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Sample records for depressive disorder diagnostic

  1. A prospective study of diagnostic conversion of major depressive disorder to bipolar disorder in pregnancy and postpartum.

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    Sharma, Verinder; Xie, Bin; Campbell, M Karen; Penava, Debbie; Hampson, Elizabeth; Mazmanian, Dwight; Pope, Carley J

    2014-02-01

    The aim of the present study was to determine the rate of, and risk factors for, a change in diagnosis from major depressive disorder to bipolar disorder, and from bipolar II disorder to bipolar I disorder in pregnancy and postpartum. Patients with a prior history of major depressive disorder or bipolar II disorder were recruited between 24 and 28 weeks' gestation and followed through to one year postpartum. Diagnostic interviews were conducted using the Structured Clinical Interview for DSM-IV at study intake and repeated using the Mini-International Psychiatric Interview at one, three, six, and 12 months after childbirth. Fisher's exact test was used to assess the association between various risk factors and diagnostic switch. A total of 146 participants completed the intake interview and at least one follow-up interview postpartum. Of these, 92 were diagnosed with major depressive disorder and 54 with bipolar II disorder at intake. Six women (6.52%) experienced a diagnostic change from major depressive disorder to bipolar II disorder during the first six months after childbirth. There were no cases of switching to bipolar I disorder, but in one participant the diagnosis changed from bipolar II disorder to bipolar I disorder during the three months after childbirth. Bipolar switch was associated with a family history of bipolar disorder. The postpartum period appears to be a time of high risk for a new onset of hypomania in women with major depressive disorder. Our rate of diagnostic switching to bipolar II disorder (6.52%) is at least 11- to 18-fold higher than the rates of switching in similar studies conducted in both men and women. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. SEMIOTICS, DIAGNOSTICS AND THERAPY TACTICS OF DEPRESSIVE DISORDERS IN CLINICAL MEDICINE

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    N. A. Kornetov

    2014-01-01

    Full Text Available Study objectives are dedicated to brief synthesized establishment of diagnostics general standard, management and therapy of major depressive disorders (MDD in clinical medicine to provide education in medical practice.Study methods are based on short-term, medium-term and long-term educational programs in 24 Russian and Ukraine cities, which were based on original educational programs under the direction of World Psychiatric Association (WPA and International Committee For Prevention and Treatment of Depression (PTD. There, about 1450 doctors of different occupations were acquainted with the detection, management and treatment of MDD. The Russian version of WPA/PTD programs was created. The program of education included 4 modules. The Core module included an overview of the epidemiology, impact, concepts and classification, and etiology of depressive disorders as well as their recognition, diagnosis, and management in the primary care setting. The second module focused on depressive disorders in physical illness and covered those major illnesses for which is reasonable evidence for an association with depressive disorders. The third module included the development of the depressive disorders in older persons. The forth module included training physicians in mental health skills. 39 theme improvements for 858 primary care setting physicians within the framework of faculty training program of physicians’ development were the part of other programs of physicians’ occupations.Results. A number of highlights were included in the general algorithm of the educational programs. The creation of optimum «physician-depressive patient» contact demands a number of new skills to establish effective communication. These skills involve training of meeting of depressive patient and physician, the ability to follow a certain communication style; identify emotional, cognitive, psychomotor and nonverbal patterns of behavior. Besides that, the education

  3. "Subthreshold" depression: is the distinction between depressive disorder not otherwise specified and adjustment disorder valid?

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    Zimmerman, Mark; Martinez, Jennifer H; Dalrymple, Kristy; Chelminski, Iwona; Young, Diane

    2013-05-01

    Patients with clinically significant symptoms of depression who do not meet the criteria for major depressive disorder or dysthymic disorder are considered to have subthreshold depression. According to DSM-IV, such patients should be diagnosed with depressive disorder not otherwise specified (NOS) if the development of the symptoms is not attributable to a stressful event or with adjustment disorder if the symptoms follow a stressor. Research on the treatment of subthreshold depression rarely addresses the distinction between depressive disorder NOS and adjustment disorder. In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we examined the validity of this distinction. From December 1995 to June 2011, 3,400 psychiatric patients presenting to the Rhode Island Hospital outpatient practice were evaluated with semistructured diagnostic interviews for DSM-IV Axis I and Axis II disorders and measures of psychosocial morbidity. Slightly less than 10% (n = 300) of the 3,400 patients were diagnosed with depressive disorder NOS or adjustment disorder with depressed mood. The patients with depressive disorder NOS were significantly more often diagnosed with social phobia (P depressive disorder NOS reported more anhedonia, increased appetite, increased sleep, and indecisiveness, whereas the patients with adjustment disorder reported more weight loss, reduced appetite, and insomnia. There was no significant difference between the groups in overall level of severity of depression or impaired functioning. The patients with depressive disorder NOS had a nonsignificantly elevated morbid risk of depression in their first-degree relatives. Clinically significant subthreshold depression was common in psychiatric outpatients, and the present results support the validity of distinguishing between depressive disorder NOS and adjustment disorder with depressed mood. Future studies of the treatment of subthreshold depression

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

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    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...

  5. A diagnosis of bipolar spectrum disorder predicts diagnostic conversion from unipolar depression to bipolar disorder: a 5-year retrospective study.

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    Woo, Young Sup; Shim, In Hee; Wang, Hee-Ryung; Song, Hoo Rim; Jun, Tae-Youn; Bahk, Won-Myong

    2015-03-15

    The major aims of this study were to identify factors that may predict the diagnostic conversion from major depressive disorder (MDD) to bipolar disorder (BP) and to evaluate the predictive performance of the bipolar spectrum disorder (BPSD) diagnostic criteria. The medical records of 250 patients with a diagnosis of MDD for at least 5 years were retrospectively reviewed for this study. The diagnostic conversion from MDD to BP was observed in 18.4% of 250 MDD patients, and the diagnostic criteria for BPSD predicted this conversion with high sensitivity (0.870) and specificity (0.917). A family history of BP, antidepressant-induced mania/hypomania, brief major depressive episodes, early age of onset, antidepressant wear-off, and antidepressant resistance were also independent predictors of this conversion. This study was conducted using a retrospective design and did not include structured diagnostic interviews. The diagnostic criteria for BPSD were highly predictive of the conversion from MDD to BP, and conversion was associated with several clinical features of BPSD. Thus, the BPSD diagnostic criteria may be useful for the prediction of bipolar diathesis in MDD patients. Copyright © 2014 Elsevier B.V. All rights reserved.

  6. Diagnostic overlap of depressive, anxiety, stress and somatoform disorders in primary care.

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    Bener, Abdulbari; Al-Kazaz, Mohammed; Ftouni, Darine; Al-Harthy, Munjid; Dafeeah, Elnour E

    2013-03-01

    The aim of the present study was to determine the prevalence of somatization, anxiety, depression and stress in a primary care population, explore their association to psychosocial stressors and determine the diagnostic overlap of these four mental disorders. This is a prospective cross-sectional study. A representative sample of 2,150 patients was approached, of whom 1,762 patients agreed to participate and responded to the questionnaire (81.9%). Anxiety was assessed with the Generalized Anxiety Disorder Scale (GAD-7). Depression was assessed with the depression module Patients Health Questionnaire-8. Somatization was measured with the somatic symptom module PHQ-15. The Perceived Stress Scale (PSS) instrument was used to identify the stress cases. Of the study sample, 23.8% of the total cases were identified as probable cases. The prevalence of somatization, depression, anxiety and stress was 11.7%, 11.3%, 8.3% and 18.6%, respectively. The specific gender prevalence of these four psychological disorders was very similar in men and women: depression (11.3% versus 11.3%), anxiety (7.7% versus 8.9%), somatization (12.5% versus 10.7%) and stress disorders (19.3% versus 17.8%). A significant difference was observed in nationality and marital status for depression and anxiety (P depression (13.3%), anxiety (9.5%), somatization (12.8%) and stress (20.4%). Unable to control worries (69.2%) was the worst symptom for anxiety disorders, while the majority of the depressed patients wanted to hurt themselves (71.9%). Stomach pain (46.1%) was the most common symptom in somatic patients. Most of the patients experiencing stress could not cope with their daily duties (65.9%). There was a high comorbidity rate of depression, anxiety, somatization and stress observed in the studied population (9.3%). The prevalence of somatization and depression was similar, but the prevalence of stress was higher in inpatient patients. Somatization, depression, anxiety and stress disorders co

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

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

    2008-01-01

    Background: The aim of the study was to investigate whether patients with bipolar depression and patients with recurrent depressive disorder present with different subtypes of depressive episode as according to ICD-10. Sampling and Methods: All patients who got a diagnosis of bipolar affective...... disorder, current episode of depression, or a diagnosis of recurrent depressive disorder, current episode of depression, in a period from 1994 to 2002 at the first outpatient treatment or at the first discharge from psychiatric hospitalization in Denmark were identified in a nationwide register. Results......: Totally, 389 patients got a diagnosis of bipolar disorder, current episode of depression, and 5.391 patients got a diagnosis of recurrent depressive disorder, current episode of depression, at first contact. Compared with patients with a diagnosis of recurrent depressive disorder, patients with bipolar...

  8. Distinguishing bipolar II depression from major depressive disorder with comorbid borderline personality disorder: demographic, clinical, and family history differences.

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    Zimmerman, Mark; Martinez, Jennifer H; Morgan, Theresa A; Young, Diane; Chelminski, Iwona; Dalrymple, Kristy

    2013-09-01

    Because of the potential treatment implications, it is clinically important to distinguish between bipolar II depression and major depressive disorder with comorbid borderline personality disorder. The high frequency of diagnostic co-occurrence and resemblance of phenomenological features has led some authors to suggest that borderline personality disorder is part of the bipolar spectrum. Few studies have directly compared patients with bipolar disorder and borderline personality disorder. In the present study from the Rhode Island Methods to Improve Diagnostic Assessment and Services project, we compared these 2 groups of patients on demographic, clinical, and family history variables. From December 1995 to May 2012, 3,600 psychiatric patients presenting to the outpatient practice at Rhode Island Hospital (Providence, Rhode Island) were evaluated with semistructured diagnostic interviews for DSM-IV Axis I and Axis II disorders. The focus of the present study is the 206 patients with DSM-IV major depressive disorder and borderline personality disorder (MDD-BPD) and 62 patients with DSM-IV bipolar II depression without borderline personality disorder. The patients with MDD-BPD were significantly more often diagnosed with posttraumatic stress disorder (P depression had a significantly higher morbid risk for bipolar disorder in their first-degree relatives than the MDD-BPD patients (P depression and major depressive disorder with comorbid borderline personality disorder differed on a number of clinical and family history variables, thereby supporting the validity of this distinction. © Copyright 2013 Physicians Postgraduate Press, Inc.

  9. Incidence and risk patterns of anxiety and depressive disorders and categorization of generalized anxiety disorder.

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    Beesdo, Katja; Pine, Daniel S; Lieb, Roselind; Wittchen, Hans-Ulrich

    2010-01-01

    Controversy surrounds the diagnostic categorization of generalized anxiety disorder (GAD). To examine the incidence, comorbidity, and risk patterns for anxiety and depressive disorders and to test whether developmental features of GAD more strongly support a view of this condition as a depressive as opposed to an anxiety disorder. Face-to-face, 10-year prospective longitudinal and family study with as many as 4 assessment waves. The DSM-IV Munich Composite International Diagnostic Interview was administered by clinically trained interviewers. Munich, Germany. A community sample of 3021 individuals aged 14 to 24 years at baseline and 21 to 34 years at last follow-up. Cumulative incidence of GAD, other anxiety disorders (specific phobias, social phobia, agoraphobia, and panic disorder), and depressive disorders (major depressive disorder, and dysthymia). Longitudinal associations between GAD and depressive disorders are not stronger than those between GAD and anxiety disorders or between other anxiety and depressive disorders. Survival analyses reveal that the factors associated with GAD overlap more strongly with those specific to anxiety disorders than those specific to depressive disorders. In addition, GAD differs from anxiety and depressive disorders with regard to family climate and personality profiles. Anxiety and depressive disorders appear to differ with regard to risk constellations and temporal longitudinal patterns, and GAD is a heterogeneous disorder that is, overall, more closely related to other anxiety disorders than to depressive disorders. More work is needed to elucidate the potentially unique aspects of pathways and mechanisms involved in the etiopathogenesis of GAD. Grouping GAD with depressive disorders, as suggested by cross-sectional features and diagnostic comorbidity patterns, minimizes the importance of longitudinal data on risk factors and symptom trajectories.

  10. Is the distinction between adjustment disorder with depressed mood and adjustment disorder with mixed anxious and depressed mood valid?

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    Zimmerman, Mark; Martinez, Jennifer H; Dalrymple, Kristy; Martinez, Jennifer H; Chelminski, Iwona; Young, Diane

    2013-11-01

    In the DSM-IV, adjustment disorder is subtyped according to the predominant presenting feature. The different diagnostic code numbers assigned to each subtype suggest their significance in DSM-IV. However, little research has examined the validity of these subtypes. In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we compared the demographic and clinical profiles of patients diagnosed with adjustment disorder subtypes to determine whether there was enough empirical evidence supporting the retention of multiple adjustment disorder subtypes in future versions of the DSM. A total of 3,400 psychiatric patients presenting to the Rhode Island Hospital outpatient practice were evaluated with semistructured diagnostic interviews for DSM-IV Axis I and Axis II disorders and measures of psychosocial morbidity. Approximately 7% (224 of 3,400) of patients were diagnosed with current adjustment disorder. Adjustment disorder with depressed mood and with mixed anxious and depressed mood were the most common subtypes, accounting for 80% of the patients diagnosed with adjustment disorder. There was no significant difference between these 2 groups with regard to demographic variables, current comorbid Axis I or Axis II disorders, lifetime history of major depressive disorder or anxiety disorders, psychosocial morbidity, or family history of psychiatric disorders. The only difference between the groups was lifetime history of drug use, which was significantly higher in the patients diagnosed with adjustment disorder with depressed mood. There is no evidence supporting the retention of both of these adjustment disorder subtypes, and DSM-IV previously set a precedent for eliminating adjustment disorder subtypes in the absence of any data. Therefore, in the spirit of nosologic parsimony, consideration should be given to collapsing the 2 disorders into 1: adjustment disorder with depressed mood.

  11. Impact of obesity on the psychometric properties of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for major depressive disorder.

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    Zimmerman, Mark; Hrabosky, Joshua I; Francione, Caren; Young, Diane; Chelminski, Iwona; Dalrymple, Kristy; Galione, Janine N

    2011-01-01

    Obesity is associated with several symptoms that are components of the diagnostic criteria for major depressive disorder (MDD). Compared with nonobese individuals, obese individuals report more fatigue, sleep disturbance, and overeating. Obesity might, therefore, impact the psychometric properties of the MDD criteria. The goal of the present report from the Rhode Island Hospital Methods to Improve Diagnostic Assessment and Services project was to examine the impact of obesity on the psychometric characteristics of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition symptom criteria for major depression. Two thousand four hundred forty-eight psychiatric outpatients were administered a semistructured diagnostic interview. We inquired about all symptoms of depression for all patients. The mean sensitivity of the 9 criteria in the nonobese and obese patients was nearly identical (74.6% vs 74.3%). The mean specificity was slightly higher in the nonobese patients (82.0% vs 79.5%). No symptom was more specific in the obese than the nonobese patients, whereas the specificity of increased appetite, increased weight, and fatigue was more than 5% lower in the obese patients. Increased appetite, increased weight, hypersomnia, and fatigue had a higher sensitivity in the obese than the nonobese patients, whereas decreased appetite, weight loss, and diminished concentration had a higher sensitivity in the nonobese than the obese patients. Thus, although there were small differences between obese and nonobese patients in the operating characteristics of some symptoms, the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for MDD generally performed equally well for obese and nonobese patients. Copyright © 2011 Elsevier Inc. All rights reserved.

  12. Prevalence of Depressive Disorder of Outpatients Visiting Two Primary Care Settings.

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    Jo, Sun-Jin; Yim, Hyeon Woo; Jeong, Hyunsuk; Song, Hoo Rim; Ju, Sang Yhun; Kim, Jong Lyul; Jun, Tae-Youn

    2015-09-01

    Although the prevalence of depressive disorders in South Korea's general population is known, no reports on the prevalence of depression among patients who visit primary care facilities have been published. This preliminary study was conducted to identify the prevalence of depressive disorder in patients that visit two primary care facilities. Among 231 consecutive eligible patients who visited two primary care settings, 184 patients consented to a diagnostic interview for depression by psychiatrists following the Diagnostic and Statistical Manual of Mental Disorders-IV criteria. There were no significant differences in sociodemographic characteristics such as gender, age, or level of education between the groups that consented and declined the diagnostic examination. The prevalence of depressive disorder and the proportion of newly diagnosed patients among depressive disorder patients were calculated. The prevalence of depressive disorder of patients in the two primary care facilities was 14.1% (95% confidence interval [CI], 9.1 to 19.2), with major depressive disorder 5.4% (95% CI, 2.1 to 8.7), dysthymia 1.1% (95% CI, 0.0 to 2.6), and depressive disorder, not otherwise specified 7.6% (95% CI, 3.7 to 11.5). Among the 26 patients with depressive disorder, 19 patients were newly diagnosed. As compared to the general population, a higher prevalence of depressive disorders was observed among patients at two primary care facilities. Further study is needed with larger samples to inform the development of a primary care setting-based depression screening, management, and referral system to increase the efficiency of limited health care resources.

  13. Prevalence of Depressive Disorder of Outpatients Visiting Two Primary Care Settings

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    Sun-Jin Jo

    2015-09-01

    Full Text Available Objectives: Although the prevalence of depressive disorders in South Korea’s general population is known, no reports on the prevalence of depression among patients who visit primary care facilities have been published. This preliminary study was conducted to identify the prevalence of depressive disorder in patients that visit two primary care facilities. Methods: Among 231 consecutive eligible patients who visited two primary care settings, 184 patients consented to a diagnostic interview for depression by psychiatrists following the Diagnostic and Statistical Manual of Mental Disorders-IV criteria. There were no significant differences in sociodemographic characteristics such as gender, age, or level of education between the groups that consented and declined the diagnostic examination. The prevalence of depressive disorder and the proportion of newly diagnosed patients among depressive disorder patients were calculated. Results: The prevalence of depressive disorder of patients in the two primary care facilities was 14.1% (95% confidence interval [CI], 9.1 to 19.2, with major depressive disorder 5.4% (95% CI, 2.1 to 8.7, dysthymia 1.1% (95% CI, 0.0 to 2.6, and depressive disorder, not otherwise specified 7.6% (95% CI, 3.7 to 11.5. Among the 26 patients with depressive disorder, 19 patients were newly diagnosed. Conclusions: As compared to the general population, a higher prevalence of depressive disorders was observed among patients at two primary care facilities. Further study is needed with larger samples to inform the development of a primary care setting-based depression screening, management, and referral system to increase the efficiency of limited health care resources.

  14. Symmetrical treatment of "Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition", for major depressive disorders.

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    Sawamura, Jitsuki; Morishita, Shigeru; Ishigooka, Jun

    2016-01-01

    We previously presented a group theoretical model that describes psychiatric patient states or clinical data in a graded vector-like format based on modulo groups. Meanwhile, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5, the current version), is frequently used for diagnosis in daily psychiatric treatments and biological research. The diagnostic criteria of DSM-5 contain simple binominal items relating to the presence or absence of specific symptoms. In spite of its simple form, the practical structure of the DSM-5 system is not sufficiently systemized for data to be treated in a more rationally sophisticated way. To view the disease states in terms of symmetry in the manner of abstract algebra is considered important for the future systematization of clinical medicine. We provide a simple idea for the practical treatment of the psychiatric diagnosis/score of DSM-5 using depressive symptoms in line with our previously proposed method. An expression is given employing modulo-2 and -7 arithmetic (in particular, additive group theory) for Criterion A of a 'major depressive episode' that must be met for the diagnosis of 'major depressive disorder' in DSM-5. For this purpose, the novel concept of an imaginary value 0 that can be recognized as an explicit 0 or implicit 0 was introduced to compose the model. The zeros allow the incorporation or deletion of an item between any other symptoms if they are ordered appropriately. Optionally, a vector-like expression can be used to rate/select only specific items when modifying the criterion/scale. Simple examples are illustrated concretely. Further development of the proposed method for the criteria/scale of a disease is expected to raise the level of formalism of clinical medicine to that of other fields of natural science.

  15. Detecting depressive and anxiety disorders in distressed patients in primary care; comparative diagnostic accuracy of the Four-Dimensional Symptom Questionnaire (4DSQ) and the Hospital Anxiety and Depression Scale (HADS).

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    Terluin, Berend; Brouwers, Evelien P M; van Marwijk, Harm W J; Verhaak, Peter F M; van der Horst, Henriëtte E

    2009-08-23

    Depressive and anxiety disorders often go unrecognized in distressed primary care patients, despite the overtly psychosocial nature of their demand for help. This is especially problematic in more severe disorders needing specific treatment (e.g. antidepressant pharmacotherapy or specialized cognitive behavioural therapy). The use of a screening tool to detect (more severe) depressive and anxiety disorders may be useful not to overlook such disorders. We examined the accuracy with which the Four-Dimensional Symptom Questionnaire (4DSQ) and the Hospital Anxiety and Depression Scale (HADS) are able to detect (more severe) depressive and anxiety disorders in distressed patients, and which cut-off points should be used. Seventy general practitioners (GPs) included 295 patients on sick leave due to psychological problems. They excluded patients with recognized depressive or anxiety disorders. Patients completed the 4DSQ and HADS. Standardized diagnoses of DSM-IV defined depressive and anxiety disorders were established with the Composite International Diagnostic Interview (CIDI). Receiver Operating Characteristic (ROC) analyses were performed to obtain sensitivity and specificity values for a range of scores, and area under the curve (AUC) values as a measure of diagnostic accuracy. With respect to the detection of any depressive or anxiety disorder (180 patients, 61%), the 4DSQ and HADS scales yielded comparable results with AUC values between 0.745 and 0.815. Also with respect to the detection of moderate or severe depressive disorder, the 4DSQ and HADS depression scales performed comparably (AUC 0.780 and 0.739, p 0.165). With respect to the detection of panic disorder, agoraphobia and social phobia, the 4DSQ anxiety scale performed significantly better than the HADS anxiety scale (AUC 0.852 versus 0.757, p 0.001). The recommended cut-off points of both HADS scales appeared to be too low while those of the 4DSQ anxiety scale appeared to be too high. In general

  16. Diagnostic utility of a one-item question to screen for depressive disorders: results from the KORA F3 study.

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    Blozik, Eva; Scherer, Martin; Lacruz, Maria E; Ladwig, Karl-Heinz

    2013-12-23

    Screening for depressive disorders in the general adult population is recommended, however, it is unclear which instruments combine user friendliness and diagnostic utility. We evaluated the test performance of a yes/no single item screener for depressive disorders ("Have you felt depressed or sad much of the time in the past year?") in comparison to the depressive disorder module of the Patient Health Questionnaire (PHQ-9). Data from 3184 participants of the population-based KORA F3 survey in Augsburg/ Germany were used to analyse sensitivity, specificity, ROC area, positive likelihood ratio (LR+), negative likelihood ratio (LR-), positive predictive value (PPV), and negative predictive value (NPV) of the single item screener in comparison with "depressive mood" and "major depressive disorder" defined according to PHQ-9 (both interviewer-administered versions). In comparison to PHQ-9 "depressive mood", sensitivity was low (46%) with an excellent specificity (94%), (PPV 76%; NPV 82%; LR + 8.04; LR- .572, ROC area .702). When using the more conservative definition for "major depressive disorder", sensitivity increased to 83% with a specificity of 88%. The PPV under the conservative definition was low (32%), but NPV was 99% (LR + 6.65; LR- .196; ROC area .852). Results varied across age groups and between males and females. The single item screener is able to moderately decrease post-test probability of major depressive disorders and to identify populations that should undergo additional, more detailed evaluation for depression. It may have limited utility in combination with additional screening tests or for selection of at-risk populations, but cannot be recommended for routine use as a screening tool in clinical practice.

  17. Depressive Personality Disorder: A Comparison of Three Self-Report Measures

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    Miller, Joshua D.; Tant, Adam; Bagby, R. Michael

    2010-01-01

    Depressive personality disorder (DPD) was included in the appendix of the "Diagnostic and Statistical Manual of Mental Disorders", Fourth Edition ("DSM-IV") for further study. Questions abound regarding this disorder in terms of its distinctiveness from extant diagnostic constructs and clinical significance.This study examines…

  18. Detecting depressive and anxiety disorders in distressed patients in primary care; comparative diagnostic accuracy of the Four-Dimensional Symptom Questionnaire (4DSQ and the Hospital Anxiety and Depression Scale (HADS

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    Verhaak Peter FM

    2009-08-01

    Full Text Available Abstract Background Depressive and anxiety disorders often go unrecognized in distressed primary care patients, despite the overtly psychosocial nature of their demand for help. This is especially problematic in more severe disorders needing specific treatment (e.g. antidepressant pharmacotherapy or specialized cognitive behavioural therapy. The use of a screening tool to detect (more severe depressive and anxiety disorders may be useful not to overlook such disorders. We examined the accuracy with which the Four-Dimensional Symptom Questionnaire (4DSQ and the Hospital Anxiety and Depression Scale (HADS are able to detect (more severe depressive and anxiety disorders in distressed patients, and which cut-off points should be used. Methods Seventy general practitioners (GPs included 295 patients on sick leave due to psychological problems. They excluded patients with recognized depressive or anxiety disorders. Patients completed the 4DSQ and HADS. Standardized diagnoses of DSM-IV defined depressive and anxiety disorders were established with the Composite International Diagnostic Interview (CIDI. Receiver Operating Characteristic (ROC analyses were performed to obtain sensitivity and specificity values for a range of scores, and area under the curve (AUC values as a measure of diagnostic accuracy. Results With respect to the detection of any depressive or anxiety disorder (180 patients, 61%, the 4DSQ and HADS scales yielded comparable results with AUC values between 0.745 and 0.815. Also with respect to the detection of moderate or severe depressive disorder, the 4DSQ and HADS depression scales performed comparably (AUC 0.780 and 0.739, p 0.165. With respect to the detection of panic disorder, agoraphobia and social phobia, the 4DSQ anxiety scale performed significantly better than the HADS anxiety scale (AUC 0.852 versus 0.757, p 0.001. The recommended cut-off points of both HADS scales appeared to be too low while those of the 4DSQ anxiety

  19. Exploratory Study of the Diagnostic Abilities of the Baptista Depression Scale Adult Version (EBADEP-A

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    Makilim Nunes Baptista

    2013-09-01

    Full Text Available This study’s objective was to analyze the diagnostic capabilities of a depression screening scale. For that, this scale was administered along with two diagnostic instruments, namely, the structured clinical interview from the DSM-IV (SCID-CV and the Hamilton Depression Scale (HAM-D, which are considered to be the gold standard for diagnosing depressive disorders. Participants were 22 subjects diagnosed by psychiatrists with Major Depressive Disorder. The EBADEP-A correctly identified cases of depression, showing a high correlation with the HAM-D, which indicates the scale correctly captures most depressive symptoms, even though it was initially used as a depression-screening tool.

  20. Two-year course of depressive and anxiety disorders: Results from the Netherlands Study of Depression and Anxiety (NESDA).

    NARCIS (Netherlands)

    Penninx, B.W.J.H.; Nolen, W.A.; Lamers, F.; Zitman, F.G.; Smit, J.H.; Spinhoven, P.; Cuijpers, P.; de Jong, P.J.; van Marwijk, H.W.J.; van der Meer, K.; Verhaak, P.; Laurant, M.G.H.; de Graaf, R.; Hoogendijk, W.J.; van der Wee, N.; Ormel, J.; van Dyck, R.; Beekman, A.T.F.

    2011-01-01

    Background: Whether course trajectories of depressive and anxiety disorders are different, remains an important question for clinical practice and informs future psychiatric nosology. This longitudinal study compares depressive and anxiety disorders in terms of diagnostic and symptom course

  1. Two-year course of depressive and anxiety disorders: Results from the Netherlands Study of Depression and Anxiety (NESDA)

    NARCIS (Netherlands)

    Penninx, B.W.J.H.; Nolen, W.A.; Lamers, F.; Zitman, F.G.; Smit, J.H.; Spinhoven, P.; Cuijpers, P.; Jong, P.J. de; Marwijk, H.W.J. van; Meer, K. van der; Verhaak, P.; Laurant, M.G.H.; Graaf, R. de; Hoogendijk, W.J.G.; Wee, N. van der; Ormel, J.; Dyck, R. van; Beekman, A.T.

    2011-01-01

    BACKGROUND: Whether course trajectories of depressive and anxiety disorders are different, remains an important question for clinical practice and informs future psychiatric nosology. This longitudinal study compares depressive and anxiety disorders in terms of diagnostic and symptom course

  2. Two-year course of depressive and anxiety disorders : Results from the Netherlands Study of Depression and Anxiety (NESDA)

    NARCIS (Netherlands)

    Penninx, B.W.; Nolen, W.A.; Lamers, F.; Zitman, F.G.; Smit, J.H.; Spinhoven, P.; Cuijpers, P.; de Jong, P.J.; van Marwijk, H.W.; van der Meer, K.; Verhaak, P.; Laurant, M.G.; de Graaf, R.; Hoogendijk, W.J.; van der Wee, N.; Ormel, J.; van Dyck, R.; Beekman, A.T.

    Background: Whether course trajectories of depressive and anxiety disorders are different, remains an important question for clinical practice and informs future psychiatric nosology. This longitudinal study compares depressive and anxiety disorders in terms of diagnostic and symptom course

  3. Two-year course of depressive and anxiety disorders: results from the Netherlands Study of Depression and Anxiety (NESDA).

    NARCIS (Netherlands)

    Penninx, B.W.J.H.; Nolen, W.A.; Lamers, F.; Zitman, F.G.; Smit, J.H.; Spinhoven, P.; Cuijpers, P.; Jong, P.J. de; Marwijk, H.W.J. van; Meer, K. van der; Verhaak, P.; Laurant, M.G.H.; Graaf, R. de; Hoogendijk, W.J.; Wee, N. van der; Ormel, J.; Dyck, R. van; Beekman, A.T.F.

    2011-01-01

    BACKGROUND: Whether course trajectories of depressive and anxiety disorders are different, remains an important question for clinical practice and informs future psychiatric nosology. This longitudinal study compares depressive and anxiety disorders in terms of diagnostic and symptom course

  4. Parent-Child Diagnostic Agreement on Anxiety Symptoms with a Structured Diagnostic Interview for Mental Disorders in Children.

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    Popp, Lukka; Neuschwander, Murielle; Mannstadt, Sandra; In-Albon, Tina; Schneider, Silvia

    2017-01-01

    Objective: In clinical structured diagnostic interviews, diagnoses based on parent and child reports have low to moderate agreement. The aims of the present study are (1) to examine diagnostic agreement on anxiety disorders between parents and children on the levels of current and lifetime diagnostic category and diagnoses focusing in particular on diagnostic criteria and (2) to identify parent- and child-related predictors for diagnostic agreement. Method: The sample consisted of 166 parent-child dyads interviewed with the Structured Diagnostic Interview for Mental Disorders in Children (Kinder-DIPS, Schneider et al., 2009). The children (51.8% girls) were between the ages of 7 and 18 years ( M = 10.94; SD = 2.22). Results: Overall, parent-child agreement on the diagnostic category of anxiety disorder ( k = 0.21; k = 0.22) and the specific anxiety diagnoses (base rate > 10%) of social phobia, specific phobia and separation anxiety disorder ( k = 0.24-0.52; k = 0.19-0.43) and corresponding diagnostic criteria ( k = 0.22-0.67; k = 0.24-0.41) were low to moderate with the highest agreement on separation anxiety disorder ( k > 0.43). Lower maternal depression, and higher social support reported by mother and father were associated with higher parent-child agreement. Maternal depression was indicated as the strongest predictor. Parental sense of competence, parental anxiety, the amount of parent-child interaction and the child's age and gender had no predictive value. Conclusions: Parent-child agreement can be expected to be higher on the level of anxiety criteria compared to specific anxiety diagnoses and diagnostic anxiety category. Psychological strains in the family-especially maternal depression and low social support-lower the parent-child agreement on anxiety symptoms. Child- and relation-related variables (age, gender, amount of time parent(s) and children interact) play no role in the prediction of low parent-child agreement.

  5. Seasonality in depressive and anxiety symptoms among primary care patients and in patients with depressive and anxiety disorders; results from the Netherlands Study of Depression and Anxiety

    Science.gov (United States)

    2011-01-01

    Background Little is known about seasonality of specific depressive symptoms and anxiety symptoms in different patient populations. This study aims to assess seasonal variation of depressive and anxiety symptoms in a primary care population and across participants who were classified in diagnostic groups 1) healthy controls 2) patients with a major depressive disorder, 3) patients with any anxiety disorder and 4) patients with a major depression and any anxiety disorder. Methods Data were used from the Netherlands Study of Depression and Anxiety (NESDA). First, in 5549 patients from the NESDA primary care recruitment population the Kessler-10 screening questionnaire was used and data were analyzed across season in a multilevel linear model. Second, in 1090 subjects classified into four groups according to psychiatric status according to the Composite International Diagnostic Interview, overall depressive symptoms and atypical versus melancholic features were assessed with the Inventory of Depressive Symptoms. Anxiety and fear were assessed with the Beck Anxiety Inventory and the Fear questionnaire. Symptom levels across season were analyzed in a linear regression model. Results In the primary care population the severity of depressive and anxiety symptoms did not show a seasonal pattern. In the diagnostic groups healthy controls and patients with any anxiety disorder, but not patients with a major depressive disorder, showed a small rise in depressive symptoms in winter. Atypical and melancholic symptoms were both elevated in winter. No seasonal pattern for anxiety symptoms was found. There was a small gender related seasonal effect for fear symptoms. Conclusions Seasonal differences in severity or type of depressive and anxiety symptoms, as measured with a general screening instrument and symptom questionnaires, were absent or small in effect size in a primary care population and in patient populations with a major depressive disorder and anxiety disorders. PMID

  6. Are Worry and Rumination Specific Pathways Linking Neuroticism and Symptoms of Anxiety and Depression in Patients with Generalized Anxiety Disorder, Major Depressive Disorder and Mixed Anxiety-Depressive Disorder?

    Science.gov (United States)

    Merino, Hipólito; Senra, Carmen; Ferreiro, Fátima

    2016-01-01

    This study examines the relationships between neuroticism (higher-order vulnerability factor), the cognitive styles of worry, brooding and reflection (second-order vulnerability factors) and symptoms of anxiety and depression in three groups of patients: patients with Generalized Anxiety Disorder (GAD), with Major Depressive Disorder (MDD) and with Mixed Anxiety-Depressive Disorder (MADD). One hundred and thirty four patients completed a battery of questionnaires including measures of neuroticism, worry, rumination (brooding and reflection), anxiety and depression. Multiple mediation analyses indicate that worry may act as a mediating mechanism linking neuroticism and anxiety symptoms in the three diagnostic groups, whereas brooding-rumination may play a mediating role between neuroticism and depressive symptoms in patients with MDD and MADD and, with less certainty, in patients with GAD. Overall, our findings suggest that neuroticism may increase the risk of anxious and depressive symptoms via specific links involving either worry or brooding, respectively, and that both worry and brooding may operate in the three groups examined, irrespectively of whether anxiety or depression are the main emotions or whether they coexist without any clear predominance; consequently, we hypothesize the existence of "specific transdiagnostic" mechanisms.

  7. Are Worry and Rumination Specific Pathways Linking Neuroticism and Symptoms of Anxiety and Depression in Patients with Generalized Anxiety Disorder, Major Depressive Disorder and Mixed Anxiety-Depressive Disorder?

