Talking about depression – an interview with Professor Marcos Gebara, Brazil

Interview with professor Marcos Gebara

Professor Marcos Gebara is a semi-retired, former hospital-based psychiatrist working in Rio de Janeiro, Brazil. Typically he sees approximately 15 patients with major depressive depression each week. Here we asked his opinions about cognition in depression.

Why is it so difficult for depressed patients to achieve sustained remission in real-life?

To be honest, residual symptoms remain even when patients achieve remission and it’s these - cognitive dysfunction, somatic symptoms, behavioral symptoms – that make treatment difficult and underlie further relapses.

These residual symptoms are easily perceived. Patients complain about them, and even when they don’t, they can be easily identified in follow-up interviews.

Now we talk about total, functional recovery. In the past, we were happy to see patients simply respond to treatment - symptoms were ameliorated and the patient had few complaints. Now this level of improvement is insufficient. We need to attain total remission.

We need complete functional recovery.

Do you think that cognitive dysfunction can trigger new depressive episodes in the patients that you follow?

Certainly. Cognitive dysfunction makes patients function suboptimally. They don’t get to work, daily tasks are not done and relationships suffer. In fact, it’s a disability. Patients become unable to take decisions, their will is impaired as is their capacity to do things. All these are impaired.

Cognitive dysfunction is important in depression – we cannot neglect this symptomatology.

In my experience, cognitive dysfunction preceded depression and is the primary signal that there is a problem. I see patients with depression associated with cognitive dysfunction so often. In fact, I frequently receive referral of elderly ladies, say over the age of 70 years of age, who have been misdiagnosed with Alzheimer’s disease and dementia. After an examination, as many as 50% actually are presenting with major depression and cognitive dysfunction. This is significant because we can do something about it.

How can today’s treatments help your depressed patients with cognitive dysfunction?

We have new medicines that allow us to treat all aspects of the syndrome. We have augmentation strategies. These allow us to make pharmacotherapy more efficient. I believe that these new medicines are the future of effective depression management.

Country selection
We are registering that you are located in Brazil - if that's correct then please continue to Progress in Mind Brazil
You are leaving Progress in Mind
Le informazioni contenute nel nuovo sito prescelto possono non essere conformi al D.Ivo 219/06 che regola la pubblicità dei medicinali per uso umano e le opinioni espresse non riflettono necessariamente le posizioni dell’azienda, non sono da essa avvallate.
Accesso riservato a Operatori Sanitari
Per accedere si prega di registrarsi o, in caso sia già stato fatto, di autenticarsi
L’accesso a Progress in Mind Italia è consentito unicamente agli Operatori Sanitari (medici e farmacisti). I contenuti di questo sito sono prodotti da un team di Operatori Sanitari il cui obiettivo è presentare le ultime novità in ambito psichiatrico e neurologico, attraverso interviste, registrazioni audio/video di seminari con opinion leader, report e sintesi di congressi sia internazionali che nazionali. Per poter accedere al sito è quindi necessario registrarsi e fornire alcuni dati così da poter verificare che l‘utente sia un Operatore Sanitario.
Please confirm your email
We have just sent you an email, with a confirmation link.
Before you can gain full access - you need to confirm your email.
The information on this site is exclusively intented for health care professionals.
All the information included in the Website is related to products of the local market and, therefore, directed to health professionals legally authorized to prescribe or dispense medications with professional practice. The technical information of the drugs is provided merely informative, being the responsibility of the professionals authorized to prescribe drugs and decide, in each concrete case, the most appropriate treatment to the needs of the patient.
Register for access to Progress in Mind in your country