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Sample records for acute depressive episode

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

    NARCIS (Netherlands)

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

    2005-01-01

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

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

    Science.gov (United States)

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

    2018-01-12

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

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

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    Bodnar, Anna; Rybakowski, Janusz K

    2017-12-06

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

  4. Age effects on trail making test during acute depressive and manic episode.

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    Mahlberg, Richard; Adli, Mazda; Bschor, Tom; Kienast, Thorsten

    2008-09-01

    Impairment of executive functions and attention has been found in patients with acute depressive episodes but has rarely been investigated in manic patients to date. At the same time, executive functions decline with age. Thus, it is currently a matter of debate how to best measure decreased executive performance in elderly patients with affective disorders. In our study, we examined 30 depressed patients, 28 manic patients, and 30 healthy subjects of all age groups, using the Trail Making Test (TMT). Both depressed and manic patients needed twice as long as healthy subjects to perform the TMT Part A. In addition to this reduced performance due to affective disorders, we were also able to detect a decline in performance due to age. One could thus postulate that age and affective disorders each influence a different neuropsychological function, age affecting executive performance and affective disorders affecting attention, as measured in both cases by the TMT.

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

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

    2005-12-01

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

  6. 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. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. Effects of asenapine on depressive symptoms in patients with bipolar I disorder experiencing acute manic or mixed episodes: a post hoc analysis of two 3-week clinical trials

    Directory of Open Access Journals (Sweden)

    Nations Kari R

    2011-06-01

    Full Text Available Abstract Background Asenapine demonstrated superiority over placebo for mania in bipolar I disorder patients experiencing acute current manic or mixed episodes in 2 randomized, placebo-and olanzapine-controlled trials. We report the results of exploratory pooled post hoc analyses from these trials evaluating asenapine's effects on depressive symptoms in patients from these trials with significant baseline depressive symptoms. Methods In the original trials (A7501004 [NCT00159744], A7501005 [NCT00159796], 977 patients were randomized to flexible-dose sublingual asenapine (10 mg twice daily on day 1; 5 or 10 mg twice daily thereafter, placebo, or oral olanzapine 5-20 mg once daily for 3 weeks. Three populations were defined using baseline depressive symptoms: (1 Montgomery-Asberg Depression Rating Scale (MADRS total score ≥20 (n = 132; (2 Clinical Global Impression for Bipolar Disorder-Depression (CGI-BP-D scale severity score ≥4 (n = 170; (3 diagnosis of mixed episodes (n = 302 by investigative site screening. For each population, asenapine and olanzapine were independently compared with placebo using least squares mean change from baseline on depressive symptom measures. Results Decreases in MADRS total score were statistically greater with asenapine versus placebo at days 7 and 21 in all populations; differences between olanzapine and placebo were not significant. Decreases in CGI-BP-D score were significantly greater with asenapine versus placebo at day 7 in all categories and day 21 in population 1; CGI-BP-D score reductions were significantly greater with olanzapine versus placebo at day 21 in population 1 and day 7 in populations 2 and 3. Conclusions These post hoc analyses show that asenapine reduced depressive symptoms in bipolar I disorder patients experiencing acute manic or mixed episodes with clinically relevant depressive symptoms at baseline; olanzapine results appeared to be less consistent. Controlled studies of asenapine in

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

    Science.gov (United States)

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

    2012-12-01

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

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

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel

    2008-01-01

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

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

    DEFF Research Database (Denmark)

    Kessing, L.V.

    2008-01-01

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

  11. 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

    2014-01-01

    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. PMID:24835805

  12. 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...

  13. Perceptive biases in major depressive episode.

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    Naudin, Marine; Carl, Tatiana; Surguladze, Simon; Guillen, Catherine; Gaillard, Philippe; Belzung, Catherine; El-Hage, Wissam; Atanasova, Boriana

    2014-01-01

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

  14. Perceptive biases in major depressive episode.

    Directory of Open Access Journals (Sweden)

    Marine Naudin

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

  15. Depressive episodes with suicide attempts in severe depression: suicides and controls differ only in the later episodes of unipolar depression.

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    Brådvik, Louise; Berglund, Mats

    2010-01-01

    The aim of the present study was to investigate the distribution of suicide attempts across the depressive episodes in suicides and controls with a severe depression. A blind record evaluation was performed of 100 suicide victims and matched controls admitted to the Department of Psychiatry between 1956 and 1969 and monitored to 2006. There was a similar number of episodes in suicides and controls and in the early episodes a similar number of suicide attempts in both groups. However, in the later episodes future suicides showed more suicide attempts as compared to controls. This was found for unipolar depression only. This difference was found despite previously shown similar rates of adequate treatment and improvement. In conclusion, more depressive episodes including suicide attempts appeared to be related to suicide.

  16. Recovery from Multiple Episodes of Bipolar I Depression

    Science.gov (United States)

    Solomon, David A; Fiedorowicz, Jess G.; Leon, Andrew C.; Coryell, William; Endicott, Jean; Li, Chunshan; Boland, Robert J.; Keller, Martin B.

    2013-01-01

    Objectives To describe the duration of bipolar I major and minor depressive episodes and factors associated with time to recovery. Method 219 participants with bipolar I disorder based on Research Diagnostic Criteria analogs to DSM-IV-TR criteria were recruited from 1978–1981 and followed for up to 25 years. Psychopathology was assessed with the Longitudinal Interval Follow-up Evaluation. The probability of recovery over time from multiple successive depressive episodes was examined with survival analytic techniques, including mixed-effects grouped-time survival models. Results The median duration of major depressive episodes was 14 weeks, and over 70% recovered within 12 months of onset of the episode. The median duration of minor depressive episodes was 8 weeks, and approximately 90% recovered within 6 months of onset of the episode. Aggregated data demonstrated similar durations of the first three major depressive episodes. However, for each participant with multiple episodes of major depression or minor depression, the duration of each episode was not consistent (intraclass correlation coefficient=0.07 and 0.25 for major and minor depression, respectively). The total number of years in episode over follow-up with major plus minor depression prior to onset of a major depressive episode was significantly associated with a decreased probability of recovery from that episode; with each additional year, the likelihood of recovery was reduced by 7% (hazard ratio: 0.93, 95% CI: 0.89–0.98, p=0.002). Conclusions Bipolar I major depression generally lasts longer than minor depression, and the duration of multiple episodes within an individual varies. However, the probability of recovery over time from an episode of major depression appears to decline with each successive episode. PMID:23561241

  17. Severity of depressive episodes according to ICD-10

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel

    2004-01-01

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

  18. Autistic traits and empathy in chronic vs. episodic depression.

    Science.gov (United States)

    Domes, Gregor; Spenthof, Ines; Radtke, Martina; Isaksson, Alexandra; Normann, Claus; Heinrichs, Markus

    2016-05-01

    Difficulties in social interaction are characteristic for depressive disorders and one of the cardinal symptoms of Autism Spectrum Disorders (ASD). It has been proposed that chronically depressed persons have profoundly impaired empathic abilities in comparison to episodically depressed persons, and that specifically they exhibit a deficit in cognitive empathy, but not in affective empathy, a pattern also reported in ASD. This study aimed to explore autistic traits and empathy deficits in chronic depression, and identify specific differences to episodic depression. Autistic traits and multimodal empathy were assessed in chronically depressed patients (n=59), episodically depressed patients (n=40), and a healthy control group (n=55) using standardized questionnaires. Regardless of the disorder's chronicity, depressed patients exhibited higher levels of autistic traits and lower levels of perspective-taking than healthy controls. Chronically depressed patients reported significantly higher impairment in social skills and higher levels of personal distress in social interactions than episodic patients. Our results suggest that patients with chronic depression share two distinct characteristics, namely lower levels of social skills and higher levels of distress in tense social situations than patients with episodic depression. Future studies will need to determine whether the elevated autistic traits in chronic depression are specific to chronic depression, or represent the general tendency to withdraw from social situations. We conclude that chronically depressed patients are not specifically impaired in understanding another person's state of mind, but are unable to deal with another person's suffering or negative affective state. Copyright © 2016 Elsevier B.V. All rights reserved.

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

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

    2003-05-01

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

  20. 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.

  1. 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...

  2. Subtypes of depressive episodes according to ICD-10

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel

    2003-01-01

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

  3. Depression following acute coronary syndrome

    DEFF Research Database (Denmark)

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

    2016-01-01

    .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......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...

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

    Science.gov (United States)

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

    2014-02-01

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

  5. Acute rejection episodes after kidney transplantation

    Directory of Open Access Journals (Sweden)

    Hamida Fethi

    2009-01-01

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

  6. The association of treatment of depressive episodes and work productivity.

    Science.gov (United States)

    Dewa, Carolyn S; Thompson, Angus H; Jacobs, Phillip

    2011-12-01

    About one-third of the annual $51 billion cost of mental illnesses is related to productivity losses. However, few studies have examined the association of treatment and productivity. The purpose of our research is to examine the association of depression and its treatment and work productivity. Our analyses used data from 2737 adults aged between 18 and 65 years who participated in a large-scale community survey of employed and recently employed people in Alberta. Using the World Health Organization's Health and Work Performance Questionnaire, a productivity variable was created to capture high productivity (above the 75th percentile). We used regression methods to examine the association of mental disorders and their treatment and productivity, controlling for demographic factors and job characteristics. In the sample, about 8.5% experienced a depressive episode in the past year. The regression results indicated that people who had a severe depressive episode were significantly less likely to be highly productive. Compared with people who had a moderate or severe depressive episode who did not have treatment, those who did have treatment were significantly more likely to be highly productive. However, about one-half of workers with a moderate or severe depressive episode did not receive treatment. Our results corroborate those in the literature that indicate mental disorders are significantly associated with decreased work productivity. In addition, these findings indicate that treatment for these disorders is significantly associated with productivity. Our results also highlight the low proportion of workers with a mental disorder who receive treatment.

  7. Respiratory symptoms and acute painful episodes in sickle cell disease.

    Science.gov (United States)

    Jacob, Eufemia; Sockrider, Marianna M; Dinu, Marlen; Acosta, Monica; Mueller, Brigitta U

    2010-01-01

    The authors examined the prevalence of respiratory symptoms and determined whether respiratory symptoms were associated with prevalence of chest pain and number of acute painful episodes in children and adolescents with sickle cell disease. Participants (N = 93; 44 females, 49 males; mean age 9.8 +/- 4.3 years) reported coughing in the morning (21.5%), at night (31.2%), and during exercise (30.1%). Wheezing occurred both when they had a cold or infection (29.0%) and when they did not have (23.7%) a cold or infection. Sleep was disturbed by wheezing in 20.4%. Among the 76 patients who were school-age (>5 years), 19.7% of patients missed more than 4 days of school because of respiratory symptoms. The majority of patients reported having acute painful episodes (82.8%), and most (66.7%) reported having chest pain during acute painful episodes in the previous 12 months. Participants with acute pain episodes greater than 3 during the previous 12 months had significantly higher reports of breathing difficulties (P = .01) and chest pain (P = .002). The high number of respiratory symptoms (cough and wheeze) among patients with sickle cell disease may trigger acute painful episodes. Early screening and recognition, ongoing monitoring, and proactive management of respiratory symptoms may minimize the number of acute painful episodes.

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

    African Journals Online (AJOL)

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

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  10. Depression in first episode psychosis: the role of subordination and shame.

    Science.gov (United States)

    Upthegrove, Rachel; Ross, Kerry; Brunet, Katerine; McCollum, Richard; Jones, Lisa

    2014-07-30

    Depression in early psychosis is linked to poor outcome, relapse and risk of suicide, yet remains poorly understood. This article aims to examine the development of depression in acute and post psychotic phases of first episode psychosis (FEP), and its relationship to persecutors, voices, insight, and recovery. Data were gathered on 92 patients with acute FEP on depression course, severity and experience of positive symptoms, insight and appraisals of illness using validated semi-structured interviews and questionnaires. Measures were repeated at 12 months. Malevolent voices, use of safety behaviours and subordination to persecutors were associated with depression and suicidal behaviour in acute FEP. Loss, Shame, low level continuing positive symptoms and longer duration of untreated psychosis were associated with post psychotic depression. Negative appraisals remained stable despite recovery in other symptom domains. Thus, depression and risk in early psychosis may be propagated by the personal significance and content of positive symptoms experienced. When in recovery, low level symptoms, longer period of illness and negative appraisals are significant factors. Crown Copyright © 2014. Published by Elsevier Ireland Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Mina Islambulchilar

    2015-03-01

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

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

    Science.gov (United States)

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

    2016-02-01

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

  13. Interleukin-1β is associated with depressive episode in major depression but not in bipolar disorder.

    Science.gov (United States)

    Mota, Rosana; Gazal, Marta; Acosta, Bruna A; de Leon, Pâmela B; Jansen, Karen; Pinheiro, Ricardo T; Souza, Luciano D; Silva, Ricardo A; Oses, Jean P; Quevedo, Luciana; Lara, Diogo R; Ghisleni, Gabriele; Kaster, Manuella P

    2013-12-01

    Our work was sought to investigate possible changes in peripheral levels of interleukin-1β (IL-1β) according to the diagnosis of major depression (MD) and bipolar disorder (BD) and in different mood episodes. This is a cross-sectional nested in a population-based study comparing 240 young adults (80 controls, 80 MD and 80 BD), balanced for age and gender. Serum levels of IL-1β were significantly higher in MD when compared to control or BD subjects. In addition, when divided by current mood episode, MD subjects in current depression presented higher IL-1β levels than controls. No differences in IL-1β levels were found between different episodes of BD (euthymic, depressed, mania or mixed). Moreover, the use of psychiatric medication was very low in our sample and not associated with changes in IL-1β levels. In conclusion, increased peripheral IL-1β might be a useful marker associated with a depressive episode in the context of MD. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Comparison of depressive episodes in bipolar disorder and in major depressive disorder within bipolar disorder pedigrees.

    Science.gov (United States)

    Mitchell, Philip B; Frankland, Andrew; Hadzi-Pavlovic, Dusan; Roberts, Gloria; Corry, Justine; Wright, Adam; Loo, Colleen K; Breakspear, Michael

    2011-10-01

    Although genetic epidemiological studies have confirmed increased rates of major depressive disorder among the relatives of people with bipolar affective disorder, no report has compared the clinical characteristics of depression between these two groups. To compare clinical features of depressive episodes across participants with major depressive disorder and bipolar disorder from within bipolar disorder pedigrees, and assess the utility of a recently proposed probabilistic approach to distinguishing bipolar from unipolar depression. A secondary aim was to identify subgroups within the relatives with major depression potentially indicative of 'genetic' and 'sporadic' subgroups. Patients with bipolar disorder types 1 and 2 (n = 246) and patients with major depressive disorder from bipolar pedigrees (n = 120) were assessed using the Diagnostic Interview for Genetic Studies. Logistic regression was used to identify distinguishing clinical features and assess the utility of the probabilistic approach. Hierarchical cluster analysis was used to identify subgroups within the major depressive disorder sample. Bipolar depression was characterised by significantly higher rates of psychomotor retardation, difficulty thinking, early morning awakening, morning worsening and psychotic features. Depending on the threshold employed, the probabilistic approach yielded a positive predictive value ranging from 74% to 82%. Two clusters within the major depressive disorder sample were found, one of which demonstrated features characteristic of bipolar depression, suggesting a possible 'genetic' subgroup. A number of previously identified clinical differences between unipolar and bipolar depression were confirmed among participants from within bipolar disorder pedigrees. Preliminary validation of the probabilistic approach in differentiating between unipolar and bipolar depression is consistent with dimensional distinctions between the two disorders and offers clinical utility in

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

    Science.gov (United States)

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

    2017-09-01

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

  16. 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

    BACKGROUND: A polymorphism in the serotonin transporter (5-HTT) gene seems to moderate the influence of stressful life events on depression. However, the results from previous studies of gene-environment interactions in depression are inconsistent and might be confounded by the history...... derived neurotrophic factor interact with recent stressful life events on depression among patients with no history of previous depressive episodes....... of depression among participants. METHOD: We applied a case-only design, including 290 ethnically homogeneous patients suffering exclusively from first episode depression. Psychiatric mo-morbidity, personality traits and disorders and stressful life events in a six months period preceding onset of depression...

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

    Science.gov (United States)

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

    2016-02-28

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

  18. Lithium's emerging role in the treatment of refractory major depressive episodes: augmentation of antidepressants.

    Science.gov (United States)

    Bauer, Michael; Adli, Mazda; Bschor, Tom; Pilhatsch, Maximilian; Pfennig, Andrea; Sasse, Johanna; Schmid, Rita; Lewitzka, Ute

    2010-01-01

    The late onset of therapeutic response and a relatively large proportion of nonresponders to antidepressants remain major concerns in clinical practice. Therefore, there is a critical need for effective medication strategies that augment treatment with antidepressants. To review the available evidence on the use of lithium as an augmentation strategy to treat depressive episodes. More than 30 open-label studies and 10 placebo-controlled double-blind trials have demonstrated substantial efficacy of lithium augmentation in the acute treatment of depressive episodes. Most of these studies were performed in unipolar depression and included all major classes of antidepressants, however mostly tricyclics. A meta-analysis including 10 randomized placebo-controlled trials has provided evidence that lithium augmentation has a statistically significant effect on the response rate compared to placebo with an odds ratio of 3.11, which corresponds to a number-needed-to-treat of 5. The meta-analysis revealed a mean response rate of 41.2% in the lithium group and 14.4% in the placebo group. One placebo-controlled trial in the continuation treatment phase showed that responders to acute-phase lithium augmentation should be maintained on the lithium-antidepressant combination for at least 12 months to prevent early relapses. Preliminary studies to assess genetic influences on response probability to lithium augmentation have suggested a predictive role of the -50T/C single nucleotide polymorphism of the GSK3beta gene. Augmentation of antidepressants with lithium is currently the best-evidenced augmentation therapy in the treatment of depressed patients who do not respond to antidepressants. Copyright 2010 S. Karger AG, Basel.

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

    Science.gov (United States)

    Cano, A; O'Leary, K D

    2000-10-01

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

  20. 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

    BACKGROUND: It has never been investigated whether first depression differs in patients who have experienced bereavement compared to patients who have not. METHOD: Patients discharged with a diagnosis of a single depressive episode from a psychiatric in- or outpatient hospital setting were...... consecutively sampled from the Danish Psychiatric Central Research Register. Patients participated in an extensive interview including the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) and the Interview of Recent Life Events (IRLE). RESULTS: Among 301 patients with a first depression, 26 patients...... (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...

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

    DEFF Research Database (Denmark)

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

    2009-01-01

    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......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.......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...

  2. [Depression: longer-lasting episode not an automatic indication for referral

    NARCIS (Netherlands)

    Bosch, W.J.H.M. van den; Weel-Baumgarten, E.M. van

    2003-01-01

    During episodes of depression, patients exhibit a low mood and a number of other emotional and/or physical symptoms for a certain period of time. Regarding depression as just the defined episode when patients meet the criteria for diagnosis, ignores the fluctuating character of the illness and the

  3. Differentiating early-onset chronic depression from episodic depression in terms of cognitive-behavioral and emotional avoidance.

    Science.gov (United States)

    Brockmeyer, Timo; Kulessa, Dominika; Hautzinger, Martin; Bents, Hinrich; Backenstrass, Matthias

    2015-04-01

    Although chronic depression is associated with lower global functioning and poorer treatment response than episodic depression, little is known about the differences between these two forms of depression in terms of psychological factors. Thus, the present study aimed at differentiating chronic and episodic depression regarding cognitive-behavioral and emotional avoidance that have been proposed as important risk factors for depression and promising targets for the treatment of depression. Thirty patients with early onset chronic depression were compared with 30 patients with episodic depression and 30 healthy, never-depressed controls in terms of self-reported cognitive-behavioral (social and non-social) and emotional avoidance. Chronically depressed patients reported more avoidance than healthy controls in each of the measures. Moreover, they reported more cognitive-nonsocial and behavioral-nonsocial as well as behavioral-social and emotional avoidance (in the form of restricted emotional expression to others) than patients with episodic depression. This kind of emotional avoidance also separated best between chronically and episodically depressed patients. Furthermore, general emotion avoidance and behavioral-social avoidance were positively correlated with levels of depression in chronically depressed patients. The results are based on self-report data and should thus be interpreted with caution. Additionally, the cross-sectional design limits any causal conclusions. The findings underscore the relevance of cognitive-behavioral and emotional avoidance in differentiating chronic from episodic depression and healthy controls and advocate a stronger focus on maladaptive avoidance processes in the treatment of chronic depression. Copyright © 2015 Elsevier B.V. All rights reserved.

  4. Factors associated with chronic depressive episodes: a preliminary report from the STAR-D project.

    Science.gov (United States)

    Gilmer, W S; Trivedi, M H; Rush, A J; Wisniewski, S R; Luther, J; Howland, R H; Yohanna, D; Khan, A; Alpert, J

    2005-12-01

    To identify baseline sociodemographic and clinical factors associated with a current chronic major depressive episode (MDE). Outpatients with major depressive disorder enrolled in 41 US primary or psychiatric care sites were divided into two groups based on self-report of current episode length ( or =24 months). Logistic regression models were used to identify factors associated with chronicity of current depressive episode. About 21.2% of 1380 subjects were in current, chronic MDEs. Older age, less education, lower income, no private insurance, unemployment, greater general medical illness burden, lower physical quality of life, concurrent generalized anxiety disorder, fewer prior episodes, and history of prior suicide attempts were all associated with chronic episodes. Blacks, Hispanics, and patients receiving care in primary as opposed to psychiatric care settings exhibited greater chronicity. Chronic depressive episodes are common and are associated with greater illness burden, comorbidity, socioeconomic disadvantage, and racial/ethnic minority status.

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

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel

    2005-01-01

    .4%). In outpatient settings, women slightly more often presented with milder types of depression than with severe depression, but no gender difference was found in the severity of depressive episodes among hospitalised patients. No differences were found between genders in the prevalence of depression with vs......BACKGROUND: It is unsure whether men and women present with different subtypes of depression. The aim of the study was to compare the prevalence of subtypes of a single depressive episode according to ICD-10 for men and women in a nationwide sample of all patients treated in psychiatric in...

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

    NARCIS (Netherlands)

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

    2017-01-01

    Objective Acute pancreatitis may be the first manifestation of pancreatic cancer. The aim of this study was to assess the risk of pancreatic cancer after a first episode of acute pancreatitis. Methods Between March 2004 and March 2007, all consecutive patients with a first episode of acute

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

    Directory of Open Access Journals (Sweden)

    Runjun Phookun

    2013-04-01

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

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

    Science.gov (United States)

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

    2017-05-01

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

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

    NARCIS (Netherlands)

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

    2015-01-01

    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

  10. 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.

  11. Symptom characteristics of depressive episodes prior to the onset of mania or hypomania.

    Science.gov (United States)

    Pfennig, A; Ritter, P S; Höfler, M; Lieb, R; Bauer, M; Wittchen, H-U; Beesdo-Baum, K

    2016-03-01

    Depressive episodes are typically the initial presentation of bipolar disorder. The evidence as to whether depressive episodes occurring in persons who later convert to bipolar disorder are symptomatically distinct from episodes of unipolar depression remains controversial. As there are crucial differences in the therapeutic management, symptom profiles indicating subsequent bipolar conversion may aid in appropriate treatment. A representative community sample of originally N = 3021 adolescents and young adults aged 14-24 years at baseline was assessed up to four times over 10 years. Assessment of symptoms was conducted by clinically trained interviewers using the standardized M-CIDI. Symptom profiles of depressive episodes were compared via logistic regression between subjects that subsequently developed (hypo-)manic episodes (n = 35) or remained unipolar depressive (n = 659). Initial depression amongst prospective converters was characterized by significantly increased suicidality (odds ratio, OR = 2.31), higher rates of feelings of worthlessness and excessive guilt (OR = 2.52), complete loss of pleasure (OR = 2.53) and diurnal variation (OR = 4.30). No differences were found for hyperphagia, hypersomnia and psychomotor alterations. Findings suggest that the symptom profile of initial depressive episodes may be useful in the identification of subjects with an elevated risk for the subsequent conversion to bipolar disorder. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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

    Directory of Open Access Journals (Sweden)

    Danyella de Melo Santos

    2011-01-01

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

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

    Science.gov (United States)

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

    2014-02-01

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

  14. Does Age at Onset of First Major Depressive Episode Indicate the Subtype of Major Depressive Disorder?: The Clinical Research Center for Depression Study

    Science.gov (United States)

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

    2014-01-01

    Purpose The purpose of this study was to evaluate the effects of age at onset of the first major depressive episode on the clinical features of individuals with major depressive disorder (MDD) in a large cohort of Korean depressed patients. Materials and Methods We recruited 419 MDD patients of age over 18 years from the Clinical Research Center for Depression study in South Korea. At the start of the study, the onset age of the first major depressive episode was self-reported by the subjects. The subjects were divided into four age-at-onset subgroups: childhood and adolescent onset (ages depressive episodes (F=3.475, p=0.016) and higher scores on the brief psychiatric rating scale (F=3.254, p=0.022), its negative symptom subscale (F=6.082, pdepressive episode is a promising clinical indicator for the clinical presentation, course, and outcome of MDD. PMID:25323911

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

    Science.gov (United States)

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

    2014-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Simoens Steven R

    2009-10-01

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

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

    NARCIS (Netherlands)

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

    2016-01-01

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

  18. 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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    NARCIS (Netherlands)

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

    2003-01-01

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

  1. 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…

  2. The Efficacy of Acute Electroconvulsive Therapy in Atypical Depression

    Science.gov (United States)

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

    2013-01-01

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

  3. 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

    - and middle-income non-Western countries. METHODS: Data from 47 countries of the 2002 World Health Organization World Health Survey were used, including 231,797 adults (mean age 41 years, 53% female). Diabetes was assessed by self-report of diagnosis or treatment. The presence of an episode of depressive......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...

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

    DEFF Research Database (Denmark)

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

    2009-01-01

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

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

    Science.gov (United States)

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

    2017-05-01

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

  6. Incident Major Depressive Episodes increase the severity and risk of apathy in HIV infection

    Science.gov (United States)

    Kamat, Rujvi; Cattie, Jordan E.; Marcotte, Thomas D.; Woods, Steven Paul; Franklin, Donald R.; Corkran, Stephanie H.; Ellis, Ronald J.; Grant, Igor; Heaton, Robert K.

    2015-01-01

    Apathy and depression are inter-related yet separable and prevalent neuropsychiatric disturbances in persons infected with HIV. In the present study of 225 HIV+ persons, we investigated the role of an incident depressive episode in changes in apathy. Participants completed the apathy subscale of the Frontal Systems Behavior Scale during a detailed neuropsychiatric and neuromedical evaluation at visit 1 and again at approximately a 14 month follow-up. The Composite International Diagnostic Interview was used to obtain diagnoses of a new major depressive disorder. At their follow-up visit, participants were classified into four groups depending on their visit 1 elevation in apathy and new major depressive episode (MDE) status. Apathetic participants at baseline with a new MDE (n=23) were at risk for continued, clinically elevated apathy at follow-up, although severity of symptoms did not increase. Of the 144 participants without clinically elevated apathy at visit 1, those who developed a new MDE (n=16) had greater apathy symptomatology at follow-up than those without MDE. These findings suggest that HIV+ individuals, who do not as yet present with elevated apathy, may be at greater risk of elevated psychiatric distress should they experience a new/recurrent depressive episode. Thus, in the context of previous findings, it appears that although apathy and depression are separable constructs, they interact such that a new depressive episode is a risk factor for incident apathy. PMID:25679203

  7. Gender Differences among Patients with a Single Depressive Episode

    DEFF Research Database (Denmark)

    Bukh, Jens D; 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...

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

    Science.gov (United States)

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

    2018-03-15

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

  9. Prevalence and risk factors of depressive episodes among student population in Wroclaw - epidemiological study results.

    Science.gov (United States)

    Zagdańska, Marta; Kiejna, Andrzej

    2016-01-01

    The aim of this study was to identify risk factors and estimate prevalence of depressive episodes among Wroclaw's universities students. Polish adaptation of the Composite International Diagnostic Interview (CIDI) was implemented to gather epidemiological data from 370 students of public universities in Wroclaw. Proportional stratified sampling was performed to obtain distinct, independent strata representing sex, year of study and educational profiles. Randomisation was ensured by recruitment procedures. Prevalence of depressive episodes among students in Wroclaw is high - 14.7% throughout life, 9.8% within 12 months prior to the interview. High prevalence of severe and moderate depressive episodes seems to be worrisome (respectively 5.1% and 6.6% throughout life, 3.8% and 3.9% within 12 months prior to the study). Year of study, profile and lack of partner relationship remain risk factor for depression. High prevalence of depressive episodes indicates the need for prevention and therapy based on epidemiological data and tailored to the students' needs. Depression among students requires further epidemiological studies.

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

    Directory of Open Access Journals (Sweden)

    Itxaso González-Ortega

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

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

    DEFF Research Database (Denmark)

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

    2010-01-01

    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...... setting were consecutively sampled from the Danish Psychiatric Central Research Register. The patients participated in an extensive interview including the Schedules for Clinical Assessment in Neuropsychiatry, the Structured Clinical Interview for DSM-IV Axis II Personality Disorders and a detailed...... of antidepressant treatment, and (2) 2 trials of antidepressant treatment. Further personality traits were assessed by means of the Eysenck Personality Questionnaire. RESULTS: Among a total of 301 patients with a single depressive episode, 31.9% fulfilled diagnostic criteria for at least 1 personality disorder...

  12. 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

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

    Science.gov (United States)

    Wakefield, J C; Schmitz, M F

    2016-04-01

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

  14. Neural basis of recollection in first-episode major depression

    NARCIS (Netherlands)

    van Eijndhoven, Philip; van Wingen, Guido; Fernández, Guillén; Rijpkema, Mark; Pop-Purceleanu, Monica; Verkes, Robbert Jan; Buitelaar, Jan; Tendolkar, Indira

    2013-01-01

    Background. Patients with major depressive disorder (MDD) display impairments in recollection, which have been explained by both hippocampal and prefrontal dysfunction. Here, we used an event-related fMRI design, to dissociate hippocampal and prefrontal contributions to the neural processes involved

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

    Science.gov (United States)

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

    2014-01-01

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

  16. Age at onset of first depressive episode as a predictor for escitalopram treatment of major depression comorbid with alcohol dependence.

    Science.gov (United States)

    Muhonen, Leea H; Lönnqvist, Jouko; Lahti, Jari; Alho, Hannu

    2009-05-15

    The aim of this study was to determine predictors of the response to escitalopram, a selective serotonin re-uptake inhibitor antidepressant and memantine, a non-competitive glutamate NMDA receptor blocker, for the treatment of major depression comorbid with alcohol dependence. Eighty alcohol dependent treatment-seeking adult patients with comorbid major depressive disorder were randomized to receive either memantine 20 mg or escitalopram 20 mg for 26 weeks. In both treatment groups, depression was reduced significantly. Comparisons were made between patients in remission (final Montgomery-Asberg Depression Rating Scale (MADRS)depressive episode significantly correlated with the treatment response in the escitalopram group; the mean age at onset of depression among patients on the non-responders group was 13.7+/-4.0 years and 31.9+/-11.9 years in remission. These results are significantly different from those with memantine. Our study provides evidence that the onset of the first major depressive episode might be a clinically relevant predictor of a response to escitalopram treatment in patients with major depression and comorbid alcohol dependence.

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

  19. Anxiety, depression and school absenteeism in youth with chronic or episodic headache

    OpenAIRE

    Rousseau-Salvador, Céline; Amouroux, Rémy; Annequin, Daniel; Salvador, Alexandre; Tourniaire, Barbara; Rusinek, Stéphane

    2014-01-01

    BACKGROUND: Chronic daily headache (CDH) in children has been documented in general and clinical populations. Comorbid psychological conditions, risk factors and functional outcomes of CDH in children are not well understood. OBJECTIVES: To examine anxiety and depression, associated risk factors and school outcomes in a clinical population of youth with CDH compared with youth with episodic headache (EH). METHODS: Data regarding headache characteristics, anxiety, depression and missed school ...

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

    Directory of Open Access Journals (Sweden)

    Elisabeth Haug

    2016-11-01

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

  1. Chronological and subjective age differences in flourishing mental health and major depressive episode.

    NARCIS (Netherlands)

    Keyes, C.L.M.; Westerhof, Gerben Johan

    2012-01-01

    Mental health is more than the absence of psychopathology, but few studies use positive mental health along with a measure of past year major depressive episode (MDE). This study addresses this gap by investigating the association of MDE and flourishing mental health (FMH) with chronological age and

  2. 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

  3. Vulnerability Before, During, and After a Major Depressive Episode : A 3-Wave Population-Based Study

    NARCIS (Netherlands)

    Ormel, J.; Oldehinkel, A.J.; Vollebergh, W.A.M.

    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

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  5. 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.

  6. 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

    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.

  7. Can Recurrence After an Acute Episode of Low Back Pain Be Predicted?

    Science.gov (United States)

    Machado, Gustavo C; Maher, Chris G; Ferreira, Paulo H; Latimer, Jane; Koes, Bart W; Steffens, Daniel; Ferreira, Manuela L

    2017-09-01

    Although recurrence is common after an acute episode of low back pain, estimates of recurrence rates vary widely and predictors of recurrence remain largely unknown. The purposes of the study were to determine the 1-year incidence of recurrence in participants who recovered from an acute episode of low back pain and to identify predictors of recurrence. The design was an inception cohort study nested in a case-crossover study. For 12 months, 832 of the 999 participants who initially presented to primary care within the first 7 days of an episode of low back pain were followed. Of these participants, 469 recovered (1 month pain free) from the index episode within 6 weeks and were included in this study. Recurrence was defined as a new episode lasting more than 1 day, or as an episode of care seeking. Putative predictors were assessed at baseline and chosen a priori. Multivariable regression analysis was used to calculate odds ratios (OR) and 95% confidence intervals (CI). The 1-year incidence of recurrence of low back pain was 33%, and the 1-year incidence of recurrence of low back pain with care seeking was 18%. Participants reporting more than 2 previous episodes of low back pain had increased odds of future recurrences (OR = 3.18, CI = 2.11-4.78). This factor was also associated with recurrent episodes that led to care seeking (OR = 2.87, CI = 1.73-4.78). No other factors were associated with recurrences. There are limitations inherent in reliance on recall. After an acute episode of low back pain, one-third of patients will experience a recurrent episode, and approximately half of those will seek care. Experiencing more than 2 previous episodes of low back pain triples the odds of a recurrence within 1 year.

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

    Science.gov (United States)

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

    2016-09-30

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

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

    DEFF Research Database (Denmark)

    Hansen, Bertel Teilfeldt; Sønderskov, Kim Mannemar; Hageman, Ida

    2017-01-01

    : Using time series intervention analysis of nationwide data from the Danish Psychiatric Central Research Register from 1995 to 2012, we compared the observed trend in the incidence rate of hospital contacts for unipolar depressive episodes after the transitions to and from summer time to the predicted...... trend in the incidence rate. Results: The analyses were based on 185,419 hospital contacts for unipolar depression and showed that the transition from summer time to standard time were associated with an 11% increase (95% CI = 7%, 15%) in the incidence rate of unipolar depressive episodes......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...

  10. Early report on brain arousal regulation in manic vs depressive episodes in bipolar disorder.

    Science.gov (United States)

    Wittekind, Dirk Alexander; Spada, Janek; Gross, Alexander; Hensch, Tilman; Jawinski, Philippe; Ulke, Christine; Sander, Christian; Hegerl, Ulrich

    2016-09-01

    The arousal regulation model of affective disorders attributes an important role in the pathophysiology of affective disorders to dysregulation of brain arousal regulation. According to this model, sensation avoidance and withdrawal in depression and sensation seeking and hyperactivity in mania can be explained as auto-regulatory attempts to counteract a tonically high (depression) or unstable (mania) arousal. The aim of this study was to compare brain arousal regulation between manic and depressive bipolar patients and healthy controls. We hypothesized that currently depressed patients with bipolar disorder show hyperstable arousal regulation, while currently manic patients show unstable arousal regulation. Twenty-eight patients with bipolar disorder received a 15-min resting electroencephalogram (EEG) during a depressive episode and 19 patients received the same during a manic/hypomanic episode. Twenty-eight healthy control subjects were matched for age and sex. The Vigilance Algorithm Leipzig (VIGALL), which classifies 1-s EEG segments as one of seven EEG-vigilance substages, was used to measure brain arousal regulation. Manic patients showed more unstable EEG-vigilance regulation as compared to the control sample (P = .004) and to patients with a depressive episode (P ≤ .001). Depressive patients had significantly higher mean vigilance levels (P = .045) than controls. A clear difference was found in the regulation of brain arousal of manic patients vs depressive patients and controls. These data suggest that brain arousal might depend on the current mood state, which would support the arousal regulation model of affective disorders. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. A comparison of capacities for social cognition and metacognition in first episode and prolonged depression.

    Science.gov (United States)

    Ladegaard, Nicolai; Lysaker, Paul H; Larsen, Erik R; Videbech, Poul

    2014-12-30

    There is a growing awareness that social cognition is a valuable construct for understanding the psycho-social disabilities in depressive illness. Numerous studies have linked affective disorders to impairments in social cognition and specifically the processing of discrete emotional stimuli. Only few studies have investigated the relation between the burden of depressive illness and social cognitive ability. To study these issues, we compared a group of first-episode depressed patients with a group of chronically depressed patients (duration >2 years) on a broad array of higher-order social cognitive measures including the metacognition assessment scale abbreviated. Contrary to prediction, deficits in social cognition were roughly equivalent between the two groups and there was no significant link between symptom severity and social cognitive ability. Having moderate to severe major depressive disorder (MDD) could be sufficient to predict the presence of deficits in social cognitive ability.

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

    Science.gov (United States)

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

    2015-08-01

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

  13. Subclinical Depressive Symptoms and Continued Cannabis Use: Predictors of Negative Outcomes in First Episode Psychosis

    Science.gov (United States)

    González-Ortega, Itxaso; Alberich, Susana; Echeburúa, Enrique; Aizpuru, Felipe; Millán, Eduardo; Vieta, Eduard; Matute, Carlos; González-Pinto, Ana

    2015-01-01

    Background 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. Methods 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. Results 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). Conclusions Subclinical depressive symptoms and continued cannabis abuse during follow-up could be predictors of negative outcomes in FEP patients. PMID:25875862

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

    Science.gov (United States)

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

    2012-12-20

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

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

    Directory of Open Access Journals (Sweden)

    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.

  16. Protective and vulnerability factors predicting new-onset depressive episode in a representative of U.S. adolescents.

