{{FAC}} should be substituted at the top of the article talk page

	Major depressive disorder is a former featured article candidate. Please view the links under Article milestones below to see why the nomination was archived. For older candidates, please check the archive.
Article milestones Date Process Result July 9, 2006 Good article nominee Listed December 31, 2006 Good article reassessment Delisted April 3, 2007 Featured article candidate Not promoted
Current status: Former featured article candidate

This article has not yet been rated on Wikipedia's content assessment scale. It is of interest to the following WikiProjects:

Psychology High‑importance This article is within the scope of WikiProject Psychology, a collaborative effort to improve the coverage of Psychology on Wikipedia. If you would like to participate, please visit the project page, where you can join the discussion and see a list of open tasks.PsychologyWikipedia:WikiProject PsychologyTemplate:WikiProject Psychologypsychology High This article has been rated as High-importance on the project's importance scale.

Archives

1, 2, 3, 4, 5, 6, 7, 8, 9, 10 11, 12, 13

This page has archives. Topics inactive for 30 days are automatically archived by Lowercase sigmabot III.

Under sub-types there needs to be included "Psychotic Depression". With this, the onset of a depressive episode also manifests with hallucinations (any type ie. visual, auditory, tactile, etc.). An important note is that people suffering from a Psychotic Depressive episode are usually able to identify their hallucinations as being products of their mind or not real, whereas a schizophrenic is not. —Preceding unsigned comment added by 74.131.111.224 (talk) 17:43, 17 October 2008 (UTC)[reply]

Thanks. It was there but appears to have disappeared somewhere...Cheers, Casliber (talk · contribs) 17:59, 17 October 2008 (UTC)[reply]

Since CBT is by far the most frequently used approach, perhaps the others could be dealt with in the sub-article. More iportantly, I have issues with the paragraph that starts, "For the treatment of adolescent depression..." It relies on primary sources, which is not good, and a search on Google Scholar shows that later secondary sources are available that don't draw the same conclusions, for example this. Looie496 (talk) 16:26, 25 September 2008 (UTC)[reply]

Well spotted. I didn't add that bit. I have FOnagy and Roth's book, and that is an interesting link too. I agree we need to address that. I stuck back in the one-liner linking to treatment-resistant depression as it is a common problem and a challenging one. Disagree about CBT being the most universal by far - not sure how it goes in the US with Managed Care but here in Oz many therapists end up being pragmatic and adopting measures from IPT, CBT and psychodynamic lore, not to mention what is now called Supposrtive Therapy in difficult periods. Furthermore, CBT is generally more often used with anxiety (and there is a more clear preponderance for its use than in depression). WRT cutting down, patients get alot more psychotherapy than they do vagal nerve stimulation, which is I guess the point we're trying to get to in the previous section above. There is a push in practice to relegate use of antidepressants to second choice behind psychotherapy, which is why I had that mentioned about "treatment of choice", and it has been a controversial issue here in Oz too, not sure about the US - agree your version is more succinct and am reading it a couple of times to see if the message is conserved (I think its ok :)) Cheers, Casliber (talk · contribs) 21:09, 25 September 2008 (UTC)[reply]

Fonagy and Roth was a bit vague but there is alot of review material that suggests effectiveness, so I replaced. Cheers, Casliber (talk · contribs) 12:44, 12 October 2008 (UTC)[reply]

• Cas, ECT is perfect now.
• I don't see why historical origin should affect the engvar issue now: it should be in the overall variety. Tony (talk) 13:25, 3 October 2008 (UTC)[reply]

Thanks - main issue now is how aggressively to reduce down to 50 kb ceiling of prose for FAC, and if so, what else to lose. There is some copyediting and some page numbers to get but otherwise...Cheers, Casliber (talk · contribs) 13:31, 3 October 2008 (UTC)[reply]

Is it a deal-breaker to get it down? I've seen FACs pass with as much info as this. I'd worry about that later. More important to address these micro-issues (well, not so micro). Tony (talk) 13:51, 3 October 2008 (UTC)[reply]

• Yes, older people are more likely to have those symptoms - should it be changed to "are more likely to..."? Cheers, Casliber (talk · contribs) 13:36, 3 October 2008 (UTC)[reply]

Yes, I think it's clear enough; too wordy to spell out "than .... RETHINK: no, I think it does need to be spelt out. See what you think of my attempt now. PS I meant to say that I'm delighted you're branching into this area; great use of your expertise. Because I'm in the know, it's easy to see the slight hospital bias, but I don't think it matters. Tony (talk) 13:51, 3 October 2008 (UTC)[reply]

