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Sample records for acute depressive episode

  1. Suicide risk in placebo-controlled trials of treatment for acute manic episode and prevention of manic-depressive episode

    NARCIS (Netherlands)

    Storosum, Jitschak G.; Wohlfarth, Tamar; Gispen-de Wied, Christine C.; Linszen, Don H.; Gersons, Berthold P. R.; van Zwieten, Barbara J.; van den Brink, Wim

    2005-01-01

    Objective: The authors' goal was to investigate whether there is a greater suicide risk in the placebo arms of placebo-controlled studies of active medication for the treatment of acute manic episode and the prevention of manic/depressive episode. If so, this would be a strong ethical argument

  2. Treatment outcomes of acute bipolar depressive episode with psychosis.

    Science.gov (United States)

    Caldieraro, Marco Antonio; Dufour, Steven; Sylvia, Louisa G; Gao, Keming; Ketter, Terence A; Bobo, William V; Walsh, Samantha; Janos, Jessica; Tohen, Mauricio; Reilly-Harrington, Noreen A; McElroy, Susan L; Shelton, Richard C; Bowden, Charles L; Deckersbach, Thilo; Nierenberg, Andrew A

    2018-05-01

    The impact of psychosis on the treatment of bipolar depression is remarkably understudied. The primary aim of this study was to compare treatment outcomes of bipolar depressed individuals with and without psychosis. The secondary aim was to compare the effect of lithium and quetiapine, each with adjunctive personalized treatments (APTs), in the psychotic subgroup. We assessed participants with DSM-IV bipolar depression included in a comparative effectiveness study of lithium and quetiapine with APTs (the Bipolar CHOICE study). Severity was assessed by the Bipolar Inventory of Symptoms Scale (BISS) and by the Clinical Global Impression Scale-Severity-Bipolar Version (CGI-S-BP). Mixed models were used to assess the course of symptom change, and Cox regression survival analysis was used to assess the time to remission. Psychotic features were present in 10.6% (n = 32) of the depressed participants (n = 303). Those with psychotic features had higher scores on the BISS before (75.2 ± 17.6 vs. 54.9 ± 16.3; P Bipolar depressive episodes with psychotic features are more severe, and compared to nonpsychotic depressions, present a similar course of improvement. Given the small number of participants presenting psychosis, the lack of statistically significant difference between lithium- and quetiapine-based treatment of psychotic bipolar depressive episodes needs replication in a larger sample. © 2018 Wiley Periodicals, Inc.

  3. Mentalization deficit in bipolar patients during an acute depressive and manic episode: association with cognitive functions.

    Science.gov (United States)

    Bodnar, Anna; Rybakowski, Janusz K

    2017-12-06

    A number of studies in bipolar patients have shown a deficit in mentalization (theory of mind), one of the main aspects of social cognition. The aim of current study was to assess both cognitive and affective mentalization in well-defined groups of depressed and manic bipolar patients, compared to healthy control subjects, using a battery of tests measuring mentalization processes. The second aim was to investigate a possible relationship between cognitive and affective mentalization and cognitive functions in bipolar patients during a depressive and manic episode. The study involved 25 bipolar disorder type I patients (10 male, 15 female) during a depressive episode (mean 24 ± 2 points in the 17-item Hamilton Depression Rating Scale) and 25 patients (10 male, 15 female) during a manic episode (mean 27 ± 4 points in the Young Mania Rating Scale). The control group consisted of 25 healthy subjects (10 male, 15 female) without psychiatric disorders. To measure mentalization, a revised version of the Reading the Mind in the Eyes (R-MET), the Strange Stories (SS), the Faux Pas Recognition (FPR), and the Moving Shapes Paradigm (MSP) tests were used. Assessment of cognitive functioning was made using the Digit Span, Trail Making, and Wisconsin Card Sorting Tests. In bipolar patients significant deficits in both cognitive and affective mentalization were demonstrated during both acute depressive and manic episodes. The impairment in FPR in manic patients was more severe than that in the depressive ones. On the other hand, in MSP, manic patients showed significantly increased intentionality for non-mentalization animations, compared with depressive patients and for "cause and effect" animations compared with control subjects. A significant relationship was found between the decrease in cognitive and affective mentalization and deficits of cognitive functions during both the depressive and manic episodes. The results obtained confirm the deficits of mentalization in

  4. Personality self-reports are concurrently reliable and valid during acute depressive episodes.

    Science.gov (United States)

    Costa, Paul T; Bagby, R Michael; Herbst, Jeffrey H; McCrae, Robert R

    2005-12-01

    It is alleged that depression distorts the assessment of general personality traits. To test that hypothesis, we examined scores on the Revised NEO Personality Inventory (NEO-PI-R) administered to acutely depressed patients at baseline and 14 to 26 weeks after treatment with antidepressant medication. Two hundred and fifty patients completed the NEO-PI-R at baseline, 109 patients after 14 to 26 weeks of antidepressant pharmacotherapy. 48 patients (49.5%) were identified as responders while 49 (50.5%) were identified as non-responders. The remaining 12 patients were excluded because they met HRSD response criteria but not the SCID-I MDD criteria at treatment completion. At baseline, NEO-PI-R scales showed high internal consistency and replicated the normative factor structure, suggesting that psychometric properties were preserved. Among non-responders, retest correlations were uniformly high (rs=.50 to .88) and mean levels showed little change, providing evidence for the consistency of personality self-reports during an acute depressive episode. NEO-PI-R scales showed construct validity in the concurrent prediction of a number of clinical criteria. Effective treatment had significant effects on the mean levels of neuroticism, which decreased, and extraversion, openness, and conscientiousness, which increased. The participants were from a clinical database and were not randomly assigned for the treatment. The results suggest that the effect of acute depression is to amplify somewhat the personality profile of people prone to depression. Rather than regard these depression-caused changes in assessed personality trait levels as a distortion, we interpret them as accurate reflections of the current condition of the individual. Personality traits have biological bases, and when they are changed (by disease or therapeutic interventions) trait levels change.

  5. [Integral Care Guide for Early Detection and Diagnosis of Depressive Episodes and Recurrent Depressive Disorder in Adults. Integral Attention of Adults with a Diagnosis of Depressive Episodes and Recurrent Depressive Disorder: Part II: General Aspects of Treatment, Management of the Acute Phase, Continuation and Maintenance of Patients with a Depression Diagnosis].

    Science.gov (United States)

    Peñaranda, Adriana Patricia Bohórquez; Valencia, Jenny García; Guarín, Maritza Rodríguez; Borrero, Álvaro Enrique Arenas; Díaz, Sergio Mario Castro; de la Hoz Bradford, Ana María; Riveros, Patricia Maldonado; Jaramillo, Luis Eduardo; Brito, Enrique; Acosta, Carlos Alberto Palacio; Pedraza, Ricardo Sánchez; González-Pacheco, Juan; Gómez-Restrepo, Carlos

    2012-12-01

    This article presents recommendations based on evidence gathered to answer a series of clinical questions concerning the depressive episode and the recurrent depressive disorder, with emphasis on general treatment aspects, treatment in the acute phase and management of the continuation/maintenance, all intended to grant health care parameters based on the best and more updated available evidence for achieving minimum quality standards with adult patients thus diagnosed. A practical clinical guide was elaborated according to standards of the Methodological Guide of the Ministry of Social Protection. Recommendation from NICE90 and CANMAT guides were adopted and updated so as to answer the questions posed while de novo questions were developed. Recommendations 5-22 corresponding to management of depression are presented. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  6. Severity of depressive episodes during the course of depressive disorder

    DEFF Research Database (Denmark)

    Kessing, L.V.

    2008-01-01

    Background It is not clear whether the severity of depressive episodes changes during the course of depressive disorder. Aims To investigate whether the severity of depressive episodes increases during the course of illness. Method Using a Danish nationwide case register, all psychiatric inpatients...... and out-patients with a main ICD-10 diagnosis of a single mild, moderate or severe depressive episode at the end of first contact were identified. Patients included in the study were from the period 1994-2003. Results A total of 19 392 patients received a diagnosis of a single depressive episode at first...... contact. The prevalence of severe depressive episodes increased from 25.5% at the first episode to 50.0% at the 15th episode and the prevalence of psychotic episodes increased from 8.7% at the first episode to 25.0% at the 15th episode. The same pattern was found regardless of gender, age at first contact...

  7. Severity of depressive episodes during the course of depressive disorder

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel

    2008-01-01

    BACKGROUND: It is not clear whether the severity of depressive episodes changes during the course of depressive disorder. AIMS: To investigate whether the severity of depressive episodes increases during the course of illness. METHOD: Using a Danish nationwide case register, all psychiatric in......-patients and out-patients with a main ICD-10 diagnosis of a single mild, moderate or severe depressive episode at the end of first contact were identified. Patients included in the study were from the period 1994-2003. RESULTS: A total of 19 392 patients received a diagnosis of a single depressive episode at first...... contact. The prevalence of severe depressive episodes increased from 25.5% at the first episode to 50.0% at the 15th episode and the prevalence of psychotic episodes increased from 8.7% at the first episode to 25.0% at the 15th episode. The same pattern was found regardless of gender, age at first contact...

  8. Depressive symptoms in first-episode psychosis

    DEFF Research Database (Denmark)

    Sönmez, Nasrettin; Røssberg, Jan Ivar; Evensen, Julie

    2016-01-01

    AIMS: The present study examined if any patient characteristics at baseline predicted depressive symptoms at 10 years and whether patients prone to depressive symptoms in the first year of treatment had a different prognosis in the following years. METHOD: A total of 299 first-episode psychosis...

  9. Perceptive biases in major depressive episode.

    Directory of Open Access Journals (Sweden)

    Marine Naudin

    Full Text Available INTRODUCTION: Alterations in emotional processing occur during a major depressive episode (MDE, and olfaction and facial expressions have implications in emotional and social interactions. To gain a better understanding of these processes, we characterized the perceptive sensorial biases, potential links, and potential remission after antidepressant treatment of MDE. METHODS: We recruited 22 patients with acute MDE, both before and after three months of antidepressant treatment, and 41 healthy volunteers matched by age and smoking status. The participants underwent a clinical assessment (Mini International Neuropsychiatry Interview, Montgomery-Åsberg Depression Rating Scale, State-Trait Anxiety Inventory, Physical and Social Anhedonia scales, Pleasure-Displeasure Scale, an olfactory evaluation (hedonic aspect, familiarity and emotional impact of odors, and a computerized Facial Affect Recognition task. RESULTS: MDE was associated with an olfactory bias concerning hedonic and emotional aspects, including negative olfactory alliesthesia (unpleasant odorants perceived as more unpleasant, facial emotion expression recognition (happy facial expressions, and in part olfactory anhedonia (pleasant odorants perceived as less pleasant. In addition, the results revealed that these impairments represent state markers of MDE, suggesting that the patients recovered the same sensory processing as healthy subjects after antidepressant treatment. DISCUSSION: This study demonstrated that MDE is associated with negative biases toward olfactory perception and the recognition of facial emotional expressions. The link between these two sensory parameters suggests common underlying processes.

  10. [Episodic autobiographical memory in depression: a review].

    Science.gov (United States)

    Lemogne, C; Piolino, P; Jouvent, R; Allilaire, J-F; Fossati, P

    2006-10-01

    Autobiographical memory and personal identity (self) are linked by a reciprocal relationship. Autobiographical memory is critical for both grounding and changing the self. Individuals' current self-views, beliefs, and goals influence their recollections of the past. According to Tulving, episodic memory is characterized by autonoetic consciousness, which is associated with a sense of the self in the past (emotions and goals) and mental reliving of an experience. Its close relationship with self and emotion strongly involves episodic autobiographical memory in the psychopathology of depression. However, due to methodological and conceptual issues, little attention has been paid to episodic autobiographical memory in depression. Since the seminal work of Williams et al. 15 years ago, there is now growing interest around this issue. We reviewed the evidence for three major features of autobiographical memory functioning in depression: an increase in general memory retrieval (overgenerality), a mood-congruent memory effect and the high occurrence of intrusive memories of stressful events. Although it was first observed among suicidal patients, overgenerality is actually associated with both depression and post-traumatic stress disorder. Overgenerality is not associated with anxious disorders other than post-traumatic stress disorder, obsessive-compulsive disorder, or borderline personality disorder. Most of controlled studies carried out on autobiographical memory in depression rely on the Williams' Autobiographical Memory Test (AMT). When presented with positive and negative cue words and asked to retrieve specific personal events, depressed patients (unlike matched controls) are less specific in their memories. They tend to recall repeated events (categorical overgeneral memories) rather than single episodes (specific memories). Overgenerality in depression is: 1) more evident with positive than with negative events (mood-congruent memory effect); 2) related to

  11. Severity of depressive episodes according to ICD-10

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel

    2004-01-01

    BACKGROUND: The ICD-10 categorisation of severity of depression into mild, moderate and severe depressive episodes has not been validated. AIMS: To validate the ICD-10 categorisation of severity of depression by estimating its predictive ability on the course of illness and suicidal outcome. METHOD......: All psychiatric in-patients in Denmark who had received a diagnosis of a single depressive episode at their first discharge between 1994 and 1999 were identified. The risk of relapse and the risk of suicide were compared for patients discharged with an ICD-10 diagnosis of a single mild, moderate...... or severe depressive episode. RESULTS: At their first discharge, 1103 patients had an ICD-10 diagnosis of mild depressive episode, 3182 had a diagnosis of moderate depressive episode and 2914 had a diagnosis of severe depressive episode. The risk of relapse and the risk of suicide were significantly...

  12. Depression following acute coronary syndrome

    DEFF Research Database (Denmark)

    Joergensen, Terese Sara Hoej; Maartensson, Solvej; Ibfelt, Else Helene

    2016-01-01

    PURPOSE: Depression is common following acute coronary syndrome, and thus, it is important to provide knowledge to improve prevention and detection of depression in this patient group. The objectives of this study were to examine: (1) whether indicators of stressors and coping resources were risk...... factors for developing depression early and later after an acute coronary syndrome and (2) whether prior depression modified these associations. METHODS: The study was a register-based cohort study, which includes 87,118 patients with a first time diagnosis of acute coronary syndrome during the period...... 2001-2009 in Denmark. Cox regression models were used to analyse hazard ratios (HRs) for depression. RESULTS: 1.5 and 9.5 % develop early (≤30 days) and later (31 days-2 years) depression after the acute coronary syndrome. Among all patients with depression, 69.2 % had first onset depression, while 30...

  13. Gender Differences among Patients with a Single Depressive Episode

    DEFF Research Database (Denmark)

    Bukh, Jens D; Bock, Camilla; Vinberg, Maj

    2010-01-01

    BACKGROUND: Studies on gender differences in depression have usually included a mixture of patients with first-episode, chronic and recurrent depression. Consequently, the results might be confounded by the history of depression among participants. The present study evaluated gender differences......, personality traits and disorders, stressful life events, family history, and treatment response. RESULTS: Female patients showed a higher level of neuroticism and more residual anxiety symptoms after treatment of the depression. There were no gender differences in severity of depression, psychiatric co...

  14. Transient acute renal failure and functional hemispheric depression after cerebral arteriography in diabetic patients

    DEFF Research Database (Denmark)

    Olsen, Tom Skyhøj; Lund, P; Praestholm, J

    1981-01-01

    Cerebral angiography was carried out in two diabetic patients in the evaluation of minor vascular ischemic episodes. A transient acute renal failure following cerebral angiography was accompanied by a transient comatose episode with severe unilateral neurological deficits. A functional depression...

  15. Oxcarbazepine for acute affective episodes in bipolar disorder.

    Science.gov (United States)

    Vasudev, Akshya; Macritchie, Karine; Vasudev, Kamini; Watson, Stuart; Geddes, John; Young, Allan H

    2011-12-07

    Oxcarbazepine, a keto derivative of the 'mood stabiliser' carbamazepine, may have efficacy in the treatment of acute episodes of bipolar disorder. Potentially, it may offer pharmacokinetic advantages over carbamazepine. To review the efficacy and acceptability of oxcarbazepine compared to placebo and other agents in the treatment of acute bipolar episodes including mania, mixed episodes and depression. Electronic databases were searched up to 2 September 2011. Specialist journals and conference proceedings were handsearched. Authors, experts in the field and pharmaceutical companies were contacted requesting information on published and unpublished trials. Randomised controlled trials (RCTs) which compared oxcarbazepine with placebo or alternative agents, where the stated intent of intervention was the acute treatment of bipolar affective disorder were sought. Participants with bipolar disorder of either sex and of all ages were included. Data were extracted from the original reports individually by two review authors. For dichotomous data, odds ratios (ORs) were calculated with 95% confidence intervals (CI). Continuous data were analysed using standardised mean differences (with 95% CI). Seven studies were included in the analysis (368 participants in total). All were on mania, hypomania, mixed episodes or rapid-cycling disorder. Overall, their methodological quality was relatively low.There was no difference in the primary outcome analysis - a fall of  50% or more on the Young Mania Rating Scale (YMRS) - between oxcarbazepine and placebo (N=1, n=110, OR =2.10, 95% CI 0.94 to 4.73) in one study, conducted in children; no studies were available in adult participants.In comparison with other mood stabilisers, there was no difference between oxcarbazepine and valproate as an antimanic agent using the primary outcome (50% or more fall in YMRS, OR=0.44, 95% CI 0.10 to 1.97, 1 study, n=60, P=0.273) or the secondary outcome measure (differences in YMRS between the two

  16. Acute manic episode is associated with an increased risk of lower limb edema.

    Science.gov (United States)

    Hochman, Eldar; Krivoy, Amir; Shoval, Gal; Valevski, Avi; Weizman, Abraham; Fischel, Tsvi

    2013-12-02

    Lower limb edema (LLE) was suggested to be associated with the use of psychotropic drugs among patients suffering from severe mental illnesses; however no direct mechanism was found. Therefore, we examined the association between the occurrence of LLE and acute untreated episode leading to hospitalization. A retrospective cross-sectional study was conducted using medical charts of 2529 patients admitted to Geha Mental Health Center between 2002 and 2012. Incident cases of LLE, demographic and clinical data were retrieved. Admission clinical status was modeled as three non-overlapping groups of patients: (i) Patients with a non-affective psychosis (NAP) episode (n = 1563), (ii) patients with a manic episode (n = 366), and (iii) patients with a depressive episode (n = 600). We performed a logistic regression analysis with LLE as the dependent variable controlling for the demographic and clinical variables that may be associated with LLE. LLE was diagnosed in 3.8% (n = 95) of the study population. The rate of LLE was 3-fold higher (χ(2) = 51.9, df = 2, p<0.001) in patients admitted with a manic episode (n = 38; 10.4%) compared to patients admitted with a NAP episode (n = 41; 2.6%) and patients admitted with a depressive episode (n = 16; 2.7%). Manic episode was associated with an increased risk for LLE compared to depressive episode (OR 8.72, 95% CI: 3.53-21.52, p<0.001) or NAP episode (OR 3.96, 95% CI: 2.16-7.26, p<0.001) after controlling for relevant confounders. Acute manic episode, leading to hospitalization, is associated with an increased risk of LLE, compared to NAP or depressive episode, suggesting causal relationship between mood and fluid imbalance. Yet, future prospective studies are needed to rule out the contribution of physical agitation and lithium treatment. © 2013.

  17. Evaluation of a depression health management program to improve outcomes in first or recurrent episode depression.

    Science.gov (United States)

    Aubert, Ronald E; Fulop, George; Xia, Fang; Thiel, Melinda; Maldonato, Debra; Woo, Cindy

    2003-05-01

    To evaluate the impact of telephone counseling and educational materials on medication adherence and persistency among members with newly diagnosed depression enrolled in a pharmacy benefit management-sponsored disease management program. Longitudinal cohort observation. The study population comprised 505 members with a new or recurrent episode of depression who consented and enrolled in a depression disease management program. After written consent was obtained, program participants received up to 4 telephone-counseling calls and 5 educational mailings focused on the importance of medication compliance, barriers to medication compliance, quality of life, symptoms, and satisfaction with the program. A control group of 3744 members was selected from client companies that opted not to offer the depression program. Measures of medication adherence, persistency with prescription drug therapy, and patient refill timeliness were computed for both groups and compared. Patients enrolled in the depression disease management program were significantly more likely to adhere to their medication regimen during acute (89.0% vs 67.7%, P management-sponsored health management depression program succeeded in encouraging patients with new or recurrent depression to stay on antidepressant medication and to reach treatment goals outlined by best practice guidelines.

  18. Depression and quality of life in first-episode psychosis.

    LENUS (Irish Health Repository)

    Renwick, Laoise

    2012-07-01

    Quality of life (QOL) has gained recognition as a valid measure of outcome in first-episode psychosis (FEP). This study aimed to determine the influence of specific groups of depressive symptoms on separate domains of subjectively appraised QOL.

  19. Subtypes of depressive episodes according to ICD-10

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel

    2003-01-01

    a period from 1994 to 1999 were identified. The risk of relapse leading to readmission and the risk of committing suicide were compared for patients discharged with an ICD-10 diagnosis of a single depressive episode with and without melancholic syndrome and for patients with and without psychotic symptoms......BACKGROUND: The long-term predictive ability of the ICD-10 subtypes of depression with melancholic syndrome and depression with psychosis has not been investigated. SAMPLING AND METHODS: All patients in Denmark who had a diagnosis of a single depressive episode at their first ever discharge during......, respectively. RESULTS: In all, 1,639 patients had a diagnosis of depressive episode without psychotic symptoms, 1,275 patients a diagnosis with psychotic symptoms, 293 a diagnosis without melancholic syndrome, and 248 a diagnosis with melancholic symptoms at first discharge. The risk of relapse leading...

  20. Chronic and Episodic Stress in Children of Depressed Mothers.

    Science.gov (United States)

    Feurer, Cope; Hammen, Constance L; Gibb, Brandon E

    2016-01-01

    The goal of this study was to examine chronic and episodic stress in children of mothers with and without a history of major depressive disorder (MDD) during the children's lives. Participants were 255 mothers selected according to their history of MDD (present vs. absent during child's life) and their children (age 8-14; 53% girls, 81% Caucasian). Mothers' and children's histories of MDD were assessed using diagnostic interviews, and their depressive symptoms were assessed via self-report measures. Children's levels of chronic and episodic stress were assessed using a semistructured contextual threat interview. Children of mothers with a history of recurrent MDD, compared to single MDD or no depression, experienced more chronic stress within several domains including peers, mother-child relations, and other family member relations as well as greater episodic dependent interpersonal stress. Each of these group differences was maintained after excluding children with a history of MDD themselves and controlling for their current depressive symptoms. However, only the group difference in chronic peer stress was maintained when controlling for mothers' current depression. The results suggest that children exposed to recurrent maternal MDD experience higher levels of both chronic and episodic stress, at least some of which they contribute to themselves (dependent interpersonal stress) and which is at least partially independent of the effects of children's depression. In addition, much of this stress is associated primarily with current depression in the mother, though it appears that chronic peer stress may remain elevated even after the remission of maternal depression.

  1. Life stress and family history for depression: the moderating role of past depressive episodes.

    Science.gov (United States)

    Monroe, Scott M; Slavich, George M; Gotlib, Ian H

    2014-02-01

    Three of the most consistently reported and powerful predictors of depression are a recent major life event, a positive family history for depression, and a personal history of past depressive episodes. Little research, however, has evaluated the inter-relations among these predictors in depressed samples. Such information is descriptively valuable and potentially etiologically informative. In the present article we summarize the existing literature and test four predictions in a sample of 62 clinically depressed individuals: (1) participants who experienced a major life event prior to onset would be less likely than participants who did not experience a major life event to have a positive family history for depression; (2) participants with a recent major life event would have fewer lifetime episodes of depression than would participants without; (3) participants with a positive family history for depression would have more lifetime episodes of depression than would participants with a negative family history for depression; and (4) we would obtain a 3-way interaction in which participants with a positive family history and without a major life event would have the most lifetime episodes, whereas participants with a negative family history and a major life event would have the fewest lifetime episodes. The first three predictions were confirmed, and the fourth prediction partially confirmed. These novel findings begin to elucidate the complex relations among these three prominent risk factors for depression, and point to avenues of research that may help illuminate the origins of depressive episodes. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Acute rejection episodes after kidney transplantation

    Directory of Open Access Journals (Sweden)

    Hamida Fethi

    2009-01-01

    Full Text Available Acute rejection episodes (AREs are a major determinant of renal allograft survival. The incorporation of new immunosuppressive agents explains, at least partially, the improvement seen in the results of transplantation in recent years. The objectives of this study are to analyze the incidence and severity of AREs, their risk factors and their influence on graft and patient survival. We retrospectively studied 280 kidney transplants performed in adults at the Charles Nicolle Hospital, Tunis, between 1986 and 2004. The diagnosis of ARE was based on clinical data and response to treatment. Allograft biopsies were performed in ten cases. The treatment of AREs consisted of pulse methylprednisolone and anti-thymocyte globulin. There were 186 males (66.4% and 94 females (33.6%, and their mean age was 31 ± 8.9 years. Overall, the 280 study patients experienced a total of 113 AREs. Of them, 85 had only one ARE, 28 had two to three and none had more than three AREs. A total of 68 AREs were completely re-versible, 42 were partially reversible while three could not be reversed with treatment. The mean inci-dence of AREs was 40.4%. The incidence was > 45% between 1986 and 1997, decreased to 20.5% between 1998 and 2000 and to 9% between 2001 and 2004. Graft survival rates in patients with and without AREs were respectively 91% and 93% at three years, 82% and 90% at five years and 73% and 83% at 10 years. We found a decrease in the incidence of AREs in recent years in our study patients, and this was related to the introduction of sensitized cross-match and the newer immunosuppressive agents, particularly MMF. Additionally, AREs had a deleterious impact on late graft survival in our study population.

  3. Safety and acceptability of transcranial direct current stimulation for the acute treatment of major depressive episodes: Analysis of individual patient data.

    Science.gov (United States)

    Moffa, Adriano H; Brunoni, André R; Fregni, Felipe; Palm, Ulrich; Padberg, Frank; Blumberger, Daniel M; Daskalakis, Zafiris J; Bennabi, Djamila; Haffen, Emmanuel; Alonzo, Angelo; Loo, Colleen K

    2017-10-15

    Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation modality that has been increasingly used for major depressive disorder (MDD) treatment. Although studies in healthy volunteers showed that the technique is well-tolerated, tDCS safety and acceptability have not been sufficiently explored in patients with MDD. We collected individual patient data from 6 randomized clinical trials that had been previously identified in a systematic review and meta-analysis. Primary outcomes were safety (rate of adverse events) and acceptability (rate of dropouts). Secondary outcomes were clinical, demographic and treatment predictors of the primary outcomes. Dropout rates between active (8.8%) and sham (12%) groups were not significantly different (OR= 0.7, p=0.38). Adverse event rates between active (73.5%) and sham (68.3%) groups were not significantly different (OR= 1.4, p= 0.23). Higher current densities were associated with lower adverse event rates. Dropout reasons were not systematically reported and adverse events were not collected using questionnaires standardized across studies. Active tDCS is as acceptable and safe as sham tDCS, as found in randomized clinical trials of MDD. Copyright © 2017. Published by Elsevier B.V.

  4. Onset and Recurrence of Depression as Predictors of Cardiovascular Prognosis in Depressed Acute Coronary Syndrome Patients : A Systematic Review

    NARCIS (Netherlands)

    Zuidersma, Marij; Thombs, Brett D.; de Jonge, Peter

    2011-01-01

    Background: Depression after acute coronary syndrome (ACS) is associated with worse cardiac outcomes. This systematic review evaluated whether depressed ACS patients are at differential risk depending on the recurrence and timing of onset of depressive episodes. Methods: MEDLINE, EMBASE and PsycINFO

  5. Direct Cost of Treating Acute Psychotic Episodes in Nnewi, South ...

    African Journals Online (AJOL)

    Background: Major psychotic disorders such as the schizophrenias consume a high proportion of health budgets in developed countries. The economic implications of acute psychotic disorders in Nigeria have not been well documented. Aim: To estimate the direct cost of treating patients with acute psychotic episodes in a ...

  6. N-acetylcysteine for major depressive episodes in bipolar disorder.

    Science.gov (United States)

    Magalhães, Pedro V; Dean, Olívia M; Bush, Ashley I; Copolov, David L; Malhi, Gin S; Kohlmann, Kristy; Jeavons, Susan; Schapkaitz, Ian; Anderson-Hunt, Murray; Berk, Michael

    2011-12-01

    In this report, we aimed to evaluate the effect of add-on N-acetylcysteine (NAC) on depressive symptoms and functional outcomes in bipolar disorder. To that end, we conducted a secondary analysis of all patients meeting full criteria for a depressive episode in a placebo controlled trial of adjunctive NAC for bipolar disorder. Twenty-four week randomised clinical trial comparing adjunctive NAC and placebo in individuals with bipolar disorder experiencing major depressive episodes. Symptomatic and functional outcome data were collected over the study period. Seventeen participants were available for this report. Very large effect sizes in favor of NAC were found for depressive symptoms and functional outcomes at endpoint. Eight of the ten participants on NAC had a treatment response at endpoint; the same was true for only one of the seven participants allocated to placebo. These results indicate that adjunctive NAC may be useful for major depressive episodes in bipolar disorder. Further studies designed to confirm this hypothesis are necessary.

  7. Effect of Taurine on Febrile Episodes in Acute Lymphoblastic Leukemia

    Directory of Open Access Journals (Sweden)

    Mina Islambulchilar

    2015-03-01

    Full Text Available Purpose: The purpose of our study was to evaluate the effect of oral taurine on the incidence of febrile episodes during chemotherapy in young adults with acute lymphoblastic leukemia. Methods: Forty young adults with acute lymphoblastic leukemia, at the beginning of maintenance course of their chemotherapy, were eligible for this study. The study population was randomized in a double blind manner to receive either taurine or placebo (2 gram per day orally. Life quality and side effects including febrile episodes were assessed using questionnaire. Data were analyzed using Pearson’s Chi square test. Results: Of total forty participants, 43.8% were female and 56.3 % were male. The mean age was 19.16±1.95 years (ranges: 16-23 years. The results indicated that the levels of white blood cells are significantly (P<0.05 increased in taurine treated group. There was no elevation in blasts count. A total of 70 febrile episodes were observed during study, febrile episodes were significantly (P<0.05 lower in taurine patients in comparison to the control ones. Conclusion: The overall incidence of febrile episodes and infectious complications in acute lymphoblastic leukemia patients receiving taurine was lower than placebo group. Taurine’s ability to increase leukocyte count may result in lower febrile episodes.

  8. Acute Unstable Depressive Syndrome (AUDS) is associated more frequently with epilepsy than major depression

    DEFF Research Database (Denmark)

    Vaaler, Arne E; Morken, Gunnar; Iversen, Valentina C

    2010-01-01

    present with an Acute Unstable Depressive Syndrome (AUDS) that does not meet DSM-IV criteria of a Major Depressive Episode (MDE). In a previous publication we have documented that AUDS patients indeed have more often a history of epileptic seizures and abnormal EEG recordings than MDE patients (Vaaler et......Depressive disorders are frequent in epilepsy and associated with reduced seizure control. Almost 50% of interictal depressive disorders have to be classified as atypical depressions according to DSM-4 criteria. Research has mainly focused on depressive symptoms in defined populations with epilepsy...... al. 2009). This study aimed to further classify the differences of depressive symptoms at admittance and follow-up of patients with AUDS and MDE....

  9. Serum biomarkers predictive of depressive episodes in panic disorder.

    Science.gov (United States)

    Gottschalk, M G; Cooper, J D; Chan, M K; Bot, M; Penninx, B W J H; Bahn, S

    2016-02-01

    Panic disorder with or without comorbid agoraphobia (PD/PDA) has been linked to an increased risk to develop subsequent depressive episodes, yet the underlying pathophysiology of these disorders remains poorly understood. We aimed to identify a biomarker panel predictive for the development of a depressive disorder (major depressive disorder and/or dysthymia) within a 2-year-follow-up period. Blood serum concentrations of 165 analytes were evaluated in 120 PD/PDA patients without depressive disorder baseline diagnosis (6-month-recency) in the Netherlands Study of Depression and Anxiety (NESDA). We assessed the predictive performance of serum biomarkers, clinical, and self-report variables using receiver operating characteristics curves (ROC) and the area under the ROC curve (AUC). False-discovery-rate corrected logistic regression model selection of serum analytes and covariates identified an optimal predictive panel comprised of tetranectin and creatine kinase MB along with patient gender and scores from the Inventory of Depressive Symptomatology (IDS) rating scale. Combined, an AUC of 0.87 was reached for identifying the PD/PDA patients who developed a depressive disorder within 2 years (n = 44). The addition of biomarkers represented a significant (p = 0.010) improvement over using gender and IDS alone as predictors (AUC = 0.78). For the first time, we report on a combination of biological serum markers, clinical variables and self-report inventories that can detect PD/PDA patients at increased risk of developing subsequent depressive disorders with good predictive performance in a naturalistic cohort design. After an independent validation our proposed biomarkers could prove useful in the detection of at-risk PD/PDA patients, allowing for early therapeutic interventions and improving clinical outcome. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Evidence that patients with single versus recurrent depressive episodes are differentially sensitive to treatment discontinuation : A meta-analysis of placebo-controlled randomized trials

    NARCIS (Netherlands)

    Kaymaz, Nil; van Os, Jim; Loonen, Anton J. M.; Nolen, Willem A.

    Background: Antidepressants are effective in the prevention of relapse after remission from an acute depressive episode. It is unclear, however, to what degree duration of the continuation phase, level of abruptness of antidepressant discontinuation, or the number of previous episodes moderate the

  11. Diagnostic depressive symptoms of the mixed bipolar episode.

    Science.gov (United States)

    Cassidy, F; Ahearn, E; Murry, E; Forest, K; Carroll, B J

    2000-03-01

    There is not yet consensus on the best diagnostic definition of mixed bipolar episodes. Many have suggested the DSM-III-R/-IV definition is too rigid. We propose alternative criteria using data from a large patient cohort. We evaluated 237 manic in-patients using DSM-III-R criteria and the Scale for Manic States (SMS). A bimodally distributed factor of dysphoric mood has been reported from the SMS data. We used both the factor and the DSM-III-R classifications to identify candidate depressive symptoms and then developed three candidate depressive symptom sets. Using ROC analysis we determined the optimal threshold number of symptoms in each set and compared the three ROC solutions. The optimal solution was tested against the DSM-III-R classification for crossvalidation. The optimal ROC solution was a set, derived from both the DSM-III-R and the SMS, and the optimal threshold for diagnosis was two or more symptoms. Applying this set iteratively to the DSM-III-R classification produced the identical ROC solution. The prevalence of mixed episodes in the cohort was 13.9% by DSM-III-R, 20.2% by the dysphoria factor and 27.4% by the new ROC solution. A diagnostic set of six dysphoric symptoms (depressed mood, anhedonia, guilt, suicide, fatigue and anxiety), with a threshold of two symptoms, is proposed for a mixed episode. This new definition has a foundation in clinical data, in the proved diagnostic performance of the qualifying symptoms, and in ROC validation against two previous definitions that each have face validity.

  12. Depressive vulnerabilities predict depression status and trajectories of depression over 1 year in persons with acute coronary syndrome.

    Science.gov (United States)

    Doyle, Frank; McGee, Hannah; Delaney, Mary; Motterlini, Nicola; Conroy, Ronán

    2011-01-01

    Depression is prevalent in patients hospitalized with acute coronary syndrome (ACS). We determined whether theoretical vulnerabilities for depression (interpersonal life events, reinforcing events, cognitive distortions, Type D personality) predicted depression, or depression trajectories, post-hospitalization. We followed 375 ACS patients who completed depression scales during hospital admission and at least once during three follow-up intervals over 1 year (949 observations). Questionnaires assessing vulnerabilities were completed at baseline. Logistic regression for panel/longitudinal data predicted depression status during follow-up. Latent class analysis determined depression trajectories. Multinomial logistic regression modeled the relationship between vulnerabilities and trajectories. Vulnerabilities predicted depression status over time in univariate and multivariate analysis, even when controlling for baseline depression. Proportions in each depression trajectory category were as follows: persistent (15%), subthreshold (37%), never depressed (48%). Vulnerabilities independently predicted each of these trajectories, with effect sizes significantly highest for the persistent depression group. Self-reported vulnerabilities - stressful life events, reduced reinforcing events, cognitive distortions, personality - measured during hospitalization can identify those at risk for depression post-ACS and especially those with persistent depressive episodes. Interventions should focus on these vulnerabilities. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. Acute Unstable Depressive Syndrome (AUDS) is associated more frequently with epilepsy than major depression

    DEFF Research Database (Denmark)

    Vaaler, Arne E; Morken, Gunnar; Iversen, Valentina C

    2010-01-01

    Depressive disorders are frequent in epilepsy and associated with reduced seizure control. Almost 50% of interictal depressive disorders have to be classified as atypical depressions according to DSM-4 criteria. Research has mainly focused on depressive symptoms in defined populations with epilepsy...... (e.g., patients admitted to tertiary epilepsy centers). We have chosen the opposite approach. We hypothesized that it is possible to define by clinical means a subgroup of psychiatric patients with higher than expected prevalence of epilepsy and seizures. We hypothesized further that these patients...... present with an Acute Unstable Depressive Syndrome (AUDS) that does not meet DSM-IV criteria of a Major Depressive Episode (MDE). In a previous publication we have documented that AUDS patients indeed have more often a history of epileptic seizures and abnormal EEG recordings than MDE patients (Vaaler et...

  14. Assessment of psychological pain in major depressive episodes.

    Science.gov (United States)

    Mee, Steven; Bunney, Blynn G; Bunney, William E; Hetrick, William; Potkin, Steven G; Reist, Christopher

    2011-11-01

    Severe psychological or mental pain is defined as an experience of unbearable torment which can be associated with a psychiatric illness (e.g., major depressive disorder) or a tragic loss such as the death of a child. A brief self-rating scale (Mee-Bunney Psychological Pain Assessment Scale [MBPPAS]) was developed to assess the intensity of psychological pain. The scale was used to measure psychological pain in 73 major depressive episode (MDE) patients and 96 non-psychiatric controls. In addition to the MBPPAS, all subjects completed four additional instruments: Suicidal Behavior Questionnaire (SBQ), Beck Depression Inventory (BDI), Beck Hopelessness Scale (BHS), and the Brief Pain Inventory (BPI). Known-groups, content and convergent validity, and internal reliability of the scale were established. MDE and control subjects were ranked according to MBPPAS scores. A threshold was set at 32 representing 0.5 SD above the mean for MDEs. MDE subjects above the threshold of 32 had significantly higher SBQ scores than those below. A significant linear correlation between psychological pain and SBQ suicidality scores was observed. This is the first study to contrast psychological pain in controls and patients with MDE. Our results suggest that psychological pain is a useful and unique construct in patients with MDE that can be reliably assessed and may aid in the evaluation of suicidal risk. Published by Elsevier Ltd.

  15. Metabolic syndrome in subjects with bipolar disorder and major depressive disorder in a current depressive episode: Population-based study: Metabolic syndrome in current depressive episode.

    Science.gov (United States)

    Moreira, Fernanda Pedrotti; Jansen, Karen; Cardoso, Taiane de Azevedo; Mondin, Thaíse Campos; Magalhães, Pedro Vieira da Silva; Kapczinski, Flávio; Souza, Luciano Dias de Mattos; da Silva, Ricardo Azevedo; Oses, Jean Pierre; Wiener, Carolina David

    2017-09-01

    To assess the differences in the prevalence of the metabolic syndrome (MetS) and their components in young adults with bipolar disorder (BD) and major depressive disorder (MDD) in a current depressive episode. This was a cross-sectional study with young adults aged 24-30 years old. Depressive episode (bipolar or unipolar) was assessed using the Mini International Neuropsychiatric Interview - Plus version (MINI Plus). The MetS was assessed using the National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP III). The sample included 972 subjects with a mean age of 25.81 (±2.17) years. Both BD and MDD patients showed higher prevalence of MetS compared to the population sample (BD = 46.9%, MDD = 35.1%, population = 22.1%, p depressive episode compared to the general population. Moreover, there was a significant difference on BMI values in the case of BD and MDD subjects (p = 0.016). Metabolic components were significantly associated with the presence of depressive symptoms, independently of the diagnosis. Copyright © 2017. Published by Elsevier Ltd.

  16. The relationship between the severity of depression and cognitive coping strategies in patients with depressive episode

    Directory of Open Access Journals (Sweden)

    Chun-feng HU

    2013-12-01

    Full Text Available Objective: To explore the relationship between the depressive mood and cognitive emotion regulation strategies.  Methods: A total of 143 major depression patients were assessed with a self-designed questionnaire, Beck Depression Inventory (BDI, the Chinese version of Cognitive Emotion Regulation Questionnaire (CERQ-C and the twenty-item Toronto Scale (TAS-20, and 95 healthy people were involved as controls. Regression analysis was carried out for the influcing factors to depressive mood. Results: Compared with controls, Patients with Depressive Episode showed significantly higher total scores of inadaptability strategy,TAS and BDI(P<0.01. There were lots of factors, such as domestic stress and maladaptive strategy showed significant correlation with total score of BDI in major depression (P<0.05 or P<0.01. The factors of domestic stress and maladaptive strategy et al entered the regression equation for BDI by turns. Conclusions: Patients with depression suffered from maladaptive strategy. Cognitive coping strategies and stressl were the important influence factors of depression emotion in patients with depression.

  17. Personality traits in the differentiation of major depressive disorder and bipolar disorder during a depressive episode.

    Science.gov (United States)

    Araujo, Jaciana Marlova Gonçalves; dos Passos, Miguel Bezerra; Molina, Mariane Lopez; da Silva, Ricardo Azevedo; Souza, Luciano Dias de Mattos

    2016-02-28

    The aim of this study was to determine the differences in personality traits between individuals with Major Depressive Disorder (MDD) and Bipolar Disorder (BD) during a depressive episode, when it can be hard to differentiate them. Data on personality traits (NEO-FFI), mental disorders (Mini International Neuropsychiatric Interview Plus) and socioeconomic variables were collected from 245 respondents who were in a depressive episode. Individuals with MDD (183) and BD (62) diagnosis were compared concerning personality traits, clinical aspects and socioeconomic variables through bivariate analyses (chi-square and ANOVA) and multivariate analysis (logistic regression). There were no differences in the prevalence of the disorders between socioeconomic and clinical variables. As for the personality traits, only the difference in Agreeableness was statistically significant. Considering the control of suicide risk, gender and anxiety comorbidity in the multivariate analysis, the only variable that remained associated was Agreeableness, with an increase in MDD cases. The brief version of the NEO inventories (NEO-FFI) does not allow for the analysis of personality facets. During a depressive episode, high levels of Agreeableness can indicate that MDD is a more likely diagnosis than BD. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. Gender differences in patients presenting with a single depressive episode according to ICD-10

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel

    2005-01-01

    .4%). In outpatient settings, women slightly more often presented with milder types of depression than with severe depression, but no gender difference was found in the severity of depressive episodes among hospitalised patients. No differences were found between genders in the prevalence of depression with vs...

  19. Infidelity and separations precipitate major depressive episodes and symptoms of nonspecific depression and anxiety.

    Science.gov (United States)

    Cano, A; O'Leary, K D

    2000-10-01

    This study examined whether humiliating marital events (HMEs; husbands' infidelity, threats of marital dissolution) precipitated Major Depressive Episodes (MDEs) when controlling for marital discord. Participants were 25 women who recently experienced an HME and 25 control women who did not experience an HME. Both groups reported similar levels of marital discord. Results indicated that HME participants were 6 times more likely to be diagnosed with an MDE than control participants. These results remained even after controlling for family and lifetime histories of depression. HME participants also reported significantly more symptoms of nonspecific depression and anxiety than control participants. However, HME and control participants did not report significantly different numbers of anhedonic depression and anxious arousal symptoms. The research and clinical implications of these findings are discussed.

  20. Validity of the diagnosis of a single depressive episode in a case register

    DEFF Research Database (Denmark)

    Bock, Camilla; Bukh, Jens Drachmann; Vinberg, Maj

    2009-01-01

    .8% for severe type of a single depression, 76.0% for moderate type of a single depression and 65.2% for mild type of a single depression). CONCLUSION: The ICD-10 diagnosis of a single depressive episode can be used in daily clinical practice with sufficient precision. The validity of the diagnosis is highest...... for severe and moderate type of depression and decreases for mild depression....

  1. Daylight savings time transitions and the incidence rate of unipolar depressive episodes

    DEFF Research Database (Denmark)

    Hansen, Bertel T; Sønderskov, Kim M; Hageman, Ida

    2017-01-01

    Background: Daylight savings time transitions affect approximately 1.6 billion people worldwide. Prior studies have documented associations between daylight savings time transitions and adverse health outcomes, but it remains unknown whether they also cause an increase in the incidence rate...... of depressive episodes. This seems likely because daylight savings time transitions affect circadian rhythms, which are implicated in the etiology of depressive disorder. Therefore, we investigated the effects of daylight savings time transitions on the incidence rate of unipolar depressive episodes. Methods...

  2. The acute and preventative treatment of episodic migraine

    Directory of Open Access Journals (Sweden)

    Sarah Miller

    2012-01-01

    Full Text Available Episodic migraine is a common debilitating condition with significant worldwide impact. An effective management plan must include acute treatment to relieve the pain and potential disability associated with the attacks and may also include preventative treatments with an aim of decreasing attack frequency and severity in the longer term. Acute treatments must be limited to a maximum of 2-3 days a week to prevent medication overuse headache and focus on simple analgesia, non-steroidal anti-inflammatory drugs and triptans. Preventative treatments are numerous and should be considered when migraine attacks are frequent and or disabling, acute medication is failing, in special circumstances such as hemiplegic migraines or if the patient requests them. All preventative medications must be given at therapeutic doses for at least 6-8 weeks before an adequate trial can be judged ineffective. The most important factor in choosing drugs is the patient and the clinical features of their attack and treatment should be tailored to these. Relative co-morbidities will influence drug choice, as will the side effect profile and the efficacy of the drug. First line preventative drugs include ß-blockers, amitriptyline and anti-epileptic drugs such as topiramate and valproate. Drugs with lower efficacy or poorer side effect profiles include selective serotonin reuptake inhibitors (SSRIs, calcium channel antagonists, gabapentin and herbal medicines.

  3. Aggression Protects Against the Onset of Major Depressive Episodes in Individuals With Bipolar Spectrum Disorder.

    Science.gov (United States)

    Ng, Tommy H; Freed, Rachel D; Titone, Madison K; Stange, Jonathan P; Weiss, Rachel B; Abramson, Lyn Y; Alloy, Lauren B

    2017-05-01

    A growing body of research suggests that bipolar spectrum disorders (BSDs) are associated with high aggression. However, little research has prospectively examined how aggression may affect time to onset of hypomanic/manic versus major depressive episodes. In a longitudinal study, we tested the hypothesis that aggression would prospectively predict a shorter time to the onset of hypomanic/manic episodes and a longer time to the onset of major depressive episodes, based on the behavioral approach system theory of BSDs. Young adults (N = 120) diagnosed with cyclothymia, bipolar II disorder, or bipolar disorder not otherwise specified were followed every 4 months for an average of 3.55 years. Participants completed measures of depressive and manic symptoms, family history of mood disorder, impulsivity, and aggression at baseline and were followed prospectively with semistructured diagnostic interview assessments of hypomanic/manic and major depressive episodes and treatment seeking for mood problems. Cox proportional hazard regression analyses indicated that overall, physical, and verbal aggression predicted a longer time to major depressive episode onset, even after controlling for baseline depressive and manic symptoms, family history of mood disorder, treatment seeking for mood problems, and impulsivity. Aggression, however, did not significantly predict time to onset of hypomanic/manic episodes, controlling for the same covariates. The findings suggest that approach-related behaviors may be utilized to delay the onset of major depressive episodes among people with BSDs. Copyright © 2016. Published by Elsevier Ltd.

  4. PROBABILISTIC ANALYSIS OF DEPRESSIVE EPISODES: APPLICATION OF RENEWAL THEORY UNDER UNIFORM PROBABILITY LAW.

    Directory of Open Access Journals (Sweden)

    Runjun Phookun

    2013-04-01

    Full Text Available The renewal process has been formulated on the basis of hazard rate of time between two consecutive occurrences of depressive episodes. The probabilistic analysis of depressive episodes can be performed under various forms of hazard rate viz. constant, linear etc. In this paper we are considering a particular form of hazard rate which is h(x=(b-x^- where b is a constant, x is the time between two consecutive episodes of depression. As a result time between two consecutive occurrences of depressive episodes follows uniform distribution in (a,b The distribution of range i.e. the difference between the longest and the shortest occurrence time to a depressive episode, and the expected number of depressive episodes in a random interval of time are obtained for the distribution under consideration. If the closed form of expression for the waiting time distribution is not available, then the Laplace transformation is used for the study of probabilistic analysis. Hazard rate of occurrence and expected number of depressive episodes have been presented graphically

  5. Differences in diagnostic subtypes among patients with late and early onset of a single depressive episode

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel

    2006-01-01

    OBJECTIVE: It is unclear whether patients with late onset and patients with early onset present with different subtypes of depression. The aim of the study was to compare the prevalence of subtypes of ICD-10 single depressive episodes for patients with late onset (age >65 years) and patient...... with early onset (age single depressive episode in a period from 1994-2002 at the end of the first outpatient treatment or at the first discharge from...... psychiatric hospitalisation ever in Denmark were identified in a nationwide register. RESULTS: In total, 18.192 patients were given a diagnosis of a single depressive episode at the first outpatient contact and 8.396 patients were given a diagnosis of a single depressive episode at the first psychiatric...

  6. The Efficacy of Acute Electroconvulsive Therapy in Atypical Depression

    Science.gov (United States)

    Husain, Mustafa M.; McClintock, Shawn M.; Rush, A. John; Knapp, Rebecca G.; Fink, Max; Rummans, Teresa A.; Rasmussen, Keith; Claassen, Cynthia; Petrides, Georgios; Biggs, Melanie M.; Mueller, Martina; Sampson, Shirlene; Bailine, Samuel H.; Lisanby, Sarah H.; Kellner, Charles H.

    2013-01-01

    Objective This study examined the characteristics and outcomes of patients with major depressive disorder (MDD), with or without atypical features, who were treated with acute bilateral electroconvulsive therapy (ECT). Method Analyses were conducted with 489 patients who met DSM-IV criteria for MDD. Subjects were identified as typical or atypical on the basis of the Structured Clinical Interview for DSM-IV obtained at baseline prior to ECT. Depression symptom severity was measured by the 24-item Hamilton Rating Scale for Depression (HAM-D24) and the 30-item Inventory of Depressive Symptomatology–Self-Report (IDS-SR30). Remission was defined as at least a 60% decrease from baseline in HAM-D24 score and a total score of 10 or below on the last 2 consecutive HAM-D24 ratings. The randomized controlled trial was performed from 1997 to 2004. Results The typical (N = 453) and atypical (N = 36) groups differed in several sociodemographic and clinical variables including gender (p = .0071), age (p = .0005), treatment resistance (p = .0014), and age at first illness onset (p < .0001) and onset of current episode (p = .0008). Following an acute course of bilateral ECT, a considerable portion of both the typical (67.1%) and the atypical (80.6%) groups reached remission. The atypical group was 2.6 (95% CI = 1.1 to 6.2) times more likely to remit than the typical group after adjustment for age, psychosis, gender, clinical site, and depression severity based on the HAM-D24. Conclusion Acute ECT is an efficacious treatment for depressed patients with typical or atypical symptom features. PMID:18278988

  7. Risk of Recurrent Pancreatitis and Progression to Chronic Pancreatitis After a First Episode of Acute Pancreatitis

    NARCIS (Netherlands)

    Ahmed Ali, Usama; Issa, Yama; Hagenaars, Julia C.; Bakker, Olaf J.; van Goor, Harry; Nieuwenhuijs, Vincent B.; Bollen, Thomas L.; van Ramshorst, Bert; Witteman, Ben J.; Brink, Menno A.; Schaapherder, Alexander F.; Dejong, Cornelis H.; Spanier, B. W. Marcel; Heisterkamp, Joos; van der Harst, Erwin; van Eijck, Casper H.; Besselink, Marc G.; Gooszen, Hein G.; van Santvoort, Hjalmar C.; Boermeester, Marja A.

    2016-01-01

    Patients with a first episode of acute pancreatitis can develop recurrent or chronic pancreatitis (CP). However, little is known about the incidence or risk factors for these events. We performed a cross-sectional study of 669 patients with a first episode of acute pancreatitis admitted to 15 Dutch

  8. Risk of Recurrent Pancreatitis and Progression to Chronic Pancreatitis After a First Episode of Acute Pancreatitis

    NARCIS (Netherlands)

    Ahmed Ali, Usama; Issa, Yama; Hagenaars, Julia C.; Bakker, Olaf J.; van Goor, Harry; Nieuwenhuijs, Vincent B.; Bollen, Thomas L.; van Ramshorst, Bert; Witteman, Ben J.; Brink, Menno A.; Schaapherder, Alexander F.; Dejong, Cornelis H.; Spanier, B. W Marcel; Heisterkamp, Joos; van der Harst, Erwin; van Eijck, Casper H.; Besselink, Marc G.; Gooszen, Hein G.; van Santvoort, Hjalmar C.; Boermeester, Marja A.

    2016-01-01

    Background & Aims: Patients with a first episode of acute pancreatitis can develop recurrent or chronic pancreatitis (CP). However, little is known about the incidence or risk factors for these events. Methods: We performed a cross-sectional study of 669 patients with a first episode of acute

  9. Risk of Recurrent Pancreatitis and Progression to Chronic Pancreatitis After a First Episode of Acute Pancreatitis

    NARCIS (Netherlands)

    Ali, U.A.; Issa, Y.; Hagenaars, J.C.; Bakker, O.J.; Goor, H. van; Nieuwenhuijs, V.B.; Bollen, T.L.; Ramshorst, B. van; Witteman, B.J.; Brink, M.A.; Schaapherder, A.F.; Dejong, C.H.; Spanier, B.W.; Heisterkamp, J.; Harst, E. van der; Eijck, C.H. van; Besselink, M.G.; Gooszen, H.G.; Santvoort, H.C. van; Boermeester, M.A.

    2016-01-01

    BACKGROUND & AIMS: Patients with a first episode of acute pancreatitis can develop recurrent or chronic pancreatitis (CP). However, little is known about the incidence or risk factors for these events. METHODS: We performed a cross-sectional study of 669 patients with a first episode of acute

  10. The association of major depressive episode and personality traits in patients with fibromyalgia

    Directory of Open Access Journals (Sweden)

    Danyella de Melo Santos

    2011-01-01

    Full Text Available INTRODUCTION: Personality traits have been associated with primary depression. However, it is not known whether this association takes place in the case of depression comorbid with fibromyalgia. OBJECTIVE: The authors investigated the association between a current major depressive episode and temperament traits (e.g., harm avoidance. METHOD: A sample of 69 adult female patients with fibromyalgia was assessed with the Temperament and Character Inventory. Psychiatric diagnoses were assessed with the Mini-International Neuropsychiatric Interview severity of depressive symptomatology with the Beck Depression Inventory, and anxiety symptomatology with the IDATE-state and pain intensity with a visual analog scale. RESULTS: A current major depressive episode was diagnosed in 28 (40.5% of the patients. They presented higher levels of harm avoidance and lower levels of cooperativeness and self-directedness compared with non-depressed patients, which is consistent with the Temperament and Character Inventory profile of subjects with primary depression. However, in contrast to previous results in primary depression, no association between a major depressive episode and self-transcendence was found. CONCLUSIONS: The results highlight specific features of depression in fibromyalgia subjects and may prove important for enhancing the diagnosis and prognosis of depression in fibromyalgia patients.

  11. Does age at onset of first major depressive episode indicate the subtype of major depressive disorder?: the clinical research center for depression study.

    Science.gov (United States)

    Park, Seon-Cheol; Hahn, Sang-Woo; Hwang, Tae-Yeon; Kim, Jae-Min; Jun, Tae-Youn; Lee, Min-Soo; Kim, Jung-Bum; Yim, Hyeon-Woo; Park, Yong Chon

    2014-11-01

    The purpose of this study was to evaluate the effects of age at onset of the first major depressive episode on the clinical features of individuals with major depressive disorder (MDD) in a large cohort of Korean depressed patients. We recruited 419 MDD patients of age over 18 years from the Clinical Research Center for Depression study in South Korea. At the start of the study, the onset age of the first major depressive episode was self-reported by the subjects. The subjects were divided into four age-at-onset subgroups: childhood and adolescent onset (ages depressive episodes (F=3.475, p=0.016) and higher scores on the brief psychiatric rating scale (F=3.254, p=0.022), its negative symptom subscale (F=6.082, pdepressive episode is a promising clinical indicator for the clinical presentation, course, and outcome of MDD.

  12. Aberrant topology of striatum's connectivity is associated with the number of episodes in depression.

    Science.gov (United States)

    Meng, Chun; Brandl, Felix; Tahmasian, Masoud; Shao, Junming; Manoliu, Andrei; Scherr, Martin; Schwerthöffer, Dirk; Bäuml, Josef; Förstl, Hans; Zimmer, Claus; Wohlschläger, Afra M; Riedl, Valentin; Sorg, Christian

    2014-02-01

    In major depressive disorder, depressive episodes reoccur in ∼60% of cases; however, neural mechanisms of depressive relapse are poorly understood. Depressive episodes are characterized by aberrant topology of the brain's intrinsic functional connectivity network, and the number of episodes is one of the most important predictors for depressive relapse. In this study we hypothesized that specific changes of the topology of intrinsic connectivity interact with the course of episodes in recurrent depressive disorder. To address this hypothesis, we investigated which changes of connectivity topology are associated with the number of episodes in patients, independently of current symptoms and disease duration. Fifty subjects were recruited including 25 depressive patients (two to 10 episodes) and 25 gender- and age-matched control subjects. Resting-state functional magnetic resonance imaging, Harvard-Oxford brain atlas, wavelet-transformation of atlas-shaped regional time-series, and their pairwise Pearson's correlation were used to define individual connectivity matrices. Matrices were analysed by graph-based methods, resulting in outcome measures that were used as surrogates of intrinsic network topology. Topological scores were subsequently compared across groups, and, for patients only, related with the number of depressive episodes and current symptoms by partial correlation analysis. Concerning the whole brain connectivity network of patients, small-world topology was preserved but global efficiency was reduced and global betweenness-centrality increased. Aberrant nodal efficiency and centrality of regional connectivity was found in the dorsal striatum, inferior frontal and orbitofrontal cortex as well as in the occipital and somatosensory cortex. Inferior frontal changes were associated with current symptoms, whereas aberrant right putamen network topology was associated with the number of episodes. Results were controlled for effects of total grey matter

  13. Pathway for inpatients with depressive episode in Flemish psychiatric hospitals: a qualitative study

    Directory of Open Access Journals (Sweden)

    Simoens Steven R

    2009-10-01

    Full Text Available Abstract Background Within the context of a biopsychosocial model of the treatment of depressive episodes, a multidisciplinary approach is needed. Clinical pathways have been developed and implemented in hospitals to support multidisciplinary teamwork. The aim of this study is to explore current practice for the treatment of depressive episodes in Flemish psychiatric hospitals. Current practice in different hospitals is studied to get an idea of the similarities (outlined as a pathway and the differences in the treatment of depressive episodes. Methods A convenience sample of 11 Flemish psychiatric hospitals participated in this qualitative study. Semi-structured interviews were conducted with different types of health care professionals (n = 43. The websites of the hospitals were searched for information on their approach to treating depressive episodes. Results A flow chart was made including the identified stages of the pathway: pre-admission, admission (observation and treatment, discharge and follow-up care. The characteristics of each stage are described. Although the stages are identified in all hospitals, differences between hospitals on various levels of the pathway exist. Hospitals emphasized the individual approach of each patient. The results point to a biopsychosocial approach to treating depressive episodes. Conclusion This study outlined current practice as a pathway for Flemish inpatients with depressive episodes. Within the context of surveillance of quality and quantity of care, this study may encourage hospitals to consider developing clinical pathways.

  14. Episodic memory and executive functioning in currently depressed patients compared to healthy controls.

    Science.gov (United States)

    Pauls, Franz; Petermann, Franz; Lepach, Anja Christina

    2015-01-01

    At present, little is still known about the link between depression, memory and executive functioning. This study examined whether there are memory-related impairments in depressed patients and whether the size of such deficits depends on the age group and on specific types of cognitive measures. Memory performances of 215 clinically depressed patients were compared to the data of a matched control sample. Regression analyses were performed to determine the extent to which executive dysfunctions contributed to episodic memory impairments. When compared with healthy controls, significantly lower episodic memory and executive functioning performances were found for depressed patients of all age groups. Effect sizes appeared to vary across different memory and executive functioning measures. The extent to which executive dysfunctions could explain episodic memory impairments varied depending on the type of measure examined. These findings emphasise the need to consider memory-related functioning of depressed patients in the context of therapeutic treatments.

  15. Within-person Changes in Individual Symptoms of Depression Predict Subsequent Depressive Episodes in Adolescents: A Prospective Study

    Science.gov (United States)

    Kouros, Chrystyna D.; Morris, Matthew C.; Garber, Judy

    2015-01-01

    The current longitudinal study examined which individual symptoms of depression uniquely predicted a subsequent Major Depressive Episode (MDE) in adolescents, and whether these relations differed by sex. Adolescents (N=240) were first interviewed in grade 6 (M=11.86 years old; SD = 0.56; 54% female; 81.5% Caucasian) and then annually through grade 12 regarding their individual symptoms of depression as well as the occurrence of MDEs. Individual symptoms of depression were assessed with the Children’s Depression Rating Scale-Revised (CDRS-R) and depressive episodes were assessed with the Longitudinal Interval Follow-up Evaluation (LIFE). Results showed that within-person changes in sleep problems and low self-esteem/excessive guilt positively predicted an increased likelihood of an MDE for both boys and girls. Significant sex differences also were found. Within-person changes in anhedonia predicted an increased likelihood of a subsequent MDE among boys, whereas irritability predicted a decreased likelihood of a future MDE among boys, and concentration difficulties predicted a decreased likelihood of an MDE in girls. These results identified individual depressive symptoms that predicted subsequent depressive episodes in male and female adolescents, and may be used to guide the early detection, treatment, and prevention of depressive disorders in youth. PMID:26105209

  16. Do depressive episodes lead to accumulation of vulnerability in the elderly?

    NARCIS (Netherlands)

    Oldehinkel, AJ; van den Berg, MD; Bouhuys, AL; Ormel, J

    2003-01-01

    The vulnerability-accumulation (or scarring) hypothesis postulates that the experience of depression induces a lasting increase in vulnerability, and through this raises the risk of recurrence. We examined the validity of the vulnerability-accumulation model for depressive episodes in later life.

  17. Maternal Depressive Symptoms as a Predictor of Alcohol Use Onset and Heavy Episodic Drinking in Youths

    Science.gov (United States)

    Lamis, Dorian A.; Malone, Patrick S.; Lansford, Jennifer E.; Lochman, John E.

    2012-01-01

    Objective: The current study addressed a gap in the literature by investigating the association between maternal depressive symptoms and subsequent timing of their children's alcohol use onset and heavy episodic drinking (HED). Childhood depression/dysthymia symptoms, harsh discipline, and parental positive regard were examined as potential…

  18. Rapid Evolution from the First Episode of Acute Pancreatitis to Chronic Pancreatitis in Human Subjects

    OpenAIRE

    Elie Aoun; Adam Slivka; Dionysios J Papachristou; David C Whitcomb; Ferga C Gleeson; Georgios I Papachristou

    2007-01-01

    Context Growing evidence suggests that recurrent acute pancreatitis leads to chronic pancreatitis, but this sequence is seldom reported in human subjects. The sentinel acute pancreatitis event hypothesis suggests that an initial episode of acute pancreatitis is the first step in a complicated series of events ultimately leading to chronic pancreatitis. Objective To identify patients who evolved from recurrent acute pancreatitis to chronic pancreatitis. Setting The Severity of Acute Pancreatit...

  19. Do stressful life events predict medical treatment outcome in first episode of depression?

    DEFF Research Database (Denmark)

    Bock, Camilla; Bukh, Jens Drachmann; Vinberg, Maj

    2009-01-01

    BACKGROUND: It is unclear whether medical treatment outcome in first episode depression differ for patients with and without stressful life events prior to onset of depression. METHODS: Patients discharged with a diagnosis of a single depressive episode from a psychiatric in- or outpatient hospital......-II) and the interview of recent life events (IRLE). Medical treatment history was assessed in detail using standardised procedures (TRAQ). Remission was defined as a score or= 4 on TRAQ following (1) first trial of antidepressant treatment (2) two adequate trials of antidepressant treatment. RESULTS: A total of 399...... patients participated in the interview and among these 301 patients obtained a SCAN diagnosis of a single depressive episode. A total of 62.8% of the 301 patients experienced at least one moderate to severe stressful life event in a 6 months period prior to symptom onset. The presence of a stressful life...

  20. 'Theory of mind' skills during an acute episode of psychosis and following recovery.

    Science.gov (United States)

    Drury, V M; Robinson, E J; Birchwood, M

    1998-09-01

    A neuropsychological formulation of schizophrenia has suggested that problems with meta-representation underpin both positive and negative symptoms. This study tested Frith's account by asking patients experiencing an acute episode of psychosis to complete a set of tasks that involved Theory of Mind (ToM) skills. Fourteen patients who fulfilled criteria for schizophrenia, 10 deluded patients who were suffering from psychotic disorders other than schizophrenia and 12 depressed patients completed second-order false belief tasks, a test which involved substitution of a co-referential term in a linguistic description of an event, and metaphor and irony tasks. The battery of tests was completed during the acute phase and following recovery. Selection of these patient groups allowed comparisons to be made between schizophrenia patients and non-schizophrenia patients and between patients with and without persecutory delusions. Schizophrenia patients, who had a multiplicity of positive and negative symptoms, performed significantly worse than non-schizophrenia patients on some of the ToM tasks during an acute episode. Patients with delusions of persecution and reference did not perform significantly worse than non-deluded patients on ToM tasks. There was no significant difference between groups in performance on any of the tasks at recovery. The results provide at best weak support for Frith's account and it remains unclear whether the ToM deficits demonstrated are genuine deficits or are a result of information-processing overload. However, it is clear that difficulties interpreting interpersonal contexts, as shown by some schizophrenia patients, are state rather than trait characteristics.

  1. Daylight Savings Time Transitions and the Incidence Rate of Unipolar Depressive Episodes.

    Science.gov (United States)

    Hansen, Bertel T; Sønderskov, Kim M; Hageman, Ida; Dinesen, Peter T; Østergaard, Søren D

    2017-05-01

    Daylight savings time transitions affect approximately 1.6 billion people worldwide. Prior studies have documented associations between daylight savings time transitions and adverse health outcomes, but it remains unknown whether they also cause an increase in the incidence rate of depressive episodes. This seems likely because daylight savings time transitions affect circadian rhythms, which are implicated in the etiology of depressive disorder. Therefore, we investigated the effects of daylight savings time transitions on the incidence rate of unipolar depressive episodes. Using time series intervention analysis of nationwide data from the Danish Psychiatric Central Research Register from 1995 to 2012, we compared the observed trend in the incidence rate of hospital contacts for unipolar depressive episodes after the transitions to and from summer time to the predicted trend in the incidence rate. The analyses were based on 185,419 hospital contacts for unipolar depression and showed that the transition from summer time to standard time were associated with an 11% increase (95% CI = 7%, 15%) in the incidence rate of unipolar depressive episodes that dissipated over approximately 10 weeks. The transition from standard time to summer time was not associated with a parallel change in the incidence rate of unipolar depressive episodes. This study shows that the transition from summer time to standard time was associated with an increase in the incidence rate of unipolar depressive episodes. Distress associated with the sudden advancement of sunset, marking the coming of a long period of short days, may explain this finding. See video abstract at, http://links.lww.com/EDE/B179.

  2. Experimental Effects of Acute Exercise on Iconic Memory, Short-Term Episodic, and Long-Term Episodic Memory

    Directory of Open Access Journals (Sweden)

    Danielle Yanes

    2018-06-01

    Full Text Available The present experiment evaluated the effects of acute exercise on iconic memory and short- and long-term episodic memory. A two-arm, parallel-group randomized experiment was employed (n = 20 per group; Mage = 21 year. The experimental group engaged in an acute bout of moderate-intensity treadmill exercise for 15 min, while the control group engaged in a seated, time-matched computer task. Afterwards, the participants engaged in a paragraph-level episodic memory task (20 min delay and 24 h delay recall as well as an iconic memory task, which involved 10 trials (at various speeds from 100 ms to 800 ms of recalling letters from a 3 × 3 array matrix. For iconic memory, there was a significant main effect for time (F = 42.9, p < 0.001, η2p = 0.53 and a trend towards a group × time interaction (F = 2.90, p = 0.09, η2p = 0.07, but no main effect for group (F = 0.82, p = 0.37, η2p = 0.02. The experimental group had higher episodic memory scores at both the baseline (19.22 vs. 17.20 and follow-up (18.15 vs. 15.77, but these results were not statistically significant. These findings provide some suggestive evidence hinting towards an iconic memory and episodic benefit from acute exercise engagement.

  3. SYMPTOM AND FUNCTIONAL TRAITS OF BRIEF MAJOR DEPRESSIVE EPISODES AND DISCRIMINATION OF BEREAVEMENT.

    Science.gov (United States)

    McCabe, Patrick J; Christopher, Paul P

    2016-02-01

    Despite the removal of the bereavement exclusion from DSM-5, clinicians may feel uncertain on how to proceed when caring for a patient who presents with depressive symptoms following the death of someone close. The ability to better distinguish, on a symptom and functional level, between patients who experience depression in the context of bereavement and those with nonbereavement-related depression, could help guide clinical decision making. Individual and clustered depressive symptom and impairment measures were used for modeling bereavement status within a nationally representative longitudinal cohort. Deviance, linear shrinkage factor, and bias-corrected c-statistic were used for identifying a well-calibrated and discriminating final model. Of the 450 (1.2%) respondents with a single brief major depressive episode, 162 (38.4%) reported the episode as bereavement-related. The bereaved were less likely to endorse worthlessness (P depressive episodes following the death of a loved one from other brief episodes. These differences can help guide clinical care of patients who present with depressive symptoms shortly after a loved one's death. © 2015 Wiley Periodicals, Inc.

  4. Cognitive impairment and medial temporal lobe structure in young adults with a depressive episode.

    Science.gov (United States)

    Donix, Markus; Haussmann, Robert; Helling, Franziska; Zweiniger, Anne; Lange, Jan; Werner, Annett; Donix, Katharina L; Brandt, Moritz D; Linn, Jennifer; Bauer, Michael; Buthut, Maria

    2018-09-01

    Cognitive deficits are common in patients with a depressive episode although the predictors for their development and severity remain elusive. We investigated whether subjective and objective cognitive impairment in young depressed adults would be associated with cortical thinning in medial temporal subregions. High-resolution magnetic resonance imaging, cortical unfolding data analysis, and comprehensive assessments of subjective and objective cognitive abilities were performed on 27 young patients with a depressive episode (mean age: 29.0 ± 5.8 years) and 23 older participants without a history of a depressive disorder but amnestic mild cognitive impairment (68.5 ± 6.6 years) or normal cognition (65.2 ± 8.7 years). Thickness reductions in parahippocampal, perirhinal and fusiform cortices were associated with subjective memory deficits only among young patients with a depressive episode and a measurable cognitive impairment. Long-term longitudinal data would be desirable to determine the trajectories of cognitive impairment associated with depression in patients with or without cortical structure changes. The presence of clinically significant cognitive deficits in young people with a depressive episode may identify a patient population with extrahippocampal cortical thinning. Copyright © 2018 Elsevier B.V. All rights reserved.

  5. Overtime Work as a Predictor of Major Depressive Episode: A 5-Year Follow-Up of the Whitehall II Study

    OpenAIRE

    Virtanen, Marianna; Stansfeld, Stephen A.; Fuhrer, Rebecca; Ferrie, Jane E.; Kivim?ki, Mika

    2012-01-01

    Background The association between overtime work and depression is still unclear. This study examined the association between overtime work and the onset of a major depressive episode (MDE). Methodology/Principal Findings Prospective cohort study with a baseline examination of working hours, psychological morbidity (an indicator of baseline depression) and depression risk factors in 1991?1993 and a follow-up of major depressive episode in 1997?1999 (mean follow-up 5.8 years) among British civ...

  6. Presence of depressive symptoms in patients with a first episode of acute Coronary Syndrome Presencia de síntomas depresivos en pacientes con primer episodio de Síndrome coronario agudo Presença de sintomas depressivos em pacientes com primeiro episódio de Síndrome coronariana aguda

    Directory of Open Access Journals (Sweden)

    Carina Aparecida Marosti Dessotte

    2013-02-01

    Full Text Available AIM: to compare possible differences regarding the presence of depressive symptoms according to the clinical diagnosis of Acute Coronary Syndrome, gender and age, one week before the first cardiac event. METHOD: cross-sectional, descriptive and exploratory study, which used the Beck Depression Inventory. The sample consisted of 253 patients. RESULTS: it was found that patients with a clinical diagnosis of unstable angina, female and under 60 years of age reported the presence of depressive symptoms more frequently. CONCLUSION: a high percentage of patients presented depressive symptoms at the time of hospitalization for the first episode of Acute Coronary Syndrome, and this prevalence was significantly higher among women, under 60 years of age, with unstable angina. These results should provide support for the care in the hospitalization, discharge and planning of the rehabilitation of these patients, as it is known that depression impairs the control of coronary disease.OBJETIVO: comparar posibles diferencias en cuanto a la presencia de síntomas depresivos según el diagnóstico clínico del Síndrome Coronario Agudo, sexo y banda etaria, una semana antes del primer evento cardíaco. MÉTODO: estudio transversal, descriptivo y exploratorio, que utilizó el Inventario de Depresión de Beck. La muestra fue compuesta por 253 pacientes. RESULTADOS: los pacientes con diagnóstico clínico de angina inestable, del sexo femenino y con edad inferior a sesenta años relataron con mayor frecuencia la presencia de síntomas depresivos. CONCLUSIONES: un elevado porcentaje de pacientes presentaba síntomas depresivos en el momento de la internación por el primer episodio del Síndrome Coronario Agudo, y esa superioridad fue significativamente mayor entre las mujeres, con menos de 60 años y con angina inestable. Estos resultados deberán hacer el embasamiento el servicio en la internación, alta y planificación de la rehabilitación de eses pacientes

  7. Co-morbid depressive disorder is associated with better neurocognitive performance in first episode schizophrenia spectrum.

    Science.gov (United States)

    Herniman, Sarah E; Cotton, Sue M; Killackey, Eóin; Hester, Robert; Allott, Kelly A

    2018-03-15

    Both major depressive disorder (MDD) and first episode schizophrenia spectrum (FES) are associated with significant neurocognitive deficits. However, it remains unclear whether the neurocognitive deficits in individuals with FES are more severe if there is comorbid depressive disorder. The aim of this study was to compare the neurocognitive profiles between those with and without full-threshold depressive disorder in FES. This study involved secondary analysis of baseline data from a randomized controlled trial of vocational intervention for young people with first-episode psychosis (N = 82; age range: 15-25 years). Those with full-threshold depressive disorder (n = 24) had significantly better information processing speed than those without full-threshold depressive disorder. Severity of depressive symptoms was also associated with better information processing speed. In additional to the cross-sectional design, limitations of this study include the absence of assessing insight as a potential mediator. After the first psychotic episode, it could be speculated that those with better information processing speed may be more likely to develop full-threshold depressive disorder, as their ability to efficiently process information may allow them to be more aware of their situations and environments, and consequently to have greater insight into the devastating consequences of FES. Such novel findings support the examination of full-threshold depressive disorder in relation to neurocognitive performance across illness phases in future work. Copyright © 2018 Elsevier B.V. All rights reserved.

