Alberta Innovates- Health Solutions

One out six Canadians will suffer some form of mental illness in their lifetime.

Many AHFMR basic biomedical scientists investigate the organic causes of mental illness in the hope their research will lead to potential treatments for those affected. Other AHFMR-funded researchers study mental illness from a psychosocial perspective, hoping to answer the general question:
What can we learn from how people behave, function, and interact that could indicate risk for mental illness?

Heritage-supported Dr. Keith Dobson attempts to answer that question in the area of recurring clinical depression.

Unlike a case of the "blues", clinical depression is

• a serious illness, characterized by observable symptoms (see Checklist) and not related to drugs, medical conditions, or post-partum depression.
• hits twice as many females as males
• once it occurs, is likely to recur as many as six times. Each succeeding bout needs fewer psychosocial triggers, and each bout tends to last longer than the one before.

These sobering facts, in addition to the toll clinical depression takes on the individual's life, make early intervention a priority.

Physicians use two major approaches in the treatment of clinical depression:

• drugs that target the production of brain chemicals
• psychotherapy, which aims to modify behaviour to circumvent negative thinking.

"Studies show that 50% of people who suffer a clinical depression and are placed on a tricyclic (a type of antidepressant) drug therapy experience a 50% relapse within a year," says Dr. Dobson. "Twenty-five percent of patients following a type of pychotherapy called cognitive therapy which is based on changing thinking and changing behaviour, experience a relapse within a year."

Tricyclic drugs, however, often have unpleasant side effects. In recent years, doctors prescribe a new generation of antidepressants called selective seratonin re-uptake inhibitors (SSRI). Dr. Dobson participates in a large American clinical trial comparing the success rates of SSRIs and cognitive therapy.

In Calgary, he will follow two groups of female patients hospitalized for clinical depression. By tracking them through recovery and a follow-up phase, he can observe those who recover completely and those who have a relapse. In conjunction with AHFMR doctoral student, Barbara Backs-Dermott, he will use an interview method that helps patients describe difficulties in their lives so he can identify the triggers, also called stressors, involved in relapses. Stressor is a term meaning any stress encountered in life--with jobs, finances, or relationships with family and friends. Mental health professionals believe fewer stressors initiate each subsequent relapse.

Dr. Dobson wishes to predict relapses and identify the variables distinguishing those people who relapse and those who do not. If he is successful, then his research could lead to effective early intervention. His other research projects include a study to identify teenagers at risk for depression and a study with Dr. Candace Konnert to compare effective programs for preventing depression in older people going into long-term care.

Dr. Keith Dobson is the Director of Clinical Psychology and Associate Head of the Clinical Psychology Department at the University of Calgary. He receives funding from the Health Research Fund, administered by AHFMR on behalf of Alberta Health and Wellness. He also receives funding from the National Institute of Mental Health (U.S.)

Dr. Candace Konnert also receives funding for her investigations on mental health and the elderly from the Health Research Fund, administered by AHFMR on behalf of Alberta Health and Wellness.

For more information:
Wing of Madness
Depression and Related Affective Disorders Association

Depression Checklist

from the Diagnostic and Statistical Manual of Mental Disorders

A diagnosis of clinical depression is based on a person experiencing at least five of the following nine symptoms for at least two weeks. The first symptom has to be present.

1. sad or irritated mood
2. loss of interest/pleasure in usual activities
3. decreased appetite/weight loss or increased appetite/weight gain
4. decreased sexual drive
5. decreased energy/fatigue
6. sleep disturbance/problems falling asleep
7. problems of focus/attention/concentration
8. self-denigration
9. suicidal thoughts/planning

And none of the above symptoms can be accounted for by drugs, medical conditions, or post-partum depression.