(ec) To clarify, the term investigation refers to blood tests, ecgs, CT scans, ultrasounds etc. and is not used for a physical examination, hence the use of both terms. Cheers, Casliber (talk · contribs) 14:02, 3 October 2008 (UTC)[reply]

• I'm slightly concerned that it's very centred on the western world. I wonder whether you might cover yourselves by adding to the lead the cultural/historical/non-western context. I was particularly concerned in reading "Clinical assessment", where it seems to assume that the neat divisions between generalists, psychiatrists and psychologists are universal. Here, "in the developed world" might cover you (if indeed that is accurate (Japan?)), after the acknowledgement of the importance of cultural construction to the disorder and its professional treatment. I know this is hard, but it's necessary, don't you think? Tony (talk) 14:01, 3 October 2008 (UTC)[reply]

• I am pretty sure the profiles of the three clinicians are similar worldwide, though would imagine more general medial doctors in less developed areas (true in Oz as well). Agree regarding getting a sense of place/context in the worldwide milieu. Will have to think on how best to do it. Cheers, Casliber (talk · contribs) 14:05, 3 October 2008 (UTC)[reply]

• PS: Found some stuff [1], [2], [3], [4] and [5]. Interesting, will try and incorporate. Cheers, Casliber (talk · contribs) 20:52, 4 October 2008 (UTC)[reply]

Cas, some MoS notes: I see incorrect use of WP:ITALICS in lots of places, and left-aligned images under third-level section headings (review WP:ACCESS and WP:MOS#Images). Something wrong here: This tendency is characteristic of a "depressive attributional style," or "pessimistic explanatory style,".[70] Incorrect use of logical punctuation, see WP:PUNC, sample: ... things leads to "neurotic anxiety,"[82] "self-alienation,"[83] ... Citation placement, why not put it after the "or", ... additional benefit[108][109] or, ... Lots of WP:DASH problems in the citations; you can ask User:Brighterorange to run his script. Don't forget WP:ALLCAPS: WOULD HONEST ABE HAVE WRITTEN THE GETTYSBURG ADDRESS ON PROZAC?". Retrieved on October 3, 2008. I assume this formatting and quality of sourcing won't be staying: <http://webspace.ship.edu/cgboer/maslow.html> I also saw some punctuation issues and WP:OVERLINKing, so you might want to review for that. I'm unsure why you don't create a History of article (Colin and I have been intending to work on History of Tourette syndrome for a year.) That was just a scan; I didn't actually read anything, and don't want to engage much deeper so I won't have to recuse at FAC. SandyGeorgia (Talk) 07:26, 5 October 2008 (UTC)[reply]

Good pickups, have reduced overlinking now and fixed the caps and image issues, Will look at other style stuff. Cheers, Casliber (talk · contribs) 20:44, 5 October 2008 (UTC)[reply]

I have read the above articles which are fascinating - question is, how to incorporate in a succinct manner; clearly a few sentences on the paucity of resources will fit very well in the treatment top section, but how much should go above it under diagnosis? I was musing on removing the subheadings of Physical investigations and Clinical assessment, as what to add there would be relevant for both, or just a statement on this being a usual pracitce in developed countries (is enough?). Cheers, Casliber (talk · contribs) 21:27, 4 October 2008 (UTC)[reply]

I came across an interesting bit of news about the relationship between depression (explicitly, both unipolar and bipolar--finally!) and creativity (i.e., an inclination to ruminate seems to be the common variable). I've already incorporated this into "Sociocultural aspects," but feel free to work with it further if it interests you. Cosmic Latte (talk) 08:39, 8 October 2008 (UTC)[reply]

Aaargh! just when we're trying to shorten the article, but seriously, it is interesting. One could argue that if it is general/inclusive, then it being placed on mood disorder may be more appropriate. I guess I am a little skeptical as many people with personality disorder somehow end up with the label of a mood disorder, from what I have seen, and just from looking at bookstores and popular literature, trauma and adverse events do prompt alot of soul-searching and what could be construed as rumination, but I digress. The connection of bipolar and depressive illnesses in highly creative people could be due to a large number of reasons (the whole chicken-or-egg conundrum comes to mind here). Anyway, the article is a bit of a hotchpotch, but seems to foucs more on bipolar more than depression, even though the latter is mentioned - would you mind if we moved it to mood disorder? That article is rather slim and there is ample room there for discussion. Cheers, Casliber (talk · contribs) 12:47, 8 October 2008 (UTC)[reply]