  8. Magnetic resonance imaging findings at the first episode of acute optic neuritis

    DEFF Research Database (Denmark)

    Soelberg, K; Skejoe, H P B; Grauslund, J

    2018-01-01

    BACKGROUND: Optic neuritis (ON) is a focal demyelinating event, which may evolve into multiple sclerosis (MS). OBJECTIVE: To study MRI characteristics in the acute phase of the first ON episode. METHODS: A prospective population-based study was performed on 31 patients with a first episode of acu...

  9. Evidence for efficacy of acute treatment of episodic tension-type headache

    DEFF Research Database (Denmark)

    Moore, R Andrew; Derry, Sheena; Wiffen, Philip J

    2014-01-01

    The International Headache Society (IHS) provides guidance on the conduct of trials for acute treatment of episodic tension-type headache (TTH), a common disorder with considerable disability. Electronic and other searches identified randomised, double-blind trials of oral drugs treating episodic...

  10. Subclinical depressive symptoms and continued cannabis use: predictors of negative outcomes in first episode psychosis.

    Directory of Open Access Journals (Sweden)

    Itxaso González-Ortega

    Full Text Available Although depressive symptoms in first episode psychosis have been associated with cannabis abuse, their influence on the long-term functional course of FEP patients who abuse cannabis is unknown. The aims of the study were to examine the influence of subclinical depressive symptoms on the long-term outcome in first episode-psychosis patients who were cannabis users and to assess the influence of these subclinical depressive symptoms on the ability to quit cannabis use.64 FEP patients who were cannabis users at baseline were followed-up for 5 years. Two groups were defined: (a patients with subclinical depressive symptoms at least once during follow-up (DPG, and (b patients without subclinical depressive symptoms during follow-up (NDPG. Psychotic symptoms were measured using the Positive and Negative Syndrome Scale (PANSS, depressive symptoms using the Hamilton Depression Rating Scale (HDRS-17, and psychosocial functioning was assessed using the Global Assessment of Functioning (GAF. A linear mixed-effects model was used to analyze the combined influence of cannabis use and subclinical depressive symptomatology on the clinical outcome.Subclinical depressive symptoms were associated with continued abuse of cannabis during follow-up (β= 4.45; 95% confidence interval [CI]: 1.78 to 11.17; P = .001 and with worse functioning (β = -5.50; 95% CI: -9.02 to -0.33; P = .009.Subclinical depressive symptoms and continued cannabis abuse during follow-up could be predictors of negative outcomes in FEP patients.

  11. The influence of comorbid personality disorder and neuroticism on treatment outcome in first episode depression

    DEFF Research Database (Denmark)

    Bock, Camilla; Bukh, Jens Drachmann; Vinberg, Maj

    2010-01-01

    setting were consecutively sampled from the Danish Psychiatric Central Research Register. The patients participated in an extensive interview including the Schedules for Clinical Assessment in Neuropsychiatry, the Structured Clinical Interview for DSM-IV Axis II Personality Disorders and a detailed...... of antidepressant treatment, and (2) 2 trials of antidepressant treatment. Further personality traits were assessed by means of the Eysenck Personality Questionnaire. RESULTS: Among a total of 301 patients with a single depressive episode, 31.9% fulfilled diagnostic criteria for at least 1 personality disorder......BACKGROUND: It has never been investigated whether comorbid personality disorder or neuroticism predicts a poor treatment outcome in first episode depression. METHODS: Medically treated patients discharged with a diagnosis of a single depressive episode from a psychiatric in- or outpatient hospital...

  12. Psychosocial functioning in prepubertal major depressive disorders. II. Interpersonal relationships after sustained recovery from affective episode.

    Science.gov (United States)

    Puig-Antich, J; Lukens, E; Davies, M; Goetz, D; Brennan-Quattrock, J; Todak, G

    1985-05-01

    Psychosocial relationships with parents, peers, and siblings, as well as school functioning, were measured at two points in time by parental interview in 21 prepubertal children: during an episode of major depression and after they had sustained an affective recovery from the index episode for at least four months. School functioning was completely normalized, but deficits in the child's intrafamilial and extra-familial relationships had improved only partially. The pattern of improvement was merely quantitative. Moderate deficits during the depressive episode reached, after affective recovery, the level of the normal control group. In contrast, severe deficits only improved to a moderate level of severity. It is suggested that treating the affective disorder is not sufficient in many children with major depression and that efficacy studies of psychotherapeutic interventions in affectively recovered children are needed.

  13. Feelings of worthlessness during a single complicated major depressive episode predict postremission suicide attempt.

    Science.gov (United States)

    Wakefield, J C; Schmitz, M F

    2016-04-01

    To establish which symptoms of major depressive episode (MDE) predict postremission suicide attempts in complicated single-episode cases. Using the nationally representative two-wave National Epidemiologic Survey on Alcohol and Related Conditions data set, we identified wave 1 lifetime single-episode MDE cases in which the episode remitted by the beginning of the wave 2 three-year follow-up period (N = 2791). The analytic sample was further limited to 'complicated' cases (N = 1872) known to have elevated suicide attempt rates, defined as having two or more of the following: suicidal ideation, marked role impairment, feeling worthless, psychomotor retardation, and prolonged (>6 months) duration. Logistic regression analyses showed that, after controlling for wave 1 suicide attempt which significantly predicted postremission suicide attempt (OR = 10.0), the additional complicated symptom 'feelings of worthlessness' during the wave 1 index episode significantly and very substantially predicted postremission suicide attempt (OR = 6.96). Neither wave 1 psychomotor retardation nor wave 1 suicidal ideation nor any of the other wave 1 depressive symptoms were significant predictors of wave 2 suicide attempt. Among depressive symptoms during an MDE, feelings of worthlessness is the only significant indicator of elevated risk of suicide attempt after the episode has remitted, beyond previous suicide attempts. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Two Prospective Studies of Changes in Stress Generation across Depressive Episodes in Adolescents and Emerging Adults

    Science.gov (United States)

    Morris, Matthew C.; Kouros, Chrystyna D.; Hellman, Natalie; Rao, Uma; Garber, Judy

    2014-01-01

    The stress generation hypothesis was tested in two different longitudinal studies examining relations between weekly depression symptom ratings and stress levels in adolescents and emerging adults at varied risk for depression. Participants in Study 1 included 240 adolescents who differed with regard to their mother’s history of depressive disorders. Youth were assessed annually across 6 years (Grades 6 through 12). Consistent with the depression autonomy model, higher numbers of prior major depressive episodes (MDEs) were associated with weaker stress generation effects, such that higher levels of depressive symptoms predicted increases in levels of dependent stressors for adolescents with ≤ 2 prior MDEs, but depressive symptoms were not significantly related to dependent stress levels for youth with ≥ 3 prior MDEs. In Study 2, participants were 32 remitted-depressed and 36 never-depressed young adults who completed a psychosocial stress task to determine cortisol reactivity and were re-assessed for depression and stress approximately eight months later. Stress generation effects were moderated by cortisol responses to a laboratory psychosocial stressor, such that individuals with higher cortisol responses exhibited a pattern consistent with the depression autonomy model, whereas individuals with lower cortisol responses showed a pattern more consistent with the depression sensitization model. Finally, comparing across the two samples, stress generation effects were weaker for older participants and for those with more prior MDEs. The complex, multi-factorial relation between stress and depression is discussed. PMID:25422968

  15. Experimental Effects of Acute Exercise on Iconic Memory, Short-Term Episodic, and Long-Term Episodic Memory.

    Science.gov (United States)

    Yanes, Danielle; Loprinzi, Paul D

    2018-06-11

    The present experiment evaluated the effects of acute exercise on iconic memory and short- and long-term episodic memory. A two-arm, parallel-group randomized experiment was employed ( n = 20 per group; M age = 21 year). The experimental group engaged in an acute bout of moderate-intensity treadmill exercise for 15 min, while the control group engaged in a seated, time-matched computer task. Afterwards, the participants engaged in a paragraph-level episodic memory task (20 min delay and 24 h delay recall) as well as an iconic memory task, which involved 10 trials (at various speeds from 100 ms to 800 ms) of recalling letters from a 3 × 3 array matrix. For iconic memory, there was a significant main effect for time (F = 42.9, p memory scores at both the baseline (19.22 vs. 17.20) and follow-up (18.15 vs. 15.77), but these results were not statistically significant. These findings provide some suggestive evidence hinting towards an iconic memory and episodic benefit from acute exercise engagement.

  16. Clinical utility of Standardised Assessment of Personality - Abbreviated Scale (SAPAS) among patients with first episode depression

    DEFF Research Database (Denmark)

    Bukh, Jens Drachmann; Bock, Camilla; Vinberg, Maj

    2010-01-01

    for comorbid personality disorder among patients suffering from depression would be of clinical use. METHOD: The present study aimed to assess the utility of the Standardised Assessment of Personality - Abbreviated Scale (SAPAS) as a screen for personality disorder in a population of patients recently......BACKGROUND: Personality disorder frequently co-occurs with depression and seems to be associated with a poorer outcome of treatment and increased risk for recurrences. However, the diagnosing of personality disorder can be lengthy and requires some training. Therefore, a brief screening interview...... diagnosed with first episode depression. A total number of 394 patients with an ICD-10 diagnosis of a single depressive episode were sampled consecutively via the Danish Psychiatric Central Research Register during a 2years inclusion period and assessed by the screening interview and, subsequently...

  17. Organizational justice and major depressive episodes in Japanese employees: a cross-sectional study.

    Science.gov (United States)

    Inoue, Akiomi; Kawakami, Norito; Tsuno, Kanami; Tomioka, Kimiko; Nakanishi, Mayuko

    2013-01-01

    Several European studies showed that low organizational justice (i.e., procedural justice and interactional justice) was associated with major depressive disorders. In these studies, however, the diagnosis of major depressive disorders may be underestimated because they identified only individuals who visited a doctor and received a diagnosis. Moreover, these studies did not consider neurotic personality traits, which can affect the occurrence of major depressive disorders. The purpose of the present study was to investigate the cross-sectional association of organizational justice with major depressive episodes in the past 12 months more precisely in Japanese employees. A total of 425 males and 708 females from five branches of a manufacturing company in Japan completed self-administered questionnaires measuring organizational justice, other job stressors (i.e., job strain, social support at work, and effort-reward imbalance), neuroticism, and demographic characteristics. A web-based self-administered version of the computerized Composite International Diagnostic Interview Version 3.0 (CIDI 3.0) was used to assess major depressive episodes. Logistic regression analyses were conducted. In the univariate analysis, low procedural justice and low interactional justice were significantly associated with major depressive episodes in the past 12 months. After adjusting for other job stressors and demographic characteristics, only the association of interactional justice remained significant. The moderating effect of neuroticism on the association of organizational justice with major depressive episodes in the past 12 months was not significant. Low interactional justice may be associated with major depressive disorders regardless or other job stressors or neurotic personality traits.

  18. The association between anomalous self-experiences, self-esteem and depression in first episode schizophrenia

    Directory of Open Access Journals (Sweden)

    Elisabeth Haug

    2016-11-01

    Full Text Available Background: Anomalous self-experiences (ASEs aggregate in schizophrenia spectrum disorders, but the relationship between ASEs, and depression has been studied to a limited extent. Lower self-esteem has been shown to be associated with depression in early psychosis. Our hypothesis is that ASEs in early phases of schizophrenia are linked to lower levels of self-esteem, which in turn is associated with depression. Aim: The aim is to examine the relationship between ASEs, self-esteem and depression in first-episode schizophrenia spectrum disorders.Method: ASEs were assessed in 55 patients with first-episode schizophrenia by means of the Examination of anomalous Self-Experience (EASE instrument. Assessment of depression was based on the Calgary Depression Scale for Schizophrenia (CDSS. Self-esteem was measured using the Rosenberg Self-Esteem Scale (RSES. Symptom severity was assessed using the Structured Clinical Interview for the Positive and Negative Syndrome Scale (SCI-PANSS. Substance misuse was measured with the Drug Use Disorder Identification Test (DUDIT, and alcohol use was measured with the Alcohol Use Disorder Identification Test (AUDIT. Data on childhood adjustment were collected using the Premorbid Adjustment Scale (PAS. Data on childhood trauma were collected using the Norwegian version of the Childhood Trauma Questionnaire, short form (CTQ-SF. Results: Analyses detected a significant association between current depression and ASEs as measured by the EASE in women, but not in men. The effect of ASEs on depression appeared to be mediated by self-esteem. No other characteristics associated with depression influenced the relationship between depression, self-esteem and ASEs. Conclusion: Evaluating ASEs can assist clinicians in understanding patients’ experience of self-esteem and depressive symptoms. The complex interaction between ASEs, self-esteem, depression and suicidality could be a clinical target for the prevention of suicidality

  19. Impaired theory of mind in first-episode schizophrenia: comparison with community, university and depressed controls.

    Science.gov (United States)

    Kettle, Jonathan W L; O'Brien-Simpson, Laurie; Allen, Nicholas B

    2008-02-01

    First order theory of mind, as measured by the 'Reading the Mind in the Eyes Test' Revised, is impaired in schizophrenia. However, no study has investigated whether this occurs in first-episode schizophrenia. Also, it is unclear whether such a deficit is specific to schizophrenia, and whether convenience control samples, particularly undergraduate university students, represent valid comparison groups. This study investigated theory of mind ability, measured by the 'Reading the Mind in the Eyes Test' Revised, in a group of first-episode schizophrenia outpatients (n=13) and three control groups: outpatients with non-psychotic major depression (n=14), individuals from the general community (n=16) and from an undergraduate university course (n=27). The schizophrenia group exhibited significant theory of mind impairments compared to both non-psychiatric control groups but not the depression group. Unexpectedly, the depression group was not significantly impaired compared to the community control group, and the university control group exhibited superior theory of mind ability relative to all three groups. The findings indicate theory of mind deficits in first episode schizophrenia and support the implementation of theory of mind interventions in first-episode schizophrenia treatment programs. Results also indicate that community rather than university control groups represent more valid comparison groups in first-episode schizophrenia research.

  20. Predictive effects of previous episodes on the risk of recurrence in depressive and bipolar disorders

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Andersen, Per Kragh

    2005-01-01

    Findings from several studies have suggested that the risk of recurrence increases with the number of previous episodes in depressive and bipolar disorders. However, a comprehensive and critical review of the literature published during the past century shows that in several previous studies...

  1. Interference control in children with first episode major depression : A brief report

    NARCIS (Netherlands)

    van der Meere, Jaap; Börger, Norbert A.; Pirila, Silja; Sallee, Floyed

    2011-01-01

    The ability to deal with sources of conflict, that is, interference control, was evaluated in a group of 11 children with first episode Major Depression and a peer control group. To this end, the Eriksen and Schultz (1979) task was used. Here, the participant is presented with a stimulus that

  2. Life events, difficulties and onset of depressive episodes in later life

    NARCIS (Netherlands)

    Brilman, EI; Ormel, J

    Background. The importance of stressful life events and long-term difficulties in the onset of episodes of unipolar depression is well established for young and middle-aged persons, but less so for older people. Method. A prospective case-control study was nested in a large community survey of older

  3. Predictors of the Onset of Manic Symptoms and a (Hypo)Manic Episode in Patients with Major Depressive Disorder

    NARCIS (Netherlands)

    Boschloo, Lynn; Spijker, Annet T.; Hoencamp, Erik; Kupka, Ralph; Nolen, Willem A.; Schoevers, Robert A.; Penninx, Brenda W. J. H.

    2014-01-01

    Objective: One third of patients with a major depressive episode also experience manic symptoms or, even, a (hypo) manic episode. Retrospective studies on the temporal sequencing of symptomatology suggest that the majority of these patients report depressive symptoms before the onset of manic

  4. The Natural History of Insomnia: Acute Insomnia and First-onset Depression

    Science.gov (United States)

    Ellis, Jason G.; Perlis, Michael L.; Bastien, Célyne H.; Gardani, Maria; Espie, Colin A.

    2014-01-01

    Study Objectives: While many studies have examined the association between insomnia and depression, no studies have evaluated these associations (1) within a narrow time frame, (2) with specific reference to acute and chronic insomnia, and (3) using polysomnography. In the present study, the association between insomnia and first-onset depression was evaluated taking into account these considerations. Design: A mixed-model inception design. Setting: Academic research laboratory. Participants: Fifty-four individuals (acute insomnia [n = 33], normal sleepers [n = 21]) with no reported history of a sleep disorder, chronic medical condition, or psychiatric illness. Interventions: N/A. Measurements and Results: Participants were assessed at baseline (2 nights of polysomnography and psychometric measures of stress and mood) and insomnia and depression status were reassessed at 3 months. Individuals with acute insomnia exhibited more stress, poorer mood, worse subjective sleep continuity, increased N2 sleep, and decreased N3 sleep. Individuals who transitioned to chronic insomnia exhibited (at baseline) shorter REM latencies and reduced N3 sleep. Individuals who exhibited this pattern in the transition from acute to chronic insomnia were also more likely to develop first-onset depression (9.26%) as compared to those who remitted from insomnia (1.85%) or were normal sleepers (1.85%). Conclusion: The transition from acute to chronic insomnia is presaged by baseline differences in sleep architecture that have, in the past, been ascribed to Major Depression, either as heritable traits or as acquired traits from prior episodes of depression. The present findings suggest that the “sleep architecture stigmata” of depression may actually develop over the course transitioning from acute to chronic insomnia. Citation: Ellis JG; Perlis ML; Bastien CH; Gardani M; Espie CA. The natural history of insomnia: acute insomnia and first-onset depression. SLEEP 2014;37(1):97-106. PMID

  5. Overgeneral autobiographical memory at baseline predicts depressive symptoms at follow-up in patients with first-episode depression.

    Science.gov (United States)

    Liu, Yansong; Zhang, Fuquan; Wang, Zhiqiang; Cao, Leiming; Wang, Jun; Na, Aiguo; Sun, Yujun; Zhao, Xudong

    2016-09-30

    Previous studies have shown that overgeneral autobiographical memory (OGM) is a characteristic of depression. However, there are no studies to explore the association between baseline OGM and depressive symptoms at follow-up in patients with first-episode depression (FE). This study investigated whether baseline OGM predicts depressive symptoms at follow-up in patients with FE. We recruited 125 patients with FE. The participants were divided into remitted group and non-remitted group according to the severity of their depression at 12 months follow-up. The measures consisted of the 17-item Hamilton Depression Rating Scale, Ruminative Response Scale, and Autobiographical Memory Test. Hierarchical linear regression analyses and bootstrap mediation analyses were conducted. The results showed that non-remitted patients had more OGM at baseline. Baseline OGM predicted depressive symptoms at follow-up in patients with FE. Rumination mediated the relationship between baseline OGM and depressive symptoms at follow-up. Our findings highlight OGM as a vulnerability factor involved in the maintenance of depression in patients with FE. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. Psychosocial work factors and first depressive episode: retrospective results from the French national SIP survey.

    Science.gov (United States)

    Niedhammer, Isabelle; Chastang, Jean-François

    2015-10-01

    The objective was to explore the associations between psychosocial work factors and first depressive episode. Additional objectives included the study of the frequency and duration of exposure, and the evaluation of the induction period between exposures and outcome and of the reversibility of the effects. The study was based on a sample of 13,648 men and women from the 2006 national representative French SIP survey. Retrospective evaluation was performed for depressive episode for the whole life history, for psychological demands, skill discretion, social support, tension with the public, reward and work-life imbalance for each job, and within each job before and after each major change, and for time-varying covariates. The outcome was the first depressive episode. Statistical analysis was performed using weighted discrete time logistic regression model. High psychological demands and low social support were risk factors for first depressive episode for both genders. The risk increased with the frequency of exposure to these factors. Associations were found with the frequency of exposure to tension with the public among women and to work-life imbalance among men. The risk increased with the duration of exposure to psychological demands and low social support for both genders, however, these associations become non-significant when recent exposure was taken into account. Past exposure older than 2 years was not associated with the outcome. Associations between psychosocial work factors and first depressive episode were observed, including dose-response associations. However, after removal of the exposure, the risk may be reduced after 2 years.

  7. Interaction between genetic polymorphisms and stressful life events in first episode depression

    DEFF Research Database (Denmark)

    Bukh, Jens Drachmann; Bock, Camilla; Vinberg, Maj

    2009-01-01

    of depression among participants. METHOD: We applied a case-only design, including 290 ethnically homogeneous patients suffering exclusively from first episode depression. Psychiatric mo-morbidity, personality traits and disorders and stressful life events in a six months period preceding onset of depression......BACKGROUND: A polymorphism in the serotonin transporter (5-HTT) gene seems to moderate the influence of stressful life events on depression. However, the results from previous studies of gene-environment interactions in depression are inconsistent and might be confounded by the history......A, 2A, and 2C. RESULTS: The low activity variants of the 5-HTT-linked polymorphic region in the serotonin transporter gene and the Met-allele of a single nucleotide polymorphism (Val66Met) in the gene encoding brain derived neurotrophic factor were independently associated with the presence...

  8. Cortisol responses to psychosocial stress predict depression trajectories: social-evaluative threat and prior depressive episodes as moderators.

    Science.gov (United States)

    Morris, Matthew C; Rao, Uma; Garber, Judy

    2012-12-20

    Alterations of hypothalamic-pituitary-adrenal (HPA) function are well-established in adults with current depression. HPA alterations may persist into remission and confer increased risk for recurrence. A modified version of the Trier Social Stress Test (TSST) was administered at baseline to 32 young adults with remitted major depressive disorder and 36 never-depressed controls. Participants were randomly assigned to either a 'high-stress' condition involving social evaluation or a 'low-stress' control condition. Cortisol concentrations were measured in saliva samples throughout the TSST. Participants were assessed again after 6 months for the occurrence of stressful life events and depressive symptoms/disorders during the follow-up period. Participants who exhibited enhanced cortisol reactivity in the low-stress condition showed increases in depressive symptoms over follow-up, after controlling for stressful life events during the follow-up period. Anticipatory stress cortisol and cortisol reactivity each interacted with history of depressive episodes to predict depression trajectories. The single TSST administration limits conclusions about whether alterations of cortisol reactivity represent trait-like vulnerability factors or consequences ("scars') of past depression. These results extend previous findings on stress sensitivity in depression and suggest that altered HPA function during remission could reflect an endophenotype for vulnerability to depression recurrence. Findings support interactive models of risk for depression recurrence implicating HPA function, depression history, and sensitivity to minor stressors. Results may have implications for interventions that match treatment approaches to profiles of HPA function. Copyright © 2012 Elsevier B.V. All rights reserved.

  9. Medicare Post-Acute Care Episodes and Payment Bundling

    Data.gov (United States)

    U.S. Department of Health & Human Services — Published in Volume 4, Issue 1, of Medicare and Medicaid Research Review, this paper provides an overview of results examining alternative Medicare post-acute care...

  10. Discovery of serum biomarkers predicting development of a subsequent depressive episode in social anxiety disorder.

    Science.gov (United States)

    Gottschalk, M G; Cooper, J D; Chan, M K; Bot, M; Penninx, B W J H; Bahn, S

    2015-08-01

    Although social anxiety disorder (SAD) is strongly associated with the subsequent development of a depressive disorder (major depressive disorder or dysthymia), no underlying biological risk factors are known. We aimed to identify biomarkers which predict depressive episodes in SAD patients over a 2-year follow-up period. One hundred sixty-five multiplexed immunoassay analytes were investigated in blood serum of 143 SAD patients without co-morbid depressive disorders, recruited within the Netherlands Study of Depression and Anxiety (NESDA). Predictive performance of identified biomarkers, clinical variables and self-report inventories was assessed using receiver operating characteristics curves (ROC) and represented by the area under the ROC curve (AUC). Stepwise logistic regression resulted in the selection of four serum analytes (AXL receptor tyrosine kinase, vascular cell adhesion molecule 1, vitronectin, collagen IV) and four additional variables (Inventory of Depressive Symptomatology, Beck Anxiety Inventory somatic subscale, depressive disorder lifetime diagnosis, BMI) as optimal set of patient parameters. When combined, an AUC of 0.86 was achieved for the identification of SAD individuals who later developed a depressive disorder. Throughout our analyses, biomarkers yielded superior discriminative performance compared to clinical variables and self-report inventories alone. We report the discovery of a serum marker panel with good predictive performance to identify SAD individuals prone to develop subsequent depressive episodes in a naturalistic cohort design. Furthermore, we emphasise the importance to combine biological markers, clinical variables and self-report inventories for disease course predictions in psychiatry. Following replication in independent cohorts, validated biomarkers could help to identify SAD patients at risk of developing a depressive disorder, thus facilitating early intervention. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. INFLEXIBLE COGNITION PREDICTS FIRST ONSET OF MAJOR DEPRESSIVE EPISODES IN ADOLESCENCE.

    Science.gov (United States)

    Stange, Jonathan P; Connolly, Samantha L; Burke, Taylor A; Hamilton, Jessica L; Hamlat, Elissa J; Abramson, Lyn Y; Alloy, Lauren B

    2016-04-19

    Major depressive disorder often is characterized by a lack of cognitive and emotional flexibility, resulting in an impaired ability to adapt to situational demands. Adolescence is an important period of risk for the first onset of depression, yet relatively little is known about whether aspects of inflexibility, such as rumination and deficits in attentional shifting, could confer risk for the development of the disorder during this time. In the present study, a sample of 285 never-depressed adolescents completed self-report and behavioral measures of rumination and attentional shifting at a baseline visit, followed by up to 4 years of annual prospective follow-up diagnostic assessments. Survival analyses indicated that adolescents with greater levels of rumination or poorer attentional shifting experienced a shorter time until the first onset of major depressive episodes, even after accounting for baseline symptoms and demographic characteristics. Although girls were twice as likely as boys to experience the first onset of depression, rumination predicted a shorter time until depression onset only for boys. Rumination and attentional shifting were not correlated and predicted time until onset of major depression independently of one another. These results provide evidence that components of cognition that are characterized by rigidity and perseveration confer risk for the first onset of major depression during adolescence. Evaluating rumination and attentional shifting in adolescence may be useful in identifying individuals who are at risk for depression and who may benefit from interventions that target or alter the development of these characteristics. © 2016 Wiley Periodicals, Inc.

  12. Acute unstable depressive syndrome (AUDS is associated more frequently with epilepsy than major depression

    Directory of Open Access Journals (Sweden)

    Iversen Valentina C

    2010-07-01

    Full Text Available Abstract Background Depressive disorders are frequent in epilepsy and associated with reduced seizure control. Almost 50% of interictal depressive disorders have to be classified as atypical depressions according to DSM-4 criteria. Research has mainly focused on depressive symptoms in defined populations with epilepsy (e.g., patients admitted to tertiary epilepsy centers. We have chosen the opposite approach. We hypothesized that it is possible to define by clinical means a subgroup of psychiatric patients with higher than expected prevalence of epilepsy and seizures. We hypothesized further that these patients present with an Acute Unstable Depressive Syndrome (AUDS that does not meet DSM-IV criteria of a Major Depressive Episode (MDE. In a previous publication we have documented that AUDS patients indeed have more often a history of epileptic seizures and abnormal EEG recordings than MDE patients (Vaaler et al. 2009. This study aimed to further classify the differences of depressive symptoms at admittance and follow-up of patients with AUDS and MDE. Methods 16 AUDS patients and 16 age- and sex-matched MDE patients were assessed using the Symptomatic Organic Mental Disorder Assessment Scale (SOMAS, the Montgomery and Åsberg Depression Rating Scale (MADRS, and the Mini-Mental State Test (MMST, at day 2, day 4-6, day 14-16 and 3 months after admittance to a psychiatric emergency unit. Life events were assessed with The Social Readjustment Rating Scale (SRRS and The Life Experience Survey (LES. We also screened for medication serum levels and illicit drug metabolites in urine. Results AUDS patients had significantly higher SOMAS scores (average score at admission 6.6 ± 0.8, reflecting increased symptom fluctuation and motor agitation, and decreased insight and concern compared to MDE patients (2.9 ± 0.7; p Conclusions AUDS patients present with rapidly fluctuating mood symptoms, motor agitation and relative lack of insight and concern. Seizures

  13. Personality traits of Japanese patients in remission from an episode of primary unipolar depression.

    Science.gov (United States)

    von Zerssen, D; Asukai, N; Tsuda, H; Ono, Y; Kizaki, Y; Cho, Y

    1997-07-01

    Personality traits were assessed by means of the Munich Personality Test (MPT) in 75 Japanese subjects, 27 patients in remission from an episode of moderate to severe primary unipolar depression, with melancholic features during one episode or more of the disorder, in 24 patients in remission from other non-organic mental disorders and in 24 healthy controls. Compared with healthy controls, unipolar depressives displayed decreased Frustration Tolerance and elevated Rigidity as well as a stronger Orientation towards Social Norms. No significant difference was found between patients in remission from either unipolar depression or other mental disorders. However, the increase in Rigidity in comparison with healthy subjects was significant in the depressives only whereas the other patients, in contrast to the depressives, had significantly lower scores in Extraversion than the healthy subjects. Our results in Japanese patients are similar to findings of previous German studies, including two high risk studies, in which the same assessment instrument was used. This suggests that, beyond cultural differences, Rigidity, possibly in combination with a strong Orientation towards Social Norms and a reduced Frustration Tolerance, is a stable vulnerability marker for at least the more severe forms of primary unipolar depression.

  14. Herbal medicine for hospitalized patients with severe depressive episode: a retrospective controlled study.

    Science.gov (United States)

    Liu, Lan-Ying; Feng, Bin; Chen, Jiong; Tan, Qing-Rong; Chen, Zheng-Xin; Chen, Wen-Song; Wang, Pei-Rong; Zhang, Zhang-Jin

    2015-01-01

    Herbal medicine is increasingly used in depressed patients. The purpose of this retrospective controlled study was to evaluate the efficacy and safety of herbal medicine treatment of severe depressive episode. A total of 146 severely depressed subjects were selected from patients who were admitted to the Department of Psychosomatics of Tongde Hospital at Hangzhou, China between 1st September 2009 and 30th November 2013. While all were medicated with psychotropic drugs, 78 received additional individualized herbal medicine. The severity of depressive symptoms was measured using 24-item Hamilton Rating Scale for Depression (HAMD-24) at admission and thereafter once weekly during hospital stay. The proportion of patients achieving clinical response and remission and incidence of adverse events were compared. The two groups had similar average length of hospital stay for approximately 28 days and were not different in the use of psychotropic medications. Survival analysis revealed that patients with herbal medicine had significantly higher chance of achieving clinical response [relative risk (RR)=2.179, Pherbal medicine. Patients with herbal medicine experienced remarkably fewer incidences of physical tiredness, headache, palpitation, dry mouth and constipation, but had a significantly higher incidence of digestive discomfort compared to patients without herbal medicine. These results indicate that additional treatment with individualized herbal medicine enhances antidepressant response and reduces certain side effects associated with psychotropic medications. Herbal medicine is an effective and relatively safe therapy for severe depressive episode (Trial Registration: ChiCTR-OCH-13003864). Copyright © 2014 Elsevier B.V. All rights reserved.

  15. Atypical major depressive episode as initial presentation of intracranial germinoma in a male adolescent

    Directory of Open Access Journals (Sweden)

    Chen YT

    2016-12-01

    Full Text Available Yi-Ting Chen,1,3,4 Kuan-Pin Su,2–5 Jane Pei-Chen Chang2–5 1Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan; 2Graduate Institute of Neural and Cognitive Sciences, China Medical University, Taichung, Taiwan; 3School of Medicine, China Medical University, Taichung, Taiwan; 4Department of Psychiatry, China Medical University Hospital, Taichung, Taiwan; 5Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK Abstract: A 17-year-old adolescent boy presented with atypical major depressive episode (MDE without specific focal neurological signs for 6 months. He had a diagnosis of intra­cranial germinoma, and the atypical MDE symptoms subsided after the operation. However, he had a relapse of atypical MDE 7 months after the first surgery. His mood and binge eating symptoms subsided, but intractable body weight gain only partially improved after treatment. When encountering manifestations of depression with atypical features, especially with binge eating symptoms in male children and adolescents, with early onset age, no family history, and prolonged depressive episodes, clinicians should consider not only mood disorders including bipolar spectrum disorders but also organic brain lesions such as intracranial germinoma. Keywords: intracranial germinoma, atypical major depressive episode, binge eating behavior, body weight gain

  16. Maternal depressive symptoms in pediatric major depressive disorder: relationship to acute treatment outcome.

    Science.gov (United States)

    Kennard, Betsy D; Hughes, Jennifer L; Stewart, Sunita M; Mayes, Taryn; Nightingale-Teresi, Jeanne; Tao, Rongrong; Carmody, Thomas; Emslie, Graham J

    2008-06-01

    In the present study, we assess maternal depressive symptoms at the beginning and end of treatment to investigate the possible reciprocal relationship of maternal illness with the child's depressive illness and treatment. We present data on 146 children and their mothers who were participating in a pediatric acute treatment study of fluoxetine. Patients were assessed with the Children's Depression Rating Scale-Revised at baseline and at each treatment visit. Mothers completed the Quick Inventory of Depressive Symptomatology-Self Report at baseline and end of acute treatment. Thirty percent of mothers had moderate to severe levels of depressive symptoms at the child's baseline assessment. Overall, mothers reported improvement in maternal depressive symptoms at the end of their child's acute treatment, although maternal depression was not specifically targeted for intervention. Furthermore, mother's depressive symptoms appear to be associated with the child's depression severity both at the beginning and end of treatment. Mothers with higher levels of depressive symptoms had children with higher levels of depression severity at baseline and over the course of treatment. However, maternal depressive symptoms at baseline had no association with the rate of improvement of child depression severity. This study indicates a positive relationship between the depression severity of mothers and their children. These findings highlight potential areas of intervention in the acute treatment of childhood depression.

  17. Low levels of docosahexaenoic acid identified in acute coronary syndrome patients with depression.

    Science.gov (United States)

    Parker, Gordon B; Heruc, Gabriella A; Hilton, Therese M; Olley, Amanda; Brotchie, Heather; Hadzi-Pavlovic, Dusan; Friend, Cheryl; Walsh, Warren F; Stocker, Roland

    2006-03-30

    As deficiencies in n-3 PUFAs have been linked separately to depression and to cardiovascular disease, they could act as a higher order variable contributing to the established link between depression and cardiovascular disease. We therefore examine the relationship between depression and omega-3 polyunsaturated fatty acids (n-3 PUFA), including total n-3 PUFA, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), in patients with acute coronary syndrome (ACS). Plasma phospholipid levels of n-3 PUFA were measured in 100 patients hospitalized with ACS. Current major depressive episode was assessed by the Composite International Diagnostic Interview (CIDI). Depression severity was assessed by the 18-item Depression in the Medically Ill (DMI-18) measure. Patients clinically diagnosed with current depression had significantly lower mean total n-3 PUFA and DHA levels. Higher DMI-18 depression severity scores were significantly associated with lower DHA levels, with similar but non-significant trends observed for EPA and total n-3 PUFA levels. The finding that low DHA levels were associated with depression variables in ACS patients may explain links demonstrated between cardiovascular health and depression, and may have prophylactic and treatment implications.

  18. Psychosocial work factors and first depressive episode: retrospective results from the French national SIP survey

    OpenAIRE

    Niedhammer , Isabelle; Chastang , Jean-François

    2015-01-01

    International audience; Objectives : The objective was to explore the associations between psychosocial work factors and first depressive episode. Additional objectives included the study of the frequency and duration of exposure, and the evaluation of the induction period between exposures and outcome and of the reversibility of the effects.Methods : The study was based on a sample of 13,648 men and women from the 2006 national representative French SIP survey. Retrospective evaluation was p...

  19. Experimental Investigation of the Time Course Effects of Acute Exercise on False Episodic Memory

    Directory of Open Access Journals (Sweden)

    Ali Siddiqui

    2018-06-01

    Full Text Available Previous experimental work suggests that acute exercise may positively influence the accurate recall of past episodic events. However, few studies have examined whether acute exercise also reduces the number of false episodic memories. We evaluated this paradigm in conjunction with an examination of the temporal effects of acute exercise, which have previously been shown to play an important role in subserving episodic memory function. Twenty young adults participated in three experimental visits, including a non-exercise control visit, a visit involving an acute bout (20 min of moderate-intensity exercise occurring prior to the memory task, and a visit involving an acute bout of exercise occurring during the encoding of the memory task. All visits were counterbalanced and occurred at least 24 h apart. The Deese–Roediger–McDermott (DRM Paradigm, involving a separate word list trial for each visit, was employed to assess accurate and false episodic memory recall. For each visit, a short-term (immediate recall and a long-term (25-min delay memory recall was assessed. For both time points, the visit that involved exercise prior to encoding resulted in better short-term and long-term memory function (F(2 = 11.56, p < 0.001, η2p = 0.38. For both time points, the control visit resulted in a greater number of false memories. These findings suggest that acute moderate-intensity exercise may help to increase the accurate recall of past episodic memories and may help to reduce the rate of false memories.

  20. Recurrent episodic acute kidney injury as presenting manifestation of mitochondrial myopathy

    Directory of Open Access Journals (Sweden)

    T P Matthai

    2014-01-01

    Full Text Available Mitochondrial cytopathies (MC are a rare heterogenous group of disorders with frequent multisystem involvement including uncommon renal manifestations. Acute kidney injury (AKI as the primary manifestation of MC is extremely rare. Here, we report a case of recurrent episodic AKI in an adult male who was subsequently diagnosed to have mitochondrial disease.

  1. Experience of stigma and discrimination reported by people experiencing the first episode of schizophrenia and those with a first episode of depression: The FEDORA project.

    Science.gov (United States)

    Corker, Elizabeth A; Beldie, Alina; Brain, Cecilia; Jakovljevic, Miro; Jarema, Marek; Karamustafalioglu, Oguz; Marksteiner, Josef; Mohr, Pavel; Prelipceanu, Dan; Vasilache, Anamaria; Waern, Margda; Sartorius, Norman; Thornicroft, Graham

    2015-08-01

    To record and measure the nature and severity of stigma and discrimination experienced by people during a first episode of schizophrenia and those with a first episode of major depressive disorder. The Discrimination and Stigma Scale (DISC-12) was used in a cross-sectional survey to elicit service user reports of anticipated and experienced discrimination by 150 people with a diagnosis of first-episode schizophrenia and 176 with a diagnosis of first-episode major depressive disorder in seven countries (Austria, Croatia, Czech Republic, Poland, Romania, Sweden and Turkey). Participants with a diagnosis of major depressive disorder reported discrimination in a greater number of life areas than those with schizophrenia, as rated by the total DISC-12 score (p = .03). With regard to specific life areas, participants with depression reported more discrimination in regard to neighbours, dating, education, marriage, religious activities, physical health and acting as a parent than participants with schizophrenia. Participants with schizophrenia reported more discrimination with regard to the police compared to participants with depression. Stigma and discrimination because of mental illness change in the course of the mental diseases. Future research may take a longitudinal perspective to better understand the beginnings of stigmatisation and its trajectory through the life course and to identify critical periods at which anti-stigma interventions can most effectively be applied. © The Author(s) 2014.

  2. Brief major depressive episode as an essential predictor of the Bipolar Spectrum Disorder

    Directory of Open Access Journals (Sweden)

    Amir Shabani

    2009-02-01

    Full Text Available

    • BACKGROUND: A bipolar spectrum definition presented to help the designation of more appropriate diagnostic criteria for the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V is Ghaemi et al. Bipolar Spectrum Disorder (BSD. The present study evaluates the BSD frequency among inpatients with major depressive disorder (MDD and tries to elucidate the contribution of second degree diagnostic items of BSD in the BSD definition.
    • METHODS: One hundred individuals aged 18-65 with current MDD consecutive admitted in three university affiliated psychiatric center were clinically interviewed. The patients with mental retardation or the history of substance dependence/ abuse were excluded. The interviews were carried out by a trained general practitioner according to an 11-item checklist comprised of criteria C (2 items and D (9 items of Ghaemi et al. BSD.
    • RESULTS: Fifty three males and 47 females entered the study. Patients' mean age was 34.16 ± 9.58. Thirty eight patients (39.2%: 18 males and 20 females met the complete diagnostic criteria of BSD. Early-onset depression (53.0%, recurrent depression (40.0% and treatment resistant depression (38.8% were the most frequent accessory items of BSD, but using logistic regression three items -recurrent major depressive episodes (MDEs, treatment resistant depression, and brief MDE- had the significant weight to predict the BSD. Then, three mentioned items were simultaneously entered the logistic regression model: brif MDE (β = 1.5, EXP (β = 4.52, p = 0.007, treatment resistant depression (β = 1.28, EXP (β = 3.62, p = 0.01, and recurrent MDEs (β = 1.28, EXP (β = 3.62, p = 0.01 had the highest strength in predicting BSD and account for 21-30% of BSD diagnosis variance in sum.
    • CONCLUSIONS: Regarding the greater diagnostic strength of some accessory items – especially brief MDE

    • Managing the acute painful episode in sickle cell disease

      Directory of Open Access Journals (Sweden)

      B. Kaya

      2011-12-01

      Full Text Available Sickle cell pain is a complex but frequently experienced symptom. Acute painful events in children can be managed effectively in the community with appropriate support and education. If hospital management is required, rapid access to a consistent, reliable and safe analgesic pathway is recommended to ensure a good standard of care. Use of oral opiates in addition to short acting easily administrable forms of analgesia and strict adherence to protocoled monitoring will enable the acute event to be well managed and the negative pain experience minimised. An important part of the outpatient evaluation is determining the impact pain events are having on the child’s quality of life. Addressing psycho-social aspects, defining and modifying precipitating factors, if any are identified, and having a holistic approach to pain management is helpful. Education and use of self-management techniques can also be productive. Use of sickle modifying interventions such as hydroxycarbamide therapy or transfusion therapy can have a significant impact on reducing the severity and frequency of the acute pain event. 镰状细胞疼痛是一种复杂的常发症。 通过适当的支助和教育,儿童急性疼痛症可以得到有效抑制。 如果需要在医院进行护理,患者应尽快寻求持续可靠且安全的止痛方式,确保良好的护理。 除采取作用短、管理方便的止痛治疗和遵守监测协议之外,患者还需口服鸦片剂,这样,急性症状可以得到良好的抑制,还可尽量减轻疼痛感。 诊断门诊病人一个重要的部分就是确定疼痛症对患儿生活质量产生的影响。 问询生理社会方面问题,确定和修改诱发因子(如有),并整体分析可行的疼痛护理方法。 教育和使用个人护理法也很有效果。 采用镰状细胞修改干预法,例如羟基尿素疗法或输液疗法,对减轻急性疼痛症和减少发作频率有着显著效果。

    • Psychosocial functioning in prepubertal major depressive disorders. I. Interpersonal relationships during the depressive episode.

      Science.gov (United States)

      Puig-Antich, J; Lukens, E; Davies, M; Goetz, D; Brennan-Quattrock, J; Todak, G

      1985-05-01

      Psychosocial environment and relationships with parents, peers, and siblings of 115 prepubertal children were measured by interview with their parent(s) for the three-month period preceding the assessment. The children had a current diagnosis of major depression (52 children) or nondepressed neurotic disorder (23) or were assessed to be normal (40). Most aspects of psychosocial relationships were found to be significantly impaired in the psychiatric groups. This impairment was generally worse in the depressives and significantly worse for aspects of verbal and affective communication with parents and siblings. Prepubertal children with major depressive disorder regularly present social relation deficits in which two components can be distinguished: one general to childhood psychiatric disorder and another specific to major depression.

    • Rates and predictors of remission, recurrence and conversion to bipolar disorder after the first lifetime episode of depression

      DEFF Research Database (Denmark)

      Bukh, J. D.; Andersen, P. K.; Kessing, L. V.

      2016-01-01

      .6% converted to bipolar disorder (6.3% within the first 2 years). Non-remission increased with younger age, co-morbid anxiety and suicidal ideations. Recurrence increased with severity and treatment resistance of the first depression, and conversion to bipolar disorder with treatment resistance, a family......BACKGROUND: In depression, non-remission, recurrence of depressive episodes after remission and conversion to bipolar disorder are crucial determinants of poor outcome. The present study aimed to determine the cumulative incidences and clinical predictors of these long-term outcomes after the first...... lifetime episode of depression. METHOD: A total of 301 in- or out-patients aged 18-70 years with a validated diagnosis of a single depressive episode were assessed from 2005 to 2007. At 5 years of follow-up, 262 patients were reassessed by means of the life chart method and diagnostic interviews from 2011...

    • Initial depressive episodes affect the risk of suicide attempts in Korean patients with bipolar disorder.

      Science.gov (United States)

      Ryu, Vin; Jon, Duk-In; Cho, Hyun Sang; Kim, Se Joo; Lee, Eun; Kim, Eun Joo; Seok, Jeong-Ho

      2010-09-01

      Suicide is a major concern for increasing mortality in bipolar patients, but risk factors for suicide in bipolar disorder remain complex, including Korean patients. Medical records of bipolar patients were retrospectively reviewed to detect significant clinical characteristics associated with suicide attempts. A total of 579 medical records were retrospectively reviewed. Bipolar patients were divided into two groups with the presence of a history of suicide attempts. We compared demographic characteristics and clinical features between the two groups using an analysis of covariance and chi-square tests. Finally, logistic regression was performed to evaluate significant risk factors associated with suicide attempts in bipolar disorder. The prevalence of suicide attempt was 13.1% in our patient group. The presence of a depressive first episode was significantly different between attempters and nonattempters. Logistic regression analysis revealed that depressive first episodes and bipolar II disorder were significantly associated with suicide attempts in those patients. Clinicians should consider the polarity of the first mood episode when evaluating suicide risk in bipolar patients. This study has some limitations as a retrospective study and further studies with a prospective design are needed to replicate and evaluate risk factors for suicide in patients with bipolar disorder.

    • The transcriptome of a complete episode of acute otitis media.

      Science.gov (United States)

      Hernandez, Michelle; Leichtle, Anke; Pak, Kwang; Webster, Nicholas J; Wasserman, Stephen I; Ryan, Allen F

      2015-04-03

      Otitis media is the most common disease of childhood, and represents an important health challenge to the 10-15% of children who experience chronic/recurrent middle ear infections. The middle ear undergoes extensive modifications during otitis media, potentially involving changes in the expression of many genes. Expression profiling offers an opportunity to discover novel genes and pathways involved in this common childhood disease. The middle ears of 320 WBxB6 F1 hybrid mice were inoculated with non-typeable Haemophilus influenzae (NTHi) or PBS (sham control). Two independent samples were generated for each time point and condition, from initiation of infection to resolution. RNA was profiled on Affymetrix mouse 430 2.0 whole-genome microarrays. Approximately 8% of the sampled transcripts defined the signature of acute NTHi-induced otitis media across time. Hierarchical clustering of signal intensities revealed several temporal gene clusters. Network and pathway enrichment analysis of these clusters identified sets of genes involved in activation of the innate immune response, negative regulation of immune response, changes in epithelial and stromal cell markers, and the recruitment/function of neutrophils and macrophages. We also identified key transcriptional regulators related to events in otitis media, which likely determine the expression of these gene clusters. A list of otitis media susceptibility genes, derived from genome-wide association and candidate gene studies, was significantly enriched during the early induction phase and the middle re-modeling phase of otitis but not in the resolution phase. Our results further indicate that positive versus negative regulation of inflammatory processes occur with highly similar kinetics during otitis media, underscoring the importance of anti-inflammatory responses in controlling pathogenesis. The results characterize the global gene response during otitis media and identify key signaling and transcription factor

    • Risk of Pancreatic Cancer After a Primary Episode of Acute Pancreatitis.

      Science.gov (United States)

      Rijkers, Anton P; Bakker, Olaf J; Ahmed Ali, Usama; Hagenaars, Julia C J P; van Santvoort, Hjalmar C; Besselink, Marc G; Bollen, Thomas L; van Eijck, Casper H

      2017-09-01

      Acute pancreatitis may be the first manifestation of pancreatic cancer. The aim of this study was to assess the risk of pancreatic cancer after a first episode of acute pancreatitis. Between March 2004 and March 2007, all consecutive patients with a first episode of acute pancreatitis were prospectively registered. Follow-up was based on hospital records audit, radiological imaging, and patient questionnaires. Outcome was stratified based on the development of chronic pancreatitis. We included 731 patients. The median follow-up time was 55 months. Progression to chronic pancreatitis was diagnosed in 51 patients (7.0%). In this group, the incidence rate per 1000 person-years for developing pancreatic cancer was 9.0 (95% confidence interval, 2.3-35.7). In the group of 680 patients who did not develop chronic pancreatitis, the incidence rate per 1000 person-years for developing pancreatic cancer in this group was 1.1 (95% confidence interval, 0.3-3.3). Hence, the rate ratio of pancreatic cancer was almost 9 times higher in patients who developed chronic pancreatitis compared with those who did not (P = 0.049). Although a first episode of acute pancreatitis may be related to pancreatic cancer, this risk is mainly present in patients who progress to chronic pancreatitis.

    • Suicide attempts in major depressive episode: evidence from the BRIDGE-II-Mix study.

      Science.gov (United States)

      Popovic, Dina; Vieta, Eduard; Azorin, Jean-Michel; Angst, Jules; Bowden, Charles L; Mosolov, Sergey; Young, Allan H; Perugi, Giulio

      2015-11-01

      The Bipolar Disorders: Improving Diagnosis, Guidance, and Education (BRIDGE-II-Mix) study aimed to estimate the frequency of mixed states in patients with a major depressive episode (MDE) according to different definitions and to compare their clinical validity, looking into specific features such as suicidality. A total of 2,811 subjects were enrolled in this multicenter cross-sectional study. Psychiatric symptoms, and sociodemographic and clinical variables were collected. The analysis compared the characteristics of patients with MDE with (MDE-SA group) and without (MDE-NSA) a history of suicide attempts. The history of suicide attempts was registered in 628 patients (22.34%). In the MDE-SA group, women (72.5%, p = 0.028), (hypo)mania in first-degree relatives (20.5%, p suicide attempts. In the MDE-SA group, 75 patients (11.9%) fulfilled Diagnostic and Statistical Manual (DSM)-5 criteria for MDE with mixed features, and 250 patients (39.8%) fulfilled research-based diagnostic criteria for a mixed depressive episode. Important differences between MDE-SA and MDE-NSA patients have emerged. Early identification of symptoms such as risky behavior, psychomotor agitation, and impulsivity in patients with MDE, and treatment of mixed depressive states could represent a major step in suicide prevention. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

    • Goethe's anxieties, depressive episodes and (self-)therapeutic strategies: a contribution to method integration in psychotherapy.

      Science.gov (United States)

      Holm-Hadulla, Rainer M

      2013-01-01

      In psychiatry and psychotherapy, abstract scientific principles need to be exemplified by narrative case reports to gain practical precision. Goethe was one of the most creative writers, productive scientists, and effective statesmen that ever lived. His descriptions of feelings, emotions, and mental states related to anxieties, depressive episodes, dysthymia, and creativity are unique in their phenomenological precision and richness. His life and work can thus serve as an excellent example enhancing our understanding of the relationship between anxiety, depression and creativity. Furthermore, he described (self-)therapeutic strategies that reinforce and refine modern views. Goethe's self-assessments in his works and letters, and the descriptions by others are analyzed under the perspective of current psychiatric classification. His therapeutic techniques and recommendations are compared with cognitive-behavioral, psychodynamic, and existential psychotherapy to amplify modern concepts of psychotherapy. From a scientific perspective, several distinctive depressive episodes can be diagnosed in Goethe's life. They were characterized by extended depressive moods, lack of drive, and loss of interest and self-esteem combined with social retreat. Goethe displayed diffuse and phobic anxieties as well as dysthymia. His (self-)therapeutic strategies were: (a) the systematic use of helping alliances, (b) behavioral techniques, (c) cognitive reflection on meanings and beliefs, (d) psychodynamic and psychoanalytic remembering, repeating, and working through, and (e) existential striving for self-actualization, social commitment, meaning, and creativity. In Goethe's life, creative incubation, illumination, and elaboration appear to have been associated with psychic instability and dysthymia, sometimes with depressive episodes in a clinical sense. On the one hand, his creative work was triggered by anxieties, dysthymia, and depressive moods. On the other hand, his creativity

    • Diagnostic stability of comorbid personality disorders among patients fully or partially remitted from first-episode depression

      DEFF Research Database (Denmark)

      Bukh, Jens Drachmann; Bech, Per; Kessing, Lars Vedel

      2017-01-01

      The diagnostic stability of comorbid personality disorders among patients with depression remains unclear. A total of 262 patients suffering from first-episode depression were assessed using the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II) and reassessed after 5...

    • The impact of the duration of an untreated episode on improvement of depression and somatic symptoms

      Directory of Open Access Journals (Sweden)

      Hung CI

      2015-08-01

      Full Text Available Ching-I Hung,1,2 Nan-Wen Yu,1,2 Chia-Yih Liu,1,2 Kuan-Yi Wu,1,2 Ching-Hui Yang3 1Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan, 2Chang Gung University College of Medicine, Tao-Yuan, Taiwan; 3Department of Nursing, Chang Gung University of Science and Technology, Tao-Yuan, Taiwan Purpose: The aim of this study was to investigate the impact of the duration of an untreated episode (DUE on the improvement of depression and somatic symptoms among patients with major depressive disorder (MDD, after the patients had received 4 weeks of pharmacotherapy. Methods: In this open-label study, there were 155 participants with MDD who were treated daily with 75 mg of venlafaxine for 4 weeks. DUE was defined as the interval between the onset of the index major depressive episode and the start of pharmacotherapy. The Depression and Somatic Symptoms Scale (DSSS, composed of the depression subscale (DS and the somatic subscale (SS, was used. The SS included the pain subscale (PS and the nonpain somatic subscale (NPSS. Multiple linear regressions were used to test the impacts of DUE on the improvement percentages (IPs of depression and somatic symptoms. Results: Eighty-five subjects completed the 4-week treatment. The IPs of the DS, SS, and NPSS were significantly negatively correlated with DUE. A shorter DUE was related to higher IPs. DUE was an independent factor, predicting the IPs of the DS, SS, and NPSS. DUE <1 month was the most powerful time-point to predict the IPs of the DS, SS, and NPSS. However, DUE was unable to predict the IP of the PS at all time-points. Conclusion: A shorter DUE might be one of the factors related to greater improvement of depression and somatic symptoms. DUE should be considered as an important factor when investigating the prognosis of depression and somatic symptoms. Keywords: early intervention, somatization, treatment response, prognosis, outcome

    • Depression After First Hospital Admission for Acute Coronary Syndrome

      DEFF Research Database (Denmark)

      Osler, Merete; Mårtensson, Solvej; Wium-Andersen, Ida Kim

      2016-01-01

      We examined incidence of depression after acute coronary syndrome (ACS) and whether the timing of depression onset influenced survival. All first-time hospitalizations for ACS (n = 97,793) identified in the Danish Patient Registry during 2001-2009 and a reference population were followed...

    • Does bereavement-related first episode depression differ from other kinds of first depressions?

      DEFF Research Database (Denmark)

      Kessing, Lars Vedel; Bukh, Jens Drachmann; Bock, Camilla

      2009-01-01

      (4.7%) had experienced death of a first degree relative (parent, sibling, child) or a near friend, 163 patients (54.2%) had experienced other moderate to severe stressful life events and 112 patients had not experienced stressful life events in a 6 months period prior to the onset of depression...

    • The reduction of adult neurogenesis in depression impairs the retrieval of new as well as remote episodic memory.

      Science.gov (United States)

      Fang, Jing; Demic, Selver; Cheng, Sen

      2018-01-01

      Major depressive disorder (MDD) is associated with an impairment of episodic memory, but the mechanisms underlying this deficit remain unclear. Animal models of MDD find impaired adult neurogenesis (AN) in the dentate gyrus (DG), and AN in DG has been suggested to play a critical role in reducing the interference between overlapping memories through pattern separation. Here, we study the effect of reduced AN in MDD on the accuracy of episodic memory using computational modeling. We focus on how memory is affected when periods with a normal rate of AN (asymptomatic states) alternate with periods with a low rate (depressive episodes), which has never been studied before. Also, unlike previous models of adult neurogenesis, which consider memories as static patterns, we model episodic memory as sequences of neural activity patterns. In our model, AN adds additional random components to the memory patterns, which results in the decorrelation of similar patterns. Consistent with previous studies, higher rates of AN lead to higher memory accuracy in our model, which implies that memories stored in the depressive state are impaired. Intriguingly, our model makes the novel prediction that memories stored in an earlier asymptomatic state are also impaired by a later depressive episode. This retrograde effect exacerbates with increased duration of the depressive episode. Finally, pattern separation at the sensory processing stage does not improve, but rather worsens, the accuracy of episodic memory retrieval, suggesting an explanation for why AN is found in brain areas serving memory rather than sensory function. In conclusion, while cognitive retrieval biases might contribute to episodic memory deficits in MDD, our model suggests a mechanistic explanation that affects all episodic memories, regardless of emotional relevance.

    • The reduction of adult neurogenesis in depression impairs the retrieval of new as well as remote episodic memory

      Science.gov (United States)

      Fang, Jing; Demic, Selver; Cheng, Sen

      2018-01-01

      Major depressive disorder (MDD) is associated with an impairment of episodic memory, but the mechanisms underlying this deficit remain unclear. Animal models of MDD find impaired adult neurogenesis (AN) in the dentate gyrus (DG), and AN in DG has been suggested to play a critical role in reducing the interference between overlapping memories through pattern separation. Here, we study the effect of reduced AN in MDD on the accuracy of episodic memory using computational modeling. We focus on how memory is affected when periods with a normal rate of AN (asymptomatic states) alternate with periods with a low rate (depressive episodes), which has never been studied before. Also, unlike previous models of adult neurogenesis, which consider memories as static patterns, we model episodic memory as sequences of neural activity patterns. In our model, AN adds additional random components to the memory patterns, which results in the decorrelation of similar patterns. Consistent with previous studies, higher rates of AN lead to higher memory accuracy in our model, which implies that memories stored in the depressive state are impaired. Intriguingly, our model makes the novel prediction that memories stored in an earlier asymptomatic state are also impaired by a later depressive episode. This retrograde effect exacerbates with increased duration of the depressive episode. Finally, pattern separation at the sensory processing stage does not improve, but rather worsens, the accuracy of episodic memory retrieval, suggesting an explanation for why AN is found in brain areas serving memory rather than sensory function. In conclusion, while cognitive retrieval biases might contribute to episodic memory deficits in MDD, our model suggests a mechanistic explanation that affects all episodic memories, regardless of emotional relevance. PMID:29879169

    • Paternal postpartum mood: bipolar episodes? Depressão paterna: episódio bipolar?

      Directory of Open Access Journals (Sweden)

      Karen Amaral Tavares Pinheiro

      2011-09-01

      Full Text Available OBJECTIVE: We describe the prevalence of depressive and bipolar spectrum episodes in fathers in antenatal and postnatal periods, as well as at 12 months after childbirth. METHOD: A longitudinal follow-up study was conducted with a representative sample of 739 fathers whose children were born between April 2007 and May 2008 in maternity wards in the city of Pelotas, southern Brazil. Paternal psychopathology was measured with the Mini Neuropsychiatric Interview (MINI across three time points: between 28 and 34 weeks of pregnancy (T1, 30 to 60 days postpartum (T2, and 12 months after childbirth (T3. RESULTS: The prevalence of depressive episodes was 5.0% at T1, 4.5% at T2, and 4.3% at T3. Mixed episodes were present in 3%, 1.7%, and 0.9% of subjects, respectively, and accounted for 61.1% of the cases of depression in the antenatal period, 37.5% in postpartum, and 21.4% at 12 months. Depressive and manic/hypomanic episodes were significantly associated during pregnancy and in postpartum, but not at 12 months after childbirth. CONCLUSION: Bipolar episodes were common in men with depressive symptoms during their partner's pregnancy in the postpartum period and, to a lesser extent, 12 months after childbirth. Therefore, this population should be carefully investigated for manic and hypomanic symptoms.OBJETIVO: Verificar a prevalência dos episódios depressivos e bipolares em homens no período pré e pós-natal, assim como 12 meses após o parto. MÉTODO: Estudo longitudinal com amostra de pais cujas crianças nasceram entre abril de 2007 e maio de 2008 em maternidades da cidade de Pelotas-RS, no sul do Brasil. Episódios depressivos e maníacos/hipomaníacos foram mensurados com o Mini Neuropsychiatric Interview em três tempos diferentes: entre a 28ª e 34ª semanas de gestação (T1, 30 a 60 dias após o parto (T2 e 12 meses após o nascimento da criança. RESULTADOS: A prevalência de episódios depressivos foi 5,0% em T1, 4,5% em T2 e 4,3% em T3

    • Acute and long-term treatment of late-life major depressive disorder: duloxetine versus placebo.

      Science.gov (United States)

      Robinson, Michael; Oakes, Tina Myers; Raskin, Joel; Liu, Peng; Shoemaker, Scarlett; Nelson, J Craig

      2014-01-01

      To compare the efficacy of duloxetine with placebo on depression in elderly patients with major depressive disorder. Multicenter, 24-week (12-week short-term and 12-week continuation), randomized, placebo-controlled, double-blind trial. United States, France, Mexico, Puerto Rico. Age 65 years or more with major depressive disorder diagnosis (one or more previous episode); Mini-Mental State Examination score ≥20; Montgomery-Asberg Depression Rating Scale total score ≥20. Duloxetine 60 or 120 mg/day or placebo; placebo rescue possible. Primary-Maier subscale of the 17-item Hamilton Depression Rating Scale (HAMD-17) at week 12. Secondary-Geriatric Depression Scale, HAMD-17 total score, cognitive measures, Brief Pain Inventory (BPI), Numeric Rating Scales (NRS) for pain, Clinical Global Impression-Severity scale, Patient Global Impression of Improvement in acute phase and acute plus continuation phase of treatment. Compared with placebo, duloxetine did not show significantly greater improvement from baseline on Maier subscale at 12 weeks, but did show significantly greater improvement at weeks 4, 8, 16, and 20. Similar patterns for Geriatric Depression Scale and Clinical Global Impression-Severity scale emerged, with significance also seen at week 24. There was a significant treatment effect for all BPI items and 4 of 6 NRS pain measures in the acute phase, most BPI items and half of the NRS measures in the continuation phase. More duloxetine-treated patients completed the study (63% versus 55%). A significantly higher percentage of duloxetine-treated patients versus placebo discontinued due to adverse event (15.3% versus 5.8%). Although the antidepressant efficacy of duloxetine was not confirmed by the primary outcome, several secondary measures at multiple time points suggested efficacy. Duloxetine had significant and meaningful beneficial effects on pain. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights

    • Fish consumption and omega-3 polyunsaturated fatty acids in relation to depressive episodes: a cross-sectional analysis.

      Directory of Open Access Journals (Sweden)

      Anna Liisa Suominen-Taipale

      Full Text Available High fish consumption and omega-3 polyunsaturated fatty acid (PUFA intake are suggested to benefit mental well-being but the current evidence is conflicting. Our aim was to evaluate whether a higher level of fish consumption, a higher intake of omega-3 PUFAs, and a higher serum concentration of omega-3 PUFAs link to a lower 12-month prevalence of depressive episodes.We used data from the nationwide Health 2000 Survey (n = 5492 and the Fishermen Study on Finnish professional fishermen and their family members (n = 1265. Data were based on questionnaires, interviews, health examinations, and blood samples. Depressive episodes were assessed with the M-CIDI (the Munich version of the Composite International Diagnostic Interview and a self-report of two CIDI probe questions, respectively. Fish consumption was measured by a food frequency questionnaire (g/day and independent frequency questions (times/month. Dietary intake (g/day and serum concentrations (% from fatty acids of PUFAs were determined. Fish consumption was associated with prevalence of depressive episodes in men but not in women. The prevalence of depressive episodes decreased from 9% to 5% across the quartiles of fish consumption (g/day in men of the Health 2000 Survey (p for linear trend = 0.01, and from17% to 3% across the quartiles of fish consumption (times/month in men of the Fishermen Study (p for linear trend = 0.05. This association was modified by lifestyle; in the Health 2000 Survey a higher level of fish consumption was related to a lower prevalence of depressive episodes in men who consumed the most alcohol, were occasional or former smokers, or had intermediate physical activity. The associations between depressive episodes and the intake or serum concentrations of omega-3 PUFAs were not consistent.In men, fish consumption appears as a surrogate for underlying but unidentified lifestyle factors that protect against depression.

    • Neural correlates of working memory in first episode and recurrent depression: An fMRI study.

      Science.gov (United States)

      Yüksel, Dilara; Dietsche, Bruno; Konrad, Carsten; Dannlowski, Udo; Kircher, Tilo; Krug, Axel

      2018-06-08

      Patients suffering from major depressive disorder (MDD) show deficits in working memory (WM) performance accompanied by bilateral fronto-parietal BOLD signal changes. It is unclear whether patients with a first depressive episode (FDE) exhibit the same signal changes as patients with recurrent depressive episodes (RDE). We investigated seventy-four MDD inpatients (48 RDE, 26 FDE) and 74 healthy control (HC) subjects performing an n-back WM task (0-back, 2-back, 3-back condition) in a 3T-fMRI. FMRI analyses revealed deviating BOLD signal in MDD in the thalamus (0-back vs. 2-back), the angular gyrus (0-back vs. 3-back), and the superior frontal gyrus (2-back vs. 3-back). Further effects were observed between RDE vs. FDE. Thus, RDE displayed differing neural activation in the middle frontal gyrus (2-back vs. 3-back), the inferior frontal gyrus, and the precentral gyrus (0-back vs. 2-back). In addition, both HC and FDE indicated a linear activation trend depending on task complexity. Although we failed to find behavioral differences between the groups, results suggest differing BOLD signal in fronto-parietal brain regions in MDD vs. HC, and in RDE vs. FDE. Moreover, both HC and FDE show similar trends in activation shapes. This indicates a link between levels of complexity-dependent activation in fronto-parietal brain regions and the stage of MDD. We therefore assume that load-dependent BOLD signal during WM is impaired in MDD, and that it is particularly affected in RDE. We also suspect neurobiological compensatory mechanisms of the reported brain regions in (working) memory functioning. Copyright © 2018 Elsevier Inc. All rights reserved.

  1. Influence of depression and anxiety on circulating endothelial progenitor cells in patients with acute coronary syndromes.

    Science.gov (United States)

    Felice, Francesca; Di Stefano, Rossella; Pini, Stefano; Mazzotta, Gianfranco; Bovenzi, Francesco M; Bertoli, Daniele; Abelli, Marianna; Borelli, Lucia; Cardini, Alessandra; Lari, Lisa; Gesi, Camilla; Michi, Paola; Morrone, Doralisa; Gnudi, Luigi; Balbarini, Alberto

    2015-05-01

    Circulating endothelial progenitor cells (EPCs) are related to endothelial function and progression of coronary artery disease. There is evidence of decreased numbers of circulating EPCs in patients with a current episode of major depression. We investigated the relationships between the level of circulating EPCs and depression and anxiety in patients with acute coronary syndrome (ACS). Patients with ACS admitted to three Cardiology Intensive Care Units were evaluated by the SCID-I to determine the presence of lifetime and/or current mood and anxiety disorders according to DSM-IV criteria. The EPCs were defined as CD133(+) CD34(+) KDR(+) and evaluated by flow cytometry. All patients underwent standardized cardiological and psychopathological evaluations. Parametric and nonparametric statistical tests were performed where appropriate. Out of 111 ACS patients, 57 were found to have a DSM-IV lifetime or current mood or anxiety disorder at the time of the inclusion in the study. The ACS group with mood or anxiety disorders showed a significant decrease in circulating EPC number compared with ACS patients without affective disorders. In addition, EPC levels correlated negatively with severity of depression and anxiety at index ACS episode. The current study indicates that EPCs circulate in decreased numbers in ACS patients with depression or anxiety and, therefore, contribute to explore new perspectives in the pathophysiology of the association between cardiovascular disorders and affective disorders. Copyright © 2015 John Wiley & Sons, Ltd.

  2. Effects of three types of potentially biasing information on symptom severity judgments for major depressive episode.

    Science.gov (United States)

    Mumma, Gregory H

    2002-10-01

    Two experiments examined the effects of potentially biasing information on judgments of symptom severity pertaining to the diagnosis of major depressive episode (MDE). In both experiments, clinicians viewed videotapes of two actor-simulated patients responding to questions from a standardized diagnostic interview. In Study 1, an expectancy effect was found for both patients such that prior information about a clear-cut history of depression resulted in lower rated severity of current symptoms. In addition, a halo effect was observed for one patient in Study 1 and both patients in Study 2: Clear-cut depressive nonverbal behavior (DNVB) resulted in greater rated severity for symptoms that should not have been affected (e.g., appetite/weight change, suicidal ideation). Clear-cut versus near-threshold information for the two essential criteria for MDE did not affect subsequent judgments in either study. Implications for diagnostic interviewing are discussed. Copyright 2002 Wiley Periodicals, Inc. J Clin Psychol 58: 1327-1345, 2002.

  3. First episode of consciousness loss: setting new standards in acute care management

    Directory of Open Access Journals (Sweden)

    Cuciureanu Dan Iulian

    2017-12-01

    Full Text Available There is a high prevalence of patients addressed to the emergency department presenting a first episode of consciousness loss. The high prevalence of patients admitted to the emergency departments (ED with a first episode of consciousness loss (ECL is well established. Although there are studies assessing acute management in these patients, there is still need for more data on clinical and paraclinical characteristics which may prompt early etiological diagnosis, especially in countries where integrated medical procedures are lacking and access to specialized medical care is still limited. Sudden death syndrome, early cerebral morphological changes emerging in chronic epilepsy is the main motivation for an early diagnosis of epilepsy. The aim of our study was to evaluate demographic, clinical and paraclinical data in adult patients referred to our emergency hospital presenting a first episode of consciousness loss, in order to avoid misdiagnosis (with personal and social high impact and unnecessary anti-epileptic treatment versus underestimation of epilepsy diagnosis. Conclusion: There is a clear need to improve multidisciplinary circuits in patients with a first episode of consciousness loss at a local level, in order to promote accurate and prompt diagnosis. We consider necessary to build a unitary online platform in order to establish an early and complete diagnosis.

  4. [Integral Care Guide for Early Detection and Diagnosis of Depressive Episodes and Recurrent Depressive Disorder in Adults. Integral Attention of Adults with a Diagnosis of Depressive Episodes and Recurrent Depressive Disorder: Part III: Treatment of Resistant Depression and Psychotic Depression, Occupational Therapy and Day Hospital Treatment].

    Science.gov (United States)

    Gómez-Restrepo, Carlos; Peñaranda, Adriana Patricia Bohórquez; Valencia, Jenny García; Guarín, Maritza Rodríguez; Ángel, Juliana Rodríguez; Jaramillo, Luis Eduardo; Acosta, Carlos Alberto Palacio; Pedraza, Ricardo Sánchez; Díaz, Sergio Mario Castro; de la Hoz Bradford, Ana María

    2012-12-01

    This article presents recommendations based on the evidence gathered to answer a series of clinical questions concerning the depressive episode and the recurrent depressive disorder. Emphasis was given to general treatment issues of resistant depression and psychotic depression, occupational therapy and day hospital treatment so as to grant diagnosed adult patients the health care parameters based on the best and more updated evidence available and achieve minimum quality standards. A practical clinical guide was elaborated according to standards of the Methodological Guide of the Ministry of Social Protection. Recommendation from NICE90 and CANMAT guides were adopted and updated so as to answer the questions posed while de novo questions were developed. Recommendations 23-25 corresponding to the management of depression are presented. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  5. Ibuprofen for acute treatment of episodic tension-type headache in adults

    DEFF Research Database (Denmark)

    Derry, Sheena; Wiffen, Philip J; Moore, R Andrew

    2015-01-01

    2015. We sought unpublished studies by asking personal contacts and searching on-line clinical trial registers and manufacturers' websites. SELECTION CRITERIA: We included randomised, placebo-controlled studies (parallel-group or cross-over) using oral ibuprofen for symptomatic relief of an acute...... episode of TTH. Studies had to be prospective and include at least 10 participants per treatment arm. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed studies for inclusion, and extracted data. Numbers of participants achieving each outcome were used to calculate risk ratio (RR...... studies, all of which enrolled adult participants with frequent episodic TTH. Nine used the IHS diagnostic criteria, but two used the older classification of the Ad Hoc Committee, and one did not describe diagnostic criteria but excluded participants with migraines. While 3094 people with TTH participated...

  6. Amygdala-prefrontal cortex resting-state functional connectivity varies with first depressive or manic episode in bipolar disorder.

    Science.gov (United States)

    Wei, Shengnan; Geng, Haiyang; Jiang, Xiaowei; Zhou, Qian; Chang, Miao; Zhou, Yifang; Xu, Ke; Tang, Yanqing; Wang, Fei

    2017-02-22

    Bipolar disorder (BD) is one of the most complex mental illnesses, characterized by interactive depressive and manic states that are 2 contrary symptoms of disease states. The bilateral amygdala and prefrontal cortex (PFC) appear to play critical roles in BD; however, abnormalities seem to manifest differently in the 2 states and may provide further insight into underlying mechanisms. Sixteen participants with first-episode depressive and 13 participants with first-episode manic states of bipolar disorder as well as 30 healthy control (HC) participants underwent resting-state functional magnetic resonance imaging (fMRI). Resting-state functional connectivity (rsFC) between the bilateral amygdala and PFC was compared among the 3 groups. Compared with depressive state participants of the BD group, manic state participants of the BD group showed a significant decrease in rsFC between the amygdala and right orbital frontal cortex (pamygdala and left middle frontal cortex was significantly decreased in depressive and manic state participants of the BD group when compared with the HC group (pamygdala- left PFC functional connectivity might present the trait feature for BD, while deficits in amygdala- right PFC functional connectivity might be specific to manic episode, compared to depressive episode. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Polyunsaturated fatty acids and inflammatory markers in major depressive episodes during pregnancy.

    Science.gov (United States)

    Chang, Jane Pei-Chen; Lin, Chih-Ying; Lin, Pan-Yen; Shih, Yin-Hua; Chiu, Tsan-Hung; Ho, Ming; Yang, Hui-Ting; Huang, Shih-Yi; Gałecki, Piotr; Su, Kuan-Pin

    2018-01-03

    Prenatal depression (PND) is a common psychiatric disorder in pregnant women and leads to psychosocial dysfunction, high suicidal rate, and adverse childcare. Patients with PND have omega-3 polyunsaturated fatty acid (omega-3 or n-3 PUFAs) deficits, which might link to chronic low-grade inflammatory process and the pathophysiological mechanisms of depression. In this case-control study, we examined the levels of PUFAs and inflammatory cytokines in PND. Blood samples were obtained and analyzed from 16 healthy controls and 17 depressed cases (PND group) diagnosed with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Independent sample t-test and correlation analysis were performed with Statistical Package for the Social Sciences (SPSS) logistics correlation analysis. PND group had significantly lower levels of total n-3 (p=0.026), docosahexaenoic acid (DHA) (p=0.020) and eicosapentaenoic (EPA) (p=0.019) but a higher omega-6 (n-6)/n-3 PUFAs ratio (p=0.007) and tumor necrosis factor alpha (TNF-α) (p=0.016) level. Moreover, the duration of current PND episodes were also significantly correlated with DHA, EPA, n-3 PUFAs, n-6/n-3 ratio and TNF-α. In terms of PUFAs and cytokine levels, only DHA was inversely correlated with TNF-α. PND is significantly associated with lower DHA, EPA, and total n-3 PUFAs levels and an increased n-6/n-3 PUFAs ratio, while the duration of PND is associated with lower levels of n-3 PUFAs, including DHA and EPA. The correlation of PUFAs levels with depression and TNF-α level grant further investigation into the inflammatory process underlying PND, mediated by PUFAs. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. The effect of comorbid depression on facial and prosody emotion recognition in first-episode schizophrenia spectrum.

