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Sample records for acute depressive episode

  1. Increased activities of both superoxide dismutase and catalase were indicators of acute depressive episodes in patients with major depressive disorder.

    Science.gov (United States)

    Tsai, Meng-Chang; Huang, Tiao-Lai

    2016-01-30

    Oxidative stress may play an important role in the pathophysiology of major depressive disorder (MDD). The aim of this study was to investigate the serum levels of oxidative stress biomarkers and S100B in patients with MDD in an acute phase, and evaluate the changes in superoxide dismutase (SOD), protein carbonyl content (PCC), glutathione peroxidase (GPX), 8-hydroxy 2'-deoxyguanosine after treatment (8-OHdG), catalase (CAT), thiobarbituric acid reactive substances (TBARS) and S100B. We consecutively enrolled 21 MDD inpatients in an acute phase and 40 healthy subjects. Serum oxidative stress markers were measured with assay kits. Serum SOD and CAT activities in MDD patients in an acute phase were significantly higher than those of healthy subjects, and serum PCC levels were significantly lower. The HAM-D scores had a significantly positive association with S100B levels. Eighteen depressed patients were followed up, and there was no significant difference among all of the markers after treatment. In conclusion, our results suggest that increased activities of both SOD and CAT might be indicators of acute depressive episodes in MDD patients.

  2. Treatment response for acute depression is not associated with number of previous episodes: lack of evidence for a clinical staging model for major depressive disorder.

    Science.gov (United States)

    Dodd, Seetal; Berk, Michael; Kelin, Katarina; Mancini, Michele; Schacht, Alexander

    2013-09-05

    Mental illness has been observed to follow a neuroprogressive course, commencing with prodrome, then onset, recurrence and finally chronic illness. In bipolar disorder and schizophrenia responsiveness to treatment mirrors these stages of illness progression, with greater response to treatment in the earlier stages of illness and greater treatment resistance in chronic late stage illness. Using data from 5627 participants in 15 controlled trials of duloxetine, comparator arm (paroxetine, venlafaxine, escitalopram) or placebo for the treatment of an acute depressive episode, the relationship between treatment response and number of previous depressive episodes was determined. Data was dichotomised for comparisons between participants who had >3 previous episodes (n=1697) or ≤3 previous episodes (n=3930), and additionally for no previous episodes (n=1381) or at least one previous episode (n=4246). Analyses were conducted by study arm for each clinical trial, and results were then pooled. There was no significant difference between treatment response and number of previous depressive episodes. This unexpected finding suggests that treatments to reduce symptoms of depression during acute illness do not lose efficacy for patients with a longer history of illness.

  3. Depressive Symptoms during an Acute Schizophrenic Episode: Frequency and Clinical Correlates.

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    Rajkumar, Ravi Philip

    2015-01-01

    Introduction. Depressive symptoms are common in schizophrenia and are associated with poorer functioning, lower quality of life, and an elevated risk of suicidal behaviour. There are few studies on the occurrence and correlates of these symptoms in acutely ill patients with schizophrenia. Method. 72 acutely ill patients with schizophrenia were assessed for depression using the Calgary Depression Scale for Schizophrenia (CDSS). A cut-off score of ≥6 on the CDSS was used to identify clinically significant depressive symptoms. The relationship between depression and illness variables, including psychotic symptom dimensions as measured by the Positive and Negative Syndrome Scale for Schizophrenia (PANSS), was examined. Results. Eleven (15.3%) patients had clinically significant depressive symptoms. These patients scored higher on the positive and general psychopathology scales of the PANSS and had higher rates of suicidal behavior and poorer functioning. The severity of depressive symptoms was positively correlated with the PANSS positive subscale and negatively correlated with the PANSS negative subscale. Discussion. These findings confirm previous reports that depressive symptoms in active schizophrenia is related to the severity of positive psychotic symptoms and is a risk factor for suicidal behaviour in these patients.

  4. Decreased neuroautonomic complexity in men during an acute major depressive episode: analysis of heart rate dynamics

    OpenAIRE

    Leistedt, S J-J; Linkowski, P.; Lanquart, J-P; Mietus, J E; Davis, Roger B.; Goldberger, Ary Louis; Costa, Madalena Damasio

    2011-01-01

    Major depression affects multiple physiologic systems. Therefore, analysis of signals that reflect integrated function may be useful in probing dynamical changes in this syndrome. Increasing evidence supports the conceptual framework that complex variability is a marker of healthy, adaptive control mechanisms and that dynamical complexity decreases with aging and disease. We tested the hypothesis that heart rate (HR) dynamics in non-medicated, young to middle-aged males during an acute major ...

  5. Acute renal failure induced by markedly decreased appetite secondary to a depressive episode after discontinuation of long-term lithium therapy in an elderly patient with bipolar disorder.

    Science.gov (United States)

    Okada, Akira

    2014-05-16

    Some elderly patients on chronic lithium therapy for bipolar disorder and their doctors may be faced with a therapeutic dilemma over whether or not to continue prescribing/taking lithium given their increased risk of reduced renal function. We present the case of a 78-year-old woman with bipolar disorder who discontinued lithium therapy due to increased risk factors for renal injury. After discontinuation, she experienced markedly decreased appetite secondary to a depressive episode, and developed acute renal failure, which subsequently progressed to a more advanced stage of chronic kidney disease. This case suggests that extreme care must be taken to prevent the recurrence of depression in elderly patients with bipolar disorder who discontinue lithium therapy, even when they had been emotionally stable for a long time while receiving lithium. Medications other than lithium for bipolar disorder may be needed at the time lithium therapy is discontinued.

  6. 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...

  7. 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.

  8. Differences between Depression Episodes of Bipolar Disorder I and II

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    Leman Inanc

    2013-09-01

    Full Text Available In 1975 Fieve and Dunner made the distinction between hypomania and mania as hypomania does not usually cause social and occupational impair-ment and hospitalization is not needed, moreover patients do not experience psychosis. Bipolar disorder type I is defined by the presence of manic and depressive episodes and differs from Bipolar disorder type II characterized with hipomanic and depressive episodes. Bipolar disorder type I and II do not differ in their depressive episodes. It is still point of contention whether bipolar type II is a variant of bipolar disorder type I or is positioned on the spectrum between bipolar type I and unipolar disorder. Even there are some similarities in characteristics of depressive episodes and outcome features of different bipolar disorder subtypes, there are differences that can be useful in differential diagnosis and treatment. This paper aims to focus on those differences between bipolar disorder type I and II.

  9. 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.......8 % developed a recurrent depression. Most patient characteristics (demographic factors, socioeconomic status, psychosocial factors, health-related behavioural factors, somatic comorbidities, and severity of acute coronary syndrome) were significantly associated with increased HRs for both early and later...

  10. Acute rejection episodes after kidney transplantation

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    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.

  11. History of Depression and Survival After Acute Myocardial Infarction

    NARCIS (Netherlands)

    Carney, Robert M.; Freedland, Kenneth E.; Steinmeyer, Brian; Blumenthal, James A.; de Jonge, Peter; Davidson, Karina W.; Czajkowski, Susan M.; Jaffe, Allan S.

    2009-01-01

    Objective: To compare survival in post-myocardial (MI) participants from the Enhancing Recovery In Coronary Heart Disease (ENRICHD) clinical trial with a first episode of major depression (MD) and those with recurrent MID, which is a risk factor for mortality after acute MI. Recent reports suggest t

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

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    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.

  13. 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....... Patients who had experienced bereavement did not differ from patients with other stressful life events or from patients without stressful life events in socio-demographic variables or in the phenomenology of the depression, psychiatric comorbidity, family history or response to antidepressant treatment....... CONCLUSION: Bereavement-related first episode depression does not differ from other kinds of first depression....

  14. 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....

  15. 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...... 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....

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

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    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.

  17. Pycnogenol treatment of acute hemorrhoidal episodes.

    Science.gov (United States)

    Belcaro, Gianni; Cesarone, Maria Rosaria; Errichi, Bruno; Di Renzo, Andrea; Grossi, Maria Giovanna; Ricci, Andrea; Dugall, Mark; Cornelli, Umberto; Cacchio, Marisa; Rohdewald, Peter

    2010-03-01

    We investigated the efficacy of orally and topically applied Pycnogenol for the management of acute hemorrhoidal attacks in a controlled, randomized study with 84 subjects. Within less than 48 h of onset of an acute attack, patients were enrolled and signs and symptoms were scored. This evaluation was repeated after seven days' treatment and again seven days following treatment cessation. The decrease in scores was significantly more pronounced in the Pycnogenol-treated groups than in the control group given placebo (p Pycnogenol for relieving signs and symptoms of acute external hemorrhoids. In a group of patients given topical (0.5%) Pycnogenol in addition to oral Pycnogenol the improvement in symptoms set in significantly faster and was more pronounced. The most prominent symptom, hemorrhoidal bleeding, was completely absent in all patients treated with Pycnogenol for seven days and also at the 14 days follow-up. In contrast, bleedings were still observed in the control group during the two weeks follow-up. This study indicates that Pycnogenol, both in oral and in topical form, is effective for controlling this common, disabling health problem. The application of Pycnogenol eases the management of acute hemorrhoidal attacks and help avoid bleedings.

  18. Cognitive reactivity to sad mood: The importance of the first depressive episode

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    Marić Zorica

    2010-01-01

    Full Text Available Cognitive reactivity to sad mood refers to the degree to which a mild dysphoric state reactivates negative thinking patterns. In this research, the contribution of the history of depression, the length of the current depressive episode and the intensity of the depressive symptoms were assessed in explaining the cognitive reactivity to sad mood measured with the Leiden Index of Depression Sensitivity (LEIDS. The sample consisted of 123 depressed outpatients. The results of principal components analysis suggested a three-factor solution of the LEIDS. The intensity of depressive symptoms, the history of depression and the length of the current depressive episode were all significant in explaining cognitive reactivity to sad mood. We have also found out a significant effect of interaction of the history of depression and the length of the current depressive episode, which demonstrated that a prolonged depression does not induce a stronger cognitive reactivity to sad mood during the relapse of a depressive episode, while during the first depressive episode a longer duration of depression does induce a stronger cognitive reactivity. Such a result demonstrates that the length of the first depressive episode, regardless of its intensity, is crucially important for the formation of cognitive reactivity.

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

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    Gether Ulrik

    2009-02-01

    Full Text Available Abstract Objective To validate the ICD-10 diagnosis of a single depressive episode as used in daily clinical psychiatric practice and as recorded in the Danish Psychiatric Central Research Register. Methods Patients discharged with a diagnosis of a single depressive episode were consecutively sampled from the register and diagnosed according to an interview using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN. Results A total of 75.4% of 399 patients with a register diagnosis of a single depressive episode also got this diagnosis according to the SCAN interview (82.8% 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.

  20. A Conceptual Model for Episodes of Acute, Unscheduled Care.

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    Pines, Jesse M; Lotrecchiano, Gaetano R; Zocchi, Mark S; Lazar, Danielle; Leedekerken, Jacob B; Margolis, Gregg S; Carr, Brendan G

    2016-10-01

    We engaged in a 1-year process to develop a conceptual model representing an episode of acute, unscheduled care. Acute, unscheduled care includes acute illnesses (eg, nausea and vomiting), injuries, or exacerbations of chronic conditions (eg, worsening dyspnea in congestive heart failure) and is delivered in emergency departments, urgent care centers, and physicians' offices, as well as through telemedicine. We began with a literature search to define an acute episode of care and to identify existing conceptual models used in health care. In accordance with this information, we then drafted a preliminary conceptual model and collected stakeholder feedback, using online focus groups and concept mapping. Two technical expert panels reviewed the draft model, examined the stakeholder feedback, and discussed ways the model could be improved. After integrating the experts' comments, we solicited public comment on the model and made final revisions. The final conceptual model includes social and individual determinants of health that influence the incidence of acute illness and injury, factors that affect care-seeking decisions, specific delivery settings where acute care is provided, and outcomes and costs associated with the acute care system. We end with recommendations for how researchers, policymakers, payers, patients, and providers can use the model to identify and prioritize ways to improve acute care delivery.

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

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    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.

  2. Abnormal cerebellar volume in acute and remitted major depression.

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    Depping, Malte S; Wolf, Nadine D; Vasic, Nenad; Sambataro, Fabio; Hirjak, Dusan; Thomann, Philipp A; Wolf, Robert C

    2016-11-01

    Abnormal cortical volume is well-documented in patients with major depressive disorder (MDD), but cerebellar findings have been heterogeneous. It is unclear whether abnormal cerebellar structure relates to disease state or medication. In this study, using structural MRI, we investigated cerebellar volume in clinically acute (with and without psychotropic treatment) and remitted MDD patients. High-resolution structural MRI data at 3T were obtained from acute medicated (n=29), acute unmedicated (n=14) and remitted patients (n=16). Data from 29 healthy controls were used for comparison purposes. Cerebellar volume was investigated using cerebellum-optimized voxel-based analysis methods. Patients with an acute MDD episode showed increased volume of left cerebellar area IX, and this was true for both medicated and unmedicated individuals (pvolume. In remitted, but not in acutely ill patients, area IX volume was significantly associated with measures of depression severity, as assessed by the Hamilton Depression Rating Scale (HAMD). In addition, area IX volume in remitted patients was significantly related to the duration of antidepressant treatment. In acutely ill patients, no significant relationships were established using clinical variables, such as HAMD, illness or treatment duration and number of depressive episodes. The data suggest that cerebellar area IX, a non-motor region that belongs to a large-scale brain functional network with known relevance to core depressive symptom expression, exhibits abnormal volume in patients independent of clinical severity or medication. Thus, the data imply a possible trait marker of the disorder. However, given bilaterality and an association with clinical scores at least in remitted patients, the current findings raise the possibility that cerebellar volume may be reflective of successful treatment as well.

  3. Prevalence of subsequent depression to an episode of myocardial infarction in Cartagena, Colombia

    OpenAIRE

    Mendoza-Franco Ray; García-del-Río Carlos; Barrios-Ayola Francisco; Bula-Anichiarico Doris; Fuentes-de-Oro Nacira; Corrales-Santander Hugo; Adie-Villafañe Richard

    2013-01-01

    Introduction: depression is the main cause of disability and suicide worldwide, ithas been associated with different diseases. At least 65% of patients with myocardialinfarction (MI) experience depressive symptoms and 15 to 20% are diagnosed withmajor depression. It is unknown the prevalence of depression after MI in our midst.Objectives: estimate the prevalence of subsequent depression to an episode of MI inthree hospitals of Cartagena, Colombia and describe the severity of the depression,th...

  4. The presence of a depressive episode predicts lower return to work rate after myocardial infarction

    NARCIS (Netherlands)

    de Jonge, Peter; Zuidersma, Marij; Bultmann, Ute

    2014-01-01

    Context: No studies have evaluated whether the presence of a depressive episode is associated with an increased risk of not returning to work following myocardial infarction (MI). Objectives: To examine the prospective associations between depressive episode and anxiety disorders with return to work

  5. Relationship Between Depressive State and Treatment Characteristics of Acute Cervical Spinal Cord Injury in Japan

    OpenAIRE

    2016-01-01

    Background Few studies have assessed whether treatment of acute cervical spinal cord injury (SCI) patients contributes to depression. Methods Using an administrative database, we assessed patients for whom the diagnosis was unspecified injuries of cervical spinal cord (International Classification of Diseases and Injuries-10th (ICD-10) code; S14.1). We categorized patients with codes for depressive episode (ICD-10 code; F32) or recurrent depressive disorder (F33), or those prescribed antidepr...

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

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    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.

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

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    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

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

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    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.

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

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    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.

  10. 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…

  11. 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...... of the injected hemisphere due to a contrast induced impairment of the blood-brain barrier is suggested as the pathophysiological background of the neurological complication....

  12. 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.

  13. Diagnostic labelling as determinant of antibiotic prescribing for acute respiratory tract episodes in general practice

    Science.gov (United States)

    van Duijn, Huug J; Kuyvenhoven, Marijke M; Tiebosch, Hanneke M; Schellevis, François G; Verheij, Theo JM

    2007-01-01

    Background Next to other GP characteristics, diagnostic labelling (the proportion of acute respiratory tract (RT) episodes to be labelled as infections) probably contributes to a higher volume of antibiotic prescriptions for acute RT episodes. However, it is unknown whether there is an independent association between diagnostic labelling and the volume of prescribed antibiotics, or whether diagnostic labelling is associated with the number of presented acute RT episodes and consequently with the number of antibiotics prescribed per patient per year. Methods Data were used from the Second Dutch National Survey of General Practice (DNSGP-2) with 163 GPs from 85 Dutch practices, serving a population of 359,625 patients. Data over a 12 month period were analysed by means of multiple linear regression analysis. Main outcome measure was the volume of antibiotic prescriptions for acute RT episodes per 1,000 patients. Results The incidence was 236.9 acute RT episodes/1,000 patients. GPs labelled about 70% of acute RT episodes as infections, and antibiotics were prescribed in 41% of all acute RT episodes. A higher incidence of acute RT episodes (beta 0.67), a stronger inclination to label episodes as infections (beta 0.24), a stronger endorsement of the need of antibiotics in case of white spots in the throat (beta 0.11) and being male (beta 0.11) were independent determinants of the prescribed volume of antibiotics for acute RT episodes, whereas diagnostic labelling was not correlated with the incidence of acute RT episodes. Conclusion Diagnostic labelling is a relevant factor in GPs' antibiotic prescribing independent from the incidence of acute RT episodes. Therefore, quality assurance programs and postgraduate courses should emphasise to use evidence based prognostic criteria (e.g. chronic respiratory co-morbidity and old age) as an indication to prescribe antibiotics in stead of single inflammation signs or diagnostic labels. PMID:17883832

  14. Diagnostic labelling as determinant of antibiotic prescribing for acute respiratory tract episodes in general practice

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    Schellevis François G

    2007-09-01

    Full Text Available Abstract Background Next to other GP characteristics, diagnostic labelling (the proportion of acute respiratory tract (RT episodes to be labelled as infections probably contributes to a higher volume of antibiotic prescriptions for acute RT episodes. However, it is unknown whether there is an independent association between diagnostic labelling and the volume of prescribed antibiotics, or whether diagnostic labelling is associated with the number of presented acute RT episodes and consequently with the number of antibiotics prescribed per patient per year. Methods Data were used from the Second Dutch National Survey of General Practice (DNSGP-2 with 163 GPs from 85 Dutch practices, serving a population of 359,625 patients. Data over a 12 month period were analysed by means of multiple linear regression analysis. Main outcome measure was the volume of antibiotic prescriptions for acute RT episodes per 1,000 patients. Results The incidence was 236.9 acute RT episodes/1,000 patients. GPs labelled about 70% of acute RT episodes as infections, and antibiotics were prescribed in 41% of all acute RT episodes. A higher incidence of acute RT episodes (beta 0.67, a stronger inclination to label episodes as infections (beta 0.24, a stronger endorsement of the need of antibiotics in case of white spots in the throat (beta 0.11 and being male (beta 0.11 were independent determinants of the prescribed volume of antibiotics for acute RT episodes, whereas diagnostic labelling was not correlated with the incidence of acute RT episodes. Conclusion Diagnostic labelling is a relevant factor in GPs' antibiotic prescribing independent from the incidence of acute RT episodes. Therefore, quality assurance programs and postgraduate courses should emphasise to use evidence based prognostic criteria (e.g. chronic respiratory co-morbidity and old age as an indication to prescribe antibiotics in stead of single inflammation signs or diagnostic labels.

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

    DEFF Research Database (Denmark)

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

    2010-01-01

    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...... of any kind. Comorbid personality disorder was associated with a 2.2-times (95% CI: 1.1-4.2) increased risk of non-remission following the first antidepressant trial, whereas no effect was found following the second antidepressant trial (OR: 1.6; 95% CI: 0.8-3.4). A high level of neuroticism...... was associated with non-remission in first as well as second trials. CONCLUSION: Comorbid personality disorder and high levels of neuroticism in first episode depression predict an increased risk of non-remission from depression....

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    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......: 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...

  17. The association between diabetes and an episode of depressive symptoms in the 2002 World Health Survey

    DEFF Research Database (Denmark)

    Mommersteeg, Paula M C; Herr, R; Pouwer, F

    2013-01-01

    AIMS: Depression is common in people with diabetes and increases the risk of poor health outcomes, including premature mortality. We explored the association between diabetes and an episode of depressive symptoms in a cross-sectional multinational study, which included a large number of low...... symptoms was assessed by self-report using an algorithm based on DSM-IV criteria. Odds ratios and 95% confidence intervals were calculated to quantify associations between diabetes and episodes of depressive symptoms in the entire sample and for countries aggregated into four continents: Africa, South...... with diabetes had increased odds of an episode of depressive symptoms compared with those without diabetes (adjusted odds ratio 2.36, 95% confidence interval 1.91-2.92). Similar associations were found in South America, Asia and Europe (odds ratio > 1.97), but not in Africa (odds ratio 0.86, 95% confidence...

  18. Gender Differences among Patients with a Single Depressive Episode

    DEFF Research Database (Denmark)

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

    2010-01-01

    , 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......-morbidity (including personality disorders), stressful life events prior to onset, family loading of psychiatric disorders, or treatment outcome. CONCLUSION: The results provide evidence for a higher level of anxiety and neuroticism among females with a recent onset of depression, whereas other clinical...

  19. 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 pancre

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

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    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.

  1. Vitamin D Deficiency and Depressive Symptomatology in Psychiatric Patients Hospitalized with a Current Depressive Episode: A Factor Analytic Study.

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    Roland von Känel

    Full Text Available Low vitamin D levels have been associated with depressive symptoms in population-based studies and non-clinical samples as well as with clinical depression. This study aimed to examine the association of vitamin D levels with the severity and dimensions of depressive symptoms in hospitalized patients with a current episode of depression taking into account confounding variables.We investigated 380 patients (mean age 47 ± 12 years, 70% women who were consecutively hospitalized with a main diagnosis of an ICD-10 depressive episode. All patients self-rated depressive symptom severity with the Hospital Anxiety and Depression Scale (HADS-D, the Beck Depression Inventory-II (BDI-II, and the Brief Symptom Inventory. A principal component analysis was performed with all 34 items of these questionnaires and serum levels of 25-hydroxyvitamin D3 (25-OH D were measured.Vitamin D deficiency ( 75 nmol/l were present in 55.5%, 31.8% and 12.6%, respectively, of patients. Patients with vitamin D deficiency scored higher on the HADS-D scale and on an anhedonia symptom factor than those with insufficient (p-values ≤ 0.023 or sufficient (p-values ≤ 0.008 vitamin D. Vitamin D deficient patients also scored higher on the BDI-II scale than those with sufficient vitamin D (p = 0.007; BDI-II cognitive/affective symptoms, but not somatic/affective symptoms, were higher in patients with vitamin D deficiency (p = 0.005 and insufficiency (p = 0.041 relative to those with sufficient vitamin D. Effect sizes suggested clinically relevant findings.Low vitamin D levels are frequent in hospitalized patients with a current episode of depression. Especially 25-OH D levels < 50 nmol/l were associated with cognitive/affective depressive symptoms, and anhedonia symptoms in particular.

  2. 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

    2014-11-01

    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. The participants in Study 1 included 240 adolescents who differed with regard to their mothers' history of depressive disorders. Youth were assessed annually across 6 years (Grades 6-12). 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 two or more prior MDEs, but depressive symptoms were not significantly related to dependent stress levels for youth with three or more prior MDEs. In Study 2, the participants were 32 remitted-depressed and 36 never-depressed young adults who completed a psychosocial stress task to determine cortisol reactivity and were reassessed for depression and stress approximately 8 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, multifactorial relation between stress and depression is discussed.

  3. 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.

    2008-01-01

    A study examined maternal depressive symptoms at the beginning and end of acute pediatric treatment of children with major depressive disorder (MDD). Results suggested a direct and possible reciprocal association between maternal and child depression severity.

  4. 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

  5. The Neighbourhood Built Environment and Trajectories of Depression Symptom Episodes in Adults: A Latent Class Growth Analysis.

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    Genevieve Gariepy

    Full Text Available To investigate the effect of the neighbourhood built environment on trajectories of depression symptom episodes in adults from the general Canadian population.We used 10 years of data collection (2000/01-2010/11 from the Canadian National Population Health Study (n = 7114. Episodes of depression symptoms were identified using the Composite International Diagnostic Interview Short-Form. We assessed the presence of local parks, healthy food stores, fast food restaurants, health services and cultural services using geospatial data. We used latent class growth modelling to identify different trajectories of depression symptom episodes in the sample and tested for the effect of neighbourhood variables on the trajectories over time.We uncovered three distinct trajectories of depression symptom episodes: low prevalence (76.2% of the sample, moderate prevalence (19.2% and high prevalence of depression symptom episodes (2.8%. The presence of any neighbourhood service (healthy food store, fast-food restaurant, health service, except for cultural service was significantly associated with a lower probability of a depression symptom episode for those following a trajectory of low prevalence of depression symptom episodes. The presence of a local park was also a significant protective factor in trajectory groups with both low and moderate prevalence of depression symptom episodes. Neighbourhood characteristics did not significantly affect the trajectory of high prevalence of depression symptom episodes.For individuals following a trajectory of low and moderate prevalence of depression symptom episodes, the neighbourhood built environment was associated with a shift in the trajectory of depression symptom episodes. Future intervention studies are recommended to make policy recommendations.

  6. Relationship Between Depressive State and Treatment Characteristics of Acute Cervical Spinal Cord Injury in Japan

    Science.gov (United States)

    Matsuda, Yasufumi; Kubo, Tatsuhiko; Fujino, Yoshihisa; Matsuda, Shinya; Wada, Futoshi; Sugita, Atsuko

    2016-01-01

    Background Few studies have assessed whether treatment of acute cervical spinal cord injury (SCI) patients contributes to depression. Methods Using an administrative database, we assessed patients for whom the diagnosis was unspecified injuries of cervical spinal cord (International Classification of Diseases and Injuries-10th (ICD-10) code; S14.1). We categorized patients with codes for depressive episode (ICD-10 code; F32) or recurrent depressive disorder (F33), or those prescribed antidepressants (tricyclic, tetracyclic, Selective Serotonin Reuptake Inhibitors, Serotonin Noradrenaline Reuptake Inhibitors, Trazodone, Sulpiride, or Mirtazapine) as having a depressive state. We compared the rate of each acute treatment between the depressive state group and the non-depressive state group using chi-square tests, and a multiple logistic regression model was used to identify the association between the acute treatment and depressive state. Results There were 151 patients who were judged to be in a depressive state, and the other 2115 patients were categorized into the non-depressive state group. Intervention of intravenous anesthesia, tracheostomy, artificial respiration, and gastrostomy had a significant positive correlation with depressive state. Multiple logistic regression analysis showed that tracheostomy (odds ratio [OR] 2.18; 95% confidence interval [CI], 1.09–4.38) and artificial respiration (OR 2.28; 95% CI, 1.32–3.93) were significantly associated with depressive state, and men had a 36% reduction in the risk of depressive state compared with women (OR 0.64; 95% CI, 0.44–0.94), whereas age, wound-treatment, all of the orthopedic procedures, intravenous anesthesia, and gastrostomy were not associated with depressive state. Conclusions These findings suggest that tracheostomy, artificial respiration and female gender in the acute phase after cervical SCI might be associated with the development of depression. PMID:26567604

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

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    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

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

    OpenAIRE

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

    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...

  9. 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.

  10. Vulnerability before, during, and after a major depressive episode - A 3-wave population-based study

    NARCIS (Netherlands)

    Ormel, J; Oldehinkel, AJ; Vollebergh, W

    2004-01-01

    Background: Vulnerability as defined by high levels of neuroticism, low self-esteem, and poor coping skills characterizes individuals with a history of major depressive episodes (MDEs). Objective: To separate postmorbid vulnerability into (1) trait effects (ie, the continuation of premorbid vulnerab

  11. Duration of major depressive episodes in the general population : results from The Netherlands Mental Health Survey and Incidence Study (NEMESIS)

    NARCIS (Netherlands)

    Spijker, J; De Graaf, R; Bijl, RV; Beekman, ATF; Ormel, J; Nolen, WA

    2002-01-01

    Background Data on the duration of major depressive episodes (MDE) in the general population are sparse. Aims To assess the duration of MDE and its clinical and socio-demographic determinants in a study group drawn from the general population with newly originated episodes of major depression. Metho

  12. Duration of major depressive episodes in the general population: results from The Netherlands Mental Health Survey and Incidence Study (NEMESIS)

    NARCIS (Netherlands)

    Spijker, J.J.A.; de Graaf, R.; Bijl, R.V.; Beekman, A.T.F.; Ormel, J.; Nolen, W.A.

    2002-01-01

    Background Data on the duration of major depressive episodes (MDE) in the general population are sparse. Aims To assess the duration of MDE and its clinical and socio-demographic determinants in a study group drawn from the general population with newly originated episodes of major depression. Metho

  13. 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 sympto

  14. Gender Differences in Self-Reported Symptoms of Depression among Patients with Acute Coronary Syndrome

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    Lorraine Frazier

    2012-01-01

    Full Text Available This study examined the prevalence of self-reported depressive symptoms and the self reported somatic depressive symptoms as measured by the Beck Depression Inventory-II (BDI-II among patients hospitalized for acute coronary syndrome (ACS, and explored the impact of gender on both. A convenience sample of 789 adults (248 women and 541 men was recruited for the study during hospital admission for ACS and participants were screened for self-reported depressive symptoms. BDI-II scores of ≥14 indicate a moderate level of depressive symptoms and this cut-off score was used to categorize patients into depressed and non-depressed groups. Pearson chi-square tests for independence (categorical variables and t tests for independent samples (continuous variables were used for gender comparisons. Results showed that depressive symptoms during ACS episodes were different between women and men. Women reported greater overall depressive symptoms (BDI-II mean = 11.89, S.D. = 9.68 than men (BDI-II mean = 9.00, S.D. = 7.93 (P<0.000. Significantly more women (7.66% were identified positive for somatic depressive symptoms (sleep and appetite disturbances and fatigue than men (2.22% (P=0.0003. Findings support that there are gender differences in depressive symptoms experienced by patients hospitalized for ACS. Somatic symptoms of depression may be important indicators of depression especially among female ACS patients.

  15. Quantitative EEG findings in patients with acute, brief depression combined with other fluctuating psychiatric symptoms: a controlled study from an acute psychiatric department

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    Linaker Olav M

    2008-11-01

    Full Text Available Abstract Background Patients with brief depressive episodes and concurrent rapidly fluctuating psychiatric symptoms do not fit current diagnostic criteria and they can be difficult to diagnose and treat in an acute psychiatric setting. We wanted to study whether these patients had signs of more epileptic or organic brain dysfunction than patients with depression without additional symptomatology. Methods Sixteen acutely admitted patients diagnosed with a brief depressive episode as well as another concurrent psychiatric diagnosis were included. Sixteen patients with major depression served as controls. Three electroencephalographic studies (EEG were visually interpreted and the background activity was also analysed with quantitative electroencephalography (QEEG. Results The group with brief depression and concurrent symptoms had multiple abnormal features in their standard EEG compared to patients with major depression, but they did not show significantly more epileptiform activity. They also had significantly higher temporal QEEG delta amplitude and interhemispheric temporal delta asymmetry. Conclusion Organic brain dysfunction may be involved in the pathogenesis of patients with brief depressive episodes mixed with rapidly fluctuating psychiatric symptoms. This subgroup of depressed patients should be investigated further in order to clarify the pathophysiology and to establish the optimal evaluation scheme and treatment in an acute psychiatric setting.

  16. 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.

  17. Effects of antipsychotics on insight in schizophrenia: results from independent samples of first-episode and acutely relapsed patients.

    Science.gov (United States)

    Misiak, Błażej; Frydecka, Dorota; Beszłej, Jan A; Moustafa, Ahmed A; Tybura, Piotr; Kucharska-Mazur, Jolanta; Samochowiec, Agnieszka; Bieńkowski, Przemysław; Samochowiec, Jerzy

    2016-07-01

    We aimed to investigate whether antipsychotics differentially impact insight and whether these effects appear because of improvement in psychopathological manifestation in 132 first-episode schizophrenia patients and 201 acutely relapsed schizophrenic patients, who were followed up for 12 weeks. Olanzapine and risperidone were administered to first-episode schizophrenia patients, whereas acutely relapsed schizophrenic patients were treated with olanzapine, perazine and ziprasidone. The Positive And Negative Syndrome Scale (PANSS) was used to assess psychopathology. Insight was assessed using the G12 item of PANSS. Unadjusted mixed-model regression analysis indicated a significant improvement in the PANSS G12 item score in both groups. There were no significant differences between distinct treatment subgroups of patients in terms of improvement in the PANSS G12 item score. After adjustment for the trajectories of changes in symptom dimensions, a decrease in the PANSS G12 item score was because of an improvement in positive, negative and excitement symptoms. A decrease in the PANSS G12 item score was also related to an increase in the severity of depressive symptomatology. Our results indicate that antipsychotics exert similar effects on insight in acute psychosis. These effects are likely because of an improvement in psychopathological manifestation. The improvement in insight might be related to the development of depressive symptoms.

  18. 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

  19. Chronic and episodic interpersonal stress as statistically unique predictors of depression in two samples of emerging adults.

    Science.gov (United States)

    Vrshek-Schallhorn, Suzanne; Stroud, Catherine B; Mineka, Susan; Hammen, Constance; Zinbarg, Richard E; Wolitzky-Taylor, Kate; Craske, Michelle G

    2015-11-01

    Few studies comprehensively evaluate which types of life stress are most strongly associated with depressive episode onsets, over and above other forms of stress, and comparisons between acute and chronic stress are particularly lacking. Past research implicates major (moderate to severe) stressful life events (SLEs), and to a lesser extent, interpersonal forms of stress; research conflicts on whether dependent or independent SLEs are more potent, but theory favors dependent SLEs. The present study used 5 years of annual diagnostic and life stress interviews of chronic stress and SLEs from 2 separate samples (Sample 1 N = 432; Sample 2 N = 146) transitioning into emerging adulthood; 1 sample also collected early adversity interviews. Multivariate analyses simultaneously examined multiple forms of life stress to test hypotheses that all major SLEs, then particularly interpersonal forms of stress, and then dependent SLEs would contribute unique variance to major depressive episode (MDE) onsets. Person-month survival analysis consistently implicated chronic interpersonal stress and major interpersonal SLEs as statistically unique predictors of risk for MDE onset. In addition, follow-up analyses demonstrated temporal precedence for chronic stress; tested differences by gender; showed that recent chronic stress mediates the relationship between adolescent adversity and later MDE onsets; and revealed interactions of several forms of stress with socioeconomic status (SES). Specifically, as SES declined, there was an increasing role for noninterpersonal chronic stress and noninterpersonal major SLEs, coupled with a decreasing role for interpersonal chronic stress. Implications for future etiological research were discussed.

  20. Acute episode of cyclic vomiting syndrome preceded by arterial hypertension – Case presentation and review.

    Science.gov (United States)

    Keller, K; Desuki, A; Hobohm, L; Münzel, T; Ostad, M A

    2015-10-01

    Cyclic vomiting syndrome (CVS) is a functional disorder with recurrent episodes of vomiting. Between these episodes patients recover to well-being. Lack of awareness often leads to a delay in making the diagnosis. The diagnosis is based on a typical medical history and exclusion of other causes. We present a case report of a middle-aged patient who had recurrent episodes of vomiting for 12 years coinciding with hypertension. After excluding other causes, CVS was diagnosed. The episodes of acute vomiting were stopped by administration of antiemetic and sedative drugs and urapidil reduced the hypertension. Treatment with sedatives stops vomiting caused by the emetic centre of the central nervous system.

  1. 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

  2. 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......BACKGROUND: 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. OBJECTIVES: To assess the efficacy and safety of oral ibuprofen for treatment of acute episodic TTH in adults. SEARCH METHODS: We searched CENTRAL (The Cochrane Library), MEDLINE, EMBASE, and our own in-house database to January...

  3. Acute effects of ambient air pollution episodes on respiratory health of children.

    NARCIS (Netherlands)

    Hoek, G.

    1992-01-01

    In this thesis the acute effects of air pollution episodes on respiratory health of seven to eleven year old children living in non-urban communities in the Netherlands are discussed. Repeated measurements of pulmonary function (spirometry) and the occurrence of acute respiratory symptoms using a da

  4. TRAJECTORIES OF DEPRESSIVE EPISODES AND HYPERTENSION OVER 24 YEARS: THE WHITEHALL II PROSPECTIVE COHORT STUDY

    Science.gov (United States)

    Nabi, Hermann; Chastang, Jean-François; Lefèvre, Thomas; Dugravot, Aline; Melchior, Maria; Marmot, Michael G.; Shipley, Martin J.; Kivimäki, Mika; Singh-Manoux, Archana

    2011-01-01

    Prospective data on depressive symptoms and blood pressure (BP) are scarce, and the impact of age on this association is poorly understood. The present study examines longitudinal trajectories of depressive episodes and the probability of hypertension associated with these trajectories over time. Participants were 6,889 men and 3,413 women London based civil servants, aged 35–55 years at baseline, followed for 24 years between 1985 and 2009. Depressive episode (defined as scoring 4 or more on the General Health Questionnaire-Depression subscale or using prescribed antidepressant medication) and hypertension (systolic/diastolic blood pressure ≥ 140/90 mm Hg or use of antihypertensive medication) were assessed concurrently at five medical examinations. In the fully adjusted longitudinal logistic regression analyses based on Generalized-Estimating-Equations using age as the time scale, participants in the “increasing depression” group had a 24% (p<0.05) lower risk of hypertension at ages 35–39, compared to those in the “low/transient depression” group. However, there was a faster age-related increase in hypertension in the “increasing depression” group, corresponding to a 7% (p<0.01) greater increase in the odds of hypertension for every each five-year increase in age. A higher risk of hypertension in the first group of participants was not evident before age 55. A similar pattern of association was observed in men and women although it was stronger in men. This study suggests that the risk of hypertension increases with repeated experience of depressive episodes over time and becomes evident in later adulthood. PMID:21339474

  5. Prevalence of metabolic syndrome among patients with major depressive disorder--differences between newly diagnosed first episode and recurrent disease.

    Science.gov (United States)

    Ljubicic, Rudolf; Jakovac, Hrvoje; Bistrović, Ivana Ljubicić; Franceski, Tanja; Mufić, Ana Kovak; Karlović, Dalibor

    2013-12-01

    The objective of the present study was to assess differences in prevalence of the metabolic syndrome among depressed patients in regard to the duration of the illness (first episode versus recurrent episodes). A total of 190 patients suffering from major depressive disorder were included in the study, diagnosed according to International classification of disorders, 10th revision. The same criteria were used to divide participants into two groups: first episode major depressive disorder and major depressive disorder with recurrent episodes. The metabolic syndrome was defined according to the criteria of the American National Cholesterol Education Program-Treatment Panel III. Results showed that metabolic syndrome is significantly more prevalent in patients with recurrent major depressive disorder (45.2%) compared to patients with first episode of major depressive disorder (27.3%), mainly due to differences in plasma glucose, triglycerides and HDL-cholesterol levels. These findings indicate the importance of the duration of depression and the number of recurring episodes as factors involved in etiopathogenesis of the associated metabolic syndrome.

  6. 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

    • 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...

    • Hippocampus, glucocorticoids and neurocognitive functions in patients with first-episode major depressive disorders.

      Science.gov (United States)

      Kaymak, Semra Ulusoy; Demir, Başaran; Sentürk, Senem; Tatar, Ilkan; Aldur, M Mustafa; Uluğ, Berna

      2010-04-01

      The aim of this study was to determine whether there was any relationship between hippocampal volume, and glucocorticoid regulation, and cognitive dysfunctions in drug-naïve major depressive disorder (MDD) patients during their first episode. Twenty drug-free female MDD patients in their first episode and 15 healthy females as control subjects were included in the study. All subjects underwent 3.0 Tesla (T) magnetic resonance imaging (MRI), comprehensive neuropsychological testing and dexamethasone suppression tests (DST). The volumes of the right and left hippocampus of the patients were found to be significantly smaller than those of the controls. Patients were found to have significantly lower scores on measures of attention, working memory, psychomotor speed, executive functions, and visual and verbal memory fields. The performance of the patients only in the recollection memory and memory of reward-associated rules were positively correlated with hippocampal volumes. The volumes of the left and right hippocampus did not correlate with basal or post-dexamethasone cortisol levels. Our findings indicate that depressed patients have smaller hippocampi even in the earlier phase of their illness. Further research efforts are needed to explain the mechanisms that are responsible for the small hippocampus in depressed patients.

    • 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

      Objective: To determine the impact of the personality traits neuroticism and extraversion as well as comorbid personality disorders on the rate of remission, recurrence, and conversion to bipolar disorder after the first lifetime episode of depression. Methods: A total of 301 inpatients or outpat......Objective: To determine the impact of the personality traits neuroticism and extraversion as well as comorbid personality disorders on the rate of remission, recurrence, and conversion to bipolar disorder after the first lifetime episode of depression. Methods: A total of 301 inpatients...... 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...

    • Diagnostic Stability of Comorbid Personality Disorders Among Patients Fully or Partially Remitted From First-Episode Depression

      DEFF Research Database (Denmark)

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

      2016-01-01

      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...

    • Nonspecific Effect of Stress on Brain Gray Matter Volume in Drug-naive Female Patients with First Depressive Episode

      Directory of Open Access Journals (Sweden)

      Chuan-Jun Zhuo

      2016-01-01

      Conclusions: Although the results of the present study suggest the absence of significant differences in brain gray matter volume between female drug-naive patients after the first episode of major depression with and without SLEs after FDR correction, the study provides useful information for exploring the definitive role of stress in the onset of depression.

    • The efficacy of mindfulness-based cognitive therapy in recurrent depressed patients with and without a current depressive episode: a randomized controlled trial.

      NARCIS (Netherlands)

      Aalderen, J.R. van; Donders, A.R.T.; Giommi, F.; Spinhoven, P.; Barendregt, H.P.; Speckens, A.E.M.

      2012-01-01

      BACKGROUND: The aim of this study is to examine the efficacy of mindfulness-based cognitive therapy (MBCT) in addition to treatment as usual (TAU) for recurrent depressive patients with and without a current depressive episode. METHOD: A randomized, controlled trial comparing MBCT+TAU (n=102) with T

    • Long-term outcome of mindfulness-based cognitive therapy in recurrently depressed patients with and without a depressive episode at baseline

      NARCIS (Netherlands)

      Aalderen, J.R. van; Donders, A.R.T.; Peffer, K.; Speckens, A.E.M.

      2015-01-01

      BACKGROUND: In a previous randomized controlled trial in patients with three or more previous depressive episodes, mindfulness-based cognitive therapy (MBCT) appeared to be equally effective in those who were depressed and those who were in remission at the start of the trial. AIM: The aim of this s

    • Association of major depressive episode with negative outcomes of tuberculosis treatment.

      Directory of Open Access Journals (Sweden)

      Cesar Ugarte-Gil

      Full Text Available BACKGROUND: Pulmonary tuberculosis (TB persists an important contributor to the burden of diseases in developing countries. TB control success is based on the patient's compliance to the treatment. Depressive disorders have been negatively associated with compliance of therapeutic schemes for chronic diseases. This study aimed to estimate the significance and magnitude of major depressive episode as a hazard factor for negative outcomes (NO, including abandon or death in patients receiving TB treatment. METHODOLOGY/PRINCIPAL FINDINGS: A longitudinal study was conducted to evaluate the association of major depressive episode (MDE, as measured by a 5-item version of the Center for Epidemiological Studies Depression Scale (CES-D with NO to TB treatment. Patients with confirmed TB were enrolled before the start of TB treatment. Baseline measurements included socio-demographic variables as well as the CES-D, which was also applied every month until the end of the treatment. Death and treatment default were assessed monthly. Survivor function (SF for NO according to MDE status (CES-D≥6 at baseline (MDEb was estimated. Cox's Regression was performed for bivariate analyses as well as for the multivariate model. A total of 325 patients accepted to participate in the study, of which 34 where excluded for diagnosis of MDR-TB. NO was observed in 24 patients (8.2%; 109 (37% presented MDEb. Statistically significant difference was found on the SF of patients with and without MDEb (0.85 vs. 0.96, p-value = 0.002. The hazard ratio for NO, controlled for age, sex, marital status and instruction level was 3.54 (95%CI 1.43-8.75; p-value = 0.006. CONCLUSION: The presence of MDE at baseline is associated to NO of TB treatment. Targeting detection and treatment of MDE may improve TB treatment outcomes.

    • 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

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

      Directory of Open Access Journals (Sweden)

      Karen Amaral Tavares Pinheiro

      2011-01-01

      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

    • Disturbances of serine and glycine metabolism as a cause of episodic acute polymorphous psychoses

      NARCIS (Netherlands)

      L. Pepplinkhuizen (Lolke)

      1983-01-01

      textabstractPsychiatrists are frequently confronted with psychoses that are difficult to classify. Many forms of these atypical psychoses have been described in European literature. They often have an acute onset and a tendency towards complete remission, albeit with an episodic course. Rich, multif

    • Cortisol response to psychosocial stress during a depressive episode and remission.

      Science.gov (United States)

      Morris, Matthew C; Rao, Uma

      2014-01-01

      This study compared cortisol responses to a standardized psychosocial stressor during a major depressive episode (MDE) and again during remission in adolescents and young adults. Twenty-six individuals with no personal or family history of a major psychiatric disorder (NC) and 24 individuals with a diagnosis of major depressive disorder (MDD) at Time 1 participated in the study. The MDD group showed robust cortisol responses during their index episode and after recovery. In contrast, the NC group showed habituation to the repeated psychosocial stressor, as evident in a flatter cortisol response profile at Time 2. Within the MDD group, net peak cortisol during the first stress test was positively associated with the duration of the index MDE and negatively associated with the total duration of all MDEs. Whereas summary indices of cortisol responses were relatively stable across repeated stress tasks within the MDD group, this was not the case for NC. Results demonstrate that cortisol responses fail to habituate to repeated psychosocial stress during recovery from an MDE and could reflect a trait-like marker of risk for recurrence.

    • Angioedema - a rare cause of acute episodic dysuria: Case report and review of literature

      Directory of Open Access Journals (Sweden)

      Panicker Radhakrishna

      2007-01-01

      Full Text Available The presentations of acute angioedema vary and depend upon the organs involved. Acute episodes of angioedema can be life-threatening if it involves the larynx leading to the obstruction of upper airways and it is a major cause of death. Angioedema involving the lips, cheek and tongue are common with bizarre presentations. Angioedema of the gastro intestinal tract frequently mimic an acute abdomen resulting in unnecessary surgical intervention and increased morbidity. Here we present an unusual case of angioedema involving the external urethra resulting in severe discomfort and burning sensation during micturition. He was later investigated and diagnosed as idiopathic urticaria with angioedema and promptly responded to antihistamines.

    • Disturbances in Hypothalamic-Pituitary-Adrenal Axis and Immunological Activity Differentiating between Unipolar and Bipolar Depressive Episodes.

      Directory of Open Access Journals (Sweden)

      Karlijn Becking

      Full Text Available Differentiating bipolar depression (BD from unipolar depression (UD is difficult in clinical practice and, consequently, accurate recognition of BD can take as long as nine years. Research has therefore focused on the discriminatory capacities of biomarkers, such as markers of the hypothalamic-pituitary-adrenal (HPA axis or immunological activity. However, no previous study included assessments of both systems, which is problematic as they may influence each other. Therefore, this study aimed to explore whether cortisol indicators and inflammatory markers were a independently associated with and/or b showed effect modification in relation to a lifetime (hypomanic episode in a large sample of depressed patients.Data were derived from the Netherlands Study of Depression and Anxiety and comprised 764 patients with a DSM-IV depressive disorder at baseline, of which 124 (16.2% had a lifetime (hypomanic episode at the 2-year assessment, or a more recent episode at the 4-year or 6-year assessment. Baseline cortisol awakening response, evening cortisol and diurnal cortisol slope were considered as cortisol indicators, while baseline C-reactive Protein (CRP, Interleukin-6 (IL-6, and Tumor Necrosis Factor Alpha (TNF-α were included as inflammatory markers.In depressed men and women, none of the cortisol indicators and inflammatory markers were (independently associated with a (hypomanic episode. However, effect modification was found of diurnal cortisol slope and CRP in relation to a (hypomanic episode. Further analyses showed that depressed men with high levels of diurnal cortisol slope and CRP had an increased odds (OR=10.99, p=.001 of having a (hypomanic episode. No significant differences were found in women.Our findings suggest that the combination of high diurnal cortisol slope and high CRP may differentiate between UD and BD. This stresses the importance of considering HPA-axis and immunological activity simultaneously, but more research is needed

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

    Science.gov (United States)

    Suominen-Taipale, Anna Liisa; Partonen, Timo; Turunen, Anu W; Männistö, Satu; Jula, Antti; Verkasalo, Pia K

    2010-05-07

    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.

  2. 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.

  3. Nonspecific Effect of Stress on Brain Gray Matter Volume in Drug-naive Female Patients with First Depressive Episode

    Institute of Scientific and Technical Information of China (English)

    Chuan-Jun Zhuo; Hai-Man Bian; Yan-Jie Gao; Xiao-Lei Ma; Sheng-Zhang Ji; Meng-Yuan Yao; Ning Zhai

    2016-01-01

    Background: This study aimed to observe the differences in brain gray matter volume in drug-naive female patients after the first episode of major depression with and without stressful life events (SLEs) before the onset of depression.Methods: Forty-three drug-naive female patients voluntarily participated in the present study after the first major depressive episode.The life event scale was used to evaluate the severity of the impact of SLEs during 6 months before the onset of the major depressive episode.High-field magnetic resonance imaging (MRI) scans were obtained, and the VBM and SPM8 software process were used to process and analyze the MRI.Results: Compared to that in patients without SLEs, the volume of brain gray matter was lower in the bilateral temporal lobe, right occipital lobe, and right limbic lobe in the SLE group.However, the gray matter volume did not differ significantly between the two groups after the application of false discovery rate (FDR) correction.Conclusions: Although the results of the present study suggest the absence of significant differences in brain gray matter volume between female drug-naive patients after the first episode of major depression with and without SLEs after FDR correction, the study provides useful information for exploring the definitive role of stress in the onset of depression.

  4. Managing the acute painful episode in sickle cell disease

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    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。

  5. Quetiapine for acute bipolar depression: a systematic review and meta-analysis

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    Suttajit S

    2014-06-01

    Full Text Available Sirijit Suttajit, Manit Srisurapanont, Narong Maneeton, Benchalak Maneeton Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand Background: Precise estimated risks and benefits of quetiapine for acute bipolar depression are needed for clinical practice. Objective: To systematically review the efficacy and the tolerability of quetiapine, either as monotherapy or combination therapy, for acute bipolar depression. Methods: We included all randomized, controlled trials (RCTs comparing quetiapine with other treatments, including placebo, in patients with acute bipolar depression (bipolar I or II disorder, major depressive episode. Published and unpublished RCTs were identified using the Cochrane Central Register of Controlled Trials, MEDLINE®, Web of Knowledge™, CINAHL®, PsycINFO®, the EU Clinical Trials Register database, and ClinicalTrials.gov. The primary outcome was the change scores of depression rating scales. Results: Eleven RCTs (n=3,488 were included. Two of them were conducted in children and adolescents. The change in depression scores was significantly greater in the quetiapine group compared with the placebo group (mean difference, [MD] =-4.66, 95% confidence interval [CI] -5.59 to -3.73. The significant difference was observed from week 1. Compared with placebo, quetiapine had higher incidence rates of extrapyramidal side effects, sedation, somnolence, dizziness, fatigue, constipation, dry mouth, increased appetite, and weight gain but lower risks of treatment-emergent mania and headache. Quetiapine treatment was associated with significant improvement of clinical global impression, quality of life, sleep quality, anxiety, and functioning. Conclusion: Quetiapine monotherapy is effective for acute bipolar depression and the prevention of mania/hypomania switching. Its common adverse effects are extrapyramidal side effects, sedation, somnolence, dizziness, fatigue, constipation, dry mouth

  6. Depression After First Hospital Admission for Acute Coronary Syndrome

    DEFF Research Database (Denmark)

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

    2016-01-01

    for depression and mortality via linkage to patient, prescription, and cause-of-death registries until the end of 2012. Incidence of depression (as defined by hospital discharge or antidepressant medication use) and the relationship between depression and mortality were examined using time-to-event models......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....... In total, 19,520 (20.0%) ACS patients experienced depression within 2 years after the event. The adjusted rate ratio for depression in ACS patients compared with the reference population was 1.28 (95% confidence interval (CI): 1.25, 1.30). During 12 years of follow-up, 39,523 (40.4%) ACS patients and 27...

  7. Depressive symptoms in first episode schizophrenic patients.%首发精神分裂症病人的抑郁症状

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    李献云; 费立鹏; 张培琰; 吉中孚

    2001-01-01

    Objective  To investigate the prevalence, characteristics and correlates of depressive symptoms in first episode schizophrenic patients. Methods To examine 164 first episode schizophrenic patients at the time of admission and at 3,6,9, and 12 months after starting treatment using the HAMD, BPRS, the Chinese version of SANS, CGI and GAF. Results 71% of the patients had depressive symptoms (mild or more) at damission, but the prevalence of depressive symptoms dropped to a mean of 12% during the recovery period. The most prominent depressive symptoms during the acute phase of schizophrenia were ‘cognitive disturbance’ and ‘retardation’ (the respective subscales constituted 35% and 29% of the total HAMD score on admission). Depressive symptoms improved in parallel with the schizophrenic illness. The severity of depressive symptoms was not related to gender, age of onset, educational level, duration of prodromal period or duration of illness. At admission the severity of depressive symptoms was only related to the BPRS anxiety and depression subscale score, but during the recovery period the HAMD total score was significantly correlated with all of the other clinical scales. The level of depressive symptoms at admission and at three months after starting treatment was not related to the subsequent course of positive or negative symptoms. Conclusions Depressive symptoms appeared to be a separate symptom cluster during the acute phase of first episode schizophrenia. The severity of depressive symptoms did not predict the clinical outcome of first episode schizophrenic patients.%目的探讨首发精神分裂症病人抑郁症状的发生率、特征及相关因素。方法于入院、治疗3、6、9、12月时用汉密尔顿抑郁量表(HAMD)、简明精神病评定量表(BPRS)、阴性症状量表中文版(SANS-CV)、临床总体印象量表(CGI)及功能总体评定量表(GAF)对164例首发精神分裂症患者进行评定。结果急性期首发精神

  8. Sudden psychotic episode probably due to meningoencephalitis and Chlamydia pneumoniae acute infection

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    Canas Nuno

    2005-09-01

    Full Text Available Abstract Background Since 9% to 20% of all cases of acute psychosis presenting to an Emergency Department (ED are due to a general medical condition, cautious medical workup should be mandatory in such patients. Differential diagnosis must consider conditions as diverse as renal failure or CNS infection. Acute Chlamydia pneumoniae infection usually causes a self-limited respiratory syndrome. Rarely, acute neurological complications occur, with acute meningoencephalitis most frequently reported. Diagnosis requires a high level of suspicion and is difficult to confirm. Case report We describe a 22 year-old female Caucasian who, three days after a mild pharingitis, developed an acute psychosis with exuberant symptoms interspersed with periods of lucidity, in a background of normal consciousness and orientation. Initial medical and imagiological workup were inconclusive. After 20 days of unsuccessful treatment with antipsychotics she developed a high fever and was re-evaluated medically. Lumbar puncture revealed an inflammatory cerebrospinal fluid. MRI showed irregular thickening and nodularity of the lateral ventricles' lining. An anti-Chlamydia pneumoniae IgM antibody titter of 85 IU/ml was detected. All symptoms cleared after treatment with antibiotics and corticosteroids. Conclusion This is, to our knowledge, the first reported case of acute CP-associated meningoencephalitis manifesting as an acute psychotic episode. It illustrates the principle that non-organic psychiatric syndromes must remain a diagnosis of exclusion in first-time acute psychosis.