    Science.gov (United States)

    Van Voorhees, Benjamin W; Paunesku, David; Kuwabara, Sachiko A; Basu, Anirban; Gollan, Jackie; Hankin, Benjamin L; Melkonian, Stephanie; Reinecke, Mark

    2008-06-01

    Depressive episodes cause considerable morbidity and mortality in adolescents. We sought to identify factors predicting new onset depressive episode in a representative sample of U.S. adolescents. We conducted logistic regression analyses to identify baseline individual, family, school/peer and community factors predicting new-onset depressive episode at a 1-year follow-up in a longitudinal cohort study of 4791 U.S. adolescents. Potential protective and vulnerability factors included individual (sociodemographics, general health and maturity, coping behavior, self-concept, and affect regulation), family (connectedness and conflict), school/peers (acceptance and performance), and community (engagement, delinquency, and adverse events). African American and Hispanic ethnicity, female gender, and low-income status predicted higher risk of onset of a depressive episode. Active coping and positive self-concept, predicted lower risk, whereas poor affect regulation and greater depressed mood predicted higher risk. Family "connectedness," parental warmth, peer acceptance, better school performance, and religious activities were protective, whereas parental conflict, delinquent activities, and greater numbers of adverse events increased risk of depressive episodes. Female gender, nonwhite ethnicity, low-income status, poor health, and parental conflict, increase risk of a depressive episode. Physicians should consider recommending behaviors that enhance perceived fitness, favorable self-concept, family connectedness, peer acceptance, and community engagement to youth as means a of mitigating this risk for developing a depressive episode.

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

    Science.gov (United States)

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

    2016-04-19

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

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

    Science.gov (United States)

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

    2015-01-01

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

  19. 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...

  20. Biological rhythms, metabolic syndrome and current depressive episode in a community sample.

    Science.gov (United States)

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

    2016-10-01

    The purpose of this study was to assess the disruption in biological rhythms and metabolic syndrome (MetS) in individuals with depressive episode. This was a cross-sectional, population-based study with a representative sample of 905 young adults. Current depressive episode were confirmed by a psychologist using the Mini International Neuropsychiatric Interview (MINI)-Plus. Self-reported biological rhythms were assessed using the Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN). MetS was defined using modified NCEP/ATPIII criteria. Significant main effects of current depressive episode (pbiological rhythm scores (p=0.002, η(2)=0.011) as well as sleep (p=0.001, η(2)=0.016) and social domains (pbiological rhythms are associated with key components of the MetS in community adults with MDD. The understanding of the complex interactions between biological rhythms, MetS and depression are important in the development of preventive and therapeutic strategies. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. 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

  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

    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......) and number needed to treat for an additional beneficial outcome (NNT) or number needed to treat for an additional harmful outcome (NNH) of oral ibuprofen compared to placebo for a range of outcomes, predominantly those recommended by the International Headache Society (IHS). MAIN RESULTS: We included 12...

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

    Science.gov (United States)

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

    2014-01-01

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

  4. Creating learning momentum through overt teaching interactions during real acute care episodes.

    Science.gov (United States)

    Piquette, Dominique; Moulton, Carol-Anne; LeBlanc, Vicki R

    2015-10-01

    Clinical supervisors fulfill a dual responsibility towards patient care and learning during clinical activities. Assuming such roles in today's clinical environments may be challenging. Acute care environments present unique learning opportunities for medical trainees, as well as specific challenges. The goal of this paper was to better understand the specific contexts in which overt teaching interactions occurred in acute care environments. We conducted a naturalistic observational study based on constructivist grounded theory methodology. Using participant observation, we collected data on the teaching interactions occurring between clinical supervisors and medical trainees during 74 acute care episodes in the critical care unit of two academic centers, in Toronto, Canada. Three themes contributed to a better understanding of the conditions in which overt teaching interactions among trainees and clinical supervisors occurred during acute care episodes: seizing emergent learning opportunities, coming up against challenging conditions, and creating learning momentum. Our findings illustrate how overt learning opportunities emerged from certain clinical situations and how clinical supervisors and trainees could purposefully modify unfavorable learning conditions. None of the acute care episodes encountered in the critical care environment represented ideal conditions for learning. Yet, clinical supervisors and trainees succeeded in engaging in overt teaching interactions during many episodes. The educational value of these overt teaching interactions should be further explored, as well as the impact of interventions aimed at increasing their use in acute care environments.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    The International Headache Society (IHS) provides guidance on the conduct of trials for acute treatment of episodic tension-type headache (TTH), a common disorder with considerable disability. Electronic and other searches identified randomised, double-blind trials of oral drugs treating episodic....... There was no evidence that any one outcome was better than others. The evidence available for treatment efficacy is small in comparison to the size of the clinical problem....

  6. Fusion analysis of first episode depression: Where brain shape deformations meet local composition of tissue

    Directory of Open Access Journals (Sweden)

    Mahdi Ramezani

    2015-01-01

    Full Text Available Computational neuroanatomical techniques that are used to evaluate the structural correlates of disorders in the brain typically measure regional differences in gray matter or white matter, or measure regional differences in the deformation fields required to warp individual datasets to a standard space. Our aim in this study was to combine measurements of regional tissue composition and of deformations in order to characterize a particular brain disorder (here, major depressive disorder. We use structural Magnetic Resonance Imaging (MRI data from young adults in a first episode of depression, and from an age- and sex-matched group of non-depressed individuals, and create population gray matter (GM and white matter (WM tissue average templates using DARTEL groupwise registration. We obtained GM and WM tissue maps in the template space, along with the deformation fields required to co-register the DARTEL template and the GM and WM maps in the population. These three features, reflecting tissue composition and shape of the brain, were used within a joint independent-components analysis (jICA to extract spatially independent joint sources and their corresponding modulation profiles. Coefficients of the modulation profiles were used to capture differences between depressed and non-depressed groups. The combination of hippocampal shape deformations and local composition of tissue (but neither shape nor local composition of tissue alone was shown to discriminate reliably between individuals in a first episode of depression and healthy controls, suggesting that brain structural differences between depressed and non-depressed individuals do not simply reflect chronicity of the disorder but are there from the very outset.

  7. Paternal postpartum mood: bipolar episodes? Depressão paterna: episódio bipolar?

    OpenAIRE

    Karen Amaral Tavares Pinheiro; Fabio Monteiro da Cunha Coelho; Luciana de Ávila Quevedo; Karen Jansen; Luciano de Mattos Souza; Jean Pierre Oses; Bernardo Lessa Horta; Ricardo Azevedo da Silva; Ricardo Tavares Pinheiro

    2011-01-01

    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: ...

  8. Causality and Pleiotropy in the Association Between Bullying Victimization in Adolescence and Depressive Episodes in Adulthood.

    Science.gov (United States)

    Kretschmer, Tina; Tropf, Felix C; Niezink, Nynke M D

    2018-02-01

    Children and adolescents who are victims or perpetrators of bullying victimization are at elevated risk for maladjustment problems, concurrently and in the long run. Previous studies suggest that this correlation is partly explained by genetic influence. However, whether the genetic correlation is independent of a causal effect of victimization on maladjustment remains unclear. Using data from 2,510 females from the TwinsUK registry, we applied an innovative extension of the Cholesky decomposition to investigate to what extent the association between victimization in adolescence and self-reported depressive episodes in adulthood is caused by shared genetic effects (pleiotropy), and to what extent it is due to a phenotypic causal relationship. We find that around 60% of the association between victimization and self-reported depressive episodes is due to a causal effect of victimization on depressive episodes, and 40% is due to pleiotropic effects. These findings underline the importance of integrating genetic information into social science research and demonstrate a neat strategy to elucidate causal mechanisms in the absence of experimental designs.

  9. 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

  10. Functional brain-imaging correlates of negative affectivity and the onset of first-episode depression.

    Science.gov (United States)

    Davey, C G; Whittle, S; Harrison, B J; Simmons, J G; Byrne, M L; Schwartz, O S; Allen, N B

    2015-04-01

    The amygdala and subgenual anterior cingulate cortex (sACC) are key brain regions for the generation of negative affect. In this longitudinal fMRI study of adolescents we investigated how amygdala-sACC connectivity was correlated with negative affectivity (NA) both cross-sectionally and longitudinally, and examined its relationship to the onset of first-episode depression. Fifty-six adolescents who were part of a larger longitudinal study of adolescent development were included. They had no history of mental illness at the time of their baseline scan (mean age 16.5 years) and had a follow-up scan 2 years later (mean age 18.8 years). We used resting-state functional-connectivity MRI to investigate whether cross-sectional and change measures of amygdala-sACC connectivity were (i) correlated with NA and its change over time, and (ii) related to the onset of first-episode depression. The magnitude of amygdala connectivity with sACC showed significant positive correlation with NA at both time-points. Further analysis confirmed that change in amygdala-sACC connectivity between assessments was correlated with change in NA. Eight participants developed a first episode of depression between the baseline and follow-up assessments: they showed increased amygdala-sACC connectivity at follow-up. Amygdala-sACC connectivity is associated with NA in adolescence, with change in connectivity between these regions showing positive correlation with change in NA. Our observation that the onset of depression was associated with an increase in connectivity between the regions provides support for the neurobiological 'scar' hypothesis of depression.

  11. 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

    • Higher-order social cognition in first-episode major depression.

      Science.gov (United States)

      Ladegaard, Nicolai; Larsen, Erik Roj; Videbech, Poul; Lysaker, Paul H

      2014-04-30

      Patients suffering from major depression experience difficulties in multiple cognitive faculties. A growing body of research has linked affective disorders to abnormalities in social cognition and specifically the processing of discrete emotional stimuli. However, little inquiry has gone into possible impairment in higher-order social cognition including theory of mind, social perception and metacognition. Forty-four medication-naïve patients with first-episode unipolar major depressive disorder and an equal number of matched controls were assessed by the Metacognitive Assessment Scale-Abbreviated (MAS-A), The Frith-Happé animations (FHA) and The Awareness of Social Inference Test (TASIT). Additionally, neurocognition was assessed utilyzing the Cambridge Neuropsychological Test Automated Battery (CANTAB). Depressed patients showed impairment in all domains of higher-order social cognitive ability. Importantly, social cognitive variables retained their inter-group significance after controlling for possible covariates including neurocognition. Results indicate that first-episode depressed patients experience difficulties in all domains of higher-order social cognition including theory of mind, social perception and metacognition. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

    • Recurrent episodic acute kidney injury as presenting manifestation of mitochondrial myopathy

      Directory of Open Access Journals (Sweden)

      T P Matthai

      2014-01-01

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

    • Anxiety, depression and school absenteeism in youth with chronic or episodic headache.

      Science.gov (United States)

      Rousseau-Salvador, Céline; Amouroux, Rémy; Annequin, Daniel; Salvador, Alexandre; Tourniaire, Barbara; Rusinek, Stéphane

      2014-01-01

      Chronic daily headache (CDH) in children has been documented in general and clinical populations. Comorbid psychological conditions, risk factors and functional outcomes of CDH in children are not well understood. To examine anxiety and depression, associated risk factors and school outcomes in a clinical population of youth with CDH compared with youth with episodic headache (EH). Data regarding headache characteristics, anxiety, depression and missed school days were collected from 368 consecutive patients eight to 17 years of age, who presented with primary headache at a specialized pediatric headache centre. A total of 297 patients (81%) were diagnosed with EH and 71 were diagnosed with CDH. Among those with CDH, 78.9% presented with chronic tension-type headache and 21.1% with chronic migraine (CM). Children with CDH had a higher depression score than the standardized reference population. No difference was observed for anxiety or depression scores between children with CDH and those with EH. However, children with CM were more anxious and more depressed than those with chronic tension-type headache. Youth experiencing migraine with aura were three times as likely to have clinically significant anxiety scores. Headache frequency and history were not associated with psychopathological symptoms. Children with CDH missed school more often and for longer periods of time. These findings document the prevalence of anxiety, depression and school absenteeism in youth with CDH or EH. The present research also extends recent studies examining the impact of aura on psychiatric comorbidity and the debate on CM criteria.

    • The natural history of insomnia: acute insomnia and first-onset depression.

      Science.gov (United States)

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

      2014-01-01

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

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

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

      2006-03-30

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

    • Managing the acute painful episode in sickle cell disease

      Directory of Open Access Journals (Sweden)

      B. Kaya

      2011-12-01

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

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

      Science.gov (United States)

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

      2015-11-01

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

    • DHA mediates the protective effect of fish consumption on new episodes of depression among women.

      Science.gov (United States)

      Reeves, John L; Otahal, Petr; Magnussen, Costan G; Dwyer, Terry; Kangas, Antti J; Soininen, Pasi; Ala-Korpela, Mika; Venn, Alison J; Smith, Kylie J

      2017-11-01

      In a longitudinal cohort study of young Australian adults, we reported that for women higher baseline levels of fish consumption were associated with reduced incidence of new depressive episodes during the 5-year follow-up. Fish are high in both n-3 fatty acids and tyrosine. In this study, we seek to determine whether n-3 fatty acids or tyrosine explain the observed association. During 2004-2006, a FFQ (nine fish items) was used to estimate weekly fish consumption among 546 women aged 26-36 years. A fasting blood sample was taken and high-throughput NMR spectroscopy was used to measure 233 metabolites, including serum n-3 fatty acids and tyrosine. During 2009-2011, new episodes of depression since baseline were identified using the lifetime version of the Composite International Diagnostic Interview. Relative risks were calculated using log-binomial regression and indirect effects estimated using the STATA binary_mediation command. Potential mediators were added to separate models, and mediation was quantified as the proportion of the total effect due to the mediator. The n-3 DHA mediated 25·3 % of the association between fish consumption and depression when fish consumption was analysed as a continuous variable and 16·6 % when dichotomised (reference group: fish other than n-3 fatty acids and tyrosine might be beneficial for women's mental health.

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

      Science.gov (United States)

      Holm-Hadulla, Rainer M

      2013-01-01

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

  1. Rapid progression of diabetic nephropathy is linked to inflammation and episodes of acute renal failure.

    Science.gov (United States)

    Kelly, K J; Dominguez, Jesus H

    2010-01-01

    Chronic kidney disease (CKD) from diabetic nephropathy is characterized by progressive loss of renal function. The renal decline has been viewed as a linear fall, presumably dependent on metabolic, hemodynamic and dietary stresses. However, renal injury in diabetic nephropathy can be rapidly aggravated by unpredictable external and internal factors, a state of affairs inconsistent with a linear loss of function. Acute renal injury and subsequent inflammation are potential factors, and we investigated their presence in renal biopsies from patients with nephropathy. In a protocol approved by the Indiana University School of Medicine Institutional Review Board, renal biopsy specimens, estimated GFR, proteinuria and renal survival were examined in patients with diabetic nephropathy. Prominent clusters of inflammatory cells, particularly macrophages, were detected in the renal biopsy specimens. CKD progressed rapidly but not linearly, in that CKD was characterized by a succession of seemingly random episodes of self-limited acute renal failure. Episodes of acute kidney injury were associated with progression to end-stage renal disease. We propose that diabetic nephropathy is complicated by unpredictable and possibly random episodes of usually self-limited acute renal failure, and by subsequent renal inflammation, which appear to accelerate progression and eventual kidney loss. Copyright © 2010 S. Karger AG, Basel.

  2. [Mixed episode: complex recognition and complicated treatment].

    Science.gov (United States)

    Gargoloff, Pedro Rafael

    2003-01-01

    Mixed Episode is a complex syndrome with difficult in its recognition, the most prolonged duration of bipolar episodes, more frequent psychotic profile than Pure Manic Episode, with high suicidality and poor response to drugs. There are evidences of less efficacy with Lithium and Carbamazepine in Manic Episode than mixed states. Valproate improve both, manic and depressive symptoms, and it is proposed to be first choice. Olanzapine has been widely evaluated, showing robust response in acute Mania as well in depressive symptoms during Mixed episode. In the field of clinical practice, there are many patients receiving more than one drug, usually Valproate plus a second generation antipsychotic.

  3. 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

  4. 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

  5. Longitudinal impact of anxiety on depressive outcomes in patients with acute coronary syndrome: Findings from the K-DEPACS study.

    Science.gov (United States)

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

    2017-09-01

    This study investigated the impact of anxiety evaluated within 2 weeks of an acute coronary syndrome (ACS) episode on depressive outcomes at a 1-year follow-up assessment. In 828 ACS patients, anxiety was determined by Hospital Anxiety and Depression Scale-anxiety subscale at baseline, and DSM-IV depressive disorders and depressive symptoms were evaluated both at baseline and follow-up. Anxiety at baseline was significantly associated with depressive disorder at the follow-up and less improvement in depressive symptoms over 1-year. Anxiety had negative longitudinal impacts on depressive outcomes of ACS, and therefore evaluation of anxiety could be recommended in recently developed ACS patients. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  6. L-Methylfolate For Bipolar I depressive episodes: An open trial proof-of-concept registry.

    Science.gov (United States)

    Nierenberg, Andrew A; Montana, Rebecca; Kinrys, Gustavo; Deckersbach, Thilo; Dufour, Steven; Baek, Ji Hyun

    2017-01-01

    L-methylfolate is a compelling candidate to treat bipolar I major depressive episodes. While approved as an adjunct for unipolar major depressive disorder, no studies have been done to assess the tolerability, safety, and efficacy of L-methylfolate for bipolar depression. As a first step, we developed a registry of bipolar patients treated with L-methylfolate to examine tolerability and outcomes. Subjects (N=10) received treatment as usual plus daily L-methylfolate 15mg for 6 weeks in this open-label registry. Depressive symptoms were assessed with the Montgomery Asberg Depression Rating Scale (MADRS) and manic symptoms with the Young Mania Rating Scale (YMRS). Effect size was measured with Cohen's d to provide an estimate of potential efficacy. The pre-treatment mean (SD) MADRS score was 23.4 (4.34); the post-treatment score was 13.9 (8.24). Cohen's d was 1.19. At post-treatment, 6/10 patients had at least 50% MADRS improvement, and 4/10 patients exhibited remission with MADRS≤10. The pre-treatment YMRS score was 3.2 (3.0); the post-treatment score was 2.7 (5.2). Cohen's d was 0.17. This registry was a small open-label clinical trial for a fluctuating disorder. We cannot rule out that our results are due to regression to the mean. A controlled trial is warranted. This first proof-of-concept open registry suggests that L-methylfolate in combination with treatment as usual has potential to treat bipolar depression. Copyright © 2016. Published by Elsevier B.V.

  7. Anxiety, depression and school absenteeism in youth with chronic or episodic headache

    Science.gov (United States)

    Rousseau-Salvador, Céline; Amouroux, Rémy; Annequin, Daniel; Salvador, Alexandre; Tourniaire, Barbara; Rusinek, Stéphane

    2014-01-01

    BACKGROUND: Chronic daily headache (CDH) in children has been documented in general and clinical populations. Comorbid psychological conditions, risk factors and functional outcomes of CDH in children are not well understood. OBJECTIVES: To examine anxiety and depression, associated risk factors and school outcomes in a clinical population of youth with CDH compared with youth with episodic headache (EH). METHODS: Data regarding headache characteristics, anxiety, depression and missed school days were collected from 368 consecutive patients eight to 17 years of age, who presented with primary headache at a specialized pediatric headache centre. RESULTS: A total of 297 patients (81%) were diagnosed with EH and 71 were diagnosed with CDH. Among those with CDH, 78.9% presented with chronic tension-type headache and 21.1% with chronic migraine (CM). Children with CDH had a higher depression score than the standardized reference population. No difference was observed for anxiety or depression scores between children with CDH and those with EH. However, children with CM were more anxious and more depressed than those with chronic tension-type headache. Youth experiencing migraine with aura were three times as likely to have clinically significant anxiety scores. Headache frequency and history were not associated with psychopathological symptoms. Children with CDH missed school more often and for longer periods of time. CONCLUSIONS: These findings document the prevalence of anxiety, depression and school absenteeism in youth with CDH or EH. The present research also extends recent studies examining the impact of aura on psychiatric comorbidity and the debate on CM criteria. PMID:24911174

  8. Frequency of acute bacterial meningitis in children with first episode of febrile seizures.

    Science.gov (United States)

    Siddiqui, Hina Batool; Haider, Nighat; Khan, Zarmast

    2017-07-01

    To determine the frequency of acute bacterial meningitis in children with first episode of febrile seizures. This cross-sectional study was conducted at the Polyclinic, Postgraduate Medical Institute, Islamabad, Pakistan, from December 2012 to August 2013, and comprised patients with first episode of fever and seizure. SPSS 10 was used for data analysis. Of the157 patients, 12(7.6%) were diagnosed to have acute bacterial meningitis with 5(41.6%) in the age group of 6-12 months, 4(33.3%) in 13-18 months and 3(25%) in the age group of 19-60 months. Clinicians evaluating children after a febrile seizure should direct their attention toward identifying the cause of the child's fever.

  9. Onset polarity in bipolar disorder: A strong association between first depressive episode and suicide attempts.

    Science.gov (United States)

    Cremaschi, Laura; Dell'Osso, Bernardo; Vismara, Matteo; Dobrea, Cristina; Buoli, Massimiliano; Ketter, Terence A; Altamura, A Carlo

    2017-02-01

    The role of onset polarity (OP) in patients with bipolar disorder (BD) has been increasingly investigated over the last few years, for its clinical, prognostic, and therapeutic implications. The present study sought to assess whether OP was associated with specific correlates, in particular with a differential suicidal risk in BD patients. A sample of 362 recovered BD patients was dichotomized by OP: depressed (DO) or elevated onset (EO: hypomanic/manic/mixed). Socio-demographic and clinical variables were compared between the subgroups. Additionally, binary logistic regression was performed to assess features associated with OP. DO compared with EO patients had older current age and were more often female, but less often single and unemployed. Clinically, DO versus EO had a more than doubled rate of suicide attempts, as well as significantly higher rates of BD II diagnosis, lifetime stressful events, current psychotropics and antidepressants use, longer duration of the most recent episode (more often depressive), but lower rates of psychosis and involuntary commitments. Retrospective design limiting the accurate assessment of total number of prior episodes of each polarity. Our results support the influence of OP on BD course and outcome. Moreover, in light of the relationship between DO and a higher rate of suicide attempts, further investigation may help clinicians in identifying patients at higher risk of suicide attempts. Copyright © 2016. Published by Elsevier B.V.

  10. Creativity and executive function across manic, mixed and depressive episodes in bipolar I disorder.

    Science.gov (United States)

    Soeiro-de-Souza, Márcio Gerhardt; Dias, Vasco Videira; Bio, Danielle Soares; Post, Robert M; Moreno, Ricardo A

    2011-12-01

    Creativity is a complex construct involving affective and cognitive components. Bipolar Disorder (BD) has been associated with creativity and is characterized by a wide range of affective and cognitive symptoms. Although studies of creativity in BD have tended to focus on creativity as a trait variable in medicated euthymic patients, it probably fluctuates during symptomatic states of BD. Since creativity is known to involve key affective and cognitive components, it is plausible to speculate that cognitive deficits and symptoms present in symptomatic BD could interfere with creativity. Sixty-seven BD type I patients medication free, age 18-35 years and experiencing a maniac, mixed, or depressive episodes, were assessed for creativity, executive functioning, and intelligence. Manic and mixed state patients had higher creativity scores than depressive individuals. Creativity was influenced by executive function measures only in manic patients. Intelligence did not influence creativity for any of the mood episode types. We propose that creativity in BD might be linked to the putative hyperdopaminergic state of mania and be dependent on intact executive function. Future studies should further explore the role of dopaminergic mechanisms in creativity in BD. Copyright © 2011 Elsevier B.V. All rights reserved.

  11. Endurance Tests Ability to predict Chronicity in First Episode Acute Low Back Pain Patients

    Directory of Open Access Journals (Sweden)

    Ali Asghar Norasteh

    2008-01-01

    Full Text Available Objective: Despite evaluation of spinal muscle endurance was done in chronic low back pain, this has not been studied in first episode acute low back pain. The purpose of present study was comparatively evaluating patients with first-episode low back pain and healthy subjects to predict disability and chronicity after six weeks with spinal muscle endurance tests. Materials & Methods: Through an analytical, cross sectional and case – control study in the first stage of research Eliot’s spinal endurance tests were used to evaluate endurance. Disability and pain were used to assess recovery. The study was conducted in two groups of patients (n=32 and normal subjects (n=51 using non-randomized simple sampling. In the second stage, a longitudinal prospective study was done. Studied variables were compared in recovered and non recovered patients after six weeks. Data were analyzed by using Kolmogorof – Smirnoff test, independent T test and Chi-Square. Results: The results of independent t tests showed lower muscular endurance in patients compared to normal individuals (P<0.0001. Also the results of independent t-tests showed lower flexor endurance in unrecovered patients (P<0.04. Conclusion: It seems low back pain patients can contract decreased endurance in the first episode and no need to repeat episodes. Results show may be endurance tests could differentiate acute low back pain patients with high risk to chronicity and disability.

  12. Characterization of treatment resistant depression episodes in a cohort of patients from a US commercial claims database.

    Directory of Open Access Journals (Sweden)

    Nicole Kubitz

    Full Text Available CONTEXT: Treatment Resistant Depression (TRD is a significant and burdensome health concern. OBJECTIVE: To characterize, compare and understand the difference between TRD and non-TRD patients and episodes in respect of their episode duration, treatment patterns and healthcare resource utilization. DESIGN AND SETTING: Patients between 18 and 64 years with a new diagnosis of major depressive disorder (MDD and without a previous or comorbid diagnosis of schizophrenia or bipolar disease were included from PharMetrics Integrated Database, a claims database of commercial insurers in the US. Episodes of these patients in which there were at least two distinct failed regimens involving antidepressants and antipsychotics were classified as TRD. PATIENTS: 82,742 MDD patients were included in the analysis; of these patients, 125,172 episodes were identified (47,654 of these were drug-treated episodes. MAIN OUTCOME MEASURES: Comparison between TRD and non-TRD episodes in terms of their duration, number and duration of lines of treatment, comorbidities, and medical resource utilization. RESULTS: Of the treated episodes, 6.6% (N = 3,134 met the criteria for TRD. The median time to an episode becoming TRD was approximately one year. The mean duration of a TRD episode was 1,004 days (vs. 452 days for a non-TRD episode. More than 75% of TRD episodes had at least four lines of therapy; half of the treatment regimens included a combination of drugs. Average hospitalization costs were higher for TRD than non-TRD episodes: $6,464 vs. $1,734, as were all other health care utilization costs. CONCLUSIONS: While this study was limited to relatively young and commercially covered patients, used a rigorous definition of TRD and did not analyze for cause or consequence, the results highlight high unmet medical need and burden of TRD on patients and health care resources.

  13. 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. © 2016 New York Academy of Sciences.

  14. Predictors of neurocognitive impairment at 2years after a first-episode major depressive disorder.

    Science.gov (United States)

    Gu, Chuan-Zheng; He, Hui-Li; Duan, Hui-Feng; Su, Zhong-Hua; Chen, Hong; Gan, Jing-Li

    2016-07-01

    Neurocognitive impairment is a contributor to major depressive disorder (MDD). However, MDD patients show great variability in the level and course of deficits. The present longitudinal study was to identify predictors of neurocognitive impairment in first-episode MDD patients. Neurocognitive performance was analyzed in a cohort of 100 patients at 2years after a first-episode MDD. Subgroups, deficit type vs. non-deficit type, were compared on baseline clinical, neuropsychological, premorbid and sociodemographic characteristics. The analysis was performed using the multivariate logistic regression to obtain a model for neurocognitive impairment determination. The predicted probabilities of multivariate logistic regression were analyzed using receiver operating characteristic (ROC) curve. Fifty-two percent of MDD participants presented general neurocognitive impairment. The regression analyses demonstrated that clinical and sociodemographic characteristics were not predictive variables. A model composed of processing speed, executive function, and attention, dexterity correctly classified 85.8% of the MDD patients with deficit type. ROC curve indicated that the changes of these three cognitions could identify MDD with deficit type from MDD with non-deficit type. In addition, ROC curve also indicated that processing speed and executive function could identify MDD from CN subjects. Finally, processing speed performance was negatively correlated with Hamilton Depression Scale scores in both MDD with deficit and non-deficit type. The present study provides novel insights on frequency and neurocognitive profile of subtypes of patients showing impairment. Our results suggest that processing speed impairment is a trait dimension of the disorder related to specific cognitive dysfunctions and the severity of depression. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Temperament and character profiles of Japanese university students with depressive episodes and ideas of suicide or self-harm: a PHQ-9 screening study.

    Science.gov (United States)

    Mitsui, Nobuyuki; Asakura, Satoshi; Shimizu, Yusuke; Fujii, Yutaka; Kako, Yuki; Tanaka, Teruaki; Oba, Koji; Inoue, Takeshi; Kusumi, Ichiro

    2013-11-01

    The aim of our study was to reveal the personality traits of individuals with major and other depressive episodes among the young adult population. Furthermore, character traits of individuals with ideas of suicide or self-harm were also investigated in this study. The subjects of this study were 1421 university students who completed the Patient Health Questionnaire (PHQ-9) and the Temperament and Character Inventory (TCI). The subjects were divided into three separate groups: the major depressive episode group (N = 41), the other depressive episode group (N = 97), and the non-depressive controls (N = 1283). This separation was achieved using the PHQ-9 algorithm diagnosis. We compared the TCI scores using an analysis of variance. Moreover, the Cochran-Armitage trend test was used to determine the diagnosis, ideas of suicide or self-harm, and analysis of character profiles. The major depressive episode group had significantly higher HA (P depressive controls. The other depressive episode group had significantly higher HA scores (P depressive controls. The Cochran-Armitage trend test revealed that the prevalence of depressive episodes decreased as the character profiles matured (χ(2)(trend) = 57.2, P depressive episodes. Furthermore, the immaturity of character profiles was clearly associated with depressive episodes and ideas of suicide or self-harm. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Longitudinal monitoring of the serotonin transporter gene expression to assess major depressive episode evolution.

    Science.gov (United States)

    Belzeaux, Raoul; Loundou, Anderson; Azorin, Jean-Michel; Naudin, Jean; Ibrahim, El Chérif

    2014-01-01

    Mood disorders are frequently characterized by uncertain prognosis and studying mRNA expression variations in blood cells represents a promising avenue of identifying biomarkers for mood disorders. State-dependent gene expression variations have been described during a major depressive episode (MDE), in particular for SLC6A4 mRNA, but how this transcript varies in relation to MDE evolution remains unclear. In this study, we prospectively assessed time trends of SCL6A4 mRNA expression in responder and nonresponder patients. We examined SLC6A4 mRNA expression in blood samples from 13 patients treated for severe MDE and their matched controls by reverse transcription and quantitative PCR. All subjects were followed for 30 weeks. Patients were classified as either responders or nonresponders based on improvement of depression according to the 17-item Hamilton Depression Rating Scale. Using a longitudinal design, we ascertained mRNA expression at baseline, 2, 8, and 30 weeks and compared mRNA expression between responder and nonresponder patients, and matched controls. We observed a decrease of SLC6A4 mRNA expression in responder patients across a 30-week follow-up, while nonresponder patients exhibited up-regulated SLC6A4 mRNA. Peripheral SLC6A4 mRNA expression could serve as a biomarker for monitoring and follow-up during an MDE and may help to more appropriately select individualized treatments. © 2014 S. Karger AG, Basel.

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

    Science.gov (United States)

    Mumma, Gregory H

    2002-10-01

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

  18. Neurocognitive Graphs of First-Episode Schizophrenia and Major Depression Based on Cognitive Features.

    Science.gov (United States)

    Liang, Sugai; Vega, Roberto; Kong, Xiangzhen; Deng, Wei; Wang, Qiang; Ma, Xiaohong; Li, Mingli; Hu, Xun; Greenshaw, Andrew J; Greiner, Russell; Li, Tao

    2018-04-01

    Neurocognitive deficits are frequently observed in patients with schizophrenia and major depressive disorder (MDD). The relations between cognitive features may be represented by neurocognitive graphs based on cognitive features, modeled as Gaussian Markov random fields. However, it is unclear whether it is possible to differentiate between phenotypic patterns associated with the differential diagnosis of schizophrenia and depression using this neurocognitive graph approach. In this study, we enrolled 215 first-episode patients with schizophrenia (FES), 125 with MDD, and 237 demographically-matched healthy controls (HCs). The cognitive performance of all participants was evaluated using a battery of neurocognitive tests. The graphical LASSO model was trained with a one-vs-one scenario to learn the conditional independent structure of neurocognitive features of each group. Participants in the holdout dataset were classified into different groups with the highest likelihood. A partial correlation matrix was transformed from the graphical model to further explore the neurocognitive graph for each group. The classification approach identified the diagnostic class for individuals with an average accuracy of 73.41% for FES vs HC, 67.07% for MDD vs HC, and 59.48% for FES vs MDD. Both of the neurocognitive graphs for FES and MDD had more connections and higher node centrality than those for HC. The neurocognitive graph for FES was less sparse and had more connections than that for MDD. Thus, neurocognitive graphs based on cognitive features are promising for describing endophenotypes that may discriminate schizophrenia from depression.

  19. Detecting Acute Otitis Media Symptom Episodes Using a Mobile App: Cohort Study.

    Science.gov (United States)

    Prins-van Ginkel, Annemarijn C; de Hoog, Marieke LA; Uiterwaal, C; Smit, Henriette A; Bruijning-Verhagen, Patricia Cj

    2017-11-28

    Population cohort studies are useful to study infectious diseases episodes not attended by health care services, but conventional paper diaries and questionnaires to capture cases are prone to noncompliance and recall bias. Use of smart technology in this setting may improve case finding. The objective of our study was to validate an interactive mobile app for monitoring occurrence of acute infectious diseases episodes in individuals, independent of health care seeking, using acute otitis media (AOM) symptom episodes in infants as a case study. We were interested in determining participant compliance and app performance in detecting and ascertaining (parent-reported) AOM symptom episodes with this novel tool compared with traditional methods used for monitoring study participants. We tested the InfectieApp research app to detect AOM symptom episodes. In 2013, we followed 155 children aged 0 to 3 years for 4 months. Parents recorded the presence of AOM symptoms in a paper diary for 4 consecutive months and completed additional disease questionnaires when AOM symptoms were present. In 2015 in a similar cohort of 69 children, parents used an AOM diary and questionnaire app instead. During conventional and app-based recording, 93.13% (17,244/18,516) and 94.56% (7438/7866) of symptom diaries were returned, respectively, and at least one symptom was recorded for 32.50% (n=5606) and 43.99% (n=3272) of diary days (Papp-based recording. The use of the study's smart diary app improved AOM case finding and disease questionnaire completeness. For common infectious diseases that often remain undetected by health care services, use of this technology can substantially improve the accurateness of disease burden estimates. ©Annemarijn C Prins-van Ginkel, Marieke LA de Hoog, C Uiterwaal, Henriette A Smit, Patricia CJ Bruijning-Verhagen. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 28.11.2017.

  20. Evaluation of Innate Immunity Biomarkers on Admission and at Discharge From an Acute Heart Failure Episode.

    Science.gov (United States)

    Silva, Nuno; Patrício, Emília; Bettencourt, Paulo; Guimarães, João Tiago

    2016-11-01

    The involvement of the immune system in heart failure (HF) has been demonstrated. Evidence shows that innate immunity can have a role in the remodeling process and progression of HF. With previous studies showing the prognostic value of some innate immunity markers and their relevance in this condition, we aim to evaluate how these markers vary on hospitalization due to an acute episode of HF and at discharge. About 154 patients admitted with acute HF were prospectively recruited. Patients were evaluated on admission and at discharge from the hospital. Patients with infection were separately analyzed. Innate immunity, inflammatory, and cardiac biomarkers were measured and were compared between groups and between admission and discharge and with reference values of biological variation. Median patients' age was 78 years, and half of the patients were men. The median duration of hospitalization was 6 days. C3 and C4 protein levels significantly increased (P innate immunity markers such as C3 and C4 increase after treatment for acute HF, supporting the hypothesis that they can be involved in the resolution of the acute episode. © 2016 Wiley Periodicals, Inc.

  1. Impact of depressive episodes on cognitive deficits in early bipolar disorder: data from the Systematic Treatment Optimization Programme for Early Mania (STOP-EM).

    Science.gov (United States)

    Muralidharan, Kesavan; Torres, Ivan J; Silveira, Leonardo E; Kozicky, Jan-Marie; Bücker, Joana; Fernando, Nadeesha; Yatham, Lakshmi N

    2014-07-01

    Although manic episodes reportedly contribute to cognitive deficits in bipolar I disorder, the contribution of depressive episodes is poorly researched. We investigated the impact of depressive episodes on cognitive function early in the course of bipolar I disorder. A total of 68 patients and 38 controls from the Systematic Treatment Optimization Programme for Early Mania (STOP-EM) first-episode mania programme were examined. We conducted (a) a cross-sectional analysis of the impact of prior depressive episodes on baseline cognitive function and (b) a prospective analysis assessing the contribution of depression recurrence within 1 year following a first episode of mania on cognitive functioning. The cross-sectional analysis showed no significant differences between patients with past depressive episodes compared with those without, on overall or individual domains of cognitive function (all P>0.09). The prospective analysis failed to reveal a significant group×time interaction for cognitive decline from baseline to 1 year (P = 0.99) in patients with a recurrence of depressive episodes compared with those with no recurrence. However, impaired verbal memory at baseline was associated with a depression recurrence within 1 year. Although deficits in all domains of cognitive function are seen in patients early in the course of bipolar disorder, depressive episodes do not confer additional burden on cognitive function. However, poorer verbal memory may serve as a marker for increased susceptibility to depression recurrence early in the course of illness. Royal College of Psychiatrists.

  2. What patients with bipolar disorder and major depressive disorder perceive as adverse life events precipitating a current major depressive episode

    Directory of Open Access Journals (Sweden)

    Robyn Anne van Schoor

    2015-05-01

    Full Text Available Background. Adverse life events (ALEs as precipitants of a major depressive episode (MDE have been the subject of many studies. These studies indicate an increase in ALEs in the 6 months preceding an MDE. Objectives. The study examined what participants, suffering from major depressive disorder (MDD or bipolar disorder (BD, perceived as the precipitating ALE of a current MDE. The severity and categories of ALEs were compared between these two patient groups. Methods. Consenting, adult inpatients were sourced from Weskoppies Hospital, Steve Biko Academic Hospital, Tshwane District Hospital, Denmar Psychiatric Hospital and Vista Clinic in the Pretoria area. A semi-structured questionnaire was used to obtain demographic data and the diagnosis. Information regarding the course of the disorder, including the number of previous MDEs and the age at which the first MDE occurred, was also obtained. The perceived precipitating ALE was detailed for each participant. A severity value referred to as a Life Change Unit Score (LCU score, based on the Recent Life Changes Questionnaire (RLCQ by Miller and Rahe, was then assigned to each participant’s perceived precipitant. Results. Of the 64 participants, 12.7 % were experiencing a first MDE. In those participants who had experienced prior episodes the average number (standard deviation (SD of previous episodes was 3.86 (2.46. The mean approximate age (SD at first onset of an MDE was 24.81 (10.9 years. The BD group had significantly more previous MDEs than the MDD group. Although the average LCU scores were higher in the BD group than the MDD group this did not reach statistical significance. Therefore, this study could not find a difference in the severity of the perceived precipitants between the BD group and MDD group. However, when the LCU scores were analysed within subcategories of the RLCQ, it was found that participants with BD perceived significantly more problems associated with the workplace as

  3. 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

    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...