Sure, it'd be fine to move it over to mood disorder--but to what section? Without a comparable section on sociocultural aspects, it might be a bit of a challenge to fit it in. Maybe a new section needs to be made on that article? Cosmic Latte (talk) 13:34, 8 October 2008 (UTC)[reply]

Absolutely, and this can be the first bit in it. Cheers, Casliber (talk · contribs) 13:40, 8 October 2008 (UTC)[reply]

Done! :-) Also moved the bit about female poets to mood disorder. After all, this finding--the Sylvia Plath effect--was named after a bipolar poet, so it's probably more appropriate there. Cosmic Latte (talk) 14:25, 8 October 2008 (UTC)[reply]

Was Sylvia Plath bipolar? I thought she was purely depressive. (Her poetry is purely depressing, for sure.) Looie496 (talk) 15:47, 8 October 2008 (UTC)[reply]

This is a tricky one, as is apparent on Plath's own talk page, but Barlow and Durand (2005, p. 223) cite a study in which they remark in a footnote, "Plath, although not treated for mania, was probably bipolar II"--so I figure mood disorder is probably a safe spot to allude to her. Cosmic Latte (talk) 16:46, 8 October 2008 (UTC)[reply]

I'd be careful, the label bipolar II is getting splashed around an awful lot these days. Issues such as personalty disorder and PTSD are often mistaken. Cheers, Casliber (talk · contribs) 21:08, 8 October 2008 (UTC)[reply]

can anyone who reffed a book who hasn't done so already please add page numbers if possible? There are a few left which I can list if we like. we are nearly ready to nominate methinks. Any last issues jot here too. Cheers, Casliber (talk · contribs) 22:59, 12 October 2008 (UTC)[reply]

• As far as article size, we are only just over the ceiling of 50k prose size [ 54 kB (8299 words)]. I thought of actually throwing this up at FAC and letting that be the forum for consensus on further pruning. What do we think, as I am stumped as to what to prune next. Cheers, Casliber (talk · contribs) 14:50, 13 October 2008 (UTC)[reply]

I'm doing one more round of copy-editing, and so far the article looks very good. The boldest thing I've felt a need to do was to remove the sentence about Gordon Parker from the item about the melancholic subtype, because it jumped out at me as glaringly out of place there. Could belong in a discussion of the validity of the DSM-IV criteria somewhere, but it doesn't belong where it was. Looie496 (talk) 16:45, 13 October 2008 (UTC)[reply]

Follow-up: I've swapped the first two paragraphs under "Medication". This might not be the ideal solution, but if you want to swap it back, the first paragraph needs something to introduce it. Looie496 (talk) 17:02, 13 October 2008 (UTC)[reply]

Okay, done with that. I do have one suggestion that I'm not quite bold enough to implement: that the "Sociocultural aspects" section be retitled "The experience of depression" and moved up near the top, below "Signs and Symptoms" and above "Diagnosis". This is material of broad interest, and really should be shown to the reader before the technical stuff. In any case, this article looks ready for FA to me. Looie496 (talk) 17:33, 13 October 2008 (UTC)[reply]

Hmm. I know what you're getting at, but I think calling it "The experience of depression" strikes me as somewhat vague and overencompassing. "Sociocultural" defines it as different from "clinical" in some ways and places it in a "bigger picture" scenario after discussion of the syndrome in a clinical (or some would say reductionistic) way. I am musing on it and will have a further look. Cheers, Casliber (talk · contribs) 20:35, 13 October 2008 (UTC)[reply]

I have a personal policy in editing that if it's in a book, it's really old (even if published this year). We can always find the proper source for anything in a book. The DSM-IV criteria probably needs a page number, but even then, it's not necessary. This is all IMHO, and if you choose to flog me, I'll cry. OrangeMarlin ^{Talk• Contributions} 21:17, 13 October 2008 (UTC)[reply]

Erm, yeah, but I think I can sort the wheat from the, er, chaff. Cheers, Casliber (talk · contribs) 22:33, 13 October 2008 (UTC)[reply]

I think this section gives too much weight to either placebo effects, discredited methods, or other stuff. I think it should be digested into one paragraph, similar to what is done in either the treatment or prevention sections of Alzheimer's disease. Sadly, people come here for there medical information. I don't want anyone to get the impression that there's any chance of treating Major depressive disorder with acupuncture or some other off-the-wall treatment. For example, St. John's wort has no effect on MJD, and worse yet, the dosage required to actually have any effect is so large, that we should consider the safety vs. efficacy of the herb. So, should we cut this section down to one paragraph or so per WP:WEIGHT?? OrangeMarlin ^{Talk• Contributions} 21:21, 13 October 2008 (UTC)[reply]