  9. 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

  10. Acute stress and episodic memory retrieval: neurobiological mechanisms and behavioral consequences.

    Science.gov (United States)

    Gagnon, Stephanie A; Wagner, Anthony D

    2016-04-01

    Episodic retrieval allows people to access memories from the past to guide current thoughts and decisions. In many real-world situations, retrieval occurs under conditions of acute stress, either elicited by the retrieval task or driven by other, unrelated concerns. Memory under such conditions may be hindered, as acute stress initiates a cascade of neuromodulatory changes that can impair episodic retrieval. Here, we review emerging evidence showing that dissociable stress systems interact over time, influencing neural function. In addition to the adverse effects of stress on hippocampal-dependent retrieval, we consider how stress biases attention and prefrontal cortical function, which could further affect controlled retrieval processes. Finally, we consider recent data indicating that stress at retrieval increases activity in a network of brain regions that enable reflexive, rapid responding to upcoming threats, while transiently taking offline regions supporting flexible, goal-directed thinking. Given the ubiquity of episodic memory retrieval in everyday life, it is critical to understand the theoretical and applied implications of acute stress. The present review highlights the progress that has been made, along with important open questions.

  11. Antibiotic Treatment for First Episode of Acute Otitis Media Is Not Associated with Future Recurrences

    Science.gov (United States)

    te Molder, Marthe; de Hoog, Marieke L. A.; Uiterwaal, Cuno S. P. M.; van der Ent, Cornelis K.; Smit, Henriette A.; Schilder, Anne G. M.; Damoiseaux, Roger A. M. J.; Venekamp, Roderick P.

    2016-01-01

    Objective Antibiotic treatment of acute otitis media (AOM) has been suggested to increase the risk of future AOM episodes by causing unfavorable shifts in microbial flora. Because current evidence on this topic is inconclusive and long-term follow-up data are scarce, we wanted to estimate the effect of antibiotic treatment for a first AOM episode occurring during infancy on AOM recurrences and AOM-related health care utilization later in life. Methods We obtained demographic information and risk factors from data of the Wheezing Illnesses Study Leidsche Rijn, a prospective birth cohort study in which all healthy newborns born in Leidsche Rijn (between 2001 and 2012), The Netherlands, were enrolled. These data were linked to children’s primary care electronic health records up to the age of four. Children with at least one family physician-diagnosed AOM episode before the age of two were included in analyses. The exposure of interest was the prescription of oral antibiotics (yes vs no) for a child’s first AOM episode before the age of two years. Results 848 children were included in analyses and 512 (60%) children were prescribed antibiotics for their first AOM episode. Antibiotic treatment was not associated with an increased risk of total AOM recurrences (adjusted rate ratio: 0.94, 95% CI: 0.78–1.13), recurrent AOM (≥3 episodes in 6 months or ≥4 in one year; adjusted risk ratio: 0.79, 95% CI: 0.57–1.11), or with increased AOM-related health care utilization during children’s first four years of life. Conclusions Oral antibiotic treatment of a first AOM episode occurring during infancy does not affect the number of AOM recurrences and AOM-related health care utilization later in life. This information can be used when weighing the pros and cons of various AOM treatment options. PMID:27632355

  12. The Epidemiology of Major Depressive Episode in the Iraqi General Population.

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    Ali Obaid Al-Hamzawi

    Full Text Available To assess the prevalence, symptom severity, functional impairment, and treatment of major depressive episode (MDE in the Iraqi general population.The Iraq Mental Health Survey is a nationally representative face-to-face survey of 4,332 non-institutionalized adults aged 18+ interviewed in 2006-2007 as part of the WHO World Mental Health Surveys. Prevalence and correlates of DSM-IV MDE were determined with the WHO Composite International Diagnostic Interview (CIDI.Lifetime and 12-month prevalence of MDE were 7.4% and 4.0%, respectively. Close to half (46% of the 12-month MDE cases were severe/very severe. MDE was more common among women and those previously married. Median age of onset was 25.2. Only one-seventh of 12-month MDE cases received treatment despite being associated with very substantial role impairment (on average 70 days out of role in the past year.MDE is a commonly occurring disorder in the Iraqi general population and is associated with considerable disability and low treatment. Efforts are needed to decrease the barriers to treatment and to educate general medical providers in Iraq about the recognition and treatment of depression.

  13. Cross-national epidemiology of DSM-IV major depressive episode

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    Matschinger Herbert

    2011-07-01

    Full Text Available Abstract Background Major depression is one of the leading causes of disability worldwide, yet epidemiologic data are not available for many countries, particularly low- to middle-income countries. In this paper, we present data on the prevalence, impairment and demographic correlates of depression from 18 high and low- to middle-income countries in the World Mental Health Survey Initiative. Methods Major depressive episodes (MDE as defined by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DMS-IV were evaluated in face-to-face interviews using the World Health Organization Composite International Diagnostic Interview (CIDI. Data from 18 countries were analyzed in this report (n = 89,037. All countries surveyed representative, population-based samples of adults. Results The average lifetime and 12-month prevalence estimates of DSM-IV MDE were 14.6% and 5.5% in the ten high-income and 11.1% and 5.9% in the eight low- to middle-income countries. The average age of onset ascertained retrospectively was 25.7 in the high-income and 24.0 in low- to middle-income countries. Functional impairment was associated with recency of MDE. The female: male ratio was about 2:1. In high-income countries, younger age was associated with higher 12-month prevalence; by contrast, in several low- to middle-income countries, older age was associated with greater likelihood of MDE. The strongest demographic correlate in high-income countries was being separated from a partner, and in low- to middle-income countries, was being divorced or widowed. Conclusions MDE is a significant public-health concern across all regions of the world and is strongly linked to social conditions. Future research is needed to investigate the combination of demographic risk factors that are most strongly associated with MDE in the specific countries included in the WMH.

  14. Impact of acute rejection episodes on long-term renal allograft survival

    Institute of Scientific and Technical Information of China (English)

    吴建永; 陈江华; 王逸民; 张建国; 朱琮; 寿张飞; 王苏娅; 张萍; 黄洪锋; 何强

    2003-01-01

    Objective To assess the impact of the number, and time of acute rejection (AR) and outcome of anti-rejection therapy on the long-term survival of renal allografts and the relative risk factors. Methods The Kaplan-Meier analysis and log-rank test were used to calculate the survival rates of patients and grafts in no acute rejection group (NAR, 895 patients), 1 rejection episode group (1AR, 183), 2 and more than 2 rejection episodes group (2AR, 17), acute rejection group [AR (1AR+2AR), 200], early acute rejection group (within 90 days after transplantation, EAR, 125), late acute rejection group (91 days later, LAR, 58), completely AR reversed group (CAR, 105), and incompletely AR reversed group (IAR, 68). The relative risk factors were analyzed by the Cox proportional hazards regression. Results The 5- and 10-year survival rates of renal allografts were 75.4% and 17.1% in AR and 93.2% and 86.5% in the NAR group (P<0.0001). The long-term graft survival was much lower in the 2AR group than in the NAR or 1AR groups (P<0.0001 and P=0.002, respectively). It was similar in either the NAR or CAR groups (P=0.31), but it was significantly lower (P<0.0001) in the IAR group. Multivariate Cox regression analysis revealed that the outcome of anti-rejection therapy is an important risk factor affecting the long-term survival of allografts.Conclusions AR is significantly associated with poor long-term survival of renal allografts. But the long-term graft survival of patients with one acute rejection but completely reversed is not significantly different from that of patients without acute rejection.

  15. 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.

  16. Symptoms of epilepsy and organic brain dysfunctions in patients with acute, brief depression combined with other fluctuating psychiatric symptoms: a controlled study from an acute psychiatric department

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    Linaker Olav M

    2009-09-01

    Full Text Available Abstract Background In psychiatric acute departments some patients present with brief depressive periods accompanied with fluctuating arrays of other psychiatric symptoms like psychosis, panic or mania. For the purpose of the present study we call this condition Acute Unstable Depressive Syndrome (AUDS. The aims of the present study were to compare clinical signs of organic brain dysfunctions and epilepsy in patients with AUDS and Major Depressive Episode (MDE. Methods Out of 1038 consecutive patients admitted to a psychiatric acute ward, 16 patients with AUDS and 16 age- and gender-matched MDE patients were included in the study. Using standardized instruments and methods we recorded clinical data, EEG and MRI. Results A history of epileptic seizures and pathologic EEG activity was more common in the AUDS group than in the MDE group (seizures, n = 6 vs. 0, p = 0.018; pathologic EEG activity, n = 8 vs. 1, p = 0.015. Five patients in the AUDS group were diagnosed as having epilepsy, whereas none of those with MDE had epilepsy (p = 0.043. There were no differences between the groups regarding pathological findings in neurological bedside examination and cerebral MRI investigation. Conclusion Compared to patients admitted with mood symptoms fulfilling DSM 4 criteria of a major depressive disorder, short-lasting atypical depressive symptoms seem to be associated with a high frequency of epileptic and pathologic EEG activity in patients admitted to psychiatric acute departments. Trial registration NCT00201474

  17. 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...... 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. CLINICAL IMPLICATIONS: Evaluation of dysthymia or neuroticism is important to perform, even...

  18. Undiagnosed Bipolar Disorders in Patients with Major Depressive Episode: Iran’s Part of a Multicenter Cross-Sectional Study

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    Seyed Ali Ahmadi Abhari

    2013-03-01

    Full Text Available Objective: Bipolar spectrum disorders may often go undiagnosed or unrecognized. The aim of this study was to determine the proportion of bipolar disorder symptoms in Iranian patients with a major depressive episode.Methods: 313 patients with a current DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders 4th ed. Text rev. diagnosed with a major depressive episode entered this cross-sectional study. Thirty two items revised Hypomania/ mania Symptoms Checklist (HCL-32 was used to determine the frequency of bipolar episodes.Results: Considerable proportion of patients (53.9% previously diagnosed as major depressive disorder fulfilled the criteria for bipolar disorder by Bipolarity Specifier. The Bipolarity Specifier additionally identified significant association for manic / hypomanic states during antidepressants therapy (p<0.0003 and current mixed mood symptoms (p<0.0001Conclusion: Bipolar symptoms meeting the criteria for bipolar disorders in depressed patients who have not been previously diagnosed with bipolar disorder are frequent. Current DSM criteria may not be sufficient to diagnose more subtle or atypical forms of bipolar disorders.

  19. The effect of negative mood and major depressive episode on working memory and implicit learning.

    Science.gov (United States)

    Borbély-Ipkovich, Emőke; Janacsek, Karolina; Németh, Dezső; Gonda, Xenia

    2014-03-01

    Major depressive episode (MDE) is one of the most common psychiatric diagnoses and it has long-term mental and physiological consequences. The status of cognitive functions is of specific importance in case of affective disorders, due to their influence not only on patients' behaviour, but to a certain extent also on the success of psychotherapy. In addition, examining the impact of mood and affective disorders on cognitive functions also helps us understand the relationship between brain plasticity and neurocognitive networks. While the relationship between explicit, conscious memory and mood are relatively well-explored, the effect of mood and affective disorders on working memory and implicit sequence learning received less attention. The present review aims to overview available results in these less-explored areas. Research suggests that while working memory performance shows impairments in MDE and in some specific mood conditions, effects of affective disorders and mood on implicit sequence learning are more contradictory, highlighting the need for further studies in this field.

  20. 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.

  1. AGE DIFFERENCES IN THE PREVALENCE AND CO-MORBIDITY OF DSM-IV MAJOR DEPRESSIVE EPISODES: RESULTS FROM THE WHO WORLD MENTAL HEALTH SURVEY INITIATIVE

    NARCIS (Netherlands)

    Kessler, R.C.; Birnbaum, H.G.; Shahly, V.; Bromet, E.; Hwang, I.; McLaughlin, K.A.; Sampson, N.; Andrade, L.H.; De Girolamo, G.; Demyttenaere, K.; Haro, J.M.; Karam, A.N.; Kostyuchenko, S.; Kovess, V.; Lara, C.; Levinson, D.; Matschinger, H.; Nakane, Y.; Browne, M.O.; Ormel, J.; Posada-Villa, J.; Sagar, R.; Stein, D.J.

    2010-01-01

    Background: Although depression appears to decrease in late life, this could be due to misattribution of depressive symptoms to physical disorders that increase in late we. Methods: We investigated this issue by studying age differences in co-morbidity of DSM-IV major depressive episodes (MDE) with

  2. 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

    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. RESULTS: Within 5 years, 83.3% obtained remission, 31.5% experienced recurrence of depression and 8......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.......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...

  3. 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

  4. Montelukast as an episodic modifier for acute viral bronchiolitis: a randomized trial.

    Science.gov (United States)

    Zedan, Magdy; Gamil, Nareman; El-Assmy, Mohamed; Fayez, Engy; Nasef, Nehad; Fouda, Ashraf; Settin, Ahmed

    2010-01-01

    This study was designed to evaluate the effect of once-daily montelukast therapy on the clinical progress and the cytokine profile of patients with acute viral bronchiolitis. A randomized, double-blind, placebo-controlled trial included 85 patients (mean age, 3.5 +/- 2.35 months), clinically diagnosed as first-episode acute bronchiolitis in addition to 10 healthy controls of matched age and sex. Patients were randomly assigned to receive either montelukast (4-mg sachets; n = 47) or placebo (n = 38) daily from the time of admission until discharge. The primary outcome measure was the length of hospital stay (LOS), and clinical severity scores (CSs) and changes in plasma levels of interferon gamma and interleukin-4 were secondary outcomes. LOS for the montelukast group was found to be significantly lower than that of the placebo group (p viral bronchiolitis.

  5. Brain activation before and after cognitivebehavior therapy in first-episode patients with mildto-moderate major depressive disorder

    Institute of Scientific and Technical Information of China (English)

    谭雅容

    2014-01-01

    Objective To explore the neurobiological mechanisms underlying cognitive-behavior therapy(CBT)for major depressive disorder(MDD)by detecting the neural changes of patients following CBT.Methods Thirteen first-episode treatment-naive patients with MDD and 13 matched healthy volunteers underwent fM RI scan.All the patients were treated with 6-week CBT only and scanned again after treatment.A gender recognition task

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

    Science.gov (United States)

    Xirasagar, Sudha; Chung, Shiu-Dong; Tsai, Ming-Chieh; Chen, Chao-Hung

    2017-01-01

    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. PMID:28222168

  7. 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

  8. Antidepressant Treatment for Acute Bipolar Depression: An Update

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    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.

  9. Study of prevalence of depression and impact of depression in patients following acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Bobby Hmar

    2017-01-01

    Full Text Available Background: Depression has been found to be associated with cardiovascular diseases in various studies done in different parts of the world. Whether depression really develops after an attack of acute myocardial infarction (AMI in hospitalised patients was not evaluated in this region of our country prior to the current work. Aim: To evaluate the prevalence of depression and impact of depression in AMI patients during the period of hospitalisation. Materials and method: Patients were recruited for the study after fulfilling the selection criteria and who had documented AMI within four to five days of hospitalisation. Informed consent of the patient and ethical committee clearance was obtained. To collect data semi-structured interview schedule was used. Assamese versions of 21 self-report items Beck Depression Inventory (BDI and observer-rated 17 items Hamilton Rating Scale for Depression (HAM-D were administered to 50 AMI patients. Data were analysed with chi-square test, Pearson coefficient of correlation, and student t test wherever applicable. p-value<0.05 was considered test of significance in this study. Result: Fifty cases of AMI were evaluated from August 2007 to July 2008. Thirty six per cent of AMI patients and 34% of AMI patients were found to have depression as per BDI and HAM-D scales respectively. Depression has an impact on duration of hospital stay significantly (p<0.019 but not on gender difference (p=0.089. Correlation of mean scores of both HAM-D and BDI scales was done by Pearson coefficient of correlation and was found to be significant at .01 level. Conclusion: Depression was found to be high in AMI patients during the period of hospitalisation in both the depression rating scales and it has an impact on prognosis of the patients.

  10. The impact a first episode of major depression has on marital dissatisfaction: Is remission associated with improvement in dissatisfaction?

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    Jaime Moyá

    2010-03-01

    Full Text Available Background and Objectives: Prior research suggests that marital dissatisfaction is associated with Major Depression (MD. The purpose of this study was to investigate whether remission from a first episode of MD is associated with improvement in marital dissatisfaction and whether the degree of marital dissatisfaction at the time of diagnosis has an influence on the outcome of MD. Methods: The Hamilton Rating Scale for Depression, the Dyadic Adjustment Scale and the Areas of Change Questionnaire were administered to 59 married couples in which one member fulfilled DSM-IV criteria for a first Episode of MD, but her husband (or his wife did not suffer any mental disorder, and to 53 control couples at 6 outpatient clinics, at baseline and after a 6-months follow-up. Results: The level of marital dissatisfaction in couples with a persistent depressed participant decreased in comparison to couples without a depressed subject (p < 0.05 CI: -10.6 and -0.2, but there were no significant differences between couples in which the depressed spouse recovered from MD and comparison couples. Regardless of MD´s severity, high levels of satisfaction were associated with a higher probability to recover. Limitations: The follow-up period was short and we assessed the level of marital dissatisfaction using self-report measures. Conclusion: This study shows that MD has an influence on Marital Satisfaction even at a very early stage of the Depressive Disorder. What is more, changes in any of the two factors (MD or marital dissatisfaction influenced the other factor´s course; thus an effective intervention on MD may have a positive impact on marital dissatisfaction as well.

  11. 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......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...

  12. Changes in Antibody Levels during and following an Episode of Acute Adenolymphangitis (ADL among Lymphedema Patients in Leogane, Haiti.

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    Katherine E Mues

    Full Text Available Episodes of acute adenolymphangitis (ADL are often the first clinical sign of lymphatic filariasis (LF. They are often accompanied by swelling of the affected limb, inflammation, fever, and general malaise and lead to the progression of lymphedema. Although ADL episodes have been studied for a century or more, questions still remain as to their etiology. We quantified antibody levels to pathogens that potentially contribute to ADL episodes during and after an episode among lymphedema patients in Léogâne, Haiti. We estimated the proportion of ADL episodes hypothesized to be attributed to specific pathogens.We measured antibody levels to specific pathogens during and following an ADL episode among 41 lymphedema patients enrolled in a cohort study in Léogâne, Haiti. We calculated the absolute and relative changes in antibody levels between the ADL and convalescent time points. We calculated the proportion of episodes that demonstrated a two-fold increase in antibody level for several bacterial, fungal, and filarial pathogens.Our results showed the greatest proportion of two-fold changes in antibody levels for the carbohydrate antigen Streptococcus group A, followed by IgG2 responses to a soluble filarial antigen (BpG2, Streptococcal Pyrogenic Exotoxin B, and an antigen for the fungal pathogen Candida. When comparing the median antibody level during the ADL episode to the median antibody level at the convalescent time point, only the antigens for Pseudomonas species (P-value = 0.0351 and Streptolysin O (P-value = 0.0074 showed a significant result.Although our results are limited by the lack of a control group and few antibody responses, they provide some evidence for infection with Streptococcus A as a potential contributing factor to ADL episodes. Our results add to the current evidence and illustrate the importance of determining the causal role of bacterial and fungal pathogens and immunological antifilarial response in ADL episodes.

  13. 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 stressful life events prior to onset of depression, also when corrected for the effect of age, gender, marital status, personality disorder, neuroticism, and severity of depressive symptoms at the time of interview. CONCLUSION: Polymorphisms in the genes encoding the serotonin transporter and the brain...

  14. 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

  15. 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...

  16. 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

  17. 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....

  18. Serotonin transporter gene moderates childhood maltreatment’s effects on persistent but not single-episode depression: Replications and implications for resolving inconsistent results

    Science.gov (United States)

    Uher, Rudolf; Caspi, Avshalom; Houts, Renate; Sugden, Karen; Williams, Benjamin; Poulton, Richie; Moffitt, Terrie E.

    2013-01-01

    Background Genetic and environmental factors shape life-long vulnerability to depression, but most gene–environment interaction (G×E) research has focused on cross-sectional assessments rather than life-course phenotypes. This study tests the hypothesis that the G×E involving the length polymorphism in the serotonin-transporter-gene-linked-promoter-region (5-HTTLPR) and childhood maltreatment is specific to depression that runs a persistent course in adulthood. Methods The hypothesis is tested in two cohorts. Men and women in the Dunedin Study (N=847), New Zealand, followed to age 32 years with 96% retention and women in the E-Risk Study (N=930), England, followed to age 40 years with 96% retention. Diagnoses of past-year major depressive episode were established at four separate assessments. Depression diagnosed on two or more occasions was considered persistent. Results In both cohorts, statistical tests of gene–environment interactions showed positive results for persistent depression but not single-episode depression. Individuals with two short 5-HTTLPR alleles and childhood maltreatment had elevated risk of persistent but not single-episode depression. Limitations Some cases of recurrent depression may have been misclassified as single-episode due to non-contiguous assessment windows, but this would have a conservative effect on the findings. Chronic and recurrent depression could not be reliably distinguished due to non-contiguous periods of assessment. Therefore, the term persistent depression is used to describe either chronic or recurrent course. Conclusions The specific effect on persistent depression increases the significance of this G×E for public health. Research that does not distinguish persistent course may underestimate G×E effects and account for some replication failures in G×E research. PMID:21439648

  19. Rorschach variables and dysfunctional attitudes as measures of depressive vulnerability: a 9-year follow-up study of individuals with different histories of major depressive episodes.

    Science.gov (United States)

    Hartmann, Ellen; Halvorsen, Marianne; Wang, Catharina E A

    2013-01-01

    Forty-six individuals with different histories of major depressive episodes (MDEs) completed the Rorschach (Exner, 2003 ) and the Dysfunctional Attitude Scale (DAS; Weissman & Beck, 1978) at 2 assessment points (T1, T2) over a 9-year follow-up. At T1, history of MDE and the Rorschach variable MOR (associated with negative self-image) emerged as significant predictors of number of MDEs over the follow-up. At T2, Rorschach markers of depressive vulnerability and scars were identified (i.e., WSum6, related to illogical thinking; X+%, related to conventional perception and social adjustment; X-%, linked to erroneous judgments; MQ-, associated with impaired social relations; and MOR). Test-retest analyses displayed significant temporal stability in Rorschach variables, with r ranging from .34 to .67 and in the DAS, r = .42. Our findings highlight MDE as a recurrent and serious disorder, number of MDEs as a risk factor for future depressions, and Rorschach variables as markers of depressive vulnerability and scars.

  20. 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.

  1. The volumetric and shape changes of the putamen and thalamus in first episode, untreated major depressive disorder.

    Science.gov (United States)

    Lu, Yi; Liang, Hongmin; Han, Dan; Mo, Yin; Li, Zongfang; Cheng, Yuqi; Xu, Xiufeng; Shen, Zonglin; Tan, Chunyan; Zhao, Wei; Zhu, Yun; Sun, Xuejin

    2016-01-01

    Previous MRI studies confirmed abnormalities in the limbic-cortical-striatal-pallidal-thalamic (LCSPT) network or limbic-cortico-striatal-thalamic-cortical (LCSTC) circuits in patients with major depressive disorder (MDD), but few studies have investigated the subcortical structural abnormalities. Therefore, we sought to determine whether focal subcortical grey matter (GM) changes might be present in MDD at an early stage. We recruited 30 first episode, untreated patients with major depressive disorder (MDD) and 26 healthy control subjects. Voxel-based morphometry was used to evaluate cortical grey matter changes, and automated volumetric and shape analyses were used to assess volume and shape changes of the subcortical GM structures, respectively. In addition, probabilistic tractography methods were used to demonstrate the relationship between the subcortical and the cortical GM. Compared to healthy controls, MDD patients had significant volume reductions in the bilateral putamen and left thalamus (FWE-corrected, p putamen, and on the dorsal and ventral aspects of left thalamus in MDD patients (FWE-corrected, p putamen and left thalamus have connections with the frontal and temporal lobes, which were found to be related to major depression. Our results suggested that structural abnormalities in the putamen and thalamus might be present in the early stages of MDD, which support the role of subcortical structure in the pathophysiology of MDD. Meanwhile, the present study showed that these subcortical structural abnormalities might be the potential trait markers of MDD.

  2. Remittances and risk of major depressive episode and sadness among new legal immigrants to the United States

    Directory of Open Access Journals (Sweden)

    Eliva Ambugo

    2016-01-01

    Full Text Available Background: The impact of remittances on health problems like depression among immigrants is understudied. Yet immigrants may be particularly emotionally vulnerable to the strains and benefits of providing remittances. Objective: This study examines the association between sending remittances and major depressive episode (MDE and sadness among legal immigrants in the United States. Methods: Cross-sectional data (N=8,236 adults come from the New Immigrant Survey (2003-2004, a representative sample of new U.S. permanent residents. Results: In logistic regression models, immigrants who remitted had a higher risk of MDE and sadness compared to those who did not, net of sociodemographic and health factors. For remitters (N=1,470, the amount of money was not significantly linked to MDE but was associated with a higher risk of sadness among refugees/asylees compared to employment migrants. Conclusions: Among socioeconomically vulnerable migrants such as refugees/asylees, sending remittances may threaten mental health by creating financial hardship. Initiatives that encourage economic stability for migrants may protect against depression.

  3. Depression in patients with schizophrenia admitted to the acute services of the Psychiatric Hospital of Havana

    OpenAIRE

    Llanes Basulto, Yasmani; Barrios Hernández, Yanquiel; Oliva Hernández, Ignacio; Pimentel Noda, Susel de la Caridad; Calvo Guerra, Esvieta

    2014-01-01

    The presence of depression in the acute phase of schizophrenia is evaluated, and the clinical and psychosocial characteristics that can be associated with depression are identified. Participants included 73 patients that were admitted to the acute services of the Psychiatric Hospital of Havana, given that depression is a symptom in a significant amount of the patients with schizophrenia, 35.6% of the patients presented clinically significant symp- toms, and these were related significantly wi...

  4. Predicting the onset and persistence of episodes of depression in primary health care. The predictD-Spain study: Methodology

    Directory of Open Access Journals (Sweden)

    Brangier-Wainberg Paulette

    2008-07-01

    Full Text Available Abstract Background The effects of putative risk factors on the onset and/or persistence of depression remain unclear. We aim to develop comprehensive models to predict the onset and persistence of episodes of depression in primary care. Here we explain the general methodology of the predictD-Spain study and evaluate the reliability of the questionnaires used. Methods This is a prospective cohort study. A systematic random sample of general practice attendees aged 18 to 75 has been recruited in seven Spanish provinces. Depression is being measured with the CIDI at baseline, and at 6, 12, 24 and 36 months. A set of individual, environmental, genetic, professional and organizational risk factors are to be assessed at each follow-up point. In a separate reliability study, a proportional random sample of 401 participants completed the test-retest (251 researcher-administered and 150 self-administered between October 2005 and February 2006. We have also checked 118,398 items for data entry from a random sample of 480 patients stratified by province. Results All items and questionnaires had good test-retest reliability for both methods of administration, except for the use of recreational drugs over the previous six months. Cronbach's alphas were good and their factorial analyses coherent for the three scales evaluated (social support from family and friends, dissatisfaction with paid work, and dissatisfaction with unpaid work. There were 191 (0.16% data entry errors. Conclusion The items and questionnaires were reliable and data quality control was excellent. When we eventually obtain our risk index for the onset and persistence of depression, we will be able to determine the individual risk of each patient evaluated in primary health care.

  5. Efficacy and safety of antidepressant's use in the treatment of depressive episodes in bipolar disorder - review of research.

    Science.gov (United States)

    Antosik-Wójcińska, Anna Zofia; Stefanowski, Bogdan; Święcicki, Łukasz

    2015-01-01

    The use of antidepressants in treatment of depression in course of bipolar disorders (BD) is controversial. In case of no improvement during monotherapy with mood stabilizer, the use of antidepressants is often necessary. The safety of this group (in context of phase change, mixed states and rapid cycling) is essential and is the subject of many research. In the paper, the authors review the literature concerning efficacy and safety of use of antidepressants in the treatment of affective disorders and long-term impact on the course of the disease. Selection of articles have been made by searching the Medline and Pubmed databases using keywords: antidepressant drugs, bipolar depression, bipolar disorder, efficacy, safety, mania, hypomania. The risk of mania is greater in bipolar disorder type I, than in type II or during treatment with Tricyclic antidepressants (TCAs) and treatment with venlafaxine. The use of SSRIs and bupropion is associated with a relatively small increase of phase change risk. There are different opinions concerning recommended duration of antidepressant treatment. Generally antidepressant use should end after 2-3 months of remission, the risk of recurrence of depression after discontinuation of antidepressants is, however, higher than in case of continuation. In BD type II or BD spectrum, antidepressant monotherapy is allowed in severe depression. In bipolar disorder type I and in case of phase change after antidepressants use in the past, use of antidepressants should be very cautious. Antidepressants are contraindicated in rapid cycling and in mixed episodes. Further work is needed to evaluate the efficacy and safety of antidepressants use.

  6. Diagnostic criteria for bipolarity based on an international sample of 5,635 patients with DSM-IV major depressive episodes.

    Science.gov (United States)

    Angst, J; Gamma, A; Bowden, C L; Azorin, J M; Perugi, G; Vieta, E; Young, A H

    2012-02-01

    To assess the clinical validity of individual DSM-IV criteria for hypomania. In an international sample of 5,635 patients with major depressive episodes (Bridge Study), DSM-IV criteria for hypomania (stem questions, number and quality of symptoms, duration and exclusion criteria) were systematically assessed and their validity analysed on the basis of clinical data including family history, course, and other clinical characteristics. Three stem questions for hypomania, irritability, elevated mood and the added question of increased activity, showed comparable validity. The results support the current DSM-IV requirement for a higher symptom threshold (4 of 7 hypomanic symptoms) in cases of irritable mood. Longer durations of hypomanic episodes were associated with higher scores on all validators. The results did not support the DSM-IV durational requirements for hypomanic episodes (4 days) and manic episodes (7 days). Brief hypomanic episodes of 1, 2 or 3 days were valid and would meet validity criteria for inclusion. The three exclusion criteria in DSM-IV (hypomania due to the use of antidepressants or of other substances, or to other medical conditions) were found to exclude patients with bipolar depression and should therefore not be retained. These results support several revisions of the DSM-IV concept of hypomanic episodes: specifically, the inclusion of increased activity as a gate question, the inclusion of 1 or 2 to 3-day episodes and the elimination of all exclusion criteria.

  7. Should a Preschool Child with Acute Episodic Wheeze be Treated with Oral Corticosteroids? A Pro/Con Debate.

    Science.gov (United States)

    Beigelman, Avraham; Durrani, Sandy; Guilbert, Theresa W

    2016-01-01

    Traditionally, preschool-aged children with an acute wheezing episode have been treated with oral corticosteroids (OCSs) based on the efficacy of OCSs in older children and adolescents. However, this practice has been recently challenged based on the results of recent studies. The argument supporting the use of OCSs underscores the observation that many children with recurrent preschool wheezing develop atopic disease in early life which predicts both an increased risk to develop asthma in later life and response to OCS therapy. Further, review of the literature demonstrates heterogeneity of study designs, OCS dosage, interventions, study medication adherence, and settings and overall lack of predefined preschool wheezing phenotypes. The heterogeneity of these studies does not allow a definitive recommendation discouraging OCS use. Advocates against the use of OCSs in this population argue that most of studies investigating the efficacy of OCSs in acute episodic wheeze in preschool-aged children have not demonstrated beneficial effects. Moreover, repeated OCS bursts may be associated with adverse effects. Finally, both sides can agree that there is a significant need to conduct efficacy trials evaluating OCS treatment in preschool-aged children with recurrent wheezing targeted at phenotypes that would be expected to respond to OCSs. This article presents a summary of recent literature regarding the use of OCSs for acute episodic wheezing in preschool-aged children and a "pro" and "con" debate for such use.

  8. 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

    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......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...

  9. Association between genetic polymorphisms in the serotonergic system and comorbid personality disorders among patients with first-episode depression.

    Science.gov (United States)

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

    2014-06-01

    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 personality disorder, and no associations between other polymorphisms and personality disorders. The study adds evidence to the effect of the serotonin transporter gene specifically on cluster B personality disorders.

  10. First-episode medication-naive major depressive disorder is associated with altered resting brain function in the affective network.

    Directory of Open Access Journals (Sweden)

    Xiaocui Zhang

    Full Text Available BACKGROUND: Major depressive disorder (MDD has been associated with abnormal structure and function of the brain's affective network, including the amygdala and orbitofrontal cortex (OFC. However, it is unclear if alterations of resting-state function in this affective network are present at the initial onset of MDD. AIMS: To examine resting-state function of the brain's affective network in first-episode, medication-naive patients with MDD compared to healthy controls (HCs. METHODS: Resting-state functional magnetic resonance imaging (rs-fMRI was performed on 32 first-episode, medication-naive young adult patients with MDD and 35 matched HCs. The amplitude of low-frequency fluctuations (ALFF of the blood oxygen level-dependent (BOLD signal and amygdala-seeded functional connectivity (FC were investigated. RESULTS: Compared to HC, MDD patients showed reduced ALFF in the bilateral OFC and increased ALFF in the bilateral temporal lobe extending to the insular and left fusiform cortices. Enhanced anti-correlation of activity between the left amygdala seed and the left OFC was found in MDD patients but not in HCs. CONCLUSIONS: Reduced ALFF in the OFC suggests hypo-functioning of emotion regulation in the affective network. Enhanced anti-correlation of activity between the amygdala and OFC may reflect dysfunction of the amygdala-OFC network and additionally represent a pathological process of MDD.

  11. Identifying Personality Pathology Associated With Major Depressive Episodes: Incremental Validity of Informant Reports

    OpenAIRE

    2013-01-01

    Major limitations are associated with the use of a single source of information to assess personality pathology. The construct validity of standardized interviews and informant reports on personality pathology has been established relative to other measures of personality pathology, but it is also important to consider these measures in relation to other constructs that should be related to personality pathology. One example is major depression. In this study, we evaluated whether less common...

  12. 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

    Brain derived neurotrophic factor (BDNF) seems to play an important role in the pathophysiology of affective disorders. The current study investigated whether blood level BDNF is correlated with the severity of depressive symptoms and recent (six months prior to onset of depression) experience......). 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....... No significant associations between the experiences of SLE before onset of depression and BDNF level were observed. Finally, peripheral BDNF differentiated between patients and healthy control persons. In the current sample of first episode depressed patients, the Val66Met polymorphism was not associated...

  13. 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

  14. Co-occurrence of major depressive episode and posttraumatic stress disorder among survivors of war: how is it different from either condition alone?

    NARCIS (Netherlands)

    Morina, N.; Ajdukovic, D.; Bogic, M.; Franciskovic, T.; Kucukalic, A.; Lecic-Tosevski, D.; Morina, L.; Popovski, M.; Priebe, S.

    2013-01-01

    OBJECTIVE: Major depressive episode (MDE) and posttraumatic stress disorder (PTSD) have been shown to be the most common mental disorders following traumatic war experiences and have been found to frequently co-occur. This study, designed as a randomized cross-sectional interview survey, aimed to id

  15. Psychosocial disability before, during, and after a major depressive episode - A 3-wave population-based study of state, scar, and trait effects

    NARCIS (Netherlands)

    Ormel, J; Oldehinkel, AJ; Nolen, WA; Vollebergh, W

    2004-01-01

    Background: Psychosocial disability after remission from a unipolar major depressive episode (MDE) can be due to (1) residual symptoms (state effect), (2) the continuation of premorbid disability (trait effect), and/or (3) disability that developed during the MDE and persisted beyond recovery (scar

  16. The volumetric and shape changes of the putamen and thalamus in first episode, untreated major depressive disorder

    Directory of Open Access Journals (Sweden)

    Yi Lu

    2016-01-01

    Full Text Available Previous MRI studies confirmed abnormalities in the limbic-cortical-striatal-pallidal-thalamic (LCSPT network or limbic-cortico-striatal-thalamic-cortical (LCSTC circuits in patients with major depressive disorder (MDD, but few studies have investigated the subcortical structural abnormalities. Therefore, we sought to determine whether focal subcortical grey matter (GM changes might be present in MDD at an early stage. We recruited 30 first episode, untreated patients with major depressive disorder (MDD and 26 healthy control subjects. Voxel-based morphometry was used to evaluate cortical grey matter changes, and automated volumetric and shape analyses were used to assess volume and shape changes of the subcortical GM structures, respectively. In addition, probabilistic tractography methods were used to demonstrate the relationship between the subcortical and the cortical GM. Compared to healthy controls, MDD patients had significant volume reductions in the bilateral putamen and left thalamus (FWE-corrected, p < 0.05. Meanwhile, the vertex-based shape analysis showed regionally contracted areas on the dorsolateral and ventromedial aspects of the bilateral putamen, and on the dorsal and ventral aspects of left thalamus in MDD patients (FWE-corrected, p < 0.05. Additionally, a negative correlation was found between local atrophy in the dorsal aspects of the left thalamus and clinical variables representing severity. Furthermore, probabilistic tractography demonstrated that the area of shape deformation of the bilateral putamen and left thalamus have connections with the frontal and temporal lobes, which were found to be related to major depression. Our results suggested that structural abnormalities in the putamen and thalamus might be present in the early stages of MDD, which support the role of subcortical structure in the pathophysiology of MDD. Meanwhile, the present study showed that these subcortical structural abnormalities might be

  17. 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

    2016-04-26

    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.

  18. 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;}

  19. 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

  20. 首发、复发和双相抑郁患者精神症状的比较%Comparison of the mental symptoms in patients with first episode depression, recurrent depression and bipolar depression

    Institute of Scientific and Technical Information of China (English)

    任志斌; 马永春; 金卫东; 王鹤秋; 王乃信

    2013-01-01

    目的:探讨首发、复发及双相抑郁患者精神症状的差异. 方法:对首次抑郁发作患者(首发组,24例)、复发性抑郁症患者(复发组,57例)及双相抑郁患者(双相组,25例)进行汉密尔顿抑郁评定量表(HAMD)、汉密尔顿焦虑评定量表(HAMA)、杨氏躁狂评定量表(YMRS)以及阳性和阴性症状评定量表(PANSS)评定和比较. 结果:HAMD、HAMA评分在3组间差异无统计学意义;YMRS评分3组间差异有统计学意义(F=5.2,P=0.007);双相组(6.6±9.0)显著高于首发组(2.8±3.4)和复发组(2.2±3.2)(q =3.86,g =4.40;P均<0.05).双相组HAMD中的躯体焦虑因子分、体重因子分均显著低于复发组(P<0.05或P<0.01);双相组精神病理学症状评分如意志活动、愤怒、幻觉、易激惹、激越、思维联想加快、破坏或攻击行为、活动增加显著高于首发组及复发组(P<0.05或P<0.01). 结论:双相障碍患者抑郁发作时可出现与躁狂相关精神症状.%Objective:To explore the difference in mental symptoms among depressive patients with first episode,recurrent and bipolar episode.Method:The evaluations of Hamilton depression scale (HAMD),Hamilton anxiety scale(HAMA),Young mania rating scale (YMRS) and positive and negative symptoms rating scale (PANSS) were preformed in 24 patients with first episode (first episode group),57 patients with recurrence depression (recurrence group) and 24 patients with bipolar depression (bipolar group).The results were compared among the three groups.Results:The scores of HAMD,HAMA among the three groups were no significant difference,but score of YMRS among the three groups were significantly different (F =5.2,P =0.007).The score of YMRS in bipolar group (6.6 ± 9.0) was significantly higher than first episode group (2.8 ± 3.4) and recurrence group (2.2 ± 3.2) (q =3.86,q =4.40 ; all P < 0.05).The scors of somatic anxiety factor and weight factor of HAMD in bipolar group were significantly lower than those in

  1. 抑郁发作与躁狂发作者暴力犯罪特点对照研究%A case control study of the characteristic of violent crime between the patients with manic episode and depressive episode

    Institute of Scientific and Technical Information of China (English)

    孔晓明; 张晓莉

    2011-01-01

    目的 比较司法精神病鉴定中躁狂发作与抑郁发作患者暴力犯罪行为的特点及其责任能力评定结果.方法 对2000年1月至2010年12月在合肥市精神病医院司法鉴定科所鉴定的33例躁狂发作和30例抑郁发作患者暴力犯罪的资料进行回顾性分析.结果 抑郁发作组凶杀案件(53.3%)显著高于躁狂发作组凶杀案件(18.2%)的比例(P<0.01);在居住地、作案地点及与受害人关系等条目两组间比较差异有统计学意义;两组责任能力评定比较差异无统计学意义(P>0.05).结论 躁狂发作和抑郁发作者的暴力犯罪行为特点各自不同,这可能与两者的疾病症状表现、严重程度以及辨认和控制能力差异有关.%Objective To investigate the characteristic of index offence and the criminal responsibility of the forensic patients with manic episode and depressive episode.Methods A comparative study was conducted between 33 cases of manic episode and 30 cases of depressive episode referred for forensic psychiatric assessment from 2000 to 2010 at Hefei psychiatric hospital.Results There was significant difference between the two groups in the homicide rate(depression 53.3% vs mania 18.2%,P <0.01),and there was asignificant difference between the two groups in place of residence,place of crime and the relationship of the victim.No difference was found in the result of criminal responsibility between the two groups.Conclusions There were differences in violent crime between patients with manic episode and depressive episode,these maybe due to the difference of the symptoms,the severity of the diseases and the ability of identification and self control between the two groups.

  2. Early Prediction of Acute Antidepressant Treatment Response and Remission in Pediatric Major Depressive Disorder

    Science.gov (United States)

    Tao, Rongrong; Emslie, Graham; Mayes, Taryn; Nakonezny, Paul; Kennard, Betsy; Hughes, Carroll

    2009-01-01

    The rate of symptom improvement during the early weeks of acute fluoxetine treatment is a good indicator of remission. This finding was made after evaluating the outcome of the fluoxetine treatment on 168 children and adults with depression.

  3. 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

  4. 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.

  5. 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.

  6. 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.

  7. Spotlight on quetiapine in acute mania and depression associated with bipolar disorder.

    Science.gov (United States)

    Dando, Toni M; Keating, Gillian M

    2006-01-01

    Quetiapine (Seroquel), an atypical antipsychotic with established efficacy in the treatment of schizophrenia, shows efficacy in the treatment of acute mania and depression associated with bipolar disorder.Quetiapine, either as monotherapy or in combination with lithium or divalproex sodium (valproate semisodium), is generally well tolerated and effective in reducing manic symptoms in adult and adolescent patients with acute bipolar mania, and is approved for use in adults for this indication. As monotherapy, the drug is also effective in reducing depressive symptoms in patients with bipolar depression. It is associated with a low incidence of extrapyramidal symptom (EPS)-related adverse events and low EPS ratings in bipolar disorder. Quetiapine thus shows potential in the treatment of bipolar depression, and represents a useful agent for the treatment of acute bipolar mania.

  8. Cognitive-behavioural therapy v. usual care in recurrent depression

    NARCIS (Netherlands)

    H.J. Conradi; P. de Jonge; J. Ormel

    2008-01-01

    We examined in a primary care sample whether acute-phase cognitive-behavioural therapy (CBT) would be more effective than usual care for patients with multiple prior episodes of depression. Depression outcome was based on a 3-monthly administered Beck Depression Inventory (BDI) during a 2-year follo

  9. EVALUATION OF ANXIETY & DEPRESSIVE SYMPTOMS IN PATIENTS WITH 1 ST EPISODE OF CHEST PAIN ATTENDING MEDICINE OUT PATIENT DEPARTMENT OF TERTIARY CARE TEACHING HOSPITAL

    Directory of Open Access Journals (Sweden)

    Bhavik S.

    2015-06-01

    Full Text Available INTRODUCTION: As chest pain is an important symptom of coronary artery disease (CAD and other non - cardiac diseases , the presentation of the symptom often prompts referral to physicians for further investigation. Previous studies h ad shown significant as sociation between chest pain and D e pr e ssive and anxiety symptoms. AIMS AND OBJECTIVES: Evaluate and screen depressive symptoms , anxiety symptoms and somatic symptoms in patients with 1 st episode of chest pain attending medicine out - patient department of tertiary care teaching hospital. METHODOLGY : Cross - sectional observational study. Prior permission from institutional ethics committee of ‘SUMANDEEP VIDYAPEETH’ had been taken. 100 patients having first episosde of chest pain coming to M edicine opd of DHIRAJ HOSPITAL are recruited randomly after 1st December 2014. Each patient is given case r eport form containing sociodemographic data , patients medical history , depression and somatic symptoms scale and Hamilton’s anxiety scale (HAM - A. All data are entered in spss 16 and analysed with different ( S tatistical tests. Differences on categorical m easures will be reported as P value. The result is significant if P <0.05. RESULT: 38% & 49% patients have clinically significant depression and anxiety respectively. DSSS score is positively correlated with duration of chest pain. CONCLUSION : significant level of depression and anxiety found in 1 st episode of chest pain patients.

  10. Depressive Symptoms Are More Strongly Related to Executive Functioning and Episodic Memory Among African American compared with Non-Hispanic White Older Adults

    Science.gov (United States)

    Zahodne, Laura B.; Nowinski, Cindy J.; Gershon, Richard C.; Manly, Jennifer J.

    2014-01-01

    We examined whether the reserve capacity model can be extended to cognitive outcomes among older African Americans. Two hundred and ninety-two non-Hispanic Whites and 37 African Americans over age 54 participated in the normative study for the NIH Toolbox for the Assessment of Neurological and Behavioral Function. Multiple-group path analysis showed that associations between depressive symptoms and cognition differed by race, independent of age, education, reading level, income, health, and recruitment site. Depressive symptoms were associated with slowed processing speed among Whites and worse task-switching, inhibition, and episodic memory among African Americans. African Americans may be more vulnerable to negative effects of depression on cognition than non-Hispanic Whites. Further research is needed to explicate the psychological and neurobiological underpinnings of this greater vulnerability. PMID:25280795

  11. 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

    BACKGROUND & AIMS: It is unclear whether patients with hepatic encephalopathy (HE) have disturbed brain oxygen metabolism and blood flow. METHODS: We measured cerebral oxygen metabolism rate (CMRO(2)) by using (15)O-oxygen positron emission tomography (PET), and cerebral blood flow (CBF) by using....../min in patients with HE, 0.47 +/- 0.02 in patients without HE, and 0.49 +/- 0.03 in healthy subjects. CMRO(2) and CBF were correlated, and both variables correlated negatively with arterial ammonia concentration. Analysis of regional values, using individual magnetic resonance co-registrations, showed...... 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...

  12. 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.

  13. 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

    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...... trajectories on any scale compared with placebo (P > 0.28). Efficacy of escitalopram may have been better among those scoring at least the normative score on general health perceptions (hazard ratio (HR) for depression 0.17 (95% confidence interval 0.02-1.42) ) or social functioning (HR = 0.12 (0...

  14. Insomnia in depression: differences in objective and subjective sleep and awakening quality to normal controls and acute effects of trazodone.

    Science.gov (United States)

    Saletu-Zyhlarz, Gerda Maria; Abu-Bakr, Manal Hassan; Anderer, Peter; Gruber, Georg; Mandl, Magdalena; Strobl, Roland; Gollner, Dietmar; Prause, Wolfgang; Saletu, Bernd

    2002-02-01

    Utilizing polysomnography (PSG) and psychometry, objective and subjective sleep and awakening quality was investigated in 11 drug-free patients (five females, six males) aged 35-75 years (mean age 54.1 +/- 11.4) suffering from nonorganic insomnia (F 51.0) related to a depressive episode (F 32) or recurrent depressive disorder (F 33). as compared with 11 age- and sex-matched normal controls (five females, six males) aged 36-75 years (mean age 53.0 +/- 13.5). PSG demonstrated decreased sleep efficiency, total sleep time (TST), total sleep period (TSP) and sleep stage S2, as well as increased wakefulness during TSP, early morning awakening, sleep latency to S1, S2, S3 and sleep stage S1 in depressed patients. Subjective sleep quality and the total score of the Self-Assessment of Sleep and Awakening Quality Scale (SSA) were deteriorated as were morning and evening well being, drive, mood and fine motor activity right. Evening and morning blood pressure, the O2 desaturation index and periodic leg movement (PLM) index were increased. In a subsequent acute, placebo-controlled cross-over design study, the acute effects of 100 mg of trazodone, a serotonin reuptake inhibitor with a sedative action due to 5-HT2 and alpha1 receptor blockade, were investigated in the patients. As compared with placebo, trazodone induced an increase in sleep efficiency (primary target variable), TST, TSP and SWS (S3 + S4), as well as a decrease in wakefulness during the TSP, early morning awakening and S2. There was no change in rapid eye movement (REM) sleep with the exception of an increase in the REM duration in minutes. Trazodone also caused an improvement in subjective sleep quality, affectivity, numerical memory and somatic complaints. All respiratory variables remained within normal limits. Critical flicker frequency and moming diastolic blood pressure were decreased. The present study demonstrated that depression induced significant changes in objective and subjective sleep and awakening

  15. Alpha2 macroglobulin elevation without an acute phase response in depressed adults with Down's syndrome: implications.

    Science.gov (United States)

    Tsiouris, J A; Mehta, P D; Patti, P J; Madrid, R E; Raguthu, S; Barshatzky, M R; Cohen, I L; Sersen, E

    2000-12-01

    Studies of immune function during depression in persons without intellectual disability (ID) have revealed elevated levels of alpha2 macroglobulin (alpha2M) and an acute phase protein (APP) response. Clinical observation suggests that people with Down's syndrome (DS) may have associated genetic abnormalities in their immune systems. The APP response and alpha2M changes in depressed versus non-depressed adults with DS was the subject of the present study. The serum pan-proteinase inhibitor alpha2M, and the AP proteins c-reactive protein (CRP), alpha1 antitrypsin (alpha1AT), ceruloplasmin (Cp), beta2 Macroglobulin (beta2M), transthyretin (Trans), serum amyloid protein (SAP), and albumin (Alb) were measured in 38 adults with DS, 19 of whom were diagnosed with and 19 without depression using a sandwich enzyme-linked immunosorbent assay (ELISA). The DSM-IV criteria were used for diagnoses. Medical and neurological examinations excluded medical disorders associated with APP response. Only alpha2M and CRP were significantly different in the depressed versus non-depressed groups. The alpha2M was higher, a response similar to one observed in depressed people without ID, but the CRP was lower in the depressed group, especially in those subjects not on psychotropic medications, contrary to the expected APP response to depression. The results suggest that alpha2M elevation in depressed adults with DS is independent of the APP response. An alternative explanation for its elevation is proposed linking the core symptom of depression with the mammalian dormancy/hibernation process. Further studies are needed to confirm that alpha2M elevation is specific to depression and that it might provide a helpful marker for the diagnosis of depression in people with ID.

  16. 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

    2017-02-24

    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.

  17. Absence of evidence for enhanced benefit of antibiotic therapy on recurrent acute rhinosinusitis episodes: a systematic review of the evidence base

    NARCIS (Netherlands)

    Kaper, N.M.; Breukel, L.; Venekamp, R.P.; Grolman, W.; van der Heijden, G.J.M.G.

    2013-01-01

    Objective To systematically review the evidence base on the effectiveness of short-course antibiotic therapy in adult patients with a recurrent episode of acute rhinosinusitis as part of a disease pattern on severity and duration of symptoms and recurrences. Data Sources PubMed, EMBASE, and the Coch

  18. Cortisol response to acute stress in asthma: Moderation by depressive mood.

    Science.gov (United States)

    Trueba, Ana F; Simon, Erica; Auchus, Richard J; Ritz, Thomas

    2016-05-15

    Both individuals with asthma and depression show signs of a dysregulated hypothalamus-pituitary-adrenal axis. However, little is known about the cortisol response to stress in the context of co-occurring asthma and depressive mood. Thirty-nine individuals with asthma and 41 healthy controls underwent a combined speech and mental arithmetic stressor. During the course of the laboratory session, salivary cortisol was collected 5 times, with 1 sample at 0min before the stressor and 4 samples at 0, 15, 30 and 45min after the stressor. Depressive mood in the past week was assessed with the Hospital Anxiety and Depression Scale at the beginning of the session. Depressive symptoms moderated cortisol response to the acute stressor, but only among asthmatic patients. Higher depressive mood was associated with a significant increase in cortisol, whereas low depressive mood was associated with no cortisol response. In healthy participants, depressive mood had no substantial effect on cortisol response to the stressor. These findings suggest that depressive mood and chronic inflammatory diseases such as asthma can interact to augment cortisol response to stress.

  19. Time trend in depression diagnoses among acute coronary syndrome patients and a reference population from 2001 to 2009 in Denmark

    DEFF Research Database (Denmark)

    Jørgensen, Terese Sara Høj; Mårtensson, Solvej; Ibfelt, Else Helene;

    2016-01-01

    and a reference population. Methods: 87 218 patients registered with acute coronary syndrome from 2001-2009 in Denmark and a match reference population were followed through hospital registries and medication prescriptions for early (≤30 days), intermediate (31 days to 6 months) and later (6 months to 2 years......) depression in the acute coronary syndrome population and overall depression in the reference population. Cox regression models were used to compare hazard ratios (HRs) for depression over calendar years. Results: During the study period, 11.0% and 6.2% were diagnosed with depression in the acute coronary...... syndrome population and in the reference population, respectively. For the acute coronary syndrome population, the adjusted HRs increased for early (HR (95% CI) 1.04 (1.01-1.06)) and intermediate depression (HR (95% CI) 1.01 (1.00-1.03)), whereas the adjusted HRs did not change for later depression (HR (95...

  20. Decreased humoral antibody episodes of acute renal allograft rejection in recipients expressing the HLA-DQβ1*0202 allele.