    Science.gov (United States)

    Merino, Hipólito; Ferreiro, Fátima

    2016-01-01

    This study examines the relationships between neuroticism (higher-order vulnerability factor), the cognitive styles of worry, brooding and reflection (second-order vulnerability factors) and symptoms of anxiety and depression in three groups of patients: patients with Generalized Anxiety Disorder (GAD), with Major Depressive Disorder (MDD) and with Mixed Anxiety-Depressive Disorder (MADD). One hundred and thirty four patients completed a battery of questionnaires including measures of neuroticism, worry, rumination (brooding and reflection), anxiety and depression. Multiple mediation analyses indicate that worry may act as a mediating mechanism linking neuroticism and anxiety symptoms in the three diagnostic groups, whereas brooding-rumination may play a mediating role between neuroticism and depressive symptoms in patients with MDD and MADD and, with less certainty, in patients with GAD. Overall, our findings suggest that neuroticism may increase the risk of anxious and depressive symptoms via specific links involving either worry or brooding, respectively, and that both worry and brooding may operate in the three groups examined, irrespectively of whether anxiety or depression are the main emotions or whether they coexist without any clear predominance; consequently, we hypothesize the existence of "specific transdiagnostic" mechanisms. PMID:27243462

  8. Are Worry and Rumination Specific Pathways Linking Neuroticism and Symptoms of Anxiety and Depression in Patients with Generalized Anxiety Disorder, Major Depressive Disorder and Mixed Anxiety-Depressive Disorder?

    Directory of Open Access Journals (Sweden)

    Hipólito Merino

    Full Text Available This study examines the relationships between neuroticism (higher-order vulnerability factor, the cognitive styles of worry, brooding and reflection (second-order vulnerability factors and symptoms of anxiety and depression in three groups of patients: patients with Generalized Anxiety Disorder (GAD, with Major Depressive Disorder (MDD and with Mixed Anxiety-Depressive Disorder (MADD. One hundred and thirty four patients completed a battery of questionnaires including measures of neuroticism, worry, rumination (brooding and reflection, anxiety and depression. Multiple mediation analyses indicate that worry may act as a mediating mechanism linking neuroticism and anxiety symptoms in the three diagnostic groups, whereas brooding-rumination may play a mediating role between neuroticism and depressive symptoms in patients with MDD and MADD and, with less certainty, in patients with GAD. Overall, our findings suggest that neuroticism may increase the risk of anxious and depressive symptoms via specific links involving either worry or brooding, respectively, and that both worry and brooding may operate in the three groups examined, irrespectively of whether anxiety or depression are the main emotions or whether they coexist without any clear predominance; consequently, we hypothesize the existence of "specific transdiagnostic" mechanisms.

  9. DSM-5: proposed changes to depressive disorders.

    Science.gov (United States)

    Wakefield, Jerome C

    2012-03-01

    The Diagnostic and Statistical Manual of Mental Disorders (DSM) is currently undergoing a revision that will lead to a fifth edition in 2013. Proposed changes for DSM-5 include the creation of several new categories of depressive disorder. Some nosologists have expressed concern that the proposed changes could yield many 'false-positive diagnoses' in which normal distress is mislabeled as a mental disorder. Such confusion of normal distress and mental disorder undermines the interpretability of clinical trials and etiological research, causes inefficient allocation of resources, and incurs risks of unnecessary treatment. To evaluate these concerns, I critically examine five proposed DSM-5 expansions in the scope of depressive and grief disorders: (1) a new mixed anxiety/depression category; (2) a new premenstrual dysphoric disorder category; (3) elimination of the major depression bereavement exclusion; (4) elimination of the adjustment disorder bereavement exclusion, thus allowing the diagnosis of subsyndromal depressive symptoms during bereavement as adjustment disorders; and (5) a new category of adjustment disorder related to bereavement for diagnosing pathological non-depressive grief. I examine each proposal's face validity and conceptual coherence as well as empirical support where relevant, with special attention to potential implications for false-positive diagnoses. I conclude that mixed anxiety/depression and premenstrual dysphoric disorder are needed categories, but are too broadly drawn and will yield substantial false positives; that the elimination of the bereavement exclusion is not supported by the evidence; and that the proposed elimination of the adjustment-disorder bereavement exclusion, as well as the new category of grief-related adjustment disorder, are inconsistent with recent grief research, which suggests that these proposals would massively pathologize normal grief responses.

  10. Type of presentation of dissociative disorder and frequency of co-morbid depressive disorder.

    Science.gov (United States)

    Alvi, Tabassum; Minhas, Fareed Aslam

    2009-02-01

    To determine the frequency distribution of various types of dissociative disorders, along with existing co-morbid depression and its level of severity in patients with dissociative disorder. Observational, cross-sectional study. The Institute of Psychiatry, Rawalpindi General Hospital from October 2004 to March 2005. Fifty consecutive patients were included in the study through non-probable purposive sampling technique. Encounter form included socio-demographic profile and brief psychiatric history. ICD 10 diagnostic criteria for research were administered for determining the presentation of dissociative disorder. Present state examination was applied to make diagnosis of depressive disorder in the studied patients. Descriptive statistics for frequency analysis of sociodemographic variables, type of presentation of dissociative disorder and the frequency of depressive disorder in patients of dissociative disorder. The mean age was 23.6+/-8.67 years with female preponderance (n=40, 80% patients). Most of them were single, unemployed and belonged to urban population. Main stress was primary support group issue. Mixed category of dissociative disorder was highest (n=18, 38%) followed by unspecified and motor symptoms (n=13, 26%) in each group. Depression was present in 42 (84%) patients. Moderate depression was most frequent (n=19, 38%). Mixed dissociative symptoms were found in 38%, while 26% had motor and unspecified category of dissociative symptoms respectively. Depressive disorder was present in 42 (84%) cases of dissociative disorder with 38% having moderate depression.

  11. [Diagnosis of depressive disorder and so-called exhaustion depression. Self-esteem--a central concept].

    Science.gov (United States)

    Beck-Friis, Johan

    2002-02-07

    Depressive disorders can be recognized by the loss of self-esteem; this contrasts with mourning and neurasthenic reactions, in which self-esteem remains intact. Just as depression can result from the gradual reduction and eventual loss of self-esteem, mourning and neurasthenic reactions can evolve into true depressive states. "Exhaustion depression", a new diagnostic category connected to "burnout" situations, should be applied only when criteria for depressive disorder are fulfilled, including loss of self-esteem. When these criteria are lacking we should refer only to an exhaustion state provoked by stress. Neurotic mechanisms may represent a special class of relevant stress factors, but are not seen in manifest neurasthenic reactions and exhaustion depression.

  12. Disentangling depressive personality disorder from avoidant, borderline, and obsessive-compulsive personality disorders.

    Science.gov (United States)

    Huprich, Steven K; Zimmerman, Mark; Chelminski, Iwona

    2006-01-01

    Several studies have found that 3 personality disorders (PDs) tend to share moderate rates of comorbidity with depressive PD: avoidant, borderline, and obsessive-compulsive. This study sought to evaluate the diagnostic criteria of each disorder in an effort to understand where areas of overlap may occur and to modify criteria sets where reasonable to reduce any degree of overlap. One thousand two hundred psychiatric outpatients were interviewed with the Structured Interview for DSM-IV Personality Disorders. The highest degree of comorbidity was observed between avoidant PD and depressive PD. Logistic regression analyses indicated that 2 criteria-avoidant criterion 5 and depressive criterion 2-could be removed from the diagnostic criteria sets and reduce the rates of overlap by as much as 15%. A factor analysis of the criteria of all 4 PDs indicated that there is a common clustering of many of the symptoms of avoidant, borderline, depressive, and obsessive-compulsive PDs and that borderline symptoms tend to cluster together most consistently. Avoidant and obsessive-compulsive personality symptoms clustered in ways that may reflect a problem of how to engage with others, suggestive of an approach-avoidance conflict. Depressive PD symptoms clustered in a way suggestive of problems with anger that is directed toward oneself and others. The factor analysis results suggest that an organization of symptoms around themes of conflict may provide useful ways of understanding the personality patterns of these 4 disorders.

  13. What characteristics of primary anxiety disorders predict subsequent major depressive disorder?

    Science.gov (United States)

    Bittner, Antje; Goodwin, Renee D; Wittchen, Hans-Ulrich; Beesdo, Katja; Höfler, Michael; Lieb, Roselind

    2004-05-01

    The goal of this study was to examine the associations between specific anxiety disorders and the risk of major depressive disorder and to explore the role of various clinical characteristics of anxiety disorders in these relationships using a prospective, longitudinal design. The data are from a 4-year prospective, longitudinal community study, which included both baseline and follow-up survey data on 2548 adolescents and young adults aged 14 to 24 years at baseline. DSM-IV diagnoses were made using the Munich-Composite International Diagnostic Interview. The presence at baseline of any anxiety disorder (odds ratio [OR] = 2.2 [95% CI = 1.6 to 3.2]) and each of the anxiety disorders (specific phobia, OR = 1.9 [95% CI = 1.3 to 2.8]; social phobia, OR = 2.9 [95% CI = 1.7 to 4.8]; agoraphobia, OR = 3.1 [95% CI = 1.4 to 6.7]; panic disorder, OR = 3.4 [95% CI = 1.2 to 9.0]; generalized anxiety disorder, OR = 4.5 [95% CI = 1.9 to 10.3]) was associated with a significantly (p depressive disorder. These associations remained significant after we adjusted for mental disorders occurring prior to the onset of the anxiety disorder, with the exception of the panic disorder association. The following clinical characteristics of anxiety disorders were associated with a significantly (p depressive disorder: more than 1 anxiety disorder, severe impairment due to the anxiety disorder, and comorbid panic attacks. In the final model, which included all clinical characteristics, severe impairment remained the only clinical characteristic that was an independent predictor of the development of major depressive disorder (OR = 2.2 [95% CI = 1.0 to 4.4]). Our findings suggest that anxiety disorders are risk factors for the first onset of major depressive disorder. Although a number of clinical characteristics of anxiety disorders appear to play a role in the association between anxiety disorders and depression, severe impairment is the strongest predictor of major depressive disorder.

  14. The relevance of 'mixed anxiety and depression' as a diagnostic category in clinical practice.

    Science.gov (United States)

    Möller, Hans-Jürgen; Bandelow, Borwin; Volz, Hans-Peter; Barnikol, Utako Birgit; Seifritz, Erich; Kasper, Siegfried

    2016-12-01

    According to ICD-10 criteria, mixed anxiety and depressive disorder (MADD) is characterized by co-occurring, subsyndromal symptoms of anxiety and depression, severe enough to justify a psychiatric diagnosis, but neither of which are clearly predominant. MADD appears to be very common, particularly in primary care, although prevalence estimates vary, often depending on the diagnostic criteria applied. It has been associated with similarly pronounced distress, impairment of daily living skills, and reduced health-related quality of life as fully syndromal depression and anxiety. Although about half of the patients affected remit within a year, non-remitting patients are at a high risk of transition to a fully syndromal psychiatric disorder. The validity and clinical usefulness of MADD as a diagnostic category are under debate. It has not been included in the recently released DSM-5 since the proposed diagnostic criteria turned out to be not sufficiently reliable. Moreover, reviewers have disputed the justification of MADD based on divergent results regarding its prevalence and course, diagnostic stability over time, and nosological inconsistencies between subthreshold and threshold presentations of anxiety and depressive disorders. We review the evidence in favor and against MADD and argue that it should be included into classification systems as a diagnostic category because it may enable patients to gain access to appropriate treatment early. This may help to reduce patients' distress, prevent exacerbation to a more serious psychiatric disorder, and ultimately reduce the societal costs of this very common condition.

  15. Comorbid personality disorders among patients with depression

    Directory of Open Access Journals (Sweden)

    Wongpakaran N

    2015-04-01

    Full Text Available Nahathai Wongpakaran, Tinakon Wongpakaran, Vudhichai Boonyanaruthee, Manee Pinyopornpanish, Suthi Intaprasert Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand Purpose: To investigate the personality disorders (PDs diagnosed in patients with depressive disorders.Material and methods: This study included a cross-sectional analysis, and was an extension of the Thai Study of Affective Disorder (THAISAD project. Eighty-five outpatients with depressive disorders were interviewed using the Mini International Neuropsychiatric Inventory to assess for depression, in accordance with the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision and using the Thai version of the Structured Clinical Interview for PDs to assess for PD.Results: Seventy-seven percent of the patients had at least one PD, 40% had one PD and 60% had two or more PDs (mixed cluster. The most common PDs found were borderline PD (20% and obsessive–compulsive PD (10.6%, while the occurrence of avoidant PD was low when compared to the findings of previous, related studies. Among the mixed cluster, cluster A combined with cluster C was the common mix. Both dysthymic disorder and double depression were found to have a higher proportion of PDs than major depressive disorder (85.7% versus 76.1%. Dependent PD was found to be less common in this study than in previous studies, including those carried out in Asia.Conclusion: The prevalence of PDs among those with depressive disorder varied, and only borderline PD seems to be consistently high within and across cultures. Mixed cluster plays a prominent role in depression, so more attention should be paid to patients in this category. Keywords: personality disorders, depressive disorder, prevalence, Asian, mixed cluster, SCID-II

  16. Association between obesity and depressive disorder in adolescents at high risk for depression.

    Science.gov (United States)

    Hammerton, G; Thapar, A; Thapar, A K

    2014-04-01

    To examine the relationship between Body Mass Index (BMI) and depressive disorder in adolescents at high risk for depression. Prospective longitudinal 3-wave study of offspring of parents with recurrent depression. Replication in population-based cohort study. Three hundred and thirty-seven families where offspring were aged 9-17 years at baseline and 10-19 years at the final data point. Replication sample of adolescents from population-based cohort study aged 11-13 years at first assessment and 14-17 years at follow-up. High risk sample used BMI, skin-fold thickness, Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV)-defined major depressive disorder and depression symptoms using the Child and Adolescent Psychiatric Assessment (CAPA). Replication sample used BMI, DSM-IV depressive disorder and depression symptoms using the Development and Well-Being Assessment (DAWBA). Two hundred and eighty-nine adolescents were included in the primary analyses. The mean BMI for each age group in this sample were significantly higher than population norms. There was no significant longitudinal association between categories of weight (or BMI) and new onset depressive disorder or depression symptoms. Similar results were found for skin-fold thickness. The association was also tested in a replication population-based sample and found to be non-significant in the subsample of offspring with mothers who had experienced recurrent depression in the past. BMI at age 12 years was, however, a significant predictor of depression symptoms but not of depressive disorder at age 15 years for the total unselected population. BMI does not significantly predict the development of depression in the offspring of parents with recurrent depression.

  17. Dimensional depression severity in women with major depression and post-traumatic stress disorder correlates with fronto-amygdalar hypoconnectivty.

    Science.gov (United States)

    Satterthwaite, T D; Cook, P A; Bruce, S E; Conway, C; Mikkelsen, E; Satchell, E; Vandekar, S N; Durbin, T; Shinohara, R T; Sheline, Y I

    2016-07-01

    Depressive symptoms are common in multiple psychiatric disorders and are frequent sequelae of trauma. A dimensional conceptualization of depression suggests that symptoms should be associated with a continuum of deficits in specific neural circuits. However, most prior investigations of abnormalities in functional connectivity have typically focused on a single diagnostic category using hypothesis-driven seed-based analyses. Here, using a sample of 105 adult female participants from three diagnostic groups (healthy controls, n=17; major depression, n=38; and post-traumatic stress disorder, n=50), we examine the dimensional relationship between resting-state functional dysconnectivity and severity of depressive symptoms across diagnostic categories using a data-driven analysis (multivariate distance-based matrix regression). This connectome-wide analysis identified foci of dysconnectivity associated with depression severity in the bilateral amygdala. Follow-up seed analyses using subject-specific amygdala segmentations revealed that depression severity was associated with amygdalo-frontal hypo-connectivity in a network of regions including bilateral dorsolateral prefrontal cortex, anterior cingulate and anterior insula. In contrast, anxiety was associated with elevated connectivity between the amygdala and the ventromedial prefrontal cortex. Taken together, these results emphasize the centrality of the amygdala in the pathophysiology of depressive symptoms, and suggest that dissociable patterns of amygdalo-frontal dysconnectivity are a critical neurobiological feature across clinical diagnostic categories.

  18. Premenstrual dysphoric disorder in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition: contributions from Asia.

    Science.gov (United States)

    Mehta, N; Mehta, S

    2014-12-01

    Premenstrual dysphoric disorder has been included as a separate diagnostic entity in the chapter of 'Depressive Disorders' of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). The antecedent, concurrent, and predictive diagnostic validators of premenstrual dysphoric disorder have been reviewed by a sub-workgroup of the DSM-5 Mood Disorders Work Group, which includes a panel of experts on women's mental health. Contributions from the Asian continent have been mainly in the form of prevalence studies. Genetic and neurobiological domains of premenstrual dysphoric disorder largely remain untouched in Asia and offer a potential area for investigation.

  19. Comparing Diagnostic Tools in Personality Disorders

    Directory of Open Access Journals (Sweden)

    Emel AKGUN AKTAS

    2016-04-01

    Full Text Available Personality Disorder is defined as; continually self experience and behavioral pattern which has great variations of individual cultural normal expectations. Several diagnostic tools were developed for diagnosing personality disorders. In our study consistency of different diagnostic tools used for thhe diagnosis of personality disorders were evaluated. 39 inpatients diagnosed as personality disorder from Diskapi Yildirim Beyazit Traning and Reseach Hospital were recruited into the study. Psychotic patients are excluded from the study. Sociodemographic Information Form, MMPI and PBQ scales were given all the patients. Both PBQ personality subscales and MMPI PD scales were compared with semi-structured SCID-II interview diagnoses. Findings suggest less correlation than expected. Relatively higher correlation was found between PBQ personality subscales and MMPI-PD. Most common psychiatric comorbid disorder was depression. These findings suggest that further studies are needed for the development of diagnostic tools which take the differences of self report scales and clinical evalution into consideration. Beside, the differences of the categorical and dimensional classification of personality disorders should be bear in mind in evaluation of this patient group. [JCBPR 2016; 5(1.000: 22-27

  20. A pilot study differentiating recurrent major depression from bipolar disorder cycling on the depressive pole

    OpenAIRE

    Hinz, Marty; Stein, Alvin; Uncini, Thomas

    2010-01-01

    Marty Hinz1, Alvin Stein2, Thomas Uncini31Clinical Research, NeuroResearch Clinics, Inc., Cape Coral, FL, USA; 2Stein Orthopedic Associates, Plantation, FL, USA; 3DBS Labs, Duluth, MN, USAPurpose: A novel method for differentiating and treating bipolar disorder cycling on the depressive pole from patients who are suffering a major depressive episode is explored in this work. To confirm the diagnosis of type 1 or type 2 bipolar disorder, the Diagnostic and Statistical Manual of Mental Disorder...

  1. 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.

  2. Reconsidering the prognosis of major depressive disorder across diagnostic boundaries: full recovery is the exception rather than the rule.

    Science.gov (United States)

    Verduijn, Judith; Verhoeven, Josine E; Milaneschi, Yuri; Schoevers, Robert A; van Hemert, Albert M; Beekman, Aartjan T F; Penninx, Brenda W J H

    2017-12-12

    Major depressive disorder (MDD) is often handled as an episodic and isolated disorder, resulting in an optimistic view about its prognosis. Herein, we test the idea that the prognosis of MDD changes if we vary the perspective in terms of (1) a longer time frame and (2) a broader diagnostic conceptualisation including dysthymia, (hypo)mania and anxiety disorders as relevant outcomes. Patients with current MDD at baseline (n = 903) and available 2-, 4-, and/or 6-year follow-up assessments were selected from the Netherlands Study of Depression and Anxiety, a psychiatric cohort study. Combining psychiatric DSM-IV-based diagnoses and life-chart data, patient course trajectories were classified as (1) recovered (no diagnoses at 2-year follow-up or thereafter), (2) recurrent without chronic episodes, (3) recurrent with chronic episodes or (4) consistently chronic since baseline. A chronic episode was defined as having a current diagnosis at the follow-up assessment and consistent symptoms over 2 years. Proportions of course trajectories were provided moving from a short, narrow perspective (2-year follow-up, considering only MDD diagnosis) to a long, broad perspective (6-year follow-up, including MDD, dysthymia, (hypo)mania and anxiety diagnoses). With the short, narrow perspective, the recovery rate was 58% and 21% had a chronic episode. However, in the long, broad perspective the recovery rate was reduced to 17%, while 55% of the patients experienced chronic episodes. Results from a long and rigorous follow-up in a large cohort suggests that most MDD patients have an unfavourable prognosis. Longer follow-up and broader diagnostic conceptualisation show that the majority of patients have a disabling and chronic disorder. Conceptualising and handling MDD as a narrowly defined and episodic disorder may underestimate the prognosis of the majority of depressed patients and, consequently, the type of care that is appropriate.

  3. Parent-Child Diagnostic Agreement on Anxiety Symptoms with a Structured Diagnostic Interview for Mental Disorders in Children

    Science.gov (United States)

    Popp, Lukka; Neuschwander, Murielle; Mannstadt, Sandra; In-Albon, Tina; Schneider, Silvia

    2017-01-01

    Objective: In clinical structured diagnostic interviews, diagnoses based on parent and child reports have low to moderate agreement. The aims of the present study are (1) to examine diagnostic agreement on anxiety disorders between parents and children on the levels of current and lifetime diagnostic category and diagnoses focusing in particular on diagnostic criteria and (2) to identify parent- and child-related predictors for diagnostic agreement. Method: The sample consisted of 166 parent-child dyads interviewed with the Structured Diagnostic Interview for Mental Disorders in Children (Kinder-DIPS, Schneider et al., 2009). The children (51.8% girls) were between the ages of 7 and 18 years (M = 10.94; SD = 2.22). Results: Overall, parent-child agreement on the diagnostic category of anxiety disorder (k = 0.21; k = 0.22) and the specific anxiety diagnoses (base rate > 10%) of social phobia, specific phobia and separation anxiety disorder (k = 0.24–0.52; k = 0.19–0.43) and corresponding diagnostic criteria (k = 0.22–0.67; k = 0.24–0.41) were low to moderate with the highest agreement on separation anxiety disorder (k > 0.43). Lower maternal depression, and higher social support reported by mother and father were associated with higher parent-child agreement. Maternal depression was indicated as the strongest predictor. Parental sense of competence, parental anxiety, the amount of parent-child interaction and the child's age and gender had no predictive value. Conclusions: Parent-child agreement can be expected to be higher on the level of anxiety criteria compared to specific anxiety diagnoses and diagnostic anxiety category. Psychological strains in the family—especially maternal depression and low social support—lower the parent-child agreement on anxiety symptoms. Child- and relation-related variables (age, gender, amount of time parent(s) and children interact) play no role in the prediction of low parent-child agreement. PMID:28396644

  4. Diagnostic performance of major depression disorder case-finding instruments used among mothers of young children in the United States: A systematic review.

    Science.gov (United States)

    Owora, Arthur H; Carabin, Hélène; Reese, Jessica; Garwe, Tabitha

    2016-09-01

    Growing recognition of the interrelated negative outcomes associated with major depression disorder (MDD) among mothers and their children has led to renewed public health interest in the early identification and treatment of maternal MDD. Healthcare providers, however, remain unsure of the validity of existing case-finding instruments. We conducted a systematic review to identify the most valid maternal MDD case-finding instrument used in the United States. We identified articles reporting the sensitivity and specificity of MDD case-finding instruments based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) by systematically searching through three electronic bibliographic databases, PubMed, PsycINFO, and EMBASE, from 1994 to 2014. Study eligibility and quality were evaluated using the Standards for the Reporting of Diagnostic Accuracy studies and Quality Assessment of Diagnostic Accuracy Studies guidelines respectively. Overall, we retrieved 996 unduplicated articles and selected 74 for full-text review. Of these, 14 articles examining 21 different instruments were included in the systematic review. The 10 item Edinburgh Postnatal Depression Scale and Postpartum Depression Screening Scale had the most stable (lowest variation) and highest diagnostic performance during the antepartum and postpartum periods (sensitivity range: 0.63-0.94 and 0.67-0.95; specificity range: 0.83-0.98 and 0.68-0.97 respectively). Greater variation in diagnostic performance was observed among studies with higher MDD prevalence. Factors that explain greater variation in instrument diagnostic performance in study populations with higher MDD prevalence were not examined. Findings suggest that the diagnostic performance of maternal MDD case-finding instruments is peripartum period-specific. Published by Elsevier B.V.

  5. [Diagnosis and treatment of anxiety-depressive disorders in patients with myocardial infarction].

    Science.gov (United States)

    Semiglazova, M V; Krasnov, V N; Dovzhenko, T V; Lebedev, A V

    2012-01-01

    The results of the study of psychopathological, somatic and functional characteristics of anxiety-depressive disorders in patients with acute myocardial infarction are presented. The authors confirmed the wide prevalence of these disorders in acute myocardial infarction and described the features of their diagnostics, dynamics and response to complex treatment. The impact of anxiety-depressive disorders on the clinical and functional state of the cardiovascular system and the dynamics of the patient's status due the concomitant anxiety-depressive disorder are considered.

  6. Low rates of depressed mood and depression diagnoses in a clinic review of children and adolescents with autistic disorder.

    Science.gov (United States)

    Henry, Charles A; Nowinski, Lisa; Koesterer, Karmen; Ferrone, Christine; Spybrook, Jessaca; Bauman, Margaret

    2014-09-01

    The purpose of this study was to investigate the prevalence of depression diagnoses and related clinical data in an outpatient sample of youth with autistic disorder. Records of 123 psychiatrically referred children and adolescents with a Diagnostic and Statistical Manual of Mental Disorders, 4th ed., Text Revision (DSM-IV-TR) diagnosis of autistic disorder were examined. Mood disorder diagnoses and chief complaints along with family mood disorder history were the primary variables analyzed. Four subjects (3%) presented with depressed mood. Irritability complaints were frequent (n=78, 63%). Six subjects (5%) received a mood disorder diagnosis; all with mood disorder, not otherwise specified. No subjects received a depressive disorder diagnosis. Family history of mood disorders was common. Findings raise questions about the appropriate characterization and potential misdiagnoses of depression in youth with autistic disorder.

  7. HPA-axis hyperactivity and mortality in psychotic depressive disorder: preliminary findings.

    Science.gov (United States)

    Coryell, William; Fiedorowicz, Jess; Zimmerman, Mark; Young, Elizabeth

    2008-06-01

    The excess mortality associated with depressive disorders has been most often attributed to risks for suicide but diverse findings indicate that depressive disorders also increase risks for cardiovascular (CV) mortality. Among the possible mediators is the hypothalamic-pituitary-adrenal (HPA)-axis hyperactivity that characterizes many cases of relatively severe depressive disorder and severity is characteristic of psychotic depressive disorder. The following describes a 17-year mortality follow-up of 54 patients with Research Diagnostic Criteria (RDC) psychotic major depression or schizoaffective, mainly affective, depression. All had baseline assessments that included a 1mg dexamethasone suppression test with post-dexamethasone samples at 8 a.m., 4 p.m. and 11 p.m. Regression analyses showed that both greater age and higher maximum post-dexamethasone cortisol concentrations predicted deaths due to CV causes (t=4.01, pdepressive disorder to CV mortality.

  8. The prevalence and clinical characteristics associated with Diagnostic and Statistical Manual Version-5-defined anxious distress specifier in adults with major depressive disorder

    DEFF Research Database (Denmark)

    McIntyre, Roger S.; Woldeyohannes, Hanna O; Soczynska, Joanna K

    2016-01-01

    OBJECTIVES: The aim of the study was to evaluate the prevalence of and illness characteristics in adults with major depressive disorder (MDD) with anxious distress specifier (ADS) enrolled in the International Mood Disorders Collaborative Project, which is a collaborative research platform...... at the Mood Disorders Psychopharmacology Unit, University of Toronto, Canada and the Cleveland Clinic, Cleveland, Ohio, USA. METHODS: Data from participants who met criteria for a current major depressive episode as part of MDD (n = 830) were included in this post hoc analysis. Diagnostic and Statistical......, employment, marital status). Greater severity of illness was observed in adults with ADS as evidenced by a higher number of hospitalizations, higher rates of suicidal ideation, greater depressive symptom severity, greater workplace impairment, decreased quality of life, and greater self-reported cognitive...

  9. Assessment of clinical depression comorbid with posttraumatic stress disorder

    Directory of Open Access Journals (Sweden)

    Simonović Maja

    2008-01-01

    Full Text Available Background/Aim. Comorbidity of the posttraumatic stress disorder (PTSD and depression is often recognized in the clinical practice. The aim of the paper was to determine the severity of depression and the group of symptoms which are the most prominent in clinical depression comorbid with PTSD. Methods. Totally 60 patients were assessed and divided into the experimental and control group using the Structured Clinical Interview for DSM-IV Axis I Disorders, Investigator Version (SCID-I, modified (SCID for DSM-IV and ICD-10 diagnostic criteria. The presence and the severity of the disorders were assessed by means of the following instruments: Clinician-Administrated PTSD Scale for DSM-IV (CAPS-DX, Montgomery-Asberg Depression Rating Scale (MADRS and 17-item Hamilton Rating Scale for Depression (HAMD. The differences between groups were evaluated using Student t test and by means of the correlation analysis of the data with p < 0.05. Results. The obtained results showed that depression witch was comorbid with PTSD was of significant clinical severity with 31.20 score on HAMD and 30.43 score on MADRS in PTSD-D group. The group of the symptoms: lassitude, inability to feel, suicidal thoughts and inner tension contributed mostly to the global severity of the comorbid clinical depression on MADRS. The group of the symptoms: suicide and somatic symptoms, gastrointestinal, guilt, hypochondriasis, work and activity, anxiety psychic, agitation, and weight loss, genital symptoms and anxiety somatic contributed mostly to the global severity of comorbid clinical depression on HAMD. The average score was 16.03 and 16.97 on HAMD and MADRS, respectively in PTSD group. Conclusion. Depression which is comorbid with posttraumatic stress disorder represents significant clinical entity with domination of the different groups of symptoms between the groups PTSD and PTSD-D on HAMD. Identification of aforementioned severity of illness and delineated group of symptoms lead

  10. Two-year course of depressive and anxiety disorders: results from the Netherlands Study of Depression and Anxiety (NESDA).

    Science.gov (United States)

    Penninx, Brenda W J H; Nolen, Willem A; Lamers, Femke; Zitman, Frans G; Smit, Johannes H; Spinhoven, Philip; Cuijpers, Pim; de Jong, Peter J; van Marwijk, Harm W J; van der Meer, Klaas; Verhaak, Peter; Laurant, Miranda G H; de Graaf, Ron; Hoogendijk, Witte J; van der Wee, Nic; Ormel, Johan; van Dyck, Richard; Beekman, Aartjan T F

    2011-09-01

    Whether course trajectories of depressive and anxiety disorders are different, remains an important question for clinical practice and informs future psychiatric nosology. This longitudinal study compares depressive and anxiety disorders in terms of diagnostic and symptom course trajectories, and examines clinical prognostic factors. Data are from 1209 depressive and/or anxiety patients residing in primary and specialized care settings, participating in the Netherlands Study of Depression and Anxiety. Diagnostic and Life Chart Interviews provided 2-year course information. Course was more favorable for pure depression (n=267, median episode duration = 6 months, 24.5% chronic) than for pure anxiety (n=487, median duration = 16 months, 41.9% chronic). Worst course was observed in the comorbid depression-anxiety group (n=455, median duration > 24 months, 56.8% chronic). Independent predictors of poor diagnostic and symptom trajectory outcomes were severity and duration of index episode, comorbid depression-anxiety, earlier onset age and older age. With only these factors a reasonable discriminative ability (C-statistic 0.72-0.77) was reached in predicting 2-year prognosis. Depression and anxiety cases concern prevalent - not incident - cases. This, however, reflects the actual patient population in primary and specialized care settings. Their differential course trajectory justifies separate consideration of pure depression, pure anxiety and comorbid anxiety-depression in clinical practice and psychiatric nosology. Copyright © 2011 Elsevier B.V. All rights reserved.

  11. Neuroanatomical Classification in a Population-Based Sample of Psychotic Major Depression and Bipolar I Disorder with 1 Year of Diagnostic Stability

    Directory of Open Access Journals (Sweden)

    Mauricio H. Serpa

    2014-01-01

    Full Text Available The presence of psychotic features in the course of a depressive disorder is known to increase the risk for bipolarity, but the early identification of such cases remains challenging in clinical practice. In the present study, we evaluated the diagnostic performance of a neuroanatomical pattern classification method in the discrimination between psychotic major depressive disorder (MDD, bipolar I disorder (BD-I, and healthy controls (HC using a homogenous sample of patients at an early course of their illness. Twenty-three cases of first-episode psychotic mania (BD-I and 19 individuals with a first episode of psychotic MDD whose diagnosis remained stable during 1 year of followup underwent 1.5 T MRI at baseline. A previously validated multivariate classifier based on support vector machine (SVM was employed and measures of diagnostic performance were obtained for the discrimination between each diagnostic group and subsamples of age- and gender-matched controls recruited in the same neighborhood of the patients. Based on T1-weighted images only, the SVM-classifier afforded poor discrimination in all 3 pairwise comparisons: BD-I versus HC; MDD versus HC; and BD-I versus MDD. Thus, at the population level and using structural MRI only, we failed to achieve good discrimination between BD-I, psychotic MDD, and HC in this proof of concept study.

  12. Associations between DSM-IV mental disorders and subsequent heart disease onset: beyond depression

    Science.gov (United States)

    Scott, Kate M.; de Jonge, Peter; Alonso, Jordi; Viana, Maria Carmen; Liu, Zhaorui; O’Neill, Siobhan; Aguilar-Gaxiola, Sergio; Bruffaerts, Ronny; Caldas-de-Almeida, Jose Miguel; Stein, Dan J.; de Girolamo, Giovanni; Florescu, Silvia E.; Hu, Chiyi; Taib, Nezar Ismet; Lépine, Jean-Pierre; Levinson, Daphna; Matschinger, Herbert; Medina-Mora, Maria Elena; Piazza, Marina; Posada-Villa, José A.; Uda, Hidenori; Wojtyniak, Bogdan J.; Lim, Carmen C. W.; Kessler, Ronald C.

    2013-01-01

    Background Prior studies on the depression-heart disease association have not usually used diagnostic measures of depression, nor taken other mental disorders into consideration. As a result, it is not clear whether the association between depression and heart disease onset reflects a specific association, or the comorbidity between depression and other mental disorders. Additionally, the relative magnitude of associations of a range of mental disorders with heart disease onset is unknown. Methods Face-to-face household surveys were conducted in 19 countries (n=52,095; person years=2,141,194). The Composite International Diagnostic Interview retrospectively assessed lifetime prevalence and age at onset of 16 DSM-IV mental disorders. Heart disease was indicated by self-report of physician’s diagnosis, or self-report of heart attack, together with their timing (year). Survival analyses estimated associations between first onset of mental disorders and subsequent heart disease onset. Results After comorbidity adjustment, depression, panic disorder, specific phobia, post-traumatic stress disorder and alcohol use disorders were associated with heart disease onset (ORs 1.3–1.6). Increasing number of mental disorders was associated with heart disease in a dose-response fashion. Mood disorders and alcohol abuse were more strongly associated with earlier onset than later onset heart disease. Associations did not vary by gender. Conclusions Depression, anxiety and alcohol use disorders were significantly associated with heart disease onset; depression was the weakest predictor. If confirmed in future prospective studies, the breadth of psychopathology’s links with heart disease onset has substantial clinical and public health implications. PMID:23993321

  13. Associations between DSM-IV mental disorders and subsequent heart disease onset: beyond depression.

    Science.gov (United States)

    Scott, Kate M; de Jonge, Peter; Alonso, Jordi; Viana, Maria Carmen; Liu, Zhaorui; O'Neill, Siobhan; Aguilar-Gaxiola, Sergio; Bruffaerts, Ronny; Caldas-de-Almeida, Jose Miguel; Stein, Dan J; de Girolamo, Giovanni; Florescu, Silvia E; Hu, Chiyi; Taib, Nezar Ismet; Lépine, Jean-Pierre; Levinson, Daphna; Matschinger, Herbert; Medina-Mora, Maria Elena; Piazza, Marina; Posada-Villa, José A; Uda, Hidenori; Wojtyniak, Bogdan J; Lim, Carmen C W; Kessler, Ronald C

    2013-10-15

    Prior studies on the depression-heart disease association have not usually used diagnostic measures of depression, or taken other mental disorders into consideration. As a result, it is not clear whether the association between depression and heart disease onset reflects a specific association, or the comorbidity between depression and other mental disorders. Additionally, the relative magnitude of associations of a range of mental disorders with heart disease onset is unknown. Face-to-face household surveys were conducted in 19 countries (n=52,095; person years=2,141,194). The Composite International Diagnostic Interview retrospectively assessed lifetime prevalence and age at onset of 16 DSM-IV mental disorders. Heart disease was indicated by self-report of physician's diagnosis, or self-report of heart attack, together with their timing (year). Survival analyses estimated associations between first onset of mental disorders and subsequent heart disease onset. After comorbidity adjustment, depression, panic disorder, specific phobia, post-traumatic stress disorder and alcohol use disorders were associated with heart disease onset (ORs 1.3-1.6). Increasing number of mental disorders was associated with heart disease in a dose-response fashion. Mood disorders and alcohol abuse were more strongly associated with earlier onset than later onset heart disease. Associations did not vary by gender. Depression, anxiety and alcohol use disorders were significantly associated with heart disease onset; depression was the weakest predictor. If confirmed in future prospective studies, the breadth of psychopathology's links with heart disease onset has substantial clinical and public health implications. © 2013.