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

    Science.gov (United States)

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

    2012-12-01

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

  5. Air pollution as a risk factor for depressive episode in patients with cardiovascular disease, diabetes mellitus, or asthma.

    Science.gov (United States)

    Cho, Jaelim; Choi, Yoon Jung; Suh, Mina; Sohn, Jungwoo; Kim, Hyunsoo; Cho, Seong-Kyung; Ha, Kyoung Hwa; Kim, Changsoo; Shin, Dong Chun

    2014-03-01

    There is currently insufficient evidence to confirm the effect of ambient air pollution on mental disorders, especially among susceptible populations. This study investigated the short-term effect of ambient air pollution on the risk of depressive episode and the effect modification across disease subpopulations. Subjects who visited the emergency department (ED) for depressive episode from 2005 to 2009 (n=4985) in Seoul, Republic of Korea were identified from medical claims data. We conducted a time-stratified case-crossover study using conditional logistic regression. Subgroup analyses were conducted after the subjects were stratified by underlying disease (cardiovascular disease, diabetes mellitus, chronic obstructive pulmonary disease, asthma, and depressive disorder). The risk was expressed as an odds ratio (OR) per 1 standard deviation of each air pollutant. SO2, PM10, NO2, and CO were positively associated with ED visits for depressive episode. The maximum risk was observed in the distributed lag 0-3 model for PM10 (OR, 1.120; 95% confidence interval, 1.067-1.176). PM10, NO2, and CO significantly increased the risks of ED visits for depressive episode in subjects with either underlying cardiovascular disease, diabetes mellitus, asthma, or depressive disorder. Our data may include a misclassification bias due to the validity of a diagnosis determined from medical services utilization data. SO2, PM10, NO2, and CO significantly increased the risk of ED visits for depressive episode, especially among individuals with pre-existing cardiovascular disease, diabetes mellitus, or asthma. Copyright © 2014 Elsevier B.V. All rights reserved.

  6. Predictive value of homocysteine for depression after acute coronary syndrome

    Science.gov (United States)

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

    2016-01-01

    We investigated roles of plasma homocysteine and MTHFR gene in relation to risks and treatment responses of depression in ACS. A sample of 969 patients with recent ACS were recruited and 711 followed 1 year later. In addition, of 378 baseline participants with depressive disorder, 255 were randomized to a 24-week double blind trial of escitalopram (N = 127) or placebo (N = 128). A higher homocysteine concentration was independently associated with prevalent depressive disorder at baseline irrespective of MTHFR genotype; and with both incident and persistent depressive disorder at follow-up only in the presence of TT genotype. MTHFR genotype was not itself associated with depressive disorder after ACS. No associations were found with 24-week antidepressant treatment responses. Plasma homocysteine could be a biomarker for depressive disorder particularly in the acute phase of ACS. Focused interventions for those with higher homocysteine level and MTHFR TT genotype might reduce the risk of later depressive disorder. PMID:27626182

  7. 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...

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

    Science.gov (United States)

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

    2017-02-22

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

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

    Directory of Open Access Journals (Sweden)

    Cuciureanu Dan Iulian

    2017-12-01

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

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

    DEFF Research Database (Denmark)

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

    2018-01-01

    lesions were observed in 84% (21/25) at onset of ON; 62%(13/25) progressed to MS with more frequent location in brainstem (p = 0.030) and lesions in periventricular areas (p = 0.015). Spinal cord lesions were detected only in patients who progressed to MS (p = 0.002). MOG-IgG was detected in one patient...... with an optic nerve lesion located at IO and CAN. Serum AQP4-IgG was detected in none. Follow-up MRI showed progression in optic nerve lesions in 55% (11/20) patients. CONCLUSIONS: Specific location of optic nerve and brain lesions and the presence of spinal cord lesions in the acute phase of the first......BACKGROUND: Optic neuritis (ON) is a focal demyelinating event, which may evolve into multiple sclerosis (MS). OBJECTIVE: To study MRI characteristics in the acute phase of the first ON episode. METHODS: A prospective population-based study was performed on 31 patients with a first episode of acute...

  11. Prolonged episodes of acute diarrhea reduce growth and increase risk of persistent diarrhea in children

    Science.gov (United States)

    Moore, Sean R.; Lima, Noélia L.; Soares, Alberto M.; Oriá, Reinaldo B.; Pinkerton, Relana C.; Barrett, Leah J.; Guerrant, Richard L.; Lima, Aldo A.M.

    2010-01-01

    Background & Aims Prolonged episodes of acute diarrhea (ProD, duration 7–13 days) or persistent diarrhea (PD, duration ≥14 days) are important causes of undernutrition, yet the epidemiology and nutritional impact of ProD are poorly understood. Methods We conducted a 10-year cohort study of 414 children from a Brazilian shantytown who were followed from birth; data were collected on diarrhea, enteric pathogens, and anthropometry. Results During 1,276 child-years of observation, we recorded 3,257 diarrheal episodes. ProD was twice as common as PD (12% and 5% of episodes, respectively); ProD and PD together accounted for 50% of all days with diarrhea. ProD was more common in infants whose mothers had not completed primary school (relative risk [RR]=2.1; 95% confidence interval=1.02–2.78). Early weaning was associated with earlier onset of ProD (Spearman's ρ, 0.309; P=0.005). Infants with ProD were twice as likely to develop PD in later childhood (log rank P=0.002) compared to infants with only acute diarrhea (AD, duration Children's growth was more severely stunted before their first episode of ProD, compared with AD (mean height-for-age Z score (HAZ) -0.81 vs. -0.51, Pchildren at risk of a vicious cycle of diarrhea and malnutrition. Further studies are needed to address the recognition and control of ProD and its consequences in resource-limited settings and assess its role in PD pathogenesis. PMID:20638937

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

    Science.gov (United States)

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

    2015-01-01

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

  13. Aberrant default mode network homogeneity in patients with first-episode treatment-naive melancholic depression.

    Science.gov (United States)

    Cui, Xilong; Guo, Wenbin; Wang, Yi; Yang, Tian-Xiao; Yang, Xin-Hua; Wang, Yefei; Gong, Jingbo; Tan, Changlian; Xie, Guangrong

    2017-02-01

    Melancholic depression is a relatively homogenous subtype of major depressive disorders (MDD). The condition has several endogenous symptoms and represents strong biological components. However, its specific neurobiological mechanisms remain unknown. Previous neuroimaging findings indicated that default mode network (DMN) is closely related to MDD. The present study examined the network homogeneity (NH) of the DMN in patients with melancholic MDD. A total of 33 first-episode, treatment-naive melancholic MDD patients and 32 healthy controls underwent a resting-state functional magnetic resonance imaging scan. The data were analyzed using the NH method. Compared with healthy controls, patients with melancholic MDD showed low NH values in the right middle temporal gyrus and temporal pole (MTG/TP). The abnormal NH of this region and clinical characteristics were not correlated. Abnormal NH pattern of DMN exists in patients with melancholic MDD. This feature may be part of the pathophysiological basis of this disorder. Copyright © 2016 Elsevier B.V. All rights reserved.

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

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    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

  15. 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

  16. Depressive episodes of bipolar disorder in early teenage years: changes with increasing age and the significance of IQ.

    Science.gov (United States)

    Shiratsuchi, T; Takahashi, N; Suzuki, T; Abe, K

    2000-05-01

    Depressive (or depression-like) episodes are the most common manifestations of bipolar affective disorder in early teenage years. The present paper analyses the clinical features and their changes over time in these episodes. By a prospective study on children who had their first affective or psychotic episodes between the ages of ten and fifteen, those who eventually met the ICD 10 diagnostic criteria for bipolar disorder were selected and followed up. There were three boys and nine girls. Their early depressive episodes were characterised by psychotic features and clinging to the mother in most cases, and in some by brief episodes and/or a good response to sulpiride. However, these characteristics tended to disappear with increasing age. Five children (42%) had an IQ of 61-75. Generalisability of the results is limited because of the small number of patients and the lack of control groups. Bipolar disorder in early teenage years may show clinical features and a drug response that are different from those in adulthood. Low IQ may expedite the onset of bipolar disorder.

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

    Directory of Open Access Journals (Sweden)

    B. I. Yaremin

    2017-01-01

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

  18. 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.

  19. Transnational Ties and Past-Year Major Depressive Episodes among Latino Immigrants

    Science.gov (United States)

    Alcántara, Carmela; Chen, Chih-Nan; Alegría, Margarita

    2014-01-01

    Objective Latino immigrants live in an increasingly global world where maintaining contact with kin in the home country is easier than ever. We examined: (a) the annual distribution of remittances burden (percentage of remittances/household income) and visits to the home country; (b) the association of these transnational ties with odds of a past-year major depressive episode (MDE); and (c) moderation by Latino sub-ethnicity or gender. Methods We conducted weighted logistic regression analyses with the Latino immigrant subsample (N=1614) of the National Latino and Asian American Study. Results Mexican and Other Latino immigrants had greater remittances burden than Puerto Rican migrants. Cuban immigrants made fewer visits back home than Puerto Rican migrants. After adjustment for socio-demographics and pre-migration psychiatric history, a percentage increase in remittances burden decreased odds of MDE (OR=0.80 [95%CI:0.67–.0.98]), whereas visits back home increased odds of MDE (OR=1.04 [95%CI:1.01–1.06]). Latino sub-ethnicity was not a significant moderator. Visits back home were more strongly linked to depression among women than men. Conclusions The distribution of transnational ties differs by Latino subgroup, although its association with depression is similar across groups. Monetary giving in the form of remittances might promote a greater sense of self-efficacy, social integration, and caregiving for relatives back home that positively affect mental health. Visits back home, especially for women, might signal social stress from strained relationships with kin/spouses/children left behind, or increased caregiving demands that negatively affect mental health. Clinical practice with immigrants should routinely assess the social resources and strains that fall outside national borders. PMID:25090146

  20. The prospective association between obesity and major depression in the general population : does single or recurrent episode matter?

    NARCIS (Netherlands)

    Nigatu, Yeshambel T.; Bultmann, Ute; Reijneveld, Sijmen A.

    2015-01-01

    Background: Obesity and major depressive disorder (MDD) are important public health problems. MDD is a heterogeneous disorder and the direction of its association with obesity remains unclear. Evidence grows that recurrent MDD (MDD-R) differs in etiology and prognosis from single episode MDD

  1. [Depression in Acute Coronary Syndromes: Application of the Beck Depression Inventory].

    Science.gov (United States)

    Arevalo, Jimmy J; Soto, Karen A; Caamaño, Beatriz

    2014-03-01

    Depression has been related to the occurrence of cardiovascular diseases, and also appears to increase the risk of death from coronary artery disease. The presence of depression after the occurrence of an acute coronary syndrome (ACS) and its relationship with socioeconomic factors has not been studied in Colombia. To describe the frequency of depression and associated factors in patients hospitalized with an ACS. A cross-sectional study was carried out between April and May 2008 in three coronary care units in Santa Marta, Colombia. The presence of depression was evaluated with the Beck Depression Inventory (BDI). Depression was considered to be present if BDI was equal or greater than 10. The relationship between the presence of depression and demographic, clinic and laboratory characteristics was analyzed. A BDI score ≥10 (any degree of depression) was seen in 21 (63.64%) of the patients. In 9 out of 10 (91.66%) patients without stable income had depression in contrast to 12 out of 23 (57.14%) with stable income (P=.037). Depression was found in in 8 of the 8 (100%) patients with electrocardiographic pathological T wave inversion, in contrast to 13 out of the 25 (52%) without changes in T wave (P=.014). Depression was detected in 17 of 22 (77.27%) patients who smoked cigarettes versus 4 of 11 (36.36%) of patients who have never smoked (P=.021). Depressive symptoms are significantly present in patients suffering an acute coronary syndrome. Unemployment, pathological T wave inversion, and smoking seem to be associated with the presence of depressive symptoms after an acute coronary event. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  2. Randomized clinical trial of observational versus antibiotic treatment for a first episode of CT-proven uncomplicated acute diverticulitis

    NARCIS (Netherlands)

    Daniels, L.; de Korte, N.; van Dieren, S.; Stockmann, H. B.; Vrouenraets, B. C.; Consten, E. C.; van der Hoeven, J. A.; Eijsbouts, Q. A.; Faneyte, I. F.; Bemelman, W. A.; Dijkgraaf, M. G.; Boermeester, M. A.; Glaap, C. E M; Croonen, A.; Cuesta, M. A.; Kuijvenhoven, J.; Buijsman, R.; Den Uil, S.; De Reuver, P. R.; Tuynman, J. B.; Van de Wall, B. J M; Stam, M. A W; Roumen, R. M H; Truin, W.; Wijn, R.; Gerhards, M. F.; Kuhlmann, K. F D; Van der Zaag, E. S.; Biemond, J. E.; Klicks, R. J.; Dhar, N.; Cense, H. A.; De Groot, G. H.; Pikoulin, Y.; Van Ramshorst, G. H.; Hoornweg, L. L.; Koet, L.; Van Geloven, A. A W; Emous, M.; Claassen, A. T P M; Mollink, S.; Sonneveld, D. J A; Bouvé, L.; Diepenhorst, G. M P; Vles, W. J.; Toorenvliet, B. R.; Lange, J. F.; Mannaerts, G. H H; Grotenhuis, B. A.; tot Nederveen Cappel, R. J De Vos; Deerenberg, E. B.; Depla, A. C T M; Bruin, S.; Vos, X.; Scheepers, J. J G; Boom, M. J.; Boerma, D.; Van Esser, S.; Pruim, J.; Reitsma, J. B.

    Background: Antibiotics are advised in most guidelines on acute diverticulitis, despite a lack of evidence to support their routine use. This trial compared the effectiveness of a strategy with or without antibiotics for a first episode of uncomplicated acute diverticulitis. Methods: Patients with

  3. Randomized clinical trial of observational versus antibiotic treatment for a first episode of CT-proven uncomplicated acute diverticulitis

    NARCIS (Netherlands)

    Daniels, L.; Unlu, C.; Korte, N. de; Dieren, S. van; Stockmann, H.B.; Vrouenraets, B.C.; Consten, E.C.; Hoeven, J.A. van der; Eijsbouts, Q.A.; Faneyte, I.F.; Bemelman, W.A.; Dijkgraaf, M.G.; Boermeester, M.A.; Reuver, P.R.; et al.,

    2017-01-01

    BACKGROUND: Antibiotics are advised in most guidelines on acute diverticulitis, despite a lack of evidence to support their routine use. This trial compared the effectiveness of a strategy with or without antibiotics for a first episode of uncomplicated acute diverticulitis. METHODS: Patients with

  4. 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.

  5. Noradrenaline plays a critical role in the switch to a manic episode and treatment of a depressive episode

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    Kurita M

    2016-09-01

    Full Text Available Masatake Kurita1–3 1Koutokukai Wakamiya Hospital, Yoshihara, Yamagata, 2Department of Cellular Signaling, Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, 3Department of Psychiatry and Behavioral Science, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan Abstract: Although antidepressants may increase the risk of switching to mania in bipolar disorder (BD, clinicians have been using antidepressants to treat patients with bipolar depression. Appropriate treatments for bipolar depression remain controversial. In BD, antidepressants comprise a double-edged sword in terms of their efficacy in treating depression and the increased risk of switching. This review presents an important table outlining the benefit in terms of depression improvement and the risk of switching in the clinical setting. It also proposes strategies based on the characteristics of antidepressants such as their pharmacology, specifically the equilibrium dissociation constant (KD of the noradrenaline transporter. This table will be useful for clinicians while considering benefit and risk. Antidepressants augmenting noradrenaline may be effective in bipolar depression. However, it is easily presumed that such antidepressants may also have a risk of switching to mania. Therefore, antidepressants augmenting noradrenaline will be the recommended treatment in combination with an antimanic agent, or they may be used for short-term treatment and early discontinuation. The corresponding medical treatment guidelines probably need to be reevaluated and updated based on biological backgrounds. From previous studies, we understand that the stability of noradrenaline levels is important for BD amelioration, based on the pathophysiology of the disorder. It is hoped that researchers will reevaluate BD by conducting studies involving noradrenaline. Keywords: 3-methoxy-4-hydroxyphenylglycol, dopamine, homovanillic acid, brain-derived neurotrophic factor

  6. Seasonal Exacerbation of Asthma Is Frequently Associated with Recurrent Episodes of Acute Urticaria.

    Science.gov (United States)

    Vadasz, Zahava; Kessel, Aharon; Hershko, Alon Y; Maurer, Marcus; Toubi, Elias

    2016-01-01

    Asthma and urticaria are both partially mediated by an increased release of histamine from highly activated mast cells. They are pathophysiologically different, as mast cell degranulation in these 2 disorders results from different mechanisms. To assess the incidence of urticaria in patients with asthma, and of asthma in patients with chronic spontaneous urticaria (CSU). Over 1 year of follow-up, asthma patients (n = 110) were assessed for the incidence and characteristics of urticaria, and a link, if it existed, to seasonal exacerbations and the severity of asthma was traced. We also prospectively assessed CSU patients (n = 95) during the same period of time for the incidence of asthma. Healthy individuals (n = 100), serving as a control group, were also assessed. Episodes of urticaria occurred in 26/110 asthma patients (23.6%), but in only 2/100 healthy control subjects (2%) (p urticaria were significantly more frequent in asthma patients with positive skin-prick test reactions (mainly seasonal pollens), and consequently occurred mostly during seasonal asthma exacerbation, i.e. during acute episodes of urticaria. The incidence of asthma in CSU patients was recorded in 10.5% of the group, similar to that in the healthy control population. Our study demonstrates, for the first time, that asthma patients frequently develop acute urticaria, mainly during seasonal exacerbations. In contrast, CSU patients do not show an increased incidence of asthma. © 2016 S. Karger AG, Basel.

  7. 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

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

    Science.gov (United States)

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

    2014-01-01

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

  9. 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

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

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    Herng-Ching Lin

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

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

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    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

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

    Science.gov (United States)

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

    2017-03-01

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

  13. Church attendance and new episodes of major depression in a community study of older adults: the Cache County Study.

    Science.gov (United States)

    Norton, Maria C; Singh, Archana; Skoog, Ingmar; Corcoran, Christopher; Tschanz, Joann T; Zandi, Peter P; Breitner, John C S; Welsh-Bohmer, Kathleen A; Steffens, David C

    2008-05-01

    We examined the relation between church attendance, membership in the Church of Jesus Christ of Latter-Day Saints (LDS), and major depressive episode, in a population-based study of aging and dementia in Cache County, Utah. Participants included 2,989 nondemented individuals aged between 65 and 100 years who were interviewed initially in 1995 to 1996 and again in 1998 to 1999. LDS church members reported twice the rate of major depression that non-LDS members did (odds ratio = 2.56, 95% confidence interval = 1.07-6.08). Individuals attending church weekly or more often had a significantly lower risk for major depression. After controlling for demographic and health variables and the strongest predictor of future episodes of depression, a prior depression history, we found that church attendance more often than weekly remained a significant protectant (odds ratio = 0.51, 95% confidence interval = 0.28-0.92). Results suggest that there may be a threshold of church attendance that is necessary for a person to garner long-term protection from depression. We discuss sociological factors relevant to LDS culture.

  14. The association between anomalous self-experience and suicidality in first-episode schizophrenia seems mediated by depression.

    Science.gov (United States)

    Haug, Elisabeth; Melle, Ingrid; Andreassen, Ole A; Raballo, Andrea; Bratlien, Unni; Øie, Merete; Lien, Lars; Møller, Paul

    2012-07-01

    A recent hypothesis is that suicidality in schizophrenia may be linked to the patients' altered basic self-awareness or sense of self, termed self-disorders (SDs). The aim of the study was to investigate whether SDs in first-episode schizophrenia spectrum disorders are related to suicidality and whether this relationship is independent of or mediated by depression or other standard clinical measures. Self-disorders were assessed in 49 patients with first-episode schizophrenia by means of the Examination of Anomalous Self-Experience (EASE) instrument. Symptoms severity and functioning were assessed using the Structured Clinical Interview for the Positive and Negative Syndrome Scale, Calgary Depression Scale for Schizophrenia, and Global Assessment of Functioning-Split Version. Suicidality was measured by the Calgary Depression Scale for Schizophrenia item 8. Analyses detected a significant association between current suicidality, current depression, and SDs as measured by the EASE. The effect of SDs on suicidal ideation appeared to be mediated by depression. The interaction between anomalous self-experiences and depression could be a rational clinical target for the prevention of suicidality in the early phases of schizophrenia and supports the rationale for including assessment of SDs in early intervention efforts. Copyright © 2012 Elsevier Inc. All rights reserved.

  15. The role of adiposity in the relationship between serum leptin and severe major depressive episode.

    Science.gov (United States)

    Ubani, Chinedu C; Zhang, Jian

    2015-08-30

    To assess the role that adiposity plays in the association between leptin and major depressive episode (MDE), we analyzed the data of 1046 men and 1359 women aged 20-39 years, who completed an interview and had blood collected as a part of the National Health and Nutrition Examination Survey (NHANES) between 1991 and 1994. Waist-hip ratio (WHR) was used as an indicator of adiposity. MDE was assessed with the Diagnostic Interview Schedule. For normal-WHR women, the prevalence of MDE was reversely associated with leptin levels, 13.7(4.4)%, 12.2(4.0)% and 2.3(1.8)% respectively for lower, interquartile, and upper quartile. For abnormal-WHR women, the prevalence of MDE was positively associated with leptin, 6.1(2.3)%, 9.1(2.4)% and 20.0 (3.8) respectively for the three leptin levels. Compared to women with lower quartile of leptin, the odds ratio of MDE for women with upper quartile was 0.09 (0.01-0.98) for normal-WHR women but 4.35 (1.55-12.2) for abnormal-WHR women. No moderating effects were observed among men. Using BMI in place of WHR revealed similar findings. The association between MDE and leptin is moderated by adiposity. High leptin levels are associated with low odds of MDE among women with normal adiposity but high odds among women with abnormal adiposity. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  16. 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.

  17. 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.

  18. Responder and nonresponder patients exhibit different peripheral transcriptional signatures during major depressive episode

    Science.gov (United States)

    Belzeaux, R; Bergon, A; Jeanjean, V; Loriod, B; Formisano-Tréziny, C; Verrier, L; Loundou, A; Baumstarck-Barrau, K; Boyer, L; Gall, V; Gabert, J; Nguyen, C; Azorin, J-M; Naudin, J; Ibrahim, E C

    2012-01-01

    To date, it remains impossible to guarantee that short-term treatment given to a patient suffering from a major depressive episode (MDE) will improve long-term efficacy. Objective biological measurements and biomarkers that could help in predicting the clinical evolution of MDE are still warranted. To better understand the reason nearly half of MDE patients respond poorly to current antidepressive treatments, we examined the gene expression profile of peripheral blood samples collected from 16 severe MDE patients and 13 matched controls. Using a naturalistic and longitudinal design, we ascertained mRNA and microRNA (miRNA) expression at baseline, 2 and 8 weeks later. On a genome-wide scale, we detected transcripts with roles in various biological processes as significantly dysregulated between MDE patients and controls, notably those involved in nucleotide binding and chromatin assembly. We also established putative interactions between dysregulated mRNAs and miRNAs that may contribute to MDE physiopathology. We selected a set of mRNA candidates for quantitative reverse transcriptase PCR (RT-qPCR) to validate that the transcriptional signatures observed in responders is different from nonresponders. Furthermore, we identified a combination of four mRNAs (PPT1, TNF, IL1B and HIST1H1E) that could be predictive of treatment response. Altogether, these results highlight the importance of studies investigating the tight relationship between peripheral transcriptional changes and the dynamic clinical progression of MDE patients to provide biomarkers of MDE evolution and prognosis. PMID:23149449

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

    Science.gov (United States)

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

    2015-01-01

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

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    .6% converted to bipolar disorder (6.3% within the first 2 years). Non-remission increased with younger age, co-morbid anxiety and suicidal ideations. Recurrence increased with severity and treatment resistance of the first depression, and conversion to bipolar disorder with treatment resistance, a family......BACKGROUND: In depression, non-remission, recurrence of depressive episodes after remission and conversion to bipolar disorder are crucial determinants of poor outcome. The present study aimed to determine the cumulative incidences and clinical predictors of these long-term outcomes after the first...... 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...

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

    DEFF Research Database (Denmark)

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

    2017-01-01

    The diagnostic stability of comorbid personality disorders among patients with depression remains unclear. A total of 262 patients suffering from first-episode depression were assessed using the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II) and reassessed after 5...... years. A total of 87 patients (33%) were diagnosed with a personality disorder at baseline, and 63 of them (72%) maintained a personality disorder diagnosis at follow-up (kappa coefficient 0.71). At cluster level, 63% maintained a diagnosis within cluster B and 48% maintained a cluster C disorder across...... the follow-up period (kappa coefficients of 0.54 and 0.64, respectively). Hence, comorbid personality disorders cannot be taken just as artifacts of the depressive mood that will remit spontaneously or with further treatment of the primary depression. Furthermore, the stability of personality disorders...

  2. Persistent inflammation and its relationship to leptin and insulin in phases of bipolar disorder from acute depression to full remission.

    Science.gov (United States)

    Tsai, Shang-Ying; Chung, Kuo-Hsuan; Huang, Shou-Hung; Chen, Pao-Huan; Lee, Hsin-Chien; Kuo, Chian-Jue

    2014-12-01

    A proinflammatory phase with various immunomodulatory mechanisms has been noted in bipolar mania and major depression. Weight gain and increased production of leptin may be associated with immunomodulation and insulin resistance in bipolar disorder. However, immunomodulation and its linkage with leptin and insulin in the depressive episode of bipolar disorder remain unclear. We investigated alterations in inflammatory markers and their relationship with leptin and insulin levels in patients with phases of bipolar disorder from acute depression to full remission. Thirty-two physically healthy bipolar I depressed patients aged insulin, high-sensitivity C-reactive protein (hs-CRP), soluble interleukin-2 receptor (sIL-2R), soluble interleukin-6 receptor (sIL-6R), soluble tumor necrosis factor receptor 1 (sTNF-R1), and interleukin-1 receptor antagonist (IL-1Ra) in three phases, i.e., acute depression, subsequent partial remission, and full remission. In acute depression, subsequent partial remission, and full remission, patients with bipolar disorder had significantly higher mean levels of hs-CRP, IL-1Ra, sTNF-R1, and sIL-2R compared with control subjects. The IL-1Ra and sTNF-R1 levels in various affective phases were significantly correlated to body mass index, leptin level, circulating lipids, and medication status. The sIL-2R levels in the three affective phases were all independent of other inflammatory markers and clinical and laboratory variables. Patients showed no alteration of sIL-6R levels through the depressive episode. Patients with bipolar disorder in depressive episodes may exhibit persistent inflammation with elevated levels of hs-CRP, IL-1Ra, sTNF-R1, and sIL-2R but not sIL-6R from the acute phases to full remission. Only sIL-2R production seems to be tightly linked with the pathophysiology of bipolar depression and is independent of insulin and leptin levels. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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

    Science.gov (United States)

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

    2016-12-01

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

  4. [Study on predicting model for acute hypotensive episodes in ICU based on support vector machine].

    Science.gov (United States)

    Lai, Lijuan; Wang, Zhigang; Wu, Xiaoming; Xiong, Dongsheng

    2011-06-01

    The occurrence of acute hypotensive episodes (AHE) in intensive care units (ICU) seriously endangers the lives of patients, and the treatment is mainly depended on the expert experience of doctors. In this paper, a model for predicting the occurrence of AHE in ICU has been developed using the theory of medical Informatics. We analyzed the trend and characteristics of the mean arterial blood pressure (MAP) between the patients who were suffering AHE and those who were not, and extracted the median, mean and other statistical parameters for learning and training based on support vector machine (SVM), then developed a predicting model. On this basis, we also compared different models consisted of different kernel functions. Experiments demonstrated that this approach performed well on classification and prediction, which would contribute to forecast the occurrence of AHE.

  5. Predicting Acute Hypotensive Episodes: The 10th Annual PhysioNet/Computers in Cardiology Challenge.

    Science.gov (United States)

    Moody, Gb; Lehman, Lh

    2009-01-01

    This year's PhysioNet/Computers in Cardiology Challenge aimed to stimulate development of methods for identifying intensive care unit (ICU) patients at imminent risk of acute hypotensive episodes (AHEs), motivated by the possibility of improving care and survival of these patients. Participants were asked to forecast the occurrence of an AHE up to an hour in advance, in two groups of ICU patient records from the MIMIC II Database, drawing on data that included at least 10 hours of physiologic waveforms, time series, and accompanying clinical data prior to the one-hour forecast window. In event 1, most participants were able to identify without errors, in a group of 10 high-risk patients receiving pressor medication, which five of the patients experienced AHEs during the forecast window. In event 2, participants were able to classify correctly as many as 37 (93%) of a diverse group of 40 patients, including nearly all of those who experienced AHEs.

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

    Science.gov (United States)

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

    2013-07-01

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

  7. Effectiveness of electroconvulsive therapy in a patient with a treatment-resistant major depressive episode and comorbid body dysmorphic disorder.

    Science.gov (United States)

    Rapinesi, Chiara; Serata, Daniele; Del Casale, Antonio; Carbonetti, Paolo; Fensore, Claudio; Scatena, Paola; Caccia, Federica; Di Pietro, Simone; Angeletti, Gloria; Tatarelli, Roberto; Kotzalidis, Georgios D; Giradi, Paolo

    2013-06-01

    A 24-year-old man experiencing comorbid body dysmorphic disorder since age 16 years, complicated in recent months by a major depressive episode with psychotic features, showed resistance to various drug and psychotherapy combinations. We suggested electroconvulsive therapy (ECT) to overcome treatment resistance. After 1 ECT cycle, mood and anxiety symptoms improved significantly, delusional interpretations and ideas of reference subsided, and dysmorphophobic symptoms improved as well. Six months later, the patient was doing well with a mood stabilizer/antipsychotic combination. Electroconvulsive therapy may improve symptoms of comorbid body dysmorphic disorder along with mood improvement in treatment-resistant depressive disorder.

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

    Science.gov (United States)

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

    2015-08-01

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

  9. [Management of a first depressive episode in the primary care setting. Use of antidepressants and referrals].

    Science.gov (United States)

    López-Lanza, J R; Villa Puente, M; Lopez Videras, R; Arribas, I; Pandiella, M J; Sineiro, E

    2016-03-01

    The majority of patients who have a first depressive episode are treated by Primary Care physicians. The aim of this study was to evaluate the use of antidepressants and referrals to mental health and the treatment modifications made by psychiatrists. A descriptive, retrospective study was conducted on patients from 64 Primary Care clinics, distributed in five Spanish provinces. The clinical history data, regarding use of antidepressants, criteria for referral, and response of psychiatric services were evaluated from June 2008 to June 2011. The study included 324 patients. The most commonly prescribed medication was escitalopram, with selective serotonin reuptake inhibitors (SSRI) making up 73.5% of the total. More than two-thirds (69.7%) of the patients were on treatment for at least 6 months, with no reason recorded for the 40.4% drop-outs. A large majority of professionals (76.9%) wait at least 3 weeks before modifying the medication, especially changing antidepressant. The Primary Care physicians referred 39.2% of patients to psychiatry, although much of these referrals (43.9%) had no justification. There was a lower referral rate to psychology (23.1%). An antidepressant was given to a large number of patients on multiple medications, without taking into account the risk of interactions in a high percentage. The Primary Care physician appropriately uses the antidepressants of the first choice, but does not pay attention to the risks in complex patients. There must be an appropriate duration of treatment and an improvement of the criteria for referral to mental health services. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  10. 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

    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...

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

    Directory of Open Access Journals (Sweden)

    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.

  12. Antidepressant Treatment for Acute Bipolar Depression: An Update

    Directory of Open Access Journals (Sweden)

    Ben H. Amit

    2012-01-01

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

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

    Science.gov (United States)

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

    2016-12-01

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

  14. Attachment representations, patterns of emotion regulation, and social exclusion in patients with chronic and episodic depression and healthy controls.

    Science.gov (United States)

    Bauriedl-Schmidt, C; Jobst, A; Gander, M; Seidl, E; Sabaß, L; Sarubin, N; Mauer, C; Padberg, F; Buchheim, A

    2017-03-01

    The experience of social exclusion (ostracism) is linked to the etiology and maintenance of depression. Most individuals experience emotional stress in states of social exclusion. Insecurely attached individuals, especially with an unresolved trauma, show maladaptive coping in response to social stress. The present study examines (a) the differences with regards to attachment representations in episodic (ED) and chronic depressive (CD) inpatients and (b) how ostracism affects their emotional reactions. Patients with CD (n=29) and ED (n=23) and healthy control subjects (n=29) were interviewed using the Adult Attachment Projective Picture System (AAP), a valid measure to assess attachment representation; and played a virtual ball tossing game simulating social exclusion (Cyberball). Multiple depression-related risk and protective factors were considered. We hypothesized that CD patients show the most severe attachment disorganization and are emotionally most affected by the social exclusion situation. Moreover, we explored the interaction between ostracism and attachment. Contradicting our hypotheses, ED and CD individuals were almost akin with regards to their attachment insecurity/disorganization and reactions to Cyberball. An emotionally altered reaction to social exclusion was identified in the insecure-disorganized depressive subgroup. Small sample size hampering further subgroup analyses. The ED sample may include single CD subjects with recent manifestation. The pattern of emotion regulation in the depressive groups matches with findings from clinical studies, including attachment research. The relationship between attachment representations and ostracism should be further investigated in larger samples of depressive individuals. Copyright © 2016 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

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

    2017-06-01

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

  16. Prolactin response to buspirone is not impaired in drug-naïve first episode patients with major depressive disorder.

    Science.gov (United States)

    Cubała, Wiesław Jerzy; Landowski, Jerzy

    2014-01-01

    An altered postsynaptic 5-HT1A receptor function along with hypercortisolemia has been associated with major depressive disorder (MDD). However, several methodological considerations related to data interpretation arise when subjects previously exposed to psychotropic medication are included in the study population. To address those issues we designed a study in a well defined cohort of first-episode, treatment-naïve MDD patients. This cross-sectional case-control pharmacologic challenge study was designed to investigate the prolactin (PRL) response to buspirone in 21 non-late-life adult, treatment-naïve MDD patients with the first affective episode and in 20 age- and sex-matched healthy controls. Depressed patients showed a basal score in the Hamilton Rating Scale for Depression (HAMD-17) higher than 20. No significant difference in PRL response to buspirone between first-episode, treatment-naïve patients with MDD and controls, was observed. The correlation between basal cortisol levels and PRL response was not observed in MDD group while significant negative correlation was found in healthy controls. The significantly higher PRL response to buspirone was observed in melancholic patients as compared to non-melancholic subjects. The current study is limited by its cross-sectional design, small sample size, factors related to neuroendocrine challenge methodology, and no placebo control. These results indicate no consistent changes in the hormonal response to the 5-HT1A agonist buspirone in major depression. Taken into account the interpretation of the buspirone test the present study does not support the hypothesis of an altered functional activity with down-regulation of the postsynaptic 5-HT1A receptor and/or in the postsynaptic receptor signal transduction in the hypothalamus in the pathogenesis of MDD. Copyright © 2013 Elsevier B.V. All rights reserved.

  17. Only incident depressive episodes after myocardial infarction are associated with new cardiovascular events

    NARCIS (Netherlands)

    de Jonge, Peter; van den Brink, Rob H. S.; Spijkerman, Titia A.; Ormel, Johan

    2006-01-01

    OBJECTIVES The purpose of this research was to study whether incident and non-incident depression after myocardial infarction (MI) are differentially associated with prospective fatal and non-fatal cardiovascular events. BACKGROUND Post-MI depression is defined as the presence of depression after

  18. Increased frequency of first episode poststroke depression following discontinuation of escitalopram

    Science.gov (United States)

    Mikami, Katsunaka; Jorge, Ricardo E.; Moser, David J.; Arndt, Stephan; Jang, Mijin; Solodkin, Ana; Small, Steven L.; Fonzetti, Pasquale; Hegel, Mark T.; Robinson, Robert G.

    2011-01-01

    Background and Purpose To compare escitalopram, problem-solving therapy (PST), and placebo, to prevent poststroke depression during 6 months after discontinuation of treatment. Methods We examined for depression, 33 patients assigned to placebo, 34 to escitalopram, and 41 to PST. Results After controlling for age, gender, prior mood disorder, and severity of stroke, new onset major depression and Hamilton Depression scores were significantly higher 6 months after escitalopram was discontinued, compared to the PST or placebo groups. Conclusions Discontinuation of escitalopram may increase poststroke depressive symptoms. PMID:21868736

  19. Increased frequency of first-episode poststroke depression after discontinuation of escitalopram.

    Science.gov (United States)

    Mikami, Katsunaka; Jorge, Ricardo E; Moser, David J; Arndt, Stephan; Jang, Mijin; Solodkin, Ana; Small, Steven L; Fonzetti, Pasquale; Hegel, Mark T; Robinson, Robert G

    2011-11-01

    The purpose of this study was to compare escitalopram, problem-solving therapy, and placebo to prevent poststroke depression during 6 months after discontinuation of treatment. We examined for depression 33 patients assigned to placebo, 34 to escitalopram, and 41 to problem-solving therapy. After controlling for age, gender, prior mood disorder, and severity of stroke, new-onset major depression and Hamilton Depression scores were significantly higher 6 months after escitalopram was discontinued compared with the problem-solving therapy or placebo groups. Discontinuation of escitalopram may increase poststroke depressive symptoms.

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

    Directory of Open Access Journals (Sweden)

    Sozeri-Varma G

    2013-08-01

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

  1. Non-invasive vagus nerve stimulation for the acute treatment of episodic and chronic cluster headache

    DEFF Research Database (Denmark)

    Goadsby, Peter J; de Coo, Ilse F; Silver, Nicholas

    2018-01-01

    Background Clinical observations and results from recent studies support the use of non-invasive vagus nerve stimulation (nVNS) for treating cluster headache (CH) attacks. This study compared nVNS with a sham device for acute treatment in patients with episodic or chronic CH (eCH, cCH). Methods...... rescue treatment. Results The Full Analysis Set comprised 48 nVNS-treated (14 eCH, 34 cCH) and 44 sham-treated (13 eCH, 31 cCH) subjects. For the primary endpoint, nVNS (14%) and sham (12%) treatments were not significantly different for the total cohort. In the eCH subgroup, nVNS (48%) was superior...... to sham (6%; p cCH subgroup. Conclusions Combing both eCH and cCH patients, nVNS was no different to sham. For the treatment of CH attacks, nVNS was superior to sham therapy in eCH but not in cCH. These results confirm...

