title: The depressed patient in a biological world: on philosophical and diagnostic strategies.
abstract: OBJECTIVE
  We questioned: what kind of relationships between mental and neurobiological levels of complexity is or could become useful in the psychiatric practice? The concept of mind and associated mood states defended here is that they are physically emergent, subjective, qualitative, unified features of the brain. We compared our neurobiological assessment also to psychoanalytical practice (first person's perspective).
  
  
  OBJECTIVE
  Applied to recent work on major depressive disorder (MDD), our ideas are among other supported by clinical and experimental studies on sleep deprivation, deep brain stimulation and epidemiological assessments of time-to-recovery.
  
  
  CONCLUSIONS
  We suggest that depression is a transient state of the brain, that is mutually exclusive to the state of pleasure (in the Freudian context), rather than a disorder or disease with a characteristic time course (like many reversible somatic diseases). MDD can best be described with stochastic transition models, which is discussed in the context of a presumed brain serotonin dysfunction in depression. Our ideas invite a reconsideration of some concepts underlying current diagnostic and therapeutic approaches in the clinical practice.
authors.affiliation: University Centre of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands. j-korf@home.nl
authors.forename: Jakob
authors.initials: J
authors.lastname: Korf
authors.forename: Fokko
authors.initials: F
authors.lastname: Bosker
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use; D001689:Biological Psychiatry; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D004644:Emotions; D005619:Freudian Theory; D006801:Humans; D009446:Neurobiology; D012701:Serotonin / Q000378:metabolism; D013997:Time Factors
chemical_list: D000928:Antidepressive Agents; D012701:Serotonin