  14. Duloxetine in the treatment of binge eating disorder with depressive disorders: a placebo-controlled trial.

    Science.gov (United States)

    Guerdjikova, Anna I; McElroy, Susan L; Winstanley, Erin L; Nelson, Eric B; Mori, Nicole; McCoy, Jessica; Keck, Paul E; Hudson, James I

    2012-03-01

    This study evaluated duloxetine in the treatment of binge eating disorder (BED) with comorbid current depressive disorders. In this 12-week, double-blind, placebo-controlled trial, 40 patients with Diagnostic and Statistical Manual of Mental Disorders-IV-TR BED and a comorbid current depressive disorder received duloxetine (N = 20) or placebo (N = 20). The primary outcome measure was weekly binge eating day frequency. In the primary analysis, duloxetine (mean 78.7 mg/day) was superior to placebo in reducing weekly frequency of binge eating days (p = .04), binge eating episodes (p = .02), weight (p = .04), and Clinical Global Impression-Severity of Illness ratings for binge eating (p = .02) and depressive disorders (p = .01). Changes in body mass index and measures of eating pathology, depression, and anxiety did not differ between the two groups. Duloxetine may be effective for reducing binge eating, weight, and global severity of illness in BED with a comorbid current depressive disorder, but this finding needs confirmation in larger, placebo-controlled trials. Copyright © 2011 Wiley Periodicals, Inc.

  15. Psychomotor Retardation in Depression: A Systematic Review of Diagnostic, Pathophysiologic, and Therapeutic Implications

    Directory of Open Access Journals (Sweden)

    Djamila Bennabi

    2013-01-01

    Full Text Available Psychomotor retardation is a central feature of depression which includes motor and cognitive impairments. Effective management may be useful to improve the classification of depressive subtypes and treatment selection, as well as prediction of outcome in patients with depression. The aim of this paper was to review the current status of knowledge regarding psychomotor retardation in depression, in order to clarify its role in the diagnostic management of mood disorders. Retardation modifies all the actions of the individual, including motility, mental activity, and speech. Objective assessments can highlight the diagnostic importance of psychomotor retardation, especially in melancholic and bipolar depression. Psychomotor retardation is also related to depression severity and therapeutic change and could be considered a good criterion for the prediction of therapeutic effect. The neurobiological process underlying the inhibition of activity includes functional deficits in the prefrontal cortex and abnormalities in dopamine neurotransmission. Future investigations of psychomotor retardation should help improve the understanding of the pathophysiological mechanisms underlying mood disorders and contribute to improving their therapeutic management.

  16. Symptomatic menopausal transition and subsequent bipolar disorder among midlife women with major depression: a nationwide longitudinal study.

    Science.gov (United States)

    Chen, Li-Chi; Yang, Albert C; Su, Tung-Ping; Bai, Ya-Mei; Li, Cheng-Ta; Chang, Wen-Han; Chen, Tzeng-Ji; Tsai, Shih-Jen; Chen, Mu-Hong

    2017-06-01

    Previous studies suggested that menopausal transition played an important role in the clinical course of major depression and bipolar disorder. However, the role of symptomatic menopausal transition in diagnostic conversion from major depression to bipolar disorder was still unknown. Using the Taiwan National Health Insurance Research Database, 50,273 midlife women aged between 40 and 60 years in 2002∼2008 with major depression were enrolled in our study and divided into two subgroups based on the presence (n = 21,120) or absence (n = 29,153) of symptomatic menopausal transition. Subjects who had subsequent bipolar disorder during the follow-up were identified. Midlife women with major depression and symptomatic menopausal transition had a higher incidence of the diagnostic conversion to bipolar disorder (7.3 vs. 6.6%, p = 0.003) than those with major depression alone. Cox regression analysis after adjusting for demographic data and psychiatric comorbidities further showed that symptomatic menopausal transition was associated with an increased risk of developing bipolar disorder (HR 1.14, 95% CI 1.07∼1.23) among midlife women with major depression. Sensitivity test after excluding the 1-year and 3-year observation exhibited the consistent findings (HR 1.18, 95% CI 1.09∼1.28; HR 1.20, 95% CI 1.08∼1.34). Midlife women with the dual diagnoses of major depression and symptomatic menopausal transition had an increased risk of the diagnostic conversion to bipolar disorder compared to those with major depression alone. Further studies may be required to investigate the underlying mechanisms among menopausal transition and the diagnostic conversion from major depression to bipolar disorder.

  17. 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

    • A pilot study differentiating recurrent major depression from bipolar disorder cycling on the depressive pole.

      Science.gov (United States)

      Hinz, Marty; Stein, Alvin; Uncini, Thomas

      2010-11-09

      A novel method for differentiating and treating bipolar disorder cycling on the depressive pole from patients who are suffering a major depressive episode is explored in this work. To confirm the diagnosis of type 1 or type 2 bipolar disorder, the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria require that at least one manic or hypomanic episode be identified. History of one or more manic or hypomanic episodes may be impossible to obtain, representing a potential blind spot in the DSM-IV diagnostic criteria. Many bipolar patients who cycle primarily on the depressive side for many years carry a misdiagnosis of recurrent major depression, leading to treatment with antidepressants that achieve little or no relief of symptoms. This article discusses a novel approach for diagnosing and treating patients with bipolar disorder cycling on the depressive pole versus patients with recurrent major depression. Patients involved in this study were formally diagnosed with recurrent major depression under DSM-IV criteria and had no medical history of mania or hypomania to support the diagnosis of bipolar disorder. All patients had suffered multiple depression treatment failures in the past, when evaluated under DSM-IV guidelines, secondary to administration of antidepressant drugs and/or serotonin with dopamine amino acid precursors. This study contained 1600 patients who were diagnosed with recurrent major depression under the DSM-IV criteria. All patients had no medical history of mania or hypomania. All patients experienced no relief of depression symptoms on level 3 amino acid dosing values of the amino acid precursor dosing protocol. Of 1600 patients studied, 117 (7.3%) nonresponder patients were identified who experienced no relief of depression symptoms when the serotonin and dopamine amino acid precursor dosing values were adjusted to establish urinary serotonin and urinary dopamine levels in the Phase III therapeutic ranges. All of the 117

    • The expression of depression among Javanese patients with major depressive disorder: a concept mapping study.

      Science.gov (United States)

      Brintnell, E Sharon; Sommer, Ryan W; Kuncoro, Bambang; Setiawan, G Pandu; Bailey, Patricia

      2013-08-01

      In this study, we explored the presentation of clinical depression in Java, Indonesia. Interviews were conducted with 20 Javanese patients (male and female) with major depressive disorder from both lower and higher socioeconomic levels. The recruited participants came from provincial and private mental health hospitals in the cities of Solo, Yogykarta (Jogja), Jakarta, and Malang on the island of Java, Indonesia. Concept mapping methodology using multidimensional scaling and hierarchical cluster analysis was used to identify underlying themes in the expression of depressive phenomena in this Indonesian population. The results identified themes that grouped into six clusters: interpersonal relationships, hopelessness, physical/somatic, poverty of thought, discourage, and defeat. Findings give support to the view that culture influences the expression of Indonesian depressive phenomenology, which nevertheless has some common roots with Western clinical pictures of the disorder. Cultural influences may mask symptoms of the disorder to clinicians. Diagnostic and assessment tools must be carefully selected to ensure they address culturally specific expressions of depression.

    • Major depressive disorder and depressive symptoms in intermittent explosive disorder.

      Science.gov (United States)

      Medeiros, Gustavo C; Seger, Liliana; Grant, Jon E; Tavares, Hermano

      2018-04-01

      It is estimated that between 1.7 and 2.6 million people have had intermittent explosive disorder (IED) during their life in the United States alone. Co-occurring psychiatric disorders are very common in IED, being major depressive disorder arguably the most common. The objective of this study was to examine the clinical correlates of IED and depressive manifestations in 74 treatment-seeking subjects. After controlling for confounders, there were associations between major depressive disorder and severity of depressive symptoms, and (a) higher assault scores, (b) more severe hostile behavior and (c) worse social adjustment. Management of depressive symptoms may be an important for IED treatment. Copyright © 2018 Elsevier B.V. All rights reserved.

  1. Detection of Mental Disorders Other Than Depression with the Edinburgh Postnatal Depression Scale in a Sample of Pregnant Women in Northern Mexico

    OpenAIRE

    Alvarado-Esquivel, Cosme; Sifuentes-Alvarez, Antonio; Salas-Martinez, Carlos

    2016-01-01

    We sought to evaluate the capacity of the Edinburgh Postnatal Depression Scale (EPDS) in discriminating mental disorders other than depression in pregnant women in northern Mexico. Three hundred pregnant women attending prenatal consultations in a public hospital in Durango City, Mexico submitted a validated EPDS and were examined for mental disorders other than depression using the Diagnostic and Statistical Manual of Mental Disorders - 4th Ed. (DSM-IV) criteria. Sensitivity and specificity ...

  2. Increased Treatment Complexity for Major Depressive Disorder for Inpatients With Comorbid Personality Disorder.

    Science.gov (United States)

    Wiegand, Hauke F; Godemann, Frank

    2017-05-01

    The study examined inpatient treatment for major depressive disorder (MDD) when it is complicated by comorbid personality disorder. In this descriptive analysis of a large data sample from 2013 (German VIPP data set) of 58,913 cases from 75 hospitals, three groups were compared: patients with MDD, patients with MDD and a comorbid personality disorder, and patients with a main diagnosis of personality disorder. Compared with MDD patients, those with comorbid personality disorder had higher rates of recurrent depression and nearly twice as many readmissions within one year, despite longer mean length of stay. Records of patients with comorbidities more often indicated accounting codes for "complex diagnostic procedures," "crisis intervention," and "constant observation." Patients with comorbid disorders differed from patients with a main diagnosis of personality disorder in treatment indicator characteristics and distribution of personality disorder diagnoses. Personality disorder comorbidity made MDD treatment more complex, and recurrence of MDD episodes and hospital readmission occurred more often than if patients had a sole MDD diagnosis.

  3. Childhood depressive disorders.

    Science.gov (United States)

    Wesselhöft, Rikke Thaarup

    2016-10-01

    Major depressive disorder (MDD) is a frequent and painful mental disorder considered among the five leading causes of disability in Western countries by the World Health Organization. MDD occurs at all ages, but childhood onset MDD has a more severe course with longer depressive episodes, more suicidality, and more frequent hospitalization, than later onset MDD. Childhood seems to be a window of opportunity for prevention of mental disorders, and subsequently prevention of MDD onset in childhood is recommended. Feasible prevention targets either individuals who present early signs of a given disorder but have not reached diagnostic threshold (indicated prevention) or individuals who are at increased risk for a disorder due to risk factor exposure (selective prevention). Indicated prevention is rational also for depressive disorders, because subthreshold depression (SD) in adults is found to be a precursor to MDD. The purpose of this thesis was to provide information necessary for the prevention of MDD onset in childhood. First, we examined whether the literature supports that SD is a MDD precursor also in children (systematic review). Second, we explored the risk that gender might constitute for pre-pubertal and post-pubertal onset MDD (register study). Third, we estimated the prevalence of SD and MDD in a large-scale pre-pubertal sample, and compared the clinical features of SD and MDD and potential risk factors (population-based study). The systematic review of the literature showed that SD in children and adolescents presents analogous comorbidity and symptom patterns (including self-harm symptoms). It also supports that SD is a precursor to MDD in children and adolescents causing poor outcomes like psychopathology, functional impairment and high use of health service. In the register study of Danish children and adolescents, we found a higher incidence of clinical MDD for girls after puberty compared to boys. Before puberty however, we demonstrated that boys

  4. Prevalence of depressive and anxiety disorders in Chinese gastroenterological outpatients

    Institute of Scientific and Technical Information of China (English)

    Xiao-Jing Li; Yan-Ling He; Hong Ma; Zhe-Ning Liu; Fu-Jun Jia; Ling Zhang; Lan Zhang

    2012-01-01

    AIM:To investigate the prevalence and physicians'detection rate of depressive and anxiety disorders in gastrointestinal (GI) outpatients across China.METHODS:A hospital-based cross-sectional survey was conducted in the GI outpatient departments of 13general hospitals.A total of 1995 GI outpatients were recruited and screened with the Hospital Anxiety and Depression Scale (HADS).The physicians of the GI departments performed routine clinical diagnosis and management without knowing the HADS score results.SubJects with HADS scores ≥ 8 were subsequently interviewed by psychiatrists using the Mini International Neuropsychiatric Interview (MINI) to make further diagnoses.RESULTS:There were 1059 patients with HADS score ≥ 8 and 674 (63.64%) of them undertook the MINI interview by psychiatrists.Based on the criteria of Diagnostic and Statistical Manual of Mental Disorders (4th edition),the adjusted current prevalence for depressive disorders,anxiety disorders,and comorbidity of both disorders in the GI outpatients was 14.39%,9.42% and 4.66%,respectively.Prevalence of depressive disorders with suicidal problems [suicide attempt or suicide-related ideation prior or current; module C (suicide) of MINI score ≥ 1] was 5.84% in women and 1.64% in men.The GI physicians' detection rate of depressive and anxiety disorders accounted for 4.14%.CONCLUSION:While the prevalence of depressive and anxiety disorders is high in Chinese GI outpatients,the detection rate of depressive and anxiety disorders by physicians is low.

  5. Endogenous, reactive and neurotic depression -- diagnostic stability and long-term outcome

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel

    2004-01-01

    with a diagnosis of endogenous, reactive or neurotic depression according to ICD-8 were identified in a nationwide register of admissions to psychiatric wards. Patients were followed up to 1999 and the long-term diagnostic stability, the risk of relapse leading to readmission and the risk of suicide was analysed...... with reactive depression had less risk of relapse. No differences were found in the risk of completed suicide between the three groups of patients during long-term follow-up. CONCLUSIONS: The study does not provide evidence for re-establishing prior diagnostic systems of depressive disorders based......BACKGROUND: No larger long-term study has been conducted of outcomes of patients diagnosed with endogenous, reactive or neurotic depression and using survival methods in the analyses. SAMPLING AND METHODS: All patients who had had their first-ever discharge in the period from 1970 to 1994...

  6. A pilot study differentiating recurrent major depression from bipolar disorder cycling on the depressive pole

    Directory of Open Access Journals (Sweden)

    Marty Hinz

    2010-11-01

    Full Text Available Marty Hinz1, Alvin Stein2, Thomas Uncini31Clinical Research, NeuroResearch Clinics, Inc., Cape Coral, FL, USA; 2Stein Orthopedic Associates, Plantation, FL, USA; 3DBS Labs, Duluth, MN, USAPurpose: A novel method for differentiating and treating bipolar disorder cycling on the depressive pole from patients who are suffering a major depressive episode is explored in this work. To confirm the diagnosis of type 1 or type 2 bipolar disorder, the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV criteria require that at least one manic or hypomanic episode be identified. History of one or more manic or hypomanic episodes may be impossible to obtain, representing a potential blind spot in the DSM-IV diagnostic criteria. Many bipolar patients who cycle primarily on the depressive side for many years carry a misdiagnosis of recurrent major depression, leading to treatment with antidepressants that achieve little or no relief of symptoms. This article discusses a novel approach for diagnosing and treating patients with bipolar disorder cycling on the depressive pole versus patients with recurrent major depression.Patients and methods: Patients involved in this study were formally diagnosed with recurrent major depression under DSM-IV criteria and had no medical history of mania or hypomania to support the diagnosis of bipolar disorder. All patients had suffered multiple depression treatment failures in the past, when evaluated under DSM-IV guidelines, secondary to administration of antidepressant drugs and/or serotonin with dopamine amino acid precursors.Results: This study contained 1600 patients who were diagnosed with recurrent major depression under the DSM-IV criteria. All patients had no medical history of mania or hypomania. All patients experienced no relief of depression symptoms on level 3 amino acid dosing values of the amino acid precursor dosing protocol. Of 1600 patients studied, 117 (7.3% nonresponder patients were identified

  7. Are Anxiety and Depression the Same Disorder?

    Directory of Open Access Journals (Sweden)

    Carey, Stephen

    2015-06-01

    Full Text Available The issue of co-morbidity in Anxiety and Depression as disorders leads to questions about the integrity of their present taxonomies in mental health diagnostics. At face value the two appear to have discrete differences, yet nonetheless demonstrate a high co-morbidity rate and shared symptoms implying pathological similarities rather than that of chance. Reviewing evidence from behavioural, neural, and biological sources that elaborate on the aspects of these two constructs, helps to illustrate the nature of these apparent differences and similarities. Integrating evidence from the anxiety and depression literature with the pathological process best illustrated by the burnout theory, alongside with support from the neurobiology of anxiety and stress, presents a proposition of a basic and natural anxiety pathology that when excessive, may result in the symptoms psychology has come to know as representative of anxiety and depressive disorders.

  8. Long-term work disability and absenteeism in anxiety and depressive disorders.

    Science.gov (United States)

    Hendriks, Sanne M; Spijker, Jan; Licht, Carmilla M M; Hardeveld, Florian; de Graaf, Ron; Batelaan, Neeltje M; Penninx, Brenda W J H; Beekman, Aartjan T F

    2015-06-01

    This longitudinal study aims to compare long-term work disability and absenteeism between anxiety and depressive disorders focusing on the effects of different course trajectories (remission, recurrence and chronic course) and specific symptom dimensions (anxiety arousal, avoidance behaviour and depressive mood). We included healthy controls, subjects with a history of - and current anxiety and/or depressive disorders with a paid job (n=1632). The Composite International Diagnostic Interview was used to diagnose anxiety and depressive disorders and to assess course trajectories at baseline, over 2 and 4 years. The World Health Organization Disability Assessment Schedule II and the Health and Labour Questionnaire Short Form were used to measure work disability and absenteeism. Symptom dimensions were measured using the Beck Anxiety Inventory, the Fear Questionnaire and the Inventory for Depressive Symptomatology. A history of - and current anxiety and/or depressive disorders were associated with increasing work disability and absenteeism over 4 years, compared to healthy controls. Long-term work disability and absenteeism were most prominent in comorbid anxiety-depressive disorder, followed by depressive disorders, and lowest in anxiety disorders. A chronic course, anxiety arousal and depressive mood were strong predictors for long-term work disability while baseline psychiatric status, a chronic course and depressive mood were strong predictors for long-term work absenteeism. Results cannot be generalized to other anxiety disorders, such as obsessive compulsive disorder, posttraumatic stress disorder and specific phobias. Self-reported measures of work disability and absenteeism were used. Our results demonstrate that depressive syndromes and symptoms have more impact on future work disability and absenteeism than anxiety, implying that prevention of depression is of major importance. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. [Diagnostics and multimodal treatment of depression in old age : New developments].

    Science.gov (United States)

    Eschweiler, Gerhard W

    2017-02-01

    Depressive disorders in elderly persons are frequent and can either first be manifested at a younger age and show a recurrent pattern during later life (ICD 10, F33.*) or have an onset beyond 60 years, which is termed late onset depression (LOD). This LOD has a higher tendency to chronification and implies an increased risk of progression, especially to vascular dementia. The multifactorial genesis of depression in old age includes psychosocial, vascular and metabolic factors and requires multimodal therapy modules at the biological and psychosocial level, which is now increasingly being empirically proven. Depressive disorders with executive and cognitive deficits have to be considered a defined entity with respect to prognosis and treatment. As a first step of treatment watchful waiting is appropriate, especially in depressive adjustment disorders triggered by acute psychosocial stressors (e.g. loss of relatives and conflicts). After 2-4 weeks pharmacological antidepressant therapy should be initiated, at least in a moderate depressive episode. Furthermore, the revised national guidelines for depressive disorders also explicitly recommend psychotherapy as an alternative or supplement to pharmacotherapy in the elderly. Several forms of psychotherapy are emphasized: cognitive behavioral therapy, interpersonal therapy and in particular problem solving, as this is a form of treatment that can also be carried out by other professional groups, thus alleviating the treatment gap caused by the lack of psychotherapists. In summary, a depressive disorder in old age should not induce therapeutic nihilism: after stepped diagnostic assessments, multimodal therapies are individually adapted to the physical, cognitive and social resources of the patients.

  10. Early-onset Major Depressive Disorder in men is associated with childlessness.

    Science.gov (United States)

    Yates, William R; Meller, William H; Lund, Brian C; Thurber, Steve; Grambsch, Patricia L

    2010-07-01

    The self-reported number of children was compared for men and women from the National Epidemiologic Survey of Alcoholism and Related Conditions Survey (NESARC). Subjects with a diagnosis of major depressive disorder or bipolar disorder were compared to those without an axis I disorder. The effect of age, gender, marriage and diagnostic status on number of children was completed using multivariate analyses. Men with a history of major depressive disorder but not bipolar disorder reported higher rates of childlessness and lower mean number of children. This reduced number of children was related to an early age of onset of MDD. Thirty percent of men with an age of onset of MDD before 22 were childless compared to only 18.9% of men without an axis I disorder (Odds ratio=1.82, 95% CI=1.45-2.27). No effect of mood disorder on number of children was found in women with major depression or bipolar disorder. This study suggests that an early age of onset of major depressive disorder contributes to childlessness in men.

  11. [Clinical study of comparing comorbidity between depression and neurological disorder with depressive disorder].

    Science.gov (United States)

    Zhang, Jing; He, Mao-Lin; Li, Shun-Wei

    2010-01-26

    To compare the clinical traits in comorbidity between depression and neurological disorder with depressive disorder and explore the characteristic of the outpatients with neurological disorder comorbidity in depression. According to Diagnosis and Statistic Manual for Mental Disorder-IV (DSM-IV) criteria, outpatients were diagnosed as depressive disorder at Departments of Neurology and Psychology. We used HAMD-17 scale to evaluate the patient's severity. There was no statistical difference in severity of depression in two groups. But the clinical traits showed significant differences between two outpatient groups: the outpatients with neurological disorder comorbidity in depression were elder, had more somatic disorders and a higher retard symptom factor score while the other are relative younger, have less physical disorders and higher the core symptom factor score on the other hand. The patients of comorbidity between depression and neurological disorders have unique clinical traits. Thus it will be helpful to improve the identification of diagnosis and choose an appropriate treatment if we know the differences well.

  12. Associations between DSM-IV mental disorders and diabetes mellitus: a role for impulse control disorders and depression

    Science.gov (United States)

    Alonso, Jordi; Stein, Dan J.; Kiejna, Andrzej; Aguilar-Gaxiola, Sergio; Viana, Maria Carmen; Liu, Zhaorui; O’Neill, Siobhan; Bruffaerts, Ronny; Caldas-de-Almeida, Jose Miguel; Lepine, Jean-Pierre; Matschinger, Herbert; Levinson, Daphna; de Girolamo, Giovanni; Fukao, Akira; Bunting, Brendan; Haro, Josep Maria; Posada-Villa, Jose A.; Al-Hamzawi, Ali Obaid; Medina-Mora, Maria Elena; Piazza, Marina; Hu, Chiyi; Sasu, Carmen; Lim, Carmen C. W.; Kessler, Ronald C.; Scott, Kate M.

    2014-01-01

    Aims/hypothesis No studies have evaluated whether the frequently observed associations between depression and diabetes could reflect the presence of comorbid psychiatric conditions and their associations with diabetes. We therefore examined the associations between a wide range of pre-existing Diagnostic Statistical Manual, 4th edition (DSM-IV) mental disorders with self-reported diagnosis of diabetes. Methods We performed a series of cross-sectional face-to-face household surveys of community-dwelling adults (n=52,095) in 19 countries. The World Health Organization Composite International Diagnostic Interview retrospectively assessed lifetime prevalence and age at onset of 16 DSM-IV mental disorders. Diabetes was indicated by self-report of physician’s diagnosis together with its timing. We analysed the associations between all mental disorders and diabetes, without and with comorbidity adjustment. Results We identified 2,580 cases of adult-onset diabetes mellitus (21 years +). Although all 16 DSM-IV disorders were associated with diabetes diagnosis in bivariate models, only depression (OR 1.3; 95% CI 1.1, 1.5), intermittent explosive disorder (OR 1.6; 95% CI 1.1, 2.1), binge eating disorder (OR 2.6; 95% CI 1.7, 4.0) and bulimia nervosa (OR 2.1; 95% CI 1.3, 3.4) remained after comorbidity adjustment. Conclusions/interpretation Depression and impulse control disorders (eating disorders in particular) were significantly associated with diabetes diagnosis after comorbidity adjustment. These findings support the focus on depression as having a role in diabetes onset, but suggest that this focus may be extended towards impulse control disorders. Acknowledging the comorbidity of mental disorders is important in determining the associations between mental disorders and subsequent diabetes. PMID:24488082

  13. Major depressive disorder: insight into candidate cerebrospinal fluid protein biomarkers from proteomics studies.

    Science.gov (United States)

    Al Shweiki, Mhd Rami; Oeckl, Patrick; Steinacker, Petra; Hengerer, Bastian; Schönfeldt-Lecuona, Carlos; Otto, Markus

    2017-06-01

    Major Depressive Disorder (MDD) is the leading cause of global disability, and an increasing body of literature suggests different cerebrospinal fluid (CSF) proteins as biomarkers of MDD. The aim of this review is to summarize the suggested CSF biomarkers and to analyze the MDD proteomics studies of CSF and brain tissues for promising biomarker candidates. Areas covered: The review includes the human studies found by a PubMed search using the following terms: 'depression cerebrospinal fluid biomarker', 'major depression biomarker CSF', 'depression CSF biomarker', 'proteomics depression', 'proteomics biomarkers in depression', 'proteomics CSF biomarker in depression', and 'major depressive disorder CSF'. The literature analysis highlights promising biomarker candidates and demonstrates conflicting results on others. It reveals 42 differentially regulated proteins in MDD that were identified in more than one proteomics study. It discusses the diagnostic potential of the biomarker candidates and their association with the suggested pathologies. Expert commentary: One ultimate goal of finding biomarkers for MDD is to improve the diagnostic accuracy to achieve better treatment outcomes; due to the heterogeneous nature of MDD, using bio-signatures could be a good strategy to differentiate MDD from other neuropsychiatric disorders. Notably, further validation studies of the suggested biomarkers are still needed.

  14. Body-Related Social Comparison and Disordered Eating among Adolescent Females with an Eating Disorder, Depressive Disorder, and Healthy Controls

    Directory of Open Access Journals (Sweden)

    Daniel Le Grange

    2012-09-01

    Full Text Available The purpose of this study was to investigate the association between body-related social comparison (BRSC and eating disorders (EDs by: (a comparing the degree of BRSC in adolescents with an ED, depressive disorder (DD, and no psychiatric history; and (b investigating whether BRSC is associated with ED symptoms after controlling for symptoms of depression and self-esteem. Participants were 75 girls, aged 12–18 (25 per diagnostic group. To assess BRSC, participants reported on a 5-point Likert scale how often they compare their body to others’. Participants also completed a diagnostic interview, Eating Disorders Inventory-2 (EDI-2, Beck Depression Inventory-II (BDI-II, and Rosenberg Self-Esteem Scale (RSE. Compared to adolescents with a DD and healthy adolescents, adolescents with an ED engaged in significantly more BRSC (p ≤ 0.001. Collapsing across groups, BRSC was significantly positively correlated with ED symptoms (p ≤ 0.01, and these associations remained even after controlling for two robust predictors of both ED symptoms and social comparison, namely BDI-II and RSE. In conclusion, BRSC seems to be strongly related to EDs. Treatment for adolescents with an ED may focus on reducing BRSC.

  15. Body-related social comparison and disordered eating among adolescent females with an eating disorder, depressive disorder, and healthy controls.

    Science.gov (United States)

    Hamel, Andrea E; Zaitsoff, Shannon L; Taylor, Andrew; Menna, Rosanne; Le Grange, Daniel

    2012-09-01

    The purpose of this study was to investigate the association between body-related social comparison (BRSC) and eating disorders (EDs) by: (a) comparing the degree of BRSC in adolescents with an ED, depressive disorder (DD), and no psychiatric history; and (b) investigating whether BRSC is associated with ED symptoms after controlling for symptoms of depression and self-esteem. Participants were 75 girls, aged 12-18 (25 per diagnostic group). To assess BRSC, participants reported on a 5-point Likert scale how often they compare their body to others'. Participants also completed a diagnostic interview, Eating Disorders Inventory-2 (EDI-2), Beck Depression Inventory-II (BDI-II), and Rosenberg Self-Esteem Scale (RSE). Compared to adolescents with a DD and healthy adolescents, adolescents with an ED engaged in significantly more BRSC (p ≤ 0.001). Collapsing across groups, BRSC was significantly positively correlated with ED symptoms (p ≤ 0.01), and these associations remained even after controlling for two robust predictors of both ED symptoms and social comparison, namely BDI-II and RSE. In conclusion, BRSC seems to be strongly related to EDs. Treatment for adolescents with an ED may focus on reducing BRSC.

  16. A clinical prediction rule for detecting major depressive disorder in primary care: the PREDICT-NL study.

    Science.gov (United States)

    Zuithoff, Nicolaas P A; Vergouwe, Yvonne; King, Michael; Nazareth, Irwin; Hak, Eelko; Moons, Karel G M; Geerlings, Mirjam I

    2009-08-01

    Major depressive disorder often remains unrecognized in primary care. Development of a clinical prediction rule using easily obtainable predictors for major depressive disorder in primary care patients. A total of 1046 subjects, aged 18-65 years, were included from seven large general practices in the center of The Netherlands. All subjects were recruited in the general practice waiting room, irrespective of their presenting complaint. Major depressive disorder according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Text Revision edition criteria was assessed with the Composite International Diagnostic Interview. Candidate predictors were gender, age, educational level, being single, number of presented complaints, presence of non-somatic complaints, whether a diagnosis was assigned, consultation rate in past 12 months, presentation of depressive complaints or prescription of antidepressants in past 12 months, number of life events in past 6 months and any history of depression. The first multivariable logistic regression model including only predictors that require no confronting depression-related questions had a reasonable degree of discrimination (area under the receiver operating characteristic curve or concordance-statistic (c-statistic) = 0.71; 95% Confidence Interval (CI): 0.67-0.76). Addition of three simple though more depression-related predictors, number of life events and history of depression, significantly increased the c-statistic to 0.80 (95% CI: 0.76-0.83). After transforming this second model to an easily to use risk score, the lowest risk category (sum score depression, which increased to 49% in the highest category (sum score > or = 30). A clinical prediction rule allows GPs to identify patients-irrespective of their complaints-in whom diagnostic workup for major depressive disorder is indicated.

  17. Differential diagnosis of bipolar disorder and major depressive disorder.

    Science.gov (United States)

    Hirschfeld, R M

    2014-12-01

    Patients with bipolar disorder spend approximately half of their lives symptomatic and the majority of that time suffering from symptoms of depression, which complicates the accurate diagnosis of bipolar disorder. Challenges in the differential diagnosis of bipolar disorder and major depressive disorder are reviewed, and the clinical utility of several screening instruments is evaluated. The estimated lifetime prevalence of major depressive disorder (i.e., unipolar depression) is over 3 and one-half times that of bipolar spectrum disorders. The clinical presentation of a major depressive episode in a bipolar disorder patient does not differ substantially from that of a patient with major depressive disorder (unipolar depression). Therefore, it is not surprising that without proper screening and comprehensive evaluation many patients with bipolar disorder may be misdiagnosed with major depressive disorder (unipolar depression). In general, antidepressants have demonstrated little or no efficacy for depressive episodes associated with bipolar disorder, and treatment guidelines recommend using antidepressants only as an adjunct to mood stabilizers for patients with bipolar disorder. Thus, correct identification of bipolar disorder among patients who present with depression is critical for providing appropriate treatment and improving patient outcomes. Clinical characteristics indicative of bipolar disorder versus major depressive disorder identified in this review are based on group differences and may not apply to each individual patient. The overview of demographic and clinical characteristics provided by this review may help medical professionals distinguish between major depressive disorder and bipolar disorder. Several validated, easily administered screening instruments are available and can greatly improve the recognition of bipolar disorder in patients with depression. Copyright © 2014 Elsevier B.V. All rights reserved.

  18. Comorbid anxiety disorders in late-life depression: results of a cohort study.

    Science.gov (United States)

    van der Veen, D C; van Zelst, W H; Schoevers, R A; Comijs, H C; Voshaar, R C Oude

    2015-07-01

    Comorbid anxiety disorders are common in late-life depression and negatively impact treatment outcome. This study aimed to examine personality characteristics as well as early and recent life-events as possible determinants of comorbid anxiety disorders in late-life depression, taking previously examined determinants into account. Using the Composite International Diagnostic Interview (CIDI 2.0), we established comorbid anxiety disorders (social phobia (SP), panic disorder (PD), generalized anxiety disorder (GAD), and agoraphobia (AGO)) in 350 patients (aged ≥60 years) suffering from a major depressive disorder according to DSM-IV-TR criteria within the past six months. Adjusted for age, sex, and level of education, we first examined previously identified determinants of anxious depression: depression severity, suicidality, partner status, loneliness, chronic diseases, and gait speed in multiple logistic regression models. Subsequently, associations were explored with the big five personality characteristics as well as early and recent life-events. First, multiple logistic regression analyses were conducted with the presence of any anxiety disorder (yes/no) as dependent variable, where after analyses were repeated for each anxiety disorder, separately. In our sample, the prevalence rate of comorbid anxiety disorders in late-life depression was 38.6%. Determinants of comorbid anxiety disorders were a lower age, female sex, less education, higher depression severity, early traumatization, neuroticism, extraversion, and conscientiousness. Nonetheless, determinants differed across the specific anxiety disorders and lumping all anxiety disorder together masked some determinants (education, personality). Our findings stress the need to examine determinants of comorbid anxiety disorder for specific anxiety disorders separately, enabling the development of targeted interventions within subgroups of depressed patients.

  19. PRKCDBP (CAVIN3) and CRY2 associate with major depressive disorder.

    Science.gov (United States)

    Kovanen, Leena; Donner, Kati; Kaunisto, Mari; Partonen, Timo

    2017-01-01

    Dysfunctions in the intrinsic clocks are suggested in patients with depressive disorders. The cryptochrome circadian clocks 1 and 2 (CRY1 and CRY2) proteins modulate circadian rhythms in a cell and influence emotional reactions and mood in an individual. The protein kinase C delta binding protein (PRKCDBP, or CAVIN3), similar to the serum deprivation response protein (SDPR, or CAVIN2), reduces metabolic stability of the PER2-CRY2 transcription factor complex that plays a role in the circadian rhythm synchronization. Our aim was to study SDPR, PRKCDBP, CRY1 and CRY2 genetic variants in depressive disorders. The sample included 5910 Finnish individuals assessed with the Munich-Composite International Diagnostic Interview (M-CIDI) in year 2000. In year 2011, 3424 individuals were assessed again. After genotype quality control, there were 383 subjects with major depressive disorder, 166 with dysthymia, and 479 with depressive disorders (major depressive disorder, dysthymia or both), and 4154 healthy controls. A total of 48 single-nucleotide polymorphisms from SDPR, PRKCDBP, CRY1 and CRY2 genes were analyzed using logistic regression models controlling for age and gender. The earlier reported association of CRY2 variants with dysthymia was confirmed and extended to major depressive disorder (qdepressive disorders (q=0.02) and with major depressive disorder in specific (q=0.007) were found. The number of cases was moderate and coverage of PRKCDB was limited. CRY2 and PRKCDBP variants may be risk factors of major depressive disorder and provide information for diagnosis. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. The state effect of depressive and anxiety disorders on big five personality traits.