    Science.gov (United States)

    Herniman, Sarah E; Allott, Kelly A; Killackey, Eóin; Hester, Robert; Cotton, Sue M

    2017-01-15

    Comorbid depression is common in first-episode schizophrenia spectrum (FES) disorders. Both depression and FES are associated with significant deficits in facial and prosody emotion recognition performance. However, it remains unclear whether people with FES and comorbid depression, compared to those without comorbid depression, have overall poorer emotion recognition, or instead, a different pattern of emotion recognition deficits. The aim of this study was to compare facial and prosody emotion recognition performance between those with and without comorbid depression in FES. This study involved secondary analysis of baseline data from a randomized controlled trial of vocational intervention for young people with first-episode psychosis (N=82; age range: 15-25 years). Those with comorbid depression (n=24) had more accurate recognition of sadness in faces compared to those without comorbid depression. Severity of depressive symptoms was also associated with more accurate recognition of sadness in faces. Such results did not recur for prosody emotion recognition. In addition to the cross-sectional design, limitations of this study include the absence of facial and prosodic recognition of neutral emotions. Findings indicate a mood congruent negative bias in facial emotion recognition in those with comorbid depression and FES, and provide support for cognitive theories of depression that emphasise the role of such biases in the development and maintenance of depression. Longitudinal research is needed to determine whether mood-congruent negative biases are implicated in the development and maintenance of depression in FES, or whether such biases are simply markers of depressed state. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. An acute episode of rhabdomyolysis associated with everolimus and cabergoline intake in a postpartum kidney recipient

    Directory of Open Access Journals (Sweden)

    B. I. Yaremin

    2017-01-01

    Full Text Available Kidney transplantation is one of the most promising ways to ensure the onset and successful maintenance of pregnancy in patients with end-stage chronic renal disease. A multicomponent drug therapy in such patients creates risks for fetal development, primarily due to the teratogenicity of mTOR receptor inhibitors and mycophenolate. Moreover, the inhibitors of the proliferative signal may have potential drug interactions, which can result in additional complications.Rhabdomyolysis is one of them. The paper describes the clinical case of an acute episode of reversible rhabdomyolysis in a patient on everolimus therapy.

  10. Ibuprofen for acute treatment of episodic tension-type headache in adults.

    Science.gov (United States)

    Derry, Sheena; Wiffen, Philip J; Moore, R Andrew; Bendtsen, Lars

    2015-07-31

    Tension-type headache (TTH) affects about one person in five worldwide. It is divided into infrequent episodic TTH (fewer than one headache per month), frequent episodic TTH (1 to 14 headaches per month), and chronic TTH (15 headaches a month or more). Ibuprofen is one of a number of analgesics suggested for acute treatment of headaches in frequent episodic TTH. To assess the efficacy and safety of oral ibuprofen for treatment of acute episodic TTH in adults. We searched CENTRAL (The Cochrane Library), MEDLINE, EMBASE, and our own in-house database to January 2015. We sought unpublished studies by asking personal contacts and searching on-line clinical trial registers and manufacturers' websites. We included randomised, placebo-controlled studies (parallel-group or cross-over) using oral ibuprofen for symptomatic relief of an acute episode of TTH. Studies had to be prospective and include at least 10 participants per treatment arm. Two review authors independently assessed studies for inclusion, and extracted data. Numbers of participants achieving each outcome were used to calculate risk ratio (RR) and number needed to treat for an additional beneficial outcome (NNT) or number needed to treat for an additional harmful outcome (NNH) of oral ibuprofen compared to placebo for a range of outcomes, predominantly those recommended by the International Headache Society (IHS). We included 12 studies, all of which enrolled adult participants with frequent episodic TTH. Nine used the IHS diagnostic criteria, but two used the older classification of the Ad Hoc Committee, and one did not describe diagnostic criteria but excluded participants with migraines. While 3094 people with TTH participated in these studies, the numbers available for any form of analysis were lower than this; placebo was taken by 733, standard ibuprofen 200 mg by 127, standard ibuprofen 400 mg by 892, and fast-acting ibuprofen 400 mg by 230. Participants had moderate or severe pain at the start of

  11. A qualitative study of the prodrome to first-episode major depressive disorder in adolescents.

    Science.gov (United States)

    Syed Sheriff, Rebecca J; McGorry, Patrick D; Cotton, Sue; Yung, Alison R

    2015-01-01

    Currently, we lack a clear picture of the evolution of major depressive disorder (MDD) in adolescents. The period of disturbance preceding MDD can be conceptualised as the prodrome. The aim of the study was to explore the prodrome of first-episode MDD retrospectively in a group of help-seeking adolescents using qualitative methodologies. Consecutively referred adolescents (15-18 years of age) with first-episode MDD were recruited for this study from Orygen Youth Health, Melbourne, Vic., Australia. After using quantitative methodologies to confirm the index episode of MDD and measure the extent of recovery, the prodrome was investigated in depth using qualitative techniques. Twenty-nine adolescents (20 females and 9 males) and 7 informants (6 mothers and 1 grandmother) participated. All 29 participants had a prodrome of varying lengths (between 6 days and 4 years). The most noticeable symptoms initially were perplexity and confusion and, thereafter, sadness and irritability. A common pattern was a reduction in their ability to fulfil their role accompanied by guilt, self-blame and reduced self-esteem. Around half of the participants had increased thoughts of suicide and increased anxiety. There were gender differences in the patterns of symptoms noticed, with males more commonly noticing a change in how they related to the world and females more commonly noticing a change in the way that they related to others. All informants noticed a prodrome of varying lengths; in 2 cases longer, in 2 cases shorter and in 3 cases around the same time period as that noticed by the participant. The changes most commonly noticed by informants were sadness, upset, irritability and reduced self-esteem. The symptoms were fewer in number and sometimes varied from those noticed by the adolescents themselves. Whilst we recognise that this study is vulnerable to autobiographical bias, we took all reasonable measures to minimise this. Symptoms not included in the diagnostic criteria for

  12. The Association between Anomalous Self-experiences, Self-esteem and Depressive Symptoms in First Episode Schizophrenia.

    Science.gov (United States)

    Haug, Elisabeth; Øie, Merete G; Andreassen, Ole A; Bratlien, Unni; Romm, Kristin L; Møller, Paul; Melle, Ingrid

    2016-01-01

    Background: Anomalous self-experiences (ASEs) aggregate in schizophrenia spectrum disorders, but the relationship between ASEs, and depression has been studied to a limited extent. Lower self-esteem has been shown to be associated with depression in early psychosis. Our hypothesis is that ASEs in early phases of schizophrenia are linked to lower levels of self-esteem, which in turn is associated with depression. Aim: The aim is to examine the relationship between ASEs, self-esteem and depression in first-episode schizophrenia spectrum disorders. Method: ASEs were assessed in 55 patients with first-episode schizophrenia by means of the Examination of anomalous Self-Experience (EASE) instrument. Assessment of depression was based on the Calgary Depression Scale for Schizophrenia (CDSS). Self-esteem was measured using the Rosenberg Self-Esteem Scale (RSES). Symptom severity was assessed using the Structured Clinical Interview for the Positive and Negative Syndrome Scale (SCI-PANSS). Substance misuse was measured with the Drug Use Disorder Identification Test (DUDIT), and alcohol use was measured with the Alcohol Use Disorder Identification Test (AUDIT). Data on childhood adjustment were collected using the Premorbid Adjustment Scale (PAS). Data on childhood trauma were collected using the Norwegian version of the Childhood Trauma Questionnaire, short form (CTQ-SF). Results: Analyses detected a significant association between current depression and ASEs as measured by the EASE in women, but not in men. The effect of ASEs on depression appeared to be mediated by self-esteem. No other characteristics associated with depression influenced the relationship between depression, self-esteem and ASEs. Conclusion: Evaluating ASEs can assist clinicians in understanding patients' experience of self-esteem and depressive symptoms. The complex interaction between ASEs, self-esteem, depression and suicidality could be a clinical target for the prevention of suicidality in this

  13. Personality and the Long-Term Outcome of First-Episode Depression

    DEFF Research Database (Denmark)

    Bukh, Jens D.; Andersen, Per K.; Kessing, Lars V.

    2016-01-01

    or outpatients aged 18–70 years with a validated diagnosis of a single depressive episode according to ICD-10 were assessed by the Structured Clinical Interview for DSM-IV Axis II Personality Disorders and the Eysenck Personality Questionnaire from 2005 through 2007. At 5-year follow-up, 262 patients were...... disorder decreased the rate of remission by 30% (HR = 0.7; 95% CI, 0.5–0.9; P = .02) and increased the rate of recurrence after remission of the first depression by 80% (HR = 1.8; 95% CI, 1.0–3.0; P = .04). A higher neuroticism score at baseline decreased the rate of remission by 20% for each increase of 1...... SD (HR = 0.8; 95% CI, 0.7–0.9; P = .002), and a higher level of extraversion increased the rate of conversion to bipolar disorder by 60% for each increase of 1 SD (HR = 1.6; 95% CI, 1.0–2.5; P = .05). Conclusions: Comorbidity of cluster C personality disorders and the level of neuroticism...

  14. Mixed features in patients with a major depressive episode: the BRIDGE-II-MIX study.

    Science.gov (United States)

    Perugi, Giulio; Angst, Jules; Azorin, Jean-Michel; Bowden, Charles L; Mosolov, Sergey; Reis, Joao; Vieta, Eduard; Young, Allan H

    2015-03-01

    To estimate the frequency of mixed states in patients diagnosed with major depressive episode (MDE) according to conceptually different definitions and to compare their clinical validity. This multicenter, multinational cross-sectional Bipolar Disorders: Improving Diagnosis, Guidance and Education (BRIDGE)-II-MIX study enrolled 2,811 adult patients experiencing an MDE. Data were collected per protocol on sociodemographic variables, current and past psychiatric symptoms, and clinical variables that are risk factors for bipolar disorder. The frequency of mixed features was determined by applying both DSM-5 criteria and a priori described Research-Based Diagnostic Criteria (RBDC). Clinical variables associated with mixed features were assessed using logistic regression. Overall, 212 patients (7.5%) fulfilled DSM-5 criteria for MDE with mixed features (DSM-5-MXS), and 818 patients (29.1%) fulfilled diagnostic criteria for a predefined RBDC depressive mixed state (RBDC-MXS). The most frequent manic/hypomanic symptoms were irritable mood (32.6%), emotional/mood lability (29.8%), distractibility (24.4%), psychomotor agitation (16.1%), impulsivity (14.5%), aggression (14.2%), racing thoughts (11.8%), and pressure to keep talking (11.4%). Euphoria (4.6%), grandiosity (3.7%), and hypersexuality (2.6%) were less represented. In multivariate logistic regression analysis, RBDC-MXS was associated with the largest number of variables including diagnosis of bipolar disorder, family history of mania, lifetime suicide attempts, duration of the current episode > 1 month, atypical features, early onset, history of antidepressant-induced mania/hypomania, and lifetime comorbidity with anxiety, alcohol and substance use disorders, attention-deficit/hyperactivity disorder, and borderline personality disorder. Depressive mixed state, defined as the presence of 3 or more manic/hypomanic features, was present in around one-third of patients experiencing an MDE. The valid symptom, illness

  15. A pilot RCT of psychodynamic group art therapy for patients in acute psychotic episodes: feasibility, impact on symptoms and mentalising capacity.

    Science.gov (United States)

    Montag, Christiane; Haase, Laura; Seidel, Dorothea; Bayerl, Martin; Gallinat, Jürgen; Herrmann, Uwe; Dannecker, Karin

    2014-01-01

    This pilot study aimed to evaluate the feasibility of an assessor-blind, randomised controlled trial of psychodynamic art therapy for the treatment of patients with schizophrenia, and to generate preliminary data on the efficacy of this intervention during acute psychotic episodes. Fifty-eight inpatients with DSM-diagnoses of schizophrenia were randomised to either 12 twice-weekly sessions of psychodynamic group art therapy plus treatment as usual or to standard treatment alone. Primary outcome criteria were positive and negative psychotic and depressive symptoms as well as global assessment of functioning. Secondary outcomes were mentalising function, estimated with the Reading the mind in the eyes test and the Levels of emotional awareness scale, self-efficacy, locus of control, quality of life and satisfaction with care. Assessments were made at baseline, at post-treatment and at 12 weeks' follow-up. At 12 weeks, 55% of patients randomised to art therapy, and 66% of patients receiving treatment as usual were examined. In the per-protocol sample, art therapy was associated with a significantly greater mean reduction of positive symptoms and improved psychosocial functioning at post-treatment and follow-up, and with a greater mean reduction of negative symptoms at follow-up compared to standard treatment. The significant reduction of positive symptoms at post-treatment was maintained in an attempted intention-to-treat analysis. There were no group differences regarding depressive symptoms. Of secondary outcome parameters, patients in the art therapy group showed a significant improvement in levels of emotional awareness, and particularly in their ability to reflect about others' emotional mental states. This is one of the first randomised controlled trials on psychodynamic group art therapy for patients with acute psychotic episodes receiving hospital treatment. Results prove the feasibility of trials on art therapy during acute psychotic episodes and justify

  16. A pilot RCT of psychodynamic group art therapy for patients in acute psychotic episodes: feasibility, impact on symptoms and mentalising capacity.

    Directory of Open Access Journals (Sweden)

    Christiane Montag

    Full Text Available This pilot study aimed to evaluate the feasibility of an assessor-blind, randomised controlled trial of psychodynamic art therapy for the treatment of patients with schizophrenia, and to generate preliminary data on the efficacy of this intervention during acute psychotic episodes. Fifty-eight inpatients with DSM-diagnoses of schizophrenia were randomised to either 12 twice-weekly sessions of psychodynamic group art therapy plus treatment as usual or to standard treatment alone. Primary outcome criteria were positive and negative psychotic and depressive symptoms as well as global assessment of functioning. Secondary outcomes were mentalising function, estimated with the Reading the mind in the eyes test and the Levels of emotional awareness scale, self-efficacy, locus of control, quality of life and satisfaction with care. Assessments were made at baseline, at post-treatment and at 12 weeks' follow-up. At 12 weeks, 55% of patients randomised to art therapy, and 66% of patients receiving treatment as usual were examined. In the per-protocol sample, art therapy was associated with a significantly greater mean reduction of positive symptoms and improved psychosocial functioning at post-treatment and follow-up, and with a greater mean reduction of negative symptoms at follow-up compared to standard treatment. The significant reduction of positive symptoms at post-treatment was maintained in an attempted intention-to-treat analysis. There were no group differences regarding depressive symptoms. Of secondary outcome parameters, patients in the art therapy group showed a significant improvement in levels of emotional awareness, and particularly in their ability to reflect about others' emotional mental states. This is one of the first randomised controlled trials on psychodynamic group art therapy for patients with acute psychotic episodes receiving hospital treatment. Results prove the feasibility of trials on art therapy during acute psychotic

  17. Alternations of White Matter Structural Networks in First Episode Untreated Major Depressive Disorder with Short Duration

    Directory of Open Access Journals (Sweden)

    Yi Lu

    2017-10-01

    Full Text Available It is crucial to explore the pathogenesis of major depressive disorder (MDD at the early stage for the better diagnostic and treatment strategies. It was suggested that MDD might be involving in functional or structural alternations at the brain network level. However, at the onset of MDD, whether the whole brain white matter (WM alterations at network level are already evident still remains unclear. In the present study, diffusion MRI scanning was adopt to depict the unique WM structural network topology across the entire brain at the early stage of MDD. Twenty-one first episode, short duration (<1 year and drug-naïve depression patients, and 25 healthy control (HC subjects were recruited. To construct the WM structural network, atlas-based brain regions were used for nodes, and the value of multiplying fiber number by the mean fractional anisotropy along the fiber bundles connected a pair of brain regions were used for edges. The structural network was analyzed by graph theoretic and network-based statistic methods. Pearson partial correlation analysis was also performed to evaluate their correlation with the clinical variables. Compared with HCs, the MDD patients had a significant decrease in the small-worldness (σ. Meanwhile, the MDD patients presented a significantly decreased subnetwork, which mainly involved in the frontal–subcortical and limbic regions. Our results suggested that the abnormal structural network of the orbitofrontal cortex and thalamus, involving the imbalance with the limbic system, might be a key pathology in early stage drug-naive depression. And the structural network analysis might be potential in early detection and diagnosis of MDD.

  18. Improving Major Depressive Episode Assessment: A New Tool Developed by Formal Psychological Assessment.

    Science.gov (United States)

    Serra, Francesca; Spoto, Andrea; Ghisi, Marta; Vidotto, Giulio

    2017-01-01

    Aim: Major depressive episode (MDE) can manifest with different features. Discriminating between different types of MDEs is crucial for proper treatment. The aim of this study is to propose a new tool for MDE assessment in bipolar disorder (BD) or major depressive disorder (MDD) to overcome some limitations of current rating scales. The proposed tool investigates all of the clinical features of different MDEs and gives qualitative information, differentiating patients with the same score but different symptoms and psychopathology severity. To achieve this purpose authors used a new methodology called Formal Psychological Assessment (FPA). FPA allows creating relations between the items of an assessment tool, and the set of diagnostic criteria of a given clinical disorder. In the application at hand, given the capability to analyze all clinical features, FPA appears a useful way to highlight and differentiate between inhibited and agitated depressive symptoms. Method: The new tool contains 41 items constructed through 23 clinical criteria from the DSM-5 and literature symptoms. In line with FPA, starting from a set of items and a set of clinical criteria, a Boolean matrix was built assigning to each item its own set of clinical criteria. The participants include 265 in the control group and 38 patients with MDE (diagnosed with MDD or BD) who answered the QuEDS. After 1 month, 63 participants performed the test again and 113 took the Depression-Anxiety-Stress Scale to analyze convergent-divergent validity. Results: The scale showed adequate reliability and validity. A hierarchical confirmatory factor analysis highlighted the presence of three sub factors (affective, somatic, and cognitive) and one high-order factor (depression). Conclusions: The new tool is potentially able to inform clinicians about the patients' most likely diagnostic configuration. Indeed, the clinical state of a patient consists of the subset of items he/she answered affirmatively, along with his

  19. Effect of HIV infection on time to recovery from an acute manic episode

    Directory of Open Access Journals (Sweden)

    E Nakimuli-Mpungu

    2010-09-01

    Full Text Available E Nakimuli-Mpungu1,2,3, B Mutamba2,3, S Nshemerirwe2,3, MS Kiwuwa4, S Musisi21Mental Health Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; 2Department of Psychiatry, Makerere College of Health Sciences, School of Medicine, Kampala; 3Butabika National Referral Mental Hospital, Ministry of Health, Kampala; 4Clinical Epidemiology Unit, Makerere College of Health Sciences, School of Medicine, Kampala, UgandaIntroduction: Understanding factors affecting the time to recovery from acute mania is critical in the management of manic syndromes. The aim of this study was to determine the effect of HIV infection on time to recovery from acute mania.Methods: We performed a retrospective study in which medical charts of individuals who were treated for acute mania were reviewed. Survival analysis with Cox regression models were used to compare time to recovery from an acute manic episode between human immunodeficiency virus (HIV-positive individuals and HIV-negative individuals.Results: Median survival time was one week for HIV-positive individuals and more than four weeks for HIV-negative individuals (Χ2 = 18.4, P value = 0.000. HIV infection was the only marginally significant independent predictor of survival probability on the acute admission ward (hazards ratio 2.87, P = 0.06.Conclusion: Acute mania in HIV-infected persons responds faster to psychotropic drugs compared with that in HIV-negative persons.Keywords: HIV-related mania, bipolar disorder, HIV infection, Uganda, immunodeficiency virus

  20. Fewer acute respiratory infection episodes among patients receiving treatment for gastroesophageal reflux disease.

    Directory of Open Access Journals (Sweden)

    Herng-Ching Lin

    Full Text Available Patients with gastroesophageal reflux disease (GERD present with comorbid complications with implications for healthcare utilization. To date, little is known about the effects of GERD treatment with a proton-pump inhibitor (PPI on patients' subsequent healthcare utilization for acute respiratory infections (ARIs. This population-based study compared ARI episodes captured through outpatient visits, one year before and one year after GERD patients received PPI treatment. We used retrospective data from the Longitudinal Health Insurance Database 2005 in Taiwan, comparing 21,486 patients diagnosed with GERD from 2010 to 2012 with 21,486 age-sex matched comparison patients without GERD. Annual ARI episodes represented by ambulatory care visits for ARI (visits during a 7-day period bundled into one episode, were compared between the patient groups during the 1-year period before and after the index date (date of GERD diagnosis for study patients, first ambulatory visit in the same year for their matched comparison counterpart. Multiple regression analysis using a difference-in-difference approach was performed to estimate the adjusted association between GERD treatment and the subsequent annual ARI rate. We found that the mean annual ARI episode rate among GERD patients reduced by 11.4%, from 4.39 before PPI treatment, to 3.89 following treatment (mean change = -0.5 visit, 95% confidence interval (CI = (-0.64, -0.36. In Poisson regression analysis, GERD treatment showed an independent association with the annual ARI rate, showing a negative estimate (with p<0.001. The study suggests that GERD treatment with PPIs may help reduce healthcare visits for ARIs, highlighting the importance of treatment-seeking by GERD patients and compliance with treatment.

  1. Associations between compulsive buying and substance dependence/abuse, major depressive episodes, and generalized anxiety disorder among men and women.

    Science.gov (United States)

    Zhang, Chenshu; Brook, Judith S; Leukefeld, Carl G; Brook, David W

    2016-01-01

    The objective of this study was to examine the associations between compulsive buying and substance dependence/abuse, major depressive episodes, and generalized anxiety disorder at the mean age of 43. Participants came from a community-based random sample of residents in 2 New York counties in 1975 (N = 548). The participants were followed from adolescence to early midlife. The mean age of participants at the most recent interview was 43.0 (standard deviation = 2.8). Of the participants, 55% were females. Over 90% of the participants were Caucasian. The prevalence of substance dependence/abuse, major depressive episodes, and generalized anxiety disorder (during the past 5 years before the interviews) was 6.6, 13.7, and 11.5%, respectively. Logistic regression analyses showed that compulsive buying was significantly associated with substance dependence/abuse (adjusted odds ratio = 1.60), major depressive episodes (adjusted odds ratio = 1.70), and generalized anxiety disorder (adjusted odds ratio = 1.63), despite controlling for substance dependence/abuse, major depressive episodes, and generalized anxiety disorder, respectively, at the mean age of 37, and demographic factors. Since the study sample is limited to predominantly Caucasian participants (over 90%) with a close association to a small geographic area, the findings may not be generalizable to racial/ethnic minority groups or individuals living in other parts of the country. Nevertheless, it is important that clinicians treating substance dependence/abuse, major depressive episodes, and generalized anxiety disorder consider the role of compulsive buying.

  2. Risk of Recurrent Pancreatitis and Progression to Chronic Pancreatitis After a First Episode of Acute Pancreatitis.

    Science.gov (United States)

    Ahmed Ali, Usama; Issa, Yama; Hagenaars, Julia C; Bakker, Olaf J; van Goor, Harry; Nieuwenhuijs, Vincent B; Bollen, Thomas L; van Ramshorst, Bert; Witteman, Ben J; Brink, Menno A; Schaapherder, Alexander F; Dejong, Cornelis H; Spanier, B W Marcel; Heisterkamp, Joos; van der Harst, Erwin; van Eijck, Casper H; Besselink, Marc G; Gooszen, Hein G; van Santvoort, Hjalmar C; Boermeester, Marja A

    2016-05-01

    Patients with a first episode of acute pancreatitis can develop recurrent or chronic pancreatitis (CP). However, little is known about the incidence or risk factors for these events. We performed a cross-sectional study of 669 patients with a first episode of acute pancreatitis admitted to 15 Dutch hospitals from December 2003 through March 2007. We collected information on disease course, outpatient visits, and hospital readmissions, as well as results from imaging, laboratory, and histology studies. Standardized follow-up questionnaires were sent to all available patients to collect information on hospitalizations and interventions for pancreatic disease, abdominal pain, steatorrhea, diabetes mellitus, medications, and alcohol and tobacco use. Patients were followed up for a median time period of 57 months. Primary end points were recurrent pancreatitis and CP. Risk factors were evaluated using regression analysis. The cumulative risk was assessed using Kaplan-Meier analysis. Recurrent pancreatitis developed in 117 patients (17%), and CP occurred in 51 patients (7.6%). Recurrent pancreatitis developed in 12% of patients with biliary disease, 24% of patients with alcoholic etiology, and 25% of patients with disease of idiopathic or other etiologies; CP occurred in 3%, 16%, and 10% of these patients, respectively. Etiology, smoking, and necrotizing pancreatitis were independent risk factors for recurrent pancreatitis and CP. Acute Physiology and Chronic Health Evaluation II scores at admission also were associated independently with recurrent pancreatitis. The cumulative risk for recurrent pancreatitis over 5 years was highest among smokers at 40% (compared with 13% for nonsmokers). For alcohol abusers and current smokers, the cumulative risks for CP were similar-approximately 18%. In contrast, the cumulative risk of CP increased to 30% in patients who smoked and abused alcohol. Based on a retrospective analysis of patients admitted to Dutch hospitals, a first

  3. Evolution of scintigraphic renal lesions in children after an episode of acute pyelonephritis

    International Nuclear Information System (INIS)

    Donoso, Gilda; Lagos, Elizabeth; Rosati, Pia; Hevia, Pilar; Cuevas, Karen; Lobo, Gabriel; Perez, Andres; Gutierrez, Daniela

    2012-01-01

    Background: Abnormal Dimercaptosuccinic acid (DMSA) renal scintigraphy performed six months after an acute pyelonephritis (AP) is generally interpreted as scarring. Aim: To perform a follow up of childhood patients showing scintigraphic renal lesions during the acute phase of pyelonephritis (within 7 days from the beginning of fever). Material and Methods: A scintigraphic control was carried out at 5-7 months and, in case of persistent lesions, an additional late scintigraphy at 10-13 months. All patients were followed clinically for one year and those with a relapse of urinary tract infection were excluded from the study. Results: Eighty five patients with a median age of 8 months were included. Among these, the first scintigraphic control was normal in 59 (69%) and abnormal in 26 patients (31%). In five of these 26 patients (5/26:19%-5/85:6%), a considerable regression of the lesions was obvious on the early control, and normalized completely on the late control. When expressing the results in kidney units, 107 showed lesions during the acute phase of infection; 69% was normal at the early control. Thirty three showed lesions persisting at the early control (31%) and 7 out of these 33 (21%) became normal on the late control (7/107: 7%). In total, 25% of the children included in the study (24% of the kidney units) remained with renal sequelae one year after the initial episode of AP. Conclusions: The persistence of scintigraphic lesions six months after an episode of AP, does not necessarily correspond to permanent scars, since normalization can sometimes be observed on late controls

  4. The validity of dysthymia to predict clinical depressive symptoms as measured by the Hamilton Depression Scale at the 5-year follow-up of patients with first episode depression.

    Science.gov (United States)

    Bech, Per; Kessing, Lars Vedel; Bukh, Jens Drachmann

    2016-11-01

    In long-term follow-up studies on depression, the Eysenck Neuroticism Scale (ENS) at the score level of dysthymia has been found to be valid at predicting poor outcome. The ENS dysthymia level was compared with the Beck Depression Inventory (BDI) level to predict the prevalence of depressive symptoms at the 5-year follow-up of patients initially diagnosed with first episode depression using the Hamilton Depression Scale (HAM-D) to express depressive symptoms. A total of 301 in- or outpatients aged 18-70 years with a recent single depressive episode were assessed by ENS, BDI, and HAM-D from 2005-2007. At 5-year follow-up from 2011-2013, the participants were re-assessed by HAM-D. The HAM-D was used to measure depressive symptoms at the 5-year follow-up. The Mokken analysis was used to indicate scalability of the BDI and ENS. A total of 185 participants were available for the psychometric analysis of the ESN and BDI, and the scalability was found acceptable. In total, 99 patients were available for the predictive analysis. Both the ENS and the BDI were significantly associated with depressive symptoms (HAM-D17 ≥ 8) at the 5-year follow-up (p Dysthymia as measured by the two self-rating scales ENS and BDI can be considered part of a 'double depression' in patients with first episode depression, implying an existence of depressive symptoms at the 5-year follow-up. Evaluation of dysthymia or neuroticism is important to perform, even in patients with first episode depression, in order to identify 'double depression'.

  5. Ineffective acute treatment of episodic migraine is associated with new-onset chronic migraine.

    Science.gov (United States)

    Lipton, Richard B; Fanning, Kristina M; Serrano, Daniel; Reed, Michael L; Cady, Roger; Buse, Dawn C

    2015-02-17

    To test the hypothesis that ineffective acute treatment of episodic migraine (EM) is associated with an increased risk for the subsequent onset of chronic migraine (CM). In the American Migraine Prevalence and Prevention Study, respondents with EM in 2006 who completed the Migraine Treatment Optimization Questionnaire (mTOQ-4) and provided outcome data in 2007 were eligible for analyses. The mTOQ-4 is a validated questionnaire that assesses treatment efficacy based on 4 aspects of response to acute treatment. Total mTOQ-4 scores were used to define categories of acute treatment response: very poor, poor, moderate, and maximum treatment efficacy. Logistic regression models were used to examine the dichotomous outcome of transition from EM in 2006 to CM in 2007 as a function of mTOQ-4 category, adjusting for covariates. Among 5,681 eligible study respondents with EM in 2006, 3.1% progressed to CM in 2007. Only 1.9% of the group with maximum treatment efficacy developed CM. Rates of new-onset CM increased in the moderate treatment efficacy (2.7%), poor treatment efficacy (4.4%), and very poor treatment efficacy (6.8%) groups. In the fully adjusted model, the very poor treatment efficacy group had a more than 2-fold increased risk of new-onset CM (odds ratio = 2.55, 95% confidence interval 1.42-4.61) compared to the maximum treatment efficacy group. Inadequate acute treatment efficacy was associated with an increased risk of new-onset CM over the course of 1 year. Improving acute treatment outcomes might prevent new-onset CM, although reverse causality cannot be excluded. © 2015 American Academy of Neurology.

  6. Critical Analysis of the Efficacy of Meditation Therapies for Acute and Subacute Phase Treatment of Depressive Disorders: A Systematic Review

    Science.gov (United States)

    Jain, Felipe A.; Walsh, Roger N.; Eisendrath, Stuart J.; Christensen, Scott; Cahn, B. Rael

    2014-01-01

    Background Recently, the application of meditative practices to the treatment of depressive disorders has met with increasing clinical and scientific interest, due to a lower side-effect burden, potential reduction of polypharmacy, as well as theoretical considerations that such interventions may target some of the cognitive roots of depression. We aimed to determine the state of the evidence supporting this application. Methods Randomized, controlled trials of techniques meeting the Agency for Healthcare Research and Quality (AHRQ) definition of meditation, for participants suffering from clinically diagnosed depressive disorders, not currently in remission, were selected. Meditation therapies were separated into praxis (i.e. how they were applied) components, and trial outcomes were reviewed. Results Eighteen studies meeting inclusionary criteria were identified, encompassing seven distinct techniques and 1173 patients, with Mindfulness-Based Cognitive Therapy comprising the largest proportion. Studies including patients suffering from acute major depressive episodes (N = 10 studies), and those with residual subacute clinical symptoms despite initial treatment (N = 8), demonstrated moderate to large reductions in depression symptoms within group, and relative to control groups. There was significant heterogeneity of techniques and trial designs. Conclusions A substantial body of evidence indicates that meditation therapies may have salutary effects on patients suffering from clinical depressive disorders during the acute and subacute phases of treatment. Due to methodological deficiences and trial heterogeneity, large-scale, randomized controlled trials with well-described comparator interventions and measures of expectation are needed to clarify the role of meditation in the depression treatment armamentarium. PMID:25591492

  7. Adverse Childhood Experiences and Risk for First-Episode Major Depression During the Menopause Transition.

    Science.gov (United States)

    Epperson, C Neill; Sammel, Mary D; Bale, Tracy L; Kim, Deborah R; Conlin, Sarah; Scalice, Stephanie; Freeman, Katharine; Freeman, Ellen W

    2017-03-01

    Stress exposures may have a differential impact on risk and resilience for depression depending on their timing across development. We sought to determine whether adverse childhood experiences (ACEs) and their onset with respect to puberty contribute to the increased risk observed in first-episode major depressive disorder (MDD) during the menopause transition. Participants were from the Penn Ovarian Aging Study cohort, which is composed of women from Philadelphia County, Pennsylvania, who underwent behavioral, cognitive, and endocrine evaluations approximately yearly from 1996 to 2012 and completed the Adverse Childhood Experiences Questionnaire at study end point (n = 243). ACEs that first occurred 2 or more years before menarche were considered prepubertal. Incident menopause MDD was defined as first observed onset of the disorder in the perimenopause to postmenopause transition using the Structured Clinical Interview for DSM-III-R and the Primary Care Evaluation of Mental Disorders. Incident menopause MDD occurred in 48% of the 100 women who reported lifetime MDD. Women reporting ≥ 2 total ACEs were at significantly greater risk for lifetime MDD (adjusted odds ratio [aOR] = 2.05, P = .034) and incident menopause MDD (aOR = 2.58, P = .03) compared to those reporting 0 ACEs; women with ≥ 2 postpubertal ACEs were 2.3 times more likely to experience incidence menopause MDD (P = .024) after controlling for race, smoking, body mass index, and employment. Experiencing only 1 ACE in the prepubertal window, regardless of additional ACEs in postpuberty, was associated with reduced risk for lifetime and incident menopause MDD. Timing and number of adverse experiences with respect to puberty differentially impacted risk and resilience for MDD across the female life span and during the menopause transition in this community cohort. © Copyright 2017 Physicians Postgraduate Press, Inc.

  8. Characterising acute coronary syndrome-associated depression: Let the data speak.

    Science.gov (United States)

    Vollmer-Conna, Uté; Cvejic, Erin; Granville Smith, Isabelle; Hadzi-Pavlovic, Dusan; Parker, Gordon

    2015-08-01

    Depression in the context of acute coronary syndrome (ACS) is understood to confer increased morbidity and mortality risk. The pathophysiological mechanisms underlying this association remain poorly understood, although several candidates including inflammation, cardiac autonomic dysregulation, and behavioural factors are viewed as of key importance. No single bio-behavioural explanatory model of ACS-associated depression has emerged, likely due the substantial heterogeneity across both conditions. We studied 344 patients with ACS; 45 fulfilled diagnostic (DSM-IV) criteria for a major depressive episode occurring within 1-month of ACS, and 13 had ongoing major depression that pre-dated ACS and continued through to 1 month post-ACS. We employed two statistical methods (multinomial logistic regression; and latent class analysis) and a range of immunological, autonomic and nutritional markers in an attempt to characterise a biological basis for ACS-associated depression. Regression modelling failed to accurately predict categorical group membership of ACS-associated depression. An alternative data-driven approach produced a three-class solution, with the derived classes differing on measure of C-reactive protein, vitamin D, omega-6:omega-3 ratio, heart rate variability, and age (all p⩽0.004). The majority of participants with ACS-associated and ongoing depression were members of the class characterised by the greatest biological disturbance. Patients with depression differed from those without depression on a range of psychological trait and state variables; additionally reporting poorer sleep quality, higher levels of social isolation, and functional impairment, but had similar biological profiles. Patients with ongoing depression generally had higher scores on these psychological/behavioural measures. Our novel analytic approach identified a combination of biomarkers suggestive of a role for immune, autonomic, and nutritional pathways in the manifestation of

  9. Low Cerebral Oxygen Consumption and Blood Flow in Patients With Cirrhosis and an Acute Episode of Hepatic Encephalopathy

    DEFF Research Database (Denmark)

    Iversen, Peter; Bak, Lasse Kristoffer; Waagepetersen, Helle Sønderby

    2009-01-01

    (15)O-water PET in 6 patients with liver cirrhosis and an acute episode of overt HE, 6 cirrhotic patients without HE, and 7 healthy subjects. RESULTS: Neither whole-brain CMRO(2) nor CBF differed significantly between cirrhotic patients without HE and healthy subjects, but were both significantly...... that the reductions in CMRO(2) and CBF in patients with HE were essentially generalized throughout the brain. CONCLUSIONS: The observations imply that reduced cerebral oxygen consumption and blood flow in cirrhotic patients with an acute episode of overt HE are associated with HE and not cirrhosis as such...

  10. Personality in remitted major depressive disorder with single and recurrent episodes assessed with the Temperament and Character Inventory.

    Science.gov (United States)

    Teraishi, Toshiya; Hori, Hiroaki; Sasayama, Daimei; Matsuo, Junko; Ogawa, Shintaro; Ishida, Ikki; Nagashima, Anna; Kinoshita, Yukiko; Ota, Miho; Hattori, Kotaro; Higuchi, Teruhiko; Kunugi, Hiroshi

    2015-01-01

    Previous studies consistently reported increased harm avoidance (HA) assessed with the Temperament and Character Inventory (TCI) in patients with major depressive disorder (MDD). However, such findings may have been related with depression severity and number of depressive episodes. The aims of the present study were twofold: to examine TCI personality profile in remitted MDD (DSM-IV) patients and to compare TCI personality between MDD patients with single episode (SGL-MDD) and those with recurrent episodes (REC-MDD) in order to elucidate personality profile associated with recurrence. TCI was administered to 86 outpatients with remitted SGL-MDD (12 male and 17 female patients; mean age 43.2 ± 12.1 years) and REC-MDD (26 male and 31 female patients; 40.3 ± 11.6 years), and 529 healthy controls (225 men and 304 women; 43.4 ± 15.5 years), matched for age, sex and education years. Logistic regression analyses were performed in which single/recurrent episodes of depression were the dependent variable and age, sex, age of onset, family history of psychiatric disease and TCI scores were entered as possible predictors. The remitted MDD patients had significantly higher scores on HA (P differences in personality profile between remitted MDD patients and controls, and between remitted REC-MDD and SGL-MDD patients, suggesting that they are trait markers. HA and fatigability might be useful to assess risk for recurrence of depression. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

  11. Migraine generator network and spreading depression dynamics as neuromodulation targets in episodic migraine

    Science.gov (United States)

    Dahlem, Markus A.

    2013-12-01

    Migraine is a common disabling headache disorder characterized by recurrent episodes sometimes preceded or accompanied by focal neurological symptoms called aura. The relation between two subtypes, migraine without aura (MWoA) and migraine with aura (MWA), is explored with the aim to identify targets for neuromodulation techniques. To this end, a dynamically regulated control system is schematically reduced to a network of the trigeminal nerve, which innervates the cranial circulation, an associated descending modulatory network of brainstem nuclei, and parasympathetic vasomotor efferents. This extends the idea of a migraine generator region in the brainstem to a larger network and is still simple and explicit enough to open up possibilities for mathematical modeling in the future. In this study, it is suggested that the migraine generator network (MGN) is driven and may therefore respond differently to different spatio-temporal noxious input in the migraine subtypes MWA and MWoA. The noxious input is caused by a cortical perturbation of homeostasis, known as spreading depression (SD). The MGN might even trigger SD in the first place by a failure in vasomotor control. As a consequence, migraine is considered as an inherently dynamical disease to which a linear course from upstream to downstream events would not do justice. Minimally invasive and noninvasive neuromodulation techniques are briefly reviewed and their rational is discussed in the context of the proposed mechanism.

  12. Pregnancy shortly after an acute episode of severe acquired thrombotic thrombocytopenic purpura.

    Science.gov (United States)

    Panaitescu, Anca M; Stoia, Razvan; Ciobanu, Anca M; Demetrian, Mihaela; Peltecu, Gheorghe

    2016-12-01

    Thrombotic thrombocytopenic purpura (TTP) is a rare but potentially fatal condition. In women with a previous history of TTP there is increased risk of recurrence during pregnancy and the puerperium. There is some evidence that the risk of relapse during pregnancy is increased if the interval between the event and conception is short. We present a case in which pregnancy was achieved a few days after full recovery from an acute episode of severe acquired TTP (ADAMTS13 activity <0.1%) which was successfully treated with four courses of plasma exchange. There was no relapse of TTP during pregnancy and a healthy baby was delivered at term; the puerperium was uneventful. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. [Management strategies for major depressive episodes as a function of initial response to an SSRI or SNRI antidepressant: results of the ORACLE survey].

    Science.gov (United States)

    Spadone, C; Sylvestre, M; Chiarelli, P; Richard-Berthe, C

    2005-01-01

    The main aim of the major depressive episode treatment is to obtain a complete remission. However, partial remission (persistence of residual symptoms) is a frequent outcome of major depressive episodes, concerning approximately half of the patients who were responders to the treatment. An inadequate treatment response after three weeks of treatment is considered by the ANAES recommendations as a potential reason to modify the treatment regimen. The primary objectives of this survey were to describe the therapeutic strategies implemented in subjects treated as outpatients for a major depressive episode following evaluation of the initial response to an SSRI or an SNRI antidepressant and to assess by a naturalistic way the impact of these strategies on the extent of remission at three months. The secondary objective was to determine, by multivariate analysis, others factors able to influence the remission. This prospective observational survey concerned 2 138 patients treated by community psychiatrists (n=582) and presenting a major depressive episode in the context of a recurrent depressive disorder. Patients were assessed at inclusion and at Weeks 3, at Week 6 and at Week 12. Changes in score on the Hamilton Depression Scale (Ham-D) and CGI severity between inclusion and Week 3 and improvement scores were evaluated. The therapeutic strategies after evaluation were described. Remission was defined as a score of 1 or 2 on the CGI-improvement scale; a treatment response at Week 3 was defined as a decrease of at least 50% in the Ham-D score. The physician also provided an overall rating of satisfaction with the treatment at Week 3. Data from 1 974 patients were analysed. The mean age at inclusion was 42.7 years, 70% of the patients were women; the mean age at first episode was 32.2 years, the average time since the last episode was 3.6 years. The mean Ham-D score at inclusion was 23.6 +/- 5.8. At Week 3, 29.1% of patients were considered treatment responders. The

  14. Antidepressant Treatment for Acute Bipolar Depression: An Update

    Directory of Open Access Journals (Sweden)

    Ben H. Amit

    2012-01-01

    Full Text Available While studies in the past have focused more on treatment of the manic phase of bipolar disorder (BD, recent findings demonstrate the depressive phase to be at least as debilitating. However, in contrast to unipolar depression, depression in bipolar patients exhibits a varying response to antidepressants, raising questions regarding their efficacy and tolerability. Methods. We conducted a MEDLINE and Cochrane Collaboration Library search for papers published between 2005 and 2011 on the subject of antidepressant treatment of bipolar depression. Sixty-eight articles were included in the present review. Results. While a few studies did advocate the use of antidepressants, most well-controlled studies failed to show a robust effect of antidepressants in bipolar depression, regardless of antidepressant class or bipolar subtype. There was no significant increase in the rate of manic/hypomanic switch, especially with concurrent use of mood stabilizers. Prescribing guidelines published in recent years rely more on atypical antipsychotics, especially quetiapine, as a first-line therapy. Conclusions. Antidepressants probably have no substantial role in acute bipolar depression. However, in light of conflicting results between studies, more well-designed trials are warranted.

  15. The subjective experience and phenomenology of depression following first episode psychosis: a qualitative study using photo-elicitation.

    Science.gov (United States)

    Sandhu, Amrita; Ives, Jonathan; Birchwood, Max; Upthegrove, Rachel

    2013-07-01

    Depression following first episode psychosis (FEP) is a frequent occurrence, with profound impact on recovery and outcome. Whilst many theories exist about the causes of depression here, research to date has been based on nosology imported wholesale from affective disorder, with little primary research on the subjective experience. This study aimed to explore the subjective experience and phenomenological features of post-psychotic depression in FEP. A qualitative methodology, photo-elicitation, together with unstructured interviews, was used to characterise aspects of depression following FEP and analysed using contemporary framework analysis. Depression was reported by participants as linked to the experience of and recovery from psychosis. The psychotic episode was a traumatic event followed by subjective doubt, shame and embarrassment. Loss and social isolation were central. Core biological symptoms did not feature. Despite the relatively small sample size, this study was able to generate in-depth data that provides useful and novel insight. Whilst generalisability is incompatible with qualitative methodology, further research using the same methodology would generate a wider range of experiences and perspectives. Understanding this dimension of psychosis in and of itself has the potential to improve and aid development of more effective and appropriately targeted interventions and associated outcomes. Crown Copyright © 2013. Published by Elsevier B.V. All rights reserved.

  16. The Impact of an Early Eclectic Rehabilitative Intervention on Symptoms in First Episode Depression among Employed People

    Directory of Open Access Journals (Sweden)

    Tero Raiskila

    2013-01-01

    Full Text Available Objective. To evaluate the effect of an early vocational-orientated eclectic intervention on beck depression inventory (BDI scores compared to treatment as usual in first ever depressive episode among employed people. Design. A randomized controlled trial comparing the rehabilitative intervention and the conventional treatment. Subjects. The subjects came from occupational health care units. Methods. Employees were sent to a rehabilitation center after being screened for depression using the BDI. They were diagnosed using the structured clinical interview for DSM-IV. The participating subjects (N=283 were randomized into intervention and control groups. The intervention group received eclectic early depression intervention treatment (N=134 and the control group was treated in the conventional way (N=100. They were followed for one year. Results. The mean decrease in BDI scores within the intervention group was from 20.8 to 11.6 and within the control group from 19.3 to 10.8. BDI score decreased by 10 or more points in 64% of the participants in the intervention group and in 53% of the control group (P=0.013. Conclusions. There was some evidence that early eclectic intervention in first ever episode depression may be more effective than conventional treatments among working age people in employment.

  17. Aspirin for acute treatment of episodic tension-type headache in adults.

    Science.gov (United States)

    Derry, Sheena; Wiffen, Philip J; Moore, R Andrew

    2017-01-13

    Tension-type headache (TTH) affects about 1 person in 5 worldwide. It is divided into infrequent episodic TTH (fewer than one headache per month), frequent episodic TTH (two to 14 headache days per month), and chronic TTH (15 headache days per month or more). Aspirin is one of a number of analgesics suggested for acute treatment of episodic TTH. To assess the efficacy and safety of aspirin for acute treatment of episodic tension-type headache (TTH) in adults compared with placebo or any active comparator. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and the Oxford Pain Relief Database from inception to September 2016, and also reference lists of relevant published studies and reviews. We sought unpublished studies by asking personal contacts and searching online clinical trial registers and manufacturers' websites. We included randomised, double-blind, placebo-controlled studies (parallel-group or cross-over) using oral aspirin for symptomatic relief of an acute episode of TTH. Studies had to be prospective, with participants aged 18 years or over, and include at least 10 participants per treatment arm. Two review authors independently assessed studies for inclusion and extracted data. For various outcomes (predominantly those recommended by the International Headache Society (IHS)), we calculated the risk ratio (RR) and number needed to treat for one additional beneficial outcome (NNT), one additional harmful outcome (NNH), or to prevent one event (NNTp) for oral aspirin compared to placebo or an active intervention.We assessed the evidence using GRADE and created a 'Summary of findings' table. We included five studies enrolling adults with frequent episodic TTH; 1812 participants took medication, of which 767 were included in comparisons of aspirin 1000 mg with placebo, and 405 in comparisons of aspirin 500 mg or 650 mg with placebo. Not all of these participants provided data for outcomes of interest in this review

  18. Paracetamol (acetaminophen) for acute treatment of episodic tension-type headache in adults.

    Science.gov (United States)

    Stephens, Guy; Derry, Sheena; Moore, R Andrew

    2016-06-16

    Tension-type headache (TTH) affects about 1 person in 5 worldwide. It is divided into infrequent episodic TTH (fewer than one headache per month), frequent episodic TTH (two to 14 headaches per month), and chronic TTH (15 headache days a month or more). Paracetamol (acetaminophen) is one of a number of analgesics suggested for acute treatment of headaches in frequent episodic TTH. To assess the efficacy and safety of paracetamol for the acute treatment of frequent episodic TTH in adults. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (CRSO), MEDLINE, EMBASE, and the Oxford Pain Relief Database to October 2015, and also reference lists of relevant published studies and reviews. We sought unpublished studies by asking personal contacts and searching online clinical trial registers and manufacturers' websites. We included randomised, double-blind, placebo-controlled studies (parallel-group or cross-over) using oral paracetamol for symptomatic relief of an acute episode of TTH. Studies had to be prospective, with participants aged 18 years or over, and include at least 10 participants per treatment arm. Two review authors independently assessed studies for inclusion and extracted data. We used the numbers of participants achieving each outcome to calculate the risk ratio (RR) and number needed to treat for one additional beneficial outcome (NNT) or one additional harmful outcome (NNH) for oral paracetamol compared to placebo or an active intervention for a range of outcomes, predominantly those recommended by the International Headache Society (IHS).We assessed the evidence using GRADE (Grading of Recommendations Assessment, Development and Evaluation) and created 'Summary of findings' tables. We included 23 studies, all of which enrolled adults with frequent episodic TTH. Twelve studies used the IHS diagnostic criteria or similar, six used the older classification of the Ad Hoc Committee, and five did not describe specific diagnostic criteria

  19. Impulsive choice and psychological pain in acutely suicidal depressed patients.

    Science.gov (United States)

    Cáceda, Ricardo; Durand, Dante; Cortes, Edmi; Prendes-Alvarez, Stefania; Moskovciak, Tori; Harvey, Philip D; Nemeroff, Charles B

    2014-01-01

    Despite identification of several risk factors, suicide prediction and prevention is still a clinical challenge. Suicide can be seen as a consequence of poor decision making triggered by overwhelming psychological pain. We examined the relationship of choice impulsivity and psychological pain in depressed patients with acute suicidality. Impulsive choice (delay discounting), psychological pain, and clinical characteristics were assessed in four groups of adults (N = 20-22): a) depressed patients within 72 hours after a suicide attempt, b) depressed patients with active suicidal ideation, c) nonsuicidal depressed patients, and d) healthy controls. Impulsive choice was higher in the suicide attempt (0.114 [0.027]) and ideation (0.099 [0.020]) groups compared with nonsuicidal depressed (0.079 [0.020]) and healthy (0.066 [0.019]) individuals (F(3,79) = 3.06, p = .042). Psychological pain data showed a similar profile (F(3,78) = 43.48, p suicide attempt, 54.3 (2.2) for suicide ideation, 37.0 (3.2) for nonsuicidal depressed, and 13.7 (0.5) for healthy groups. Within the suicide attempt group, persisting suicidal ideation was associated with more severe depression (36.6 [2.9] versus 21.5 [3.1], p = .007) and choice impulsivity (0.134 [0.03] versus 0.078 [0.04], p = .015). Both measures normalized within a week: depression (29.9 [2.6] versus 14.4 [3.0], p = .006) and choice impulsivity (0.114 [0.026] versus 0.066 [0.032], p = .019). Transient impulsive choice abnormalities are found in a subset of those who attempt suicide. Both, suicidal ideation and behavior were associated with choice impulsivity and intense psychological pain.

  20. Oral Astragalus (Huang qi) for preventing frequent episodes of acute respiratory tract infection in children.

    Science.gov (United States)

    Su, Guobin; Chen, Xiankun; Liu, Zhuangzhu; Yang, Lihong; Zhang, La; Stålsby Lundborg, Cecilia; Wen, Zehuai; Guo, Xinfeng; Qin, Xindong; Liang, Jueyao; Liu, Xusheng

    2016-12-01

    Acute respiratory tract infections (ARTIs) are common in children and can involve both upper and lower airways. Many children experience frequent ARTI episodes or recurrent respiratory tract infections (RRTIs) in early life, which creates challenges for paediatricians, primary care physicians, parents and carers of children.In China, Astragalus (Huang qi), alone or in combination with other herbs, is used by Traditional Chinese Medicine (TCM) practitioners in the form of a water extract, to reduce the risk of ARTIs; it is believed to stimulate the immune system. Better understanding of the therapeutic mechanisms of Astragalus may provide insights into ARTI prevention, and consequently reduced antibiotic use. To assess the effectiveness and safety of oral Astragalus for preventing frequent episodes of acute respiratory tract infections (ARTIs) in children in community settings. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 12, 2015), MEDLINE (Ovid) (1946 to 31 December 2015), Embase (Elsevier) (1974 to 31 December 2015), AMED (Ovid) (1985 to 31 December 2015), Chinese National Knowledge Infrastructure (CNKI) (1979 to 31 December 2015) and Chinese Scientific Journals full text database (CQVIP) (1989 to 31 December 2015), China Biology Medicine disc (CBM 1976 to 31 December 2015) and Wanfang Data Knowledge Service Platform (WanFang) (1998 to 31 December 2015). We included randomised controlled trials (RCTs) comparing oral Astragalus as a sole Chinese herbal preparation with placebo to prevent frequent episodes of ARTIs in children. We used standard Cochrane methodological procedures for this review. We assessed search results to identify relevant studies. We planned to extract data using standardised forms. Disagreements were to be resolved through discussion. Risk of bias was to be assessed using the Cochrane 'Risk of bias' tool. We planned to use mean difference (MD) or standardised mean difference (SMD) for continuous data and risk

  1. The effects of acute stress on episodic memory: A meta-analysis and integrative review.

    Science.gov (United States)

    Shields, Grant S; Sazma, Matthew A; McCullough, Andrew M; Yonelinas, Andrew P

    2017-06-01

    A growing body of research has indicated that acute stress can critically impact memory. However, there are a number of inconsistencies in the literature, and important questions remain regarding the conditions under which stress effects emerge as well as basic questions about how stress impacts different phases of memory. In this meta-analysis, we examined 113 independent studies in humans with 6,216 participants that explored effects of stress on encoding, postencoding, retrieval, or postreactivation phases of episodic memory. The results indicated that when stress occurred prior to or during encoding it impaired memory, unless both the delay between the stressor and encoding was very short and the study materials were directly related to the stressor, in which case stress improved encoding. In contrast, postencoding stress improved memory unless the stressor occurred in a different physical context than the study materials. When stress occurred just prior to or during retrieval, memory was impaired, and these effects were larger for emotionally valenced materials than neutral materials. Although stress consistently increased cortisol, the magnitude of the cortisol response was not related to the effects of stress on memory. Nonetheless, the effects of stress on memory were generally reduced in magnitude for women taking hormonal contraceptives. These analyses indicate that stress disrupts some episodic memory processes while enhancing others, and that the effects of stress are modulated by a number of critical factors. These results provide important constraints on current theories of stress and memory, and point to new questions for future research. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  2. Does the risk of developing dementia increase with the number of episodes in patients with depressive disorder and in patients with bipolar disorder?

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Andersen, Per Kragh

    2004-01-01

    OBJECTIVE: Several findings suggest that some patients with depressive or bipolar disorder may be at increased risk of developing dementia. The present study aimed to investigate whether the risk of developing dementia increases with the number of affective episodes in patients with depressive...... following the first discharge after 1985 was estimated. A total of 18,726 patients with depressive disorder and 4248 patients with bipolar disorder were included in the study. RESULTS: The rate of a diagnosis of dementia on readmission was significantly related to the number of prior affective episodes...... leading to admission. On average, the rate of dementia tended to increase 13% with every episode leading to admission for patients with depressive disorder and 6% with every episode leading to admission for patients with bipolar disorder, when adjusted for differences in age and sex. CONCLUSION...

  3. Quitting smoking does not increase the risk of major depressive episodes among users of Internet smoking cessation interventions.

    Science.gov (United States)

    Torres, L D; Barrera, A Z; Delucchi, K; Penilla, C; Pérez-Stable, E J; Muñoz, R F

    2010-03-01

    Limited evidence has suggested that quitting smoking increases the incidence of major depressive episodes (MDEs), particularly for smokers with a history of depression. Further evidence for this increase would have important implications for guiding smoking cessation. Spanish- and English-speaking smokers without a current MDE (n=3056) from an international, online smoking cessation trial were assessed for abstinence 1 month after their initial quit date and followed for a total of 12 months. Incidence of screened MDE was examined as a function of abstinence and depression history. Continued smoking, not abstinence, predicted MDE screened at 1 month [smoking 11.5% v. abstinence 7.8%, odds ratio (OR) 1.36, 95% confidence interval (CI) 1.04-1.78, p=0.02] but not afterwards (smoking 11.1% v. abstinence 9.8%, OR 1.05, 95% CI 0.77-1.45, p=0.74). Depression history predicted MDE screened at 1 month (history 17.1% v. no history 8.6%, OR 1.71, 95% CI 1.29-2.27, pincreased MDE, even for smokers with a history of depression, although a history of depression was. Instead, not quitting was associated with increased MDE shortly following a quit attempt. Results from this online, large, international sample of smokers converge with similar findings from smaller, clinic-based samples, suggesting that in general, quitting smoking does not increase the incidence of MDEs.

  4. Neural basis of emotion recognition deficits in first-episode major depression

    NARCIS (Netherlands)

    van Wingen, G. A.; van Eijndhoven, P.; Tendolkar, I.; Buitelaar, J.; Verkes, R. J.; Fernández, G.

    2011-01-01

    Depressed individuals demonstrate a poorer ability to recognize the emotions of others, which could contribute to difficulties in interpersonal behaviour. This emotion recognition deficit appears related to the depressive state and is particularly pronounced when emotions are labelled semantically.

  5. Neural basis of emotion recognition deficits in first-episode major depression

    NARCIS (Netherlands)

    Wingen, G.A. van; Eijndhoven, P.F.P. van; Tendolkar, I.; Buitelaar, J.K.; Verkes, R.J.; Fernandez, G.S.E.

    2011-01-01

    BACKGROUND: Depressed individuals demonstrate a poorer ability to recognize the emotions of others, which could contribute to difficulties in interpersonal behaviour. This emotion recognition deficit appears related to the depressive state and is particularly pronounced when emotions are labelled

  6. Level of soluble CD30 after kidney transplantation correlates with acute rejection episodes.

    Science.gov (United States)

    Yang, J L; Hao, H J; Zhang, B; Liu, Y X; Chen, S; Na, Y Q

    2008-12-01

    Measurement of soluble CD30 (sCD30) levels may predict acute rejection episodes (ARE). To explore the value of sCD30 after transplantation, we tested serum sCD30 levels in 58 kidney transplant cases at 1 day before and 7 and 28 days after transplantation by enzyme-linked immunosorbent assay (ELISA). The incidences of ARE after kidney transplantation were recorded simultaneously. Meanwhile, 31 healthy individuals were selected as a control group. The results showed a relationship between sCD30 level in serum before kidney transplantation and the incidence of ARE. However, the relationship was more significant between serum sCD30 levels at day 7 after kidney transplantation and the incidence of ARE. There was no obvious relationship between serum sCD30 levels at day 28 after kidney transplantation and the incidence of ARE. These results suggested that the level of sCD30 at day 7 posttransplantation provides valuable data to predict ARE.

  7. Randomized, Double-Blind, Placebo-Controlled Trial of Asenapine Maintenance Therapy in Adults With an Acute Manic or Mixed Episode Associated With Bipolar I Disorder.

    Science.gov (United States)

    Szegedi, Armin; Durgam, Suresh; Mackle, Mary; Yu, Sung Yun; Wu, Xiao; Mathews, Maju; Landbloom, Ronald P

    2018-01-01

    The authors determined the efficacy and safety of asenapine in preventing recurrence of any mood episode in adults with bipolar I disorder. Adults with an acute manic or mixed episode per DSM-IV-TR criteria were enrolled in this randomized, placebo-controlled trial consisting of an initial 12- to 16-week open-label period and a 26-week double-blind randomized withdrawal period. The target asenapine dosage was 10 mg b.i.d. in the open-label period but could be titrated down to 5 mg b.i.d. After completing the open-label period, subjects meeting stabilization/stable-responder criteria were randomized to asenapine or placebo treatment in the double-blind period. The primary efficacy endpoint was time to recurrence of any mood event during the double-blind period. Kaplan-Meier estimation was performed, and 95% confidence intervals were determined. Safety was assessed throughout. A total of 549 subjects entered the open-label period, of whom 253 enrolled in the double-blind randomized withdrawal period (127 in the placebo group; 126 in the asenapine group). Time to recurrence of any mood episode was statistically significantly longer for asenapine- than placebo-treated subjects. In post hoc analyses, significant differences in favor of asenapine over placebo were seen in time to recurrence of manic and depressive episodes. The most common treatment-emergent adverse events were somnolence (10.0%), akathisia (7.7%), and sedation (7.7%) in the open-label period and mania (11.9% of the placebo group compared with 4.0% of the asenapine group) and bipolar I disorder (6.3% compared with 1.6%) in the double-blind period. Long-term treatment with asenapine was more effective than placebo in preventing recurrence of mood events in adults with bipolar I disorder and was generally well-tolerated.

  8. Major depressive episodes are associated with poor concordance with therapy in rheumatoid arthritis patients: the impact on disease outcomes.

    Science.gov (United States)

    Cabrera-Marroquín, Ricardo; Contreras-Yáñez, Irazú; Alcocer-Castillejos, Natasha; Pascual-Ramos, Virginia

    2014-01-01

    Our objective was to investigate associations between major depressive episodes (MDE), concordance with therapy (CwT) and disease outcomes in rheumatoid arthritis patients. Seventy-eight outpatients receiving ≥1 disease modifying anti-rheumatic drug and without significant comorbidity had concomitant rheumatic and psychiatric evaluations. CwT was defined according to a questionnaire. MDE was defined using the Mini International Neuropsychiatric Interview and the severity of depressive symptoms was assessed with the Beck Depression Inventory (BDI-II). Appropriated statistic was used. IRB approval was obtained. Patients included (73 ♀) had (mean±SD) age of 44±10 years and (median, range) disease duration of 10 years (5.2-15.8). Current MDE were diagnosed in 24 patients (30.8%); 60 patients (76.9%) were CwT. Patient-non-CwT were more frequently diagnosed with MDE and tend to have higher BDI scores. They had significantly more disease activity according to patient-pain VAS and swollen joint counts. Both groups were similar regarding demographic variables, treatment and comorbid conditions. Forty-one patients (53%) had clinically important depressive symptoms (BDI≥10), among them 20 had mild depression, 14 moderate and 7 severe depression. Patient-non-CwT had more frequently moderate depression (according to BDI score) than their counterparts and similar tendency was found regarding severe depression. Patient-CwT who additionally had lower BDI scores had better disease outcomes than concordant patients with higher BDI scores. Similar results were found in non-CwT patients but statistical significance was limited to disease activity. Prevalence of current MDE in RA patients was of 31%; those patients had poorer CwT and worse outcomes than mentally healthy patients.

  9. Neurochemical metabolites in prefrontal cortex in patients with mild/moderate levels in first-episode depression

    Directory of Open Access Journals (Sweden)

    Sozeri-Varma G

    2013-08-01

    Full Text Available Gülfizar Sözeri-Varma,1 Nalan Kalkan-Oğuzhanoglu,1 Muharrem Efe,1 Yilmaz Kiroglu,2 Taçlan Duman11Department of Psychiatry, 2Department of Radiology, Faculty of Medicine, Pamukkale University, Denizli, TurkeyBackground: Previous studies have determined the neurochemical metabolite abnormalities in major depressive disorder (MDD. The results of studies are inconsistent. Severity of depression may relate to neurochemical metabolic changes. The aim of this study is to investigate neurochemical metabolite levels in the prefrontal cortex (PFC of patients with mild/moderate MDD.Methods: Twenty-one patients with mild MDD, 18 patients with moderate MDD, and 16 matched control subjects participated in the study. Patients had had their first episode. They had not taken treatment. The severity of depression was assessed by the Hamilton Rating Scale for Depression (HAM-D. Levels of N-acetyl aspartate (NAA, choline-containing compounds (Cho, and creatine-containing compounds (Cr were measured using proton magnetic resonance spectroscopy (1H-MRS at 1.5 T, with an 8-cm3 single voxel placed in the right PFC.Results: The moderate MDD patients had lower NAA/Cr levels than the control group. No differences were found in neurochemical metabolite levels between the mild MDD and control groups. No correlation was found between the patients’ neurochemical metabolite levels and HAM-D scores.Conclusion: Our findings suggest that NAA/Cr levels are low in moderate-level MDD in the PFC. Neurochemical metabolite levels did not change in mild depressive disorder. Our results suggest that the severity of depression may affect neuronal function and viability. Studies are needed to confirm this finding, including studies on severely depressive patients.Keywords: major depressive disorder, magnetic resonance spectroscopy, N-acetyl aspartate, creatine, choline

  10. Frontal-insula gray matter deficits in first-episode medication-naïve patients with major depressive disorder.

    Science.gov (United States)

    Lai, Chien-Han; Wu, Yu-Te

    2014-05-01

    This study is designed to investigate the gray matter volume (GMV) deficits in patients with first-episode medication-naïve major depressive disorder (MDD). We enrolled 38 patients with first-episode medication-naïve MDD and 27 controls in this project. Voxel-based morphometry was used to compare GMV differences between two groups. Besides, the relationship between GMV of patients and the severity of clinical symptoms was estimated to confirm the role of GMV deficits in clinical symptoms. The correlation between total GMV and illness duration was also performed to elucidate the impacts of untreated duration on the GMV. We found that first-episode medication-naïve MDD patients had significant GMV deficits in bilateral superior frontal gyri, left middle frontal gyrus, left medial frontal gyrus and left insula. The GMV of patient group was negatively correlated with the severity of clinical symptoms and the illness duration. A pattern of GMV deficits in fronto-insula might represent the biomarker for first-episode medication-naïve MDD. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. Motivational deficits in effort-based decision making in individuals with subsyndromal depression, first-episode and remitted depression patients.

    Science.gov (United States)

    Yang, Xin-Hua; Huang, Jia; Zhu, Cui-Ying; Wang, Ye-Fei; Cheung, Eric F C; Chan, Raymond C K; Xie, Guang-Rong

    2014-12-30

    Anhedonia is a hallmark symptom of major depressive disorder (MDD). Preliminary findings suggest that anhedonia is characterized by reduced reward anticipation and motivation of obtaining reward. However, relatively little is known about reward-based decision-making in depression. We tested the hypothesis that anhedonia in MDD may reflect specific impairments in motivation on reward-based decision-making and the deficits might be associated with depressive symptoms severity. In study 1, individuals with and without depressive symptoms performed the modified version of the Effort Expenditure for Rewards Task (EEfRT), a behavioral measure of cost/benefit decision-making. In study 2, MDD patients, remitted MDD patients and healthy controls were recruited for the same procedures. We found evidence for decreased willingness to make effort for rewards among individuals with subsyndromal depression; the effect was amplified in MDD patients, but dissipated in patients with remitted depression. We also found that reduced anticipatory and consummatory pleasure predicted decreased willingness to expend efforts to obtain rewards in MDD patients. For individuals with subsyndromal depression, the impairments were correlated with anticipatory anhedonia but not consummatory anhedonia. These data offer novel evidence that motivational deficits in MDD are correlated with depression severity and predicted by self-reported anhedonia. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  12. The validity of dysthymia to predict clinical depressive symptoms as measured by the Hamilton Depression Scale at the 5-year follow-up of patients with first episode depression

    DEFF Research Database (Denmark)

    Bech, Per; Kessing, Lars Vedel; Bukh, Jens Drachmann

    2016-01-01

    BACKGROUND: In long-term follow-up studies on depression, the Eysenck Neuroticism Scale (ENS) at the score level of dysthymia has been found to be valid at predicting poor outcome. AIMS: The ENS dysthymia level was compared with the Beck Depression Inventory (BDI) level to predict the prevalence...... of depressive symptoms at the 5-year follow-up of patients initially diagnosed with first episode depression using the Hamilton Depression Scale (HAM-D) to express depressive symptoms. METHODS: A total of 301 in- or outpatients aged 18-70 years with a recent single depressive episode were assessed by ENS, BDI......, and HAM-D from 2005-2007. At 5-year follow-up from 2011-2013, the participants were re-assessed by HAM-D. The HAM-D was used to measure depressive symptoms at the 5-year follow-up. The Mokken analysis was used to indicate scalability of the BDI and ENS. RESULTS: A total of 185 participants were available...

  13. Effects of escitalopram in prevention of depression in patients with acute coronary syndrome (DECARD)

    DEFF Research Database (Denmark)

    Hansen, Baiba Hedegaard; Hanash, Jamal Abed; Rasmussen, Alice

    2012-01-01

    Depression is a major problem in patients after acute coronary syndrome (ACS) with negative impact on survival and quality of life. No studies have examined prevention of post-ACS depression. We examined whether treatment with escitalopram can prevent post-ACS depression.......Depression is a major problem in patients after acute coronary syndrome (ACS) with negative impact on survival and quality of life. No studies have examined prevention of post-ACS depression. We examined whether treatment with escitalopram can prevent post-ACS depression....

  14. Predictive Factors of Anxiety and Depression in Patients with Acute Coronary Syndrome.

    Science.gov (United States)

    Altino, Denise Meira; Nogueira-Martins, Luiz Antônio; de Barros, Alba Lucia Bottura Leite; Lopes, Juliana de Lima

    2017-12-01

    To identify the predictive factors of anxiety and depression in patients with acute coronary syndrome. Cross-sectional and retrospective study conducted with 120 patients hospitalized with acute coronary syndrome. Factors interfering with anxiety and depression were assessed. Anxiety was related to sex, stress, years of education, and depression, while depression was related to sex, diabetes mellitus, obesity, years of education, and trait-anxiety. Obesity and anxiety were considered predictive factors for depression, while depression and fewer years of education were considered predictive factors for anxiety. Copyright © 2017. Published by Elsevier Inc.

  15. Does the risk of developing dementia increase with the number of episodes in patients with depressive disorder and in patients with bipolar disorder?

    Science.gov (United States)

    Kessing, L V; Andersen, P K

    2004-12-01

    Several findings suggest that some patients with depressive or bipolar disorder may be at increased risk of developing dementia. The present study aimed to investigate whether the risk of developing dementia increases with the number of affective episodes in patients with depressive disorder and in patients with bipolar disorder. This was a case register study including all hospital admissions with primary affective disorder in Denmark during 1970-99. The effect of the number of prior episodes leading to admission on the rate of readmission with a diagnosis of dementia following the first discharge after 1985 was estimated. A total of 18,726 patients with depressive disorder and 4248 patients with bipolar disorder were included in the study. The rate of a diagnosis of dementia on readmission was significantly related to the number of prior affective episodes leading to admission. On average, the rate of dementia tended to increase 13% with every episode leading to admission for patients with depressive disorder and 6% with every episode leading to admission for patients with bipolar disorder, when adjusted for differences in age and sex. On average, the risk of dementia seems to increase with the number of episodes in depressive and bipolar affective disorders.

  16. Mirtazapine Treatment of a Severe Depressive Episode and Resolution of Elevated Inflammatory Markers

    Directory of Open Access Journals (Sweden)

    Shahzad M. Alikhan

    2013-01-01

    Full Text Available Depression has been shown to be associated with systemic inflammatory activity and the mode of action of several antidepressants appears to involve immunomodulation. Effects on immune system activity have also recently been observed in correlation with therapeutic response to mirtazapine in cardiac patients with depression, but no study has yet examined these effects in otherwise physically healthy depressed patients treated with mirtazapine. This report describes an association between a clinical antidepressant response and a decrease in markers of systemic inflammation observed during pharmacotherapy with mirtazapine in a severely depressed but physically well patient. This observation adds to the evidence that changes in inflammatory responses may be implicated in the mode of action of antidepressants. Further studies of antidepressant responses to mirtazapine and levels of inflammatory markers in depressed patients without medical comorbidity can help elucidate the role of the immune system in the pathophysiology of depression, and hence contribute to the development of novel antidepressant therapies.

  17. Interventions for treating acute bleeding episodes in people with acquired hemophilia A.

    Science.gov (United States)

    Zeng, Yan; Zhou, Ruiqing; Duan, Xin; Long, Dan; Yang, Songtao

    2014-08-28

    Acquired hemophilia A is a rare bleeding disorder caused by autoantibodies to coagulation factor VIII (FVIII). In most cases, bleeding episodes are spontaneous and severe at presentation. The optimal hemostatic therapy is controversial. To determine the efficacy of hemostatic therapies for acute bleeds in people with acquired hemophilia A; and to compare different forms of therapy for these bleeds. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 4) and MEDLINE (Ovid) (1948 to 30 April 2014). We searched the conference proceedings of the: American Society of Hematology; European Hematology Association; International Society on Thrombosis and Haemostasis (ISTH); and the European Association for Haemophilia and Allied Disorders (EAHAD) (from 2000 to 30 April 2014). In addition to this we searched clinical trials registers. All randomised controlled trials and quasi-randomised trials of hemostatic therapies for people with acquired hemophilia A, with no restrictions on gender, age or ethnicity. No trials matching the selection criteria were eligible for inclusion. No trials matching the selection criteria were eligible for inclusion. No randomised clinical trials of hemostatic therapies for acquired hemophilia A were found. Thus, we are not able to draw any conclusions or make any recommendations on the optimal hemostatic therapies for acquired hemophilia A based on the highest quality of evidence. GIven that carrying out randomized controlled trials in this field is a complex task, the authors suggest that, while planning randomised controlled trials in which patients can be enrolled, clinicians treating the disease continue to base their choices on alternative, lower quality sources of evidence, which hopefully, in the future, will also be appraised and incorporated in a Cochrane Review.

  18. Suicidality and symptoms of anxiety, irritability, and agitation in patients experiencing manic episodes with depressive symptoms: a naturalistic study

    Directory of Open Access Journals (Sweden)

    Eberhard J

    2016-08-01

    Full Text Available Jonas Eberhard,1 Emmanuelle Weiller2 1Department of Clinical Sciences, Lund University, Lund, Sweden; 2H. Lundbeck A/S, Copenhagen, Denmark Purpose: Patients with a bipolar I disorder (BD-I manic episode meeting the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5, criteria for “with mixed features” have a high incidence of suicide attempts and of anxiety, irritability, and agitation (AIA symptoms. The aim of this analysis was to explore the relationship between suicidality and AIA symptoms in patients with BD-I experiencing mania with depressive symptoms, using data from a previous naturalistic study.Patients and methods: Psychiatrists completed an online questionnaire about their adult patients who had a current BD-I manic episode. Questions covered the DSM-5 “with mixed features” specifier, the severity of AIA symptoms, the frequency and controllability of suicidal ideation, and the number of suicide attempts.Results: Of 1,035 patients with BD-I mania who were included in the analyses, 348 (33.6% met the criteria for the DSM-5 “with mixed features” specifier (three or more depressive symptoms. These patients were further stratified according to the severity of their AIA symptoms: “mild AIA” (zero or one AIA symptom above a severity threshold; 105 patients or “severe AIA” (all three AIA symptoms above a severity threshold; 167 patients. A greater incidence of suicidal ideation was observed in the severe AIA group (71.9% than in the mild AIA group (47.6%. Twice as many patients had easily controlled suicidal ideation than difficult-to-control suicidal ideation in both subgroups. The mean number of suicide attempts was higher in the severe AIA group than in the mild AIA group, during the current episode (0.84 vs 0.34 attempts, respectively; P<0.05 and over the patient’s lifetime (1.56 vs 1.04 attempts, respectively.Conclusion: The high risk of suicide among BD-I mania patients with depressive

  19. Guidelines disconcordance in acute bipolar depression: data from the national Bipolar Mania Pathway Survey (BIPAS) in mainland China.