  2. Pancreatic exocrine function and morphology following an episode of acute pancreatitis.

    Science.gov (United States)

    Xu, Yaping; Wu, Deqing; Zeng, Yue; Wang, Xingpeng

    2012-08-01

    The objective of this study was to assess pancreatic exocrine function (PEF) and morphology in patients recovering from a first episode of acute pancreatitis (AP). Sixty-five eligible patients recovering from AP and 70 healthy volunteers were enrolled in this study. We evaluated PEF by fecal elastase 1 (FE-1) and used ultrasonography to detect pancreatic morphology for all patients and 40 controls. Exocrine pancreatic insufficiency (EPI) incidence in the severe and mild AP subgroups was 60.5% and 39.5%, respectively. The FE-1 level in patients who had undergone surgical care was significantly lower compared with the controls (P 0.05). Surprisingly, the defecation change correlated with the EPI level. In these patients, a stepwise recovery was observed over the following 2.4 years. Compared with the controls, the diameter of pancreatic duct was enlarged, and abdominal pain during recovery was found to be the independent risk factor for pancreatic duct expansion, although a significant difference was not exhibited between the AP subgroups concerning FE-1 concentration (P = 0.591). Our results indicated that many AP patients may have long-lasting EPI and an expanded main pancreatic duct; thus, routine evaluation of PEF is warranted.

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

    Directory of Open Access Journals (Sweden)

    Shahzad M. Alikhan

    2013-01-01

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

  4. The association between diabetes and an episode of depressive symptoms in the 2002 World Health Survey : an analysis of 231 797 individuals from 47 countries

    NARCIS (Netherlands)

    Mommersteeg, P.M.C.; Herr, R.; Pouwer, F.; Holt, R.I.G.; Loerbroks, A.

    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- and

  5. 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...

  6. Depression during first episode psychosis and subsequent suicide risk: A systematic review and meta-analysis of longitudinal studies.

    Science.gov (United States)

    McGinty, Jessica; Sayeed Haque, M; Upthegrove, Rachel

    2017-10-02

    Evidence suggests first episode psychosis (FEP) is associated with suicide, and the influence of depression on suicidal behaviour in cross sectional studies is clear. However the influence of depression during FEP on longer-term mortality is not certain. Existing evidence was synthesised to understand the influence of depressive symptoms during FEP on subsequent suicidal behaviour. Medline, Embase, PsycINFO, Cochrane Library, Web of Science, OpenGrey, and NICE Evidence were searched from inception to Jan 25, 2017. Longitudinal observational studies assessing the relationship between depressive symptoms during FEP with a measure of s at a specified follow-up time were included. Summary estimates were extracted. The Downs and Black Instrument was used to appraise study quality. Odds ratio (OR) of suicidal behaviour were calculated using random effects meta-analyses. The study protocol was registered with PROSPERO (CRD42017055881). Of 4210 articles found, 23 fulfilled eligibility criteria. 13 were included in meta-analysis (n=3002). 428 participants demonstrated suicidal behaviour in the study periods. Odds of suicidal behaviour during follow-up were significantly higher among patients with depressive symptoms during FEP compared to those without (OR=1.59, 95% CI 1.14-2.21; I2=50.0%, p=0.02). Meta-regression demonstrated no evidence of influence of length of follow-up on results. Depressive symptoms during FEP are associated with increased longer-term risk of suicidal behaviour. This association should be acknowledged during early management planning. Large-scale clinical trials are needed to identify efficacious management of depression during FEP. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. The impact of brief depressive episodes on the outcome of bipolar disorder and major depressive disorder: a 1-year prospective study.

    Science.gov (United States)

    Altamura, A Carlo; Buoli, Massimiliano; Dell'osso, Bernardo; Albano, Alessandra; Serati, Marta; Colombo, Francesca; Pozzoli, Sara; Angst, Jules

    2011-11-01

    Brief depressive episodes (BDEs) cause psychosocial impairment and increased risk of suicide, worsening the outcome and long-term course of affective disorders. The aim of this naturalistic observational study was to assess the frequency of BDEs and very brief depressive episodes (VBDEs) and their impact on clinical outcome in a sample of patients with major depressive disorder (MDD) and bipolar disorder (BD). Seventy patients with a diagnosis of MDD or BD were followed up and monthly visited for a period of 12 months, assessing the eventual occurrence of BDEs and/or VBDEs. Clinical and demographic variables of the total sample and of the groups divided according to the presence of BDEs or VBDEs were collected and compared by one-way ANOVAs. Hamilton Depression Rating Scale 21 items (HDRS), Young Mania Rating Scale (YMRS), Clinical Global Impression (severity of illness) (CGIs) and the Short Form Health Survey (SF-36-item 1) were administered at baseline and logistic regression was performed to evaluate whether baseline scores were predictive of the onset of BDEs or VBDEs. BDEs (88.6% of the total sample), VBDEs (44.3% of the total sample) and BDEs+VBDEs (40.0% of the total sample) were found to occur frequently across the sample. BDE patients showed more death thoughts during major depressive episodes (χ(2) = 4.14, df = 1, p = 0.04, Phi = 0.24) compared to patients without BDEs. Indeed VBDE patients showed a higher rate of hospitalization (χ(2) = 5.71, df = 1, p = 0.031, phi = 0.29), a more frequent prescription of a combined treatment (χ(2) = 13.07, df = 7, p = 0.03, phi = 0.43) and higher scores at SF-36 item 1 (F = 6.65, p = 0.01) compared to patients without VBDEs. Finally, higher SF-36 item 1 scores were found to be predictive of VBDEs (odds ratio = 2.81, p = 0.03). Major depressives, either unipolar or bipolar, with BDEs or VBDEs showed a worse outcome, represented by a more severe psychopathology and higher rates of hospitalization. VBDEs were predicted

  8. Association of episodic physical and sexual activity with triggering of acute cardiac events: systematic review and meta-analysis.

    Science.gov (United States)

    Dahabreh, Issa J; Paulus, Jessica K

    2011-03-23

    Evidence has suggested that physical and sexual activity might be triggers of acute cardiac events. To assess the effect of episodic physical and sexual activity on acute cardiac events using data from case-crossover studies. MEDLINE and EMBASE (through February 2, 2011) and Web of Science (through October 6, 2010). Case-crossover studies investigating the association between episodic physical or sexual activity and myocardial infarction (MI) or sudden cardiac death (SCD). Two reviewers extracted descriptive and quantitative information from each study. We calculated summary relative risks (RRs) using random-effects meta-analysis and absolute event rates based on US data for the incidence of MI and SCD. We used the Fisher P value synthesis method to test whether habitual physical activity levels modify the triggering effect and meta-regression to quantify the interaction between habitual levels of physical activity and the triggering effect. We identified 10 studies investigating episodic physical activity, 3 studies investigating sexual activity, and 1 study investigating both exposures. The outcomes of interest were MI (10 studies), acute coronary syndrome (1 study), and SCD (3 studies). Episodic physical and sexual activity were associated with an increase in the risk of MI (RR = 3.45; 95% confidence interval [CI], 2.33-5.13, and RR = 2.70; 95% CI, 1.48-4.91, respectively). Episodic physical activity was associated with SCD (RR = 4.98; 95% CI, 1.47-16.91). The effect of triggers on the absolute rate of events was limited because exposure to physical and sexual activity is infrequent and their effect is transient; the absolute risk increase associated with 1 hour of additional physical or sexual activity per week was estimated as 2 to 3 per 10,000 person-years for MI and 1 per 10,000 person-years for SCD. Habitual activity levels significantly affected the association of episodic physical activity and MI (P effect. For every additional time per week an individual

  9. 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

  10. Enhanced Depression Care for Patients With Acute Coronary Syndrome and Persistent Depressive Symptoms

    Science.gov (United States)

    Davidson, Karina W.; Rieckmann, Nina; Clemow, Lynn; Schwartz, Joseph E.; Shimbo, Daichi; Medina, Vivian; Albanese, Gabrielle; Kronish, Ian; Hegel, Mark; Burg, Matthew M.

    2010-01-01

    Background Depressive symptoms are an established predictor of mortality and major adverse cardiac events (defined as nonfatal myocardial infarction or hospitalization for unstable angina or urgent/emergency revascularizations) in patients with acute coronary syndrome (ACS). This study was conducted to determine the acceptability and efficacy of enhanced depression treatment in patients with ACS. Methods A 3-month observation period to identify patients with ACS and persistent depressive symptoms was followed by a 6-month randomized controlled trial. From January 1, 2005, through February 29, 2008, 237 patients with ACS from 5 hospitals were enrolled, including 157 persistently depressed patients randomized to intervention (initial patient preference for problem-solving therapy and/or pharmacotherapy, then a stepped-care approach; 80 patients) or usual care (77 patients) and 80 nondepressed patients who underwent observational evaluation. The primary outcome was patient satisfaction with depression care. Secondary outcomes were depressive symptom changes (assessed with the Beck Depression Inventory), major adverse cardiac events, and death. Results At the end of the trial, the proportion of patients who were satisfied with their depression care was higher in the intervention group (54% of 80) than in the usual care group (19% of 77) (odds ratio, 5.4; 95% confidence interval [CI], 2.2–12.9 [P<.001]). The Beck Depression Inventory score decreased significantly more (t155=2.85 [P=.005]) for intervention patients (change, −5.7; 95% CI, −7.6 to −3.8; df=155) than for usual care patients (change, −1.9; 95% CI, −3.8 to −0.1; df=155); the depression effect size was 0.59 of the standard deviation. At the end of the trial, 3 intervention patients and 10 usual care patients had experienced major adverse cardiac events (4% and 13%, respectively; log-rank test, χ12=3.93 [P=.047]), as well as 5 nondepressed patients (6%) (for the intervention vs nondepressed

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

    Science.gov (United States)

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

    2015-12-01

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

  12. Analysis of AHG-PRA and ELISA-PRA in kidney transplant patients with acute rejection episodes.

    Science.gov (United States)

    Kaufman, Arnauld; de Souza Pontes, Luciane Faria; Queiroz Marques, Maria Teresa; Sampaio, José Cavaliere; de Moraes Sobrino Porto, Luís Cristóvão; de Moraes Souza, Edison Régio

    2003-01-01

    Many centers determined a significant correlation between post-transplant anti-HLA antibodies production and clinical outcome. In order to confirm this correlation and ascertain the sequential appearance of anti-HLA antibodies, we compared the ELISA (ELISA-PRA) and the anti-human globulin enhanced complement-dependent lymphocytotoxicity panel-reactive antibodies test (AHG-PRA) with the occurrence of acute rejection episodes. Thirty patients who underwent kidney transplantation between December 1998 and October 1999 were assayed. One pre-transplant and 10 post-transplant serum samples were tested from each recipient except from one of them who lost his graft on the 1 week post-transplant. The diagnosis of acute rejection episode was based on classical criteria (fever, graft swelling and tenderness, oliguria, weight gain) and a rapid rise in serum creatinine levels, confirmed by an allograft biopsy graded by the Banff working classification. The 322 pre- and post-transplant serum specimens were tested by AHG-PRA methodology and 298 of them by the ELISA-PRA. The agreement coefficient (kappa) for both methodologies was 0.63. There were 27 acute rejection episodes in 19 patients. AHG-PRA results were significantly correlated (Hazard ratio=10.06; P=0.006) with this occurrence. These data were not confirmed with the ELISA-PRA procedure. Our results suggest that a routine post-transplant AHG-PRA test offers an early risk assessment of acute rejection episodes and may be a useful method for monitoring the kidney transplant evolution.

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

    Science.gov (United States)

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

    2016-04-01

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

  14. 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

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

    Science.gov (United States)

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

    2014-08-28

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

  16. 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. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  17. 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.

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

    Science.gov (United States)

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

    2017-11-01

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

  19. 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....

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

    Science.gov (United States)

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

    2017-12-01

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

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

    Science.gov (United States)

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

    2010-01-01

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

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

    Science.gov (United States)

    Harris, Patricia RE; Sommargren, Claire E; Stein, Phyllis K; Fung, Gordon L; Drew, Barbara J

    2014-01-01

    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 studies’ results indicate that there may be a relationship between abnormal HRV and clinical depression when assessed early after an ACS event, offering the possibility that these risk factors play a modest role in patient outcomes. Conclusion While a definitive conclusion about the relevance of HRV and clinical depression measurement in ACS patients would be premature, the literature suggests that these measures may provide additional information in risk assessment. Potential avenues for further research are proposed. PMID:25071372

  3. Psychosocial predictors of the short-term course and outcome of major depression: a longitudinal study of a nonclinical sample with recent-onset episodes.

    Science.gov (United States)

    Lara, M E; Klein, D N; Kasch, K L

    2000-11-01

    Three variables have been hypothesized to play important roles in prolonging the course of depressive episodes: a ruminative response style, significant interpersonal relationships, and childhood adversity. The authors examined whether these variables predicted the short-term course of major depressive disorder (MDD). Participants (n = 84) were college students with a recent-onset major depressive episode. Assessments included several interview and self-report measures, and data on interpersonal relationships were obtained from close confidants. Follow-up interviews were conducted 6 months later. After controlling for baseline severity, harsh discipline in childhood significantly predicted mean level of depression across the follow-up and level of depression at follow-up. Harsh discipline was also significantly associated with relapse but not with recovery. After controlling for baseline severity, rumination and the interpersonal variables did not predict the outcome of MDD.

  4. Electroconvulsive therapy and age: Age-related clinical features and effectiveness in treatment resistant major depressive episode.

    Science.gov (United States)

    Socci, Chiara; Medda, Pierpaolo; Toni, Cristina; Lattanzi, Lorenzo; Tripodi, Beniamino; Vannucchi, Giulia; Perugi, Giulio

    2018-02-01

    This study was aimed to compare clinical features, treatments outcomes and tolerability between young (18-45 years), middle age (46-64 years) and old (≥ 65 years) patients treated with bilateral ECT for treatment resistant major depressive episode. 402 patients were evaluated 1 day prior to ECT and a week after the treatment termination using the Clinical Global Impression Scale (CGI), the Hamilton Rating Scale for Depression-17 items (HAM-D-17), the Brief Psychiatric Rating Scale (BPRS), the Young Mania Rating Scale (YMRS) and the Mini Mental State Examination (MMSE). Response was defined as a reduction of at least 50% from baseline on the HAM-D-17 score. Remission was defined as a score ≤ 7 on the HAM-D-17 at the final evaluation. Rates of response were not statistically different in the three groups (69.6% in old versus 63.5% in young and 55.5% in middle age groups). No significant differences were also observed in the proportions of remitters between the age groups (31.4% in young group, 27.7% in middle age group and 29.3% in old group). One week after the end of the ECT course the middle and old age groups showed a statistically significant increase in the MMSE score compared to baseline. We did not find significant differences between the three age groups in rates of premature drops-out due to ECT-related side effects. Our data support the use of ECT in elderly patients with treatment-resistant major depressive episode, with rates of response around 70% and effectiveness being independent from age. In the old age group the baseline cognitive impairment improved after ECT and no life-threatening adverse event was detected. Copyright © 2017 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

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

    2012-12-01

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

  6. 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

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

    Science.gov (United States)

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

    2016-01-01

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

  8. Default Mode Network Alterations during Implicit Emotional Faces Processing in First-episode, Treatment-naive Major Depression Patients

    Directory of Open Access Journals (Sweden)

    Huqing eShi

    2015-08-01

    Full Text Available Previous studies have focused on resting-state default mode network (DMN alterations in the development and maintenance of depression; however, only a few studies have addressed DMN changes during task-related processing and their results are inconsistent. Therefore, we explored DMN patterns in young adult patients with first-episode, treatment-naïve major depressive disorder (MDD performing an implicit emotional processing task. Patients with MDD (N = 29 and healthy controls (N = 33 were subjected to functional magnetic resonance imaging (fMRI at rest and while performing a gender judgment task. Group independent component analysis (ICA was used to identify DMN component under task state for both groups. The DMN of participants with MDD had decreased functional connectivity in bilateral prefrontal areas compared to controls. Right prefrontal gyrus connectivity for MDD patients correlated negatively with scores on maladaptive scales of the Cognitive Emotion Regulation Questionnaire (CERQ. Our findings suggest that depressed people have altered DMN patterns during implicit emotional processing, which might be related to impaired internal monitoring and emotional regulation ability.

  9. Discovery of a Partner Affair and Major Depressive Episode in a Probability Sample of Married or Cohabiting Adults.

    Science.gov (United States)

    Whisman, Mark A

    2016-12-01

    Prior research has found that humiliating marital events are associated with depression. Building on this research, the current study investigated the association between one specific humiliating marital event-discovering that one's partner had an affair-and past-year major depressive episode (MDE) in a probability sample of married or cohabiting men and women who were at high risk for depression based on the criterion that they scored below the midpoint on a measure of marital satisfaction (N = 227). Results indicate that (i) women were more likely than men to report discovering their partner had an affair in the prior 12 months; (ii) discovering a partner affair was associated with a higher prevalence of past-year MDE and a lower level of marital adjustment; and (iii) the association between discovering a partner affair and MDE remained statistically significant when holding constant demographic variables and marital adjustment. These results support continued investigation into the impact that finding out about an affair has on the mental health of the person discovering a partner affair. © 2015 Family Process Institute.

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

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Andersen, Per Kragh

    2004-01-01

    OBJECTIVE: Several findings suggest that some patients with depressive or bipolar disorder may be at increased risk of developing dementia. The present study aimed to investigate whether the risk of developing dementia increases with the number of affective episodes in patients with depressive...... disorder and in patients with bipolar disorder. METHODS: This was a case register study including all hospital admissions with primary affective disorder in Denmark during 1970-99. The effect of the number of prior episodes leading to admission on the rate of readmission with a diagnosis of dementia...... following the first discharge after 1985 was estimated. A total of 18,726 patients with depressive disorder and 4248 patients with bipolar disorder were included in the study. RESULTS: The rate of a diagnosis of dementia on readmission was significantly related to the number of prior affective episodes...

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

    Science.gov (United States)

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

    2015-01-01

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

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

    International Nuclear Information System (INIS)

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

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ajeet Sidana

    2014-01-01

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

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

    Science.gov (United States)

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

    2018-04-03

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

  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. The Daily Functionality in a Major Depressive Episode Cohort of Romanian Patients - a Non-Interventional Study.

    Science.gov (United States)

    Prelipceanu, Dan; Purnichi, Traian; Marinescu, Victor; Matei, Valentin

    2015-03-01

    The aim of this non-interventional, investigator driven study was to assess the functionality of patients with major depression under treatment with agomelatine in real life clinical practice. The study was multicenter, non-interventional and evaluated the functionality of the adult patients with a DSM-IV diagnosis of MDD (single or recurrent episode and no treatment in the previous 6 months). It took place in Romania and it was a 10-weeks study. After the clinicians took the medical decision of treatment with agomelatine and if the patient agreed to be evaluated more accurate in this study, in order to assess functionality, patients completed at each visit the Sheehan Disability Scale (SDS). Patients were assessed also with QIDS-C (Quick Inventory of Depressive Symptomatology), a measure of depression symptoms severity and CGI scale severity (CGI-S), CGI scale improvement (CGI-I) and therapeutic index. Also, data about demographics and disease were collected during clinical interviews and from medical records. The functionality as assessed with SDS showed a significant functional impairment at baseline with scores >6 for each of the 3 inter-related domains of work/school, social and family life. At the end of the study, all functional aspects were improved although a mild impairment still persist requiring further treatment. A total of 1191 patients were analyzed (mean age: 47 years, 68% female). Mean QIDS-16 total score at baseline was 14.3 and decreased over the 10-week prospective period to 2.3. Most patients were treated with agomelatine. This study outcome confirms the fast on set of functionality improvement of agomelatine and further treatment need for the total remission of clinical depressive symptomatology after 10 weeks of treatment.

  17. Functioning before and after a major depressive episode: pre-existing vulnerability or scar? A prospective three-wave population-based study.

    Science.gov (United States)

    Bos, E H; Ten Have, M; van Dorsselaer, S; Jeronimus, B F; de Graaf, R; de Jonge, P

    2018-01-14

    The vulnerability hypothesis suggests that impairments after remission of depressive episodes reflect a pre-existing vulnerability, while the scar hypothesis proposes that depression leaves residual impairments that confer risk of subsequent episodes. We prospectively examined vulnerability and scar effects in mental and physical functioning in a representative Dutch population sample. Three waves were used from the Netherlands Mental Health Survey and Incidence Study-2, a population-based study with a 6-years follow-up. Mental and physical functioning were assessed with the Medical Outcomes Study Short Form (SF-36). Major depressive disorder (MDD) was assessed with the Composite International Diagnostic Interview 3.0. Vulnerability effects were examined by comparing healthy controls (n = 2826) with individuals who developed a first-onset depressive episode during first follow-up but did not have a lifetime diagnosis of MDD at baseline (n = 181). Scarring effects were examined by comparing pre- and post-morbid functioning in individuals who developed a depressive episode after baseline that was remitted at the third wave (n = 108). Both mental (B = -5.4, s.e. = 0.9, p vulnerability rather than a scar.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  20. Screening for bipolar disorder among patients undergoing a major depressive episode: report from the BRIDGE study in Egypt.

    Science.gov (United States)

    Okasha, Tarek; Fikry, Mohamed; Kowailed, Aref; El-Guwiely, Tamer; Sadek, Hisham

    2013-05-01

    To estimate the frequency of bipolar disorder (BPD) among patients with a major depressive episode (MDE) and elucidate clinically-relevant factors predictive of bipolarity. We evaluated 306 patients undergoing a MDE at facilities throughout Egypt. Patients were given the HCL-32 R2 questionnaire to assess the presence of manic/hypomanic symptoms; those scoring >14 were considered bipolar. We also investigated how various clinical criteria for bipolarity changed the incidence of bipolar diagnosis. Finally, we examined if demographics, psychiatric history, clinical characteristics, and the incidence of co-morbid conditions differed significantly between bipolar and unipolar patients. The positive screen rate for BPD based on HCL-32 R2 scores was 62.2% (188/302). However, only 26% (80/306) of patients had been diagnosed previously as bipolar. In contrast, when DSM-IV criteria were used, only 13.7% (42/306) of patients qualified as bipolar. A number of factors were highly predictive of bipolarity including: seasonality, number of past mood episodes, history of psychiatric hospitalization, mixed state, and mood reactivity. Of the comorbidities examined, only borderline personality disorder occurred at a higher rate in bipolar than in unipolar patients. Participating centers were not randomly selected and there could be a bias if only psychiatrists having specific interest in BPD were included. The positive HCL-32-R2-based bipolar screen rate of 62% suggests that a substantial proportion of patients with a MDE may have BPD. Further, a number of factors in the patient's psychiatric history as well as clinical aspects of the episode itself may signal an increased likelihood of bipolarity. Copyright © 2012 Elsevier B.V. All rights reserved.

  1. Increased anterior default-mode network homogeneity in first-episode, drug-naive major depressive disorder: A replication study.

    Science.gov (United States)

    Guo, Wenbin; Cui, Xilong; Liu, Feng; Chen, Jindong; Xie, Guangrong; Wu, Renrong; Zhang, Zhikun; Chen, Huafu; Zhao, Jingping

    2018-01-01

    Abnormal default-mode network (DMN) homogeneity has been involved in the neurophysiology of major depressive disorder (MDD) with inconsistent findings. The inconsistency may be due to clinical and methodological variability, and the reproducibility of the findings is limited. The present study aimed to examine alterations of the DMN homogeneity in two independent samples of patients with first-episode, drug-naive MDD. The samples included 59 patients with MDD and 31 comparison subjects from Sample 1 and 29 patients with MDD and 24 comparison subjects from Sample 2. Network homogeneity (NH) was computed with an overlapping technique, which was employed to define brain regions with abnormal NH common to the MDD samples. Compared with comparison subjects, patients with MDD exhibited increased NH in an overlapped brain region of the left superior medial prefrontal cortex (MPFC). No correlations were found between abnormal NH and HAMD total/subscale scores in the patients of each sample and in the combined patients from both samples. This study is the first to examine alterations of DMN homogeneity in first-episode, drug-naive patients with MDD in two independent samples by using an overlapping technique. Patients with MDD exhibit increased NH in an overlapped region in the anterior DMN. The present study thus highlights the importance of the DMN in the neurophysiology of MDD. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Pancreatic morphological changes in long-term follow-up after initial episode of acute alcoholic pancreatitis.

    Science.gov (United States)

    Nikkola, Jussi; Rinta-Kiikka, Irina; Räty, Sari; Laukkarinen, Johanna; Lappalainen-Lehto, Riitta; Järvinen, Satu; Seppänen, Hanna; Nordback, Isto; Sand, Juhani

    2014-01-01

    The long-term morphological changes induced by a single episode of alcoholic pancreatitis are not known. Our aim was to study these morphological changes in secretin-stimulated magnetic resonance cholangiopancreatography (S-MRCP) after the first episode of alcohol-associated acute pancreatitis and to evaluate the risk factors and possible protective factors potentially associated with later chronic findings. We have previously reported 2-year follow-up results in pancreatic morphology. This study extends the follow-up to 9 years. In this prospective follow-up study, S-MRCP imaging was performed for 44 (41 M, 3 F; mean age, 46 (25-68) years) patients after their first episode of alcohol-associated pancreatitis. Pancreatic morphology was evaluated at 3 months and at 2, 7, and 9 years after hospitalization. Recurrent attacks of pancreatitis were studied and pancreatic function was monitored by laboratory tests. Patients' alcohol consumption was evaluated with questionnaires, laboratory markers, and self-estimated alcohol consumption via interview. Smoking and body mass index were annually recorded. At 3 months, 32 % of the patients had normal findings in S-MRCP, 52 % had acute, and 16 % had chronic changes. At 7 years, S-MRCP was performed on 36 patients with normal findings in 53 %, the rest (47 %) having chronic findings. Pancreatic cyst was present in 36 %, parenchymal changes in 28 %, and atrophy in 28 % of the cases. There were no new changes in the pancreas in the attending patients between 7 and 9 years (18 patients). Of the patients with only acute findings at 3 months, 60 % resolved to normal in 7 years, but the rest (40 %) showed chronic changes later on. The initial attack was mild in 65 %, moderate in 25 %, and severe in 10 % of the patients. Patients with mild first attack had fewer chronic changes at 7 years compared to patients with moderate or moderate and severe together (p = 0.03, p = 0.01). Of the patients in the

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

    OpenAIRE

    Duthe, G.; Rossier, C.; Bonnet, Doris; Soura, A. B.; Corker, J.

    2016-01-01

    Background: In sub-Saharan African cities, the epidemiological transition has shifted a greater proportion of the burden of non-communicable diseases, including mental and behavioral disorder, to the adult population. The burden of major depressive disorder and its social risk factors in the urban sub-Saharan African population are not well understood and estimates vary widely. We conducted a study in Ouagadougou, Burkina Faso, in order to estimate the prevalence of major depressive episodes ...

  4. Pathogenesis of Cardiac Depression in Acute Destructive Pancreatitis

    Directory of Open Access Journals (Sweden)

    A. V. Ershov

    2016-01-01

    Full Text Available Objective is to identify the pathogenic factors for progression of pancreatogenic cardiac failure in the nearest and remote periods.Materials and methods. The study was carried out on 130 male Wistar rats (292±4.0 g divided into 4 groups. The animals were anesthetized with ethyl ether. Acute destructive pancreatitis was simulated in three experimental groups by infusion of bile (0.15 ml/kg body weight taken from the bile duct into the pancreatic tissue. The isolated isovolumically contracting rat heart (according to E. L. Fallen et al was simulated 24 hours, 7 days and 1 month after the bile infusion. The pressure in the left ventricle was measured by electric manometer BMT and registered along with the first derivative at the device N3384P calculating the systolic and diastolic blood pressure, and the speed of contraction and relaxation. At the same time the perfusate samples passed through the coronary arteries were har vested, and aspartate aminotransferase (AST and glucose were determined by standard methods. To identify the cardiac depression, the high contraction rhythm and hypercalcemic and hypoxic perfusion were applied.Results. It was found that in acute destructive pancreatitis the power and speed parameters of the heart con tractile function were altered that led to lowering the systolic blood pressure and velocity of contraction and relax ation of the left ventricular myocardium and increased diastolic blood pressure as an indicator of cardyomyocyte contracture rate. These abnormalities were evidently manifested in increased heartbits, including hypercalcemic and hypoxic perfusion of the isolated hearts. Glucose consumption was raised per each mmHg generated by the ventricular pressure.Conclusion. the most significant pathogenetic factors of pancreatogenic heart failure include hypoxia, car diomyocyte membrane destruction, inhibition of sarcolemma Capump, sarcoplasmic reticulum, and mitochondrial dysfunction. The maximum depression

  5. [Total parenteral nutrition for recurrent episodes of acute pancreatitis during pregnancy. A case report and literature review].

    Science.gov (United States)

    Forget, S; Senesse, P; Burlet, G; Lacroix, N; Boulot, P

    2007-12-01

    We report on a 35-year-old woman who underwent at 15 weeks of pregnancy exclusive parenteral nutrition for recurrent episodes of acute pancreatitis. She had a pancreatico-jejunal anastomosis stenosis secondary to cephalic duodenopancreatectomy. Nocturnal exclusive parenteral nutrition was used 79 days during pregnancy and 12 days during post-partum. The fetal growth was normal and the foetal well-being was normal. She presented cholestasis at 30 weeks of pregnancy treated medically. She delivered at 33 weeks of pregnancy by cesarean section a healthy baby girl with normal birth weight.

  6. Modafinil Improves Episodic Memory and Working Memory Cognition in Patients With Remitted Depression: A Double-Blind, Randomized, Placebo-Controlled Study.

    Science.gov (United States)

    Kaser, Muzaffer; Deakin, Julia B; Michael, Albert; Zapata, Camilo; Bansal, Rachna; Ryan, Dragana; Cormack, Francesca; Rowe, James B; Sahakian, Barbara J

    2017-03-01

    Cognitive dysfunction is a core feature of depression and tends to persist even after mood symptoms recover, leading to detrimental effects on clinical and functional outcomes. However, most currently available treatments have not typically addressed cognition. Modafinil has been shown to have beneficial effects on cognitive function and therefore has the potential to improve cognition in depression. The objective of this double-blind, placebo-controlled study was to investigate the effects of modafinil on cognitive functions in patients with remitted depression. In total, 60 patients with remitted depression participated in the study. Cognitive functions were evaluated with tests of working memory, planning, attention, and episodic memory from the Cambridge Neuropsychological Test Automated Battery at the baseline session and after treatment. A double-blind, randomized, placebo-controlled, parallel groups design was used to assess the effects of single-dose (200 mg) modafinil ( n = 30) or placebo ( n = 30) on cognition and fatigue. The main outcome measures were neurocognitive test scores from the Cambridge Neuropsychological Test Automated Battery. Visual analogue scales for subjective feelings and fatigue were used as secondary measures. The modafinil group had significantly better performance on tests of episodic memory ( p = .01, η p 2 = .10) and working memory ( p = .04, η p 2 = .06). Modafinil did not improve planning or sustained attention. This study suggested that modafinil (200 mg) could improve episodic memory and working memory performance in patients with remitted depression. Modafinil may have potential as a therapeutic agent to help remitted depressed patients with persistent cognitive difficulties.

  7. Older maternal age and major depressive episodes in the first two years after birth: findings from the Parental Age and Transition to Parenthood Australia (PATPA) study.

    Science.gov (United States)

    McMahon, Catherine A; Boivin, Jacky; Gibson, Frances L; Hammarberg, Karin; Wynter, Karen; Fisher, Jane R W

    2015-04-01

    This study examines whether (1) older maternal age is associated with increased risk of depressive episodes between four months and two years after first birth and (2) the role of subsequent reproductive, social and child factors in vulnerability to later onset depression. 592 women were recruited in the third trimester of pregnancy in three age-groups (≤ 30 years; 31-36 years,≥37 years); 434 (73%) completed all assessments at four months and two years after birth. Major Depression episodes (MDE) were assessed at four months and two years using the Mini International Neuropsychiatric Interview (MINI). Maternal (age, mode of conception, prior mood symptoms, health), child (temperament, health), reproductive (subsequent fertility treatment, pregnancy, birth, pregnancy loss) and social contextual variables (language background, paid work, practical support, life stresses) were assessed in pregnancy and postnatally using validated questionnaires and structured interview questions. Maternal age was not related to prevalence or timing of MDE. Depression symptoms, poor child health, low practical support at four months and a non-English language background predicted episodes of depression between four months and two years, ps two years after birth. Prevalence for the whole sample was at the lower end of reported community ranges and was comparable early and later in the postpartum period. Screening for depression after childbirth should not be restricted to the early months. Copyright © 2015 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

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

    2014-03-01

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

  9. 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

  10. 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

  11. Insomnia brings soldiers into mental health treatment, predicts treatment engagement, and outperforms other suicide-related symptoms as a predictor of major depressive episodes.

    Science.gov (United States)

    Hom, Melanie A; Lim, Ingrid C; Stanley, Ian H; Chiurliza, Bruno; Podlogar, Matthew C; Michaels, Matthew S; Buchman-Schmitt, Jennifer M; Silva, Caroline; Ribeiro, Jessica D; Joiner, Thomas E

    2016-08-01

    Given the high rates of suicide among military personnel and the need to characterize suicide risk factors associated with mental health service use, this study aimed to identify suicide-relevant factors that predict: (1) treatment engagement and treatment adherence, and (2) suicide attempts, suicidal ideation, and major depressive episodes in a military sample. Army recruiters (N = 2596) completed a battery of self-report measures upon study enrollment. Eighteen months later, information regarding suicide attempts, suicidal ideation, major depressive episodes, and mental health visits were obtained from participants' military medical records. Suicide attempts and suicidal ideation were very rare in this sample; negative binomial regression analyses with robust estimation were used to assess correlates and predictors of mental health treatment visits and major depressive episodes. More severe insomnia and agitation were significantly associated with mental health visits at baseline and over the 18-month study period. In contrast, suicide-specific hopelessness was significantly associated with fewer mental health visits. Insomnia severity was the only significant predictor of major depressive episodes. Findings suggest that assessment of sleep problems might be useful in identifying at-risk military service members who may engage in mental health treatment. Additional research is warranted to examine the predictive validity of these suicide-related symptom measures in a more representative, higher suicide risk military sample. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    King, M; Marston, L; Bower, P

    2014-07-01

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

  13. First episode schizophrenia-related psychosis and substance use disorders: acute response to olanzapine and haloperidol.

    Science.gov (United States)

    Green, Alan I; Tohen, Mauricio F; Hamer, Robert M; Strakowski, Stephen M; Lieberman, Jeffrey A; Glick, Ira; Clark, W Scott

    2004-02-01

    Co-occurring substance use disorders, mostly involving alcohol, cannabis or cocaine, occur commonly in patients with schizophrenia and are associated with increased morbidity and mortality. Available but limited data suggest that substance use disorders (especially cannabis use disorders) may also be common in first-episode patients and appear linked to a poor outcome in these patients. Strategies to curtail substance use form an important dimension of the treatment program for both first-episode and chronic patients. We report on rates of co-occurring substance use disorders in patients within their first episode of schizophrenia-related psychosis from a multicenter, international treatment trial of olanzapine vs. haloperidol. The study involved 262 patients (of 263 who were randomized and who returned for a post-randomization evaluation) within their first episode of psychosis (schizophrenia, schizoaffective disorder or schizophreniform disorder) recruited from 14 academic medical centers in North America and Western Europe. Patients with a history of substance dependence within 1 month prior to entry were excluded. Of this sample, 97 (37%) had a lifetime diagnosis of substance use disorder (SUD); of these 74 (28% of the total) had a lifetime cannabis use disorder (CUD) and 54 (21%) had a lifetime diagnosis of alcohol use disorder (AUD). Patients with SUD were more likely to be men. Those with CUD had a lower age of onset than those without. Patients with SUD had more positive symptoms and fewer negative symptoms than those without SUD, and they had a longer duration of untreated psychosis. The 12-week response data indicated that 27% of patients with SUD were responders compared to 35% of those without SUD. Patients with AUD were less likely to respond to olanzapine than those without AUD. These data suggest that first-episode patients are quite likely to have comorbid substance use disorders, and that the presence of these disorders may negatively influence

  14. First-episode acute and transient psychotic disorder in Latvia: a 6-year follow-up study.

    Science.gov (United States)

    Rusaka, Marija; Rancāns, Elmārs

    2014-01-01

    Acute and transient psychotic disorder (ATPD; F23, ICD-10) is an acute, short-lived psychosis, which has variable prevalence worldwide and has not been extensively studied. To explore the first episode of ATPD in patients in Latvia by describing the clinical features, analyzing the longitudinal changes of diagnosis and associated socio-demographic characteristics. Retrospective chart review of all first-time hospitalized patients fulfilling the ICD-10 criteria for ATPD treated at the Riga Centre of Psychiatry and Addiction Disorders, Latvia, during a 3-year period. Patients were followed-up and assessed using standardized instruments. During a 3-year period, 294 patients were first-time hospitalized with a ATPD diagnosis; 54% were women. The average age at first psychotic episode was 35.7 ± 12.3 years for women, and 30.0 ± 10.8 years for men (P Latvia, with data from other countries may help to predict the development of disease and provide the possible basis for potential changes to ICD-11.

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

    Science.gov (United States)

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

    2014-01-01

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

  16. Spreading depression is facilitated in adult rats previously submitted to short episodes of malnutrition during the lactation period

    Directory of Open Access Journals (Sweden)

    A.P. Rocha-de-Melo

    1997-05-01

    Full Text Available Lactating rat dams were submitted to short episodes (1, 2 or 3 weeks of nutritional restriction by receiving the "regional basic diet" (RBD, with 8% protein of low-income human populations of Northeast Brazil. Their pups were then studied regarding the developmental effects on body and brain weights. When the rats reached adulthood, cortical susceptibility to the phenomenon of spreading depression (SD was evaluated by performing electrophysiological recordings on the surface of the cerebral cortex. SD was elicited at 20-min intervals by applying 2% KCl for 1 min to a site on the frontal cortex and its occurrence was monitored at 2 sites in the parietal region by recording the electrocorticogram and the slow potential change of SD. When compared to control rats fed a commercial diet with 23% protein, early malnourished rats showed deficits in body and brain weights (10% to 60% and 3% to 15%, respectively, as well as increases in velocity of SD propagation (10% to 20%. These effects were directly related to the duration of maternal dietary restriction, with pups malnourished for 2 or 3 weeks presenting more intense weight and SD changes than those malnourished for 1 week. The effects of 1-week restrictions on SD were less evident in the pups malnourished during the second week of lactation and were more evident in pups receiving the RBD during the third week. The results indicate that short episodes of early malnutrition during the suckling period can affect body and brain development, as well as the cortical susceptibility to SD during adulthood. The data also suggest that the third week of lactation is the period during which the brain is most sensitive to malnutrition, concerning the effects on SD

  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

    2017-01-01

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

  18. Self-blame-Selective Hyperconnectivity Between Anterior Temporal and Subgenual Cortices and Prediction of Recurrent Depressive Episodes.