    Science.gov (United States)

    Karsten, Julie; Penninx, Brenda W J H; Riese, Hariëtte; Ormel, Johan; Nolen, Willem A; Hartman, Catharina A

    2012-05-01

    Neuroticism and extraversion are affected by depressive disorder state. Less is known about depressive state effects on conscientiousness, agreeableness and openness. Furthermore, state effects of anxiety disorders on personality have been far less studied than those of depressive disorder. Here, we aim to determine the extent of change in all five personality traits associated with the occurrence of or recovery from depressive and anxiety disorders. Using the Composite International Diagnostic Interview (CIDI) at baseline and two-year follow-up, respondents from the Netherlands Study of Depression and Anxiety (NESDA) were divided into four groups: unaffected at baseline and follow-up, occurrence, recovery, and affected at baseline and follow-up. Personality change (NEO-five factor inventory) was examined in the occurrence and recovery groups relative to the unaffected and affected groups, respectively. Analyses were repeated, differentiating between (specific) depressive and anxiety disorders. We found small state effects of affective disorders on neuroticism, extraversion and conscientiousness. Corrected for each other, both depressive and anxiety disorders showed small state effects on neuroticism, but effects on extraversion and conscientiousness were mainly associated with depressive disorders. State effects were small. When assessing neuroticism, the presence of both depressive and anxiety disorders should be taken into account, as both may independently increase neuroticism scores. However, when assessing extraversion and conscientiousness, depressive disorders but not anxiety disorders are likely to be of influence. Agreeableness and openness are influenced by neither. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. Cortical thickness differences between bipolar depression and major depressive disorder.

    Science.gov (United States)

    Lan, Martin J; Chhetry, Binod Thapa; Oquendo, Maria A; Sublette, M Elizabeth; Sullivan, Gregory; Mann, J John; Parsey, Ramin V

    2014-06-01

    Bipolar disorder (BD) is a psychiatric disorder with high morbidity and mortality that cannot be distinguished from major depressive disorder (MDD) until the first manic episode. A biomarker able to differentiate BD and MDD could help clinicians avoid risks of treating BD with antidepressants without mood stabilizers. Cortical thickness differences were assessed using magnetic resonance imaging in BD depressed patients (n = 18), MDD depressed patients (n = 56), and healthy volunteers (HVs) (n = 54). A general linear model identified clusters of cortical thickness difference between diagnostic groups. Compared to the HV group, the BD group had decreased cortical thickness in six regions, after controlling for age and sex, located within the frontal and parietal lobes, and the posterior cingulate cortex. Mean cortical thickness changes in clusters ranged from 7.6 to 9.6% (cluster-wise p-values from 1.0 e-4 to 0.037). When compared to MDD, three clusters of lower cortical thickness in BD were identified that overlapped with clusters that differentiated the BD and HV groups. Mean cortical thickness changes in the clusters ranged from 7.5 to 8.2% (cluster-wise p-values from 1.0 e-4 to 0.023). The difference in cortical thickness was more pronounced when the subgroup of subjects with bipolar I disorder (BD-I) was compared to the MDD group. Cortical thickness patterns were distinct between BD and MDD. These results are a step toward developing an imaging test to differentiate the two disorders. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. [Eating disorders and depressive symptoms: an epidemiological study in a male population].

    Science.gov (United States)

    Valls, M; Callahan, S; Rousseau, A; Chabrol, H

    2014-06-01

    The objective of the study was to evaluate the incidence of eating disorders, including not otherwise specified eating disorders (EDNOS) and subthreshold disorders, inappropriate compensatory behaviors (such as self-induced vomiting, strict dieting, fasting) along with depressive symptoms among young French adult males. The sample was composed of 458 young men in age ranging from 18 to 30 years (mean age=21.9±2.4). The average body mass index was 22.8±3. Participants completed two questionnaires: the Questionnaire for Eating Disorders Diagnoses (Q-EDD) assessing full-criteria eating disorder symptoms based on DSM-IV criteria (i.e. clinical eating disorders) and subthreshold disorders, and the Center for Epidemiological Studies-Depression scale (CES-D) assessing depressive symptoms. Out of the 458 surveyed respondents, eating disorders were reported by approximately 17% of the overall sample, with 1.5% meeting diagnostic criteria for serious clinical disorders, 3% meeting diagnostic criteria for EDNOS and 12% meeting diagnostic criteria for subthreshold disorders. Exercise bulimia represented 1% of the overall sample and binge-eating disorder 2%. The most frequent subthreshold disorder was subthreshold nonbinging bulimia (7%). Participants with eating disorders were equally divided between those desiring weight gain, those desiring weight loss and those wanting to keep their current weight. Participants without eating disorders were more likely to want to gain weight compared to participants with eating disorders (45.5% versus 30% respectively; Peating episodes (recurrent or not) were reported by 8% of young men, including 32% of participants with eating disorders and 3% of participants without eating disorder. Six percent reported repeated binging (at least twice a week for at least once a month). Inappropriate compensatory behaviors were mostly used by participants with eating disorders, except for excessive exercise (34% versus 35% for participants without

  3. Comorbidity of ADHD and subsequent bipolar disorder among adolescents and young adults with major depression: a nationwide longitudinal study.

    Science.gov (United States)

    Chen, Mu-Hong; Chen, Ying-Sheue; Hsu, Ju-Wei; Huang, Kai-Lin; Li, Cheng-Ta; Lin, Wei-Chen; Chang, Wen-Han; Chen, Tzeng-Ji; Pan, Tai-Long; Su, Tung-Ping; Bai, Ya-Mei

    2015-05-01

    Previous studies have found that attention-deficit hyperactivity disorder (ADHD) in childhood and adolescence is associated with an increased risk of major depression and bipolar disorder in later life. However, the effect of ADHD comorbidity on the diagnostic conversion to bipolar disorder among patients with major depression is still uncertain. Using the Taiwan National Health Insurance Research Database, 58,023 subjects bipolar disorder during the follow-up to the end of 2011 were identified. Adolescents and young adults who had major depression with ADHD comorbidity had an increased incidence of subsequent bipolar disorder (18.9% versus 11.2%, p bipolar disorder among those with major depression, adjusting for demographic data and psychiatric comorbidities. Patients with comorbid diagnoses of major depression and ADHD had an increased risk of diagnostic conversion to bipolar disorder compared to those who had major depression alone. Further studies would be required to validate this finding and to investigate the possible underlying mechanisms. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. The Relationship of Hypochondriasis to Anxiety, Depressive, and Somatoform Disorders

    Science.gov (United States)

    Scarella, Timothy M.; Laferton, Johannes A. C.; Ahern, David K.; Fallon, Brian A.; Barsky, Arthur

    2015-01-01

    Background Though the phenotype of anxiety about medical illness has long been recognized, there continues to be debate as to whether it is a distinct psychiatric disorder and, if so, to which diagnostic category it belongs. Our objective was to investigate the pattern of psychiatric co-morbidity in hypochondriasis and to assess the relationship of health anxiety to anxiety, depressive, and somatoform disorders. Methods Data were collected as part of a clinical trial on treatment methods for hypochondriasis. 194 participants meeting criteria for DSM-IV hypochondriasis were assessed by sociodemographic variables, results of structured diagnostic interviews, and validated instruments for assessing various symptom dimensions of psychopathology. Results The majority of individuals with hypochondriasis had co-morbid psychiatric illness; the mean number of co-morbid diagnoses was 1.4, and 35.1% had hypochondriasis as their only diagnosis. Participants were more likely to have only co-morbid anxiety disorders than only co-morbid depressive or somatoform disorders. Multiple regression analysis of continuous measures of symptoms revealed the strongest correlation of health anxiety with anxiety symptoms, and a weaker correlation with somatoform symptoms; in multiple regression analysis, there was no correlation between health anxiety and depressive symptoms. Conclusion Our findings suggest that the entity of health anxiety (Hypochondriasis in DSM-IV, Illness Anxiety Disorder in DSM-5) is a clinical syndrome distinct from other psychiatric disorders. Analysis of co-morbidity patterns and continuous measures of symptoms suggest its appropriate classification is with anxiety rather than somatoform or mood disorders. PMID:26785798

  5. Relationship between Comorbidity of Cluster Personality Disorders with Major Depression Disorder and Depression Relapse

    Directory of Open Access Journals (Sweden)

    Shima Tamanaei-Far

    2008-12-01

    Full Text Available Objective: this research studied the relation between cluster B personality disorders and major depression disorder with relapse. Materials & Methods: In this analytical and comparative study, samples consisted of the major depressive disorders patients that had experienced major depression through 5 years ago and were experiencing partial remission in research time. Samples were selected by non probability sampling in outpatient centers. The patients with more than two relapses were assigned as case group and the patients without any relapse were assigned as control group (two groups on the base of demographic in formations were matched. They completed BDI_II and SCID_II to assess cluster B personality disorders, and a questionnaire made by researcher to gather information’s. Results: Comorbidity of borderline personality disorder (P<0.001 and narcissitic personality disorder (P=0.016 with depression in patient with relapse of the depression is more significantly than patients with first episode of depression, but comorbidity of exhibitive personality disorder with depression and relapse had no significant difference between two groups (P=0.401. Conclusion: according to the relationship between narcissistic and borderline personality disorders and the role of them in relapse of depression, for making an effective psychotherapy for depression, it is necessary to consider personality beside special symptoms.

  6. Relations of mindfulness facets with psychological symptoms among individuals with a diagnosis of obsessive-compulsive disorder, major depressive disorder, or borderline personality disorder.

    Science.gov (United States)

    Didonna, Fabrizio; Rossi, Roberta; Ferrari, Clarissa; Iani, Luca; Pedrini, Laura; Rossi, Nicoletta; Xodo, Erica; Lanfredi, Mariangela

    2018-03-25

    To explore differences in mindfulness facets among patients with a diagnosis of either obsessive-compulsive disorder (OCD), major depressive disorder (MDD), or borderline personality disorder (BPD), and healthy controls (HC), and their associations with clinical features. One hundred and fifty-three patients and 50 HC underwent a clinical assessment including measures of mindfulness (Five Facets Mindfulness Questionnaire - FFMQ), psychopathological symptoms (Symptom Check List-90-R), dissociation (Dissociative Experience Scale), alexithymia (Alexithymia Scale 20), and depression (Beck Depression Inventory-II). Analysis of variance (ANOVA) and analysis of covariance (ANCOVA) were performed to assess differences in mindfulness scores and their associations with clinical features. The three diagnostic groups scored lower on all mindfulness facets (apart from FFMQobserving) compared to the HC group. OCD group had a significant higher FFMQ total score (FFMQ-TS) and FFMQacting with awareness compared to the BPD group, and scored higher on FFMQdescribing compared to BPD and MDD groups. The scores in non-judging facet were significantly lower in all the three diagnostic groups compared to the HC group. Interestingly, higher FFMQ-TS was inversely related to all psychological measures, regardless of diagnostic group. Deficits in mindfulness skills were present in all diagnostic groups. Furthermore, we found disease-specific relationships between some mindfulness facets and specific psychological variables. Clinical implications are discussed. The study showed deficits in mindfulness scores in all diagnostic groups compared to a healthy control group. Overall, mindfulness construct has a significantly negative association with indexes of global distress, dissociative symptoms, alexithymia, and depression. Mindfulness-based interventions in clinical settings should take into account different patterns of mindfulness skills and their impact on disease-specific maladaptive

  7. Relationship between anhedonia and impulsivity in schizophrenia, major depression and schizoaffective disorder.

    Science.gov (United States)

    Amr, Mostafa; Volpe, Fernando Madalena

    2013-12-01

    Anhedonia and impulsivity are prominent symptoms of many psychiatric disorders and may indicate worse prognosis, notably in schizophrenia and major depression. Despite the convergence of negative outcomes from both dimensions, the relationship between anhedonia and impulsivity in psychiatric disorders has been seldom directly assessed. The objective of the present study is to examine the correlations between anhedonia and impulsivity in three diagnostic groups: major depression, schizophrenia and schizoaffective disorder. 121 outpatients (Mansoura University Hospital, Egypt) with major depressive disorder (N=29), schizophrenia (N=59), and schizoaffective disorder (N=33), were assessed and responded to the Beck Depression Inventory, Barrat's Impulsivity Scale-11, and Chapman's Social and Physical Anhedonia Scales. Physical and social anhedonia scores were negatively correlated to impulsivity scores in major depression patients. Conversely, higher scores in physical and social anhedonia predicted higher impulsivity scores in schizophrenia. No correlations between impulsivity and anhedonia were evidenced among schizoaffectives. The relationship between self-reported physical and social anhedonia and impulsivity is diagnosis-specific. Copyright © 2013 Elsevier B.V. All rights reserved.

  8. The quality of life of hematological malignancy patients with major depressive disorder or subsyndromal depression.

    Science.gov (United States)

    Rezaei, Omid; Sharifian, Ramezan-Ali; Soleimani, Mehdi; Jahanian, Amirabbas

    2012-01-01

    The purpose of the present study was to compare the quality of life of hematological malignancy patients with major depressive disorder or subsyndromal depression. Sample consisted of 93 hematological malignancy patients recruited from oncology ward of Valieasr hospital for Imam Khomeini complex hospital at Tehran through purposeful sampling. Participants were divided into three groups through diagnostic interview based on DSM-IV-TR criteria and the Beck Depression Inventory-2 (BDI-II): Major depressive disorder (MDD) (n = 41; 44.1%); subsyndromal depression (SSD) (n = 23; 24.7%), and without depression (WD) (n = 29; 31.2%). Participants completed the short-form health survey (SF-36) as a measure of the quality of life. We carried out an analysis of covariance to examine the collected data. Findings showed that there was not a significant difference between patients with MDD and SSD based on measure of quality of life. But patients with MDD and SSD showed significantly worse quality of life than patients with WD. This finding highlights the clinical importance of subsyndromal depressive symptoms and casts doubt on the clinical utility of separation between MDD and subsyndromal depression in terms of important clinical outcomes.

  9. Depression in Adults with Attention-Deficit/Hyperactivity Disorder (ADHD): The Mediating Role of Cognitive-Behavioral Factors

    Science.gov (United States)

    Zvorsky, Ivori; Safren, Steven A.

    2015-01-01

    Adults with Attention-Deficit/Hyperactivity Disorder (ADHD) are at increased risk for depressive disorders but little is known about the potential cognitive and behavioral mechanisms of risk that could shape treatment. This study evaluated the degree to which cognitive-behavioral constructs associated with depression and its treatment—dysfunctional attitudes and cognitive-behavioral avoidance—accounted for variance in depressive symptoms and disorder in adults with ADHD. 77 adults clinically diagnosed with ADHD completed self-report questionnaires, diagnostic interviews, and clinician-administered symptom rating scales. Statistical mediation analysis was employed and indirect effects assessed using bootstrap analysis and bias-corrected confidence intervals. Controlling for recent negative life events, dysfunctional attitudes and cognitive-behavioral avoidance fully accounted for the variance between ADHD symptoms and depressive symptoms. Each independent variable partially mediated the other in accounting for depression symptoms suggesting overlapping and unique variance. Cognitive-behavioral avoidance, however, was more strongly related to meeting diagnostic criteria for a depressive disorder than were dysfunctional attitudes. Processes that are targeted in cognitive behavior therapy (CBT) for depression were associated with symptoms in adults with ADHD. Current CBT approaches for ADHD incorporate active coping skills and cognitive restructuring and such approaches could be further tailored to address the ADHD-depression comorbidity. PMID:26089578

  10. Test-retest reliability of schizoaffective disorder compared with schizophrenia, bipolar disorder, and unipolar depression--a systematic review and meta-analysis.

    Science.gov (United States)

    Santelmann, Hanno; Franklin, Jeremy; Bußhoff, Jana; Baethge, Christopher

    2015-11-01

    Schizoaffective disorder is a frequent diagnosis, and its reliability is subject to ongoing discussion. We compared the diagnostic reliability of schizoaffective disorder with its main differential diagnoses. We systematically searched Medline, Embase, and PsycInfo for all studies on the test-retest reliability of the diagnosis of schizoaffective disorder as compared with schizophrenia, bipolar disorder, and unipolar depression. We used meta-analytic methods to describe and compare Cohen's kappa as well as positive and negative agreement. In addition, multiple pre-specified and post hoc subgroup and sensitivity analyses were carried out. Out of 4,415 studies screened, 49 studies were included. Test-retest reliability of schizoaffective disorder was consistently lower than that of schizophrenia (in 39 out of 42 studies), bipolar disorder (27/33), and unipolar depression (29/35). The mean difference in kappa between schizoaffective disorder and the other diagnoses was approximately 0.2, and mean Cohen's kappa for schizoaffective disorder was 0.50 (95% confidence interval: 0.40-0.59). While findings were unequivocal and homogeneous for schizoaffective disorder's diagnostic reliability relative to its three main differential diagnoses (dichotomous: smaller versus larger), heterogeneity was substantial for continuous measures, even after subgroup and sensitivity analyses. In clinical practice and research, schizoaffective disorder's comparatively low diagnostic reliability should lead to increased efforts to correctly diagnose the disorder. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Plasma Nervonic Acid Is a Potential Biomarker for Major Depressive Disorder: A Pilot Study.

    Science.gov (United States)

    Kageyama, Yuki; Kasahara, Takaoki; Nakamura, Takemichi; Hattori, Kotaro; Deguchi, Yasuhiko; Tani, Munehide; Kuroda, Kenji; Yoshida, Sumiko; Goto, Yu-Ichi; Inoue, Koki; Kato, Tadafumi

    2018-03-01

    Diagnostic biomarkers of major depressive disorder, bipolar disorder, and schizophrenia are urgently needed, because none are currently available. We performed a comprehensive metabolome analysis of plasma samples from drug-free patients with major depressive disorder (n=9), bipolar disorder (n=6), schizophrenia (n=17), and matched healthy controls (n=19) (cohort 1) using liquid chromatography time-of-flight mass spectrometry. A significant effect of diagnosis was found for 2 metabolites: nervonic acid and cortisone, with nervonic acid being the most significantly altered. The reproducibility of the results and effects of psychotropic medication on nervonic acid were verified in cohort 2, an independent sample set of medicated patients [major depressive disorder (n=45), bipolar disorder (n=71), schizophrenia (n=115)], and controls (n=90) using gas chromatography time-of-flight mass spectrometry. The increased levels of nervonic acid in patients with major depressive disorder compared with controls and patients with bipolar disorder in cohort 1 were replicated in the independent sample set (cohort 2). In cohort 2, plasma nervonic acid levels were also increased in the patients with major depressive disorder compared with the patients with schizophrenia. In cohort 2, nervonic acid levels were increased in the depressive state in patients with major depressive disorder compared with the levels in the remission state in patients with major depressive disorder and the depressive state in patients with bipolar disorder. These results suggested that plasma nervonic acid is a good candidate biomarker for the depressive state of major depressive disorder. © The Author 2017. Published by Oxford University Press on behalf of CINP.

  12. Major depressive disorder, panic disorder, and post-traumatic stress disorder in Korean subway drivers.

    Science.gov (United States)

    Kim, Hyoung-Ryoul; Yim, Hyeon Woo; Jo, Sun-Jin; Choi, Bongkyoo; Jeong, Seung Hee; Lee, Kang Sook; Park, Jong-Ik; Chang, Sung Man

    2013-05-01

    The purposes of this study are to investigate the prevalence of major depressive disorder, panic disorder, and post-traumatic stress disorder (PTSD) in Korean subway drivers, and find the association between these disorders and the drivers' person-under-train (PUT) experiences. A total of 826 subway drivers who participated in a cross-sectional work and health survey were included for this study. The Korean version of the Composite International Diagnostic Interview 2.1 was applied to assess major depressive disorder, panic disorder, and PTSD. The date of PUT, whether victim died, and how many PUTs the drivers experienced were asked using a structured questionnaire. The standardized prevalence ratios (SPRs) for lifetime prevalence of panic disorder and PTSD in subway drivers were 13.3 (95 % confidence interval [CI] 6.6-22.4) and 2.1 (95 % CI 1.1-3.4), respectively. In lifetime prevalence, after adjusting for age, education, income, and working career, the drivers who experienced PUT had significantly higher risks for panic disorder (odds ratio [OR] = 4.2, 95 % CI 1.2-16.6) and PTSD (OR = 4.4, 95 % CI 1.3-16.4). In 1-year prevalence, the drivers who experienced PUT had a significantly higher risk for PTSD (OR = 11.7, 95 % CI 1.9-225.8). There was no significant value of SPR and OR in major depressive disorder. This study suggests that Korean subway drivers are at higher risk for panic disorder and PTSD compared to the general population, and PUT experience is associated with panic disorder and PTSD. Drivers who have experienced PUT should be treated quickly, sympathetically, and sensitively by a psychological professional and their colleagues, so they can return to work soon.

  13. Major depressive disorder and generalized anxiety disorder and response to treatment in hepatitis C patients in Egypt.

    Science.gov (United States)

    MM, Bassiony; A, Yousef; U, Youssef; GM, Salah El-Deen; M, Abdelghani; H, Al-Gohari; E, Fouad; MM, El-Shafaey

    2015-01-01

    The aim of the study was to estimate the prevalence and associated correlates of major depressive disorder and generalized anxiety disorder in hepatitis C virus patients before and after treatment and to investigate the relationship between major depressive disorder and generalized anxiety disorder and treatment response. A total of 116 consecutive hepatitis C virus patients from hepatitis C virus treatment center in Zagazig city, Egypt, were included in the study and divided into treated group (N = 58) and untreated group (N = 58). All hepatitis C virus patients were screened for major depressive disorder and generalized anxiety disorder using hospital anxiety and depression scale, and those who screened positive were interviewed to confirm the diagnosis of major depressive disorder and generalized anxiety disorder using DSM-IV-TR diagnostic criteria. These measures were done at baseline and after 12 weeks of treatment or observation. At baseline, 3.5% and 12.1% of hepatitis C virus patients (treated group) had major depressive disorder and generalized anxiety disorder, respectively. After 12 weeks of treatment 37.9% of hepatitis C virus patients (treated group) had major depressive disorder and 46.6% had generalized anxiety disorder. There was a significant statistical difference between hospital anxiety and depression scale scores for depression (3.3 ± 2.3 vs. 6.4 ± 3.2, t = 9.6, p = 0.001) and for anxiety (4.6 ± 2.4 vs. 7.3 ± 3.0, t = 10.2, p = 0.001) before and after treatment. There was also significant statistical difference between treated group and untreated group regarding hospital anxiety and depression scale scores after treatment and observation (depression, treated group 6.4 ± 3.2 vs. untreated group 4.0 ± 2.4, t = 3.7, p = 0.001; anxiety, treated group 7.3 ± 3.0 vs. untreated group 4.5 ± 2.3, t = 4.4, p = 0.001). There was no association between major depressive disorder

  14. Major Depressive Disorder

    Directory of Open Access Journals (Sweden)

    G Grobler

    2013-08-01

    Full Text Available The treatment guideline draws on several international guidelines: (iPractice Guidelines of the American Psychiatric Association (APAfor the Treatment of Patients with Major Depressive Disorder, SecondEdition;[1](ii Clinical Guidelines for the Treatment of DepressiveDisorders by the Canadian Psychiatric Association and the CanadianNetwork for Mood and Anxiety Treatments (CANMAT;[2](iiiNational Institute for Clinical Excellence (NICE guidelines;[3](iv RoyalAustralian and New Zealand College of Psychiatrists Clinical PracticeGuidelines Team for Depression (RANZCAP;[4](v Texas MedicationAlgorithm Project (TMAP Guidelines;[5](vi World Federation ofSocieties of Biological Psychiatry (WFSBP Treatment Guideline forUnipolar Depressive Disorder;[6]and (vii British Association forPsychopharmacology Guidelines.[7

  15. Dimensional psychiatry: reward dysfunction and depressive mood across psychiatric disorders.

    Science.gov (United States)

    Hägele, Claudia; Schlagenhauf, Florian; Rapp, Michael; Sterzer, Philipp; Beck, Anne; Bermpohl, Felix; Stoy, Meline; Ströhle, Andreas; Wittchen, Hans-Ulrich; Dolan, Raymond J; Heinz, Andreas

    2015-01-01

    A dimensional approach in psychiatry aims to identify core mechanisms of mental disorders across nosological boundaries. We compared anticipation of reward between major psychiatric disorders, and investigated whether reward anticipation is impaired in several mental disorders and whether there is a common psychopathological correlate (negative mood) of such an impairment. We used functional magnetic resonance imaging (fMRI) and a monetary incentive delay (MID) task to study the functional correlates of reward anticipation across major psychiatric disorders in 184 subjects, with the diagnoses of alcohol dependence (n = 26), schizophrenia (n = 44), major depressive disorder (MDD, n = 24), bipolar disorder (acute manic episode, n = 13), attention deficit/hyperactivity disorder (ADHD, n = 23), and healthy controls (n = 54). Subjects' individual Beck Depression Inventory-and State-Trait Anxiety Inventory-scores were correlated with clusters showing significant activation during reward anticipation. During reward anticipation, we observed significant group differences in ventral striatal (VS) activation: patients with schizophrenia, alcohol dependence, and major depression showed significantly less ventral striatal activation compared to healthy controls. Depressive symptoms correlated with dysfunction in reward anticipation regardless of diagnostic entity. There was no significant correlation between anxiety symptoms and VS functional activation. Our findings demonstrate a neurobiological dysfunction related to reward prediction that transcended disorder categories and was related to measures of depressed mood. The findings underline the potential of a dimensional approach in psychiatry and strengthen the hypothesis that neurobiological research in psychiatric disorders can be targeted at core mechanisms that are likely to be implicated in a range of clinical entities.

  16. Paediatric Obsessive-Compulsive Disorder and Depressive Symptoms: Clinical Correlates and CBT Treatment Outcomes.

    Science.gov (United States)

    Brown, H M; Lester, K J; Jassi, A; Heyman, I; Krebs, G

    2015-07-01

    Depression frequently co-occurs with paediatric obsessive-compulsive disorder (OCD), yet the clinical correlates and impact of depression on CBT outcomes remain unclear. The prevalence and clinical correlates of depression were examined in a paediatric specialist OCD-clinic sample (N = 295; Mean = 15 [7 - 18] years, 42 % female), using both dimensional (Beck Depression Inventory-youth; n = 261) and diagnostic (Development and Wellbeing Assessment; n = 127) measures of depression. The impact of depressive symptoms and suspected disorders on post-treatment OCD severity was examined in a sub-sample who received CBT, with or without SSRI medication (N = 100). Fifty-one per-cent of patients reported moderately or extremely elevated depressive symptoms and 26 % (95 % CI: 18 - 34) met criteria for a suspected depressive disorder. Depressive symptoms and depressive disorders were associated with worse OCD symptom severity and global functioning prior to CBT. Individuals with depression were more likely to be female, have had a psychiatric inpatient admission and less likely to be attending school (ps depressive symptom severity significantly decreased after CBT. Depressive symptoms and depressive disorders predicted worse post-treatment OCD severity (βs = 0.19 and 0.26, ps Depression is common in paediatric OCD and is associated with more severe OCD and poorer functioning. However, depression severity decreases over the course of CBT for OCD and is not independently associated with worse outcomes, supporting the recommendation for treatment as usual in the presence of depressive symptoms.

  17. Social relationship correlates of major depressive disorder and depressive symptoms in Switzerland: nationally representative cross sectional study.

    Science.gov (United States)

    Barger, Steven D; Messerli-Bürgy, Nadine; Barth, Jürgen

    2014-03-24

    The quality and quantity of social relationships are associated with depression but there is less evidence regarding which aspects of social relationships are most predictive. We evaluated the relative magnitude and independence of the association of four social relationship domains with major depressive disorder and depressive symptoms. We analyzed a cross-sectional telephone interview and postal survey of a probability sample of adults living in Switzerland (N=12,286). Twelve-month major depressive disorder was assessed via structured interview over the telephone using the Composite International Diagnostic Interview (CIDI). The postal survey assessed depressive symptoms as well as variables representing emotional support, tangible support, social integration, and loneliness. Each individual social relationship domain was associated with both outcome measures, but in multivariate models being lonely and perceiving unmet emotional support had the largest and most consistent associations across depression outcomes (incidence rate ratios ranging from 1.55-9.97 for loneliness and from 1.23-1.40 for unmet support, p'sdepressive symptoms whereas only loneliness and unmet support were associated with depressive disorder. Perceived quality and frequency of social relationships are associated with clinical depression and depressive symptoms across a wide adult age spectrum. This study extends prior work linking loneliness to depression by showing that a broad range of social relationship domains are associated with psychological well-being.

  18. Diagnostic and therapeutic utility of neuroimaging in depression: an overview

    Directory of Open Access Journals (Sweden)

    Wise T

    2014-08-01

    Full Text Available Toby Wise,1 Anthony J Cleare,1 Andrés Herane,1,2 Allan H Young,1 Danilo Arnone1 1King’s College London, Institute of Psychiatry, Department of Psychological Medicine, Centre for Affective Disorders, London, United Kingdom; 2Clínica Psiquiátrica Universitaria, Universidad de Chile, Santiago, Chile Abstract: A growing number of studies have used neuroimaging to further our understanding of how brain structure and function are altered in major depression. More recently, these techniques have begun to show promise for the diagnosis and treatment of depression, both as aids to conventional methods and as methods in their own right. In this review, we describe recent neuroimaging findings in the field that might aid diagnosis and improve treatment accuracy. Overall, major depression is associated with numerous structural and functional differences in neural systems involved in emotion processing and mood regulation. Furthermore, several studies have shown that the structure and function of these systems is changed by pharmacological and psychological treatments of the condition and that these changes in candidate brain regions might predict clinical response. More recently, “machine learning” methods have used neuroimaging data to categorize individual patients according to their diagnostic status and predict treatment response. Despite being mostly limited to group-level comparisons at present, with the introduction of new methods and more naturalistic studies, neuroimaging has the potential to become part of the clinical armamentarium and may improve diagnostic accuracy and inform treatment choice at the patient level. Keywords: depression, mood disorder, neuroimaging, diagnosis, treatment

  19. Specificity of abnormal brain volume in major depressive disorder: a comparison with borderline personality disorder.

    Science.gov (United States)

    Depping, Malte S; Wolf, Nadine D; Vasic, Nenad; Sambataro, Fabio; Thomann, Philipp A; Christian Wolf, R

    2015-03-15

    Abnormal brain volume has been frequently demonstrated in major depressive disorder (MDD). It is unclear if these findings are specific for MDD since aberrant brain structure is also present in disorders with depressive comorbidity and affective dysregulation, such as borderline personality disorder (BPD). In this transdiagnostic study, we aimed to investigate if regional brain volume loss differentiates between MDD and BPD. Further, we tested for associations between brain volume and clinical variables within and between diagnostic groups. 22 Females with a DSM-IV diagnosis of MDD, 17 females with a DSM-IV diagnosis of BPD and without comorbid posttraumatic stress disorder, and 22 age-matched female healthy controls (HC) were investigated using magnetic resonance imaging. High-resolution structural data were analyzed using voxel-based morphometry. A significant (pdisorders. Copyright © 2014 Elsevier B.V. All rights reserved.

  20. Uric acid in major depressive and anxiety disorders.

    Science.gov (United States)

    Black, Catherine N; Bot, Mariska; Scheffer, Peter G; Snieder, Harold; Penninx, Brenda W J H

    2018-01-01

    Uric acid has neuroprotective effects, owing to its antioxidant properties. Lowered antioxidant capacity, causing increased oxidative stress, may be involved in affective disorders and might be altered by antidepressants. This study investigated the association of plasma uric acid, the greatest contributor to blood antioxidant capacity, with major depressive disorder (MDD) and anxiety disorders. Data were from the Netherlands Study of Depression and Anxiety including patients with current (N = 1648), remitted (N = 609) MDD and/or anxiety disorders (of which N = 710 antidepressant users) and 618 controls. Diagnoses were established with the Composite International Diagnostic Interview. Symptom severity was assessed with the Inventory of Depressive Symptoms-Self Report, Beck Anxiety Inventory and Fear Questionnaire. Uric acid was measured in plasma. Analyses were adjusted for sociodemographic, health and lifestyle variables. Plasma uric acid adjusted mean levels were lower in current MDD and/or anxiety disorder(s) (289μmol/l) compared to remitted disorders (298μmol/l, p uric acid. Limitations include the lack of data on dietary intake which could be a potential confounding factor. From these cross-sectional findings, the association between uric acid and psychopathology cannot be inferred to be causal. This large scale study finds plasma uric acid levels are lower in current, but not remitted, MDD and/or anxiety disorders, according to a dose-response gradient. This suggests the involvement of decreased antioxidant status in affective disorders, and points to their potential as an avenue for treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Teacher and Parent Ratings of Children with Depressive Disorders

    Science.gov (United States)

    Mattison, Richard E.; Carlson, Gabrielle A.; Cantwell, Dennis P.; Asarnow, Joan Rosenbaum

    2007-01-01

    The fields of child psychology and psychiatry have not yet established the clinical presentation in school of children and adolescents who have been diagnosed as having a depressive disorder. To address this issue, the authors used teacher ratings on scale oriented to the third, revised edition of the "Diagnostic and Statistical Manual of…

  2. Concordance between a simpler definition of major depressive disorder and Diagnostic and statistical manual of mental disorders, fourth edition: an independent replication in an outpatient sample.

    Science.gov (United States)

    Zimmerman, Mark; Emmert-Aronson, Benjamin O; Brown, Timothy A

    2011-01-01

    The diagnostic and statistical manual of mental disorders, fourth edition (DSM-IV) symptom criteria for major depressive disorder (MDD) are somewhat lengthy with several studies showing that clinicians have difficulty recalling all 9 symptoms. Moreover, the criteria include somatic symptoms that are difficult to apply in patients with medical illnesses. To address these problems, a simpler definition of MDD was developed that did not include the somatic symptoms. Previous reports found high levels of agreement between the simplified and full DSM-IV definition of MDD. However, the same research group has conducted all previous studies of psychiatric patients. The goal of the present study was to determine if a high level of concordance between the 2 definitions would be replicated in an independent setting. We interviewed 2907 psychiatric outpatients presenting for treatment at the Boston University Center for Anxiety and Related Disorders. A trained diagnostic rater administered a semistructured interview and inquired about all symptoms of depression for all patients. A high level of agreement was found between the DSM-IV and the simpler definition of MDD. The absolute level of agreement between the 2 definitions was 95.5% and the κ coefficient was 0.88. Thus, consistent with previous studies, a high level of concordance was found between a simpler definition of MDD and the DSM-IV definition. This new definition offers 2 advantages over the current DSM-IV definition-it is briefer, and it is easier to apply with medically ill patients because it is free of somatic symptoms. Implications of these findings for DSM-5 are discussed. Copyright © 2011 Elsevier Inc. All rights reserved.

  3. Social relationship correlates of major depressive disorder and depressive symptoms in Switzerland: nationally representative cross sectional study

    Science.gov (United States)

    2014-01-01

    Background The quality and quantity of social relationships are associated with depression but there is less evidence regarding which aspects of social relationships are most predictive. We evaluated the relative magnitude and independence of the association of four social relationship domains with major depressive disorder and depressive symptoms. Methods We analyzed a cross-sectional telephone interview and postal survey of a probability sample of adults living in Switzerland (N = 12,286). Twelve-month major depressive disorder was assessed via structured interview over the telephone using the Composite International Diagnostic Interview (CIDI). The postal survey assessed depressive symptoms as well as variables representing emotional support, tangible support, social integration, and loneliness. Results Each individual social relationship domain was associated with both outcome measures, but in multivariate models being lonely and perceiving unmet emotional support had the largest and most consistent associations across depression outcomes (incidence rate ratios ranging from 1.55-9.97 for loneliness and from 1.23-1.40 for unmet support, p’s social relationship domains except marital status were independently associated with depressive symptoms whereas only loneliness and unmet support were associated with depressive disorder. Conclusions Perceived quality and frequency of social relationships are associated with clinical depression and depressive symptoms across a wide adult age spectrum. This study extends prior work linking loneliness to depression by showing that a broad range of social relationship domains are associated with psychological well-being. PMID:24656048

  4. An investigation of diagnostic accuracy and confidence related to diagnostic checklists as well as gender biases in relation to mental disorders

    Directory of Open Access Journals (Sweden)

    Jan Christopher Cwik

    2016-11-01

    Full Text Available This study examines the utility of checklists in attaining more accurate diagnoses in the context of diagnostic decision-making for mental disorders. The study also aimed to replicate results from a meta-analysis indicating that there is no association between patients’ gender and misdiagnoses. To this end, 475 psychotherapists were asked to judge three case vignettes describing patients with Major Depressive Disorder, Generalized Anxiety Disorder, and Borderline Personality Disorder. Therapists were randomly assigned to experimental conditions in a 2 (diagnostic method: with using diagnostic checklists vs. without using diagnostic checklists x 2 (gender: male vs. female case vignettes between-subjects design. Multinomial logistic and linear regression analyses were used to examine the association between the usage of diagnostic checklists as well as patients’ gender and diagnostic decisions.The results showed that when checklists were used, fewer incorrect co-morbid diagnoses were made, but clinicians were less likely to diagnose MDD even when the criteria were met. Additionally, checklists improved therapists’ confidence with diagnostic decisions, but were not associated with estimations of patients’ characteristics. As expected, there were no significant associations between gender and diagnostic decisions.