    Science.gov (United States)

    Wang, Zuowei; Gao, Keming; Hong, Wu; Xing, Mengjuan; Wu, Zhiguo; Chen, Jun; Zhang, Chen; Yuan, Chengmei; Huang, Jia; Peng, Daihui; Wang, Yong; Lu, Weihong; Yi, Zhenghui; Yu, Xin; Zhao, Jingping; Fang, Yiru

    2014-01-01

    With the recent attention to the importance of evidence-based medicine in psychiatry, a number of treatment guidelines have been published. This survey investigated prescribing pattern and predictors for guideline disconcordance in the acute treatment of bipolar depression across mainland China. Pharmacological treatments of 1078 patients with bipolar depression were examined. Guidelines disconcordance was determined by comparing the medication(s) patients were prescribed with the recommendation(s) in the guidelines of the Canadian Network for Mood and Anxiety Treatments. Predictors for guidelines discordance were analyzed with logistic regression. Of the 1078 patients, 50.2% patients were treated against treatment guidelines recommendations. The patients who were treated in general hospitals (OR = 1.53, 95% CI 1.18-1.97), with a depressive episode (OR = 1.67, 95% CI 1.27-2.19) and an older age at first onset (OR = 1.62, 95% CI 1.15-2.28) were more likely to receive guideline-disconcordant treatment than their counterparts. In contrast, the patients with current mental comorbidity, an older age at study entry, a longer duration of disease, and more frequent episodes in past year were less likely to receive guideline-disconcordant treatments than their counterparts with an OR of 0.43 (95% CI 0.24-0.77), 0.52 (95CI% 0.36-0.75), 0.48 (95% CI 0.36-0.65), and 0.50 (95% CI 0.38-0.64), respectively. Our finding suggested the disconcordance with treatment guidelines in patients with an acute bipolar depression is common under naturalistic conditions in mainland China, and the predicting factors correlated with guidelines disconcordance include both psychiatrist-specific (clinicians from general hospitals) and patient-specific features (a depressive episode at first onset, no current co-morbidity with mental disorders, a younger age at study entry, an older age at first onset, shorter duration of disease, and non-frequent episodes in past year).

  20. Lack of association between prior depressive episodes and cerebral [(11)C]PiB binding

    DEFF Research Database (Denmark)

    Madsen, K; Hasselbalch, Bo Jacob; Frederiksen, K S

    2012-01-01

    Depressive symptoms are frequent in Alzheimer's disease (AD), but it is controversial whether depression is a risk factor for AD. This study measured for the first time cortical amyloid-ß (Aß) levels using [(11)C] Pittsburgh Compound B (PiB) positron emission tomography (PET) in a group of nondem...

  1. Cost-effectiveness of gammaCore (non-invasive vagus nerve stimulation) for acute treatment of episodic cluster headache.

    Science.gov (United States)

    Mwamburi, Mkaya; Liebler, Eric J; Tenaglia, Andrew T

    2017-11-01

    Cluster headache is a debilitating disease characterized by excruciatingly painful attacks that affects 0.15% to 0.4% of the US population. Episodic cluster headache manifests as circadian and circannual seasonal bouts of attacks, each lasting 15 to 180 minutes, with periods of remission. In chronic cluster headache, the attacks occur throughout the year with no periods of remission. While existing treatments are effective for some patients, many patients continue to suffer. There are only 2 FDA-approved medications for episodic cluster headache in the United States, while others, such as high-flow oxygen, are used off-label. Episodic cluster headache is associated with comorbidities and affects work, productivity, and daily functioning. The economic burden of episodic cluster headache is considerable, costing more than twice that of nonheadache patients. gammaCore adjunct to standard of care (SoC) was found to have superior efficacy in treatment of acute episodic cluster headaches compared with sham-gammaCore used with SoC in ACT1 and ACT2 trials. However, the economic impact has not been characterized for this indication. We conducted a cost-effectiveness analysis of gammaCore adjunct to SoC compared with SoC alone for the treatment of acute pain associated with episodic cluster headache attacks. The model structure was based on treatment of acute attacks with 3 outcomes: failures, nonresponders, and responders. The time horizon of the model is 1 year using a payer perspective with uncertainty incorporated. Parameter inputs were derived from primary data from the randomized controlled trials for gammaCore. The mean annual costs associated with the gammaCore-plus-SoC arm was $9510, and mean costs for the SoC-alone arm was $10,040. The mean quality-adjusted life years for gammaCore-plus-SoC arm were 0.83, and for the SoC-alone arm, they were 0.74. The gammaCore-plus-SoC arm was dominant over SoC alone. All 1-way and multiway sensitivity analyses were cost

  2. Rates and predictors of remission, recurrence and conversion to bipolar disorder after the first lifetime episode of depression--a prospective 5-year follow-up study.

    Science.gov (United States)

    Bukh, J D; Andersen, P K; Kessing, L V

    2016-04-01

    In depression, non-remission, recurrence of depressive episodes after remission and conversion to bipolar disorder are crucial determinants of poor outcome. The present study aimed to determine the cumulative incidences and clinical predictors of these long-term outcomes after the first lifetime episode of depression. A total of 301 in- or out-patients aged 18-70 years with a validated diagnosis of a single depressive episode were assessed from 2005 to 2007. At 5 years of follow-up, 262 patients were reassessed by means of the life chart method and diagnostic interviews from 2011 to 2013. Cumulative incidences and the influence of clinical variables on the rates of remission, recurrence and conversion to bipolar disorder, respectively, were estimated by survival analysis techniques. Within 5 years, 83.3% obtained remission, 31.5% experienced recurrence of depression and 8.6% converted to bipolar disorder (6.3% within the first 2 years). Non-remission increased with younger age, co-morbid anxiety and suicidal ideations. Recurrence increased with severity and treatment resistance of the first depression, and conversion to bipolar disorder with treatment resistance, a family history of affective disorder and co-morbid alcohol or drug abuse. The identified clinical characteristics of the first lifetime episode of depression should guide patients and clinicians for long-term individualized tailored treatment.

  3. Escitalopram treatment for depressive disorder following acute coronary syndrome: a 24-week double-blind, placebo-controlled trial.

    Science.gov (United States)

    Kim, Jae-Min; Bae, Kyung-Yeol; Stewart, Robert; Jung, Bo-Ok; Kang, Hee-Ju; Kim, Sung-Wan; Shin, Il-Seon; Hong, Young Joon; Kim, Ju Han; Shin, Hee-Young; Kang, Gaeun; Ahn, Youngkeun; Kim, Jong-Keun; Jeong, Myung Ho; Yoon, Jin-Sang

    2015-01-01

    Depression is common after acute coronary syndrome (ACS) and has adverse effects on prognosis. There are few evidence-based interventions for treating depression in ACS. This study investigated the efficacy and safety of escitalopram in treating depressive disorders identified 2-14 weeks after a confirmed ACS episode. A total of 217 patients with DSM-IV depressive disorders (121 major and 96 minor) and ACS were randomly assigned to receive escitalopram in flexible doses of 5-20 mg/d (n = 108) or placebo (n = 109) for 24 weeks. The study was conducted from 2007 to 2013. The primary outcome measure was the Hamilton Depression Rating Scale (HDRS). Secondary outcome measures included the Montgomery-Asberg Depression Rating Scale (MADRS), Beck Depression Inventory (BDI), Clinical Global Impressions-Severity of Illness scale (CGI-S), Social and Occupational Functioning Assessment Scale (SOFAS), and World Health Organization Disability Assessment Schedule-12. Cardiovascular safety outcomes included echocardiography, electrocardiography, laboratory test, body weight, and blood pressure results. Escitalopram was superior to placebo in reducing HDRS scores (mean difference = 2.3, P = .016, effect size = 0.38). Escitalopram was also superior to placebo in decreasing depressive symptoms evaluated by the MADRS, BDI, and CGI-S and in improving SOFAS functioning level. Escitalopram was not associated with any harmful changes in cardiovascular safety measures. Dizziness was significantly more frequently reported in the escitalopram group (P = .018), but there were no significant differences in any other adverse events. These results indicate that escitalopram has clinically meaningful antidepressant effects with no evidence of reduced cardiovascular safety in depressive disorder following ACS. ClinicalTrials.gov identifier: NCT00419471. © Copyright 2015 Physicians Postgraduate Press, Inc.

  4. Episodic Visual Learning/Memory and Attentional Flexibility in Patients With Major Depressive Disorder After Clinically Effective Electroconvulsive Therapy.

    Science.gov (United States)

    Kalogerakou, Stamatina; Oulis, Panagiotis; Anyfandi, Eleni; Konstantakopoulos, George; Papakosta, Vasiliki-Maria; Kontis, Dimitrios; Theochari, Eirini; Angelopoulos, Elias; Zervas, Ioannis M; Mellon, Robert C; Papageorgiou, Charalambos C; Tsaltas, Eleftheria

    2015-12-01

    This study is a follow-up of a previous one reporting that the neuropsychological profile of pharmacoresistant patients with major depressive disorder referred for electroconvulsive therapy (ECT, ECT group) contrasted with that of their pharmacorespondent counterparts (NECT group). The NECT group exhibited severe visuospatial memory and minor executive deficits; the ECT group presented the reverse pattern. In that same ECT group, the current follow-up study examined the effects of clinically effective ECT on both cognitive domains 2 months later. Fifteen ECT patients were administered Hamilton Depression (HAMD-24), Hamilton Anxiety (HAMA), Mini-Mental State Examination Scales and 5 tests of Cambridge Neuropsychological Test Automated Battery at intake (pre-ECT), end of ECT course (post-ECT), and 2 months thereafter (follow-up). Electroconvulsive therapy was effective in relieving clinical depression. After a post-ECT decline, the patients exhibited significant improvement in both Cambridge Neuropsychological Test Automated Battery, paired associate learning, and Stockings of Cambridge. By contrast, their major pre-ECT deficit in intra/extradimensional set shifting remained virtually unaffected. Our findings suggest that attentional flexibility deficits may constitute a neuropsychological trait-like feature of pharmacoresistant, ECT-referred major depressive disorder patients. However, this deficit does not seem generalized, given patient improvement in episodic visual learning/memory and some indication of improvement in spatial planning after ECT.

  5. Residual symptoms in patients with partial versus complete remission of a major depressive disorder episode: patterns of painful physical symptoms in depression

    Directory of Open Access Journals (Sweden)

    Harada E

    2016-06-01

    Full Text Available Eiji Harada,1 Yoichi Satoi,2 Toshiaki Kikuchi,3 Koichiro Watanabe,3 Levent Alev,1 Masaru Mimura4 1Medical Science, Medicines Development Unit-Japan, 2Statistical Science, Medicines Development Unit-Japan, Eli Lilly Japan K.K., Kobe, Hyogo, 3Department of Neuropsychiatry, Kyorin University School of Medicine, 4Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan Objective: The patterns of residual painful physical symptoms (PPS and emotional symptoms among patients with partial remission (PR or complete remission (CR of a major depressive disorder (MDD episode were compared. Methods: This is a multicenter, cross-sectional, observational study. Patients who had originally been diagnosed with MDD, were treated with an antidepressant for 12 weeks for that episode, and achieved either PR or CR at study entry were enrolled in the study. Using the 17-item Hamilton Rating Scale for Depression (HAM-D17, PR was defined as a score of ≥8 and ≤18 and CR as a score of ≤7. Residual symptoms were assessed using the Brief Pain Inventory-Short Form (BPI-SF and the HAM-D17.Results: A total of 323 patients (CR =158, PR =165 were included in the study. Patients in the PR group had a higher mean (standard deviation score in the HAM-D17 than those in the CR group (11.8 [3.1] and 4.4 [2.0], respectively. BPI-SF results showed that “at least moderate PPS” (score ≥3 on BPI-SF question 5 was significantly more prevalent among patients with PR than those with CR (37.0% vs 16.5%, respectively; odds ratio =3.04; P<0.001. Presence of pain (any severity was also more prevalent among patients with PR than those with CR (54.5% vs 35.4%, respectively. The HAM-D17 results for individual items indicated that impaired work and activities, depressed mood, psychological and somatic anxiety, and general somatic symptoms were observed in at least 75% of patients with PR.Conclusion: PR was associated with a higher prevalence of at least moderate PPS

  6. Does psychomotor agitation in major depressive episodes indicate bipolarity? Evidence from the Zurich Study.

    Science.gov (United States)

    Angst, Jules; Gamma, Alex; Benazzi, Franco; Ajdacic, Vladeta; Rössler, Wulf

    2009-02-01

    Kraepelin's partial interpretation of agitated depression as a mixed state of "manic-depressive insanity" (including the current concept of bipolar disorder) has recently been the focus of much research. This paper tested whether, how, and to what extent both psychomotor symptoms, agitation and retardation in depression are related to bipolarity and anxiety. The prospective Zurich Study assessed psychiatric and somatic syndromes in a community sample of young adults (N = 591) (aged 20 at first interview) by six interviews over 20 years (1979-1999). Psychomotor symptoms of agitation and retardation were assessed by professional interviewers from age 22 to 40 (five interviews) on the basis of the observed and reported behaviour within the interview section on depression. Psychiatric diagnoses were strictly operationalised and, in the case of bipolar-II disorder, were broader than proposed by DSM-IV-TR and ICD-10. As indicators of bipolarity, the association with bipolar disorder, a family history of mania/hypomania/cyclothymia, together with hypomanic and cyclothymic temperament as assessed by the general behavior inventory (GBI) [15], and mood lability (an element of cyclothymic temperament) were used. Agitated and retarded depressive states were equally associated with the indicators of bipolarity and with anxiety. Longitudinally, agitation and retardation were significantly associated with each other (OR = 1.8, 95% CI = 1.0-3.2), and this combined group of major depressives showed stronger associations with bipolarity, with both hypomanic/cyclothymic and depressive temperamental traits, and with anxiety. Among agitated, non-retarded depressives, unipolar mood disorder was even twice as common as bipolar mood disorder. Combined agitated and retarded major depressive states are more often bipolar than unipolar, but, in general, agitated depression (with or without retardation) is not more frequently bipolar than retarded depression (with or without agitation), and

  7. Altered functional connectivity of the dorsolateral prefrontal cortex in first-episode patients with major depressive disorder

    International Nuclear Information System (INIS)

    Ye, Ting; Peng, Jing; Nie, Binbin; Gao, Juan; Liu, Jiangtao; Li, Yang; Wang, Gang; Ma, Xin; Li, Kuncheng

    2012-01-01

    Background: The aim of this study was to investigate resting-state functional connectivity alteration of the right dorsolateral prefrontal cortex (DLPFC) in patients with first-episode major depressive disorder (MDD). Methods: Twenty-two first-episode MDD patients and thirty age-, gender- and education-matched healthy control subjects were enrolled. Rest state functional magnetic resonance images and structure magnetic resonance images were scanned. The functional connectivity analysis was done based on the result of voxel-based morphometry (VBM). And the right DLPFC was chosen as the seed region of interests (ROI), as its gray matter density (GMD) decreased in the MDD patients compared with controls and its GMD values were negative correlation with the Hamilton Depression Rating Scale (HDRS) scores. Results: Compared to healthy controls, the MDD patients showed increased functional connectivity with right the DLPFC in the left dorsal anterior cingulate cortex (ACC), left parahippocampal gyrus (PHG), thalamus and precentral gyrus. In contrast, there were decreased functional connectivity between the right DLPFC and right parietal lobe. Conclusions: By applying the VBM results to the functional connectivity analysis, the study suggested that abnormality of GMD in right DLPFC might be related to the functional connectivity alteration in the pathophysiology of MDD, which might be useful in further characterizing structure–function relations in this disorder.

  8. Altered functional connectivity of the dorsolateral prefrontal cortex in first-episode patients with major depressive disorder

    Energy Technology Data Exchange (ETDEWEB)

    Ye, Ting, E-mail: yeting@ihep.ac.cn [Key Laboratory of Nuclear Analytical Techniques, Institute of High Energy Physics, Chinese Academy of Sciences, PO Box 918, Yu-Quan St, Shijingshan District, Beijing 100049 (China); Graduate School of Chinese Academy of Sciences, PO Box 918, Yu-Quan St, Shijingshan District, Beijing 100049 (China); Peng, Jing, E-mail: ppengjjing@sina.com.cn [Department of Radiology, Xuanwu Hospital of Capital Medical University, No. 45, Chang-Chun St, Xuanwu District, Beijing 100053 (China); Nie, Binbin, E-mail: niebb@ihep.ac.cn [Key Laboratory of Nuclear Analytical Techniques, Institute of High Energy Physics, Chinese Academy of Sciences, PO Box 918, Yu-Quan St, Shijingshan District, Beijing 100049 (China); Gao, Juan, E-mail: gaojuan@ihep.ac.cn [Key Laboratory of Nuclear Analytical Techniques, Institute of High Energy Physics, Chinese Academy of Sciences, PO Box 918, Yu-Quan St, Shijingshan District, Beijing 100049 (China); Graduate School of Chinese Academy of Sciences, PO Box 918, Yu-Quan St, Shijingshan District, Beijing 100049 (China); Liu, Jiangtao, E-mail: Liujiangtao813@sina.com [Department of Radiology, Xuanwu Hospital of Capital Medical University, No. 45, Chang-Chun St, Xuanwu District, Beijing 100053 (China); Li, Yang, E-mail: Liyang2007428@hotmail.com [Department of Psychiatry, Anding Hospital of Capital Medical University, No. 5, An Kang Hutong, Deshengmen wai, Xicheng District, Beijing 100088 (China); Wang, Gang, E-mail: gangwang@gmail.com [Department of Psychiatry, Anding Hospital of Capital Medical University, No. 5, An Kang Hutong, Deshengmen wai, Xicheng District, Beijing 100088 (China); Ma, Xin, E-mail: lijianshe@medmail.com.cn [Department of Psychiatry, Anding Hospital of Capital Medical University, No. 5, An Kang Hutong, Deshengmen wai, Xicheng District, Beijing 100088 (China); Li, Kuncheng [Department of Radiology, Xuanwu Hospital of Capital Medical University, No. 45, Chang-Chun St, Xuanwu District, Beijing 100053 (China); and others

    2012-12-15

    Background: The aim of this study was to investigate resting-state functional connectivity alteration of the right dorsolateral prefrontal cortex (DLPFC) in patients with first-episode major depressive disorder (MDD). Methods: Twenty-two first-episode MDD patients and thirty age-, gender- and education-matched healthy control subjects were enrolled. Rest state functional magnetic resonance images and structure magnetic resonance images were scanned. The functional connectivity analysis was done based on the result of voxel-based morphometry (VBM). And the right DLPFC was chosen as the seed region of interests (ROI), as its gray matter density (GMD) decreased in the MDD patients compared with controls and its GMD values were negative correlation with the Hamilton Depression Rating Scale (HDRS) scores. Results: Compared to healthy controls, the MDD patients showed increased functional connectivity with right the DLPFC in the left dorsal anterior cingulate cortex (ACC), left parahippocampal gyrus (PHG), thalamus and precentral gyrus. In contrast, there were decreased functional connectivity between the right DLPFC and right parietal lobe. Conclusions: By applying the VBM results to the functional connectivity analysis, the study suggested that abnormality of GMD in right DLPFC might be related to the functional connectivity alteration in the pathophysiology of MDD, which might be useful in further characterizing structure–function relations in this disorder.

  9. Diagnostic pitfalls in a young Romanian ranger with an acute psychotic episode

    Directory of Open Access Journals (Sweden)

    Nagy EE

    2016-05-01

    battery of other autoimmune encephalitis markers showed negative. A complex program of treatment was applied, including antibiotics, beginning with ceftazidime and ciprofloxacin – for suspected aspiration bronchopneumonia – and thereafter with ceftriaxone. A gradual improvement was noticed and the treatment continued at the Infectious Disease Clinic. Finally, the patient was discharged with a doxycycline, antidepressant, and anxiolytic maintenance treatment. On his first and second control (days 44 and 122 from the disease onset, the patient was stable with no major complaints, Borrelia seropositivity was confirmed both for IgM and IgG while the cerebrospinal fluid also showed reactivity for IgG on immunoblot. On the basis of the putative occupational risk, acute psychotic episode, and the success of antibiotic therapy, we registered this case as a late neuroborreliosis with atypical appearance.Keywords: Borrelia burgdorferi, neuroborreliosis, neuropsychiatric symptoms, encephalitis, anti-NMDAR

  10. Depressive symptoms in younger women and men with acute myocardial infarction : Insights from the VIRGO Study

    NARCIS (Netherlands)

    Smolderen, Kim G.; Strait, Kelly M.; Dreyer, Rachel P.; D'Onofrio, Gail; Zhou, Shengfan; Lichtman, Judith H.; Geda, Mary; Bueno, Hector; Beltrame, John; Safdar, Basmah; Krumholz, Harlan M.; Spertus, John A.

    2015-01-01

    Background Depression was recently recognized as a risk factor for adverse medical outcomes in patients with acute myocardial infarction (AMI). The degree to which depression is present among younger patients with an AMI, the patient profile associated with being a young AMI patient with depressive

  11. [Integral Care Guide for Early Detection and Diagnosis of Depressive Episodes and Recurrent Depressive Disorder in Adults. Integral Attention of Adults with a Diagnosis of Depressive Episodes and Recurrent Depressive Disorder: Part I: Risk Factors, Screening, Suicide Risk Diagnosis and Assessment in Patients with a Depression Diagnosis].

    Science.gov (United States)

    Gómez-Restrepo, Carlos; Peñaranda, Adriana Patricia Bohórquez; Valencia, Jenny García; Guarín, Maritza Rodríguez; Narváez, Eliana Bravo; Jaramillo, Luis Eduardo; Acosta, Carlos Alberto Palacio; Pedraza, Ricardo Sánchez; Díaz, Sergio Mario Castro

    2012-12-01

    Depression is an important cause of morbidity and disability in the world; however, it is under-diagnosed at all care levels. The purpose here is to present recommendations based on the evidence gathered to answer a series of clinical questions concerning risk factors, screening, suicide risk diagnosis and evaluation in patients undergoing a depressive episode and recurrent depressive disorder. Emphasis has been made upon the approach used at the primary care level so as to grant adult diagnosed patients the health care guidelines based on the best and more updated evidence available thus achieving minimum quality standards. A practical clinical guide was elaborated according to standards of the Methodological Guide of the Ministry of Social Protection. Recommendation from guides NICE90 and CANMAT were adopted and updated so as to answer the questions posed while de novo questions were developed. Recommendations 1-22 corresponding to screening, suicide risk and depression diagnosis were presented. The corresponding degree of recommendation is included. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  12. Rumination as a Vulnerability Factor to Depression in Adolescents in Mainland China: Lifetime History of Clinically Significant Depressive Episodes

    Science.gov (United States)

    Hong, Wei; Abela, John R. Z.; Cohen, Joseph R.; Sheshko, Dana M.; Shi, Xiao Ting; Hamel, Anton Van; Starrs, Claire

    2010-01-01

    The current study tested the vulnerability and sex differences hypotheses of the response styles theory of depression (Nolen-Hoeksema, 1991). Participants included 494 tenth-grade students (M = 15.25 years, SD = 0.47) recruited from two secondary schools in Beijing, China. Participants completed self-report measures assessing rumination and…

  13. A comparative study of olanzapine versus asenapine in acute treatment of manic episode: A 3-week prospective study

    Directory of Open Access Journals (Sweden)

    Ajeet Sidana

    2014-01-01

    Full Text Available Introduction: Treatment of bipolar disorders has evolved over the years from conventional mood stabilizers to second-generation antipsychotics. Among the atypical antipsychotics, few have been approved by Food and Drug Administration as treatment of bipolar disorders. Aim: To study the efficacy and tolerability of olanzapine and asenapine in the acute treatment of bipolar disorder-manic episode in a 3-week randomized prospective study. Materials and Methods: A 3-week randomized, prospective, comparative, flexible doses of olanzapine (5-30 mg/day and asenapine (10-20 mg/day for acute treatment of bipolar disorder-current manic episode with or without psychotic symptoms in hospitalized patients. Results: The end-point reduction in mean score of Young Mania rating scale in the olanzapine group was 15.82 in comparison to 6.88 in the asenapine group. Mean score on clinical global impression for bipolar disorder and positive and negative syndrome scale was significantly less in the olanzapine group at the end of the study. 81.81% patients in olanzapine group and 17.60% patients in asenapine group had clinical response. There was significant average weight gain in the olanzapine group - 1.9 kg in comparison to 0.87 kg in asenapine group. Conclusion: The clinical response with olanzapine is significantly higher than the asenapine in the treatment of bipolar disorder-manic episode with or without psychotic symptoms. However, there is significant weight gain in olanzapine-treated patients.

  14. Diagnostic role of initial renal cortical scintigraphy in children with the first episode of acute pyelonephritis

    International Nuclear Information System (INIS)

    Jaksic, E.; Bogdanovic, R.; Artiko, V.

    2011-01-01

    Assessment of the first febrile urinary tract infection (UTI) in children has been the subject of debate for many years. Diagnosis of acute pyelonephritis (APN) is usually based on clinical and biological data. The clinical usefulness of early Tc-99m dimercaptosuccinic acid (DMSA) scintigraphy remains controversial, although it may influence the type and duration of treatment. The aim of this study was to assess the role of initial cortical scintigraphy in the detection of early renal parenchymal damage in children highly suspected of having APN and to compare the scintigraphic findings with selected clinical/laboratory parameters and ultrasonography. A prospective study was conducted in 34 infants and young children (18 boys, 16 girls), aged 1.5-36 months (mean 9.8±8.7 months), hospitalized with a first episode of clinically suspected APN. Within the first 5 days after admission, Tc-99m DMSA renal scintigraphy, ultrasonography (US), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), white blood cell count (WBC) and urine analyses were performed. DMSA scintigraphy showed changes consistent with APN in 27/34 (79%) patients, with a mean age of 10.9 months, including 12 males (44%) and 15 (56%) females. Out of 9 febrile children with negative urine culture and supportive evidence of UTI, scintigraphy showed parenchymal involvement in 8 children (24% in the whole group, 30% in scintigraphically documented APN). There were no statistically significant correlations between the frequency or size of the initial scintigraphic abnormalities and age, sex, body temperature, CRP levels or ESR. A CRP level of >54 mg/L and a WBC of >13,300/mm 3 had sensitivities of 56 and 59% and specificities of 86 and 71%, respectively. US showed changes consistent with APN in 7/34 (21%) in the whole group and in 7/27 (26%) patients with positive cortical scan (p<0.05). Initial DMSA renal scintigraphy is a sensitive method for the early diagnosis of APN in young children and is

  15. Criticism and Depression among the Caregivers of At-Risk Mental State and First-Episode Psychosis Patients.

    Directory of Open Access Journals (Sweden)

    Yumiko Hamaie

    Full Text Available Expressed emotion (EE, especially criticism, is an important predictor of outcomes for the patient for a wide range of mental health problems. To understand complex links between EE and various relevant variables in early phase psychosis, this study examined criticism, distress of caregivers, other patients', and caregivers' variables, and links between criticism and these variables in those with at-risk mental state (ARMS for psychosis and first-episode psychosis (FEP. The participants were 56 patients (mean age 18.8 ± 4.2 years with ARMS and their caregivers (49.4 ± 5.8 years and 43 patients (21.7 ± 5.2 years with FEP and their caregivers (49.3 ± 7.4 years. We investigated criticisms made by caregivers using the Japanese version of the Family Attitude Scale and caregiver depressive symptoms via the self-report Beck Depression Inventory. We also assessed psychiatric symptoms and functioning of the patients. Approximately one-third of caregivers of patients with ARMS or FEP had depressive symptoms, predominately with mild-to-moderate symptom levels, whereas only a small portion exhibited high criticism. The level of criticism and depression were comparable between ARMS and FEP caregivers. The link between criticism, caregivers' depression, and patients' symptoms were observed in FEP but not in ARMS caregivers. These findings imply that the interaction between criticism and caregivers' and patients' mental states may develop during or after the onset of established psychosis and interventions for the caregivers should be tailored to the patient's specific stage of illness. Interventions for FEP caregivers should target their emotional distress and include education about patient's general symptoms.

  16. Mental health and urban living in sub-Saharan Africa: major depressive episodes among the urban poor in Ouagadougou, Burkina Faso.

    Science.gov (United States)

    Duthé, Géraldine; Rossier, Clémentine; Bonnet, Doris; Soura, Abdramane Bassiahi; Corker, Jamaica

    2016-01-01

    In sub-Saharan African cities, the epidemiological transition has shifted a greater proportion of the burden of non-communicable diseases, including mental and behavioral disorder, to the adult population. The burden of major depressive disorder and its social risk factors in the urban sub-Saharan African population are not well understood and estimates vary widely. We conducted a study in Ouagadougou, Burkina Faso, in order to estimate the prevalence of major depressive episodes among adults in this urban setting. The Ouagadougou Health and Demographic System Site (HDSS) has followed the inhabitants of five outlying neighborhoods of the city since 2008. In 2010, a representative sample of 2,187 adults (aged 15 and over) from the Ouaga HDSS was interviewed in depth regarding their physical and mental health. Using criteria from the Mini International Neuropsychiatric Interview (MINI), we identified the prevalence of a major depressive episode at the time of the interview among respondents and analyzed its association with demographic, socioeconomic, and health characteristics through a multivariate analysis. Major depressive episode prevalence was 4.3 % (95 % CI: 3.1-5.5 %) among the survey respondents. We found a strong association between major depressive episode and reported chronic health problems, functional limitations, ethnicity and religion, household food shortages, having been recently a victim of physical violence and regularly drinking alcohol. Results show a U-shaped association of the relationship between major depressive episode and standard of living, with individuals in both the poorest and richest groups most likely to suffer from major depressive disorder than those in the middle. Though, the poorest group remains the most vulnerable one, even when controlling by health characteristics. Major depressive disorder is a reality for many urban residents in Burkina Faso and likely urbanites throughout sub-Saharan Africa. Countries in the region

  17. Depression

    DEFF Research Database (Denmark)

    Pouwer, Frans

    2017-01-01

    There is ample evidence that depression is000  a common comorbid health issue in people with type 1 or type 2 diabetes. Reviews have also concluded that depression in diabetes is associated with higher HbA1c levels, less optimal self-care behaviours, lower quality of life, incident vascular...... complications and higher mortality rates. However, longitudinal studies into the course of depression in people with type 1 diabetes remain scarce. In this issue of Diabetologia, Kampling and colleagues (doi: 10.1007/s00125-016-4123-0 ) report the 5 year trajectories of depression in adults with newly diagnosed...... type 1 diabetes (mean age, 28 years). Their baseline results showed that shortly after the diagnosis of type 1 diabetes a major depressive episode was diagnosed in approximately 6% of participants, while 8% suffered from an anxiety disorder. The longitudinal depression data showed that, in a 5 year...

  18. Add-on high frequency deep transcranial magnetic stimulation (dTMS) to bilateral prefrontal cortex in depressive episodes of patients with major depressive disorder, bipolar disorder I, and major depressive with alcohol use disorders.

    Science.gov (United States)

    Rapinesi, Chiara; Kotzalidis, Georgios D; Ferracuti, Stefano; Girardi, Nicoletta; Zangen, Abraham; Sani, Gabriele; Raccah, Ruggero N; Girardi, Paolo; Pompili, Maurizio; Del Casale, Antonio

    2018-04-03

    Dorsolateral prefrontal cortex (DLPFC) is critically involved in mood and alcohol use disorders. We aimed to investigate the safety of intervention with add-on bilateral prefrontal high-frequency deep transcranial magnetic stimulation (dTMS) and between-group differences in treatment response in patients with different types of depressive episodes, including major depressive episodes in the course of major depressive disorder (MDD), bipolar disorder, type I (BD-I), and MDD with alcohol use disorder (MDAUD). We conducted a 6-month open-label study, involving 82 patients with DSM-5 Depressive Episode. Of these, 41 had diagnosis of MDD, 20 BD-I, and 21 MDAUD. All patients received standard drug treatment and add-on dTMS over the bilateral DLPFC with left prevalence for four weeks, with five sessions in each week. We rated mood state with the Hamilton Depression Rating Scale (HDRS) at baseline, one-month, and six-month follow-up visits. Mean total HDRS scores dropped from 22.8 (SD = 5.9) at baseline to 10.4 (SD = 3.6) at 1 month, to 10.0 (SD = 4.5) at 6 months, while response/remission were 70.73% (N = 58) and 19.51% (N = 16) at 1 month and 76.83% (N = 63) and 32.93% (27) at 6 months, respectively, with no between-group differences. No patient experienced any side effects. High-frequency DLPFC dTMS was well tolerated and did not significantly differ on improvement of depression in MDD, BD-I, and MDAUD. Copyright © 2018 Elsevier B.V. All rights reserved.

  19. Association Between Genetic Polymorphisms in the Serotonergic System and Comorbid Personality Disorders Among Patients with First-Episode Depression

    DEFF Research Database (Denmark)

    Bukh, Jens D; Bock, Camilla; Kessing, Lars V

    2014-01-01

    Studies on the association between genetic polymorphisms and personality disorders have provided inconsistent results. Using the "enriched sample method," the authors of the present study aimed to assess the association between polymorphisms in the serotonergic transmitter system and comorbid...... personality disorders in patients recently diagnosed with first-episode depression. A total of 290 participants were systematically recruited via the Danish Psychiatric Central Research Register. Diagnoses of personality disorders were assessed by a SCID-II interview, and polymorphisms in the genes encoding...... the serotonin transporter, serotonin receptors 1A, 2A, 2C, and tryptophan hydroxylase 1 were genotyped. The authors found a significant effect of the length polymorphism in the serotonin transporter gene (5-HTTLPR) on cluster B personality disorder (mainly borderline disorder), but no influence on cluster C...

  20. A 64-year old man who sustained many episodes of acute cardiogenic pulmonary edema successfully treated with Boussignac continuous positive airway pressure : A case report

    NARCIS (Netherlands)

    Dieperink, Willem; van der Horst, Iwan C. C.; Nannenberg-Koops, Jaqueline W.; Brouwer, Henk W.; Jaarsma, T.; Nieuwland, Wybe; Zijlstra, Felix; Nijsten, Maarten W. N.

    2007-01-01

    Continuous positive airway pressure (CPAP) is standard treatment for patients with acute cardiogenic pulmonary edema. We describe a patient who had 21 episodes of acute cardiogenic pulmonary edema due to very poor patient compliance. This 64-year old man had end-stage congestive heart failure based

  1. DEPRESSION AND ANXIETY IN PATIENT WITH ACUTE CORONARY SYNDROME

    Directory of Open Access Journals (Sweden)

    Kadek Dwi Krisnayanti

    2013-07-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE Depression and anxiety are two conditions that common happened in patient with acute coronary syndrome which can cause negative cardiovascular outcomes. Although the prevalencies of these two conditions are slightly high, most of them had not been treated well. The mechanisms that underly the association between depression and anxiety with the negative cardiovascular outcome are possibly correlates with their effect on inflammatory process, cathecolamine release, heart rate variability, endothelial function and also their effect on health promoting behavior. Fortunately, the standard therapies that available for these conditions are safe, effective, and can be tolerated well in most patients. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  2. Tele-Interpersonal Psychotherapy Acutely Reduces Depressive Symptoms in Depressed HIV-Infected Rural Persons: A Randomized Clinical Trial.

    Science.gov (United States)

    Heckman, Timothy G; Heckman, Bernadette D; Anderson, Timothy; Lovejoy, Travis I; Markowitz, John C; Shen, Ye; Sutton, Mark

    2017-01-01

    Human immunodeficiency virus (HIV)-positive rural individuals carry a 1.3-times greater risk of a depressive diagnosis than their urban counterparts. This randomized clinical trial tested whether telephone-administered interpersonal psychotherapy (tele-IPT) acutely relieved depressive symptoms in 132 HIV-infected rural persons from 28 states diagnosed with Diagnostic and Statistical Manual of Mental Disorders-IV major depressive disorder (MDD), partially remitted MDD, or dysthymic disorder. Patients were randomized to either 9 sessions of one-on-one tele-IPT (n = 70) or standard care (SC; n = 62). A series of intent-to-treat (ITT), therapy completer, and sensitivity analyses assessed changes in depressive symptoms, interpersonal problems, and social support from pre- to postintervention. Across all analyses, tele-IPT patients reported significantly lower depressive symptoms and interpersonal problems than SC controls; 22% of tele-IPT patients were categorized as a priori "responders" who reported 50% or higher reductions in depressive symptoms compared to only 4% of SC controls in ITT analyses. Brief tele-IPT acutely decreased depressive symptoms and interpersonal problems in depressed rural people living with HIV.

  3. Episode-specific risk factors for progression of acute diarrhoea to persistent diarrhoea in west African children

    DEFF Research Database (Denmark)

    Sodemann, Morten; Jakobsen, M S; Mølbak, Kare

    2013-01-01

    that these episodes initially were less acute. Use of oral rehydration salts did not have an impact on development of PD, whereas home medication tended to increase the risk of PD. Our study confirms the close association between systemic illness and PD as well as the importance of cryptosporidiosis as a cause of PD...... the episode stopped or after 14 days with diarrhoea. Children who still had diarrhoea after 14 days (n = 40, 12.5% of episodes) were regarded as suffering from PD. Clinical signs, perceived by the mother, were recorded together with care-seeking behaviour and management actions. Tired and rapid breathing...... prior (OR = 6.52 (95% CI 1.69-25.1)), mother had to force breast feeding (OR = 8.01 (2.99-21.5)) and current infection with Cryptosporidium (OR = 5.53 (2.10-14.6)) were the most important independent risk factors for the development of PD. Late consultation (> 48 h) was associated with PD, reflecting...

  4. Heavy Smoking Is Associated With Lower Age at First Episode of Acute Pancreatitis and a Higher Risk of Recurrence.

    Science.gov (United States)

    Munigala, Satish; Conwell, Darwin L; Gelrud, Andres; Agarwal, Banke

    2015-08-01

    There is limited data on cigarette smoking and the risk of acute pancreatitis (AP). We evaluated the influence of cigarette smoking on AP risk and clinical presentation in a large cohort of Veteran's Administration (VA) patients. Retrospective study of VA patients from 1998 to 2007. Exclusion criteria included (1) history of chronic pancreatitis (n = 3222) or gallstones (n = 14,574) and (2) age younger than 15 years (n = 270). A 2-year washout period was used to exclude patients with pre-existing recurrent AP. The study included 484,624 patients. From 2001 to 2007, a total of 6799 (1.4%) patients had AP. Alcohol (risk ratio, 4.20) and smoking (risk ratio, 1.78) were independent significant risk factors of AP on multiple regression analysis. Smoking increased the risk of AP in both nonalcoholics (0.57% vs 1.1%) and alcoholics (2.6% vs 4.1%). Smoking was associated with younger mean age at first episode of AP and higher likelihood of recurrent AP (≥4 episodes) in both nonalcoholics and alcoholics. The interval between recurrent episodes was not altered by alcohol or smoking. In a large cohort of VA patients, smoking is an independent risk factor for AP and augmented the effect of alcohol on the risk, age of onset, and recurrence of AP.

  5. Is video gaming, or video game addiction, associated with depression, academic achievement, heavy episodic drinking, or conduct problems?

    Science.gov (United States)

    Brunborg, Geir Scott; Mentzoni, Rune Aune; Frøyland, Lars Roar

    2014-03-01

    While the relationships between video game use and negative consequences are debated, the relationships between video game addiction and negative consequences are fairly well established. However, previous studies suffer from methodological weaknesses that may have caused biased results. There is need for further investigation that benefits from the use of methods that avoid omitted variable bias. Two wave panel data was used from two surveys of 1,928 Norwegian adolescents aged 13 to 17 years. The surveys included measures of video game use, video game addiction, depression, heavy episodic drinking, academic achievement, and conduct problems. The data was analyzed using first-differencing, a regression method that is unbiased by time invariant individual factors. Video game addiction was related to depression, lower academic achievement, and conduct problems, but time spent on video games was not related to any of the studied negative outcomes. The findings were in line with a growing number of studies that have failed to find relationships between time spent on video games and negative outcomes. The current study is also consistent with previous studies in that video game addiction was related to other negative outcomes, but it made the added contribution that the relationships are unbiased by time invariant individual effects. However, future research should aim at establishing the temporal order of the supposed causal effects. Spending time playing video games does not involve negative consequences, but adolescents who experience problems related to video games are likely to also experience problems in other facets of life.

  6. Heart rate variability measurement and clinical depression in acute coronary syndrome patients: narrative review of recent literature

    Directory of Open Access Journals (Sweden)

    Harris PR

    2014-07-01

    Full Text Available Patricia RE Harris,1 Claire E Sommargren,2 Phyllis K Stein,3 Gordon L Fung,4,5 Barbara J Drew6,7 1ECG Monitoring Research Lab, 2Department of Physiological Nursing, School of Nursing, University of California, San Francisco, CA, USA; 3Heart Rate Variability Laboratory, School of Medicine, Washington University, St Louis, MO, USA; 4Asian Heart & Vascular Center at Mount Zion, Division of Cardiology, University of California, 5Cardiology Consultation Service, Cardiac Noninvasive Laboratory, and The Enhanced External Counterpulsation Unit, Department of Medicine, University of California, San Francisco Medical Center, 6Division of Cardiology, 7Department of Physiological Nursing, School of Nursing, University of California, San Francisco, CA, USA Aim: We aimed to explore links between heart rate variability (HRV and clinical depression in patients with acute coronary syndrome (ACS, through a review of recent clinical research literature. Background: Patients with ACS are at risk for both cardiac autonomic dysfunction and clinical depression. Both conditions can negatively impact the ability to recover from an acute physiological insult, such as unstable angina or myocardial infarction, increasing the risk for adverse cardiovascular outcomes. HRV is recognized as a reflection of autonomic function. Methods: A narrative review was undertaken to evaluate state-of-the-art clinical research, using the PubMed database, January 2013. The search terms “heart rate variability” and “depression” were used in conjunction with “acute coronary syndrome”, “unstable angina”, or “myocardial infarction” to find clinical studies published within the past 10 years related to HRV and clinical depression, in patients with an ACS episode. Studies were included if HRV measurement and depression screening were undertaken during an ACS hospitalization or within 2 months of hospital discharge. Results: Nine clinical studies met the inclusion criteria. The

  7. Moderation of the Alliance-Outcome Association by Prior Depressive Episodes: Differential Effects in Cognitive-Behavioral Therapy and Short-Term Psychodynamic Supportive Psychotherapy.

    Science.gov (United States)

    Lorenzo-Luaces, Lorenzo; Driessen, Ellen; DeRubeis, Robert J; Van, Henricus L; Keefe, John R; Hendriksen, Mariëlle; Dekker, Jack

    2017-09-01

    Prior studies have suggested that the association between the alliance and depression improvement varies as a function of prior history of depression. We sought to replicate these findings and extend them to short-term psychodynamic supportive psychotherapy (SPSP) in a sample of patients who were randomized to one of these treatments and were administered the Helping Alliance Questionnaire (N=282) at Week 5 of treatment. Overall, the alliance was a predictor of symptom change (d=0.33). In SPSP, the alliance was a modest but robust predictor of change, irrespective of prior episodes (d=0.25-0.33). By contrast, in CBT, the effects of the alliance on symptom change were large for patients with 0 prior episodes (d=0.86), moderate for those with 1 prior episode (d=0.49), and small for those with 2+ prior episodes (d=0.12). These findings suggest a complex interaction between patient features and common vs. specific therapy processes. In CBT, the alliance relates to change for patients with less recurrent depression whereas other CBT-specific processes may account for change for patients with more recurrent depression. Copyright © 2016. Published by Elsevier Ltd.

  8. Changes of grey matter volume in first-episode drug-naive adult major depressive disorder patients with different age-onset

    Directory of Open Access Journals (Sweden)

    Zonglin Shen

    2016-01-01

    Conclusions: The GMV of the brain areas that were related to mood regulation was decreased in the first-episode, drug-naive adult patients with MDD. Adult patients with EOD and LOD exhibited different GMV changes relative to each age-matched comparison group, suggesting depressed adult patients with different age-onset might have different pathological mechanism.

  9. Comparison of non-directive counselling and cognitive behaviour therapy for patients presenting in general practice with an ICD-10 depressive episode: a randomized control trial.

    Science.gov (United States)

    King, M; Marston, L; Bower, P

    2014-07-01

    Most evidence in the UK on the effectiveness of brief therapy for depression concerns cognitive behaviour therapy (CBT). In a trial published in 2000, we showed that non-directive counselling and CBT were equally effective in general practice for patients with depression and mixed anxiety and depression. Our results were criticized for including patients not meeting diagnostic criteria for a depressive disorder. In this reanalysis we aimed to compare the effectiveness of the two therapies for patients with an ICD-10 depressive episode. Patients with an ICD-10 depressive episode or mixed anxiety and depression were randomized to counselling, CBT or usual general practitioner (GP) care. Counsellors provided nondirective, interpersonal counselling following a manual that we developed based on the work of Carl Rogers. Cognitive behaviour therapists provided CBT also guided by a manual. Modelling was carried out using generalized estimating equations with the multiply imputed datasets. Outcomes were mean scores on the Beck Depression Inventory, Brief Symptom Inventory, and Social Adjustment Scale at 4 and 12 months. A total of 134 participants were randomized to CBT, 126 to counselling and 67 to usual GP care. We undertook (1) an interaction analysis using all 316 patients who were assigned a diagnosis and (2) a head-to-head comparison using only those 130 (41%) participants who had an ICD-10 depressive episode at baseline. CBT and counselling were both superior to GP care at 4 months but not at 12 months. There was no difference in the effectiveness of the two psychological therapies. We recommend that national clinical guidelines take our findings into consideration in recommending effective alternatives to CBT.

  10. Correlation of symptom depression levels with mean platelet volume rate on patients of acute coronary syndrome

    Science.gov (United States)

    Hasugian, L.; Hanum, H.; Hanida, W.; Safri, Z.

    2018-03-01

    Patients with Depression and the acute coronary syndrome (ACS) is rarely detected, although in some studies say that depression can worsen cardiovascularly and increase mortality. From research, Canan F et al found that increasing levels of Mean platelet volume (MPV) as a risk factor for atherosclerosis and MPV was higher in patients with depression compared with patients without depression. In this study used observational methods of measurement of cross-sectional data. Research began in November 2015 - May 2016 against General Hospital inpatients H. Adam Malik Medan. There are 64 patients with a diagnosis of ACS were given quieter Beck Depression Inventory (BDI), then calculated a score of BDI patients and MPV levels were seen when they first entered the hospital before being given treatment. Patients answered quieter on days 3-7 after diagnosis ACS. ACS Patients were divided into 3 groups: acute myocardial infarction with ST elevation, acute myocardial infarction with non-ST elevation and unstable angina pectoris. The level of depression is grouped into not depression, mild depression, moderate depression and severe depression. Statistically significant with p-value<0.05Based on the linear correlation analysis, it was found a positive correlation with r=0.542. And the relationship is statistically significant with p-value 0.000003.

  11. The association between suicide risk and self-esteem in Japanese university students with major depressive episodes of major depressive disorder.

    Science.gov (United States)

    Mitsui, Nobuyuki; Asakura, Satoshi; Shimizu, Yusuke; Fujii, Yutaka; Toyomaki, Atsuhito; Kako, Yuki; Tanaka, Teruaki; Kitagawa, Nobuki; Inoue, Takeshi; Kusumi, Ichiro

    2014-01-01

    The suicide risk among young adults is related to multiple factors; therefore, it is difficult to predict and prevent suicidal behavior. We conducted the present study to reveal the most important factors relating to suicidal ideation in Japanese university students with major depressive episodes (MDEs) of major depressive disorder (MDD). The subjects were 30 Japanese university students who had MDEs of MDD, and were aged between 18 and 26 years old. They were divided into two groups - without suicide risk group (n=15), and with suicide risk group (n=15) - based on the results of the Mini-International Neuropsychiatric Interview. Additionally, healthy controls were recruited from the same population (n=15). All subjects completed the self-assessment scales including the Beck Depression Inventory 2nd edition (BDI-II), the Beck Hopelessness Scale (BHS), Rosenberg's Self-Esteem Scale (RSES), and SF-36v2™ (The Medical Outcomes Study 36-item short-form health survey version 2), and they were all administered a battery of neuropsychological tests. The RSES score of the suicide risk group was significantly lower than the RSES score of the without suicide risk group, whereas the BDI-II score and the BHS score were not significantly different between the two groups. The mean social functioning score on the SF-36v2 of the with suicide risk group was significantly lower than that of the without suicide risk group. The individual's self-esteem and social functioning may play an important role in suicide risk among young adults with MDEs of MDD.

  12. Symptoms of anxiety and depression and risk of acute myocardial infarction: the HUNT 2 study

    OpenAIRE

    Gustad, Lise Tuset; Laugsand, Lars Erik; Janszky, Imre; Dalen, Håvard; Bjerkeset, Ottar

    2013-01-01

    Aims The nature of the association of depression and anxiety with risk for acute myocardial infarction (AMI) remains unclear. We aimed to study the prospective association of single and recurrent self-reported symptoms of anxiety and depression with a risk of AMI in a large Norwegian population based cohort. Methods and results In the second wave of the Nord-Trøndelag Health Study (HUNT2, 1995–97) baseline data on anxiety and depression symptoms, sociodemographic variables, health status...

  13. Relationship between plasma glutamate levels and post-stroke depression in patients with acute ischemic stroke

    Institute of Scientific and Technical Information of China (English)

    钱方媛

    2014-01-01

    Objective To test the association between the plasma glutamate levels during acute ischemic stroke andpost-stroke depression(PSD)initially.Methods Seventy-four ischemic stroke patients admitted to the hospital within the first day of stroke onset were evaluated at a follow-up of 2 weeks.The Beck Depression Inventory(BDI,21-item)and DSM-Ⅳcriteria was used to diagnose post-stroke depression(PSD)at 2 weeks after stroke.

  14. Social deprivation, population dependency ratio and an extended hospital episode - Insights from acute medicine.

    Science.gov (United States)

    Cournane, Seán; Dalton, Ann; Byrne, Declan; Conway, Richard; O'Riordan, Deirdre; Coveney, Seamus; Silke, Bernard

    2015-11-01

    Patients from deprived backgrounds have a higher in-patient mortality following an emergency medical admission; this study aimed to investigate the extent to which Deprivation status and the population Dependency Ratio influenced extended hospital episodes. All Emergency Medical admissions (75,018 episodes of 41,728 patients) over 12 years (2002-2013) categorized by quintile of Deprivation Index and Population Dependency Rates (proportion of non-working/working) were evaluated against length of stay (LOS). Patients with an Extended LOS (ELOS), >30 days, were investigated, by Deprivation status, Illness Severity and Co-morbidity status. Univariate and multi-variable risk estimates (Odds Rates or Incidence Rate Ratios) were calculated, using truncated Poisson regression. Hospital episodes with ELOS had a frequency of 11.5%; their median LOS (IQR) was 55.0 (38.8, 97.6) days utilizing 57.6% of all bed days by all 75,018 emergency medical admissions. The Deprivation Index independently predicted the rate of such ELOS admissions; these increased approximately five-fold (rate/1000 population) over the Deprivation Quintiles with model adjusted predicted admission rates of for Q1 0.93 (95% CI: 0.86, 0.99), Q22.63 (95% CI: 2.55, 2.71), Q3 3.84 (95% CI: 3.77, 3.91), Q4 3.42 (95% CI: 3.37, 3.48) and Q5 4.38 (95% CI: 4.22, 4.54). Similarly the Population Dependency Ratio Quintiles (dependent to working structure of the population by small area units) independently predicted extended LOS admissions. The admission of patients with an ELOS is strongly influenced by the Deprivation status and the population Dependency Ratio of the catchment area. These factors interact, with both high deprivation and Dependency cohorts having a major influence on the numbers of emergency medical admission patients with an extended hospital episode. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  15. A systematic review on the role of anticonvulsants in the treatment of acute bipolar depression.

    Science.gov (United States)

    Reinares, María; Rosa, Adriane R; Franco, Carolina; Goikolea, José Manuel; Fountoulakis, Kostas; Siamouli, Melina; Gonda, Xenia; Frangou, Sophia; Vieta, Eduard

    2013-03-01

    Despite the high morbidity and mortality associated with bipolar depression, the optimal treatment for this phase is still a matter of debate. The aim of the current review was to provide updated evidence about the efficacy and tolerability of anticonvulsants in the treatment of acute bipolar depression. A comprehensive review of randomized controlled trials (RCTs) evaluating the use of anticonvulsants for the treatment of acute bipolar depression up to June 2011 was conducted by means of the PubMed-Medline database. Eligibility criteria included active comparator-controlled or placebo-controlled randomized studies involving monotherapy or combination therapy. A total of 18 RCTs fulfilled the inclusion criteria. Studies supported the efficacy of divalproex as monotherapy in acute bipolar depression but small sample size was a common methodological limitation. Findings were inconclusive for lamotrigine and carbamazepine although overall lamotrigine may have a beneficial but modest effect. Negative results were found for levetiracetam and gabapentin but the evidence base on these agents is scant. All anticonvulsants were generally well tolerated. No double-blind RCTs were found for the use of other anticonvulsants such as oxcarbazepine, licarbazepine, zonisamide, retigabine, pregabalin, tiagabine, felbamate and vigabatrine in the acute treatment of bipolar depression. To sum up, taking into consideration the efficacy and tolerability profiles of anticonvulsants, current evidence supports the use of divalproex and lamotrigine in the treatment of acute bipolar depression. However, available data for most other anticonvulsants are inconclusive and further RCTs with larger sample sizes are needed before drawing firm conclusions.

  16. Is video gaming, or video game addiction, associated with depression, academic achievement, heavy episodic drinking, or conduct problems?

    Science.gov (United States)

    Brunborg, Geir Scott; Mentzoni, Rune Aune; Frøyland, Lars Roar

    2014-01-01

    Background and aims: While the relationships between video game use and negative consequences are debated, the relationships between video game addiction and negative consequences are fairly well established. However, previous studies suffer from methodological weaknesses that may have caused biased results. There is need for further investigation that benefits from the use of methods that avoid omitted variable bias. Methods: Two wave panel data was used from two surveys of 1,928 Norwegian adolescents aged 13 to 17 years. The surveys included measures of video game use, video game addiction, depression, heavy episodic drinking, academic achievement, and conduct problems. The data was analyzed using first-differencing, a regression method that is unbiased by time invariant individual factors. Results: Video game addiction was related to depression, lower academic achievement, and conduct problems, but time spent on video games was not related to any of the studied negative outcomes. Discussion: The findings were in line with a growing number of studies that have failed to find relationships between time spent on video games and negative outcomes. The current study is also consistent with previous studies in that video game addiction was related to other negative outcomes, but it made the added contribution that the relationships are unbiased by time invariant individual effects. However, future research should aim at establishing the temporal order of the supposed causal effects. Conclusions: Spending time playing video games does not involve negative consequences, but adolescents who experience problems related to video games are likely to also experience problems in other facets of life. PMID:25215212

  17. Workplace social capital and the onset of major depressive episode among workers in Japan: a 3-year prospective cohort study.

    Science.gov (United States)

    Sakuraya, Asuka; Imamura, Kotaro; Inoue, Akiomi; Tsutsumi, Akizumi; Shimazu, Akihito; Takahashi, Masaya; Totsuzaki, Takafumi; Kawakami, Norito

    2017-06-01

    This study examined the prospective association of workplace social capital (WSC) with major depressive episode (MDE) among Japanese employees. A 3-year prospective cohort study was conducted among 1058 employees from a private think-tank company who participated in a baseline survey; after excluding those with MDE in the past 12 months, 929 were followed up. WSC at baseline was measured using a 3-item scale. MDE was assessed at baseline and at follow-up every year, by using a web-based, self-administered version of the WHO Composite International Diagnostic Interview (WHO-CIDI) 3.0 depression section, based on the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition: Text Revision (DSM-IV-TR)/DSM-5 criteria. Cox discrete-time hazards analyses were used to estimate HRs and 95% CIs, adjusting for covariates. A group with middle-level WSC scores had the lowest risk of MDE after being fully adjusted (HR 0.34, 95% CI 0.14 to 0.84, p=0.02). The relationship between WSC and MDE was U-shaped, although a non-linear model fit better than a linear model, with only marginally statistical significance (p=0.06). Dichotomised and continuous variables of WSC scores were significantly and negatively associated with MDE (p=0.03 and pMDE in Japan. The slightly U-shaped relationship, that is, the group with high WSC having a small elevated risk of MDE, may reflect a dark side of WSC in a country with collectivity-oriented and hierarchy-oriented culture, such as Japan. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  18. Affective temperaments are associated with specific clusters of symptoms and psychopathology: a cross-sectional study on bipolar disorder inpatients in acute manic, mixed, or depressive relapse.

    Science.gov (United States)

    Iasevoli, Felice; Valchera, Alessandro; Di Giovambattista, Emanuela; Marconi, Massimo; Rapagnani, Maria Paola; De Berardis, Domenico; Martinotti, Giovanni; Fornaro, Michele; Mazza, Monica; Tomasetti, Carmine; Buonaguro, Elisabetta F; Di Giannantonio, Massimo; Perugi, Giulio; de Bartolomeis, Andrea

    2013-11-01

    The aim of this study was to assess whether different affective temperaments could be related to a specific mood disorder diagnosis and/or to different therapeutic choices in inpatients admitted for an acute relapse of their primary mood disorder. Hundred and twenty-nine inpatients were consecutively assessed by means of the Structured and Clinical Interview for axis-I disorders/Patient edition and by the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego auto-questionnaire, Young Mania Rating Scale, Hamilton Scale for Depression and for Anxiety, Brief Psychiatry Rating Scale, Clinical Global impression, Drug Attitude Inventory, Barratt Impulsiveness Scale, Toronto Alexithymia Scale, and Symptoms Checklist-90 items version, along with records of clinical and demographic data. The following prevalence rates for axis-I mood diagnoses were detected: bipolar disorder type I (BD-I, 28%), type II (31%), type not otherwise specified (BD-NOS, 33%), major depressive disorder (4%), and schizoaffective disorder (4%). Mean scores on the hyperthymic temperament scale were significantly higher in BD-I and BD-NOS, and in mixed and manic acute states. Hyperthymic temperament was significantly more frequent in BD-I and BD-NOS patients, whereas depressive temperament in BD-II ones. Hyperthymic and irritable temperaments were found more frequently in mixed episodes, while patients with depressive and mixed episodes more frequently exhibited anxious and depressive temperaments. Affective temperaments were associated with specific symptom and psychopathology clusters, with an orthogonal subdivision between hyperthymic temperament and anxious/cyclothymic/depressive/irritable temperaments. Therapeutic choices were often poorly differentiated among temperaments and mood states. Cross-sectional design; sample size. Although replication studies are needed, current results suggest that temperament-specific clusters of symptoms severity and psychopathology domains could be

  19. Prevention of depression in patients with acute coronary syndrome (DECARD) randomized trial

    DEFF Research Database (Denmark)

    Hjorthøj, Carsten Rygaard; Hansen, Baiba Hedegaard; Hanash, Jamal Abed

    2015-01-01

    .02-0.99) ) than in the full sample of patients (HR = 0.20 (0.04-0.90) ), although not statistically significant. CONCLUSIONS: The SF-36 may be too broad an outcome measure in trials or treatments that seek to prevent depression following acute coronary syndrome. The SF-36 may, however, indicate who is more likely......AIM: Escitalopram may prevent depression following acute coronary syndrome. We sought to estimate the effects of escitalopram on self-reported health and to identify subgroups with higher efficacy. METHODS: This is a secondary analysis of a 12-month double-blind clinical trial randomizing non-depressed...... acute coronary syndrome patients to escitalopram (n = 120) or matching placebo (n = 120). The main outcomes were mean scores on Short Form 36 Health Survey (SF-36) domains, and diagnosis of depression was adjusted for baseline SF-36 scores. RESULTS: Escitalopram did not yield different SF-36...

  20. Acute traumatic and depressive symptoms in family members of hospitalized individuals with delirium.

    Science.gov (United States)

    Lloyd, Robert B; Rosenthal, Lisa J

    2015-01-01

    This study characterized symptoms of acute stress and depression in caregivers present during the hospitalization of a loved one with delirium. This is an observational, cross-sectional analysis of caregivers of patients hospitalized with delirium. Standardized questionnaires were used in caregiver interviews to assess psychological reactions to traumatic situations and understanding of medical care. Of the 40 caregivers recruited, half had significant symptoms of acute stress and 12.5% of caregivers were highly symptomatic across all domains related to trauma. Elevated acute stress was positively correlated with both past or current depression and prior mental health treatment (p delirium as having a negative impact on their lives were also at elevated risk (p delirium are at elevated risk for experiencing severe acute traumatic and depressive symptoms, and this response might place them at risk for developing traumatic disorders. © The Author(s) 2015.

  1. Psychosocial risks in small enterprises: The mediating role of perceived working conditions in the relationship between enterprise size and workers' anxious or depressive episodes.

    Science.gov (United States)

    Encrenaz, Gaëlle; Laberon, Sonia; Lagabrielle, Christine; Debruyne, Gautier; Pouyaud, Jacques; Rascle, Nicole

    2018-03-20

    The relationship between enterprise size and psychosocial working conditions has received little attention so far but some findings suggest that they are more favorable in small enterprises. This could have a positive impact on workers' mental health. The objective of this study was to test the mediating effect of perceived working conditions in the relationship between enterprise size and anxious or depressive episodes. Data from the 2010 SUMER French periodical cross-sectional survey was analyzed (N=31 420 for the present study). Anxious or depressive episodes were measured with the hospital anxiety and depression scale (HAD) and perceived working conditions were psychological demand, decision latitude and social support as assessed with Karasek's job content questionnaire (JCQ). The indirect effect was tested according to the method proposed by Preacher and Hayes (2008). In a multivariate logistic regression, the risk of anxious or depressive episodes was found to be lower in micro-enterprises (2-9 employees). Formal tests pointed to a significant indirect effect of enterprise size on mental health through perceived working conditions, with a larger effect for psychological demand. Conclusion This study highlights perceived working conditions as an explanation of the effects of enterprise size.

  2. Associations Between Compulsive Buying and Substance Dependence/Abuse, Major Depressive Episode, and Generalized Anxiety Disorder Among Men and Women

    Science.gov (United States)

    Zhang, Chenshu; Brook, Judith S.; Leukefeld, Carl G.; Brook, David W.

    2016-01-01

    Aims The objective of this study was to examine the associations between compulsive buying (CB) and substance dependence/abuse, major depressive episode (MDE), and generalized anxiety disorder (GAD) at mean age 43. Methods Participants came from a community-based random sample of residents in two New York counties (N=548). The participants were followed from adolescence to early midlife. The mean age of participants at the most recent interview was 43.0 (SD=2.8). Fifty five percent of the participants were females. Over 90% of the participants were white. The prevalence of substance dependence/abuse, MDE, and GAD (during the past 5 years before the interviews) was 6.6%, 13.7, and 11.5%, respectively. Results Logistic regression analyses showed that CB was significantly associated with substance dependence/abuse [Adjusted Odds Ratio (A.O.R.) = 1.60], MDE (A.O.R. = 1.70), and GAD (A.O.R. = 1.63), despite controlling for substance dependence/abuse, MDE, and GAD, respectively, at mean age 37, and demographic factors. Discussion Since the study sample is limited to predominantly white participants (over 90%) with a close association to a small geographic area, the findings may not be generalizable to racial/ethnic minority groups or individuals living in other parts of the country. Nevertheless, it is important that clinicians treating substance dependence/abuse, MDE, and GAD consider the role of CB. PMID:27215919

  3. Impaired visual, working, and verbal memory in first-episode, drug-naive patients with major depressive disorder in a Chinese population.

    Science.gov (United States)

    Chen, Ce; Jiang, Wen-Hui; Wang, Wei; Ma, Xian-Cang; Li, Ye; Wu, Jin; Hashimoto, Kenji; Gao, Cheng-Ge

    2018-01-01

    Cognitive impairment has been observed in patients with major depressive disorder (MDD). However, it remains unclear whether the deficits in specific cognitive domains are present in first-episode, drug-naïve patients or medicated patients. In the present study, using the CogState battery (CSB) Chinese language version, we evaluated the visual, working, and verbal memory in first-episode drug-naive patients and medicated patients with MDD in a Chinese population. We measured the cognitive function in first-episode drug-naïve patients (n = 36), medicated MDD patients (n = 71), and age- and sex-matched healthy control subjects (n = 59) in a Chinese population. The CSB composite scores in both first-episode drug-naive patients and medicated patients were significantly poorer than those in the healthy control subjects. The CSB sub-scores, including visual, working, and verbal memory were also significantly poorer in both patient groups than those in the healthy control subjects. In contrast, processing speed, attention/vigilance, executive function, spatial working memory, and social cognition were no different from healthy controls, whereas the executive function was significantly better in the medicated patients than in the healthy control subjects and first-episode drug-naïve patients. These findings suggest an impairment in the visual, working, and verbal memory in first-episode, drug-naive MDD patients in a Chinese population.

  4. Depression screening in stroke: a comparison of alternative measures with the structured diagnostic interview for the diagnostic and statistical manual of mental disorders, fourth edition (major depressive episode) as criterion standard.

    Science.gov (United States)

    Turner, Alyna; Hambridge, John; White, Jennifer; Carter, Gregory; Clover, Kerrie; Nelson, Louise; Hackett, Maree

    2012-04-01

    Screening tools for depression and psychological distress commonly used in medical settings have not been well validated in stroke populations. We aimed to determine the accuracy of common screening tools for depression or distress in detecting caseness for a major depressive episode compared with a clinician-administered structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders Fourth Edition as the gold standard. Seventy-two participants ≥3 weeks poststroke underwent a diagnostic interview for major depressive episode and completed the Patient Health Questionnaire-2 and -9, Hospital Anxiety and Depression Scale, Beck Depression Inventory-II, Distress Thermometer, and Kessler-10. Internal consistency, sensitivity, specificity, likelihood ratios, and posttest probabilities were calculated. Each measure was validated against the gold standard using receiver operating characteristic curves with comparison of the area under the curve for all measures. Internal consistency ranged from acceptable to excellent for all measures (Cronbach α=0.78-0.94). Areas under the curve (95% CI) for the Patient Health Questionnaire-2, Patient Health Questionnaire-9, Hospital Anxiety and Depression Scale depression and total score, Beck Depression Inventory-II, and Kessler-10 ranged from 0.80 (0.69-0.89) for the Kessler-10 to 0.89 (0.79-0.95) for the Beck Depression Inventory-II with no significant differences between measures. The Distress Thermometer had an area under the curve (95% CI) of 0.73 (0.61-0.83), significantly smaller than the Beck Depression Inventory-II (P<0.05). Apart from the Distress Thermometer, selected scales performed adequately in a stroke population with no significant difference between measures. The Patient Health Questionnaire-2 would be the most useful single screen given free availability and the shortest number of items.

  5. The association between suicide risk and self-esteem in Japanese university students with major depressive episodes of major depressive disorder

    Directory of Open Access Journals (Sweden)

    Mitsui N

    2014-05-01

    Full Text Available Nobuyuki Mitsui,1 Satoshi Asakura,1,2 Yusuke Shimizu,1 Yutaka Fujii,1 Atsuhito Toyomaki,1 Yuki Kako,1 Teruaki Tanaka,1 Nobuki Kitagawa,3 Takeshi Inoue,1 Ichiro Kusumi1 1Department of Psychiatry, Hokkaido University Graduate School of Medicine, 2Health care center of Hokkaido University, Kita-ku, Sapporo, 3Department of Clinical Social Work, Health Sciences University of Hokkaido School of Nursing and Social Services, Tobetsu, Ishikari, Japan Background: The suicide risk among young adults is related to multiple factors; therefore, it is difficult to predict and prevent suicidal behavior. Aim: We conducted the present study to reveal the most important factors relating to suicidal ideation in Japanese university students with major depressive episodes (MDEs of major depressive disorder (MDD. Methods: The subjects were 30 Japanese university students who had MDEs of MDD, and were aged between 18 and 26 years old. They were divided into two groups – without suicide risk group (n=15, and with suicide risk group (n=15 – based on the results of the Mini-International Neuropsychiatric Interview. Additionally, healthy controls were recruited from the same population (n=15. All subjects completed the self-assessment scales including the Beck Depression Inventory 2nd edition (BDI-II, the Beck Hopelessness Scale (BHS, Rosenberg's Self-Esteem Scale (RSES, and SF-36v2TM (The Medical Outcomes Study 36-item short-form health survey version 2, and they were all administered a battery of neuropsychological tests. Results: The RSES score of the suicide risk group was significantly lower than the RSES score of the without suicide risk group, whereas the BDI-II score and the BHS score were not significantly different between the two groups. The mean social functioning score on the SF-36v2 of the with suicide risk group was significantly lower than that of the without suicide risk group. Conclusion: The individual's self-esteem and social functioning may play an

  6. [The association between plasma neurotransmitters levels and depression in acute hemorrhagic stroke].

    Science.gov (United States)

    Yuan, Huai-wu; Zhang, Ning; Wang, Chun-xue; Shi, Yu-zhi; Qi, Dong; Luo, Ben-yan; Wang, Yong-jun

    2013-08-01

    To explore the relation between plasma neurotransmitters (Glutamic acid, GAA; γ-aminobutyric acid, GABA; 5-hydroxytryptamine, 5-HT; and noradrenaline, NE) and depression in acute hemorrhagic stroke. Objectives were screened from consecutive hospitalized patients with acute stroke. Fasting blood samples were taken on the day next to hospital admission, and neurotransmitters were examined by the liquid chromatography-high resolution mass spectrometry (LC-HRMS). The fourth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) was used to diagnose depression at two weeks after onset of stroke. The modified Ranking Scale (mRS) was followed up at 1 year. Pearson test was used to analyse the correlation between serum concentration of neurotransmitters and the Hamilton Depression scale-17-items (HAMD-17) score. Logistic regression was used to analyse the relation of serum concentration of neurotransmitters and depression and outcome of stroke. One hundred and eighty-one patients were included in this study. GABA significantly decreased [6.1(5.0-8.2) µg/L vs 8.1(6.3-14.7) µg/L, P depression in hemorrhagic stroke, and there was no significant difference in GAA, 5-HT, or NE. GABA concentration was negatively correlated with HAMD-17 score (r = -0.131, P depression in acute phase of hemorrhagic stroke was reduced by 5.6% (OR 0.944, 95%CI 0.893-0.997). While concentration of serum GAA rose by 1 µg/L, risk of worse outcome at 1 year was raised by 0.1%, although a statistic level was on marginal status (OR 1.001, 95%CI 1.000-1.002). In patients with depression in the acute phase of hemorrhagic stroke, there was a significant reduction in plasma GABA concentration. GABA may have a protective effect on depression in acute phase of hemorrhagic stroke. Increased concentrations of serum GAA may increase the risk of worse outcomes at 1 year after stroke.

  7. Cerebral and cerebellar gray matter reduction in first-episode patients with major depressive disorder: A voxel-based morphometry study

    Energy Technology Data Exchange (ETDEWEB)

    Peng Jing, E-mail: ppengjjing@sina.com.cn [Department of Radiology, Xuanwu Hospital of Capital Medical University, No. 45, Chang-Chun St, Xuanwu District, Beijing 100053 (China); Liu Jiangtao, E-mail: Liujiangtao813@sina.com [Department of Radiology, Xuanwu Hospital of Capital Medical University, No. 45, Chang-Chun St, Xuanwu District, Beijing 100053 (China); Nie Binbin, E-mail: niebb@ihep.ac.cn [Institute of High Energy Physics, Chinese Academy of Sciences, PO Box 918, Yu-Quan St, Shijingshan District, Beijing 100049 (China); Li Yang, E-mail: Liyang2007428@hotmail.com [Department of Psychiatry, Anding Hospital of Capital Medical University, No. 5, An Kang Hutong, Deshengmen wai, Xicheng District, Beijing 100088 (China); Shan Baoci, E-mail: shanbc@ihep.ac.cn [Institute of High Energy Physics, Chinese Academy of Sciences, PO Box 918, Yu-Quan St, Shijingshan District, Beijing 100049 (China); Wang Gang, E-mail: gangwang@gmail.com [Department of Psychiatry, Anding Hospital of Capital Medical University, No. 5, An Kang Hutong, Deshengmen wai, Xicheng District, Beijing 100088 (China); Li Kuncheng, E-mail: likuncheng1955@yahoo.com.cn [Department of Radiology, Xuanwu Hospital of Capital Medical University, No. 45, Chang-Chun St, Xuanwu District, Beijing 100053 (China)

    2011-11-15

    Purpose: To investigate cerebral and cerebellar gray matter abnormalities in patients with first-episode major depressive disorder (MDD). Materials and methods: We examined the structural difference in regional gray matter density (GMD) between 22 first-episode MDD patients and 30 age-, gender- and education-matched healthy controls by optimized voxel-based morphometry (VBM) based on magnetic resonance imaging. Results: Compared with healthy controls, MDD patients showed decreased GMD in the right medial and left lateral orbitofrontal cortex, right dorsolateral prefrontal cortex (DLPFC), bilateral temporal pole, right superior temporal gyrus, bilateral anterior insular cortex, left parahippocampal gyrus, and left cerebellum. In addition, in MDD patients, there was a negative correlation between GMD values of the right DLPFC and the score of the depression rating scale. Conclusions: Our findings provided additional support for the involvement of limbic-cortical circuits in the pathophysiology of MDD and preliminary evidence that a defect involving the cerebellum may also be implicated.

  8. Cerebral and cerebellar gray matter reduction in first-episode patients with major depressive disorder: A voxel-based morphometry study

    International Nuclear Information System (INIS)

    Peng Jing; Liu Jiangtao; Nie Binbin; Li Yang; Shan Baoci; Wang Gang; Li Kuncheng

    2011-01-01

    Purpose: To investigate cerebral and cerebellar gray matter abnormalities in patients with first-episode major depressive disorder (MDD). Materials and methods: We examined the structural difference in regional gray matter density (GMD) between 22 first-episode MDD patients and 30 age-, gender- and education-matched healthy controls by optimized voxel-based morphometry (VBM) based on magnetic resonance imaging. Results: Compared with healthy controls, MDD patients showed decreased GMD in the right medial and left lateral orbitofrontal cortex, right dorsolateral prefrontal cortex (DLPFC), bilateral temporal pole, right superior temporal gyrus, bilateral anterior insular cortex, left parahippocampal gyrus, and left cerebellum. In addition, in MDD patients, there was a negative correlation between GMD values of the right DLPFC and the score of the depression rating scale. Conclusions: Our findings provided additional support for the involvement of limbic-cortical circuits in the pathophysiology of MDD and preliminary evidence that a defect involving the cerebellum may also be implicated.

  9. The value of microparticles in detecting acute rejection episodes after liver transplantation.

    Science.gov (United States)

    Morgul, Mehmet Haluk; Splith, Katrin; Leonhardt, Christoph; Raschzok, Nathanael; Reutzel-Selke, Anja; Schmuck, Rosa Bianca; Andreou, Andreas; Atanasov, Georgi; Benzing, Christian; Krenzien, Felix; Hau, Hans-Michael; Felgendreff, Philipp; Klunk, Sergej; Pratschke, Johann; Sauer, Igor Maximillian; Schmelzle, Moritz

    2018-02-01

    Non-invasive markers for diagnosis of acute rejection (AR) following liver transplantation have not been developed, yet. We analyzed the correlation of plasma microparticle levels (MP) with AR. MP (CD4, CD8, CD25, CD31, MHC) of 11 AR patients and 11 controls were analyzed within the first week after transplantation. CD4, CD8 and CD31 positive MP were higher in the AR, whereas overall MP count, CD25 and MHCI positive MP proportions did not differ between both groups. MP dynamics within the first period of transplantation could help to clarify on-going mechanisms of immunomodulation.