    Science.gov (United States)

    Mannam, Venkat K R; Santos, Mark; Lewis, Robert E; Cruse, Julius M

    2012-10-01

    The present investigation was designed to show the effect of human leukocyte antigen (HLA) class II molecular allelic specificities in the recipient on the induction of humoral antibody rejection, identified by C4d peritubular capillary staining, as well as specific antibody identified by Luminex technology. Major histocompatibility complex (MHC) class II molecules are expressed on dendritic cells, macrophages, and B lymphocytes and they present antigenic peptides to CD4 positive T lymphocytes. Human renal peritubular and glomerular capillaries express class II MHC molecules upon activation. Expression of class II molecules on renal microvascular endothelial cells exposes them to possible interaction with specific circulating antibodies. We hypothesize that HLA-DQβ1*0202 expression in recipients decreases the likelihood of antibody-mediated renal allograft rejection. We found that 80% (=25) of DQ2 positive haplotype recipients failed to induce humoral antibody renal allograft rejection and 20% (n=25) of DQ2 positive haplotype recipients induced humoral antibody renal allograft rejection (p=0.008). By contrast, 48% (n=46) of DQ2 negative haplotype recipients failed to induce a humoral antibody component of renal allograft rejection and 52% (n=46) of DQ2 negative haplotype recipients induced humoral antibody-mediated renal allograft rejection. Our results suggest that recipients who express the DQβ1*0202 allele are less likely to induce a humoral antibody component of acute renal allograft rejection than are those expressing DQ1, DQ3, or DQ4 alleles. DQβ1*0202 allele expression in recipients could possibly be protective against acute humoral allograft rejection and might serve as a future criterion in recipient selection and in appropriate therapy for acute renal rejection episodes.

  1. Depressive symptoms are associated with mental stress-induced myocardial ischemia after acute myocardial infarction.

    Directory of Open Access Journals (Sweden)

    Jingkai Wei

    Full Text Available Depression is an adverse prognostic factor after an acute myocardial infarction (MI, and an increased propensity toward emotionally-driven myocardial ischemia may play a role. We aimed to examine the association between depressive symptoms and mental stress-induced myocardial ischemia in young survivors of an MI.We studied 98 patients (49 women and 49 men age 38-60 years who were hospitalized for acute MI in the previous 6 months. Patients underwent myocardial perfusion imaging at rest, after mental stress (speech task, and after exercise or pharmacological stress. A summed difference score (SDS, obtained with observer-independent software, was used to quantify myocardial ischemia under both stress conditions. The Beck Depression Inventory-II (BDI-II was used to measure depressive symptoms, which were analyzed as overall score, and as separate somatic and cognitive depressive symptom scores.There was a significant positive association between depressive symptoms and SDS with mental stress, denoting more ischemia. After adjustment for demographic and lifestyle factors, disease severity and medications, each incremental depressive symptom was associated with 0.14 points higher SDS. When somatic and cognitive depressive symptoms were examined separately, both somatic [β = 0.17, 95% CI: (0.04, 0.30, p = 0.01] and cognitive symptoms [β = 0.31, 95% CI: (0.07, 0.56, p = 0.01] were significantly associated with mental stress-induced ischemia. Depressive symptoms were not associated with ischemia induced by exercise or pharmacological stress.Among young post-MI patients, higher levels of both cognitive and somatic depressive symptoms are associated with a higher propensity to develop myocardial ischemia with mental stress, but not with physical (exercise or pharmacological stress.

  2. Neural state and trait bases of mood-incongruent memory formation and retrieval in first-episode major depression.

    Science.gov (United States)

    van Wingen, Guido A; van Eijndhoven, Philip; Cremers, Henk R; Tendolkar, Indira; Verkes, Robbert Jan; Buitelaar, Jan K; Fernández, Guillén

    2010-06-01

    Mood-congruent cognitive biases constitute critical factors for the vulnerability to depression and its maintenance. One important aspect is impaired memory for positive information during depression and after recovery. To elucidate its state (during depression only) and trait (during depression and recovery) related neural bases, we investigated medication free depressed, recovered, and healthy individuals with functional MRI while they memorized and recognized happy and neutral face stimuli. The imaging results revealed group differences in mood-incongruent successful memory encoding and retrieval activity already in the absence of significant memory performance differences. State effects were observed in the amygdala and posterior cingulate cortex. Whereas the amygdala was generally involved in memory formation, its activity predicted subsequent forgetting of neutral faces in depressed patients. Furthermore, the amygdala and posterior cingulate cortex were involved in memory retrieval of happy faces in depressed patients only. Trait effects were observed in the fusiform gyrus and prefrontal cortex. The fusiform gyrus was involved in memory formation and retrieval of happy faces in both patient groups, whereas it was involved in memory formation and retrieval of neutral faces in healthy individuals. Similar trait effects were observed during memory retrieval in the orbitofrontal cortex and left inferior frontal gyrus. Thus, while memory processing of positive information in the amygdala and posterior cingulate cortex is biased during depression only, memory processing in the fusiform gyrus and prefrontal cortex is biased also after recovery. These distinct neural mechanisms may respectively constitute symptom maintenance and cognitive vulnerability factors for depression.

  3. Understanding Heroin Overdose: A Study of the Acute Respiratory Depressant Effects of Injected Pharmaceutical Heroin.

    Science.gov (United States)

    Jolley, Caroline J; Bell, James; Rafferty, Gerrard F; Moxham, John; Strang, John

    2015-01-01

    Opioids are respiratory depressants and heroin/opioid overdose is a major contributor to the excess mortality of heroin addicts. The individual and situational variability of respiratory depression caused by intravenous heroin is poorly understood. This study used advanced respiratory monitoring to follow the time course and severity of acute opioid-induced respiratory depression. 10 patients (9/10 with chronic airflow obstruction) undergoing supervised injectable opioid treatment for heroin addiction received their usual prescribed dose of injectable opioid (diamorphine or methadone) (IOT), and their usual prescribed dose of oral opioid (methadone or sustained release oral morphine) after 30 minutes. The main outcome measures were pulse oximetry (SpO2%), end-tidal CO2% (ETCO2%) and neural respiratory drive (NRD) (quantified using parasternal intercostal muscle electromyography). Significant respiratory depression was defined as absence of inspiratory airflow >10s, SpO2% 10s and ETCO2% per breath >6.5%. Increases in ETCO2% indicated significant respiratory depression following IOT in 8/10 patients at 30 minutes. In contrast, SpO2% indicated significant respiratory depression in only 4/10 patients, with small absolute changes in SpO2% at 30 minutes. A decline in NRD from baseline to 30 minutes post IOT was also observed, but was not statistically significant. Baseline NRD and opioid-induced drop in SpO2% were inversely related. We conclude that significant acute respiratory depression is commonly induced by opioid drugs prescribed to treat opioid addiction. Hypoventilation is reliably detected by capnography, but not by SpO2% alone. Chronic suppression of NRD in the presence of underlying lung disease may be a risk factor for acute opioid-induced respiratory depression.

  4. Depressants

    Science.gov (United States)

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Depressants KidsHealth > For Teens > Depressants A A A What's ... How Can Someone Quit? Avoiding Depressants What Are Depressants? Depressants are drugs that calm nerves and relax ...

  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 eva

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

    Directory of Open Access Journals (Sweden)

    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.

  7. Presence of individual (residual) symptoms during depressive episodes and periods of remission : a 3-year prospective study

    NARCIS (Netherlands)

    Conradi, H. J.; Ormel, J.; de Jonge, P.

    2011-01-01

    Background. Residual depressive symptomatology constitutes a substantial risk for relapse in depression. Treatment until full remission is achieved is therefore implicated. However, there is a lack of knowledge about the prevalence of (1) residual symptoms in general and (2) the individual residual

  8. ASSOCIATION OF PSYCHOSOCIAL FACTORS WITH ANXIETY AND DEPRESSION IN PATIENTS FOLLOWING ACUTE MYOCARDIAL INFARCTION

    Directory of Open Access Journals (Sweden)

    Sejal Bheda

    2015-12-01

    Full Text Available Background: Anxiety and depression are proven independent predictors of mortality, disability, and reduced health related quality of life (HRQoL. Hence, this study was undertaken with aim to find the prevalence of anxiety and depression in patients following acute myocardial infarction (AMI and to find out its association with various psychosocial factors. Methods: Stable patients admitted during 3 month period in Cardiology Intensive care unit of tertiary care Hospital with the diagnosis of acute myocardial infarction were included in this cross sectional study. Data was collected using a Semi- structured questionnaire. Anxiety and depression were assessed using Hospital Anxiety and Depression Scale (HADS .Scores were analyzed using SPSS version 16. Results: A total of 75 patients (73.3% men and 26.7% women with mean age 54.86 ± 9.91 years were included. Mean scores of anxiety and depression were 4.49 and 4.0 out of 21, respectively. Probable cases of anxiety and depression as per HADS were 29.33% and 21.33% respectively. There was a statistically significant association of Anxiety and depression with gender (P= 0.004(A, P= 0.002(D; education [P=0.018(A, P= 0.002 (D]; and pre-existing known stressor [P=<0.001 (A and P=0.002(D]. The association of anxiety and depression with age, addiction, presence of co-morbidies and previous history of AMI / stroke was not statistically significant. Conclusion: Anxiety and depression are common after AMI. It was seen more in females, low literacy and those with pre-existing known cause of stress (stressor. Hence, psychological screening should be incorporated in routine assessment in patients with AMI during hospitalization to plan early intervention that could potentially improve recovery pattern.

  9. 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 episode

  10. Depression, anxiety and influencing factors in patients with acute pulmonary embolism

    Institute of Scientific and Technical Information of China (English)

    LIU Chun-ping; LI Xiao-mei; CHEN Hang-wei; CUI Jun-yu; NIU Li-li; HE Yu-bin; TIAN Xin-li

    2011-01-01

    Background Psychological distress has been widely studied in many cardiovascular and pulmonary diseases, but the condition in acute pulmonary embolism (APE) is unknown. The purpose of this study was to investigate levels of depression and anxiety and their influencing factors in APE patients.Methods Sixty consecutive patients with APE were subjected to investigation of depression and anxiety by the Beck Depression Inventory and State-Trait Anxiety Inventory, and 60 community-based subjects were enrolled as controls.APE patients were stratified as high-risk, intermediate-risk and low-risk according to the disease severity. Scores of depression and anxiety were compared by statistical analysis using paired t tests between APE patients and controls,and by analysis of variance within the APE patients with the three risk stratification. Factors influencing depression and anxiety were evaluated.Results The mean age of the patients (38 males and 22 females) was (52+12) years. APE patients displayed higher scores of depression (P=0.04) and anxiety (P=0.001) compared with controls. Patients in the high-risk group displayed higher scores of depression (P=0.004) and anxiety (P=0.001) compared with those in the intermediate- and low-risk groups. Depression scores were highly correlated with anxiety scores (r=0.60, P <0.001). Both depression and anxiety inversely related to risk stratification (P <0.01), age (P <0.05), and arterial blood oxygen pressure (PaO2) (P <0.05).Linear regression analysis showed that PaO2 was independently inversely related to both depression (P <0.01) and anxiety (P <0.05); risk stratification and age were independently inversely related to anxiety (P <0.05).Conclusions Patients of APE suffered high levels of depression and anxiety, which were negatively influenced by PaO2,risk stratification and age.

  11. [Aids-related toxoplasma-encephalitis presenting with acute psychotic episode].

    Science.gov (United States)

    Ilniczky, Sándor; Debreczeni, Róbert; Kovács, Tibor; Várkonyi, Viktória; Barsi, Péter; Szirmai, Imre

    2006-07-20

    The most frequent neurological manifestations of the Acquired Immunodeficiency Syndrome-(AIDS) are Cerebral Toxoplasmosis, Primary Central Nervous System Lymphoma (PCNSL), Progressive Multifocal Leukoencephalopathy (PML) and AIDS-encephalitis (AIDS-dementia complex, multinucleated giant cell encephalitis, HIV-encephalopathy). Neurological complications usually occur in the advanced stages of the disease, and they are uncommon in the beginning as presenting illness, but may result in life-threatening condition or in death. Rarely the disease presents as a neuropsychiatric illness in an undiagnosed AIDS patient, delaying a proper diagnosis. We present the case of a 34 years old patient treated for AIDS-related Toxoplasma-encephalitis in our department. His illness started as an acute psychosis followed by rapid mental and somatic decline, leading to death in three months. His HIV-seropositivity was not known at his admission, and the extraneural manifestations were slight. The diagnosis was established by serology, imaging methods and histopathological investigation. After presenting the medical history and results of autopsy studies of the patient we discuss the problems of the differential diagnosis, especially regarding the findings of the imaging methods.

  12. The level of recognition of physical symptoms in patients with a major depression episode in the outpatient psychiatric practice in Puerto Rico: An observational study

    Directory of Open Access Journals (Sweden)

    Román Karis

    2005-06-01

    Full Text Available Abstract Background This study was designed to evaluate the psychiatrists' level of recognition of somatic symptoms associated to a major depressive episode (MDE (DSM-IV-TR criteria and the impact of those somatic symptoms on the treatment effectiveness. Methods This non-interventional study was conducted in 25 medical offices in Puerto Rico from February to December 2003. It had 2 visits separated by 8 weeks. The level of recognition was determined by: the correlation between the physician clinical evaluation and their patients' self-evaluations through different validated instruments using kappa statistics. Chi-square test was used to evaluate the impact of somatic symptoms on treatment antidepressants' effectiveness. Results All the 145 recruited patients reported the presence of at least one somatic symptom associated with their current MDE. In the two visits covered by the study, a fair agreement between the psychiatrists' and the patients' reports was noted for headache, abdominal pain and upper limb pains (0.4003 ≤ κ ≥ 0.6594. For other painful symptoms and painless somatic symptoms, the Kappa values obtained were non-significant. Slight but significant reductions in depression and painful symptoms severity were observed after 8 weeks of treatment. A proportional relationship between the pain and depression severity was observed (p Conclusion The study results show that somatic symptoms: are very common in depressed Puerto Rican patients; are significant under-reported by psychiatrists; and have a significant impact on the antidepressant effectiveness.

  13. Role of the cannabinoid system in pain control and therapeutic implications for the management of acute and chronic pain episodes.

    Science.gov (United States)

    Manzanares, J; Julian, Md; Carrascosa, A

    2006-07-01

    Cannabis extracts and synthetic cannabinoids are still widely considered illegal substances. Preclinical and clinical studies have suggested that they may result useful to treat diverse diseases, including those related with acute or chronic pain. The discovery of cannabinoid receptors, their endogenous ligands, and the machinery for the synthesis, transport, and degradation of these retrograde messengers, has equipped us with neurochemical tools for novel drug design. Agonist-activated cannabinoid receptors, modulate nociceptive thresholds, inhibit release of pro-inflammatory molecules, and display synergistic effects with other systems that influence analgesia, especially the endogenous opioid system. Cannabinoid receptor agonists have shown therapeutic value against inflammatory and neuropathic pains, conditions that are often refractory to therapy. Although the psychoactive effects of these substances have limited clinical progress to study cannabinoid actions in pain mechanisms, preclinical research is progressing rapidly. For example, CB(1)mediated suppression of mast cell activation responses, CB(2)-mediated indirect stimulation of opioid receptors located in primary afferent pathways, and the discovery of inhibitors for either the transporters or the enzymes degrading endocannabinoids, are recent findings that suggest new therapeutic approaches to avoid central nervous system side effects. In this review, we will examine promising indications of cannabinoid receptor agonists to alleviate acute and chronic pain episodes. Recently, Cannabis sativa extracts, containing known doses of tetrahydrocannabinol and cannabidiol, have granted approval in Canada for the relief of neuropathic pain in multiple sclerosis. Further double-blind placebo-controlled clinical trials are needed to evaluate the potential therapeutic effectiveness of various cannabinoid agonists-based medications for controlling different types of pain.

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

    Directory of Open Access Journals (Sweden)

    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.

  15. High-field magnetic resonance imaging of structural alterations in first-episode, drug-naive patients with major depressive disorder.

    Science.gov (United States)

    Chen, Z; Peng, W; Sun, H; Kuang, W; Li, W; Jia, Z; Gong, Q

    2016-11-08

    Previous structural imaging studies have found evidence of brain morphometric changes in patients with major depressive disorder (MDD), but these studies rarely excluded compounding effects of certain important factors, such as medications and long duration of illnesses. Furthermore, the neurobiological mechanism of the macroscopic findings of structural alterations in MDD patients remains unclear. In this study, we utilized magnetization transfer imaging, a quantitative measure of the macromolecular structural integrity of brain tissue, to identify biophysical alterations, which are represented by a magnetization transfer ratio (MTR), in MDD patients. To ascertain whether MTR changes occur independent of volume loss, we also conduct voxel-based morphometry (VBM) analysis. The participants included 27 first-episode, drug-naive MDD patients and 28 healthy controls matched for age and gender. Whole-brain voxel-based analysis was used to compare MTR and gray matter volume across groups and to analyse correlations between MTR and age, symptom severity, and illness duration. The patients exhibited significantly lower MTR in the left superior parietal lobule and left middle occipital gyrus compared with healthy controls, which may be related to the attentional and cognitive dysfunction in MDD patients. The VBM analysis revealed significantly increased gray matter volume in right postcentral gyrus in MDD patients. These findings in first-episode, drug-naive MDD patients may reflect microstructural gray matter changes in the parietal and occipital cortices close to illness onset that existed before volume loss, and thus potentially provide important new insight into the early neurobiology of depression.

  16. Depressed natural killer cell activity in acute myocardial infarction

    DEFF Research Database (Denmark)

    Klarlund, K; Pedersen, B K; Theander, T G

    1987-01-01

    Natural killer (NK) cell activity against K562 target cells was measured in patients within 24 h of acute myocardial infarction (AMI) and regularly thereafter for 6 weeks. NK cell activity was suppressed on days 1, 3, and 7 (P less than 0.01), day 14 (P less than 0.05) and at 6 weeks (P = 0...

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

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    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.

  18. Validation of the Chinese version of the "Mood Disorder Questionnaire" for screening bipolar disorder among patients with a current depressive episode

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    Gan Zhaoyu

    2012-01-01

    Full Text Available Abstract Background The Mood Disorder Questionnaire (MDQ is a well-recognized screening tool for bipolar disorder, but its Chinese version needs further validation. This study aims to measure the accuracy of the Chinese version of the MDQ as a screening instrument for bipolar disorder (BPD in a group of patients with a current major depressive episode. Methods 142 consecutive patients with an initial DSM-IV-TR diagnosis of a major depressive episode were screened for BPD using the Chinese translation of the MDQ and followed up for one year. The final diagnosis, determined by a special committee consisting of three trained senior psychiatrists, was used as a 'gold standard' and ROC was plotted to evaluate the performance of the MDQ. The optimal cut-off was chosen by maximizing the Younden's index. Results Of the 142 patients, 122 (85.9% finished the one year follow-up. On the basis of a semi-structured clinical interview 48.4% (59/122 received a diagnosis of unipolar depression (UPD, 36.9% (45/122 BPDII and 14.8% (18/122 BPDI. At the end of the one year follow-up,9 moved from UPD to BPD, 2 from BPDII to UPD, 1 from BPDII to BPDI, the overall rate of initial misdiagnosis was 16.4%. MDQ showed a good accuracy for BPD: the optimal cut-off was 4, with a sensitivity of 0.72 and a specificity of 0.73. When BPDII and BPDI were calculated independently, the optimal cut-off for BPDII was 4, with a sensitivity of 0.70 and a specificity of 0.73; while the optimal cut-off for BPDI was 5, with a sensitivity of 0.67 and a specificity of 0.86. Conclusions Our results show that the Chinese version of MDQ is a valid tool for screening BPD in a group of patients with current depressive episode on the Chinese mainland.

  19. Sustained Liver Glucose Release in Response to Adrenaline Can Improve Hypoglycaemic Episodes in Rats under Food Restriction Subjected to Acute Exercise

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    Lucas K. R. Babata

    2014-01-01

    Full Text Available Background. As the liver is important for blood glucose regulation, this study aimed at relating liver glucose release stimulated by glucagon and adrenaline to in vivo episodes of hypoglycaemia. Methods. The blood glucose profile during an episode of insulin-induced hypoglycaemia in exercised and nonexercised male Wistar control (GC and food-restricted (GR, 50% rats and liver glucose release stimulated by glucagon and adrenaline were investigated. Results. In the GR, the hypoglycaemic episodes showed severe decreases in blood glucose, persistent hypoglycaemia, and less complete glycaemic recovery. An exercise session prior to the episode of hypoglycaemia raised the basal blood glucose, reduced the magnitude of the hypoglycaemia, and improved the recovery of blood glucose. In fed animals of both groups, liver glucose release was activated by glucagon and adrenaline. In fasted GR rats, liver glycogenolysis activated by glucagon was impaired, despite a significant basal glycogenolysis, while an adrenaline-stimulated liver glucose release was recorded. Conclusions. The lack of liver response to glucagon in the GR rats could be partially responsible for the more severe episodes of hypoglycaemia observed in vivo in nonexercised animals. The preserved liver response to adrenaline can partially account for the less severe hypoglycaemia in the food-restricted animals after acute exercise.

  20. Criterion Validity of the Mood and Feelings Questionnaire for Depressive Episodes in Clinic and Non-Clinic Subjects

    Science.gov (United States)

    Daviss, W. Burleson; Birmaher, Boris; Melhem, Nadine A.; Axelson, David A.; Michaels, Shana M.; Brent, David A.

    2006-01-01

    Background: Previous measures of pediatric depression have shown inconsistent validity in groups with differing demographics, comorbid diagnoses, and clinic or non-clinic origins. The current study re-examines the criterion validity of child- and parent-versions of the Mood and Feelings Questionnaire (MFQ-C, MFQ-P) in a heterogeneous sample of…

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

    NARCIS (Netherlands)

    Mocking, R. J. T.; Bockting, C. L. H.; Figueroa, C. A.; Rive, M. M.; Geugies, H.; Servaas, M. N.; Assies, J.; Koeter, M. W. J.; Vaz, F.M.; Wichers, M.; Van Straalen, J. P.; De Raedt, R.; Harmer, C. J.; Schene, A. H.; Ruhé, H. G.

    2016-01-01

    Abstract 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-recu

  2. 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, Frédéric M; Wichers, Marieke; van Straalen, Jan P; de Raedt, Rudi; Bockting, Claudi L H; Harmer, Catherine J; Schene, Aart H; Ruhe, Eric

    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 h

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. Dysfunctional Attitudes Scale Perfectionism: A Predictor and Partial Mediator of Acute Treatment Outcome among Clinically Depressed Adolescents

    Science.gov (United States)

    Jacobs, Rachel H.; Silva, Susan G.; Reinecke, Mark A.; Curry, John F.; Ginsburg, Golda S.; Kratochvil, Christopher J.; March, John S.

    2009-01-01

    The effect of perfectionism on acute treatment outcomes was explored in a randomized controlled trial of 439 clinically depressed adolescents (12-17 years of age) enrolled in the Treatment for Adolescents with Depression Study (TADS) who received cognitive behavior therapy (CBT), fluoxetine, a combination of CBT and FLX, or pill placebo. Measures…

  8. 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.

    2012-01-01

    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

  9. Differential effects of acute and repeat dosing with the H3 antagonist GSK189254 on the sleep–wake cycle and narcoleptic episodes in Ox−/− mice

    Science.gov (United States)

    Guo, RX; Anaclet, C; Roberts, JC; Parmentier, R; Zhang, M; Guidon, G; Buda, C; Sastre, JP; Feng, JQ; Franco, P; Brown, SH; Upton, N; Medhurst, AD; Lin, JS

    2009-01-01

    Background and purpose: Histamine H3 receptor antagonists are currently being evaluated in clinical trials for a number of central nervous system disorders including narcolepsy. These agents can increase wakefulness (W) in cats and rodents following acute administration, but their effects after repeat dosing have not been reported previously. Experimental approach: EEG and EMG recordings were used to investigate the effects of acute and repeat administration of the novel H3 antagonist GSK189254 on the sleep–wake cycle in wild-type (Ox+/+) and orexin knockout (Ox−/−) mice, the latter being genetically susceptible to narcoleptic episodes. In addition, we investigated H3 and H1 receptor expression in this model using radioligand binding and autoradiography. Key results: In Ox+/+ and Ox−/− mice, acute administration of GSK189254 (3 and 10 mg·kg−1 p.o.) increased W and decreased slow wave and paradoxical sleep to a similar degree to modafinil (64 mg·kg−1), while it reduced narcoleptic episodes in Ox−/− mice. After twice daily dosing for 8 days, the effect of GSK189254 (10 mg·kg−1) on W in both Ox+/+ and Ox−/− mice was significantly reduced, while the effect on narcoleptic episodes in Ox−/− mice was significantly increased. Binding studies revealed no significant differences in H3 or H1 receptor expression between Ox+/+ and Ox−/− mice. Conclusions and implications: These studies provide further evidence to support the potential use of H3 antagonists in the treatment of narcolepsy and excessive daytime sleepiness. Moreover, the differential effects observed on W and narcoleptic episodes following repeat dosing could have important implications in clinical studies. PMID:19413575

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

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    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.

  11. Similarities and differences of functional connectivity in drug-naïve, first-episode adolescent and young adult with major depressive disorder and schizophrenia

    Science.gov (United States)

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

    2017-01-01

    Major depressive disorder (MDD) and schizophrenia (SZ) are considered two distinct psychiatric disorders. Yet, they have considerable overlap in symptomatology and clinical features, particularly in the initial phases of illness. The amygdala and prefrontal cortex (PFC) appear to have critical roles in these disorders; however, abnormalities appear to manifest differently. In our study forty-nine drug-naïve, first-episode MDD, 45 drug-naïve, first-episode SZ, and 50 healthy control (HC) participants from 13 to 30 years old underwent resting-state functional magnetic resonance imaging. Functional connectivity (FC) between the amygdala and PFC was compared among the three groups. Significant differences in FC were observed between the amygdala and ventral PFC (VPFC), dorsolateral PFC (DLPFC), and dorsal anterior cingulated cortex (dACC) among the three groups. Further analyses demonstrated that MDD showed decreased amygdala-VPFC FC and SZ had reductions in amygdala-dACC FC. Both the diagnostic groups had significantly decreased amygdala-DLPFC FC. These indicate abnormalities in amygdala-PFC FC and further support the importance of the interaction between the amygdala and PFC in adolescents and young adults with these disorders. Additionally, the alterations in amygdala-PFC FC may underlie the initial similarities observed between MDD and SZ and suggest potential markers of differentiation between the disorders at first onset. PMID:28287187

  12. Self-experienced vulnerability, prodromal symptoms and coping strategies preceding schizophrenic and depressive relapses.

    Science.gov (United States)

    Bechdolf, Andreas; Schultze-Lutter, Frauke; Klosterkötter, Joachim

    2002-11-01

    For the first time, the present study explores pre-episodic disturbances, i.e. self-experienced vulnerability and prodromal symptoms, and related coping strategies preceding schizophrenic and depressive relapses. After complete recovery from the acute episode, 27 patients with recurrent schizophrenic and 24 patients with recurrent depressive episodes were assessed retrospectively for pre-episodic disturbances and related coping strategies with the "Bonn scale for the assessment of basic symptoms-BSABS". All (100%) of the schizophrenic and 23 (96%) of the depressive patients showed pre-episodic disturbances. Patients with schizophrenia showed significantly more often an increased emotional reactivity and certain perception and thought disturbances. Depressive patients reported significantly more often an impaired tolerance to certain stress and disorders of emotion and affect. Sixty-three percent of the schizophrenics and 87% of the depressives reacted to pre-episodic disturbances with coping strategies. The pre-episodic disturbances in patients with schizophrenia could be described in terms of mild psychotic productivity, those in depressives in terms of mild depressive syndrome. Future studies will have to show if these findings can be replicated in first episode or initial prodromal state samples and if the assessment of mild psychotic productivity and mild depressive syndrome can be used for early diagnosis and early intervention in schizophrenia and depression.

  13. Maintenance of a positive outlook during acute stress protects against pro-inflammatory reactivity and future depressive symptoms

    Science.gov (United States)

    Aschbacher, K.; Epel, E.; Wolkowitz, O.M.; Prather, A.A.; Puterman, E.; Dhabhar, F.S.

    2014-01-01

    Cognitive and affective responses to acute stress influence pro-inflammatory cytokine reactivity, and peripheral cytokines (particularly lnterleukin-1 beta (IL-1β)), can act on the brain to promote depressive symptoms. It is unknown whether acute stress-induced changes in positive affect and cognitions (POS) and pro-inflammatory reactivity predict future depressive symptoms. We examined acute stress responses among women, to determine prospective predictors of depressive symptoms. Hypotheses: 1) Stress-induced decreases in POS will be associated with stress-related increases in circulating IL-1β. 2) Acute stress-induced decreases in POS and increases in IL-1β reactivity will predict increases in depressive symptoms one year later. Thirty-five post-menopausal women were exposed to acute stress with the Trier Social Stress Task (TSST) and provided blood samples under resting conditions and 30 minutes after the conclusion of the TSST, which were assayed for IL-1β. IL-1β reactivity was quantified as post minus pre-TSST. Failure to maintain POS was quantified as the decrease in POS during the TSST. Change in depressive symptoms from the study baseline to the following year was determined. Greater acute stress-induced declines in POS were significantly associated with increased IL-1β reactivity (p≤.02), which significantly predicted increases in depressive symptoms over the following year (p<.01), controlling for age, body mass index, chronic stress, antidepressant use and baseline depressive symptoms. IL-1β reactivity was a significant mediator of the relationship between POS decline and future increases in depressive symptoms (p=.04). Difficulty maintaining positivity under stress and heightened pro-inflammatory reactivity may be markers and/or mechanisms of risk for future increases in depressive symptoms. PMID:22119400

  14. Depressive symptoms and disability in acute patients with comorbidities in departments of internal medicine

    Directory of Open Access Journals (Sweden)

    Salvatore La Carrubba

    2012-01-01

    Full Text Available Introduction: There are few data on the prevalence of depression among acute patients with comorbidities. The current study aimed to determine the prevalence of depressive symptoms in hospitalized patients admitted to Internal Medicine Units and the correlation between these symptoms and comorbidities and disability indexes. Materials and methods: All consecutive patients admitted to 26 Internal Medicine Units of the Italian National Public Health System in Sicily, Italy, from September 2001 to March 2002 were screened. Within 24 hours of admission, patients were administered the Geriatric Depression Scale (GDS, Mini-Mental State Examination, Activities of Daily Living (ADL, Instrumental Activities of Daily Living (IADL and Charlson’s Comorbidity Index. Results: 1,947 subjects were included in the analyses. Of the patients, 509 (26.1% showed depressive symptoms (indicated by GDS score > 15. Depression was significantly associated (univariate analyses with hypertension (OR 1.45; CI 95% 1.18-1.79, diabetes (OR 1.48, CI 95% 1.17-1.87, cerebrovascular disease (OR 1.50, CI 95% 1.08-2.07, cirrhosis (OR 1.49, CI 95% 1.01- 2.19, ADL score (OR 0.72: CI 95% 0.63-0.82, and IADL score (OR 0.83; CI 95% 0.78-0.87, but not with Charlson’s Comorbidity Index (OR 1.04; CI 95% 0.98-1.10. Multivariate analysis showed that independent predictive factors for depression were age (OR 1.02, CI 95% 1.01-1.02, female gender (OR 2.29, CI 95% 1.83 - 2.87, and IADL score (OR 0.86, CI 95% 0.81 - 0.93. Conclusions: The data suggest that depressive symptoms are not linked to worse clinical conditions but are associated with the loss of autonomy in Instrumental Activities of Daily Living.

  15. [Self-experienced vulnerability, prodromic symptoms and coping strategies before schizophrenic and affective episodes].

    Science.gov (United States)

    Bechdolf, A; Halve, S; Schultze-Lutter, F; Klosterkötter, J

    1998-08-01

    For the first time, the present study explores self-experienced vulnerability, prodromal symptoms and coping strategies preceding schizophrenic and affective episodes. 33 schizophrenic and 29 depressive patients were assessed retrospectively for preepisodic alterations by means of the "Bonn Scale for the Assessment of Basic Symptoms- BSABS" after complete recovery from the acute episode. 97% of the schizophrenic and 93% of the depressive patients showed preepisodic alterations. In the schizophrenic group the first alteration occurred with a median of 10 weeks and in the depressive group with a median of 18 weeks before the onset of the acute episode. With regard to self-experienced vulnerability depressive cases were significantly less tolerant to stress, i.e work under time pressure or unusual, unexpected requirements. With regard to prodromal symptoms schizophrenics showed significantly more often interpersonal irritation and certain perception and thought disturbances, whereas depressive patients reported more often adynamia and certain disturbances of proprioception. 73% of the schizophrenic patients and 90% of the depressive patients reacted to early symptoms with coping strategies. The preepisodic alterations in schizophrenic patients could be described in terms of mild psychotic productivity, early symptoms of depressive patients could be described as a mild depressive syndrome. Prospective studies are necessary to show if assessment of mild psychotic productivity could be used for early diagnosis and early intervention in schizophrenia.

  16. Depression

    Science.gov (United States)

    ... overview URL of this page: //medlineplus.gov/ency/article/003213.htm Depression - overview To use the sharing features on this ... older adults Major depression Persistent depressive disorder Postpartum depression Premenstrual ... Review Date 1/4/2016 Updated by: Timothy Rogge, ...

  17. 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

    2014-01-01

    Background 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. Methods and Results 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. Conclusions 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. PMID:25359402

  18. Effects of cumulative stressful and acute variation episodes of farm climate conditions on late embryo/early fetal loss in high producing dairy cows

    Science.gov (United States)

    Santolaria, Pilar; López-Gatius, Fernando; García-Ispierto, Irina; Bech-Sàbat, Gregori; Angulo, Eduardo; Carretero, Teresa; Sánchez-Nadal, Jóse Antonio; Yániz, Jesus

    2010-01-01

    The aim of this study was to determine possible relationships between farm climate conditions, recorded from day 0 to day 40 post-artificial insemination (AI), and late embryo/early fetal loss in high producing dairy cows. Pregnancy was diagnosed by rectal ultrasonography between 28 and 34 days post-AI. Fetal loss was registered when a further 80- to 86-day diagnosis proved negative. Climate variables such as air temperature and relative humidity (RH) were monitored in the cubicles area for each 30-min period. Temperature-humidity indices (THI); cumulative stressful values and episodes of acute change (defined as the mean daily value 1.2 times higher or lower than the mean daily values of the 10 previous days) of the climate variables were calculated. The data were derived from 759 cows in one herd. A total of 692 pregnancies (91.2%) carried singletons and 67 (8.8%) carried twins. No triplets were recorded. Pregnancy loss was recorded in 6.7% (51/759) of pregnancies: 5.6% (39/692) in single and 17.9% (12/67) in twin pregnancies. Using logistic regression procedures, a one-unit increase in the daily cumulative number of hours for the THI values higher than 85 during days 11-20 of gestation caused a 1.57-fold increase in the pregnancy loss, whereas the likelihood of fetal loss increased by a factor of 1.16 for each additional episode of acute variation for the maximum THI values during gestation days 0-40. THI values higher than 85 and episodes of acute variation for the maximum THI values were only recorded during the warm and cool periods, respectively. The presence of twins led to a 3.98-fold increase in pregnancy loss. In conclusion, our findings show that cumulative stressful and episodes of acute variation of climatic conditions can compromise the success of gestation during both the cool and warm periods of the year. Twin pregnancy was confirmed as a main factor associated with pregnancy loss.

  19. 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.

  20. 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

    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...

  1. Depression

    DEFF Research Database (Denmark)

    Kessing, Lars Veddel; Bukh, Jens Drachmann

    2014-01-01

    , 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......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...

  2. Depression

    DEFF Research Database (Denmark)

    Kessing, Lars Veddel; Bukh, Jens Otto 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...

  3. 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

  4. 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.

  5. Dorsal striatal volumes in never-treated patients with first-episode schizophrenia before and during acute treatment

    NARCIS (Netherlands)

    Emsley, Robin; Asmal, Laila; du Plessis, Stéfan; Chiliza, Bonginkosi; Kidd, Martin; Carr, Jonathan; Vink, Matthijs

    2015-01-01

    BACKGROUND: Studies of pre-and post-treatment striatal volume in schizophrenia have reported conflicting results. MATERIALS AND METHODS: We assessed dorsal striatal (caudate and putamen) volumes bilaterally in 22 never-treated, non-substance-abusing patients with first-episode schizophrenia or schiz

  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. Depression

    Science.gov (United States)

    ... Health (NIMH)’s website ( www.nimh.nih.gov ). What causes depression? Scientists at NIMH and across the country are studying the causes of depression. Research suggests that a combination of genetic, biological, ...

  8. Depression

    Directory of Open Access Journals (Sweden)

    Grace Sherry L

    2004-08-01

    Full Text Available Abstract Health Issue Depression causes significant distress or impairment in physical, social, occupational and other key areas of functioning. Women are approximately twice as likely as men to experience depression. Psychosocial factors likely mediate the risks for depression incurred by biological influences. Key Findings Data from the 1999 National Population Health Survey show that depression is more common among Canadian women, with an annual self-reported incidence of 5.7% compared with 2.9% in men. The highest rates of depression are seen among women of reproductive age. Predictive factors for depression include previous depression, feeling out of control or overwhelmed, chronic health problems, traumatic events in childhood or young adulthood, lack of emotional support, lone parenthood, and low sense of mastery. Although depression is treatable, only 43% of depressed women had consulted a health professional in 1998/99 and only 32.4% were taking antidepressant medication. People with lower education, inadequate income, and fewer contacts with a health professional were less likely to receive depression treatment. Data Gaps and Recommendations A better understanding of factors that increase vulnerability and resilience to depression is needed. There is also a need for the collection and analysis of data pertaining to: prevalence of clinical anxiety; the prevalence of depression band 12 months after childbirth factors contributing to suicide contemplation and attempts among adolescent girls, current treatments for depression and their efficacy in depressed women at different life stages; interprovincial variation in depression rates and hospitalizations and the impact and costs of depression on work, family, individuals, and society.

  9. Management of bipolar depression

    Directory of Open Access Journals (Sweden)

    Jae Seung Chang

    2011-01-01

    Full Text Available Patients with bipolar disorder spend more time in a depressed than manic state, even with individualized treatment. To date, bipolar depression is often misdiagnosed and ineffectively managed both for acute episodes and residual symptoms. This review attempts to summarize the current status of available treatment strategies in the treatment of bipolar depression. For acute and prophylactic treatment, a substantial body of evidence supports the antidepressive efficacy of lithium for bipolar disorders and its antisuicidal effects. Among numerous anticonvulsants with mood-stabilizing properties, valproate and lamotrigine could be first-line options for bipolar depression. Due to receptor profile, mood-stabilizing properties of second-generation antipsychotics have been explored, and up to date, quetiapine and olanzapine appear to be a reasonable option for bipolar depression. The usefulness of antidepressants in bipolar depression is still controversial. Current guidelines generally recommend the cautious antidepressant use in combination with mood stabilizers to reduce the risk of mood elevation or cycle acceleration. Results from clinical trials on psychosocial intervention are promising, especially when integrated with pharmacotherapy. Most patients with bipolar depression need individualized and combined treatment, although the published evidence on this type of treatment strategy is limited. Future studies on the utility of currently available agents and modalities including psychosocial intervention are required.

  10. 叙事疗法治疗抑郁发作1例%Narrative therapy for 1 patient with depressive episode

    Institute of Scientific and Technical Information of China (English)

    李江婵

    2014-01-01

    Narrative psychotherapy is a postmodern psychotherapy newly emerging in psy-chotherapy domain at present ,throw s off traditional treatment idea that sees people as a problem ,makes client’s mind growth ,and its treatment techniques are mainly problem exteriorization ,story re-deconstruction ,from thin to thick and so on .This paper describes that narrative therapy is used for 1 case with depressive episode in order to clarify its im-portant significance for overcoming risk caused by stress events .%叙事心理治疗是当今心理治疗领域中新兴起的一种后现代心理疗法,他摆脱了传统意义上将人视为问题的治疗观念,让当事人的心理得以成长,其治疗技术主要有问题外化、故事重新解构、由薄到厚等。本文描述了对1例抑郁发作患者运用叙事疗法进行心理治疗的过程,旨在阐明该疗法对于克服应激事件所产生的危机心理的重要意义。

  11. 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....

  12. 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

  13. Performance benefits of depression: sequential decision making in a healthy sample and a clinically depressed sample.

    Science.gov (United States)

    von Helversen, Bettina; Wilke, Andreas; Johnson, Tim; Schmid, Gabriele; Klapp, Burghard

    2011-11-01

    Previous research reported conflicting results concerning the influence of depression on cognitive task performance. Whereas some studies reported that depression enhances performance, other studies reported negative or null effects. These discrepant findings appear to result from task variation, as well as the severity and treatment status of participant depression. To better understand these moderating factors, we study the performance of individuals-in a complex sequential decision task similar to the secretary problem-who are nondepressed, depressed, and recovering from a major depressive episode. We find that depressed individuals perform better than do nondepressed individuals. Formal modeling of participants' decision strategies suggested that acutely depressed participants had higher thresholds for accepting options and made better choices than either healthy participants or those recovering from depression.

  14. 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...

  15. 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.

  16. Comparison of overgeneral autobiographical memory between first-episode and recurrent depressive patients%首发与复发抑郁症患者的过度概括化自传体记忆比较

    Institute of Scientific and Technical Information of China (English)

    柳艳松; 王军; 张付全; 王国强; 陈新宇; 王志强

    2013-01-01

    Object To explore the difference of overgeneral autobiographical memory (OGM) between first-episode and recurrent depressive patients,and whether the overgeneral autobiographical memory can affect the symptoms of depression or not.Methods 34 first-episode depression patients and 31 recurrent depression patients were enrolled.All patients were measured by autobiographical memory test (AMT),Hamilton Depression Scale-17 (HAMD-17) and Beck depression rating scale(BDI).Results ①The OGM score was higher in recurrent depressive group than that in first-episode group (respectively,(3.90 ± 1.65),(3.10± 1.57),t =2.035,P<0.05).②The positive OGM score was higher in recurrent depressive group than that in first-episode group(respectively,(2.40± 1.36),(1.70± 1.08),t =2.308,P< 0.05).③The correlation coefficient (r value) between the total score of OGM and total score of BDI,total score of HAMD,two subfactors (cognitive disorder and slow)scores of HAMD in recurrent depressive group were 0.497,0.552,0.631,and 0.553 respectively,which significantly correlated.Conclusion Compared with first-episode depressive patients,the OGM in recurrent depressive patients is more severe.The OGM can increase the symptoms of depression,the cognitive disorder and slow.%目的 探索复发性抑郁症与首发抑郁症患者过度概括化自传体记忆(OGM)的差异,以及过度概括化自传体记忆对抑郁症状的影响.方法 对34例首发性抑郁症患者以及31例复发性抑郁症患者,采用自传体记忆测评(autobiographical memory test,AMT)评定过度概括化自传体记忆水平、汉密尔顿抑郁量表测评(HAMD-17)及贝克抑郁量表(BDI)评定抑郁严重程度.结果 ①复发性抑郁症组OGM总分显著高于首发抑郁症组[分别为(3.90± 1.65)分,(3.10±1.57)分,t=2.035,P<0.05];②复发性抑郁症组积极线索词诱导的OGM总分显著高于首发抑郁症组[分别为(2.40± 1.36)分,(1.70±1.08)分,t=2.308,P<0.05];③OGM与BDI总分

  17. Cross-country variation in the sociodemographic factors associated with major depressive episode in Norway, the United Kingdom, Ghana, and Kenya.

    Science.gov (United States)

    Ambugo, Eliva A

    2014-07-01

    Studies based on Western samples generally show that status characteristics like gender or marital status are associated with better mental health for individuals who occupy advantageous positions, such as men or the married. However, these patterns may not hold in developing regions that differ in important ways from the West. Guided by the Stress Process Model (SPM), this study uses logistic regression to examine the effect of gender, education, and other status characteristics on major depressive episode (MDE). Similarities and differences in these associations across two Western and two African countries are also assessed. Nationally representative data for adults ages 18 years and older are from the World Health Surveys (2002-2004) for Norway (N = 943), the United Kingdom (UK: N = 1195), Ghana (N = 3922), and Kenya (N = 4331). Results indicate a mixed pattern of associations between status characteristics and MDE across the four countries. Norwegian men face higher risk of MDE than Norwegian women-an anomalous finding. With some exceptions, education and employment status are not significantly related to MDE across the countries, providing little support for SPM. Marital status differences in risk of MDE are largest for Norway and smallest for Ghana. For the UK, men face lower risk of MDE than women across levels of mastery, and the gender gap in MDE is larger at higher levels of mastery. Overall, there is some heterogeneity in the associations between status characteristics and MDE even in somewhat similar environments like Ghana and Kenya. This study extends the reach of SPM to settings in sub-Saharan Africa, and contributes to the sparse empirical literature on the prevalence and sociodemographic correlates of MDE in the general populations of Ghana and Kenya.

  18. Rationale, design and methodology of a double-blind, randomized, placebo-controlled study of escitalopram in prevention of Depression in Acute Coronary Syndrome (DECARD

    Directory of Open Access Journals (Sweden)

    Hansen Jørgen

    2009-04-01

    Full Text Available Abstract Background The prevalence of depression in patients with acute coronary syndrome, i.e. myocardial infarction and unstable angina, is higher than in the general population. The prevalence of anxiety is higher as well. Both depression and anxiety are associated with poor cardiac outcomes and higher mortality. Comorbid depression in patients with acute coronary syndrome often goes undiagnosed, and it is therefore a challenging task to prevent this risk factor. The study of DEpression in Coronary ARtery Disease (DECARD is designed to examine if it is possible to prevent depression in patients 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 of depression and Hamilton Depression Scale are the primary outcome measures. Discussion This is the first study of prevention of depression in patients after acute coronary syndrome with a selective serotonin reuptake inhibitor. Trial Registration http://www.ClinicalTrials.gov. Identifier: NCT00140257

  19. 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...

  20. Depression.

    Science.gov (United States)

    Strock, Margaret

    Approximately ten percent of the population suffers from a depressive illness each year. Although the economic cost is high, the cost in human suffering is immeasurable. To help educate the population about this disorder, this paper presents a definition of depression and its common manifestations. The symptoms that people often experience are…

  1. 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…

  2. The effect of depressive symptomatology on plasma cortisol responses to acute bicycle exercise among post-menopausal women

    NARCIS (Netherlands)

    van der Pompe, G.; Bernards, N; Meijman, T.F.; Heijnen, C.J

    1999-01-01

    The present study was designed to elucidate the effect of depressive symptomatology on the cortisol response to strenuous exercise. Thirteen healthy, post-menopausal women participated in this study. The results show that acute bicycle exercise activates the hypothalamic-pituitary-adrenal (HPA) axis

  3. 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.

  4. A Test of the Effects of Acute Sleep Deprivation on General and Specific Self-Reported Anxiety and Depressive Symptoms: An Experimental Extension

    OpenAIRE

    Babson, Kimberly A; Trainor, Casey D.; Feldner, Matthew T.; Blumenthal, Heidemarie

    2010-01-01

    Evidence indicates acute sleep deprivation affects negative mood states. The present study experimentally tested the effects of acute sleep deprivation on self-reported symptoms of state anxiety and depression as well as general distress among 88 physically and psychologically healthy adults. As hypothesized, the effects of acute sleep deprivation increased state anxiety and depression, as well as general distress, relative to a normal night of sleep control condition. Based on the tripartite...

  5. 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

  6. 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...

  7. 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.

  8. 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.

  9. Predictors of longitudinal outcomes after unstable response to acute-phase cognitive therapy for major depressive disorder.

    Science.gov (United States)

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

    2015-06-01

    After patients with major depressive disorder (MDD) respond to acute-phase cognitive therapy (CT), continuation-phase treatments may be applied to improve long-term outcomes. We clarified which CT responders experience remission, recovery, relapse, and recurrence by testing baseline demographic, clinical, and personality variables. The sample of CT responders at higher risk of relapse (N = 241) was randomized to 8 months of continuation-phase CT, double-blinded fluoxetine, or pill placebo, and followed 24 months (Jarrett & Thase, 2010). Patients with lower positive emotionality and behavioral activation at the end of acute-phase CT showed increased risk for relapse/recurrence of MDD. In addition, patients with lower positive emotionality and behavioral activation, as well as higher residual depression (including emotional, cognitive, and social facets), showed decreased probability of remission (≥6 continuous weeks of minimal or absent symptoms) after acute-phase CT. Finally, patients with greater residual depression, as well as younger age and earlier MDD onset, showed decreased probability of recovery (≥35 continuous weeks of minimal or absent symptoms) after acute-phase CT. Moderator analyses did not reveal differential prediction across the continuation phase treatment arms. These results may help clinicians gauge the prognoses and need for continuation treatment among MDD patients who respond to acute-phase CT.

  10. 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.

  11. 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

  12. Role of the Cannabinoid System in Pain Control and Therapeutic Implications for the Management of Acute and Chronic Pain Episodes

    OpenAIRE

    2006-01-01

    Cannabis extracts and synthetic cannabinoids are still widely considered illegal substances. Preclinical and clinical studies have suggested that they may result useful to treat diverse diseases, including those related with acute or chronic pain. The discovery of cannabinoid receptors, their endogenous ligands, and the machinery for the synthesis, transport, and degradation of these retrograde messengers, has equipped us with neurochemical tools for novel drug design. Agonist-activated canna...

  13. Depression

    Science.gov (United States)

    ... caring for children and aging parents, abuse, and poverty may trigger depression in some people. Medical illness – ... federal government website managed by the Office on Women’s Health in the Office of the Assistant Secretary ...

  14. Effects of acute or chronic administration of substituted benzamides in experimental models of depression in rats.

    Science.gov (United States)

    Drago, F; Arezzi, A; Virzì, A

    2000-12-01

    The effects of substituted benzamides, sulpiride and raclopride on experimental models of depression were studied in male rats after acute or chronic administration in comparison to those of the classical antidepressant, clomipramine. In contrast to clomipramine (50 mg/kg), acute doses of sulpiride or raclopride (1 or 5 mg/kg) failed to change the behavioral response of animals tested in the despair (constrained swim) test or in the model of reserpine-induced changes in the open field behavior. These doses also did not modify the grooming response of rats exposed to a novel environment. Sulpiride or raclopride 10 mg/kg increased the immobility time in the despair test and reduced novelty-induced grooming. The repeated injection for 21 days of sulpiride or raclopride (1 or 5 mg/kg, but not 10 mg/kg) induced a reduction of the immobility period during the constrained swim test similar to that following the chronic treatment with clomipramine 50 mg/kg. This appeared to be a clear-cut reversed dose-response relationship for both substituted benzamides, being the dose potency 1 mg/kg>5 mg/kg>10 mg/kg. Raclopride was more potent than sulpiride in this respect. Furthermore, like clomipramine, sulpiride (1 or 5 mg/kg) and raclopride (1 mg/kg) antagonized reserpine-induced changes in the open field behavior and enhanced novelty-induced grooming. These results indicate that, in contrast to acute injection, repeated administration of small doses of the substituted benzamides, sulpiride or raclopride induce an effect similar to that of the classical antidepressant, clomipramine. The reverse dose-response relationship suggests that these drugs in small doses act on presynaptic dopamine D(2) receptors. This may be consistent with a postsynaptic action of greater doses that exert sedative effects and increase immobility time in the despair test.

  15. 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.

  16. Impact of post myocardial infarction depression on drug adherence of cardiological medicines

    OpenAIRE

    Hemanta Dutta; Soumitra Ghosh; DJ Dutta

    2015-01-01

    Background: Depressive symptoms are very usual in patients experiencing a history of myocardial infarction (MI). An individual who has developed depression after an episode of MI becomes non compliant with the treatment of cardiology. Aim: To test the impact of post MI depression on drug adherence of cardiological medicines. Settings and design: The study was conducted on patients of acute MI (n=50) attending cardiology outpatient department (OPD) of Assam Medical College and Hospital...

  17. The papez circuit in first-episode, treatment-naive adults with major depressive disorder: combined atlas-based tract-specific quantification analysis and voxel-based analysis.

    Science.gov (United States)

    Jiang, Wenyan; Gong, Gaolang; Wu, Feng; Kong, Lingtao; Chen, Kaiyuan; Cui, Wenhui; Ren, Ling; Fan, Guoguang; Sun, Wenge; Ma, Huan; Xu, Ke; Tang, Yanqing; Wang, Fei

    2015-01-01

    Previous findings suggest that the Papez Circuit may have a role in major depressive disorders. We used atlas-based tract-specific quantification analysis and voxel-based analysis to examine the integrity of white matter tracts involved in mood regulation (including tracts in the Papez Circuit). Diffusion tensor imaging acquired from 35 first-episode, treatment-naive adults with major depressive disorders and 34 healthy adult controls were compared. Our statistical approach compared structural integrity of 11 major white matter tracts between the major depressive disorder and adult controls, as well as illness duration influence in patients. Fractional anisotropy was decreased in the hippocampal cingulum and in the anterior thalamic radiation according to both analytical approaches, all of which were important tracts included in the Papez Circuit. Our results support the role of the Papez Circuit in major depressive disorders with the minimal probability of false positive due to similar findings in both analyses that have complementary advantages. Dysfunction of the Papez Circuit may be a potential marker for studying the pathogenesis of major depressive disorders.

  18. The study of brain structural in adolescents first-episode depression%青少年首发抑郁症患者大脑结构异常的研究

    Institute of Scientific and Technical Information of China (English)

    王崴; 陈策; 王红梅; 贾敏; 高成阁; 张明

    2014-01-01

    目的:探讨首发青少年抑郁症患者大脑结构异常脑区的形态学改变。方法收集青少年首发抑郁症患者16例及健康志愿者16例,行 MRI形态学检查。随后对数据利用基于优化的体素的形态学分析方法观察青少年抑郁症患者大脑受损脑区的变化。结果与正常健康对照组相比,青少年首发抑郁症患者左侧背外侧前额叶皮层(DLPFC),右侧梭状回(fusiform)灰质体积减小。左侧DLPFC的灰质密度与抑郁症的汉密尔顿抑郁量表(hamilton depression scale,HAMD)评分呈负相关。结论青少年首发抑郁症患者存在左侧DLPFC和右侧 Fusiform灰质异常,并且左侧DLPFC的灰质密度与 HAMD评分呈负相关。%Objective To explore the morphological changes of the brain structure in youngsters first-episode depression.Methods Collecting 1 6 youngsters patients with first-episode depression and 1 6 healthy volunteers,separately examining morphological changes in their brain regions by MRI,and then analyzing data by Voxel-Based Morphometry in order to observe the damaged brain areas in depression patients.Results Comparing with control group,gray mater volume of the left dorsolateral prefrontal cortex and right fusiform gyrus decreased in depression patients.The gray matter density of left dorsolateral prefrontal cortex showed negative correlation with HAMD scores.Conclusion The gray matter decreased in left dorsolateral prefrontal cortex and right fusiform gyrus in youngsters first-episode depression patients.In addition,the gray matter density of left dorsolateral prefrontal cortex had negative correlation with HAMD scores.

  19. Similarities in acute phase protein response during hibernation in black bears and major depression in humans: A response to underlying metabolic depression?

    Science.gov (United States)

    Tsiouris, J.A.; Chauhan, V.P.S.; Sheikh, A.M.; Chauhan, A.; Malik, M.; Vaughan, M.R.

    2004-01-01

    This study investigated the effects of hibernation with mild hypothermia and the stress of captivity on levels of six acute-phase proteins (APPs) in serial samples of serum from 11 wild and 6 captive black bears (Ursus americanus Pallas, 1780) during active and hibernating states. We hypothesize that during hibernation with mild hypothermia, bears would show an APP response similar to that observed in major depression. Enzyme-linked immunoabsorbent assay was used to measure alpha2-macroglobulin and C-reactive protein, and a nephelometer to measure alpha1-antitrypsin, haptoglobin, ceruloplasmin, and transferrin. Levels of all other proteins except ceruloplasmin were significantly elevated during hibernation in both wild and captive bears at the p neurobiology of depression.