  5. An Investigation of Diagnostic Accuracy and Confidence Associated with Diagnostic Checklists as Well as Gender Biases in Relation to Mental Disorders.

    Science.gov (United States)

    Cwik, Jan C; Papen, Fabienne; Lemke, Jan-Erik; Margraf, Jürgen

    2016-01-01

    This study examines the utility of checklists in attaining more accurate diagnoses in the context of diagnostic decision-making for mental disorders. The study also aimed to replicate results from a meta-analysis indicating that there is no association between patients' gender and misdiagnoses. To this end, 475 psychotherapists were asked to judge three case vignettes describing patients with Major Depressive Disorder (MDD), Generalized Anxiety Disorder, and Borderline Personality Disorder. Therapists were randomly assigned to experimental conditions in a 2 (diagnostic method: with using diagnostic checklists vs. without using diagnostic checklists) × 2 (gender: male vs. female case vignettes) between-subjects design. Multinomial logistic and linear regression analyses were used to examine the association between the usage of diagnostic checklists as well as patients' gender and diagnostic decisions. The results showed that when checklists were used, fewer incorrect co-morbid diagnoses were made, but clinicians were less likely to diagnose MDD even when the criteria were met. Additionally, checklists improved therapists' confidence with diagnostic decisions, but were not associated with estimations of patients' characteristics. As expected, there were no significant associations between gender and diagnostic decisions.

  6. Prevalence and characteristics of depressive disorders in early adolescents in central Norway

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    Larsson Bo

    2011-08-01

    Full Text Available Abstract Background Prevalence of depressive disorders among adolescents has varied across studies. The present study aims to assess current and lifetime prevalence and characteristics of adolescent Major Depressive Disorder (MDD, Dysthymia and Depression NOS among adolescents in Central Norway in addition to socio-demographics and use of mental health care. Method In the Youth and Mental Health Study a representative sample of 2432 junior high school students (mean age 14.9 years, SD = 0.6 from two counties in Central Norway were screened with the Mood and Feelings Questionnaire (MFQ. A subset of 345 of these adolescents (72.5% girls, 220 high scorers (MFQ = > 26, 74 middle scorers (MFQ 7-25, and 50 low scorers (MFQ Results Almost one in four subjects (23% had life-time depression. Prevalences of current Major Depressive Disorder (MDD, Dysthymia and "Double depression" were 2.6%, 1.0% and 0.6%, respectively, and for Depression NOS 6.3%. All depressive disorders were characterized by long duration of episodes with large variations, and for any depressive disorder onset before 12 years of age. In multivariate analyses MDD and Dysthymia were most strongly associated with gender and not living with both biological parents. There was no gender difference for Depression NOS. Although a considerable number of depressed subjects had received mental health care, the reason for contact with services was seldom due to affective symptoms. Less than 20% had been in contact with specialist mental health services. Conclusion High rates of Depression NOS, early onset of depressive episodes, long duration, and low use of specialized services point to the need for improved diagnostic assessment and treatment for young individuals.

  7. The influence of comorbid personality disorders on recovery from depression

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    Wongpakaran T

    2015-03-01

    Full Text Available Tinakon Wongpakaran, Nahathai Wongpakaran, Vudhichai Boonyanaruthee, Manee Pinyopornpanish, Suthi Intaprasert Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand Purpose: The impact of personality disorders on the treatment of and recovery from depression is still a controversial topic. The aim of this paper is to provide more information on what has led to this disagreement.Materials and methods: Clinician-rated Hamilton Depression Rating Scale (HAMD scores were assessed among 82 depressed outpatients who were receiving a routine treatment combination of antidepressant medication and psychosocial intervention. The participants were followed up over five visits at 3-month intervals: at the baseline, at 3, 6, 9 and 12 months. Personality disorders were assessed after the last visit in accordance with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. These repeated measures were used to explore the impact of personality disorders on HAMD scores by using a linear mixed model.Results: Among the four personality clusters that were used (A, B, C, and mixed, only those in cluster B and in the mixed cluster were found to take significantly longer than those without personality disorders, for reduction in HAMD scores over the course of treatment.Conclusion: In this study, the impact of personality disorders on treatment outcomes varied with the way that the personality disorder variables were described and used as independent predictors. This is because the outcomes were influenced by the impact weight of each personality disorder, even within the same cluster. Keywords: depressive disorder, mixed linear model, impact, multilevel analysis

  8. Childhood adversity and adult depressive disorder: a case-controlled study in Malaysia.

    Science.gov (United States)

    Loh, S F; Maniam, T; Tan, S M K; Badi'ah, Y

    2010-06-01

    To describe the association between childhood adversity and depression in adult depressed patients in a Malaysian population. Fifty-two patients, who met the criteria for major depressive disorder or dysthymia according to the Structured Clinical Interview based on the revised 3rd edition of the Diagnostic and Statistical Manual of Mental Disorders, were used as cases and compared with 52 controls matched for age and sex. Cases and controls were assessed using a sexual and physical abuse questionnaire and a Parental Bonding Instrument. There was a positive relationship between childhood abuse in general and childhood physical abuse with adult depressive disorder in particular. Nearly a quarter (23%) of depressed patients reported being abused in childhood compared with none in the control group. There was no significant association between childhood loss and depression in adulthood. Low level of parental care during childhood was significantly correlated with adult depressive disorder. Clinicians should assiduously seek a history of childhood adversities in adult patients with depression. This information can influence clinical management by way of implementing secondary preventive measures. In all depressed patients, mental health professionals also need to look out for their poor attachment with parents during childhood. This may enable interventions directed at parenting skills and improved attachment relationships with their own children. These types of interventions together with pharmacotherapy may provide the optimal approach to the management of depression in adults and help prevent the cycle of depression perpetuating itself in the next generation.

  9. Differences in depressive symptoms between Korean and American outpatients with major depressive disorder.

    Science.gov (United States)

    Jeon, Hong Jin; Walker, Rosemary S; Inamori, Aya; Hong, Jin Pyo; Cho, Maeng Je; Baer, Lee; Clain, Alisabet; Fava, Maurizio; Mischoulon, David

    2014-05-01

    Previous epidemiologic studies have revealed that East-Asian populations experience fewer depressive symptoms than American populations do. However, it is unclear whether this difference applies to clinical patients with major depressive disorder (MDD). This present study included 1592 Korean and 3744 American outpatients who were 18 years of age or older and met the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. criteria for single or recurrent episodes of nonpsychotic MDD, and evaluated their symptoms of depression using the Hamilton Depression Rating Scale and the Quality of Life Enjoyment and Satisfaction Questionnaire Short Form. Korean patients scored significantly lower for guilt and depressed mood items, and higher for hypochondriasis and suicidality items than American patients did, after adjusting for total Hamilton Depression Rating Scale scores. Conversely, no significant differences were found in quality and function of daily life between groups. Multivariate logistic regression analyses revealed that Korean patients experienced less frequent depressed mood and guilt, including verbal and nonverbal expression of depressed mood [adjusted odds ratio (AOR) = 0.14, 95% confidence interval (CI) 0.08-0.23] and feelings of punishment (AOR = 0.036, 95% CI 0.025-0.054) when compared with Americans after adjusting for age and sex. Conversely, Korean patients experienced more frequent suicidality and hypochondriasis, including suicidal ideas or gestures (AOR = 2.10, 95% CI 1.60-2.76) and self-absorption of hypochondriasis (AOR = 1.94, 95% CI 1.70-2.20). In conclusion, decreased expression of depressed mood and guilt may cause underdiagnosis of MDD in Korean patients. Early diagnosis of and intervention for depression and suicide may be delayed because of this specific cross-cultural difference in depression symptoms.

  10. A Korean validation study of the Clinically Useful Anxiety Outcome Scale: Comorbidity and differentiation of anxiety and depressive disorders

    Science.gov (United States)

    Jeon, Sang Won; Ko, Young-Hoon; Yoon, Seoyoung; Pae, Chi-Un; Choi, Joonho; Kim, Jae-Min; Yoon, Ho-Kyoung; Lee, Hoseon; Patkar, Ashwin A.; Zimmerman, Mark

    2017-01-01

    Background This study aimed to evaluate the psychometric properties of the Korean version of the Clinically Useful Anxiety Outcome Scale (CUXOS) and to examine the current diagnostic comorbidity and differential severity of anxiety symptoms between major depressive disorder (MDD) and anxiety disorders. Methodology In total, 838 psychiatric outpatients were analyzed at their intake appointment. Diagnostic characteristics were examined using the structured clinical interview from the DSM-IV because the DSM5 was not available at the start of the study. The CUXOS score was measured and compared with that of 3 clinician rating scales and 4 self-report scales. Principal findings The CUXOS showed excellent results for internal consistency (Cronbach’s α = 0.90), test–retest reliability (r = 0.74), and discriminant and convergent validity. The CUXOS significantly discriminated between different levels of anxiety severity, and the measure was sensitive to change after treatment. Approximately 45% of patients with MDD were additionally diagnosed with anxiety disorders while 55% of patients with anxiety disorders additionally reported an MDD. There was a significant difference in CUXOS scores between diagnostic categories (MDD only, anxiety only, both disorders, and no MDD or anxiety disorder). The CUXOS scores differed significantly between all categories of depression (major, minor, and non-depression) except for the comparison between minor depression and non-depression groups. Conclusions The Korean version of the CUXOS is a reliable and valid measure of the severity of anxiety symptoms. The use of the CUXOS could broaden the understanding of coexisting and differentiating characteristics of anxiety and depression. PMID:28604808

  11. A Korean validation study of the Clinically Useful Anxiety Outcome Scale: Comorbidity and differentiation of anxiety and depressive disorders.

    Directory of Open Access Journals (Sweden)

    Sang Won Jeon

    Full Text Available This study aimed to evaluate the psychometric properties of the Korean version of the Clinically Useful Anxiety Outcome Scale (CUXOS and to examine the current diagnostic comorbidity and differential severity of anxiety symptoms between major depressive disorder (MDD and anxiety disorders.In total, 838 psychiatric outpatients were analyzed at their intake appointment. Diagnostic characteristics were examined using the structured clinical interview from the DSM-IV because the DSM5 was not available at the start of the study. The CUXOS score was measured and compared with that of 3 clinician rating scales and 4 self-report scales.The CUXOS showed excellent results for internal consistency (Cronbach's α = 0.90, test-retest reliability (r = 0.74, and discriminant and convergent validity. The CUXOS significantly discriminated between different levels of anxiety severity, and the measure was sensitive to change after treatment. Approximately 45% of patients with MDD were additionally diagnosed with anxiety disorders while 55% of patients with anxiety disorders additionally reported an MDD. There was a significant difference in CUXOS scores between diagnostic categories (MDD only, anxiety only, both disorders, and no MDD or anxiety disorder. The CUXOS scores differed significantly between all categories of depression (major, minor, and non-depression except for the comparison between minor depression and non-depression groups.The Korean version of the CUXOS is a reliable and valid measure of the severity of anxiety symptoms. The use of the CUXOS could broaden the understanding of coexisting and differentiating characteristics of anxiety and depression.

  12. The relevance of 'mixed anxiety and depression' as a diagnostic category in clinical practice.

    OpenAIRE

    Möller, Hans-Jürgen; Bandelow, Borwin; Volz, Hans-Peter; Barnikol, Utako Birgit; Seifritz, Erich; Kasper, Siegfried

    2016-01-01

    According to ICD-10 criteria, mixed anxiety and depressive disorder (MADD) is characterized by co-occurring, subsyndromal symptoms of anxiety and depression, severe enough to justify a psychiatric diagnosis, but neither of which are clearly predominant. MADD appears to be very common, particularly in primary care, although prevalence estimates vary, often depending on the diagnostic criteria applied. It has been associated with similarly pronounced distress, impairment of daily living skills,...

  13. The role of depression in perceived parenting style among patients with anxiety disorders.

    Science.gov (United States)

    Fentz, Hanne N; Arendt, Mikkel; O'Toole, Mia S; Rosenberg, Nicole K; Hougaard, Esben

    2011-12-01

    Despite a long tradition of research on the relationship between parenting style and anxiety disorders, few studies have taken the effect of comorbid depression into account. This study investigated perceived parenting in 504 outpatients with panic disorder/agoraphobia, social phobia or obsessive-compulsive disorder, and in 210 psychology students. The anxiety group reported both parents as less caring and their fathers as more controlling than did the student group. However, these between-group differences disappeared when taking self-reported depressive symptoms into consideration. Also no differences in parental style were found between the three diagnostic anxiety groups, when depressive symptoms were taken into account. Self-reported depressive symptoms were more consistently associated with negatively perceived parenting style than with self-reported anxiety symptoms in both the anxiety group and the student group. Results do not support theories of parental control as a specific risk factor for anxiety disorders, but they are in accordance with prior findings showing an association between depression and perceived lack of parental care. Copyright © 2011 Elsevier Ltd. All rights reserved.

  14. Brief Report: Overgeneral Autobiographical Memory in Adolescent Major Depressive Disorder

    Science.gov (United States)

    Champagne, Katelynn; Burkhouse, Katie L.; Woody, Mary L.; Feurer, Cope; Sosoo, Effua; Gibb, Brandon E.

    2016-01-01

    The current study examined whether overgeneral autobiographical memory (OGM) bias serves as a state-like marker of major depressive disorder (MDD) in adolescence or whether it would also be observed in currently nondepressed adolescents with a history of MDD. We examined differences in OGM to positive and negative cue words between adolescents (aged 11–18 years) with current MDD (n = 15), remitted MDD (n = 25), and no history of any depressive disorder (n = 25). Youth and their parents were administered a structured diagnostic interview and adolescents completed the autobiographical memory test. Compared to never depressed adolescents, adolescents with current or remitted MDD recalled less specific memories in response to positive and negative cue words. The difference between the two MDD groups was small and nonsignificant. These findings suggest that OGM is not simply a state-like marker in currently depressed adolescents, but is also evident in adolescents with remitted MDD, indicating that it may represent a trait-like vulnerability that increases risk for relapse. PMID:27498000

  15. Anxiety and depressive disorders in elderly with chronic dizziness of vestibular origin

    Directory of Open Access Journals (Sweden)

    Érica Toledo Piza Peluso

    2016-04-01

    Full Text Available ABSTRACT INTRODUCTION: Dizziness is one of the most prevalent symptoms in the elderly. Anxiety and depression are common in dizzy adult patients, but there is scarce information about comorbidity between vestibular disturbances and psychiatric disorders in the aged. OBJECTIVE: To assess the prevalence of anxiety and depression disorders in elderly with chronic dizziness of vestibular origin. METHODS: Transversal study that used the Brazilian version of the Composite International Diagnostic Interview 2.1 to assess anxiety and depressive disorders in elderly patients (≥60 years old with chronic dizziness. RESULTS: Most of the 44 patients included in the study were female (88.6% with a mean age of 71 years (±7.5, 68.1% had experienced dizziness for 1 year or more. The most prevalent diagnosis was benign paroxysmal positional vertigo (52.3%. The prevalence of generalized anxiety disorder and specific phobias during life were 29.5% and 22.7%, respectively, and, in the last 12 months, 18.2% and 15.9%. There was no patient with panic disorder, agoraphobia or social phobia. The prevalence of depressive disorder during life was 45.4%, and, in the last 12 months, were 11.3%. CONCLUSION: Aged patients with chronic dizziness had high prevalence of some mental disorders.

  16. Multi-centre diagnostic classification of individual structural neuroimaging scans from patients with major depressive disorder.

    Science.gov (United States)

    Mwangi, Benson; Ebmeier, Klaus P; Matthews, Keith; Steele, J Douglas

    2012-05-01

    Quantitative abnormalities of brain structure in patients with major depressive disorder have been reported at a group level for decades. However, these structural differences appear subtle in comparison with conventional radiologically defined abnormalities, with considerable inter-subject variability. Consequently, it has not been possible to readily identify scans from patients with major depressive disorder at an individual level. Recently, machine learning techniques such as relevance vector machines and support vector machines have been applied to predictive classification of individual scans with variable success. Here we describe a novel hybrid method, which combines machine learning with feature selection and characterization, with the latter aimed at maximizing the accuracy of machine learning prediction. The method was tested using a multi-centre dataset of T(1)-weighted 'structural' scans. A total of 62 patients with major depressive disorder and matched controls were recruited from referred secondary care clinical populations in Aberdeen and Edinburgh, UK. The generalization ability and predictive accuracy of the classifiers was tested using data left out of the training process. High prediction accuracy was achieved (~90%). While feature selection was important for maximizing high predictive accuracy with machine learning, feature characterization contributed only a modest improvement to relevance vector machine-based prediction (~5%). Notably, while the only information provided for training the classifiers was T(1)-weighted scans plus a categorical label (major depressive disorder versus controls), both relevance vector machine and support vector machine 'weighting factors' (used for making predictions) correlated strongly with subjective ratings of illness severity. These results indicate that machine learning techniques have the potential to inform clinical practice and research, as they can make accurate predictions about brain scan data from

  17. Prolidase activity and oxidative stress in patients with major depressive disorder.

    Science.gov (United States)

    Kokacya, Mehmet Hanifi; Bahceci, Bulent; Bahceci, Ilkay; Dilek, Aziz Ramazan; Dokuyucu, Recep

    2014-12-01

    The aim of the current study was to determine whether the serum prolidase levels are associated with the etiopathogenesis of depression. This study included 29 patients with major depressive disorder (MDD), who were consecutively recruited from the psychiatric outpatient clinic, and 30 healthy individuals recruited from the general community. Each patient underwent a detailed diagnostic evaluation by two psychiatrists using the Structured Clinical Interview for DSM-IV (SCID-I). Serum prolidase activity and oxidative parameters were measured in the patient and control groups. The severity of depressive symptoms was assessed using the Hamilton Depression Rating Scale. Serum prolidase level was significantly higher in patients with MDD compared to healthy subjects (pStress Index (OSI) were also significantly higher in patients with MDD (pstress in patients with MDD. Increased serum prolidase levels in patients with MDD may be interpreted as the interaction of prolidase activity, glutamate transmission and oxidative stress. It is suggested that prolidase activity is involved in the etiopathogenesis of depressive disorder.

  18. Comparison of demographic and clinical characteristics between children and adolescents with major depressive disorder.

    Science.gov (United States)

    Fu-I, Lee; Wang, Yuan Pang

    2008-06-01

    To compare clinical characteristics of major depressive disorder symptoms between children and adolescents. The subjects were 58 patients of a Child and Adolescent Affective Disorder Clinic consecutively admitted during a six-month period. Children aged 5-9 years old and adolescents from 10-17 years old currently meeting DSM-IV criteria diagnosis of major depressive disorder were chosen. Current MDD diagnosis and depressive psychopathology were assessed by a clinical interview and the Diagnostic Interview for Children and Adolescents-DSM-IV version. The Children's Depression Rating Scale-Revised Version and the Children Global Assessment Scale rated the severity and global functioning of major depressive disorder. The most common depressive symptoms were: anhedonia (72.4%), depressed mood (72.4%), decreased concentration (62.1%), and irritability (58.6%). The intensity of depressive episodes of this sample ranged from mild to moderate. Fifty percent reported thoughts of death, and 29.3% presented a variety of psychotic symptoms. When compared with children, adolescents reported a significantly more depressed mood (p = 0.043), lower self-esteem (p = 0.002), and had more difficulty concentrating (p = 0.020). Female adolescents had lower self-esteem (p = 0.003), and male adolescents showed more decreased concentration (p = 0.016). This study suggests that age and gender differences might influence the clinical presentation of major depressive disorder in children and adolescents. Further studies with larger samples are needed.

  19. Depressive disorder due to craniopharyngioma.

    Science.gov (United States)

    Spence, S A; Taylor, D G; Hirsch, S R

    1995-01-01

    Secondary causes of depression are legion, and must always be considered in patients presenting with features atypical of primary idiopathic depressive disorder. The case described is that of a middle-aged woman presenting initially with a major depressive disorder who was subsequently found to have a craniopharyngioma, leading to a revised diagnosis of mood disorder due to the tumour. Some features of the presentation might have led to earlier diagnosis had their localizing significance been recognized. Diencephalic lesions should always be considered in patients presenting with the hypersomnic-hyperphagic variant of depressive disorder. Images Figure 1 PMID:8544149

  20. A composite peripheral blood gene expression measure as a potential diagnostic biomarker in bipolar disorder

    DEFF Research Database (Denmark)

    Munkholm, Klaus; Peijs, L; Vinberg, M

    2015-01-01

    as a diagnostic and state biomarker in bipolar disorder. First, messenger RNA levels of 19 candidate genes were assessed in peripheral blood mononuclear cells of 37 rapid cycling bipolar disorder patients in different affective states (depression, mania and euthymia) during a 6-12-month period and in 40 age...... subjects. In patients with bipolar disorder, upregulation of NDUFV2 was observed in a depressed state compared with a euthymic state. The composite gene expression measure for discrimination between patients and healthy control subjects on the basis of 19 genes generated an area under the receiver...

  1. Does relational dysfunction mediate the association between anxiety disorders and later depression? Testing an interpersonal model of comorbidity.

    Science.gov (United States)

    Starr, Lisa R; Hammen, Constance; Connolly, Nicole Phillips; Brennan, Patricia A

    2014-01-01

    Anxiety disorders tend to precede onset of comorbid depression. Several researchers have suggested a causal role for anxiety in promoting depressive episodes, but few studies have identified specific mechanisms. The current study proposes an interpersonal model of comorbidity, where anxiety disorders disrupt interpersonal functioning, which in turn elevates risk for depression. At age 15 (T1), 815 adolescents oversampled for maternal depression completed diagnostic interviews, social chronic stress interviews, and self-report measures. At age 20 (T2), participants repeated all measures and reported on self-perceived interpersonal problems. At approximately age 23 (T3), a subset of participants (n = 475) completed a self-report depressive symptoms measure. Consistent with other samples, anxiety disorders largely preceded depressive disorders. Low sociability and interpersonal oversensitivity mediated the association between T1 social anxiety disorder and later depression (including T2 depressive diagnosis and T3 depressive symptoms), controlling for baseline. Interpersonal oversensitivity and social chronic stress similarly mediated the association between generalized anxiety disorder before age 15 and later depression. Interpersonal dysfunction may be one mechanism through which anxiety disorders promote later depression, contributing to high comorbidity rates. © 2013 Wiley Periodicals, Inc.

  2. Social phobia, panic disorder and suicidality in subjects with pure and depressive mania.

    Science.gov (United States)

    Dilsaver, Steven C; Chen, Yuan-Who

    2003-11-01

    The objective of this study is to ascertain the rates of social phobia, panic disorder and suicidality in the midst of the manic state among subjects with pure and depressive mania. Subjects received evaluations entailing the use of serial standard clinical interviews, the Schedule for Affective Disorders and Schizophrenia (SADS) and a structured interview to determine whether they met the criteria for intra-episode social phobia (IESP) and panic disorder (IEPD). The diagnoses of major depressive disorder and mania were rendered using the Research Diagnostic Criteria. The diagnoses of IESP and IEPD were rendered using DSM-III-R criteria. Categorization as being suicidal was based on the SADS suicide subscale score. Twenty-five (56.8%) subjects had pure and 19 (43.2%) subjects had depressive mania. None of the subjects with pure and 13 (68.4%) with depressive mania had IESP (Pdepressive mania had IEPD (Pdepressive were suicidal. Twelve of 13 (92.3%) subjects with depressive mania met the criteria for IESP and IEPD concurrently (Pdepressive but not pure mania exhibited high rates of both IESP and IEPD. Concurrence of the disorders is the rule. The findings suggest that databases disclosing a relationship between panic disorder and suicidality merit, where possible, reanalysis directed at controlling for the effect of social phobia.

  3. Suicidal ideation, deliberate self-harm behaviour and suicide attempts among adolescent outpatients with depressive mood disorders and comorbid axis I disorders.

    Science.gov (United States)

    Tuisku, Virpi; Pelkonen, Mirjami; Karlsson, Linnea; Kiviruusu, Olli; Holi, Matti; Ruuttu, Titta; Punamäki, Raija-Leena; Marttunen, Mauri

    2006-06-01

    We aimed to analyse and compare prevalence and associated clinical features of suicidal ideation, self-harm behaviour with no suicidal intent and suicide attempts among adolescent outpatients with depressive mood disorders with or without comorbidity. A sample of 218 consecutive adolescent outpatients aged 13-19 years with depressive mood disorders was interviewed using K-SADS-PL for DSM-IV Axis I diagnoses. They filled out self-report questionnaires assessing depressive and anxiety symptoms. Suicidal behaviour was assessed by K-SADS-PL suicidality items. Half of the subjects reported suicidal ideation or behaviour. There was no difference in prevalence of suicidal behaviour between non-comorbid and comorbid mood disorder groups. Multivariate logistic regression analyses produced the following associations: (1) suicidal ideation with self-reported depressive symptoms and poor psychosocial functioning, (2) deliberate self-harm behaviour with younger age and poor psychosocial functioning, and (3) suicide attempts with self-reported depressive symptoms and poor psychosocial functioning. Depressed mood disorders, whether comorbid or not, are associated with suicidal ideation and suicide attempts. Diagnostic assessment should be supplemented by self-report methods when assessing suicidal behaviour in depressed adolescents.

  4. Depression and eating disorders following abuse in childhood in two generations of women.

    Science.gov (United States)

    Andrews, B; Valentine, E R; Valentine, J D

    1995-02-01

    The relation of sexual and physical abuse in childhood to subsequent depression and eating disorders was explored in a community sample of mothers and their teenage and young adult daughters respectively. It was hypothesized that age would be a moderating influence on diagnosis following abuse in that depression would be more common in the mothers and eating disorders more common in the daughters. Depression was more common in mothers than daughters, using Bedford College caseness criteria (Finlay-Jones, et al., 1980), but the difference decreased when Research Diagnostic Criteria (RDC: Spitzer, Endicott & Robbins, 1978) were used. Bulimia was more common in the daughters using DSM-III criteria. Both physical and sexual abuse were associated with chronic and recurrent depression but not with single short episodes of depression in the mothers. However, the relationship of depression to abuse showed only a weak trend in the daughter sample. Both physical and sexual abuse were related to bulimia in the daughters, but not in the mothers, as only one mother had such a disorder.

  5. Depressive disorders and the menopause transition.

    Science.gov (United States)

    Llaneza, Plácido; García-Portilla, María P; Llaneza-Suárez, David; Armott, Begoña; Pérez-López, Faustino R

    2012-02-01

    Depressive disorders and symptoms are common among middle-aged women. The effects of hormones on depression remain unclear. This review aims to clarify the nature of depressive disorders during the menopause transition as well as their links with climacteric syndrome, sexuality, cardiovascular risk and cognitive function. The recent literature on depressive disorders and menopause is reviewed. Women are more vulnerable than men to depressive disorders. Endocrine influences have been postulated but differences in, for example, coping style and response to stress may also contribute to the gender difference in the prevalence of depressive disorders. Gender differences in socialization may lead to higher rates of depression in women. There are data top suggest that menopause and depression are associated, although there is not a common clear causative factor. Women with climacteric symptoms (hot flushes, night sweats, vaginal dryness and dyspareunia) are more likely to report anxiety and/or depressive symptoms. Bothersome vasomotor symptoms could be associated with sleep disturbances, which in turn can increase reports of anxiety and depressive symptoms. Biopsychosocial and partner factors have a significant influence on middle-aged women's sexuality and depressive disorders, and most antidepressants can have a negative effect on sexual response. Lastly, studies have consistently shown that women with high levels of depressive symptoms are at greater cardiovascular risk and have poorer cognitive function than non-depressed women. At present, a direct relationship between psychiatric symptoms and hormonal changes such as estrogen decrease has not been clearly found. Stress, educational level, ethnicity, socioeconomic factors and partner status may influence the prevalence and clinical course of both menopause symptoms and depressive disorders. Since in many cases depression is a lifelong condition, and is associated with severe comorbid conditions, further studies are

  6. The temperament and character traits in patients with major depressive disorder and bipolar affective disorder with and without suicide attempt.

    Science.gov (United States)

    Erić, Anamarija Petek; Erić, Ivan; Ćurković, Mario; Dodig-Ćurković, Katarina; Kralik, Kristina; Kovač, Vlatka; Filaković, Pavo

    2017-06-01

    Suicide and mood disorders (especially major depressive disorder (MDD) and bipolar affective disorder (BD)) represent a significant global health burden. Major depressive disorder and bipolar affective disorder have been associated with increased risk for suicide. Some specific suicide risk factors might be found in underlying individual personality traits. Specific personality features may predispose an individual to mood disorders (MDD or BD) hence increased suicide risk. The specificity of this research is in the assessment of personality features during the acute phase of illness immediately after suicide attempt which resulted in psychiatric inpatient treatment. The study included 119 unrelated Caucasian participants with MDD-severe depressive episode without psychotic symptoms (MDD) and BD-severe depressive episode without psychotic symptoms (BD-sDE). Both groups of patients with MDD and BD-sDE were divided into the suicide attempters and non-suicidal group. The diagnoses of the severe depressive episode without psychotic symptoms in major depressive disorder (MDD; F32.2) and bipolar disorder (BD-sDE; F31.4) were made according to ICD-10 (WHO 1992) diagnostic criteria. Methods of suicide attempts were also assessed according to ICD-10 and a self-report questionnaire, the Temperament and Character Inventory (TCI) was applied. The participants who exhibited suicide attempt had significantly higher scores on harm-avoidance (HA) (psuicidal attempt had significantly lower scores on self-directedness (SD) (psuicide attempt may have some significantly different personality traits than non-suicidal patients with mood disorders. The combination of high harm-avoidance (HA) and low self-directedness (SD) may be specific for depressive episode while the combination of high HA, novelty-seeking (NS), and self-transcendence (ST) with low SD may be related to suicide attempts during the depressive episode in bipolar disorder. The novelty-seeking (NS), self-transcendence (ST

  7. Depressive Disorders

    Science.gov (United States)

    Brown, Jacqueline A.; Russell, Samantha; Rasor, Kaitlin

    2017-01-01

    Depression is among the most common mental disorders in the United States. Its diagnosis is often related to impairment of functioning across several domains, including how an individual thinks, feels, and participates in daily activities. Although depression has a relatively high prevalence among adults, the rate is alarmingly higher among…

  8. Adjunctive minocycline treatment for major depressive disorder: A proof of concept trial.

    Science.gov (United States)

    Dean, Olivia M; Kanchanatawan, Buranee; Ashton, Melanie; Mohebbi, Mohammadreza; Ng, Chee Hong; Maes, Michael; Berk, Lesley; Sughondhabirom, Atapol; Tangwongchai, Sookjaroen; Singh, Ajeet B; McKenzie, Helen; Smith, Deidre J; Malhi, Gin S; Dowling, Nathan; Berk, Michael

    2017-08-01

    Conventional antidepressant treatments result in symptom remission in 30% of those treated for major depressive disorder, raising the need for effective adjunctive therapies. Inflammation has an established role in the pathophysiology of major depressive disorder, and minocycline has been shown to modify the immune-inflammatory processes and also reduce oxidative stress and promote neuronal growth. This double-blind, randomised, placebo-controlled trial examined adjunctive minocycline (200 mg/day, in addition to treatment as usual) for major depressive disorder. This double-blind, randomised, placebo-controlled trial investigated 200 mg/day adjunctive minocycline (in addition to treatment as usual) for major depressive disorder. A total of 71 adults with major depressive disorder ( Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition) were randomised to this 12-week trial. Outcome measures included the Montgomery-Asberg Depression Rating Scale (primary outcome), Clinical Global Impression-Improvement and Clinical Global Impression-Severity, Hamilton Anxiety Rating Scale, Quality of Life Enjoyment and Satisfaction Questionnaire, Social and Occupational Functioning Scale and the Range of Impaired Functioning Tool. The study was registered on the Australian and New Zealand Clinical Trials Register: www.anzctr.org.au , #ACTRN12612000283875. Based on mixed-methods repeated measures analysis of variance at week 12, there was no significant difference in Montgomery-Asberg Depression Rating Scale scores between groups. However, there were significant differences, favouring the minocycline group at week 12 for Clinical Global Impression-Improvement score - effect size (95% confidence interval) = -0.62 [-1.8, -0.3], p = 0.02; Quality of Life Enjoyment and Satisfaction Questionnaire score - effect size (confidence interval) = -0.12 [0.0, 0.2], p minocycline may be a useful adjunct to improve global experience, functioning and quality of life in people with

  9. Specificity of posttraumatic stress disorder symptoms: an investigation of comorbidity between posttraumatic stress disorder symptoms and depression in treatment-seeking veterans.

    Science.gov (United States)

    Gros, Daniel F; Simms, Leonard J; Acierno, Ron

    2010-12-01

    In response to high levels of comorbidity and symptom overlap between posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and other disorders, much attention has been devoted to the role of specific and nonspecific symptoms among the disorders. The present study investigated the overlapping symptoms of PTSD and MDD in treatment-seeking veterans. Exploratory factor analyses were used to identify latent factors of both self-reported and clinician-rated symptoms of PTSD and MDD. Results of exploratory factor analyses supported a 2-factor model representing symptoms of depression and PTSD; however, a subset of PTSD symptoms, characterized by emotional numbing and dysphoria, loaded onto the depression factor, rather than the PTSD factor. These nonspecific PTSD symptoms were predictive of comorbid MDD and increased depression symptomatology in patients with PTSD. Together, these findings demonstrate the importance of accounting for nonspecific symptoms in diagnosis and treatment of PTSD, highlighting a need for revisions to our current diagnostics.

  10. Predictors for switch from unipolar major depressive disorder to bipolar disorder type I or II: a 5-year prospective study.

    Science.gov (United States)

    Holma, K Mikael; Melartin, Tarja K; Holma, Irina A K; Isometsä, Erkki T

    2008-08-01

    In this naturalistic study, we investigated the rate, time course, and predictors of a diagnostic switch from unipolar major depressive disorder (MDD) to bipolar disorder type I or II during a 5-year follow-up. The Vantaa Depression Study included at baseline 269 psychiatric outpatients (82.9%) and inpatients (17.1%) with DSM-IV MDD, diagnosed using structured and semi-structured interviews and followed up at 6 months, 18 months, and 5 years between February 1, 1997 and April 30, 2004. Information on 248 MDD patients (92.2%) was available for analyses of the risk of diagnostic switch. Cox proportional hazards models were used. Twenty-two subjects (8.9%) with previous unipolar MDD switched to bipolar disorder type II and 7 (2.8%) to type I. Median time for switch to bipolar type I was significantly shorter than to type II. In Cox proportional hazards analyses, severity of MDD (hazard ratio [HR] = 1.08, 95% CI = 1.00 to 1.15, p = .036), obsessive-compulsive disorder (OCD) (HR = 5.00, 95% CI = 2.04 to 12.5, p social phobia (HR = 2.33, 95% CI = 1.00 to 5.26, p = .050), and large number of cluster B personality disorder symptoms (HR = 1.10, 95% CI = 1.02 to 1.20, p = .022) predicted switch. Among outpatients with MDD in secondary level psychiatric settings, diagnostic switch to bipolar disorder usually refers to type II rather than type I. The few switching to bipolar type I do so relatively early. Predictors for diagnostic switch include not only features of mood disorder, such as severity, but may also include some features of psychiatric comorbidity, such as concurrent social phobia, OCD, and symptoms of cluster B personality disorders.

  11. Prevalence of major depressive disorder in patients receiving beta-blocker therapy versus other medications.

    Science.gov (United States)

    Carney, R M; Rich, M W; teVelde, A; Saini, J; Clark, K; Freedland, K E

    1987-08-01

    Depression is believed to be a common side effect in patients receiving beta-blocker therapy. However, diagnoses of depression defined by current diagnostic criteria may not be more common in patients receiving beta-blockers than in patients with the same medical disorder receiving other medications. Seventy-seven patients undergoing elective cardiac catheterization for evaluation of chest pain received a semi-structured diagnostic psychiatric interview. Twenty-one percent of the patients receiving beta-blockers and 33 percent of the patients receiving medications other than beta-blockers met the current American Psychiatric Association criteria for major depressive disorder (DSM-III) (p = NS). The mean heart rate and state anxiety scores for patients taking beta-blockers were significantly lower than those measured in patients taking medications other than beta-blockers. No other medical or demographic differences were observed between the two groups. Despite the methodologic limitations of the study, there does not appear to be a difference in the point prevalence of depression between patients receiving beta-blockers and those receiving other medications.