  10. Duration of episodes of untreated Acute Malnutrition in children 6–59 months as observed during monthly growth monitoring sessions in South of Bangladesh

    International Nuclear Information System (INIS)

    Hoq, Mohammad; Waid, Jillian

    2014-01-01

    Full text: Background: Planning for management of severe and moderate acute malnutrition programs requires estimation of the caseload of children in need of care. Since incidence of acute malnutrition is not readily available, estimate of caseload is often derived from survey prevalence and the estimated duration of untreated episodes of acute malnutrition. However, information on the duration of acute malnutrition is limited. Sufficient guidance has not been given to planners on how to translate wasting prevalence rates into the probable caseload of a program based on Mid Upper Arm Circumference for admission. Objective: To report the duration of acute malnutrition in children 6 – 59 months as observed during community growth monitoring in the south of Bangladesh. Methodology: The study design was retrospective cohort using administrative data from Terre des hommes’ monthly Growth Monitoring Program in Patharghata Union of Barguna District in absence of any community management. Monitoring data were available between November 2011 and December 2012 for 3340 children and on average, 1766 children were measured each month. Of these children only 585 had observations for every time point. During analysis two models were run, one which imputed missing observations based on status before and after the missing observation and one utilizing complete records. Case definition: Based on the World Health Organization’s threshold for weight-for-height z-scores and MUAC, the duration of acute malnutrition began when children were identified with acute malnutrition The duration of acute malnutrition ended when children were not identified as suffering with acute malnutrition at any monthly visit. Episodes of acute malnutrition observed during the first and last periods of growth monitoring were excluded from the estimation of duration. Results: The prevalence of global acute malnutrition varied over the year, with a peak in June/July (29.7% & 29.0%) and a low in December

  11. 'Living a life in shades of grey': experiencing depressive symptoms in the acute phase after stroke.

    Science.gov (United States)

    Kouwenhoven, Siren E; Kirkevold, Marit; Engedal, Knut; Kim, Hesook S

    2012-08-01

    The aim of the present study was to describe the lived experience of stroke survivors suffering from depressive symptoms in the acute phase; addressing the following questions: (a) what is the nature of depression as experienced by post-stroke patients in the acute phase? (b) what is it like to live with depression within the first weeks following stroke? Post-stroke depression occurs in at least one quarter of stroke survivors and is linked to poorer outcomes. This qualitative study is methodologically grounded in hermeneutic phenomenology, influenced by van Manen and Ricoeur. A descriptive, qualitative design was used applying in-depth interviews as the method of data collection with nine participants. The data collection took place in 2008. The material revealed two main themes that generate the feeling and description of 'living a life in shades of grey': (a) being trapped and (b) losing oneself. 'Shades of grey' could be understood as being confined in a new life-world and losing oneself as the person one knew. The participants confirmed suffering from depressive symptoms, but depression was not seen as meaningful on its own. They related their experiences of post-stroke depression in the acute phase to the losses they experienced. Nurses ought to take into account the depth of the life changes that stroke survivors may experience. There is a need for continued empirical research on how nurses may help and support stroke survivors dealing with depressive symptoms in the acute phase after stroke and how depressive symptoms develop over time. © 2011 Blackwell Publishing Ltd.

  12. Work Engagement as a Predictor of Onset of Major Depressive Episode (MDE) among Workers, Independent of Psychological Distress: A 3-Year Prospective Cohort Study

    OpenAIRE

    Imamura, Kotaro; Kawakami, Norito; Inoue, Akiomi; Shimazu, Akihito; Tsutsumi, Akizumi; Takahashi, Masaya; Totsuzaki, Takafumi

    2016-01-01

    Objective This study investigated work engagement as a baseline predictor of onset of major depressive episode (MDE). Methods The study used a prospective cohort design, conforming to the STROBE checklist. Participants were recruited from the employee population of a private think tank company (N = 4,270), and 1,058 (24.8%) of them completed a baseline survey, of whom 929 were included in this study. Work engagement and psychological distress at baseline were assessed as predictor variables. ...

  13. [A naturalistic study: 100 consecutive episodes of acute agitation in a psychiatric emergency department].

    Science.gov (United States)

    Pascual, J C; Madre, M; Puigdemont, D; Oller, S; Corripio, I; Díaz, A; Faus, G; Perez, V; Alvarez, E

    2006-01-01

    Psychomotor agitation is a common event in psychiatric emergency services (PES) with a prevalence of approximately 10 %. There is no general consensus on to how to manage psychomotor agitation; benzodiazepines, typical antipsychotics and now atypical antipsychotics have demonstrated similar efficacy. The aim of our study was to describe the epidemiology and clinical management of agitation in "real-life" in a psychiatric emergency service. A naturalistic study was performed in acutely agitated patients recruited consecutively in a psychiatric emergency service. Demographics, clinical and therapeutic characteristics were analyzed. Efficacy was assessed by the Excitement Component of the Positive and Negative Syndrome Scale (PANSS-EC) and the Agitation-Calmness Evaluation Scale (ACES). Pragmatic variables such as the need for second pharmacological intervention and the need for physical restraints were assessed. The study included 100 patients with psychomotor agitation. Mean age was 36.2 % and 54% were women. The most prevalent diagnoses were psychotic disorder (48 %) and personality disorder (24 %). Physical restraint was required in 39 % of patients and 52 % accepted oral treatment. Haloperidol was the most frequent oral treatment and olanzapine was the most frequent intramuscular treatment. A naturalistic approach provides data based on clinical reality in psychiatric emergency services. Strict research designs of clinical trials of efficacy imply sample selection biases and are generally distanced from the clinical reality. Atypical antipsychotics have become the first-line treatment in acute agitation

  14. Pregnancy-associated Sweet's syndrome in an acute episode of ulcerative colitis.

    Science.gov (United States)

    Best, J; Dechene, A; Esser, S; Gerken, G; Canbay, A

    2009-08-01

    A 33-year old pregnant patient (pregnancy week 15) with a past medical history of ulcerative colitis with onset of the disease following the birth of her first child was admitted to the hospital with symptoms of weight loss, pyrexia, leukocytosis and bloody and mucous diarrhoea. Total ileocolonoscopy revealed an acute flare of ulcerative colitis. Within a few days, tender erythematous skin lesions occurred and were histologically proven to be neutrophilic dermatosis. Treatment with highly-dosed prednisone led to a complete remission of both cutaneous and intestinal manifestations. Both pathogenic entities are associated with similar immunological alterations, such as comparable cytokine and chemokine release patterns and recruitment of inflammatory cells. Recent data also indicates that proinflammatory cytokine levels are elevated in pregnancy, which might be pivotal in the pathogenesis and the severity of intestinal and extraintestinal symptoms. We present and discuss a diagnostic algorithm and an overall therapeutic rationale for Sweet's syndrome. Copyright Georg Thieme Verlag KG Stuttgart. New York.

  15. Comorbid trajectories of substance use as predictors of Antisocial Personality Disorder, Major Depressive Episode, and Generalized Anxiety Disorder.

    Science.gov (United States)

    Brook, Judith S; Zhang, Chenshu; Rubenstone, Elizabeth; Primack, Brian A; Brook, David W

    2016-11-01

    To determine longitudinal associations between patterns of comorbid cigarette, alcohol, and marijuana use and Antisocial Personality Disorder (ASPD), Major Depressive Episode (MDE), and Generalized Anxiety Disorder (GAD) in adulthood. A random community-based sample [X̅ age=36.6 (SD=2.8)] from the Children and Adults in the Community Study, an on-going investigation of substance use and psychiatric disorders. Data were collected at six time waves. Conjoint trajectories of cigarette, alcohol, and marijuana use spanning adolescence to adulthood were determined; multivariable logistic regression analyses assessed associations between trajectory group membership and having ASPD, MDE, or GAD in adulthood. Five conjoint trajectory groups were obtained: HHH (chronic cigarette, alcohol, and marijuana use), DDD (delayed/late-starting cigarette, alcohol, and marijuana use), LML (low/no smoking, moderate alcohol use, occasional marijuana use), HMN (chronic smoking, moderate alcohol use, no marijuana use), and NON (occasional alcohol use only). Compared with members of the NON group, those in the HHH group had significantly greater odds for having ASPD (Adjusted Odds Ratio [AOR]=28.52, 95% Confidence Interval [CI]=9.44-86.17), MDE (AOR=2.67, 95% CI=1.14-6.26), and GAD (AOR=6.39, 95% CI=2.62-15.56). Members of the DDD, LML, and HMN groups had weaker and less consistent associations with the three psychiatric outcomes. In a large, community-based sample, long-term concurrent use of more than one substance was associated with both externalizing and internalizing psychiatric disorders in adulthood. Prevention and treatment programs might target individuals in the community and general clinical populations with comorbid substance use, even if they haven't been identified as having a substance use disorder. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Evidence for efficacy of acute treatment of episodic tension-type headache: methodological critique of randomised trials for oral treatments.

    Science.gov (United States)

    Moore, R Andrew; Derry, Sheena; Wiffen, Philip J; Straube, Sebastian; Bendtsen, Lars

    2014-11-01

    The International Headache Society (IHS) provides guidance on the conduct of trials for acute treatment of episodic tension-type headache (TTH), a common disorder with considerable disability. Electronic and other searches identified randomised, double-blind trials of oral drugs treating episodic TTH with moderate or severe pain at baseline, or that tested drugs at first pain onset. The aims were to review methods, quality, and outcomes reported (in particular the IHS-recommended primary efficacy parameter pain-free after 2 hours), and to assess efficacy by meta-analysis. We identified 58 reports: 55 from previous reviews and searches, 2 unpublished reports, and 1 clinical trial report with results. We included 40 reports of 55 randomised trials involving 12,143 patients. Reporting quality was generally good, with potential risk of bias from incomplete outcome reporting and small size; the 23 largest trials involved 82% of patients. Few trials reported IHS outcomes. The number needed to treat values for being pain-free at 2 hours compared with placebo were 8.7 (95% confidence interval [CI] 6.2 to 15) for paracetamol 1000 mg, 8.9 (95% CI 5.9 to 18) for ibuprofen 400mg, and 9.8 (95% CI 5.1 to 146) for ketoprofen 25mg. Lower (better) number needed to treat values were calculated for outcomes of mild or no pain at 2 hours, and patient global assessment. These were similar to values for these drugs in migraine. No other drugs had evaluable results for these patient-centred outcomes. There was no evidence that any one outcome was better than others. The evidence available for treatment efficacy is small in comparison to the size of the clinical problem. Copyright © 2014 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  17. Acute coronary syndrome patients with depression have low blood cell membrane omega-3 fatty acid levels.

    Science.gov (United States)

    Amin, Alpesh A; Menon, Rishi A; Reid, Kimberly J; Harris, William S; Spertus, John A

    2008-10-01

    To determine the extent to which levels of membrane eicosapentaenoic (EPA)+docosahexaenoic acids (DHA) (the omega-3 index) were associated with depression in patients with acute coronary syndrome (ACS). Depression is associated with worse cardiovascular (CV) outcomes in patients with ACS. Reduced levels of blood cell membrane omega-3 (n-3) fatty acids (FAs), an emerging risk factor for both CV disease and depression, may help to explain the link between depression and adverse CV outcomes. We measured membrane FA composition in 759 patients with confirmed ACS. The analysis included not only EPA and DHA but also the n-6 FAs linoleic and arachidonic acids (LA and AA). Depressive symptoms were measured with the Patient Health Questionnaire-9 (PHQ). Multivariable linear regression was used to adjust for demographic and clinical characteristics. There was a significant inverse relationship between the n-3 index and depressive symptoms (PHQ) in the fully adjusted model (p = .034). For every 4.54% point rise in the n-3 index, there was a 1-point decline in depressive symptoms. In contrast to the n-3 FAs, membrane levels of the n-6 FAs LA and AA were not different between depressed and nondepressed ACS patients. We found an inverse relationship between the n-3 index and the prevalence of depressive symptoms in patients with ACS. Therefore, this study supports the hypothesis that reduced n-3 FA tissue levels are a common and potentially modifiable link between depression and adverse CV outcomes.

  18. The relationship between depression, anxiety, and cardiovascular outcomes in patients with acute coronary syndromes

    OpenAIRE

    Huffman, Jeff C; Celano, Christopher M; Januzzi, James L

    2010-01-01

    Jeff C Huffman1, Christopher M Celano1, James L Januzzi21Department of Psychiatry, 2Department of Cardiology, Massachusetts General Hospital, Boston, MA USAAbstract: Depression and anxiety occur at high rates among patients suffering an acute coronary syndrome (ACS). Both depressive symptoms and anxiety appear to adversely affect in-hospital and long term cardiac outcomes of post-ACS patients, independent of traditional risk factors. Despite their high prevalence and serious impact, mood and ...

  19. Relationships between serum BDNF and the antidepressant effect of acute exercise in depressed women.

    Science.gov (United States)

    Meyer, Jacob D; Koltyn, Kelli F; Stegner, Aaron J; Kim, Jee-Seon; Cook, Dane B

    2016-12-01

    Brain-derived neurotrophic factor (BDNF) has recently emerged as one potential mechanism with which exercise improves mood in major depressive disorder (MDD). This study examined the relationship between changes in serum total BDNF and mood following acute exercise in MDD. It was hypothesized that acute exercise would increase BDNF in an intensity-dependent manner and that changes in BDNF would be significantly related to improvement in depressed mood post-exercise. Twenty-four women (age: 38.6±14.0years) with MDD exercised for 30min on a stationary bicycle at light, moderate and hard exercise intensities and performed a quiet rest session using a within-subjects, randomized and counter-balanced design. Before, 10 and 30min after each session, participants completed the profile of mood states (POMS). Blood was drawn before and within 10min after completion of each session and serum total BDNF (sBDNF) was measured by enzyme-linked immunosorbent assay. Acute exercise-induced changes in POMS Depression and sBDNF were analyzed via 4 session (quiet rest, light, moderate, hard) by 2 measurement (pre, post) ANOVA. Secondary analyses examined the effects of baseline mood and antidepressant usage on sBDNF. Exercise resulted in an acute improvement in depressed mood that was not intensity dependent (p>0.05), resulting in significant acute increases in sBDNF (p=0.006) that were also not intensity-dependent (p>0.05). Acute changes in sBDNF were not significantly correlated to changes in POMS depression at 10m (r=-0.171, p=0.161) or 30m (r=-0.151, p=0.215) post-exercise. The fourteen participants taking antidepressant medications exhibited lower post-exercise sBDNF (p=0.015) than the participants not currently taking antidepressants, although mood responses were similar. Acute exercise is an effective mood-enhancing stimulus, although sBDNF does not appear to play a role in this short-term response. Patients who are not currently taking antidepressant medications and those who

  20. Major depressive episodes over the course of 7 years and hippocampal subfield volumes at 7 tesla MRI: the PREDICT-MR study.

    Science.gov (United States)

    Wisse, L E M; Biessels, G J; Stegenga, B T; Kooistra, M; van der Veen, P H; Zwanenburg, J J M; van der Graaf, Y; Geerlings, M I

    2015-04-01

    Smaller hippocampal volumes have been associated with major depressive disorder (MDD). The hippocampus consists of several subfields that may be differentially related to MDD. We investigated the association of occurrence of major depressive episodes (MDEs), assessed five times over seven years, with hippocampal subfield and entorhinal cortex volumes at 7 tesla MRI. In this prospective study of randomly selected general practice attendees, MDEs according to DSM-IV-R criteria were assessed at baseline and after 6, 12, 39 and 84 months follow-up. At the last follow-up, a T2 (0.7 mm(3)) 7 tesla MRI scan was obtained in 47 participants (60±10 years). The subiculum, cornu ammonis (CA) 1 to 3, dentate gyrus&CA4 and entorhinal cortex volumes were manually segmented according a published protocol. Of the 47 participants, 13 had one MDE and 5 had multiple MDEs. ANCOVAs, adjusted for age, sex, education and intracranial volume, revealed no significant differences in hippocampal subfield or entorhinal cortex volumes between participants with and without an MDE in the preceding 84 months. Multiple episodes were associated with smaller subiculum volumes (B=-0.03 mL/episode; 95% CI -0.06; -0.003), but not with the other hippocampal subfield volumes, entorhinal cortex, or total hippocampal volume. A limitation of this study is the small sample size which makes replication necessary. In this exploratory study, we found that an increasing number of major depressive episodes was associated with smaller subiculum volumes in middle-aged and older persons, but not with smaller volumes in other hippocampal subfields or the entorhinal cortex. Copyright © 2014 Elsevier B.V. All rights reserved.

  1. Epidemiological and clinical characterization following a first psychotic episode in major depressive disorder: comparisons with schizophrenia and bipolar I disorder in the Cavan-Monaghan First Episode Psychosis Study (CAMFEPS).

    Science.gov (United States)

    Owoeye, Olabisi; Kingston, Tara; Scully, Paul J; Baldwin, Patrizia; Browne, David; Kinsella, Anthony; Russell, Vincent; O'Callaghan, Eadbhard; Waddington, John L

    2013-07-01

    While recent research on psychotic illness has focussed on the nosological, clinical, and biological relationships between schizophrenia and bipolar disorder, little attention has been directed to the most common other psychotic diagnosis, major depressive disorder with psychotic features (MDDP). As this diagnostic category captures the confluence between dimensions of psychotic and affective psychopathology, it is of unappreciated heuristic potential to inform on the nature of psychotic illness. Therefore, the epidemiology and clinical characteristics of MDDP were compared with those of schizophrenia and bipolar disorder within the Cavan-Monaghan First Episode Psychosis Study (n = 370). Epidemiologically, the first psychotic episode of MDDP (n = 77) was uniformly distributed across the adult life span, while schizophrenia (n = 73) and bipolar disorder (n = 73) were primarily disorders of young adulthood; the incidence of MDDP, like bipolar disorder, did not differ between the sexes, while the incidence of schizophrenia was more common in males than in females. Clinically, MDDP was characterized by negative symptoms, executive dysfunction, neurological soft signs (NSS), premorbid intellectual function, premorbid adjustment, and quality of life similar to those for schizophrenia, while bipolar disorder was characterized by less prominent negative symptoms, executive dysfunction and NSS, and better quality of life. These findings suggest that what we currently categorize as MDDP may be more closely aligned with other psychotic diagnoses than has been considered previously. They indicate that differences in how psychosis is manifested vis-à-vis depression and mania may be quantitative rather than qualitative and occur within a dimensional space, rather than validating categorical distinctions.

  2. Epidemiological and clinical characterization following a first psychotic episode in major depressive disorder: Comparisons with Schizophrenia and Bipolar I Disorder in the Cavan-Monaghan First Episode Psychosis Study (CAMFEPS).

    LENUS (Irish Health Repository)

    Owoeye, Olabisi

    2013-05-28

    While recent research on psychotic illness has focussed on the nosological, clinical, and biological relationships between schizophrenia and bipolar disorder, little attention has been directed to the most common other psychotic diagnosis, major depressive disorder with psychotic features (MDDP). As this diagnostic category captures the confluence between dimensions of psychotic and affective psychopathology, it is of unappreciated heuristic potential to inform on the nature of psychotic illness. Therefore, the epidemiology and clinical characteristics of MDDP were compared with those of schizophrenia and bipolar disorder within the Cavan-Monaghan First Episode Psychosis Study (n = 370). Epidemiologically, the first psychotic episode of MDDP (n = 77) was uniformly distributed across the adult life span, while schizophrenia (n = 73) and bipolar disorder (n = 73) were primarily disorders of young adulthood; the incidence of MDDP, like bipolar disorder, did not differ between the sexes, while the incidence of schizophrenia was more common in males than in females. Clinically, MDDP was characterized by negative symptoms, executive dysfunction, neurological soft signs (NSS), premorbid intellectual function, premorbid adjustment, and quality of life similar to those for schizophrenia, while bipolar disorder was characterized by less prominent negative symptoms, executive dysfunction and NSS, and better quality of life. These findings suggest that what we currently categorize as MDDP may be more closely aligned with other psychotic diagnoses than has been considered previously. They indicate that differences in how psychosis is manifested vis-à-vis depression and mania may be quantitative rather than qualitative and occur within a dimensional space, rather than validating categorical distinctions.

  3. Depression and Suicide in Schizophrenic Patients.

    Science.gov (United States)

    Salama, Aziz A.

    1988-01-01

    Identified schizophrenic patients as distinctive subgroup of patients who can suffer from major depressive illness and can commit suicide. Found 22.4 percent of 620 schizophrenics in psychiatric facility showed symptoms of major depressive episode. Seven patients committed suicide during acute phase of illness, 9 attempted suicide while…

  4. Chronic and acute adenosine A2A receptor blockade prevents long-term episodic memory disruption caused by acute cannabinoid CB1 receptor activation.

    Science.gov (United States)

    Mouro, Francisco M; Batalha, Vânia L; Ferreira, Diana G; Coelho, Joana E; Baqi, Younis; Müller, Christa E; Lopes, Luísa V; Ribeiro, Joaquim A; Sebastião, Ana M

    2017-05-01

    Cannabinoid-mediated memory impairment is a concern in cannabinoid-based therapies. Caffeine exacerbates cannabinoid CB 1 receptor (CB 1 R)-induced memory deficits through an adenosine A 1 receptor-mediated mechanism. We now evaluated how chronic or acute blockade of adenosine A 2A receptors (A 2A Rs) affects long-term episodic memory deficits induced by a single injection of a selective CB 1 R agonist. Long-term episodic memory was assessed by the novel object recognition (NOR) test. Mice received an intraperitoneal (i.p.) injection of the CB 1 /CB 2 receptor agonist WIN 55,212-2 (1 mg/kg) immediately after the NOR training, being tested for novelty recognition 24 h later. Anxiety levels were assessed by the Elevated Plus Maze test, immediately after the NOR. Mice were also tested for exploratory behaviour at the Open Field. For chronic A 2A R blockade, KW-6002 (istradefylline) (3 mg/kg/day) was administered orally for 30 days; acute blockade of A 2A Rs was assessed by i.p. injection of SCH 58261 (1 mg/kg) administered either together with WIN 55,212-2 or only 30 min before the NOR test phase. The involvement of CB 1 Rs was assessed by using the CB 1 R antagonist, AM251 (3 mg/kg, i.p.). WIN 55,212-2 caused a disruption in NOR, an action absent in mice also receiving AM251, KW-6002 or SCH 58261 during the encoding/consolidation phase; SCH 58251 was ineffective if present during retrieval only. No effects were detected in the Elevated Plus maze or Open Field Test. The finding that CB 1 R-mediated memory disruption is prevented by antagonism of adenosine A 2A Rs, highlights a possibility to prevent cognitive side effects when therapeutic application of CB 1 R drugs is desired. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Treatment of depression in acute coronary syndromes with selective serotonin reuptake inhibitors

    NARCIS (Netherlands)

    van Melle, Joost P.; de Jonge, Peter; van den Berg, Maarten P.; Pot, Harm J.; van Veldhuisen, Dirk J.

    2006-01-01

    Depression in patients with acute coronary syndromes (ACS) is common and associated with impaired cardiovascular prognosis in terms of cardiac mortality and new cardiovascular events. It remains unclear whether antidepressant treatment may reverse these effects. In this review, the literature is

  6. [Psychosocial functioning in non-psychiatric acute and chronic inpatients: depression, alexithymia and lack of assertiveness].

    Science.gov (United States)

    Arancibia, Marcelo; Behar, Rosa; Marín, Sofía; Inzunza, Nicolás; Madrid, Eva

    2016-11-01

    Depression, alexithymia, and lack of assertiveness interfere with individual psychosocial functioning and may result in longer hospitalization stay and poorer therapeutic results. To analyze the psychosocial functioning in acute and chronic patients and its association with psychological, clinical and sociodemographic variables. We performed a cross-sectional study that included 80 inpatients of both sexes with organic pathology, aged between 18 to 70 years old, without any current psychiatric disorder. Clinical and sociodemographic data were collected from a semi-structured interview and hospital records. Beck Depression Inventory-IA, Toronto Alexithymia Scale-20 and Rathus Assertiveness Scale were administered. Fifty five percent of patients had some degree of depression, 33% alexithymia and 34% lack of assertiveness. The levels of depression, alexithymia and lack of assertiveness in chronic patients were significantly higher than those observed in acute patients. Women and participants older than 60 years exhibited the highest degrees of depression. Alexithymia and lack of assertiveness were associated with a lower educational level. A negative significant correlation between alexithymia and assertiveness scores was observed among acute patients. Participants with chronic diseases had a lower psychosocial functioning. Less educated patients showed more alexithymic and less assertive features. We emphasized the need of a better management of these aspects by the health team, since social functioning might interfere with the outcome of physical illnesses.

  7. Treatments for acute bipolar depression: meta-analyses of placebo-controlled, monotherapy trials of anticonvulsants, lithium and antipsychotics.

    Science.gov (United States)

    Selle, V; Schalkwijk, S; Vázquez, G H; Baldessarini, R J

    2014-03-01

    Optimal treatments for bipolar depression, and the relative value of specific drugs for that purpose, remain uncertain, including agents other than antidepressants. We searched for reports of placebo-controlled, monotherapy trials of mood-stabilizing anticonvulsants, second-generation antipsychotics, or lithium for acute major depressive episodes in patients diagnosed with type I or II bipolar disorder and applied random-effects meta-analysis to evaluate their efficacy, comparing outcomes based on standardized mean drug-placebo differences (SMD) in improvement, relative response rates (RR), and number-needed-to-treat (NNT). We identified 24 trials of 10 treatments (lasting 7.5 weeks, with ≥ 50 collaborating sites/trial) that met eligibility criteria: lamotrigine (5 trials), quetiapine (5), valproate (4), 2 each for aripiprazole, olanzapine, ziprasidone, and 1 each for carbamazepine, lithium, lurasidone, and olanzapine-fluoxetine. Overall, pooled drug-over-placebo responder-rate superiority (RR) was moderate (29% [CI: 19-40%]), and NNT was 8.2 (CI: 6.4-11). By SMD, apparent efficacy ranked: olanzapine + fluoxetine ≥ valproate > quetiapine > lurasidone > olanzapine, aripiprazole, and carbamazepine; ziprasidone was ineffective, and lithium remains inadequately studied. Notably, drugs were superior to placebo in only 11/24 trials (5/5 with quetiapine, 2/4 with valproate), and only lamotrigine, quetiapine and valproate had > 2 trials. Treatment-associated mania-like reactions were uncommon (drugs: 3.7%; placebo: 4.7%). Controlled trials of non-antidepressant treatments for bipolar depression remain scarce, but findings with olanzapine-fluoxetine, lurasidone, quetiapine, and perhaps carbamazepine and valproate were encouraging; lithium requires adequate testing. © Georg Thieme Verlag KG Stuttgart · New York.

  8. Amplitude of low-frequency fluctuations in first-episode, drug-naïve depressive patients: A 5-year retrospective study.

    Directory of Open Access Journals (Sweden)

    Kerang Zhang

    Full Text Available Despite different treatments and courses of illness, depressive symptoms appear similar in bipolar disorder (BD and major depressive disorder (MDD, causing BD with an onset of depressive episode being frequently misdiagnosed as MDD, and leading to inappropriate treatment and poor clinical outcomes. Therefore, there is an urgent need to explore underlying neural basis to distinguish BD from MDD. The medical records of 80 first-episode, drug-naïve depressive patients with an initial diagnosis of MDD and illness duration of at least 5 years were reviewed retrospectively for this study. Fourteen bipolar depressed patients with a diagnosis conversion from MDD to BD, 14 patients with diagnosis of MDD, and 14 healthy subjects demographically matched with the BD group, were selected to participate in the study. Firstly, we examined whether there were differences among the three groups in whole brain fALFF during resting state. Secondly, clusters showing group differences in fALFF in any two groups were chosen as regions of interest (ROI and then correlation between clinical features and fALFF values of ROIs were calculated. The BD group showed increased fALFF in bilateral putamen relative to both the MDD group and controls, while the MDD group exhibited decreased fALFF in left superior frontal gyrus (SFG relative to both the BD group and controls (p < 0.05, corrected. Positive correlations between abnormality in the putamen and symptom severity were observed (significant for the MDD group, p = 0.043; marginally significant for the BD group, p = 0.060/0.076. These results implicate that abnormalities of key regions in the striatum and prefrontal areas may be trait markers for BD and MDD.

  9. Effectiveness of the management of major depressive episodes/disorder in adults with comorbid chronic physical diseases: a protocol for a systematic review and meta-analysis.

    Science.gov (United States)

    Martínez, Pablo; Castro, Ariel; Alonso, Diego; Vöhringer, Paul A; Rojas, Graciela

    2017-07-20

    Depression is a global-scale public health problem, and a significant association has been established between depression and chronic physical diseases. This growing comorbidity poses a challenge to healthcare systems. We aim to assess the effectiveness of the management of major depressive episodes/disorder in adults with comorbid chronic physical diseases. We will conduct a systematic review and meta-analysis of randomised clinical trials. Two databases MEDLINE and Cochrane Library (Cochrane Database for Systematic Reviews and CENTRAL), as well as the reference lists of the included articles, will be searched for studies either in English or Spanish with published results within the 2005-2015 period. Studies must fulfil the following conditions: (1) participants aged 18 years or older, diagnosed as having a major depressive episodes/disorder according to standardised criteria and chronic physical diseases; (2)interventions (be it pharmacological, psychological, psychosocial or a combination) must be compared with control conditions (other 'active' intervention, treatment as usual, waiting list or placebo); (3)and must report reduction in depressive symptoms after treatment, response to treatment, remission of major depressive episodes/disorder and significant improvement in quality of life. Data extraction, risk of bias evaluation, results summarisation and quality of the evidence (GRADE) will be performed as recommended by the Cochrane Collaboration. A qualitative synthesis and a random effects meta-analysis will be carried out. Effect sizes will be calculated (relative risk and Cohen's d), I 2 and Q statistics will be employed to study heterogeneity and publication bias analysis will be performed. Subgroup analyses and meta-regression will be carried out. Results are expected to be published in specialised peer-reviewed journals (preferred topics: Mental Health, Psychology, Psychiatry and/or Systematic Reviews) and dissemination activities will be targeted to

  10. Long-term non-invasive ventilation reduces readmissions in COPD patients with two or more episodes of acute hypercapnic respiratory failure

    DEFF Research Database (Denmark)

    Ankjærgaard, Kasper Linde; Maibom, Sophia Liff; Wilcke, Jon Torgny

    2016-01-01

    BACKGROUND: Chronic obstructive pulmonary disease (COPD) patients who have had an episode of acute hypercapnic respiratory failure (AHRF) have a large 1-year risk of death or readmission. Acute non-invasive ventilation (NIV) has been shown to be an effective treatment of AHRF; and long-term NIV.......88 (p=0.0092). Four patients (20%) died in 1 year. LTNIV tended to reduce arterial CO2. No changes were found in lung function. CONCLUSIONS: LTNIV seems effective in reducing recurrent AHRF and readmissions in a highly select group of patients with severe, unstable COPD and frequent AHRF....

  11. Comparing the executive function of patients with schizophrenia, acute/chronic type I disorder (manic episode, and healthy controls on Wisconsin Card Sorting Test and Continuous Performance Test

    Directory of Open Access Journals (Sweden)

    Hossein Zare

    2017-05-01

    Full Text Available Introduction: From among various cognitive deficits, deficits in executive processes have an effective role in limiting the patients’ ability to retain, acquire, and re-learn the skills necessary for real-life performance. Thus, the present study aimed to compare the executive function of patients with schizophrenia, acute/chronic type I disorder, and the healthy group. Methods: The present research was an analytical-comparative study. The statistical population consisted of all the outpatients and inpatients with acute/chronic schizophrenia and acute/chronic type I disorder (manic episode visiting Shafa Psychiatric Hospital, Rasht, Iran. Using convenience sampling, 60 male subjects aging 18-49 years old were selected in 2014-2015. They were matched for the variables of sex, age, and education level. The Wisconsin Card Sorting Test, Continuous Performance Test, and Raven’s Progressive Matrices were administered, and the data were analyzed using MANOVA and Tukey post-hoc test. Results: A significant difference was observed between the acute/chronic schizophrenia group, acute/chronic type I disorder (manic episode, and healthy group on the two tests. Patients with schizophrenia had a weaker executive function and attention deficit compared to those with type I disorder and the healthy group (P0.05. Conclusion: Both schizophrenia and type I disorder patients show deficits in executive function and attention. However, the former group manifests higher impairment in cognitive activities, concept formation, cognitive flexibility, and attention deficit.

  12. ISSLS PRIZE IN CLINICAL SCIENCE 2018: longitudinal analysis of inflammatory, psychological, and sleep-related factors following an acute low back pain episode-the good, the bad, and the ugly.

    Science.gov (United States)

    Klyne, David M; Barbe, Mary F; van den Hoorn, Wolbert; Hodges, Paul W

    2018-04-01

    Prospective longitudinal study. To determine whether systemic cytokines and C-reactive protein (CRP) during an acute episode of low back pain (LBP) differ between individuals who did and did not recover by 6 months and to identify sub-groups based on patterns of inflammatory, psychological, and sleep features associated with recovery/non-recovery. Systemic inflammation is observed in chronic LBP and may contribute to the transition from acute to persistent LBP. Longitudinal studies are required to determine whether changes present early or develop over time. Psychological and/or sleep-related factors may be related. Individuals within 2 weeks of onset of acute LBP (N = 109) and pain-free controls (N = 55) provided blood for assessment of CRP, tumor necrosis factor (TNF), interleukin-6 (IL-6) and interleukin-1β, and completed questionnaires related to pain, disability, sleep, and psychological status. LBP participants repeated measurements at 6 months. Biomarkers were compared between LBP and control participants at baseline, and in longitudinal (baseline/6 months) analysis, between unrecovered (≥pain and disability), partially recovered (reduced pain and/or disability) and recovered (no pain and disability) participants at 6 months. We assessed baseline patterns of inflammatory, psychological, sleep, and pain data using hierarchical clustering and related the clusters to recovery (% change in pain) at 6 months. CRP was higher in acute LBP than controls at baseline. In LBP, baseline CRP was higher in the recovered than non-recovered groups. Conversely, TNF was higher at both time-points in the non-recovered than recovered groups. Two sub-groups were identified that associated with more ("inflammatory/poor sleep") or less ("high TNF/depression") recovery. This is the first evidence of a relationship between an "acute-phase" systemic inflammatory response and recovery at 6 months. High inflammation (CRP/IL-6) was associated with good recovery, but specific

  13. El Salvador earthquakes: relationships among acute stress disorder symptoms, depression, traumatic event exposure, and resource loss.

    Science.gov (United States)

    Sattler, David N; de Alvarado, Ana Maria Glower; de Castro, Norma Blandon; Male, Robert Van; Zetino, A M; Vega, Raphael

    2006-12-01

    Four and seven weeks after powerful earthquakes in El Salvador, the authors examined the relationships among demographics, traumatic event exposure, social support, resource loss, acute stress disorder (ASD) symptoms, depression, and posttraumatic growth. Participants were 253 college students (Study 1) and 83 people in the community (Study 2). In Study 1, female gender, traumatic event exposure, low social support, and loss of personal characteristic, condition, and energy resources contributed to ASD symptoms and depression. In Study 2, damage to home and loss of personal characteristic and object resources contributed to ASD symptoms and depression. Posttraumatic growth was not associated with ASD symptoms or depression. Findings support the conservation of resources stress theory (Hobfoll, 1998). Resource loss spirals, excessive demands on coping, and exposure to multiple disasters are discussed.

  14. Clinical features of and risk factors for major depression with history of postpartum episodes in Han Chinese women: A retrospective study.

    Science.gov (United States)

    Yang, Fuzhong; Gardner, Charles O; Bigdeli, Tim; Gao, Jingfang; Zhang, Zhen; Tao, Ming; Liu, Ying; Li, Youhui; Wang, Gang; Shi, Jianguo; Gao, Chengge; Zhang, Kerang; Li, Kan; Wang, Xumei; Liu, Lanfen; Sun, Jing; Du, Bo; Shi, Shenxun; Zhang, Jingbei; Wu, Wenyuan; Wang, Xueyi; Shen, Jianhua; Liu, Tiebang; Gu, Danhua; Liang, Wei; Deng, Hong; Pan, Jiyang; Yang, Lijun; Jian, Hu; Jiang, Guoqin; Meng, Huaqing; Miao, Guodong; Li, Yi; Hu, Chunmei; Huang, Guoping; Zhang, Yutang; Chen, Yunchun; Ha, Baowei; Gao, Shu; Fang, Xiang; Mei, Qiyi; Hong, Xiaohong; Yang, Donglin; Liu, Tieqiao; Fengyu, Yu; Zhong, Hui; Sang, Hong; Chen, Guibing; Cai, Min; Song, Yan; Dong, Jicheng; Shen, Zhenmin; Zhang, Wei; Wang, Xiaoping; Pan, Runde; Liu, Xiaojuan; Li, Yi; Liu, Zhengrong; Zhang, Qiwen; Li, Gongying; Flint, Jonathan; Kendler, Kenneth S

    2015-09-01

    We sought to investigate the clinical features of and risk factors for recurrent major depression (MD) with history of postpartum episodes (PPD) in Han Chinese women and the differences between first-onset postpartum MD (MD that has its first lifetime depressive episode in the postpartum period) and first-onset non-postpartum MD (MD with history of PPD and has its first lifetime depressive episode in a period other than postpartum). Data were derived from the China, Oxford and Virginia Commonwealth University Experimental Research on Genetic Epidemiology (CONVERGE) study (N=6017 cases) and analyzed in two steps. We first examined the clinical features of and risk factors for MD patients with (N=981) or without (N=4410) a history of PPD. We then compared the differences between first-onset postpartum MD (N=583) and first-onset non-postpartum MD (N=398) in those with a history of PPD. Linear, logistic and multinomial logistic models were employed to measure the associations. A history of PPD was associated with more guilt feelings, greater psychiatric comorbidity, higher neuroticism, earlier onset and more chronicity (OR 0.2-2.8). Severe premenstrual symptoms (PMS) and more childbirths increased the risk of PPD, as did a family history of MD, childhood sexual abuse, stressful life events and lack of social support (OR 1.1-1.3). In the MD with history of PPD subsample, first-onset postpartum MD was associated with fewer recurrent major depressive episodes, less psychiatric comorbidity, lower neuroticism, less severe PMS and fewer disagreements with their husbands (OR 0.5-0.8), but more childbirths (OR 1.2). Data were obtained retrospectively through interview and recall bias may have affected the results. MD with history of PPD in Han Chinese women is typically chronic and severe, with particular risk factors including severe PMS and more childbirths. First-onset postpartum MD and first-onset non-postpartum MD can be partly differentiated by their clinical features

  15. Structural magnetic resonance imaging in patients with first-episode schizophrenia, psychotic and severe non-psychotic depression and healthy controls. Results of the schizophrenia and affective psychoses (SAP) project.

    Science.gov (United States)

    Salokangas, R K R; Cannon, T; Van Erp, T; Ilonen, T; Taiminen, T; Karlsson, H; Lauerma, H; Leinonen, K M; Wallenius, E; Kaljonen, A; Syvälahti, E; Vilkman, H; Alanen, A; Hietala, J

    2002-09-01

    Structural brain abnormalities are prevalent in patients with schizophrenia and affective disorders. To study how regional brain volumes and their ratios differ between patients with schizophrenia, psychotic depression, severe non-psychotic depression and healthy controls. Magnetic resonance imaging scans of the brain on first-episode patients and on healthy controls. Patients with schizophrenia had a smaller left frontal grey matter volume than the other three groups. Patients with psychotic depression had larger ventricular and posterior sulcal cerebrospinal fluid (CSF) volumes than controls. Patients with depression had larger white matter volumes than the other patients. Left frontal lobe, especially its grey matter volume, seems to be specifically reduced in first-episode schizophrenia. Enlarged cerebral ventricles and sulcal CSF volumes are prevalent in psychotic depression. Preserved or expanded white matter is typical of non-psychotic depression.

  16. Self-esteem stability and depressive symptoms in acute stroke rehabilitation: methodological and conceptual expansion.

    Science.gov (United States)

    Vickery, Chad D; Evans, Clea C; Sepehri, Arash; Jabeen, Linsa N; Gayden, Monee

    2009-08-01

    Explore the relationship of self-esteem level, self-esteem stability, and other moderating variables with depressive symptoms in acute stroke rehabilitation. One hundred twenty participants completed measures of state self-esteem, perceived recovery, hospitalization-based hassles, impairment-related distress, and tendency to overgeneralize negative self-connotations of bad events. Self-report of depressive symptoms was collected at admission and on discharge. Four regression analyses explored the relationship of self-esteem level and stability and each of 4 moderating variables (perceived recovery, hassles, impairment-related distress, and overgeneralization) with depressive symptoms at discharge. Analyses indicated significant 3-way interactions in the 4 regression models. In general, individuals with unstable high self-esteem endorsed greater depressive symptoms under conditions of vulnerability (e.g., lower perceived recovery) than did individuals with stable high self-esteem. Under conditions of vulnerability, participants with stable low self-esteem indicated the highest levels of depressive symptoms. Self-esteem level and stability interact with psychological, environmental, and stroke-specific variables to predict depressive symptoms at discharge from stroke rehabilitation. This suggests the viability of self-esteem stability in exploring depressive symptoms in this setting and the complexity of emotional adjustment early after stroke. (c) 2009 APA

  17. The secondary prophylactic efficacy of beta-blocker after endoscopic gastric variceal obturation for first acute episode of gastric variceal bleeding

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    Moon Han Choi

    2013-09-01

    Full Text Available Background/AimsThe most appropriate treatment for acute gastric variceal bleeding (GVB is currently endoscopic gastric variceal obturation (GVO using Histoacryl®. However, the secondary prophylactic efficacy of beta-blocker (BB after GVO for the first acute episode of GVB has not yet been established. The secondary prophylactic efficacy of BB after GVO for the first acute episode of GVB was evaluated in this study.MethodsNinety-three patients at Soonchunhyang University Hospital with acute GVB who received GVO using Histoacryl® were enrolled between June 2001 and March 2010. Among these, 42 patients underwent GVO alone (GVO group and 51 patients underwent GVO with adjuvant BB therapy (GVO+BB group. This study was intended for patients in whom a desired heart rate was reached. The rates of rebleeding-free survival and overall survival were calculated for the two study groups using Kaplan-Meyer analysis and Cox's proportional-hazards model.ResultsThe follow-up period after the initial eradication of gastric varices was 18.14±25.22 months (mean±SD. During the follow-up period, rebleeding occurred in 10 (23.8% and 21 (41.2% GVO and GVO+BB patients, respectively, and 39 patients died [23 (54.8% in the GVO group and 16 (31.4% in the GVO+BB group]. The mean rebleeding-free survival time did not differ significantly between the GVO and GVO+BB groups (65.40 and 37.40 months, respectively; P=0.774, whereas the mean overall survival time did differ (52.54 and 72.65 months, respectively; P=0.036.Conclusions Adjuvant BB therapy after GVO using Histoacryl® for the first acute episode of GVB could decrease the mortality rate relative to GVO alone. However, adjuvant BB therapy afforded no benefit for the secondary prevention of rebleeding in GV.

  18. Mindfulness-based interventions for people diagnosed with a current episode of an anxiety or depressive disorder: a meta-analysis of randomised controlled trials.

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    Clara Strauss

    Full Text Available OBJECTIVE: Mindfulness-based interventions (MBIs can reduce risk of depressive relapse for people with a history of recurrent depression who are currently well. However, the cognitive, affective and motivational features of depression and anxiety might render MBIs ineffective for people experiencing current symptoms. This paper presents a meta-analysis of randomised controlled trials (RCTs of MBIs where participants met diagnostic criteria for a current episode of an anxiety or depressive disorder. METHOD: Post-intervention between-group Hedges g effect sizes were calculated using a random effects model. Moderator analyses of primary diagnosis, intervention type and control condition were conducted and publication bias was assessed. RESULTS: Twelve studies met inclusion criteria (n = 578. There were significant post-intervention between-group benefits of MBIs relative to control conditions on primary symptom severity (Hedges g = -0.59, 95% CI = -0.12 to -1.06. Effects were demonstrated for depressive symptom severity (Hedges g = -0.73, 95% CI = -0.09 to -1.36, but not for anxiety symptom severity (Hedges g = -0.55, 95% CI = 0.09 to -1.18, for RCTs with an inactive control (Hedges g = -1.03, 95% CI = -0.40 to -1.66, but not where there was an active control (Hedges g = 0.03, 95% CI = 0.54 to -0.48 and effects were found for MBCT (Hedges g = -0.39, 95% CI = -0.15 to -0.63 but not for MBSR (Hedges g = -0.75, 95% CI = 0.31 to -1.81. CONCLUSIONS: This is the first meta-analysis of RCTs of MBIs where all studies included only participants who were diagnosed with a current episode of a depressive or anxiety disorder. Effects of MBIs on primary symptom severity were found for people with a current depressive disorder and it is recommended that MBIs might be considered as an intervention for this population.

  19. Mindfulness-Based Interventions for People Diagnosed with a Current Episode of an Anxiety or Depressive Disorder: A Meta-Analysis of Randomised Controlled Trials

    Science.gov (United States)

    Strauss, Clara; Cavanagh, Kate; Oliver, Annie; Pettman, Danelle

    2014-01-01

    Objective Mindfulness-based interventions (MBIs) can reduce risk of depressive relapse for people with a history of recurrent depression who are currently well. However, the cognitive, affective and motivational features of depression and anxiety might render MBIs ineffective for people experiencing current symptoms. This paper presents a meta-analysis of randomised controlled trials (RCTs) of MBIs where participants met diagnostic criteria for a current episode of an anxiety or depressive disorder. Method Post-intervention between-group Hedges g effect sizes were calculated using a random effects model. Moderator analyses of primary diagnosis, intervention type and control condition were conducted and publication bias was assessed. Results Twelve studies met inclusion criteria (n = 578). There were significant post-intervention between-group benefits of MBIs relative to control conditions on primary symptom severity (Hedges g = −0.59, 95% CI = −0.12 to −1.06). Effects were demonstrated for depressive symptom severity (Hedges g = −0.73, 95% CI = −0.09 to −1.36), but not for anxiety symptom severity (Hedges g = −0.55, 95% CI = 0.09 to −1.18), for RCTs with an inactive control (Hedges g = −1.03, 95% CI = −0.40 to −1.66), but not where there was an active control (Hedges g = 0.03, 95% CI = 0.54 to −0.48) and effects were found for MBCT (Hedges g = −0.39, 95% CI = −0.15 to −0.63) but not for MBSR (Hedges g = −0.75, 95% CI = 0.31 to −1.81). Conclusions This is the first meta-analysis of RCTs of MBIs where all studies included only participants who were diagnosed with a current episode of a depressive or anxiety disorder. Effects of MBIs on primary symptom severity were found for people with a current depressive disorder and it is recommended that MBIs might be considered as an intervention for this population. PMID:24763812

  20. Depression and Anxiety are Common in Acute HIV Infection and Associate with Plasma Immune Activation.

    Science.gov (United States)

    Hellmuth, Joanna; Colby, Donn; Valcour, Victor; Suttichom, Duanghathai; Spudich, Serena; Ananworanich, Jintanat; Prueksakaew, Peeriya; Sailasuta, Napapon; Allen, Isabel; Jagodzinski, Linda L; Slike, Bonnie; Ochi, Derek; Paul, Robert

    2017-11-01

    This observational study of 123 Thai participants sought to determine the rate and severity of affective symptoms during acute HIV infection (AHI) and possible associations to disease mechanisms. At diagnosis, just prior to starting combination antiretroviral therapy (cART), AHI participants completed assessments of depression and anxiety symptoms that were repeated at 4, 12, and 24 weeks. Blood markers of HIV infection and immune activation were measured at study entry, with optional cerebrospinal fluid measures. A high frequency of participants reported symptoms that exceeded published thresholds supportive of depression (55.0%) and anxiety (65.8%) at diagnosis, with significant reductions after starting cART. Meeting a threshold for clinically relevant depressive symptoms at study entry was associated with higher baseline plasma HIV RNA (5.98 vs. 5.50, t = 2.46, p = 0.015), lower CD4 counts (328 vs. 436 cells/mm 3 , t = 3.46, p = 0.001), and higher plasma neopterin, a marker of macrophage activation (2694 vs. 1730 pg/mL, Mann-Whitney U = 152.5, p = 0.011). Controlling for plasma HIV RNA and CD4 count, higher baseline plasma neopterin correlated with worse initial depression and anxiety scores. Depression and anxiety symptoms are frequent in acute HIV infection, associate with plasma immune activation, and can improve concurrent with cART.

  1. EFFECTS OF ACUTE AND WEEKLY EPISODIC EXPOSURES TO ANATOXIN-A ON THE MOTOR ACTIVITY OF RATS: COMPARISON WITH NICOTINE.

    Science.gov (United States)

    Anatoxin-a is a potent nicotinic cholinergic agonist, that is produced by many genera of cyanobacteria, and has caused several poisoning episodes of wildlife, livestock, and domestic animals. Cyanobacterial blooms and toxin exposures are likely to occur episodically as environmen...

  2. Comparing Anxiety and Depression in Patients With Takotsubo Stress Cardiomyopathy to Those With Acute Coronary Syndrome.

    Science.gov (United States)

    Goh, Anne C H; Wong, Stephanie; Zaroff, Jonathan G; Shafaee, Navid; Lundstrom, Robert J

    2016-01-01

    To determine whether anxiety or depression is associated with takotsubo stress cardiomyopathy (TSCM). A retrospective case-control study was conducted among 73 TSCM cases and 111 acute coronary syndrome (ACS) controls matched for age, sex, and cardiac catheterization date. The study was conducted between May 1, 2009, and February 28, 2010. The Hospital Anxiety and Depression Scale was completed by all participants after hospital discharge. The Hospital Anxiety and Depression Scale was used to assess psychological distress with measurement of anxiety and depression scores. The presence of a stressful emotional or physical trigger before the TSCM presentation was determined. Univariate testing was performed to quantify the associations between anxiety and depression and TSCM trigger status. Multivariable logistic regression was used to quantify the independent associations between anxiety and depression and TSCM status after controlling for relevant covariates. The mean anxiety score was 6.7 ± 4.7 for TSCM cases versus 5.4 ± 3.4 for ACS controls (P = .06). The mean depression score was 4.3 ± 3.7 for TSCM cases versus 4.0 ± 3.1 for controls (P = .61). Anxiety was particularly associated with TSCM status with an emotional trigger (P = .05). After multivariable adjustment, anxiety (OR = 1.13; 95% CI, 1.01-1.26; P = .03) was associated with TSCM status but depression was not (OR = 0.94; 95% CI, 0.83-1.05; P = .29). In comparison with a control group with ACS, patients who presented with TSCM have higher levels of anxiety but not depression.

  3. Surface-Based Regional Homogeneity in First-Episode, Drug-Naïve Major Depression: A Resting-State fMRI Study

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    Hui-Jie Li

    2014-01-01

    Full Text Available Background. Previous volume-based regional homogeneity (ReHo studies neglected the intersubject variability in cortical folding patterns. Recently, surface-based ReHo was developed to reduce the intersubject variability and to increase statistical power. The present study used this novel surface-based ReHo approach to explore the brain functional activity differences between first-episode, drug-naïve MDD patients and healthy controls. Methods. Thirty-three first-episode, drug-naïve MDD patients and 32 healthy controls participated in structural and resting-state fMRI scans. MDD patients were rated with a 17-item Hamilton Rating Scale for Depression prior to the scan. Results. In comparison with the healthy controls, MDD patients showed reduced surface-based ReHo in the left insula. There was no increase in surface-based ReHo in MDD patients. The surface-based ReHo value in the left insula was not significantly correlated with the clinical information or the depressive scores in the MDD group. Conclusions. The decreased surface-based ReHo in the left insula in MDD may lead to the abnormal top-down cortical-limbic regulation of emotional and cognitive information. The surface-based ReHo may be a useful index to explore the pathophysiological mechanism of MDD.

  4. Does Internet-based cognitive behavioral therapy (iCBT) prevent major depressive episode for workers? A 12-month follow-up of a randomized controlled trial.

    Science.gov (United States)

    Imamura, K; Kawakami, N; Furukawa, T A; Matsuyama, Y; Shimazu, A; Umanodan, R; Kawakami, S; Kasai, K

    2015-07-01

    In this study we investigated whether an Internet-based computerized cognitive behavioral therapy (iCBT) program can decrease the risk of DSM-IV-TR major depressive episodes (MDE) during a 12-month follow-up of a randomized controlled trial of Japanese workers. Participants were recruited from one company and three departments of another company. Those participants who did not experience MDE in the past month were randomly allocated to intervention or control groups (n = 381 for each). A 6-week, six-lesson iCBT program was provided to the intervention group. While the control group only received the usual preventive mental health service for the first 6 months, the control group was given a chance to undertake the iCBT program after a 6-month follow-up. The primary outcome was a new onset of DSM-IV-TR MDE during the 12-month follow-up, as assessed by means of the web version of the WHO Composite International Diagnostic Interview (CIDI), version 3.0 depression section. The intervention group had a significantly lower incidence of MDE at the 12-month follow-up than the control group (Log-rank χ2 = 7.04, p MDE in the working population. However, it should be noted that MDE was measured by self-report, while the CIDI can measure the episodes more strictly following DSM-IV criteria.

  5. Pattern of cognitive impairment after giving total intravenous anaesthesia vs general anesthesia for electroconvulsive therapy in patients with depressive episode severe

    International Nuclear Information System (INIS)

    Malik, U.E.; Ahmed, N.; Hyder, R.R.

    2017-01-01

    To study the pattern of cognitive impairment after giving total intravenous anesthesia Vs general anesthesia for ECT for patients of Depressive Episode Severe. Study Design: Randomized controlled trial. Place and Duration of Study: Combined Military Hospital Skardu, from 15 Jul 2015 till 15 Jan 2016. Material and Methods: Hundred patients fulfilling the inclusion criteria were included by consecutive sampling technique for this study and divided in to two groups of 50 each. Patients of group A were given TIVA (propofol + succinylcholine). Patients in group B received GA (propofol + succinylcholine + isoflurane). Cognitive functions of patient were assessed by psychiatrist via mini mental state examination (MMSE) test before ECT and two weeks after ECT respectively. Results: Both the groups were assessed for cognitive impairment after TIVA Vs GA. In group A the MMSE showed less cognitive impairment as compared to group B (p<0.05). Conclusion: Cognitive impairment is less in total intravenous anesthesia as compared to general anesthesia for ECT in patients of depressive episode severe. (author)

  6. Verbal expressions used by anaclitic and introjective patients with depressive symptomatology: Analysis of change and stuck episodes within therapeutic sessions

    Directory of Open Access Journals (Sweden)

    Nelson Valdés

    2015-01-01

    Full Text Available A person’s speech makes it possible to identify significant indicators which reflect certain characteristics of his/her personality organization, but also can vary depending on the relevance of specific moments of the session and the symptoms type. The present study analyzed 10 completed and successful therapeutic processes using a mixed methodology. The therapies were video–and audio-taped, as well as observed through a one-way mirror by trained observers. All the sessions of each therapy were considered (N = 230 in order to identify, delimit, transcribe, and analyze Change Episodes (CEs = 24 and Stuck Episodes (SEs = 26. Each episode was made up by patients’ speech segments (N = 1,282, which were considered as the sampling unit. The Therapeutic Activity Coding System (TACS-1.0 was used to manually code each patient’s verbalizations, nested within episodes and individuals, in order to analyze them using Hierarchical Linear Modelling (HLM. The findings suggest that anaclitic patients tend to use more verbalizations in order to ask for feedback or to be understood by their therapists (attune, whereas introjective patients tend to use more verbalizations in order to construct new meanings (resignify during therapeutic conversation, but especially during SEs. Clinical implications to enrich the therapeutic practice are discussed.

  7. Acute exercise improves cognition in the depressed elderly: the effect of dual-tasks

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    Paulo Eduardo Vasques

    2011-01-01

    Full Text Available OBJECTIVE: The goal of this study was to assess the acute effect of physical exercise on the cognitive function of depressed elderly patients in a dual-task experiment. INTRODUCTION: Physical exercise has a positive effect on the brain and may even act as a treatment for major depressive disorder. However, the effects of acute cardiovascular exercise on cognitive function during and after one session of aerobic training in elderly depressive patients are not known. METHODS: Ten elderly subjects diagnosed with major depressive disorder performed neuropsychological tests during and after a moderate physical exercise session (65-75%HRmax. A Digit Span Test (Forward and Backward and a Stroop Color-Word Test were used to assess cognitive function. The elderly participants walked on an electric treadmill for 30 minutes and underwent the same cognitive testing before, during, immediately after, and 15 minutes after the exercise session. In the control session, the same cognitive testing was conducted, but without exercise training. RESULTS: The results of the Digit Span Test did not change between the control and the exercise sessions. The results of the Stroop Color-Word Test improved after physical exercise, indicating a positive effect of exercise on cognition. CONCLUSIONS: These data suggest that the cognitive functions of depressed elderly persons, especially attention and inhibitory control, are not impaired during and after an acute session of physical exercise. In contrast, the effect of dual-tasks showed beneficial results for these subjects, mainly after exercise. The dual-task may be a safe and useful tool for assessing cognitive function.

  8. Episodic memory and organizational strategy in free recall in unipolar depression: the role of cognitive support and executive functions.

    Science.gov (United States)

    Taconnat, Laurence; Baudouin, Alexia; Fay, Severine; Raz, Naftali; Bouazzaoui, Badiaa; El-Hage, Wissam; Isingrini, Michel; Ergis, Anne-Marie

    2010-08-01

    Executive functioning and memory impairment have been demonstrated in adults with depression. Executive functions and memory are related, mainly when the memory tasks require controlled processes (attentional resource demanding processes)--that is, when a low cognitive support (external aid) is provided. A cross-sectional study was carried out on 45 participants: 21 with depression, and 24 healthy controls matched for age, verbal ability, education level, and anxiety score. Cognitive support was manipulated by providing a categorized word list at encoding, presented either clustered (high cognitive support) or randomized (low cognitive support) to both depressed and healthy adults. The number of words recalled was calculated, and an index of clustering was computed to assess organizational strategies. Participants were also administered cognitive tests (executive functions, cognitive speed, and categorical fluency) to explore the mediators of organizational strategies. Depressed participants had greater difficulty recalling and organizing the words, but the differences between the two groups were reduced for both measures when high cognitive support was provided at encoding. Healthy adults performed better on all cognitive tests. Statistical analyses revealed that in the depressed group, executive functions were the only variable associated with clustering and only when low cognitive support was provided. These findings support the view that the decrement in executive function due to depression may lead to impairment in organization when this mnemonic strategy has to be self-initiated.

  9. N-acetylcysteine for major depressive episodes in bipolar disorder N-acetilcisteína para o tratamento de episódios de depressão maior no transtorno bipolar

    Directory of Open Access Journals (Sweden)

    Pedro V Magalhães

    2011-12-01

    Full Text Available OBJECTIVE: In this report, we aimed to evaluate the effect of add-on N-acetylcysteine (NAC on depressive symptoms and functional outcomes in bipolar disorder. To that end, we conducted a secondary analysis of all patients meeting full criteria for a depressive episode in a placebo controlled trial of adjunctive NAC for bipolar disorder. METHOD: Twenty-four week randomised clinical trial comparing adjunctive NAC and placebo in individuals with bipolar disorder experiencing major depressive episodes. Symptomatic and functional outcome data were collected over the study period. RESULTS: Seventeen participants were available for this report. Very large effect sizes in favor of NAC were found for depressive symptoms and functional outcomes at endpoint. Eight of the ten participants on NAC had a treatment response at endpoint; the same was true for only one of the seven participants allocated to placebo. DISCUSSION: These results indicate that adjunctive NAC may be useful for major depressive episodes in bipolar disorder. Further studies designed to confirm this hypothesis are necessary.OBJETIVO: Neste relato, avaliamos o efeito da N-acetilcisteína (NAC adjuvante em sintomas depressivos e desfechos funcionais no transtorno bipolar. Para isso, conduzimos uma análise secundária de todos os pacientes com critérios diagnósticos para um episódio depressivo em um ensaio clínico randomizado comparando NAC adjuvante com placebo no transtorno bipolar. MÉTODO: Ensaio clínico randomizado comparando NAC adjuvante com placebo para episódios depressivos no transtorno bipolar durante 24 semanas. Desfechos funcionais e sintomáticos foram coletados no período. RESULTADOS: Dezessete participantes estavam disponíveis para esta análise. Tamanhos de efeito grandes foram encontrados para sintomas depressivos e desfechos funcionais. Oito dos dez participantes no grupo da NAC tiveram resposta clínica ao fim do tratamento. O mesmo ocorreu em apenas um dos sete

  10. Use of escitalopram to prevent depression and cognitive impairments in the acute phase of stroke

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    Dina Rustemovna Khasanova

    2013-01-01

    Full Text Available The purpose of the study was to comparatively analyze the rate of post-stroke depression and cognitive impairments in escitalopram (cipralex-treated and untreated (control patients. Emotional and affective cognitive symptoms, neurological deficit, and day-to-day activity were evaluated over time 1, 3, and 6 months after treatment. The results of the study indicated that escitalopram used to prevent depression in the acute phase of stroke provided a good effect. This drug caused a prompter recovery of cognitive impairments and reduced the pace of development of neurodegenerative disorders underlying the post-stroke 2D (depression and dementia syndrome. The study group was recorded to have more favorable functional outcomes of stroke and patient mobility indicators associated with lower disability rates.

  11. Lower Choline-Containing Metabolites/Creatine (Cr) Rise and Failure to Sustain NAA/Cr Levels in the Dorsolateral Prefrontal Cortex Are Associated with Depressive Episode Recurrence under Maintenance Therapy: A Proton Magnetic Resonance Spectroscopy Retrospective Cohort Study.

    Science.gov (United States)

    Henigsberg, Neven; Šarac, Helena; Radoš, Marko; Radoš, Milan; Ozretić, David; Foro, Tamara; Erdeljić Turk, Viktorija; Hrabač, Pero; Bajs Janović, Maja; Rak, Benedict; Kalember, Petra

    2017-01-01

    The aim of this study was to evaluate the relationship between changes in proton magnetic resonance spectroscopy (1H-MRS) parameters at the start of the index episode recovery phase and at recurrence in patients with recurrent depression who were treated with prolonged maintenance therapy. 1H-MRS parameters were analyzed in 48 patients with recurrent depression who required maintenance therapy with antidepressant medication prescribed by a psychiatrist and who continued with the same antidepressant during the maintenance phase, either to recurrence of depression, completion of the 10-year observation period, or the start of the withdrawal phase (tapering-off antidepressant). N-acetylaspartate (NAA), choline-containing metabolites (Cho), creatine (Cr), and glutamine/glutamate were measured at the start of the recovery phase and 6 months later. Recurrent depressive episodes occurred in 20 patients. These individuals had a smaller increase in Cho/Cr after the beginning of the recovery phase compared to the non-recurrent patient group and also exhibited a decreased NAA/Cr ratio. Sustainable NAA and increased Cho levels at the onset of the recovery phase of the index episode are early markers of antidepressant effectiveness associated with a lower risk of major depressive disorder recurrence. The NAA and Cho changes in the non-recurrent group may be attributable to increased brain resilience, contrary to the transient temporal effect observed in subjects who experienced a depressive episode.

  12. [Dysfunctional resting-state connectivity of default mode network in adolescent patients with first-episode drug-naive major depressive disorder].

    Science.gov (United States)

    Li, S Y; Zhu, Y; Wang, Y L; Lü, P P; Zuo, W B; Li, F Y

    2017-12-05

    Objective: To study resting-state functional connectivity (FC) of default mode network (DMN) in adolescent patients with first-episode drug-naive major depressive disorder (MDD). Methods: We enrolled thirty first-episode and drug-naive adolescent MDD patients and twenty-nine adolescent healthy control (HC) participants in the First Affiliated Hospital of Zhengzhou University. There were no differences in age, sex, and education between the MDD and HC group. Resting-state functional magnetic resonance images (fMRI) was performed. We selected posterior cingulate cortex (PCC) and medial prefrontal cortex (MPFC) of DMN as regions of interests (ROI). The differences of these regions from the whole brain functional connectivity were analyzed. The relations between abnormalities in FCs of DMN and clinical variables were further investigated. Results: Compared to the HCs, the MDD patients had congruently reduced FCs between the PCC and cerebellum, temporal cortices, occipital cortices, fusiform, dorsolateral prefrontal cortex. MPFC not only had reduced FCs with fusiform, temporal cortices, anterior cingulate cortex, but also had enhanced FCs with occipital cortices, parietal cortices, and precentral gyrus. In addition, the increased FC between the right MPFC and right precentral gyrus was positive correlated with Hamilton Rating Scale for Depression (HAMD) scores ( r =0.38, P =0.04). The reduced FC between the left middle temporal gyrus and left PCC as well as the enhanced FC between the right middle cingulum and right MPFC were positive correlated with the duration of depression since onset ( r =0.39, P =0.03; r =0.38, P =0.04). Conclusions: These findings show dysfunctional DMN connectivity of adolescent MDD patients. Neurodevelopmental abnormalities in DMN may present in adolescent MDD.

  13. Evidence of a dissociation pattern in resting-state default mode network connectivity in first-episode, treatment-naive major depression patients.

    Science.gov (United States)

    Zhu, Xueling; Wang, Xiang; Xiao, Jin; Liao, Jian; Zhong, Mingtian; Wang, Wei; Yao, Shuqiao

    2012-04-01

    Imaging studies have shown that major depressive disorder (MDD) is associated with altered activity patterns of the default mode network (DMN). However, the neural correlates of the resting-state DMN and MDD-related pathopsychological characteristics, such as depressive rumination and overgeneral autobiographical memory (OGM) phenomena, still remain unclear. Using independent component analysis, we analyzed resting-state functional magnetic resonance imaging data obtained from 35 first-episode, treatment-naive young adults with MDD and from 35 matched healthy control subjects. Patients with MDD exhibited higher levels of rumination and OGM than did the control subjects. We observed increased functional connectivity in the anterior medial cortex regions (especially the medial prefrontal cortex and anterior cingulate cortex) and decreased functional connectivity in the posterior medial cortex regions (especially the posterior cingulate cortex/precuneus) in MDD patients compared with control subjects. In the depressed group, the increased functional connectivity in the anterior medial cortex correlated positively with rumination score, while the decreased functional connectivity in the posterior medial cortex correlated negatively with OGM score. We report dissociation between anterior and posterior functional connectivity in resting-state DMNs of first-episode, treatment-naive young adults with MDD. Increased functional connectivity in anterior medial regions of the resting-state DMN was associated with rumination, whereas decreased functional connectivity in posterior medial regions was associated with OGM. These results provide new evidence for the importance of the DMN in the pathophysiology of MDD and suggest that abnormal DMN activity may be an MDD trait. Copyright © 2012 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  14. Acute and chronic changes in brain activity with deep brain stimulation for refractory depression.

    Science.gov (United States)

    Conen, Silke; Matthews, Julian C; Patel, Nikunj K; Anton-Rodriguez, José; Talbot, Peter S

    2018-04-01

    Deep brain stimulation is a potential option for patients with treatment-refractory depression. Deep brain stimulation benefits have been reported when targeting either the subgenual cingulate or ventral anterior capsule/nucleus accumbens. However, not all patients respond and optimum stimulation-site is uncertain. We compared deep brain stimulation of the subgenual cingulate and ventral anterior capsule/nucleus accumbens separately and combined in the same seven treatment-refractory depression patients, and investigated regional cerebral blood flow changes associated with acute and chronic deep brain stimulation. Deep brain stimulation-response was defined as reduction in Montgomery-Asberg Depression Rating Scale score from baseline of ≥50%, and remission as a Montgomery-Asberg Depression Rating Scale score ≤8. Changes in regional cerebral blood flow were assessed using [ 15 O]water positron emission tomography. Remitters had higher relative regional cerebral blood flow in the prefrontal cortex at baseline and all subsequent time-points compared to non-remitters and non-responders, with prefrontal cortex regional cerebral blood flow generally increasing with chronic deep brain stimulation. These effects were consistent regardless of stimulation-site. Overall, no significant regional cerebral blood flow changes were apparent when deep brain stimulation was acutely interrupted. Deep brain stimulation improved treatment-refractory depression severity in the majority of patients, with consistent changes in local and distant brain regions regardless of target stimulation. Remission of depression was reached in patients with higher baseline prefrontal regional cerebral blood flow. Because of the small sample size these results are preliminary and further evaluation is necessary to determine whether prefrontal cortex regional cerebral blood flow could be a predictive biomarker of treatment response.

  15. Effect of obstructive sleep apnea on response to cognitive behavior therapy for depression after an acute myocardial infarction

    NARCIS (Netherlands)

    Freedland, Kenneth E.; Carney, Robert M.; Hayano, Junichiro; Steinmeyer, Brian C.; Reese, Rebecca L.; Roest, Annelieke M.

    Objective: To determine whether obstructive sleep apnea (OSA) interferes with cognitive behavior therapy (CBT) for depression in patients with coronary heart disease. Methods: Patients who were depressed within 28 days after an acute myocardial infarction (MI) were enrolled in the Enhancing Recovery

  16. Association between anxiety and depression in patients with acute coronary syndromes due to financial crisis.

    Science.gov (United States)

    Lampropoulos, Kostandinos; Kavvouras, Charalampos; Megalou, Aikaterini; Tsikouri, Pinelopi; Kafkala, Chrysanthi; Derka, Dimitra; Bonou, Maria; Barbetseas, John

    2016-01-01

    The effect of anxiety and depression on patients with acute coronary syndromes (ACS) warrants investigation, especially during periods of economic crisis. To investigate the relation between anxiety and depression in patients presenting with ACS due to financial crisis and to investigate whether these two entities could predict long-term cardiovascular mortality. Anxiety and depression symptoms were assessed in 350 patients (210 men) presenting with ACS, with 70 (20%) patients showing elevated scores (Hellenic Heart Failure Protocol). Over a mean follow-up of 48 months there were 36 (10%) cardiovascular deaths. Cox proportional hazards models adjusted for other prognostic factors (including age, sex, marital status, creatinine levels, left ventricular ejection fraction, heart failure, atrial fibrillation, previous hospitalisation, and baseline medications) showed that elevated anxiety and depression scores significantly predicted cardiovascular mortality (primary outcome) and all-cause mortality. Elevated anxiety and depression symptoms are related to cardiovascular mortality due probably to financial crisis, even after adjustment for other prognostic indicators in patients with ACS, who received optimised medical treatment.

  17. Episodes of Guillain-Barré syndrome associated with the acute phase of HIV-1 infection and with recurrence of viremia

    Directory of Open Access Journals (Sweden)

    Castro Gleusa de

    2006-01-01

    Full Text Available We report a severe case of Guillain-Barré syndrome (GBS characterized by flaccid areflexive tetraplegia and signs of autonomic instability related to acute HIV-1 infection, and the occurrence of relapse episodes coinciding with the detection of HIV-1 RNA in blood during the phase of irregular treatment with antiretroviral agents. The patient has been asymptomatic for 3 years and has an HIV-1 load below the limit of detection. The recurrence of GBS in this case may be related to alterations of the immunologic response caused by disequilibrium in the host-HIV relationship due to the increase in HIV-1 viremia.

  18. Clinical implications of anterior S-T segment depression in patients with acute inferior myocardial infarction

    International Nuclear Information System (INIS)

    Croft, C.H.; Woodward, W.; Nicod, P.; Corbett, J.R.; Lewis, S.E.; Willerson, J.T.; Rude, R.E.

    1982-01-01

    To assess various factors associated with anterior S-T segment depression during acute inferior myocardial infarction, 47 consecutive patients with electrocardiographic evidence of a first transmural inferior infarction were studied prospectively with radionuclide ventriculography an average of 7.3 hours (range 2.9 to 15.3) after the onset of symptoms. Thirty-nine patients (Group I) had anterior S-T depression in the initial electrocardiogram and 8 (Group II) did not have such reciprocal changes. There was no difference between the two groups in left ventricular end-diastolic or end-diastolic volume index or left ventricular ejection fraction. Stroke volume index was greater in Group I than in Group II. There were no group differences in left ventricular total or regional wall motion scores. A weak correlation existed between the quantities (mV) or inferior S-T segment elevation and reciprocal S-T depression. No relation between anterior S-T segment depression and the left ventricular end-diastolic volume index could be demonstrated; the extent of left ventricular apical and right ventricular wall motion abnormalities, both frequently associated with inferior infarction, did not correlate with the quantity of anterior S-T depression. These data show that anterior S-T segment depression occurs commonly during the early evolution of transmural inferior infarction, is not generally a marker of functionally significant anterior ischemia and cannot be used to predict left ventricular function in individual patients. Anterior S-T segment depression may be determined by reciprocal mechanisms

  19. Vulnerability for new episodes in recurrent major depressive disorder : protocol for the longitudinal DELTA-neuroimaging cohort study

    NARCIS (Netherlands)

    Mocking, Roel J. T.; Figueroa, Caroline A.; Rive, Maria M.; Geugies, Hanneke; Servaas, Michelle N.; Assies, Johanna; Koeter, Maarten W. J.; Vaz, Frederic M.; Wichers, Marieke; van Straalen, Jan P.; de Raedt, Rudi; Bockting, Claudi L. H.; Harmer, Catherine J.; Schene, Aart H.; Ruhe, Henricus G.

    2016-01-01

    Introduction Major depressive disorder (MDD) is widely prevalent and severely disabling, mainly due to its recurrent nature. A better understanding of the mechanisms underlying MDD-recurrence may help to identify high-risk patients and to improve the preventive treatment they need. MDD-recurrence

  20. Can an experience of a punishment episode in childhood period be connected with depressive or anxiety conditions in adulthood?

    Directory of Open Access Journals (Sweden)

    Saša Poljak Lukek

    2013-06-01

    Full Text Available Punishment, when understood as parents' response to undesirable behavior of a child and representing gradual restricting of such behavior, is an essential part of parents' role in the family. In the context of the paradigm of affective regulation, anxiety and depression states represent another unsuccessful attempt of trying to get closer and to find a connection in the relationship. This study, conducted on 197 participants, addressed the connection between punishment in upbringing and behavior disturbances in adulthood. Depressive states in adulthood were statistically significantly, although weakly connected with the experience of corporal punishment, punishment and restitution, and psychological aggression form both parents. Anxiety states were statistically significantly, although weakly connected with the experience of psychological aggression from both parents and with the experience of corporal punishment, and punishment and restitution of the mother. The participants who attained the criteria for diagnosis of depression were more exposed to corporal punishment at the age of 10 years (from both parents, punishment and restitution (from the father and psychological aggression (from the father compared to the participants without the diagnosis of depression. The paradigm of affective regulation is presented as a possible explanation of the connection between experiences of punishment as a way of upbringing in childhood and later mood disorders in adulthood. Punishment during upbringing that is not accompanied by parents' maintaining of the connection with the child can present the first experience of negative affection, which is the core of anxiety and depressive states. The mood disorders in adulthood can be understood as another failure when trying to reestablish the balance between external information and internal experiences that were primarily disturbed by the experience of punishment when growing up.

  1. Confluence of depression and acute psychological stress among patients with stable coronary heart disease: effects on myocardial perfusion.