  20. Slowing down of recovery as generic risk marker for acute severity transitions in chronic diseases

    NARCIS (Netherlands)

    Olde Rikkert, M.G.M.; Dakos, V.; Buchman, T.; Boer, de R.; Glass, L.; Cramer, A.O.J.; Levin, S.; Nes, van E.H.; Sugihara, G.; Ferrari, M.D.; Tolner, E.A.; Leemput, van de I.A.

    2016-01-01

    OBJECTIVE:

    We propose a novel paradigm to predict acute attacks and exacerbations in chronic episodic disorders such as asthma, cardiac arrhythmias, migraine, epilepsy, and depression. A better generic understanding of acute transitions in chronic dynamic diseases is increasingly important

  1. 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...... but did not predict participation in the study of prevention of depression....... whether symptoms of depression and anxiety in participants and non-participants predicted participation in the study. Methods: This substudy was conducted between May 2005 and April 2007. Patients with ACS, eligible for the study (n=302) were asked four questions on depression and anxiety from the Primary...

  2. Predictors for nephrology outpatient care and recurrence of acute kidney injury (AKI) after an in-hospital AKI episode.

    Science.gov (United States)

    Xie, Mingyang; Iqbal, Sameena

    2014-10-01

    Acute kidney injury (AKI) is associated with increased long-term risk of end-stage kidney disease (ESKD) and mortality. Nephrology care following discharge from hospital may improve survival through prevention of recurrent AKI events. In this study, we examined the factors that were associated with outpatient nephrology follow-up after the development of AKI on patients who had a nephrology in-hospital consultation and were discharged from McGill University Health Centre between January 1, 2006 and December 31, 2010. The associated factors for AKI-free survival postdischarge were assessed applying multivariate Cox hazard proportional models. Of 170 patients, only 22% of the AKI admissions studied were booked with nephrology follow-up after discharge. The unadjusted hazard ratio (HR) of outpatient nephrology care postdischarge was 1.82 (95% confidence interval [CI] 0.93-3.56) for AKI-free survival postdischarge. The adjusted HR was 2.04 (95% CI 1.01-4.12) when we adjusted for follow-up with other medical clinics, significant stage 4 and stage 5 chronic kidney disease and diabetes status. Patients with less comorbidities and higher serum creatinine on discharge received outpatient nephrology care. Nephrology outpatient care is associated with decreased risk of recurrence of AKI after discharge from hospital.

  3. Acute stress disorder and major depressive disorder in flood victims from Tingo Maria: prevlence and the effect of relocating

    OpenAIRE

    2008-01-01

    Objectives. To determine the prevalence of acute stress disorder (ASD) and comorbidity with major depressive disorder (ASD+MDD) in flood victims from Tingo María, Huánuco (Peruvian central jungle), 20 days after the traumatic event. Material and methods: One hundred and twenty injured (people relocated after disaster) and 110 affected (people living in their own homes) were surveyed and compared. Was applied to structured clinical interview for disorders axis I from DSM-IV, clinical versi...

  4. Depression.

    Science.gov (United States)

    McCarron, Robert M; Vanderlip, Erik R; Rado, Jeffrey

    2016-10-04

    This issue provides a clinical overview of depression, focusing on screening, diagnosis, treatment, and practice improvement. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers.

  5. Acute variations of cytokine levels after antipsychotic treatment in drug-naïve subjects with a first-episode psychosis: A meta-analysis.

    Science.gov (United States)

    Capuzzi, Enrico; Bartoli, Francesco; Crocamo, Cristina; Clerici, Massimo; Carrà, Giuseppe

    2017-03-08

    Schizophrenia is likely to be associated with immunological abnormalities. However, antipsychotics may induce immunomodulatory effects, by influencing plasma cytokines. In order to distinguish these influences, we carried out a systematic review and meta-analysis exploring the acute effect of antipsychotics on candidate cytokines plasma levels (IL-1β, IL-2, IL-6, IL-17, IFN-γ, TNF-α) among drug-naïve subjects with first episode psychosis. We searched main Electronic Databases, identifying eight studies meeting our inclusion criteria. Pre and post-treatment plasma cytokines values were used to estimate standardized mean differences. Heterogeneity was estimated using the I(2) index. Heterogeneity-based sensitivity analyses were performed. IL-2 (p=0.023) and IL-6 (p=0.012) levels showed a significant decrease after four weeks of antipsychotic treatment. Relevant sensitivity analysis confirmed these findings. IL-1β had high between-study heterogeneity. However, leaving out one study, significant after treatment decrease was found. IL-6 and IL-2, and possibly IL-1β, could be considered state markers, decreasing after antipsychotic treatment, whilst TNF-α, IL-17, and IFN-γ might be considered trait markers. Options for novel treatments in FEP, involving cytokine-modulating agents, should be further studied.

  6. The cumulative load of depressive illness is associated with cognitive function in the remitted state of unipolar depressive disorder

    DEFF Research Database (Denmark)

    Hasselbalch, BJ; Knorr, U; Hasselbalch, S G;

    2013-01-01

    episodes with psychotic features, respectively. CONCLUSION: Our findings suggest that cognitive dysfunction is associated with the cumulative duration of depressive episodes, and that, in particular, depressive episodes with psychotic features in the course of illness may be a significant predictor...

  7. Acute Phase Cognitive Therapy for Recurrent Major Depressive Disorder: Who Drops Out and How Much do Patient Skills Influence Response?

    Science.gov (United States)

    Jarrett, Robin B.; Minhajuddin, Abu; Kangas, Julie L.; Friedman, Edward S.; Callan, Judith A.; Thase, Michael E.

    2013-01-01

    Objective The aims were to predict cognitive therapy (CT) noncompletion and to determine, relative to other putative predictors, the extent to which the patient skills in CT for recurrent major depressive disorder predicted response in a large, two-site trial. Method Among 523 outpatients aged 18-70, exposed to 12-14 weeks of CT, 21.6% dropped out. Of the 410 completers, 26.1% did not respond. To predict these outcomes, we conducted logistic regression analyses of demographics, pre-treatment illness characteristics and psychosocial measures, and mid-treatment therapeutic alliance. Results The 17-item Hamilton Rating Scale for Depression (HRSD17) scores at entry predicted drop-out and nonresponse. Patients working for pay, of non-Hispanic white race, who were older, or had more education were significantly more likely to complete. Controlling for HRSD17, significant predictors of nonresponse included: lower scores on the Skills of Cognitive Therapy-Observer Version (SoCT-O), not working for pay, history of only two depressive episodes, greater pre-treatment social impairment. Mid-phase symptom reduction was a strong predictor of final outcome. Conclusions These prognostic indicators forecast which patients tend to be optimal candidates for standard CT, as well as which patients may benefit from changes in therapy, its focus, or from alternate modalities of treatment. Pending replication, the findings underscore the importance of promoting patients’ understanding and use of CT skills, as well as reducing depressive symptoms early. Future research may determine the extent to which these findings generalize to other therapies, providers who vary in competency, and patients with other depressive subtypes or disorders. PMID:23485420

  8. Importance of Depression in Diabetes.

    Science.gov (United States)

    Lustman, Patrick J.; Clouse, Ray E.; Anderson, Ryan J.

    Depression doubles the likelihood of comorbid depression, which presents as major depression in 11% and subsyndromal depression in 31% of patients with the medical illness. The course of depression is chronic, and afflicted patients suffer an average of one episode annually. Depression has unique importance in diabetes because of its association…

  9. 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

  10. Female sexual dysfunction: A comparative study in drug naive 1st episode of depression in a general hospital of South Asia

    OpenAIRE

    Roy, Payel; Manohar, Shivananda; Raman, Rajesh; Sathyanarayana Rao, T. S.; Darshan, M. S.

    2015-01-01

    Background: Women's sexual dysfunction is found to be highly prevalent in western and Indian literature. Limited studies are available on drug naive depression in western literature and in Indian population. Aim: To determine the prevalence rate and symptom profile of female sexual dysfunctions in patients with untreated depression. Design: A cross-sectional study in the psychiatry out-patient department of general hospital in South India. Materials and Methods: Following written informed con...

  11. A test of the effects of acute sleep deprivation on general and specific self-reported anxiety and depressive symptoms: an experimental extension.

    Science.gov (United States)

    Babson, Kimberly A; Trainor, Casey D; Feldner, Matthew T; Blumenthal, Heidemarie

    2010-09-01

    Evidence indicates acute sleep deprivation affects negative mood states. The present study experimentally tested the effects of acute sleep deprivation on self-reported symptoms of state anxiety and depression as well as general distress among 88 physically and psychologically healthy adults. As hypothesized, the effects of acute sleep deprivation increased state anxiety and depression, as well as general distress, relative to a normal night of sleep control condition. Based on the tripartite model of anxiety and depression, these findings replicate and extend prior research by suggesting sleep deprivation among individuals without current Axis I disorders increases both state symptoms of anxiety and depression specifically, and general distress more broadly. Extending this work to clinical samples and prospectively testing mechanisms underlying these effects are important future directions in this area of research.

  12. 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

  13. Efficacy of Paroxetine plus Amisulpride for Depressive Episode Associated with Psychotic Symptoms%帕罗西汀联合氨磺必利治疗伴精神病症状抑郁发作的效果评价

    Institute of Scientific and Technical Information of China (English)

    杨薇; 陈怡兰; 陈雪; 张礼会

    2015-01-01

    目的:探讨帕罗西汀联合氨磺必利治疗伴精神病症状抑郁发作的的临床效果。方法:选择玉溪市第二人民医院就诊的伴精神病症状抑郁发作患者100例,随机分为观察组和对照组,每组50例。观察组采用帕罗西汀联合氨磺必利治疗,对照组单用帕罗西汀治疗,采用汉密尔顿抑郁量表( HAMD)减分率评定治疗后第1周、第2周、第4周、第8周的疗效;并使用症状量表( TESS)评定不良反应。结果:观察组有效率为90.0%,对照组有效率为64.0%,观察组有效率显著高于对照组( P<0.05);治疗前,两组HAMD评分差异无统计学意义(P>0.05),治疗后两组评分差异均有统计学意义(P<0.05),表明伴精神病症状的抑郁发作采用两种方法治疗均有良好疗效,两组第1周、2周、4周、8周比较差异均有统计学意义( P<0.05)。结论:帕罗西汀联合氨磺必利治疗伴精神病症状抑郁发作是一种更安全、有效的治疗方法,值得临床推广。%OBJECTIVE:To investigate the clinical efficacy of paroxetine plus amisulpride for depressive episodes associated with psychotic symptoms.METHODS: 140 patients with depressive episodes associated with psychotic symptoms were randomly assigned to either observation group or control group, of 50 cases each.The control group received paroxetine alone while the observation group received paroxetine plus amisulpride.The curative efficacy was evaluated at 1, 2, 4, and 8 weeks of treatment using Hamilton depression scale ( HAMD) and the adverse drug reactions were evaluated using the symptoms scale ( TESS) .RESULTS:The response rate in the observation group was significantly higher than in the control group ( 90.0% vs.64.0%; P 0.05 ) , however, after treatment, statistically significant differences were noted in HAMD scores for the two groups ( P<0.05 ) , indicating that both paroxetine alone and

  14. Control study on executive function between patients with first-episode and recurrent depression%首次发病与复发抑郁症患者执行功能的对照研究

    Institute of Scientific and Technical Information of China (English)

    李宝花; 王彬; 刘红霞; 于立; 李秀荣

    2014-01-01

    目的:探讨首发和复发抑郁症患者执行功能损害情况。方法:采用威斯康星卡片分类测验(WCST)、Stroop 测验、汉密尔顿抑郁量表(HAMD-17)对100例抑郁症患者进行评定,其中首次发病(首发组)患者41例,复发(复发组)患者59例;同时以50名正常人作为对照组进行测评并分析比较。结果:在 WSCT 的总错误数、分类完成数、持续性错误数及持续性应答数、以及 Stroop 色词测验的彩色文字阅读(Stroop-c)时间和彩色文字的色彩阅读(Stroop-cw)正确数上,首发组、复发组与对照组之间差异均有统计学意义(P ﹤0.05或 P ﹤0.01);Stroop-c 正确数上首发组和复发组之间差异无统计学意义(P ﹥0.05)。结论:无论首发还是复发抑郁症患者均存在明显的执行功能损害,复发者更为显著。%Objective:To explore the impairment of executive function between patients with first-epi-sode and recurrent depression. Method:The Wisconsin card sorting test(WCST),Stroop test,Hamilton de-pression scale( HAMD-17)were used to evaluate 100 depressive patients,in which the first onset patients (first-episode group)41 cases,recurrence patients(recurrent group)59 cases. The results were compared with 50 normal controls. Results:There were statistically significant difference among the first-episode group,the recurrent group and the control group(P ﹤ 0. 05 or P ﹤ 0. 01)on the total number of errors,classification num-ber,perseverative errors,sustained responders of the WCST,time of Stroop-c and correct number of Stroop-cw, but no statistically significant difference on the Stroop-c correct number between the first episode group and the recurrent group(P ﹥ 0. 05). Conclusion:There are significant impairment of executive function in patients with first-episode and recurrent depression,which in recurrent depression patients are more obvious impairment.

  15. Effects of nicotinic acetylcholine receptor agonists in assays of acute pain-stimulated and pain-depressed behaviors in rats.

    Science.gov (United States)

    Freitas, Kelen C; Carroll, F Ivy; Negus, S Stevens

    2015-11-01

    Agonists at nicotinic acetylcholine receptors (nAChRs) constitute one drug class being evaluated as candidate analgesics. Previous preclinical studies have implicated α4β2 and α7 nAChRs as potential mediators of the antinociceptive effects of (–)-nicotine hydrogen tartrate (nicotine) and other nAChR agonists; however, these studies have relied exclusively on measures of pain-stimulated behavior, which can be defined as behaviors that increase in frequency, rate, or intensity after presentation of a noxious stimulus. Pain is also associated with depression of many behaviors, and drug effects can differ in assays of pain-stimulated versus pain-depressed behavior. Accordingly, this study compared the effects of nicotine, the selective α4/6β2 agonist 5-(123I)iodo-3-[2(S)-2-azetidinylmethoxy]pyridine (5-I-A-85380), and the selective α7 agonist N-(3R)-1-azabicyclo(2.2.2)oct-3-yl-4-chlorobenzamide in assays of pain-stimulated and pain-depressed behavior in male Sprague-Dawley rats. Intraperitoneal injection of dilute lactic acid served as an acute noxious stimulus to either stimulate a stretching response or depress the operant responding, which is maintained by electrical brain stimulation in an intracranial self-stimulation (ICSS) procedure. Nicotine produced a dose-dependent, time-dependent, and mecamylamine-reversible blockade of both acid-stimulated stretching and acid-induced depression of ICSS. 5-I-A-85380 also blocked both acid-stimulated stretching and acid-induced depression of ICSS, whereas N-(3R)-1-azabicyclo(2.2.2)oct-3-yl-4-chlorobenzamide produced no effect in either procedure. Both nicotine and 5-I-A-85380 were ≥10-fold more potent in blocking the acid-induced depression of ICSS than in blocking the acid-induced stimulation of stretching. These results suggest that stimulation of α4β2 and/or α6β2 nAChRs may be especially effective to alleviate the signs of pain-related behavioral depression in rats; however, nonselective behavioral effects

  16. The association of asthma and wheezing with major depressive episodes: an analysis of 245 727 women and men from 57 countries

    NARCIS (Netherlands)

    A. Loerbroks; R.M. Herr; S.V. Subramanian; J.A. Bosch

    2012-01-01

    Background: Epidemiological studies have shown that asthma is positively associated with depression. Most of this evidence stems from individual studies conducted in Western populations (e.g. Europe, North America and Australia). It is still unclear whether such findings generalize to non-Western co

  17. The Role of Setting-up Exercise on Rehabilitation in Patients with Depressive Episode%健身操在抑郁发作患者康复中的作用

    Institute of Scientific and Technical Information of China (English)

    石贵凤

    2015-01-01

    目的:探讨健身操对抑郁发作患者康复的影响。方法:对70例住院抑郁发作患者在药物治疗的同时,随机分为研究组35例辅以健身操训练8周,采用汉密尔顿抑郁量表( HAMD-24)于入组第一天、4周、8周进行评定,护士用住院精神病人观察量表( NOSIE-30)于入组前后进行评定,并与单纯药物治疗的35例抑郁发作患者进行对照。结果:经8周健身操训练后,研究组汉密尔顿抑郁量表总分明显低于对照组,差异有极显著性( t=-5.761, P<0.01),研究组治愈率达88.57%,对照组治愈率62.85%(χ2=6.293,P<0.05),护士用住院病人观察量表研究组总积极因子分、病情总估计明显高于对照组,总消极因子分明显低于对照组,差异有极显著性(P均<0.01).结论:健身操训练能明显改善抑郁发作患者的抑郁情绪,提高疗效,较单用抗抑郁剂治疗效果更显著。%Objective:To discuss the influences of setting -up exercise on rehabilitation in patients with depressive episode .Methods:70 cases of hospitalized patients with depressive episode in drug treat-ment were randomly divided into control group and research group .The research group was supplemented by setting-up exercise training for 8 weeks.And Hamilton depression scale(HAMD-24)were used in the first day,4h week,8h week.The nurse in hospitalized psychiatric patients observation scale (NOSIE-30 ) was used before and after the grouping treatment ,and the scores were compared between two groups . Results:After 8 weeks,the Hamilton depression rating scale total score was significantly lower in the re-search group than that in the control group (t=-5.761,P<0.01),group cure rate was 88.57%,control group cure rate 62.85%(χ2 =6.293,P<0.05),the nurses with inpatient observation scale 'positive fac-tors'scores,total estimate were significantly higher than those in the control group ,the

  18. Investigation of attentional bias to emotional-related words in first-episode depressive patients%首发抑郁症患者对情绪词注意偏向相关研究

    Institute of Scientific and Technical Information of China (English)

    程丽; 谢思思

    2014-01-01

    Objective To explore the attentional bias in first-episode depressive patients and the correlations between the attentional bias.Methods In the beginning of the treatment,a total of 34 first-episode depressive patients in treatment-naive and demography matched 40 healthy controls completed the Chinese Emotional Stroop Task that assessed the attentional bias.Results The comparison between depressive patients and healthy controls on the reaction time of negative,neutral and positive-related words were significant ((1185.71±410.60)ms/(754.68±215.36) ms,t=5.775,P<0.01 ; (1127.92±344.89) ms/(755.37±213.49) ms,t=5.675,P<0.01 ;(1166.17±395.72) ms/(761.70± 194.66) ms,t=5.708,P<0.01 respectively).Through analysis of variance,the difference of error numbers among the neutral,negative and positive-related words ((3.41 ± 2.11) times,(2.24±1.65) times,(2.97± 1.17) times) in the depressive patients were significant (F=4.197,P=0.018).The difference of error numbers between negative-related words and neutral-related words were significant through analysis of least significant difference(P<0.01).Conclusion The results suggest that depressive patients before treatment have attentional bias in negative-related word.Attentional bias in negative-related stimuli may be one of the characteristics of cognitive function in first-episode depressive patients.%目的 探讨首发型抑郁症患者注意偏向特点.方法 选取34例未经治疗的首发型抑郁症患者以及与其人口学资料相匹配的40例健康对照组(HC)作为研究对象,采用中文情绪词stroop实验进行注意偏向的测试.结果 患者组在负性词、中性词、正性词的反应时[分别为(1185.71±410.60) ms,(1127.92±344.89) ms,(1166.17±395.72) ms],高于HC组[分别为(754.68±215.36) ms,(755.37±213.49)ms,(761.70±194.66)ms],差异有统计学意义(t=5.775,P<0.01;t=5.675,P<0.01;t=5.708,P<0.01);方差分析显示患者组在负性词、中

  19. Study on the Episodic Memory of Depression Patients in Remission in a Hospital, Wenzhou%温州市某医院缓解期抑郁障碍患者情景记忆分析

    Institute of Scientific and Technical Information of China (English)

    郑天生; 马晓韵; 黄子夜; 王文霞; 叶敏捷

    2015-01-01

    Objective: To study the depression patients in remission related episodic memory characters.Methods:The study chose 30 ca-ses of patients with depression in remission and 30 cases of healthy controls during Oct 2009 to Mar 2013 in a hospital, in wenzhou as study ob-jects, assessing their mood subscale and testing their episodic memory.Results:The HAMD and HAMA scores of depression patients in remission are significantly higher than those in the control group;The two groups have statistically significant (P0.05);The free recall and delayed recall scores of patients with depressive disorder in remission were 27.40±6.81 and 10.60±2.33 significantly lower than the control group 33.53±4.96 and 12.57±1.81 (P0.05);The patients of depressive disorder in remission with poorer learning ability than the control group, but no statistical difference (P >0.05).Conclusion:This study suggests that depression patients with remission exist episodic memory damage.%目的:探讨抑郁障碍患者缓解期的情景记忆特点。方法:选择2009年10月-2013年3月温州市某医院就诊的30名缓解期抑郁障碍患者和30名招募的健康人员作为研究对象。采用情绪量表测评和情景记忆测试,对被试进行测评。结果:缓解期抑郁障碍患者的HAMD、HAMA评分均显著高于健康对照组,两组存在统计学差异( P<0.001);两组的数字广度测试和词汇流畅性测试均无统计学差异(P>0.05);缓解期的抑郁障碍患者自由回忆和延迟回忆得分分别为27.40±6.81和10.60±2.33,低于对照组33.53±4.96和12.57±1.81,两组存在统计学差异(P<0.01),而延迟再认缘分,两组不存在统计学差异(P>0.05);缓解期抑郁障碍患者的学习能力差于对照组,但无统计学差异(P>0.05)。结论:缓解期抑郁障碍患者的情景记忆存在损伤。

  20. 肺心病急性发作期血糖观察探讨%Cor Pulmonale with Acute Episodes Glucose to Observe

    Institute of Scientific and Technical Information of China (English)

    王漫丽

    2015-01-01

    Objective To observe the cor pulmonale with acute episodes blood sugar levels. Methods From May 2014 to May 2014 patients of cor pulmonale, 100 patients with acute phase, review the clinical data for analysis. Results The hy-perglycemia group case fatality rate was 20.00%, no high blood glucose group was 5.00%, hyperglycemia group were signif-icantly higher than those without a high blood glucose group (P<0.05). High blood glucose group was in the hospital for an average of d (14.33+1.67), no (9.67-1.26) for high blood sugar group d, high blood glucose significantly longer than without high blood glucose group (P<0.05). Breathing, heart failure, fasting hyperglycemia group, the incidence of postprandial hy-perglycemia are 23.68% and 23.68% respectively, without breathing, heart failure group were 6.45%, 16.13%, breathing, heart failure group were significantly higher than those without breathing, heart failure group (P<0.05). Conclusion The cor pulmonale patients with acute phase may occur high blood sugar, high blood glucose will influence on the course and prog-nosis, observe the blood sugar level, and take active treatment.%目的:观察肺心病急性发作期血糖水平。方法选取从2014年5月-2015年5月收治的肺心病急性发作期患者100例,回顾分析其临床资料。结果高血糖组病死率为20.00%,无高血糖组为5.00%,高血糖组明显高于无高血糖组(P<0.05)。高血糖组住院时间平均为(14.33±1.67)d,无高血糖组为(9.67±1.26)d,高血糖组明显长于无高血糖组(P<0.05)。呼吸、心力衰竭组空腹高血糖、餐后高血糖发生率分别为23.68%、39.47%,无呼吸、心力衰竭组分别为6.45%、16.13%,呼吸、心力衰竭组明显高于无呼吸、心力衰竭组(P<0.05)。结论肺心病急性发作期患者可能会发生高血糖,高血糖会对病程、预后产生影响,注意观察血糖水平,并采取积极治疗。

  1. Changes in cognitive symptoms after a buspirone-melatonin combination treatment for Major Depressive Disorder.

    Science.gov (United States)

    Targum, Steven D; Wedel, Pamela C; Fava, Maurizio

    2015-09-01

    Cognitive deficits are often associated with acute depressive episodes and contribute to the functional impairment seen in patients with Major Depressive Disorder (MDD). Many patients sustain residual cognitive deficits after treatment that may be independent of the core MDD disorder. We tracked changes in cognitive deficits relative to antidepressant treatment response using the patient self-rated Massachusetts General Hospital Cognitive and Physical Functioning Questionnaire (MGH-CPFQ) during a 6-week, double-blind trial of a combination antidepressant treatment (buspirone 15 mg with melatonin-SR 3 mg) versus buspirone (15 mg) monotherapy versus placebo in MDD patients with acute depressive episodes. The CPFQ includes distinct cognitive and physical functioning dimension subscales. Treatment response was determined using the Inventory of Depressive Symptomatology (IDSc30). Treatment responders improved significantly more on the total CPFQ than non-responders (p symptoms and that some aspects of cognition may be specific targets for treatment within a population of patients with MDD.

  2. A subtle grey-matter increase in first-episode, drug-naive major depressive disorder with panic disorder after 6 weeks' duloxetine therapy.

    Science.gov (United States)

    Lai, Chien-Han; Hsu, Yuan-Yu

    2011-03-01

    We designed this study to investigate the modulating effects of duloxetine on symptoms and grey matter of patients with major depressive disorder combined with panic disorder. We also aimed to discover if there was any persistence of grey-matter deficits after remission and to find 'trait markers' for this comorbidity. High-resolution magnetic resonance imaging and voxel-based morphometric measurements were performed on 15 patients at baseline and remitted status (week 6) compared to 15 healthy control subjects who were scanned twice within 6 wk. The rating scales of depressive and panic symptoms improved with statistical significance (corrected pgrey-matter deficits in infero-frontal, limbic, occipital, temporo-parietal, cerebellar areas (trait marker regions) in drug-naive patients were observed compared to controls at baseline (family-wise error corrected pgrey matter in healthy controls over the 6-wk period. Duloxetine-induced increases of grey matter were very subtle in left infero-frontal cortex, right fusiform gyrus, and right cerebellum VIIIa areas (state marker regions) after 6-wk therapy (uncorrected pgrey matter to the level of control subjects and grey-matter deficits in patients appear largely unaffected by duloxetine. We suggest that short-term duloxetine therapy improved the clinical symptoms of patients with major depressive disorder combined with panic disorder. These improvements might be related to a modest increase of grey matter in state marker regions of the brain. The deficits of trait marker regions were more evident and are likely to be important for pathogenesis.

  3. 强迫性障碍伴抑郁发作患者护理多元化干预%Diversified Intervention Nursing on Patients of Obsessive-compulsive Disorder With Depressive Episode

    Institute of Scientific and Technical Information of China (English)

    缪丽华

    2016-01-01

    目的:探讨护理多元化干预措施对强迫性障碍伴抑郁发作患者的康复影响。方法选取我院收治的64例强迫障碍伴抑郁发作患者作为研究对象,将其随机均分为观察组和对照组,观察组进行护理等多元化干预措施合并氯米帕明系统治疗,对照组接受氯米帕明系统治疗加常规护理。分别在入组前和入组干预后3周和6周用抑郁自评量表(Self-rating depression scale,SDS)和耶鲁布朗强迫障碍量表(The Yale-Brown Obsessive Compulsive Scale,Y-BOCS)≥18分、强迫性思维因子和强迫性行为因子评定效果。结果观察组治疗有效率为84.4%,高于对照组53.1%,两组比较,差异具有统计学意义(P<0.05)。结论护理多元化干预措施可以显著改善强迫性障碍伴抑郁发作患者的病情,提高患者的生活质量。%Objective To explore the Rehabilitation effect of diversified intervention nursing on patients of obsessive-compulsive disorder with depressive episode.Methods 64 cases of patients of obsessive-compulsive disorder with depressive episode from our hospital were reviewed and analyzed and were randomly assigned to the observation group and the control group, the observation group patients were accepted diversiifed intervention nursing merged clomipramine, the control group patients were accepted clomipramine merged regular nursing. Evaluation of the effect with self rating depression scale, the Yale-Brown obsessive compulsive scale, compulsive thinking factor, compulsive behavior factor before and after intervention 3 weeks, 6 weeks.Results The observation group effective rate is 84.4% higher than the control group 53.1% effective rate, the difference of effective rate between the two groups were statistically signiifcant (P < 0.05).Conclusion Diversiifed intervention nursing may significantly improve state of an illness of obsessive-compulsive disorder with depressive episode patients and enhance

  4. 首发抑郁症患者认知功能损害及认知行为治疗%Cognitive Impairment and Cognitive Behavioral Therapy in Patients With First Episode Depression

    Institute of Scientific and Technical Information of China (English)

    刘少林

    2015-01-01

    Objective Analyzing the characteristics of the patients with first-episode depression cognitive impairment,and to explore the influence of cognitive behavioral therapy in patients.Methods Selected 80 patients with first-episode depression(observation group)and 50 cases of healthy physical examination(control group)as the research object in our hospital from March 2014 to March 2015. Using wechsler memory scale(WMS),the Stroop colour word test(Stroop)and continuous operation test(CPT)for two groups of cognitive function test. And 80 cases of patients'combined cognitive behavioral therapy and drug for therapy, after 8 weeks,using the above indexes and 17 Milton depression scale (HAMD)to evaluate the therapeutic effect.Results Observation group'WMS score, Stroop score, CPT score compared with control group,were significantly worse than control group(P<0.05). After using drugs with cognitive behavioral therapy,HAMD scores were improved significantly(P<0.05). Conclusion First-episode depression exist in patients with severe cognitive function damage and cognitive behavioral therapy combined with drug therapy can effectively relieve depression and improve cognitive function in patients.%目的 分析首发抑郁症患者认知功能损害特点,并探讨认识行为治疗对患者认知功能的影响.方法 选取本院2014年3月~2015年3月收治的首发抑郁症患者80例(观察组)和健康体检者50例(对照组)作为研究对象.采用韦氏记忆量表(WMS)、斯特鲁色词测验(Stroop)以及持续性操作试验(CPT)对两组患者进行认知功能测试.并给予80例患者认识行为治疗联合药物治疗,治疗8周后,采用上述指标和17项密尔顿抑郁量表(HAMD)评定治疗效果.结果 观察组WMS评分、Stroop评分、CPT评分与对照组比较,均低于对照组(P<0.05);采用药物联合认知行为干预治疗后的HAMD评分均得到改善(P<0.05).结论 首发抑郁症患者广泛存在严重的认识功能损害,采用认识行

  5. Prenatal stress produces sex-specific changes in depression-like behavior in rats

    DEFF Research Database (Denmark)

    Sickmann, H M; Arentzen, T S; Dyrby, T B;

    2015-01-01

    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......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...

  6. Acute and long-term effectiveness of clozapine in treatment-resistant psychotic depression.

    Science.gov (United States)

    Ranjan, R; Meltzer, H Y

    1996-08-15

    The treatment of refractory major depression, including the psychotic subtype, is a therapeutic challenge. Three cases of resistant psychotic depression were treated with clozapine monotherapy, an atypical antipsychotic drug effective in treatment-resistant schizophrenia and mania. Both psychotic and mood symptoms responded well to clozapine monotherapy, although response was delayed in one case. Tardive dyskinesia improved markedly, and tardive dystonia improved moderately in one patient. No patient relapsed during a follow-up period of 4-6 years of clozapine treatment. Clozapine was well-tolerated with few side effects. These observations suggest controlled trials of clozapine in the treatment of psychotic depression that fails to respond to electroconvulsive therapy or typical neuroleptics plus tricyclic antidepressants are indicated. The same is true for the use of clozapine in maintenance treatment for psychotic depression in those cases in which typical neuroleptic drugs are required, in order to reduce the risk of tardive dyskinesia and dystonia.

  7. Importance of retardation and fatigue/interest domains for the diagnosis of major depressive episode after stroke: a four months prospective study Lentificação e fadiga/interesse no diagnóstico do episódio depressivo maior após o acidente vascular cerebral: um estudo prospectivo de quatro meses

    Directory of Open Access Journals (Sweden)

    Luisa de Marillac Niro Terroni

    2009-09-01

    Full Text Available OBJECTIVE: Post-stroke major depressive episode is very frequent, but underdiagnosed. Researchers have investigated major depressive episode symptomatology, which may increase its detection. This study was developed to identify the depressive symptoms that better differentiate post-stroke patients with major depressive episode from those without major depressive episode. METHOD: We screened 260 consecutive ischemic stroke patients admitted to the neurology clinic of a university hospital. Seventy-three patients were eligible and prospectively evaluated. We assessed the diagnosis of major depressive episode using the Structured Clinical Interview for DSM-IV and the profile of depressive symptoms using the 31-item version of the Hamilton Depression Rating Scale. For data analysis we used cluster analyses and logistic regression equations. RESULTS: Twenty-one (28.8% patients had a major depressive episode. The odds ratio of being diagnosed with major depressive episode was 3.86; (95% CI, 1.23-12.04 for an increase of one unit in the cluster composed by the domains of fatigue/interest and retardation, and 2.39 (95% CI, 1.21-4.71 for an increase of one unit in the cluster composed by the domains of cognitive, accessory and anxiety symptoms. The domains of eating/weight and insomnia did not contribute for the major depressive episode diagnosis. CONCLUSION: The domains of retardation and interest/fatigue are the most relevant for the diagnosis of major depressive episode after stroke.OBJETIVO: O episódio depressivo maior após acidente vascular cerebral é muito frequente, mas é subdiagnosticado. Pesquisas têm investigado a sintomatologia do episódio depressivo maior pós-acidente vascular cerebral, o que pode facilitar sua identificação. Este estudo foi desenvolvido para identificar os sintomas depressivos que melhor diferenciam pacientes com episódio depressivo maior daqueles sem episódio depressivo maior após o acidente vascular cerebral

  8. Relationship of depression in participants with nonspecific acute or subacute low back pain and no-pain by age distribution

    Science.gov (United States)

    Calvo-Lobo, Cesar; Vilar Fernández, Juan Manuel; Becerro-de-Bengoa-Vallejo, Ricardo; Losa-Iglesias, Marta Elena; Rodríguez-Sanz, David; Palomo López, Patricia; López López, Daniel

    2017-01-01

    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 subacute LBP (9.590±6.370) and no-pain (5.825±5.113). Significantly higher BDI scores were obtained from participants with nonspecific acute and subacute LBP in those aged 40–64 years (p<0.001; 9.140±6.074 vs 4.700±3.777) and 65–79 years (p<0.001; 10.672±6.126 vs 6.210±5.052). Differences were not significant in younger patients aged 19–24 (p=0.494; 5.000±2.646 vs 8.250±7.498), 25–39 (p=0.138; 5.440±5.245 vs 3.634±4.397), and in those aged ≥80 years (p=0.094; 13.625±6.1331 vs 10.440±5.591). Conclusion Participants with nonspecific acute and subacute LBP present higher BDI depression scores, influenced by age distribution. Specifically, patients in the age range from 40 to 80 years with LBP could require more psychological care in addition to any medical or physical therapy. Nevertheless, physical factors, different outcomes, and larger sample size should be considered in future studies. PMID:28138263

  9. Episodic acidification of small streams in the northeastern united states: ionic controls of episodes

    Science.gov (United States)

    Wigington, P.J.; DeWalle, David R.; Murdoch, Peter S.; Kretser, W.A.; Simonin, H.A.; Van Sickle, J.; Baker, J.P.

    1996-01-01

    As part of the Episodic Response Project (ERP), we intensively monitored discharge and stream chemistry of 13 streams located in the Northern Appalachian region of Pennsylvania and in the Catskill and Adirondack Mountains of New York from fall 1988 to spring 1990. The ERP clearly documented the occurrence of acidic episodes with minimum episodic pH ??? 5 and inorganic monomeric Al (Alim) concentrations >150 ??g/L in at least two study streams in each region. Several streams consistently experienced episodes with maximum Alim concentrations >350 ??g/L. Acid neutralizing capacity (ANC) depressions resulted from complex interactions of multiple ions. Base cation decreases often made the most important contributions to ANC depressions during episodes. Organic acid pulses were also important contributors to ANC depressions in the Adirondack streams, and to a lesser extent, in the Catskill and Pennsylvania streams. Nitrate concentrations were low in the Pennsylvania streams, whereas the Catskill and Adirondack study streams had high NO3- concentrations and large episodic pulses (???54 ??eq/L). Most of the Pennsylvania study streams also frequently experienced episodic pulses of SO42- (???78 ??eq/L), whereas the Adirondack and Catskill streams did not. High baseline concentrations of SO42- (all three study areas) and NO3- (Adirondacks and Catskills) reduced episodic minimum ANC, even when these ions did not change during episodes. The ion changes that controlled the most severe episodes (lowest minimum episodic ANC) differed from the ion changes most important to smaller, more frequent episodes. Pulses of NO3- (Catskills and Adirondacks), SO42- (Pennsylvania), or organic acids became more important during major episodes. Overall, the behavior of streamwater SO42- and NO4- is an indicator that acidic deposition has contributed to the severity of episodes in the study streams.

  10. Genetics of emergent suicidality during antidepressive treatment--data from a naturalistic study on a large sample of inpatients with a major depressive episode.

    Science.gov (United States)

    Musil, Richard; Zill, Peter; Seemüller, Florian; Bondy, Brigitta; Meyer, Sebastian; Spellmann, Ilja; Bender, Wolfram; Adli, Mazda; Heuser, Isabella; Fisher, Robert; Gaebel, Wolfgang; Maier, Wolfgang; Rietschel, Marcella; Rujescu, Dan; Schennach, Rebecca; Möller, Hans-Jürgen; Riedel, Michael

    2013-07-01

    Factors contributing to treatment-emergent suicidal ideation (TESI) using antidepressants have been in the focus of recent research strategies. We investigated previously established clinical predictors of TESI and combined these with several polymorphisms of candidate genes in patients with major depressive disorder. Common polymorphisms involved in the tryptophan hydroxylase 1 (TPH1) and 2 (TPH2), serotonin transporter, monoamine oxidase A (MAOA) and brain-derived neurotrophic factor (BDNF) were investigated in a naturalistic inpatient study of the German research network on depression. We compared patients showing TESI with non-TESI suicidal patients and with non-suicidal patients using univariate tests to detect relevant factors, which were further tested in logistic regression and CART (Classification and Regression Trees) analyses. Of the 269 patients, TESI occurred in 22 patients (17 female), 117 patients were defined as non-TESI suicidal patients, and 130 patients were classified as non-suicidal. When comparing cases with both control groups we found the TPH2 rs1386494 (C/T) polymorphism to be moderately associated with TESI (Univariate tests: TESI vs. non-suicidality: p=0.005; adjusted: p=0.09; TESI vs. non-TESI suicidal patients: p=0.0024; adjusted: p=0.086). This polymorphism remained the only significant genetic factor in addition to clinical predictors in logistic regression and CART analyses. CART analyses suggested interactions with several clinical predictors. Haplotype analyses further supported a contribution of this polymorphism in TESI. The TPH2 rs1386494 (C/T) polymorphism might contribute to the genetic background of TESI. This polymorphism has been previously associated with committed suicide and major depressive disorder. The small number of cases warrants replication in larger patient samples. Lack of a placebo control group hampers definite conclusions on an association with antidepressive treatment.

  11. 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.

  12. Circulating C19 steroids and progesterone metabolites in women with acute depression and anxiety disorders.

    Science.gov (United States)

    Hill, Martin; Řípová, Daniela; Mohr, Pavel; Kratochvílová, Zuzana; Velíková, Marta; Dušková, Michaela; Bičíková, Marie; Stárka, Luboslav

    2016-06-01

    Depression and anxiety disorders are highly prevalent in women. Although several studies have reported altered circulating steroids accompanying various mental disturbances, knowledge about alterations in the peripheral steroid pattern in such pathologies is incomplete. Therefore, we attempted to add to this knowledge using the simultaneous quantification of circulating steroids by gas chromatography mass spectrometry (GC-MS) in groups of premenopausal women in the follicular phase of the menstrual cycle (22 women with depression, 17 with anxiety disorders, 17 healthy controls). In addition to age-adjusted analysis of covariance (ANCOVA) followed by multiple comparisons, we developed models to successfully discriminate these groups from each other on the basis of steroid levels. Women with depression showed a reduced sulfoconjugation of steroids as well as lower levels of 7α-, 7β- and 16α-hydroxy-metabolites of C19 Δ5 steroids. Women with depression have significantly lower circulating levels of 5α/β-reduced pregnane steroids (with exception of free isopregnanolone) than women with anxiety or controls. Finally, our data indicate higher levels of estrogens in women with anxiety disorders when compared to women with depression.

  13. Depression of contraction and the calcium transient in single cardiomyocytes with acute ethanol exposure

    Energy Technology Data Exchange (ETDEWEB)

    Rozanski, D.J.; Delaville, F.J.; Thomas, A.P. (Thomas Jefferson Univ., Philadelphia, PA (United States))

    1992-01-01

    The mechanism by which acute ethanol (ET) exposure causes reversible myocardial dysfunction is unknown. The purpose of this study was to examine the effects of ET exposure on contraction and cytosolic free Ca[sup 2+] ([Ca[sup 2+

  14. 自动思维在首发女性抑郁症患者发病中的交互作用%The interaction of automatic thinking in female patients with first-episode depressive disorders

    Institute of Scientific and Technical Information of China (English)

    杨致蓉; 罗晓东; 王卫平

    2014-01-01

    目的:探讨首发女性抑郁症患者自动思维与抑郁症相关的应激因素之间存在交互作用。方法选取住院的60例首发女性抑郁症患者,经过自动思维问卷、功能失调性态度问卷、社会支持量表、应付方式问卷及YG性人格测验测评,用Spearman相关分析及路径分析方法,分析自动思维与抑郁症相关的应激因素在首发女性抑郁症患者发病过程中的相互作用。结果①自动思维总分与抑郁/焦虑总分、功能失调性认知总分、脆弱性、吸引和排斥、完美化和自主性态度等因子分呈正相关(P<0.05或P<0.01)。②自动思维总分与十二种性格中的自卑感、神经质、缺乏客观性和非合作性因子分呈正相关,与支配性、社会内外向性因子分呈负相关(P<0.05或P<0.01)。③自动思维和自责、合理化呈正相关,自动思维和社会支持总分、主观支持呈负相关(P<0.05或P<0.01)。④路径分析表明:自动思维对抑郁有直接预测作用;神经质、完美化、自责、焦虑通过自动思维对抑郁有间接预测作用;主观支持对自动思维有负向预测作用,且通过自动思维对抑郁有间接预测作用(P<0.05或P<0.01)。结论自动思维与抑郁症相关的应激因素之间存在交互作用,在开展抑郁症的心理治疗时需要综合考虑这些因素。%Objective To investigate the interaciton of automatic thoughts and stress factors related depression in fe-male patients with first-episode depressive disorder. Methods The 60 female patients with first-episode depression were enrolled and assessed by Hamilton Depression Rating Scale(HAMD),Hamilton anxiety scale(HAMA),Automatic thought questionnaire (ATQ), Dysfunctional attitude scale (DAS),ways of coping, the social support scale and Y-G Personality Questionnaire. Spearman correlation analysis and path analysis were used to analyse the interaciton of auto-matic thoughts and stress factors

  15. Assessing Rates and Predictors of Tachyphylaxis During the Prevention of Recurrent Episodes of Depression With Venlafaxine ER for Two Years (PREVENT) Study

    Science.gov (United States)

    Rothschild, Anthony J.; Dunlop, Boadie W.; Dunner, David L.; Friedman, Edward S.; Gelenberg, Alan; Holland, Peter; Kocsis, James H.; Kornstein, Susan G.; Shelton, Richard; Trivedi, Madhukar H.; Zajecka, John M.; Goldstein, Corey; Thase, Michael E.; Pedersen, Ron; Keller, Martin B.

    2013-01-01

    Background Antidepressant tachyphylaxis describes the return of apathetic depressive symptoms, such as fatigue and decreased motivation, despite continued use of a previously effective treatment. Methods Data were collected from a multiphase, double-blind, placebo-controlled study that assessed the efficacy of venlafaxine extended release (ER) during 2 sequential 1-year maintenance phases (A and B) in patients with recurrent major depressive disorder (MDD). The primary outcome was the cumulative probability of tachyphylaxis in patients receiving venlafaxine ER, fluoxetine, or placebo. Tachyphylaxis was defined as Rothschild Scale for Antidepressant Tachyphylaxis (RSAT) scored ≥ 7 in patients with prior satisfactory therapeutic response. A Kaplan-Meier estimate of the cumulative probability of not experiencing tachyphylaxis, and a 2-sided Fisher exact test was used to assess the relationship between tachyphylaxis and recurrence. Results The maintenance phase A population was comprised of 337 patients (venlafaxine ER [n = 129], fluoxetine [n = 79], placebo [n = 129]), whereas 128 patients (venlafaxine ER [n = 43], fluoxetine [n = 45], placebo [n = 40]) were treated during maintenance phase B. No difference in the probability of experiencing tachyphylaxis were observed between the active treatment groups during either maintenance phase; however, a significant difference between venlafaxine ER and placebo was observed at the completion of maintenance phase A. A significant relationship between tachyphylaxis and recurrence was observed. Limitations Despite demonstrating psychometric validity and reliability, the current definition of tachyphylaxis has not been widely studied Conclusions Although no significant differences were observed in the probability of tachyphylaxis among patients receiving active treatment, the relationship between tachyphylaxis and recurrence suggests that tachyphylaxis may be a predrome of recurrence. PMID:19752838

  16. Hemispheric dominance on visuo-spatial cognitive function in patients with first-episode depression%抑郁症首次发作患者视觉空间认知的功能偏侧化研究

    Institute of Scientific and Technical Information of China (English)

    陈玖; 杨来启; 李亚萍; 刘光雄; 吴银霞; 王大刚; 贾婷

    2012-01-01

    Objective To explore the functional laterality between left and right hemisphere on visuo-spatial cognitive function in first-episode depressive disorder patients. Methods A total of 35 depressive disorder patients ( experiment group ) and 36 normal healthy subjects ( control group ) were tested to make visuo-spatial rotation tasks by the event-related potential system, and the change of the brain distribution topographic map was observed. Results ①Compared with control group,the mean error rate [ ( 22. 3 ±6. 5 )% vs ( 18. 4 ± 5. 6 )% ] and the mean response time [ ( 761. 4 ± 94. 2 )ms vs ( 634.7 ± 84. 9 )ms ] significantly increased in depressive disorder group ( P <0. 05 ). ②Compared with control group,the normal P500 volatility at P4 was significantly decreased in depressive disorder group [ ( 7. 63 ±2. 63 )μV vs ( 9. 58 ±3. 22 )μV,P <0. 05 ],and the mirror P500 volatility at P4 was significantly increased[ ( 6. 90 ± 1. 92 )ΜV VS ( 4. 95 ± 1. 92 )μV ,P < 0. 05 ]. In P500, the self mirror-normal difference of excitability disappeared in depressive disorder group. The normal excitability in the right parietal-occipital lobe was significantly higher than that in the left parietal-occipital lobe ( P <0. 05 ),but the mirror excitement difference disappeared in depressive disorder group ( P >0. 05 ). The normal and mirror excitement in the right parietal-occipital lobe were both significantly higher than those in the left in control group ( P <0. 05 ). Conclusion The visuo-spatial cognitive function is impaired in patients with first-episode depression for both normal oriented images and mirror images. The functional laterality is found in normal images for visuo-spatial rotation,but not in mirror images. Specific topographic characteristics of EEG during visuo-spatial rotation tasks are potential biomarkers for first-episode depressive disorder.%目的 探讨首发抑郁症患者视觉空间认知的左右大脑

  17. Association of depression and stress in acute myocardial infarction: a case-control study

    Directory of Open Access Journals (Sweden)

    Patricia RM Goldfeld

    2015-07-01

    Full Text Available Background. Psychosocial factors have been reported to be independently associated with coronary artery disease (CAD. However the stress variable is still sub detailed and there are few studies that used coronary angiography (CA to assess CAD. Objectives. To compare levels of depression, stress and stressful life events in three groups of individuals: post-MI (Myocardial Infarction patients; patients presenting symptoms and no previous MI who underwent cardiac catheterization and had non-significant obstructive CAD and individuals with no symptoms of cardiac disease or others diseases. Methods. We conducted a case-control study, with two cases groups and one control group. The study included 105 patients with recent Myocardial Infarction (MI group, 101 patients with cardiac symptoms and normal CA (CS group, and 100 patients without symptoms of disease (NS group. Multivariate logistic regression was used to assess stress and vital events with an Odds Ratio of 95% confidence interval (CI, controlling for age, sex, education level, income, social support group, Body Mass Index (BMI, sedentary lifestyle and family history of MI or sudden death. Results. MI patients group showed depression with an OR= 4.47(95% CI, 2:36 to 8:46, p<.001, and stress OR= 5.37(95%CI, 2.94-9.78, p<.001 whereas CS group showed depression: OR= 6.95(95%CI, 3.64-13.28, p<.001 and stress: OR=9.18 (95%CI, 4.73-17.82, p<.001 compared to patients without symptoms. After adjusting the groups for the following risk factors: age, sex, education, income, social support, obesity, sedentary lifestyle, family history of MI or sudden death, the OR showed the following variation: in the MI group, depression OR=2.51 (95%CI, 1:05 to 5:98, p=.038, stress, OR=8.76(95%CI, 3:48 to 22:01, p<.001, while the CS group showed: depression OR=3.25(95%CI, 1.40-7.55,p<01 and stress OR=12.24 (95%, CI, 4.81-31.14, p<.001. The raised effect of variable stress after adjustment was promoted by age, sex and

  18. Explore the Visual Space Working Memory in First-episode Patients with Depressive Disorder%首发抑郁症患者的视空间工作记忆探究

    Institute of Scientific and Technical Information of China (English)

    吴宇棋; 吴晓珺; 杨漫欣

    2012-01-01

    Objective: The paper aimed to study characteristics and influencing factors of the visual spatial working memory of the patients with the first-episode depression. Methods: 30 first-episode depression patients and 30 normal controls were measured by Hamilton Depression Scale (HAMD), neuropsychological testing and the spatial working memory test. Results: The experimental group and control group has no difference in terms of base memory (P> 0.05). Visual spatial working memory of the first-episode patients was significantly damaged (P= 0.035), while their location memory relatively Temained(P= 0.518). Degree of depression has relevance to the damage degree of both visual spatial working memory and distance memory (r =- 0.272, P = 0.036; r =- 0.323, P= 0.012), while it has no relevance to the damage degree of position memory (r=-0.083,P = 0.572). Visual spatial working memory is influenced by gender and education level (P = 0.011, p = 0.298; P = 0.000, p = 0.536), but not by age (P= 0.345, P = 0.129), among which education level has a greater impact on the distance memory (P = 0.000, P = 0.568) while gender and educational level has impact on position memory (P = 0.029, p = 0.263; P = 0.001,p = 0.484). Conclusion; The distance memory of patients with first-episode depression is damaged, while their location memory relatively remained. The damage degree of the distance working memory has relevance to the degree of depression. It can be predicted that the process of the visual spatial distance working memory and visual spatial location working memory may have applied different neural circuits.%目的:探究首发抑郁症患者的视空间工作记忆特点及影响因素.方法:收集首发抑郁症患者、健康对照者各30例,分别进行汉密尔顿抑郁量表的评估、神经心理背景测试和视空间工作记忆测试.结果:实验组和对照组的基础记忆水平差异没有统计学意义(P>0.05).抑郁患者视空间距

  19. The changes of inflammatory cytokines and their clinical significance in patients of inferior ST-segment elevation acute myocardial infarction with anterior ST-segment depression

    Institute of Scientific and Technical Information of China (English)

    叶明

    2014-01-01

    Objective To investigate the level of Hs-CRP,Fib,IL-6,TNF-α,MDA,SOD,and analyze the correlation between the level of plasma inflammatory cytokines and clinical significance in patients with anterior ST-segment depression.Methods We chose 360 patients with inferior ST Segment elavation acute myocardial infarction from May 2007 to Sep 2012 in emergency department of

  20. 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.

  1. Cushing's syndrome masquerading as treatment resistant depression

    OpenAIRE

    Anil Kumar, B. N.; Sandeep Grover

    2016-01-01

    Treatment resistant depression (TRD) is a common clinical occurrence among patients treated for major depressive disorder. A significant proportion of patients remain significantly depressed in spite of aggressive pharmacological and psychotherapeutic approaches. Management of patient with treatment resistant depression requires thorough evaluation for physical causes. We report a case of recurrent depressive disorder, who presented with severe depressive episode without psychotic symptoms, n...

  2. First-episode depression resting state of brain function low frequency amplitude research%首发抑郁症静息态脑功能低频振幅研究

    Institute of Scientific and Technical Information of China (English)

    郭冬玲; 高阳; 牛广明; 谢生辉

    2016-01-01

    Objective: We used the method of resting-state functional magnetic resonance imaging (rfMRI) to explore the abnormal brain activity under the basic statusofpatientswithfirst-episode depression and its significance.Materials and Methods: Thirty patients with depression(the DSM-IV diagnostic criteria for depression) and thirty healthy volunteers matched with it were examined using resting-state functional MRI. Data analysis was processed by using the method of low-frequency amplitude (ALFF). Results:Intergroup analysis between depression and normal ALFF group:ALFF values of the parts of bilateral frontal lobes, temporal lobe and the cingulate gyrus and the right angular gyrus in depression groups are significantly higher than those in the control group; and ALFF values of bilateral medial prefrontal cortex, cuneus, precuneus, cerebellar hemisphere decreased. Conclusion:ALFF technology which can directly reflect the change of BOLD signal caused by abnormal metabolism of depressions with emotion disorder would contribute to exploration of the pathophysiological mechanisms of depression.%目的:采用静息态功能磁共振成像(resting-state functional magnetic resonance imaging, rfMRI)研究方法,探讨首发抑郁症患者基础状态下异常脑活动区及其意义。材料与方法对30例抑郁症患者(符合DSM-IV抑郁症的诊断标准)和与之匹配的30例健康志愿者进行静息态脑功能扫描。运用低频振幅(amplitude of low frequence fluctuation, ALFF)方法对数据分析,并采用双样本检验方法进行组间对比处理。结果抑郁症组与正常对照组ALFF图组间分析:抑郁症组大脑的双侧部分额叶、颞叶、扣带回及右侧角回等区域ALFF值显著高于正常对照组;而在双侧内侧前额叶、楔叶、楔前叶、小脑半球的ALFF值显著减低。结论ALFF技术可以直接反映抑郁症患者情绪异常引起的血氧水平依赖(blood oxygen level dependent, BOLD)信号代谢的改

  3. 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).