    Science.gov (United States)

    Lythe, Karen E; Moll, Jorge; Gethin, Jennifer A; Workman, Clifford I; Green, Sophie; Lambon Ralph, Matthew A; Deakin, John F W; Zahn, Roland

    2015-11-01

    Patients with remitted major depressive disorder (MDD) were previously found to display abnormal functional magnetic resonance imaging connectivity (fMRI) between the right superior anterior temporal lobe (RSATL) and the subgenual cingulate cortex and adjacent septal region (SCSR) when experiencing self-blaming emotions relative to emotions related to blaming others (eg, "indignation or anger toward others"). This finding provided the first neural signature of biases toward overgeneralized self-blaming emotions (eg, "feeling guilty for everything"), known to have a key role in cognitive vulnerability to MDD. It is unknown whether this neural signature predicts risk of recurrence, a crucial step in establishing its potential as a prognostic biomarker, which is urgently needed for stratification into pathophysiologically more homogeneous subgroups and for novel treatments. To use fMRI in remitted MDD at baseline to test the hypothesis that RSATL-SCSR connectivity for self-blaming relative to other-blaming emotions predicts subsequent recurrence of depressive episodes. A prospective cohort study from June 16, 2011, to October 10, 2014, in a clinical research facility completed by 75 psychotropic medication-free patients with remitted MDD and no relevant comorbidity. In total, 31 remained in stable remission, and 25 developed a recurring episode over the 14 months of clinical follow-up and were included in the primary analysis. Thirty-nine control participants with no personal or family history of MDD were recruited for further comparison. Between-group difference (recurring vs stable MDD) in RSATL connectivity, with an a priori SCSR region of interest for self-blaming vs other-blaming emotions. We corroborated our hypothesis that during the experience of self-blaming vs other-blaming emotions, RSATL-SCSR connectivity predicted risk of subsequent recurrence. The recurring MDD group showed higher connectivity than the stable MDD group (familywise error-corrected P

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    BACKGROUND: Chronic obstructive pulmonary disease (COPD) patients who have had an episode of acute hypercapnic respiratory failure (AHRF) have a large 1-year risk of death or readmission. Acute non-invasive ventilation (NIV) has been shown to be an effective treatment of AHRF; and long-term NIV...... (LTNIV) has been shown to be an effective treatment of chronic respiratory failure in stable hypercapnic COPD. We investigated the effects of LTNIV in a group of patients with severe, unstable COPD: frequent admissions and multiple previous episodes of AHRF treated with NIV. METHODS: We conducted...... a retrospective analysis of 20 COPD patients treated with LTNIV after two or more episodes of AHRF during 1 year. RESULTS: The mean number of AHRF episodes decreased from 2.44 in the year prior to LTNIV initiation to 0.44 in the year following (p

  20. Personality Traits and Anxiety and Depressive Disorders in Patients With Medication-Overuse Headache Versus Episodic Migraine.

    Science.gov (United States)

    Mohseni, Nima; Togha, Mansooreh; Arzaghi, Seyed Masoud; Nekooie, Sepideh; Tafti, Mehrnaz Fallah; Fatehi, Farzad

    2017-12-14

    An episodic migraine (EM) may lead to medication-overuse headache (MOH), an abnormal behavioral pattern of noncompliance. Anxiety disorders, mood disorders, and disorders caused by psychoactive substances other than analgesics all have been reported with MOH at higher rates than with EM. The objective of this study was to evaluate the relationships between personality traits and anxiety and depressive disorders and headache type. In this cross-sectional study, 55 patients with EM and 50 patients with MOH were recruited from were recruited from 2 university hospital clinics in Tehran, Iran, from January 2013 to November 2015. Personality traits were assessed with the Temperament and Character Inventory (TCI-125). Patients were assessed for depression with the 9-item Patient Health Questionnaire (PHQ-9) and anxiety with the 7-item Generalized Anxiety Disorder scale (GAD-7). There was no significant difference between the 2 groups regarding sex, age, or educational level. The TCI-125 analysis between the 2 groups showed a significant mean ± SD difference in reward dependence (EM: 9.77 ± 2.06, MOH: 8.69 ± 2.15, P = .01) and self-transcendence (EM: 8.42 ± 2.45, MOH: 6.83 ± 3.90, P = .03). The GAD-7 and PHQ-9 analyses demonstrated no significant difference between the 2 groups. Reward-dependence and self-transcendence scores were significantly lower in patients with MOH than in those with EM. These results suggest that people with lower reward-dependence and self-transcendence scores may not adequately respond to prescribed medications, leading them to the frequent use of multiple drugs at higher doses. A multidisciplinary approach to management may be suggested for migraine patients, and it is reasonable to consider behavioral therapy in conjunction with pharmacotherapy to ameliorate comorbid conditions. © Copyright 2017 Physicians Postgraduate Press, Inc.

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

    Science.gov (United States)

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

    2017-06-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

  3. 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

  4. Classification of Acute Rejection Episodes in Kidney Transplantation: a Proposal Based on Factor Analysis.

    Science.gov (United States)

    Rodríguez Castellanos, Francisco E; Domínguez Quintana, Francisco; Soto Abraham, Virgilia; Mancilla Urrea, Eduardo

    2018-03-01

    Kidney transplantation is considered the ideal treatment for end-stage renal disease. Acute rejection can influence graft survival. The aim of this study was to propose a classification system for acute rejection based on factor analysis. Data were collected from kidney transplant recipients with acute rejection diagnosis based on standard histological variables, the presence of peritubular eosinophils, and immunolabeling for lysozyme and myeloperoxidase in kidney tissue. Factor analysis was employed for data reduction and generation of a new case classification, with orthogonal rotation as a strategy to simplify factors, and principal component analysis was used as an extraction method. Seventy-nine kidney biopsies were obtained from 74 patients. The total population was divided into humoral rejection (39.2%), cellular rejection (34.1%), and mixed acute rejection (26.7%). No significant differences were found between the three groups in clinical and biochemical variables. We extracted 4 factors using factor analysis. The 1st factor was characterized by the presence of capillaritis, plasma cells infiltration, tubulitis, and inflammation. The 2nd factor included positivity for lysozyme and myeloperoxidase, while the 3rd factor included the presence of eosinophils and glomerulitis. The 4th component consisted of the presence of C4d and endarteritis. The cases belonging to the 3rd factor showed the greatest increase in serum creatinine. The cases belonging to the 4th factor exhibited greater urinary excretion of proteins. This proposal of classification of acute rejection could contribute to evaluate the prognosis of kidney transplant recipients.

  5. [Low-dose (0.5 mg) DST in manic and major depressive episodes: in relation to the severity of symptoms].

    Science.gov (United States)

    Matsunaga, H; Sarai, M

    2000-01-01

    Results of previous studies and our own preliminary study suggest that the dexamethasone suppression test (DST) using 1 mg of dexamethasone might result in lower sensitivity in Japanese and Asian people with major depressive episodes, when compared to Caucasian people. We investigated the clinical utility of low-dose (0.5 mg) DST in Japanese patients with manic or major depressive episodes. Low-dose (0.5 mg) DST was performed 276 times in 122 patients with bipolar disorder (manic or depressed) or major depressive disorder who visited the Department of Psychiatry of Osaka Prefectural General Hospital. After strict exclusion criteria were applied, the remaining 225 test results in 98 patients were analyzed. The severity of symptoms was estimated in accordance with the DSM-IV, namely, severe, moderate, mild, or in remission. A 0.5 mg dose of dexamethasone was administered orally at 20:30, and blood samples were taken the following day at 8:00 (9:00 in outpatients) and 13:00. Serum cortisol levels were measured by radioimmunoassay. Nonsuppression was considered to have occurred when at least one of the postdexamethasone cortisol values was 4.0 micrograms/dl or over. In manic episodes, the postdexamethasone cortisol levels were significantly correlated with the severity of the symptoms, and the postdexamethasone cortisol levels in patients with severe symptoms were significantly higher than in those in remission. The rates of nonsuppression in manic episodes with severe, moderate, mild symptoms, and in remission, were 7/8 (88%), 1/4 (25%), 1/3 (33%) and 2/7 (29%), respectively. In major depressive episodes, the postdexamethasone cortisol levels were significantly correlated with the severity of the symptoms. The rates of nonsuppression in major depressive episodes with each grading of severity were 47/58 (81%), 28/52 (54%), 14/40 (35%), 10/53 (19%), respectively. In major depressive episodes, patients aged 50 or over showed significantly higher postdexamethasone

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

    Science.gov (United States)

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

    2018-03-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2018-03-20

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

  9. Increased affective empathy in bipolar patients during a manic episode.

    Science.gov (United States)

    Bodnar, Anna; Rybakowski, Janusz K

    2017-01-01

    To assess both cognitive and affective empathy in patients with bipolar disorder (BD) during an acute manic or depressive episode. The study included 25 patients with BD (aged 35±14 years) during an acute manic episode, 25 bipolar patients (aged 41±14 years) during a depressive episode, and 25 healthy control subjects (aged 36±11 years). Cognitive and affective empathy were assessed using the Multifaceted Empathy Test. In both manic and depressive patients, a significant deficit in cognitive empathy was demonstrated. However, indices of affective empathy were significantly higher in the manic group than in depressed and control subjects. In the depressed patients, indices did not differ from those of healthy controls. For affective empathy, a significant positive correlation was found with intensity of manic symptoms and a negative correlation was found with intensity of depressive symptoms. No such correlations were observed with cognitive empathy. We found evidence of increased affective empathy (overempathizing) during a manic episode in bipolar patients. This phenomenon may be connected with disturbances in emotion inhibition related to anastrophic thinking and associated with increased activity of mirror neurons, all of which occur during a manic episode.

  10. Heart rate variability in acute coronary syndrome patients with major depression: influence of sertraline and mood improvement.

    Science.gov (United States)

    Glassman, Alexander H; Bigger, J Thomas; Gaffney, Michael; Van Zyl, Louis T

    2007-09-01

    Major depressive disorder (MDD) associated with acute coronary syndrome (ACS) increases the risk of mortality. Decreased heart rate variability (HRV), also a predictor of mortality, is reduced in patients with MDD after ACS, and has been suggested to be a mediator of MDD mortality after ACS. Although selective serotonin reuptake inhibitors may reduce mortality post-ACS, little is known about their effects on HRV. To examine the influence of both sertraline and improvement in mood on HRV. The Sertraline Antidepressant Heart Attack Randomized Trial assessed HRV from 24-hour Holter electrocardiogram recordings at baseline in 290 patients and from a second recording in 258 of these patients 16 weeks after randomization to sertraline or placebo. Frequency domain measures of HRV included high-frequency power, low-frequency power, very low-frequency power, ultra low-frequency power, and total power. Depression severity was measured by the Hamilton Rating Scale for Depression. Clinical response was measured with the Clinical Global Impressions Improvement scale. At baseline, prior episodes of MDD were associated with lower HRV. Sertraline significantly increased ultra low-frequency power, while improvement in mood was associated with higher low-frequency power independent of treatment. However, the expected recovery in HRV following ACS was not observed in patients with MDD. Higher ultra low-frequency during sertraline treatment and higher low-frequency power in patients whose mood improved resulted primarily from these measures decreasing in their comparison groups. Heart rate variability recovery is impaired in depressed patients after ACS. Previously reported differences in baseline HRV between patients with and without depression after ACS grew larger in the 16 weeks following a coronary event. Both sertraline treatment and symptomatic recovery from depression were associated with increased HRV compared with placebo-treated and nonrecovered post-ACS control groups

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

    Science.gov (United States)

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

    2012-04-01

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

  12. Antidepressants for the acute treatment of bipolar depression: a systematic review and meta-analysis.

    Science.gov (United States)

    Sidor, Michelle M; Macqueen, Glenda M

    2011-02-01

    The role of antidepressants in the acute treatment of bipolar depression remains a contentious issue. A previous meta-analysis of randomized controlled trials (RCTs) concluded that antidepressants were effective and safe for bipolar depression. Several trials published since then suggest that antidepressants may not be as beneficial as previously concluded. The current systematic review and meta-analyses reexamine the efficacy and safety of antidepressant use for the acute treatment of bipolar depression. EMBASE, MEDLINE, CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials databases were searched for double-blind RCTs published from 2003 to 2009 using the following diagnostic medical subject heading (MESH) terms: bipolar disorder, bipolar depression, bipolar I disorder, bipolar II disorder, bipolar III disorder, bipolar mania, cyclothymia, manic depressive psychosis, mixed mania and depression, and rapid cycling and bipolar disorder. Databases of trial registries were also searched for unpublished RCTs. These searches were supplemented by hand searches of relevant articles and review articles. Trials that compared acute (antidepressant treatment with either an active drug or a placebo comparator in adult bipolar patients, depressive phase were eligible for inclusion. Main outcome measures were clinical response, remission, and affective switch. Six RCTs (N = 1,034) were identified since publication in 2004 of the first meta-analysis that assessed antidepressant use in the acute treatment of bipolar depression. These studies were combined with earlier studies for a total of 15 studies containing 2,373 patients. Antidepressants were not statistically superior to placebo or other current standard treatment for bipolar depression. Antidepressants were not associated with an increased risk of switch. Studies that employed more sensitive criteria to define switch did report elevated switch rates for antidepressants. Although antidepressants were

  13. 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.

  14. Management of first depression or generalized anxiety disorder episode in adults in primary care: A systematic metareview.

    Science.gov (United States)

    Driot, Damien; Bismuth, Michel; Maurel, Adrien; Soulie-Albouy, Julie; Birebent, Jordan; Oustric, Stéphane; Dupouy, Julie

    2017-12-01

    General Practitioners (GPs) are the leading antidepressants prescribers in Europe and in France. Difficulties in implementing existing recommendations in daily practice have been described. The objective of this study was to elaborate two algorithms to guide GPs in the patient management for a first major depressive disorder (MDD) or generalized anxiety disorder (GAD) episode in primary care. PubMed, Cochrane, and ISI Web of Science were explored using mainly the following keywords: depressive disorder, anxiety disorders, antidepressive agents or antidepressant. PubMed was explored using Medical Subject Headings (MeSH). Grey literature was also considered through the analysis of articles references, congress publications, guidelines and clinical practice recommendations. A systematic meta-review (overview of reviews) including systematic reviews, meta-analyses, guidelines and clinical practice recommendations, published from January 2002 to December 2015, was performed. The methodological and report qualities were assessed by the AGREE II, PRISMA checklist and R-AMSTAR grid. Each step was performed independently by two researchers following a process derived from the PRISMA statement. A narrative synthesis on main clinical data to collect before prescription in primary care, key information for patients, and recommended follow-up was realized. Thirty articles were included: 11 meta-analyses, 19 guidelines. For moderate to severe MDD, selective serotonin reuptake inhibitors (SSRI) should be associated with psychotherapy (cognitive behavioral therapy). For GAD, SSRI or CBT should be proposed if functional impairment is marked. Two algorithms to guide GPs for the management of MDD and or the management of GAD were created based on the data synthesis of this review. A GPs expert group discussed and adapted the algorithms to match with GPs expectancies. Few articles dealt specifically with primary care practice, and only one meta-analysis of clinical trial on

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

    Science.gov (United States)

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

    2016-11-01

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

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

    Science.gov (United States)

    Lloyd, Robert B; Rosenthal, Lisa J

    2015-01-01

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

  17. Case-control resting-state fMRI study of brain functioning among adolescents with first-episode major depressive disorder.

    Science.gov (United States)

    Gong, Yun; Hao, Lili; Zhang, Xiyan; Zhou, Yan; Li, Jianqi; Zhao, Zhimin; Jiang, Wenqing; DU, Yasong

    2014-08-01

    Adolescent depression results in severe and protracted suffering for affected individuals and their family members, but the underlying mechanism of this disabling condition remains unclear. Compare resting-state brain functioning between first-episode, drug-naïve adolescents with major depressive disorder and matched controls. Fifteen adolescents with major depressive disorder and 16 controls underwent a resting-state fMRI scan performed using a 3T magnetic resonance scanner. The amplitude of low frequency fluctuation (ALFF) was used to assess resting-state brain function. 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, left 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 left occipital lobe, and the left medial frontal lobe. Adolescent depression is associated with significant changes in the functioning of several regions of the brain.

  18. Asenapine for the Acute Treatment of Pediatric Manic or Mixed Episode of Bipolar I Disorder.

    Science.gov (United States)

    Findling, Robert L; Landbloom, Ronald L; Szegedi, Armin; Koppenhaver, Janelle; Braat, Sabine; Zhu, Qi; Mackle, Mary; Chang, Kiki; Mathews, Maju

    2015-12-01

    To evaluate asenapine versus placebo in 403 patients aged 10 to 17 years with bipolar I disorder currently in manic or mixed episodes. In this double-blind, placebo-controlled, international trial, patients were randomized 1:1:1:1 to placebo, asenapine 2.5, 5, or 10 mg b.i.d. (twice daily). Primary efficacy measure was change from baseline in Young-Mania Rating Scale (YMRS) total score at day 21. Analyses of patients with/without attention-deficit/hyperactivity disorder (ADHD) and with/without stimulant use were performed. The mean difference in asenapine versus placebo in YMRS was -3.2 (p = .0008), -5.3 (p bipolar I disorder in manic or mixed states. Increases in weight and fasting insulin were associated with asenapine. Clinical trial registration information-Efficacy and Safety of Asenapine Treatment for Pediatric Bipolar Disorder; http://clinicaltrials.gov; NCT01244815. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2006-01-01

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

  20. 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

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

    International Nuclear Information System (INIS)

    Hoq, Mohammad; Waid, Jillian

    2014-01-01

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

  2. The Long-term Prospective Follow-up of Pancreatic Function After the First Episode of Acute Alcoholic Pancreatitis: Recurrence Predisposes One to Pancreatic Dysfunction and Pancreatogenic Diabetes.

    Science.gov (United States)

    Nikkola, Jussi; Laukkarinen, Johanna; Lahtela, Jorma; Seppänen, Hanna; Järvinen, Satu; Nordback, Isto; Sand, Juhani

    2017-02-01

    Data on the prevalence of pancreatic dysfunction after an episode of acute pancreatitis are conflicting. Our aim was to evaluate the natural course of endocrine and exocrine pancreatic function in the long-term follow-up after the first episode of acute alcoholic pancreatitis (AAP). A total of 77 patients who survived their first episode of AAP between January 2001 and February 2005 were prospectively followed up for a maximum of 13 years. During the follow-up, patients were repeatedly interviewed and monitored for recurrences, new diabetes, and chronic pancreatitis. The pancreatic function was evaluated repeatedly during the follow-up. Of the patients, 35% had ≥1 recurrent acute pancreatitis (RAP) episodes during the follow-up. New pancreatogenic diabetes developed in 19% of the previously nondiabetic patients, but only in patients with RAP (13/26 vs. 0/42; OR=39; 95% CI, 4.6-327.1). In addition, 55% of the patients developed new prediabetes or diabetes, and even this was more frequent in patients with RAP (86% vs. 42%; OR=8.2; 95% CI, 1.2-54.3). Exocrine dysfunction developed in 24% of the patients and was associated with abnormal findings in the endocrine function (P=0.003). Patients with RAP had a higher overall mortality compared with patients without RAP episodes during the follow-up (36% vs. 13%; HR=4.0; 95% CI, 1.4-11.0). The risk for pancreatic endocrine dysfunction, pancreatogenic diabetes and mortality increases significantly if the patient has recurrent episodes of AAP. The risk of developing pancreatic dysfunction after AAP should be recognized and pancreatic function should be screened routinely during the years after the first episode of AAP.

  3. Episode of Familial Mediterranean Fever-Related Peritonitis in the Second Trimester of Pregnancy Followed by Acute Cholecystitis: Dilemmas and Pitfalls.

    Science.gov (United States)

    Kosmidis, Christophoros; Anthimidis, Georgios; Varsamis, Nikolaos; Makedou, Fotini; Georgakoudi, Eleni; Efthimiadis, Christophoros

    2016-02-24

    Differential diagnosis of acute abdomen in pregnant patients is one of the greatest challenges for the clinician. Occurrence of Familial Mediterranean Fever (FMF) paroxysm of peritonitis and acute cholecystitis during pregnancy is a unique clinical entity that leads to serious diagnostic and therapeutic dilemmas. We present the case of a 33-year-old Armenian patient at 16 weeks' gestational age with a history of FMF, who was admitted twice within 1 month with acute abdomen. The first episode was attributed to FMF and successfully treated conservatively with colchicine. The second episode was diagnosed as acute cholecystitis and led to emergent laparoscopic cholecystectomy and lysis of peritoneal adhesions from previous FMF attacks. The patient presented an uneventful postoperative clinical course and had a normal delivery of a healthy infant at the 39th week of gestation. Pregnant patients with acute abdomen should be evaluated with open mind. To the best of our knowledge, this is the first published report of the coexistence of 2 different causes of acute abdomen during pregnancy. Meticulous history and thorough physical, laboratory, and radiologic examination are the keys to reach a correct diagnosis. Treatment of pregnant patients with acute abdomen should be individualized. Administration of colchicine should be continued during conception, pregnancy, and lactation in patients with FMF history. Laparoscopic intervention in pregnant patients with surgical abdomen such as acute cholecystitis is the optimal method of treatment.

  4. Parasite Specific Antibody Increase Induced by an Episode of Acute P. falciparum Uncomplicated Malaria.

    Directory of Open Access Journals (Sweden)

    Mark Kaddumukasa

    Full Text Available There is no approved vaccine for malaria, and precisely how human antibody responses to malaria parasite components and potential vaccine molecules are developed and maintained remains poorly defined. In this study, antibody anamnestic or memory response elicited by a single episode of P. falciparum infection was investigated.This study involved 362 malaria patients aged between 6 months to 60 years, of whom 19% were early-diagnosed people living with HIV/AIDS (PLWHA. On the day malaria was diagnosed and 42 days later, blood specimens were collected. Parasite density, CD4+ cells, and antibodies specific to synthetic peptides representing antigenic regions of the P. falciparum proteins GLURP, MSP3 and HRPII were measured.On the day of malaria diagnosis, Immunoglobulin (IgG antibodies against GLURP, MSP3 and HRP II peptides were present in the blood of 75%, 41% and 60% of patients, respectively. 42 days later, the majority of patients had boosted their serum IgG antibody more than 1.2 fold. The increase in level of IgG antibody against the peptides was not affected by parasite density at diagnosis. The median CD4+ cell counts of PLWHAs and HIV negative individuals were not statistically different, and median post-infection increases in anti-peptide IgG were similar in both groups of patients.In the majority (70% of individuals, an infection of P. falciparum elicits at least 20% increase in level of anti-parasite IgG. This boost in anti-P. falciparum IgG is not affected by parasite density on the day of malaria diagnosis, or by HIV status.

  5. 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.

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

    Science.gov (United States)

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

    2015-04-01

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

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

    NARCIS (Netherlands)

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

    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

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

    Science.gov (United States)

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

    2012-08-01

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

  9. 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

    2006-01-01

    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 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, CB1mediated suppression of mast cell activation responses, CB2-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. PMID:18615144

  10. Acute treatment of cycloid psychosis: study on a sample of naive hospitalized patients with first-episode psychosis (FEP).

    Science.gov (United States)

    García-Andrade, Rafael F; López-Ibor, Juan J

    2015-01-01

    In spite of the historic, clinical and therapeutic importance of cycloid psychosis, no controlled studies have been performed as yet on its treatment. Electroconvulsive therapy has classically been the treatment of choice and the first generation antipsychotics have not been indicated. This study has aimed to analyze the acute treatment (and response to it) of cycloid psychoses. In a sample of 75 hospitalized medication- naive patients treated for a First Psychotic Episode (FPE), possible cases of cycloid psychoses were detected using the Perris and Brockington operative diagnostic criteria. The sample was divided into “cycloids” and “non-cycloids” and both groups were compared based on clinical and therapeutic variables. All the patients were treated with second generation antipsychotics. No significant differences (p=0.17; t-1.39) were found in the antipsychotic dose prescribed (equivalents of chlorpromazine). However, significant differences were observed in the improvement on hospital discharge (clinical global impression severity: CGI-S), with better response in the “cycloid” group” (p=0.002; u=162). Significant differences were also observed in the dose of benzodiazepines, there being significantly greater improvement for the “cycloid” group (p>0.001; u=28). Without contradicting the classical idea of the treatment of cycloid psychoses, the present study contributes to the opening of a new therapeutic prospect. Thus, the use of second generation antipsychotics could have a particularly beneficial effect, especially if combined with high doses of benzodiazepines in the acute treatment of cycloid psychoses. However, controlled studies need to be carried out to confirm this.

  11. Serotonergic genes and depressive disorder in acute coronary syndrome: The Korean depression in ACS (K-DEPACS) study.

    Science.gov (United States)

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

    2015-06-01

    Genes coding for the serotonergic pathway have been associated with depressive disorders. However, these associations have rarely been tested in acute coronary syndrome (ACS) patients vulnerable to depression. This study aimed to investigate whether polymorphisms of serotonin transporter (5-HTT) and serotonin 2a receptor (5-HTR2a) genes are associated with occurrence of depressive disorder in ACS. 969 patients with recently developed ACS were recruited at baseline, and 711 were followed 1 year thereafter. Depressive disorder was diagnosed according to DSM-IV criteria, and analysed as an outcome at baseline (prevalence), and follow up (incidence and persistence). Genotypes were ascertained for 5-HTTLPR, STin2 VNTR, 5-HTR2a 102T/C, and 5-HTR2a 1438A/G. Logistic regression models were used to investigate associations. The 5-HTTLPR s/s genotype was independently associated with depressive disorder prevalence and persistence following ACS, but no significant associations were found with the other polymorphisms. ACS patients with the 5-HTTLPR s allele are thus potentially susceptible to depressive disorder in the early phase after ACS, and with its persistence over the subsequent year. Copyright © 2015 Elsevier B.V. and ECNP. All rights reserved.

  12. 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...

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

    Science.gov (United States)

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

    2008-10-01

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

  14. EEG microstate duration and syntax in acute, medication-naive, first-episode schizophrenia: a multi-center study.

    Science.gov (United States)

    Lehmann, Dietrich; Faber, Pascal L; Galderisi, Silvana; Herrmann, Werner M; Kinoshita, Toshihiko; Koukkou, Martha; Mucci, Armida; Pascual-Marqui, Roberto D; Saito, Naomi; Wackermann, Jiri; Winterer, Georg; Koenig, Thomas

    2005-02-28

    In young, first-episode, productive, medication-naive patients with schizophrenia, EEG microstates (building blocks of mentation) tend to be shortened. Koenig et al. [Koenig, T., Lehmann, D., Merlo, M., Kochi, K., Hell, D., Koukkou, M., 1999. A deviant EEG brain microstate in acute, neuroleptic-naive schizophrenics at rest. European Archives of Psychiatry and Clinical Neuroscience 249, 205-211] suggested that shortening concerned specific microstate classes. Sequence rules (microstate concatenations, syntax) conceivably might also be affected. In 27 patients of the above type and 27 controls, from three centers, multichannel resting EEG was analyzed into microstates using k-means clustering of momentary potential topographies into four microstate classes (A-D). In patients, microstates were shortened in classes B and D (from 80 to 70 ms and from 94 to 82 ms, respectively), occurred more frequently in classes A and C, and covered more time in A and less in B. Topography differed only in class B where LORETA tomography predominantly showed stronger left and anterior activity in patients. Microstate concatenation (syntax) generally were disturbed in patients; specifically, the class sequence A-->C-->D-->A predominated in controls, but was reversed in patients (A-->D-->C-->A). In schizophrenia, information processing in certain classes of mental operations might deviate because of precocious termination. The intermittent occurrence might account for Bleuler's "double bookkeeping." The disturbed microstate syntax opens a novel physiological comparison of mental operations between patients and controls.

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

    OpenAIRE

    Ellis, Jason; Perlis, Michael; Bastien, Célyne; Gardani, Maria; Espie, Colin

    2014-01-01

    Study Objectives: While many studies have examined the association between insomnia and depression, no studies have evaluated these associations 1) within a narrow time frame, 2) with specific reference to acute & chronic insomnia, and 3) using polysomnography. In the present study, the association between insomnia and first-onset depression was evaluated taking into account these considerations. \\ud \\ud Design: A mixed-model inception design. \\ud \\ud Setting: Academic research laboratory. \\u...

  16. Enhanced depression care for patients with acute coronary syndrome and persistent depressive symptoms: coronary psychosocial evaluation studies randomized controlled trial.

    Science.gov (United States)

    Davidson, Karina W; Rieckmann, Nina; Clemow, Lynn; Schwartz, Joseph E; Shimbo, Daichi; Medina, Vivian; Albanese, Gabrielle; Kronish, Ian; Hegel, Mark; Burg, Matthew M

    2010-04-12

    Depressive symptoms are an established predictor of mortality and major adverse cardiac events (defined as nonfatal myocardial infarction or hospitalization for unstable angina or urgent/emergency revascularizations) in patients with acute coronary syndrome (ACS). This study was conducted to determine the acceptability and efficacy of enhanced depression treatment in patients with ACS. A 3-month observation period to identify patients with ACS and persistent depressive symptoms was followed by a 6-month randomized controlled trial. From January 1, 2005, through February 29, 2008, 237 patients with ACS from 5 hospitals were enrolled, including 157 persistently depressed patients randomized to intervention (initial patient preference for problem-solving therapy and/or pharmacotherapy, then a stepped-care approach; 80 patients) or usual care (77 patients) and 80 nondepressed patients who underwent observational evaluation. The primary outcome was patient satisfaction with depression care. Secondary outcomes were depressive symptom changes (assessed with the Beck Depression Inventory), major adverse cardiac events, and death. At the end of the trial, the proportion of patients who were satisfied with their depression care was higher in the intervention group (54% of 80) than in the usual care group (19% of 77) (odds ratio, 5.4; 95% confidence interval [CI], 2.2-12.9 [P < .001]). The Beck Depression Inventory score decreased significantly more (t(155) = 2.85 [P = .005]) for intervention patients (change, -5.7; 95% CI, -7.6 to -3.8; df = 155) than for usual care patients (change, -1.9; 95% CI, -3.8 to -0.1; df = 155); the depression effect size was 0.59 of the standard deviation. At the end of the trial, 3 intervention patients and 10 usual care patients had experienced major adverse cardiac events (4% and 13%, respectively; log-rank test, chi(2)(1) = 3.93 [P = .047]), as well as 5 nondepressed patients (6%) (for the intervention vs nondepressed cohort, chi(2)(1) = 0

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

    Directory of Open Access Journals (Sweden)

    Kerang Zhang

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

  18. Randomized clinical trial of observational versus antibiotic treatment for a first episode of CT-proven uncomplicated acute diverticulitis.

    Science.gov (United States)

    Daniels, L; Ünlü, Ç; de Korte, N; van Dieren, S; Stockmann, H B; Vrouenraets, B C; Consten, E C; van der Hoeven, J A; Eijsbouts, Q A; Faneyte, I F; Bemelman, W A; Dijkgraaf, M G; Boermeester, M A

    2017-01-01

    Antibiotics are advised in most guidelines on acute diverticulitis, despite a lack of evidence to support their routine use. This trial compared the effectiveness of a strategy with or without antibiotics for a first episode of uncomplicated acute diverticulitis. Patients with CT-proven, primary, left-sided, uncomplicated, acute diverticulitis were included at 22 clinical sites in the Netherlands, and assigned randomly to an observational or antibiotic treatment strategy. The primary endpoint was time to recovery during 6 months of follow-up. Main secondary endpoints were readmission rate, complicated, ongoing and recurrent diverticulitis, sigmoid resection and mortality. Intention-to-treat and per-protocol analyses were done. A total of 528 patients were included. Median time to recovery was 14 (i.q.r. 6-35) days for the observational and 12 (7-30) days for the antibiotic treatment strategy, with a hazard ratio for recovery of 0·91 (lower limit of 1-sided 95 per cent c.i. 0·78; P = 0·151). No significant differences between the observation and antibiotic treatment groups were found for secondary endpoints: complicated diverticulitis (3·8 versus 2·6 per cent respectively; P = 0·377), ongoing diverticulitis (7·3 versus 4·1 per cent; P = 0·183), recurrent diverticulitis (3·4 versus 3·0 per cent; P = 0·494), sigmoid resection (3·8 versus 2·3 per cent; P = 0·323), readmission (17·6 versus 12·0 per cent; P = 0·148), adverse events (48·5 versus 54·5 per cent; P = 0·221) and mortality (1·1 versus 0·4 per cent; P = 0·432). Hospital stay was significantly shorter in the observation group (2 versus 3 days; P = 0·006). Per-protocol analyses were concordant with the intention-to-treat analyses. Observational treatment without antibiotics did not prolong recovery and can be considered appropriate in patients with uncomplicated diverticulitis. Registration number: NCT01111253 (http://www.clinicaltrials.gov). © 2016 BJS Society Ltd Published by John

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

    Science.gov (United States)

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

    2015-09-01

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

  20. 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.

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

    Directory of Open Access Journals (Sweden)

    Caroline J Jolley

    Full Text Available 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.

  2. Acute severe depression following peri-operative ondansetron

    African Journals Online (AJOL)

    Anaesthesia with a propofol infusion and avoidance of serotonin antagonists provided a nausea-tree postoperative course without exacerbation of the depression disorder. S Afr Med J 1997; 87: 1013-1014. Ondansetron, a serotonin or 5-hydroxytryptamine-3 receptor. (5-HT3) antagonist, is often used as a potent anti-emetic.

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

    Directory of Open Access Journals (Sweden)

    Hossein Zare

    2017-05-01

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

  4. 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.

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

    NARCIS (Netherlands)

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

    2006-01-01

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

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

    Science.gov (United States)

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

    2016-11-01

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

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

    Science.gov (United States)

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

    2018-04-01

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

  8. 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 = 0.05) w...

  9. The relationship between depressive syndrome and suicidal risk in patients with acute schizophrenia.

    Science.gov (United States)

    Bagaric, Dario; Brecic, Petrana; Ostojic, Drazenka; Jukic, Vlado; Goles, Ana

    2013-10-28

    To determine the relationship between scores on five factors of the Positive and Negative Syndrome Scale (PANSS) and Calgary Depression scale for Schizophrenia (CDSS) and scores on the InterSePT Scale for Suicidal Thinking (ISST) in patients with acute schizophrenia. Data were collected on sociodemographic and clinical characteristics of 180 drug-treated in-patients with acute schizophrenia. Their symptoms were assessed with PANSS, CDSS, and ISST and correlations between the scores were calculated. Statistically significant correlations were included in the logistic regression analysis to identify predictors of suicidal risk. CDSS (Psuicidal risk. Our results suggested a considerable association between depressive syndrome as assessed by the PANSS emotional factor and CDSS score and suicidal risk in patients with acute schizophrenia.

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

    Science.gov (United States)

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

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

    Directory of Open Access Journals (Sweden)

    Nelson Valdés

    2015-01-01

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

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

    International Nuclear Information System (INIS)

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

    2017-01-01

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

  13. 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.

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

    Directory of Open Access Journals (Sweden)

    Moon Han Choi

    2013-09-01

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

  15. Effectiveness of psychological and/or educational interventions to prevent the onset of episodes of depression: A systematic review of systematic reviews and meta-analyses.

    Science.gov (United States)

    Bellón, Juan Ángel; Moreno-Peral, Patricia; Motrico, Emma; Rodríguez-Morejón, Alberto; Fernández, Ana; Serrano-Blanco, Antoni; Zabaleta-del-Olmo, Edurne; Conejo-Cerón, Sonia

    2015-07-01

    To determine the effectiveness of psychological and/or educational interventions to prevent the onset of episodes of depression. Systematic review of systematic reviews and meta-analyses (SR/MA). We searched PubMed, PsycINFO, Cochrane Database of Systematic Reviews, OpenGrey, and PROSPERO from their inception until February 2014. Two reviewers independently evaluated the eligibility criteria of all SR/MA, abstracted data, and determined bias risk (AMSTAR). Twelve SR/MA (156 non-repeated trials and 56,158 participants) were included. Of these, 142 (91%) were randomized-controlled, 13 (8.3%) controlled trials, and 1 (0.6%) had no control group. Five SR/MA focused on children and adolescents, four on specific populations (women after childbirth, of low socioeconomic status, or unfavorable circumstances; patients with severe traumatic physical injuries or stroke) and three addressed the general population. Nine (75%) SR/MA concluded that interventions to prevent depression were effective. Of the 156 trials, 137 (87.8%) reported some kind of effect size calculation. Effect sizes were small in 45 (32.8%), medium in 26 (19.1%), and large in 25 (18.2%) trials; 41 (29.9%) trials were not effective. Of the 141 trials for which follow-up periods were available, only 34 (24.1%) exceeded 12 months. Psychological and/or educational interventions to prevent onset of episodes of depression were effective, although most had small or medium effect sizes. Copyright © 2014. Published by Elsevier Inc.

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

    Science.gov (United States)

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

    2012-04-01

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

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

    Science.gov (United States)

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

    2009-08-01

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

  18. Adjunctive armodafinil for major depressive episodes associated with bipolar I disorder: a randomized, multicenter, double-blind, placebo-controlled, proof-of-concept study.

    Science.gov (United States)

    Calabrese, Joseph R; Ketter, Terence A; Youakim, James M; Tiller, Jane M; Yang, Ronghua; Frye, Mark A

    2010-10-01

    To evaluate the efficacy and safety of armodafinil, the longer-lasting isomer of modafinil, when used adjunctively in patients with bipolar depression. In this 8-week, multicenter, randomized, double-blind, placebo-controlled study conducted between June 2007 and December 2008, patients who were experiencing a major depressive episode associated with bipolar I disorder (according to DSM-IV-TR criteria) despite treatment with lithium, olanzapine, or valproic acid were randomly assigned to adjunctive armodafinil 150 mg/d (n = 128) or placebo (n = 129) administered once daily in the morning. The primary outcome measure was change from baseline in the total 30-item Inventory of Depressive Symptomatology, Clinician-Rated (IDS-C₃₀) score. Secondary outcomes included changes from baseline in scores on the Montgomery-Åsberg Depression Rating Scale, among other psychological symptom scales. Statistical analyses were performed using analysis of covariance (ANCOVA), with study drug and concurrent mood stabilizer treatment for bipolar disorder as factors and the corresponding baseline value as a covariate. A prespecified sensitivity analysis was done using analysis of variance (ANOVA) if a statistically significant treatment-by-baseline interaction was found. Tolerability was also assessed. A significant baseline-by-treatment interaction in the total IDS-C₃₀ score (P = .08) was found. Patients administered adjunctive armodafinil showed greater improvement in depressive symptoms as seen in the greater mean ± SD change on the total IDS-C₃₀ score (-15.8 ± 11.57) compared with the placebo group (-12.8 ± 12.54) (ANOVA: P = .044; ANCOVA: P = .074). No differences between treatment groups were observed in secondary outcomes. Adverse events reported more frequently in patients receiving adjunctive armodafinil were headache, diarrhea, and insomnia. Armodafinil was not associated with an increased incidence and/or severity of suicidality, depression, or mania or with

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

    Directory of Open Access Journals (Sweden)

    Neven Henigsberg

    2017-12-01

    Full Text Available BackgroundThe aim of this study was to evaluate the relationship between changes in proton magnetic resonance spectroscopy (1H-MRS parameters at the start of the index episode recovery phase and at recurrence in patients with recurrent depression who were treated with prolonged maintenance therapy.Methods1H-MRS parameters were analyzed in 48 patients with recurrent depression who required maintenance therapy with antidepressant medication prescribed by a psychiatrist and who continued with the same antidepressant during the maintenance phase, either to recurrence of depression, completion of the 10-year observation period, or the start of the withdrawal phase (tapering-off antidepressant. N-acetylaspartate (NAA, choline-containing metabolites (Cho, creatine (Cr, and glutamine/glutamate were measured at the start of the recovery phase and 6 months later.ResultsRecurrent depressive episodes occurred in 20 patients. These individuals had a smaller increase in Cho/Cr after the beginning of the recovery phase compared to the non-recurrent patient group and also exhibited a decreased NAA/Cr ratio.ConclusionSustainable NAA and increased Cho levels at the onset of the recovery phase of the index episode are early markers of antidepressant effectiveness associated with a lower risk of major depressive disorder recurrence. The NAA and Cho changes in the non-recurrent group may be attributable to increased brain resilience, contrary to the transient temporal effect observed in subjects who experienced a depressive episode.