    Science.gov (United States)

    Burg, Matthew M; Meadows, Judith; Shimbo, Daichi; Davidson, Karina W; Schwartz, Joseph E; Soufer, Robert

    2014-10-30

    Depression is prevalent in coronary heart disease (CHD) patients and increases risk for acute coronary syndrome (ACS) recurrence and mortality despite optimal medical care. The pathways underlying this risk remain elusive. Psychological stress (PS) can provoke impairment in myocardial perfusion and trigger ACS. A confluence of acute PS with depression might reveal coronary vascular mechanisms of risk. We tested whether depression increased risk for impaired myocardial perfusion during acute PS among patients with stable CHD. Patients (N=146) completed the Beck Depression Inventory-I (BDI-I), a measure of depression linked to recurrent ACS and post-ACS mortality, and underwent single-photon emission computed tomography myocardial perfusion imaging at rest and during acute PS. The likelihood of new/worsening impairment in myocardial perfusion from baseline to PS as a function of depression severity was tested. On the BDI-I, 41 patients scored in the normal range, 48 in the high normal range, and 57 in the depressed range previously linked to CHD prognosis. A BDI-I score in the depressed range was associated with a significantly greater likelihood of new/worsening impairment in myocardial perfusion from baseline to PS (odds ratio =2.89, 95% CI: 1.26 to 6.63, P=0.012). This remained significant in models controlling ACS recurrence/mortality risk factors and medications. There was no effect for selective serotonin reuptake inhibitor medications. Depressed patients with CHD are particularly susceptible to impairment in myocardial perfusion during PS. The confluence of PS with depression may contribute to a better understanding of the depression-associated risk for ACS recurrence and mortality. © 2014 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  2. Early maladaptive schema-related impairment and co-occurring current major depressive episode-related enhancement of mental state decoding ability in borderline personality disorder.

    Science.gov (United States)

    Unoka, Zsolt Szabolcs; Fogd, Dóra; Seres, Imola; Kéri, Szabolcs; Csukly, Gábor

    2015-04-01

    Disturbed interpersonal relationships specific to borderline personality disorder (BPD) suggest biased processing of social information. The goal of this study was to examine alterations in mental state decoding (MSD) and their associations with early maladaptive schemas (EMS) that may lead to the misinterpretation of incoming information. In addition, the authors' aim was to evaluate the effects of a co-occurring current major depressive episode (MDE) on the MSD performance of BPD patients. Seventy-eight BPD patients (34 with MDE) and 76 matched healthy controls (HC) were assessed for Reading the Mind in the Eyes Test (RMET) and the level of EMS. The authors found that impairment in the total RMET performance, as well as specific impairment regarding the recognition of positive and neutral items, was associated with EMS, and enhanced vigilance to negative mental states was characteristic to BPD with MDE. Results suggest that MSD ability is altered in two independent ways in BPD.

  3. Frontal-subcortical volumetric deficits in single episode, medication-naïve depressed patients and the effects of 8 weeks fluoxetine treatment: a VBM-DARTEL study.

    Directory of Open Access Journals (Sweden)

    Lingtao Kong

    Full Text Available BACKGROUND: Convergent studies suggest that morphological abnormalities of frontal-subcortical circuits which involved with emotional and cognitive processing may contribute to the pathophysiology of major depressive disorder (MDD. Antidepressant treatment which has been reported to reverse the functional abnormalities of frontal-subcortical circuits in MDD may have treating effects to related brain morphological abnormalities. In this study, we used voxel-based morphometry method to investigate whole brain structural abnormalities in single episode, medication-naïve MDD patients. Furthermore, we investigated the effects of an 8 weeks pharmacotherapy with fluoxetine. METHODS: 28 single episode, medication-naïve MDD participants and 28 healthy controls (HC acquired the baseline high-resolution structural magnetic resonance imaging (sMRI scan. 24 MDD participants acquired a follow-up sMRI scan after 8 weeks antidepressant treatment. Gray matter volumetric (GMV difference between groups was examined. RESULTS: Medication-naïve MDD had significantly decreased GMV in the right dorsolateral prefrontal cortex and left middle frontal gyrus as well as increased GMV in the left thalamus and right insula compared to HC (P<0.05, corrected. Moreover, treated MDD had significantly increased GMV in the left middle frontal gyrus and right orbitofrontal cortex compared to HC (P<0.05, corrected. No difference on GMV was detected between medication-naïve MDD group and treated MDD group. CONCLUSIONS: This study of single episode, medication-naïve MDD subjects demonstrated structural abnormalities of frontal-subcortical circuitsin the early stage of MDD and the effects of 8 weeks successful antidepressant treatment, suggesting these abnormalities may play an important role in the neuropathophysiology of MDD at its onset.

  4. Disrupted Structural and Functional Connectivity in Prefrontal-Hippocampus Circuitry in First-Episode Medication-Naïve Adolescent Depression.

    Directory of Open Access Journals (Sweden)

    Haiyang Geng

    Full Text Available Evidence implicates abnormalities in prefrontal-hippocampus neural circuitry in major depressive disorder (MDD. This study investigates the potential disruptions in prefrontal-hippocampus structural and functional connectivity, as well as their relationship in first-episode medication-naïve adolescents with MDD in order to investigate the early stage of the illness without confounds of illness course and medication exposure.Diffusion tensor imaging and resting-state functional magnetic resonance imaging (rs-fMRI data were acquired from 26 first-episode medication-naïve MDD adolescents and 31 healthy controls (HC. Fractional anisotropy (FA values of the fornix and the prefrontal-hippocampus functional connectivity was compared between MDD and HC groups. The correlation between the FA value of fornix and the strength of the functional connectivity in the prefrontal cortex (PFC region showing significant differences between the two groups was identified.Compared with the HC group, adolescent MDD group had significant lower FA values in the fornix, as well as decreased functional connectivity in four PFC regions. Significant negative correlations were observed between fornix FA values and functional connectivity from hippocampus to PFC within the HC group. There was no significant correlation between the fornix FA and the strength of functional connectivity within the adolescent MDD group.First-episode medication-naïve adolescent MDD showed decreased structural and functional connectivity as well as deficits of the association between structural and functional connectivity shown in HC in the PFC-hippocampus neural circuitry. These findings suggest that abnormal PFC-hippocampus neural circuitry may present in the early onset of MDD and play an important role in the neuropathophysiology of MDD.

  5. Anhedonia correlates with abnormal functional connectivity of the superior temporal gyrus and the caudate nucleus in patients with first-episode drug-naive major depressive disorder.

    Science.gov (United States)

    Yang, Xin-Hua; Tian, Kai; Wang, Dong-Fang; Wang, Yi; Cheung, Eric F C; Xie, Guang-Rong; Chan, Raymond C K

    2017-08-15

    Recent empirical findings have suggested that imbalanced neural networks may underlie the pathophysiology of major depressive disorder (MDD). However, the contribution of the superior temporal gyrus (STG) and the caudate nucleus to its pathophysiology remains unclear. Functional magnetic resonance imaging (MRI) date were acquired from 40 patients with first-episode drug-naive MDD and 36 matched healthy controls during wakeful rest. We used whole-brain voxel-wise statistical maps to quantify within-group resting state functional connectivity (RSFC) and between-group differences of bilateral caudate and STG seeds. Compared with healthy controls, first-episode MDD patients were found to have reduced connectivity between the ventral caudate and several brain regions including the superior frontal gyrus (SFG), the superior parietal lobule (SPL) and the middle temporal gyrus (MTG), as well as increased connectivity with the cuneus. We also found increased connectivity between the left STG and the precuneus, the angular gyrus and the cuneus. Moreover, we found that increased anhedonia severity was correlated with the magnitude of ventral caudate functional connectivity with the cuneus and the MTG in MDD patients. Due to our small sample size, we did not correct the statistical threshold in the correlation analyses between clinical variables and connectivity abnormalities. The present study suggests that anhedonia is mainly associated with altered ventral caudate-cortical connectivity and highlights the importance of the ventral caudate in the neurobiology of MDD. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Duration of Untreated Psychosis Is Associated with More Negative Schizophrenia Symptoms after Acute Treatment for First-Episode Psychosis

    Science.gov (United States)

    Grano, Niklas; Lindsberg, Jenni; Karjalainen, Marjaana; Gronroos, Peter; Blomberg, Ari-Pekka

    2010-01-01

    Evidence of association between duration of untreated psychosis (DUP) and negative symptoms of schizophrenia in first-episode psychosis (FEP) patients is inconsistent in the recent literature. In the present study, DUP, schizophrenia symptoms, duration of medication, and diagnosis were obtained from hospital archives in a sample of FEP patients.…

  7. The effect of MElatonin on Depressive symptoms, Anxiety, CIrcadian and Sleep disturbances in patients after acute coronary syndrome (MEDACIS)

    DEFF Research Database (Denmark)

    Madsen, Michael Tvilling; Isbrand, Anders; Andersen, Ulla Overgaard

    2017-01-01

    , Anxiety, CIrcadian and Sleep disturbances in patients after acute coronary syndrome" trial (MEDACIS) is a multicenter, double-blinded, placebo-controlled, randomized clinical trial. A total of 240 patients with ACS and no depressive symptoms will be included in the trial for treatment with either 25 mg...... melatonin or placebo for a 12-week period. Development and severity of depressive symptoms will be evaluated using Major Depression Inventory every 2 weeks with the purpose of investigating the potential preventive effect of melatonin on depressive symptoms. DISCUSSION: Previously, only selective serotonin...

  8. Acute episodes of predator exposure in conjunction with chronic social instability as an animal model of post-traumatic stress disorder.

    Science.gov (United States)

    Zoladz, Phillip R; Conrad, Cheryl D; Fleshner, Monika; Diamond, David M

    2008-07-01

    People who are exposed to horrific, life-threatening experiences are at risk for developing post-traumatic stress disorder (PTSD). Some of the symptoms of PTSD include persistent anxiety, exaggerated startle, cognitive impairments and increased sensitivity to yohimbine, an alpha(2)-adrenergic receptor antagonist. We have taken into account the conditions known to induce PTSD, as well as factors responsible for long-term maintenance of the disorder, to develop an animal model of PTSD. Adult male Sprague-Dawley rats were administered a total of 31 days of psychosocial stress, composed of acute and chronic components. The acute component was a 1-h stress session (immobilization during cat exposure), which occurred on Days 1 and 11. The chronic component was that on all 31 days the rats were given unstable housing conditions. We found that psychosocially stressed rats had reduced growth rate, reduced thymus weight, increased adrenal gland weight, increased anxiety, an exaggerated startle response, cognitive impairments, greater cardiovascular and corticosterone reactivity to an acute stressor and heightened responsivity to yohimbine. This work demonstrates the effectiveness of acute inescapable episodes of predator exposure administered in conjunction with daily social instability as an animal model of PTSD.

  9. Precordial ST-segment depression during acute inferior myocardial infarction: clinical, scintigraphic and angiographic correlations

    International Nuclear Information System (INIS)

    Gibson, R.S.; Crampton, R.S.; Watson, D.D.; Taylor, G.J.; Carabello, B.A.; Holt, N.D.; Beller, G.A.

    1982-01-01

    The cause and associated pathophysiology of precordial ST-segment depression during acute inferior myocardial infarction (IMI) are controversial. To investigate this problem, electrocardiographic findings in 48 consecutive patients with acute IMI were prospectively compared with results of coronary angiography, submaximal exercise thallium-201 ( 201 Tl) scintigraphy and multigated blood pool imaging, all obtained 2 weeks after IMI, and with clinical follow-up at 3 months. Patients were classified according to the admission ECG obtained 3.3 +/- 3.1 hours after the onset of chest pain. Twenty-one patients (group A) had no or 201 Tl perfusion abnormalities (p 201 Tl defects or wall motion abnormalities in anterior or septal segments

  10. Acute rCBF changes in depressed patients receiving repetitive transcranial magnetic stimulation (rTMS)

    International Nuclear Information System (INIS)

    Haindl, W.; Loo, C.; Mitchell, P.; Sachdev, P.; Zheng, X.; Som, S.; Walker, B.

    1999-01-01

    Full text: Electroconvulsant therapy (ECT) is very effective in treatment resistant severe depression with response rates of 70-90%. However, ECT has major limitations including the need for anaesthesia, memory difficulties and public apprehension about its use. Transcranial magnetic stimulation (rTMS) has been used as a diagnostic technique in neurology with recent reports of potential benefit in depressed patients. In this study, 5 patients (3 females, 2 males aged 36-66 years, mean 48.6 years) with major depression underwent SPET brain scanning using a Picker 3000 triple-headed camera. Each patient had a baseline rCBF scan with 500 MBq of 99 Tc m HMPAO injected intravenously during sham rTMS. On the following day, each patient received another 500 MBq of 99 Tc m HMPAo during rTMS to the left dorsolateral prefrontal cortex using a Magstim Super Rapid magnetic stimulator with a 70-mm figure eight coil. The stimulator parameters were 15 Hz, 90% of resting motor threshold, 1 s on 3 s off for 30 trains prior to injection and 15-30 trains following injection. Each patient continued to receive their usual medication during this period. The reconstructed SPET data sets were normalized to the global mean, registered to the Talairach template and analysed using statistical parametric mapping (SPM). Compared with the baseline group, the rTMS group showed a significant perfusion increase in the pre-frontal cortices, especially on the left, and also in the anterior left temporal lobe (P < 0.05). Frontal lobe perfusion reduction is a common finding in depression. This study demonstrates the ability of rTMS to acutely increase frontal lobe perfusion, and therefore a possible mechanism for its therapeutic use as an adjunct to pharmacological therapy or as an alternative to ECT in depression

  11. Nomothetic and idiographic symptom change trajectories in acute-phase cognitive therapy for recurrent depression.

    Science.gov (United States)

    Vittengl, Jeffrey R; Clark, Lee Anna; Thase, Michael E; Jarrett, Robin B

    2013-08-01

    We tested nomothetic and idiographic convergence and change in 3 symptom measures during acute-phase cognitive therapy (CT) for depression and compared outcomes among patients showing different change patterns. Outpatients (N = 362; 69% women; 85% White; age M = 43 years) with recurrent major depressive disorder according to criteria in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000) completed the Hamilton Rating Scale for Depression (Hamilton, 1960), Beck Depression Inventory (Beck, Ward, Mendelson, Mock, & Erbaugh, 1961), and Inventory for Depressive Symptomatology-Self-Report (Rush, Gullion, Basco, Jarrett, & Trivedi, 1996) on 14 occasions as well as pre/post-CT measures of social-interpersonal functioning and negative cognitive content. The 3 symptom measures marked the same severity and change constructs, and we offer improved formulas for intermeasure score conversions via their common factor. Pre/post-CT symptom reductions were large (ds = 1.71-1.92), and nomothetic symptom curves were log-linear (larger improvements earlier and smaller improvements later in CT). Nonetheless, only 30% of individual patients showed clear log-linear changes, whereas other patients showed linear (e.g., steady decreases; 20%), 1-step (e.g., a quick drop; 16%), and unclassified (34%) patterns. Log-linear, linear, and 1-step patients were generally similar to one another and superior to unclassified patients post-CT in symptom levels, response and stable remission rates, social-interpersonal functioning, and cognitive content (median d = 0.69). Reaching a low-symptom "destination" at the end of CT via any coherent "path" is more important in the short term than which path patients take. We discuss implications for theories of change, clinical monitoring of individuals' progress in CT, and the need to investigate long-term outcomes of patients with differing patterns of symptom change. PsycINFO Database Record

  12. The Relationship between Symptom Relief and Psychosocial Functional Improvement during Acute Electroconvulsive Therapy for Patients with Major Depressive Disorder.

    Science.gov (United States)

    Lin, Ching-Hua; Yang, Wei-Cheng

    2017-07-01

    We aimed to compare the degree of symptom relief to psychosocial functional (abbreviated as "functional") improvement and explore the relationships between symptom relief and functional improvement during acute electroconvulsive therapy for patients with major depressive disorder. Major depressive disorder inpatients (n=130) requiring electroconvulsive therapy were recruited. Electroconvulsive therapy was generally performed for a maximum of 12 treatments. Symptom severity, using the 17-item Hamilton Depression Rating Scale, and psychosocial functioning (abbreviated as "functioning"), using the Modified Work and Social Adjustment Scale, were assessed before electroconvulsive therapy, after every 3 electroconvulsive therapy treatments, and after the final electroconvulsive therapy. Both 17-item Hamilton Depression Rating Scale and Modified Work and Social Adjustment Scale scores were converted to T-score units to compare the degrees of changes between depressive symptoms and functioning after electroconvulsive therapy. Structural equation modeling was used to test the relationships between 17-item Hamilton Depression Rating Scale and Modified Work and Social Adjustment Scale during acute electroconvulsive therapy. One hundred sixteen patients who completed at least the first 3 electroconvulsive therapy treatments entered the analysis. Reduction of 17-item Hamilton Depression Rating Scale T-scores was significantly greater than that of Modified Work and Social Adjustment Scale T-scores at assessments 2, 3, 4, and 5. The model analyzed by structural equation modeling satisfied all indices of goodness-of-fit (chi-square = 32.882, P =.107, TLI = 0.92, CFI = 0.984, RMSEA = 0.057). The 17-item Hamilton Depression Rating Scale change did not predict subsequent Modified Work and Social Adjustment Scale change. Functioning improved less than depressive symptoms during acute electroconvulsive therapy. Symptom reduction did not predict subsequent functional improvement

  13. Episodic Memories

    Science.gov (United States)

    Conway, Martin A.

    2009-01-01

    An account of episodic memories is developed that focuses on the types of knowledge they represent, their properties, and the functions they might serve. It is proposed that episodic memories consist of "episodic elements," summary records of experience often in the form of visual images, associated to a "conceptual frame" that provides a…

  14. First episode schizophrenia

    African Journals Online (AJOL)

    with schizophrenia present clinically with psychotic, negative and cognitive ... changes in their emotions, cognition or behaviour which may indicate a ... contribute 80% to the risk of schizophrenia developing. A number of .... Positive symptoms ... Depression ... treatment of first episode schizophrenia is of critical importance.

  15. Effect of goal attainment theory based education program on cardiovascular risks, behavioral modification, and quality of life among patients with first episode of acute myocardial infarction: Randomized study.

    Science.gov (United States)

    Park, Moonkyoung; Song, Rhayun; Jeong, Jin-Ok

    2017-06-01

    Effect of goal-attainment-theory-based education program on cardiovascular risks, behavioral modification, and quality of life among patients with first episode of acute myocardial infarction: randomized study BACKGROUND: The behavioral modification strategies should be explored at the time of admission to lead the maximum effect of cardiovascular risk management. This randomized study aimed to elucidate the effects of a nurse-led theory-based education program in individuals with a first episode of acute myocardial infarction on cardiovascular risks, health behaviors, and quality of life over 6 months. The study involved a convenience sample of 64 patients with acute myocardial infarction who were randomly assigned to either the education group or the control group. The goal-attainment-based education program was designed to set the mutually agreed goals of risk management and the behavioral modification strategies for achieving those goals. Those in the control group received routine management only. The participants in both groups were contacted at 6-8 weeks and at 6 months after discharge to measure outcome variables. Repeated measure ANOVA was conducted using SPSSWIN (version 20.0) to determine the significance of differences in outcome variables over 6 months between the groups. Both groups showed significant positive changes in cardiovascular risks, health behaviors, and quality of life over 6 months. The 2-year risk of cardiovascular disease was significantly reduced in both study groups, but with no significant interaction effect (F=2.01, p=0.142). The performance and maintenance of health behaviors (F=3.75, p=0.029) and the mental component of quality of life (F=4.03, p=0.020) were significantly better in the education group than the control group. Applying a goal-oriented education program at an early stage of hospital management improved and maintained blood glucose, health behaviors, and mental component of the quality of life up to six months in

  16. Anti-inflammatory treatment and risk of depression in 91,842 patients with acute coronary syndrome and 91,860 individuals without acute coronary syndrome in Denmark

    DEFF Research Database (Denmark)

    Wium-Andersen, Ida Kim; Wium-Andersen, Marie Kim; Jørgensen, Martin Balslev

    2017-01-01

    Background We examined if treatment with acetylsalicylic acid (ASA), non-steroid anti-inflammatory drugs (NSAID), or statins after acute coronary syndrome (ACS) are associated with decreased risk of depression. Method This register-based cohort study included all individuals with a first...

  17. A 6 week randomized double-blind placebo-controlled trial of ziprasidone for the acute depressive mixed state.

    Directory of Open Access Journals (Sweden)

    Ashwin Patkar

    Full Text Available OBJECTIVE: To examine the efficacy of ziprasidone vs. placebo for the depressive mixed state in patients with bipolar disorder type II or major depressive disorder (MDD. METHODS: 73 patients were randomized in a double-blinded, placebo-controlled study to ziprasidone (40-160 mg/d or placebo for 6 weeks. They met DSM-IV criteria for a major depressive episode (MDE, while also meeting 2 or 3 (but not more nor less DSM-IV manic criteria. They did not meet DSM-IV criteria for a mixed or manic episode. Baseline psychotropic drugs were continued unchanged. The primary endpoint measured was Montgomery-Åsberg Depression Rating Scale (MADRS scores over time. The mean dose of ziprasidone was 129.7±45.3 mg/day and 126.1±47.1 mg/day for placebo. RESULTS: The primary outcome analysis indicated efficacy of ziprasidone versus placebo (p = 0.0038. Efficacy was more pronounced in type II bipolar disorder than in MDD (p = 0.036. Overall ziprasidone was well tolerated, without notable worsening of weight or extrapyramidal symptoms. CONCLUSIONS: There was a statistically significant benefit with ziprasidone versus placebo in this first RCT of any medication for the provisional diagnostic concept of the depressive mixed state. TRIAL REGISTRATION: Clinicaltrials.gov NCT00490542.

  18. Effect of acute tryptophan depletion on emotions in individuals with personal and family history of depression following a mood induction.

    Science.gov (United States)

    Altman, Sarah E; Shankman, Stewart A; Spring, Bonnie

    2010-08-01

    Acute tryptophan depletion (ATD) has shown depletion-specific increases in depressed mood and overall depressive symptoms, especially in those with a family history and in remitted patients. However, its effect on a broad range of emotions beyond depressed mood has been inconsistent, and studies have rarely employed a negative mood induction. The present double-blind study administered tryptophan-depleted and taste-matched placebo challenge drinks to individuals with a past diagnosis and family history of depression (i.e. depression-vulnerable subjects) and controls in order to investigate the effect of ATD on positive affect, anxiety, anger and depressed mood following a negative mood induction. Certain aspects of positive affect decreased due to ATD in the depression vulnerables but not in the controls. No differential effects were found on depressed mood and anxiety. A stress-induced blunted hedonic capacity may increase vulnerability to ATD and may be a core emotional abnormality in depression. Additionally, serotonin may have a stronger influence on positive affect than on other depression-related emotions during periods of stress. (c) 2010 S. Karger AG, Basel.

  19. Association between abnormal serum myelin-specific protein levels and white matter integrity in first-episode and drug-naïve patients with major depressive disorder.

    Science.gov (United States)

    Jiang, Linling; Cheng, Yuqi; Jiang, Hongyan; Xu, Jian; Lu, Jin; Shen, Zonglin; Lu, Yi; Liu, Fang; Li, Luqiong; Xu, Xiufeng

    2018-05-01

    Although the structural abnormalities of white matter (WM) have been described in patients with major depressive disorder (MDD), the neuropathological changes remain unclear. The current study aimed to investigate the myelin oligodendrocyte glycoprotein (MOG) and myelin-associated glycoprotein (MAG) levels and their correlations with WM integrity in first-episode, drug-naïve MDD patients. We obtained diffusion tensor images of 102 first-episode, drug-naïve MDD patients and 81 age- and sex-matched controls. Serum MOG and MAG levels of all participants were measured and compared between the two groups. The correlations between WM integrity and MOG and MAG levels were examined. MOG and MAG serum levels were significantly higher in MDD patients than in controls. Patients with MDD also showed decreased fractional anisotropy (FA) and axial diffusivity in the WM of the bilateral thalamus, right hippocampus, right temporal lobe, and left pulvinar. At the whole-brain level, no regions showed any correlations of diffusivity parameters with MOG or MAG levels in healthy subjects. However, we observed two-way correlations between the MOG and MAG levels and the FA and mean diffusivity values in the WM of the left middle frontal lobe, right inferior parietal lobe, and right supplementary motor area in MDD patients. Further investigation with a larger sample size and longitudinal studies are required to better understand the neuropathology of WM integrity in MDD. Our findings represent the first evidence of a relationship between abnormal serum myelin-specific protein levels and impaired WM integrity, which may help to better understand the neurobiological mechanisms of MDD. Copyright © 2018 Elsevier B.V. All rights reserved.

  20. Predictors of depressive disorder following acute coronary syndrome: Results from K-DEPACS and EsDEPACS.

    Science.gov (United States)

    Kang, Hee-Ju; Stewart, Robert; Bae, Kyung-Yeol; Kim, Sung-Wan; Shin, Il-Seon; Hong, Young Joon; Ahn, Youngkeun; Jeong, Myung Ho; Yoon, Jin-Sang; Kim, Jae-Min

    2015-08-01

    Depression is common and associated with poor prognosis in acute coronary syndrome (ACS). There are few reports on the predictors of incident and persistent post-discharge depressive disorders in ACS. This study aimed to investigate the incidence and persistence of depressive disorder over a one year follow-up, and predictors of these outcomes. 1152 patients with recently developed ACS were recruited at baseline, and 828 were followed one year thereafter. Depressive disorder (major and minor) was diagnosed according to DSM-IV criteria, and analyzed according to baseline prevalence, and follow up incidence and persistence. Of 446 baseline participants with depressive disorders, 300 were randomized to a 24-week double blind trial of escitalopram or placebo, while the remaining 146 received medical treatment as usual. Associations of baseline socio-demographic and clinical characteristics with depressive disorder were investigated using logistic regression models. Two-week prevalence, and one-year incidence and persistence of depressive disorder were 38.7%, 13.1%, and 46.3%, respectively. Baseline depressive disorder was independently associated with female, lower educational level, previous ACS and higher heart rate. Incident depressive disorder was independently predicted by current unemployment, family history of depression, higher baseline Hamilton Depression Rating Scale(HAMD) score and lower left ventricular ejection fraction, and persistent depressive disorder by higher baseline HAMD score and the placebo or medical treatment as usual group in the 24-week trial. The generalizability should be considered since this study conducted in a single center. Depressive disorder in ACS patients is common and often persistent, and is associated with baseline characteristics and insufficient treatment. Appropriate detection and treatment of depressive disorder are clearly important in ACS patients. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. Acute Stress-Induced Epigenetic Modulations and Their Potential Protective Role Toward Depression

    Directory of Open Access Journals (Sweden)

    Francesco Rusconi

    2018-05-01

    Full Text Available Psychiatric disorders entail maladaptive processes impairing individuals’ ability to appropriately interface with environment. Among them, depression is characterized by diverse debilitating symptoms including hopelessness and anhedonia, dramatically impacting the propensity to live a social and active life and seriously affecting working capability. Relevantly, besides genetic predisposition, foremost risk factors are stress-related, such as experiencing chronic psychosocial stress—including bullying, mobbing and abuse—, and undergoing economic crisis or chronic illnesses. In the last few years the field of epigenetics promised to understand core mechanisms of gene-environment crosstalk, contributing to get into pathogenic processes of many disorders highly influenced by stressful life conditions. However, still very little is known about mechanisms that tune gene expression to adapt to the external milieu. In this Perspective article, we discuss a set of protective, functionally convergent epigenetic processes induced by acute stress in the rodent hippocampus and devoted to the negative modulation of stress-induced immediate early genes (IEGs transcription, hindering stress-driven morphostructural modifications of corticolimbic circuitry. We also suggest that chronic stress damaging protective epigenetic mechanisms, could bias the functional trajectory of stress-induced neuronal morphostructural modification from adaptive to maladaptive, contributing to the onset of depression in vulnerable individuals. A better understanding of the epigenetic response to stress will be pivotal to new avenues of therapeutic intervention to treat depression, especially in light of limited efficacy of available antidepressant drugs.

  2. Efficacy and acceptability of acute treatments for persistent depressive disorder: a network meta-analysis.

    Science.gov (United States)

    Kriston, Levente; von Wolff, Alessa; Westphal, Annika; Hölzel, Lars P; Härter, Martin

    2014-08-01

    We aimed to synthesize the available evidence on the relative efficacy and acceptability of specific treatments for persistent depressive disorder. We searched several databases up to January 2013 and included randomized controlled trials that compared acute pharmacological, psychotherapeutic, and combined interventions with each other or placebo. The outcome measures were the proportion of patients who responded to (efficacy) or dropped out from (acceptability) the allocated treatment. Data synthesis was performed with network meta-analysis. A network of 45 trials that tested 28 drugs included data from 5,806 and 5,348 patients concerning efficacy and acceptability, respectively. A second network of 15 trials that tested five psychotherapeutic and five combined interventions included data from 2,657 and 2,719 patients concerning efficacy and acceptability, respectively. Among sufficiently tested treatments, fluoxetine (odds ratio (OR) 2.94), paroxetine (3.79), sertraline (4.47), moclobemide (6.98), imipramine (4.53), ritanserin (2.35), amisulpride (5.63), and acetyl-l-carnitine (5.67) were significantly more effective than placebo. Pairwise comparisons showed advantages of moclobemide (2.38) and amisulpride (1.92) over fluoxetine. Sertraline (0.57) and amisulpride (0.53) showed a lower dropout rate than imipramine. Interpersonal psychotherapy with medication outperformed medication alone in chronic major depression but not in dysthymia. Evidence on cognitive behavioral analysis system of psychotherapy plus medication was partly inconclusive. Interpersonal psychotherapy was less effective than medication (0.48) and cognitive behavioral analysis system of psychotherapy (0.45). Several other treatments were tested in single studies. Several evidence-based acute pharmacological, psychotherapeutic, and combined treatments for persistent depressive disorder are available with significant differences between them. © 2014 Wiley Periodicals, Inc.

  3. Are Improvements in Cognitive Content and Depressive Symptoms Correlates or Mediators during Acute-Phase Cognitive Therapy for Recurrent Major Depressive Disorder?

    Science.gov (United States)

    Vittengl, Jeffrey R; Clark, Lee Anna; Thase, Michael E; Jarrett, Robin B

    2014-01-09

    The cognitive model of depression posits that cognitive therapy's (CT) effect on depressive symptoms is mediated by changes in cognitive content (e.g., automatic negative thoughts dysfunctional attitudes, failure attributions). We tested improvement and normalization of cognitive content among outpatients ( N = 523) with recurrent major depressive disorder treated with acute-phase CT (Jarrett & Thase, 2010; Jarrett et al., 2013). We also tested whether improvement in cognitive content accounted for subsequent changes in depressive symptoms and vice versa. Five measures of content improved substantively from pre- to post-CT (median d = 0.96), and the proportions of patients scoring in "healthy" ranges increased (median 45% to 82%). Evidence for cognitive mediation of symptom reduction was limited (median r = .06), as was evidence for symptom mediation of cognitive content improvement (median r = .07). We discuss measurement and design issues relevant to detection of mediators and consider alternative theories of change.

  4. Association between N-terminal proB-type Natriuretic Peptide and Depressive Symptoms in Patients with Acute Myocardial Infarction

    Institute of Scientific and Technical Information of China (English)

    Yan Ren; Jiao Jia; Jian Sa; Li-Xia Qiu; Yue-Hua Cui; Yue-An Zhang; Hong Yang

    2017-01-01

    Background:While depression and certain cardiac biomarkers are associated with acute myocardial infarction (AMI),the relationship between them remains largely unexplored.We examined the association between depressive symptoms and biomarkers in patients with AMI.Methods:We performed a cross-sectional study using data from 103 patients with AMI between March 2013 and September 2014.The levels of depression,N-terminal proB-type natriuretic peptide (NT-proBNP),and troponin I (TnI) were measured at baseline.The patients were divided into two groups:those with depressive symptoms and those without depressive symptoms according to Zung Self-rating Depression Scale (SDS) score.Baseline comparisons between two groups were made using Student's t-test for continuous variables,Chi-square or Fisher's exact test for categorical variables,and Wilcoxon test for variables in skewed distribution.Binomial logistic regression and multivariate linear regression were performed to assess the association between depressive symptoms and biomarkers while adjusting for demographic and clinical variables.Results:Patients with depressive symptoms had significantly higher NT-proBNP levels as compared to patients without depressive symptoms (1135.0 [131.5,2474.0] vs.384.0 [133.0,990.0],Z =-2.470,P =0.013).Depressive symptoms were associated with higher NT-proBNP levels (odds ratio [OR] =2.348,95% CI:1.344 to 4.103,P =0.003) and higher body mass index (OR =1.169,95% confidence interval [CI]:1.016 to 1.345,P =0.029).The total SDS score was associated with the NT-proBNP level (β =0.327,95% CI:1.674 to 6.119,P =0.001) after multivariable adjustment.In particular,NT-proBNP was associated with three of the depressive dimensions,including core depression (β =0.299,95% CI:0.551 to 2.428,P =0.002),cognitive depression (β =0.320,95% CI:0.476 to 1.811,P=0.001),and somatic depression (β =0.333,95% CI:0.240 to 0.847,P =0.001).Neither the overall depressive symptomatology nor the individual

  5. Differential effects of acute cortisol administration on deep and shallow episodic memory traces: a study on healthy males.

    Science.gov (United States)

    Cioncoloni, David; Galli, Giulia; Mazzocchio, Riccardo; Feurra, Matteo; Giovannelli, Fabio; Santarnecchi, Emiliano; Bonifazi, Marco; Rossi, Alessandro; Rossi, Simone

    2014-10-01

    We aimed at investigating rapid effects of plasma cortisol elevations on the episodic memory phase of encoding or retrieval, and on the strength of the memory trace. Participants were asked either to select a word containing the letter "e" (shallow encoding task) or to judge if a word referred to a living entity (deep encoding task). We intravenously administered a bolus of 20mg of cortisol either 5 min before encoding or 5 min before retrieval, in a between-subjects design. The study included only male participants tested in the late afternoon, and neutral words as stimuli. When cortisol administration occurred prior to retrieval, a main effect of group emerged. Recognition accuracy was higher for individuals who received cortisol compared to placebo. The higher discrimination accuracy for the cortisol group was significant for words encoded during deep but not shallow task. Cortisol administration before encoding did not affect subsequent retrieval performance (either for deep or shallow stimuli) despite a facilitatory trend. Because genomic mechanisms take some time to develop, such a mechanism cannot apply to our findings where the memory task was performed shortly after the enhancement of glucocorticoid levels. Therefore, glucocorticoids, through non-genomic fast effects, determine an enhancement in episodic memory if administered immediately prior to retrieval. This effect is more evident if the memory trace is laid down through deep encoding operations involving the recruitment of specific neural networks. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Acute administration of fluoxetine normalizes rapid eye movement sleep abnormality, but not depressive behaviors in olfactory bulbectomized rats.

    Science.gov (United States)

    Wang, Yi-Qun; Tu, Zhi-Cai; Xu, Xing-Yuan; Li, Rui; Qu, Wei-Min; Urade, Yoshihiro; Huang, Zhi-Li

    2012-01-01

    In humans, depression is associated with altered rapid eye movement (REM) sleep. However, the exact nature of the relationship between depressive behaviors and sleep abnormalities is debated. In this study, bilateral olfactory bulbectomy (OBX) was carried out to create a model of depression in rats. The sleep-wake profiles were assayed using a cutting-edge sleep bioassay system, and depressive behaviors were evaluated by open field and forced swimming tests. The monoamine content and monoamine metabolite levels in the brain were determined by a HPLC-electrochemical detection system. OBX rats exhibited a significant increase in REM sleep, especially between 15:00 and 18:00 hours during the light period. Acute treatment with fluoxetine (10 mg/kg, i.p.) immediately abolished the OBX-induced increase in REM sleep, but hyperactivity in the open field test and the time spent immobile in the forced swimming test remained unchanged. Neurochemistry studies revealed that acute administration of fluoxetine increased serotonin (5-HT) levels in the hippocampus, thalamus, and midbrain and decreased levels of the 5-HT metabolite 5-hydroxyindoleacetic acid (5-HIAA). The ratio of 5-HIAA to 5-HT decreased in almost all regions of the brain. These results indicate that acute administration of fluoxetine can reduce the increase in REM sleep but does not change the depressive behaviors in OBX rats, suggesting that there was no causality between REM sleep abnormalities and depressive behaviors in OBX rats. © 2011 The Authors. Journal of Neurochemistry © 2011 International Society for Neurochemistry.

  7. Depression

    Science.gov (United States)

    ... in the winter. Depression is one part of bipolar disorder. There are effective treatments for depression, including antidepressants, talk therapy, or both. NIH: National Institute of Mental Health

  8. Strategies to mitigate dissociative and psychotomimetic effects of ketamine in the treatment of major depressive episodes: a narrative review.

    Science.gov (United States)

    Cooper, Matthew D; Rosenblat, Joshua D; Cha, Danielle S; Lee, Yena; Kakar, Ron; McIntyre, Roger S

    2017-09-01

    Objectives Replicated evidence has demonstrated that ketamine exerts rapid-acting and potent antidepressant effects. Notwithstanding, its promise to mitigate depressive symptoms and suicidality in antidepressant-resistant populations, several limitations and safety concerns accompany ketamine including, but not limited to, the potential for abuse and psychotomimetic/dissociative experiences. The focus of the current narrative review is to synthesise available evidence of strategies that may mitigate and fully prevent treatment-emergent psychotomimetic and dissociative effects associated with ketamine administration. Methods PubMed, Google Scholar and ClinicalTrials.gov were searched for relevant articles. Results Potential avenues investigated to minimise psychotomimetic effects associated with ketamine administration include the following: (1) altering dosing and infusion rates; (2) route of administration; (3) enantiomer choice; (4) co-administration with mood stabilisers of antipsychotics; and (5) use of alternative N-methyl-d-aspartate (NMDA)-modulating agents. Emerging evidence indicates that dissociative experiences can be significantly mitigated by using an intranasal route of administration, lower dosages, or use of alternative NMDA-modulating agents, namely lanicemine (AZD6765) and GLYX-13. Conclusions Currently, intranasal administration presents as the most promising strategy to mitigate dissociative and psychotomimetic effects; however, studies of strategies to mitigate the adverse events of ketamine are limited in number and quality and thus further investigation is still needed.

  9. Anti-NMDA Receptor Encephalitis Presenting as an Acute Psychotic Episode in a Young Woman: An Underdiagnosed yet Treatable Disorder

    Directory of Open Access Journals (Sweden)

    Shikma Keller

    2014-01-01

    Full Text Available Anti-NMDA receptor (NMDAR encephalitis is a recently identified autoimmune disorder with prominent psychiatric symptoms. Patients usually present with acute behavioral change, psychosis, catatonic symptoms, memory deficits, seizures, dyskinesias, and autonomic instability. In female patients an ovarian teratoma is often identified. We describe a 32-year-old woman who presented with acute psychosis. Shortly after admission, she developed generalized seizures and deteriorated into a catatonic state. Although ancillary tests including MRI, electroencephalogram, and cerebrospinal fluid (CSF analysis were unremarkable, the presentation of acute psychosis in combination with recurrent seizures and a relentless course suggested autoimmune encephalitis. The patient underwent pelvic ultrasound which disclosed a dermoid cyst and which led to an urgent cystectomy. Plasmapheresis was then initiated, yielding partial response over the next two weeks. Following the detection of high titers of anti-NMDAR antibodies in the CSF, the patient ultimately received second line immunosuppressive treatment with rituximab. Over several months of cognitive rehabilitation a profound improvement was eventually noted, although minor anterograde memory deficits remained. In this report we call for attention to the inclusion of anti-NMDAR encephalitis in the differential diagnosis of acute psychosis. Prompt diagnosis is critical as early immunotherapy and tumor removal could dramatically affect outcomes.

  10. Efficacy of intravenous ondansetron to prevent vomiting episodes in acute gastroenteritis: a randomized, double blind, and controlled trial

    Directory of Open Access Journals (Sweden)

    Sanguansak Rerksuppaphol

    2010-09-01

    Full Text Available Acute gastroenteritis is one of the most common infectious diseases of childhood. Its symptoms are vomiting, diarrhea, and dehydration. In the emergency ward, intravenous rather than oral rehydration is usually preferred because of the high likelihood of emesis. Treatments to reduce emesis are of value in improving the rehydration procedure. Our study is a double-blind randomized trial and proposes the use of ondansetron as an anti-emetic drug to treat children with acute gastroenteritis. Seventy-four in-patients, aged 3 months to 15 years, were enrolled and randomly assigned to an ondansetron or placebo group. Inclusion criteria were the diagnosis of acute gastroenteritis and the absence of other diseases or allergies to drugs. A single bolus (0.15 mg/kg of ondansetron was injected intravenously; normal 0.9% saline solution was used as a placebo. This treatment induced vomiting cessation in the ondansetron group significantly in comparison to the placebo group. The length of the hospital stay and the oral rehydration fluid volume were similar in the two groups and no adverse effects were noticed. Thus, safety, low cost, and overall bene­fit of ondansetron treatment suggests that this drug can be administered successfully to children with acute gastroenteritis.

  11. Methadone, monoamine oxidase, and depression: opioid distribution and acute effects on enzyme activity

    International Nuclear Information System (INIS)

    Kaufmann, C.A.; Kreek, M.J.; Raghunath, J.; Arns, P.

    1983-01-01

    Narcotic withdrawal is often accompanied by an atypical depression which responds to resumption of narcotics. It was hypothesized that methadone might exert its antidepressant effects through monoamine oxidase (MAO) inhibition. The current study examined 3 H-methadone distribution in rat brain and effects on regional MAO activity with acute doses (2.5 mg/kg) which approximate those found during chronic methadone maintenance in man. Limbic areas (amygdala, basomedial hypothalamus, caudate-putamen, hippocampus, preoptic nucleus), as well as pituitary and liver were assayed for MAO activity and methadone concentration. MAO activities did not differ significantly in acute methadone or saline-treated cage-mates at 1 or 24 hr. The concentrations of methadone at 1 hr ranged between 17 and 223 ng/100 mg wet wt tissue in the preoptic nucleus and pituitary, respectively. No significant correlation was found between change in MAO activity (MAO methadone/MAO saline) and methadone concentration in any region at 1 or 24 hr. This study does not support the hypothesis that methadone acts as an antidepressant through MAO inhibition, at least not following acute administration of this exogenous opioid

  12. Methadone, monoamine oxidase, and depression: opioid distribution and acute effects on enzyme activity

    Energy Technology Data Exchange (ETDEWEB)

    Kaufmann, C.A.; Kreek, M.J.; Raghunath, J.; Arns, P.

    1983-09-01

    Narcotic withdrawal is often accompanied by an atypical depression which responds to resumption of narcotics. It was hypothesized that methadone might exert its antidepressant effects through monoamine oxidase (MAO) inhibition. The current study examined /sub 3/H-methadone distribution in rat brain and effects on regional MAO activity with acute doses (2.5 mg/kg) which approximate those found during chronic methadone maintenance in man. Limbic areas (amygdala, basomedial hypothalamus, caudate-putamen, hippocampus, preoptic nucleus), as well as pituitary and liver were assayed for MAO activity and methadone concentration. MAO activities did not differ significantly in acute methadone or saline-treated cage-mates at 1 or 24 hr. The concentrations of methadone at 1 hr ranged between 17 and 223 ng/100 mg wet wt tissue in the preoptic nucleus and pituitary, respectively. No significant correlation was found between change in MAO activity (MAO methadone/MAO saline) and methadone concentration in any region at 1 or 24 hr. This study does not support the hypothesis that methadone acts as an antidepressant through MAO inhibition, at least not following acute administration of this exogenous opioid.

  13. Rates and predictors of depression status among caregivers of patients with COPD hospitalized for acute exacerbations: a prospective study

    Directory of Open Access Journals (Sweden)

    Bernabeu-Mora R

    2016-12-01

    Full Text Available Roberto Bernabeu-Mora,1–3 Gloria García-Guillamón,2 Joaquina Montilla-Herrador,2,3 Pilar Escolar-Reina,2,3 José Antonio García-Vidal,2 Francesc Medina-Mirapeix2,3 1Division of Pneumology, Hospital Morales Meseguer, 2Department of Physical Therapy, University of Murcia, 3Physiotherapy and Disability Research Group, Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB, Murcia, Spain Background: Hospitalization is common for acute exacerbation of COPD, but little is known about its impact on the mental health of caregivers. Objective: The aim of this study was to determine the rates and predictors of depressive symptoms in caregivers at the time of hospitalization for acute exacerbation of COPD and to identify the probability and predictors of subsequent changes in depressive status 3 months after discharge. Materials and methods: This was a prospective study. Depression symptoms were measured in 87 caregivers of patients hospitalized for exacerbation at hospitalization and 3 months after discharge. We measured factors from four domains: context of care, caregiving demands, caregiver resources, and patient characteristics. Univariate and multivariate multiple logistic regressions were used to determine the predictors of depression at hospitalization and subsequent changes at 3 months. Results: A total of 45 caregivers reported depression at the time of hospitalization. After multiple adjustments, spousal relationship, dyspnea, and severe airflow limitation were the strongest independent predictors of depression at hospitalization. Of these 45 caregivers, 40% had a remission of their depression 3 months after discharge. In contrast, 16.7% of caregivers who were not depressive at hospitalization became depressive at 3 months. Caregivers caring >20 hours per week for patients with dependencies had decreased odds of remission, and patients having dependencies after discharge increased the odds of caregivers becoming

  14. Assessment of Health Care and Economic Costs Due to Episodes of Acute Pesticide Intoxication in Workers of Rural Areas of the Coquimbo Region, Chile.

    Science.gov (United States)

    Ramírez-Santana, Muriel; Iglesias-Guerrero, Juan; Castillo-Riquelme, Marianela; Scheepers, Paul T J

    2014-12-01

    The increase in agricultural activity that Chile experienced in the past 20 years resulted in a boost in the use of pesticides. Despite pesticides' productivity benefits, they caused health problems such as the increased frequency of episodes of acute poisoning, which constitutes a relevant problem in terms of occupational health. The Chilean authorities require several preventive measures at workplaces, which are not always implemented, increasing the risk of intoxications in farmers. So far in Chile, there are no studies concerning the public health care expenses associated with acute work-related pesticide intoxications. From the societal perspective, there are costs involved if the worker needs to take sick leave and families incur costs to take care of their sick members. This study aimed to determine the costs associated with health care services used by people who suffered from work-related acute pesticide poisoning, as well as the economic costs for the families of the workers involved, and finally the costs of these episodes for the employer/industrial sector. This study considered a 3-year period (January 2009 to December 2011). Three sources of data were reviewed: reported cases at the Regional Health Authority, for the profile of the intoxications; registers of patients attended in public hospitals, for data on costs of health care services; and public information of living conditions nationwide. The overall costs of a single case depend on the severity of intoxication, days of sick leave, and type of health care needed. Most cases (77%) would be ambulatory and would be assisted at an emergency room, with an average cost of US $330 per case. Those cases that might need hospitalization (23%) and, therefore, more days off work have an average cost of US $1158 per case. Taking into account the number of patients reported each year in the country, the cost per annum would be about US $185,000, but considering the underreporting of intoxications and

  15. Rationale, design and methodology of a double-blind, randomized, placebo-controlled study of escitalopram in prevention of Depression in Acute Coronary Syndrome (DECARD)

    DEFF Research Database (Denmark)

    Hansen, Baiba Hedegaard; Hanash, Jamal Abed; Rasmussen, Alice

    2009-01-01

    with acute coronary syndrome. METHODS: Two hundred forty non-depressed patients with acute coronary syndrome are randomized to treatment with either escitalopram or placebo for 1 year. Psychiatric and cardiac assessment of patients is performed to evaluate the possibility of preventing depression. Diagnosis...

  16. Work Engagement as a Predictor of Onset of Major Depressive Episode (MDE) among Workers, Independent of Psychological Distress: A 3-Year Prospective Cohort Study

    Science.gov (United States)

    Imamura, Kotaro; Kawakami, Norito; Inoue, Akiomi; Shimazu, Akihito; Tsutsumi, Akizumi; Takahashi, Masaya; Totsuzaki, Takafumi

    2016-01-01

    Objective This study investigated work engagement as a baseline predictor of onset of major depressive episode (MDE). Methods The study used a prospective cohort design, conforming to the STROBE checklist. Participants were recruited from the employee population of a private think tank company (N = 4,270), and 1,058 (24.8%) of them completed a baseline survey, of whom 929 were included in this study. Work engagement and psychological distress at baseline were assessed as predictor variables. MDE was measured at baseline and at each of the follow-ups as the outcome, using the web-based, self-administered version of the Japanese WHO-CIDI 3.0 depression section based upon DSM-IV-TR/DSM-5 criteria. Cox discrete-time hazards analyses were conducted to estimate hazard ratios (95% confidence intervals CIs). Results Follow-up rates of participants (N = 929) were 78.4%, 67.2%, and 51.6% at 1-, 2-, and 3-year follow-ups, respectively. The association between work engagement at baseline and the onset of MDE was U-shaped. Compared with a group with low work engagement scores, groups with the middle and high scores showed significantly (HR = 0.19, 95% CI = 0.05 to 0.64; p = 0.007) and marginally significantly (HR = 0.48, 95% CI = 0.20 to 1.15, p = 0.099) lower risks of MDE, respectively, over the follow-ups, after adjusting for covariates. The pattern remained the same after additionally adjusting for psychological distress. Conclusions The present study first demonstrated work engagement as an important predictor of the onset of MDE diagnosed according to an internationally standard diagnostic criteria of mental disorders. PMID:26841020

  17. Work Engagement as a Predictor of Onset of Major Depressive Episode (MDE among Workers, Independent of Psychological Distress: A 3-Year Prospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Kotaro Imamura

    Full Text Available This study investigated work engagement as a baseline predictor of onset of major depressive episode (MDE.The study used a prospective cohort design, conforming to the STROBE checklist. Participants were recruited from the employee population of a private think tank company (N = 4,270, and 1,058 (24.8% of them completed a baseline survey, of whom 929 were included in this study. Work engagement and psychological distress at baseline were assessed as predictor variables. MDE was measured at baseline and at each of the follow-ups as the outcome, using the web-based, self-administered version of the Japanese WHO-CIDI 3.0 depression section based upon DSM-IV-TR/DSM-5 criteria. Cox discrete-time hazards analyses were conducted to estimate hazard ratios (95% confidence intervals CIs.Follow-up rates of participants (N = 929 were 78.4%, 67.2%, and 51.6% at 1-, 2-, and 3-year follow-ups, respectively. The association between work engagement at baseline and the onset of MDE was U-shaped. Compared with a group with low work engagement scores, groups with the middle and high scores showed significantly (HR = 0.19, 95% CI = 0.05 to 0.64; p = 0.007 and marginally significantly (HR = 0.48, 95% CI = 0.20 to 1.15, p = 0.099 lower risks of MDE, respectively, over the follow-ups, after adjusting for covariates. The pattern remained the same after additionally adjusting for psychological distress.The present study first demonstrated work engagement as an important predictor of the onset of MDE diagnosed according to an internationally standard diagnostic criteria of mental disorders.

  18. Work Engagement as a Predictor of Onset of Major Depressive Episode (MDE) among Workers, Independent of Psychological Distress: A 3-Year Prospective Cohort Study.

    Science.gov (United States)

    Imamura, Kotaro; Kawakami, Norito; Inoue, Akiomi; Shimazu, Akihito; Tsutsumi, Akizumi; Takahashi, Masaya; Totsuzaki, Takafumi

    2016-01-01

    This study investigated work engagement as a baseline predictor of onset of major depressive episode (MDE). The study used a prospective cohort design, conforming to the STROBE checklist. Participants were recruited from the employee population of a private think tank company (N = 4,270), and 1,058 (24.8%) of them completed a baseline survey, of whom 929 were included in this study. Work engagement and psychological distress at baseline were assessed as predictor variables. MDE was measured at baseline and at each of the follow-ups as the outcome, using the web-based, self-administered version of the Japanese WHO-CIDI 3.0 depression section based upon DSM-IV-TR/DSM-5 criteria. Cox discrete-time hazards analyses were conducted to estimate hazard ratios (95% confidence intervals CIs). Follow-up rates of participants (N = 929) were 78.4%, 67.2%, and 51.6% at 1-, 2-, and 3-year follow-ups, respectively. The association between work engagement at baseline and the onset of MDE was U-shaped. Compared with a group with low work engagement scores, groups with the middle and high scores showed significantly (HR = 0.19, 95% CI = 0.05 to 0.64; p = 0.007) and marginally significantly (HR = 0.48, 95% CI = 0.20 to 1.15, p = 0.099) lower risks of MDE, respectively, over the follow-ups, after adjusting for covariates. The pattern remained the same after additionally adjusting for psychological distress. The present study first demonstrated work engagement as an important predictor of the onset of MDE diagnosed according to an internationally standard diagnostic criteria of mental disorders.

  19. Effects of an internet-based cognitive behavioural therapy intervention on preventing major depressive episodes among workers: a protocol for a randomised controlled trial.

    Science.gov (United States)

    Imamura, Kotaro; Kawakami, Norito; Furukawa, Toshi A; Matsuyama, Yutaka; Shimazu, Akihito; Kasai, Kiyoto

    2015-05-12

    The aim of this study is to examine the effects of an internet-based cognitive behavioural therapy (iCBT) program on decreasing the risk of major depressive episodes (MDEs) among workers employed in a private corporate group in Japan, using a randomised controlled trial design. All of the workers in a corporate group (n=20,000) will be recruited through an invitation email. Participants who fulfil the inclusion criteria will be randomly allocated to intervention or control groups (planned N=4050 for each group). They will be allowed to complete the six lessons of the iCBT program within 10 weeks after the baseline survey. Those in the control group will receive the same iCBT after 12 months. The program includes several CBT skills: self-monitoring, cognitive restructuring, assertiveness, problem-solving and relaxation. The primary outcome measure is no new onset of MDE (using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR)/DSM-5 criteria) during the 12-month follow-up. Assessment will use the web version of the WHO Composite International Diagnostic Interview V.3.0 depression section. The Research Ethics Review Board of Graduate School of Medicine, the University of Tokyo (No. 3083-(2)), approved the study procedures. The study protocol is registered at the UMIN Clinical Trials Registry (UMIN-CTR; ID=UMIN000014146). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  20. No change in N-acetyl aspartate in first episode of moderate depression after antidepressant treatment: 1H magnetic spectroscopy study of left amygdala and left dorsolateral prefrontal cortex

    Directory of Open Access Journals (Sweden)

    Bajs Janović M

    2014-09-01

    Full Text Available Maja Bajs Janović,1,3 Petra Kalember,2 Špiro Janović,1,3 Pero Hrabač,2 Petra Folnegović Grošić,1 Vladimir Grošić,4 Marko Radoš,5 Neven Henigsberg2,61University Department of Psychiatry, Clinical Hospital Center Zagreb, Zagreb, 2Polyclinic Neuron, Croatian Institute for Brain Research, School of Medicine, University of Zagreb, Zagreb, 3University North, Varaždin, 4Psychiatric Hospital Sveti Ivan, Zagreb, 5University Department of Radiology, Clinical Hospital Center Zagreb, Zagreb, 6Psychiatric Clinic Vrapče, Zagreb, CroatiaBackground: The role of brain metabolites as biological correlates of the intensity, symptoms, and course of major depression has not been determined. It has also been inconclusive whether the change in brain metabolites, measured with proton magnetic spectroscopy, could be correlated with the treatment outcome. Methods: Proton magnetic spectroscopy was performed in 29 participants with a first episode of moderate depression occurring in the left dorsolateral prefrontal cortex and left amygdala at baseline and after 8 weeks of antidepressant treatment with escitalopram. The Montgomery-Asberg Depression Rating Scale, the Hamilton Rating Scale for Depression, and the Beck Depression Inventory were used to assess the intensity of depression at baseline and at the endpoint of the study. At endpoint, the participants were identified as responders (n=17 or nonresponders (n=12 to the antidepressant therapy. Results: There was no significant change in the N-acetyl aspartate/creatine ratio (NAA/Cr after treatment with antidepressant medication. The baseline and endpoint NAA/Cr ratios were not significantly different between the responder and nonresponder groups. The correlation between NAA/Cr and changes in the scores of clinical scales were not significant in either group. Conclusion: This study could not confirm any significant changes in NAA after antidepressant treatment in the first episode of moderate depression, or in

  1. Pericardial adipose tissue and the metabolic syndrome is increased in patients with chronic major depressive disorder compared to acute depression and controls.

    Science.gov (United States)

    Kahl, K G; Herrmann, J; Stubbs, B; Krüger, T H C; Cordes, J; Deuschle, M; Schweiger, U; Hüper, K; Helm, S; Birkenstock, A; Hartung, D

    2017-01-04

    Major depressive disorder (MDD) is associated with an estimated fourfold risk for premature death, largely attributed to cardiovascular disorders. Pericardial adipose tissue (PAT), a fat compartment surrounding the heart, has been implicated in the development of coronary artery disease. An unanswered question is whether people with chronic MDD are more likely to have elevated PAT volumes versus acute MDD and controls (CTRL). The study group consists of sixteen patients with chronic MDD, thirty-four patients with acute MDD, and twenty-five CTRL. PAT and adrenal gland volume were measured by magnetic resonance tomography. Additional measures comprised factors of the metabolic syndrome, cortisol, relative insulin resistance, and pro-inflammatory cytokines (interleukin-6; IL-6 and tumor necrosis factor-α, TNF-α). PAT volumes were significantly increased in patients with chronic MDD>patients with acute MDD>CTRL. Adrenal gland volume was slightly enlarged in patients with chronic MDD>acute MDD>CTRL, although this difference failed to reach significance. The PAT volume was correlated with adrenal gland volume, and cortisol concentrations were correlated with depression severity, measured by BDI-2 and MADRS. Group differences were found concerning the rate of the metabolic syndrome, being most frequent in chronic MDD>acute MDD>CTRL. Further findings comprised increased fasting cortisol, increased TNF-α concentration, and decreased physical activity level in MDD compared to CTRL. Our results extend the existing literature in demonstrating that patients with chronic MDD have the highest risk for developing cardiovascular disorders, indicated by the highest PAT volume and prevalence of metabolic syndrome. The correlation of PAT with adrenal gland volume underscores the role of the hypothalamus-pituitary-adrenal system as mediator for body-composition changes. Metabolic monitoring, health advices and motivation for the improvement of physical fitness may be recommended in

  2. An Acute Multispecies Episode of Sheep-Associated Malignant Catarrhal Fever in Captive Wild Animals in an Italian Zoo.

    Science.gov (United States)

    Frontoso, R; Autorino, G L; Friedrich, K G; Li, H; Eleni, C; Cocumelli, C; Di Cerbo, P; Manna, G; Scicluna, M T

    2016-12-01

    In July 2011, in a zoological garden in Rome, Italy, malignant catarrhal fever (MCF), a fatal, systemic disease of Artiodactyla, was suspected on the basis of neurological signs and gross lesions observed in a banteng, the first animal to die of this infection. An MCF type-specific PCR with subsequent sequencing of the PCR amplicon confirmed the aetiological agent as ovine herpesvirus-2 (OvHV-2). Biological samples were collected from the dead animals for gross, histological, bacteriological, virological and serological examinations. An epidemiological investigation was conducted to identify the source of the outbreak, as further deaths due to OvHV-2 still occurred after the removal of the acknowledged reservoirs, domestic sheep and goats. For this purpose, samples from other susceptible species and reservoir hosts were collected for virological and serological analysis. In conjunction, a retrospective sero-investigation was conducted on sera collected between 1999 and 2010 from some of the species involved in the present episode. In total, 11 animals belonging to four different species (banteng, Himalayan tahr, Nile lechwe and sika deer) died between July 2011 and October 2012. The severe gross and histological lesions were consistent with the disease, namely haemorrhages and congestion of several organs as well as lymphoid cell infiltrates and vasculitis of varying severity. The virological tests confirmed that all animals had died of sheep-associated MCF. The investigation indicated that the OvHV-2 infection could have been due to the arrival of sheep in the petting zoo, with cases commencing after first lambing and subsequent shedding of virus. This was also supported by the serological retrospective study that indicated limited previous MCF virus circulation. Further MCF cases that occurred even after the removal of the domestic sheep and goats were attributed to the mouflon. This episode confirms the importance of biosecurity measures in zoos, which house MCF

  3. Depression

    Science.gov (United States)

    ... reasons why a woman may have depression: Family history . Women with a family history of depression may be more at risk. But depression can also happen in women who don’t have a family history of depression. Brain changes. The brains of people ...

  4. Abnormal functional connectivity of the amygdala in first-episode and untreated adult major depressive disorder patients with different ages of onset.

    Science.gov (United States)

    Ye, Jing; Shen, Zonglin; Xu, Xiufeng; Yang, Shuran; Chen, Wei; Liu, Xiaoyan; Lu, Yi; Liu, Fang; Lu, Jin; Li, Na; Sun, Xuejin; Cheng, Yuqi

    2017-03-01

    Major depressive disorder (MDD) is a common mental disorder with high morbidity. As a part of the limbic system, the amygdala is important in the processing of emotional information. Structural and functional connectivity (FC) abnormalities in the amygdala have been observed in MDD patients. The present study was carried out to identify the features of amygdala FC in adult MDD patients with different ages of onset. Sixty-nine first-episode and untreated MDD patients and 81 healthy controls (CTLs) were included in this study and underwent 3D structural imaging and resting-state functional MRI scanning. The patients and CTLs were divided into two groups according to age of onset: young adult (abnormal resting-state FC with other regions compared with matched controls. However, in old adult patients, compared with matched controls, the right amygdala showed more abnormal changes in the resting-state FC with other regions. MDD patients with different ages of onset showed different changes in the structure and FC of the amygdala. These results might help us to understand the high heterogeneity of MDD.

  5. Diminished caudate and superior temporal gyrus responses to effort-based decision making in patients with first-episode major depressive disorder.

    Science.gov (United States)

    Yang, Xin-hua; Huang, Jia; Lan, Yong; Zhu, Cui-ying; Liu, Xiao-qun; Wang, Ye-fei; Cheung, Eric F C; Xie, Guang-rong; Chan, Raymond C K

    2016-01-04

    Anhedonia, the loss of interest or pleasure in reward processing, is a hallmark feature of major depressive disorder (MDD), but its underlying neurobiological mechanism is largely unknown. The present study aimed to examine the underlying neural mechanism of reward-related decision-making in patients with MDD. We examined behavioral and neural responses to rewards in patients with first-episode MDD (N=25) and healthy controls (N=25) using the Effort-Expenditure for Rewards Task (EEfRT). The task involved choices about possible rewards of varying magnitude and probability. We tested the hypothesis that individuals with MDD would exhibit a reduced neural response in reward-related brain structures involved in cost-benefit decision-making. Compared with healthy controls, patients with MDD showed significantly weaker responses in the left caudate nucleus when contrasting the 'high reward'-'low reward' condition, and blunted responses in the left superior temporal gyrus and the right caudate nucleus when contrasting high and low probabilities. In addition, hard tasks chosen during high probability trials were negatively correlated with superior temporal gyrus activity in MDD patients, while the same choices were negatively correlated with caudate nucleus activity in healthy controls. These results indicate that reduced caudate nucleus and superior temporal gyrus activation may underpin abnormal cost-benefit decision-making in MDD. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Mood disturbance and depression in Arab women following hospitalisation from acute cardiac conditions: a cross-sectional study from Qatar

    Science.gov (United States)

    Donnelly, Tam Truong; Al Suwaidi, Jassim Mohd; Al-Qahtani, Awad; Asaad, Nidal; Fung, Tak; Singh, Rajvir; Qader, Najlaa Abdul

    2016-01-01

    Objectives Depression is associated with increased morbidity and mortality rates among cardiovascular patients. Depressed patients have three times higher risk of death than those who are not. We sought to determine the presence of depressive symptoms, and whether gender and age are associated with depression among Arab patients hospitalised with cardiac conditions in a Middle Eastern country. Setting Using a non-probability convenient sampling technique, a cross-sectional survey was conducted with 1000 Arab patients ≥20 years who were admitted to cardiology units between 2013 and 2014 at the Heart Hospital in Qatar. Patients were interviewed 3 days after admission following the cardiac event. Surveys included demographic and clinical characteristics, and the Arabic version of the Beck Depression Inventory Second Edition (BDI-II). Depression was assessed by BDI-II clinical classification scale. Results 15% of the patients had mild mood disturbance and 5% had symptoms of clinical depression. Twice as many females than males suffered from mild mood disturbance and clinical depression symptoms, the majority of females were in the age group 50 years and above, whereas males were in the age group 40–49 years. χ2 Tests and multivariate logistic regression analyses indicated that gender and age were statistically significantly related to depression (p<0.001 for all). Conclusions Older Arab women are more likely to develop mood disturbance and depression after being hospitalised with acute cardiac condition. Gender and age differences approach, and routine screening for depression should be conducted with all cardiovascular patients, especially for females in the older age groups. Mental health counselling should be available for all cardiovascular patients who exhibit depressive symptoms. PMID:27388362

  7. Adult-onset of mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome presenting as acute meningoencephalitis: a case report.

    Science.gov (United States)

    Hsu, Yu-Chuan; Yang, Fu-Chi; Perng, Cherng-Lih; Tso, An-Chen; Wong, Lee-Jun C; Hsu, Chang-Hung

    2012-09-01

    Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome is a rare mitochondrial disorder with a wide range of multisystemic symptoms. Epileptic seizures are common features of both MELAS and meningoencephalitis and are typically treated with anticonvulsants. To provide the reader with a better understanding of MELAS and the adverse effects of valproic acid. A 47-year-old man with a history of diabetes, hearing loss, sinusitis, and otitis media was brought to our emergency department due to acute onset of fever, headache, generalized seizure, and agitation. Because acute meningoencephalitis was suspected, the patient was treated with antibiotics on an empirical basis. The seizure activity was aggravated by valproic acid and abated after its discontinuation. MELAS was suspected and the diagnosis was confirmed by the presence of a nucleotide 3243 A→G mutation in the mitochondrial DNA. Detailed history-taking and systematic review help emergency physicians differentiate MELAS from meningoencephalitis in patients with the common presentation of epileptic seizures. Use of valproic acid to treat epilepsy in patients suspected of having mitochondrial disease should be avoided. Underlying mitochondrial disease should be suspected if seizure activity worsens with valproic acid therapy. Copyright © 2012 Elsevier Inc. All rights reserved.

  8. Intravenous dipyrone for the acute treatment of episodic tension-type headache: A randomized, placebo-controlled, double-blind study

    Directory of Open Access Journals (Sweden)

    M.E. Bigal

    2002-10-01

    Full Text Available Acute headaches are responsible for a significant percentage of the case load at primary care units and emergency rooms in Brazil. Dipyrone (metamizol is easily available in these settings, being the most frequently used drug. We conducted a randomized, placebo-controlled, double-blind study to assess the effect of dipyrone in the acute treatment of episodic tension-type headache. Sixty patients were randomized to receive placebo (intravenous injection of 10 ml saline or 1 g dipyrone in 10 ml saline. We used seven parameters of analgesic evaluation. The patients receiving dipyrone showed a statistically significant improvement (P<0.05 of pain compared to placebo up to 30 min after drug administration. The therapeutic gain was 30% in 30 min and 40% in 60 min. The number of patients needed to be treated for at least one to have benefit was 3.3 in 30 min and 2.2 in 60 min. There were statistically significant reductions in the recurrence (dipyrone = 25%, placebo = 50% and use of rescue medication (dipyrone = 20%, placebo = 47.6% for the dipyrone group. Intravenous dipyrone is an effective drug for the relief of pain in tension-type headache and its use is justified in the emergency room setting.

  9. Chronic and Acute Stress, Gender, and Serotonin Transporter Gene-Environment Interactions Predicting Depression Symptoms in Youth

    Science.gov (United States)

    Hammen, Constance; Brennan, Patricia A.; Keenan-Miller, Danielle; Hazel, Nicholas A.; Najman, Jake M.

    2010-01-01

    Background: Many recent studies of serotonin transporter gene by environment effects predicting depression have used stress assessments with undefined or poor psychometric methods, possibly contributing to wide variation in findings. The present study attempted to distinguish between effects of acute and chronic stress to predict depressive…

  10. Adjunctive agomelatine therapy in the treatment of acute bipolar II depression: a preliminary open label study

    Directory of Open Access Journals (Sweden)

    Fornaro M

    2013-02-01

    Full Text Available Michele Fornaro,1 Michael J McCarthy,2,3 Domenico De Berardis,4 Concetta De Pasquale,1 Massimo Tabaton,5 Matteo Martino,6 Salvatore Colicchio,7 Carlo Ignazio Cattaneo,8 Emanuela D'Angelo,9 Pantaleo Fornaro61Department of Formative Sciences, University of Catania, Catania, Italy; 2Department of Psychiatry, Veteran's Affairs San Diego Healthcare System, 3University of California San Diego, La Jolla, CA, USA; 4Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, "ASL 4", Teramo, Italy; 5Department of Internal Medicine and Medical Specialties, University of Genova, Genoa, Italy; 6Department of Neurosciences, Section of Psychiatry, University of Genova, Genoa, Italy; 7Unit of Sleep Medicine, Department of Neuroscience, Catholic University, Rome, Italy; 8National Health System, "ASL 13", Novara, Italy; 9National Health System, "ASL 3", Genoa, ItalyPurpose: The circadian rhythm hypothesis of bipolar disorder (BD suggests a role for melatonin in regulating mood, thus extending the interest toward the melatonergic antidepressant agomelatine as well as type I (acute or II cases of bipolar depression.Patients and methods: Twenty-eight depressed BD-II patients received open label agomelatine (25 mg/bedtime for 6 consecutive weeks as an adjunct to treatment with lithium or valproate, followed by an optional treatment extension of 30 weeks. Measures included the Hamilton depression scale, Pittsburgh Sleep Quality Index, the Clinical Global Impression Scale–Bipolar Version, Young Mania Rating Scale, and body mass index.Results: Intent to treat analysis results demonstrated that 18 of the 28 subjects (64% showed medication response after 6 weeks (primary study endpoint, while 24 of the 28 subjects (86% responded by 36 weeks. When examining primary mood stabilizer treatment, 12 of the 17 (70.6% valproate and six of the 11 (54.5% lithium patients responded by the first endpoint. At 36 weeks, 14 valproate treated (82.4% and 10 lithium

  11. N-terminal pro-atrial natriuretic peptide response to acute exercise in depressed patients and healthy controls

    DEFF Research Database (Denmark)

    Krogh, Jesper; Ströhle, Andreas; Westrin, Asa

    2011-01-01

    that patients with depression would have an attenuated N-terminal proANP (NT-proANP) response to acute exercise compared to healthy controls. Secondly, we aimed to assess the effect of antidepressants on NT-proANP response to acute exercise. METHODS: We examined 132 outpatients with mild to moderate depression......BACKGROUND: The dysfunction of hypothalamic-pituitary-adrenal (HPA) axis in major depression includes hyperactivity and reduced feedback inhibition. Atrial natriuretic peptide (ANP) is able to reduce the HPA-axis response to stress and has an anxiolytic effect in rodents and humans. We hypothesized...... (ICD-10) and 44 healthy controls, group matched for age, sex, and BMI. We used an incremental bicycle ergometer test as a physical stressor. Blood samples were drawn at rest, at exhaustion, and 15, 30, and 60min post-exercise. RESULTS: The NT-proANP response to physical exercise differed between...

  12. N-terminal pro-atrial natriuretic peptide response to acute exercise in depressed patients and healthy controls

    DEFF Research Database (Denmark)

    Krogh, Jesper; Ströhle, Andreas; Westrin, Asa

    2011-01-01

    BACKGROUND: The dysfunction of hypothalamic-pituitary-adrenal (HPA) axis in major depression includes hyperactivity and reduced feedback inhibition. Atrial natriuretic peptide (ANP) is able to reduce the HPA-axis response to stress and has an anxiolytic effect in rodents and humans. We hypothesized...... that patients with depression would have an attenuated N-terminal proANP (NT-proANP) response to acute exercise compared to healthy controls. Secondly, we aimed to assess the effect of antidepressants on NT-proANP response to acute exercise. METHODS: We examined 132 outpatients with mild to moderate depression...... (ICD-10) and 44 healthy controls, group matched for age, sex, and BMI. We used an incremental bicycle ergometer test as a physical stressor. Blood samples were drawn at rest, at exhaustion, and 15, 30, and 60min post-exercise. RESULTS: The NT-proANP response to physical exercise differed between...

  13. Combined hepatoprotective and antidepressant effects of resveratrol in an acute model of depression

    Directory of Open Access Journals (Sweden)

    Rania F. Ahmed

    2014-12-01

    Full Text Available There are numerous herbal medicines that have been introduced into psychiatric practice because of greater compliance and milder side effects. Polygonum cuspidatum is a native Asian plant; known for its medicinal properties and traditionally used in the treatment of neuropsychiatric disorders, such as psychosocial stress, dementia and Parkinson’s disease. Resveratrol is the active ingredient of P. cuspidatum. Researchers have suggested that the trans-isomer of resveratrol demonstrates a variety of pharmacological activities including antioxidant, anti-inflammatory, hepatic and neuroprotective properties. In this study we examined the hepatoprotective and antidepressant effects of trans-resveratrol against fluoxetine in an acute reserpine model of depression in rats. Main methods: depression-like behaviors were induced by single reserpine intraperitoneal injection (6 mg/kg, i.p.. Trans-resveratrol (15, 30 and 60 mg/kg bwt and fluoxetine (24 mg/kg bwt were administered orally for the following 3 days. Behavioral effects namely open field test (OFT and forced swimming test (FST and biochemical parameters namely neurotransmitters levels and antioxidant contents were assessed. Liver histopathological examination was performed. Key findings: Results revealed that resveratrol (60 mg/kg bwt showed a potential hepatoprotective and an antidepressant-like effects compared to those of fluoxetine.

  14. Anterior ST depression with acute transmural inferior infarction due to posterior infarction. A vectorcardiographic and scintigraphic study

    International Nuclear Information System (INIS)

    Mukharji, J.; Murray, S.; Lewis, S.E.; Croft, C.H.; Corbett, J.R.; Willerson, J.T.; Rude, R.E.

    1984-01-01

    The hypothesis that anterior ST segment depression represents concomitant posterior infarction was tested in 49 patients admitted with a first transmural inferior myocardial infarction. Anterior ST depression was defined as 0.1 mV or more ST depression in leads V1, V2 or V3 on an electrocardiogram recorded within 18 hours of infarction. Serial vectorcardiograms and technetium pyrophosphate scans were obtained. Eighty percent of the patients (39 of 49) had anterior ST depression. Of these 39 patients, 34% fulfilled vectorcardiographic criteria for posterior infarction, and 60% had pyrophosphate scanning evidence of posterior infarction. Early anterior ST depression was neither highly sensitive (84%) nor specific (20%) for the detection of posterior infarction as defined by pyrophosphate imaging. Of patients with persistent anterior ST depression (greater than 72 hours), 87% had posterior infarction detected by pyrophosphate scan. In patients with inferior myocardial infarction, vectorcardiographic evidence of posterior infarction correlated poorly with pyrophosphate imaging data. Right ventricular infarction was present on pyrophosphate imaging in 40% of patients with pyrophosphate changes of posterior infarction but without vectorcardiographic evidence of posterior infarction. It is concluded that: 1) the majority of patients with acute inferior myocardial infarction have anterior ST segment depression; 2) early anterior ST segment depression in such patients is not a specific marker for posterior infarction; and 3) standard vectorcardiographic criteria for transmural posterior infarction may be inaccurate in patients with concomitant transmural inferior myocardial infarction or right ventricular infarction, or both

  15. Depression

    DEFF Research Database (Denmark)

    Kessing, Lars Veddel; Bukh, Jens Drachmann

    2014-01-01

    The prevalence of depression is not clearly established, but estimated to 3-4% in a Danish questionnaire study. Lifetime's prevalences of 12-17% are reported in other community samples. In the current diagnostic system depression is defined categorically and operationally. It has been argued......, that these diagnostic criteria represent an oversimplification, which has blurred the concept of depression. We suggest a greater emphasis on the depressed mood as the core symptom of depression, which may increase the specificity of the diagnosis. Furthermore, basic principles for the treatment of depression...