  4. 广泛性焦虑障碍和抑郁症患者归因方式的对照研究%Comparison of attributional style between generalized anxiety disorder and depressive episode patients

    Institute of Scientific and Technical Information of China (English)

    周云飞; 丘日阳; 刘铁榜; 刘妹; 位照国; 周娇艳; 方亚明; 闫小华; 杨颖佳; 梁杰

    2015-01-01

    目的:比较广泛性焦虑障碍和抑郁发作的归因方式差异。方法:评估广泛性焦虑障碍、抑郁发作患者、正常对照组各90例的归因方式,并比较其差异。结果:对负性事件的结果归因方式正常人倾向于外归因、不稳定性和特定性归因,抑郁发作患者对负性事件的归因方式倾向于内归因、持久性和全面性归因,广泛性焦虑障碍患者对负性事件的归因方式倾向于内归因、不稳定性和特定性归因(F=13.051,p=0.001;F=31.142,p=0.000;F=3.910,p=0.025);对正性事件的归因方式抑郁症患者倾向于外归因( F=3.898,p=0.023),广泛性焦虑障碍对正性事件的内归因、不稳定性和特定性归因和正常对照组差异无统计学意义(t=1.502,p=0.226;t=1.481,p=0.230;t=0.999,p=0.371);归因方式中全面性和持久性、内在性相互关联(r=0.278,p﹤0.05;r=0.301,p﹤0.05),但持久性和全面性归因相关最明显( r=0.428,p﹤0.01)。结论:归因方式可作为临床上鉴别诊断广泛性焦虑障碍和抑郁发作的心理学指标,其中内归因影响最大,持久性和全面性归因明显相关。%Objective:To compare attributional style between generalized anxiety disorder and depressive episode. Method:To compare and evaluate the attributional style of 90 generalized anxiety disorder,depres-sive episode patients and normal control group. Results:External,unstable,and specific attribution for the negative events were the characteristic attribution in normal control group;Depressive episode patients exhibited an inclination towards interna stablel ,and global attribution for negative events. The tendency of negative event attributional style of patients with generalized anxiety disorder were intemal,unstable,and specific(F=13. 051, p=0. 001;F=31. 142,p=0. 000;F=3. 910,p=0. 025). Attribution style of patients with depressive episode tend to external attributions

  5. 对首发抑郁症患者实施认知行为干预的效果观察%The effect of cognitive behavioral intervention in patients with first-episode depression

    Institute of Scientific and Technical Information of China (English)

    何丽婵; 苏保育; 谢雪华; 肖旭曼; 黎建容

    2015-01-01

    Objective To explore the effect of cognitive behavioral intervention in patients with first -episode depression. Methods 80 patients with first -episodewere randomly divided into observation group and control group, 40 cases in each group. Patients in both groups were received routine treatment and nursing, moreover, patients in observation group were dealing with cognitive behavioral intervention. Using Automatic Thoughts Questionnaire ( ATQ) and Social Supporting Rating Scale ( SSRS) to assess the effect of the intervention. Results The score of three dimension and total scores of SSRS in observation group were higher than that in control group (P<0.01,P<0.05).But the score of ATQ in observation group was lower than that in control group( P<0.01 ). Conclusions Early cognitive behavioral intervention can effectively improvesocial support level of patients with first -episode depression, reduce frequency of the negative automatic thoughts, and it is helpful to reduce disease situation, shorten the course of the disease.%目的:探讨对首发抑郁症患者实施认知行为干预的效果。方法将80例首发抑郁症患者随机分为观察组和对照组,各组40例。两组均进行常规治疗和护理,观察组在此基础上实施认知行为干预。采用社会支持评定量表(SSRS)、自动思维问卷(ATQ),于干预前、干预8周后对两组患者进行效果评定。结果干预8周后,观察组社会支持的3个维度和总分均高于对照组( P<0.01,P<0.05);负性自动思维问卷评分明显低于对照组(P<0.01)。结论对首发抑郁症患者作早期的认知行为干预能够提高其社会支持水平,降低负性自动思维的频率,有助于减轻病情,缩短病程。

  6. Depression and Anxiety after Acute Myocardial Infarction Treated by Primary PCI

    Science.gov (United States)

    Kala, Petr; Hudakova, Nela; Jurajda, Michal; Kasparek, Tomas; Ustohal, Libor; Parenica, Jiri; Sebo, Marek; Holicka, Maria

    2016-01-01

    Aims The main objective of the study was to find out prevalence of depression and anxiety symptoms in the population of patients with AMI with ST-segment elevation (STEMI), treated with primary PCI (pPCI). Secondary target indicators included the incidence of sleep disorders and loss of interest in sex. Methods and results The project enrolled 79 consecutive patients with the first AMI, aged <80 years (median 61 years, 21.5% of women) with a follow-up period of 12 months. Symptoms of depression or anxiety were measured using the Beck Depression Inventory II tests (BDI-II, cut-off value ≥14) and Self-Rating Anxiety Scale (SAS, cut-off ≥ 45) within 24 hours of pPCI, before the discharge, and in 3, 6 and 12 months). Results with the value p<0.05 were considered as statistically significant. The BDI-II positivity was highest within 24 hours after pPCI (21.5%) with a significant decline prior to the discharge (9.2%), but with a gradual increase in 3, 6 and 12 months (10.4%; 15.4%; 13.8% respectively). The incidence of anxiety showed a relatively similar trend: 8.9% after pPCI, and 4.5%, 10.8% and 6.2% in further follow-up. Conclusions Patients with STEMI treated by primary PCI have relatively low overall prevalence of symptoms of depression and anxiety. A significant decrease in mental stress was observed before discharge from the hospital, but in a period of one year after pPCI, prevalence of both symptoms was gradually increasing, which should be given medical attention. PMID:27074002

  7. Cognitive Distortions in Depressed Women: Trait, or State Dependent?

    Directory of Open Access Journals (Sweden)

    Sedat BATMAZ

    2016-07-01

    Full Text Available Objective: According to the cognitive theory developed by Beck, cognitive distortions are important mediators for the onset and maintenance of depressive disorders. It has not been researched if these cognitive distortions are more frequently encountered during the depressive episode, or if they are trait-like features. This study aims to investigate this. The hypothesis of the study is that cognitive distortions are state dependent. Method: Three groups of outpatients (n=178 patients in acute major depressive episode, n=168 depressive patients in remission, n=177 healthy controls presenting to the psychiatry clinics of three different state hospitals were recruited for the study. The participants were diagnostically interviewed by the MINI according to the DSM-IV criteria. The participants were asked to complete the Cognitive Distortions Scale and the severity of their depression was measured by the Inventory for Depressive Symptomatology. Results: According to the cognitive distortion subscales, except for the self-blame subscale, the acute depressive group scored the highest. Also it was found that the cognitive distortions of the depressive populations, except for the self-blame related ones, statistically differed from the healthy controls’. Self-blame related distortions were mood state dependent. Conclusion: The results have revealed that self-criticism, helplessness, hopelessness and preoccupation with danger related distortions had trait-like features, whereas selfblame related distortions were state dependent. This has clinical implications for the psychotherapeutic treatment of cognitive distortions in depression. Specifically, self-criticism related distortions should be managed during cognitive therapy for depression since the other subscales seem rather problematic.

  8. 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.

    Prenatal maternal stress increases the predisposition for affective disorders. Furthermore, women appear twice as likely as men to develop stress- and depression-related disorders. Comparable behavioral changes characteristic of clinical depression are found in rat offspring following prenatal...... stress (PS). These include increased helplessness, altered anxiety indicators and sleep modifications. Our purpose was to further investigate behavioral depression indices following PS as well as CNS structural changes including sex specificity of these variables. Pregnant Sprague-Dawley rats were...... 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...

  9. Sleep, fatigue, depression, and quality of life in survivors of childhood acute lymphoblastic leukemia.

    NARCIS (Netherlands)

    Gordijn, M.S.; Litsenburg, R.R. van; Gemke, R.J.; Huisman, J.; Bierings, M.B.; Hoogerbrugge, P.M.; Kaspers, G.J.L.

    2013-01-01

    BACKGROUND: With the improved survival of childhood acute lymphoblastic leukemia (ALL), the effect of treatment on psychosocial well-being becomes increasingly relevant. Literature on sleep and fatigue during treatment is emerging. However, information on these subjects after treatment is sparse. Th

  10. Acute cortisol administration modulates EEG alpha asymmetry in volunteers : relevance to depression

    NARCIS (Netherlands)

    Tops, M; Wijers, AA; van Staveren, ASJ; Bruin, KJ; Den Boer, JA; Meijman, TF; Korf, J

    2005-01-01

    The acute effects of cortisol (35 mg) administration in 11 healthy male volunteers on resting frontal EEG asymmetry measured in the alpha band were investigated, using a within-subjects double-blind design. Results were indicative of a relative increase of right frontal activity with cortisol. This

  11. Analysis of Alzheimer's Disease with First-episod Depressive Symptoms%以抑郁症状为首发的阿尔茨海默病分析探究

    Institute of Scientific and Technical Information of China (English)

    吴昊; 李龙宣; 梁唯

    2013-01-01

    Objective:To analyze the clinical features of Alzheimer's disease symptoms of depression for the first .Methods:in our hospital from 2011 January to 2012 January, 72 cases of hospitalized patients with Alzheimer's disease, in which 36 patients with de-pressive symptoms as initial as study group, another 36 cases without depressive symptoms for first -episode patients as control group, were analyzed for the two groups of patients and psychiatric symptoms .Results:the disease symptoms of depression , the study group of psychological factors, morbidity was higher than that of control group , the study group personality change, behavior disorder rate was significantly lower than that of the control group, the difference was statistically significant (P<0.05).Conclusion:passive and with-drawal behavior personality and affective symptoms in patients with Alzheimer's disease often appear in early duration of dementia, with social and psychological factors have more severe depressive symptoms , such as depression symptoms as the first symptom in patients with Alzheimer's disease in the process of diagnosis is prone to be misdiagnosed , so for this kind of patients with long-term follow-up, which is important, can make patients early treatment, the progression of the disease slowed down, but also can greatly improve the quality of life in patients.%目的:分析以抑郁症状为首发的阿尔茨海默病临床特征。方法:选择我院从2011年1月~2012年1月收治的阿尔茨海默病患者72例,其中36例以抑郁症状为首发的患者作为研究组,另外36例不以抑郁症状为首发的患者作为对照组,对于2组患者的各项情况以及精神症状进行对比分析。结果:研究组的抑郁症状、病前心理因素要明显高于对照组,研究组的人格改变、行为障碍发生率要明显低于对照组,差异均有统计学意义( P<0.05)。结论:阿尔茨海默病患者的被动和退缩行为人格和情

  12. Correlation Analysis on Coping Styles and Acute Emotional Depression in Elderly Patients with Acute Abdominal Diseases%老年急腹症患者急性期应对方式与情感抑郁的相关性

    Institute of Scientific and Technical Information of China (English)

    孙海霞; 夏丽芳; 蔡文芳; 杨英芳

    2011-01-01

    目的 调查普外科老年急腹症患者急性期情感抑郁的现状以及所采用的应对方式,并分析其与情感抑郁的相关性.方法 2008年3月至2009年3月,采用自行设计的调查问卷对236例老年急腹症急性期患者进行调查,问卷内容包括一般社会人口学资料、基本病情、患者的应对方式以及抑郁情绪等.结果 236例老年急腹症急性期患者中,抑郁者98例 ,其中轻度抑郁者44例 、中重度抑郁者54例;不同文化程度的老年急腹症患者在面对和回避的应对方式上,差异无统计学意义(P>0.05);自费的老年急腹症患者抑郁情绪比享受医保的老年急腹症患者严重,且多采用回避的应对方式(P<0.01);老年急腹症患者回避和屈服的应对方式与抑郁情绪之间具有相关性(P<0.01).结论 情感抑郁在老年急腹症急性期患者中发生率高,与医疗付费方式、采取的应对方式等多种因素有关,应采取积极的护理干预措施,以避免或减少老年急腹症患者情感抑郁的发生.%Objective To investigate the status quo and coping styles of acute emotional depression in elderly patients with acute abdominal diseases so as to analyze the correlation between different coping styles and emotional depression.Methods From March 2008 through March 2009, a questionnaire survey was conducted in 236 elderly patients with acute abdominal diseases concerning general social demographic data,the basic condition,the patient's coping style and depression,etc.Results Of the 236 elderly patients with acute abdominal diseases,depression occurred in 98 cases, including 44 mild and 54 moderate or severe depression.The elderly patients with acute abdominal diseases who had different education backgrounds had no significant difference in coping styles for depression, facing and avoidance(P>0.05).The depression levels in the elderly patients with acute abdominal diseases were significantly higher in those at their own

  13. Importance of psychological factors for the recovery from a first episode of acute non-specific neck pain - a longitudinal observational study

    OpenAIRE

    2016-01-01

    Background The influence of psychological factors on acute neck pain is sparsely studied. In a secondary analysis of prospectively collected data, this study investigated how several psychological factors develop in the first three months of acute neck pain and how these factors influence self-perceived recovery. Methods Patients were recruited in various chiropractic practices throughout Switzerland between 2010 and 2014. The follow-up telephone interviews were conducted for all patients by ...

  14. Effect of a cognitive behavioral self-help intervention on depressive symptoms and mental health status of ifrst-episode depression outpatients%基于认知行为疗法的自助干预对门诊首发抑郁症患者心理健康水平影响的研究

    Institute of Scientific and Technical Information of China (English)

    王霞; 杨敏; 陈琼妮

    2016-01-01

    Objective: To explore the effect of self-help intervention based on Cognitive Behavioral Therapy on depressive symptoms and mental health status of ifrst-episode depression outpatients. Methods: We randomly divided 126 ifrst-episode depression outpatients from two tertiary hospitals in Changsha into the no-guided experimental group (n=42) ,the guided experimental group (n=42) and the control group (n=42). During and after the intervention, 25 subjects were lost to follow-up, Finally, there were 39 subjects in the no-guided experimental group, 32 in the guided experimental group and 30 in the control group. An antidepressant skills workbook was provided for each patient in the non-guided experimental group, besides, one telephone guidence every two weeks was provided for each patient in the guided experimental group, while no speciifc training was supplied to the control group. We evaluated all subjects with Beck Depression Inventory (BDI) and 10-item Kessler Scale (K10) before the self-help intervention and 2 months after the intervention. Results: After the intervention, the scores of both BDI and K10 in three groups decreased signiifcantly (P0.05). Conclusions: The cognitive behavioral self-help intervention by self-help manual could not effectively improve depressive symptoms and mental health status of ifrst-episode depression outpatients. We suggest that intensity of intervention should be strengthened in future study.%目的:评价基于认知行为疗法的自助干预对改善门诊首发抑郁症患者抑郁症状与心理健康水平的效果。方法:将126名门诊首发抑郁症患者随机分成无指导的干预组(n=42)、有指导的干预组(n=42)和对照组(n=42),干预中及干预结束后共失访25人,最终入组的无指导的干预组39人,有指导的干预组32人,对照组30人。无指导的干预组接受自助手册形式的自助干预,有指导的干预组接受自助手册加上电话形式的自助干预,对照

  15. Temperament and Character in Psychotic Depression Compared with Other Subcategories of Depression and Normal Controls

    Directory of Open Access Journals (Sweden)

    Jaap G. Goekoop

    2011-01-01

    Full Text Available Background. Support has been found for high harm avoidance as general vulnerability trait for depression and decreased self-directedness (SD as central state-related personality change. Additional personality characteristics could be present in psychotic depression (PD. Increased noradrenergic activation in PD predicts the involvement of reward dependence (RD. Methods. The data during the acute episode and after full remission from the same subjects, that we used before, were reanalyzed. The dependence of the 7 dimensions of the Temperament and Character Inventory version 9 on PD, three other subcategories of depression, and a group of normal controls was tested by MANCOVA. Results. Low RD at both time points, and low Cooperativeness during the acute episode, were found as additional characteristics of PD. Conclusion. The combination of two premorbid temperaments, high HA and low RD, and the development of a state-related reduction of two character functions, SD and CO, may be the precondition for the development of combined depressive and psychotic psychopathology.

  16. 激越/迟滞型抑郁症首次发作患者的认知功能%A study of cognitive function in patients with first-episode agitated and retarded major depressive disorder

    Institute of Scientific and Technical Information of China (English)

    李泾; 吴天诚

    2012-01-01

    Objective: To study the characteristics of cognitive function and influence factors by the neu-ropsychological tests in patients with first-episode agitated and retarded major depressive disorder. Method: 77 first-episode depressive participants were grouped according to the scores of agition and retardation in Hamilton depression scale( HAMD). Three or more points of each item were separately recrudited agitated-group(n = 20) or retarded-group (n = 24), less than three points in both items were non-interactive group (n =33). All participants and normal controls(n =40) were tested by Wisconsin card sorting test( WCST) ,continuous performance test ( CPT) and Wechsler memory test ( WMS) , to record the indexes and correlate with dosage of an-tipsychotics,clinical symptoms. Results:(1)There were wide cognitive impairment in depression patients(P< 0.05 or P <0. 01 ) :(2)A11 indexes of WCST,CPT parameters( number of cancel,number of commission, mean reaction time) and WMS indexes (memory quotient,short-term memory,immediate memory) in agitated and retarded groups were significantly different compared with non-interactive ones( P < 0. 05 or P < 0.01): (3)There were obvious diversities between agitated and retarded groups including non-preservative errors of WCST, number of commission and mean reaction time of CPT, short-term memory of WMS(p <0.05 or P <0. 01) :(4)No significant correlation was found between most of parameters and clinical symptoms or the amounts of psycho-tropic drugs (imipramine-equivalent dose of anti-depressants,diazepam-equivalent dose of sedatives,chlorprom-azine-equivalent dose of antipsychotics). Conclusion: The cognitive dysfunction of agitated depression pa-lients were not the same as those of retarded ones entirely,which supplied a positive evidence for the heterology of major depressive disorder.%目的:探讨激越型和迟滞型抑郁症首次发作患者的认知功能特征及其影响因素. 方法:77例抑郁症首次发作患者根

  17. 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

  18. Atypical Antipsychotics in the Treatment of Acute Bipolar Depression with Mixed Features: A Systematic Review and Exploratory Meta-Analysis of Placebo-Controlled Clinical Trials

    Science.gov (United States)

    Fornaro, Michele; Stubbs, Brendon; De Berardis, Domenico; Perna, Giampaolo; Valchera, Alessandro; Veronese, Nicola; Solmi, Marco; Ganança, Licínia

    2016-01-01

    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 and

  19. Psychotherapy utilization for acute depression within the Veterans Affairs health care system.

    Science.gov (United States)

    Burnett-Zeigler, Inger E; Pfeiffer, Paul; Zivin, Kara; Glass, Joseph E; Ilgen, Mark A; Flynn, Heather A; Austin, Karen; Chermack, Stephen T

    2012-11-01

    This study examined the demographic characteristics and psychiatric comorbidities associated with the receipt of psychotherapy. The sample included 217,816 VA patients with a new depression diagnosis. Multinomial logistic regression analyses examined the relationships between the independent variables and the initiation of individual, group, or both individual and group psychotherapy within 90 days of a new diagnosis. Eighteen percent of VA patients received some form of psychotherapy. Veterans received a greater mean number of group therapy than individual therapy visits. Veterans who were female, younger than 35, unmarried, and with substance use, anxiety, or personality disorders were more likely to receive individual therapy only. Veterans who were male, 35-49 years old, Black, Other, or Hispanic, and with substance-use or anxiety disorders were more likely to receive group therapy only than no psychotherapy. Veterans who were male, 35-49 years old, Black, or Other race and with substance-use or anxiety disorders were more likely to receive both individual and group psychotherapy. Increased efforts are needed to encourage early initiation of psychotherapy treatment among depressed veterans.

  20. Does the initiation of urate-lowering treatment during an acute gout attack prolong the current episode and precipitate recurrent attacks: a systematic literature review.

    Science.gov (United States)

    Eminaga, Fatma; Le-Carratt, Jonathan; Jones, Adrian; Abhishek, A

    2016-12-01

    The aim of this study was to systematically review the literature on effect of initiating urate-lowering treatment (ULT) during an acute attack of gout on duration of index attack and persistence on ULT. OVID (Medline), EMBASE and AMED were searched to identify randomized controlled trials (RCTs) of ULT initiation during acute gout attack published in English language. Two reviewers appraised the study quality and extracted data independently. Standardized mean difference (SMD) and relative risk (RR) were used to pool continuous and categorical data. Meta-analysis was carried out using STATA version 14. A total of 537 studies were selected. A total of 487 titles and abstracts were reviewed after removing duplicates. Three RCTs were identified. There was evidence from two high-quality studies that early initiation of allopurinol did not increase pain severity at days 10-15 [SMDpooled (95 % CI) 0.18 (-0.58, 0.93)]. Data from three studies suggested that initiation of ULT during an acute attack of gout did not associate with dropouts [RRpooled (95 % CI) 1.16 (0.58, 2.31)]. There is moderate-quality evidence that the initiation of ULT during an acute attack of gout does not increase pain severity and risk of ULT discontinuation. Larger studies are required to confirm these findings so that patients with acute gout can be initiated on ULT with confidence.

  1. Association of urodynamic findings in new onset multiple sclerosis with subsequent occurrence of urinary symptoms and acute episode of disease in females

    Directory of Open Access Journals (Sweden)

    Farhad Tadayyon

    2012-01-01

    Full Text Available Background: The aim of the study was to determine the relative frequency of abnormal urodynamic findings in new multiple sclerosis (MS cases without micturition complaints and to find its correlation with the number of MS plaques on magnetic resonance imaging (MRI, urinary tract involvement and the number of disease episodes. Methods : In this prospective study, 50 new female case of multiple sclerosis were enrolled. Age, urodynamic findings, micturition complaints and number of plaques on MRI were recorded on admission. Occurrence of urinary symptoms and number of episodes of the disease were recorded every three months during one-year follow-up. Results : The mean patients′ age was 32.4 ± 7.2 years and all patients were female. Of the 50 patients, 19 (38% had a normal urodynamic test and 31 (62% had abnormal urodynamic findings at the beginning of the study. The occurrence of micturition complaints during follow-up in patients with abnormal urodynamic findings (94% was significantly higher (p < 0.0001 than patients with normal urodynamic findings (37%. In addition, the number of plaques on MRI at the beginning of the study in patients with abnormal urodynamic finding was significantly higher (p < 0.004 compared to patients with a normal urodynamic study. The number of episodes during follow-up was not statistically different between patients with normal and abnormal urodynamic findings (p = 0.46. Conclusions : According to this study, 62% of all new MS patients had an abnormal urodynamic test. This is a considerable proportion of patients and it seems urodynamic studies can be used when MS is first diagnosed.

  2. 舍曲林治疗首发青少年抑郁症认知功能的研究%The cognitive function after sertraline treatment in first-episode adolescent depression

    Institute of Scientific and Technical Information of China (English)

    张喜燕; 杜亚松; 龚云; 李惠琳; 赵滢; 刘文文; 李炎; 杨曹骅

    2013-01-01

    Objective To explore the effects of sertraline on cognitive function in first-episode adolescent depression and some related factors of cognitive function. Methods Twenty-one adolescents with first-episode depression were recruited and given sertraline treatment for 6 weeks, and 21 healthy adolescents were involved as controls. Children's depression inventory(CDI) were evaluated at the baseline and the end point of treatment. A series of neuropsychological tests including Wisconsin card sorting test (WCST), wpatial working tnemory(SWM), stockings of Cambridge(SOC), intra-dimensional/ extra-dimensional shifts(IED) and delayed matching to sample (DMS)were performed twice to evaluate cognitive function. Results The patients had significant improvement in WCST and IED after sertraline treatment (P< 0.01). There was no obvious improvement on SWM strategy score after treatment, which was statistically higher than that of the control group(F<0.05). The amendment of IED EDS errors were positively correlated to the reductions in CDI total score and interpersonal problems item score (r=0.539, P=0.038; r=0.502, P=0.034). The amendment of DMS percent correct was negatively correlated to the reductions in negative mood item score(r=-0.585, P =0.011). The amendment of SOC four mean moves was positively correlated to the reductions in negative self-esteem item score(r=0.518, P=0.028). Conclusion The cognitive function can be improved after sertraline treatment in first-episode depressive adolescents correlated to the symptoms alleviation. Sertraline has no effect on working memory.%目的 探讨舍曲林对首发青少年抑郁症患者认知功能的影响及其相关因素.方法 对21例首发青少年抑郁症患者(抑郁症组)给予舍曲林(一日50 mg)治疗,共6周,并以21例健康者(健康对照组)为对照,评估治疗前后儿童抑郁量表(CDI)、威斯康辛卡片分类测验(WCST)、空间工作记忆(SWM)、剑桥袜(SOC)、目标内外注意转换(IED)和

  3. The role of nitrergic system in antidepressant effects of acute administration of zinc, magnesium and thiamine on progesterone induced postpartum depression in mice

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    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.

  4. 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

  5. Determinants of Noninvasive Ventilation Outcomes during an Episode of Acute Hypercapnic Respiratory Failure in Chronic Obstructive Pulmonary Disease: The Effects of Comorbidities and Causes of Respiratory Failure

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    Angela Maria Grazia Pacilli

    2014-01-01

    Full Text Available Objectives. To investigate the effect of the cause of acute respiratory failure and the role of comorbidities both acute and chronic on the outcome of COPD patients admitted to Respiratory Intensive Care Unit (RICU with acute respiratory failure and treated with NIV. Design. Observational prospective study. Patients and Methods. 176 COPD patients consecutively admitted to our RICU over a period of 3 years and treated with NIV were evaluated. In all patients demographic, clinical, and functional parameters were recorded including the cause of acute respiratory failure, SAPS II score, Charlson comorbidity index, and further comorbidities not listed in the Charlson index. NIV success was defined as clinical improvement leading to discharge to regular ward, while exitus or need for endotracheal intubation was considered failure. Results. NIV outcome was successful in 134 patients while 42 underwent failure. Univariate analysis showed significantly higher SAP II score, Charlson index, prevalence of pneumonia, and lower serum albumin level in the failure group. Multivariate analysis confirmed a significant predictive value for pneumonia and albumin. Conclusions. The most important determinants of NIV outcome in COPD patients are the presence of pneumonia and the level of serum albumin as an indicator of the patient nutritional status.

  6. Etiological Misidentification by Routine Biochemical Tests of Bacteremia Caused by Gordonia terrae Infection in the Course of an Episode of Acute Cholecystitis

    Science.gov (United States)

    Gil-Sande, E.; Brun-Otero, M.; Campo-Cerecedo, F.; Esteban, E.; Aguilar, L.; García-de-Lomas, J.

    2006-01-01

    Gordonia terrae has been reported to be a rare cause of bacteremia. We report the first case of bacteremia associated with acute cholecystitis. Commercial biochemical testing was not able to identify the strain at the genus level, classifying it instead as Rhodococcus sp. Definitive identification was obtained by sequencing of the 16S rRNA gene. PMID:16825404

  7. Time elapsed after transplantation influences the relationship between the number of regulatory T cells in lung allograft biopsies and subsequent acute rejection episodes

    DEFF Research Database (Denmark)

    Krustrup, Dorrit; Iversen, Martin; Martinussen, Torben;

    2014-01-01

    scored for acute rejection according to the ISHLT criteria (A0-A4) and immunohistochemically stained with antibodies against FoxP3. Results: There was a tendency for a decrease in the number of Tregs/mm2 with time. However, the previous levels of Tregs/mm2 did not have any significant effect on future...

  8. A randomised, feasibility trial of a tele-health intervention for Acute Coronary Syndrome patients with depression ('MoodCare': Study protocol

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    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

  9. 蝮蛇抗栓酶治疗肺心病急性发作32例疗效观察%Therapeutic Effect of Ahylysantinfarctase on 32Cases with the Acute Episode of Chronic Cor pulmonale

    Institute of Scientific and Technical Information of China (English)

    蔡远玲; 张乃芬; 周红坚

    2000-01-01

    Objective: To study the therapeutic effect of Ahylysantinfarctase on acute episode of chronic cor pulmonale. Method: Using Ahylysantinfaretase with other therapeutic measures to treat 32 cases with acute episode of chronic cor pulrnonale. Results: Of 32 cases treated by Ahylysantinfarctase, 20 cases show a prominent effect and 9 cases are better than before. The total effective rate reaches 90.6% in the test group (the group treated by Ahylysantinfarctase) while only 65.6% in the control group. The curative effect in the test group is much better than that in the control group (P<0.05). Conclusion: The application of Ahylysanfinfarctase has provided an effective method for treating cor pulmonale.%目的:探讨蝮蛇抗栓酶在治疗肺心病急性发作中的临床应用价值。方法:采用蝮蛇抗栓酶联合其它综合措施治疗肺心病急性发作32例。结果:蝮蛇抗栓酶组32例显效20例,有效9例,总有效率达90.6%;对照组总有效率仅达65.6%。蝮蛇抗栓酶组疗效明显高于对照组(P<0.05)。结论:蝮蛇抗栓酶的应用为治疗肺心病提供了有效的方法。

  10. [Depression in schizophrenia].

    Science.gov (United States)

    Rigaud, A S

    1991-03-01

    Depressive symptoms are frequent during schizophrenia. Depression occurs in the course of a schizo affective psychose or in the course of a schizophrenia (either with acute psychotic symptoms, either without acute psychotic symptoms). Differentiating depression from negative symptoms of schizophrenia or from antipsychotic drug induced side effects can be difficult. The question to know whether depression is intrinsic to the disease process itself whether it is secondary to the schizophrenic process is still a matter of inquiry. Efficacy of antidepressive drugs during depression in schizophrenia remains a matter of controversy. Depression increases the risk for pejorative evolution and for suicide in schizophrenia.

  11. 重性抑郁发作缓解后8周和2年的疗效及其预测因素%The outcomes and outcome predictive factors of major depressive episodes at 8 weeks and 2 years after discharge

    Institute of Scientific and Technical Information of China (English)

    韩自力; 甘照宇; 唐秀梅; 张晋碚

    2011-01-01

    Objective To reevaluate major depressive episodes' treatment outcome at 8 weeks and 2 years after transitory remission ( remission time lasted 1 - 7 weeks ) based on the redefinition of treatment outcomes for major depressive episodes( MDE ) and to explore the predictive factors for outcomes. Methods A 2-year open, prospective and natural study was conducted on 84 inpatients with MDE who had achieved transitory remission at discharge and their outcomes were assessed using 24-item Hamilton depression rating scale ( HAMD ), Bech-Rafaelsen mania scale( BRMS ) and self-made questionnaire. Results At 8 weeks after discharge, 46.4% ( 39/84 ) patients remained in remission ( remission time lasted 8 weeks or longer ) , 10.7% ( 9/84 ) patients experienced subthreshold episode, 21.4% ( 18/84 ) patients presented residual symptoms and 21.4% ( 18/84 ) patients relapsed. At 2 years after discharge, 39.3% ( 33/84 )patients completely recovered, 25.0%( 21/84 )patients partially recovered, 35.7% ( 30/84 )patients had a chronic course or frequently recurred.Binary logistic regression analysis showed that remission at 8 weeks after discharge was associated with illness duration( P =0.047, OR =0.89,β =-0.12 ), and recovery at 2 years after discharge was associated with the remission at 8 weeks after discharge ( P < 0.001,OR = 109.97 ,β = 4.70 ) and treatment compliance (P=0.002, OR =0.23 , β=-1.46 ). Age,sex, comorbidity, psychotic features, numher of episodes, illness severity, family history, unipolar or bipolar disorder didn't significantly affect the short-term and long-term treatment outcomes ( P > 0.05 ). Conclusions Remission should bethe treatment goal for patients with acute MDE and good long-term outcomes for patients with MDE depend on an early,complete and whole-course treatment.%目的 基于对重性抑郁发作疗效的重新定义,重新评价重性抑郁发作暂时缓解后8周和2年后的疗效并探讨其预测因素.方法

  12. Differences in the ICD-10 diagnostic subtype of depression in bipolar disorder compared to recurrent depressive disorder

    DEFF Research Database (Denmark)

    Jensen, H.M.; Christensen, E.M.; Kessing, Lars Vedel

    2008-01-01

    Background: The aim of the study was to investigate whether patients with bipolar depression and patients with recurrent depressive disorder present with different subtypes of depressive episode as according to ICD-10. Sampling and Methods: All patients who got a diagnosis of bipolar affective......: Totally, 389 patients got a diagnosis of bipolar disorder, current episode of depression, and 5.391 patients got a diagnosis of recurrent depressive disorder, current episode of depression, at first contact. Compared with patients with a diagnosis of recurrent depressive disorder, patients with bipolar...... for patients with bipolar disorder, current episode of depression, compared with patients with a current depression as part of a recurrent depressive disorder (HR = 1.50, 95% CI = 1.20-1.86). Conclusions: The results consistently indicate that a depressive episode is severer and/or more often associated...

  13. 首发抑郁症患者认知功能三个月随访研究%The longitudinal study of cognitive function in first-episode patients with major depressive

    Institute of Scientific and Technical Information of China (English)

    杜巧荣; 左丽娜; 张红玲; 李素萍; 彭菊意; 张克让

    2011-01-01

    目的 研究首发抑郁症患者治疗前(第0周)和治疗后(第6周、第3个月)的认知功能改变及特点.方法 对62例首发抑郁症患者(患者组),于治疗前和治疗后评定汉密尔顿抑郁量表(HAMD)、重复性神经心理状态(RBANS)测验、威斯康星卡片分类测验(WCST),并与82名健康志愿者(对照组)比较.结果 (1)患者组治疗前后方差分析表明,HAMD总分(F=97.69,P<0.01)、RBANS即刻记忆(F=26.10,P<0.01)、延时记忆(F=11.20,P<0.01)、总分(F=3.81,P<0.05)、WCST的总测验数(F=9.99,P<0.01)、持续错误数(F=21.81,P<0.01)、分类数(F=5.49,P<0.05)均有统计学差异.(2)患者组治疗前HAMD总分(t=29.92,P<0.01),RBANS即刻记忆(t=-4.55,P<0.01)、视觉广度(t=-2.41,P<0.05)、言语功能(t=-3.01,P<0.01)、延时记忆(t=-2.99,P<0.01)、总分(t=-4.52,P<0.01)与对照组之间均有统计学差异;患者组治疗6周后HAMD总分(t=6.37,P<0.01)、RBANS即刻记忆(t=2.73,P<0.01)、WCST的分类数(t=2.49,P<0.05)、总应答数(t=-3.98,P<0.01)、正确应答数(t=2.68,P<0.05)、持续错误数(t=-4.80,P<0.01)均与对照组有统计学差异;患者组治疗3个月后HAMD总分(t=2.20,P<0.05),RBANS即刻记忆(t=4.42,P<0101),WCST的分类数(t=2.41,Pepisode patients with major depressive disorder before treatment ( 0 week ) and after treatment ( 6 weeks, 3 months ). Methods 62 patients with major depressive disorder ( patient group ) were measured with Hamilton depression scale (HAMD) ,Repeatable Battery for the Assessment of Neuropsychological Status (RBANS)and Wisconsin card sorting test ( WCST) before and after treatment. 82 normal controls ( control

  14. What mediates the link between childhood maltreatment and depression? The role of emotion dysregulation, attachment, and attributional style

    Directory of Open Access Journals (Sweden)

    Anna Schierholz

    2016-10-01

    Full Text Available Background: Childhood maltreatment (CM has been shown to be related to a severe and/or chronic course of depression. This study investigated which psychological processes mediate this relationship. Method: A large sample of acute or recovered depressed individuals (N=340 participated in an online survey assessing characteristics of depression, trauma exposure, and potential mediators (emotion regulation difficulties, attributional style, and attachment. Results: The experience of CM was related to more severe depression and more depressive episodes. In multiple mediation models, emotion dysregulation, a depressogenic attributional style, and avoidance in close relationships conjointly mediated the relationship between CM and depression severity as well as number of depressive episodes. However, a significant direct path between CM and depression characteristics remained. Exploratory analyses suggested that posttraumatic stress disorder symptom severity was an important additional mediator in our sample. Conclusions: Our findings provide preliminary evidence for psychological mediators between CM and depression that may be promising targets for interventions tailored for the treatment of depression in this subgroup.

  15. An evoked potential (P500) study of self rotation in first-episode depressive disorders%首发抑郁症患者自我旋转任务下诱发电位P500研究

    Institute of Scientific and Technical Information of China (English)

    陈玖; 杨来启; 张锋; 廖扬; 杨志兵; 闫小飞; 孙海婷; 关可心

    2012-01-01

    Objective To explore the electrophysiological mechanisms underlying self rotation and to better understand the impairment of space cognitive ability in depressive disorders. Methods Self rotation tasks were conducted on twenty-three patients with first-episode depressive disorders and 22 normal healthy people. Their neuropsy-chological performance and latency and amplitude of P500 were measured during self rotation tasks. Results Compared with normal control group, error rates of the left and right hand were significantly higher [left hand; (28 ± 5)% vs. (24 ± 4)%, right hand; (26 ± 4)% vs. (24 ± 3)%], P < 0.05); reaction time for left and right hand was significantly longer [left hand; (1193.79 ± 53.32)ms vs. (742.62 ± 15.2l)ms, right hand; (1105.57 ± 51.61) ms vs. (732.10 ± 16.53)ms, all P < 0.05] in the depression group. The elevated error rate and extended reaction time were higher in the left hand rotation than in the right hand rotation. Compared with control group, latencies in the left and right hand were significantly longer [left hand; (551.37 ± 45.27)ms vs. (508.22 ± 28.22) ms, right hand: (542.74 ± 46.73) ms vs. (507.52 ± 31.48)ms, all P < 0.05], and volatility in the left and right hand were significantly lower [left hand: (5.22 ± 2.41 )μV vs. (8.28 ± 3.11)μV, right hand: (6.79 ± 3.24)μV vs. (8.29 ± 3.41 )μV, P < 0.05] in the depression group. The prolonged latencies and reduced volatility were more pronounced in the left hand rotation than in the right hand rotation in the depression group. Conclusion This study shows that depressed patients have deficits in self rotation in which the speed and depth of information processing are damaged. The deficits in self rotation were more severe in the left hand than in the right hand, suggesting different mechanisms for the information processing between the left and right hands.%目的 探讨抑郁症的自我旋转能力及其脑电生理机制,进一步了解抑郁症空

  16. 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.

  17. 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

  18. 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 depression with phobic symptoms, the following clinical variants are marked: depression with generalized social phobia and/or anthropophobia and depression with generalized pathological body sensations and hypochondriacal phobias. In other words, we are talking about a necessity to allocate a special type of schizophrenia with affective structure episodes and comorbid neurosis-like symptoms. Information on the basic treatment strategy of schizophrenia with depressive structure episodes and comorbid neurosis-like symptoms in everyday psychiatric practice is also provided.

  19. 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...

  20. 抑郁症首次发病未治疗患者脑网络模块化研究%Brain network modularity study in treatment-na(i)ve, first episode major depressive disorder

    Institute of Scientific and Technical Information of China (English)

    陈超; 郝熠; 王丽; 李科; 曾亚伟; 张庆娥; 苏允爱; 金真; 司天梅

    2016-01-01

    Objective To examine the changes of functional network modularity in treatment-na(i)ve,first episode major depressive disorder (MDD) patients and the relationship between modularity related indicators and clinical severity.Methods 50 treatment-naive,first episode patients with MDD and 37 age,gender,and education level matched healthy control (HC) were included.They all received fMRI scanning during quiet,eye closed and awake state.We used the 90 automated anatomical labeling (ALL) template to construct functional connectivity matrix.Several modularity related indicators,including global modularization,intra-module connectivity,inter-module connectivity,were computed.The differences in these indicators were compared between MDD group and HC group.The Pearson correlation analysis were performed to show correlation between the regions showing modularity changes and severity of disease.Result There were 4 modules in MDD patients and 3 modules in HC group.MDD patients showed significant decline in modularity degree in the left middle orbitofrontal gyrus,the inferior orbitofrontal gyrns,the superior occipital gyrus,and the rolandic operculum.No significant correlation were found between modularity degree values of these four regions and the severity of disease (r=0.21,P>0.05).No significant differences were found in global modularization,intra connectivity and inter connectivity between two groups (r=0.11,P>0.05).Conclusion MDD patients may have changed connectivity in orbitofrontal cortex,superior occipital gyrus and rolandic operculum,which are relevant nodes of neural network basis of MDD.%目的 观察首次发病未治疗抑郁症患者脑功能网络中模块化及其相关特征的改变,为了解抑郁症的脑网络机制提供证据.方法 纳入首次发病、未经治疗的抑郁症患者(病例组,50例)及年龄、性别、受教育程度相匹配的健康志愿者(对照组,37名),基于静息态fMRI的数据,构建全脑功能连接网络,比较2组

  1. Change of slope parameters in volumetric capnography of asthma patients at acute episodes%急性发作期支气管哮喘患者的容积二氧化碳图斜率参数变化

    Institute of Scientific and Technical Information of China (English)

    齐广生; 刘锦铭; 顾文超; 杨文兰; 郭建; 王英敏; 郑卫; 徐黎青

    2016-01-01

    Objective: To investigate the diagnostic value of volumetric capnography (VCap) parameters for asthma patients at acute episodes. Methods:VCap and spirometry were performed in 53 asthma patients at acute episodes and 43 healthy subjects. Correlation between VCap slope parameters and spirametory parameters were tested by Pearson analysis. Diagnostic performance of VCap slope for differentiating asthma patients from healthy subjects was evaluated by receiver operator characteristic (ROC) curve. Result: dC3/DV and SR23 were negatively correlated with FEV1/pre and FEV1/FVC%, respectively (P<0.05), while dC2/DV was positively correlated with FEV1/FVC% (P<0.05). dC3/DV and SR23 increased significantly in asthma group than those in healthy subjects. ROC curve analysis showed that AUC for dC2/DV, dC3/DV and SR23 were 0.605,0.724 and 0.757, respectively. Conclusions: Change of slope parameters in VCap is a simple method, which could provide references for diagnosing asthma patient at acute episode.%目的:探讨容积二氧化碳图(volumetric capnography,VCap)斜率参数对急性发作期支气管哮喘(以下简称哮喘)的诊断价值。方法:对53例急性发作期哮喘患者(哮喘组)及43名健康者(健康组)进行肺通气功能及VCap测定。采用Pearson相关性分析检验肺通气功能与VCap斜率指标间的相关性,采用独立样本t检验比较哮喘组与健康组间的VCap斜率指标差异,并用受试者工作特征曲线(receiver operator characteristic curve,ROC曲线)分析VCap斜率指标对急性发作期哮喘患者与健康人的鉴别效能。结果:Ⅲ相斜率(dC3/DV)、SR23分别与一秒钟用力呼气量(forced expiratory volume in one second,FEV1)占预计值百分比(FEV1/pre)、FEV1/用力肺活量(forced vital capacity, FVC)%呈负相关(P<0.05)。 dC2/DV与FEV1/FVC%成正相关(P<0.05)。哮喘组dC3/DV、SR23均较健康组增大,差异有统计学意义(P<0.01

  2. Study on metabolic risk of first-episode acute schizophrenia patients treated with aripiprazole%阿立哌唑对首发急性精神分裂症患者代谢风险的探讨

    Institute of Scientific and Technical Information of China (English)

    吴小立; 文飞; 钟智勇; 韩自力

    2011-01-01

    目的:探讨阿立哌唑对首发急性期精神分裂症患者的代谢影响.方法:31例首发急性期精神分裂症患者入选病例组接受阿立哌唑治疗,治疗前后各测量一次体重、腰围、腰臀比、血清TC、TG、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、载脂蛋白A1(Apo-A1)、载脂蛋白B(Apo B100)、脂蛋白a(LPa)、空腹血糖(FBS)、空腹胰岛素(INS)、C肽(C-P),并分别计算出BMI、胰岛素抵抗指数(HOMA-IR).另设健康对照组44例,同法测量上述指标.将病例组与健康对照组、病例组治疗前后各项指标进行比较分析.结果:病例组INS、C-P及HOMA-IR均高于正常对照组,差异有统计学意义(P<0.05);病例组治疗后体重、BMI、腰围、腰臀比均较治疗前增加,差异有统计学意义(P<0.05);治疗后:病例组TG、INS、C-P、HOMA-IR均高于对照组,差异有统计学意义(P<0.05);且aPOA1低于对照组,差异有统计学意义(P<0.05).结论:精神分裂症患者本身可能存在有代谢异常;非典型抗精神病药物(APS)阿立哌唑对患者血糖、血脂代谢相对影响较小.%AIM: To study the metabolic risk of first-episode acute schizophrenia patients trea ted with aripiprazole.METHODS: 31 first-episode acute patients with schizophrenic were enrolled into case group and 44 healthy subjects were enrolled into controle group, all cases accepted treatment with oral aripiprazole.At the baseline and at the end, all patients were checked or tested for weight, waist circumference, waist-to-hipratio(WHR), TC, TG, high density lipoprotein(HDL), low density lipoprotein(LDL), apolipoprotein A1 ( Apo Al), apolipoprotein B (Apo-B100), lipoprotein a (LPa),fasting blood glucose (FBS), fasting insulin (INS)and c-peptide(C-P),respectively.The BMI and insulin resistance index (HOMA-IR) were calculated.All indexes were compared and analysed between the case group and controle group,pre and post treatment in the case group.RESULTS:The INS, C-P and HOMA

  3. Major depression

    Science.gov (United States)

    Depression - major; Depression - clinical; Clinical depression; Unipolar depression; Major depressive disorder ... providers do not know the exact causes of depression. It is believed that chemical changes in the ...

  4. Cost effectiveness of olanzapine in prevention of affective episodes in bipolar disorder in the United Kingdom.

    Science.gov (United States)

    McKendrick, J; Cerri, K H; Lloyd, A; D'Ausilio, A; Dando, S; Chinn, C

    2007-08-01

    This study evaluated the cost effectiveness of olanzapine compared with lithium as maintenance therapy for patients with bipolar I disorder (BP1) in the UK. A Markov model was developed to assess costs and outcomes from the perspective of the UK National Health Service over a 1-year period. Patients enter the model after stabilization of a manic episode and are then treated with olanzapine or lithium. Using the findings of a recent randomized clinical trial, the model considers the monthly risk of manic or depressive episodes and of dropping out from allocated therapy. health care resources associated with acute episodes were derived primarily from a recent UK chart review. Costs of maintenance therapy and monitoring were also considered. Key factors influencing cost effectiveness were identified and included in a stochastic sensitivity analysis. The model estimated that, compared to lithium, olanzapine significantly reduced the annual number of acute mood episodes per patient from 0.81 to 0.58 (difference -0.23; 95% CI: -0.34, -0.12). Per patient average annual care costs fell by 799 UK pounds (95% CI: - 1,824 UK pounds, 59 UK pounds) driven by reduced inpatient days--but the cost difference was not statistically significant. Sensitivity analysis found the results to be robust to plausible variation in the model's parameters. The model estimated that using olanzapine instead of lithium as maintenance therapy for BP1 would significantly reduce the rate of acute mood events resulting in reduced hospital costs. Based on available evidence, there is a high likelihood that olanzapine would reduce costs of care compared to lithium.

  5. Effect of low-frequency transcranial magnetic stimulation on an affective go/no-go task in patients with major depression: role of stimulation site and depression severity.

    Science.gov (United States)

    Bermpohl, Felix; Fregni, Felipe; Boggio, Paulo S; Thut, Gregor; Northoff, Georg; Otachi, Patricia T M; Rigonatti, Sergio P; Marcolin, Marco A; Pascual-Leone, Alvaro

    2006-01-30

    Repetitive transcranial magnetic stimulation (rTMS) holds promise as a therapeutic tool in major depression. However, a means to assess the effects of a single rTMS session on mood to guide subsequent sessions would be desirable. The present study examined the effects of a single rTMS session on an affective go/no-go task known to measure emotional-cognitive deficits associated with major depression. Ten patients with an acute episode of unipolar major depression and eight partially or completely remitted (improved) patients underwent 1 Hz rTMS over the left and right dorsolateral prefrontal cortex prior to task performance. TMS over the mesial occipital cortex was used as a control. We observed significantly improved performance in depressed patients following right prefrontal rTMS. This beneficial effect declined with decreasing depression severity and tended to reverse in the improved group. Left prefrontal rTMS had no significant effect in the depressed group, but it resulted in impaired task performance in the improved group. Our findings indicate that the acute response of depressed patients to rTMS varies with the stimulation site and depression severity. Further studies are needed to determine whether the present paradigm could be used to predict antidepressant treatment success or to individualize stimulation parameters according to specific pathology.

  6. 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

  7. 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

    and monthly depression ratings. Data on psychotropic drugs were retrieved from hospital case records. Independent associations between baseline, treatment and outcome variables were examined by logistic regression models. Results: Depressive symptoms subsided gradually. After 6 months, 21% had dropped out, 43...

  8. Randomized Trial of Behavioral Activation, Cognitive Therapy, and Antidepressant Medication in the Acute Treatment of Adults with Major Depression

    Science.gov (United States)

    Dimidjian, Sona; Hollon, Steven D.; Dobson, Keith S.; Schmaling, Karen B.; Kohlenberg, Robert J.; Addis, Michael E.; Gallop, Robert; McGlinchey, Joseph B.; Markley, David K.; Gollan, Jackie K.; Atkins, David C.; Dunner, David L.; Jacobson, Neil S.

    2006-01-01

    Antidepressant medication is considered the current standard for severe depression, and cognitive therapy is the most widely investigated psychosocial treatment for depression. However, not all patients want to take medication, and cognitive therapy has not demonstrated consistent efficacy across trials. Moreover, dismantling designs have…

  9. 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....

  10. The comparison of impairment of cognitive function in first-episode schizophrenia, bipolar disorder and major depressive disorder%首发精神分裂症与双相障碍及抑郁障碍认知功能比较

    Institute of Scientific and Technical Information of China (English)

    陈大春; 陈科; 张荣珍; 冯薇; 高岚; 杨甫德; 张向阳

    2016-01-01

    Objective To evaluate impairment of cognitive function in first-episode schizophrenia, bipolar disor⁃der and major depressive disorder. Methods Sixty one first-episode schizophrenia patients, fifty seven bipolar disorder patients, forty eight major depressive disorder patients and fifty nine healthy controls were recruited. Cognitive function of all subjects was assessed using Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The psychiatric symptoms of schizophrenia patients and the depressive, anxiety symptoms and manic symptoms of bipolar dis⁃order patients and major depressive patients were assessed using positive and negative syndrome scale (PANSS), Hamil⁃ton depression scale (HAMD), Hamilton anxiety scale (HAMA) and Bech-Rafaelsen mania scale (BRMS), respectively. Results The total score of RBANS (F=5.18,P<0.01). and the factor scores of immediate memory (F=9.53,P<0.01), de⁃layed memory (F=3.87,P=0.01) and language function (F=9.86,P<0.01) were significantly different in four groups. Com⁃pared to healthy controls, the total score of RBANS were significantly lower in first-episode schizophrenia group and bi⁃ polar disorder group (P<0.01), and the factor scores of immediate memory, delayed memory and language function were significantly lower in first-episode schizophrenia group, bipolar disorder group and major depressive group (P<0.05). Ma⁃jor depressive group performed worse than first-episode schizophrenia group in language function factor (P<0.01). The factor score of attention in first-episode schizophrenia group was significantly lower than major depressive and control group (P<0.01). Conclusions First-episode schizophrenia, bipolar disorder and major depressive disorder are associated with significant cognitive impairments. Cognitive function impairments in the patients with first-episode schizophrenia are worse than patients with major depressive disorder, but better than patients with bipolar disorder.%目的

  11. Cognitive improvement after treatment of depressive symptoms in the acute phase of stroke Melhora cognitiva com tratamento antidepressivo na fase aguda do acidente vascular cerebral

    Directory of Open Access Journals (Sweden)

    Samuel Simis

    2006-06-01

    Full Text Available The outcome of antidepressant treatment for depressive symptoms and cognitive impairment at the acute phase of stroke is controversial. We investigated 93 patients, treating with citalopram 36 with severe depressive symptoms (HAM-D: Hamilton Depression Rating Scale >18, whilst 19 patients with mild depressive symptoms, and 38 non-depressed patients, remained untreated. At baseline (two weeks after stroke, patients with severe depressive symptoms had lower scores in total Dementia Rating Scale (DRS and in the attention and memory DRS subscales, than the non-depressed patients (pOs resultados do tratamento com antidepressivo para os sintomas depressivos e comprometimento cognitivo da fase aguda do acidente vascular cerebral não estão estabelecidos. Investigamos 93 pacientes, 36 com sintomas depressivos graves (HAM-D: Escala de Depressão de Hamilton >18 foram tratados com citalopram, enquanto 19 pacientes com sintomas depressivos leves e 38 não-deprimidos não foram tratados. Ao início do tratamento (duas semanas depois do icto, pacientes com sintomas depressivos graves tinham escores mais baixos na Escala de Avaliação de Demência (DRS total e nas subescalas de atenção e de memória da DRS do que os pacientes não-deprimidos (p<0,001. Ao fim de três meses de acompanhamento essas diferenças tinham desaparecido, mas pacientes que inicialmente tinham sintomas depressivos leves passaram a ter escores mais altos no HAM-D do que os não-deprimidos (p=0,015, e escores mais baixos nas subescalas de atenção e memória da DRS (p<0,01 do que os pacientes tratados com citalopram. O tratamento associou-se a melhora de humor, memória e atenção, e demonstra que é necessário um estudo controlado com placebo para o tratamento de sintomas depressivos leves.