Agree. Given it duplicates Treatment for depression, there's no reason to go into much detail in this article. --Ronz (talk) 21:41, 13 October 2008 (UTC)[reply]

Yeah, good point. we did a bit but should do some more. Cheers, Casliber (talk · contribs) 22:35, 13 October 2008 (UTC)[reply]

Let me take a pass. I need to work on a real article for awhile. OrangeMarlin ^{Talk• Contributions} 22:46, 13 October 2008 (UTC)[reply]

Go for it (sigh of relief) - bit busy off keyboard..Cheers, Casliber (talk · contribs) 23:05, 13 October 2008 (UTC)[reply]

I'm always suspicious of the CAM sections of any medical article. Most of us ignore it, so it just is filled with stuff. I reviewed each of the citations, and few, if any, supported the statement in the article. In fact, there is no evidence that Omega-3 or tryptophan have any effect on any type of depression. Light therapy has an effect on seasonal disorder, but not on depression, specifically because they couldn't do any trials long enough to determine if it could work. St John's wort may work for major depression, but the pharmaceutical quality of the herb in your local store is so variable, that it probably shouldn't be used. I deleted the stuff that obviously doesn't work. OrangeMarlin ^{Talk• Contributions} 23:32, 13 October 2008 (UTC)[reply]

(Back again for a sec)..where I am the connection is so damn slow, just what I need when trying to look at a )^*$&)#(#%( large article....Cheers, Casliber (talk · contribs) 23:51, 13 October 2008 (UTC)[reply]

What do you have down there for internet connection, a tin can and string? OrangeMarlin ^{Talk• Contributions} 00:00, 14 October 2008 (UTC)[reply]

Nice bit of pruning there; article now at 51 kb readable prose...any other problems?Cheers, Casliber (talk · contribs) 09:24, 14 October 2008 (UTC)[reply]

←I wasn't happy about the changes to the section. They were weasel-worded and often outside of what was written in the citations. I reverted. I'm doing some copy editing--I'm finding some redundant prose, that need some work. I think it will help out. OrangeMarlin ^{Talk• Contributions} 17:15, 14 October 2008 (UTC)[reply]

I certainly don't want an edit war, but I'm a bit puzzled at OrangeMarlin's changes. He is insisting on, "Other supplements such as omega-3 fatty acids,[161] tryptophan, and 5-hydroxytryptophan (5-HTP),[162] no effect beyond placebo." And yet reference [162] states in the abstract, "Available evidence does suggest these substances are better than placebo at alleviating depression", referring to Trypt and 5-HTP. And again, he is insisting on, "Exercise has shown to have moderate, but not statistically significant, effects in reducing the symptoms of depression.[168]" Reference [168] states in the abstract, "Exercise seems to improve depressive symptoms in people with a diagnosis of depression, but when only methodologically robust trials are included, the effect sizes are only moderate and not statistically significant." In short, the sources are drawing the conclusion that there probably are effects but that more studies are needed, whereas the current wording is drawing the conclusion that there probably are not effects. Looie496 (talk) 17:22, 14 October 2008 (UTC)[reply]

Dude, I have no patience for this type of discussion. Abstracts are useless. The conclusion states clearly that they have no effect beyond placebo. OrangeMarlin ^{Talk• Contributions} 17:35, 14 October 2008 (UTC)[reply]

What you're saying in effect is, the way that the authors summarized their findings is useless, I can summarize them better myself. Anyway, I'm going to leave it there until Casliber can express an opinion on this. Looie496 (talk) 17:51, 14 October 2008 (UTC)[reply]

The writer's conclusions are what I used. OrangeMarlin ^{Talk• Contributions} 17:53, 14 October 2008 (UTC)[reply]

Just to further waste my valuable time, here's what the authors say about Omega 3 in their conclusions: "The evidence available provides little support for the use of n-3 PUFAs to improve depressed mood." I believe that summarizes it perfectly. Using non-weasel wording, with clear writing, as I have done, Omega 3 is useless for MDD. OrangeMarlin ^{Talk• Contributions} 17:56, 14 October 2008 (UTC)[reply]

OM has a point - we always forget abot effects like placebo effect and regression to the mean etc. so caution is advised. I will have a look myself a bit later but need to hop off again - brekfast/coffee/dog walk beckon...Cheers, Casliber (talk · contribs) 20:26, 14 October 2008 (UTC)[reply]