  20. Age differences in the prevalence and comorbidity of DSM-IV major depressive episodes: Results from the WHO World Mental Health Survey Initiative

    Science.gov (United States)

    Kessler, Ronald C.; Birnbaum, Howard; Shahly, Victoria; Bromet, Evelyn; Hwang, Irving; McLaughlin, Katie A.; Sampson, Nancy; Andrade, Laura Helena; de Girolamo, Giovanni; Demyttenaere, Koen; Haro, Josep Maria; Karam, Aimee N.; Kostyuchenko, Stanislav; Kovess, Viviane; Lara, Carmen; Levinson, Daphna; Matschinger, Herbert; Nakane, Yoshibumi; Browne, Mark Oakley; Ormel, Johan; Posada-Villa, Jose; Sagar, Rajesh; Stein, Dan J.

    2011-01-01

    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 life. Methods We investigated this issue by studying age differences in comorbidity of DSM-IV major depressive episodes (MDE) with chronic physical conditions in the WHO World Mental Health (WMH) surveys, a series of community epidemiological surveys carried out in 10 developed countries (n = 51,771) and 8 developing countries (n = 37,265). MDE and other mental disorders were assessed with the Composite International Diagnostic Interview (CIDI). Organic exclusion rules were not used to avoid inappropriate exclusion of cases with physical comorbidity. Physical conditions were assessed with a standard chronic conditions checklist. Results Twelve-month DSM-IV/CIDI MDE was significantly less prevalent among respondents ages 65+ than younger respondents in developed but not developing countries. Prevalence of comorbid mental disorders generally either decreased or remained stable with age, while comorbidity of MDE with mental disorders generally increased with age. Prevalence of physical conditions, in comparison, generally increased with age, while comorbidity of MDE with physical conditions generally decreased with age. Depression treatment was lowest among the elderly in developed and developing countries. Conclusions The weakening associations between MDE and physical conditions with increasing age argue against the suggestion that the low estimated prevalence of MDE among the elderly is due to increased confounding with physical disorders. Future study is needed to investigate processes that might lead to a decreasing impact of physical illness on depression among the elderly. PMID:20037917

  1. Acute stress and depression 3 days after vaginal delivery--observational, comparative study.

    Science.gov (United States)

    Imsiragić, Azijada Srkalović; Begić, Drazen; Martić-Biocina, Sanja

    2009-06-01

    During the first month postpartum, 85% of women experience some form of mood disorders. The most common are: postpartum blues, non-psychotic postpartum depression, puerperal psychosis. Delivery of a child can be traumatic for some women. Several authors have found that women could get symptoms of one form of posttraumatic stress disorder (PTSD) after childbirth. However, etiology of established postpartum disorders is still unknown. The aim of this study is to detect symptoms of acute stress reaction and acute depressive state as a consequence of peripartal complications, as early as three days postpartum using Impact of Events Scale revised (IES-R) and the Edinburgh Postnatal Depression Scale (EPDS) questionnaires and to demonstrate their potential usage for the early detection of vulnerable mothers with greater risk to develop any of postpartum psychiatric disorder, including PTSD. For that purpose 103 subjects, without previous medical history of psychiatric illness, were included in the investigation. Long duration of delivery (> or = 12 h), very painful delivery, complication and illness of mother during and after delivery as a consequence of delivery, preterm delivery (before week 36) and/or illness of the child (as a consequence of delivery or congenital) are considered to be risk factors for acute stress reaction and acute depressive state after delivery. Sixty one out of 103 investigated mothers had one or more researched peripartal complications. A statistically significant difference has been found between the control (n=42) and the peripartal complications (n=61) groups in both the mean IES-R (4.67 +/- 5.43 and 13.50 +/- 14.12, respectively, p depressive state in the peripartal complications group there were no cases of these states in the control group. Based on our findings we conclude that using IES-R and EPDS questionnaires as early as three days after delivery could provide an early detection of previously healthy mothers with greater risk for

  2. Episodic ozone exposure in adult and Senescent Brown Norway rats: Acute and delayed cardiovascular and thermoregulatory responses

    Science.gov (United States)

    Setting exposure standards for environmental pollutants may consider the aged as a susceptible population but the few published studies assessing susceptibility of the aged to air pollutants are inconsistent. Episodic ozone (O(3)) is more reflective of potential exposures occurri...

  3. 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.

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

    NARCIS (Netherlands)

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

    2016-01-01

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

  5. 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.

  6. Suicidal Ideation Induced by Episodic Cannabis Use

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    Michele Raja

    2009-01-01

    Full Text Available The report describes a patient who presented suicidal ideation only in two different occasions, immediately after acute cannabis intoxication. He used cannabis only in these two circumstances. Although a definite association between cannabis use and suicidal ideation or behavior has been already reported in the literature, the described case presents two original clinical aspects that deserve consideration. First, episodic assumption of cannabis induced suicidal ideation abruptly. Second, suicidal ideation appeared independent of mood depression, stressors, or life events, suggesting that suicidality may be not a direct consequence of depression and appears to be a relatively independent psychopathological dimension. There seems to be no linear relation between the severity of depression and the risk of suicide.

  7. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

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    Haiyang Geng

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

  11. Frontal-subcortical volumetric deficits in single episode, medication-naïve 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.

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

    Science.gov (United States)

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

    2017-08-15

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

  13. 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.

  14. 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.

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

    Science.gov (United States)

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

    2018-04-01

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

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

    NARCIS (Netherlands)

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

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

  17. 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.…

  18. Concordance between telephone survey classification and face-to-face interview diagnosis of one-year major depressive episode in Hong Kong.

    Science.gov (United States)

    Lee, Sing; Tsang, Adley; Mak, Arthur; Lee, Athene; Lau, Lisa; Ng, K L

    2010-10-01

    Community-based telephone surveys of depression have generated reliable findings but their concordance with standardized clinical diagnostic interviews is uncommonly examined, especially in non-western populations. 106 consenting participants from a previous telephone-based population survey of major depressive episode (MDE) using a structured questionnaire were re-assessed face-to-face by clinical interviewers using the Structured Clinical Interview for DSM-IV Axis I Disorder (SCID-I). Receiver operating characteristic and other predictive indicators were used to investigate the concordance between the telephone survey instrument and SCID interview. The telephone survey instrument adequately classified MDE when the DSM-IV symptom number standard was fulfilled at moderate to severe levels of distress and impairment. It performed best when the cut-off was set at a severe level of distress or impairment in any one of four domains of functioning (AUC=0.76). Feeling useless, fatigue, loss of motivation and difficulty in concentration were the most prominent items for increasing the certainty of SCID-MDE diagnosis. Classification of MDE by telephone-based structured interview of MDE exhibited generally good agreement with face-to-face clinical interview diagnosis in the Chinese population of Hong Kong. Further research on the telephone-based methodology should address inter-rater reliability, specificity of diagnosis, and variability of concordance across different mental disorder diagnoses and criteria of clinically significant impairment. Copyright 2010 Elsevier B.V. All rights reserved.

  19. Effects of acute paroxetine treatment on the consumption of cigarette smoking and caffeine in depressed patients.

    Science.gov (United States)

    Miyamoto, Kyoko; Yoshimura, Reiji; Ueda, Nobuhisa; Sugita, Atsuko; Umene, Wakako; Hori, Hikaru; Mitoma, Masae; Nakamura, Jun

    2007-10-01

    In the present study, we examined the effects of acute treatment with paroxetine on the consumption of cigarette smoking and caffeine in 65 patients who met the DSM-IV criteria for major depressive disorder (M/F: 28/37, age: 48 +/- 15 years). Plasma levels of cotinine or caffeine were analysed using high-performance liquid chromatography (HPLC). The amount of cigarette smoking and plasma levels of cotinine, but not caffeine, decreased 4 weeks after paroxetine treatment. There was no difference between smokers and nonsmokers with respect to their response to paroxetine treatment. In addition, plasma 3-methoxy-4-hydroxyphenylglycol (MHPG) levels in responders to paroxetine treatment was higher than those in nonresponders, and there was a negative correlation between the changes in plasma MHPG levels and the changes in Hamilton rating scale for depression (Ham-D) scores before and 4 weeks after paroxetine administration. These results suggest that paroxetine has the potential to reduce the amount of cigarette smoking in depressed smokers, and we reconfirmed our previous results that depressed patients with higher plasma MHPG levels had better response to paroxetine treatment than those with lower plasma MHPG levels using larger depressed samples. Copyright 2007 John Wiley & Sons, Ltd.

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

    International Nuclear Information System (INIS)

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

    1982-01-01

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

  1. Aberrant topographical organization in default-mode network in first-episode remitted geriatric depression: a graph-theoretical analysis.

    Science.gov (United States)

    Zhu, Yan; Wang, Dongqing; Liu, Zhe; Li, Yuefeng

    2018-02-12

    Neuroimaging studies have shown that major depressive disorder is associated with altered activity patterns of the default-mode network (DMN). In this study, we sought to investigate the topological organization of the DMN in patients with remitted geriatric depression (RGD) and whether RGD patients would be more likely to show disrupted topological configuration of the DMN during the resting-state. Thirty-three RGD patients and thirty-one healthy control participants underwent clinical and cognitive evaluations as well as resting-state functional magnetic resonance imaging scans. The functional connectivity (FC) networks were constructed by thresholding Pearson correlation metrics of the DMN regions defined by group independent component analysis, and their topological properties (e.g. small-world and network efficiency) were analyzed using graph theory-based approaches. Relative to the healthy controls, the RGD patients showed decreased FC in the posterior regions of the DMN (i.e. the posterior cingulate cortex/precuneus, angular gyrus, and middle temporal gyrus). Furthermore, the RGD patients showed abnormal global topology of the DMN (i.e. increased characteristic path length and reduced global efficiency) when compared with healthy controls. Importantly, significant correlations between these network measures and cognitive performance indicated their potential use as biomarkers of cognitive dysfunction in RGD. The present study indicated disrupted FC and topological organization of the DMN in the context of RGD, and further implied their contribution to cognitive deficits in RGD patients.

  2. Episodic Memories

    Science.gov (United States)

    Conway, Martin A.

    2009-01-01

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

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

    Science.gov (United States)

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

    2014-10-30

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

  4. Major Depression Among Adults

    Science.gov (United States)

    ... Depressive Episode Among Adolescents Data Sources Share Major Depression Definitions Major depression is one of the most common mental disorders in the United States. For some individuals, major depression can result in severe impairments that interfere with ...

  5. Acute Pain and Depressive Symptoms: Independent Predictors of Insomnia Symptoms among Adults with Sickle Cell Disease.

    Science.gov (United States)

    Moscou-Jackson, Gyasi; Allen, Jerilyn; Kozachik, Sharon; Smith, Michael T; Budhathoki, Chakra; Haywood, Carlton

    2016-02-01

    No studies to date have systematically investigated insomnia symptoms among adults with sickle cell disease (SCD). The purpose of this study was to (1) describe the prevalence of insomnia symptoms and (2) identify biopsychosocial predictors in community-dwelling adults with SCD. Cross-sectional analysis of baseline data from 263 African American adults with SCD (aged 18 years or older). Measures included the Insomnia Severity Index (ISI), Center for Epidemiologic Studies in Depression scale, Urban Life Stress Scale, Brief Pain Inventory, and a chronic pain item. SCD genotype was extracted from the medical record. A slight majority (55%) of the sample reported clinically significant insomnia symptomatology (ISI ≥ 10), which suggests that insomnia symptoms are prevalent among community-dwelling African American adults with SCD. While insomnia symptoms were associated with a number of biopsychosocial characteristics, depressive symptoms and acute pain were the only independent predictors. Given the high number of participants reporting clinically significant insomnia symptoms, nurses should screen for insomnia symptoms and explore interventions to promote better sleep among adults with SCD, with an emphasis on recommending treatment for pain and depression. In addition, current pain and depression interventions in this population could add insomnia measures and assess the effect of the intervention on insomnia symptomatology as a secondary outcome. Copyright © 2016 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  6. The correlation between biochemical abnormalities in frontal white matter, hippocampus and serum thyroid hormone levels in first-episode patients with major depressive disorder.

    Science.gov (United States)

    Jia, Yanbin; Zhong, Shuming; Wang, Ying; Liu, Tao; Liao, Xiaoxiao; Huang, Li

    2015-07-15

    Previous neuroimaging studies found evidence of potential brain biochemical abnormalities in patients with major depressive disorder (MDD). Abnormal serum thyroid hormone levels were also found in MDD patients, which may correlated with the abnormal biochemical metabolism of brain. However, they rarely excluded the compounding effects of medication, and brain degeneration. This study sought to investigate the relationship between the biochemical metabolism and the serum thyroid hormone levels in first-episode, treatment-naive, non-late-life patients with MDD. 26 first-episode, treatment-naive, non-late-life patients with MDD and 13 healthy controls were enrolled in this study. Participants underwent two-dimensinal multivoxel proton magnetic resonance spectroscopy ((1)H MRS) [repetition time (TR)=1000ms; echo-time (TE)=144ms] at 1.5T to obtain bilateral metabolite levels from the white matter in prefrontal (WMP) lobe, anterior cingulate cortex (ACC), and hippocampus. The ratios of N-acetylaspartate (NAA)/creatine (Cr) and choline containg compounds (Cho)/creatine (Cr) were calculated. Morning serum free triiodothyronine (FT3), free thyroxin (FT4), total triiodothyronine (T3), total thyroxin (T4), and thyroid-stimulating hormone (TSH) were measured before antidepressant treatment. On the comparison of brain biochemical changes, MDD patients had a significantly lower NAA/Cr ratio in the left WMP, and lower NAA/Cr and Cho/Cr ratios in the right WMP when compared to the controls. There were no significant differences in the metabolite ratios in the bilateral ACC, and hippocampus. On the comparison of serum thyroid hormone levels, MDD patients had a significantly decreased T3 and TSH levels. On the comparison of correlation of brain biochemical changes and serum thyroid hormone levels in patients with MDD, the NAA/Cr ratio in the right WMP was positively correlated with the level of TSH. These findings suggest that biochemical abnormalities and thyroid dysfunction may

  7. A Randomized Comparison of Aripiprazole and Risperidone for the Acute Treatment of First-Episode Schizophrenia and Related Disorders: 3-Month Outcomes.

    Science.gov (United States)

    Robinson, Delbert G; Gallego, Juan A; John, Majnu; Petrides, Georgios; Hassoun, Youssef; Zhang, Jian-Ping; Lopez, Leonardo; Braga, Raphael J; Sevy, Serge M; Addington, Jean; Kellner, Charles H; Tohen, Mauricio; Naraine, Melissa; Bennett, Natasha; Greenberg, Jessica; Lencz, Todd; Correll, Christoph U; Kane, John M; Malhotra, Anil K

    2015-11-01

    Research findings are particularly important for medication choice for first-episode patients as individual prior medication response to guide treatment decisions is unavailable. We describe the first large-scale double-masked randomized comparison with first-episode patients of aripiprazole and risperidone, 2 commonly used first-episode treatment agents. One hundred ninety-eight participants aged 15-40 years with schizophrenia, schizophreniform disorder, schizoaffective disorder or psychotic disorder Not Otherwise Specified, and who had been treated in their lifetime with antipsychotics for 2 weeks or less were randomly assigned to double-masked aripiprazole (5-30 mg/d) or risperidone (1-6 mg/d) and followed for 12 weeks. Positive symptom response rates did not differ (62.8% vs 56.8%) nor did time to response. Aripiprazole-treated participants had better negative symptom outcomes but experienced more akathisia. Body mass index change did not differ between treatments but advantages were found for aripiprazole treatment for total and low-density lipoprotein cholesterol, fasting glucose, and prolactin levels. Post hoc analyses suggested advantages for aripiprazole on depressed mood. Overall, if the potential for akathisia is a concern, low-dose risperidone as used in this trial maybe a preferred choice over aripiprazole. Otherwise, aripiprazole would be the preferred choice over risperidone in most situations based upon metabolic outcome advantages and some symptom advantages within the context of similar positive symptom response between medications. © The Author 2015. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

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

    Science.gov (United States)

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

    2017-06-01

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

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

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    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.

  10. 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

  11. Efficacy of intravenous ondansetron to prevent vomiting episodes in acute gastroenteritis: a randomized, double blind, and controlled trial

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    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.

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

    Science.gov (United States)

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

    2013-08-01

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

  13. The Comparison of Depression and Anxiety Levels in Patients with Acute Coronary Syndrome

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    Dilek Yesilbursa

    2013-10-01

    Full Text Available Aim: In this study we aimed to compare depression and anxiety levels of patients admitted for acute coronary syndrome (ACS with patients followed for stable coronary artery disease in outpatient clinics and control group without coronary artery disease. Material and Method: Study population was composed of 300 patients. Firstly all patients underwent standardized mini mental test and patients whose test scores were under 23 were excluded and patients whose scores were 23 or higher were included in the study. After the demograhic characteristics of patients had been recorded all patients were administered the following scales: Geriatric Depression Scale( GDS, Beck Depression Inventory(BDI, Beck Anxiety Inventory(BAI, State and Trait Anxiety Inventory(STAI 1 and STAI 2. The scores obtained from these scales were compared between all three groups. Results: All test scores were significantly higher in ACS group (p<0.001.In ACS group GDS, BDI and BAI scores were higher in male patients compared to females (p<0.05. When ACS group was divided as ST elevation myocardial infarction (STEMI, Non ST elevation myocardial infarction and unstable angina pectoris the test scores were higher in STEMI subgroup but the relation was not statistically significant. The hospitalisation period length was found to be significantly related to all test scores in patients with ACS (p<0,001. Discussion: Depression and and levels of patients with ACS syndrome must be surely evaluated. This will help us both to improve life quality of these patients and decrease mortality and morbidity of these patients by diagnosing depression and anxiety disorders and treating them on time.

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

    International Nuclear Information System (INIS)

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

    1999-01-01

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

  15. Abnormal functional connectivity of the amygdala in first-episode and untreated adult major depressive disorder patients with different ages of onset.

    Science.gov (United States)

    Ye, Jing; Shen, Zonglin; Xu, Xiufeng; Yang, Shuran; Chen, Wei; Liu, Xiaoyan; Lu, Yi; Liu, Fang; Lu, Jin; Li, Na; Sun, Xuejin; Cheng, Yuqi

    2017-03-01

    Major depressive disorder (MDD) is a common mental disorder with high morbidity. As a part of the limbic system, the amygdala is important in the processing of emotional information. Structural and functional connectivity (FC) abnormalities in the amygdala have been observed in MDD patients. The present study was carried out to identify the features of amygdala FC in adult MDD patients with different ages of onset. Sixty-nine first-episode and untreated MDD patients and 81 healthy controls (CTLs) were included in this study and underwent 3D structural imaging and resting-state functional MRI scanning. The patients and CTLs were divided into two groups according to age of onset: young adult (amygdala seeds to the whole brain of MDD patients and matched CTLs in these two different onset age groups were analysed. We found that the volume of the bilateral amygdala increased to a greater extent in young adult patients compared with old adult patients. We also observed a trend toward different amygdala FC by onset age in MDD patients. In young adult patients, the left amygdala showed more abnormal resting-state FC with other regions compared with matched controls. However, in old adult patients, compared with matched controls, the right amygdala showed more abnormal changes in the resting-state FC with other regions. MDD patients with different ages of onset showed different changes in the structure and FC of the amygdala. These results might help us to understand the high heterogeneity of MDD.

  16. Diminished caudate and superior temporal gyrus responses to effort-based decision making in patients with first-episode major depressive disorder.

    Science.gov (United States)

    Yang, Xin-hua; Huang, Jia; Lan, Yong; Zhu, Cui-ying; Liu, Xiao-qun; Wang, Ye-fei; Cheung, Eric F C; Xie, Guang-rong; Chan, Raymond C K

    2016-01-04

    Anhedonia, the loss of interest or pleasure in reward processing, is a hallmark feature of major depressive disorder (MDD), but its underlying neurobiological mechanism is largely unknown. The present study aimed to examine the underlying neural mechanism of reward-related decision-making in patients with MDD. We examined behavioral and neural responses to rewards in patients with first-episode MDD (N=25) and healthy controls (N=25) using the Effort-Expenditure for Rewards Task (EEfRT). The task involved choices about possible rewards of varying magnitude and probability. We tested the hypothesis that individuals with MDD would exhibit a reduced neural response in reward-related brain structures involved in cost-benefit decision-making. Compared with healthy controls, patients with MDD showed significantly weaker responses in the left caudate nucleus when contrasting the 'high reward'-'low reward' condition, and blunted responses in the left superior temporal gyrus and the right caudate nucleus when contrasting high and low probabilities. In addition, hard tasks chosen during high probability trials were negatively correlated with superior temporal gyrus activity in MDD patients, while the same choices were negatively correlated with caudate nucleus activity in healthy controls. These results indicate that reduced caudate nucleus and superior temporal gyrus activation may underpin abnormal cost-benefit decision-making in MDD. Copyright © 2015 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    Lin, Ching-Hua; Yang, Wei-Cheng

    2017-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Ashwin Patkar

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

  19. N-terminal pro-atrial natriuretic peptide response to acute exercise in depressed patients and healthy controls

    DEFF Research Database (Denmark)

    Krogh, Jesper; Ströhle, Andreas; Westrin, Asa

    2011-01-01

    BACKGROUND: The dysfunction of hypothalamic-pituitary-adrenal (HPA) axis in major depression includes hyperactivity and reduced feedback inhibition. Atrial natriuretic peptide (ANP) is able to reduce the HPA-axis response to stress and has an anxiolytic effect in rodents and humans. We hypothesized...... that patients with depression would have an attenuated N-terminal proANP (NT-proANP) response to acute exercise compared to healthy controls. Secondly, we aimed to assess the effect of antidepressants on NT-proANP response to acute exercise. METHODS: We examined 132 outpatients with mild to moderate depression...... depressed subjects and healthy controls (group×time; F(4,162.9)=10.92; p...

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

    Science.gov (United States)

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

    2014-08-01

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

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

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  2. Tryptophan-kynurenine and lipid related metabolites as blood biomarkers for first-episode drug-naïve patients with major depressive disorder: An exploratory pilot case-control study.

    Science.gov (United States)

    Kuwano, Nobuki; Kato, Takahiro A; Setoyama, Daiki; Sato-Kasai, Mina; Shimokawa, Norihiro; Hayakawa, Kohei; Ohgidani, Masahiro; Sagata, Noriaki; Kubo, Hiroaki; Kishimoto, Junji; Kang, Dongchon; Kanba, Shigenob

    2018-04-15

    Early intervention in depression has been critical to prevent its negative impact including suicide. Recent blood biomarker studies for major depressive disorder (MDD) have suggested that tryptophan-kynurenine and lipid related metabolites are involved in the pathophysiology of MDD. However, there have been limited studies investigating these blood biomarkers in first-episode drug-naïve MDD, which are particularly important for early intervention in depression. As an exploratory pilot case-control study, we examined the above blood biomarkers, and analyzed how these biomarkers are associated with clinical variables in first-episode drug-naïve MDD patients, based on metabolome/lipidome analysis. Plasma tryptophan and kynurenine levels were significantly lower in MDD group (N = 15) compared to healthy controls (HC) group (N = 19), and plasma tryptophan was the significant biomarker to identify MDD group (area under the curve = 0.740). Lower serum high density lipoprotein-cholesterol (HDL-C) was the predictive biomarker for severity of depression in MDD group (R 2 = 0.444). Interestingly, depressive symptoms were variously correlated with plasma tryptophan-kynurenine and lipid related metabolites. Moreover, plasma tryptophan-kynurenine metabolites and cholesteryl esters (CEs) were significantly correlated in MDD group, but not in HC group. This study had small sample size, and we did not use the multiple test correction. This is the first study to suggest that not only tryptophan-kynurenine metabolites but also HDL-C and CEs are important blood biomarkers for first-episode drug-naïve MDD patients. The present study sheds new light on early intervention in clinical practice in depression, and further clinical studies especially large-scale prospective studies are warranted. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. [Association of obesity and depression].

    Science.gov (United States)

    Rihmer, Zoltán; Purebl, György; Faludi, Gábor; Halmy, László

    2008-10-01

    It has been long known that the frequency of overweight and obese people is higher among depressed and bipolar patients than in the general population. The marked alteration of body weight (and appetite) is one of the most frequent of the 9 symptoms of major depressive episode, and these symptoms occur during recurrent episodes of depression with a remarkably high consequence. According to studies with representative adult population samples, in case of obesity (BMI over 30) unipolar or bipolar depression is significantly more frequently (20-45%) observable. Since in case of depressed patients appetite and body weight reduction is observable during the acute phase, the more frequent obesity in case of depressed patients is related (primarily) not only to depressive episodes, but rather to lifestyle factors, to diabetes mellitus also more frequently occurring in depressed patients, to comorbid bulimia, and probably to genetic-biological factors (as well as to pharmacotherapy in case of medicated patients). At the same time, according to certain studies, circadian symptoms of depression give rise to such metabolic processes in the body which eventually lead to obesity and insulin resistance. According to studies in unipolar and bipolar patients, 57-68% of patients is overweight or obese, and the rate of metabolic syndrome was found to be between 25-49% in bipolar patients. The rate of metabolic syndrome is further increased by pharmacotherapy. Low total and HDL cholesterol level increases the risk for depression and suicide and recent studies suggest that omega-3-fatty acids possess antidepressive efficacy. Certain lifestyle factors relevant to healthy metabolism (calorie reduction in food intake, regular exercise) may be protective factors related to depression as well. The depression- and possibly suicide-provoking effect of sibutramine and rimonabant used in the pharmacotherapy of obesity is one of the greatest recent challenges for professionals and patients

  4. Effects of Acute Administration of Adipokinetic Hormone on Depression, Anxiety, Pain, Locomotion and Memory in Mice.

    Science.gov (United States)

    Mutlu, Oguz; Ulak, Guner; Akar, Furuzan; Erden, Faruk; Celikyurt, Ipek Komsuoglu; Bektas, Emine; Tanyeri, Pelin; Kaya, Havva

    2017-04-30

    The neurosecretory cells in the corpus cardiacum of insects synthesize a set of hormones that are called adipokinetic, hypertrehalosemic or hyperprolinemic depending on the insect in question. They are the Adipokinetic Hormone/Red Pigment-Concentrating Hormone (AKH/RPCH) family of peptides. The present study investigated the effects of acute administration of Locusta Migratoria (Locmi-AKHII) and Anax Imperator (Anaim-AKH) on depression, anxiety, pain (analgesy), locomotion and memory in mice in forced swimming (FST), elevated plus maze (EPM), hot plate, locomotor activity and passive avoidance tests. Both Locmi-AKH-II (4 mg/kg) and Anaim-AKH (0.25 and 0.50 mg/kg) decreased immobility time (in sec, s) in the FST test. Anaim-AKH (0.5 and 1 mg/kg) increased the percentage of time spent in open arms/total time spent and the percentage of the number of open arm/total arm entries in the EPM test. Anaim-AKH (1 and 2 mg/kg) significantly increased latency (s) (initial time passed) for mice to lick their hind paws or jumping in the hot plate test. Anaim-AKH (4 mg/kg) significantly decreased the total distance (cm) moved, or the speed (cm/s) of movement of the animals in the locomotor activity test. Neither Locmi-AKH-II nor Anaim-AKH altered the retention latency (s) in the passive avoidance test. Both Locmi-AKH-II and Anaim-AKH exerted antidepressant effects, while only Anaim-AKH had anxiolytic and analgesic effects when administered acutely. Anaim-AKH diminished locomotion at higher doses while Locmi-AKH-II had no such effects. Neither Locmi-AKH-II nor Anaim-AKH disturbed learning and memory when acutely administered. Data of our studies suggest clinical potentials of AKH to be used in depression, anxiety and pain without disturbing memory.

  5. 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

  6. Methadone, monoamine oxidase, and depression: opioid distribution and acute effects on enzyme activity

    International Nuclear Information System (INIS)

    Kaufmann, C.A.; Kreek, M.J.; Raghunath, J.; Arns, P.

    1983-01-01

    Narcotic withdrawal is often accompanied by an atypical depression which responds to resumption of narcotics. It was hypothesized that methadone might exert its antidepressant effects through monoamine oxidase (MAO) inhibition. The current study examined 3 H-methadone distribution in rat brain and effects on regional MAO activity with acute doses (2.5 mg/kg) which approximate those found during chronic methadone maintenance in man. Limbic areas (amygdala, basomedial hypothalamus, caudate-putamen, hippocampus, preoptic nucleus), as well as pituitary and liver were assayed for MAO activity and methadone concentration. MAO activities did not differ significantly in acute methadone or saline-treated cage-mates at 1 or 24 hr. The concentrations of methadone at 1 hr ranged between 17 and 223 ng/100 mg wet wt tissue in the preoptic nucleus and pituitary, respectively. No significant correlation was found between change in MAO activity (MAO methadone/MAO saline) and methadone concentration in any region at 1 or 24 hr. This study does not support the hypothesis that methadone acts as an antidepressant through MAO inhibition, at least not following acute administration of this exogenous opioid

  7. 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.

  8. 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...

  9. Pericardial adipose tissue and the metabolic syndrome is increased in patients with chronic major depressive disorder compared to acute depression and controls.

    Science.gov (United States)

    Kahl, K G; Herrmann, J; Stubbs, B; Krüger, T H C; Cordes, J; Deuschle, M; Schweiger, U; Hüper, K; Helm, S; Birkenstock, A; Hartung, D

    2017-01-04

    Major depressive disorder (MDD) is associated with an estimated fourfold risk for premature death, largely attributed to cardiovascular disorders. Pericardial adipose tissue (PAT), a fat compartment surrounding the heart, has been implicated in the development of coronary artery disease. An unanswered question is whether people with chronic MDD are more likely to have elevated PAT volumes versus acute MDD and controls (CTRL). The study group consists of sixteen patients with chronic MDD, thirty-four patients with acute MDD, and twenty-five CTRL. PAT and adrenal gland volume were measured by magnetic resonance tomography. Additional measures comprised factors of the metabolic syndrome, cortisol, relative insulin resistance, and pro-inflammatory cytokines (interleukin-6; IL-6 and tumor necrosis factor-α, TNF-α). PAT volumes were significantly increased in patients with chronic MDD>patients with acute MDD>CTRL. Adrenal gland volume was slightly enlarged in patients with chronic MDD>acute MDD>CTRL, although this difference failed to reach significance. The PAT volume was correlated with adrenal gland volume, and cortisol concentrations were correlated with depression severity, measured by BDI-2 and MADRS. Group differences were found concerning the rate of the metabolic syndrome, being most frequent in chronic MDD>acute MDD>CTRL. Further findings comprised increased fasting cortisol, increased TNF-α concentration, and decreased physical activity level in MDD compared to CTRL. Our results extend the existing literature in demonstrating that patients with chronic MDD have the highest risk for developing cardiovascular disorders, indicated by the highest PAT volume and prevalence of metabolic syndrome. The correlation of PAT with adrenal gland volume underscores the role of the hypothalamus-pituitary-adrenal system as mediator for body-composition changes. Metabolic monitoring, health advices and motivation for the improvement of physical fitness may be recommended in

  10. SHARED, NOT UNIQUE, COMPONENTS OF PERSONALITY AND PSYCHOSOCIAL FUNCTIONING PREDICT DEPRESSION SEVERITY AFTER ACUTE-PHASE COGNITIVE THERAPY

    Science.gov (United States)

    Clark, Lee Anna; Vittengl, Jeffrey R.; Kraft, Dolores; Jarrett, Robin B.

    2005-01-01

    In a sample of 100 patients with recurrent major depression, we collected depression severity data early and late in acute-phase cognitive therapy, plus a wide range of psychosocial variables that have been studied extensively in depression research, including measures of interpersonal, cognitive, and social functioning, and personality traits using an inventory that is linked with the Big-Three tradition in personality assessment theory. By assessing this broad range of variables in a single study, we could examine the extent to which relations of these variables with depression were due to (a) a common factor shared across this diverse set of constructs, (b) factors shared among each type of construct (personality vs. psychosocial measures), or (c) specific aspects of the individual measures. Only the most general factor shared across the personality and psychosocial variables predicted later depression. PMID:14632375

  11. Farmacovigilancia de la sertralina en pacientes cubanos con episodio de depresión mayor Pharmaceutical surveillance of sertraline in Cuban patients affected by major depression episode

    Directory of Open Access Journals (Sweden)

    Leslie Pérez Ruiz

    2011-03-01

    Full Text Available En la depresión predominan síntomas como: desinterés, fatiga, sentimientos de inutilidad, desconcentración, deseos de muerte e insomnio. Entre los medicamentos para tratarla se encuentra la sertralina. Con el objetivo de evaluar su seguridad, se revisaron 40 historias clínicas y cuadernos de recogida de datos de los pacientes incluidos en ensayo clínico fase III, aletatorizado, controlado y a doble ciegas: "Uso de sertralina en pacientes con episodio de depresión mayor", pertenecientes al Hospital "Dr. Gustavo Aldereguía Lima". Se obtuvieron datos demográficos, clínicos y eventos adversos, con los cuales se realizó un estudio descriptivo, observacional y transversal que clasifica como un estudio de utilización de medicamentos sobre consecuencias prácticas. La información fue analizada mediante SPSS, versión 13.0 para Windows. De los 40 pacientes incluidos, 24 presentaron eventos adversos para un 60 %; de ellos, 16 (67 % en el grupo tratado con sertralina y 8 (33 % en los tratados con placebo. Los eventos adversos más frecuentes fueron: disminución de peso, sequedad bucal, cefalea, diarreas y náuseas. En su mayoría resultaron de intensidad ligera, causalidad probable y sin necesidad de tratamiento. El uso del fármaco se consideró seguro en el tratamiento de estos pacientes.Some predominant symptoms in depression are lack of interest, fatigue, feeling of uselessness, lack of concentration, desire of being dead and insomnia. One of the drugs to treat this illness is Sertraline. For the purpose of evaluating its safety, 40 medical histories and data collection logs with information on patients included in a double-blind, controlled, randomized phase III clinical trial "Use of Sertraline in patients suffering episodes of great depression" were reviewed. These patients were seen at "Gustavo Aldereguía Lima" hospital. Demographic, clinical and adverse event data were obtained to undertake a descriptive, observational and cross

  12. Depression

    DEFF Research Database (Denmark)

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

  13. Depression

    DEFF Research Database (Denmark)

    Kessing, Lars Veddel; Bukh, Jens Drachmann

    2014-01-01

    The prevalence of depression is not clearly established, but estimated to 3-4% in a Danish questionnaire study. Lifetime's prevalences of 12-17% are reported in other community samples. In the current diagnostic system depression is defined categorically and operationally. It has been argued......, that these diagnostic criteria represent an oversimplification, which has blurred the concept of depression. We suggest a greater emphasis on the depressed mood as the core symptom of depression, which may increase the specificity of the diagnosis. Furthermore, basic principles for the treatment of depression...

  14. Serotonin transporter gene expression predicts the worsening of suicidal ideation and suicide attempts along a long-term follow-up of a Major Depressive Episode.

    Science.gov (United States)

    Consoloni, Julia-Lou; Ibrahim, El Chérif; Lefebvre, Marie-Noëlle; Zendjidjian, Xavier; Olié, Emilie; Mazzola-Pomietto, Pascale; Desmidt, Thomas; Samalin, Ludovic; Llorca, Pierre-Michel; Abbar, Mocrane; Lopez-Castroman, Jorge; Haffen, Emmanuel; Baumstarck, Karine; Naudin, Jean; Azorin, Jean-Michel; El-Hage, Wissam; Courtet, Philippe; Belzeaux, Raoul

    2017-12-26

    The quest for biomarkers in suicidal behaviors has been elusive so far, despite their potential utility in clinical practice. One of the most robust biological findings in suicidal behaviors is the alteration of the serotonin transporter function in suicidal individuals. Our main objective was to investigate the predictive value of the serotonin transporter gene expression (SLC6A4) for suicidal ideation and as secondary, for suicide attempts in individuals with a major depressive episode (MDE). A 30-week prospective study was conducted on 148 patients with a MDE and 100 healthy controls including 4 evaluation times (0, 2, 8 and 30 weeks). Blood samples and clinical data were collected and SLC6A4 mRNA levels were measured from peripheral blood mononuclear cells using RT-qPCR. We first demonstrated the stability and reproducibility of SLC6A4 mRNA expression measures over time in healthy controls (F=0.658; p=0.579; η 2 =0.008; ICC=0.91, 95% CI [0.87-0.94]). Baseline SLC6A4 expression level (OR=0.563 [0.340-0.932], p=0.026) as well as early changes in SLC6A4 expression between baseline and the 2 nd week (β=0.200, p=0.042) predicted the worsening of suicidal ideation (WSI) in the following 8 weeks. Moreover, changes in SLC6A4 expression between the 2 nd and 8 th weeks predicted the occurrence of a suicide attempt within 30 weeks (OR=10.976 [1.438-83.768], p=0.021). Altogether, the baseline level and the changes in SLC6A4 mRNA expression during a MDE might predict the WSI and the occurrence of suicidal attempts and could be a useful biomarker in clinical practice. Copyright © 2017 Elsevier B.V. and ECNP. All rights reserved.