  12. Effects of escitalopram combined with psychological therapy on the first episode depression%艾司西酞普兰联合心理治疗对首次抑郁发作的影响

    Institute of Scientific and Technical Information of China (English)

    王玮

    2014-01-01

    目的:探讨艾司西酞普兰联合心理治疗对首次抑郁发作的临床疗效。方法选取在山东省精神卫生中心门诊治疗的符合《国际疾病分类(第10版)》( ICD-10)中的首次抑郁发作诊断标准的患者120例,随机分为研究组和对照组各60例,研究组给予艾司西酞普兰联合心理治疗,对照组给予艾司西酞普兰治疗。共观察24周。于治疗前、治疗后第2、8、24周末采用汉密尔顿抑郁量表( HRSD)进行评定,比较治疗后24周末两组总有效率;并于2年后电话随访,比较两组复发率。结果治疗2、8周末HRSD评分研究组均低于同时点对照组[(21.03±4.89)分vs.(25.57±4.37)分,(9.60±4.22)分vs.(21.52±2.72)分,P﹤0.05或0.01];24周末研究组痊愈率与对照组比较差异无统计学意义(60.0%vs.56.7%,χ2=0.14,P﹥0.05);2年末电话随访研究组复发率低于对照组(31.7%vs.61.7%,χ2=10.85,P﹤0.01)。结论艾司西酞普兰联合心理治疗对首次抑郁发作疗效优于单纯艾司西酞普兰治疗,复发率低。%Objective To investigate the Effects of escitalopram combined with psychological therapy on the first episode depres-sion. Methods 120 patients were divided into the study group(60,psychological therapy combined with escitalopram)and control group (60,escitalopram therapy). All patients were assessed with Hamilton Rating Scale for Depression(HRSD)at the baseline and at the end of the 2nd ,8th ,24th week of the treatment to evaluate the efficacy. Compared recurrence rate of the two groups by telephone in the follow-up 2 years. Results Treatment of 2th ,8th week study group scores were lower than the control group at the same time[(21. 03 ± 4. 89) vs.(25. 57 ± 4. 37)(,9. 60 ± 4. 22)vs.(21. 52 ± 2. 72),P﹤0. 05 or 0. 01]. 24th week study groupˊs cure rate and control groupˊs quite (60. 0% vs. 56. 7%,χ2 =0. 14,P﹥0. 05);follow-up 2 years study group

  13. PET-CT检测首发单相重度抑郁症患者神经环路的葡萄糖代谢水平%Glucose metabolism level changes in neural circuits of the first-episode single-phase major depressive disorder patients using PET-CT

    Institute of Scientific and Technical Information of China (English)

    周群; 李月峰; 朱彦

    2015-01-01

    Objective:To study the changes of glucose metabolism in neural circuits of the first-episode single-phase major depressive disorder patients changes of glucose metabolism.Methods:Using PET-CT to scan 30 first-episode single-phase major depressive disorder patients and 30 healthy persons,injecting 0.2 mCi of 18 F-FDG per kilogram of body weight,detecting the SUVmax value of the neural circuits respectively (including hippocampus,thalamus,frontal lobe and cingulate gyrus).Results:Compared with the healthy group ,the SUVmax of bilateral hippocampus ,thalamus ,frontal lobe and cingulate gyrus in the first-episode single-phase major depressive disorder patients were reduced significantly(P<0.001 or P<0.05 );the thalamus changes more obviously.Conclusion:The nerve cells in neural circuits of the first-episode single-phase major depressive disorder patients have been damaged,it was reflected in the intake of energy utiliza-tion,and the thalamus displayed more obviously.%目的:研究首发单相重度抑郁症患者神经环路中神经细胞的葡萄糖代谢水平。方法:选取30例健康受试者及30例首发单相重度抑郁症患者,每位受试者按0.2 mCi /kg静脉注射18 F-FDG,PET-CT检测神经环路各脑区(包括海马、丘脑、额叶及扣带回)的最高标准摄取值(SUVmax)值。结果:与对照组相比,首发单相重度抑郁症患者双侧海马、丘脑、额叶及扣带回的SUV max均明显减低(P<0.001或P<0.05),其中双侧丘脑SUVmax在神经环路脑区中减低最明显。结论:首发单相重度抑郁症患者神经环路中的神经细胞受损,主要体现在神经细胞对能量的摄取利用上,丘脑尤为明显。

  14. Talking about Teaching Episodes

    Science.gov (United States)

    Nemirovsky, Ricardo; DiMattia, Cara; Ribeiro, Branca; Lara-Meloy, Teresa

    2005-01-01

    This paper examines two types of discourse in which teachers engage when discussing case studies based on classroom episodes, and the ways in which the availability of video data of these episodes may motivate a shift in the mode of discourse used. We interviewed two pairs of secondary school mathematics teachers after they had read a case study…

  15. 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.

    Directory of Open Access Journals (Sweden)

    Merete Osler

    Full Text Available 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 after ACS was influenced by comorbid conditions including depression.From 2001 to 2009 all first-time ACS patients were identified in the Danish National Patient Registry. This cohort of 83 062 ACS patients and a matched reference population were followed for incident depression and mortality 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 identified by drawing a directed acyclic graph and analysed using multiple Cox regression analyses.During follow-up, 29 583(35.6% of ACS patients and 19 105(22.9% of the reference population died. Cox regression analyses showed an increased mortality in the lowest educated compared to those with high education in both ACS patients and the reference population. Adjustment for previous and incident depression or other covariables only attenuated the relations slightly. This pattern of associations was seen for mortality after 30 days, 1 year and during total follow-up.In this study 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.

  16. Depression (Major Depressive Disorder)

    Science.gov (United States)

    ... generally miserable or unhappy without really knowing why. Depression symptoms in children and teens Common signs and ... interest. However, major depression can occur with ADHD. Depression symptoms in older adults Depression is not a ...

  17. Breaking the Rhythm of Depression: Cognitive Behavior Therapy and Relapse Prevention for Depression

    Directory of Open Access Journals (Sweden)

    Claudi L.H. Bockting

    2010-12-01

    Full Text Available A crucial part of the treatment of depression is the prevention of relapse and recurrence. Psychological interventions, especially cognitive behavior therapy (CBT are helpful in preventing relapse and recurrence in depression. The effectivity of four types of relapse prevention cognitive behavior therapy strategies will be addressed, i.e. acute prophylactic cognitive behavior therapy, continuation cognitive behavior therapy, sequential cognitive behavior therapy and cognitive behavior therapy in partial remission.Specific ingredients of three sequential cognitive behavior therapy programs (well-being cognitive therapy, preventive cognitive therapy, and mindfulness-based cognitive therapy will be discussed as applied after remission in patients that experienced previous depressive episodes. Sequential preventive cognitive behavior therapy after acute treatment may be an attractive alternative treatment for many patients who currently use antidepressants for years and years to prevent relapse and recurrence. This is an extremely challenging issue to research thoroughly. Future studies must rule out what intervention for whom is the best protection against relapse and recurrence in depression.

  18. Impact of post myocardial infarction depression on drug adherence of cardiological medicines

    Directory of Open Access Journals (Sweden)

    Hemanta Dutta

    2015-07-01

    Full Text Available Background: Depressive symptoms are very usual in patients experiencing a history of myocardial infarction (MI. An individual who has developed depression after an episode of MI becomes non compliant with the treatment of cardiology. Aim: To test the impact of post MI depression on drug adherence of cardiological medicines. Settings and design: The study was conducted on patients of acute MI (n=50 attending cardiology outpatient department (OPD of Assam Medical College and Hospital, Dibrugarh at eight weeks after the index event. Methods: Screening was performed by the Primary Care Evaluation of Mental Disorders (PRIME-MD and diagnoses of major depressive disorder were established according to the text revision of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR criteria. The eight-item Morisky Medication Adherence Questionnaire was applied to the patients to assess drug adherence after eight weeks from the MI episode. Results: Statistically significant strong association and correlation were found between post MI depression and drug adherence of cardiological medicines (Wald 9.84, Odd’s ratio 2.054, p=0.002, rho=0.714. Conclusion: The result of analysis has revealed that post MI depression has an unfavourable impact on drug adherence, ultimately contributing to increased risk of cardiological morbidity and death rate. Therefore, routine screening of depressive symptoms should be mandatory in cardiology.

  19. State and trait olfactory markers of major depression.

    Directory of Open Access Journals (Sweden)

    Marine Naudin

    Full Text Available Nowadays, depression is a major issue in public health. Because of the partial overlap between the brain structures involved in depression, olfaction and emotion, the study of olfactory function could be a relevant way to find specific cognitive markers of depression. This study aims at determining whether the olfactory impairments are state or trait markers of major depressive episode (MDE through the study of the olfactory parameters involving the central olfactory pathway. In a pilot study, we evaluated prospectively 18 depressed patients during acute episodes of depression and 6 weeks after antidepressant treatment (escitalopram against 54 healthy volunteers, matched by age, gender and smoking status. We investigated the participants' abilities to identify odors (single odors and in binary mixture, to evaluate and discriminate the odors' intensity, and determine the hedonic valence of odors. The results revealed an "olfactory anhedonia" expressed by decrease of hedonic score for high emotional odorant as potential state marker of MDE. Moreover, these patients experienced an "olfactory negative alliesthesia", during the odor intensity evaluation, and failed to identify correctly two odorants with opposite valences in a binary iso-mixture, which constitute potential trait markers of the disease. This study provides preliminary evidence for olfactory impairments associated with MDE (state marker that are persistent after the clinical improvement of depressive symptoms (trait marker. These results could be explained by the chronicity of depression and/or by the impact of therapeutic means used (antidepressant treatment. They need to be confirmed particularly the ones obtained in complex olfactory environment which corresponds a more objective daily life situation.

  20. Personality in recovered depressed elderly.

    Science.gov (United States)

    Schneider, L S; Zemansky, M F; Bender, M; Sloane, R B

    1992-01-01

    Personality traits in euthymic elderly subjects with and without past histories of major depressive episodes were assessed using the Structured Clinical Interview for DSM-III-R and the Social Adjustment Scale-SR. Recovered depressed subjects were characterized by significantly more personality traits from DSM-III-R Clusters B and C than controls, and they exhibited differences in social adjustment, as well. Subjects who have recovered from depressive episodes may show significant differences in personality and social adjustment that might represent residua of past depression, a trait characteristic, or a risk factor for recurrence.

  1. 首发未治疗成人重型抑郁症患者皮层厚度的MRI研究%Brain cortical thickness abnormalities in first-episode, never-medicated, adult major depressive disorder patients

    Institute of Scientific and Technical Information of China (English)

    赵又瑾; 陈丽舟; 张文静; 孙怀强; 邱丽华; 孙学礼; 吕粟; 龚启勇

    2016-01-01

    目的:探索首发未治疗成人重型抑郁症(MDD)患者皮层厚度是否存在异常及其与病程及临床症状的相关性。方法研究纳入2013年3月至2015年8月间招募的37例MDD患者(患者组)及41名健康志愿者(对照组)。所有受试者通过三维扰相梯度回波(3D-SPGR)序列获得3D T1图像。应用FreeSurfer软件完成3D-SPGR图像皮层表面的建造,然后通过自动重建表面、转换、高分辨个体间校准步骤来测量整个皮层的厚度。最后采用一般线性模型对2组皮层厚度进行比较,将患者组全脑皮层厚度与病程及临床评分进行相关分析。结果与对照组比较,MDD患者左侧前、中扣带回,双侧中央前回,左侧中央旁小叶,双侧顶上回,左侧颞极及右侧枕外叶皮层厚度增加(皮层厚度1.89~2.87 mm,皮层表面积34~384 mm2,P0.05)。结论首发未治疗MDD患者皮层厚度改变的脑区主要位于前额叶-边缘系统。%Objective Present study aimed to characterize the alteration of cortical thickness in first-episode, never-medicated, adult patients with major depressive disorder (MDD), and explore whether such deficits were related with their disease duration and clinical symptom severity. Methods Thirty-seven adult MDD patients were recruited from March 2013 to August 2015 as patient group, and 41 healthy volunteers were as control group. All the patients underwent three-dimensional spoiled gradient recalled (3D-SPGR) sequences, and the images were acquired. Constructions of the cortical surface were developed from 3D-SPGR images using FreeSurfer software, and the thickness of the entire cortex was measured according to the automated surface reconstruction, transformation, and high-resolution inter-subject alignment procedures. Finally, cortical thickness was compared between the two groups, and the relativity between clinical symptom severity, disease progression and clinical scores were analyzed

  2. Aβ induces acute depression of excitatory glutamatergic synaptic transmission through distinct phosphatase-dependent mechanisms in rat CA1 pyramidal neurons.

    Science.gov (United States)

    Yao, Wen; Zou, Hao-Jun; Sun, Da; Ren, Si-Qiang

    2013-06-17

    Beta-amyloid peptide (Aβ) has a causal role in the pathophysiology of Alzheimer's disease (AD). Recent studies indicate that Aβ can disrupt excitatory glutamatergic synaptic function at synaptic level. However, the underlying mechanisms remain obscure. In this study, we recorded evoked and spontaneous EPSCs in hippocampal CA1 pyramidal neurons via whole-cell voltage-clamping methods and found that 1 μM Aβ can induce acute depression of basal glutamatergic synaptic transmission through both presynaptic and postsynaptic dysfunction. Moreover, we also found that Aβ-induced both presynaptic and postsynaptic dysfunction can be reversed by the inhibitor of protein phosphatase 2B (PP2B), FK506, whereas only postsynaptic disruption can be ameliorated by the inhibitor of PP1/PP2A, Okadaic acid (OA). These results indicate that PP1/PP2A and PP2B have overlapping but not identical functions in Aβ-induced acute depression of excitatory glutamatergic synaptic transmission of hippocampal CA1 pyramidal neurons.

  3. First Episode Psychosis

    Science.gov (United States)

    ... About Psychosis Treatment Share Fact Sheet: First Episode Psychosis Download PDF Download ePub Order a free hardcopy En Español Facts About Psychosis The word psychosis is used to describe conditions ...

  4. Genetics Home Reference: episodic ataxia

    Science.gov (United States)

    ... Understand Genetics Home Health Conditions episodic ataxia episodic ataxia Enable Javascript to view the expand/collapse boxes. Download PDF Open All Close All Description Episodic ataxia is a group of related conditions that affect ...

  5. 利培酮口服液治疗首发精神分裂症急性期对照观察%A control study of risperidone oral solution in treating first-episode schizophrenia patients in acute phase

    Institute of Scientific and Technical Information of China (English)

    黄卓玮; 龚传鹏

    2011-01-01

    目的:探讨利培酮13服液治疗首发精神分裂症急性期的疗效和安全性.方法:96例精神分裂症的急性期患者随机分为两组,分别给予利培酮口服液(研究组,n=49)和氯氮平(对照组,n=47)单药治疗4周.采用阳性和阴性症状量表(PANSS)评定临床疗效,临床总体印象量表(CGI-SI)评定病情严重程度,治疗中出现的症状量表(TESS)评定不良反应,自编依从性量表评定依从性.结果:治疗后两组患者PANSS及CGI-SI评分显著下降(P0.05).治疗后第4天,研究组兴奋、敌对、不合作、冲动控制缺乏因子分下降较对照组显著(P<0.05);研究组不良反应发生率明显低于对照组(P<0.05);研究组治疗依从性在治疗14 d、28 d、3个月和6个月时均优于对照组(P<0.05).结论:利培酮口服液对首发精神分裂症急性期患者的疗效和氯氮平相当,但利培酮口服液改善兴奋、敌对性等因子分较迅速,耐受性和依从性较好.%Objective: To evaluate the efficacy and safety of risperidone oral solution in the treatment of patients on the acute phase with first-episode schizophrenia. Method:96 schizophrenia patients were randomly assigned to the group treated with risperidone oral solution group ( n = 49 ) and the other group treated with clozapine (n =47 ),respectively for 4 weeks. The positive and negative syndrome scale (PANSS) and clinical global impressions-severity of illness rating scale(CGI-SI) were used to rate the efficacy;the treatment emergent symptom scale (TESS) was used to measure side effects and the compliance scale was used to assess the subjects'compliance with the treatment. Results:Both risperidone and clozapine group significantly showed score decrease on PANSS and CGI-SI after 4 weeks (P <0.01 ), but no significant difference was found between two groups ( P > 0.05 ). Excitement, hostility, uncooperativeness and poor impulse control of PANSS significantly decreased more in risperidone oral solution group

  6. Is blunted cardiovascular reactivity in depression mood-state dependent? A comparison of major depressive disorder remitted depression and healthy controls.

    Science.gov (United States)

    Salomon, Kristen; Bylsma, Lauren M; White, Kristi E; Panaite, Vanessa; Rottenberg, Jonathan

    2013-10-01

    Prior work has repeatedly demonstrated that people who have current major depression exhibit blunted cardiovascular reactivity to acute stressors (e.g., Salomon et al., 2009). A key question regards the psychobiological basis for these deficits, including whether such deficits are depressed mood-state dependent or whether these effects are trait-like and are observed outside of depression episodes in vulnerable individuals. To examine this issue, we assessed cardiovascular reactivity to a speech stressor task and a forehead cold pressor in 50 individuals with current major depressive disorder (MDD), 25 with remitted major depression (RMD), and 45 healthy controls. Heart rate (HR), blood pressure and impedance cardiography were assessed and analyses controlled for BMI and sex. Significant group effects were found for SBP, HR, and PEP for the speech preparation period and HR, CO, and PEP during the speech. For each of these parameters, only the MDD group exhibited attenuated reactivity as well as impaired SBP recovery. Reactivity and recovery in the RMD group more closely resembled the healthy controls. Speeches given by the MDD group were rated as less persuasive than the RMD or healthy controls' speeches. No significant differences were found for the cold pressor. Blunted cardiovascular reactivity and impaired recovery in current major depression may be mood-state dependent phenomena and may be more reflective of motivational deficits than deficits in the physiological integrity of the cardiovascular system.

  7. How are neuroticism and depression related to the psychophysiological stress response to acute stress in healthy older people?

    Science.gov (United States)

    Puig-Perez, Sara; Villada, Carolina; Pulopulos, Matias M; Hidalgo, Vanesa; Salvador, Alicia

    2016-03-15

    Neuroticism and depressive symptomatology have been related to a heightened and diminished physiological stress response, which may partly explain their negative relationship with health and wellbeing. Identifying factors that may increase disease vulnerability is especially relevant in older people, whose physiological systems decline. With this in mind, we investigated the influence of neuroticism and depression on the psychophysiological stress response in healthy older people (from 55 to 76years old). A total of 36 volunteers were exposed to a stressful task (Trier Social Stress Test, TSST), while 35 volunteers performed a control non-stressful task. The physiological stress response was assessed through measures of cortisol, alpha-amylase, heart rate (HR). Our results showed that, neuroticism was not related to physiological stress response. However, depression was related to higher cortisol response and lower HR reactivity in the stress condition. In summary, emotional states such as depressive mood seem to amplify the cortisol stress response and reduce the cardiovascular response, whereas more stable dispositions such as neuroticism did not affect stress response in older people. These findings confirm, in healthy older people, the adverse effects of depression, acting on different subsystems of the stress response.

  8. Migraine with benign episodic unilateral mydriasis

    Directory of Open Access Journals (Sweden)

    Jabr FI

    2011-06-01

    Full Text Available Nedaa Skeik1, Fadi I Jabr21Mayo Clinic, Rochester, MN, USA; 2Horizon Medical Center, Hospital Medicine, Dickson, TN, USAAbstract: Pupil asymmetry or anisocoria can have benign or malignant causes, and be categorized as acute or chronic. It can also be a normal finding in about 20% of cases. Benign episodic unilateral mydriasis is an isolated benign cause of intermittent pupil asymmetry. The exact pathophysiology is not always understood. According to one hypothesis, it is due to discordance between the sympathetic and parasympathetic systems. It is occasionally seen in patients with migraine. Some authors consider it a limited form of ophthalmoplegic migraine. We report a case of benign episodic unilateral mydriasis diagnosed in a 30-year-old lady with a history of migraine who had extensive negative neurological evaluation.Keywords: anisocoria, migraine, unilateral episodic mydriasis

  9. Depression and Coronary Heart Disease

    OpenAIRE

    2012-01-01

    There are exciting findings in the field of depression and coronary heart disease. Whether diagnosed or simply self-reported, depression continues to mark very high risk for a recurrent acute coronary syndrome or for death in patients with coronary heart disease. Many intriguing mechanisms have been posited to be implicated in the association between depression and heart disease, and randomized controlled trials of depression treatment are beginning to delineate the types of depression manage...

  10. Concordance between clinician and patient ratings as predictors of response, remission, and recurrence in major depressive disorder

    Science.gov (United States)

    Dunlop, Boadie W.; Li, Thomas; Kornstein, Susan G.; Friedman, Edward S.; Rothschild, Anthony J.; Pedersen, Ron; Ninan, Philip; Keller, Martin; Trivedi, Madhukar H.

    2013-01-01

    We conducted a secondary analysis of data from the Prevention of Recurrent Episodes of Depression With Venlafaxine Extended Release (ER) for Two Years (PREVENT) trial to evaluate whether discrepancies between clinician and patient ratings of depression severity were predictive of response, remission, and recurrence during treatment for a depressive episode. Patients who self-rated depression severity in concordance with the clinician (“concordant patients”) were defined as having a standardized patient-rated Inventory of Depressive Symptoms-Self Report (IDS-SR30) score minus standardized clinician-rated Hamilton Rating Scale for Depression (HAM-D17) score <1 SD from mean. Non-concordant patients (“underrating patients” [−1 SD], “overrating patients” [+1 SD]) were identified. Cohorts were compared for remission and response on the HAM-D17, Clinician Global Impression–Severity (CGI-S), and IDS-SR30 during acute and continuation therapy and time to recurrence during maintenance therapy. During acute treatment female patients were more likely to overrate their depression severity compared to the clinician; older age predicted overrating during continuation treatment. Overrating patients had a slower onset of response on the HAM-D17 during acute treatment (P = 0.004). There were no differences between cohorts for remission or response on the HAM-D17 or CGI-S. Overrating patients at week 10 had lower remission and response rates on the IDS-SR30 during continuation therapy (32% and 50%, respectively; P ≤ 0.001) compared with underrating patients (76%, 77%) or concordant patients (64%, 78%). Patient concordance at the end of continuation therapy did not predict recurrence during maintenance therapy, indicating that patient rating scales may be useful in tracking recurrence during maintenance therapy. Poor agreement between patient- and clinician-ratings of depression severity is primarily a state phenomenon, although it is trait-like for some patients

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

    NARCIS (Netherlands)

    Selle, V.; Schalkwijk, S.J.; Vazquez, G.H.; Baldessarini, R.J.

    2014-01-01

    BACKGROUND: Optimal treatments for bipolar depression, and the relative value of specific drugs for that purpose, remain uncertain, including agents other than antidepressants. METHODS: We searched for reports of placebo-controlled, monotherapy trials of mood-stabilizing anticonvulsants, second-gene

  12. The effects of acute tryptophan depletion on speech and behavioural mimicry in individuals at familial risk for depression

    NARCIS (Netherlands)

    Hogenelst, K.; Sarampalis, A.; Leander, N.P.; Müller, B.C.N.; Schoevers, R.A.; Rot, M. aan het

    2016-01-01

    Major depressive disorder (MDD) has been associated with abnormalities in speech and behavioural mimicry. These abnormalities may contribute to the impairments in interpersonal functioning that are often seen in MDD patients. MDD has also been associated with disturbances in the brain serotonin syst

  13. 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...

  14. A control study of psychological traits of patients with anxie-ty,depression and first-episode schizophrenia%焦虑症抑郁症与首发精神分裂症患者心理特质对照研究

    Institute of Scientific and Technical Information of China (English)

    杨云斌; 周朝当

    2014-01-01

    Objective To explore the differences of psychological traits of patients with anxiety ,depres-sion and first-episode schizophrenia .Methods Assessments were carried out Minnesota Multiphasic Per-sonality Inventory (M M PI) in 39 anxiety and depression patients and 32 first-episode schizophrenics .Re-sults Scores of neuroticism ,paranoia and psychopathic personality scale in anxiety and depression patients were significantly higher than norm (P<0 .01) ,so was that of neuroticism than schizophrenia (P<0 .01);neuroticism scale scores of anxiety and depression patients were positively related to psychopathic personal-ity notably (P<0 .01) and negatively to paranoia (P<0 .01) .Conclusion Neuroticism of anxiety and de-pression patients is more outstanding than that of schizophrenics ,they have two different psychological traits of neuroticism-psychopathic personality and paranoia .%目的:探讨焦虑症、抑郁症患者与首发精神分裂症患者心理特质的差异性。方法对39例焦虑症、抑郁症患者及32例首发精神分裂症患者采用明尼苏达多相人格测验附加量表进行测评分析。结果焦虑症、抑郁症患者神经质、偏执及病态人格量表评分显著高于常模(P<0.01),神经质量表评分显著高于精神分裂症(P<0.01);焦虑症、抑郁症患者神经质量表评分与病态人格量表评分呈显著正相关(P<0.01),与偏执量表评分呈显著负相关(P<0.01)。结论焦虑症、抑郁症患者的神经质较精神分裂症患者突出,可能存在神经质-病态人格、偏执2种不同的心理特质。

  15. The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Bipolar Disorders: Update 2010 on the treatment of acute bipolar depression

    DEFF Research Database (Denmark)

    Grunze, Heinz; Vieta, Eduard; Goodwin, Guy M;

    2010-01-01

    bipolar depression in adults. METHODS: The data used for these guidelines have been extracted from a MEDLINE and EMBASE search, from the clinical trial database clinicaltrials.gov, from recent proceedings of key conferences, and from various national and international treatment guidelines......OBJECTIVES: These guidelines are based on a first edition that was published in 2002, and have been edited and updated with the available scientific evidence until September 2009. Their purpose is to supply a systematic overview of all scientific evidence pertaining to the treatment of acute....... Their scientific rigor was categorised into six levels of evidence (A-F). As these guidelines are intended for clinical use, the scientific evidence was finally assigned different grades of recommendation to ensure practicability. RESULTS: We identified 10 pharmacological monotherapies or combination treatments...

  16. Animal models of recurrent or bipolar depression.

    Science.gov (United States)

    Kato, T; Kasahara, T; Kubota-Sakashita, M; Kato, T M; Nakajima, K

    2016-05-03

    Animal models of mental disorders should ideally have construct, face, and predictive validity, but current animal models do not always satisfy these validity criteria. Additionally, animal models of depression rely mainly on stress-induced behavioral changes. These stress-induced models have limited validity, because stress is not a risk factor specific to depression, and the models do not recapitulate the recurrent and spontaneous nature of depressive episodes. Although animal models exhibiting recurrent depressive episodes or bipolar depression have not yet been established, several researchers are trying to generate such animals by modeling clinical risk factors as well as by manipulating a specific neural circuit using emerging techniques.

  17. Effect of Beta vulgaris Linn. leaves extract on anxiety- and depressive-like behavior and oxidative stress in mice after acute restraint stress

    Directory of Open Access Journals (Sweden)

    Kunjbihari Sulakhiya

    2016-01-01

    Full Text Available Background: Stress plays a significant role in the pathogenesis of neuropsychiatric disorders such as anxiety and depression. Beta vulgaris is commonly known as "beet root" possessing antioxidant, anticancer, hepatoprotective, nephroprotective, wound healing, and anti-inflammatory properties. Objective: To study the protective effect of Beta vulgaris Linn. ethanolic extract (BVEE of leaves against acute restraint stress (ARS-induced anxiety- and depressive-like behavior and oxidative stress in mice. Materials and Methods: Mice (n = 6 were pretreated with BVEE (100 and 200 mg/kg, p. o. for 7 days and subjected to ARS for 6 h to induce behavioral and biochemical changes. Anxiety- and depressive-like behavior were measured by using different behavioral paradigms such as open field test (OFT, elevated plus maze (EPM, forced swim test (FST, and tail suspension test (TST 40 min postARS. Brain homogenate was used to analyze oxidative stress parameters, that is, malondialdehyde (MDA and reduced glutathione (GSH level. Results: BVEE pretreatment significantly (P < 0.05 reversed the ARS-induced reduction in EPM parameters, that is, percentage entries and time spent in open arms and in OFT parameters, that is, line crossings, and rearings in mice. ARS-induced increase in the immobility time in FST and TST was attenuated significantly (P < 0.05 by BVEE pretreatment at both the dosage. An increase in MDA and depletion of GSH level postARS was prevented significantly (P < 0.05 with BVEE pretreatment at both the dosage (100 and 200 mg/kg. Conclusion: BVEE exhibits anxiolytic and antidepressant activity in stressed mice along with good antioxidant property suggesting its therapeutic potential in the treatment of stress-related psychiatric disorders.

  18. A single bout of resistance exercise can enhance episodic memory performance

    OpenAIRE

    Weinberg, Lisa; Hasni, Anita; Shinohara, Minoru; Duarte, Audrey

    2014-01-01

    Acute aerobic exercise can be beneficial to episodic memory. This benefit may occur because exercise produces a similar physiological response as physical stressors. When administered during consolidation, acute stress, both physical and psychological, consistently enhances episodic memory, particularly memory for emotional materials. Here we investigated whether a single bout of resistance exercise performed during consolidation can produce episodic memory benefits 48 hours later. We used a ...

  19. Correlational study between auditory sense P50 and cognitive function in treatment-resistant depression and first episode depression patients%难治性抑郁症和首发抑郁症听觉P50与认知功能的相关研究

    Institute of Scientific and Technical Information of China (English)

    王勇; 李则挚; 黄佳; 陈兴时; 楼翡璎; 陈冲; 方贻儒

    2012-01-01

    目的 探讨难治性抑郁症(TRD)和首发抑郁症(FED)患者听觉诱发电位P50和认知功能的相关性及其可能的神经生理机制.方法应用美国Nicolet Bravo脑电生理仪,对33例TRD、37例FED和35名健康对照者(HC)进行P50和认知功能检测,并对两者进行相关分析.结果①TRD患者的S2-P50波幅以及S2/S1、S1-S2和100(1-S2/S1)三种表达式与FED、HC组存在显著性差异(P < 0.05或P < 0.01);②TRD患者的总智商、操作智商、长时记忆和短时记忆与FED、HC组存在显著性差异(P < 0.05或P < 0.01);③TRD患者的P50异常指标与其短时记忆中的图片、再生和触觉功能损害显著相关(P < 0.05或P < 0.01).结论 TRD患者比FED患者存在更为显著的感觉门P50异常和认知功能损害,其P50异常与患者的短时记忆损害存在显著的相关性.%Objective To explore the relationship between auditory evoked potential P50 and cognitive function and their possible neurophysiology mechanism in treatment-resistant depression (TRD) and first episode depression (FED) paitents. Methods American Nicolet Bravo instrument was used. P50 and cognitive function were tested and their correlation was analyzed in 33 TRD, 37 FED patients and 35 healthy controls (HC). Results ①Compared with FED and HC, significant differences were showed in S2-P50 amplitudes, S2/S1, S1-S2 and 100 (1-S2/S1) in TRD group (P < 0.05 or P < 0.01). ②Compared with FED and HC, significant differences were showed in FIQ, PIQ, long and short term memory in TRD group (P < 0.05 or P < 0.01). ③Significant correlation were found between abnormal P50 indexes and picture, regeneration and tac-tus of short term memory in TRD group (P < 0.05 or P < 0.01). Conclusion TRD patients show more severe sensory gating P50 abnormality and cognitive function impairments than FED patients, and their P50 changes show significant correlation with short term memory impairment.

  20. The acute response of plasma brain-derived neurotrophic factor as a result of exercise in major depressive disorder.

    Science.gov (United States)

    Gustafsson, Gunnar; Lira, Claudia Mallea; Johansson, Jon; Wisén, Anita; Wohlfart, Björn; Ekman, Rolf; Westrin, Asa

    2009-10-30

    Brain-derived neurotrophic factor (BDNF) and other neurotrophins are believed to play an important role in affective disorders. In this study we investigated plasma-BDNF response during an incremental exercise test in 18 patients suffering from moderate major depressive disorder (MDD) and 18 controls. The patients were not treated with antidepressants or neuroleptics. Possible associations between plasma plasma-BDNF levels, dexamethasone suppression test cortisol levels and Montgomery-Asberg Depression Rating Scale (MADRS) scores were also tested. No difference in basal BDNF levels between patients and controls was found. BDNF increased significantly during exercise in both male and female patients as well as in male controls, with no significant differences between the groups. BDNF levels declined after exercise, but after 60 min of rest BDNF levels showed tendencies to increase again in male patients. No correlation between BDNF and cortisol or MADRS scores was found. We conclude that unmedicated patients with moderate depression and normal activity of the hypothalamic-pituitary-adrenal axis do not have a disturbed peripheral BDNF release during exercise. The BDNF increase 60 min after interruption of exercise in male patients might indicate up-regulated BDNF synthesis, but this needs to be further investigated in future studies.

  1. Comparative study of local consistency with the resting state magnetic resonance imaging under ifrst-episode depression%首发抑郁症脑局部一致性静息态MRI对比研究

    Institute of Scientific and Technical Information of China (English)

    谢生辉; 牛广明; 高阳; 乔鹏飞

    2015-01-01

    Objective:To explore the abnormal active area of brain function in patients with depression and the impact of depressive mood to the patient’s brain function using resting-state functional MRI(rfMRI) technology. Materials and Methods:30 patients with depression [live up to DSM-IV diagnostic criteria for depression, Hamilton Depression Scale (HAMD-17) score≥17 points] and 30 healthy volunteers were examed by rfMRI. The difference between depression and normal control group was analyzed using the method of regional homogeneity (ReHo). Results:ReHo was signiifcantly higher than the control group in the brain area of Bilateral part of the brain the amount of depression group, temporal, parietal, and bilateral putamen, right caudate nucleus, amygdala, cortex, cerebellar vermis, etc, while in the brain area of bilateral prefrontal cortex, precuneus, lingual gyrus and cerebellum, etc. reduced signiifcantly (P10) on ReHo chart analysis of depression group and normal control group. Conclusions: ReHo method can detect synchronised changes of regional cerebral tissue BOLD signal caused by depressed mood, more objectively relfect the functional state of the whole brain, thereby contribute to basic and clinical research of patients with depression.%目的利用静息态功能磁共振成像(resting-state functional MRI,rfMRI)技术,探索抑郁症患者异常脑功能活动区域及抑郁心境对患者脑功能的影响。材料与方法对30例抑郁症患者[符合DSM-IV抑郁症的诊断标准,汉密尔顿抑郁量表(HAMD-17)评分≥17分]和30例健康志愿者行rfMRI扫描。使用局部一致性(regional homogeneity,ReHo)方法对比分析ReHo在抑郁症组与正常对照组之间的不同。结果抑郁症组与正常对照ReHo图组间分析:抑郁症组大脑的双侧部分额、颞、顶叶、双侧壳核、右侧尾状核、杏仁核、扣带回、小脑蚓部等脑区的ReHo显著高于正常对照组,而在双侧前额叶、楔前叶、舌回

  2. Staying well after depression: trial design and protocol

    Directory of Open Access Journals (Sweden)

    Duggan Danielle S

    2010-03-01

    Full Text Available Abstract Background Depression is often a chronic relapsing condition, with relapse rates of 50-80% in those who have been depressed before. This is particularly problematic for those who become suicidal when depressed since habitual recurrence of suicidal thoughts increases likelihood of further acute suicidal episodes. Therefore the question how to prevent relapse is of particular urgency in this group. Methods/Design This trial compares Mindfulness-Based Cognitive Therapy (MBCT, a novel form of treatment combining mindfulness meditation and cognitive therapy for depression, with both Cognitive Psycho-Education (CPE, an equally plausible cognitive treatment but without meditation, and treatment as usual (TAU. It will test whether MBCT reduces the risk of relapse in recurrently depressed patients and the incidence of suicidal symptoms in those with a history of suicidality who do relapse. It recruits participants, screens them by telephone for main inclusion and exclusion criteria and, if they are eligible, invites them to a pre-treatment session to assess eligibility in more detail. This trial allocates eligible participants at random between MBCT and TAU, CPE and TAU, and TAU alone in a ratio of 2:2:1, stratified by presence of suicidal ideation or behaviour and current anti-depressant use. We aim to recruit sufficient participants to allow for retention of 300 following attrition. We deliver both active treatments in groups meeting for two hours every week for eight weeks. We shall estimate effects on rates of relapse and suicidal symptoms over 12 months following treatment and assess clinical status immediately after treatment, and three, six, nine and twelve months thereafter. Discussion This will be the first trial of MBCT to investigate whether MCBT is effective in preventing relapse to depression when compared with a control psychological treatment of equal plausibility; and to explore the use of MBCT for the most severe recurrent

  3. First-episode psychosis

    DEFF Research Database (Denmark)

    Simonsen, Erik

    2011-01-01

    . Patients with first-episode psychosis had significantly high NEO-PI-R scores for neuroticism and agreeableness, and lower scores for conscientiousness and extroversion. The median time for remission in the total sample was three months. Female gender and better premorbid functioning were predictive of less...

  4. Quetiapine monotherapy in acute phase for major depressive disorder: a meta-analysis of randomized, placebo-controlled trials

    Directory of Open Access Journals (Sweden)

    Maneeton Narong

    2012-09-01

    Full Text Available Abstract Background Schizophrenia and bipolar depression trials suggest that quetiapine may have an antidepressant effect. Objectives This meta-analysis aimed to determine the efficacy, acceptability and tolerability of quetiapine treatment for major depressive disorder (MDD. Only the randomized controlled trials (RCTs comparison between quetiapine and placebo were included. The authors searched such clinical trials carried out between 1991 and February 2012. Data sources MEDLINE, EMBASE, CINHL, PsycINFO and Cochrane Controlled Trials Register were searched in February 2012. Study populations comprised adults with MDD or major depression. Study eligible criteria, participants and interventions Eligible studies were randomized, placebo-controlled trials of quetiapine monotherapy carried out in adults with MDD and presenting endpoint outcomes relevant to: i depression severity, ii response rate, iii overall discontinuation rate, or iv discontinuation rate due to adverse events. No language restriction was applied. Study appraisal and synthesis methods All abstracts identified by the electronic searches were examined. The full reports of relevant studies were assessed, and the data of interest were extracted. Based on the Cochrane methods of bias assessment, risks of bias were determined. The studies with two risks or less were included. The efficacy outcomes were the mean change scores of depression rating scales, the overall response rate, and the overall remission rates. The overall discontinuation rate was considered as a measure of acceptability. The discontinuation rate due to adverse events was a measure of tolerability. Relative risks (RRs and weighted mean differences (WMDs with 95% confidence intervals (CIs were computed by using a random effect model. Results A total of 1,497 participants in three RCTs were included. All trials examined the quetiapine extended-release (XR. The pooled mean change scores of the Montgomery-Asberg Depression

  5. Autobiographical memory in the euthymic phase of recurrent depression

    NARCIS (Netherlands)

    Spinhoven, Philip; Bockting, Claudi L H; Schene, Aart H; Koeter, Maarten W J; Wekking, Elizabeth M; Williams, J Mark G

    2006-01-01

    The authors investigated autobiographical memory specificity in subjects who formerly had depression. In 122 euthymic patients with at least two previous major depressive episodes, memory specificity was significantly impaired compared to matched control participants but not related to residual symp

  6. Clinical analysis of microscopic polyangitis in first-episode acute renal failure%急性肾衰竭首发的显微镜下多血管炎分析

    Institute of Scientific and Technical Information of China (English)

    吴晓蓉

    2012-01-01

    目的 分析急性肾衰竭首发的显微镜下多血管炎(MPA)的临床特点.方法 7例急性肾衰竭患者,均诊断为MPA.进行实验室血尿常规、C反应蛋白、ANCA、ELISA、影像学检测.7例接受肾上腺皮质激素治疗,5例联合环磷酰胺治疗,2例应用硫唑嘌呤治疗.观察患者的实验室及影像学表现、治疗后的肾功能改善情况及临床症状.结果 尿常规检查,患者表现不同程度的蛋白尿和血尿.血常规Hb(80.50±20.57)g/L,血沉(82.20±36.61)mm/h;5例C反应蛋白明显增高.所有患者p-ANCA阳性,anti-MPO阳性.全部患者经治疗,肾功能均有不同程度恢复,临床症状明显减轻.结论 患者出现肾损害临床表现时,应考虑MPA的可能,在常规检查的同时应注意肾功能检测,以免漏诊MPA.%Objective To explore the clinical features of microscopic polyangitis (MPA) in first - episode acute renal failure. Methods Seven acute renal failure patients were diagnosed as MPA, who received laboratory urinalysis, Oreactive protein, ANCA and ELISA imaging test. Seven patients received adrenal cortex hormone therapy. Among them, five patients received additional cyclophosphamide treatment, and two patients azathioprine. The laboratory, imaging, renal function and clinical symptoms after treatment were observed. Results Routine urine examinations showed that patients had varying degrees of protein uria and hematuria. The blood of Hb was (80. 50 ± 20. 57) g/L, and crythrocyte sedimentation rate was (82. 20 ± 36. 61) mm/h. Oreactive proteins of 5 patients were significantly higher. All patients had positive p-ANCA and anti-of MPO. After treatment, all patients renal function recovered with varying degrees, and clinical symptoms were relieved. Conclusion Patients with clinical manifestations of renal impairment should be given consideration the possibility of MPA. Renal function tests should conducted in the routine examination at the same time in order to avoid

  7. Episodic memory training with emphasis on categorization for older adults without dementia and depression / Treino de memória episódica com ênfase em categorização para idosos sem demência e depressão

    Directory of Open Access Journals (Sweden)

    Fabiana Castillo Roda Carvalho

    2010-01-01

    Full Text Available Aging may lead to cognitive changes, especially in memory. Yet, research suggests that older adults may improve memory performance after training. The present study aimed at evaluating the effects of episodic memory training offered to healthy Brazilian older adults. Fifty seven participants were randomly divided into control group (COG = 26 and experimental group (EXG = 31. The EXG participants completed a pre-test, five sessions of episodic memory training in which they were instructed to categorize grocery lists and pictures, and a post-test. Results indicated that episodic memory training involving learning and practice with categorization promoted significant improvement in episodic memory performance and in better using the trained strategy.

  8. 支气管哮喘急性发作期呼吸道感染患儿的临床诊治分析%Analysis of Clinical Diagnosis and Treatment of Children With Bronchial Asthma Acute Episodes of Respiratory Tract Infection

    Institute of Scientific and Technical Information of China (English)

    段艳飞; 刘冬霞

    2016-01-01

    目的:探析支气管哮喘急性发作期呼吸道感染患儿治疗。方法随机将80例支气管哮喘急性发作期呼吸道感染患儿分为两组,分别行常规疗法和联合用药,比较两组疗效。结果两组治疗效果比较,差异有统计学意义(P<0.05)。结论临床上给予支气管哮喘急性发作期呼吸道感染患儿联合用药效果显著。%Objective To analyze the treatment for children with bronchial asthma acute episodes of respiratory tract infection.Methods 80 cases of children with bronchial asthma acute phase were randomly divided into two groups, which were respectively treated with routine therapy and combined medication, to compare the curative effect of two groups.Results There was the signiifcant difference between the treatment effect of two groups (P<0.05).Conclusion the effect of combined medication for children with bronchial asthma acute episodes of respiratory tract infection is remarkable.

  9. A comparison study of the big five personality characteristics in patients with first-episode, treatment-naive major depressive disorder%首发未用药抑郁症患者大五人格特征对照研究

    Institute of Scientific and Technical Information of China (English)

    沈宗霖; 程宇琪; 刘晓妍; 杨舒然; 叶靖; 许秀峰

    2016-01-01

    Objective To explore the big five personality characteristics of the first-episode, treatment-naive major depressive disorder. Method Neuroticism Extraversion Openness Five-Factor Inventory (NEO-FFI) was used to assess the personality. A comparison was conducted between 112 first-episode, treatment-naive major depressive disorder (MDD) patients and 99 sex-, age- and education level-matched healthy controls (HC). The Hamilton depression scale (HAMD) was used to evaluate patients’symptom. Result Compared with HC, the neuroticism score in MDD group was significantly higher, while the extraversion, openness, agreeableness and conscientiousness were significantly lower. Lo⁃gistic regression analysis showed that MDD was significantly associated with higher neuroticism (OR=1.106, 95%CI:1.029~1.189, P=0.006) and lower extraversion (OR=0.809, 95%CI: 0.733~0.893, P<0.001) and agreeableness (OR=0.870, 95%CI:0.794~0.953, P=0.003). Linear regression showed that the HAMD score was significantly associated with higher neuroticism (B=0.121, P=0.003). The onset age of MDD was significantly associated with conscientiousness (B=0.015, P=0.001). Conclusion This study confirms that the personality of MDD is different from HC. Higher neuroticism is an important personality facets in treatment-naive patients with first-episode MDD. The low conscientiousness might associate with early age of depression onset.%目的:探讨首发未服药抑郁症患者的大五人格特征。方法采用大五人格量表简化版(neuroticism extraversion openness five-factor inventory, NEO-FFI),对112例首发未服药抑郁症患者及99名性别、年龄、文化背景相匹配的正常对照进行大五人格特征评估,汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评定患者的抑郁症状。结果患者组神经质维度得分高于对照组,而外向性、开放性、宜人性及责任感维度得分均低于对照组(P<0.05)。Logistic回归分析示,抑

  10. Episodes, events, and models

    Directory of Open Access Journals (Sweden)

    Sangeet eKhemlani

    2015-10-01

    Full Text Available We describe a novel computational theory of how individuals segment perceptual information into representations of events. The theory is inspired by recent findings in the cognitive science and cognitive neuroscience of event segmentation. In line with recent theories, it holds that online event segmentation is automatic, and that event segmentation yields mental simulations of events. But it posits two novel principles as well: first, discrete episodic markers track perceptual and conceptual changes, and can be retrieved to construct event models. Second, the process of retrieving and reconstructing those episodic markers is constrained and prioritized. We describe a computational implementation of the theory, as well as a robotic extension of the theory that demonstrates the processes of online event segmentation and event model construction. The theory is the first unified computational account of event segmentation and temporal inference. We conclude by demonstrating now neuroimaging data can constrain and inspire the construction of process-level theories of human reasoning.

  11. Orbitofrontal cortex action of 5-hydroxytryptamine and its receptor in an acute forced swimming stress-induced depression model

    Institute of Scientific and Technical Information of China (English)

    Huipeng Li; Fengli An; Shucheng An

    2009-01-01

    BACKGROUND: The orbitofrontal cortex (OFC) is a brain region closely associated with emotion.5-hydroxytryptamine (5-HT) has been shown to be involved in human depression.OBJECTIVE: To investigate OFC actions and mechanisms of 5-HT and 5-HT1A receptor (5-HT1AR)in stress-induced depression.DESIGN, TIME AND SEI-rlNG: A randomized, controlled, animal experiment was performed at Laboratory of Neurobiology, College of Life Science, Shaanxi Normal University between May 2006 and March 2008.MATERIALS: 5-HT, p-chlorophenylalanine (PCPA, an inhibitor to tryptophan hydroxylase) andspiperone (5-HT1AR antagonist) were provided by Sigma, USA; rabbit anti-rat 5-HT1AR antibody was provided by Tlanjin Haoyang Biological Manufacture.METHODS: A total of 40 male Sprague Dawley rats, aged 3 months, were randomly divided into five groups: control, model, 5-HT, spiperone+5-HT, and PCPA, with 8 rats in each group. Except for control group, rats in the other four groups were used to establish depression models by forced swimming for 15 minutes. At 30 minutes before forced swimming test, 0.5μL of 5-HT (12.5μg/pL),PCPA (20μg/μL), spiperone (1.3 μg/μL)+5-HT (12.5μg/μL, 10 minutes later), and saline were respectively injected into the OFC of 5-HT, PCPA, spiperone+5-HT, and model groups, respectively.The control group received a saline microinjection into the OFC.MAIN OUTCOME MEASURES: Forced swimming and open field tests were employed to measure animal behaviors, and immunohistochemistry was used to analyze 5-HT1AR expression in the OFC,cingulate cortex, and piriform cortex.RESULTS: (1) Compared with the model group, 5-HT microinjection into the OFC prominently reduced immobility time in the forced swimming test and rearing in open field test (P0.05). Furthermore, following PCPA microinjection into the OFC (PCPA + forced swimming stress),immobility time in forced swimming test increased dramatically (P<0.01), locomotion and rearing inopen field test declined (P<0.05 and P<0

  12. Perspectives on Episodic-like and Episodic Memory

    Directory of Open Access Journals (Sweden)

    Bettina M Pause

    2013-04-01

    Full Text Available Episodic memory refers to the conscious recollection of a personal experience that contains information on what has happened and also where and when it happened. Recollection from episodic memory also implies a kind of first-person subjectivity that has been termed autonoetic consciousness. Episodic memory is extremely sensitive to cerebral aging and neurodegenerative diseases. In Alzheimer’s disease deficits in episodic memory function are among the first cognitive symptoms observed. Furthermore, impaired episodic memory function is also observed in a variety of other neuropsychiatric diseases including dissociative disorders, schizophrenia and Parkinson disease. Unfortunately, it is quite difficult to induce and measure episodic memories in the laboratory and it is even more difficult to measure it in clinical populations. Presently, the tests used to assess episodic memory function do not comply with even down-sized definitions of episodic-like memory as a memory for what happened, where and when. They also require sophisticated verbal competences and are difficult to apply to patient populations. In this review, we will summarize the progress made in defining behavioral criteria of episodic-like memory in animals (and humans as well as the perspectives in developing novel tests of human episodic memory which can also account for phenomenological aspects of episodic memory such as autonoetic awareness. We will also define basic behavioral, procedural and phenomenological criteria which might be helpful for the development of a valid and reliable clinical test of human episodic memory.

  13. Depression - resources

    Science.gov (United States)

    Resources - depression ... Depression is a medical condition. If you think you may be depressed, see a health care provider. ... following organizations are good sources of information on depression : American Psychological Association -- www.apa.org/topics/depress/ ...

  14. Evaluation on Effect of Paroxetine and Amisulpride in Treatment of De-pressive Episode with Schizophrenic Symptoms%帕罗西汀联合氨磺必利治疗伴精神病症状抑郁发作的效果评价

    Institute of Scientific and Technical Information of China (English)

    洪汉林; 段秀荣

    2016-01-01

    目的:研究帕罗西汀联合氨磺必利治疗伴精神病症状抑郁发作的效果。方法病例来源:方便选取该院2014年4月—2015年2月住院接受治疗的60例伴精神病症状抑郁发作患者。患者分组方法:随机抽签法。60例患者分为抗抑郁组和联合干预组两个组别。抗抑郁组以帕罗西汀单药治疗;联合干预组以帕罗西汀、氨磺必利联用药治疗。观察指标:①总有效率;②用药副反应率;③治疗前和治疗后患者汉密尔顿抑郁量表评分的差异。结果①联合干预组相比于抗抑郁组总有效率更高,分别为93.33%和66.67%,差异有统计学意义(P﹤0.05);②联合干预组、抗抑郁组用药副反应率接近,抗抑郁组为13.33%,联合干预组为10.00%,差异无统计学意义(P﹥0.05);③治疗前两组汉密尔顿抑郁量表评分相似,差异无统计学意义(P﹥0.05);治疗后联合干预组相比于抗抑郁组汉密尔顿抑郁量表评分改善更显著,差异有统计学意义(P﹤0.05)。结论帕罗西汀联合氨磺必利治疗伴精神病症状抑郁发作的效果确切,可有效改善患者抑郁症状,用药安全可靠,值得推广。%Objective To research the effect of paroxetine and amisulpride in treatment of depressive episode with schizophrenic symptoms. Methods 60 cases of patients with depressive episode with schizophrenic symptoms hospitalized in our hospital from April 2014 to February 2015 were selected and randomly divided into two groups, the anti-depression group were treated with single paroxetine, the combined intervention group were treated with paroxetine and amisulpride, and the total effective rate, side reaction rate of medication and the difference in the Hamilton depression rating scale score before and after treatment were observed. Results The total effective rate in the combined intervention group was higher than that in the anti-depression group(93.33% vs 66.67%), and

  15. Effects of μ-opioid receptor agonists in assays of acute pain-stimulated and pain-depressed behavior in male rats: role of μ-agonist efficacy and noxious stimulus intensity.

    Science.gov (United States)

    Altarifi, Ahmad A; Rice, Kenner C; Negus, S Stevens

    2015-02-01

    Pain is associated with stimulation of some behaviors and depression of others, and μ-opioid receptor agonists are among the most widely used analgesics. This study used parallel assays of pain-stimulated and pain-depressed behavior in male Sprague-Dawley rats to compare antinociception profiles for six μ-agonists that varied in efficacy at μ-opioid receptors (from highest to lowest: methadone, fentanyl, morphine, hydrocodone, buprenorphine, and nalbuphine). Intraperitoneal injection of diluted lactic acid served as an acute noxious stimulus to either stimulate stretching or depress operant responding maintained by electrical stimulation in an intracranial self-stimulation (ICSS). All μ-agonists blocked both stimulation of stretching and depression of ICSS produced by 1.8% lactic acid. The high-efficacy agonists methadone and fentanyl were more potent at blocking acid-induced depression of ICSS than acid-stimulated stretching, whereas lower-efficacy agonists displayed similar potency across assays. All μ-agonists except morphine also facilitated ICSS in the absence of the noxious stimulus at doses similar to those that blocked acid-induced depression of ICSS. The potency of the low-efficacy μ-agonist nalbuphine, but not the high-efficacy μ-agonist methadone, to block acid-induced depression of ICSS was significantly reduced by increasing the intensity of the noxious stimulus to 5.6% acid. These results demonstrate sensitivity of acid-induced depression of ICSS to a range of clinically effective μ-opioid analgesics and reveal distinctions between opioids based on efficacy at the μ-receptor. These results also support the use of parallel assays of pain-stimulated and -depressed behaviors to evaluate analgesic efficacy of candidate drugs.

  16. Recurrence in Major Depression: A Conceptual Analysis

    Science.gov (United States)

    Monroe, Scott M.; Harkness, Kate L.

    2011-01-01

    Theory and research on major depression have increasingly assumed a recurrent and chronic disease model. Yet not all people who become depressed suffer recurrences, suggesting that depression is also an acute, time-limited condition. However, few if any risk indicators are available to forecast which of the initially depressed will or will not…

  17. Persistent increase in oxygen consumption and impaired neurovascular coupling after spreading depression in rat neocortex

    DEFF Research Database (Denmark)

    Hansen, Henning Piilgaard; Lauritzen, Martin

    2009-01-01

    Cortical spreading depression (CSD) is associated with a dramatic failure of brain ion homeostasis and increased energy metabolism. There is strong clinical and experimental evidence to suggest that CSD is the mechanism of migraine, and involved in progressive neuronal injury in stroke and head...... trauma. Here we tested the hypothesis that single episodes of CSD induced acute hypoxia, and prolonged impairment of neurovascular and neurometabolic coupling. Cortical spreading depression was induced in rat frontal cortex, whereas cortical electrical activity and local field potentials (LFPs) were...... recorded by glass microelectrodes, cerebral blood flow (CBF) by laser-Doppler flowmetry, and tissue oxygen tension (tpO(2)) with polarographic microelectrodes. Cortical spreading depression increased cerebral metabolic rate of oxygen (CMRO(2)) by 71%+/-6.7% and CBF by 238%+/-48.1% for 1 to 2 mins...