Looie, stuff like The presence of funnel plot asymmetry suggested that publication bias was the likely source of heterogeneity. doesn't look good (i.e. the studies which showed no benefit weren't published)....still looking. Cheers, Casliber (talk · contribs) 13:43, 15 October 2008 (UTC)[reply]

I think have shown no effect beyond placebo is best solution as it states exactly that. The omega 3 does say they are of little use and then leaves the door open a little (tantalizingly or annoyingly I guess, depending on how you look at it) WRT more data required yada yada yada. FWIW - the whole shebang can be read from a link here. Cheers, Casliber (talk · contribs) 14:07, 15 October 2008 (UTC)[reply]

I'm having some issues with this section. First of all, the title of the section, "Physical investigations" is kind of weird. Sounds like a UFO investigation. :D Also, what's a medical practitioner? A nurse practitioner? A physician's assistant? A registered nurse? A physician? In the US, in a managed care environment (about 95% of health care), a "primary care" physician usually makes the first diagnosis of depression. In children, that's a pediatrician, in adults, an internist. Can't we just write physician, who is the only person that can prescribe medications? OrangeMarlin ^{Talk• Contributions} 17:20, 14 October 2008 (UTC)[reply]

Physician in Oz means someone who is an internal medicine specialist (eg neurologist, gastroenterologsit etc.) i.e. not GP or family doctor really, medical practitioner is standard word for doctor here, hmmm...how about (gasp) "doctor"? Cheers, Casliber (talk · contribs) 20:18, 15 October 2008 (UTC)[reply]

How about Primary Care Physician? Doctor might work, but it's fairly generalized. OrangeMarlin ^{Talk• Contributions} 18:33, 17 October 2008 (UTC)[reply]

I guess if that is the only common mutually understandable term, then so be it..(?) you guys don't say GP or family doctor (although the later is a bit informal)? Cheers, Casliber (talk · contribs) 18:36, 17 October 2008 (UTC)[reply]

GP is hardly used anymore. Mostly, in US managed care, the Primary Care Physician (PCP) is the gatekeeper to healthcare, including prescriptions, diagnostic testing, hospital admission, and referrals to specialists (including headshrinkers). The PCP is almost always Internist (Internal Medicine), Ob-Gyn, or Pediatrician. Again, taking a US perspective, a medical practitioner is so generic and nonspecific, that when I read it, I was a bit confused. Maybe medical doctor is the best term. OrangeMarlin ^{Talk• Contributions} 18:47, 17 October 2008 (UTC)[reply]

I'm kind of anal-retentive (I wonder if that's in DSM IV?), so I'm rearranging to meet WP:MEDMOS, especially if this article is going to be FAC'ed, there are many editors (myself included) who think that all medical articles should meet that standard. I tried to read over some of the comments to see if this was discussed, and I didn't see it anywhere. So, if this has been discussed, and there was some reason to not use MEDMOS, then I'm all right with it, and I'll find some drug to treat my retentiveness. Is there a drug? OrangeMarlin ^{Talk• Contributions} 17:33, 14 October 2008 (UTC)[reply]

Alcohol works pretty well. But seriously, I had intended to make it comply with MEDMOS (oh where did I go wrong...)...Cheers, Casliber (talk · contribs) 20:19, 14 October 2008 (UTC)[reply]

At first I didn't like MEDMOS, but I like the consistency. And it walks us through the story in a logical manner. OK, now I've got to go turn on the fireplace...it's cold here this morning. OrangeMarlin ^{Talk• Contributions} 14:29, 15 October 2008 (UTC)[reply]

Is everyone okay with the Kierkegaard image in the causes section? I added this picture, of an existential philosopher, after delldot pointed out that the earlier picture, of existential psychologist Rollo May, was unsourced. But if this seems like too much of a stretch (which I tried to compensate for in the caption), I could replace this image with a picture of a more famously psychological/psychiatric figure, such as Freud. Cosmic Latte (talk) 23:00, 17 October 2008 (UTC)[reply]

I do think it is a bit tangential, and a photo of someone more directly involved so to speak would be preferable - this is a hard article to illustrate...Cheers, Casliber (talk · contribs) 12:10, 18 October 2008 (UTC)[reply]

I went ahead and added a picture of Freud instead. Will this be all right? It's too bad that there don't seem to be any PD images of Beck or Bandura out there. Cosmic Latte (talk) 04:08, 19 October 2008 (UTC)[reply]