  12. Acculturation and other risk factors of depressive disorders in individuals with Turkish migration backgrounds.

    Science.gov (United States)

    Janssen-Kallenberg, Hanna; Schulz, Holger; Kluge, Ulrike; Strehle, Jens; Wittchen, Hans-Ulrich; Wolfradt, Uwe; Koch-Gromus, Uwe; Heinz, Andreas; Mösko, Mike; Dingoyan, Demet

    2017-07-19

    Acculturation is a long-term, multi-dimensional process occurring when subjects of different cultures stay in continuous contact. Previous studies have suggested that elevated rates of depression among different migrant groups might be due to patterns of acculturation and migration related risk factors. This paper focused on prevalence rates of depressive disorders and related risk factors among individuals with Turkish migration backgrounds. A population-based sample of 662 individuals with Turkish migration backgrounds were interviewed by bilingual interviewers using a standardised diagnostic interview for DSM-IV-TR and ICD-10 diagnoses (CIDI DIA-X Version 2.8). Associations between 12-month prevalence rates of depressive disorders with potential risk factors were assessed, including gender, age, socioeconomic status, acculturation status and migration status. 12-month prevalence rates of any depressive disorder were 29.0%, 14.4% of major depressive disorder (MDD) and 14.7% of dysthymia. Older age and low socioeconomic status were most consistently related to higher risks of depressive disorders. Acculturation status showed associations with subtypes of depressive disorder. Associations differed between men and women. Symptom severity of MDD was linked to gender, with females being more affected by severe symptoms. The prevalence of depressive disorders is high in individuals with Turkish migration backgrounds, which can be partly explained by older age, low socioeconomic status and acculturation pressures. Only a limited number of risk factors were assessed. Acculturation in particular is a complex process which might not be sufficiently represented by the applied measures. Further risk factors have to be identified in representative samples of this migrant group.

  13. Depressive disorder among Turkish women in the Netherlands: a qualitative study of idioms of distress.

    Science.gov (United States)

    Borra, Ria

    2011-11-01

    The provision of mental health services to immigrants in the Netherlands is hampered by difficulty in establishing valid diagnoses of psychiatric disorders. To improve the process of diagnosing depressive disorder among Turkish women in Dutch mental healthcare, we conducted a qualitative study of women with depression in Rotterdam. A bilingual Turkish-Dutch diagnostic interview was developed to explore Turkish women's idioms of distress. Interviews were conducted with 20 women with a disputed diagnosis of depression. Results showed that distress among the Turkish women was characterized by a wide range of somatic complaints, with anxiety and agitation occurring as frequently as depressive complaints. Because the range of complaints is so varied, major depression may be underdiagnosed in the Turkish immigrant population.

  14. Neural substrates of trait impulsivity, anhedonia, and irritability: Mechanisms of heterotypic comorbidity between externalizing disorders and unipolar depression.

    Science.gov (United States)

    Zisner, Aimee; Beauchaine, Theodore P

    2016-11-01

    Trait impulsivity, which is often defined as a strong preference for immediate over delayed rewards and results in behaviors that are socially inappropriate, maladaptive, and short-sighted, is a predisposing vulnerability to all externalizing spectrum disorders. In contrast, anhedonia is characterized by chronically low motivation and reduced capacity to experience pleasure, and is common to depressive disorders. Although externalizing and depressive disorders have virtually nonoverlapping diagnostic criteria in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, heterotypic comorbidity between them is common. Here, we review common neural substrates of trait impulsivity, anhedonia, and irritability, which include both low tonic mesolimbic dopamine activity and low phasic mesolimbic dopamine responding to incentives during reward anticipation and associative learning. We also consider how other neural networks, including bottom-up emotion generation systems and top-down emotion regulation systems, interact with mesolimbic dysfunction to result in alternative manifestations of psychiatric illness. Finally, we present a model that emphasizes a translational, transdiagnostic approach to understanding externalizing/depression comorbidity. This model should refine ways in which internalizing and externalizing disorders are studied, classified, and treated.

  15. [Autobiographical memory in depressive disorders].

    Science.gov (United States)

    Żuchowicz, Paulina; Jasionowska, Justyna; Gałecki, Piotr; Talarowska, Monika

    2017-08-21

    Contemporary research studies regarding autobiographical memory (AM) indicate that its deficits have a significant impact on the development of mental disorders. We find particularly many reports regarding the comorbidity of AM deficits and depressive disorders. The characteristic feature of AM in the people suffering from depressive disorders is the presence of overgeneral autobiographical memory (OGM), i.e. the reminiscences which contain a summary of many emotion-laden situations, yet without significant detail. This type of reminiscences is observed in the patients with depressive disorders and the ones susceptible to the disease but not experiencing presently an episode of depression, as well as the ones being in the phase of disease remission. In recent years, the interest in the significance of negative thinking processes, such as ruminations, as risk factors in the development of depression has been growing. It is emphasized that they are significantly associated with the occurrence of OGM. Research shows that people suffering from OGM and characterised by a rumination-based style of processing experience a greater number of depressive episodes. There are also research studies which confirm that the activities aimed at reducing the number of ruminations influence an improvement of the detail level of reminiscences. These data may serve as valuable therapeutic advice in depression disorders. The aim of the paper is to present results of contemporary research regarding mutual interrelations between autobiographical memory dysfunctions and the occurrence of symptoms of depression and its course.

  16. Baseline characteristics of depressive disorders in Thai outpatients: findings from the Thai Study of Affective Disorders

    Directory of Open Access Journals (Sweden)

    Wongpakaran T

    2014-01-01

    Full Text Available Tinakon Wongpakaran,1 Nahathai Wongpakaran,1 Manee Pinyopornpanish,1 Usaree Srisutasanavong,1 Peeraphon Lueboonthavatchai,2 Raviwan Nivataphand,2 Nattaporn Apisiridej,3 Donruedee Petchsuwan,3 Nattha Saisavoey,4 Kamonporn Wannarit,4 Ruk Ruktrakul,5 Thawanrat Srichan,5 Sirina Satthapisit,6 Daochompu Nakawiro,7 Thanita Hiranyatheb,7 Anakevich Temboonkiat,8 Namtip Tubtimtong,9 Sukanya Rakkhajeekul,9 Boonsanong Wongtanoi,10 Sitthinant Tanchakvaranont,11 Putipong Bookkamana121Faculty of Medicine, Chiang Mai University, Chiang Mai, 2Faculty of Medicine, Chulalongkorn University, Bangkok, 3Trang Hospital, Trang, 4Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, 5Lampang Hospital, Lampang, 6KhonKaen Hospital, Khon Kaen, 7Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 8Phramongkutklao Hospital, Bangkok, 9Faculty of Medicine Naresuan University, Pitsanulok, 10Srisangwal Hospital, Mae Hong Son, 11Queen Savang Vadhana Memorial Hospital, Chonburi, 12Faculty of Science, Chiang Mai University, Chiang Mai Kingdom of ThailandBackground: The Thai Study of Affective Disorders was a tertiary hospital-based cohort study developed to identify treatment outcomes among depressed patients and the variables involved. In this study, we examined the baseline characteristics of these depressed patients.Methods: Patients were investigated at eleven psychiatric outpatient clinics at tertiary hospitals for the presence of unipolar depressive disorders, as diagnosed by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The severity of any depression found was measured using the Clinical Global Impression and 17-item Hamilton Depression Rating Scale (HAMD clinician-rated tools, with the Thai Depression Inventory (a self-rated instrument administered alongside them. Sociodemographic and psychosocial variables were collected, and quality of life was also captured using the health-related quality of life (SF-36v2

  17. New diagnostic perspectives on obsessive-compulsive personality disorder and its links with other conditions.

    Science.gov (United States)

    Starcevic, Vladan; Brakoulias, Vlasios

    2014-01-01

    This review examines the conceptualization of obsessive-compulsive personality disorder (OCPD), its epidemiology and efforts to better understand the relationships between OCPD and other conditions. The alternative Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders conceptualization of OCPD is radically different in that it combines categorical and dimensional diagnostic approaches and introduces a hierarchy of diagnostic criteria. OCPD is one of the most common personality disorders in the general population. The relationship between OCPD and obsessive-compulsive disorder (OCD) is important, but to a large extent obfuscated by the overlap between their diagnostic criteria. Frequent changes in the OCPD diagnostic criteria make it difficult to ascertain the 'true' relationship between OCPD and OCD. It is not uncommon for OCPD to occur with anorexia nervosa, depression, hypochondriasis, certain other personality disorders and Parkinson's disease, but further research is necessary to understand the implications of these links. OCPD is yet to be conceptualized consistently and in the manner that would make a clear and well supported distinction between its core and peripheral features. Future studies need to separate a genuine from overlap-driven co-occurrence of OCPD and other conditions, as that would give a better insight into the way in which OCPD relates to other disorders.

  18. Patterns of self-reported depressive symptoms in relation to morningness-eveningness in inpatients with a depressive disorder.

    Science.gov (United States)

    Müller, Matthias Johannes; Olschinski, Christiane; Kundermann, Bernd; Cabanel, Nicole

    2016-05-30

    The stable and persisting preference for activities in the late evening (i.e. eveningness) is associated with a higher risk for depression, suicidality, and non-remission in major depression. The present study investigated symptom patterns in hospitalized patients with depressive syndromes in relation to morningness-eveningness (chronotypes). Depressive symptoms (Beck Depression Inventory [BDI-II]) and chronotype (German version of the Morningness-Eveningness Questionnaire [D-MEQ]) were assessed after admission and before discharge in inpatients with mainly major depression. Group differences of BDI-II single items and three BDI-II factors (cognitive, affective, somatic) between patients divided at the D-MEQ sample median into "morning preference" (MP) and "evening preference" (EP) were calculated. Data from 64 consecutively admitted patients (31MP/33EP) were analyzed. Both groups (MP/EP) were comparable regarding age, sex, diagnosis, length of stay, and subjective sleep quality, BDI-II scores were significantly higher in EP than in MP at admission. At admission and discharge, cognitive symptoms were significantly more pronounced in EP vs. MP; non-significant differences between EP and MP were found for affective and somatic symptoms. The results underline the importance of the trait-like chronotype for severity and symptomatology in patients with depressive disorders. The patients' chronotype should be taken into account in diagnostics and treatment of depressive disorders. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Maternal anxiety versus depressive disorders: specific relations to infants' crying, feeding and sleeping problems.

    Science.gov (United States)

    Petzoldt, J; Wittchen, H-U; Einsle, F; Martini, J

    2016-03-01

    Maternal depression has been associated with excessive infant crying, feeding and sleeping problems, but the specificity of maternal depression, as compared with maternal anxiety remains unclear and manifest disorders prior to pregnancy have been widely neglected. In this prospective longitudinal study, the specific associations of maternal anxiety and depressive disorders prior to, during and after pregnancy and infants' crying, feeding and sleeping problems were investigated in the context of maternal parity. In the Maternal Anxiety in Relation to Infant Development (MARI) Study, n = 306 primiparous and multiparous women were repeatedly interviewed from early pregnancy until 16 months post partum with the Composite International Diagnostic Interview for Women (CIDI-V) to assess DSM-IV anxiety and depressive disorders. Information on excessive infant crying, feeding and sleeping problems was obtained from n = 286 mothers during postpartum period via questionnaire and interview (Baby-DIPS). Findings from this study revealed syndrome-specific risk constellations for maternal anxiety and depressive disorders as early as prior to pregnancy: Excessive infant crying (10.1%) was specifically associated with maternal anxiety disorders, especially in infants of younger and lower educated first-time mothers. Feeding problems (36.4%) were predicted by maternal anxiety (and comorbid depressive) disorders in primiparous mothers and infants with lower birth weight. Infant sleeping problems (12.2%) were related to maternal depressive (and comorbid anxiety) disorders irrespective of maternal parity. Primiparous mothers with anxiety disorders may be more prone to anxious misinterpretations of crying and feeding situations leading to an escalation of mother-infant interactions. The relation between maternal depressive and infant sleeping problems may be better explained by a transmission of unsettled maternal sleep to the fetus during pregnancy or a lack of daily

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  1. Diagnostic conversion to bipolar disorder in unipolar depressed patients participating in trials on antidepressants

    DEFF Research Database (Denmark)

    Holmskov, J; Licht, R W; Andersen, K

    2017-01-01

    OBJECTIVE: In unipolar depressed patients participating in trials on antidepressants, we investigated if illness characteristics at baseline could predict conversion to bipolar disorder. METHOD: A long-term register-based follow-up study of 290 unipolar depressed patients with a mean age of 50.......8 years (SD=11.9) participating in three randomized trials on antidepressants conducted in the period 1985-1994. The independent effects of explanatory variables were examined by applying Cox regression analyses. RESULTS: The overall risk of conversion was 20.7%, with a mean follow-up time of 15.2 years...... per patient. The risk of conversion was associated with an increasing number of previous depressive episodes at baseline, [HR 1.18, 95% CI (1.10-1.26)]. No association with gender, age, age at first depressive episode, duration of baseline episode, subtype of depression or any of the investigated HAM...

  2. Prevalence of and Risk Factors for Anxiety and Depressive Disorders after Traumatic Brain Injury: A Systematic Review

    NARCIS (Netherlands)

    Scholten, Annemieke C.; Haagsma, Juanita A.; Cnossen, Maryse C.; Olff, Miranda; van Beeck, Ed F.; Polinder, Suzanne

    2016-01-01

    This review examined pre- and post-injury prevalence of, and risk factors for, anxiety disorders and depressive disorders after traumatic brain injury (TBI), based on evidence from structured diagnostic interviews. A systematic literature search was conducted in EMBASE, MEDLINE, Cochrane Central,

  3. The depressed patient in a biological world: on philosophical and diagnostic strategies.

    Science.gov (United States)

    Korf, Jakob; Bosker, Fokko

    2013-06-01

    We questioned: what kind of relationships between mental and neurobiological levels of complexity is or could become useful in the psychiatric practice? The concept of mind and associated mood states defended here is that they are physically emergent, subjective, qualitative, unified features of the brain. We compared our neurobiological assessment also to psychoanalytical practice (first person's perspective). Applied to recent work on major depressive disorder (MDD), our ideas are among other supported by clinical and experimental studies on sleep deprivation, deep brain stimulation and epidemiological assessments of time-to-recovery. We suggest that depression is a transient state of the brain, that is mutually exclusive to the state of pleasure (in the Freudian context), rather than a disorder or disease with a characteristic time course (like many reversible somatic diseases). MDD can best be described with stochastic transition models, which is discussed in the context of a presumed brain serotonin dysfunction in depression. Our ideas invite a reconsideration of some concepts underlying current diagnostic and therapeutic approaches in the clinical practice. © 2013 John Wiley & Sons Ltd.

  4. Major Depressive Disorder Among Preadolescent Canadian Children: Rare Disorder or Rarely Detected?

    Science.gov (United States)

    Korczak, Daphne J; Ofner, Marianna; LeBlanc, John; Wong, Sam; Feldman, Mark; Parkin, Patricia C

    2017-03-01

    Despite agreement that preadult onset of depression is associated with greater illness severity, and that children can meet the diagnostic criteria for major depressive disorder (MDD), few studies have examined the presentation of MDD among young children. This is the first nationwide study of MDD among preadolescent children in Canada. Pediatrician members (2500) of a Canadian pediatric surveillance network were surveyed monthly over 3 years to report new cases of MDD among 5- to 12-year-olds. Survey response and questionnaire completion rates were 80% and 85%, respectively. Symptom presentation and duration, impairment, medical and psychiatric history, and management were reported. Twenty-nine new cases of MDD were identified by pediatricians. Of these, 23 (79%) experienced symptoms for >6 months before presentation with global functional impairment. Parental depression or anxiety, commonly maternal, was present in 21 cases (72%). Twenty-two children (76%) reported suicidal ideation; 6 (21%) had attempted suicide. Twenty-three children (79%) were treated with medication. Thirteen children (45%) were treated with 2 or more medications. Children with MDD frequently had a parental history of mood disorders, experienced long-standing symptom presence, high symptom burden and functional impairment prior to presentation; and commonly treatment with polypharmacy. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  5. Depression and suicidal behavior in adolescents: a multi-informant and multi-methods approach to diagnostic classification.

    Directory of Open Access Journals (Sweden)

    Andrew James Lewis

    2014-07-01

    Full Text Available Background: Informant discrepancies have been reported between parent and adolescent measures of depressive disorders and suicidality. We aimed to examine the concordance between adolescent and parent ratings of depressive disorder using both clinical interview and questionnaire measures and assess multi-informant and multi-method approaches to classification.Method: Within the context of assessment of eligibility for a randomized clinical trial, 50 parent–adolescent pairs (mean age of adolescents = 15.0 years were interviewed separately with a structured diagnostic interview for depression, the KID-SCID. Adolescent self-report and parent-report versions of the Strengths and Difficulties Questionnaire, the Short Mood and Feelings Questionnaire and the Depressive Experiences Questionnaire were also administered. We examined the diagnostic concordance rates of the parent vs. adolescent structured interview methods and the prediction of adolescent diagnosis via questionnaire methods.Results: Parent proxy reporting of adolescent depression and suicidal thoughts and behavior is not strongly concordant with adolescent report. Adolescent self-reported symptoms on depression scales provide a more accurate report of diagnosable adolescent depression than parent proxy reports of adolescent depressive symptoms. Adolescent self-report measures can be combined to improve the accuracy of classification. Parents tend to over report their adolescent’s depressive symptoms while under reporting their suicidal thoughts and behavior.Conclusion: Parent proxy report is clearly less reliable than the adolescent’s own report of their symptoms and subjective experiences, and could be considered inaccurate for research purposes. While parent report would still be sought clinically where an adolescent refuses to provide information, our findings suggest that parent reporting of adolescent suicidality should be interpreted with caution.

  6. Post-traumatic stress disorder, depression and suicidality in inpatients with substance use disorders.

    Science.gov (United States)

    Dore, Glenys; Mills, Katherine; Murray, Robin; Teesson, Maree; Farrugia, Philippa

    2012-05-01

    The international literature suggests that traumatic events are common for patients with substance use disorders (SUDs), and are often associated with the development of post-traumatic stress disorder (PTSD) and other psychiatric comorbidities. However, limited research has been conducted among Australian SUD patients. The aim of the present study was to examine the prevalence of these disorders in a group of Australian patients admitted for detoxification. Data were collected from 253 inpatients using a modified version of the Composite International Diagnostic Interview, the 10-item Trauma Screening Questionnaire, the Zung Self-rating Depression Scale and questions from the PsyCheck. Approximately 20% of inpatients experienced moderate to severe depressive symptoms, and 37% had a lifetime history of self-harm or attempted suicide. Approximately 80% of patients had experienced at least one traumatic event, most experiencing multiple traumas. The mean age of first trauma was 14years. Almost 45% of patients screened positive for current PTSD symptoms. Women were nine times more likely to have been raped and five times more likely to have been sexually molested than men. PTSD symptoms were associated with greater trauma exposure, younger age of first trauma, specific trauma types, moderate to severe depressive symptoms and a history of self-harm or attempted suicide. Despite their difficulties, patients with PTSD symptoms had high rates of retention in treatment. Patients entering treatment for SUDs should be assessed for PTSD, depression and suicidality. These conditions impact significantly on treatment outcomes, and require the development of appropriate treatment strategies. © 2011 Australasian Professional Society on Alcohol and other Drugs.

  7. Anxiety and depression: One, two or three disorders?

    Directory of Open Access Journals (Sweden)

    Novović Zdenka

    2004-01-01

    Full Text Available The study deals with theoretical psychiatric proposals about relations between anxiety and depressive disorders. Three theoretical positions developed on the basis of numerous evidence on relationship of anxiety and depressive disorders: unitaristic (anxious and depressive disorders represent one disorder with different clinical pictures or phases of the disorder, pluralistic (there are two classes of disorders with clearly recognizable boundaries and anxious-depressive position (mixed anxious-depressive disorder represents also a single disorder. Possible reasons for antagonisms, connections (i.e. lack of connections to some proposals of psychologists are commented upon, as well as the significance of this problem for classification of mental disorders in general.

  8. Anxiety and depression: One, two or three disorders?

    OpenAIRE

    Novović Zdenka

    2004-01-01

    The study deals with theoretical psychiatric proposals about relations between anxiety and depressive disorders. Three theoretical positions developed on the basis of numerous evidence on relationship of anxiety and depressive disorders: unitaristic (anxious and depressive disorders represent one disorder with different clinical pictures or phases of the disorder), pluralistic (there are two classes of disorders with clearly recognizable boundaries) and anxious-depressive position (mixed anxi...

  9. Depression and coping in subthreshold eating disorders.

    Science.gov (United States)

    Dennard, E Eliot; Richards, C Steven

    2013-08-01

    The eating disorder literature has sought to understand the role of comorbid psychiatric diagnoses and coping in relation to eating disorders. The present research extends these findings by studying the relationships among depression, coping, and the entire continuum of disordered eating behaviors, with an emphasis on subthreshold eating disorders. 109 undergraduate females completed questionnaires to assess disordered eating symptoms, depressive symptoms, and the use of active and avoidant coping mechanisms. Hypotheses were tested using bivariate linear regression and multivariate linear regression. Results indicated that depression was a significant predictor of disordered eating symptoms after controlling for relationships between depression and coping. Although avoidant coping was positively associated with disordered eating, it was not a significant predictor after controlling for depression and coping. Previous research has found associations between depression and diagnosable eating disorders, and this research extends those findings to the entire continuum of disordered eating. Future research should continue to investigate the predictors and correlates of the disordered eating continuum using more diverse samples. Testing for mediation and moderation among these variables may also be a fruitful area of investigation. Published by Elsevier Ltd.

  10. Attention-deficit/hyperactivity disorder in adolescence predicts onset of major depressive disorder through early adulthood.

    Science.gov (United States)

    Meinzer, Michael C; Lewinsohn, Peter M; Pettit, Jeremy W; Seeley, John R; Gau, Jeff M; Chronis-Tuscano, Andrea; Waxmonsky, James G

    2013-06-01

    The aim of this study was to examine the prospective relationship between a history of attention-deficit/hyperactivity disorder (ADHD) assessed in mid-adolescence and the onset of major depressive disorder (MDD) through early adulthood in a large school-based sample. A secondary aim was to examine whether this relationship was robust after accounting for comorbid psychopathology and psychosocial impairment. One thousand five hundred seven participants from the Oregon Adolescent Depression Project completed rating scales in adolescence and structured diagnostic interviews up to four times from adolescence to age 30. Adolescents with a lifetime history of ADHD were at significantly higher risk of MDD through early adulthood relative to those with no history of ADHD. ADHD remained a significant predictor of MDD after controlling for gender, lifetime history of other psychiatric disorders in adolescence, social and academic impairment in adolescence, stress and coping in adolescence, and new onset of other psychiatric disorders through early adulthood (hazard ratio, 1.81; 95% confidence interval, 1.04, 3.06). Additional significant, robust predictors of MDD included female gender, a lifetime history of an anxiety disorder, and poor coping skills in mid-adolescence, as well as the onset of anxiety, oppositional defiant disorder, and substance-use disorder after mid-adolescence. A history of ADHD in adolescence was associated with elevated risk of MDD through early adulthood and this relationship remained significant after controlling for psychosocial impairment in adolescence and co-occurring psychiatric disorders. Additional work is needed to identify the mechanisms of risk and to inform depression prevention programs for adolescents with ADHD. © 2013 Wiley Periodicals, Inc.

  11. Toward psychiatry as a ‘human’ science of mind. The Case of Depressive Disorders in DSM-5

    Directory of Open Access Journals (Sweden)

    Marco eCastiglioni

    2015-01-01

    Full Text Available The aim of this paper is to argue that a strictly reductionist approach to psychiatry represents a theoretical and clinical obstacle to a fruitful synthesis between neurobiological and sociocultural aspects of the sciences of mind. We examine the theoretical and practical motivations underlying this approach, by analyzing the case of depressive disorders, as defined in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM, and the related removal of the bereavement exclusion clause. We first explore the claim that DSM is atheoretical, observing that, far from being atheoretical, DSM adopts an implicit, biologically-inspired view of the mind; we show that such a view leads to a sort of circularity in the definition of depressive disorders, in which psychopharmacology seems to play a key role. We then turn to further problems deriving from this a position, analyzing the issue of placebo effects in the treatment of depressive disorders and the philosophical question of normative preconditions for psychopathological diagnosis. Finally, we address the issue of subjectivity, which, together with the related aspect of the subject’s relational context, appears to be crucial to any scientific theorizing about mental disorders, despite DSM’s attempt to exclude it. Our defence of a non-reductionist view of mental disorders, however, does not imply that we endorse any sort of metaphysical dualism, or anti-diagnostic or anti-psychiatric positions. On the contrary, we argue that adoption of a reductionist position actually undermines theoretical and clinical accuracy in explaining depressive disorders.

  12. Severity of anxiety- but not depression- is associated with oxidative stress in Major Depressive Disorder.

    Science.gov (United States)

    Steenkamp, Lisa R; Hough, Christina M; Reus, Victor I; Jain, Felipe A; Epel, Elissa S; James, S Jill; Morford, Alexandra E; Mellon, Synthia H; Wolkowitz, Owen M; Lindqvist, Daniel

    2017-09-01

    Oxidative stress is implicated in both depression and anxiety, but it is currently unclear whether this relates to syndromal diagnoses or trans-diagnostic dimensional symptoms. We examined the relationship between oxidative stress and severity of depression and anxiety symptoms in individuals with Major Depressive Disorder (MDD). Plasma oxidative stress markers F2-isoprostanes and oxidized glutathione (GSSG), and the antioxidant reduced glutathione (GSH), were assessed in 69 physically healthy, medication-free MDD subjects. Symptoms of anxiety and depression were assessed using the Hamilton Anxiety (HAM-A) and Hamilton Depression (HAM-D) Rating Scales. Total HAM-A and HAM-D scores, along with "core" anxiety and depression subscales, and individual HAM-D items "psychic anxiety" and "depressed mood," were related to oxidative stress markers. Analyses controlled for age, sex, BMI, and smoking. Total HAM-A ratings were positively associated with F2-isoprostanes (β=.26, p=.042) and GSSG (β=.25, p=.049), but not GSH (β=.05, p=.711). Core anxiety severity was positively associated with F2-isoprostanes (β=.34, p=.012) and GSSG, although this did not reach significance (β=.24, p=.074). None of the biological markers were significantly associated with total HAM-D or core depression ratings (all p>.13). Subjects scoring high on "psychic anxiety" had elevated F2-isoprostanes (p=.030) and GSSG (p=.020). This was not seen with "depressed mood" scores (all p>.12). We assessed peripheral oxidative markers, but their relationship to the brain is unclear. Oxidative stress is more closely related to anxiety than depression symptoms in MDD. This highlights the importance of relating oxidative stress to specific symptoms and could provide new insights into the biological correlates of affective disorders. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Depressed suicide attempters with posttraumatic stress disorder.

    Science.gov (United States)

    Ramberg, Maria; Stanley, Barbara; Ystgaard, Mette; Mehlum, Lars

    2015-01-01

    Posttraumatic stress disorder and major depressive disorder are well-established risk factors for suicidal behavior. This study compared depressed suicide attempters with and without comorbid posttraumatic stress disorder with respect to additional diagnoses, global functioning, depressive symptoms, substance abuse, history of traumatic exposure, and suicidal behavior. Adult patients consecutively admitted to a general hospital after a suicide attempt were interviewed and assessed for DSM-IV diagnosis and clinical correlates. Sixty-four patients (71%) were diagnosed with depression; of them, 21 patients (32%) had posttraumatic stress disorder. There were no group differences in social adjustment, depressive symptoms, or suicidal intent. However, the group with comorbid depression and posttraumatic stress disorder had more additional Axis I diagnoses, a higher degree of childhood trauma exposure, and more often reported previous suicide attempts, non-suicidal self-harm, and vengeful suicidal motives. These findings underline the clinical importance of diagnosis and treatment of posttraumatic stress disorder in suicide attempters.

  14. State-Dependent Differences in Emotion Regulation Between Unmedicated Bipolar Disorder and Major Depressive Disorder.

    Science.gov (United States)

    Rive, Maria M; Mocking, Roel J T; Koeter, Maarten W J; van Wingen, Guido; de Wit, Stella J; van den Heuvel, Odile A; Veltman, Dick J; Ruhé, Henricus G; Schene, Aart H

    2015-07-01

    Major depressive disorder (MDD) and bipolar disorder (BD) are difficult to distinguish clinically during the depressed or remitted states. Both mood disorders are characterized by emotion regulation disturbances; however, little is known about emotion regulation differences between MDD and BD. Better insight into these differences would be helpful for differentiation based on disorder-specific underlying pathophysiological mechanisms. Previous studies comparing these disorders often allowed medication use, limiting generalizability and validity. Moreover, patients with MDD and BD were mostly compared during the depressed, but not the remitted, state, while state might potentially modulate differences between MDD and BD. To investigate positive and negative emotion regulation in medication-free patients with MDD and BD in 2 mood states: depressed or remitted. A cross-sectional study conducted from May 2009 to August 2013 comparing behavioral and functional magnetic resonance imaging emotion regulation data of 42 patients with MDD, 35 with BD, and 36 healthy control (HC) participants free of psychotropic medication recruited from several psychiatric institutions across the Netherlands. A voluntary emotion regulation functional magnetic resonance imaging task using positive and negative pictures. Behavioral and functional magnetic resonance imaging blood oxygen level-dependent responses during emotion regulation. In the remitted state, only patients with BD showed impaired emotion regulation (t = 3.39; P emotion type and associated with increased dorsolateral prefrontal cortex activity compared with those with MDD and healthy control participants (P = .008). In the depressed state, patients with MDD and BD differed with regard to happy vs sad emotion regulation (t = 4.19; P differences in rostral anterior cingulate activity (P emotions poorly compared with those with BD and healthy control participants, while they demonstrated no rostral anterior

  15. Impaired intuition in patients with major depressive disorder.

    Science.gov (United States)

    Remmers, Carina; Topolinski, Sascha; Dietrich, Detlef E; Michalak, Johannes

    2015-06-01

    In daily life, many decisions of minor and major importance have to be made. Thereby, intuitive judgments serve as useful guides and help us to adapt to our environment. People with major depressive disorder (MDD) often have difficulties to come to decisions. Is their intuition impaired? Since this question has not been addressed until now, the present study explored intuition in MDD. Depressed patients (n = 29) and healthy control participants (n = 27) completed the Judgment of Semantic Coherence Task, a well-established paradigm used in basic cognitive research to measure intuition. Furthermore, participants' severity of depressive symptoms (BDI-II), negative affect (PANAS), and rumination (RSQ) were assessed. All participants were interviewed with the SCID. Depressed patients showed impaired intuition compared to healthy control participants. In the depressed sample, negative affect accounts for the association between rumination and impaired intuition. Results further reveal that negative affect overall mediates the depression-intuition relationship. Patients with diminished ability to concentrate or indecisiveness had lower intuition indices compared to patients who did not fulfil this diagnostic criterion of MDD. The study introduces the phenomenon of intuition into depression research. Additionally, these results extent findings from basic research showing that induced negative mood as well difficulties to down-regulate negative affect impair intuitive coherence judgments. Current results indicate that the negative affectivity of patients is the crucial mediator in the association between depression and impaired intuition. Limitations of the study as well as the potential etiological role of intuition in MDD are discussed. The finding that intuition is impaired in depressed patients extends our knowledge as to the cognitive profile of patients with MDD. Patients who suffer from indecisiveness have lower intuition indices compared to patients who do not

  16. Increased prospective health service use for depression among adults with childhood onset bipolar disorder.

    Science.gov (United States)

    Sala, Regina; Goldstein, Benjamin I; Wang, Shuai; Flórez-Salamanca, Ludwing; Iza, Miren; Blanco, Carlos

    2013-11-01

    To examine the prospective relationship between age of onset of bipolar disorder and the demographic and clinical characteristics, treatment, new onset of psychiatric comorbidity, and psychosocial functioning among adults with bipolar disorder. As part of the National Epidemiologic Survey on Alcohol and Related Conditions, 1600 adults who met lifetime Statistical Manual of Mental Disorders, 4th edition criteria for bipolar disorder-I (n = 1172) and bipolar disorder-II (n = 428) were included. Individuals were evaluated using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV version for Diagnostic and Statistical Manual of Mental Disorders, 4th edition, and data were analyzed from Waves 1 and 2, approximately 3 years apart. Individuals with bipolar disorder were divided into three age at onset groups: childhood (adolescence (13-18 years old, n = 396), and adulthood (>19 year old, n = 1017). After adjusting for confounding factors, adults with childhood-onset bipolar disorder were more likely to see a counselor, have been hospitalized, and have received emergency room treatment for depression compared with those with adulthood-onset bipolar disorder. By contrast, there were no differences in the severity of mania or hypomania, new onset of comorbidity, and psychosocial functioning by age of bipolar disorder onset. Childhood-onset bipolar disorder is prospectively associated with seeking treatment for depression, an important proxy for depressive severity. Longitudinal studies are needed in order to determine whether prompt identification, accurate diagnosis, and early intervention can serve to mitigate the burden of childhood onset on the long-term depressive burden of bipolar disorder. Copyright © 2013 Mosby, Inc. All rights reserved.

  17. Sleep disorders and depressive feelings: a global survey with the Beck depression scale.

    Science.gov (United States)

    Vandeputte, Melissa; de Weerd, Al

    2003-07-01

    Patients with (chronic) sleep disorders are prone to depression. Until now studies on the prevalence of depression in the various sleep disorders focused mainly on obstructive sleep apnea patients and narcolepsy. Studies in other common sleep disorders are scarce. The aim of our study was to estimate the prevalence of depressive feelings in the various sleep disorders diagnosed in a Center for Sleep and Wake Disorders. We included 917 consecutive patients (age between 14 and 84 years, median age: 49, 396 male and 521 female), seen in our center for sleep and wake disorders during 2001 and first half of 2002. The diagnosis was based on the history taken at the outpatient-clinic and two consecutive 24-h polysomnographic recordings at home (APSG). The final decisions on the diagnosis were made according to the ASDA international classification of sleep disorders. The severity of depressive feelings was based on the Beck depression scale. Overall, the prevalence of depressive feelings was high. There were no significant differences in age and gender. In psychophysiological insomnia, inadequate sleep- and wake hygiene, sleep state misperception and periodic limb movement disorder/restless legs syndrome some form of depression occurred in more than half of the patients. Moderate to severe depression was found in 3.5% of the patients. The study suggests that the use of a depression scale in the daily routine of diagnosing and treating sleep disorders should be encouraged in order to optimise diagnosis and therapy in these patients.

  18. Disability and comorbidity among major depressive disorder and double depression in African-American adults.

    Science.gov (United States)

    Torres, Elisa R

    2013-09-25

    Few studies have examined differences in disability and comorbity among major depressive disorder (MDD), dysthymia, and double depression in African-Americans (AA). A secondary analysis was performed on AA in the National Survey of American Life. Interviews occurred 2001-2003. A four stage national area probability sampling was performed. DSM-IV-TR diagnoses were obtained with a modified version of the World Health Organization's expanded version of the Composite International Diagnostic Interview. Disability was measured by interview with the World Health Organization's Disability Assessment Schedule II. Compared to non-depressed AA, AA endorsing MDD (t=19.0, p=0.0001) and double depression (t=18.7, p=0.0001) reported more global disability; AA endorsing MDD (t=8.5, p=0.0063) reported more disability in the getting around domain; AA endorsing MDD (t=19.1, p=0.0001) and double depression (t=12.1, p=0.0014) reported more disability in the life activities domain. AA who endorsed double depression reported similar disability and comorbidities with AA who endorsed MDD. Few AA endorsed dysthymia. This was a cross-sectional study subject to recall bias. The NSAL did not measure minor depression. The current study supports the idea of deleting distinct chronic subtypes of depression and consolidating them into a single category termed chronic depression. © 2013 Elsevier B.V. All rights reserved.

  19. Prevalence and correlates of DSM-IV-TR major depressive disorder, self-reported diagnosed depression and current depressive symptoms among adults in Germany.