  18. 舍曲林与帕罗西汀治疗首发老年期抑郁症患者的对照研究%Control research on Sertraline and Paroxetine in the treatment of patients with first episode of depression in the elderly

    Institute of Scientific and Technical Information of China (English)

    秦素萍

    2012-01-01

    目的 探讨舍曲林与帕罗西汀治疗首发老年期抑郁症患者的临床疗效.方法 选取我院2009年11月~2011年12月收治的首发老年期抑郁症患者70例,按入院先后顺序分为舍曲林组(100~175 mg/d)和帕罗西汀组(20~40 mg/d),疗程均为8周,治疗前后以汉密尔顿抑郁量表17项(HAMD-17),记录不良反应及实验室情况.结果 在治疗第1、2、4、6、8周两组治疗总有效率比较,差异无统计学意义(P > 0.05).治疗后舍曲林组与帕罗西汀组焦虑/躯体化因子、认知障碍因子、体质量因子、睡眠障碍因子、阻滞因子、HAMD-17总评分均明显下降,治疗前后差异均有统计学意义(P < 0.05),舍曲林组与帕罗西汀组间相比较,差异均无统计学意义(P > 0.05).两组患者在治疗前后无血生化、血常规、心电图的明显异常.舍曲林组的不良反应发生率明显低于帕罗西汀组,差异有统计学意义(P < 0.05).结论 舍曲林与帕罗西汀治疗首发老年抑郁症均具有显著的临床疗效,但舍曲林起效的不良反应发生率较低,更适合于患者长期服用.%Objective To investigate the clinical efficacy of Sertraline and Paroxetine in the treatment of elderly patients with first episode of depression. Methods 70 elderly patients with first episode of depression were selected in our hospital from November 2009 to December 2011. According to the sequence of admission, patients were divided into Sertraline group (100-175 mg/d ) and Paroxetine group (20-40 mg/d). Course of treatment was 8 weeks. Hamilton depression rating scale of 17 (HAMD-17) was performed before and after treatment. Adverse reactions and lab were recorded. Results In the treatment of 1, 2, 4, 6, 8 weeks, the difference of the effective rate in the two groups were not statistically significant (P > 0.05). After treatment, anxiety/somatization factor, cognitive factor, quality factor, sleep disturbance factor, retardation factor, total

  19. Memory imPairment and its relationshiP with serum cortisol in the first ePisode of major dePressive dis-order%重性抑郁障碍首次发病患者记忆损害及其与血清皮质醇水平的关系

    Institute of Scientific and Technical Information of China (English)

    周云; 刘军

    2014-01-01

    Objective:To explore the relationship between serum cortisol and memory impairment in first episode patients with major depressive disorder. Method:Thirty patients with first episode major depression and 30 healthy controls were measured by Wechsler memory scale( WMS)to assess their memory levels and their serum cortisol levels were measured. Results:Wechsler memory quotient and factor mind,pictures,rec-ognition,reproduction,association,comprehension and digit span of the depression group were significantly lower than the healthy group(P ﹤ 0. 01);Wechsler memory factors including mind,pictures,recognition,reproduction, association,comprehension,digit span and memory quotient were significantly negatively correlated with HAMD total score and HAMD factor which included anxiety/ somatization,awareness barriers,blocking,sleep disorders (P ﹤ 0. 02);There was significant negative correlation between serum cortisol concentrations and Wechsler memory factor including mind,pictures,recognition,reproduction,association,digit span and memory quotient (r = - 0. 432,- 0. 410,- 0. 399,- 0. 421,- 0. 472,- 0. 436,respectivelyP ﹤ 0. 02);Wechsler Memory fac-tor scores was significantly negatively correlated with age and disease duration(P ﹤ 0. 02). Conclusion:The first episode patient with major depressive disorder shows memory deficiency;which may be correlated with ser-um cortisol levels.%目的:探讨重性抑郁障碍首次发病患者记忆损害与血清皮质醇的关系。方法:对30例重性抑郁障碍首次发病患者和30名正常对照者进行韦氏记忆量表(WMS)测量以评定其记忆水平,同时进行血清皮质醇的浓度测定。结果:重性抑郁障碍组的韦氏记忆商数及心智、图片、再认、再生、联想、理解、背数因子分显著低于正常对照组( P ﹤0.01);韦氏记忆因子中的心智、图片、再认、再生、联想、背数、理解、记忆商数与 HAMD 总分以及 HAMD 因子中的焦虑/躯

  20. Challenges in comparing the acute cognitive outcomes of high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) vs. electroconvulsive therapy (ECT) in major depression: A systematic review.

    Science.gov (United States)

    Kedzior, Karina Karolina; Schuchinsky, Maria; Gerkensmeier, Imke; Loo, Colleen

    2017-03-02

    The present study aimed to systematically compare the cognitive outcomes of high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) and electroconvulsive therapy (ECT) in head-to-head studies with major depression (MDD) patients. A systematic literature search identified six studies with 219 MDD patients that were too heterogeneous to reliably detect meaningful differences in acute cognitive outcomes after ECT vs. HF-rTMS. Cognitive effects of brain stimulation vary depending on the timeframe and methods of assessment, stimulation parameters, and maintenance treatment. Thus, acute and longer-term differences in cognitive outcomes both need to be investigated at precisely defined timeframes and with similar instruments assessing comparable functions.

  1. Life Stress, the "Kindling" Hypothesis, and the Recurrence of Depression: Considerations From a Life Stress Perspective

    Science.gov (United States)

    Monroe, Scott M.; Harkness, Kate L.

    2005-01-01

    Major depression is frequently characterized by recurrent episodes over the life course. First lifetime episodes of depression, however, are typically more strongly associated with major life stress than are successive recurrences. A key theoretical issue involves how the role of major life stress changes from an initial episode over subsequent…

  2. Activated depression: mixed bipolar disorder or agitated unipolar depression?

    Science.gov (United States)

    Swann, Alan C

    2013-08-01

    The combination of depression and activation presents clinical and diagnostic challenges. It can occur, in either bipolar disorder or major depressive disorder, as increased agitation as a dimension of depression. What is called agitation can consist of expressions of painful inner tension or as disinhibited goal-directed behavior and thought. In bipolar disorder, elements of depression can be combined with those of mania. In this case, the agitation, in addition to increased motor activity and painful inner tension, must include symptoms of mania that are related to goal-directed behavior or manic cognition. These diagnostic considerations are important, as activated depression potentially carries increased behavioral risk, especially for suicidal behavior, and optimal treatments for depressive episodes differ between bipolar disorder and major depressive disorder.

  3. 急性冠脉综合征患者焦虑抑郁情绪的随访%Follow-up of anxiety and depression symptoms in patients with acute coronary syndrome

    Institute of Scientific and Technical Information of China (English)

    谢南姿; 马文林; 刘光辉; 沈玉芹; 陈罗蔓; 周璐

    2013-01-01

    目的 观察急性冠脉综合征(acute coronary syndrome,ACS)患者焦虑抑郁情绪的变化.方法 对782例ACS患者的焦虑抑郁情绪进行平均(8.0±5.8)m的随访测评,应用综合性医院情绪测量表(hospital anxiety and depression scales,HADS)、贝克焦虑量表(Beck Anxiety Inventory,BAI)和贝克抑郁量表(Beck Depression Inventory,BDI),分析ACS患者焦虑抑郁情绪的变化.结果 与基线期相比,ACS患者的抑郁评分下降具有统计学意义[(7.07±5.37) vs(6.28±5.51),P<0.05],焦虑评分下降无统计学意义(P>0.05),焦虑、抑郁的构成比例无统计学意义(P>0.05).结论 ACS后抑郁程度虽然呈现自然下降趋势,但构成比例降低却无统计学意义,故仍需早发现,早治愈.关于ACS后的焦虑有待进一步深入研究.%Objective To observe changes in anxiety and depression symptoms in acute coronary syndrome patients. Methods A prospective cohort study of 782 patients with ACS were followed up anxiety and depression symptoms were assessed and collected, application of hospital anxiety and depression scales (HADS)、beck anxiety inventory (BAI) and beck depression inventory (BDI). Results The follow-up Beck depression inventory (BDI) score decreased significantly compared with the baseline BDI score [(7.07±5.37) vs (6.28±5.51, P 0.05). Conclusion Among ACS population, though the depression level was decline spontaneously 7 months later, the proportions of anxiety and depression were still as high as the baseline, So as for the improvement of clinic outcome of ACS population, post-ACS depression should be assessed and treated effectively as early as possible. In the case of post-ACS anxiety, large sample and long term investigations were needed to make it clear.

  4. Impact of Identification and Treatment of Depression in Heart Transplant Patients

    Directory of Open Access Journals (Sweden)

    Ike Okwuosa

    2014-01-01

    Full Text Available Background. The effects of clinical depression after orthotopic heart transplantation (OHT are relatively unknown. The purpose of this study was to evaluate the impact of depression on outcomes after OHT. Methods. We performed a single center retrospective review of 102 consecutive patients who underwent OHT at Northwestern Memorial Hospital from June 2005 to October 2009. The diagnosis of depression was obtained from attending physician documentation. The primary endpoints were all-cause mortality (ACM, hospitalizations, and rejection. Results. Of 102 OHT patients, 26 (26% had depression. Depressed patients were similar in age to nondepressed patients (57.6 years versus 56.9, P=0.79. There was no statistical difference in survival between groups at 5 years after OHT (P=0.94. All-cause hospitalizations were higher in depressed versus nondepressed patients (4.3 versus 2.6 hospitalizations P=0.05. There were no significant differences in hospitalizations between the two groups for the following complications: cardiac (heart failure, edema, arrhythmias, and acute rejection and infections. There was no significant difference in episodes of 2R and 3R rejection. Conclusion. Early identification and treatment of depression in OHT patients result in outcomes similar to nondepressed patients.

  5. Bilateral Continuous Quadratus Lumborum Block for Acute Postoperative Abdominal Pain as a Rescue After Opioid-Induced Respiratory Depression.

    Science.gov (United States)

    Shaaban, Mohamed; Esa, Wael Ali Sakr; Maheshwari, Kamal; Elsharkawy, Hesham; Soliman, Loran Mounir

    2015-10-01

    We present a case of acute postoperative abdominal pain after proctosigmoidectomy and colorectal anastomosis that was treated by bilateral continuous quadratus lumborum block. The block was performed in the lateral position under ultrasound guidance with a 15-mL bolus of 0.5% bupivacaine injected anterior to the quadratus lumborum muscle followed by bilateral catheter placement. Each catheter received a continuous infusion of 0.1% bupivacaine at 8 mL/h and an on-demand bolus 5 mL every 30 minutes. Sensory level was confirmed by insensitivity to cold from T7 through T12. The block was devoid of hemodynamic side effects or motor weakness. This case demonstrates that bilateral continuous quadratus lumborum catheters can provide extended postoperative pain control.

  6. Predicting Response to Depression Treatment: The Role of Negative Cognition

    Science.gov (United States)

    Beevers, Christopher G.; Wells, Tony T.; Miller, Ivan W.

    2007-01-01

    Repeated experiences with major depressive disorder (MDD) may strengthen associations between negative thinking and dysphoria, rendering negative cognition more accessible and pronounced with each episode. According to cognitive theory, greater negative cognition should lead to a more protracted episode of depression. In this study of 121 adults…

  7. Depression is more than just sadness: A case of excessive anger and its management in depression

    Directory of Open Access Journals (Sweden)

    Anamika Sahu

    2014-01-01

    Full Text Available People with depressive illness often have symptoms of overt or suppressed anger. Those with anger traits face exaggerated problem during symptomatic period of depression. Pharmacological management helps in control of depressive and anxiety symptoms, but rarely address anger symptoms. Non-pharmacological management like cognitive-behavioral therapy (CBT is effective in depression as well as in anger management, but is not used frequently in anger associated or exacerbated by depression. We present the case of a 27-year-old male suffering from moderate depressive episode with associated anger outburst. He underwent CBT, which resulted in a significant decrease in anger symptoms as well as in severity of depression.

  8. Emerging antidepressants to treat major depressive disorder.

    Science.gov (United States)

    Block, Samantha G; Nemeroff, Charles B

    2014-12-01

    Depression is a common disorder with an annual risk of a depressive episode in the United States of 6.6%. Only 30-40% of patients remit with antidepressant monotherapy, leaving 60-70% of patients who do not optimally respond to therapy. Unremitted depressive patients are at increased risk for suicide. Considering the prevalence of treatment resistant depression and its consequences, treatment optimization is imperative. This review summarizes the latest treatment modalities for major depressive disorder including pharmacotherapy, electroconvulsive therapy, repetitive transcranial magnetic stimulation and psychotherapy. Through advancements in research to better understand the pathophysiology of depression, advances in treatment will be realized.

  9. Cushing's syndrome masquerading as treatment resistant depression

    Directory of Open Access Journals (Sweden)

    B N Anil Kumar

    2016-01-01

    Full Text Available Treatment resistant depression (TRD is a common clinical occurrence among patients treated for major depressive disorder. A significant proportion of patients remain significantly depressed in spite of aggressive pharmacological and psychotherapeutic approaches. Management of patient with treatment resistant depression requires thorough evaluation for physical causes. We report a case of recurrent depressive disorder, who presented with severe depressive episode without psychotic symptoms, not responding to multiple adequate trials of antidepressants, who on investigation was found to have Cushing's syndrome and responded well to Ketoconazole.

  10. 急性脑梗死抑郁症发生相关因素与预防分析%Analysis of Related Factors and Prevention of Depression in Patients With Acute Cerebral Infarction

    Institute of Scientific and Technical Information of China (English)

    郑容; 郭洛宁; 王芬

    2016-01-01

    目的:分析急性脑梗死抑郁症发生相关因素与预防。方法随机选取我院2013年3月~2016年3月收治的60例急性脑梗死抑郁症患者,将其作为研究组,选取60例急性脑梗死患者,将其作为对照组,即研究组(60例)和对照组(60例);给予研究组患者,应用丁螺环酮合并氟西汀治疗,根据汉密尔顿抑郁量表对临床患者的疗效进行评定,分析急性脑梗死抑郁症发生相关因素,并分析其预防措施。结果两组中,研究组与对照组比较,差异有统计学意义(P<0.05),可发现心理社会危险因素,会导致抑郁、焦虑,使患者血清 IL-6、TNF-α浓度升高,形成抑郁症,研究组经心理干预及药物治疗后,患者抑郁症状得到改善,治疗前后对比临床疗效显著(P<0.05)。结论在临床中,急性脑梗死抑郁症发生与患者神经功能缺失、性格内向、情绪不稳定、体验较多负性事件、社会支持低下有关,对患者采取药物治疗及心理干预,有助于改善患者抑郁症状,预防抑郁症形成。%Objective To analyze the related factors and prevention of depression in patients with acute cerebral infarction.Methods 60 cases of acute cerebral infarction patients with depression were randomly selected in our hospital from March 2013 to March 2016, as the study group, 60 cases of acute cerebral infarction patients were selected, as control group, that is, to study the group (60 cases) and control group (60 cases), give the study group patients, application with buspirone combined with lfuoxetine in the treatment of, according to Hamilton Depression Scale to the clinical therapeutic effects were assessed. Analysis of acute cerebral infarction depression related factors and analysis the preventive measures. Results In the two groups, the study group and the control group, there are differences (P<0.05), to find the psychological and social risk factors

  11. Stress sensitivity interacts with depression history to predict depressive symptoms among youth: prospective changes following first depression onset.

    Science.gov (United States)

    Technow, Jessica R; Hazel, Nicholas A; Abela, John R Z; Hankin, Benjamin L

    2015-04-01

    Predictors of depressive symptoms may differ before and after the first onset of major depression due to stress sensitization. Dependent stressors, or those to which characteristics of individuals contribute, have been shown to predict depressive symptoms in youth. The current study sought to clarify how stressors' roles may differ before and after the first depressive episode. Adolescents (N = 382, aged 11 to 15 at baseline) were assessed at baseline and every 3 months over the course of 2 years with measures of stressors and depressive symptoms. Semi-structured interviews were conducted every 6 months to assess for clinically significant depressive episodes. Hierarchical linear modeling showed a significant interaction between history of depression and idiographic fluctuations in dependent stressors to predict prospective elevations of symptoms, such that dependent stressors were more predictive of depressive symptoms after onset of disorder. Independent stressors predicted symptoms, but the strength of the association did not vary by depression history. These results suggest a synthesis of dependent stress and stress sensitization processes that might maintain inter-episode depressive symptoms among youth with a history of clinical depression.

  12. Case-control resitng-state fMRI study of brain funcitoning among adolescents with ifrst-episode major depressive disorder%首发抑郁症青少年患者的大脑功能--静息态功能磁共振成像的病例对照研究

    Institute of Scientific and Technical Information of China (English)

    龚云; 郝丽丽; 张喜燕; 周滟; 李建奇; 赵志民; 江文庆; 杜亚松

    2014-01-01

    背景:青少年抑郁症对患者及其家庭成员会产生长期严重的痛苦,但这种致残状况的潜在机制仍不清楚。目的:比较未经药物的青少年首发抑郁症患者和匹配的对照者之间的大脑功能静息状态。  方法:使用3T磁共振扫描仪对15名青少年抑郁症患者和16名对照者进行功能磁共振静息状态扫描。采用低频振荡振幅(amplitude of low frequency fluctuation,ALFF)来评估脑功能静息态。  结果:青少年抑郁症患者的儿童抑郁量表评分的均值(标准差)高于对照组(22.13[9.21]与9.37[5.65])。与对照组相比,青少年抑郁症患者在扣带回后部、左颞下回、右颞上回、右岛叶、右侧顶叶和右侧梭状回具有较高的ALFF;而在双侧楔叶、左枕叶和左内侧额叶表现出较低的ALFF。  结论:青少年抑郁症与大脑多个区域的显著功能变化有关。%Background: Adolescent depression results in severe and protracted suffering for affected individuals and their family members, but the underlying mechanism of this disabling condiiton remains unclear. Objectives: Compare resting-state brain functioning between first-episode, drug-naïve adolescents with major depressive disorder and matched controls. Methods: Fifteen adolescents with major depressive disorder and 16 controls underwent a resting-state fMRI scan performed using a 3Tmagneitc resonancescanner. The amplitude of low frequency lfuctuaiton (ALFF) was used to assess resitng-state brain funciton. Results: Adolescents with depression had higher mean (sd) scores on the Children Depression Inventory (CDI) than controls (22.13 [9.21] vs. 9.37 [5.65]). Compared with controls, adolescents with depression had higher ALFF in the posterior cingulate gyrus, letf inferior temporal gyrus, right superior temporal gyrus, right insula, right parietal lobe, and right fusiform gyrus; they also exhibited lower ALFF in the bilateral cuneus, the

  13. Study on comparison of temperament character between switching and no-switching patients of depressive episode by antidepressants%抗抑郁药引发转相与抑郁症患者气质特征的关系

    Institute of Scientific and Technical Information of China (English)

    陈正昕; 王伟; 金卫东

    2011-01-01

    目的:了解抗抑郁药引发转相过程中气质特征的作用. 方法:103例抑郁症患者选用气质量表进行气质评定后接受单一抗抑郁药治疗3个月,于治疗后1周、1个月、2个月和3个月,分别采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)以及Young躁狂量表(YMRS)进行评定,比较转相与未转相患者之间气质特征的差异. 结果:在3个月治疗过程中,103例患者中有27例在治疗的不同时期出现了转相,占26.2%;未转相患者粘液质和抑郁质更为明显(t =2.004、3.480,P=0.048、0.001).进一步相关分析发现,粘液质和抑郁质躁狂评分呈显著负相关(r=-0.201,P=0.039),与抑郁评分的变化也呈显著负相关(r=-0.201,P=0.041);转相患者胆汁质与抑郁质亦呈显著正相关(r=0.389,P=0.026). 结论:抑郁症患者的气质特征在抗抑郁药转相过程中可能有一定的作用.%Objective: To understand the role of temperament in switching by antidepressants. Method: 103 depressive patients were assessed with temperament scale and accepted simple treatment with antidepressants for 3 months, first assessed by temperament scale, then assessed with Hamilton depression rating scale (HAMD) .Hamilton anxiety scale (HAMA) and Young mania scale (YMRS) at 1 week,l month,2 month,3 month of the treatment, at last compared the differences of temperament characters between switching and no-switching patients. Results:27 patients switch to mania (26.2% ). The phlegmatic and melancholic temperament of no-switching patients had higher scales than that of switching patients (t = 2.004, 3.480;P -0.048, 0.001) and also negatively correlated with the scales of mania,and negatively significantly change of depression too ( r =- 0. 201,-0.201; P = 0.039,0.041). The significant positive correlation can be seen between choleric and melancholic temperament in switching patients ( r = 0. 389, P = 0.026). Conclusion: The temperament characters may play some roles in

  14. Role of respiratory pathogens in infants hospitalized for a first episode of wheezing and their impact on recurrences

    NARCIS (Netherlands)

    Bosis, S.; Esposito, S.; Niesters, H. G. M.; Zuccotti, G. V.; Marseglia, G.; Lanari, M.; Zuin, G.; Pelucchi, C.; Osterhaus, A. D. M. E.; Principi, N.

    2008-01-01

    In order to evaluate the infectious agents associated with the first episode of severe acute wheezing in otherwise healthy infants and to define the role of each of them in recurrences, 85 patients in Italy, aged <12 months, hospitalized because of a first acute episode of wheezing, were prospective

  15. Atypical Depression

    Science.gov (United States)

    Diseases and Conditions Atypical depression By Mayo Clinic Staff Any type of depression can make you feel sad and keep you from enjoying life. However, atypical depression — also called depression with atypical features — means that ...

  16. Postpartum depression

    Science.gov (United States)

    ... depression. Alternative Names Depression - postpartum; Postnatal depression; Postpartum psychological reactions References American Psychiatric Association. Depressive disorders. Diagnostic and Statistical Manual of Mental Disorders . 5th ed. Arlington, VA: American ...

  17. Decreased antitoxic activities among children with clinical episodes of malaria

    DEFF Research Database (Denmark)

    Jakobsen, P H; McKay, V; N'Jie, R

    1998-01-01

    erythrocyte membrane protein 1 and "Pfalhesin" (band #3) peptides, indicating that such IgG antibodies are stimulated by acute disease but are lost rapidly after the disease episode. Half of the children with symptomatic infections had low levels of haptoglobin, suggesting that these children had chronic P...

  18. 小剂量利培酮强化抗抑郁剂治疗双相抑郁发作的疗效和安全性研究%Efficacy and safety of low dosage risperidone added on valproate and citalopram in the treatment of acute bipolar depression

    Institute of Scientific and Technical Information of China (English)

    王健; 王刚; 马辛

    2014-01-01

    目的考察小剂量利培酮强化抗抑郁剂治疗对双相抑郁发作的疗效和安全性。方法符合入组标准的住院患者,先接受2周的丙戊酸钠( valproate,VPA)合并西酞普兰( citalopram,CIT)治疗。2周末相对于基线的蒙哥马利抑郁量表( Montgomery and Asberg Depression Scale,MADRS)减分率0.05)。 CGI-I 2组对比,差异具有统计学意义(P0.05)。随机治疗第1周末BPRS阳性因子评分VPA+CIT+RIS组较VPA+CIT组明显降低,差异有统计学意义(P<0.05),显示VPA+CIT+RIS组较VPA+CIT组在改善阳性精神病性症状方面起效更快。在随机治疗第2周,VPA+CIT+RIS组有效率为66.0%,VPA+CIT组为33.3%,显示VPA+CIT+RIS组较VPA+CIT组起效更快。结论 VPA+CIT+RIS与VPA+CIT治疗双相抑郁发作均安全有效。在快速起效及降低转相风险方面,VPA+CIT+RIS组优于VPA+CIT组。%Objective To evaluate the augmentation efficacy and safety of low dosage risperidone, added on the usual treatment ( valproate and citalopram) in the acute treatment of bipolar depression. Methods A total of 46 inpatients with a diagnostic criteria for acute depression episode with bipolar disorder according to DSM-IV-TR were first given valproate and citalopram treatment. The subjects who achieve little clinical response( i. e. reduction from baseline in total MADRS score by<50%) at the end of 2-week will enter into the randomized open-label 6-week treatment phase. The eligible subjects will be randomized to treatment with valproate & citalopram or valproate & citalopram & risperidone in a 1:1 ratio. Efficacy rating scales to be used in the study include MADRS, YMRS, BPRS( total score and positive subscale), CGI-S, and CGI-I. The evaluations of safety and tolerability include SAS, treatment-emergent mania, clinical laboratory tests, vital signs , ECG, and adverse events reports. Results At the end of treatment, the scores of MADRS, BPRS, GIC-I, and CGI-S in both treatment groups decreased significantly compared

  19. Treino de memória episódica com ênfase em categorização para idosos sem demência e depressão Episodic memory training with emphasis on categorization for older adults without dementia and depression

    Directory of Open Access Journals (Sweden)

    Fabiana Castillo Roda Carvalho

    2010-01-01

    Full Text Available Com o envelhecimento, podem ocorrer alterações cognitivas, especialmente, na memória. Ao mesmo tempo, as pesquisas apontam a possibilidade de melhorar a capacidade da memória por meio de treino cognitivo. O objetivo deste estudo foi verificar os efeitos do treino de memória episódica com idosos saudáveis brasileiros. Cinqüenta e sete idosos recrutados foram divididos aleatoriamente em grupo controle (GCO= 26 e grupo experimental (GEX= 31. Os participantes do grupo GEX participaram do pré-teste, seguido de cinco sessões de treino de memória episódica, nas quais foram instruídos a categorizar listas de supermercado e figuras, e do pós-teste. Os resultados indicaram que o treino de memória episódica envolvendo a aprendizagem e a prática com a estratégia de categorização promoveu melhora significativa no desempenho em tarefa de memória episódica e um maior uso da estratégia treinada.Aging may lead to cognitive changes, especially in memory. Yet, research suggests that older adults may improve memory performance after training. The present study aimed at evaluating the effects of episodic memory training offered to healthy Brazilian older adults. Fifty seven participants were randomly divided into control group (COG = 26 and experimental group (EXG = 31. The EXG participants completed a pre-test, five sessions of episodic memory training in which they were instructed to categorize grocery lists and pictures, and a post-test. Results indicated that episodic memory training involving learning and practice with categorization promoted significant improvement in episodic memory performance and in better using the trained strategy.

  20. 急性脑卒中偏瘫患者的抑郁发病率及相关因素分析%Study on the Incidence of Depression and Related Factors of Acute Stroke Patients with Hemiplegia

    Institute of Scientific and Technical Information of China (English)

    邓强

    2014-01-01

    目的:观察急性脑卒中偏瘫患者抑郁的发生,分析影响急性脑卒中偏瘫患者发生抑郁的因素。方法选取2009-12-2012-12在我院住院治疗的急性脑卒中偏瘫患者194例为研究对象。统计194例患者抑郁的发生率,对抑郁和非抑郁患者进行神经功能缺损和日常生活能力评估,分析急性脑卒中偏瘫患者发生抑郁的影响因素。结果 SDS评分≥50分78例,SAS评分≥50分81例。单纯焦虑18例,单纯抑郁15例,焦虑伴抑郁63例。抑郁患者的日常生活能力评分和神经功能缺损评分与非抑郁患者相比差异具有统计学意义( P<0.05)。根据抑郁发生率影响因素的单因素分析显示,病变部位、病程以及NDS可能与抑郁发生有关。Logistic回归分析显示,病变部位、病程及NDS与抑郁发生具有相关性。结论病变部位、病程及NDS会影响急性脑卒中偏瘫患者发生抑郁,应该采取恰当的预防措施降低抑郁的发生率。%Objective To observe and analyze the Incidence of Depression and Related Factors of Patients with Hemiplegia caused by Acute Stroke.Methods 194 patients with hemiplegia admitted to our hospital from December 2009 to December 2012 were selected as the object of study. The incidence of depression in the 194 cases of patients was analyzed ,evaluation of neural function defect and activities of daily living in patients with depression and non-depression were conducted ,and the influencing factors of depression were analyzed.Results Patients with SDS score ≥ 50 points took up 78 cases ,those with SAS score ≥50 points were 81 cases. Patients with mere anxiety were 18 cases ,and 15 cases with depression ,63 cases with anxiety and de-pression. Scores of activities of daily living and neurologic impairment scores of patients with depression were significantly dif-ferent from those of non depressive patients ,and the difference was statistically significant (P<0.05). The

  1. Why Is Past Depression the Best Predictor of Future Depression? Stress Generation as a Mechanism of Depression Continuity in Girls

    Science.gov (United States)

    Rudolph, Karen D.; Flynn, Megan; Abaied, Jamie L.; Groot, Alison; Thompson, Renee

    2009-01-01

    This study examined whether a transactional interpersonal life stress model helps to explain the continuity in depression over time in girls. Youth (86 girls, 81 boys; M age = 12.41, SD = 1.19) and their caregivers participated in a three-wave longitudinal study. Depression and episodic life stress were assessed with semistructured interviews.…

  2. Is Valproate Depressogenic in Patients Remitting from Acute Mania? Case Series

    Directory of Open Access Journals (Sweden)

    Kamini Vasudev

    2015-01-01

    Full Text Available Valproate is an effective antimanic agent and is recommended as a first-line medication in the treatment of acute mania. Current evidence based guidelines recommend that valproate should be given as a loading dose as it produces a rapid antimanic and antipsychotic response with minimal side-effects. However, no clear guidelines are available on the appropriate dosing or serum levels of valproate in the continuation or maintenance phase of bipolar disorder. We present 4 clinical cases to hypothesize that the higher doses of valproate, such as those used in the treatment of acute mania, may cause a depressive switch. So consideration should be given to reducing the dose of valproate if a patient develops depressive symptoms following recovery from the manic episode, as a therapeutic strategy. The cases also indicate that relatively lower doses and serum levels of valproate are effective in the maintenance phase compared to those needed in the acute manic phase of bipolar disorder. This is the first set of case series that questions the depressogenic potential of valproate in patients remitting from an acute manic episode. It highlights that different doses and serum levels of valproate may be therapeutic in different phases of bipolar disorder.

  3. [Elderly depression and depressive state with Alzheimer's disease].

    Science.gov (United States)

    Hattori, Hideyuki

    2009-04-01

    Depression and dementia, particularly Alzheimer's disease, are frequently observed in the elderly, and their diagnosis and treatment require complex knowledge of gerontology and psychiatry. Gerontologically, these diseases should be considered as geriatric syndrome. For the differentiation between depression and that associated with Alzheimer's disease, radiological examinations such as single photon emission CT and psychological examinations using the Geriatric Depression Scale (GDS) and Vitality Index are useful. Against depressive state with Alzheimer's disease, in addition to donepezil hydrochloride, selective serotonin reuptake inhibitors (SSRI) and serotonin-noradrenaline reuptake inhibitors (SNRI) are effective, and a small dose of sulpiride is also expected to be effective. In the treatment of elderly depression, its stage should be classified as acute or chronic. Treatment in the acute stage is similar to that in other age groups. In the chronic stage, activation treatment focusing on the prevention of functional decreases is necessary. For both depression and dementia, care and support for daily life are indispensable.

  4. The use of a volatile anesthetic regimen protects against acute normovolemic hemodilution induced myocardial depression in patients with coronary artery disease

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    Lorsomradee Sratwadee

    2009-01-01

    Full Text Available Background: Previous studies indicated that acute normovolemic hemodilution (ANH was associated with a depression of myocardial function in coronary surgery patients with baseline heart rate faster than 90 bpm. It was suggested that this phenomenon could be explained by the occurrence of myocardial ischemia. In the present study, we hypothesized that the cardioprotective properties of a volatile anesthetic regimen might protect against the ANH related myocardial functional impairment. Materials and Methods: Forty elective coronary surgery patients with baseline heart rate faster than 90 bpm were randomly allocated to receive different anesthetic regimens. Group A (n = 20 received midazolam-based anesthesia. Group B (n = 20 received a sevoflurane-based anesthesia. Five-lead electrocardiogram, pulse oximetry, capnography, radial arterial pressure, and Swan Ganz continuous thermodilution cardiac output via right internal jugular vein were monitored. Measurements were obtained before and after ANH. Data were compared using paired t test. All data were expressed as mean ± SD. Data were considered significant if P < 0.05. Results: After ANH, systemic vascular resistance was slightly decreased in group A while there was a significant decrease in group B. In group A, cardiac output was slightly decreased from 5.07±1.17 l/min to 5.02±1.28 l/min after ANH, whereas in group B, cardiac output was significantly increased from 4.84±1.21 l/min to 6.02±1.28 l/min after ANH. Conclusion: In coronary surgery patients, with baseline heart rate faster than 90 bpm, anesthesia with sevoflurane during ANH was associated with an improvement in myocardial function after ANH, which was not present in patients anesthetized with midazolam.

  5. COMT Val158Met, but not BDNF Val66Met, is associated with white matter abnormalities of the temporal lobe in patients with first-episode, treatment-naïve major depressive disorder: a diffusion tensor imaging study

    Directory of Open Access Journals (Sweden)

    Hayashi K

    2014-06-01

    Full Text Available Kenji Hayashi,1 Reiji Yoshimura,1 Shingo Kakeda,2 Taro Kishi,3 Osamu Abe,4 Wakako Umene-Nakano,1 Asuka Katsuki,1 Hikaru Hori,1 Atsuko Ikenouchi-Sugita,1 Keita Watanabe,2 Satoru Ide,2 Issei Ueda,2 Junji Moriya,2 Nakao Iwata,3 Yukunori Korogi,2 Marek Kubicki,5 Jun Nakamura1 1Department of Psychiatry, 2Department of Radiology, University of Occupational and Environmental Health, Kitakyushu, Japan; 3Department of Psychiatry, Fujita Health University, Toyoake, Japan; 4Department of Radiology, Nihon University School of Medicine, Tokyo, Japan; 5Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA Abstract: We investigated the association between the Val158Met polymorphism of the catechol-O-methyltransferase (COMT gene, the Val66Met polymorphism of the brain-derived neurotrophic factor (BDNF gene, and white matter changes in patients with major depressive disorder (MDD and healthy subjects using diffusion tensor imaging (DTI. We studied 30 patients with MDD (17 males and 13 females, with mean age ± standard deviation [SD] =44±12 years and 30 sex- and age-matched healthy controls (17 males and 13 females, aged 44±13 years. Using DTI analysis with a tract-based spatial statistics (TBSS approach, we investigated the differences in fractional anisotropy, radial diffusivity, and axial diffusivity distribution among the three groups (patients with the COMT gene Val158Met, those with the BDNF gene Val66Met, and the healthy subjects. In a voxel-wise-based group comparison, we found significant decreases in fractional anisotropy and axial diffusivity within the temporal lobe white matter in the Met-carriers with MDD compared with the controls (P<0.05. No correlations in fractional anisotropy, axial diffusivity, or radial diffusivity were observed between the MDD patients and the controls, either among those with the BDNF Val/Val genotype or among the BDNF Met-carriers. These results suggest an association

  6. A diffusion tensor imaging study in middle-aged female patients with first-episode major depressive disorder%抑郁症首次发病中年女性患者的弥散张量成像研究

    Institute of Scientific and Technical Information of China (English)

    任俊杰; 边海曼; 李功迎; 姚孟元; 陈胜利; 纪盛章

    2014-01-01

    Objective To explore the microstructural abnormalities of white matter in middle-aged female patients with first-episode major depressive disorder by tract-based spatial statistics (TBSS).Methods Diffusion tensor imaging(DTI) was performed in 20 patients with major depressive disorder and 15 healthy controls matched for age,gender,and education.Fractional anisotropy (FA) values were compared between the patients and controls by TBSS.Results Compared with normal controls,FA values were significantly decreased in the white matter of the left prefrontal cortex,left internal capsule and the right precuneus (P < 0.005,cluster > 40).Conclusion The microstructural abnormalities of white matter integrity may occur early in the course of depression,the abnormal brain areas include the prefrontal-subcortical neural circuit and default mode network which are related to cognitive and emotional adjustment.%目的 运用基于纤维束示踪的空间统计学方法(tract-based spatial statistics,TBSS)探索首次发病抑郁症中年女性患者脑白质微观结构的损害.方法 对20例首次发病抑郁症中年女性患者(患者组)和15名与患者组性别、年龄、受教育程度相匹配的健康志愿者(对照组)进行全脑弥散张量成像扫描.应用TBSS方法对患者组和对照组的部分各向异性(fractional anisotropy,FA)值进行组间比较.结果 与对照组相比,患者组左侧前额叶、左侧内囊、右侧楔前叶白质的FA值显著降低(P <0.005,簇>40).结论 脑白质病变在抑郁症发病的早期即已存在,异常脑区涉及与认知和情感调节关系较密切的前额叶-子皮质神经环路和默认网络的纤维束.

  7. Attentional episodes in visual perception

    NARCIS (Netherlands)

    Wyble, Brad; Potter, Mary C.; Bowman, Howard; Nieuwenstein, Mark

    2011-01-01

    Is one's temporal perception of the world truly as seamless as it appears? This article presents a computationally motivated theory suggesting that visual attention samples information from temporal episodes (episodic simultaneous type/serial token model; Wyble, Bowman, & Nieuwenstein, 2009). Breaks

  8. Superficial Priming in Episodic Recognition

    Science.gov (United States)

    Dopkins, Stephen; Sargent, Jesse; Ngo, Catherine T.

    2010-01-01

    We explored the effect of superficial priming in episodic recognition and found it to be different from the effect of semantic priming in episodic recognition. Participants made recognition judgments to pairs of items, with each pair consisting of a prime item and a test item. Correct positive responses to the test item were impeded if the prime…

  9. Investigation and Nursing of Depression in Elderly Patients with Acute Coronary Syndrome%老年急性冠脉综合征患者抑郁状态调查及其护理

    Institute of Scientific and Technical Information of China (English)

    罗桃; 乐小英; 刘红珍; 蒙小晶; 饶及兰

    2014-01-01

    目的:对老年急性冠脉综合征患者抑郁状态及护理进行分析研究。方法:选取2013年3月-2014年3月笔者所在医院接诊的70例老年急性冠脉综合征患者,采用老年抑郁量表(GDS)进行抑郁状态调查,对患者予以护理干预,采用汉密顿抑郁量表(HAMD)评定护理干预的效果。结果:本组70例急性冠脉疾病患者中无抑郁患者16例(22.9%),轻度抑郁30例(42.9%),中、重度抑郁24例(34.3%),患者主要心理特征为恐惧、焦虑、悲观、孤独、自怜;护理干预后患者HAMD评分为(12.3±1.3)分,低于护理前(21.6±1.5)分,比较差异有统计学意义(P<0.05)。结论:老年急性冠脉综合征患者抑郁发生率较高,心理干预有助于改善老年急性冠脉综合征患者的抑郁状况,具有非常积极的临床应用价值。%Objective:To analyze the depression and nursing method of elderly patients with acute coronary syndrome. Method:Seventy elderly patients with acute coronary syndrome from March 2013 to March 2014 in our hospital were investigated with geriatric depression scale (GDS).All patients were treated with nursing intervention for depression,the effect were assessed with Hamilton depression scale(HAMD).Result:There were 16 patients with no depression(22.9%), 30 patients with mild depression(42.9%),24 patients with moderate and severe depression(34.3%),the main psychological characteristics of patients were fear, anxiety,pessimism,loneliness,self-pity. After nursing,the HAMD score(12.3±1.3) of patients was lower than (21.6±1.5)score before nuring,the difference was statistically significant(P<0.05). Conclusion:Elderly patients with acute coronary syndrome has a higher incidence of depression,nursing intervention can contribute to improve the depression of elderly patients with acute coronary syndrome,and has very positive value for clinical application.

  10. Implicit Stereotype before and after Cognitive Behavior Therapy in Fisrt-episode Young Patients with Mild-to-mod erate Major Depressive Disorder%首发轻中度青年抑郁症患者接受认知行为治疗前后的内隐刻板印象

    Institute of Scientific and Technical Information of China (English)

    柳艳松; 孙倩芸; 陈新宇

    2015-01-01

    目的:探讨首发轻中度青年抑郁症患者接受认知行为治疗前后内隐刻板印象的变化。方法:选取首次发病未经治疗的青年抑郁症患者21例和正常对照者20例,抑郁症患者接受8次的认知行为治疗,正常被试仅接受8周的观察,实验前后,所有被试均接受汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD-24)、自动思维问卷( The Automatic Thoughts Questionnaire ,ATQ)、内隐联想测验( Implicit association test IAT )评估与测验。结果:①实验组治疗后,在HAMD总分、ATQ总分、IAT测验效应值均有显著性改善,分别为(t=-6.81,-3.06,3.86;P<0.05);②治疗后与正常对照组相比,实验组在HAMD总分、ATQ总分、IAT测验效应值均存在显著性的差异,分别为( t=3.50,3.81,-3.11;P<0.05)。结论:认知行为治疗对首发轻中度抑郁症患者内隐刻板印象的改善具有一定的积极意义。%Objective:To explore the effectiveness of cognitive behavior therapy for implicit stereotype of patients with mild-to-moderate major depressive disorder ( MDD) .Methods:21 First-episode mild-to-moderate patients with MDD and 20 matched healthy volunteers were recruited .The MDD group re-ceived cognitive behavior therapy for 8 weeks;The health control ( HC) group did not receive any medica-tion.Before and the after of experiment ,all the subjects accepted the Hamilton Depression Scale ( HAMD-24),the Automatic Thoughts Questionnaire (ATQ),implicit association test (IAT),respectively.Re-sults:①After treatment,in the MDD group,the total scores of HAMD,ATQ,and the D_biep(D measure with built-in error penalty ) were enhanced significantly at the end of experiment than the start of experi-ment(t=-6.81,-3.06,3.86;P<0.05));②After treatment,compared with HC group,the MDD group was still higher in the total scores of HAMD,ATQ,D_biep(t=3.50,3.81,-3.11;P<0.05).Conclu

  11. Constitutive, but Not Challenge-Induced, Interleukin-10 Production Is Robust in Acute Pre-Pubescent Protein and Energy Deficits: New Support for the Tolerance Hypothesis of Malnutrition-Associated Immune Depression Based on Cytokine Production in vivo

    Directory of Open Access Journals (Sweden)

    Bill Woodward

    2011-01-01

    Full Text Available The tolerance model of acute (i.e., wasting pre-pubescent protein and energy deficits proposes that the immune depression characteristic of these pathologies reflects an intact anti-inflammatory form of immune competence that reduces the risk of autoimmune reactions to catabolically released self antigens. A cornerstone of this proposition is the finding that constitutive (first-tier interleukin(IL-10 production is sustained even into the advanced stages of acute malnutrition. The IL-10 response to inflammatory challenge constitutes a second tier of anti-inflammatory regulation and was the focus of this investigation. Weanling mice consumed a complete diet ad libitum, a low-protein diet ad libitum (mimicking incipient kwashiorkor, or the complete diet in restricted daily quantities (mimicking marasmus, and their second-tier IL-10 production was determined both in vitro and in vivo using lipopolysaccharide (LPS and anti-CD3 as stimulants of innate and adaptive defences, respectively. Both early (3 days and advanced (14 days stages of wasting pathology were examined and three main outcomes emerged. First, classic in vitro systems are unreliable for discerning cytokine production in vivo. Secondly, in diverse forms of acute malnutrition declining challenge-induced IL-10 production may provide an early sign that anti-inflammatory control over immune competence is failing. Thirdly, and most fundamentally, the investigation provides new support for the tolerance model of malnutrition-associated inflammatory immune depression.

  12. Advanced Circadian Phase in Mania and Delayed Circadian Phase in Mixed Mania and Depression Returned to Normal after Treatment of Bipolar Disorder

    Directory of Open Access Journals (Sweden)

    Joung-Ho Moon, M.S.

    2016-09-01

    Full Text Available Disturbances in circadian rhythms have been suggested as a possible cause of bipolar disorder (BD. Included in this study were 31 mood episodes of 26 BD patients, and 18 controls. Circadian rhythms of BD were evaluated at admission, at 2-week intervals during hospitalization, and at discharge. All participants wore wrist actigraphs during the studies. Saliva and buccal cells were obtained at 8:00, 11:00, 15:00, 19:00, and 23:00 for two consecutive days. Collected saliva and buccal cells were used for analysis of the cortisol and gene circadian rhythm, respectively. Circadian rhythms had different phases during acute mood episodes of BD compared to recovered states. In 23 acute manic episodes, circadian phases were ~7 hour advanced (equivalent to ~17 hour delayed. Phases of 21 out of these 23 cases returned to normal by ~7 hour delay along with treatment, but two out of 23 cases returned to normal by ~17 hour advance. In three cases of mixed manic episodes, the phases were ~6–7 hour delayed. For five cases of depressive episodes, circadian rhythms phases were ~4–5 hour delayed. After treatment, circadian phases resembled those of healthy controls. Circadian misalignment due to circadian rhythm phase shifts might be a pathophysiological mechanism of BD.

  13. Advanced Circadian Phase in Mania and Delayed Circadian Phase in Mixed Mania and Depression Returned to Normal after Treatment of Bipolar Disorder.

    Science.gov (United States)

    Moon, Joung-Ho; Cho, Chul-Hyun; Son, Gi Hoon; Geum, Dongho; Chung, Sooyoung; Kim, Hyun; Kang, Seung-Gul; Park, Young-Min; Yoon, Ho-Kyoung; Kim, Leen; Jee, Hee-Jung; An, Hyonggin; Kripke, Daniel F; Lee, Heon-Jeong

    2016-09-01

    Disturbances in circadian rhythms have been suggested as a possible cause of bipolar disorder (BD). Included in this study were 31 mood episodes of 26 BD patients, and 18 controls. Circadian rhythms of BD were evaluated at admission, at 2-week intervals during hospitalization, and at discharge. All participants wore wrist actigraphs during the studies. Saliva and buccal cells were obtained at 8:00, 11:00, 15:00, 19:00, and 23:00 for two consecutive days. Collected saliva and buccal cells were used for analysis of the cortisol and gene circadian rhythm, respectively. Circadian rhythms had different phases during acute mood episodes of BD compared to recovered states. In 23 acute manic episodes, circadian phases were ~7hour advanced (equivalent to ~17hour delayed). Phases of 21 out of these 23 cases returned to normal by ~7hour delay along with treatment, but two out of 23 cases returned to normal by ~17hour advance. In three cases of mixed manic episodes, the phases were ~6-7hour delayed. For five cases of depressive episodes, circadian rhythms phases were ~4-5hour delayed. After treatment, circadian phases resembled those of healthy controls. Circadian misalignment due to circadian rhythm phase shifts might be a pathophysiological mechanism of BD.

  14. Late postoperative nocturnal episodic hypoxaemia and associated sleep pattern

    DEFF Research Database (Denmark)

    Rosenberg, J; Wildschiødtz, G; Pedersen, M H;

    1994-01-01

    pattern is disturbed severely with early depression of REM and slow wave sleep and with rebound of REM sleep on the second and third nights. Postoperative rebound of REM sleep may contribute to the development of sleep disordered breathing and nocturnal episodic hypoxaemia....... significantly after surgery (P sleep decreased significantly on the first night after operation (P sleep (rebound) on the second, third or both nights after operation compared with the preoperative night. Slow wave sleep...... was depressed significantly on the first two nights after operation (P sleep-associated hypoxaemic episodes for individual patients increased about three-fold on the second and third nights after operation compared with the night before operation (P sleep...

  15. Genetik og stressende livsbegivenheder interagerer ved depression

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Bukh, Jens Otto Drachmann

    2013-01-01

    to a lesser extent are preceded by stressful life events. Clinical features do not differ between depressions with or without prior stressful life events. Certain genetic variations in the serotonin receptor system seem to increase the risk of developing depression in relation to experiencing stressful life......The aim of the present review was to present clinical aspects of recent research in genes, the experience of stressful life events and depression. 60-70% experience a moderate to severe stressful life event half a year prior to the first onset of depression, whereas later depressive episodes...

  16. Communication Counseling as Part of a Treatment Plan for Depression

    Science.gov (United States)

    Puterbaugh, Dolores T.

    2006-01-01

    It has been estimated that 1 in 4 persons will experience a depressive episode over his or her lifetime (G. Gintner, 2001). The author discusses various etiologies of depression, interpersonal factors related to depression, and research on various communication-focused counseling interventions. The author maintains that published literature…

  17. Pharmacological Management of Treatment-Resistant Pediatric Depression

    Science.gov (United States)

    Kratochvil, Christopher J.; Wagner, Karen Dineen; Emslie, Graham; March, John

    2005-01-01

    A 13-year-old boy presents with treatment-resistant symptoms of major depression. This is his first episode of depression, initially treated with 200 mg sertraline for 12 weeks with no significant benefit. The severe depression has shown a partial response to weekly cognitive-behavioral therapy (CBT) and fluoxetine, which was titrated up to 60 mg…

  18. Correlation between patient and clinician assessments of depression severity in the PREVENT study☆

    Science.gov (United States)

    Dunlop, Boadie W.; Li, Thomas; Kornstein, Susan G.; Friedman, Edward S.; Rothschild, Anthony J.; Pedersen, Ron; Ninan, Philip; Keller, Martin

    2013-01-01

    Background The degree of agreement between patient- and clinician-rated scales of depressive severity varies widely. This study analyzed agreement between commonly used depression rating scales in the Prevention of Recurrent Episodes of Depression with Venlafaxine Extended Release (ER) for Two Years (PREVENT) trial. Methods The PREVENT trial was a multiphase, randomized, double-blind study of patients with recurrent major depressive disorder. This secondary analysis evaluated acute (10 weeks) and continuation phase (6 months) data. Pearson correlation coefficients at each acute-phase (weekly) and continuation-phase (monthly) visit were calculated for patient-rated (30-item Inventory of Depressive Symptomatology-Self-Rated [IDS-SR30] and clinician-rated (17-item Hamilton Rating Scale for Depression [HAM-D17] and Clinical Global Impressions-Severity [CGI-S]) measures and for response and remission. Results Data from 1,047 patients were analyzed. The respective correlation coefficients at baseline, week 10, and month 6 were: IDS-SR30: HAM-D17: 0.46, 0.75, 0.70; and for IDS-SR30: CGI-S 0.28, 0.67, 0.65. Agreement between IDS-SR30- and HAM-D17-defined remission and response was relatively poor: week 10, 0.52 and 0.34, respectively; month 6, 0.45 and 0.32, respectively. Conclusions These findings suggest that patient-rated measures of depression severity do not correspond strongly with clinician ratings, and are particularly poor prior to the initiation of treatment. PMID:20304503

  19. 双极性指标对抑郁发作患者中双相障碍的识别效能:中国桥筛查研究%Recognition validity of bipolarity specifier for bipolar disorders among patients with major depressive episode: BRIDGE-China

    Institute of Scientific and Technical Information of China (English)

    马燕桃; 于欣; 魏镜; 郑毅; 张晋碚; 梅其一; 张心保; 刘铁榜; 苗国栋

    2013-01-01

    目的 验证双极性指标对重性抑郁发作(major depressive episode,MDE)患者中双相障碍(bipolar disorder,BD)和双相Ⅱ型障碍(bipolar disorder typeⅡ,BDⅡ)的识别效能.方法 采用多中心、横断面诊断性研究,2008年3月至9月在20家精神专科医院连续性收录727例MDE患者,采用双极性指标、《美国精神障碍诊断与统计手册(第4版)》修改版(DSM-Ⅳ-TR)标准和临床诊断进行BD或BDⅡ筛查,比较二者筛检率,采用多因素回归分析分析BD相关危险因素.结果 双极性指标、DSM-Ⅳ-TR标准和临床诊断对MDE患者中BD检出率分别为39.9%(290/727)、14.4%(105/727)和31.9% (232/727),对BDⅡ检出率分别为30.8%(192/623)、9.5%(59/623)和20.5%(128/623).与DSM-Ⅳ-TR标准相比,双极性指标筛检BD具备较高的灵敏度和特异度(100.0%和70.3%);与临床诊断相比,双极性指标筛检BDⅡ具备良好的灵敏度和特异度(85.9%和83.4%),较低的误诊率和漏诊率.双极性指标筛查BD阳性者共病边缘型人格障碍或焦虑障碍比例高于筛查阴性者.多因素回归分析显示,双极性指标识别BD的临床标记中,既往抗抑郁疗效转(轻)躁狂(OR=4.66)和抗抑郁治疗中出现情感发作(OR=3.68)为BD的高危因素;双极性指标和DSM-Ⅳ-TR标准识别BD的相同临床标记中,一级亲属存在躁狂或轻躁狂史(OR =3.58)、病程完全缓解(OR=2.54)和以往抗抑郁治疗出现易激惹(OR =2.40)为BD高危因素(均P<0.01).结论 初步证实双极性指标在MDE患者中筛检BD或BDⅡ型的识别效能良好,对BD亚类区分具有一定临床意义.%Objective To validate the recognition efficacy of bipolar disorders (BD) and BD type Ⅱ (BD Ⅱ) under bipolarity specifier among patients with major depressive episode(MDE).Methods This is a multi-site,cross-sectional diagnostic study.727 consecutive subjects with major depressive episode (MDE) were screened for BD and BD Ⅱ under the bipolarity

  20. 认知行为治疗对首次发病轻中度抑郁症患者膝下前扣带回功能连接的影响%The effect of cognitive behavior therapy on functional connectivity of subgenual anterior cingulated cortex in first-episode treatment-na(i)ve mild to moderate patients with major depressive disorder

    Institute of Scientific and Technical Information of China (English)

    滕昌军; 王纯; 张宁; 马辉; 谭雅容; 肖朝勇; 高帅; 李鸿磊; 张文瑄

    2016-01-01

    目的 通过静息态功能连接探讨认知行为治疗(cognitive behavior therapy,CBT)早期对首次发病轻中度抑郁症患者膝下前扣带回(subgenual anterior cingulated cortex,sgACC)功能连接的影响,初步探讨CBT对抑郁症患者的神经作用机制.方法 对18例首次发病未服药轻中度抑郁症患者(抑郁症组)及相匹配的20名健康对照者(对照组)进行静息态功能磁共振扫描.抑郁症组接受6周CBT后进行第2次扫描.采用DPARSF和REST软件以sgACC为种子点进行基于感兴趣区的全脑功能连接分析并比较差异.结果 治疗前,抑郁症组sgACC与左侧额上回(t=-5.50)、左侧额中回(t=-3.78)、左侧角回(t=-3.38)功能连接低于对照组(均P<0.05).治疗后,抑郁症组sgACC与右侧额下回(蒙特利尔神经科学研究所坐标:x=42,y=33,z=6;t=3.61)、右侧小脑(蒙特利尔神经科学研究所坐标:x=36,y=-42,z=-48;t=4.08)功能连接较对照组增高(均P<0.05),与右侧额上回(t=-4.02)、左侧额上回(t=-3.67)、左侧内侧额上回(t=-4.38)、右侧楔前叶(t=-4.59)、左侧角回(t=-4.71)功能连接低于对照组(均P<0.05).治疗后,抑郁症组sgACC与左侧额下回(t=6.22)、右侧额下回(t=4.66)、左侧颞中回(t=4.76)、右侧颞中回(t=4.43)、左侧颞下回(t=5.33)、右侧缘上回(t=5.51)、左侧中央前回(t=4.68)和右侧小脑(t=3.88)功能连接较治疗前增加(均P<0.05).结论 CBT早期可能通过直接调节sgACC与额下回、默认网络内节点的功能连接而改善抑郁症患者反应抑制功能、降低自我参照性加工和反刍.%Objective To explore the neurobiological mechanism of cognitive behavior therapy(CBT) by detecting alterations of resting state functional connectivitiy of subgenual anterior cingulate cortex (sgACC) of CBT for first episode patients with mild to moderate depression.Methods Resting state fMRI data were collected from 18 first-episode treatment na(i)ve patients who suffered from major

  1. Detailed course of depressive symptoms and risk for developing depression in late adolescents with subthreshold depression: a cohort study

    Science.gov (United States)

    Jinnin, Ran; Okamoto, Yasumasa; Takagaki, Koki; Nishiyama, Yoshiko; Yamamura, Takanao; Okamoto, Yuri; Miyake, Yoshie; Takebayashi, Yoshitake; Tanaka, Keisuke; Sugiura, Yoshinori; Shimoda, Haruki; Kawakami, Norito; Furukawa, Toshi A; Yamawaki, Shigeto

    2017-01-01

    Purpose Despite its clinical importance, adolescent subthreshold depression remains a largely neglected topic. The aims of this study were to accurately identify the natural course of depressive symptoms and the risk for developing major depressive episode (MDE) in late adolescents with subthreshold depression over 1 year. Patients and methods One hundred and seventy-two participants <20 years of age (mean age: 18.32 years, standard deviation: 0.50), who did not meet the full criteria for an MDE, were selected from 2,494 screened freshmen based on the Beck Depression Inventory, 2nd edition (BDI-II). We conducted a cohort study of three groups (low-, middle-, and high-symptom groups) divided based on BDI-II scores, over a 1 year period with the use of bimonthly assessments. Temporal changes of depressive symptoms were analyzed using linear mixed modeling and growth mixture modeling. Results First, we found that late adolescents with subthreshold depression (high depressive symptoms) were split between the increasing and decreasing depressive symptoms groups, whereas the majority of the less-symptoms group remained stable during 1 year. Second, in comparison with late adolescents with less depressive symptoms, those with subthreshold depression had an elevated risk of later depression. Conclusion Some late adolescents with subthreshold depression had increased depressive symptoms and developed an MDE during 1 year. Therefore, it is necessary for us to rigorously assess the changes in subthreshold depressive symptoms over time in late adolescents. PMID:28053534

  2. A clinical study comparing manic and mixed episodes in patients with bipolar disorder Estudo clínico comparativo entre episódios de mania e mistos em pacientes com transtorno bipolar

    Directory of Open Access Journals (Sweden)

    Ângela Maria Schwartzmann

    2007-06-01

    Full Text Available OBJECTIVE: Mixed episodes have been described as more severe than manic episodes, especially due to their longer duration and their association with higher rates of suicide attempts, hospitalization and psychotic symptoms. The purpose of this study was to compare the severity between mixed and pure manic episodes according to DSM-IV criteria, through the evaluation of sociodemographic data and clinical characteristics. METHOD: Twenty-nine bipolar I patients presenting acute mixed episodes were compared to 20 bipolar I patients with acute manic episodes according to DSM-IV criteria. We analyzed (cross-sectionally episode length, presence of psychotic symptoms, frequency of suicide attempts and hospitalization, Young Mania Rating Scale scores, Hamilton Depression Rating Scale scores and the Clinical Global Assessment Scale scores. RESULTS: Young Mania Rating Scale scores were higher in manic episodes than in mixed episodes. There were no differences in gender frequency, CGI scores and rates of hospitalization, suicide attempts and psychotic symptoms, when mixed and manic episodes where compared. Patients with mixed episodes were younger. CONCLUSION: In our sample, mixed states occurred at an earlier age than manic episodes. Contrary to previous reports, we did not find significant differences between manic and mixed episodes regarding severity of symptomatology, except for manic symptoms ratings, which were higher in acute manic patients. In part, this may be explained by the different criteria adopted on previous studies.OBJETIVO: Estados mistos têm sido descritos como mais graves que episódios de mania, especialmente pela maior duração dos episódios, maiores taxas de suicídio, hospitalização e sintomas psicóticos. O objetivo deste estudo foi comparar a severidade entre episódios mistos e mania pura definidos segundo critérios do DSM-IV, avaliando-se características clínicas e sociodemográficas dos pacientes. MÉTODO: Vinte e nove

  3. Delayed mood transitions in major depressive disorder.

    Science.gov (United States)

    Korf, Jakob

    2014-05-01

    The hypothesis defended here is that the process of mood-normalizing transitions fails in a significant proportion of patients suffering from major depressive disorder. Such a failure is largely unrelated to the psychological content. Evidence for the hypothesis is provided by the highly variable and unpredictable time-courses of the depressive episodes. The main supporting observations are: (1) mood transitions within minutes or days have been reported during deep brain stimulation, naps after sleep deprivation and bipolar mood disorders; (2) sleep deprivation, electroconvulsive treatment and experimental drugs (e.g., ketamine) may facilitate mood transitions in major depressive disorder within hours or a few days; (3) epidemiological and clinical studies show that the time-to-recovery from major depressive disorder can be described with decay models implying very short depressive episodes; (4) lack of relationship between the length of depression and recovery episodes in recurrent depression; (5) mood fluctuations predict later therapeutic success in major depressive disorder. We discuss some recent models aimed to describe random mood transitions. The observations together suggest that the mood transitions have a wide variety of apparently unrelated causes. We suggest that the mechanism of mood transition is compromised in major depressive disorder, which has to be recognized in diagnostic systems.