  16. Prospective case series on trabecular-iris angle status after an acute episode of phacomorphic angle closure

    Directory of Open Access Journals (Sweden)

    Jacky Lee

    2013-02-01

    Full Text Available AIM:To investigate the trabecular-iris angle with ultrasound biomicroscopy (UBM post cataract extraction after an acute attack of phacomorphic angle closure.METHODS: This prospective study involved 10 cases of phacomorphic angle closure that underwent cataract extraction and intraocular lens insertion after intraocular pressure (IOP lowering. Apart from visual acuity and IOP, the trabecular-iris angle was measured by gonioscopy and UBM at 3 months post attack.RESULTS: In 10 consecutive cases of acute phacomorphic angle closure from December 2009 to December 2010, gonioscopic findings showed peripheral anterior synechiae (PAS ≤ 90° in 30% of phacomorphic patients and a mean Shaffer grading of (3.1±1.0. UBM showed a mean angle of (37.1°±4.5° in the phacomorphic eye with the temporal quadrant being the most opened and (37.1°±8.0° in the contralateral uninvolved eye. The mean time from consultation to cataract extraction was (1.4±0.7 days and the mean total duration of phacomorphic angle closure was (3.6±2.8 days but there was no correlation to the degree of angle closure on UBM (Spearman correlation P=0.7. The presenting mean IOP was (50.5±7.4 mmHg and the mean IOP at 3 months was (10.5±3.4 mmHg but there were no correlations with the degree of angle closure (Spearman correlations P=0.9.CONCLUSION:An open trabecular-iris angle and normal IOP can be achieved after an acute attack of phacomorphic angle closure if cataract extraction is performed within 1 day - 2 days after IOP control. Gonioscopic findings were in agreement with UBM, which provided a more specific and object angle measurement. The superior angle is relatively more narrowed compared to the other quadrants. All contralateral eyes in this series had open angles.

  17. Perceived life stress exposure modulates reward-related medial prefrontal cortex responses to acute stress in depression.

    Science.gov (United States)

    Kumar, Poornima; Slavich, George M; Berghorst, Lisa H; Treadway, Michael T; Brooks, Nancy H; Dutra, Sunny J; Greve, Douglas N; O'Donovan, Aoife; Bleil, Maria E; Maninger, Nicole; Pizzagalli, Diego A

    2015-07-15

    Major depressive disorder (MDD) is often precipitated by life stress and growing evidence suggests that stress-induced alterations in reward processing may contribute to such risk. However, no human imaging studies have examined how recent life stress exposure modulates the neural systems that underlie reward processing in depressed and healthy individuals. In this proof-of-concept study, 12 MDD and 10 psychiatrically healthy individuals were interviewed using the Life Events and Difficulties Schedule (LEDS) to assess their perceived levels of recent acute and chronic life stress exposure. Additionally, each participant performed a monetary incentive delay task under baseline (no-stress) and stress (social-evaluative) conditions during functional MRI. Across groups, medial prefrontal cortex (mPFC) activation to reward feedback was greater during acute stress versus no-stress conditions in individuals with greater perceived stressor severity. Under acute stress, depressed individuals showed a positive correlation between perceived stressor severity levels and reward-related mPFC activation (r=0.79, p=0.004), whereas no effect was found in healthy controls. Moreover, for depressed (but not healthy) individuals, the correlations between the stress (r=0.79) and no-stress (r=-0.48) conditions were significantly different. Finally, relative to controls, depressed participants showed significantly reduced mPFC gray matter, but functional findings remained robust while accounting for structural differences. Small sample size, which warrants replication. Depressed individuals experiencing greater recent life stress recruited the mPFC more under stress when processing rewards. Our results represent an initial step toward elucidating mechanisms underlying stress sensitization and recurrence in depression. Copyright © 2015 Elsevier B.V. All rights reserved.

  18. Quality of Acute Psychedelic Experience Predicts Therapeutic Efficacy of Psilocybin for Treatment-Resistant Depression.

    Science.gov (United States)

    Roseman, Leor; Nutt, David J; Carhart-Harris, Robin L

    2017-01-01

    Introduction: It is a basic principle of the "psychedelic" treatment model that the quality of the acute experience mediates long-term improvements in mental health. In the present paper we sought to test this using data from a clinical trial assessing psilocybin for treatment-resistant depression (TRD). In line with previous reports, we hypothesized that the occurrence and magnitude of Oceanic Boundlessness (OBN) (sharing features with mystical-type experience) and Dread of Ego Dissolution (DED) (similar to anxiety) would predict long-term positive outcomes, whereas sensory perceptual effects would have negligible predictive value. Materials and Methods: Twenty patients with treatment resistant depression underwent treatment with psilocybin (two separate sessions: 10 and 25 mg psilocybin). The Altered States of Consciousness (ASC) questionnaire was used to assess the quality of experiences in the 25 mg psilocybin session. From the ASC, the dimensions OBN and DED were used to measure the mystical-type and challenging experiences, respectively. The Self-Reported Quick Inventory of Depressive Symptoms (QIDS-SR) at 5 weeks served as the endpoint clinical outcome measure, as in later time points some of the subjects had gone on to receive new treatments, thus confounding inferences. In a repeated measure ANOVA, Time was the within-subject factor (independent variable), with QIDS-SR as the within-subject dependent variable in baseline, 1-day, 1-week, 5-weeks. OBN and DED were independent variables. OBN-by-Time and DED-by-Time interactions were the primary outcomes of interest. Results: For the interaction of OBN and DED with Time (QIDS-SR as dependent variable), the main effect and the effects at each time point compared to baseline were all significant ( p = 0.002 and p = 0.003, respectively, for main effects), confirming our main hypothesis. Furthermore, Pearson's correlation of OBN with QIDS-SR (5 weeks) was specific compared to perceptual dimensions of the ASC ( p

  19. Quality of Acute Psychedelic Experience Predicts Therapeutic Efficacy of Psilocybin for Treatment-Resistant Depression

    Directory of Open Access Journals (Sweden)

    Leor Roseman

    2018-01-01

    Full Text Available Introduction: It is a basic principle of the “psychedelic” treatment model that the quality of the acute experience mediates long-term improvements in mental health. In the present paper we sought to test this using data from a clinical trial assessing psilocybin for treatment-resistant depression (TRD. In line with previous reports, we hypothesized that the occurrence and magnitude of Oceanic Boundlessness (OBN (sharing features with mystical-type experience and Dread of Ego Dissolution (DED (similar to anxiety would predict long-term positive outcomes, whereas sensory perceptual effects would have negligible predictive value.Materials and Methods: Twenty patients with treatment resistant depression underwent treatment with psilocybin (two separate sessions: 10 and 25 mg psilocybin. The Altered States of Consciousness (ASC questionnaire was used to assess the quality of experiences in the 25 mg psilocybin session. From the ASC, the dimensions OBN and DED were used to measure the mystical-type and challenging experiences, respectively. The Self-Reported Quick Inventory of Depressive Symptoms (QIDS-SR at 5 weeks served as the endpoint clinical outcome measure, as in later time points some of the subjects had gone on to receive new treatments, thus confounding inferences. In a repeated measure ANOVA, Time was the within-subject factor (independent variable, with QIDS-SR as the within-subject dependent variable in baseline, 1-day, 1-week, 5-weeks. OBN and DED were independent variables. OBN-by-Time and DED-by-Time interactions were the primary outcomes of interest.Results: For the interaction of OBN and DED with Time (QIDS-SR as dependent variable, the main effect and the effects at each time point compared to baseline were all significant (p = 0.002 and p = 0.003, respectively, for main effects, confirming our main hypothesis. Furthermore, Pearson's correlation of OBN with QIDS-SR (5 weeks was specific compared to perceptual dimensions of the

  20. Depressants

    Science.gov (United States)

    ... For Teens / Depressants Print en español Depresores del sistema nervioso What They Are: Tranquilizers and other depressants ... of Use Notice of Nondiscrimination Visit the Nemours Web site. Note: All information on TeensHealth® is for ...

  1. Farmacovigilancia de la sertralina en pacientes cubanos con episodio de depresión mayor Pharmaceutical surveillance of sertraline in Cuban patients affected by major depression episode

    Directory of Open Access Journals (Sweden)

    Leslie Pérez Ruiz

    2011-03-01

    Full Text Available En la depresión predominan síntomas como: desinterés, fatiga, sentimientos de inutilidad, desconcentración, deseos de muerte e insomnio. Entre los medicamentos para tratarla se encuentra la sertralina. Con el objetivo de evaluar su seguridad, se revisaron 40 historias clínicas y cuadernos de recogida de datos de los pacientes incluidos en ensayo clínico fase III, aletatorizado, controlado y a doble ciegas: "Uso de sertralina en pacientes con episodio de depresión mayor", pertenecientes al Hospital "Dr. Gustavo Aldereguía Lima". Se obtuvieron datos demográficos, clínicos y eventos adversos, con los cuales se realizó un estudio descriptivo, observacional y transversal que clasifica como un estudio de utilización de medicamentos sobre consecuencias prácticas. La información fue analizada mediante SPSS, versión 13.0 para Windows. De los 40 pacientes incluidos, 24 presentaron eventos adversos para un 60 %; de ellos, 16 (67 % en el grupo tratado con sertralina y 8 (33 % en los tratados con placebo. Los eventos adversos más frecuentes fueron: disminución de peso, sequedad bucal, cefalea, diarreas y náuseas. En su mayoría resultaron de intensidad ligera, causalidad probable y sin necesidad de tratamiento. El uso del fármaco se consideró seguro en el tratamiento de estos pacientes.Some predominant symptoms in depression are lack of interest, fatigue, feeling of uselessness, lack of concentration, desire of being dead and insomnia. One of the drugs to treat this illness is Sertraline. For the purpose of evaluating its safety, 40 medical histories and data collection logs with information on patients included in a double-blind, controlled, randomized phase III clinical trial "Use of Sertraline in patients suffering episodes of great depression" were reviewed. These patients were seen at "Gustavo Aldereguía Lima" hospital. Demographic, clinical and adverse event data were obtained to undertake a descriptive, observational and cross

  2. Pharmacoeconomics of quetiapine for the management of acute mania in bipolar I disorder

    NARCIS (Netherlands)

    Klok, Rogier M; Al Hadithy, Asmar Fy; van Schayk, Nathalie Pjt; Antonisse, Ad Jj; Caro, Jaime J; Brouwers, Jacobus Rbj; Postma, Maarten J

    2007-01-01

    Bipolar disorder (or manic depression) is a lifelong, severe and complex psychiatric illness characterized by recurrent episodes of depression and mania. The aim of this study is to explore the cost-effectiveness of quetiapine compared with other alternatives for the treatment of acute manic

  3. Effects of asenapine on agitation and hostility in adults with acute manic or mixed episodes associated with bipolar I disorder

    Directory of Open Access Journals (Sweden)

    Citrome L

    2017-12-01

    Full Text Available Leslie Citrome,1 Ronald Landbloom,2 Cheng-Tao Chang,3 Willie Earley4 1Department of Psychiatry and Behavioral Sciences, New York Medical College, Valhalla, NY, USA; 2Department of Neuroscience, Merck, Whitehouse Station, NJ, USA; 3Biostatistics, Allergan, Jersey City, NJ, USA; 4Clinical Development, Allergan, Jersey City, NJ, USA Background: Bipolar disorder is associated with an increased risk of aggression. However, effective management of hostility and/or agitation symptoms may prevent patients from becoming violent. This analysis investigated the efficacy of the antipsychotic asenapine on hostility and agitation in patients with bipolar I disorder.Methods: Data were pooled from three randomized, double-blind, placebo-controlled, Phase III trials of asenapine in adults with manic or mixed episodes of bipolar I disorder (NCT00159744, NCT00159796, and NCT00764478. Post hoc analyses assessed the changes from baseline to day 21 on the Young Mania Rating Scale (YMRS and the Positive and Negative Syndrome Scale (PANSS hostility-related item scores in asenapine- or placebo-treated patients with at least minimal or mild symptom severity and on the PANSS-excited component (PANSS-EC total score in agitated patients. Changes were adjusted for improvements in overall mania symptoms to investigate direct effects on hostility.Results: Significantly greater changes in favor of asenapine versus placebo were observed in YMRS hostility-related item scores (irritability: least squares mean difference [95% confidence interval] =–0.5 [–0.87, –0.22], P=0.001; disruptive–aggressive behavior: –0.7 [–0.99, –0.37], P<0.0001, PANSS hostility item score (–0.2 [–0.44, –0.04]; P=0.0181, and PANSS-EC total score (–1.4 [–2.4, –0.4]; P=0.0055. Changes in the YMRS disruptive–aggressive behavior score and the sum of the hostility-related items remained significant after adjusting for improvements in other YMRS item scores.Conclusion: Asenapine

  4. Depression

    DEFF Research Database (Denmark)

    Cizza, G; Ravn, Pernille; Chrousos, G P

    2001-01-01

    Existing studies of the relationship between depression and osteoporosis have been heterogeneous in their design and use of diagnostic instruments for depression, which might have contributed to the different results on the comorbidity of these two conditions. Nevertheless, these studies reveal...... a strong association between depression and osteoporosis. Endocrine factors such as depression-induced hypersecretion of corticotropin-releasing hormone and hypercortisolism, hypogonadism, growth hormone deficiency and increased concentration of circulating interleukin 6, might play a crucial role...... in the bone loss observed in subjects suffering from major depression....

  5. Major depression is associated with lower omega-3 fatty acid levels in patients with recent acute coronary syndromes.

    Science.gov (United States)

    Frasure-Smith, Nancy; Lespérance, François; Julien, Pierre

    2004-05-01

    Polyunsaturated fatty acids (PUFAs) are intrinsic cell membrane components and closely involved in neurotransmission and receptor function. Lower omega-3 levels are associated with increased risk of coronary artery disease (CAD), increases in cardiac events in CAD patients, and depression. We sought to examine relationships between depression and serum levels of omega-3 and omega-6 PUFAs in patients recovering from acute coronary syndromes (ACS). We carried out a case-control study of serum PUFA levels and current major depression in 54 age- and sex-matched pairs approximately 2 months following ACS. Depressed patients had significantly lower concentrations of total omega-3 and docosahexaenoic acid (DHA), and higher ratios of arachidonic acid (AA) to DHA, AA to eicosapentaenoic acid (EPA), and n-3 to n-6 than controls. There were no baseline differences in any potential risk or protective factors for depression. Results are consistent with previous reports in depressed patients without CAD, and with literature concerning omega-3 levels and risk of CAD events. Dietary, genetic, and hormonal factors may all play a role in both depression and CAD. Both prospective studies and randomized trials are needed to help clarify the interrelationships.

  6. Self-esteem level and stability, admission functional status, and depressive symptoms in acute inpatient stroke rehabilitation.

    Science.gov (United States)

    Vickery, Chad D; Sepehri, Arash; Evans, Clea C; Jabeen, Linsa N

    2009-11-01

    Explore the relationship of self-esteem level, self-esteem stability, and admission functional status on discharge depressive symptoms in acute stroke rehabilitation. One hundred twenty stroke survivors serially completed a measure of state self-esteem during inpatient rehabilitation and completed a measure of depressive symptoms at discharge. Functional status was rated at admission using the Functional Independence Measure (FIM). Regressions explored main effects and interactions of self-esteem level and stability and admission FIM self-care, mobility, and cognitive functioning on discharge depressive symptoms. After controlling for potential moderating variables, self-esteem level interacted with FIM self-care and cognitive functioning to predict discharge depressive symptoms, such that survivors with lower self-rated self-esteem and poorer functional status indicated higher levels of depressive symptoms. Self-esteem stability interacted with FIM mobility functioning, such that self-esteem instability in the presence of lower mobility functioning at admission was related to higher depressive symptoms at discharge. These results suggest that self-esteem variables may moderate the relationship between functional status and depressive symptoms. Self-esteem level and stability may differentially moderate functional domains, although this conclusion requires further empirical support.

  7. Major Depression Among Adults

    Science.gov (United States)

    ... Depressive Episode Among Adolescents Data Sources Share Major Depression Definitions Major depression is one of the most ... Bethesda, MD 20892-9663 Follow Us Facebook Twitter YouTube Google Plus NIMH Newsletter NIMH RSS Feed NIMH ...

  8. Symptoms of anxiety and depression are frequent in patients with acute hepatitis C and are not associated with disease severity.

    Science.gov (United States)

    Deterding, Katja; Grüner, Norbert; Buggisch, Peter; Galle, Peter R; Spengler, Ulrich; Hinrichsen, Holger; Berg, Thomas; Potthoff, Andrej; Grohennig, Anika; Koch, Armin; Diepolder, Helmut; Lüth, Stefan; Feyerabend, Sandra; Jung, Maria C; Rogalska-Taranta, Magdalena; Schlaphoff, Verena; Cornberg, Markus; Manns, Michael P; Wedemeyer, Heiner; Wiegand, Johannes

    2016-02-01

    Neuropsychiatric symptoms of hepatitis C virus (HCV) infection and during peginterferon α therapy have been investigated in the chronic stage of the infection, but have not been described during the acute phase of the disease so far. We therefore evaluated anxiety and depression in patients with acute hepatitis C by the Hospital Anxiety and Depression Scale (HADS) within a clinical trial. Data were analysed from the German Hep-Net Acute HCV-III study. Anxiety and depression were characterized by an anxiety (HADS-A) and a depression subscale (HADS-D). More than eight points in each subscale were considered clinically relevant. Data were prospectively collected at baseline, end of treatment and at the end of the study. At baseline, a HADS-A above eight points was observed significantly more frequently than a HADS-D above eight points [n=23/103 (22%) vs. n=12/103 (12%); P=0.041].A pathological HADS-A or HADS-D score did not correlate with age, sex, IL28B genotype, the probable mode of infection, HCV genotype or severity of disease as investigated by alanine aminotransferase and bilirubin levels.Antiviral therapy did not influence anxiety as 12/50 (24%) of patients had HADS-A above 8 at the end of therapy. The proportion of patients with HADS-D above eight points increased from 12% at baseline to 24% (n=12/50) at the end of therapy (P=0.06). HADS results were not associated with lost to follow-up or sustained virological response rates. HADS data in acute HCV infection indicate that anxiety and depression do not correlate with severity of the disease, mode of acquisition, lost to follow-up and sustained virological response rates.

  9. Validity of the brief Zung's scale for screening major depressive episode among the general population from Bucaramanga, Colombia Validez de la escala breve de Zung para tamizaje del episodio depresivo mayor en la población general de Bucaramanga, Colombia

    OpenAIRE

    Luis Alfonso Díaz; Adalberto Campo; Germán Eduardo Rueda

    2011-01-01

    Introduction. Brief scales for identiying depressive disorder are as useful as long scales for screening. However, a validated scale with these characteristics is not avalaible in Colombia.
    Objective. To design a brief Zung's self-rating depression scale in order to screen major depressive episodes among adults dwelling in the general community.
    Materials and methods. After filling-out the 20-item Zung's self-rating depression scale, the ten items with the higher correl...

  10. Acute exercise attenuates negative affect following repeated sad mood inductions in persons who have recovered from depression.

    Science.gov (United States)

    Mata, Jutta; Hogan, Candice L; Joormann, Jutta; Waugh, Christian E; Gotlib, Ian H

    2013-02-01

    Identifying factors that may protect individuals from developing Major Depressive Disorder (MDD) in the face of stress is critical. In the current study we experimentally tested whether such a potentially protective factor, engaging in acute exercise, reduces the adverse effects of repeated sad mood inductions in individuals who have recovered from depression. We hypothesized that recovered depressed participants who engage in acute exercise report a smaller increase in negative affect (NA) and a smaller decrease in positive affect (PA) when exposed to a repeated sad mood induction (i.e., habituation), whereas participants who do not exercise show sensitization (i.e., increased NA and decreased PA in response to a repeated adverse stimulus). Forty-one women recovered from MDD and 40 healthy control women were randomly assigned to either exercise for 15 minutes or quiet rest. Afterward, participants were exposed to two sad mood inductions and reported their levels of affect throughout the study. Recovered depressed participants who had not exercised exhibited higher NA after the second sad mood induction, a finding consistent with sensitization. In contrast, both recovered depressed participants who had engaged in acute exercise and healthy control participants showed no increase in NA in response to the repeated sad mood induction. Participants who exercised reported higher PA after the exercise bout; however, our hypothesis concerning reported PA trajectories following the sad mood inductions was not supported. Results suggest that exercise can serve as a protective factor in the face of exposure to repeated emotional stressors, particularly concerning NA in individuals who have recovered from depression. 2013 APA, all rights reserved

  11. Impact of chronic obstructive pulmonary disease on clinical course after an episode of acute heart failure. EAHFE-COPD study.

    Science.gov (United States)

    Jacob, Javier; Tost, Josep; Miró, Òscar; Herrero, Pablo; Martín-Sánchez, Francisco Javier; Llorens, Pere

    2017-01-15

    To study if the coexistence of chronic obstructive pulmonary disease (COPD) in patients diagnosed with acute heart failure (AHF) at the emergency department (ED) has an impact on short- and long-term outcomes. The EAHFE-COPD study included patients who attended in 34 Spanish EDs for AHF. We compared patients with AHF plus COPD with patients with AHF in whom COPD was neither diagnosed nor excluded by functional respiratory tests (FRT). Outcome analysis included all-cause mortality, prolonged hospitalization, and ED revisit. Crude results were adjusted by differences between patients with and without COPD. We included 8099 patients with AHF, 2069 having COPD (25.6%; AHF-COPD-known). Compared with AHF-COPD-unknown, AHF-COPD-known differed in 20 variables. After adjusting for differences between the two groups, AHF-COPD-known patients showed no significant differences in 30-day mortality (OR=0.89; 95% CI=0.71-1.11), prolonged hospitalization in general wards (OR=1.04; 95% CI=0.89-1.22) or SSU (OR=1.38; 95% CI=0.97-1.97), and 1-year mortality (HR: 1.02; 95% CI=0.89-1.17), but showed a higher 30-day revisit rate (OR=1.32; 95% CI=1.13-1.54). In patients attending the ED for AHF, the coexistence of COPD is only associated with an increased risk of short-term ED revisit, but not prolonged hospitalization and short- or long-term mortality. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  12. Psychometric Evaluation of Persian Version of Death Depression Scale in Iranian Patients with Acute Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Hamid Sharif Nia

    2017-06-01

    Full Text Available AbstractObjective: The psychometric properties of a scale should be re-assessed routinely with different samples to ensure its generalizability. The present study aimed to determine the reliability and validity of the Persian Version of Death Depression Scale (DDS in Iranian patients with Acute Myocardial Infarction (AMI.Methods: The face validity, content validity and construct validity (i.e. factorial, convergent, and discriminant validity of the DDS were assessed using a sample of 407 AMI patients. Confirmatory factor analysis was conducted using the ratio chi-square by degrees of freedom (χ2/df, the Goodness-of-fit index (GFI, Comparative Fit Index (CFI, Incremental Fit Index (IFI, Normed Fit Index (NFI, and Root Mean Square Error of Approximation (RMSEA. Convergent and discriminant validity were assessed using average variance extracted (AVE, maximum shared squared variance (MSV, and average shared square variance (ASV. Internal consistency, test–retest, and construct reliability (CR were used to assess reliability of the Persian Version of DDS.Results: Based on principle component analysis and consideration of conceptual meaning, a four-factor solution was selected, explaining 75.89% of the total variance. Goodness-of-fit indices (c2(98 = 583.646, p < .05, c2/df= 5.956, GFI = .856, CFI = .902, NFI = .885, IFI = .902, RMSEA (90% C.I. = .110 (.102 - .119 in the final DDS structure demonstrated the adequacy of the four-domain structure of the DDS. Convergent and discriminant validity was used to assess the construct validity of the DDS. The reliability was greater than .70.Conclusion: The DDS was found to be a valid and reliable assessment tool for death depression in Iranian patients with AMI.

  13. Anterior ST segment depression in acute inferior myocardial infarction as a marker of greater inferior, apical, and posterolateral damage

    International Nuclear Information System (INIS)

    Ruddy, T.D.; Yasuda, T.; Gold, H.K.; Leinbach, R.C.; Newell, J.B.; McKusick, K.A.; Boucher, C.A.; Strauss, H.W.

    1986-01-01

    The clinical significance of anterior precordial ST segment depression during acute inferior myocardial infarction was evaluated in 67 consecutive patients early after onset of symptoms with gated blood pool scans, thallium-201 perfusion images, and 12-lead ECGs. Patients with anterior ST depression (n = 33) had depressed mean values for left ventricular ejection fraction (54 +/- 2% [mean +/- S.E.M.] vs 59 +/- 2%; p = 0.02), cardiac index (3.1 +/- 0.2 vs 3.6 +/- 0.2 L/m2; p = 0.03), and ratio of systolic blood pressure to end-systolic volume (2.0 +/- 0.1 vs 2.5 +/- 0.3 mm Hg/ml; p = 0.04) compared to patients with no anterior ST depression (n = 34). Patients with anterior ST depression had (1) lower mean wall motion values for the inferior, apical, and inferior posterolateral segments (p less than 0.05) and (2) greater reductions in thallium-201 uptake in the inferior and posterolateral regions (p less than 0.05). However, anterior and septal (1) wall motion and (2) thallium-201 uptake were similar in patients with and without ST depression. Thus, anterior precordial ST segment depression in patients with acute inferior wall myocardial infarction represents more than a reciprocal electrical phenomenon. It identifies patients with more severe wall motion impairment and greater hypoperfusion of the inferior and adjacent segments. The poorer global left ventricular function in these patients is a result of more extensive inferior infarction and not of remote septal or anterior injury

  14. Acute posttraumatic stress symptoms and depression after exposure to the 2005 Saskatchewan Centennial Air Show disaster: prevalence and predictors.

    Science.gov (United States)

    Taylor, Steven; Asmundson, Gordon J G; Carleton, R Nicholas; Brundin, Peter

    2007-01-01

    The purpose of this study was to determine the prevalence of acute distress-that is, clinically significant posttraumatic stress symptoms (PTSS) and depression-and to identify predictors of each in a sample of people who witnessed a fatal aircraft collision at the 2005 Saskatchewan Centennial Air Show. Air Show attendees (N = 157) were recruited by advertisements in the local media and completed an Internet-administered battery of questionnaires. Based on previously established cut-offs, 22 percent respondents had clinically significant PTSS and 24 percent had clinically significant depressive symptoms. Clinically significant symptoms were associated with posttrauma impairment in social and occupational functioning. Acute distress was associated with several variables, including aspects of Air Show trauma exposure, severity of prior trauma exposure, low posttrauma social support (ie, negative responses by others), indices of poor coping (eg, intolerance of uncertainty, rumination about the trauma), and elevated scores on anxiety sensitivity, the personality trait of absorption, and dissociative tendencies. Results suggest that clinically significant acute distress is common in the aftermath of witnessed trauma. The statistical predictors (correlates) of acute distress were generally consistent with the results of studies of other forms of trauma. People with elevated scores on theoretical vulnerability factors (eg, elevated anxiety sensitivity) were particularly likely to develop acute distress.

  15. Functional alterations of fronto-limbic circuit and default mode network systems in first-episode, drug-naïve patients with major depressive disorder: A meta-analysis of resting-state fMRI data.

    Science.gov (United States)

    Zhong, Xue; Pu, Weidan; Yao, Shuqiao

    2016-12-01

    The neurobiological mechanisms of depression are increasingly being explored through resting-state brain imaging studies. However, resting-state fMRI findings have varied, perhaps because of differences between study populations, which included the disorder course and medication use. The aim of our study was to integrate studies of resting-state fMRI and explore the alterations of abnormal brain activity in first-episode, drug-naïve patients with major depressive disorder. Relevant imaging reports in English were searched, retrieved, selected and subjected to analysis by activation likelihood estimation, a coordinate-based meta-analysis technique (final sample, 31 studies). Coordinates extracted from the original reports were assigned to two categories based on effect directionality. Compared with healthy controls, the first-episode, medication-naïve major depressive disorder patients showed decreased brain activity in the dorsolateral prefrontal cortex, superior temporal gyrus, posterior precuneus, and posterior cingulate, as well as in visual areas within the occipital lobe, lingual gyrus, and fusiform gyrus, and increased activity in the putamen and anterior precuneus. Not every study that has reported relevant data met the inclusion criteria. Resting-state functional alterations were located mainly in the fronto-limbic system, including the dorsolateral prefrontal cortex and putamen, and in the default mode network, namely the precuneus and superior/middle temporal gyrus. Abnormal functional alterations of the fronto-limbic circuit and default mode network may be characteristic of first-episode, drug-naïve major depressive disorder patients. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. Oak Forest Responses to Episodic-Seasonal-Drought, Chronic Multi-year Precipitation Change and Acute Drought Manipulations in a Region With Deep Soils and High Precipitation

    Science.gov (United States)

    Hanson, Paul J.; Wullschleger, Stan D.; Todd, Donald E.; Auge, Robert M.; Froberg, Mats; Johnson, Dale W.

    2010-05-01

    Implications of episodic-seasonal drought (extremely dry late summers), chronic multi-year precipitation manipulations (±33 percent over 12 years) and acute drought (-100 percent over 3 years) were evaluated for the response of vegetation and biogeochemical cycles for an upland-oak forest. The Quercus-Acer forest is located in eastern Tennessee on deep acidic soils with mean annual temperatures of 14.2 °C and abundant precipitation (1352 mm y-1). The multi-year observations and chronic manipulations were conducted from 1993 through 2005 using understory throughfall collection troughs and redistribution gutters and pipes. Acute manipulations of dominant canopy trees (Quercus prinus; Liriodendron tulipifera) were conducted from 2003 through 2005 using full understory tents. Regional and severe late-summer droughts were produced reduced stand water use and photosynthetic carbon gain as expected. Likewise, seedlings and saplings exhibited reduced survival and cumulative growth reductions. Conversely, multi-year chronic increases or decreases in precipitation and associated soil water deficits did not reduce large tree basal area growth for the tree species present. The resilience of canopy trees to chronic-change was the result of a disconnect between carbon allocation to tree growth (an early-season phenomenon) and late-season drought occurrence. Acute precipitation exclusion from the largest canopy trees also produced limited physiological responses and minimal cumulative growth reductions. Lateral root water sources were removed through trenching and could not explain the lack of response to extreme soil drying. Therefore, deep rooting the primary mechanism for large-tree resilience to severe drought. Extensive trench-based assessments of rooting depth suggested that ‘deep' water supplies were being obtained from limited numbers of deep fine roots. Observations of carbon stocks in organic horizons demonstrated accumulation with precipitation reductions and

  17. A new chronobiological approach to discriminate between acute and chronic depression using peripheral temperature, rest-activity, and light exposure parameters.

    Science.gov (United States)

    Ávila Moraes, Cláudia; Cambras, Trinitat; Diez-Noguera, Antoni; Schimitt, Regina; Dantas, Giovana; Levandovski, Rosa; Hidalgo, Maria Paz

    2013-03-09

    Circadian theories for major depressive disorder have suggested that the rhythm of the circadian pacemaker is misaligned. Stable phase relationships between internal rhythms, such as temperature and rest/activity, and the external day-night cycle, are considered to be crucial for adapting to life in the external environmental. Therefore, the relationship and possible alterations among (i) light exposure, (ii) activity rhythm, and (iii) temperature rhythm could be important factors in clinical depression. This study aimed to investigate the rhythmic alterations in depression and evaluate the ability of chronobiological parameters to discriminate between healthy subjects and depressed patients. Thirty female subjects, including healthy subjects, depressed patients in the first episode, and major recurrent depression patients. Symptoms were assessed using Hamilton Depression Scale, Beck Depression Inventory and Montgomery-Äsberg Scale. Motor activity, temperature, and light values were determined for 7 days by actigraph, and circadian rhythms were calculated. Depressed groups showed a lower amplitude in the circadian rhythm of activity and light exposure, but a higher amplitude in the rhythm of peripheral temperature. The correlation between temperature and activity values was different in the day and night among the control and depressed groups. For the same level of activity, depressed patients had lowest temperature values during the day. The amplitudes of temperature and activity were the highest discriminant parameters. These results indicate that the study of rhythms is useful for diagnosis and therapy for depressive mood disorders.

  18. Depression

    DEFF Research Database (Denmark)

    Johansen, Jon O. J.

    2013-01-01

    Nyhederne er fulde af historier om depression. Overskrifter som: ’Danskerne propper sig med lykkepiller’ eller ‘depression er stadigvæk tabu’ går tit igen i dagspressen. Men hvor er nuancerne, og hvorfor gider vi læse de samme historier igen og igen? Måske er det fordi, vores egne forestillinger er...

  19. Effects of Acute Exercise on Circulating Soluble Form of the Urokinase Receptor in Patients With Major Depressive Disorder

    Directory of Open Access Journals (Sweden)

    Anna Gustafsson

    2017-04-01

    Full Text Available Inflammation has been proposed to play a role in the generation of depressive symptoms. Previously, we demonstrated that patients with major depressive disorder (MDD have increased plasma levels of the soluble form of the urokinase receptor (suPAR, a marker for low-grade inflammation. The aim of this study was to test the hypothesis that acute exercise would induce inflammatory response characterized by increased suPAR and elucidate whether patients with MDD display altered levels of suPAR in response to acute exercise. A total of 17 patients with MDD and 17 controls were subjected to an exercise challenge. Plasma suPAR (P-suPAR was analyzed before, during, and after exercise. There was a significantly higher baseline P-suPAR in the patients with MDD, and the dynamic changes of P-suPAR during the exercise were significantly lower in the patients with MDD, compared with the controls. This study supports the hypothesis that an activation of systemic inflammatory processes, measured as elevated P-suPAR, is involved in the pathophysiology of depression. The study concludes that P-suPAR is influenced by acute exercise, most likely due to release from activated neutrophils.

  20. Reducing length of stay for acute diabetic foot episodes: employing an extended scope of practice podiatric high-risk foot coordinator in an acute foundation trust hospital.

    Science.gov (United States)

    Cichero, Matthew J; Bower, Virginia M; Walsh, Tom P; Yates, Ben J

    2013-12-11

    To enhance the acute management of people with diabetic foot disease requiring admission, an extended scope of practice, podiatric high-risk foot coordinator position, was established at the Great Western Hospital, Swindon in 2010. The focus of this new role was to facilitate more efficient and timely management of people with complex diabetic foot disease. The aim of this project was to investigate the impact of the podiatric high-risk foot coordinator role on length of stay, rate of re-admission and bed cost. This study evaluated the difference in length of stay and rate of re-admission between an 11- month pre-pilot period (November 2008 to October 2009) and a 10-month pilot period (August 2010 to June 2011). The estimated difference in bed cost between the pre-pilot and pilot audits was also calculated. Inclusion criteria were restricted to inpatients admitted with a diabetic foot ulcer, gangrene, cellulitis or infection as the primary cause for admission. Eligible records were retrieved using ICD-10 (V9) coding via the hospital clinical audit department for the pre-pilot period and a unique database was used to source records for the pilot phase. Following the introduction of the podiatric high-risk foot coordinator, the average length of stay reduced from 33.7 days to 23.3 days (mean difference 10.4 days, 95% CI 0.0 to 20.8, p = 0.050). There was no statistically significant difference in re-admission rate between the two study periods, 17.2% (95% CI 12.2% to 23.9%) in the pre-pilot phase and 15.4% (95% CI 12.0% to 19.5%) in the pilot phase (p = 0.820). The extrapolated annual cost saving following the implementation of the new coordinator role was calculated to be £234,000 for the 2010/2011 year. This audit found that the extended scope of practice coordinator role may have a positive impact on reducing length of stay for diabetic foot admissions. This paper advocates the role of a podiatric high-risk foot coordinator utilising an extended scope of

  1. Acute working memory improvement after tDCS in antidepressant-free patients with major depressive disorder.

    Science.gov (United States)

    Oliveira, Janaina F; Zanão, Tamires A; Valiengo, Leandro; Lotufo, Paulo A; Benseñor, Isabela M; Fregni, Felipe; Brunoni, André R

    2013-03-14

    Based on previous studies showing that transcranial direct current stimulation (tDCS), a non-invasive brain stimulation technique that employs weak, direct currents to induce cortical-excitability changes, might be useful for working memory (WM) enhancement in healthy subjects and also in treating depressive symptoms, our aim was to evaluate whether tDCS could acutely enhance WM in depressed patients. Twenty-eight age- and gender-matched, antidepressant-free depressed subjects received a single-session of active/sham tDCS in a randomized, double-blind, parallel design. The anode was positioned over the left and the cathode over the right dorsolateral prefrontal cortex. The n-back task was used for assessing WM and it was performed immediately before and 15min after tDCS onset. We found that active vs. sham tDCS led to an increase in the rate of correct responses. We also used signal detection theory analyses to show that active tDCS increased both discriminability, i.e., the ability to discriminate signal (correct responses) from noise (false alarms), and response criterion, indicating a lower threshold to yield responses. All effect sizes were large. In other words, one session of tDCS acutely enhanced WM in depressed subjects, suggesting that tDCS can improve "cold" (non affective-loaded) working memory processes in MDD. Based on these findings, we discuss the effects of tDCS on WM enhancement in depression. We also suggest that the n-back task could be used as a biomarker in future tDCS studies investigating prefrontal activity in healthy and depressed samples. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  2. Comparison of participants and non-participants in a randomized study of prevention of depression in patients with acute coronary syndrome

    DEFF Research Database (Denmark)

    Hansen, Baiba; Hanash, Jamal A.; Rasmussen, Alice

    2011-01-01

    Background: The prevalence of depression and anxiety in patients after acute coronary syndrome (ACS) is higher than in the general population. In a study on prevention of post-ACS depression, more than half of eligible patients declined participation. Aims: The aim of this study was to evaluate...

  3. Impact of preexisting depression on length of stay and discharge destination among patients hospitalized for acute stroke - Linked register-based study

    NARCIS (Netherlands)

    Nuyen, Jasper; Spreeuwenberg, Peter M.; Groenewegen, Peter P.; van den Bos, Geertrudis A. M.; Schellevis, Francois G.

    2008-01-01

    Background and Purpose-There exists limited knowledge regarding the relation between depression and healthcare utilization in stroke patients. The objective of this register-based study was to examine the impact of having preexisting depression at the time of hospital admission for acute stroke on

  4. Impact of Preexisting Depression on Length of Stay and Discharge Destination Among Patients Hospitalized for Acute Stroke : Linked Register-Based Study

    NARCIS (Netherlands)

    Nuyen, Jasper; Spreeuwenberg, Peter M.; Groenewegen, Peter P.; Bos, Geertrudis A.M. van den; Schellevis, Francois G.

    2008-01-01

    Background and Purpose—There exists limited knowledge regarding the relation between depression and healthcare utilization in stroke patients. The objective of this register-based study was to examine the impact of having preexisting depression at the time of hospital admission for acute stroke on

  5. Impact of preexisting depression on length of stay and discharge destination among patients hospitalized for acute stroke: linked register-based study.

    NARCIS (Netherlands)

    Nuyen, J.; Spreeuwenberg, P.; Groenewegen, P.P.; Bos, G.A.M. van den; Schellevis, F.G.

    2008-01-01

    Background and Purpose: There exists limited knowledge regarding the relation between depression and healthcare utilization in stroke patients. The objective of this register-based study was to examine the impact of having preexisting depression at the time of hospital admission for acute stroke on

  6. Symptom specificity in the acute treatment of Major Depressive Disorder: a re-analysis of the treatment of depression collaborative research program.

    Science.gov (United States)

    Stewart, Jeremy G; Harkness, Kate L

    2012-03-01

    Antidepressant medications, Cognitive-Behavioral Therapy (CBT) and Interpersonal Psychotherapy (IPT) are equally efficacious in the acute treatment of Major Depressive Disorder (MDD). Nevertheless, remission rates remain unacceptably low. Examining the differential time course of remission of specific symptom clusters across treatments may provide a basis for assigning patients to treatments that have the highest chance of being effective. This study re-analyzed data from the NIMH Treatment of Depression Collaborative Research Project (TDCRP), which included 250 adult outpatients with MDD randomized to 16 weeks of CBT, IPT, imipramine+clinical management (IMI-CM), or pill placebo (PLA-CM). We derived four symptom factors from the 23-item Hamilton Depression Rating Scale, and three symptom factors from the Beck Depression Inventory. Within-subject hierarchical regression models were specified to examine the linear and quadratic patterns of symptom remission over five assessment points. IMI-CM produced a more rapid rate of remission than CBT or IPT for both the somatic/vegetative and cognitive-affective symptoms of MDD. There were no statistically significant differences in the rates of improvement of any of the symptom factors between the IMI-CM and PLA-CM groups. Some core symptoms of depression were excluded due to low factor loadings. Past research has argued that the CBT arm in the TDCRP may have been weak. We failed to find evidence that treatments act preferentially on specific symptom clusters. Therefore, the symptoms of MDD may be inter-dependent when it comes to their courses of remission in treatment. Copyright © 2011 Elsevier B.V. All rights reserved.

  7. Olanzapine approved for the acute treatment of schizophrenia or manic/mixed episodes associated with bipolar I disorder in adolescent patients

    Directory of Open Access Journals (Sweden)

    Ann E Maloney

    2010-11-01

    Full Text Available Ann E Maloney1,2, Linmarie Sikich31Maine Medical Center Research Institute, Scarborough, ME, USA; 2Department of Psychiatry, Tufts University School of Medicine, Boston, MA, USA; 3Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USABackground: Severe and persistent mental illnesses in children and adolescents, such as early-onset schizophrenia spectrum (EOSS disorders and pediatric bipolar disorder (pedBP, are increasingly recognized. Few treatments have demonstrated efficacy in rigorous clinical trials. Enduring response to current medications appears limited. Recently, olanzapine was approved for the treatment of adolescents with schizophrenia or acute manic/mixed episodes in pedBP.Methods: PubMed searches were conducted for olanzapine combined with pharmacology, schizophrenia, or bipolar disorder. Searches related to schizophrenia and bipolar disorder were limited to children and adolescents. The bibliographies of the retrieved articles were hand-checked for additional relevant studies. The epidemiology, phenomenology, and treatment of EOSS and pedBP, and olanzapine’s pharmacology are reviewed. Studies of olanzapine treatment in youth with EOSS and pedBP are examined.Results: Olanzapine is efficacious for EOSS and pedBP. However, olanzapine is not more efficacious than risperidone, molindone, or haloperidol in EOSS and is less efficacious than clozapine in treatment-resistant EOSS. No comparative trials have been done in pedBP. Olanzapine is associated with weight gain, dyslipidemia, and transaminase elevations in youth. Extrapyramidal symptoms, neuroleptic malignant syndrome, and blood dyscrasias have also been reported but appear rare.Conclusions: The authors conclude that olanzapine should be considered a second-line agent in EOSS and pedBP due to its risks for significant weight gain and lipid dysregulation. Awareness of the consistent weight and metabolic changes observed in olanzapine

  8. Healing the heart: a randomized pilot study of a spiritual retreat for depression in acute coronary syndrome patients.

    Science.gov (United States)

    Warber, Sara L; Ingerman, Sandra; Moura, Vera L; Wunder, Jenna; Northrop, Alyssa; Gillespie, Brenda W; Durda, Kate; Smith, Katherine; Rhodes, Katherine S; Rubenfire, Melvyn

    2011-01-01

    Depression is associated with increased risk of cardiovascular morbidity and mortality in coronary heart disease. Numerous conventional and complementary therapies may address depression. Few involving spirituality have been tested. The aim of this study was to compare the effects of a nondenominational spiritual retreat, Medicine for the Earth (MFTE), on depression and other measures of well-being six- to 18-months post acute coronary syndrome (ACS). A randomized controlled pilot study of MFTE, Lifestyle Change Program (LCP), or usual cardiac care (control) was conducted in Southeastern Michigan. ACS patients were recruited via local and national advertising (n = 58 enrolled, 41 completed). The four-day MFTE intervention included guided imagery, meditation, drumming, journal writing, and nature-based activities. The four-day LCP included nutrition education, exercise, and stress management. Both retreat groups received follow-up phone coaching biweekly for three months. Validated self-report scales of depression, spiritual well-being, perceived stress, and hope were collected at baseline, immediately post-retreat, and at three and six months. Depression was not significantly different among groups (P = .21). However, the MFTE group had the highest depression scores at baseline and had significantly lower scores at all postintervention time points (P ≤ .002). Hope significantly improved among MFTE participants, an effect that persisted at three- and six-month follow-up (P = .014). Although several measures showed improvement in all groups by six months, the MFTE group had immediate improvement post-retreat, which was maintained. This pilot study shows that a nondenominational spiritual retreat, MFTE, can be used to increase hope while reducing depression in patients with ACS. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. Tryptophan pathway alterations in the postpartum period and in acute postpartum psychosis and depression.

    Science.gov (United States)

    Veen, Cato; Myint, Aye Mu; Burgerhout, Karin M; Schwarz, Markus J; Schütze, Gregor; Kushner, Steven A; Hoogendijk, Witte J; Drexhage, Hemmo A; Bergink, Veerle

    2016-01-01

    Women are at very high risk for the first onset of acute and severe mood disorders the first weeks after delivery. Tryptophan breakdown is increased as a physiological phenomenon of the postpartum period and might lead to vulnerability for affective psychosis (PP) and severe depression (PD). The aim of the current study was to investigate alterations in tryptophan breakdown in the physiological postpartum period compared to patients with severe postpartum mood disorders. We included 52 patients (29 with PP, 23 with PD), 52 matched healthy postpartum women and 29 healthy non-postpartum women. Analyzes of serum tryptophan metabolites were performed using LC-MS/MS system for tryptophan, kynurenine, 3-hydroxykynurenine, kynurenic acid and 5-hydroxyindoleacetic acid. The first two months of the physiological postpartum period were characterized by low tryptophan levels, increased breakdown towards kynurenine and a downstream shift toward the 3-OH-kynurenine arm, away from the kynurenic acid arm. Kynurenine was significantly lower in patients with PP and PD as compared to healthy postpartum women (p=0.011 and p=0.001); the remaining tryptophan metabolites demonstrated few differences between patients and healthy postpartum women. Low prevalence of the investigated disorders and strict exclusion criteria to obtain homogenous groups, resulted in relatively small sample sizes. The high kynurenine levels and increased tryptophan breakdown as a phenomenon of the physiological postpartum period was not present in patients with severe postpartum mood disorders. No differences were observed in the levels of the 'neurotoxic' 3-OH-kynurenine and the 'neuroprotective' kynurenic acid arms between patients and healthy postpartum women. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. Are variations in whole blood BDNF level associated with the BDNF Val66Met polymorphism in patients with first episode depression?

    DEFF Research Database (Denmark)

    Vinberg, Maj; Bukh, Jens Otto Drachmann; Bennike, Bente

    2013-01-01

    ). Symptomatology was rated using Hamilton Rating Scale for Depression (HAMD-17) and Becks Depression Inventory (BDI 21). No differences in whole blood BDNF was seen in relation to the BDNF Val66Met polymorphism and no significant correlations between whole blood BDNF and HAMD-17 or BDI 21 scores were found...

  11. The interplay and etiological continuity of neuroticism, difficulties, and life events in the etiology of major and subsyndromal, first and recurrent depressive episodes in later life

    NARCIS (Netherlands)

    Ormel, J; Oldehinkel, AJ; Brilman, EI

    Objective: Stressful life events, longterm difficulties, and high neuroticism are established risk factors for depression. Less is known about their role in late-life depression, how they modify or mediate one another's effects, and whether this differs between major and subsyndromal, first and

  12. Longitudinal social-interpersonal functioning among higher-risk responders to acute-phase cognitive therapy for recurrent major depressive disorder.

    Science.gov (United States)

    Vittengl, Jeffrey R; Clark, Lee Anna; Thase, Michael E; Jarrett, Robin B

    2016-07-15

    Social-interpersonal dysfunction increases disability in major depressive disorder (MDD). Here we clarified the durability of improvements in social-interpersonal functioning made during acute-phase cognitive therapy (CT), whether continuation CT (C-CT) or fluoxetine (FLX) further improved functioning, and relations of functioning with depressive symptoms and relapse/recurrence. Adult outpatients (N=241) with recurrent MDD who responded to acute-phase CT with higher risk of relapse (due to unstable or partial remission) were randomized to 8 months of C-CT, FLX, or pill placebo plus clinical management (PBO) and followed 24 additional months. We analyzed repeated measures of patients' social adjustment, interpersonal problems, dyadic adjustment, depressive symptoms, and major depressive relapse/recurrence. Large improvements in social-interpersonal functioning occurring during acute-phase CT (median d=1.4) were maintained, with many patients (median=66%) scoring in normal ranges for 32 months. Social-interpersonal functioning did not differ significantly among C-CT, FLX, and PBO arms. Beyond concurrently measured residual symptoms, deterioration in social-interpersonal functioning preceded and predicted upticks in depressive symptoms and major depressive relapse/recurrence. Results may not generalize to other patient populations, treatment protocols, or measures of social-interpersonal functioning. Mechanisms of risk connecting poorer social-interpersonal functioning with depression were not studied. Average improvements in social-interpersonal functioning among higher-risk responders to acute phase CT are durable for 32 months. After acute-phase CT, C-CT or FLX may not further improve social-interpersonal functioning. Among acute-phase CT responders, deteriorating social-interpersonal functioning provides a clear, measurable signal of risk for impending major depressive relapse/recurrence and opportunity for preemptive intervention. Copyright © 2016 Elsevier B

  13. Adiposity moderates links from early adversity and depressive symptoms to inflammatory reactivity to acute stress during late adolescence.

    Science.gov (United States)

    Chiang, Jessica J; Bower, Julienne E; Irwin, Michael R; Taylor, Shelley E; Fuligni, Andrew J

    2017-11-01

    Both early adversity and depression are associated with heightened inflammation. However, few studies have focused on inflammatory reactivity to psychosocial stress and examined adiposity as a potential moderator. Yet, repeated heightened inflammatory reactivity over time is thought to contribute to low-grade chronic inflammation and adipose tissue is a key source of pro-inflammatory cytokines. The purpose of the present study was to examine whether early adversity and depressive symptoms were related to stress-induced inflammation and whether these associations varied by total body and abdominal adiposity as measured by body mass index (BMI) and waist circumference (WC) in a sample of late adolescents. Participants reported on their early family environment and current depressive symptoms, had their height, weight, and WC assessed for adiposity markers, and provided blood samples for IL-6 assessment before and after a standardized laboratory stress task. No main effect of early adversity on IL-6 reactivity to acute stress was observed. However, significant interactions between early adversity and BMI and WC emerged. Greater exposure to early adversity was associated with greater IL-6 responses only among adolescents with higher BMI or WC. The same pattern of findings was observed for depressive symptoms. Additionally, moderated mediation analyses indicated that among adolescents with greater adiposity, early adversity indirectly influenced IL-6 reactivity via current depressive symptoms. These findings contribute to our understanding of vulnerability factors that may amplify the associations between early adversity and depressive symptoms and inflammation during relatively early stages of life. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Procoagulant reactivity to laboratory acute mental stress in Africans and Caucasians, and its relation to depressive symptoms: the SABPA study.

    Science.gov (United States)

    von Känel, R; Hamer, M; Malan, N T; Scheepers, K; Meiring, M; Malan, L

    2013-11-01

    The risk of cardiovascular disease is dramatically increasing in Africans (black). The prothrombotic stress response contributes to atherothrombotic disease and is modulated by depressive symptoms. We examined coagulation reactivity to acute mental stress and its relation to psychological well-being in Africans relative to Caucasians (white). A total of 102 African and 165 Caucasian school teachers underwent the Stroop Color-Word Conflict test. Circulating levels of von Willebrand factor (VWF) antigen, fibrinogen, and D-dimer were measured before and after the Stroop. Cardiovascular reactivity measures were also obtained. All participants completed the Patient Health Questionnaire-9 and the General Health Questionnaire-28 for the assessment of depressive symptoms and total psychological distress, respectively. After controlling for covariates, resting levels of VWF, fibrinogen, and D-dimer were higher in Africans than in Caucasians (all p-values ≤0.006). Depressive symptoms and psychological distress were not significantly associated with resting coagulation measures. Stress reactivity in VWF (pstress when compared with Caucasians. Ethnic differences in the vascular adrenergic stress response might partially explain this finding. Depressive symptoms were associated with exaggerated VWF reactivity in Africans relative to Caucasians. The clinical implications of these findings for Africans need further study.

  15. Psychometric Properties of the Persian Version of Death Depression Scale-Revised in Iranian Patients with Acute Myocardial Infarction.

    Science.gov (United States)

    Sharif Nia, Hamid; Pahlevan Sharif, Saeed; Lehto, Rebecca H; Allen, Kelly A; Goudarzian, Amir Hossein; Yaghoobzadeh, Ameneh; Soleimani, Mohammad Ali

    2017-07-01

    Objective: Limited research has examined the psychometric properties of death depression scales in Persian populations with cardiac disease despite the need for valid assessment tools for evaluating depressive symptoms in patients with life-limiting chronic conditions. The present study aimed at evaluating the reliability and validity of the Persian Version of Death Depression Scale - Revised (DDS-R) in Iranian patients who had recent acute myocardial infarction (AMI). Method: This psychometric study was conducted with a convenience sample of 407 patients with AMI diagnosis who completed the Persian version of the DDS-R. The face, content, and construct validity of the scale were ascertained. Internal consistency, test-retest, and construct reliability (CR) were used to assess reliability of the Persian Version of DDS-R. Results: Based on maximum likelihood exploratory factor analysis and consideration of conceptual meaning, a 4-factor solution was identified, explaining 75.89% of the total variance. Goodness-of-fit indices (GFI), Comparative Fit Index (CFI), Normed Fit Index (NFI), Incremental Fit Index (IFI), and Root Mean Square Error of Approximation (RMSEA) in the final DDS-R structure demonstrated the adequacy of the 4-domain structure. The internal consistency, construct reliability, and Intra-class Correlation Coefficients (ICC) were greater than .70. Conclusion: The DDS-R was found to be a valid and reliable assessment tool for evaluating death depression symptoms in Iranian patients with AMI.

  16. Anxiety, depression, stress, and cortisol levels in mothers of children undergoing maintenance therapy for childhood acute lymphoblastic leukemia.

    Science.gov (United States)

    Neu, Madalynn; Matthews, Ellyn; King, Nancy A; Cook, Paul F; Laudenslager, Mark L

    2014-01-01

    The purpose of this study was to compare anxiety, depression, and stress between mothers of children during maintenance treatment for acute lymphoblastic leukemia (ALL) and matched controls. Twenty-six mothers were recruited from the hematology unit at a children's hospital, and 26 mothers were recruited from the community. Participants were matched to their child's age and gender. Mothers completed the Hospital Anxiety and Depression Scale, the Perceived Stress Sale, and collected salivary cortisol 4 times a day for 3 consecutive days. Compared with mothers of healthy children, anxiety scores did not differ (P=.10), but depression scores were higher (P=.003) in mothers of children with ALL. More mothers in the ALL group scored above the cutoff of 7 indicating clinical anxiety (46%) and depressive symptoms (27%). A trend toward increased stress was found in mothers in the ALL group. No difference was found in overall daily cortisol (area under the curve), daily decrease in cortisol (slope), and cortisol awakening response. Mothers of children with ALL experienced emotional symptoms many months after the initial diagnosis.

  17. Psychometric Evaluation of a Persian Version of the Cardiac Depression Scale in Iranian Patients With Acute Myocardial Infarction.

    Science.gov (United States)

    Nia, Hamid Sharif; Sharif, Saeed Pahlevan; Froelicher, Erika Sivarajan; Boyle, Christopher; Goudarzian, Amir Hossein; Yaghoobzadeh, Ameneh; Oskouie, Fatemeh

    2018-04-01

    The aim of this study was to validate a Persian version of the Cardiac Depression Scale (CDS) in Iranian patients with acute myocardial infarction (AMI). The CDS was forward translated from English into Persian and back-translated to English. Validity was assessed using face, content, and construct validity. Also Cronbach's alpha (α), theta (), and McDonald's omega coefficient were used to evaluate the reliability. Construct validity of the scale showed two factors with eigenvalues greater than one. The Cronbach's α, , McDonald's omega, and construct reliability were greater than .70. The Persian version of the CDS has a two-factor structure (i.e., death anxiety and life satisfaction) and has acceptable reliability and validity. Therefore, the validated instrument can be used in future studies to assess depression in patients with AMI in Iranians.

  18. Associação entre comportamento alimentar, consumo de cigarro, drogas e episódios depressivos em adolescentes Association between eating behavior and smoking, use of illicit drugs and depressive episodes in adolescents

    Directory of Open Access Journals (Sweden)

    Juliany Piazzon Gomes

    2010-10-01

    Full Text Available Objetivo Identificar a prevalência de sintomas de transtornos alimentares em estudantes do sexo feminino matriculadas no ensino fundamental da rede estadual do município de Toledo (PR, bem como relacionar esses sintomas com o hábito de fumar, o uso de drogas e episódios depressivos. Métodos Foram utilizados os instrumentos Teste de Investigação Bulímica de Edimburgo, com escala de sintoma e gravidade, e o Eating Attitudes Test-26, acrescido de perguntas sobre tabagismo, uso de drogas e episódios depressivos. A amostra constituiu-se de cerca de 300 estudantes do sexo feminino, na faixa etária entre 10 e 15 anos. Resultados Os resultados demonstraram que as estudantes apresentaram prevalências de sintomas de transtornos alimentares na ordem de 4,2% para a escala Teste de Investigação Bulímica de Edimburgo e 3,6% para o Eating Attitudes Test-26. A prevalência de consumo de cigarro foi de 4,2%, do uso de drogas, 4,9% e de episódios depressivos, 10,7%. Observaram-se associações significativas entre episódios depressivos e os seguintes parâmetros: Teste de Investigação Bulímica de Edimburgo - escala de sintomas (p=0,04 e Teste de Investigação Bulímica de Edimburgo - escala de gravidade (p=0,02. Os hábitos de fumar (p=0,01 e de usar drogas (p=0,04 também apresentaram associação com Teste de Investigação Bulímica de Edimburgo - escala de sintomas. Conclusão Verificou-se nas estudantes deste estudo elevada probabilidade de desenvolver comportamentos de risco, tais como transtornos alimentares e episódios depressivos.Objective The goal of this study was to identify the prevalence of symptoms of eating disorders in female students enrolled in state elementary schools and investigate a possible association between these eating disorders and smoking, illicit drug use and depressive episodes. Methods The Bulimic Investigatory Test of Edinburgh with symptom and severity scales and the Eating Attitudes Test - 26 with

  19. Family functioning is associated with depressive symptoms in caregivers of acute stroke survivors.

    Science.gov (United States)

    Epstein-Lubow, Gary P; Beevers, Christopher G; Bishop, Duane S; Miller, Ivan W

    2009-06-01

    To determine whether family functioning is uniquely associated with caregiver depressive symptoms in the immediate aftermath of stroke. Cross-sectional data from the baseline assessment of an intervention study for stroke survivors and their families. Neurology inpatient service of a large urban hospital. Stroke survivors (n=192), each with a primary caregiver. The mean age of stroke survivors was 66 years, and most, 57%, were men (n=110). The mean age of caregivers was 57 years, and 73% (n=140) of the caregivers were women. Eighty-five percent of caregivers were white. Not applicable. Measures were chosen to assess caregivers' depressive symptoms (Centers for Epidemiologic Studies Depression Scale), family functioning (Family Assessment Device), and additional factors such as health status (Medical Outcomes Study 36-Item Short-Form Health Survey) and stroke survivors' cognitive abilities (modified Mini-Mental State Examination) and functional impairments (FIM and Frenchay Activities Index). Depressive symptoms were mild to moderate in 14% and severe in 27% of caregivers. Family functioning was assessed as unhealthy in 34% of caregiver-patient dyads. In statistical regression models, caregiver depression was associated with patients' sex, caregivers' general health, and family functioning. Forty-one percent of caregivers experienced prominent depressive symptoms after their family member's stroke. Higher depression severity in caregivers was associated with caring for a man, and having worse health and poor family functioning. After stroke, the assessment of caregivers' health and family functioning may help determine which caregivers are most at risk for a depressive syndrome.

  20. Sleep Changes in a Rat Prenatal Stress Model of Depression

    DEFF Research Database (Denmark)

    Skoven, Christian; Sickman, Helle M.; Bastlund, Jesper Frank

    Major depression is one of the most frequently occurring mental health disorders, but is characterized by diverse symptomatology. Sleep disturbances, however, are commonplace in depressive patients. These alterations include increased duration of Rapid Eye Movement Sleep (REMS) and increased sleep...... determination of sleep-wakefulness state. As traumatic episodes can trigger episodes of clinical depression, we also investigated effects of an acute stressor during the recording period. PNS animals (n=21) had an 82% increase in amount of REMS (11.6±1.4% vs 6.3±0.9%; p...-related increase in REMS after lights-off (pREMS rebound thus seems blunted in PNS animals. PNS alters sleep-wakefulness behavior under baseline conditions and after acute stress. This underscores the value of the PNS...

  1. Impact of Neuromuscular Electrical Stimulation (NMES) on 90-Day Episode Costs and Post-Acute Care Utilization in Total Knee Replacement Patients with Disuse Atrophy.

    Science.gov (United States)

    Pal, Sarmistha; Chughtai, Morad; Sultan, Assem A; Khlopas, Anton; Sodhi, Nipun; George, Nicole E; Etcheson, Jennifer I; Gwam, Chukwuweike U; Newman, Jared M; Samuel, Linsen T; Bhave, Anil; DaVanzo, Joan E; Mont, Michael A

    2017-12-22

    This study evaluated differences in: 1) total episode payments, 2) probability of hospital readmission, 3) probability of inpatient rehab facility (IRF) and utilization, and 4) probability of skilled nursing care facility (SNF) utilization in patients who had disuse atrophy and underwent a total knee arthroplasty (TKA) and either did, or did not, receive preoperative home-based neuromuscular electrical stimulation (NMES) therapy. We used the Medicare limited dataset for a 5% sample of beneficiaries from 2014 and 2015 to construct episodes-of-care for TKA (DRG-470) patients with disuse atrophy who underwent a TKA during the 30 days prior to hospital admission and 90 days post-discharge. Patients were stratified into those who either did or did not receive pre- and postoperative NMES therapy. An ordinary least square (OLS) model was used to estimate the impact of NMES on total episode. Linear probability models were used to estimate the impact of NMES on SNF or IRF utilization and readmission. A $3,274 reduction in episode payments for patients who used preoperative NMES versus those who did not (ptotal episode payments and SNF utilization for TKA patients with disuse atrophy who had NMES therapy was demonstrated.

  2. Clinical predictors of acute response to transcranial direct current stimulation (tDCS) in major depression.

    Science.gov (United States)

    D'Urso, Giordano; Dell'Osso, Bernardo; Rossi, Rodolfo; Brunoni, Andre Russowsky; Bortolomasi, Marco; Ferrucci, Roberta; Priori, Alberto; de Bartolomeis, Andrea; Altamura, Alfredo Carlo

    2017-09-01

    Transcranial direct current stimulation (tDCS) is a promising neuromodulation intervention for poor-responding or refractory depressed patients. However, little is known about predictors of response to this therapy. The present study aimed to analyze clinical predictors of response to tDCS in depressed patients. Clinical data from 3 independent tDCS trials on 171 depressed patients (including unipolar and bipolar depression), were pooled and analyzed to assess predictors of response. Depression severity and the underlying clinical dimensions were measured using the Hamilton Depression Rating Scale (HDRS) at baseline and after the tDCS treatment. Age, gender and diagnosis (bipolar/unipolar depression) were also investigated as predictors of response. Linear mixed models were fitted in order to ascertain which HDRS factors were associated with response to tDCS. Age, gender and diagnosis did not show any association with response to treatment. The reduction in HDRS scores after tDCS was strongly associated with the baseline values of "Cognitive Disturbances" and "Retardation" factors, whilst the "Anxiety/Somatization" factor showed a mild association with the response. Open-label design, the lack of control group, and minor differences in stimulation protocols. No differences in response to tDCS were found between unipolar and bipolar patients, suggesting that tDCS is effective for both conditions. "Cognitive disturbance", "Retardation", and "Anxiety/Somatization", were identified as potential clinical predictors of response to tDCS. These findings point to the pre-selection of the potential responders to tDCS, therefore optimizing the clinical use of this technique and the overall cost-effectiveness of the psychiatric intervention for depressed patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Health-Related Quality of Life, Depression, Anxiety, and Self-Image in Acute Lymphocytic Leukemia Survivors

    Directory of Open Access Journals (Sweden)

    Birol Baytan

    2016-12-01

    Full Text Available Objective: With increasing survival rates in childhood acute lymphocytic leukemia (ALL, the long-term side effects of treatment have become important. Our aim was to investigate health-related quality of life, depression, anxiety, and self-image among ALL survivors. Materials and Methods: Fifty patients diagnosed with ALL and their siblings were enrolled. The Kovacs Children’s Depression Inventory, State-Trait Anxiety Inventory, Offer Self-Image Questionnaire, and Pediatric Quality of Life InventoryTM were used for collecting data. ANOVA tests were used to determine if there were any significant differences between groups. Results: ALL survivors had higher depression, more anxiety symptoms, lower quality of life, and more negative self-image when compared to their siblings. Conclusion: Continuous diagnostic and interventional mental health services might be necessary for possible emotional side effects of treatment during and after the treatment. Rehabilitation and followup programs should be implemented for children during and after treatment for ALL.

  4. Gender differences in quality of life and functional disability for depression outpatients with or without residual symptoms after acute phase treatment in China.

    Science.gov (United States)

    Zhao, Na; Wang, Xiaohong; Wu, Wenyuan; Hu, Yongdong; Niu, Yajuan; Wang, Xueyi; Gao, Chengge; Zhang, Ning; Fang, Yiru; Huang, Jizhong; Liu, Tiebang; Jia, Fujun; Zhu, Xuequan; Hu, Jian; Wang, Gang

    2017-09-01

    Depression is associated with substantial personal suffering and reduced quality of life and functioning. The aim of this study was to investigate gender differences on quality of life and functional impairment of outpatients with depression after acute phase treatment. 1503 depression outpatients were recruited from eleven hospitals in China. Subjects were evaluated with sociodemographic characteristics, history and self-report instruments, related to severity of symptoms, function and quality of life. All data were analyzed to determine the gender differences. Men had a younger age at onset and the first onset age, higher education compared to women in total patients and with or without residual symptoms group. Using regression analysis, it was found that gender was significantly statistically related to severity scores of SDS and had no correlation with Q-LES-Q-SF total scores. In the residual symptoms group, greater functional impairment was noted by men in the area of work and social life. Significant gender differences of mood, work and sexual life in quality of life were observed. This is a cross-sectional study of depressed outpatients and duration of acute phase treatment may not an adequate time to measure changes. Depression appears to affect men more seriously than women after acute phase treatment. Men had a younger age at onset and the first onset age, higher education, more functional impairment and lower satisfaction of quality of life in mood, work and sexual life. Gender differences affect acute treatment, remission and recovery. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Add-on treatment with N-acetylcysteine for bipolar depression

    DEFF Research Database (Denmark)

    Ellegaard, Pernille Kempel; Licht, Rasmus Wentzer; Poulsen, Henrik Enghusen

    2018-01-01

    BACKGROUND: Oxidative stress and inflammation may be involved in the development and progression of mood disorders, including bipolar disorder. Currently, there is a scarcity of useful treatment options for bipolar depressive episodes, especially compared with the efficacy of treatment for acute ...

  6. Patterns of persistence with pharmacological treatment among patients with current depressive episode and their impact on long-term outcome: a naturalistic study with 5-year follow-up

    Directory of Open Access Journals (Sweden)

    Li K

    2018-05-01

    Full Text Available Kanglai Li,1,* Jiong Tao,2,* Yuemei Li,3 Minhua Chen,2 Xiuhua Wu,2 Yingtao Liao,2 Xiaolan Lin,4 Zhaoyu Gan2 1Department of Very Important Patient, the 3rd Affiliated Hospital of Sun Yat-sen University, Guangzhou, People’s Republic of China; 2Department of Psychiatry, the 3rd Affiliated Hospital of Sun Yat-sen University, Guangzhou, People’s Republic of China; 3Department of Obstetrics, Wuzhou Gongren Hospital, Wuzhou, People’s Republic of China; 4Department of Infectious Diseases, the 3rd Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People’s Republic of China *These authors contributed equally to this work Background: The aim of the study was to describe and compare the patterns of medication persistence among patients with unipolar depression (UD or bipolar depression in a 5-year follow-up, and explore their impact on long-term outcome. Patients and methods: A total of 333 eligible patients with current major depressive episode were observed and followed up from the first index prescription for 5 years. Lack of persistence or treatment interruption was defined as a gap of at least 2 consecutive months without taking any medication. Time to lack of persistence in the first (TLP1 and the second (TLP2 episode of treatment, number of visits before the first treatment interruption (NV and number of treatment interruptions (NTI were measured. Results: During the 5-year follow-up, nearly 50% of patients experienced at least two times of treatment interruption. Pattern of medication persistence did not significantly differ between UD and bipolar disorder (BD patients. TLP1 was positively associated with TLP2. Shorter TLP1 predicted a higher possibility of subsequent visits because of recurrence or relapse and more NTI meant a lower likelihood of achieving full remission in the fifth year for both UD and BD patients. For UD patients, shorter TLP1 or less NV predicted a lower chance of achieving remission, while for BD patients

  7. Prevalence and predictors of anxiety and depression after completion of chemotherapy for childhood acute lymphoblastic leukemia: A prospective longitudinal study

    Science.gov (United States)

    Kunin-Batson, Alicia S.; Lu, Xiaomin; Balsamo, Lyn; Graber, Kelsey; Devidas, Meenakshi; Hunger, Stephen P.; Carroll, William L.; Winick, Naomi J.; Mattano, Leonard A.; Maloney, Kelly W.; Kadan-Lottick, Nina S.

    2016-01-01

    Background The months immediately following completion of treatment for childhood acute lymphoblastic leukemia (ALL) are often regarded as a stressful time for children and families. In this prospective, longitudinal study, the prevalence and predictors of anxiety and depressive symptoms after completion of treatment were examined. Methods Participants included 160 children (ages 2-9 years) with standard-risk ALL enrolled on Children's Oncology Group protocol AALL0331. Parents completed standardized rating scales of children's emotional-behavioral functioning, and measures of coping and family functioning at ∼1, 6, and 12 months after diagnosis, and again 3 months following completion of chemotherapy. Results Three months off-therapy, 24% of survivors had at-risk/clinically elevated anxiety scores and 28% had elevated depression scores, significantly higher than the expected 15% in the general population (p=0.028 and 0.001, respectively). Patients with elevated anxiety one-month post-diagnosis were at greater risk for off–therapy anxiety (OR=4.1; 95% CI, 1.31-12.73, p=0.022), and those with elevated depressive symptoms 6-months post-diagnosis were at greater risk for off-therapy depression (OR=7.88, 95% CI, 2.61-23.81, p=0.0002). In adjusted longitudinal analyses, unhealthy family functioning (p=0.008), and less reliance on social support coping (p=0.009) were associated with risk for emotional distress. Children from Spanish-speaking families (p=0.05) were also at greater risk for distress. Conclusions A significant proportion of children experience emotional distress during and after therapy for ALL. These data provide a compelling rationale for targeted early screening, and psychosocial interventions to support family functioning and coping skills. PMID:27028090

  8. Acute deviations from long-term trait depressive symptoms predict systemic inflammatory activity.

    Science.gov (United States)

    Rohleder, Nicolas; Miller, Gregory E

    2008-07-01

    Depressive symptoms increase morbidity and mortality from coronary heart disease and systemic inflammation has been proposed as the underlying mechanism. While higher levels of inflammatory mediators have been found in dysphoric individuals, it is not known whether long-term or short-term mood changes are responsible for this phenomenon. A sample of 65 young women provided weekly web-based self-ratings of depressive mood over a period of 20 weeks using the CES-D, and systemic inflammation was assessed by measuring plasma interleukin-6 (IL-6) and C-reactive protein (CRP) before and after the observation period. CES-D ratings were used to develop state and trait indicators of depressed mood and evaluate their relationship with inflammatory mediators. Hierarchical linear regressions controlling for baseline inflammation, age, and BMI revealed that trait levels of depressive symptoms were not associated with IL-6 (beta=0.09; n.s.) and CRP (beta=0.01; n.s.) concentrations after the observation period. In contrast, state levels of depressive symptoms were associated with changes in IL-6, but not CRP, particularly when they were indexed as the disparity between a person's trait level of symptoms and her CES-D score just prior to IL-6 assessment (beta=0.35; p=0.03). These results lead us to conclude that in young women, state, rather than trait depressed mood stimulates peripheral inflammation as measured by IL-6. This pattern suggests that in this age group, fast-reacting inflammatory mediators such as IL-6 probably respond to short-term changes, for example, in stress hormones or stress hormone sensitivity, rather than long-term dysregulations of allostatic mechanisms.

  9. Depression as a risk factor for poor prognosis among patients with acute coronary syndrome: systematic review and recommendations: a scientific statement from the American Heart Association.

    Science.gov (United States)

    Lichtman, Judith H; Froelicher, Erika S; Blumenthal, James A; Carney, Robert M; Doering, Lynn V; Frasure-Smith, Nancy; Freedland, Kenneth E; Jaffe, Allan S; Leifheit-Limson, Erica C; Sheps, David S; Vaccarino, Viola; Wulsin, Lawson

    2014-03-25

    Although prospective studies, systematic reviews, and meta-analyses have documented an association between depression and increased morbidity and mortality in a variety of cardiac populations, depression has not yet achieved formal recognition as a risk factor for poor prognosis in patients with acute coronary syndrome by the American Heart Association and other health organizations. The purpose of this scientific statement is to review available evidence and recommend whether depression should be elevated to the status of a risk factor for patients with acute coronary syndrome. Writing group members were approved by the American Heart Association's Scientific Statement and Manuscript Oversight Committees. A systematic literature review on depression and adverse medical outcomes after acute coronary syndrome was conducted that included all-cause mortality, cardiac mortality, and composite outcomes for mortality and nonfatal events. The review assessed the strength, consistency, independence, and generalizability of the published studies. A total of 53 individual studies (32 reported on associations with all-cause mortality, 12 on cardiac mortality, and 22 on composite outcomes) and 4 meta-analyses met inclusion criteria. There was heterogeneity across studies in terms of the demographic composition of study samples, definition and measurement of depression, length of follow-up, and covariates included in the multivariable models. Despite limitations in some individual studies, our review identified generally consistent associations between depression and adverse outcomes. Despite the heterogeneity of published studies included in this review, the preponderance of evidence supports the recommendation that the American Heart Association should elevate depression to the status of a risk factor for adverse medical outcomes in patients with acute coronary syndrome.

  10. 脑梗死急性期合并抑郁障碍的康复与功能预后%Rehabilitation and functional prognosis of acute brain infarct complicated with depression

    Institute of Scientific and Technical Information of China (English)

    戴慧寒; 张纯

    2001-01-01

    Objective To observe rehabilitation and functional prognosis of patients suffered from brain infarction of acute phase complicated by depression. Method We selected 38 cases of acute brain infarct complicated with depression disorder as depression group, 40 cases of non- depression patient admitted at the same period were selected as non depression group.Antidepressants drugs administration and rehabilitation therapy were performed.We evaluated patients according to functional independence measure(FIM)of Chinese edition. HAMD grading comparison was carried out in depression group. Result Before treatment,two groups score nearly the same,compared with pretreatment. After treatment,patients in depression group and non depression group showed significant improvement esp non- depression group (P<0.01).11 cases with severe depression in the depression showed no changes in FIM score before and after treatment. Conclusion Compared with non- depression patients,functional recovery of patients with depression following brain infarction of acute stage is much slower,especially for patients with severe depression.