Yeah, images are tough. Good as any. Cheers, Casliber (talk · contribs) 08:46, 19 October 2008 (UTC)[reply]

But the word "guilt" is used 5 times. 11:45, 27 October 2008 (UTC) —Preceding unsigned comment added by 68.187.233.197 (talk)

In response to this, I've come up with the following passage:

Depression and loneliness have enough features in common that loneliness may be viewed as a differential diagnosis.^[1] In general, depression is likely to coexist with loneliness if the loneliness is chronic rather than transient. If the patient has global concerns that do not focus strictly on interpersonal relationships, if the patient feels a high degree of guilt, or if the patient is particularly vegetative, then he or she is likely to be depressed; if these conditions are not met, he or she may be lonely instead.

Should it be added to the article? If so, where?

As for guilt being mentioned more often, note that my source states that "guilt appears to be more typical of depression than [of] loneliness." Cosmic Latte (talk) 03:10, 28 October 2008 (UTC)[reply]

I've gone ahead and added it to Major_depressive_disorder#Differential_diagnoses, but feel free to remove it if it's misplaced or too much text. Cosmic Latte (talk) 15:55, 28 October 2008 (UTC)[reply]

From FAC:

This statement noted by Tony as being from a questionable source is still in the article. I am concerned also that many of the sources in this article similarly are very old and/or reference a single study. I am trying to correct some of them, where the sources are accessible, to clarify the meaning in the article in the context of the reference. —Mattisse (Talk) 14:51, 30 October 2008 (UTC)[reply]

I don't see why a loss of religious faith would be any less depressing now than it was 36 years ago, at least in individuals for whom faith had been their primary source of meaning. I do wonder which is more often the cause and which more often the effect (e.g., I can picture something like, X --> MDD --> blame/doubt God --> lose religious faith), but if "lose religious faith --> MDD" is sourced, then it at least jives with what I'd call common sense or intuition. Cosmic Latte (talk) 15:07, 30 October 2008 (UTC)[reply]

The point is not what you or I think now, but rather that the reference to a statement given prominence in the section is from one questionable source, the Journal of Religion and Health, and is 36 years old. —Mattisse (Talk) 15:18, 30 October 2008 (UTC)[reply]

It looks like the journal is still taken reasonably seriously, e.g., [6], [7], [8]. In any event, my point was that there is no reason to assume that the veracity of the referenced finding has changed in the past 36 years. Questioning the finding on account of its age raises the question, "why?"--and I, for one, don't see a reason why the finding would be dated. And as it's worded now, "A depressive episode may also be related to a loss of religious faith," without implying cause or effect, and placed after other components of MDD and directly before a statement that cause and effect are unclear, I certainly don't think it's being given any undue prominence. Cosmic Latte (talk) 15:34, 30 October 2008 (UTC)[reply]

I refer you to Tony's comment that the source is not mainstream in the field. The links you give are not reliable sources as to the mainstream importance of the journal. Further, the text in one of your links says: "The Journal of Religion and Health explores the most contemporary modes of religious thought with particular emphasis on their relevance to current medical and psychological research." Current medical and psychological research is not 36 years ago. In medically-related field, recency counts. References to such statements should be to recent review articles (within the last few years). Further discussion of this should move to the talk page. —Mattisse (Talk) 15:56, 30 October 2008 (UTC)[reply]

--

The source may not be mainstream, but it is an independent publication expressing, in this case, the argument of a MD/PhD psychiatrist, namely Nancy Coover Andreasen, who is extremely well-renowned. Barring the discovery of some source that refutes the thesis that depression and a loss of religious faith may be related, I really think it's appropriate to let this be. Cosmic Latte (talk) 16:40, 30 October 2008 (UTC)[reply]

Reading the beginning of Andreasen's [9] article, she does not say that a depressive episode may be related to a loss of religious faith. She says depression may be expressed in the form of exaggerated guilt experienced by people who worry that they have committed sins or who have feelings of estrangement from God, or in the form of feelings of torment from punishment by an angry God. She is suggesting that if the symptoms of depression are expressed in the form of religious concerns, the best way for a sensitive therapist to proceed is to be flexible and attempt to separate genuine religious concerns from the symptoms of depression. It appears that the article is not research but an opinion piece and makes sense in that context. But Tony's point was also that a great many things may impact depression, as the Major depression article indicates, and is loss of religious faith one of the most frequent and foremost causes? Where is the evidence that it is? —Mattisse (Talk) 17:58, 30 October 2008 (UTC)[reply]