is warranted.