  4. Somatic/affective symptoms, but not cognitive/affective symptoms, of depression after acute coronary syndrome are associated with 12-month all-cause mortality

    NARCIS (Netherlands)

    Roest, Annelieke M.; Thombs, Brett D.; Grace, Sherry L.; Stewart, Donna E.; Abbey, Susan E.; de Jonge, Peter

    2011-01-01

    Background: Symptom dimensions of post myocardial infarction (MI) depression may be differently related to prognosis. Somatic/affective symptoms appear to be associated with a worse cardiac outcome than cognitive/affective symptoms. We examined the relationship between depressive symptom dimensions

  5. Caregiver Depression

    Science.gov (United States)

    ... will not sell or share your name. Caregiver Depression Tweet Bookmark this page | Email | Print Many caregivers ... depression See your doctor Treatment Coping Symptoms of depression Caregiving is hard — and can lead to feelings ...

  6. Postpartum Depression

    Science.gov (United States)

    ... starts about 1–3 weeks after childbirth. What causes postpartum depression? Postpartum depression probably is caused by a combination ... better. Can antidepressants cause side effects? Antidepressants can ... If your depression worsens soon after starting medication or if you ...

  7. Early-life stress and HPA axis trigger recurrent adulthood depression.

    Science.gov (United States)

    Juruena, Mario F

    2014-09-01

    It is now broadly accepted that psychological stress may change the internal homeostatic state of an individual. During acute stress, adaptive physiological responses occur, which include hyperactivity of the HPA axis. Whenever there is an acute interruption of this balance, illness may result. The social and physical environments have an enormous impact on our physiology and behavior, and they influence the process of adaptation or 'allostasis'. It is correct to state that at the same time that our experiences change our brain and thoughts, namely, changing our mind, we are changing our neurobiology. Increased adrenocortical secretion of hormones, primarily cortisol in major depression, is one of the most consistent findings in neuropsychiatry. A significant percentage of patients with major depression have been shown to exhibit increased concentrations of cortisol, an exaggerated cortisol response to adrenocorticotropic hormone, and an enlargement of both the pituitary and adrenal glands. The maintenance of the internal homeostatic state of an individual is proposed to be based on the ability of circulating glucocorticoids to exert negative feedback on the secretion of hypothalamic-pituitary-adrenal (HPA) hormones through binding to mineralocorticoid (MR) and glucocorticoid (GR) receptors limiting the vulnerability to diseases related to psychological stress in genetically predisposed individuals. The HPA axis response to stress can be thought of as a mirror of the organism's response to stress: acute responses are generally adaptive, but excessive or prolonged responses can lead to deleterious effects. Evidence indicates that early-life stress can induce persistent changes in the ability of the HPA axis to respond to stress in adulthood. These abnormalities appear to be related to changes in the ability of hormones to bind to GR and MR receptors. First episodes may begin with an environmental stressor, but if the cycles continue or occur unchecked, the brain

  8. 总胆固醇水平对首发青年抑郁症患者认知功能的影响研究%Effects of total cholesterol level on the cognitive function in first-episode depression in young patients

    Institute of Scientific and Technical Information of China (English)

    周珊珊; 李宁; 刘维娟; 何津春; 张永霞

    2013-01-01

    Objective To study the effect of cholesterol levels within the normal range of serum cholesterol on cognitive function in patients with first-episode depression in youth.Methods 128 depression patients were divided into the study group and control group.The cognitive function were measured by WAIS-RC,Wechsler Memory Scale and Wisconsin Card Sorting Test (WCST).Resuits There were significant differences in some neuropsychological tests between experimental and control groups (P<0.05),such as digit span (9.74 ± 2.40,10.74 ± 2.91),pictures fill in the blank (5.54 ± 1.65,6.30 ± 1.91),visual recognition (8.07 ±2.35,8.98±2.76),and long term memory(35.28±6.87,51.32±13.41).For understanding(6.41±2.57,8.28±2.23)and persistent number of errors(69.02-11.42,54.11±12.92),there was significant difference between the two groups (P<0.01).Conclusion The cognitive level of the group of low serum total cholesterol is poor than that of the group of high serum total cholesterol.Low cholesterol level plays a certain role in depression suicide.Low level of cognition is important to assess depression suicide risk.%目的 探究正常血清总胆固醇(TC)范围内总胆固醇水平对首发青年抑郁症患者认知功能的影响.方法 将128例抑郁症患者分为研究组(3.1<TC<4.3 mmol/L)和对照组(4.3≤TC<5.5 mmol/L),然后对两组进行认知功能的对照性评估,用韦氏成人智能量表、韦氏记忆量表、威斯康星卡片分类测验评估其认知功能.结果 研究组的数字广度、图画填空、再认、长时记忆[分别为(9.74±2.40)分、(5.54±1.65)分、(8.07±2.35)分、(35.28±6.87)分]与对照组[分别为(10.74±2.91)分、(6.30±1.91)分、(8.98±2.76)分、(51.32±13.41)分],差异有统计学意义(P<0.05);研究组的理解和持续错误数[分别为(6.41±2.57)分,(69.02±11.42)分]与对照组[分别为(8.28±2.23)分、(54.11±12.92)分]差异有极显著性(P<0.01).结论 血清总胆固醇偏低组的认

  9. Episodic tremor triggers small earthquakes

    Science.gov (United States)

    Balcerak, Ernie

    2011-08-01

    It has been suggested that episodic tremor and slip (ETS), the weak shaking not associated with measurable earthquakes, could trigger nearby earthquakes. However, this had not been confirmed until recently. Vidale et al. monitored seismicity in the 4-month period around a 16-day episode of episodic tremor and slip in March 2010 in the Cascadia region. They observed five small earthquakes within the subducting slab during the ETS episode. They found that the timing and locations of earthquakes near the tremor suggest that the tremor and earthquakes are related. Furthermore, they observed that the rate of earthquakes across the area was several times higher within 2 days of tremor activity than at other times, adding to evidence of a connection between tremor and earthquakes. (Geochemistry, Geophysics, Geosystems, doi:10.1029/2011GC003559, 2011)

  10. Guidance for Contributors to Episodes

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Episodes is distributed to awide range of scientists in over 150 countries. It aims to keep readers informed, of new and current developments in earth science and is a vital communications link in the global geological community.

  11. 中国慢性病前瞻性研究:中国30~79岁成年人抑郁发作的地区及人群分布特征%Epidemiology of major depressive episodes among Chinese adults aged 30-79 years: data from the China Kadoorie Biobank

    Institute of Scientific and Technical Information of China (English)

    余灿清; 吕筠; 陈怡平; 郭彧; Paul Sherliker; 卞铮; 周汇燕; 谭云龙; 陈君石

    2015-01-01

    目的 描述我国30 ~ 79岁成年人群过去1年内抑郁发作(MDE)的地区及人群分布特征,了解MDE患者的主要临床表现及治疗现状.方法 利用中国慢性病前瞻性研究2004-2008年在基线问卷中收集的人口社会学特征和通过WHO短版复合性国际诊断访谈表(CIDI-SF)诊断1年内MDE情况.采用x2检验和非参数方法比较不同人群MDE表现和治疗情况的差异,采用多元logistic回归模型分析不同人口社会学特征与MDE的关联.结果 共有3281人(6.40‰)在过去1年内有MDE.性别、婚姻状况、职业和家庭收入等与MDE有关.在3 281名MDE患者中,躯体化症状明显,以体重改变、睡眠紊乱和精力丧失为主(分别为99.91%、83.60%和81.59%).女性患者各症状出现的比例和数目均高于男性(P<0.05).发作后仍有约1/3的患者没有寻求过社会支持和心理治疗,抗精神病药物的使用率仅为8.99%.结论 我国30 ~ 79岁成年MDE在不同特征人群中存在显著性差异,65.19%的患者寻求社会心理治疗或药物治疗.%Objective To examine the socio-demographic patterns on 12-month major depressive episodes (MDE) among Chinese adults aged 30-79 years.Methods Socio-demographic variables from half a million Chinese people aged 30-79 years in the China Kadoorie Biobank study during 2004-2008,were collected.For those showing signs of depression,an additional World Health Organization Composite International Diagnostic Interview-Short Form (CIDI-SF) was face to face administrated,to assess the MDE according to Diagnostic and Statistical Manual of Mental Disorder (DSM)-Ⅳ criteria.Chi squared and non-parametric tests were used to compare the differences between socio-demographic categories,depressive symptoms and help-seeking behaviors.Associations with MDE for soeio-demographic variables were examined by logistic models.Results A total of 3 281 (6.40‰) studied subjects showed an MDE in the preceding 12 months

  12. 脑源性神经营养因子基因甲基化与首发抑郁症患者发病及自杀观念的相关性%Associations of BDNF promoter methylation with the morbidity and suicidal ideation in patients with first-episode major depressive disorder

    Institute of Scientific and Technical Information of China (English)

    王蕾; 王江涛; 徐建勋; 党海红; 谭立文

    2015-01-01

    Objective To explore the role of brain derived neurotrophic factor(BDNF) promoter methylation for the morbidity of depression patients,and to investigate the relevance between BDNF promoter methylation and the suicidal ideation in patients with first-episode major depressive disorder.Methods The peripheral blood samples from 23 cases of depression patients with suicide ideation ,24 cases of depression patients without suicide ideation,and 27 healthy controls were grouped using simple randomization method, and the methylation status of CpG island of BDNF promoter were subsequently evaluated using bisulphite sequencing.Results The methylation rates(median,quartile interval) of depression patients with suicidal ideation, depression patients without suicidal attempt, and the healthy control were detected as follows, CPG-1 : 2.60 (0.28), 2.70 (0.60), 6.40 (1.00);CPG-2:3.35 (1.15),3.20 (1.00),14.50 (2.60);CPG-3:1.50 (0.40),1.50 (0.60),4.60 (0.90);CPG-4:1.75 (0.90) ,1.50 (0.50),3.90 (0.90);CPG-5:0.80 (0.58),0.90 (1.00),5.70 (2.10);CPG-6:6.05 (1.03),6.20 (1.70), 14.50 (1.70);CPG-7:10.55 (1.68), 10.10 (1.50), 14.70 (1.70);CPG-8:16.35 (0.90), 16.40 (1.00),4.80 (1.20);CPG-9:4.20 (4.80),4.70 (1.30),28.50 (19.30);CPG-10:10.25 (1.08),10.30 (1.20) ,4.30 (0.90);CPG-11:62.80 (4.05) ,62.30 (4.00) ,37.20 (2.60);CPG-12:5.60 (1.05) ,5.60 (1.30) ,12.30 (1.80);CPG-13:4.15 (1.10) ,4.10 (1.10) ,59.70 (4.90);CPG-14:5.45 (0.78) ,5.70 (0.90),6.30 (0.60);CPG-15:3.70 (0.70) ,3.90 (1.00) ,62.40 (6.50);CPG-16:8.05 (1.75) ,8.10 (1.60) ,74.30 (50.90);CPG-17:3.20 (0.78),3.20 (0.80),32.40 (13.20);CPG-18:1.90 (0.48),1.80 (0.40),2.30 (0.30);CPG-19 : 35.00 (6.27), 35.20 (3.00), 64.20 (44.70).There was an obvious difference in methylation rate among three groups,which was statistically significant (P<0.01).However, no statistical significance for the methylation rates was observed between the depression patients with suicidal ideation and without suicidal ideation.Interestingly, statistical

  13. Regional homogeneity in first-episode patients with mild-to-moderate depressive disorder before and after cognitive-behavior therapy:a resting-state fMRI study%首发轻中度抑郁症患者认知行为治疗前后大脑局部变化的功能磁共振研究

    Institute of Scientific and Technical Information of China (English)

    谭雅容; 王阳; 张宁; 王纯; 肖朝勇; 曹瑞想; 高帅; 杨娟; 李鸿磊

    2014-01-01

    Objective To explore the effect of cognitive-behavior therapy(CBT) for the first-episode patients with mild to moderate depression using functional magnetic resonance imaging (fMRI) in resting-state.Methods 13 first-episode treatment-naive patients who suffered from major depressive disorder (MDD) from a mild to moderate degree and 13 matched healthy control subjects underwent fMRI scan.Afterwards,patients were scanned again after the 6-week CBT.The whole brain ReHo maps of subjects were calculated by DPARSF software.Two-sample t-test for comparison between groups and paired t-test for comparisons between pre-and post-treatment were conducted by SPM8.Results Compared with the controls,at baseline,patients exhibited decreased ReHo in right supramarginal gyrus(t=-3.18,P<0.05) and right opercular part of inferior frontal gyrus(t=-2.99,P<0.05) which tended to normalize after treatment.After treatment,patients exhibited increased ReHo in left middle frontal gyrus(t=3.24,P<0.05) and right middle frontal gyrus(t=3.06,P<0.05).From pre-to post-treatment,patients showed that ReHo increased in hippocampus(t=-3.92,P<0.05).Conclusion CBT may have an effect on MDD via activating both right inferior frontal gyrus and dorsolateral prefrontal cortex in cognitive inhibition system.%目的 探讨认知行为治疗对首发未服药轻中度抑郁症患者脑功能的作用.方法 对13例首发未服药轻中度抑郁症患者及13例正常对照组进行静息态功能磁共振扫描,患者在6周的认知行为治疗后再次接受功能磁共振扫描.运用Dparsf软件计算被试全脑的局部一致性(Regional homogeneity,ReHo)值,采用SPM8软件进行两独立样本t检验以及配对t检验,以分别检测两组间以及抑郁组治疗前后的脑功能差异.结果 与正常对照组比较,患者治疗前右缘上回(t=-3.18,P<0.05)和右额下回岛盖部(t=-2.99,P<0.05)的ReHo值降低,且在治疗后趋于正常.患者治疗后左额中回眶面(t=3.24,P

  14. 黄芪注射液联合超声雾化吸入治疗小儿支气管炎急性发作的临床效果和安全性%Clinical Efficacy and Safety of Astragalus Injection Combined with Ultrasonic Aerosol Inhalation in the Treatment of Children with Acute Episode of Bronchitis

    Institute of Scientific and Technical Information of China (English)

    程鲲

    2016-01-01

    Objective:To investigate the clinical efficacy and safety of Astragalus Injection combined with ultrasonic aerosol inhalation in the treatment of children with acute episode of bronchitis.Method:In our hospital,100 children with bronchitis acute attack were selected,50 cases were treated by ultrasonic atomizing inhalation therapy(the control group),50 cases were treated by Huangqi Injection combined with ultrasonic atomizing inhalation therapy(the observation group),the clinical efficacy and safety in two groups were compared.Result:The total effective rate of the observation group was significantly higher than that of the control group,the difference was statistically significant(P0.05).Conclusion:The therapeutic effect of Astragalus Injection combined with ultrasonic atomizing inhalation in the treatment of children with acute episode of bronchitis is better,which can be used as a preferred choice.%目的:探讨黄芪注射液联合超声雾化吸入治疗小儿支气管炎急性发作的临床效果和安全性。方法:选择在笔者所在医院就诊的支气管炎急性发作患儿100例,其中50例行超声雾化吸入治疗(对照组),50例行黄芪注射液联合超声雾化吸入治疗(观察组),比较两组的临床疗效和安全性。结果:观察组总有效率明显高于对照组,组间比较差异有统计学意义(P0.05)。结论:黄芪注射液联合超声雾化吸入治疗小儿支气管炎急性发作效果佳,可作为优先选择方式。

  15. Course of insight in manic episode

    Directory of Open Access Journals (Sweden)

    A Kumar

    2013-01-01

    Full Text Available Background: Insight is an important factor associated with non compliance and poor outcome. Poor level of insight has been described as a characteristic in patients with acute bipolar disorder with more unawareness in social consequences with increasing severity in manic episode. Aim: Main aim of study was to see the baseline and longitudinal relationship between dimensions of insight with improvement in psychopathology. Setting and Design: Forty four patients diagnosed with mania, were selected from an inpatient setting at Institute of Mental Health and Hospital, Agra with mean age of 31.07(±9.00 years. They were assessed at base line and were followed up weekly or psychopathology and insight. Materials and Methods: The Young′s mania rating scale for psychopathology and insight was assessed on three dimensions of SUMD. Results: Twenty five patients eventually completed the study. There was a positive correlation with global insight and with psychopathology consistent in longitudinal follow-up (P<0.05, but not correlating for awareness for achieved effect of medication and social consequences. Linear regression showed a positive relationship at the first and second week of assessment of SUMD and YMRS scores (P=0.001; 0.019. Conclusion: Improvement in insight is graded in a manic episode as compared to psychopathology. There is slower improvement in awareness of social consequences of mental disorder. It means that improvement in psychopathology may not necessarily indicate remission and need further supervision to improve insight and hence monitoring.

  16. Influencing factors of anxiety and Depression in patients with acute myocardial infarction%急性心肌梗死患者焦虑抑郁状态分析

    Institute of Scientific and Technical Information of China (English)

    陈立颖; 刘文娴; 吴勤; 魏金玲; 杨鲲

    2013-01-01

    目的:探讨急性心肌梗死(acute myocardial infarction,AMI)患者焦虑抑郁状态及相关影响因素.方法:连续入选2011年1月至2012年1月我院心内科住院的AMI患者214例,采用综合医院焦虑抑郁评分量表对所有患者行心理测评,评价焦虑抑郁状态的发生率,对年龄、性别、医保类型及合并疾病等影响因素进行分析.结果:214例患者中,焦虑73例,占34.1%;抑郁患者63例,占29.4%;焦虑抑郁共50例,占23.4%.女性患者、报销比例≤40%者焦虑发生率更高,差异具有统计学意义(P<0.05);女性、报销比例≤40%者、合并糖尿病者抑郁发生率更高,差异具有统计学意义(P<0.05).Logistic回归分析发现,女性是发生焦虑抑郁的影响因素;抑郁的影响因素还包括报销比例≤40%和合并糖尿病史.结论:AMI并发焦虑抑郁状态,为多种影响因素共同作用结果.对于此类患者,应引起临床医师重视,尽早给予心理干预,改善预后.%Objective: To investigate prevalences and influential factors of anxiety and depression in patients with acute myocardial infarction (AMI). Methods; We collected 214 patients with AMI that admitted in our hospital from January of 2011 to January of 2012. All the subjects were assessed with Hospital Anxiety and Depression Scale. To evaluate the incidences of anxiety and depression influencing factors such as age,gender, type of health insurance,other diseases etc. Results; Of all the subjects,about 34. 1% were identifed as anxiety ,29. 4% as depression. The rate of the comorbidity of anxiety and depression was 23. 4%. Patients of AMI with anxiety symptom were more seen in femal and medical reimbursement ≤40%. Patients of AMI with depressive symptom were more seen in femal 、medical reimbursement ≤40% and with history of Diabetes. Multivariate logistic regression analysis showed female was the major influences of anxiety and depression. Medical reimbursement ≤40% ; with

  17. Depression in patients with refractory temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Eleonora Borges Gonçalves

    2011-10-01

    Full Text Available OBJECTIVE: To evaluate the comorbidity of depressive disorders in patients with refractory temporal lobe epilepsy (TLE. METHOD: We evaluated 25 consecutive patients with refractory TLE (16 women and 9 men, using semi-structured psychiatric interviews, according to the International Classification of Diseases (ICD-10, and the Beck Depression Inventory. RESULTS: Seventeen of 25 patients (68% had depressive disorder: 6 with dysthymia, three with major depressive episodes and 8 with recurrent depressive disorders. Two (8% were diagnosed with mixed anxiety and depression. Only 5 of 17 patients (29.4% were previously diagnosed with depressive disorder and received prior antidepressant treatment. Duration of epilepsy was significantly higher in patients with depressive disorder (p=0.016, but there was no relationship between depression and seizure frequency. CONCLUSION: This study confirmed that depressive disorders are common and underdiagnosed in patients with TLE refractory to AEDs. Patients with longer duration of epilepsy are at higher risk of having depression.

  18. Factitious psychogenic nonepileptic paroxysmal episodes

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    Alissa Romano

    2014-01-01

    Full Text Available Mistaking psychogenic nonepileptic paroxysmal episodes (PNEPEs for epileptic seizures (ES is potentially dangerous, and certain features should alert physicians to a possible PNEPE diagnosis. Psychogenic nonepileptic paroxysmal episodes due to factitious seizures carry particularly high risks of morbidity or mortality from nonindicated emergency treatment and, often, high costs in wasted medical treatment expenditures. We report a case of a 28-year-old man with PNEPEs that were misdiagnosed as ES. The patient had been on four antiseizure medications (ASMs with therapeutic serum levels and had had multiple intubations in the past for uncontrolled episodes. He had no episodes for two days of continuous video-EEG monitoring. He then disconnected his EEG cables and had an episode of generalized stiffening and cyanosis, followed by jerking and profuse bleeding from the mouth. The manifestations were unusually similar to those of ES, except that he was clearly startled by spraying water on his face, while he was stiff in all extremities and unresponsive. There were indications that he had sucked blood from his central venous catheter to expel through his mouth during his PNEPEs while consciously holding his breath. Normal video-EEG monitoring; the patient's volitional and deceptive acts to fabricate the appearance of illness, despite pain and personal endangerment; and the absence of reward other than remaining in a sick role were all consistent with a diagnosis of factitious disorder.

  19. The cognitive functioning after sertraline and paroxetine treatment in first-episode major depression patients%舍曲林与帕罗西汀治疗抑郁症首次发病患者认知功能的相关研究

    Institute of Scientific and Technical Information of China (English)

    姚军; 吴香巍; 张海音; 季建林; 李清伟; 樊晔; 陈华; 刘文娟; 吴文源

    2011-01-01

    Objective To compare the effects of sertraline and paroxetine on cognitive function in first-episode major depressed patients,and to explore the related factors of cognitive function.Methods In this 12-week randomized open study,patients who met ICD-10 criteria for major depression,aged 18-65years old,scored HAMD17 ≥ 17,signed in informed consent form were recruited and assigned to sertraline (n =51 ) or paroxetine treatment group (n =49).Hamilton Depression Scale ( 17 item,HAMD17 ) were valuated at the baseline and endpoint of treatment,and neuropsychological assessments (WAIS-RC,WCST,Stroop) were performed twice to valuate cognition function.Result The patients had significant improvement in HAMD17 score and neuropsychological tests score after treatment.The patients with sertraline treatment had significantly reduced in Stroop card-CC time (67.59 ± 15.48 ) s,card-CC errors (3.66 ±4.03 ),card-CW errors (5.68 ± 5.02 ),SIE time2 ( 35.86 ± 13.74) s and SIE errors2 ( 3.18 ± 3.34) after treatment.The patients with paroxetine treatment had significantly reduced scores in WCST persistent errors (61.52 ± 11.07 ) and Stroop card-CC time ( 73.02 ± 16.45 ) s,card-CW errors ( 3.90 ± 4.12 ),card-CC errors (6.00±5.01),SIE time2 (39.24 ± 14.21 ) s and SIE errors2(3.48 ±3.79),had significantly improved in WCST correct answerings ( 26.55 ± 22.51 ) and conceptualization ( 0.74 ± 0.23 ) after treatment.There was no statistic difference on neuropsychological test score between the two groups,but the mean score of Stroop and WAIS was better in sertraline than paroxetine group.The amendment of Stroop card-CW errors had relation with the improvement degree of depressed symptom ( r =0.25,P < 0.05 ),the amendment of Stroop card-SIE errors had relation with the deduction of body weight ( r =0.27,P < 0.05 ),the amendment of WCST categories,total answering,persistent errors,random errors,conceptualization,and Stroop card-CC errors had relation with the deduction of

  20. [Therapeutic strategies in the first psychotic episode].

    Science.gov (United States)

    Douki, S; Taktak, M J; Ben Zineb, S; Cheour, M

    1999-11-01

    A first psychotic episode includes a wide range of disorders with different outcomes: schizophrenia, bipolar disorder, schizophreniform disorder, schizoaffective disorder, drug-induced psychosis, brief reactive psychosis, organic psychoses and delusional disorder. The course and outcome of a first psychotic episode is greatly dependent on its initial management. Major clinical, etiopathogenic and therapeutic advances have been achieved in this field and have allowed specific management strategies to be adopted. The primary task of therapists involved in the management of patients who have experienced a first episode of psychosis is promotion of recovery and prevention of secondary morbidity, relapse and persistent disability. The main guidelines of an early psychosis management are:--to keep in mind that early psychosis is not early schizophrenia. Thus, clinicians and therapists should avoid an early diagnosis of schizophrenia. Diagnosis in early psychosis can be highly unstable. A diagnosis of schizophrenia, with its implications of pessimism, relapse and disability, does not contribute anything positive in terms of guiding treatment. On the contrary, such a diagnosis may damage the patient and family by stigmatizing them and affecting the way they are viewed and managed by healthcare professionals.--To integrate biological, psychological and social interventions: effective medications is useful in reducing the risk of relapse, but is not a guarantee against it. Psychological and social interventions can greatly help promote recovery.--To tailor the various strategies to met the needs of an individual: as an example, it is important to formulate appropriate strategies for the different stages of the illness (prodromal phase, acute phase, early recovery phase and late recovery phase) because patients have different therapeutic needs at each stage.--In the acute treatment, not to concentrate on short-term goals in indicating antipsychotic treatment: prescribing

  1. Apathy in first episode psychosis patients

    DEFF Research Database (Denmark)

    Evensen, Julie; Røssberg, Jan Ivar; Barder, Helene

    2012-01-01

    Apathy is a common symptom in first episode psychosis (FEP), and is associated with poor functioning. Prevalence and correlates of apathy 10 years after the first psychotic episode remain unexplored.......Apathy is a common symptom in first episode psychosis (FEP), and is associated with poor functioning. Prevalence and correlates of apathy 10 years after the first psychotic episode remain unexplored....

  2. Course and Severity of Maternal Depression: Associations with Family Functioning and Child Adjustment

    Science.gov (United States)

    Foster, Cynthia Ewell; Webster, Melissa C.; Weissman, Myrna M.; Pilowsky, Daniel J.; Wickramaratne, Priya J.; Rush, A. John; Hughes, Carroll W.; Garber, Judy; Malloy, Erin; Cerda, Gabrielle; Kornstein, Susan G.; Alpert, Jonathan E.; Wisniewski, Stephen R.; Trivedi, Madhukar H.; Fava, Maurizio; King, Cheryl A.

    2008-01-01

    Number of lifetime episodes, duration of current episode, and severity of maternal depression were investigated in relation to family functioning and child adjustment. Participants were the 151 mother-child pairs in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) child multi-site study. Mothers were diagnosed with Major…

  3. The correlation between event-related potential P300 and grey matter volume in female patients with drug-naive first episode major depressive disorder%女性抑郁症首次发病患者认知事件相关电位P300与脑灰质体积的相关分析

    Institute of Scientific and Technical Information of China (English)

    沈宗霖; 莫茵; 李娜; 刘芳; 卢瑾; 陈伟; 许秀峰; 程宇琪

    2014-01-01

    Objective The present study aims to explore the grey matter volume changes in drugnaive first-episode major depressive disorder (MDD) female patients and to find out their correlation with event-related potential P3oo.Methods Twenty-five patients,aging between 18-58 years,diagnosed with first-episode MDD and 28 gender-,age-,education level-matched healthy controls were included in this study.All participants were assigned to receive 3D structural magnetic resonance imaging brain scans,and the patients were assigned to receive P30o tests.Results In contrast with healthy controls,decreased grey matter volume was detected in the right frontal operculum and the right precentral gyrus of patients,both P3 and N2 latencies were positively correlated with bilateral putamen nuclei (all P < 0.01).The P3 latency was also positively associated with the volumes of left middle temporal gyrus,left middle frontal gyrus,and leftfusiform gyrus.The N2 latency was also positively associated with the volumes of left posterior cingulate gyrus,the right fusiform gyrus,the occipital lobe,and the left cerebellum (all P < 0.01).The P3 amplitude was negatively associated with the volumes of left angular gyrus and right superior frontal gyrus (all P <0.01).No statistically significant correlation was found between each component of P300 and Hamilton Depression Scale scores (total and factor).Conclusions The abnormalities of grey matter volume are observed in certain brain regions in unmedicated female patients with first-episode MDD in this study.And the P300 in those patients are in correlation with many grey matter regions of the brain,especially temporal lobes and basal ganglia.%目的 探讨首次发病未服药女性抑郁症患者脑灰质体积变化特点,以及与认知事件相关电位P300的相关分析.方法 对25例18 ~58岁首次发病未服药女性抑郁症患者(患者组)和28名健康对照者(对照组)行头部3D结构MRI扫描,并对患者组进行P300

  4. Psychiatric disorders and muscle tenderness in episodic and chronic migraine.

    Science.gov (United States)

    Mongini, Franco; Deregibus, Andrea; Rota, Eugenia

    2005-09-01

    This review first reports on the data concerning the relationship between migraine and personality traits and psychiatric disorders. The relationship between migraine and tenderness of the pericranial and cervical muscles is then discussed. In one study, a psychologic assessment was performed in 56 women with migraine, and the Minnesota Multiphase Personality Inventory (MMPI) and State Trait Anxiety Inventory were administered at baseline (T0) and after 6-7 years (T2). Frequency, severity and duration of migraine were recorded at T0, after treatment (T1) and at T2, and their relationship to the prevalence of depression, MMPI and State Trait Anxiety Inventory data were examined. Pain parameters improved in all patients in T0-1, but were higher at T2 in patients with depression at T0. The patients whose migraine improved at T2 had significantly lower MMPI and State Trait Anxiety Inventory scores at T0 and T2. Moreover, the prevalence of depression of the patients whose migraine improved at T2 was 37.5% at T0 and decreased to 12.5% at T2. The authors subsequently studied the function of the frontal lobe in 23 female patients previously treated for chronic migraine and 23 controls by applying three neuropsychologic tests (gambling task, tower of hanoi-3 and object alternation test). The patient group performed significantly worse on the tower of hanoi-3 and the object alternation test. In order to assess the extent to which muscle tenderness may relate to psychiatric disorders in patients with migraine and tension-type headache, diagnosed according International Headache Society criteria [2004], a psychologic assessment was performed and palpation tenderness scores calculated for the pericranial and cervical muscles in 459 patients. In total, 125 patients had frequent episodic migraine, 97 had chronic migraine, 82 had frequent episodic tension-type headache and chronic tension-type headache was present in 83. In a further 72 patients, both episodic migraine and

  5. Avaliação da utilização do placebo nas crises agudas de migrânea sem aura, migrânea com aura e cefaléia do tipo tensional episódica Evaluation of placebo use in migraine without aura, migraine with aura and episodic tension-type headache acute attacks

    Directory of Open Access Journals (Sweden)

    Marcelo Eduardo Bigal

    2001-09-01

    Full Text Available O presente estudo apresenta a avaliação do efeito placebo no tratamento agudo da migrânea sem aura, migrânea com aura e cefaléia do tipo tensional episódica. Foram estudados pacientes que deram entrada entre 1 de março de 1997 a 31 de novembro de 1999 em dois pronto-socorros. Definiram-se três grupos, cada um com 30 pacientes: 1 - migrânea sem aura (MSA; 2 -- migrânea com aura (MCO; 3 -- cefaléia do tipo tensional episódica (CTTE. Os pacientes participavam de estudo randomizado para avaliar a eficácia de 4 drogas; aqueles randomizados para o placebo foram incluídos também. Os parâmetros avaliados foram: 1 -- dor; 2 - sintomas associados. Avaliados uma hora após a administração do placebo, 50% dos pacientes do grupo MSA, 23,3% dos pacientes do grupo MCA e 26,7% dos pacientes do grupo CTTE apresentavam melhora da dor. A melhora, avaliada pela escala numérica da dor foi, em média, de 41,6%, 23,1% e 36%, respectivamente. Houve também redução significativa de todos os sintomas associados. A utilização do placebo é, portanto, essencial na avaliação de drogas utilizadas no tratamento de cefaléias agudas.This study presents an evaluation of placebo response in the acute treatment of migraine with or without aura and episodic tension type headache. We studied patients admitted between March 1st,1997 and November 31st,1999 in two Emergency Room Units. Three groups had been defined, each one with 30 participants: migraine without aura (MWOA, migraine with aura (MWA and episodic tension-type headache (ETTH. Patients were participating of a randomized study to evaluate efficacy of 4 different drugs; those randomized to receive placebo were included. We evaluated pain and associated symptoms. After one hour of placebo administration, 50% of MWOA patients, 23.3% of MWA and 26.7% of ETTH had presented pain relief. The mean of this relief, evaluated by the numerical pain scale, was 41.6%, 23.1% and 36%, respectively. Use of placebo

  6. Imagining the personal past: Episodic counterfactuals compared to episodic memories and episodic future projections

    DEFF Research Database (Denmark)

    Özbek, Müge; Bohn, Annette; Berntsen, Dorthe

    2016-01-01

    Episodic counterfactuals are imagined events that could have happened, but did not happen, in a person’s past. Such imagined past events are important aspects of mental life, affecting emotions, decisions, and behaviors. However, studies examining their phenomenological characteristics and content...... are few. Here we introduced a new method to systematically compare self-generated episodic counterfactuals to self-generated episodic memories and future projections with regard to their phenomenological characteristics (e.g., imagery, emotional valence, rehearsal) and content (e.g., reference to cultural...... distance. The findings show that imagined events are phenomenologically different from memories of experienced events, consistent with reality monitoring theory, and that imagined future events are different from both actual and imagined past events, consistent with some theories of motivation....

  7. The impact of phenomena El Niño and La Niña and other environmental factors on episodes of acute diarrhoea disease in the population of Aguascalientes, Mexico: a case study

    Science.gov (United States)

    Esthela Venegas-Pérez, Martha; Ramírez-López, Elsa Marcela; López-Santos, Armando; Orlando Magaña-Rueda, Víctor; Avelar-González, Francisco Javier

    2016-03-01

    Acute diarrhoea diseases (ADDs) are one of the major health problems in Aguascalientes, Mexico. Due to the risk of significant increases of ADDs in the hot season, it has been necessary to determine the weather conditions that might lead to escalating ADD events. The effects of El Niño and La Niña phenomena on the morbidity rate of ADD (MRADD) in the State of Aguascalientes were determined during the period of 2000-2010. The MRADD was calculated from cases reported by the State Health Department. The Oceanic Niño Index (ONI) was obtained from the US National Oceanic and Atmospheric Administration. The impact of El Niño and La Niña on the MRADD was determined using the Pearson correlation coefficient and analysis of variance (ANOVA). The results gave a significant inverse correlation between El Niño phenomenon and MRADD (r = -0.55, P = 0.001), but a correlation was not observed on the La Niña phenomenon (r = -0.022, P = 0.888). Field data showed significant inverse influence of El Niño on MRADD for the years 2000-2010.

  8. Gender differences in episodic memory.

    Science.gov (United States)

    Herlitz, A; Nilsson, L G; Bäckman, L

    1997-11-01

    The relationship between gender and memory has been largely neglected by research, despite occasional studies reporting gender differences in episodic memory performance. The present study examined potential gender differences in episodic memory, semantic memory, primary memory, and priming. Five hundred thirty women and 470 men, randomly sampled from the city of Umeå, Sweden, 35-80 years of age, participated in the study. There were no differences between men and women with regard to age or education, or on a measure of global intellectual functioning. As has been demonstrated previously, men out performed women on a visuospatial task and women outperformed men on tests of verbal fluency. In addition, the results demonstrated that women consistently performed at a higher level than did men on the episodic memory tasks, although there were no differences between men and women on the tasks assessing semantic memory, primary memory, or priming. The women's higher level of performance on the episodic memory tasks could not be fully explained by their higher verbal ability.

  9. 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

    Care Evaluation of Mental Disorders (PRIME-MD) screening questionnaire. Results: The PRIME-MD screening data were available on 232 patients (76.8% of eligible patients). Thirty-eight (35.5%) of 107 participants and 30 (24.0%) of 125 non-participants had a positive screening for depression (NS), and 47...... (43.9%) participants and 55 (44%) non-participants were screened positive for anxiety (NS). Non-participants were older (P=0.002), while no significant differences in gender or cardiac diagnosis were found. Conclusions: Symptoms of depression and anxiety were highly prevalent in patients after ACS...

  10. 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

    with high education in both ACS patients and the reference population. Adjustment for previous and incident depression or other covariables only attenuated the relations slightly. This pattern of associations was seen for mortality after 30 days, 1 year and during total follow-up. CONCLUSION: In this study...... 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....

  11. The decreasing importance of acidification episodes with recovery from acidification: an analysis of the 30-year record from Birkenes, Norway

    Directory of Open Access Journals (Sweden)

    R. F. Wright

    2007-09-01

    Full Text Available The 30-year record 1975–2004 of weekly samples of streamwater chemistry from Birkenes, Norway, shows 106 acid episodes below the threshold of ANC –50 μeq l−1. The frequency, severity and duration of episodes have diminished since about 1990 due to chemical recovery following reduced deposition of sulphur. In particular SO4-driven episodes in the first runoff following drought have become less intense and less frequent, whereas episodes driven by climate (wind, high flow continue. The data show significant empirical relationships between strength of the driver, degree of chemical recovery, and severity of ANC depression.

  12. The decreasing importance of acidification episodes with recovery from acidification: an analysis of the 30-year record from Birkenes, Norway

    Directory of Open Access Journals (Sweden)

    R. F. Wright

    2008-03-01

    Full Text Available The 30-year record 1975–2004 of weekly samples of streamwater chemistry from Birkenes, Norway, shows 106 acid episodes below the threshold of ANC−50 µeq l−1. The frequency, severity and duration of episodes have diminished since about 1990 due to chemical recovery following reduced deposition of sulphur. In particular SO4-driven episodes in the first runoff following drought have become less intense and less frequent, whereas episodes driven by climate (wind, high flow continue. The data show significant empirical relationships between strength of the driver, degree of chemical recovery, and severity of ANC depression.

  13. Diastolic dysfunction predicts new-onset atrial fibrillation and cardiovascular events in patients with acute myocardial infarction and depressed left ventricular systolic function: a CARISMA substudy

    DEFF Research Database (Denmark)

    Jons, Christian; Joergensen, Rikke Moerch; Hassager, Christian;

    2010-01-01

    The aim of this study was to investigate the association between diastolic dysfunction and long-term occurrence of new-onset atrial fibrillation (AF) and cardiac events in patients with acute myocardial infarction (AMI) and left ventricular (LV) systolic dysfunction.......The aim of this study was to investigate the association between diastolic dysfunction and long-term occurrence of new-onset atrial fibrillation (AF) and cardiac events in patients with acute myocardial infarction (AMI) and left ventricular (LV) systolic dysfunction....

  14. Hot spots and labyrinths: Why cortical neuromodulation for episodic migraine with aura should be personalized

    Directory of Open Access Journals (Sweden)

    Markus A Dahlem

    2015-03-01

    Full Text Available Stimulation protocols for medical devices should be rationally designed. For episodic migraine with aura we outline model-based design strategies towards preventive and acute therapies using stereotactic cortical neuromodulation. To this end, we regard a localized spreading depression (SD wave segment as a central element in migraine pathophysiology. To describe nucleation and propagation features of the SD wave segment, we define the new concepts of cortical hot spots and labyrinths, respectively. In particular, we firstly focus exclusively on curvature-induced dynamical properties by studying a generic reaction-diffusion model of SD on the folded cortical surface. This surface is described with increasing level of details, including finally personalized simulations using patient's magnetic resonance imaging (MRI scanner readings. At this stage, the only relevant factor that can modulate nucleation and propagation paths is the Gaussian curvature, which has the advantage of being rather readily accessible by MRI. We conclude with discussing further anatomical factors, such as areal, laminar, and cellular heterogeneity, that in addition to and in relation to Gaussian curvature determine the generalized concept of cortical hot spots and labyrinths as target structures for neuromodulation. Our numerical simulations suggest that these target structures are like fingerprints, they are individual features of each migraine sufferer. The goal in the future will be to provide individualized neural tissue simulations. These simulations should predict the clinical data and therefore can also serve as a test bed for exploring stereotactic cortical neuromodulation.

  15. [Recited depression].

    Science.gov (United States)

    Barucci, M; Cossio, M

    1984-01-01

    Several subjects who tell their depression and play a part of it in front of the doctor without being really depressed are reported. Some of them try to hide the symptoms (irritability or erethism, ceremonials of obsessive neurosis, shunning of phobia) which, in their opinion, might be detrimental to their reputation. Others neglect to describe some of the symptoms of their polymorphous clinical picture only underlining the depressive signs. Some others play a part of depression because they have believed to recognize themselves in persons presented by mass media, because it seems to them a duty to show an adequate depression in case of mournful event, or because they "convert" their problem into a depression. Some others use depression as a blackmail, or to obtain an advantage from doctor's conviction about their illness. The reason for the high frequency of similar cases in the present time are examined: the scientific divulgation and the acceptance of depression by the modern society are among the most important ones. The peculiar semantic vicissitudes of the word depression are also reviewed. A widening of the boundaries of depression has contributed to an increase in the number of the cases. Finally, in addition to patients who are depressed without being aware of it, the authors focus the inverse possibility: patients who believed or try to make their doctor believe (playing the part of depression in front of them) that they are depressed.

  16. Executive summary of the report by the WPA section on pharmacopsychiatry on general and comparative efficacy and effectiveness of antidepressants in the acute treatment of depressive disorders.

    Science.gov (United States)

    Baghai, Thomas C; Blier, Pierre; Baldwin, David S; Bauer, Michael; Goodwin, Guy M; Fountoulakis, Kostas N; Kasper, Siegfried; Leonard, Brian E; Malt, Ulrik F; Stein, Dan J; Versiani, Marcio; Möller, Hans-Jürgen

    2012-02-01

    Current gold standard in the treatment of depression includes pharmacotherapeutic and psychotherapeutic strategies together with social support. Due to the actually discussed controversies concerning the differential efficacy of antidepressants, a contribution to a comprehensive clarification seems to be necessary to avert further deterioration and uncertainty from patients, relatives, and their treating psychiatrists and general practitioners. Both efficacy and clinical effectiveness of antidepressants in the treatment of depressive disorders can be confirmed. Clinically meaningful antidepressant treatment effects were confirmed in different types of studies. Methodological issues of randomized controlled studies, meta-analyses, and effectiveness studies will be discussed. Furthermore, actual data about the differential efficacy and effectiveness of antidepressants with distinct pharmacodynamic properties and about outcome differences in studies using antidepressants and/or psychotherapy are discussed. This is followed by a clinically oriented depiction-the differential clinical effectiveness of different pharmacodynamic modes of action of antidepressants in different subtypes of depressive disorders. It can be summarized that the spectrum of different antidepressant treatments has broadened during the last decades. The efficacy and clinical effectiveness of antidepressants is statistically significant and clinically relevant and proven repeatedly. For further optimizing antidepressant treatment plans, clearly structured treatment algorithms and the implementation of psychotherapy seem to be useful. A modern individualized antidepressant treatment in most cases is a well-tolerated and efficacious tool to minimize the negative impact of the otherwise devastating and life-threatening outcome of depressive disorders.

  17. Depressive mixed state: Evidence for a new form of depressive state in type I and II bipolar patients

    Directory of Open Access Journals (Sweden)

    Katia M’Bailara

    2007-01-01

    Full Text Available Katia M’Bailara1, Donatienne Van den Bulke2, Nicolas Demazeau2, Jacques Demotes-Mainard3, Chantal Henry11EA4139 Laboratoire de psychologie, Université Victor Segalen, Bordeaux Cedex, France; 2Centre Hospitalier Charles Perrens, Bordeaux Cedex, France; 3INSERM-DRCT, ECRIN, Paris, FranceBackground: A high proportion of unipolar and bipolar type II patients can present a depressive mixed state (DMX. This state is defined by an association of a major depressive episode with at least two specific hypomanic symptoms. This state seems underdiagnosed and this could have treatment implications. The aims of our study were: (i to investigate the frequency of DMX in type I and II bipolar patients hospitalized for a severe or resistant depressive episode and (ii to assess the therapeutic response in naturalistic conditions.Methods: Forty-two consecutive bipolar patients referred by psychiatrists for a severe or resistant depressive episode were assessed using the French version of the Mini International Neuropsychiatric Interview 5.0 (MINI 5.0, which assesses the suicide risk and provides DSM-IV diagnosis. The intensity of mood episodes was evaluated using the MADRS and Bech-Rafaelsen Mania Scale. One group of patients included patients presenting only depressive symptoms (ie, pure major depressive episode (MDE, and the second group included patients with a major depressive episode and at least two specific hypomanic symptoms (DMX.Results: Twenty-one patients (50% had a pure MDE and 21 patients (50% had a DMX. The treatment leading to recovery was very different in the two groups. Antidepressants were effective (77% in MDE patients, whereas antipsychotics were effective (81% in DMX. 38% of patients with a MDE also received a mood stabilizer versus 86% in the group of DMX. Five MDE patients (24% and one DMX patient required electroconvulsive therapy. The suicidal ideations did not differ between the two groups (p = 0.7.Conclusions: Some mood episodes in

  18. Postpartum Depression

    Science.gov (United States)

    ... do not need treatment. The symptoms of postpartum depression last longer and are more severe. You may ... treatment right away, often in the hospital. Postpartum depression can begin anytime within the first year after ...

  19. Depression Treatment

    Science.gov (United States)

    ... 3286 After hours (404) 639-2888 Contact Media Depression Treatment Recommend on Facebook Tweet Share Compartir On ... How Do I Know if I Am Experiencing Depression? The following questions may help you determine if ...

  20. Depression Screening

    Science.gov (United States)

    ... Centers Diseases + Condition Centers Mental Health Medical Library Depression Screening (PHQ-9) - Instructions The following questions are ... this tool, there is also text-only version . Depression Screening - Manual Instructions The following questions are a ...

  1. Teen Depression

    Science.gov (United States)

    ... something you did wrong Learn more Share Teen Depression Download PDF Download ePub Order a free hardcopy ... get back to being yourself. Regular sadness and depression are not the same Regular sadness Feeling moody, ...

  2. Therapeutic effects of aripiprazole and olanzapine on the patients with first-episode acute schizophrenia and their influence on plasma prolactin level%阿立哌唑与奥氮平对首发精神分裂症 急性期疗效及对催乳素的影响

    Institute of Scientific and Technical Information of China (English)

    吴小立; 王继辉; 钟智勇; 韩自力

    2011-01-01

    AIM:To study the efficacy on first-episode acute schizophrenia treated with aripiprazole and olanzapine and the effect on plasma prolactin level. METHODS: 65 inpatients with first-episode acute schizophrenia were divided into either olanzapine group [n = 42, M21, F21; age(23. 9±6. 6)year] or aripiprazole group[(n=23, M1l, F12; age (23. 7 ± 7. 2) year] for 4 week treatment. The plasma prolactin level, the Positive and Negative Syndrome Scale (PANSS) and clinical global impressionglobal improvement (CGI-I) were measured before and after 4 week treatment. RESULTS: The score of PANSS (59 ± 13) after therapy in olanzapine group was significantly lower than that before therapy (103+15) (P 0.05) in the CGI-I score between the two groups. The difference of negative symptoms and general psychopathological sub-scale scoreschanging from base to end between the two groups was statistically significant (P<0. 01). Compared with the prolactin baseline level (547 ±382) uIu/mL,the plasma prolactin level (418 ±362) ulu/mL in olanzapine group was significantly decreased after treatment, and there was no difference. Compared with the prolactin baseline level (351 ±299) ulu/mL, the plasma prolactin level (123 ±114) ulu/mL in aripiprazole group was significantly decreased after treatment, and there was significant difference ( P < 0.01). CONCLUSION: The therapeutic effects were similar in the aripiprazole and olanzapine group for first-episode acute schizophrenia. Olanzapine is better for the general psychopathological symptoms, and aripiprazole is better for the negative symptoms. Aripiprazole maybe decrease the plasma prolactin level of first-episode acute schizophrenia.%目的:研究奥氮平和阿立哌唑对首发精神分裂症患者急性期疗效及对血中催乳素(PRI)水平的影响.方法:65例首发精神分裂症患者分为奥氮平组42例[男21例,女21例;年龄(23.9±6.6)岁]和阿立哌唑组23例[男11例,女12例;年龄(23.7±7.2)岁].分别给予奥

  3. Differentiating Acute Otitis Media and Acute Mastoiditis in Hospitalized Children.

    Science.gov (United States)

    Laulajainen-Hongisto, Anu; Aarnisalo, Antti A; Jero, Jussi

    2016-10-01

    Acute otitis media is a common infection in children. Most acute otitis media episodes can be treated at an outpatient setting with antimicrobials, or only expectant observation. Hospital treatment with parenteral medication, and myringotomy or tympanostomy, may be needed to treat those with severe, prolonged symptoms, or with complications. The most common intratemporal complication of acute otitis media is acute mastoiditis. If a child with acute mastoiditis does not respond to this treatment, or if complications develop, further examinations and other surgical procedures, including mastoidectomy, are considered. Since the treatment of complicated acute otitis media and complicated acute mastoiditis differs, it is important to differentiate these two conditions. This article focuses on the differential diagnostics of acute otitis media and acute mastoiditis in children.

  4. [Diabetic ketoacidosis. Revision of 82 episodes].

    Science.gov (United States)

    Zanchetta, J R; Cortés, E; Pallotta, M G; Domínguez, J M

    1980-01-01

    A total of 82 episodes of diabetic ketoacidosis were analysed in 70 adult patients. Population characteristics can be seen in Table 1. It was possible to determine the causes of 74 episodes (Table 2); infections, insulin reduction or suppression and psychic stress included 89 % of these causes. The most frequent infection sites were airway, urinary tract and skin surface. The most important symptoms and signs shown by patients on admission (Table 3) were digestive and those derived from dehydration and acidosis. Figure 2 shows laboratory data on admission: average glycemia, 395 mg %, 90 % with pH values below 7.30; the majority revealed high hematocrit urea and kaliemia values. Unusual treatment performed in the classical way (Figure 3) can be divided into two periods: the first of eapid expansion and insulinization (first three hours) and the second of slow replenishment (4 to 24 hours) consisting of two stages in which the velocity of liquid infusion is diminished while glucose and potassium backing is started. No difference was found between the results of those who received bicarbonate and those who did not (Table 4). Response to treatment is shown in Fig. 4. On pointing out the decrease in kalemia (1.18 mEq/l in the first 6 hours), however, it must be kept in mind that on admission 10 % of the patients were in a state of hypokalemia with less than 3.5 mEq/l. Table 5 shows complications that arose during treatment: hypokalemia, 32 %; hupoglucemia, 11 % and phlebitis, 17 % (catheterized). Five patients, (7 5) died. Four had been admitted in a state of coma with a severe infectious state (bronchopneumonia, acute pyelonephritis, meningo-encephalitis). The analysis of this paper shows the importance of an adequate diabetic education and briefing both for the patients, to be aware of the unleashing factors, and for the physicians, in order to avoid the complications of treatment.

  5. Measuring consistency of autobiographical memory recall in depression.

    LENUS (Irish Health Repository)

    Semkovska, Maria

    2012-05-15

    Autobiographical amnesia assessments in depression need to account for normal changes in consistency over time, contribution of mood and type of memories measured. We report herein validation studies of the Columbia Autobiographical Memory Interview - Short Form (CAMI-SF), exclusively used in depressed patients receiving electroconvulsive therapy (ECT) but without previous published report of normative data. The CAMI-SF was administered twice with a 6-month interval to 44 healthy volunteers to obtain normative data for retrieval consistency of its Semantic, Episodic-Extended and Episodic-Specific components and assess their reliability and validity. Healthy volunteers showed significant large decreases in retrieval consistency on all components. The Semantic and Episodic-Specific components demonstrated substantial construct validity. We then assessed CAMI-SF retrieval consistencies over a 2-month interval in 30 severely depressed patients never treated with ECT compared with healthy controls (n=19). On initial assessment, depressed pat