    Science.gov (United States)

    Maske, Ulrike E; Buttery, Amanda K; Beesdo-Baum, Katja; Riedel-Heller, Steffi; Hapke, Ulfert; Busch, Markus A

    2016-01-15

    While standardized diagnostic interviews using established criteria are the gold standard for assessing depression, less time consuming measures of depression and depressive symptoms are commonly used in large population health surveys. We examine the prevalence and health-related correlates of three depression measures among adults aged 18-79 years in Germany. Using cross-sectional data from the national German Health Interview and Examination Survey for Adults (DEGS1) (n=7987) and its mental health module (DEGS1-MH) (n=4483), we analysed prevalence and socio-demographic and health-related correlates of (a) major depressive disorder (MDD) established by Composite International Diagnostic Interview (CIDI) using DSM-IV-TR criteria (CIDI-MDD) in the last 12 months, (b) self-reported physician or psychotherapist diagnosed depression in the last 12 months, and (c) current depressive symptoms in the last two weeks (PHQ-9, score ≥10). Prevalence of 12-month CIDI-MDD was 4.2% in men and 9.9% in women. Prevalence of 12-month self-reported health professional-diagnosed depression was 3.8% and 8.1% and of current depressive symptoms 6.1% and 10.2% in men and women, respectively. Case-overlap between measures was only moderate (32-45%). In adjusted multivariable analyses, depression according to all three measures was associated with lower self-rated health, lower physical and social functioning, higher somatic comorbidity (except for women with 12-month CIDI-MDD), more sick leave and higher health service utilization. Persons with severe depression may be underrepresented. Associations between CIDI-MDD and correlates and overlap with other measures may be underestimated due to time lag between DEGS1 and DEGS1-MH. Prevalence and identified cases varied between these three depression measures, but all measures were consistently associated with a wide range of adverse health outcomes. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Storm in My Brain: Kids and Mood Disorders (Bipolar Disorder and Depression)

    Science.gov (United States)

    ... Brain Kids and Mood Disorders (Bipolar Disorder and Depression) What is a mood disorder? Everyone feels sad, ... one part of bipolar disorder, also called manic depression. In bipolar disorder, moods change between mania (excited ...

  1. Correlation of weight-based objectifying experiences with depression and eating disorder in overweight women

    Directory of Open Access Journals (Sweden)

    Leila Khabir

    2015-06-01

    Full Text Available Background: This study was carried out to investigate the correlation of self-objectification, internalized weight bias and body image concern with depression and eating disorder Methods: A total of 200 female students with overweight and obesity were selected using convenience random sampling among female students with overweight and obesity referring to Shiraz sport clubs in 2013. They responded to Stigmatizing Situations Inventory (SSI, Trait Self- Objectification Questionnaire (TSOQ, Weight Bias Internalization Scale (WBIS, Body Image Concern Inventory (BICI, Center for Epidemiological Studies- Depression Scale (CES-D and Eating Disorder Diagnostic Scale (EDDS. Data were analyzed by structural equation modeling (SEM. Results: Result showed that self-objectification, internalized weight bias and body image concern can mediate the relationship of weight-based objectifying experiences with depression and eating disorder. Conclusion: The findings of this study showed that fitness index of the proposed model can acceptably fit the data.

  2. Detecting recurrent major depressive disorder within primary care rapidly and reliably using short questionnaire measures.

    Science.gov (United States)

    Thapar, Ajay; Hammerton, Gemma; Collishaw, Stephan; Potter, Robert; Rice, Frances; Harold, Gordon; Craddock, Nicholas; Thapar, Anita; Smith, Daniel J

    2014-01-01

    Major depressive disorder (MDD) is often a chronic disorder with relapses usually detected and managed in primary care using a validated depression symptom questionnaire. However, for individuals with recurrent depression the choice of which questionnaire to use and whether a shorter measure could suffice is not established. To compare the nine-item Patient Health Questionnaire (PHQ-9), the Beck Depression Inventory, and the Hospital Anxiety and Depression Scale against shorter PHQ-derived measures for detecting episodes of DSM-IV major depression in primary care patients with recurrent MDD. Diagnostic accuracy study of adults with recurrent depression in primary care predominantly from Wales Scores on each of the depression questionnaire measures were compared with the results of a semi-structured clinical diagnostic interview using Receiver Operating Characteristic curve analysis for 337 adults with recurrent MDD. Concurrent questionnaire and interview data were available for 272 participants. The one-month prevalence rate of depression was 22.2%. The area under the curve (AUC) and positive predictive value (PPV) at the derived optimal cut-off value for the three longer questionnaires were comparable (AUC = 0.86-0.90, PPV = 49.4-58.4%) but the AUC for the PHQ-9 was significantly greater than for the PHQ-2. However, by supplementing the PHQ-2 score with items on problems concentrating and feeling slowed down or restless, the AUC (0.91) and the PPV (55.3%) were comparable with those for the PHQ-9. A novel four-item PHQ-based questionnaire measure of depression performs equivalently to three longer depression questionnaires in identifying depression relapse in patients with recurrent MDD.

  3. The relationship between temperament and character in conversion disorder and comorbid depression.

    Science.gov (United States)

    Erten, Evrim; Yenilmez, Yelda; Fistikci, Nurhan; Saatcioglu, Omer

    2013-05-01

    The aim of this study was to compare conversion disorder patients with healthy controls in terms of temperament and character, and to determine the effect of these characteristics on comorbid depression, based on the idea that conversion disorder patients may have distinctive temperament and character qualities. The study involved 58 patients diagnosed with conversion disorder, based on the DSM-IV diagnostic criteria, under observation at the Bakırköy Psychiatric and Neurological Disorders Outpatient Center, Istanbul. The patients were interviewed with a Structured Clinical Interview (SCID-I) and 57 healthy volunteers, matched for age, sex and education level, were interviewed with a Structured Clinical Interview for people without a psychiatric disorder (SCID-I/NP). All the participants completed a sociodemographic form, the Hamilton Depression Rating Scale, the Hamilton Anxiety Scale and the Temperament and Character Inventory. The conversion disorder patients displayed more harm avoidance (Pconversion disorder patients had high self-transcendence (PConversion disorder patients are significantly different from healthy controls on temperament and character measures of harm avoidance, persistence, self-transcendence and self-directedness. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. Non-fatal disease burden for subtypes of depressive disorder: population-based epidemiological study.

    Science.gov (United States)

    Biesheuvel-Leliefeld, Karolien E M; Kok, Gemma D; Bockting, Claudi L H; de Graaf, Ron; Ten Have, Margreet; van der Horst, Henriette E; van Schaik, Anneke; van Marwijk, Harm W J; Smit, Filip

    2016-05-12

    Major depression is the leading cause of non-fatal disease burden. Because major depression is not a homogeneous condition, this study estimated the non-fatal disease burden for mild, moderate and severe depression in both single episode and recurrent depression. All estimates were assessed from an individual and a population perspective and presented as unadjusted, raw estimates and as estimates adjusted for comorbidity. We used data from the first wave of the second Netherlands-Mental-Health-Survey-and-Incidence-Study (NEMESIS-2, n = 6646; single episode Diagnostic and Statistical Manual (DSM)-IV depression, n = 115; recurrent depression, n = 246). Disease burden from an individual perspective was assessed as 'disability weight * time spent in depression' for each person in the dataset. From a population perspective it was assessed as 'disability weight * time spent in depression *number of people affected'. The presence of mental disorders was assessed with the Composite International Diagnostic Interview (CIDI) 3.0. Single depressive episodes emerged as a key driver of disease burden from an individual perspective. From a population perspective, recurrent depressions emerged as a key driver. These findings remained unaltered after adjusting for comorbidity. The burden of disease differs between the subtype of depression and depends much on the choice of perspective. The distinction between an individual and a population perspective may help to avoid misunderstandings between policy makers and clinicians.

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  6. A clinically useful self-report measure of the DSM-5 anxious distress specifier for major depressive disorder.

    Science.gov (United States)

    Zimmerman, Mark; Chelminski, Iwona; Young, Diane; Dalrymple, Kristy; Walsh, Emily; Rosenstein, Lia

    2014-06-01

    To acknowledge the clinical significance of anxiety in depressed patients, DSM-5 included criteria for an anxious distress specifier for major depressive disorder. In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we modified our previously published depression scale to include a subscale assessing the DSM-5 anxious distress specifier. From December 1995 to August 2013, 773 psychiatric outpatients with major depressive disorder completed the Clinically Useful Depression Outcome Scale (CUDOS) supplemented with questions for the DSM-5 anxious distress specifier (CUDOS-A). To examine discriminant and convergent validity, the patients were rated on clinician severity indices of depression, anxiety, and irritability. Discriminant and convergent validity was further examined in a subset of patients who completed other self-report symptom severity scales. Test-retest reliability was examined in a subset who completed the CUDOS-A twice. We compared patients who did and did not meet the DSM-5 anxious distress specifier on indices of psychosocial functioning and quality of life. The CUDOS-A subscale had high internal consistency and test-retest reliability; was more highly correlated with other self-report measures of anxiety than with measures of depression, substance use problems, eating disorders, and anger; and was more highly correlated with clinician severity ratings of anxiety than depression and irritability. CUDOS-A scores were significantly higher in depressed outpatients with a current anxiety disorder than in depressed patients without a comorbid anxiety disorder (P depressive disorder. © Copyright 2014 Physicians Postgraduate Press, Inc.

  7. 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.

  8. Differences in the clinical characteristics of adolescent depressive disorders.

    Science.gov (United States)

    Karlsson, Linnea; Pelkonen, Mirjami; Heilä, Hannele; Holi, Matti; Kiviruusu, Olli; Tuisku, Virpi; Ruuttu, Titta; Marttunen, Mauri

    2007-01-01

    Our objective was to analyze differences in clinical characteristics and comorbidity between different types of adolescent depressive disorders. A sample of 218 consecutive adolescent (ages 13-19 years) psychiatric outpatients with depressive disorders was interviewed for DSM-IV Axis I and Axis II diagnoses. We obtained data by interviewing the adolescents themselves and collecting additional background information from the clinical records. Lifetime age of onset for depression, current episode duration, frequency of suicidal behavior, psychosocial impairment, and the number of current comorbid psychiatric disorders varied between adolescent depressive disorder categories. The type of co-occurring disorder was mainly consistent across depressive disorders. Minor depression and dysthymia (DY) presented as milder depressions, whereas bipolar depression (BPD) and double depression [DD; i.e., DY with superimposed major depressive disorder (MDD)] appeared as especially severe conditions. Only earlier lifetime onset distinguished recurrent MDD from first-episode MDD, and newly emergent MDD appeared to be as impairing as recurrent MDD. Adolescent depressive disorder categories differ in many clinically relevant aspects, with most differences reflecting a continuum of depression severity. Identification of bipolarity and the subgroup with DD seems especially warranted. First episode MDD should be considered as severe a disorder as recurring MDD. (c) 2006 Wiley-Liss, Inc.

  9. Extended Family and Friendship Support Networks are both Protective and Risk Factors for Major Depressive Disorder, and Depressive Symptoms Among African Americans and Black Caribbeans

    Science.gov (United States)

    Taylor, Robert Joseph; Chae, David H.; Lincoln, Karen D.; Chatters, Linda M.

    2014-01-01

    This study explores relationships between lifetime and 12 month DSM-IV major depressive disorder (MDD), depressive symptoms and involvement with family and friends within a national sample of African American and Black Caribbean adults (n=5,191). MDD was assessed using the DSM-IV World Mental Health Composite International Diagnostic Interview (WMH-CIDI) and depressive symptoms were assessed using the CES-D and the K6. Findings indicated that among both populations close supportive ties with family members and friends are associated with lower rates of depression and major depressive disorder. For African Americans, closeness to family members was important for both 12 month and lifetime MDD; and both family and friend closeness were important for depressive symptoms. For Caribbean Blacks, family closeness had more limited associations with outcomes and was directly associated with psychological distress only. Negative interactions with family (conflict, criticisms), however, were associated with higher MDD and depressive symptoms among both African Americans and Black Caribbeans. PMID:25594791

  10. Feasibility and utility of screening for depression and anxiety disorders in patients with cardiovascular disease.

    Science.gov (United States)

    Celano, Christopher M; Suarez, Laura; Mastromauro, Carol; Januzzi, James L; Huffman, Jeff C

    2013-07-01

    Depression and anxiety in patients with cardiac disease are common and independently associated with morbidity and mortality. We aimed to explore the use of a 3-step approach to identify inpatients with cardiac disease with depression, generalized anxiety disorder (GAD), or panic disorder; understand the predictive value of individual screening items in identifying these disorders; and assess the relative prevalence of these disorders in this cohort. To identify depression and anxiety disorders in inpatients with cardiac disease as part of a care management trial, an iterative 3-step screening procedure was used. This included an existing 4-item (Coping Screen) tool in nursing data sets, a 5-item screen for positive Coping Screen patients (Patient Health Questionnaire-2 [PHQ-2], GAD-2, and an item about panic attacks), and a diagnostic evaluation using PHQ-9 and the Primary Care Evaluation of Mental Disorders anxiety disorder modules. Overall, 6210 inpatients received the Coping Screen, 581 completed portions of all 3 evaluation steps, and 210 received a diagnosis (143 depression, 129 GAD, 30 panic disorder). Controlling for age, sex, and the other screening items, PHQ-2 items independently predicted depression (little interest/pleasure: odds ratio [OR]=6.65, Pdepression: OR=5.24, P=0.001), GAD-2 items predicted GAD (anxious: OR=4.09, P=0.003; unable to control worrying: OR=10.46, Pdepression in this cohort, and GAD-2 was an effective screening tool; however, panic disorder was rare. These results support the use of 2-step screening for depression and GAD beginning with a 4-item scale (GAD-2 plus PHQ-2). Unique Identifier: NCT01201967. URL: http://www.clinicaltrials.gov/ct2/show/NCT01201967.

  11. Clinical study on role of life events in genesis of neurotic disorders and depression

    Directory of Open Access Journals (Sweden)

    Deepanjali Medhi

    2015-07-01

    Full Text Available Background: This study was conducted to know about the role of life events in genesis of neurotic disorders and depression in four groups of patients with dissociative disorder, somatisation disorder, generalized anxiety disorder (GAD, and depression. It was conducted in the Department of Psychiatry, Gauhati Medical College and Hospital, Guwahati, Assam, India. Methods and materials: It was a case control study with 100 cases of neurotic disorders and depression (25 cases in each group attending indoor and outdoor, and diagnosed using research diagnostic criteria of the tenth revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10. The groups were compared with similar number of matched controls, in respect to number, scoring, and type of life events occurring within one year prior to the onset of illness using the Presumptive Stressful Life Events Scale (PSLES. Variables related to socio-demographic characteristics were also seen between cases and controls. Result and conclusion: Number of life events was significantly higher in depressive and generalized anxiety groups than control group. Total life events scores were significantly higher in depressive and generalized anxiety group than control group. Undesirable events were significantly higher in all groups. Personal events were significantly higher in depressives than control. Events related to interpersonal relation were significantly higher in depressive, dissociative, and GAD groups than control. Bereavement was closely associated with depression and GAD. Events related to health, finance, and education were higher in dissociative group than control. Events related to move were found significantly higher in GAD group than control. Implications of the findings are discussed.

  12. Casting wider nets for anxiety and depression: disability-driven cross-diagnostic subtypes in a large cohort.

    Science.gov (United States)

    Wanders, R B K; van Loo, H M; Vermunt, J K; Meijer, R R; Hartman, C A; Schoevers, R A; Wardenaar, K J; de Jonge, P

    2016-12-01

    In search of empirical classifications of depression and anxiety, most subtyping studies focus solely on symptoms and do so within a single disorder. This study aimed to identify and validate cross-diagnostic subtypes by simultaneously considering symptoms of depression and anxiety, and disability measures. A large cohort of adults (Lifelines, n = 73 403) had a full assessment of 16 symptoms of mood and anxiety disorders, and measurement of physical, social and occupational disability. The best-fitting subtyping model was identified by comparing different hybrid mixture models with and without disability covariates on fit criteria in an independent test sample. The best model's classes were compared across a range of external variables. The best-fitting Mixed Measurement Item Response Theory model with disability covariates identified five classes. Accounting for disability improved differentiation between people reporting isolated non-specific symptoms ['Somatic' (13.0%), and 'Worried' (14.0%)] and psychopathological symptoms ['Subclinical' (8.8%), and 'Clinical' (3.3%)]. Classes showed distinct associations with clinically relevant external variables [e.g. somatization: odds ratio (OR) 8.1-12.3, and chronic stress: OR 3.7-4.4]. The Subclinical class reported symptomatology at subthreshold levels while experiencing disability. No pure depression or anxiety, but only mixed classes were found. An empirical classification model, incorporating both symptoms and disability identified clearly distinct cross-diagnostic subtypes, indicating that diagnostic nets should be cast wider than current phenomenology-based categorical systems.

  13. No association between serum cholesterol and death by suicide in patients with schizophrenia, bipolar affective disorder, or major depressive disorder.

    Science.gov (United States)

    Park, Subin; Yi, Ki Kyoung; Na, Riji; Lim, Ahyoung; Hong, Jin Pyo

    2013-12-05

    Previous research on serum total cholesterol and suicidality has yielded conflicting results. Several studies have reported a link between low serum total cholesterol and suicidality, whereas others have failed to replicate these findings, particularly in patients with major affective disorders. These discordant findings may reflect the fact that studies often do not distinguish between patients with bipolar and unipolar depression; moreover, definitions and classification schemes for suicide attempts in the literature vary widely. Subjects were patients with one of the three major psychiatric disorders commonly associated with suicide: schizophrenia, bipolar affective disorder, and major depressive disorder (MDD). We compared serum lipid levels in patients who died by suicide (82 schizophrenia, 23 bipolar affective disorder, and 67 MDD) and non-suicide controls (200 schizophrenia, 49 bipolar affective disorder, and 175 MDD). Serum lipid profiles did not differ between patients who died by suicide and control patients in any diagnostic group. Our results do not support the use of biological indicators such as serum total cholesterol to predict suicide risk among patients with a major psychiatric disorder.

  14. A literature review of the application of the Geriatric Depression Scale, Depression Anxiety Stress Scales and Post-traumatic Stress Disorder Checklist to community nursing cohorts.

    Science.gov (United States)

    Allen, Jacqui; Annells, Merilyn

    2009-04-01

    To explore through literature review the appropriateness of three common tools for use by community nurses to screen war veteran and war widow(er) clients for depression, anxiety and post-traumatic stress disorder. War veterans and, to a lesser extent, war widow(er)s, are prone to mental health challenges, especially depression, anxiety and post-traumatic stress disorder. Community nurses do not accurately identify such people with depression and related disorders although they are well positioned to do so. The use of valid and reliable self-report tools is one method of improving nurses' identification of people with actual or potential mental health difficulties for referral to a general practitioner or mental health practitioner for diagnostic assessment and treatment. The Geriatric Depression Scale, Depression Anxiety Stress Scales and Post-traumatic Stress Disorder Checklist are frequently recommended for mental health screening but the appropriateness of using the tools for screening war veteran and war widow(er) community nursing clients who are often aged and have functional impairment, is unknown. Systematic review. Current literature informs that the Geriatric Depression Scale accurately predicts a diagnosis of depression in community nursing cohorts. The three Depression Anxiety Stress Scales subscales of depression, anxiety and stress are valid; however, no studies were identified that compared the performance of the Depression Anxiety Stress Scales in predicting diagnoses of depression or anxiety. The Post-traumatic Stress Disorder Checklist predicts post-traumatic stress disorder in community cohorts although no studies meeting the selection criteria included male participants. This review provides recommendations for the use of the Geriatric Depression Scale, Depression Anxiety Stress Scales and The Post-traumatic Stress Disorder Checklist based on examination of the published evidence for the application of these screening tools in samples

  15. Blood serum concentrations of kynurenic acid in patients diagnosed with recurrent depressive disorder, depression in bipolar disorder, and schizoaffective disorder treated with electroconvulsive therapy.

    Science.gov (United States)

    Olajossy, Marcin; Olajossy, Bartosz; Wnuk, Sebastian; Potembska, Emilia; Urbańska, Ewa

    2017-06-18

    The aim of the present study was to compare blood serum kynurenic acid (KYNA) concentrations measured before ECT and after 1, 6 and 12 electroconvulsive treatment (ECT) sessions in patients with diagnoses of recurrent depressive disorder (RDD), depression in bipolar disorder (DBD) and schizoaffective disorder (SAD). The study group comprised of 50 patients with ICD-10 diagnoses of RDD, DBD and SAD. Blood serum KYNA concentrations were determined and clinical assessment was performed using the MADRS and the GAF scale. Significant differences were found in blood serum KYNA levels between RDD, DBD and SAD patients treated with electroconvulsive therapy and healthy controls: 1) KYNA concentrations in DBD patients measured before ECT and after 12 ECT sessions were significantly lower than in the control group; 2) KYNA concentrations in the serum of RDD patients measured before ECT and after one and 12 ECT sessions were significantly lower than in the control group, while those measured after 6 ECT session did not differ significantly from KYNA concentrations in healthy controls; 3) higher pre-treatment blood serum concentrations of KYNA in DBD patients correlated with a higher number of illness phases and poorer general functioning before treatment; 4) significant relationships were found between higher blood serum concentrations of KYNA in RDD patients after 1 ECT session and male gender, and between higher KYNA concentrations after 6 ECT sessions and increased depression and poorer functioning before treatment in those patients. Results show that KYNA concentrations in all diagnostic groups were lower before ECT (not statistically significant for the SAD group) and that there were no significant changes in those concentrations (compared with the baseline) during ECT.

  16. Comparison of Sleep Disturbances in Post-Traumatic Stress Disorder and Depression Patients

    Science.gov (United States)

    Britvić, Dolores; Antičević, Vesna; Klepac, Nataša

    2016-09-01

    The aim of this study was to explore differences in the intensity of depressiveness, sleep disturbances and sleepiness between post-traumatic stress disorder (PTSD) patients and patients with depression. A total of 170 patients were examined, including 120 PTSD patients and 50 patients with depression. All participants completed the Beck Depression Inventory, Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale. The results showed difference in the subjective assessment of sleep quality between the war veterans with PTSD and civilians with depression, without significant differences between them in the level of depressiveness and sleepiness. Considering the fact that insomnia can occur as an early, covert sign of both PTSD and depression and that differences in the intensity of sleep disturbances between the groups were established, the use of these and similar instruments for the assessment of sleep quality can be useful in distinguishing patients with PTSD and depression, treatment of their sleep disturbances, and prevention of more severe symptoms in both diagnostic categories.

  17. Relationship between affective temperaments and aggression in euthymic patients with bipolar mood disorder and major depressive disorder.

    Science.gov (United States)

    Dolenc, B; Dernovšek, M Z; Sprah, L; Tavcar, R; Perugi, G; Akiskal, H S

    2015-03-15

    So far there is a scarce of studies dealing with the relationship between different aspects of aggressive behaviour and affective temperaments among various mood disorders. The aim of the present study was to explore in a group of patients with affective mood disorders the relationship between affective temperaments and aggression. 100 consecutive outpatients in euthymic phase of mood disorders (46 with bipolar disorder-type I, 18 with bipolar disorder-type II and 36 with major depressive disorder) were self-assessed with the Aggression Questionnaire and the short version of Slovenian Temperament Evaluation of Memphis, Pisa, Paris and San Diego - Autoquestionnaire (TEMPS-A). The factorial analysis of the TEMPS-A subscales revealed 2 main factors: Factor 1 (prominent cyclothymic profile) consisted of cyclothymic, depressive, irritable, and anxious temperaments and Factor 2 (prominent hyperthymic profile) which was represented by the hyperthymic temperament, and by depressive and anxious temperaments as negative components. Patients with prominent cyclothymic profile got their diagnosis later in their life and had significantly higher mean scores on anger and hostility (non-motor aggressive behaviour) compared with patients with prominent hyperthymic profile. We included patients with different mood disorders, therefore the sample selection may influence temperamental and aggression profiles. We used self-report questionnaires which can elicit sociable desirable answers. Anger and hostility could represent stable personality characteristics of prominent cyclothymic profile that endure even in remission. It seems that distinct temperamental profile could serve as a good diagnostic and prognostic value for non-motor aspects of aggressive behaviour. Copyright © 2014 Elsevier B.V. All rights reserved.

  18. Brief report: Overgeneral autobiographical memory in adolescent major depressive disorder.

    Science.gov (United States)

    Champagne, Katelynn; Burkhouse, Katie L; Woody, Mary L; Feurer, Cope; Sosoo, Effua; Gibb, Brandon E

    2016-10-01

    The current study examined whether overgeneral autobiographical memory (OGM) bias serves as a state-like marker of major depressive disorder (MDD) in adolescence or whether it would also be observed in currently nondepressed adolescents with a history of MDD. We examined differences in OGM to positive and negative cue words between adolescents (aged 11-18 years) with current MDD (n = 15), remitted MDD (n = 25), and no history of any depressive disorder (n = 25). Youth and their parents were administered a structured diagnostic interview and adolescents completed the autobiographical memory test. Compared to never depressed adolescents, adolescents with current or remitted MDD recalled less specific memories in response to positive and negative cue words. The difference between the two MDD groups was small and nonsignificant. These findings suggest that OGM is not simply a state-like marker in currently depressed adolescents, but is also evident in adolescents with remitted MDD, indicating that it may represent a trait-like vulnerability that increases risk for relapse. Copyright © 2016 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  19. Depressive disorders during weaning from prolonged mechanical ventilation.

    Science.gov (United States)

    Jubran, Amal; Lawm, Gerald; Kelly, Joanne; Duffner, Lisa A; Gungor, Gokay; Collins, Eileen G; Lanuza, Dorothy M; Hoffman, Leslie A; Tobin, Martin J

    2010-05-01

    Patients who require mechanical ventilation are at risk of emotional stress because of total dependence on a machine for breathing. The stress may negatively impact ventilator weaning and survival. The purpose of this study was to determine whether depressive disorders in patients being weaned from prolonged mechanical ventilation are linked to weaning failure and decreased survival. A prospective study of 478 consecutive patients transferred to a long-term acute care hospital for weaning from prolonged ventilation was undertaken. A clinical psychologist conducted a psychiatric interview to assess for the presence of depressive disorders. Of the 478 patients, 142 had persistent coma or delirium and were unable to be evaluated for depressive disorders. Of the remaining 336 patients, 142 (42%) were diagnosed with depressive disorders. In multivariate analysis, co-morbidity score [odds ratio (OR), 1.23; P = 0.007], functional dependence before the acute illness (OR, 1.70, P = 0.03) and history of psychiatric disorders (OR, 3.04, P = 0.0001) were independent predictors of depressive disorders. The rate of weaning failure was higher in patients with depressive disorders than in those without such disorders (61 vs. 33%, P = 0.0001), as was mortality (24 vs. 10%, P = 0.0008). The presence of depressive disorders was independently associated with mortality (OR, 4.3; P = 0.0002); age (OR, 1.06; P = 0.001) and co-morbidity score (OR, 1.24; P = 0.02) also predicted mortality. Depressive disorders were diagnosed in 42% of patients who were being weaned from prolonged ventilation. Patients with depressive disorders were more likely to experience weaning failure and death.

  20. Comorbidity of substance use with depression and other mental disorders: from Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) to DSM-V.

    Science.gov (United States)

    Nunes, Edward V; Rounsaville, Bruce J

    2006-09-01

    To arrive at recommendations for addressing co-occurring psychiatric and substance use disorders in the development of the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-V) criteria. Synthesis of findings of other papers from a consensus conference and from the literature on diagnosis and treatment of co-occurring psychiatric and substance use disorders. Most of the relevant studies examine co-occurring depression. The diagnosis and treatment of psychiatric syndromes that co-occur with substance use disorders has been a source of controversy, fueled in part by limitations of pre-DSM-IV nosologies. The DSM-IV scheme of classifying co-occurring disorders as primary (also referred to as independent) or substance-induced has promise in terms of good predictive validity, although pertinent longitudinal and treatment studies are limited. The substance-induced category answers the need of clinicians for a way to categorize patients with clinically significant psychiatric symptoms that occur in the setting of ongoing substance use. DSM-V should retain the primary (independent) and substance-induced categories. In DSM-IV these categories are broadly defined and leave much to clinical judgement. Existing data sets should be brought to bear to refine the criteria, making them more detailed with clearer anchor points and more specificity around particular substances and psychiatric syndromes. More longitudinal studies and clinical trials are also needed. Looking beyond DSM-V, co-occurring psychiatric syndromes are likely to be important in the quest for a nosology founded on pathophysiology.

  1. Effects of maternal negativity and of early and recent recurrent depressive disorder on children's false belief understanding.

    Science.gov (United States)

    Rohrer, Lisa M; Cicchetti, Dante; Rogosch, Fred A; Toth, Sheree L; Maughan, Angeline

    2011-01-01

    Research has shown that children of depressed mothers are at risk for problems in a variety of developmental domains; however, little is known about the effects of maternal depression on children's emerging understanding of false beliefs. In this study, 3 false belief tasks were administered to 5-year-old children whose mothers had either met criteria for major depressive disorder within the first 20 months of the child's life (n = 91) or had never been depressed (n = 50). Significant difficulties in performance were found among the children of depressed mothers, especially those whose mothers had experienced early and recent recurrent depressive disorder. Regardless of diagnostic status, children whose mothers exhibited negativity during problem-solving tasks administered at an earlier developmental period also were less likely to demonstrate false belief understanding. These effects remained even after child verbal ability was controlled.

  2. Right brain, left brain in depressive disorders: Clinical and theoretical implications of behavioral, electrophysiological and neuroimaging findings.

    Science.gov (United States)

    Bruder, Gerard E; Stewart, Jonathan W; McGrath, Patrick J

    2017-07-01

    The right and left side of the brain are asymmetric in anatomy and function. We review electrophysiological (EEG and event-related potential), behavioral (dichotic and visual perceptual asymmetry), and neuroimaging (PET, MRI, NIRS) evidence of right-left asymmetry in depressive disorders. Recent electrophysiological and fMRI studies of emotional processing have provided new evidence of altered laterality in depressive disorders. EEG alpha asymmetry and neuroimaging findings at rest and during cognitive or emotional tasks are consistent with reduced left prefrontal activity in depressed patients, which may impair downregulation of amygdala response to negative emotional information. Dichotic listening and visual hemifield findings for non-verbal or emotional processing have revealed abnormal perceptual asymmetry in depressive disorders, and electrophysiological findings have shown reduced right-lateralized responsivity to emotional stimuli in occipitotemporal or parietotemporal cortex. We discuss models of neural networks underlying these alterations. Of clinical relevance, individual differences among depressed patients on measures of right-left brain function are related to diagnostic subtype of depression, comorbidity with anxiety disorders, and clinical response to antidepressants or cognitive behavioral therapy. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Association study of obstetrical complication and depressive disorder

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective:To investigate the correlation between obstetrical complications and depressive disorder.Methods:Depressive disorder probands and their adult sibling were diagnosed using CCMD-3 criteria.Obstetrical data from maternal reports were scored,applying published scales that take into account number and severity of complication.Results:The scores of obstetric complication and prenatal complications and low birth weight were significantly worse in probands than siblings without depressive disorders.Conclusion:Results suggest obstetric complications are etiologically significant in depressive disorder.

  4. Depressive and bipolar disorders

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Hansen, Hanne Vibe; Demyttenaere, Koen

    2005-01-01

    of the patients (40-80%) had erroneous views as to the effect of antidepressants. Older patients (over 40 years of age) consistently had a more negative view of the doctor-patient relationship, more erroneous ideas concerning the effect of antidepressants and a more negative view of antidepressants in general....... Moreover, their partners agreed on these negative views. Women had a more negative view of the doctor-patient relationship than men, and patients with a depressive disorder had a more negative view of antidepressants than patients with bipolar disorder. The number of psychiatric hospitalizations......BACKGROUND: There is increasing evidence that attitudes and beliefs are important in predicting adherence to treatment and medication in depressive and bipolar disorders. However, these attitudes have received little study in patients whose disorders were sufficiently severe to require...

  5. Comorbidity of depressive and dermatologic disorders - therapeutic aspects.

    Science.gov (United States)

    Filaković, Pavo; Petek, Anamarija; Koić, Oliver; Radanović-Grgurić, Ljiljana; Degmecić, Dunja

    2009-09-01

    Depressive disorders are more common in the population affected with dermatologic disorders. Comorbidity of depression and dermatologic disorders is around 30%. The correlation between depressive and dermatologic disorders still remains unclear. In psychodermatology three disorders are described: a) psychophysiological disorders (both disorders induced and maintained by stressors), b) secondary psychiatric disorders (mental disorder as a result of skin leasions and treatment) and c) primary psychiatric disorders (skin alterations as a result of mental disorders and treatment). In depression and dermatology disorders in which certain precipitating factors are required thereby causing alteration of the patient's immunological identity causing a combination of hereditary features and ones acquired through adaptation occur to cause the disorder to develop. The cytokines are vital in the regulation of the immunology response and are also mediators of non-infective inflammatory processes leading to recurrent hormonal secretion affecting the function of the vegetative and central nervous system leading to so called "sickness behaviour", marked by loss of appetite, anhedonia, anxiety, decrease of concentration and interest along with other changes which generate a picture of depressive disorder. Treatment of depressive and dermatologic disorders is complex and requires an integral therapeutic approach encompassing all aspects of both disorders and their comorbidity. Therefore therapeutic success lies in a team approach to the patient under the auspice of consultative-liason psychiatry by setting the frame for efficient collaboration and bridging the gap between the mental and the physical in everyday clinical practice.

  6. The relationship between acculturation strategies and depressive and anxiety disorders in Turkish migrants in the Netherlands.

    Science.gov (United States)

    Ünlü Ince, Burçin; Fassaert, Thijs; de Wit, Matty A S; Cuijpers, Pim; Smit, Jan; Ruwaard, Jeroen; Riper, Heleen

    2014-09-05

    Turkish migrants in the Netherlands have a high prevalence of depressive and/or anxiety disorders. Acculturation has been shown to be related to higher levels of psychological distress, although it is not clear whether this also holds for depressive and anxiety disorders in Turkish migrants. This study aims to clarify the relationship between acculturation strategies (integration, assimilation, separation and marginalization) and the prevalence of depressive and anxiety disorders as well as utilisation of GP care among Turkish migrants. Existing data from an epidemiological study conducted among Dutch, Turkish and Moroccan inhabitants of Amsterdam were re-examined. Four scales of acculturation strategies were created in combination with the bi-dimensional approach of acculturation by factor analysis. The Lowlands Acculturation Scale and the Composite International Diagnostic Interview were used to assess acculturation and mood and anxiety disorders. Socio-demographic variables, depressive, anxiety and co-morbidity of both disorders and the use of health care services were associated with the four acculturation strategies by means of Chi-Squared and Likelihood tests. Three two-step logistic regression analyses were performed to control for possible, confounding variables. The sample consisted of 210 Turkish migrants. Significant associations were found between the acculturation strategies and age (p acculturation strategies and depressive disorders (p = .049): integration was associated with a lower risk of depression, separation with a higher risk. Using the axis separately, participation in Dutch society showed a significant relationship with a decreased risk of depressive, anxiety and co-morbidity of both disorders (OR = .15; 95% CI: .024 - .98). Non-participation showed no significant association. No association was found between the acculturation strategies and uptake of GP care. Turkish migrants who integrate may have a lower risk of developing a

  7. Anxiety and Depression Symptoms in Children with Asperger Syndrome Compared with Attention-Deficit/Hyperactivity Disorder and Depressive Disorder

    Science.gov (United States)

    Park, Subin; Park, Min-Hyeon; Kim, Hyo Jin; Yoo, Hee Jeong

    2013-01-01

    The objective of this study was to examine (a) anxiety and depression symptoms in children with Asperger syndrome (AS) compared to children with attention-deficit/hyperactivity disorder (ADHD) and children with depressive disorder; (b) parental anxiety and depressive symptoms in the three groups; and (c) the association between the anxiety and…

  8. Evaluating the Psychometric Properties and Responsiveness to Change of 3 Depression Measures in a Sample of Persons With Traumatic Spinal Cord Injury and Major Depressive Disorder.