  11. Time to lack of persistence with pharmacological treatment among patients with current depressive episodes: a natural study with 1-year follow-up

    Directory of Open Access Journals (Sweden)

    Li K

    2016-10-01

    Full Text Available Kanglai Li,1,* Qinling Wei,2,* Guanying Li,2 Xiangjun He,2 Yingtao Liao,2 Zhaoyu Gan2 1Very Important Patient Department, 2Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Tianhe District, Guangzhou, Guangdong, People’s Republic of China *These authors contributed equally to this work Introduction: Medication nonadherence remains a big challenge for depressive patients. This study aims to assess and compare the medication persistence between unipolar depression (UD and bipolar depression (BD. Methods: A total of 146 UD and 187 BD patients were recruited at their first index prescription. Time to lack of persistence with pharmacological treatment (defined as a gap of at least 60 days without taking any medication was calculated, and clinical characteristics were collected. Final diagnosis was made at the end of 1-year follow-up. Results: A total of 101 (69.2% UD and 126 (67.4% BD patients discontinued the treatment, with a median duration of 36 days and 27 days, respectively. No significant difference was found between UD and BD in terms of time to lack of persistence with pharmacological treatment. The highest discontinuation rate (>40% occurred in the first 3 months for both groups of patients. For UD patients, those with a higher risk of suicide (odds ratio [OR] =0.696, P=0.035 or comorbidity of any anxiety disorder (OR =0.159, P<0.001 were less likely to prematurely drop out (drop out within the first 3 months, while those with onset in the summer (OR =4.702, P=0.049 or autumn (OR =7.690, P=0.012 were more likely to prematurely drop out than those with onset in the spring (OR =0.159, P<0.001. For BD patients, being female (OR =2.250, P=0.012 and having a history of spontaneous remission or switch to hypomania (OR =2.470, P=0.004 were risk factors for premature drop out, while hospitalization (OR =0.304, P=0.023 and misdiagnosis as UD (OR =0.283, P<0.001 at the first index prescription were protective

  12. ST-segment depression in aVR as a predictor of culprit artery in acute inferior wall ST-segment elevation myocardial infarction

    Directory of Open Access Journals (Sweden)

    Ahmed Hafez el-neklawy

    2014-03-01

    Conclusions: ST depression in aVR is common in patients with LCX-related acute inferior myocardial infarction. The ST changes in this lead are associated with an excellent specificity and a good sensitivity in differentiating LCX from RCA as the IRA.

  13. Prenatal Stress and Acute Stress Later in Life Impacts the Responses in Tests for Depressive-Like Behavior in a Sex-Specific Manner

    DEFF Research Database (Denmark)

    Sickmann, Helle Mark; Skoven, Christian; Arentzen, Tina S.

    in locomotor activity, depressive- and anxiety-like behavior as well as sleep architecture. Some animals were analyzed for CNS microstructural changes based on diffusion MRI. Subsets of PS and control rats were exposed to an acute stressor prior to the behavioral tests. Rearing/climbing activity in a familiar...

  14. 'Spreading depression of Leão' and its emerging relevance to acute brain injury in humans

    DEFF Research Database (Denmark)

    Lauritzen, Martin; Strong, Anthony J

    2016-01-01

    experiencing the visual (or sensorimotor) aura of migraine. In this review, we trace from their first description in rabbits through to their detection and study in migraine and the injured human brain, and from our personal perspectives, the evolution of understanding of the importance of spread of mass......A new research field in translational neuroscience has opened as a result of the recognition since 2002 that "spreading depression of Leão" can be detected in many patients with acute brain injury, whether vascular and spontaneous, or traumatic in origin, as well as in those many individuals...... depolarisations in cerebral grey matter. Detection of spontaneous depolarisations occurring and spreading in the periphery or penumbra of experimental focal cortical ischemic lesions and of their adverse effects on the cerebral cortical microcirculation and on the tissue glucose and oxygen pools has led...

  15. Relationship of depression in participants with nonspecific acute or subacute low back pain and no-pain by age distribution

    Directory of Open Access Journals (Sweden)

    Calvo-Lobo C

    2017-01-01

    Full Text Available Cesar Calvo-Lobo,1 Juan Manuel Vilar Fernández,2 Ricardo Becerro-de-Bengoa-Vallejo,3 Marta Elena Losa-Iglesias,4 David Rodríguez-Sanz,5 Patricia Palomo López,6 Daniel López López7 1Physical Therapy Department, Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid; 2Modeling, Optimization and Statistical Inference Research Group, Universidade da Coruña, A Coruña; 3School of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, Madrid; 4Faculty of Health Sciences, Universidad Rey Juan Carlos, Madrid; 5Physical Therapy & Health Sciences Research Group, Facultad de Ciencias de la Salud, el Ejercicio y el Deporte, Universidad Europea de Madrid, Madrid; 6University Center of Plasencia, Universidad de Extremadura, Badajoz; 7Research, Health and Podiatry Unit, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, A Coruña, Spain Background and purpose: Nonspecific low back pain (LBP is the most prevalent musculoskeletal condition in various age ranges and is associated with depression. The aim of this study was to determine the Beck Depression Inventory (BDI scores in participants with nonspecific LBP and no-pain by age distribution.Methods: A case–control study was carried out following the Strengthening the Reporting of Observational Studies in Epidemiology criteria. A sample of 332 participants, divided into the following age categories: 19–24 (n=11, 25–39 (n=66, 40–64 (n=90, 65–79 (n=124, and ≥80 (n=41 years was recruited from domiciliary visits and an outpatient clinic. The BDI scores were self-reported in participants with nonspecific acute or subacute (≤3 months LBP (n=166 and no-pain (n=166.Results: The BDI scores, mean ± standard deviation, showed statistically significant differences (p<0.001 between participants with nonspecific acute or

  16. Never, non-daily, and daily smoking status and progression to daily cigarette smoking as correlates of major depressive episode in a national sample of youth: Results from the National Survey of Drug Use and Health 2013 to 2015.

    Science.gov (United States)

    Cohn, Amy M

    2018-09-01

    Cigarette smoking is associated with depression, and new initiates who progress more quickly to daily smoking may be at enhanced risk. In a nationally representative sample of youth, this study examined the association between daily, non-daily, and never smoking with past-year and lifetime major depressive episode (MDE) and, among daily smokers, whether faster progression to daily smoking was associated with increased MDE risk. Data were from n = 44,921 youth aged 12-17 in the 2013-2015 National Survey on Drug Use and Health. Weighted adjusted multivariable logistic regression models were used to examine the association of smoking status (daily, non-daily, never) with lifetime and past-year MDE, and the association between progression from cigarette trial to daily smoking with MDE outcomes among daily smokers. Daily and non-daily smokers had similar rates of lifetime and past-year MDE; rates of MDE were approximately 50% lower among never smokers. Compared to never smokers, adjusted models showed that non-daily smokers had a higher risk of past-year and lifetime MDE, while daily smokers had a higher risk of past-year but not lifetime MDE. Daily smoking youth who progressed more quickly from cigarette trial to daily use had an increased risk of both lifetime and past-year MDE. Prevention programs should target factors associated with the shift from cigarette experimentation to regular use to curb deleterious consequences of use. Copyright © 2018. Published by Elsevier Ltd.

  17. Small Acute Benefits of 4 Weeks Processing Speed Training Games on Processing Speed and Inhibition Performance and Depressive Mood in the Healthy Elderly People: Evidence from a Randomized Control Trial.

    Science.gov (United States)

    Nouchi, Rui; Saito, Toshiki; Nouchi, Haruka; Kawashima, Ryuta

    2016-01-01

    Background: Processing speed training using a 1-year intervention period improves cognitive functions and emotional states of elderly people. Nevertheless, it remains unclear whether short-term processing speed training such as 4 weeks can benefit elderly people. This study was designed to investigate effects of 4 weeks of processing speed training on cognitive functions and emotional states of elderly people. Methods: We used a single-blinded randomized control trial (RCT). Seventy-two older adults were assigned randomly to two groups: a processing speed training game (PSTG) group and knowledge quiz training game (KQTG) group, an active control group. In PSTG, participants were asked to play PSTG (12 processing speed games) for 15 min, during five sessions per week, for 4 weeks. In the KQTG group, participants were asked to play KQTG (four knowledge quizzes) for 15 min, during five sessions per week, for 4 weeks. We measured several cognitive functions and emotional states before and after the 4 week intervention period. Results: Our results revealed that PSTG improved performances in processing speed and inhibition compared to KQTG, but did not improve performance in reasoning, shifting, short term/working memory, and episodic memory. Moreover, PSTG reduced the depressive mood score as measured by the Profile of Mood State compared to KQTG during the 4 week intervention period, but did not change other emotional measures. Discussion: This RCT first provided scientific evidence related to small acute benefits of 4 week PSTG on processing speed, inhibition, and depressive mood in healthy elderly people. We discuss possible mechanisms for improvements in processing speed and inhibition and reduction of the depressive mood. Trial registration: This trial was registered in The University Hospital Medical Information Network Clinical Trials Registry (UMIN000022250).

  18. In Schizophrenia, Depression, Anxiety, and Physiosomatic Symptoms Are Strongly Related to Psychotic Symptoms and Excitation, Impairments in Episodic Memory, and Increased Production of Neurotoxic Tryptophan Catabolites: a Multivariate and Machine Learning Study.

    Science.gov (United States)

    Kanchanatawan, Buranee; Thika, Supaksorn; Sirivichayakul, Sunee; Carvalho, André F; Geffard, Michel; Maes, Michael

    2018-04-01

    The depression, anxiety and physiosomatic symptoms (DAPS) of schizophrenia are associated with negative symptoms and changes in tryptophan catabolite (TRYCAT) patterning. The aim of this study is to delineate the associations between DAPS and psychosis, hostility, excitation, and mannerism (PHEM) symptoms, cognitive tests as measured using the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) and IgA/IgM responses to TRYCATs. We included 40 healthy controls and 80 participants with schizophrenia. Depression and anxiety symptoms were measured with The Hamilton Depression (HAM-D) and Anxiety (HAM-A) Rating Scales, respectively. Physiosomatic symptoms were assessed with the Fibromyalgia and Chronic Fatigue Syndrome Rating Scale (FF). Negative symptoms as well as CERAD tests, including Verbal Fluency Test (VFT), Mini-Mental State Examination (MMSE), Word List Memory (WLM), and WL Delayed Recall were measured, while ratios of IgA responses to noxious/protective TRYCATs (IgA NOX_PRO) were computed. Schizophrenia symptoms consisted of two dimensions, a first comprising PHEM and negative symptoms, and a second DAPS symptoms. A large part of the variance in DAPS was explained by psychotic symptoms and WLM. Of the variance in HAM-D, 58.9% was explained by the regression on excitement, IgA NOX_PRO ratio, WLM, and VFT; 29.9% of the variance in HAM-A by psychotic symptoms and IgA NOX/PRO; and 45.5% of the variance in FF score by psychotic symptoms, IgA NOX/PRO, and WLM. Neural network modeling shows that PHEM, IgA NOX_PRO, WLM, and MMSE are the dominant variables predicting DAPS. DAPS appear to be driven by PHEM and negative symptoms coupled with impairments in episodic memory, especially false memory creation, while all symptom dimension and cognitive impairments may be driven by an increased production of noxious TRYCATs, including picolinic, quinolinic, and xanthurenic acid.

  19. Negative symptoms, anxiety, and depression as mechanisms of change of a 12-month trial of assertive community treatment as part of integrated care in patients with first- and multi-episode schizophrenia spectrum disorders (ACCESS I trial).

    Science.gov (United States)

    Schmidt, Stefanie J; Lange, Matthias; Schöttle, Daniel; Karow, Anne; Schimmelmann, Benno G; Lambert, Martin

    2017-05-24

    Assertive community treatment (ACT) has shown to be effective in improving both functional deficits and quality of life (QoL) in patients with severe mental illness. However, the mechanisms of this beneficial effect remained unclear. We examined mechanisms of change by testing potential mediators including two subdomains of negative symptoms, i.e. social amotivation as well as expressive negative symptoms, anxiety, and depression within a therapeutic ACT model (ACCESS I trial) in a sample of 120 first- and multi-episode patients with a schizophrenia spectrum disorder (DSM-IV). Path modelling served to test the postulated relationship between the respective treatment condition, i.e. 12-month ACT as part of integrated care versus standard care, and changes in functioning and QoL. The final path model resulted in 3 differential pathways that were all significant. Treatment-induced changes in social amotivation served as a starting point for all pathways, and had a direct beneficial effect on functioning and an additional indirect effect on it through changes in anxiety. Expressive negative symptoms were not related to functioning but served as a mediator between changes in social amotivation and depressive symptoms, which subsequently resulted in improvements in QoL. Our results suggest that social amotivation, expressive negative symptoms, depression, and anxiety functioned as mechanisms of change of ACCESS. An integrated and sequential treatment focusing on these mediators may optimise the generalisation effects on functioning as well as on QoL by targeting the most powerful mechanism of change that fits best to the individual patient.

  20. Reversal alterations of amplitude of low-frequency fluctuations in early and late onset, first-episode, drug-naive depression.

    Science.gov (United States)

    Guo, Wen-bin; Liu, Feng; Xun, Guang-lei; Hu, Mao-rong; Guo, Xiao-feng; Xiao, Chang-qing; Chen, Hua-fu; Wooderson, Sarah C; Chen, Jin-dong; Zhao, Jing-ping

    2013-01-10

    It is unclear how patients with early onset depression (EOD) and late onset depression (LOD) differ at the neural level. Using amplitude of low-frequency fluctuations (ALFF) approach, we are to test the hypothesis of the different abnormal neural activities between patients with EOD and LOD. Fifteen patients with EOD, 15 patients with LOD, 15 young healthy subjects (HS) and 15 old HS were enrolled in the study. ALFF approach was employed to analyze the images. ANOVA analysis revealed widespread differences in ALFF values among the four groups throughout frontal, parietal, temporal, occipital cortex, cerebellum and limbic regions. Compared to LOD group, EOD group had higher ALFF in bilateral precuneus, superior medial frontal gyrus and superior frontal gyrus, and lower ALFF in left brainstem and left superior temporal gyrus. Compared to young HS, lower ALFF in left superior/inferior temporal gyrus, left lingual gyrus and right middle occipital gyrus and higher ALFF in left medial frontal gyrus and bilateral superior frontal gyrus were seen in the EOD group; in contrast, in the LOD group, lower ALFF in bilateral superior frontal gyrus and higher ALFF in left superior temporal gyrus were observed. Further ROC analysis suggested that the mean ALFF values in the bilateral superior frontal gyrus and left superior temporal gyrus could serve as markers to separate patients with EOD from individuals with LOD. Patients with EOD and LOD exhibit reversal pattern of abnormal ALFF in bilateral superior frontal gyrus and left superior temporal gyrus. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. A multicenter, open-label, long-term safety and tolerability study of DFN-02, an intranasal spray of sumatriptan 10 mg plus permeation enhancer DDM, for the acute treatment of episodic migraine.

    Science.gov (United States)

    Munjal, Sagar; Brand-Schieber, Elimor; Allenby, Kent; Spierings, Egilius L H; Cady, Roger K; Rapoport, Alan M

    2017-12-01

    DFN-02 is a novel intranasal spray formulation composed of sumatriptan 10 mg and a permeation-enhancing excipient comprised of 0.2% 1-O-n-Dodecyl-β-D-Maltopyranoside (DDM). This composition of DFN-02 allows sumatriptan to be rapidly absorbed into the systemic circulation and exhibit pharmacokinetics comparable to subcutaneously administered sumatriptan. Rapid rate of absorption is suggested to be important for optimal efficacy. The objective of this study was to evaluate the safety and tolerability of DFN-02 (10 mg) in the acute treatment of episodic migraine with and without aura over a 6-month period based on the incidence of treatment-emergent adverse events and the evaluation of results of clinical laboratory tests, vital signs, physical examination, and electrocardiograms. This was a multi-center, open-label, repeat-dose safety study in adults with episodic migraine with and without aura. Subjects diagnosed with migraine with or without aura according to the criteria set forth in the International Classification of Headache Disorders, 2nd edition, who experienced 2 to 6 attacks per month with fewer than 15 headache days per month and at least 48 headache-free hours between attacks, used DFN-02 to treat their migraine attacks acutely over the course of 6 months. A total of 173 subjects was enrolled, 167 (96.5%) subjects used at least 1 dose of study medication and were evaluable for safety, and 134 (77.5%) subjects completed the 6-month study. A total of 2211 migraine attacks was reported, and 3292 doses of DFN-02 were administered; mean per subject monthly use of DFN-02 was 3.6 doses. Adverse events were those expected for triptans, as well as for nasally administered compounds. No new safety signals emerged. Dysgeusia and application site pain were the most commonly reported treatment-emergent adverse events over 6 months (21% and 30.5%, respectively). Most of the treatment-emergent adverse events were mild. There were 5 serious adverse events, all

  2. An exploratory study of the association of acute posttraumatic stress, depression, and pain to cognitive functioning in mild traumatic brain injury.

    Science.gov (United States)

    Massey, Jessica S; Meares, Susanne; Batchelor, Jennifer; Bryant, Richard A

    2015-07-01

    Few studies have examined whether psychological distress and pain affect cognitive functioning in the acute to subacute phase (up to 30 days postinjury) following mild traumatic brain injury (mTBI). The current study explored whether acute posttraumatic stress, depression, and pain were associated with performance on a task of selective and sustained attention completed under conditions of increasing cognitive demands (standard, auditory distraction, and dual-task), and on tests of working memory, memory, processing speed, reaction time (RT), and verbal fluency. At a mean of 2.87 days (SD = 2.32) postinjury, 50 adult mTBI participants, consecutive admissions to a Level 1 trauma hospital, completed neuropsychological tests and self-report measures of acute posttraumatic stress, depression, and pain. A series of canonical correlation analyses was used to explore the relationships of a common set of psychological variables to various sets of neuropsychological variables. Significant results were found on the task of selective and sustained attention. Strong relationships were found between psychological variables and speed (r(c) = .56, p = .02) and psychological variables and accuracy (r(c) = .68, p = .002). Pain and acute posttraumatic stress were associated with higher speed scores (reflecting more correctly marked targets) under standard conditions. Acute posttraumatic stress was associated with lower accuracy scores across all task conditions. Moderate but nonsignificant associations were found between psychological variables and most cognitive tasks. Acute posttraumatic stress and pain show strong associations with selective and sustained attention following mTBI. (c) 2015 APA, all rights reserved).

  3. Cooccurrence of and remission from general anxiety, depression, and posttraumatic stress disorder symptoms after acute lung injury: a 2-year longitudinal study.

    Science.gov (United States)

    Bienvenu, O Joseph; Colantuoni, Elizabeth; Mendez-Tellez, Pedro A; Shanholtz, Carl; Dennison-Himmelfarb, Cheryl R; Pronovost, Peter J; Needham, Dale M

    2015-03-01

    To evaluate the cooccurrence, and predictors of remission, of general anxiety, depression, and posttraumatic stress disorder symptoms during 2-year follow-up in survivors of acute lung injury treated in an ICU. Prospective cohort study, with follow-up at 3, 6, 12, and 24 months post-acute lung injury. Thirteen medical and surgical ICUs in four hospitals. Survivors among 520 patients with acute lung injury. The outcomes of interest were measured using the Hospital Anxiety and Depression Scale anxiety and depression subscales (scores ≥ 8 indicating substantial symptoms) and the Impact of Event Scale-Revised (scores ≥ 1.6 indicating substantial posttraumatic stress disorder symptoms). Of the 520 enrolled patients, 274 died before 3-month follow-up; 186 of 196 consenting survivors (95%) completed at least one Hospital Anxiety and Depression Scale and Impact of Event Scale-Revised assessment during 2-year follow-up, and most completed multiple assessments. Across follow-up time points, the prevalence of suprathreshold general anxiety, depression, and posttraumatic stress disorder symptoms ranged from 38% to 44%, 26% to 33%, and 22% to 24%, respectively; more than half of the patients had suprathreshold symptoms in at least one domain during 2-year follow-up. The majority of survivors (59%) with any suprathreshold symptoms were above threshold for two or more types of symptoms (i.e., general anxiety, depression, and/or posttraumatic stress disorder). In fact, the most common pattern involved simultaneous general anxiety, depression, and posttraumatic stress disorder symptoms. Most patients with general anxiety, depression, or posttraumatic stress disorder symptoms during 2-year follow-up had suprathreshold symptoms at 24-month (last) follow-up. Higher Short-Form-36 physical functioning domain scores at the prior visit were associated with a greater likelihood of remission from general anxiety and posttraumatic stress disorder symptoms during follow-up. The majority

  4. Serum proBDNF/BDNF and response to fluvoxamine in drug-naïve first-episode major depressive disorder patients.

    Science.gov (United States)

    Yoshimura, Reiji; Kishi, Taro; Hori, Hikaru; Atake, Kiyokazu; Katsuki, Asuka; Nakano-Umene, Wakako; Ikenouchi-Sugita, Atsuko; Iwata, Nakao; Nakamura, Jun

    2014-01-01

    We investigated the association between serum proBDNF, a precursor of brain-derived neurotrophic factor (BDNF), and response to fluvoxamine in patients with major depressive disorder (MDD) using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR): physically healthy and free of current alcohol or drug abuse, comorbid anxiety, or personality disorders. Fifty-one patients with MDD (M/F, 19:32; age, 38 ± 19 years) and 51 healthy controls (M/F, 22:29; age, 34 ± 17 years) were studied using DSM-IV-TR: physically healthy and free of current alcohol or drug abuse, comorbid anxiety, or personality disorders. Serum levels of proBDNF and MDNF were measured by sandwich enzyme-linked immunosorbent assay (ELISA). Serum mature BDNF levels in the MDD patients were significantly lower than those in the healthy controls (t = 3.046, p = 0.0018). On the other hand, no difference was found in serum proBDNF between the MDD patients and the healthy controls (t = -0.979, p = 0.833). A trend of negative correlation was found between baseline serum BDNF and baseline scores of the 17 items of the Hamilton Rating Scale for Depression (HAMD17) (r = -0.183, p = 0.071). No correlation was however found between HAMD17 scores and proBDNF at baseline (r = 0.092, p = 0.421). Furthermore, no correlation was observed between baseline HAMD17 scores and baseline proBDNF/BDNF (r = -0.130, p = 0.190). No changes were observed in serum levels of proBDNF and BDNF during the treatment periods. These results suggest that there is no association between serum proBDNF/BDNF and fluvoxamine response in MDD patients at least within 4 weeks of the treatment.

  5. Sex hormones affect acute and chronic stress responses in sexually dimorphic patterns: Consequences for depression models.

    Science.gov (United States)

    Guo, Lei; Chen, Yi-Xi; Hu, Yu-Ting; Wu, Xue-Yan; He, Yang; Wu, Juan-Li; Huang, Man-Li; Mason, Matthew; Bao, Ai-Min

    2018-05-21

    Alterations in peripheral sex hormones may play an important role in sex differences in terms of stress responses and mood disorders. It is not yet known whether and how stress-related brain systems and brain sex steroid levels fluctuate in relation to changes in peripheral sex hormone levels, or whether the different sexes show different patterns. We aimed to investigate systematically, in male and female rats, the effect of decreased circulating sex hormone levels following gonadectomy on acute and chronic stress responses, manifested as changes in plasma and hypothalamic sex steroids and hypothalamic stress-related molecules. Experiment (Exp)-1: Rats (14 males, 14 females) were gonadectomized or sham-operated (intact); Exp-2: gonadectomized and intact rats (28 males, 28 females) were exposed to acute foot shock or no stressor; and Exp-3: gonadectomized and intact rats (32 males, 32 females) were exposed to chronic unpredictable mild stress (CUMS) or no stressor. For all rats, plasma and hypothalamic testosterone (T), estradiol (E2), and the expression of stress-related molecules were determined, including corticotropin-releasing hormone, vasopressin, oxytocin, aromatase, and the receptors for estrogens, androgens, glucocorticoids, and mineralocorticoids. Surprisingly, no significant correlation was observed in terms of plasma sex hormones, brain sex steroids, and hypothalamic stress-related molecule mRNAs (p > 0.113) in intact or gonadectomized, male or female, rats. Male and female rats, either intact or gonadectomized and exposed to acute or chronic stress, showed different patterns of stress-related molecule changes. Diminished peripheral sex hormone levels lead to different peripheral and central patterns of change in the stress response systems in male and female rats. This has implications for the choice of models for the study of the different types of mood disorders which also show sex differences. Copyright © 2018 Elsevier Ltd. All rights reserved.

  6. Atypical Antipsychotics in the Treatment of Acute Bipolar Depression with Mixed Features: A Systematic Review and Exploratory Meta-Analysis of Placebo-Controlled Clinical Trials

    Directory of Open Access Journals (Sweden)

    Michele Fornaro

    2016-02-01

    Full Text Available Evidence supporting the use of second generation antipsychotics (SGAs in the treatment of acute depression with mixed features (MFs associated with bipolar disorder (BD is scarce and equivocal. Therefore, we conducted a systematic review and preliminary meta-analysis investigating SGAs in the treatment of acute BD depression with MFs. Two authors independently searched major electronic databases from 1990 until September 2015 for randomized (placebo- controlled trials (RCTs or open-label clinical trials investigating the efficacy of SGAs in the treatment of acute bipolar depression with MFs. A random-effect meta-analysis calculating the standardized mean difference (SMD between SGA and placebo for the mean baseline to endpoint change in depression as well as manic symptoms score was computed based on 95% confidence intervals (CI. Six RCTs and one open-label placebo-controlled studies (including post-hoc reports representing 1023 patients were included. Participants received either ziprasidone, olanzapine, lurasidone, quetiapine or asenapine for an average of 6.5 weeks across the included studies. Meta-analysis with Duval and Tweedie adjustment for publication bias demonstrated that SGA resulted in significant improvements of (hypo-manic symptoms of bipolar mixed depression as assessed by the means of the total scores of the Young Mania Rating Scale (YMRS (SMD −0.74, 95% CI −1.20 to −0.28, n SGA = 907, control = 652. Meta-analysis demonstrated that participants in receipt of SGA (n = 979 experienced a large improvement in the Montgomery–Åsberg Depression Rating Scale (MADRS scores (SMD −1.08, 95% CI −1.35 to −0.81, p < 0.001 vs. placebo (n = 678. Publication and measurement biases and relative paucity of studies. Overall, SGAs appear to offer favorable improvements in MADRS and YMRS scores vs. placebo. Nevertheless, given the preliminary nature of the present report, additional original studies are required to allow more reliable

  7. Prenatal Stress Produces Sex Specific Changes in Depression-like Behavior in Rats: Implications for Increased Vulnerability in Females

    DEFF Research Database (Denmark)

    Sickmann, Helle Mark; Arentzen, Tine S; Dyrby, Tim

    2015-01-01

    Stress during rat gestation can elicit depression-like physiological and behavioral responses in the offspring. However, human clinical depression is more prevalent among females than males. Accordingly, we examined how repeated variable prenatal stress (PS) alters rat anxiety- and depression...... and measured anxiety- (elevated plus maze, EPM) and depression-like (forced swim test, FST) behaviors in the offspring at a young adult age. As a stressful event later in life (in addition to PS) may be needed to actually trigger an episode of clinical depression, half of the animals were exposed to an acute...... affected in control animals after acute stressor exposure, however, this response was blunted in PS offspring. Moreover, FST immobility, as an indicator of depressive-like behavior, was increased in female but not male PS rats. Altogether, our results identify both sex- and circadian phase-specific effects...

  8. Central estrogenic pathways protect against the depressant action of acute nicotine on reflex tachycardia in female rats

    International Nuclear Information System (INIS)

    El-Mas, Mahmoud M.; Fouda, Mohamed A.; El-gowilly, Sahar M.; Saad, Evan I.

    2012-01-01

    We have previously shown that acute exposure of male rats to nicotine preferentially attenuates baroreceptor-mediated control of reflex tachycardia in contrast to no effect on reflex bradycardia. Here, we investigated whether female rats are as sensitive as their male counterparts to the baroreflex depressant effect of nicotine and whether this interaction is modulated by estrogen. Baroreflex curves relating reflex chronotropic responses evoked by i.v. doses (1–16 μg/kg) of phenylephrine (PE) or sodium nitroprusside (SNP), were constructed in conscious freely moving proestrus, ovariectomized (OVX), and estrogen (50 μg/kg/day s.c., 5 days)-replaced OVX (OVXE 2 ) rats. Slopes of the curves were taken as a measure of baroreflex sensitivity (BRS PE and BRS SNP ). Nicotine (100 μg/kg i.v.) reduced BRS SNP in OVX rats but not in proestrus or OVXE 2 rats. The attenuation of reflex tachycardia by nicotine was also evident in diestrus rats, which exhibited plasma estrogen levels similar to those of OVX rats. BRS PE was not affected by nicotine in all rat preparations. Experiments were then extended to determine whether central estrogenic receptors modulate the nicotine–BRS SNP interaction. Intracisteral (i.c.) treatment of OVX rats with estrogen sulfate (0.2 μg/rat) abolished the BRS SNP attenuating effect of i.v. nicotine. This protective effect of estrogen disappeared when OVX rats were pretreated with i.c. ICI 182,780 (50 μg/rat, selective estrogen receptor antagonist). Together, these findings suggest that central neural pools of estrogen receptors underlie the protection offered by E 2 against nicotine-induced baroreceptor dysfunction in female rats. -- Highlights: ► Estrogen protects against the depressant effect of nicotine on reflex tachycardia. ► The baroreflex response and estrogen status affect the nicotine–BRS interaction. ► The protection offered by estrogen is mediated via central estrogen receptors.

  9. Acute agmatine administration, similar to ketamine, reverses depressive-like behavior induced by chronic unpredictable stress in mice.

    Science.gov (United States)

    Neis, Vivian B; Bettio, Luis E B; Moretti, Morgana; Rosa, Priscila B; Ribeiro, Camille M; Freitas, Andiara E; Gonçalves, Filipe M; Leal, Rodrigo B; Rodrigues, Ana Lúcia S

    Agmatine is an endogenous neuromodulator that has been shown to have antidepressant-like properties. We have previously demonstrated that it can induce a rapid increase in BDNF levels after acute administration, suggesting that agmatine may be a fast-acting antidepressant. To investigate this hypothesis, the present study evaluated the effects of a single administration of agmatine in mice subjected to chronic unpredictable stress (CUS), a model of depression responsive only to chronic treatment with conventional antidepressants. The ability of agmatine to reverse CUS-induced behavioral and biochemical alterations was evaluated and compared with those elicited by the fast-acting antidepressant (ketamine) and the conventional antidepressant (fluoxetine). After exposed to CUS for 14days, mice received a single oral dose of agmatine (0.1mg/kg), ketamine (1mg/kg) or fluoxetine (10mg/kg), and were submitted to behavioral evaluation after 24h. The exposure to CUS caused an increased immobility time in the tail suspension test (TST) but did not change anhedonic-related parameters in the splash test. Our findings provided evidence that, similarly to ketamine, agmatine is able to reverse CUS-induced depressive-like behavior in the TST. Western blot analyses of prefrontal cortex (PFC) demonstrated that mice exposed to CUS and/or treated with agmatine, fluoxetine or ketamine did not present alterations in the immunocontent of synaptic proteins [i.e. GluA1, postsynaptic density protein 95 (PSD-95) and synapsin]. Altogether, our findings indicate that a single administration of agmatine is able to reverse behavioral alterations induced by CUS in the TST, suggesting that this compound may have fast-acting antidepressant-like properties. However, there was no alteration in the levels of synaptic proteins in the PFC, a result that need to be further investigated in other time points. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. PECULIARITIES OF PARAMETERS OF ECHOCARDIOGRAPHY IN PATIENTS WITH ACUTE CORONARY SYNDROMES WITH COMORBID ANXIETY AND DEPRESSIVE DISORDERS

    Directory of Open Access Journals (Sweden)

    N. Yu. Shimohina

    2014-01-01

    Full Text Available This study has assessed the functional parameters of the cardiovascular system by echocardiography in patients with acute coronary syndrome (ACS in combination with anxiety and depressive disorders (ADD. Were examined 152 patients in the first 24 hours after the onset of ACS. All patients in the first 48 hours after hospitalization was performed transthoracic echocardiography (EchoCG on the apparatus Vivid E9 (General Electric, USA. These echocardiographic indices were analyzed: stroke volume (SV of left ventricular (LV, minute volume of heart (MVH, ejection fraction (EF, determined by the method Teicholz, end-systolic volume (ESV, end-diastolic volume (EDV, thickness of interventricular septum in diastole (TISD, thickness of posterior wall the LV in diastole (TPWLD, anteroposterior size of the left atrium (LA. Local contractility of LV assessed by the presence of hypo- or akinesia and dyskinesia zones. Diastolic function of LV was assessed by transmitral blood Dopplerograms, noted the presence of valvular cardiac pathology. In the first 72 hours after being transferred from emergency rooms all patients were tested of test of Spielberg–Hanin, Hospital Anxiety and Depression Scale, Beck questionnaire and depression scale epidemiological studies Center USA for determine the presence or not ADD.A result of study patients with ACS in conjunction with ADD have significant excess volume indices of LV in comparison with patients without ADD, in addition, this group have an increase in the size of the LA, MVH and left ventricular has hypertrophy in terms TISD comparison with the group. According to data EchoCG in patients with ACS and ADD very often visualized local contractility disturbances LV, zone of dyskinesia and defeat sclerotic of the aortic and mitral valves and diastolic dysfunction of LV in the type “slow relaxation” in comparison with patients with ACS without ADD.In patients with ACS concomitant ADD has a negative effect on the

  11. Inflammatory Mediators and Pain in the First Year After Acute Episode of Low-Back Pain in Elderly Women: Longitudinal Data from Back Complaints in the Elders-Brazil.

    Science.gov (United States)

    Queiroz, Bárbara Zille; Pereira, Daniele Sirineu; Rosa, Nayza Maciel de Britto; Lopes, Renata Antunes; Andrade, André Gustavo Pereira; Felício, Diogo Carvalho; Jardim, Renata Muniz Freire Vinhal Siqueira; Leopoldino, Amanda Aparecida Oliveira; Silva, Juscélio Pereira; Pereira, Leani Souza Máximo

    2017-08-01

    The aims of this study were to determine the course of plasma levels of inflammatory mediators (interleukin 6 [IL-6], tumor necrosis factor α [TNF-α], soluble TNF receptor 1 [sTNF-R1]) and the severity of low-back pain (LBP) over 6 to 12 months after an acute episode of LBP in elderly women and to establish an association between inflammatory mediators and LBP recovery. This was a longitudinal study of a subsample (155 elderly women with acute LBP, aged ≥65 years) of the international Back Complaints in the Elders cohort study. Plasma levels of IL-6, TNF-α, and sTNF-R1 were measured using enzyme-linked immunosorbent assays and pain severity using the numerical pain scale. There was a decrease in the severity of LBP (P = 0.033) and in the levels of IL-6 and TNF-α (P relief at the 12-month follow-up was 2.22 times higher in elderly women who had low levels of IL-6 (<1.58 pg/mL) at baseline. Our findings showed a relationship between inflammation and LBP by establishing that low IL-6 plasma levels preceded outcome (LBP recovery), supporting the concept that proinflammatory cytokines promote pain.

  12. Acute Frontal Lobe Dysfunction Following Prefrontal Low-Frequency Repetitive Transcranial Magnetic Stimulation in a Patient with Treatment-Resistant Depression

    Directory of Open Access Journals (Sweden)

    Guilhem Carle

    2017-05-01

    Full Text Available The potential of repetitive transcranial magnetic stimulation (rTMS to treat numerous neurological and psychiatric disorders has been thoroughly studied for the last two decades. Here, we report for the first time, the case of a 65-year-old woman suffering from treatment-resistant depression who developed an acute frontal lobe syndrome following eight sessions of low-frequency rTMS (LF-rTMS to the right dorsolateral prefrontal cortex while also treated with sertraline and mianserin. The pathophysiological mechanisms underlying such an unexpected acute frontal lobe dysfunction are discussed in relation to the therapeutic use of LF-rTMS in combination with pharmacotherapy in depressed patients.

  13. Faster onset of antidepressant effects of citalopram compared with sertraline in drug-naïve first-episode major depressive disorder in a Chinese population: a 6-week double-blind, randomized comparative study.

    Science.gov (United States)

    Hsu, Ju-Wei; Su, Tung-Ping; Huang, Chen-Ying; Chen, Ying-Sheue; Chou, Yuan-Hwa

    2011-10-01

    Several previous studies, including a meta-analysis, reported no significant differences between various selective serotonin reuptake inhibitors (SSRIs) in the treatment of major depressive disorder. However, because of the different chemical structure of SSRIs and the difference in the frequency of serotonin transporter polymorphisms between ethnic groups, a head-to-head comparative study between SSRIs in different populations may be enlightening. We compared the efficacy and adverse effect profiles of citalopram and sertraline in a double-blinded randomized clinical trial in a Chinese population of drug-naïve patients with first-episode major depressive disorder. Fifty-one patients were randomly assigned to citalopram or sertraline treatment. The Montgomery-Åsberg Depression Rating Scale (MADRS) was used as the primary outcome. Efficacy and adverse effects were analyzed in an intent-to-treat population. Efficacy was analyzed using a last-observation-carried-forward method for early terminators. There were no significant differences in demographic characteristics at baseline. No significant differences were found in MADRS scores between citalopram and sertraline at baseline (36.6 ± 5.5 vs 38.2 ± 4.9; P = 0.322) or at the end of treatment (week 6; 10.8 ± 10.0 vs 16.7 ± 11.3; P = 0.082). However, MADRS scores in the citalopram group were significantly lower at week 1 (25.2 ± 8.5 vs 30.4 ± 6.1; P = 0.029) and week 3 (15.9 ± 10.0 vs 22.1 ± 8.7; P = 0.037). Overall, treatment-emergent adverse effects were reported by 14.3% and 28.6% of patients in the citalopram and sertraline groups, respectively. In conclusion, citalopram and sertraline were both efficacious and well tolerated. However, citalopram exhibited a significantly faster onset than sertraline during the early weeks of treatment and tended to have a better efficacy in overall treatment, although the statistic was not significant.

  14. The role of nitrergic system in antidepressant effects of acute administration of zinc, magnesium and thiamine on progesterone induced postpartum depression in mice

    Directory of Open Access Journals (Sweden)

    Nikseresht S

    2010-08-01

    Full Text Available "nBackground: Postpartum depression is a mood disorder that has harmful effects on mothers, infants, family and relationships. Acute decrease of progesterone after delivery has been proposed as a cause for postpartum depression. This hormone can affect neurotransmitters' function. Zinc (Zn and magnesium (Mg as trace elements exert their antidepressant effects through neurotransmitter pathways. On the other hand, thiamin (Vit B1 deficiency leads to depression in animal models. The aim of this study was to evaluate effects of combination of zinc, magnesium and thiamine on postpartum depression and role of nitrergic system. "n"nMethods: One hundred ten female mice in five groups were used. Postpartum depression was conducted using progesterone injections. Combinations of Zinc chloride, magnesium chloride and thiamine HCL were administered 30 minutes before open field and forced swimming test (FST. In order to investigate role of nitrergic system, L-arginine and LNAME were administered. "n"nResults: All treatment groups spent less immobility time than the control group (p< 0.05. Combined administration of Zn+ Mg+ Vit B1 caused the most reduction in immobility time. Administration of L-NAME in Zn+ Mg+ Vit B1 group caused reduction in immobility time while administration of L-arginine caused increase in immobility time in the same group. "nConclusion: Zinc, magnesium and thiamine can improve depressive symptoms by nitrergic pathway. These elements as supplement compounds could be alternatives for antidepressants in postpartum period.

  15. Diagnosis, symptoms, frequency and mortality of 260 patients with urea cycle disorders from a 21-year, multicentre study of acute hyperammonaemic episodes.

    Science.gov (United States)

    Summar, Marshall L; Dobbelaere, Dries; Brusilow, Saul; Lee, Brendan

    2008-10-01

    A large longitudinal interventional study of patients with a urea cycle disorder (UCD) in hyperammonaemic crisis was undertaken to amass a significant body of data on their presenting symptoms and survival. Between 1982 and 2003, as part of the FDA approval process, data were collected on patients receiving an intravenous combination of nitrogen scavenging drugs (Ammonul sodium phenylacetate and sodium benzoate (10%, 10%)) for the treatment of hyperammonaemic crises caused by urea cycle disorders. A final diagnosis of a UCD was made for 260 patients, representing 975 episodes of hospitalization. Only 34% of these patients presented within the first 30 days of life and had a mortality rate of 32%. The most common presenting symptoms were neurological (80%), or gastrointestinal (33%). This cohort is the largest collection of patients reported for these diseases and the first large cohort in the United States. Surprisingly, the majority (66%) of patients with heritable causes of hyperammonaemia present beyond the neonatal period (>30 days). Patients with late-onset presenting disorders exhibited prolonged survival compared to the neonatal-presenting group.

  16. Asenapine effects on individual Young Mania Rating Scale items in bipolar disorder patients with acute manic or mixed episodes: a pooled analysis

    Directory of Open Access Journals (Sweden)

    Cazorla P

    2013-03-01

    Full Text Available Pilar Cazorla, Jun Zhao, Mary Mackle, Armin Szegedi Merck, Rahway, NJ, USA Background: An exploratory post hoc analysis was conducted to evaluate the potential differential effects over time of asenapine and olanzapine compared with placebo on the eleven individual items comprising the Young Mania Rating Scale (YMRS in patients with manic or mixed episodes in bipolar I disorder. Methods: Data were pooled from two 3-week randomized, controlled trials in which the eleven individual items comprising the YMRS were measured over 21 days. An analysis of covariance model adjusted by baseline value was used to test for differences in changes from baseline in YMRS scores between groups. Results: Each of the eleven individual YMRS item scores was significantly reduced compared with placebo at day 21. After 2 days of treatment, asenapine and olanzapine were superior to placebo for six of the YMRS items: disruptive/aggressive behavior, content, irritability, elevated mood, sleep, and speech. Conclusion: Reduction in manic symptoms over 21 days was associated with a broad-based improvement across all symptom domains with no subset of symptoms predominating. Keywords: asenapine, Young Mania Rating Scale, bipolar disorder, YMRS, antipsychotic, olanzapine

  17. Correlation between the Efficacy of Lamotrigine and the Serum Lamotrigine Level during the Remission Phase of Acute Bipolar II Depression: A Naturalistic and Unblinded Prospective Pilot Study.

    Science.gov (United States)

    Kikkawa, Akiyoshi; Kitamura, Yoshihisa; Aiba, Tetsuya; Hiraki, Koichi; Sendo, Toshiaki

    2017-01-01

    Lamotrigine has acute antidepressant effects in patients with bipolar disorder. However, there is little information regarding appropriate serum levels of lamotrigine and the time until remission after the start of lamotrigine therapy in patients with bipolar II depression. This was a naturalistic and unblinded prospective pilot study. Twelve patients' depressive symptoms were evaluated using the Montgomery-Åsberg Depression Rating Scale (MADRS) at the start of treatment and at the time of remission, and blood samples were obtained at the time of remission. Mahalanobis distance was used to analyze the relationship between the MADRS improvement rate and the serum lamotrigine level. Furthermore, we calculated the Spearman's rank correlation coefficient for the relationship between the MADRS improvement rate and the serum lamotrigine level, and produced box plots of the serum lamotrigine level at remission and the time until remission. The Mahalanobis distance for the patient that was co-administered lamotrigine and valproic acid differed significantly from those of the other patients (p<0.001). There was no linear relationship between the serum lamotrigine level and the MADRS improvement rate among the patients that did not receive valproic acid. The median time from the start of lamotrigine therapy until remission was 6 weeks. The serum lamotrigine level does not have an important impact on the acute therapeutic effects of lamotrigine on bipolar II depression. In addition, we consider that different treatment options should be considered for non-responders who do not exhibit any improvement after the administration of lamotrigine for approximately 6 weeks.

  18. A randomised, feasibility trial of a tele-health intervention for Acute Coronary Syndrome patients with depression ('MoodCare': Study protocol

    Directory of Open Access Journals (Sweden)

    Hare David L

    2011-02-01

    Full Text Available Abstract Background Coronary heart disease (CHD and depression are leading causes of disease burden globally and the two often co-exist. Depression is common after Myocardial Infarction (MI and it has been estimated that 15-35% of patients experience depressive symptoms. Co-morbid depression can impair health related quality of life (HRQOL, decrease medication adherence and appropriate utilisation of health services, lead to increased morbidity and suicide risk, and is associated with poorer CHD risk factor profiles and reduced survival. We aim to determine the feasibility of conducting a randomised, multi-centre trial designed to compare a tele-health program (MoodCare for depression and CHD secondary prevention, with Usual Care (UC. Methods Over 1600 patients admitted after index admission for Acute Coronary Syndrome (ACS are being screened for depression at six metropolitan hospitals in the Australian states of Victoria and Queensland. Consenting participants are then contacted at two weeks post-discharge for baseline assessment. One hundred eligible participants are to be randomised to an intervention or a usual medical care control group (50 per group. The intervention consists of up to 10 × 30-40 minute structured telephone sessions, delivered by registered psychologists, commencing within two weeks of baseline screening. The intervention focuses on depression management, lifestyle factors (physical activity, healthy eating, smoking cessation, alcohol intake, medication adherence and managing co-morbidities. Data collection occurs at baseline (Time 1, 6 months (post-intervention (Time 2, 12 months (Time 3 and 24 months follow-up for longer term effects (Time 4. We are comparing depression (Cardiac Depression Scale [CDS] and HRQOL (Short Form-12 [SF-12] scores between treatment and UC groups, assessing the feasibility of the program through patient acceptability and exploring long term maintenance effects. A cost-effectiveness analysis of

  19. Unipolar depression suddenly switches to hypomania in a patient who has just started taking venlafaxine. A case study [Acute stemmingsomslag naar hypomanie bij een pati�nte met een unipolaire depressie direct na starten van venlafaxine

    NARCIS (Netherlands)

    Krol, D.G.H.; Nolen, W.A.

    2006-01-01

    A woman with a recurrent episode of a depression that hitherto had been unipolar developed a hypomania the day after her treatment with paroxetine 20 mg/day was switched to venlafaxine 75 mg/day. The hypomanic symptoms subsided gradually as the dosage was reduced and the patient thereafter remained

  20. Central estrogenic pathways protect against the depressant action of acute nicotine on reflex tachycardia in female rats

    Energy Technology Data Exchange (ETDEWEB)

    El-Mas, Mahmoud M., E-mail: mahelm@hotmail.com; Fouda, Mohamed A.; El-gowilly, Sahar M.; Saad, Evan I.

    2012-02-01

    We have previously shown that acute exposure of male rats to nicotine preferentially attenuates baroreceptor-mediated control of reflex tachycardia in contrast to no effect on reflex bradycardia. Here, we investigated whether female rats are as sensitive as their male counterparts to the baroreflex depressant effect of nicotine and whether this interaction is modulated by estrogen. Baroreflex curves relating reflex chronotropic responses evoked by i.v. doses (1–16 μg/kg) of phenylephrine (PE) or sodium nitroprusside (SNP), were constructed in conscious freely moving proestrus, ovariectomized (OVX), and estrogen (50 μg/kg/day s.c., 5 days)-replaced OVX (OVXE{sub 2}) rats. Slopes of the curves were taken as a measure of baroreflex sensitivity (BRS{sub PE} and BRS{sub SNP}). Nicotine (100 μg/kg i.v.) reduced BRS{sub SNP} in OVX rats but not in proestrus or OVXE{sub 2} rats. The attenuation of reflex tachycardia by nicotine was also evident in diestrus rats, which exhibited plasma estrogen levels similar to those of OVX rats. BRS{sub PE} was not affected by nicotine in all rat preparations. Experiments were then extended to determine whether central estrogenic receptors modulate the nicotine–BRS{sub SNP} interaction. Intracisteral (i.c.) treatment of OVX rats with estrogen sulfate (0.2 μg/rat) abolished the BRS{sub SNP} attenuating effect of i.v. nicotine. This protective effect of estrogen disappeared when OVX rats were pretreated with i.c. ICI 182,780 (50 μg/rat, selective estrogen receptor antagonist). Together, these findings suggest that central neural pools of estrogen receptors underlie the protection offered by E{sub 2} against nicotine-induced baroreceptor dysfunction in female rats. -- Highlights: ► Estrogen protects against the depressant effect of nicotine on reflex tachycardia. ► The baroreflex response and estrogen status affect the nicotine–BRS interaction. ► The protection offered by estrogen is mediated via central estrogen receptors.

  1. Acute and continuation therapy in unipolar depression: observations from the run-in phase of a maintenance trial

    DEFF Research Database (Denmark)

    Rasmussen, N.A.; Andersen, P.M.; Licht, R.W.

    2008-01-01

    Objective: The aim of the study was to analyze treatments and outcome in depressed patients. Method: Patients with recurrent depressive disorder (n = 289), recruited for a prophylaxis study, were followed up in hospital settings for 6 months with diagnostic and depression ratings at baseline and ...

  2. Serial Holter ST-segment monitoring after first acute myocardial infarction. Prevalence, variability, and long-term prognostic importance of transient myocardial ischemia

    DEFF Research Database (Denmark)

    Mickley, H; Nielsen, J R; Berning, J

    1998-01-01

    Based on serial Holter monitoring performed 7 times within 3 years after a first acute myocardial infarction, we assessed the prevalence, variability and long-term clinical importance of transient myocardial ischemia (TMI) defined as episodes of ambulatory ST-segment depression. In all, 121...... consecutive male patients variability was found within and between patients...

  3. Depressive symptomatology in relation to 10-year (2004-2014) acute coronary syndrome incidence; the moderating role of diet and financial status.

    Science.gov (United States)

    Notara, Venetia; Panagiotakos, Demosthenes B; Tsompanaki, Elena; Kouvari, Matina; Kogias, Yannis; Papanagnou, George; Antonoulas, Antonis; Stravopodis, Petros; Zombolos, Spyros; Stergiouli, Ifigenia; Mantas, Yannis; Babatsikou, Fotoula; Pitsavos, Christos

    2016-05-01

    The association between depression status and 10-year cardiovascular disease (CVD) incidence among acute coronary syndrome (ACS) patients, in relation to nutritional and financial status, was evaluated. From October 2003 to September 2004, a sample of 2172 consecutive ACS patients from 6 Greek hospitals was enrolled. In 2013-14, the 10-year follow-up was performed. Depressive symptoms were evaluated using the validated CES-D score (range 0-60). Adherence to Mediterranean diet was assessed through MedDietScore (range 0-55) and financial status was determined by the annual income. Ranking from the 1st to 3rd CES-D tertile, recurrent fatal/non fatal ACS rates were 33%, 37% and 42%, respectively (p=0.006). Multiple logistic regression models revealed an adverse association of severe depression status (i.e. 3rd tertile) compared to no depression (i.e. 1st tertile) [odds ratio (OR)=1.31, 95% confidence interval (95% CI) 1.01, 1.69]. When controlling for financial status, the relationship between depression and ACS prognosis remained marginally significant; while subgroup analysis revealed that only patients with low/moderate income were negatively affected [OR=1.36, 95% CI 0.98, 1.88]. Further stratified analysis, by MedDietScore group, was applied; the above association remained significant only in patients with low compliance to this dietary pattern [OR=1.68, 95% CI 1.10, 2.18]. ACS coexisting with severe depression status seems to result in adverse disease outcomes while financial status and Mediterranean diet are proposed as potential moderators. Public health programs should focus on vulnerable groups and minimize depressive symptoms through appropriate medical treatment and lifestyle interventions, so as to ameliorate the disease prognosis in clinical and community levels. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Short-term effects of escitalopram on regional brain function in first-episode drug-naive patients with major depressive disorder assessed by resting-state functional magnetic resonance imaging.

    Science.gov (United States)

    Wang, L; Li, K; Zhang, Q; Zeng, Y; Dai, W; Su, Y; Wang, G; Tan, Y; Jin, Z; Yu, X; Si, T

    2014-05-01

    Most knowledge regarding the effects of antidepressant drugs is at the receptor level, distal from the nervous system effects that mediate their clinical efficacy. Using functional magnetic resonance imaging (fMRI), this study investigated the effects of escitalopram, a selective serotonin reuptake inhibitor (SSRI), on resting-state brain function in patients with major depressive disorder (MDD). Fourteen first-episode drug-naive MDD patients completed two fMRI scans before and after 8 weeks of escitalopram therapy. Scans were also acquired in 14 matched healthy subjects. Data were analyzed using the regional homogeneity (ReHo) approach. Compared to controls, MDD patients before treatment demonstrated decreased ReHo in the frontal (right superior frontal gyrus), temporal (left middle and right inferior temporal gyri), parietal (right precuneus) and occipital (left superior occipital gyrus and right cuneus) cortices, and increased ReHo in the left dorsal medial prefrontal gyrus and left anterior lobe of the cerebellum. Compared to the unmedicated state, ReHo in the patients after treatment was decreased in the left dorsal medial prefrontal gyrus, the right insula and the bilateral thalamus, and increased in the right superior frontal gyrus. Compared to controls, patients after treatment displayed a ReHo decrease in the right precuneus and a ReHo increase in the left anterior lobe of the cerebellum. Successful treatment with escitalopram may be associated with modulation of resting-state brain activity in regions within the fronto-limbic circuit. This study provides new insight into the effects of antidepressants on functional brain systems in MDD.

  5. Rock climbing and acute emotion regulation in patients with major depressive disorder in the context of a psychological inpatient treatment: a controlled pilot trial

    Directory of Open Access Journals (Sweden)

    Kleinstäuber M

    2017-08-01

    Full Text Available Maria Kleinstäuber,1,2 Merle Reuter,3 Norbert Doll,4 Andreas J Fallgatter4 1Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, Philipps University, Marburg, Germany; 2Department of Psychological Medicine, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; 3Department of Educational Psychology, Faculty of Psychology, Eberhard Karls University, Tübingen, Germany, 4Department of General Psychiatry and Psychotherapy, University Hospital for Psychiatry and Psychotherapy, Eberhard Karls University, Tübingen, Germany Background: Major depressive disorder is characterized by deficits in emotion regulation. This study examined associations between rock climbing and acute emotion regulating effects in patients with major depression. Patients and methods: In a nonrandomized, controlled study, 40 major depressive disorder inpatients were assigned to either a climbing session (n=20 or a relaxation session (n=20. Positive and negative affect, depressiveness, and coping emotions were assessed immediately before and after the session. Results: Mixed analyses of variance and covariance revealed significant time × group interaction effects for all assessed outcomes (p≤0.012: positive affect and coping emotions significantly increased and negative affect and depressiveness significantly decreased after the climbing session (1.04≤ Cohen’s d ≤1.30, in contrast to a relaxation session (0.16≤ Cohen’s d ≤0.36. Conclusion: The results show that rock climbing is associated with acute emotion regulatory effects. These findings have to be replicated with a randomized design, and future research should pay attention to possible mechanisms of rock climbing in regard to emotion regulation. Keywords: physical activity, controlled trial, relaxation, inpatient treatment

  6. Influences of the Big Five personality traits on the treatment response and longitudinal course of depression in patients with acute coronary syndrome: A randomised controlled trial.

    Science.gov (United States)

    Kim, Seon-Young; Stewart, Robert; Bae, Kyung-Yeol; Kim, Sung-Wan; Shin, Il-Seon; Hong, Young Joon; Ahn, Youngkeun; Jeong, Myung Ho; Yoon, Jin-Sang; Kim, Jae-Min

    2016-10-01

    Influences of the Big Five personality traits on the treatment response and longitudinal course of depression in patients with acute coronary syndrome: A randomised controlled trial. This naturalistic observational study initially recruited 1152 ACS patients; 685 patients completed personality assessments at baseline, of whom 630 were followed-up one year later. Of the 294 patients with depression, 207 participated in a 24-week double blind trial of escitalopram or placebo. The remaining 87 patients who received medical treatment only and the 391 who had not depression were also followed in a one year naturalistic observational study. The Big five personality traits were assessed using the Big Five Inventory. The influences of personality on the Hamilton Depression Rating Scale score changes were analysed using a mixed-model repeated-measures analysis of covariance. A Cluster analysis identified two personality types: resilient and vulnerable. The vulnerable personality type was characterized by lower extraversion, agreeableness, and conscientiousness - but higher neuroticism - than the resilient type. This personality type was independently associated with a poorer outcome of depression in ACS patients during the 24-week treatment period and the one year longitudinal follow-up period compared to the resilient personality type, irrespective of treatment allocation. Recruitment from a single institution may limit generalisability. Personality traits were investigated 12-weeks after ACS; thus, the responses may have been influenced by the prior receipt of escitalopram. Personality types influences the treatment outcome and longitudinal course of depression in ACS patients independent of antidepressant treatment. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. Rapid onset of treatment effects on psychosis, depression, and mania in patients with acute exacerbation of schizoaffective disorder following treatment with oral extended-release paliperidone.

    Science.gov (United States)

    Fu, Dong-Jing; Turkoz, Ibrahim; Bossie, Cynthia A; Patel, Hiren; Alphs, Larry

    2016-03-15

    Patients with schizoaffective disorder (SCA) experience complicated interplays of psychotic, depressive, and manic symptoms. Paliperidone extended-release (pali ER) tablets have been shown to be efficacious in these patients, but treatment response has not been studied relative to the onset of effects for these symptom domains. In a pooled analysis of data from two 6-week, randomized, placebo-controlled studies, the onset of treatment effects with oral pali ER was evaluated by symptom domain (psychosis, depression, mania) in patients with an acute SCA exacerbation. Subjects were categorized as having prominent psychotic (Positive and Negative Syndrome Scale score >70), depressive (Hamilton Rating Scale for Depression-21 score ≥16), or manic (Young Mania Rating Scale score ≥16) symptoms at baseline. Of the 614 patients in these analyses, 597 (97.2%), 411 (66.9%), and 488 (79.5%) had prominent psychotic, depressive, and manic symptoms at baseline, respectively. Pali ER treatment was associated with rapid and significant improvement of all three symptom domains versus placebo within 1 week of initiation, regardless of whether treatment was given as monotherapy or in combination with mood stabilizers and/or antidepressants. Adverse events were similar to those reported in the original published studies. This post hoc analysis of two phase 3 trials requires confirmation in prospective studies. This pooled analysis suggests that treatment with pali ER is associated with rapid control of psychotic, depressive, and manic symptoms in patients with SCA. Its findings support the benefit of pali ER as a primary treatment for the management of SCA. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

  8. The Impact of Comorbid Depression on Educational Inequality in Survival after Acute Coronary Syndrome in a Cohort of 83 062 Patients and a Matched Reference Population

    DEFF Research Database (Denmark)

    Osler, Merete; Prescott, Eva; Wium-Andersen, Ida Kim

    2015-01-01

    BACKGROUND: Patients with low socioeconomic position have higher rates of mortality after diagnosis of acute coronary syndrome (ACS), but little is known about the mechanisms behind this social inequality. The aim of the present study was to examine whether any educational inequality in survival...... until December 2012 by linkage to person, patients and prescription registries. Educational status was defined at study entry and the impact of potential confounders and mediators (age, gender, cohabitation status, somatic comorbidity and depression) on the relation between education and mortality were...... the relative excess mortality rate in lower educated ACS patients was comparable with the excess risk associated with low education in the background population. This educational inequality in survival remained after adjustment for somatic comorbidity and depression....

  9. Depression and marital status determine the 10-year (2004-2014) prognosis in patients with acute coronary syndrome: the GREECS study.

    Science.gov (United States)

    Notara, Venetia; Panagiotakos, Demosthenes B; Papataxiarchis, Evagellos; Verdi, Margarita; Michalopoulou, Moscho; Tsompanaki, Elena; Kogias, Yannis; Stravopodis, Petros; Papanagnou, George; Zombolos, Spyros; Stergiouli, Ifigenia; Mantas, Yannis; Pitsavos, Christos

    2015-01-01

    The aim of the present work was to examine the association of depression and marital status, with the long-term prognosis of acute coronary syndrome (ACS), among a Greek sample of cardiac patients. From October 2003 to September 2004, a sample of 2172 consecutive ACS patients from 6 hospitals was enrolled. In 2013-2014, the 10-year follow-up was performed in 1918 participants. Depressive symptoms were evaluated using the validated CES-D score (range 0-60), while marital status was classified as: single, married/cohabitants, divorced and widowed at the time of entry to the study. Patients in the upper tertile of CES-D (>20 score) had 41% (95%CI 14%, 75%) higher risk of ACS incidence as compared with those in the lowest (marital relationships among ACS patients. Secondary public health care intervention programmes are needed to improve patient outcomes and minimise disease burden in clinical and community setting.

  10. The role of religious faith, spirituality and existential considerations among heart patients in a secular society: relation to depressive symptoms 6 months post acute coronary syndrome.

    Science.gov (United States)

    Bekke-Hansen, Sidsel; Pedersen, Christina G; Thygesen, Kristian; Christensen, Søren; Waelde, Lynn C; Zachariae, Robert

    2014-06-01

    We explored the significance of religious faith/coping and spirituality and existential considerations reported during hospitalisation on depressive symptoms at 6-month follow-up and addressed patients' perceived influence of their faith among 97 consecutive acute coronary syndrome patients (72.2% male patients; mean age, 60.6 years) in a secular society. All faith variables were found unrelated to depressive symptoms. Having unambiguous religious or spiritual faith at follow-up was associated with a perceived positive influence of this faith on quality of life and the disease itself compared to patients with ambiguous faith. These findings underscore the importance of examining degrees of faith in secular settings. © The Author(s) 2013.

  11. Clinical efficacy, onset time and safety of bright light therapy in acute bipolar depression as an adjunctive therapy: A randomized controlled trial.

    Science.gov (United States)

    Zhou, Tian-Hang; Dang, Wei-Min; Ma, Yan-Tao; Hu, Chang-Qing; Wang, Ning; Zhang, Guo-Yi; Wang, Gang; Shi, Chuan; Zhang, Hua; Guo, Bin; Zhou, Shu-Zhe; Feng, Lei; Geng, Shu-Xia; Tong, Yu-Zhen; Tang, Guan-Wen; He, Zhong-Kai; Zhen, Long; Yu, Xin

    2018-02-01

    Bright light therapy (BLT) is an effective treatment for seasonal affective disorder and non- seasonal depression. The efficacy of BLT in treating patients with bipolar disorder is still unknown. The aim of this study is to examine the efficacy, onset time and clinical safety of BLT in treating patients with acute bipolar depression as an adjunctive therapy (trial registration at ClinicalTrials.gov: NCT02009371). This was a multi-center, single blind, randomized clinical trial. Seventy-four participants were randomized in one of two treatment conditions: BLT and control (dim red light therapy, dRLT). Sixty-three participants completed the study (33 BLT, 30 dRLT). Light therapy lasted for two weeks, one hour every morning. All participants were required to complete several scales assessments at baseline, and at the end of weeks 1 and 2. The primary outcome measures were the clinical efficacy of BLT which was assessed by the reduction rate of HAMD-17 scores, and the onset time of BLT which was assessed by the reduction rate of QIDS-SR16 scores. The secondary outcome measures were rates of switch into hypomania or mania and adverse events. 1) Clinical efficacy: BLT showed a greater ameliorative effect on bipolar depression than the control, with response rates of 78.19% vs. 43.33% respectively (p < 0.01). 2) Onset day: Median onset day was 4.33 days in BLT group. 3) BLT-emergent hypomania: No participants experienced symptoms of hypomania. 4) Side effects: No serious adverse events were reported. BLT can be considered as an effective and safe adjunctive treatment for patients with acute bipolar depression. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Fractal analysis of heart rate dynamics as a predictor of mortality in patients with depressed left ventricular function after acute myocardial infarction. TRACE Investigators. TRAndolapril Cardiac Evaluation

    DEFF Research Database (Denmark)

    Mäkikallio, T H; Høiber, S; Køber, L

    1999-01-01

    A number of new methods have been recently developed to quantify complex heart rate (HR) dynamics based on nonlinear and fractal analysis, but their value in risk stratification has not been evaluated. This study was designed to determine whether selected new dynamic analysis methods of HR...... variability predict mortality in patients with depressed left ventricular (LV) function after acute myocardial infarction (AMI). Traditional time- and frequency-domain HR variability indexes along with short-term fractal-like correlation properties of RR intervals (exponent alpha) and power-law scaling...

  13. The day-to-day acute effect of wake therapy in patients with major depression using the HAM-D6 as primary outcome measure

    DEFF Research Database (Denmark)

    Martiny, Klaus; Refsgaard, Else; Lund, Vibeke

    2013-01-01

    This paper reports day-to-day data for from a one-week intervention phase, part of a 9-weeks randomised parallel study with patient having major depression (data from weekly visits have been reported). Wake therapy (sleep deprivation) has an established antidepressant effect with onset of action...... within hours. Deterioration on the following night's sleep is, however, common, and we used daily light therapy and sleep time stabilisation as a preventive measure. In particular, we evaluated the day-to-day acute effect of and tolerance to sleep deprivation and examined predictors of response....

  14. Remission and Recovery in the Treatment for Adolescents with Depression Study (TADS): Acute and Long-Term Outcomes

    Science.gov (United States)

    Kennard, Betsy D.; Silva, Susan G.; Tonev, Simon; Rohde, Paul; Hughes, Jennifer L.; Vitiello, Benedetto; Kratochvil, Christopher J.; Curry, John F.; Emslie, Graham J.; Reinecke, Mark; March, John

    2009-01-01

    The remission and recovery rates of adolescent patients with depression who were treated with fluoxetine, cognitive-behavioral therapy, their combination, and placebos were examined through a multisite clinical trial. It is concluded that most depressed adolescents who received such therapies achieved remission at the end of nine months.

  15. Depressão e síndromes isquêmicas miocárdicas instáveis: diferenças entre homens e mulheres Depression and acute coronary syndromes: gender-related differences

    Directory of Open Access Journals (Sweden)

    Glória Heloise Perez

    2005-11-01

    Full Text Available OBJETIVO: Investigar, em portadores de Síndromes Isquêmicas Miocárdicas Instáveis (SIMI estratificados por sexo, se características sociodemográficas, diagnóstico clínico, tabagismo, consumo de álcool e ansiedade estão associados com depressão. MÉTODOS: Foram entrevistados 345 pacientes consecutivos com SIMI (206 com infarto agudo do miocárdio e 139 com angina instável. As entrevistas incluíram questões sobre características sociodemográficas, tabagismo, avaliação de depressão (Prime MD e BDI, de ansiedade traço e ansiedade estado (IDATE, e de consumo de álcool (AUDIT. RESULTADOS: O diagnóstico de depressão se correlacionou, significativamente, com sexo feminino, idade inferior a 50 anos e escores médios mais elevados de ansiedade traço e ansiedade estado. Os homens (245 com depressão eram freqüentemente mais jovens que 50 anos, fumantes, e apresentavam escore médio de ansiedade traço e ansiedade estado mais elevado que os não deprimidos. A análise multivariada aponta que, no sexo masculino, idade está negativamente associada (OR 0,9519, 95% IC 0,9261 - 0,9784 e escores mais altos de ansiedade traço estão positivamente associados (OR 1,0691 95% IC 1,0375 - 1,1017 com depressão. Na amostra feminina (100, mulheres com depressão diferenciam-se das sem depressão por apresentarem escore médio mais alto de ansiedade traço e de ansiedade estado. Na análise multivariada da amostra feminina, escore mais alto de ansiedade traço associou-se de forma independente à depressão (OR 1,1267 95% IC 1,0632-1,1940. CONCLUSÃO: Conclui-se que, em pacientes hospitalizados com SIMI, as mulheres, os homens com menos de 50 anos e os ansiosos têm mais chance de apresentarem depressão.OBJECTIVE: Investigate whether social and demographic characteristics, clinical diagnosis, smoking status, alcohol consumption, and anxiety are associated with depression in patients with Acute Coronary Syndromes (ACS stratified by gender

  16. Co-occurrence of and remission from general anxiety, depression, and posttraumatic stress disorder symptoms after acute lung injury: a 2-year longitudinal study

    Science.gov (United States)

    Bienvenu, O. Joseph; Colantuoni, Elizabeth; Mendez-Tellez, Pedro A.; Shanholtz, Carl; Dennison-Himmelfarb, Cheryl R.; Pronovost, Peter J.; Needham, Dale M.

    2014-01-01

    Objective To evaluate the co-occurrence, and predictors of remission, of general anxiety, depression, and posttraumatic stress disorder (PTSD) symptoms during 2-year follow-up in survivors of acute lung injury (ALI) treated in an intensive care unit (ICU). Design, Setting, and Patients This prospective cohort study enrolled 520 patients from 13 medical and surgical ICUs in 4 hospitals, with follow-up at 3, 6, 12, and 24 months post-ALI. Measurements and Main Results The outcomes of interest were measured using the Hospital Anxiety and Depression Scale (HADS) anxiety and depression subscales (scores ≥8 indicating substantial symptoms) and the Impact of Event Scale-Revised (IESR, scores ≥1.6 indicating substantial PTSD symptoms). Of the 520 enrolled patients, 274 died before 3-month follow-up; 186/196 consenting survivors (95%) completed at least one HADS and IESR assessment during 2-year follow-up, and most completed multiple assessments. Across follow-up time points, the prevalence of supra-threshold general anxiety, depression, and PTSD symptoms ranged from 38–44%, 26–33%, and 22–24%, respectively; more than half of the patients had supra-threshold symptoms in at least one domain during 2-year follow-up. The majority (59%) of survivors with any supra-threshold symptoms were above threshold for 2 or more types of symptoms (i.e., of general anxiety, depression, and/or PTSD). In fact, the most common pattern involved simultaneous general anxiety, depression, and PTSD symptoms. Most patients with general anxiety, depression, or PTSD symptoms during 2-year follow-up had supra-threshold symptoms at 24-month (last) follow-up. Higher SF-36 physical functioning domain scores at the prior visit were associated with a greater likelihood of remission from general anxiety and PTSD symptoms during follow-up. Conclusions The majority of ALI survivors had clinically significant general anxiety, depressive, or PTSD symptoms, and these symptoms tended to co-occur across

  17. Effects of Short-Term Inpatient Treatment on Sensitivity to a Size Contrast Illusion in First-Episode Psychosis and Multiple-Episode Schizophrenia

    Directory of Open Access Journals (Sweden)

    Steven M Silverstein

    2013-07-01

    Full Text Available Introduction: In the Ebbinghaus illusion, a shape appears larger than its actual size when surrounded by small shapes and smaller than its actual size when surrounded by large shapes. Resistance to this illusion has been previously reported in schizophrenia, and linked to disorganized symptoms and poorer prognosis in cross-sectional studies. It is unclear, however, when in the course of illness this resistance first emerges or how it varies longitudinally with illness phase. Method: First-episode psychosis patients, multiple-episode schizophrenia patients and healthy controls completed a psychophysical task at two different time points, corresponding to hospital admission and discharge for patients. The task required judging the relative size of two circles centered on either side of the screen. Targets were presented without context (baseline, or were surrounded by shapes that made the size judgment harder or easier (misleading and helpful contexts, respectively. Context sensitivity was operationalized as improvement relative to baseline in the helpful condition minus the amount of decrement (relative to baseline in the misleading condition. Results: At admission, context sensitivity was lower in the multiple-episode group than in the other groups, and was marginally less in the first episode than in the control group. In addition, schizophrenia patients were significantly more and less accurate than the other groups in the misleading and helpful conditions, respectively. At discharge, all groups exhibited similar context sensitivity. Poorer context sensitivity was related to higher levels of disorganized symptoms, and lower level of depression, excitement, and positive symptoms. Discussion: Resistance to the Ebbinghaus illusion, as a characteristic of the acute phase of schizophrenia, emerges after the first episode of psychosis. This suggests that visual context processing is a state-marker in schizophrenia and a biomarker of relapse and

  18. Effects of short-term inpatient treatment on sensitivity to a size contrast illusion in first-episode psychosis and multiple-episode schizophrenia.

    Science.gov (United States)

    Silverstein, Steven M; Keane, Brian P; Wang, Yushi; Mikkilineni, Deepthi; Paterno, Danielle; Papathomas, Thomas V; Feigenson, Keith

    2013-01-01

    In the Ebbinghaus illusion, a shape appears larger than its actual size when surrounded by small shapes and smaller than its actual size when surrounded by large shapes. Resistance to this visual illusion has been previously reported in schizophrenia, and linked to disorganized symptoms and poorer prognosis in cross-sectional studies. It is unclear, however, when in the course of illness this resistance first emerges or how it varies longitudinally with illness phase. We addressed these issues by having first-episode psychosis patients, multiple-episode schizophrenia patients and healthy controls complete a psychophysical task at two different time points, corresponding to hospital admission and discharge for patients. The task required judging the relative size of two circular targets centered on either side of the screen. Targets were presented without context (baseline), or were surrounded by shapes that made the size judgment harder or easier (misleading and helpful contexts, respectively). Context sensitivity was operationalized as the amount of improvement relative to baseline in the helpful condition minus the amount of decrement relative to baseline in the misleading condition. At hospital admission, context sensitivity was lower in the multiple-episode group than in the other groups, and was marginally less in the first episode than in the control group. In addition, schizophrenia patients were significantly more and less accurate than the other groups in the misleading and helpful conditions, respectively. At discharge, all groups exhibited similar context sensitivity. In general, poorer context sensitivity was related to higher levels of disorganized symptoms, and lower level of depression, excitement, and positive symptoms. Resistance to the Ebbinghaus illusion, as a characteristic of the acute phase of illness in schizophrenia, increases in magnitude after the first episode of psychosis. This suggests that visual context processing is a state-marker in

  19. The temperament and character traits in patients with major depressive disorder and bipolar affective disorder with and without suicide attempt.

    Science.gov (United States)

    Erić, Anamarija Petek; Erić, Ivan; Ćurković, Mario; Dodig-Ćurković, Katarina; Kralik, Kristina; Kovač, Vlatka; Filaković, Pavo

    2017-06-01

    Suicide and mood disorders (especially major depressive disorder (MDD) and bipolar affective disorder (BD)) represent a significant global health burden. Major depressive disorder and bipolar affective disorder have been associated with increased risk for suicide. Some specific suicide risk factors might be found in underlying individual personality traits. Specific personality features may predispose an individual to mood disorders (MDD or BD) hence increased suicide risk. The specificity of this research is in the assessment of personality features during the acute phase of illness immediately after suicide attempt which resulted in psychiatric inpatient treatment. The study included 119 unrelated Caucasian participants with MDD-severe depressive episode without psychotic symptoms (MDD) and BD-severe depressive episode without psychotic symptoms (BD-sDE). Both groups of patients with MDD and BD-sDE were divided into the suicide attempters and non-suicidal group. The diagnoses of the severe depressive episode without psychotic symptoms in major depressive disorder (MDD; F32.2) and bipolar disorder (BD-sDE; F31.4) were made according to ICD-10 (WHO 1992) diagnostic criteria. Methods of suicide attempts were also assessed according to ICD-10 and a self-report questionnaire, the Temperament and Character Inventory (TCI) was applied. The participants who exhibited suicide attempt had significantly higher scores on harm-avoidance (HA) (psuicidal attempt had significantly lower scores on self-directedness (SD) (psuicide attempt may have some significantly different personality traits than non-suicidal patients with mood disorders. The combination of high harm-avoidance (HA) and low self-directedness (SD) may be specific for depressive episode while the combination of high HA, novelty-seeking (NS), and self-transcendence (ST) with low SD may be related to suicide attempts during the depressive episode in bipolar disorder. The novelty-seeking (NS), self-transcendence (ST

  20. Unipolar Depression in Paroxysmal Schizophrenia

    Directory of Open Access Journals (Sweden)

    Alexander S. Bobrov

    2013-12-01

    Full Text Available Based on the current study, the clinical characteristics of unipolar depression in the clinical picture of schizophrenia with the paroxysmal type of disease course are presented. Given the concomitant