  15. Mood disturbance and depression in Arab women following hospitalisation from acute cardiac conditions: a cross-sectional study from Qatar

    Science.gov (United States)

    Donnelly, Tam Truong; Al Suwaidi, Jassim Mohd; Al-Qahtani, Awad; Asaad, Nidal; Fung, Tak; Singh, Rajvir; Qader, Najlaa Abdul

    2016-01-01

    Objectives Depression is associated with increased morbidity and mortality rates among cardiovascular patients. Depressed patients have three times higher risk of death than those who are not. We sought to determine the presence of depressive symptoms, and whether gender and age are associated with depression among Arab patients hospitalised with cardiac conditions in a Middle Eastern country. Setting Using a non-probability convenient sampling technique, a cross-sectional survey was conducted with 1000 Arab patients ≥20 years who were admitted to cardiology units between 2013 and 2014 at the Heart Hospital in Qatar. Patients were interviewed 3 days after admission following the cardiac event. Surveys included demographic and clinical characteristics, and the Arabic version of the Beck Depression Inventory Second Edition (BDI-II). Depression was assessed by BDI-II clinical classification scale. Results 15% of the patients had mild mood disturbance and 5% had symptoms of clinical depression. Twice as many females than males suffered from mild mood disturbance and clinical depression symptoms, the majority of females were in the age group 50 years and above, whereas males were in the age group 40–49 years. χ2 Tests and multivariate logistic regression analyses indicated that gender and age were statistically significantly related to depression (p<0.001 for all). Conclusions Older Arab women are more likely to develop mood disturbance and depression after being hospitalised with acute cardiac condition. Gender and age differences approach, and routine screening for depression should be conducted with all cardiovascular patients, especially for females in the older age groups. Mental health counselling should be available for all cardiovascular patients who exhibit depressive symptoms. PMID:27388362

  16. Depressants

    Science.gov (United States)

    ... system. Doctors use them to treat things like insomnia or anxiety . But if depressant drugs (like sedatives, tranquilizers, or barbiturates) are abused, they can cause addiction , serious injury, or death. Depressants are usually ...

  17. 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

  18. 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…

  19. Antenatal depressive symptoms and subjective birth experience in association with postpartum depressive symptoms and acute stress reaction in mothers and fathers: A longitudinal path analysis.

    Science.gov (United States)

    Gürber, Susanne; Baumeler, Luzia; Grob, Alexander; Surbek, Daniel; Stadlmayr, Werner

    2017-08-01

    Postpartum depressive symptoms (PDS) and acute stress reactions (ASR) after childbirth are frequently documented in mothers, but research is scarce in fathers. In a longitudinal path analysis, the interplay of depressive symptoms in pregnancy and the subjective childbirth experience of mothers and fathers are examined with regard to the development of PDS and ASR postpartum. One hundred eighty nine expectant couples were recruited between August 2006 and September 2009. They completed the Edinburgh Postnatal Depression Scale (EPDS) in the last trimester of pregnancy. In the first week postpartum, they answered the Salmon's Item List (subjective birth experience), and four weeks after birth the EPDS and the Impact of Event Scale - revised (IES-r). The data were evaluated in a longitudinal path analysis. Compared with fathers, mothers reported more depressive symptoms (pregnancy: pexperience' (p0.10), but moderately correlated four weeks after birth (r=0.387, pexperience were independently predictive of PDS and ASR after childbirth in mothers and fathers controlling for age, mode of delivery, parity, epidural anaesthesia, infant gender and birth weight. Antenatal depressive symptoms were related to subjective childbirth experience only in fathers. Parental prenatal depressive symptoms and subjective birth experience are important predictors of postnatal psychological adjustment in mothers and fathers. Copyright © 2017. Published by Elsevier B.V.

  20. 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

  1. Adherence to Mediterranean Diet and All-Cause Mortality After an Episode of Acute Heart Failure: Results of the MEDIT-AHF Study.

    Science.gov (United States)

    Miró, Òscar; Estruch, Ramon; Martín-Sánchez, Francisco J; Gil, Víctor; Jacob, Javier; Herrero-Puente, Pablo; Herrera Mateo, Sergio; Aguirre, Alfons; Andueza, Juan A; Llorens, Pere

    2018-01-01

    The authors sought to evaluate clinical outcomes of patients after an episode of acute heart failure (AHF) according to their adherence to the Mediterranean diet (MedDiet). It has been proved that MedDiet is a useful tool in primary prevention of cardiovascular diseases. However, it is unknown whether adherence to MedDiet is associated with better outcomes in patients who have already experienced an episode of AHF. We designed a prospective study that included consecutive patients diagnosed with AHF in 7 Spanish emergency departments (EDs). Patients were included if they or their relatives were able to answer a 14-point score of adherence to the MedDiet, which classified patients as adherents (≥9 points) or nonadherents (≤8 points). The primary endpoint was all-cause mortality at the end of follow-up, and secondary endpoints were 1-year ED revisit without hospitalization, rehospitalization, death, and a combined endpoint of all these variables for patients discharged after the index episode. Unadjusted and adjusted hazard ratios (HRs) were calculated. We included 991 patients (mean age of 80 ± 10 years, 57.8% women); 523 (52.9%) of whom were adherent to the MedDiet. After a mean follow-up period of 2.1 ± 1.3 years, no differences were observed in survival between adherent and nonadherent patients (HR of adherents [HR adh ] = 0.86; 95% confidence interval [CI]: 0.73 to 1.02). The 1-year cumulative ED revisit for the whole cohort was 24.5% (HR adh  = 1.10; 95% CI: 0.84 to 1.42), hospitalization 43.7% (HR adh  = 0.74; 95% CI: 0.61 to 0.90), death 22.7% (HR adh  = 1.05; 95% CI: 0.8 to 1.38), and combined endpoint 66.8% (HR adh  = 0.89; 95% CI: 0.76 to 1.04). Adjustment by age, hypertension, peripheral arterial disease, previous episodes of AHF, treatment with statins, air-room pulsioxymetry, and need for ventilation support in the ED rendered similar results, with no statistically significant differences in mortality (HR adh  = 0.94; 95% CI: 0.80 to 1

  2. N-terminal pro-atrial natriuretic peptide response to acute exercise in depressed patients and healthy controls

    DEFF Research Database (Denmark)

    Krogh, Jesper; Ströhle, Andreas; Westrin, Asa

    2011-01-01

    BACKGROUND: The dysfunction of hypothalamic-pituitary-adrenal (HPA) axis in major depression includes hyperactivity and reduced feedback inhibition. Atrial natriuretic peptide (ANP) is able to reduce the HPA-axis response to stress and has an anxiolytic effect in rodents and humans. We hypothesized...... that patients with depression would have an attenuated N-terminal proANP (NT-proANP) response to acute exercise compared to healthy controls. Secondly, we aimed to assess the effect of antidepressants on NT-proANP response to acute exercise. METHODS: We examined 132 outpatients with mild to moderate depression...... (ICD-10) and 44 healthy controls, group matched for age, sex, and BMI. We used an incremental bicycle ergometer test as a physical stressor. Blood samples were drawn at rest, at exhaustion, and 15, 30, and 60min post-exercise. RESULTS: The NT-proANP response to physical exercise differed between...

  3. Anterior ST depression with acute transmural inferior infarction due to posterior infarction. A vectorcardiographic and scintigraphic study

    International Nuclear Information System (INIS)

    Mukharji, J.; Murray, S.; Lewis, S.E.; Croft, C.H.; Corbett, J.R.; Willerson, J.T.; Rude, R.E.

    1984-01-01

    The hypothesis that anterior ST segment depression represents concomitant posterior infarction was tested in 49 patients admitted with a first transmural inferior myocardial infarction. Anterior ST depression was defined as 0.1 mV or more ST depression in leads V1, V2 or V3 on an electrocardiogram recorded within 18 hours of infarction. Serial vectorcardiograms and technetium pyrophosphate scans were obtained. Eighty percent of the patients (39 of 49) had anterior ST depression. Of these 39 patients, 34% fulfilled vectorcardiographic criteria for posterior infarction, and 60% had pyrophosphate scanning evidence of posterior infarction. Early anterior ST depression was neither highly sensitive (84%) nor specific (20%) for the detection of posterior infarction as defined by pyrophosphate imaging. Of patients with persistent anterior ST depression (greater than 72 hours), 87% had posterior infarction detected by pyrophosphate scan. In patients with inferior myocardial infarction, vectorcardiographic evidence of posterior infarction correlated poorly with pyrophosphate imaging data. Right ventricular infarction was present on pyrophosphate imaging in 40% of patients with pyrophosphate changes of posterior infarction but without vectorcardiographic evidence of posterior infarction. It is concluded that: 1) the majority of patients with acute inferior myocardial infarction have anterior ST segment depression; 2) early anterior ST segment depression in such patients is not a specific marker for posterior infarction; and 3) standard vectorcardiographic criteria for transmural posterior infarction may be inaccurate in patients with concomitant transmural inferior myocardial infarction or right ventricular infarction, or both

  4. 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. © 2014 International Society for Hemodialysis.

  5. Personality factors and depression as predictors of hospital-based health care utilization following acute myocardial infarction.

    Science.gov (United States)

    Schlyter, Mona; Östman, Margareta; Engström, Gunnar; André-Petersson, Lena; Tydén, Patrik; Leosdottir, Margrét

    2017-04-01

    Whether personality factors and depressive traits affect patients' utilization of health care following an acute myocardial infarction is relatively unknown. The aim of this study was to examine whether hospital-based health care utilization after a myocardial infarction was correlated with patients' personality factors and depressive symptoms. We studied 366 myocardial infarction patients admitted to Malmö University Hospital between 2002 and 2005 who subsequently participated in a cardiac rehabilitation programme. The patients were followed for two years after their index event. We investigated whether personality factors and depressive traits were correlated with the participants' health care utilization, defined as a) out-patient Cardiology visits and phone calls to a physician, nurse or a social worker, and b) acute visits or admissions to the Emergency or Cardiology Departments, using negative binominal regression analysis. In unadjusted comparisons neuroticism predicted more out-patient contacts. This significance remained after adjusting for age, sex, smoking, alcohol consumption and size of the myocardial infarction (measured as max level on troponin-I and left ventricular ejection fraction). There were no significant correlations between other personality factors or depression and out-patient contacts. None of the personality factors or depression predicted acute admissions. Apart from neuroticism, personality factors did not explain utilization of health care in terms of Cardiology out-patient contacts or acute admissions in myocardial infarction patients participating in a cardiac rehabilitation programme. Neither did depressive symptoms predict more health care utilization. This might indicate a robust cardiac rehabilitation programme offered to the study subjects, minimizing the need for additional health care contacts.

  6. Dyadic discord at baseline is associated with lack of remission in the acute treatment of chronic depression.

    Science.gov (United States)

    Denton, W H; Carmody, T J; Rush, A J; Thase, M E; Trivedi, M H; Arnow, B A; Klein, D N; Keller, M B

    2010-03-01

    Dyadic discord, while common in depression, has not been specifically evaluated as an outcome predictor in chronic major depressive disorder. This study investigated pretreatment dyadic discord as a predictor of non-remission and its relationship to depressive symptom change during acute treatment for chronic depression. Out-patients with chronic depression were randomized to 12 weeks of treatment with nefazodone, the Cognitive Behavioral Analysis System of Psychotherapy or their combination. Measures included the Marital Adjustment Scale (MAS) and the Inventory of Depressive Symptomatology - Self Report (IDS-SR30). Of 681 original patients, 316 were partnered and 171 of these completed a baseline and exit MAS, and at least one post-baseline IDS-SR30. MAS scores were analysed as continuous and categorical variables ('dyadic discord' v. 'no dyadic discord' defined as an MAS score >2.36. Remission was defined as an IDS-SR30 of 14 at exit (equivalent to a 17-item Hamilton Rating Scale for Depression of 7). Patients with dyadic discord at baseline had lower remission rates (34.1%) than those without dyadic discord (61.2%) (all three treatment groups) (chi2=12.6, df=1, p=0.0004). MAS scores improved significantly with each of the treatments, although the change was reduced by controlling for improvement in depression. Depression remission at exit was associated with less dyadic discord at exit than non-remission for all three groups [for total sample, 1.8 v. 2.4, t(169)=7.3, p<0.0001]. Dyadic discord in chronically depressed patients is predictive of a lower likelihood of remission of depression. Couple therapy for those with dyadic discord may increase remission rates.

  7. Perceived life stress exposure modulates reward-related medial prefrontal cortex responses to acute stress in depression.

    Science.gov (United States)

    Kumar, Poornima; Slavich, George M; Berghorst, Lisa H; Treadway, Michael T; Brooks, Nancy H; Dutra, Sunny J; Greve, Douglas N; O'Donovan, Aoife; Bleil, Maria E; Maninger, Nicole; Pizzagalli, Diego A

    2015-07-15

    Major depressive disorder (MDD) is often precipitated by life stress and growing evidence suggests that stress-induced alterations in reward processing may contribute to such risk. However, no human imaging studies have examined how recent life stress exposure modulates the neural systems that underlie reward processing in depressed and healthy individuals. In this proof-of-concept study, 12 MDD and 10 psychiatrically healthy individuals were interviewed using the Life Events and Difficulties Schedule (LEDS) to assess their perceived levels of recent acute and chronic life stress exposure. Additionally, each participant performed a monetary incentive delay task under baseline (no-stress) and stress (social-evaluative) conditions during functional MRI. Across groups, medial prefrontal cortex (mPFC) activation to reward feedback was greater during acute stress versus no-stress conditions in individuals with greater perceived stressor severity. Under acute stress, depressed individuals showed a positive correlation between perceived stressor severity levels and reward-related mPFC activation (r=0.79, p=0.004), whereas no effect was found in healthy controls. Moreover, for depressed (but not healthy) individuals, the correlations between the stress (r=0.79) and no-stress (r=-0.48) conditions were significantly different. Finally, relative to controls, depressed participants showed significantly reduced mPFC gray matter, but functional findings remained robust while accounting for structural differences. Small sample size, which warrants replication. Depressed individuals experiencing greater recent life stress recruited the mPFC more under stress when processing rewards. Our results represent an initial step toward elucidating mechanisms underlying stress sensitization and recurrence in depression. Copyright © 2015 Elsevier B.V. All rights reserved.

  8. Perceived Chronic Stress Exposure Modulates Reward-Related Medial Prefrontal Cortex Responses to Acute Stress in Depression

    Science.gov (United States)

    Kumar, Poornima; Slavich, George M.; Berghorst, Lisa H.; Treadway, Michael T.; Brooks, Nancy H.; Dutra, Sunny J.; Greve, Douglas N.; O'Donovan, Aoife; Bleil, Maria E.; Maninger, Nicole; Pizzagalli, Diego A.

    2015-01-01

    Introduction Major depressive disorder (MDD) is often precipitated by life stress and growing evidence suggests that stress-induced alterations in reward processing may contribute to such risk. However, no human imaging studies have examined how recent life stress exposure modulates the neural systems that underlie reward processing in depressed and healthy individuals. Methods In this proof-of-concept study, 12 MDD and 10 psychiatrically healthy individuals were interviewed using the Life Events and Difficulties Schedule (LEDS) to assess their perceived levels of recent acute and chronic life stress exposure. Additionally, each participant performed a monetary incentive delay task under baseline (no-stress) and stress (social-evaluative) conditions during functional MRI. Results Across groups, medial prefrontal cortex (mPFC) activation to reward feedback was greater during acute stress versus no-stress conditions in individuals with greater perceived stressor severity. Under acute stress, depressed individuals showed a positive correlation between perceived stressor severity levels and reward-related mPFC activation (r = 0.79, p = 0.004), whereas no effect was found in healthy controls. Moreover, for depressed (but not healthy) individuals, the correlations between the stress (r = 0.79) and no-stress (r = −0.48) conditions were significantly different. Finally, relative to controls, depressed participants showed significantly reduced mPFC grey matter, but functional findings remained when accounting for structural differences. Limitation Small sample size, which warrants replication. Conclusion Depressed individuals experiencing greater recent life stress recruited the mPFC more under stress when processing rewards. Our results represent an initial step toward elucidating mechanisms underlying stress sensitization and recurrence in depression. PMID:25898329

  9. Quality of Acute Psychedelic Experience Predicts Therapeutic Efficacy of Psilocybin for Treatment-Resistant Depression

    Science.gov (United States)

    Roseman, Leor; Nutt, David J.; Carhart-Harris, Robin L.

    2018-01-01

    Introduction: It is a basic principle of the “psychedelic” treatment model that the quality of the acute experience mediates long-term improvements in mental health. In the present paper we sought to test this using data from a clinical trial assessing psilocybin for treatment-resistant depression (TRD). In line with previous reports, we hypothesized that the occurrence and magnitude of Oceanic Boundlessness (OBN) (sharing features with mystical-type experience) and Dread of Ego Dissolution (DED) (similar to anxiety) would predict long-term positive outcomes, whereas sensory perceptual effects would have negligible predictive value. Materials and Methods: Twenty patients with treatment resistant depression underwent treatment with psilocybin (two separate sessions: 10 and 25 mg psilocybin). The Altered States of Consciousness (ASC) questionnaire was used to assess the quality of experiences in the 25 mg psilocybin session. From the ASC, the dimensions OBN and DED were used to measure the mystical-type and challenging experiences, respectively. The Self-Reported Quick Inventory of Depressive Symptoms (QIDS-SR) at 5 weeks served as the endpoint clinical outcome measure, as in later time points some of the subjects had gone on to receive new treatments, thus confounding inferences. In a repeated measure ANOVA, Time was the within-subject factor (independent variable), with QIDS-SR as the within-subject dependent variable in baseline, 1-day, 1-week, 5-weeks. OBN and DED were independent variables. OBN-by-Time and DED-by-Time interactions were the primary outcomes of interest. Results: For the interaction of OBN and DED with Time (QIDS-SR as dependent variable), the main effect and the effects at each time point compared to baseline were all significant (p = 0.002 and p = 0.003, respectively, for main effects), confirming our main hypothesis. Furthermore, Pearson's correlation of OBN with QIDS-SR (5 weeks) was specific compared to perceptual dimensions of the ASC (p

  10. Quality of Acute Psychedelic Experience Predicts Therapeutic Efficacy of Psilocybin for Treatment-Resistant Depression

    Directory of Open Access Journals (Sweden)

    Leor Roseman

    2018-01-01

    Full Text Available Introduction: It is a basic principle of the “psychedelic” treatment model that the quality of the acute experience mediates long-term improvements in mental health. In the present paper we sought to test this using data from a clinical trial assessing psilocybin for treatment-resistant depression (TRD. In line with previous reports, we hypothesized that the occurrence and magnitude of Oceanic Boundlessness (OBN (sharing features with mystical-type experience and Dread of Ego Dissolution (DED (similar to anxiety would predict long-term positive outcomes, whereas sensory perceptual effects would have negligible predictive value.Materials and Methods: Twenty patients with treatment resistant depression underwent treatment with psilocybin (two separate sessions: 10 and 25 mg psilocybin. The Altered States of Consciousness (ASC questionnaire was used to assess the quality of experiences in the 25 mg psilocybin session. From the ASC, the dimensions OBN and DED were used to measure the mystical-type and challenging experiences, respectively. The Self-Reported Quick Inventory of Depressive Symptoms (QIDS-SR at 5 weeks served as the endpoint clinical outcome measure, as in later time points some of the subjects had gone on to receive new treatments, thus confounding inferences. In a repeated measure ANOVA, Time was the within-subject factor (independent variable, with QIDS-SR as the within-subject dependent variable in baseline, 1-day, 1-week, 5-weeks. OBN and DED were independent variables. OBN-by-Time and DED-by-Time interactions were the primary outcomes of interest.Results: For the interaction of OBN and DED with Time (QIDS-SR as dependent variable, the main effect and the effects at each time point compared to baseline were all significant (p = 0.002 and p = 0.003, respectively, for main effects, confirming our main hypothesis. Furthermore, Pearson's correlation of OBN with QIDS-SR (5 weeks was specific compared to perceptual dimensions of the

  11. Do Physical Activities Trigger Flare-ups During an Acute Low Back Pain Episode?: A Longitudinal Case-Crossover Feasibility Study.

    Science.gov (United States)

    Suri, Pradeep; Rainville, James; de Schepper, Evelien; Martha, Julia; Hartigan, Carol; Hunter, David J

    2018-03-15

    Prospective, longitudinal case-crossover study. The aim of this study was to determine whether physical activities trigger flare-ups of pain during the course of acute low back pain (LBP). .: There exist no evidence-based estimates for the transient risk of pain flare-ups associated with specific physical activities, during acute LBP. Participants with LBP of duration up, defined as "a period of increased pain lasting at least 2 hours, when your pain intensity is distinctly worse than it has been recently." Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for associations between potential triggers during the past 24 hours, and the risk of LBP flare-ups, using conditional logistic regression. Of 48 participants followed longitudinally, 30 participants had both case ("flare") and control periods and contributed data to the case-crossover analysis. There were 81 flare periods and 247 control periods, an average of 11 periods per participant. Prolonged sitting (>6 hours) was the only activity that was significantly associated with flare-ups(OR 4.4, 95% CI 2.0-9.7; P ups (OR 2.5, 95% CI 1.0-6.0; P = 0.04). In multivariable analyses, prolonged sitting (OR 4.2, 95% CI 1.9-9.1; P up risk. Among participants with acute LBP, prolonged sitting (>6 hours) and stress or depression triggered LBP flare-ups. PT was a deterrent of flare-ups. 2.

  12. 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 bears in both active and hibernating states at the p hibernation with mild hypothermia, black bears do not show immunosuppression, but show an increased APP response similar to that in patients with major depression. This APP response is explained as an adaptive response to the underlying metabolic depression in both conditions. Metabolic depression in hibernating bears is suggested as a natural model for research to explain the neurobiology of depression.

  13. Major depression is associated with lower omega-3 fatty acid levels in patients with recent acute coronary syndromes.

    Science.gov (United States)

    Frasure-Smith, Nancy; Lespérance, François; Julien, Pierre

    2004-05-01

    Polyunsaturated fatty acids (PUFAs) are intrinsic cell membrane components and closely involved in neurotransmission and receptor function. Lower omega-3 levels are associated with increased risk of coronary artery disease (CAD), increases in cardiac events in CAD patients, and depression. We sought to examine relationships between depression and serum levels of omega-3 and omega-6 PUFAs in patients recovering from acute coronary syndromes (ACS). We carried out a case-control study of serum PUFA levels and current major depression in 54 age- and sex-matched pairs approximately 2 months following ACS. Depressed patients had significantly lower concentrations of total omega-3 and docosahexaenoic acid (DHA), and higher ratios of arachidonic acid (AA) to DHA, AA to eicosapentaenoic acid (EPA), and n-3 to n-6 than controls. There were no baseline differences in any potential risk or protective factors for depression. Results are consistent with previous reports in depressed patients without CAD, and with literature concerning omega-3 levels and risk of CAD events. Dietary, genetic, and hormonal factors may all play a role in both depression and CAD. Both prospective studies and randomized trials are needed to help clarify the interrelationships.

  14. Self-esteem level and stability, admission functional status, and depressive symptoms in acute inpatient stroke rehabilitation.

    Science.gov (United States)

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

    2009-11-01

    Explore the relationship of self-esteem level, self-esteem stability, and admission functional status on discharge depressive symptoms in acute stroke rehabilitation. One hundred twenty stroke survivors serially completed a measure of state self-esteem during inpatient rehabilitation and completed a measure of depressive symptoms at discharge. Functional status was rated at admission using the Functional Independence Measure (FIM). Regressions explored main effects and interactions of self-esteem level and stability and admission FIM self-care, mobility, and cognitive functioning on discharge depressive symptoms. After controlling for potential moderating variables, self-esteem level interacted with FIM self-care and cognitive functioning to predict discharge depressive symptoms, such that survivors with lower self-rated self-esteem and poorer functional status indicated higher levels of depressive symptoms. Self-esteem stability interacted with FIM mobility functioning, such that self-esteem instability in the presence of lower mobility functioning at admission was related to higher depressive symptoms at discharge. These results suggest that self-esteem variables may moderate the relationship between functional status and depressive symptoms. Self-esteem level and stability may differentially moderate functional domains, although this conclusion requires further empirical support.

  15. Depression

    Science.gov (United States)

    ... and insomnia References American Psychiatric Association. Depressive disorders. Diagnostic and Statistical Manual of Mental Disorders . 5th ed. Arlington, VA: American Psychiatric Publishing; 2013: ...

  16. Oak Forest Responses to Episodic-Seasonal-Drought, Chronic Multi-year Precipitation Change and Acute Drought Manipulations in a Region With Deep Soils and High Precipitation

    Science.gov (United States)

    Hanson, Paul J.; Wullschleger, Stan D.; Todd, Donald E.; Auge, Robert M.; Froberg, Mats; Johnson, Dale W.

    2010-05-01

    Implications of episodic-seasonal drought (extremely dry late summers), chronic multi-year precipitation manipulations (±33 percent over 12 years) and acute drought (-100 percent over 3 years) were evaluated for the response of vegetation and biogeochemical cycles for an upland-oak forest. The Quercus-Acer forest is located in eastern Tennessee on deep acidic soils with mean annual temperatures of 14.2 °C and abundant precipitation (1352 mm y-1). The multi-year observations and chronic manipulations were conducted from 1993 through 2005 using understory throughfall collection troughs and redistribution gutters and pipes. Acute manipulations of dominant canopy trees (Quercus prinus; Liriodendron tulipifera) were conducted from 2003 through 2005 using full understory tents. Regional and severe late-summer droughts were produced reduced stand water use and photosynthetic carbon gain as expected. Likewise, seedlings and saplings exhibited reduced survival and cumulative growth reductions. Conversely, multi-year chronic increases or decreases in precipitation and associated soil water deficits did not reduce large tree basal area growth for the tree species present. The resilience of canopy trees to chronic-change was the result of a disconnect between carbon allocation to tree growth (an early-season phenomenon) and late-season drought occurrence. Acute precipitation exclusion from the largest canopy trees also produced limited physiological responses and minimal cumulative growth reductions. Lateral root water sources were removed through trenching and could not explain the lack of response to extreme soil drying. Therefore, deep rooting the primary mechanism for large-tree resilience to severe drought. Extensive trench-based assessments of rooting depth suggested that ‘deep' water supplies were being obtained from limited numbers of deep fine roots. Observations of carbon stocks in organic horizons demonstrated accumulation with precipitation reductions and

  17. Effect of High-quality Nursing on Improvement of Anxiety and Depression of Patients with Acute Stroke in MRI Examination.

    Science.gov (United States)

    Wu, Lin; Zhang, Li

    2017-12-01

    We aimed to evaluate the effect of high-quality nursing on improvement of anxiety and depression of patients with acute stroke in magnetic resonance imaging (MRI) examination. A total of 120 patients diagnosed as acute stroke for the first time were enrolled in Liaocheng People's Hospital from 2016-2017 and randomly divided into control group (n=60) and observation group (n=60). All patients received cerebral MRI examination at 6h and 24h after admission and before discharge. The control group was treated with routine nursing, while the observation group was treated with high-quality nursing, and the specific nursing measures included the establishment of high-quality nursing group, full evaluation of the severity of disease, timely solving of difficulties in MRI examination, understanding of the patient's anxiety and depression, establishment of personal information files before discharge, etc. The completion rate and average duration of examination, the improvement of anxiety and depression and the nursing satisfaction were compared between the two groups. In observation group, the completion rate of MRI examination was significantly increased ( P =0.035), the average duration was shortened ( P =0.011), the anxiety and depression scores (self-rating anxiety scale (SAS) and self-rating depression scale (SDS)) were improved obviously ( P =0.006 and 0.009), and the nursing satisfaction score and rate was increased ( P =0.000 and 0.027); the differences were statistically significant ( P <0.05). High-quality nursing can significantly improve the anxiety and depression of patients with acute stroke in MRI examination, which has a better application value in increasing the completion rate of examination, shortening the duration of examination and improving the nursing satisfaction.

  18. 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

  19. 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...

  20. 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...

  1. Psychometric Evaluation of Persian Version of Death Depression Scale in Iranian Patients with Acute Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Hamid Sharif Nia

    2017-06-01

    Full Text Available AbstractObjective: The psychometric properties of a scale should be re-assessed routinely with different samples to ensure its generalizability. The present study aimed to determine the reliability and validity of the Persian Version of Death Depression Scale (DDS in Iranian patients with Acute Myocardial Infarction (AMI.Methods: The face validity, content validity and construct validity (i.e. factorial, convergent, and discriminant validity of the DDS were assessed using a sample of 407 AMI patients. Confirmatory factor analysis was conducted using the ratio chi-square by degrees of freedom (χ2/df, the Goodness-of-fit index (GFI, Comparative Fit Index (CFI, Incremental Fit Index (IFI, Normed Fit Index (NFI, and Root Mean Square Error of Approximation (RMSEA. Convergent and discriminant validity were assessed using average variance extracted (AVE, maximum shared squared variance (MSV, and average shared square variance (ASV. Internal consistency, test–retest, and construct reliability (CR were used to assess reliability of the Persian Version of DDS.Results: Based on principle component analysis and consideration of conceptual meaning, a four-factor solution was selected, explaining 75.89% of the total variance. Goodness-of-fit indices (c2(98 = 583.646, p < .05, c2/df= 5.956, GFI = .856, CFI = .902, NFI = .885, IFI = .902, RMSEA (90% C.I. = .110 (.102 - .119 in the final DDS structure demonstrated the adequacy of the four-domain structure of the DDS. Convergent and discriminant validity was used to assess the construct validity of the DDS. The reliability was greater than .70.Conclusion: The DDS was found to be a valid and reliable assessment tool for death depression in Iranian patients with AMI.

  2. Anterior ST segment depression in acute inferior myocardial infarction as a marker of greater inferior, apical, and posterolateral damage

    International Nuclear Information System (INIS)

    Ruddy, T.D.; Yasuda, T.; Gold, H.K.; Leinbach, R.C.; Newell, J.B.; McKusick, K.A.; Boucher, C.A.; Strauss, H.W.

    1986-01-01

    The clinical significance of anterior precordial ST segment depression during acute inferior myocardial infarction was evaluated in 67 consecutive patients early after onset of symptoms with gated blood pool scans, thallium-201 perfusion images, and 12-lead ECGs. Patients with anterior ST depression (n = 33) had depressed mean values for left ventricular ejection fraction (54 +/- 2% [mean +/- S.E.M.] vs 59 +/- 2%; p = 0.02), cardiac index (3.1 +/- 0.2 vs 3.6 +/- 0.2 L/m2; p = 0.03), and ratio of systolic blood pressure to end-systolic volume (2.0 +/- 0.1 vs 2.5 +/- 0.3 mm Hg/ml; p = 0.04) compared to patients with no anterior ST depression (n = 34). Patients with anterior ST depression had (1) lower mean wall motion values for the inferior, apical, and inferior posterolateral segments (p less than 0.05) and (2) greater reductions in thallium-201 uptake in the inferior and posterolateral regions (p less than 0.05). However, anterior and septal (1) wall motion and (2) thallium-201 uptake were similar in patients with and without ST depression. Thus, anterior precordial ST segment depression in patients with acute inferior wall myocardial infarction represents more than a reciprocal electrical phenomenon. It identifies patients with more severe wall motion impairment and greater hypoperfusion of the inferior and adjacent segments. The poorer global left ventricular function in these patients is a result of more extensive inferior infarction and not of remote septal or anterior injury

  3. Reducing length of stay for acute diabetic foot episodes: employing an extended scope of practice podiatric high-risk foot coordinator in an acute foundation trust hospital.

    Science.gov (United States)

    Cichero, Matthew J; Bower, Virginia M; Walsh, Tom P; Yates, Ben J

    2013-12-11

    To enhance the acute management of people with diabetic foot disease requiring admission, an extended scope of practice, podiatric high-risk foot coordinator position, was established at the Great Western Hospital, Swindon in 2010. The focus of this new role was to facilitate more efficient and timely management of people with complex diabetic foot disease. The aim of this project was to investigate the impact of the podiatric high-risk foot coordinator role on length of stay, rate of re-admission and bed cost. This study evaluated the difference in length of stay and rate of re-admission between an 11- month pre-pilot period (November 2008 to October 2009) and a 10-month pilot period (August 2010 to June 2011). The estimated difference in bed cost between the pre-pilot and pilot audits was also calculated. Inclusion criteria were restricted to inpatients admitted with a diabetic foot ulcer, gangrene, cellulitis or infection as the primary cause for admission. Eligible records were retrieved using ICD-10 (V9) coding via the hospital clinical audit department for the pre-pilot period and a unique database was used to source records for the pilot phase. Following the introduction of the podiatric high-risk foot coordinator, the average length of stay reduced from 33.7 days to 23.3 days (mean difference 10.4 days, 95% CI 0.0 to 20.8, p = 0.050). There was no statistically significant difference in re-admission rate between the two study periods, 17.2% (95% CI 12.2% to 23.9%) in the pre-pilot phase and 15.4% (95% CI 12.0% to 19.5%) in the pilot phase (p = 0.820). The extrapolated annual cost saving following the implementation of the new coordinator role was calculated to be £234,000 for the 2010/2011 year. This audit found that the extended scope of practice coordinator role may have a positive impact on reducing length of stay for diabetic foot admissions. This paper advocates the role of a podiatric high-risk foot coordinator utilising an extended scope of

  4. A new chronobiological approach to discriminate between acute and chronic depression using peripheral temperature, rest-activity, and light exposure parameters.

    Science.gov (United States)

    Ávila Moraes, Cláudia; Cambras, Trinitat; Diez-Noguera, Antoni; Schimitt, Regina; Dantas, Giovana; Levandovski, Rosa; Hidalgo, Maria Paz

    2013-03-09

    Circadian theories for major depressive disorder have suggested that the rhythm of the circadian pacemaker is misaligned. Stable phase relationships between internal rhythms, such as temperature and rest/activity, and the external day-night cycle, are considered to be crucial for adapting to life in the external environmental. Therefore, the relationship and possible alterations among (i) light exposure, (ii) activity rhythm, and (iii) temperature rhythm could be important factors in clinical depression. This study aimed to investigate the rhythmic alterations in depression and evaluate the ability of chronobiological parameters to discriminate between healthy subjects and depressed patients. Thirty female subjects, including healthy subjects, depressed patients in the first episode, and major recurrent depression patients. Symptoms were assessed using Hamilton Depression Scale, Beck Depression Inventory and Montgomery-Äsberg Scale. Motor activity, temperature, and light values were determined for 7 days by actigraph, and circadian rhythms were calculated. Depressed groups showed a lower amplitude in the circadian rhythm of activity and light exposure, but a higher amplitude in the rhythm of peripheral temperature. The correlation between temperature and activity values was different in the day and night among the control and depressed groups. For the same level of activity, depressed patients had lowest temperature values during the day. The amplitudes of temperature and activity were the highest discriminant parameters. These results indicate that the study of rhythms is useful for diagnosis and therapy for depressive mood disorders.

  5. Sickness absence due to back pain or depressive episode and the risk of all-cause and diagnosis-specific disability pension: A Swedish cohort study of 4,823,069 individuals.

    Science.gov (United States)

    Dorner, T E; Alexanderson, K; Svedberg, P; Ropponen, A; Stein, K V; Mittendorfer-Rutz, E

    2015-10-01

    The aim of this study was to investigate the associations between sickness absence due to back pain or depressive episode with future all-cause and diagnosis-specific disability pension, while adjusting for comorbidity and socio-demographics, for all and stratifying for sex. In total, 4,823,069 individuals aged 16-64 years, living in Sweden at the end of 2004, not on old-age or disability pension in 2005 and without ongoing sickness absence at the turn of 2004/2005 formed the study population. Crude and adjusted hazard ratios (HRs) for all-cause and diagnosis-specific disability pension (2006-2010) in relation to diagnosis-specific sickness absence with sickness benefits paid by the Social Insurance Agency were estimated using Cox regression. The HR for all-cause disability pension was 7.52 (7.25-7.52) in individuals with an incident sick-leave spell due to back pain, compared to individuals without sickness absence in 2005 in the fully adjusted (socio-demographics and comorbidity) model. The fully adjusted (multivariate) HRs for diagnosis-specific disability pension were musculoskeletal diagnoses 23.87 (22.75-25.04), mental 2.49 (2.27-2.73) or all other diagnoses, 3.44 (3.17-3.75). In individuals with an incident sick-leave spell due to a depressive episode in 2005, the multivariate adjusted HR for all-cause disability pension was 12.87 (12.42-13.35), while the multivariate HRs for disability pension due to musculoskeletal diagnoses were 4.39 (3.89-4.96), for mental diagnoses 25.32 (24.29-26.38) and for all other somatic diagnoses 3.44 (3.09-3.82). Men who were sickness absent due to a depressive episode had a higher HR for disability pension compared to women. Results indicate that sickness absence due to a depressive episode or back pain is a strong risk factor for a future disability pension due to mental, musculoskeletal or other somatic diagnoses. © 2015 European Pain Federation - EFIC®

  6. 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

  7. Health-Related Quality of Life, Depression, Anxiety, and Self-Image in Acute Lymphocytic Leukemia Survivors.

    Science.gov (United States)

    Baytan, Birol; Aşut, Çiğdem; Çırpan Kantarcıoğlu, Arzu; Sezgin Evim, Melike; Güneş, Adalet Meral

    2016-12-01

    With increasing survival rates in childhood acute lymphocytic leukemia (ALL), the long-term side effects of treatment have become important. Our aim was to investigate health-related quality of life, depression, anxiety, and self-image among ALL survivors. Fifty patients diagnosed with ALL and their siblings were enrolled. The Kovacs Children's Depression Inventory, State-Trait Anxiety Inventory, Offer Self-Image Questionnaire, and Pediatric Quality of Life InventoryTM were used for collecting data. ANOVA tests were used to determine if there were any significant differences between groups. ALL survivors had higher depression, more anxiety symptoms, lower quality of life, and more negative self-image when compared to their siblings. Continuous diagnostic and interventional mental health services might be necessary for possible emotional side effects of treatment during and after the treatment. Rehabilitation and follow-up programs should be implemented for children during and after treatment for ALL.

  8. Depression

    Science.gov (United States)

    ... don't have the right balance of chemicals. Hormonal factors – Menstrual cycle changes, pregnancy, miscarriage, postpartum period, perimenopause, and menopause may all cause a woman to develop depression. ...

  9. Development and Validation of an International Risk Prediction Algorithm for Episodes of Major Depression in General Practice Attendees The PredictD Study

    NARCIS (Netherlands)

    King, Michael; Walker, Carl; Levy, Gus; Bottomley, Christian; Royston, Patrick; Weich, Scott; Bellon-Saameno, Juan Angel; Moreno, Berta; Svab, Igor; Rotar, Danica; Rifel, J.; Maaroos, Heidi-Ingrid; Aluoja, Anu; Kalda, Ruth; Neeleman, Jan; Geerlings, Mirjam I.; Xavier, Miguel; Carraca, Idalmiro; Goncalves-Pereira, Manuel; Vicente, Benjamin; Saldivia, Sandra; Melipillan, Roberto; Torres-Gonzalez, Francisco; Nazareth, Irwin

    2008-01-01

    Context: Strategies for prevention of depression are hindered by lack of evidence about the combined predictive effect of known risk factors. Objectives: To develop a risk algorithm for onset of major depression. Design: Cohort of adult general practice attendees followed up at 6 and 12 months. We

  10. Increases in exhaled nitric oxide after acute stress: association with measures of negative affect and depressive mood.

    Science.gov (United States)

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

    2014-01-01

    Increases in fractional exhaled nitric oxide (FeNO) have been observed after acute laboratory stress, which could indicate a strengthening of immune defenses in acute stress because of the quick onset of the response and the role of nitric oxide in airway-protective functions. In addition, because sustained psychological distress and depression are known to deteriorate immune defenses systems, they may dampen the FeNO response to acute stress. FeNO and negative affect were measured before and after a speech and mental arithmetic stressor. We examined the association of stress-induced FeNO changes with momentary negative affect and questionnaires of perceived stress, anxious mood, and depressive mood in 39 asthma patients and 41 healthy controls. FeNO increased from baseline to stress in participants with asthma (from 3.38 [0.102] to 3.46 [0.103] ln(ppb)) and controls (2.86 [0.098] to 2.92 [0.099]; F(4,141) = 3.26, p = .014), but the magnitude of the FeNO response did not differ between groups (F mood were associated with FeNO increases after stress (most pronounced at 0 minute poststress; t(76) = 3.87, p mood is associated with a reduced mobilization of airway nitric oxide in acute stress, whereas other indicators of negative affect are positively associated with overall FeNO levels and reactivity.

  11. Symptom specificity in the acute treatment of Major Depressive Disorder: a re-analysis of the treatment of depression collaborative research program.

    Science.gov (United States)

    Stewart, Jeremy G; Harkness, Kate L

    2012-03-01

    Antidepressant medications, Cognitive-Behavioral Therapy (CBT) and Interpersonal Psychotherapy (IPT) are equally efficacious in the acute treatment of Major Depressive Disorder (MDD). Nevertheless, remission rates remain unacceptably low. Examining the differential time course of remission of specific symptom clusters across treatments may provide a basis for assigning patients to treatments that have the highest chance of being effective. This study re-analyzed data from the NIMH Treatment of Depression Collaborative Research Project (TDCRP), which included 250 adult outpatients with MDD randomized to 16 weeks of CBT, IPT, imipramine+clinical management (IMI-CM), or pill placebo (PLA-CM). We derived four symptom factors from the 23-item Hamilton Depression Rating Scale, and three symptom factors from the Beck Depression Inventory. Within-subject hierarchical regression models were specified to examine the linear and quadratic patterns of symptom remission over five assessment points. IMI-CM produced a more rapid rate of remission than CBT or IPT for both the somatic/vegetative and cognitive-affective symptoms of MDD. There were no statistically significant differences in the rates of improvement of any of the symptom factors between the IMI-CM and PLA-CM groups. Some core symptoms of depression were excluded due to low factor loadings. Past research has argued that the CBT arm in the TDCRP may have been weak. We failed to find evidence that treatments act preferentially on specific symptom clusters. Therefore, the symptoms of MDD may be inter-dependent when it comes to their courses of remission in treatment. Copyright © 2011 Elsevier B.V. All rights reserved.

  12. Sleep Changes in a Rat Prenatal Stress Model of Depression

    DEFF Research Database (Denmark)

    Skoven, Christian; Sickman, Helle M.; Bastlund, Jesper Frank

    Major depression is one of the most frequently occurring mental health disorders, but is characterized by diverse symptomatology. Sleep disturbances, however, are commonplace in depressive patients. These alterations include increased duration of Rapid Eye Movement Sleep (REMS) and increased sleep...... fragmentation. Stressful life events during the second trimester of human pregnancy increase the risk of depression in the offspring. Similarly, rodents exposed to prenatal stress (PNS) during gestation express depression- like behavioral changes. Accordingly, we investigated sleep changes in a rat PNS model...... determination of sleep-wakefulness state. As traumatic episodes can trigger episodes of clinical depression, we also investigated effects of an acute stressor during the recording period. PNS animals (n=21) had an 82% increase in amount of REMS (11.6±1.4% vs 6.3±0.9%; p

  13. [Earthquake in Chile: acute stress and post traumatic stress disorder among women in treatment for severe depression].

    Science.gov (United States)

    Vitriol G, Verónica; Cancino A, Alfredo; Riquelme S, Paula; Reyes F, Ignacia

    2013-03-01

    Depression is a risk factor for developing secondary post-traumatic stress disorder. The earthquake on February 27th, 2010, destroyed the Hospital of Curicó. Despite the prevailing chaos, patients in treatment for severe depression actively maintained their treatment from the first post-earthquake working day To determine prevalence of acute stress (AS) and post-traumatic stress disorder (PTSD) after the earthquake among women in treatment for severe depression. Seventy five women aged 20 to 73 years in treatment for depression for at least six months before the oceurrence of the earthquake, who continued in follow up after the event, were studied. According to the Tenth International Classification of Diseases, the frequency of AS was assessed during the consultation oceurring one month after the event and the frequency of PTSD was assessed during the consultation oceurring six months after the event. Fifty nine percent of women had AS symptoms at the first month and 53.3% had PTSD, six months later. AS was significantly associated with a low educational level. PTSD was significantly associated with prior oceurrence of AS and a history of childhood trauma history. A high frequeney of PTSD was observed in this group of depressive patients, which was significantly associated with a history of previous AS and childhood trauma.

  14. 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

  15. 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

    2013-05-01

    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. Among 523 outpatients aged 18e70, exposed to 12e14 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 midtreatment therapeutic alliance. The 17-item Hamilton Rating Scale for Depression (HRSD17) scores at entry predicted dropout 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. Midphase symptom reduction was a strong predictor of final outcome. 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.

  16. Tryptophan pathway alterations in the postpartum period and in acute postpartum psychosis and depression.

    Science.gov (United States)

    Veen, Cato; Myint, Aye Mu; Burgerhout, Karin M; Schwarz, Markus J; Schütze, Gregor; Kushner, Steven A; Hoogendijk, Witte J; Drexhage, Hemmo A; Bergink, Veerle

    2016-01-01

    Women are at very high risk for the first onset of acute and severe mood disorders the first weeks after delivery. Tryptophan breakdown is increased as a physiological phenomenon of the postpartum period and might lead to vulnerability for affective psychosis (PP) and severe depression (PD). The aim of the current study was to investigate alterations in tryptophan breakdown in the physiological postpartum period compared to patients with severe postpartum mood disorders. We included 52 patients (29 with PP, 23 with PD), 52 matched healthy postpartum women and 29 healthy non-postpartum women. Analyzes of serum tryptophan metabolites were performed using LC-MS/MS system for tryptophan, kynurenine, 3-hydroxykynurenine, kynurenic acid and 5-hydroxyindoleacetic acid. The first two months of the physiological postpartum period were characterized by low tryptophan levels, increased breakdown towards kynurenine and a downstream shift toward the 3-OH-kynurenine arm, away from the kynurenic acid arm. Kynurenine was significantly lower in patients with PP and PD as compared to healthy postpartum women (p=0.011 and p=0.001); the remaining tryptophan metabolites demonstrated few differences between patients and healthy postpartum women. Low prevalence of the investigated disorders and strict exclusion criteria to obtain homogenous groups, resulted in relatively small sample sizes. The high kynurenine levels and increased tryptophan breakdown as a phenomenon of the physiological postpartum period was not present in patients with severe postpartum mood disorders. No differences were observed in the levels of the 'neurotoxic' 3-OH-kynurenine and the 'neuroprotective' kynurenic acid arms between patients and healthy postpartum women. Copyright © 2015 Elsevier B.V. All rights reserved.

  17. Marital satisfaction and depression among couples following men's acute coronary syndrome: testing dyadic dynamics in a longitudinal design.

    Science.gov (United States)

    Dekel, Rachel; Vilchinsky, Noa; Liberman, Gabriel; Leibowitz, Morton; Khaskia, Abed; Mosseri, Morris

    2014-05-01

    The current study examined the contribution of marital satisfaction to symptoms of depression among patients with acute coronary syndrome (ACS) and their partners. The sample comprised of 91 ACS male patients and their female partners. Data were collected at the time of initial hospitalization and 6 months later. Patients' and partners' assessments of marital satisfaction were measured using the ENRICH scale. Symptoms of depression were measured using the Brief Symptoms Inventory (BSI). Dyadic analysis applying the Actor-Partner Inter-dependence Model (APIM) was used. Different patterns emerged for the two phases. In the acute phase, only the Actor effect was significant: for both patients and partners, one's greater marital satisfaction was associated with one's lower levels of depression. In the chronic phase, both Actor and Partner effects were significant, while different trends were found for patients and partners. Partners' marital satisfaction was associated with their own and the patients' decreased depression symptoms, whereas among patients, higher levels of marital satisfaction were associated with elevated levels of depression both for themselves and for their partners. A dyadic perspective and phases of illness have to be taken into account in understanding adjustment and developing interventions following ACS. What is already known on this subject? The contribution of marital satisfaction to psychological adjustment following cardiac illness has been explored, but mainly from the perspective of one partner only. Different phases of an illness present different challenges for both patients and family members. What does this study add? A dyadic perspective on recovery from cardiac illness. The partner's contribution during the different phases of the illness. © 2013 The British Psychological Society.

  18. Mortality after an episode of acute heart failure in a cohort of patients with intermediate ventricular function: Global analysis and relationship with admission department.

    Science.gov (United States)

    Miró, Òscar; Javaloyes, Patricia; Gil, Víctor; Jacob, Javier; Herrero-Puente, Pablo; Martín-Sánchez, Francisco Javier; Salvo, Eva; Alonso, Héctor; Juan Gómez, María Ángeles; Parissis, John; Llorens, Pere

    2017-12-23

    To compare the outcome of patients with acute heart failure (AHF) with a mid-range left ventricular ejection fraction (HFmrEF) with patients with a reduced (HFrEF) or preserved (HFpEF) left ventricular ejection fraction. A prospective observational study included patients diagnosed with AHF in 41 emergency departments. Patients were divided into 3 groups: HFrEF<40%, HFmrEF 40-49% and HFpEF≥50%. We collected 38 independent variables and the adjusted and crude all-cause mortality at one-year in the HFmrEF group was compared with that of the HFrEF and HFpEF groups. The analysis was stratified according to patient destination following ED care. Three thousand nine hundred and fifty-eight patients were included: 580 HFmrEF (14.6%), 929 HFrEF (23.5%) and 2,449 HFpEF (61.9%). Global mortality at one year was 28.5%. The crude mortality of the HFmrEF group was similar to that of the HFpEF group (HR 1.009; 95% CI 0.819-1.243; P=.933) and lower than the HFrEF group (HR 0.800; 95% CI 0.635-1.008; P=.058), but after adjustment for discordant basal characteristics among groups, the mortality of the HFmrEF group did not differ from that of the HFpEF (HRa 1.025; 95% CI 0.825-1.275; P=.821) or HFrEF group (HRa 0.924; 95% CI 0.720-1.186; P=.535). Neither were significant differences found between the HFmrEF group and the other 2 groups in the analysis stratified according to admission or discharge direct from the emergency department. Mortality at one-year after an AHF episode in patients with HFmrEF does not differ from that of patients with HFpEF or HfrEF, either globally or based on the main destinations after emergency department care. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  19. Illness history: Not associated with remission during treatment of major depression in 515 mood disorder patients.

    Science.gov (United States)

    Baldessarini, Ross J; Tondo, Leonardo; Visioli, Caterina; Vázquez, Gustavo H

    2016-02-01

    There is suggestive evidence that prior illness history may have little association with response to long-term treatment in bipolar disorder (BD) or recurrent major depressive disorder (MDD), but relationships of illness-history to treatment-response in acute episodes of depression require further testing. We tested for associations of selected measures of illness history with remission during treatment of an acute index episode of major depression in 515 mood-disorder patients (327 MDD, 188 BD), using bivariate and multivariate methods. Remission of depression was more likely with lesser initial symptom-severity and bipolar diagnosis, but not related to years since illness-onset, previous depressions or episodes (based on counts, yearly rates, or %-of months ill), or other indices of illness-severity (hospitalization, co-morbidity, suicide attempt). Likelihood of response to standard treatments for acute major depressive episodes in MDD or BD appeared to be largely independent of prior illness-history. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Longitudinal social-interpersonal functioning among higher-risk responders to acute-phase cognitive therapy for recurrent major depressive disorder.

    Science.gov (United States)

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

    2016-07-15

    Social-interpersonal dysfunction increases disability in major depressive disorder (MDD). Here we clarified the durability of improvements in social-interpersonal functioning made during acute-phase cognitive therapy (CT), whether continuation CT (C-CT) or fluoxetine (FLX) further improved functioning, and relations of functioning with depressive symptoms and relapse/recurrence. Adult outpatients (N=241) with recurrent MDD who responded to acute-phase CT with higher risk of relapse (due to unstable or partial remission) were randomized to 8 months of C-CT, FLX, or pill placebo plus clinical management (PBO) and followed 24 additional months. We analyzed repeated measures of patients' social adjustment, interpersonal problems, dyadic adjustment, depressive symptoms, and major depressive relapse/recurrence. Large improvements in social-interpersonal functioning occurring during acute-phase CT (median d=1.4) were maintained, with many patients (median=66%) scoring in normal ranges for 32 months. Social-interpersonal functioning did not differ significantly among C-CT, FLX, and PBO arms. Beyond concurrently measured residual symptoms, deterioration in social-interpersonal functioning preceded and predicted upticks in depressive symptoms and major depressive relapse/recurrence. Results may not generalize to other patient populations, treatment protocols, or measures of social-interpersonal functioning. Mechanisms of risk connecting poorer social-interpersonal functioning with depression were not studied. Average improvements in social-interpersonal functioning among higher-risk responders to acute phase CT are durable for 32 months. After acute-phase CT, C-CT or FLX may not further improve social-interpersonal functioning. Among acute-phase CT responders, deteriorating social-interpersonal functioning provides a clear, measurable signal of risk for impending major depressive relapse/recurrence and opportunity for preemptive intervention. Copyright © 2016 Elsevier B

  1. The bacterial lysate Lantigen B reduces the number of acute episodes in patients with recurrent infections of the respiratory tract: the results of a double blind, placebo controlled, multicenter clinical trial.

    Science.gov (United States)

    Braido, Fulvio; Melioli, Giovanni; Candoli, Piero; Cavalot, Andrea; Di Gioacchino, Mario; Ferrero, Vittorio; Incorvaia, Cristoforo; Mereu, Carlo; Ridolo, Erminia; Rolla, Giovanni; Rossi, Oliviero; Savi, Eleonora; Tubino, Libero; Reggiardo, Giorgio; Baiardini, Ilaria; di Marco, Eddi; Rinaldi, Gilberto; Canonica, Giorgio Walter; Accorsi, Carlo; Bossilino, Claudia; Bonzano, Laura; DiLizia, Michela; Fedrighini, Barbara; Garelli, Valentina; Gerace, Vincenzo; Maniscalco, Sara; Massaro, Ilaria; Messi, Alessandro; Milanese, Manlio; Peveri, Silvia; Penno, Arminio; Pizzimenti, Stefano; Pozzo, Tiziana; Raie, Alberto; Regina, Sergio; Sclifò, Francesca

    2014-12-01

    Studies in the 1970s and 1980s reported that bacterial lysates (BL) had a prophylactic effect on recurrent respiratory tract infections (RRTI). However, controlled clinical study procedures have evolved substantially since then. We performed a trial using updated methods to evaluate the efficacy of Lantigen B®, a chemical BL. This double blind, placebo controlled, multi-center clinical trial had the primary objective of assessing the capacity of Lantigen B to significantly reduce the total number of infectious episodes in patients with RRTI. Secondary aims were the RRTI duration, the frequency and the severity of the acute episodes, the use of drugs and the number of missed workdays. In the subgroup of allergic patients with RRTI, the number of allergic episodes (AE) and the use of anti-allergic drugs were also evaluated. One hundred and sixty patients, 79 allocated to the treated group (TG) and 81 to the placebo group (PG), were enrolled; 30 were lost during the study and 120 (79 females and 38 males) were evaluated. The PG had 1.43 episodes in the 8-months of follow-up while the TG had 0.86 episodes (p=0.036). A similar result was observed in the allergic patients (1.80 and 0.86 episodes for the PG and the TG, respectively, p=0.047). The use of antibiotics was reduced (mean 1.24 and 2.83 days of treatment for the TG and the PG). Logistic regression analysis indicated that the estimated risk of needing antibiotics and NSAIDs was reduced by 52.1 and 30.6%, respectively. With regard to the number of AE, no significant difference was observed between the two groups, but bronchodilators, antihistamines and local corticosteroids were reduced by 25.7%, 56.2% and 41.6%, respectively, in the TG. Lantigen B significantly reduced the number of infectious episodes in patients with RRTI. This finding suggests a first line use of this drug for the prophylaxis of infectious episodes in these patients. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights

  2. Depression

    DEFF Research Database (Denmark)

    Eriksen, Stine Aistrup

    2017-01-01

    Use of antidepressants is associated with an increased risk of fractures, and may be a result of both negative effects on the skeleton as well as increased risk of falling; however, the specific mechanisms are not yet known. Vitamin D play important roles for bone and muscle, and has previously...... shown positive effects in lowering the risk of osteoporosis and risk of falling. In addition, vitamin D may improve mental health, and deficiency of vitamin D is a common condition among patients suffering from depression. This thesis investigates bone and factors related to fall risk (including muscle...

  3. Turning Towards or Turning Away: A Comparison of Mindfulness Meditation and Guided Imagery Relaxation in Patients with Acute Depression.

    Science.gov (United States)

    Costa, Ana; Barnhofer, Thorsten

    2016-07-01

    Disengaging from maladaptive thinking is an important imperative in the treatment of depression. Mindfulness training is aimed at helping patients acquire relevant skills for this purpose. It remains unclear, however, whether this practice is helpful when patients are acutely depressed. In order to investigate effects of mindfulness on symptoms and self-regulatory capacities in this group, the current study compared a brief training in mindfulness (n = 19) to guided imagery relaxation (n = 18). Participants were introduced to the respective techniques in a single session, and practised daily over one week. Self-reported severity of symptoms, difficulties in emotion-regulation, attentional control, the ability to decentre, and mindfulness were assessed pre and postintervention, and at a one-week follow-up. Symptoms of depression significantly decreased and self-regulatory functioning significantly increased in both groups, with changes being maintained during follow-up. When controlling for change in depressive symptoms, results showed significantly higher improvements in emotion regulation at follow-up in the mindfulness group. The ability to decentre predicted changes in symptoms from pre to postintervention, while mindfulness skills predicted changes in symptoms during the maintenance phase. The findings suggest that both practices can help to instigate reductions in symptoms and enhance self-regulatory functioning in depression. However, in order to improve emotion regulation above levels explained by reductions in symptoms more intentional mental training seems necessary. Furthermore, while the ability to disengage from negative patterns of thinking seems crucial for initial reduction of symptoms, maintenance of gains might require broader skills in mindfulness.

  4. Capgras' syndrome in first-episode psychotic disorders.

    Science.gov (United States)

    Salvatore, Paola; Bhuvaneswar, Chaya; Tohen, Mauricio; Khalsa, Hari-Mandir K; Maggini, Carlo; Baldessarini, Ross J

    2014-01-01

    Misidentification phenomena, including the delusion of 'imposters' named after Joseph Capgras, occur in various major psychiatric and neurological disorders but have rarely been studied systematically in broad samples of modern patients. This study investigated the prevalence and correlated clinical factors of Capgras' phenomenon in a broad sample of patient-subjects with first-lifetime episodes of psychotic affective and nonaffective disorders. We evaluated 517 initially hospitalized, first-episode psychotic-disorder patients for the prevalence of Capgras' phenomenon and its association with DSM-IV-TR diagnoses including schizophreniform, brief psychotic, unspecified psychotic, delusional, and schizoaffective disorders, schizophrenia, bipolar-I disorder and major depression with psychotic features, and with characteristics of interest including antecedent psychiatric and neurological morbidity, onset type and presenting psychopathological phenomena, using standard bivariate and multivariate statistical methods. Capgras' syndrome was identified in 73/517 (14.1%) patients (8.2-50% across diagnoses). Risk was greatest with acute or brief psychotic disorders (schizophreniform psychoses 50%, brief psychoses 34.8%, or unspecified psychoses 23.9%), intermediate in major depression (15%), schizophrenia (11.4%) and delusional disorder (11.1%), and lowest in bipolar-I (10.3%) and schizoaffective disorders (8.2%). Associated were somatosensory, olfactory and tactile hallucinations, Schneiderian (especially delusional perception), and cycloid features including polymorphous psychotic phenomena, rapidly shifting psychomotor and affective symptoms, pananxiety, ecstasy, overconcern with death, and perplexity or confusion, as well as rapid onset, but not sex, age, abuse history, dissociative features, or indications of neurological disorders. Capgras' syndrome was prevalent across a broad spectrum of first-episode psychotic disorders, most often in acute psychoses of rapid onset.

  5. Capgras Syndrome in First-Episode Psychotic Disorders

    Science.gov (United States)

    Salvatore, Paola; Bhuvaneswar, Chaya; Tohen, Mauricio; Khalsa, Hari-Mandir K.; Maggini, Carlo; Baldessarini, Ross J.

    2014-01-01

    Background Misidentification phenomena, including the delusion of “imposters” named after Joseph Capgras, occur in various major psychiatric and neurological disorders but have rarely been studied systematically in broad samples of modern patients. This study investigated the prevalence and correlated clinical factors of Capgras phenomenon in a broad sample of patient-subjects with first-lifetime episodes of psychotic affective and non affective disorders. Methods We evaluated 517 initially hospitalized, first-episode psychotic-disorder patients for prevalence of Capgras phenomenon and its association with DSM-IV-TR diagnoses including schizophreniform, brief psychotic, unspecified psychotic, delusional, and schizoaffective disorders, schizophrenia, bipolar-I disorder and major depression with psychotic features, and with characteristics of interest including antecedent psychiatric and neurological morbidity, onset-type and presenting psychopathological phenomena, using standard bivariate and multivariate statistical methods. Results Capgras syndrome was identified in 73/517 (14.1%) patients (8.2%–50% across diagnoses). Risk was greatest with acute or brief psychotic disorders (schizophreniform [50%], brief [34.8%], or unspecified [23.9%] psychoses), intermediate in major depression (15%), schizophrenia (11.4%) and delusional disorder (11.1%), and lowest in bipolar-I (10.3%) and schizoaffective disorders (8.2%). Associated were somatosensory, olfactory and tactile hallucinations, Schneiderian (especially delusional perception), and cycloid features as described by Perris and Brockington including polymorphous psychotic phenomena, rapidly shifting psychomotor and affective symptoms, pan-anxiety, ecstasy, over-concern with death, and perplexity or confusion, as well as rapid-onset, but not sex, age, abuse-history, dissociative features, or indications of neurological disorders. Conclusions Capgras syndrome was prevalent across a broad spectrum of first-episode

  6. 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

  7. Gender differences in quality of life and functional disability for depression outpatients with or without residual symptoms after acute phase treatment in China.

    Science.gov (United States)

    Zhao, Na; Wang, Xiaohong; Wu, Wenyuan; Hu, Yongdong; Niu, Yajuan; Wang, Xueyi; Gao, Chengge; Zhang, Ning; Fang, Yiru; Huang, Jizhong; Liu, Tiebang; Jia, Fujun; Zhu, Xuequan; Hu, Jian; Wang, Gang

    2017-09-01

    Depression is associated with substantial personal suffering and reduced quality of life and functioning. The aim of this study was to investigate gender differences on quality of life and functional impairment of outpatients with depression after acute phase treatment. 1503 depression outpatients were recruited from eleven hospitals in China. Subjects were evaluated with sociodemographic characteristics, history and self-report instruments, related to severity of symptoms, function and quality of life. All data were analyzed to determine the gender differences. Men had a younger age at onset and the first onset age, higher education compared to women in total patients and with or without residual symptoms group. Using regression analysis, it was found that gender was significantly statistically related to severity scores of SDS and had no correlation with Q-LES-Q-SF total scores. In the residual symptoms group, greater functional impairment was noted by men in the area of work and social life. Significant gender differences of mood, work and sexual life in quality of life were observed. This is a cross-sectional study of depressed outpatients and duration of acute phase treatment may not an adequate time to measure changes. Depression appears to affect men more seriously than women after acute phase treatment. Men had a younger age at onset and the first onset age, higher education, more functional impairment and lower satisfaction of quality of life in mood, work and sexual life. Gender differences affect acute treatment, remission and recovery. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. The effect of MElatonin on Depressive symptoms, Anxiety, CIrcadian and Sleep disturbances in patients after acute coronary syndrome (MEDACIS): study protocol for a randomized controlled trial.

    Science.gov (United States)

    Madsen, Michael Tvilling; Isbrand, Anders; Andersen, Ulla Overgaard; Andersen, Lars Juel; Taskiran, Mustafa; Simonsen, Erik; Gögenur, Ismail

    2017-02-23

    Depression following acute coronary syndrome (ACS) constitutes a serious and debilitating problem. Approximately one in five patients will develop significant depression following ACS and less severe depressive symptoms are even more frequent. Furthermore, anxiety symptoms and sleep-wake disturbances are frequent. The objective of the MEDACIS trial is to investigate whether prophylactic treatment with melatonin has a preventive effect on depression, depressive and anxiety symptoms, sleep, and circadian disturbances following ACS. "The effect of MElatonin and Depressive symptoms, Anxiety, CIrcadian and Sleep disturbances in patients after acute coronary syndrome" trial (MEDACIS) is a multicenter, double-blinded, placebo-controlled, randomized clinical trial. A total of 240 patients with ACS and no depressive symptoms will be included in the trial for treatment with either 25 mg melatonin or placebo for a 12-week period. Development and severity of depressive symptoms will be evaluated using Major Depression Inventory every 2 weeks with the purpose of investigating the potential preventive effect of melatonin on depressive symptoms. Previously, only selective serotonin reuptake inhibitors (SSRIs) have been investigated in a primary preventive setup in patients following ACS. However, SSRIs are associated with several side effects. An ideal intervention would constitute the highest degree of prevention of depressive symptoms with the lowest risk of side effects. In this regard, melatonin may have advantages due to its low toxicity as well as its proven anxiolytic and hypnotic effects. ClinicalTrials.gov, Identifier: NCT02451293 . Registered on 12 May 2015. EudraCT nr. 2015-002116-32.

  9. Fractal analysis of heart rate dynamics as a predictor of mortality in patients with depressed left ventricular function after acute myocardial infarction. TRACE Investigators. TRAndolapril Cardiac Evaluation

    DEFF Research Database (Denmark)

    Mäkikallio, T H; Høiber, S; Køber, L

    1999-01-01

    variability predict mortality in patients with depressed left ventricular (LV) function after acute myocardial infarction (AMI). Traditional time- and frequency-domain HR variability indexes along with short-term fractal-like correlation properties of RR intervals (exponent alpha) and power-law scaling...... (exponent beta) were studied in 159 patients with depressed LV function (ejection fraction ... variables and LV function. A short-term fractal-like scaling exponent was the most powerful HR variability index in predicting mortality in patients with depressed LV function. Reduction in fractal correlation properties implies more random short-term HR dynamics in patients with increased risk of death...

  10. Depression as a risk factor for poor prognosis among patients with acute coronary syndrome: systematic review and recommendations: a scientific statement from the American Heart Association.

    Science.gov (United States)

    Lichtman, Judith H; Froelicher, Erika S; Blumenthal, James A; Carney, Robert M; Doering, Lynn V; Frasure-Smith, Nancy; Freedland, Kenneth E; Jaffe, Allan S; Leifheit-Limson, Erica C; Sheps, David S; Vaccarino, Viola; Wulsin, Lawson

    2014-03-25

    Although prospective studies, systematic reviews, and meta-analyses have documented an association between depression and increased morbidity and mortality in a variety of cardiac populations, depression has not yet achieved formal recognition as a risk factor for poor prognosis in patients with acute coronary syndrome by the American Heart Association and other health organizations. The purpose of this scientific statement is to review available evidence and recommend whether depression should be elevated to the status of a risk factor for patients with acute coronary syndrome. Writing group members were approved by the American Heart Association's Scientific Statement and Manuscript Oversight Committees. A systematic literature review on depression and adverse medical outcomes after acute coronary syndrome was conducted that included all-cause mortality, cardiac mortality, and composite outcomes for mortality and nonfatal events. The review assessed the strength, consistency, independence, and generalizability of the published studies. A total of 53 individual studies (32 reported on associations with all-cause mortality, 12 on cardiac mortality, and 22 on composite outcomes) and 4 meta-analyses met inclusion criteria. There was heterogeneity across studies in terms of the demographic composition of study samples, definition and measurement of depression, length of follow-up, and covariates included in the multivariable models. Despite limitations in some individual studies, our review identified generally consistent associations between depression and adverse outcomes. Despite the heterogeneity of published studies included in this review, the preponderance of evidence supports the recommendation that the American Heart Association should elevate depression to the status of a risk factor for adverse medical outcomes in patients with acute coronary syndrome.

  11. Synthetic cannabinoid induced acute respiratory depression: Case series and literature review

    Directory of Open Access Journals (Sweden)

    Mark Henry Alon

    2017-01-01

    The use of Synthetic Cannabinoids can cause respiratory depression in individuals without an underlying pulmonary disease and adds to the growing number of literature about the presentation and debilitating adverse events from its consumption. Although there is no specific toxidrome associated with it, clinicians should have a high index of suspicion with its use especially in patients presenting with a history of drug overdose.

  12. ST-segment depression in aVR as a predictor of culprit artery in acute inferior wall ST-segment elevation myocardial infarction

    Directory of Open Access Journals (Sweden)

    Ahmed Hafez el-neklawy

    2014-03-01

    Conclusions: ST depression in aVR is common in patients with LCX-related acute inferior myocardial infarction. The ST changes in this lead are associated with an excellent specificity and a good sensitivity in differentiating LCX from RCA as the IRA.

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

    Directory of Open Access Journals (Sweden)

    Calvo-Lobo C

    2017-01-01

    Full Text Available Cesar Calvo-Lobo,1 Juan Manuel Vilar Fernández,2 Ricardo Becerro-de-Bengoa-Vallejo,3 Marta Elena Losa-Iglesias,4 David Rodríguez-Sanz,5 Patricia Palomo López,6 Daniel López López7 1Physical Therapy Department, Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid; 2Modeling, Optimization and Statistical Inference Research Group, Universidade da Coruña, A Coruña; 3School of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, Madrid; 4Faculty of Health Sciences, Universidad Rey Juan Carlos, Madrid; 5Physical Therapy & Health Sciences Research Group, Facultad de Ciencias de la Salud, el Ejercicio y el Deporte, Universidad Europea de Madrid, Madrid; 6University Center of Plasencia, Universidad de Extremadura, Badajoz; 7Research, Health and Podiatry Unit, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, A Coruña, Spain Background and purpose: Nonspecific low back pain (LBP is the most prevalent musculoskeletal condition in various age ranges and is associated with depression. The aim of this study was to determine the Beck Depression Inventory (BDI scores in participants with nonspecific LBP and no-pain by age distribution.Methods: A case–control study was carried out following the Strengthening the Reporting of Observational Studies in Epidemiology criteria. A sample of 332 participants, divided into the following age categories: 19–24 (n=11, 25–39 (n=66, 40–64 (n=90, 65–79 (n=124, and ≥80 (n=41 years was recruited from domiciliary visits and an outpatient clinic. The BDI scores were self-reported in participants with nonspecific acute or subacute (≤3 months LBP (n=166 and no-pain (n=166.Results: The BDI scores, mean ± standard deviation, showed statistically significant differences (p<0.001 between participants with nonspecific acute or

  14. A multicenter, open-label, long-term safety and tolerability study of DFN-02, an intranasal spray of sumatriptan 10 mg plus permeation enhancer DDM, for the acute treatment of episodic migraine.

    Science.gov (United States)

    Munjal, Sagar; Brand-Schieber, Elimor; Allenby, Kent; Spierings, Egilius L H; Cady, Roger K; Rapoport, Alan M

    2017-12-01

    DFN-02 is a novel intranasal spray formulation composed of sumatriptan 10 mg and a permeation-enhancing excipient comprised of 0.2% 1-O-n-Dodecyl-β-D-Maltopyranoside (DDM). This composition of DFN-02 allows sumatriptan to be rapidly absorbed into the systemic circulation and exhibit pharmacokinetics comparable to subcutaneously administered sumatriptan. Rapid rate of absorption is suggested to be important for optimal efficacy. The objective of this study was to evaluate the safety and tolerability of DFN-02 (10 mg) in the acute treatment of episodic migraine with and without aura over a 6-month period based on the incidence of treatment-emergent adverse events and the evaluation of results of clinical laboratory tests, vital signs, physical examination, and electrocardiograms. This was a multi-center, open-label, repeat-dose safety study in adults with episodic migraine with and without aura. Subjects diagnosed with migraine with or without aura according to the criteria set forth in the International Classification of Headache Disorders, 2nd edition, who experienced 2 to 6 attacks per month with fewer than 15 headache days per month and at least 48 headache-free hours between attacks, used DFN-02 to treat their migraine attacks acutely over the course of 6 months. A total of 173 subjects was enrolled, 167 (96.5%) subjects used at least 1 dose of study medication and were evaluable for safety, and 134 (77.5%) subjects completed the 6-month study. A total of 2211 migraine attacks was reported, and 3292 doses of DFN-02 were administered; mean per subject monthly use of DFN-02 was 3.6 doses. Adverse events were those expected for triptans, as well as for nasally administered compounds. No new safety signals emerged. Dysgeusia and application site pain were the most commonly reported treatment-emergent adverse events over 6 months (21% and 30.5%, respectively). Most of the treatment-emergent adverse events were mild. There were 5 serious adverse events, all

  15. Combining Antidepressants in Acute Treatment of Depression: A Meta-Analysis of 38 Studies Including 4511 Patients

    Science.gov (United States)

    Henssler, Jonathan; Bschor, Tom

    2016-01-01

    Objective: Combining antidepressants (ADs) for therapy of acute depression is frequently employed, but randomized studies have yielded conflicting results. We conducted a systematic review and meta-analysis aimed at determining efficacy and tolerability of combination therapy. Methods: MEDLINE, Embase, PsycINFO, and CENTRAL databases were systematically searched through March 2014 for controlled studies comparing combinations of ADs with AD monotherapy in adult patients suffering from acute depression. The prespecified primary outcome was standardized mean difference (SMD), secondary outcomes were response, remission, and dropouts. Results: Among 8688 articles screened, 38 studies were eligible, including 4511 patients. Combination treatment was statistically, significantly superior to monotherapy (SMD 0.29; 95% CI 0.16 to 0.42). During monotherapy, slightly fewer patients dropped out due to adverse events (OR 0.90; 95% CI 0.53 to 1.53). Studies were heterogeneous (I2 = 63%), and there was indication of moderate publication bias (fail-safe N for an effect of 0.1:44), but results remained robust across prespecified secondary outcomes and subgroups, including analyses restricted to randomized controlled trials and low risk of bias studies. Meta-regression revealed an association of SMD with difference in imipramine-equivalent dose. Combining a reuptake inhibitor with an antagonist of presynaptic α2-autoreceptors was superior to other combinations. Conclusion: Combining ADs seems to be superior to monotherapy with only slightly more patients dropping out. Combining a reuptake inhibitor with an antagonist of presynaptic α2-autoreceptors seems to be significantly more effective than other combinations. Overall, our search revealed a dearth of well-designed studies. PMID:27582451

  16. Combining Antidepressants in Acute Treatment of Depression: A Meta-Analysis of 38 Studies Including 4511 Patients.

    Science.gov (United States)

    Henssler, Jonathan; Bschor, Tom; Baethge, Christopher

    2016-01-01

    Combining antidepressants (ADs) for therapy of acute depression is frequently employed, but randomized studies have yielded conflicting results. We conducted a systematic review and meta-analysis aimed at determining efficacy and tolerability of combination therapy. MEDLINE, Embase, PsycINFO, and CENTRAL databases were systematically searched through March 2014 for controlled studies comparing combinations of ADs with AD monotherapy in adult patients suffering from acute depression. The prespecified primary outcome was standardized mean difference (SMD), secondary outcomes were response, remission, and dropouts. Among 8688 articles screened, 38 studies were eligible, including 4511 patients. Combination treatment was statistically, significantly superior to monotherapy (SMD 0.29; 95% CI 0.16 to 0.42). During monotherapy, slightly fewer patients dropped out due to adverse events (OR 0.90; 95% CI 0.53 to 1.53). Studies were heterogeneous (I(2) = 63%), and there was indication of moderate publication bias (fail-safe N for an effect of 0.1:44), but results remained robust across prespecified secondary outcomes and subgroups, including analyses restricted to randomized controlled trials and low risk of bias studies. Meta-regression revealed an association of SMD with difference in imipramine-equivalent dose. Combining a reuptake inhibitor with an antagonist of presynaptic α2-autoreceptors was superior to other combinations. Combining ADs seems to be superior to monotherapy with only slightly more patients dropping out. Combining a reuptake inhibitor with an antagonist of presynaptic α2-autoreceptors seems to be significantly more effective than other combinations. Overall, our search revealed a dearth of well-designed studies. © The Author(s) 2016.

  17. Small Acute Benefits of 4 Weeks Processing Speed Training Games on Processing Speed and Inhibition Performance and Depressive Mood in the Healthy Elderly People: Evidence from a Randomized Control Trial.

    Science.gov (United States)

    Nouchi, Rui; Saito, Toshiki; Nouchi, Haruka; Kawashima, Ryuta

    2016-01-01

    Background: Processing speed training using a 1-year intervention period improves cognitive functions and emotional states of elderly people. Nevertheless, it remains unclear whether short-term processing speed training such as 4 weeks can benefit elderly people. This study was designed to investigate effects of 4 weeks of processing speed training on cognitive functions and emotional states of elderly people. Methods: We used a single-blinded randomized control trial (RCT). Seventy-two older adults were assigned randomly to two groups: a processing speed training game (PSTG) group and knowledge quiz training game (KQTG) group, an active control group. In PSTG, participants were asked to play PSTG (12 processing speed games) for 15 min, during five sessions per week, for 4 weeks. In the KQTG group, participants were asked to play KQTG (four knowledge quizzes) for 15 min, during five sessions per week, for 4 weeks. We measured several cognitive functions and emotional states before and after the 4 week intervention period. Results: Our results revealed that PSTG improved performances in processing speed and inhibition compared to KQTG, but did not improve performance in reasoning, shifting, short term/working memory, and episodic memory. Moreover, PSTG reduced the depressive mood score as measured by the Profile of Mood State compared to KQTG during the 4 week intervention period, but did not change other emotional measures. Discussion: This RCT first provided scientific evidence related to small acute benefits of 4 week PSTG on processing speed, inhibition, and depressive mood in healthy elderly people. We discuss possible mechanisms for improvements in processing speed and inhibition and reduction of the depressive mood. Trial registration: This trial was registered in The University Hospital Medical Information Network Clinical Trials Registry (