    Science.gov (United States)

    Williams, Ryan T; Heinemann, Allen W; Neumann, Holly Demark; Fann, Jesse R; Forchheimer, Martin; Richardson, Elizabeth J; Bombardier, Charles H

    2016-06-01

    To compare the measurement properties and responsiveness to change of the Patient Health Questionnaire-9 (PHQ-9), the Hopkins Symptom Checklist-20 (HSCL-20), and the Hamilton Depression Rating Scale (HAM-D) in people with spinal cord injury (SCI) diagnosed with major depressive disorder (MDD). Secondary analysis of depression symptoms measured at 6 occasions over 12 weeks as part of a randomized controlled trial of venlafaxine XR for MDD in persons with SCI. Outpatient and community settings. Individuals (N=133) consented and completed the drug trial. Eligibility criteria were age at least 18 years, traumatic SCI, and diagnosis of MDD. Venlafaxine XR. Patients completed the PHQ-9 and the HSCL-20 depression scales; clinical investigators completed the HAM-D and the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) Dissociative Disorders, which was used as a diagnostic criterion measure. All 3 instruments were improved with rating scale analysis. The HSCL-20 and the HAM-D contained items that misfit the underlying construct and that correlated weakly with the total scores. Removing these items improved the internal consistency, with floor effects increasing slightly. The HAM-D correlated most strongly with Structured Clinical Interview for DSM-IV Dissociative Disorders diagnoses. Improvement in depression was similar on all outcome measures in both treatment and control groups. The psychometric properties of the revised depression instruments are more than adequate for routine use in adults with SCI and are responsive to clinical improvement. The PHQ-9 is the simplest instrument with measurement properties as good as or better than those of the other instruments and required the fewest modifications. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  9. Diagnostic conversion to bipolar disorder in unipolar depressed patients participating in trials on antidepressants.

    Science.gov (United States)

    Holmskov, J; Licht, R W; Andersen, K; Bjerregaard Stage, T; Mørkeberg Nilsson, F; Bjerregaard Stage, K; Valentin, J B; Bech, P; Ernst Nielsen, R

    2017-02-01

    In unipolar depressed patients participating in trials on antidepressants, we investigated if illness characteristics at baseline could predict conversion to bipolar disorder. A long-term register-based follow-up study of 290 unipolar depressed patients with a mean age of 50.8 years (SD=11.9) participating in three randomized trials on antidepressants conducted in the period 1985-1994. The independent effects of explanatory variables were examined by applying Cox regression analyses. The overall risk of conversion was 20.7%, with a mean follow-up time of 15.2 years per patient. The risk of conversion was associated with an increasing number of previous depressive episodes at baseline, [HR 1.18, 95% CI (1.10-1.26)]. No association with gender, age, age at first depressive episode, duration of baseline episode, subtype of depression or any of the investigated HAM-D subscales included was found. The patients were followed-up through the Danish Psychiatric Central Research Register, which resulted in inherent limitations such as possible misclassification of outcome. In a sample of middle-aged hospitalized unipolar depressed patients participating in trials on antidepressants, the risk of conversion was associated with the number of previous depressive episodes. Therefore, this study emphasizes that unipolar depressed patients experiencing a relatively high number of recurrences should be followed more closely, or at least be informed about the possible increased risk of conversion. Copyright © 2016. Published by Elsevier Masson SAS.

  10. Predictors of new-onset depressive disorders - Results from the longitudinal Finnish Health 2011 Study.

    Science.gov (United States)

    Markkula, Niina; Marola, Niko; Nieminen, Tarja; Koskinen, Seppo; Saarni, Samuli I; Härkänen, Tommi; Suvisaari, Jaana

    2017-01-15

    Identifying risk factors for depression is important for understanding etiological mechanisms and targeting preventive efforts. No prior studies have compared risk factors of dysthymia and major depressive disorder (MDD) in a longitudinal setting. Predictors of new-onset MDD and dysthymia were examined in a longitudinal general population study (Health 2000 and 2011 Surveys, BRIF8901). 4057 persons free of depressive disorders at baseline were followed up for 11 years. DSM-IV MDD and dysthymia were diagnosed with the Composite International Diagnostic Interview. 126 persons (4.4%, 95%CI 3.6-5.2) were diagnosed with MDD or dysthymia at follow-up. Predictors of new-onset depressive disorders were younger age (adjusted OR 0.97, 95%CI 0.95-0.99 per year), female gender (aOR 1.46, 95%CI 1.01-2.12), multiple childhood adversities (aOR 1.76, 95%CI 1.10-2.83), low trust dimension of social capital (aOR 0.58, 95%CI 0.36-0.96 for high trust), baseline anxiety disorder (aOR 2.75, 95%CI 1.36-5.56), and baseline depressive symptoms (aOR 1.65, 95%CI 1.04-2.61 for moderate and aOR 2.49, 95%CI 1.20-5.17 for severe symptoms). Risk factors for MDD were younger age, female gender, anxiety disorder and depressive symptoms, whereas younger age, multiple childhood adversities, low trust, and having 1-2 somatic diseases predicted dysthymia. We only had one follow-up point at eleven years, and did not collect information on the subjects' health during the follow-up period. Persons with subclinical depressive symptoms, anxiety disorders, low trust, and multiple childhood adversities have a higher risk of depressive disorders. Predictors of MDD and dysthymia appear to differ. This information can be used to target preventive efforts and guide social policies. Copyright © 2016 Elsevier B.V. All rights reserved.

  11. [Enviromental factors related to depressive disorders].

    Science.gov (United States)

    Hernández-Benítez, Catalina Teresa; García-Rodríguez, Alfonso; Leal-Ugarte, Evelia; Peralta-Leal, Valeria; Durán-González, Jorge

    2014-01-01

    As a result of their high prevalence, mayor depressive disorder single episode (MDDSE); major depressive disorder recurrent episodes (MDDREC); and dysthymia are considered an important public health problem. The objective of this paper was to identify and correlate environmental factors in patients with MDDSE, MDDREC and dysthymia. 121 patients from the Instituto Mexicano del Seguro Social's Subzone General Hospital of San Andres Tuxtla, at Veracruz, were questioned by history with the risk variables. 16 of them were diagnosed with MDDREC, 72 with MDD and 33 with dysthymia; in all of those cases, females prevailed. Depressive disorders were observed more frequently in people over 40 years, married, with medium or low educational level, with dysfunctional family environment, victims of family violence and who were the middle siblings. The main comorbidities that arose were gastrointestinal disorders, obesity and hypertension. 16 of them were diagnosed with MDDREC, 72 with MDD and 33 with dysthymia; in all of those cases, females prevailed. Depressive disorders were observed more frequently in people over 40 years, married, with medium or low educational level, with dysfunctional family environment, victims of family violence and who were the middle siblings. The main comorbidities that arose were gastrointestinal disorders, obesity and hypertension. The main risk factors identified for developing depressive disorders were: being female, over 40 years old and being married. The differences obtained in this study, if it is compared with others, are probably due to sample size, selection criteria and ethnic origin.

  12. Social functioning in major depressive disorder.

    Science.gov (United States)

    Kupferberg, Aleksandra; Bicks, Lucy; Hasler, Gregor

    2016-10-01

    Depression is associated with social risk factors, social impairments and poor social functioning. This paper gives an overview of these social aspects using the NIMH Research and Domain Criteria 'Systems for Social Processes' as a framework. In particular, it describes the bio-psycho-social interplay regarding impaired affiliation and attachment (social anhedonia, hyper-sensitivity to social rejection, competition avoidance, increased altruistic punishment), impaired social communication (impaired emotion recognition, diminished cooperativeness), impaired social perception (reduced empathy, theory-of-mind deficits) and their impact on social networks and the use of social media. It describes these dysfunctional social processes at the behavioural, neuroanatomical, neurochemical and genetic levels, and with respect to animal models of social stress. We discuss the diagnostic specificity of these social deficit constructs for depression and in relation to depression severity. Since social factors are importantly involved in the pathogenesis and the consequences of depression, such research will likely contribute to better diagnostic assessments and concepts, treatments and preventative strategies both at the diagnostic and transdiagnostic level. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. Suicide risk in depression and bipolar disorder: Do impulsiveness-aggressiveness and pharmacotherapy predict suicidal intent?

    Directory of Open Access Journals (Sweden)

    Maurizio Pompili

    2008-03-01

    Full Text Available Maurizio Pompili1,2, Marco Innamorati3, Michele Raja4, Ilaria Falcone2, Giuseppe Ducci5, Gloria Angeletti2, David Lester6, Paolo Girardi2, Roberto Tatarelli2, Eleonora De Pisa21McLean Hospital, Harvard Medical School, Boston, MA, USA; 2Department of Psychiatry, Sant’Andrea Hospital, “Sapienza” University of Rome, Italy; 3Università Europea di Roma, Italy; 4Diagnostic and Therapeutic Psychiatric Services, Department of Mental Health, Santo Spirito Hospital, Rome, Italy; 5Diagnostic and Therapeutic Psychiatric Services, Department of Mental Health, San Filippo Neri Hospital, Rome, Italy; 6Center for the Study of Suicide, Blackwood, NJ, USAAbstract: The aims of the present study were to examine clinical, personality, and sociodemographic predictors of suicide risk in a sample of inpatients affected by major affective disorders. The participants were 74 inpatients affected by major depressive disorder or bipolar disorder-I. Patients completed a semi-structured interview, the Beck Hopelessness Scale, the Aggression Questionnaire, the Barratt Impulsiveness Scale, and the Hamilton scales for depression and anxiety. Over 52% of the patients were high suicide risks. Those at risk reported more severe depressive-anxious symptomatology, more impulsivity and more hostility. Impulsivity, the use of antidepressants, anxiety/somatization, and the use of mood stabilizers (a negative predictor resulted in accurate predicting of suicide intent. Impulsivity and antidepressant use were the strongest predictors even after controlling for several sociodemographic and clinical variables.Keywords: suicide, mood disorders, pharmacotherapy, impulsiveness, aggressiveness

  14. Are the ICD-10 or DSM-5 diagnostic systems able to define those who will benefit from treatment for depression?

    Science.gov (United States)

    Montgomery, Stuart

    2016-08-01

    Two widely used diagnostic systems, the International Statistical Classification of Diseases and Related Health Problems (ICD-10) and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), are reviewed for their ability to define those who will benefit from active treatment rather than placebo. Both systems suffer from a weakness in defining symptoms sufficiently clearly to separate depression from normal mood variations in the general population. Consequently, normal individuals may be medicalized and defined as suffering from and treated for depression. Also, in mild depression, unlike moderate depression, a lack of significant separation of active treatment from placebo has been shown in individual double-blind, placebo-controlled studies and in meta-analyses of these treatment studies. Both systems would be more useful for treatment purposes if they provided a clearer symptomatic definition of moderate depression, as is widely used in pivotal regulatory standard efficacy studies.

  15. The Collaborative Longitudinal Personality Disorders Study: baseline Axis I/II and II/II diagnostic co-occurrence.

    Science.gov (United States)

    McGlashan, T H; Grilo, C M; Skodol, A E; Gunderson, J G; Shea, M T; Morey, L C; Zanarini, M C; Stout, R L

    2000-10-01

    To describe baseline diagnostic co-occurrence in the Collaborative Longitudinal Personality Disorders Study. Six hundred and sixty-eight patients were reliably assessed with diagnostic interviews for DSM-IV Axis I and II disorders to create five groups: Schizotypal (STPD), Borderline (BPD), Avoidant (AVPD), Obsessive-Compulsive (OCPD) and Major Depressive Disorder (MDD) without personality disorder (PD). Mean number of Axis I lifetime diagnoses was 3.4; STPD and BPD groups had more diagnoses than AVPD, OCPD, and MDD groups. Significant Axis I co-occurrences emerged for Social Phobia/ AVPD, PTSD/BPD and Substance Use/BPD. Mean number of co-occurring PDs was 1.4; STPD had more than BPD group which had more than AVPD and OCPD groups. Significant PD co-occurrence emerged for: STPD/ Paranoid and Schizoid PDs, BPD with Antisocial and Dependent PDs, and lower frequency for OCPD/Antisocial PD. Diagnostic co-occurrences generally followed base rates, while significant departures resemble those of controlled literature.

  16. Relationship of premenstrual syndrome and premenstrual dysphoric disorder with major depression: relevance to clinical practice.

    Science.gov (United States)

    Padhy, Susanta Kumar; Sarkar, Sidharth; Beherre, Prakash B; Rathi, Rajesh; Panigrahi, Mahima; Patil, Pradeep Sriram

    2015-01-01

    Premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD) and depressive disorder are fairly common; symptoms do overlap, often under-identified and under-emphasized, particularly in rural India. The objective was to assess the occurrence of PMS and PMDD in a sample of students and staff of a nursing college and to find their correlation with depression. A prospective cohort study; Tertiary Care Hospital in Rural India (Wardha, Maharashtra); 118 female nursing students or staff aged between 18 and 40 years, who were likely to stay within the institution for the study period. The participants were rated on Penn daily symptom report prospectively for a period of 3-month. Those who scored positive were applied diagnostic and statistical manual of mental disorders, 4(th) edition, text revision (DSM-IV TR) criteria for PMDD; and were applied primary care evaluation of mental disorders depression screening followed by DSM-IV TR criteria for depression. Severity of depression was measured using Hamilton Depression Rating Scale. Main outcome measures were frequency and severity of depression in individuals with PMS and PMDD and their clinical and sociodemographic correlation. The age range of the sample was 18-37 years. Some PMS symptoms were observed in 67%; diagnosis of PMDD in 10%; depressive symptoms in 28% of the sample. 46.4% of those with depressive symptoms had major depression. The diagnosis of major depression was significantly associated with the severity of PMS symptoms as well as the presence of PMDD. Premenstrual syndrome is present in a substantial proportion of young females. Concurrent depression is increased by the severity of PMS symptoms and the presence of PMDD. Gynecologist needs to screen such subjects for depression and refer to mental-health professional early, in routine clinical practice.

  17. [Recurrent depressive disorder in Caspar David Friedrich. A pathographical approach with operationalized diagnosis].

    Science.gov (United States)

    Spitzer, C; Dahlenburg, B; Freyberger, H J

    2006-07-01

    Caspar David Friedrich (1774 - 1840) is one of the most important German Romantic painters. In his paintings, he prototypically represents the melancholy, which has been mentioned by his contemporaries and later biographers. Art scientists have also referred to his melancholy for the interpretation of his work. From a medical point of view, there are only two pathographies which remain inconclusive. Having applied diagnostic criteria for psychiatric disorders to his letters and publications, to statements of his contemporaries and to his art, we propose that he had suffered from a recurrent major depression which occurred in 1799 for the first time. At least three depressive episodes followed before he was struck by a stroke in 1835. There are epidemiological, psychodynamic and personality-typological reasons supporting our diagnostic assumption. The course of his depression corresponds to phases of reduced creativity, to the chosen techniques and motives. Finally we discuss the implications of our approach for the pathographical method in general.

  18. Lifetime and 12-month prevalence of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition disorders among older African Americans: findings from the National Survey of American Life.

    Science.gov (United States)

    Ford, Briggett C; Bullard, Kai McKeever; Taylor, Robert Joseph; Toler, Amanda K; Neighbors, Harold W; Jackson, James S

    2007-08-01

    The purpose of this study was to estimate lifetime and 12-month prevalence of 13 psychiatric disorders for older African Americans. Data are from the older African American subsample of the National Survey of American Life. Selected measures of lifetime and 12-month Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) psychiatric disorders were examined (i.e., panic disorder, agoraphobia, social phobia, generalized anxiety disorder, obsessive compulsive disorder, posttraumatic stress disorder (PTSD), major depressive disorder, dysthymia, bipolar I and II disorders, alcohol abuse/dependence, and drug abuse/dependence). Twenty-three percent of older African Americans reported at least one lifetime disorder and 8.54% reported at least one 12-month disorder. Alcohol abuse, PTSD, and major depression were the most prevalent lifetime disorders. The most prevalent 12-month disorders were PTSD, major depression, and social phobia. Age, sex, education, and region were significantly associated with the odds of having a lifetime disorder. This is the first study of prevalence rates of serious mental disorders for older African Americans based on a national sample. Demographic correlates of the prevalence of disorders are discussed with an emphasis on age and regional differences.

  19. Role of depression severity and impulsivity in the relationship between hopelessness and suicidal ideation in patients with major depressive disorder.

    Science.gov (United States)

    Wang, Yan-yu; Jiang, Neng-zhi; Cheung, Eric F C; Sun, Hong-wei; Chan, Raymond C K

    2015-09-01

    Hopelessness, depression and impulsivity all contribute to the development of suicidal ideation in patients with major depressive disorder, but the pathway of these factors to suicidal ideation is not clear. This study examined the meditating effect of depression severity on the relationship between hopelessness and suicidal ideation and explored how this mediating effect was moderated by impulsivity. A total of 162 patients with major depressive disorder (MDD) completed a structured clinical diagnostic interview and a battery of scales assessing depression severity, hopelessness, suicidal ideation, and impulsivity. Regression analyses with bootstrapping methods were used to examine the mediating and moderating effects of various risk factors. Mediation analysis revealed a significant indirect effect of hopelessness on suicidal ideation, and the effect was fully mediated through depression severity. On moderation analysis, the moderating effects of the relationship between depression severity and suicidal ideation were significant in both the medium and high impulsivity groups. The present study was limited by the assessment of trait impulsivity and observer-rated depression severity, which might not fully reflect momentary impulsivity and feeling of depression when suicidal ideation occurs. Depression severity plays a mediator role in the relationship between hopelessness and suicidal ideation and this mechanism is contingent on the levels of impulsivity. MDD patients with higher impulsivity appear to be more likely to have suicidal ideations even when they are less depressed. These findings highlight the importance of impulsivity assessment and alleviation of depressive symptoms to prevent suicidality in patients with MDD. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Comorbid psychiatric disorders in depressed outpatients: demographic and clinical features.

    Science.gov (United States)

    Rush, A John; Zimmerman, Mark; Wisniewski, Stephen R; Fava, Maurizio; Hollon, Steven D; Warden, Diane; Biggs, Melanie M; Shores-Wilson, Kathy; Shelton, Richard C; Luther, James F; Thomas, Brandi; Trivedi, Madhukar H

    2005-07-01

    This study evaluated the clinical and sociodemographic features associated with various degrees of concurrent comorbidity in adult outpatients with nonpsychotic major depressive disorder (MDD). Outpatients enrolled in the STAR*D trial completed the Psychiatric Diagnostic Screening Questionnaire (PDSQ). An a priori 90% specificity threshold was set for PDSQ responses to ascertain the presence of 11 different concurrent DSM-IV Axis I disorders. Of 1376 outpatients, 38.2% had no concurrent comorbidities, while 25.6% suffered one, 16.1% suffered two, and 20.2% suffered three or more comorbid conditions. Altogether, 29.3% met threshold for social anxiety disorder, 20.8% for generalized anxiety disorder, 18.8% for posttraumatic stress disorder, 12.4% for bulimia, 11.9% for alcohol abuse/dependence, 13.4% for obsessive-compulsive disorder, 11.1% for panic disorder, 9.4% for agoraphobia, 7.3% for drug abuse/dependence, 3.7% for hypochondriasis, and 2.2% for somatoform disorder. Those with more concurrent Axis I conditions had earlier ages at first onset of MDD, longer histories of MDD, greater depressive symptom severity, more general medical comorbidity (even though they were younger than those with fewer comorbid conditions), poorer physical and mental function, health perceptions, and life satisfaction; and were more likely to be seen in primary care settings. Participants had to meet entry criteria for STAR*D. Ascertainment of comorbid conditions was not based on a structured interview. Concurrent Axis I conditions (most often anxiety disorders) are very common with MDD. Greater numbers of concurrent comorbid conditions were associated with increased severity, morbidity, and chronicity of their MDD.

  1. Differential gene expression in patients with subsyndromal symptomatic depression and major depressive disorder.

    Science.gov (United States)

    Yang, Chengqing; Hu, Guoqin; Li, Zezhi; Wang, Qingzhong; Wang, Xuemei; Yuan, Chengmei; Wang, Zuowei; Hong, Wu; Lu, Weihong; Cao, Lan; Chen, Jun; Wang, Yong; Yu, Shunying; Zhou, Yimin; Yi, Zhenghui; Fang, Yiru

    2017-01-01

    Subsyndromal symptomatic depression (SSD) is a subtype of subthreshold depressive and can lead to significant psychosocial functional impairment. Although the pathogenesis of major depressive disorder (MDD) and SSD still remains poorly understood, a set of studies have found that many same genetic factors play important roles in the etiology of these two disorders. Nowadays, the differential gene expression between MDD and SSD is still unknown. In our previous study, we compared the expression profile and made the classification with the leukocytes by using whole-genome cRNA microarrays among drug-free first-episode subjects with SSD, MDD and matched healthy controls (8 subjects in each group), and finally determined 48 gene expression signatures. Based on these findings, we further clarify whether these genes mRNA was different expressed in peripheral blood in patients with SSD, MDD and healthy controls (60 subjects respectively). With the help of the quantitative real-time reverse transcription-polymerase chain reaction (RT-qPCR), we gained gene relative expression levels among the three groups. We found that there are three of the forty eight co-regulated genes had differential expression in peripheral blood among the three groups, which are CD84, STRN, CTNS gene (F = 3.528, p = 0.034; F = 3.382, p = 0.039; F = 3.801, p = 0.026, respectively) while there were no significant differences for other genes. CD84, STRN, CTNS gene may have significant value for performing diagnostic functions and classifying SSD, MDD and healthy controls.

  2. Comorbid personality disorder predicts suicide after major depression: a 10-year follow-up

    DEFF Research Database (Denmark)

    Hansen, Poul Erik Buchholtz; Wang, A.G.; Stage, K.B.

    2003-01-01

    OBJECTIVE: To identify psychopathological predictors for suicide in a population of major depressed Diagnostic Statistical Manual-III (DSM-III) in-patients. METHOD: A total of 210 previous participants in multicentre antidepressant drug trials, carried out in a randomized double-blind design, were...... followed prospectively through a maximum of 10 years. Patients with a drug or alcohol abuse were excluded. The association between suicide and the pretreatment psychopathological profile was analysed using survival statistics. RESULTS: The suicide rate for non-melancholic depressed patients...... was significantly higher than for melancholic depressed patients. Comorbid personality disorder was independently associated with an increased suicide rate [relative hazard 3.41(CI: 1.15-10.10)]. CONCLUSION: The study indicates that the non-melancholic aspect of depression, and especially comorbid personality...

  3. Overvaluation of Shape and Weight in Binge Eating Disorder and Overweight Controls: Refinement of a Diagnostic Construct

    Science.gov (United States)

    Grilo, Carlos M.; Hrabosky, Joshua I.; White, Marney A.; Allison, Kelly C.; Stunkard, Albert J.; Masheb, Robin M.

    2013-01-01

    Debate continues regarding the nosological status of binge eating disorder (BED) as a diagnosis as opposed to simply reflecting a useful marker for psychopathology. Contention also exists regarding the specific criteria for the BED diagnosis, including whether, like anorexia nervosa and bulimia nervosa, it should be characterized by overvaluation of shape/weight. The authors compared features of eating disorders, psychological distress, and weight among overweight BED participants who overvalue their shape/weight (n = 92), BED participants with subclinical levels of overvaluation (n = 73), and participants in an overweight comparison group without BED (n = 45). BED participants categorized with clinical overvaluation reported greater eating-related psychopathology and depression levels than those with subclinical overvaluation. Both BED groups reported greater overall eating pathology and depression levels than the overweight comparison group. Group differences existed despite similar levels of overweight across the 3 groups, as well as when controlling for group differences in depression levels. These findings provide further support for the research diagnostic construct and make a case for the importance of shape/weight overvaluation as a diagnostic specifier. PMID:18489217

  4. Decreased Prostaglandin D2 Levels in Major Depressive Disorder Are Associated with Depression-Like Behaviors.

    Science.gov (United States)

    Chu, Cuilin; Wei, Hui; Zhu, Wanwan; Shen, Yan; Xu, Qi

    2017-09-01

    Prostaglandin (PG) D2 is the most abundant prostaglandin in the mammalian brain. The physiological and pharmacological actions of PGD2 in the central nervous system seem to be associated with some of the symptoms exhibited by patients with major depressive disorder. Previous studies have found that PGD2 synthase was decreased in the cerebrospinal fluid of major depressive disorder patients. We speculated that there may be a dysregulation of PGD2 levels in major depressive disorder. Ultra-performance liquid chromatography-tandem mass spectrometry coupled with a stable isotopic-labeled internal standard was used to determine PGD2 levels in the plasma of major depressive disorder patients and in the brains of depressive mice. A total of 32 drug-free major depressive disorder patients and 30 healthy controls were recruited. An animal model of depression was constructed by exposing mice to 5 weeks of chronic unpredictable mild stress. To explore the role of PGD2 in major depressive disorder, selenium tetrachloride was administered to simulate the change in PGD2 levels in mice. Mice exposed to chronic unpredictable mild stress exhibited depression-like behaviors, as indicated by reduced sucrose preference and increased immobility time in the forced swimming test. PGD2 levels in the plasma of major depressive disorder patients and in the brains of depressive mice were both decreased compared with their corresponding controls. Further inhibiting PGD2 production in mice resulted in an increased immobility time in the forced swimming test that could be reversed by imipramine. Decreased PGD2 levels in major depressive disorder are associated with depression-like behaviors. © The Author 2017. Published by Oxford University Press on behalf of CINP.

  5. Abnormal reward functioning across substance use disorders and major depressive disorder: Considering reward as a transdiagnostic mechanism.

    Science.gov (United States)

    Baskin-Sommers, Arielle R; Foti, Dan

    2015-11-01

    A common criticism of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013) is that its criteria are based more on behavioral descriptions than on underlying biological mechanisms. Increasingly, calls have intensified for a more biologically-based approach to conceptualizing, studying, and treating psychological disorders, as exemplified by the Research Domain Criteria Project (RDoC). Among the most well-studied neurobiological mechanisms is reward processing. Moreover, individual differences in reward sensitivity are related to risk for substance abuse and depression. The current review synthesizes the available preclinical, electrophysiological, and neuroimaging literature on reward processing from a transdiagnostic, multidimensional perspective. Findings are organized with respect to key reward constructs within the Positive Valence Systems domain of the RDoC matrix, including initial responsiveness to reward (physiological 'liking'), approach motivation (physiological 'wanting'), and reward learning/habit formation. In the current review, we (a) describe the neural basis of reward, (b) elucidate differences in reward activity in substance abuse and depression, and (c) suggest a framework for integrating these disparate literatures and discuss the utility of shifting focus from diagnosis to process for understanding liability and co-morbidity. Ultimately, we believe that an integrative focus on abnormal reward functioning across the full continuum of clinically heterogeneous samples, rather than within circumscribed diagnostic categories, might actually help to refine the phenotypes and improve the prediction of onset and recovery of these disorders. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Co-altered functional networks and brain structure in unmedicated patients with bipolar and major depressive disorders.

    Science.gov (United States)

    He, Hao; Sui, Jing; Du, Yuhui; Yu, Qingbao; Lin, Dongdong; Drevets, Wayne C; Savitz, Jonathan B; Yang, Jian; Victor, Teresa A; Calhoun, Vince D

    2017-12-01

    Bipolar disorder (BD) and major depressive disorder (MDD) share similar clinical characteristics that often obscure the diagnostic distinctions between their depressive conditions. Both functional and structural brain abnormalities have been reported in these two disorders. However, the direct link between altered functioning and structure in these two diseases is unknown. To elucidate this relationship, we conducted a multimodal fusion analysis on the functional network connectivity (FNC) and gray matter density from MRI data from 13 BD, 40 MDD, and 33 matched healthy controls (HC). A data-driven fusion method called mCCA+jICA was used to identify the co-altered FNC and gray matter components. Comparing to HC, BD exhibited reduced gray matter density in the parietal and occipital cortices, which correlated with attenuated functional connectivity within sensory and motor networks, as well as hyper-connectivity in regions that are putatively engaged in cognitive control. In addition, lower gray matter density was found in MDD in the amygdala and cerebellum. High accuracy in discriminating across groups was also achieved by trained classification models, implying that features extracted from the fusion analysis hold the potential to ultimately serve as diagnostic biomarkers for mood disorders.

  7. Distress and functioning in mixed anxiety and depressive disorder.

    Science.gov (United States)

    Małyszczak, Krzysztof; Pawłowski, Tomasz

    2006-04-01

    The aim of the present study was to evaluate the validity of mixed anxiety and depressive disorder (MADD) with reference to functional characteristics and symptomatic characteristics in comparison with anxiety disorders, depressive disorders, and groups showing subthreshold symptoms (exclusively depressive or anxiety related). The present study was carried out in the following three medical settings: two psychiatric and one primary care. Patients seeking care in psychiatric institutions due to anxiety and depressive symptoms and attending primary medical settings for any reason were taken into account. A total of 104 patients (65 women and 39 men, mean age 41.1 years) were given a General Health Questionnaire (GHQ-30), Global Assessment of Functioning (GAF) and Present State Examination questionnaire, a part of Schedules for Clinical Assessment in Neuropsychiatry, Version 2.0. There were no statistically relevant differences between MADD and anxiety disorders in median GHQ score (19 vs 16) and median GAF score (median 68.5 vs 65). When considering depressive disorders the median GHQ score (28) was higher, and median GAF score (59) was lower than that in MADD. In groups with separated subthreshold anxiety or depressive symptoms, median GHQ scores (12) were lower and median GAF scores (75) were higher than that in MADD. The most frequent symptoms of MADD are symptoms of generalized anxiety disorder (GAD) and depression. Mixed anxiety and depressive disorder differs significantly from GAD only in higher rates of depressed mood and lower rates of somatic anxiety symptoms. Distinction from depression was clearer; six of 10 depressive symptoms are more minor in severity in MADD than in the case of depression. Distress and interference with personal functions in MADD are similar to that of other anxiety disorders. A pattern of MADD symptoms locates this disorder between depression and GAD.

  8. Experiences of depression

    DEFF Research Database (Denmark)

    Rønberg, Mette

    In this thesis, I examine the complex experiences of what we call depression in everyday life, the multifaceted and ambiguous experiences of getting a depression diagnosis, and the in-depth processes involved in learning to live under the description of depression. The thesis is based......-and-for-all-dealt-with matters but rather messy and complicated processes, that involve several actors and multiple relations to the diagnosis. The thesis furthermore challenges the dominant diagnostic understanding depression as a neurobiological, and individual disorder in present-day diagnostic cultures, by arguing...

  9. Diagnostic Accuracy of the Primary Care Screener for Affective Disorder (PC-SAD) in Primary Care.

    Science.gov (United States)

    Picardi, Angelo; Adler, D A; Rogers, W H; Lega, I; Zerella, M P; Matteucci, G; Tarsitani, L; Caredda, M; Gigantesco, A; Biondi, M

    2013-01-01

    Depression goes often unrecognised and untreated in non-psychiatric medical settings. Screening has recently gained acceptance as a first step towards improving depression recognition and management. The Primary Care Screener for Affective Disorders (PC-SAD) is a self-administered questionnaire to screen for Major Depressive Disorder (MDD) and Dysthymic Disorder (Dys) which has a sophisticated scoring algorithm that confers several advantages. This study tested its performance against a 'gold standard' diagnostic interview in primary care. A total of 416 adults attending 13 urban general internal medicine primary care practices completed the PC-SAD. Of 409 who returned a valid PC-SAD, all those scoring positive (N=151) and a random sample (N=106) of those scoring negative were selected for a 3-month telephone follow-up assessment including the administration of the Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID-I) by a psychiatrist who was masked to PC-SAD results. Most selected patients (N=212) took part in the follow-up assessment. After adjustment for partial verification bias the sensitivity, specificity, positive and negative predictive value for MDD were 90%, 83%, 51%, and 98%. For Dys, the corresponding figures were 78%, 79%, 8%, and 88%. While some study limitations suggest caution in interpreting our results, this study corroborated the diagnostic validity of the PC-SAD, although the low PPV may limit its usefulness with regard to Dys. Given its good psychometric properties and the short average administration time, the PC-SAD might be the screening instrument of choice in settings where the technology for computer automated scoring is available.

  10. [Predictors of remission from major depressive disorder in secondary care].

    Science.gov (United States)

    Salvo, Lilian; Saldivia, Sandra; Parra, Carlos; Cifuentes, Manuel; Bustos, Claudio; Acevedo, Paola; Díaz, Marcela; Ormazabal, Mitza; Guerra, Ivonne; Navarrete, Nicol; Bravo, Verónica; Castro, Andrea

    2017-12-01

    Background The knowledge of predictive factors in depression should help to deal with the disease. Aim To assess potential predictors of remission of major depressive disorders (MDD) in secondary care and to propose a predictive model. Material and Methods A 12 month follow-up study was conducted in a sample of 112 outpatients at three psychiatric care centers of Chile, with baseline and quarterly assessments. Demographic, psychosocial, clinical and treatment factors as potential predictors, were assessed. A clinical interview with the checklist of DSM-IV diagnostic criteria, the Hamilton Depression Scale and the List of Threatening Experiences and Multidimensional Scale of Perceived Social Support were applied. Results The number of stressful events, perceived social support, baseline depression scores, melancholic features, time prior to beginning treatment at the secondary level and psychotherapeutic sessions were included in the model as predictors of remission. Sex, age, number of previous depressive episodes, psychiatric comorbidity and medical comorbidity were not significantly related with remission. Conclusions This model allows to predict depression score at six months with 70% of accuracy and the score at 12 months with 72% of accuracy.

  11. Depressive personality and treatment outcome in major depressive disorder.

    Science.gov (United States)

    Ryder, Andrew G; Quilty, Lena C; Vachon, David D; Bagby, R Michael

    2010-06-01

    Depressive personality disorder (DPD) is currently included in the DSM-IV Appendix B, Criteria Sets and Axes Provided for Further Study. Evidence of the clinical utility of DPD will likely play an important role in the determination of whether it warrants inclusion in future editions of DSM. The current investigation examines the capacity of DPD traits to predict overall and preferential treatment outcome for patients with Major Depressive Disorder (MDD) (N = 120) using data from a randomized control trial, which included cognitive behavioral therapy (CBT), interpersonal therapy (IPT), and antidepressant medication (ADM) treatment arms. Patients were treated for 16-20 weeks and completed the Structured Clinical Interview for DSM-IV Axis II Personality Disorders Questionnaire (SCID-II/PQ) and the 17-item Hamilton Rating Scale for Depression immediately before and after treatment. Higher scores on a dimensionalized SCID-II/PQ subscale assessing DPD traits were associated with poor outcome for IPT, but not CBT or ADM. This result remained after accounting for variance associated with other personality disorder (PD) traits; none of the other 10 main text PDs predicted treatment outcome.

  12. The association between hypertension and depression and anxiety disorders: results from a nationally-representative sample of South African adults.

    Directory of Open Access Journals (Sweden)

    Anna Grimsrud

    Full Text Available Growing evidence suggests high levels of comorbidity between hypertension and mental illness but there are few data from low- and middle-income countries. We examined the association between hypertension and depression and anxiety in South Africa.Data come from a nationally-representative survey of adults (n = 4351. The Composite International Diagnostic Interview was used to measure DSM-IV mental disorders during the previous 12-months. The relationships between self-reported hypertension and anxiety disorders, depressive disorders and comorbid anxiety-depression were assessed after adjustment for participant characteristics including experience of trauma and other chronic physical conditions.Overall 16.7% reported a previous medical diagnosis of hypertension, and 8.1% and 4.9% were found to have a 12-month anxiety or depressive disorder, respectively. In adjusted analyses, hypertension diagnosis was associated with 12-month anxiety disorders [Odds ratio (OR = 1.55, 95% Confidence interval (CI = 1.10-2.18] but not 12-month depressive disorders or 12-month comorbid anxiety-depression. Hypertension in the absence of other chronic physical conditions was not associated with any of the 12-month mental health outcomes (p-values all <0.05, while being diagnosed with both hypertension and another chronic physical condition were associated with 12-month anxiety disorders (OR = 2.25, 95% CI = 1.46-3.45, but not 12-month depressive disorders or comorbid anxiety-depression.These are the first population-based estimates to demonstrate an association between hypertension and mental disorders in sub-Saharan Africa. Further investigation is needed into role of traumatic life events in the aetiology of hypertension as well as the temporality of the association between hypertension and mental disorders.

  13. Different manifestation of depressive disorder in the elderly.

    Science.gov (United States)

    Shahpesandy, Homayun

    2005-12-01

    To compare the clinical manifestation of depressive disorder in elderly, and younger adults. To compare the clinical manifestation of depressive disorder, we evaluate 46 elderly (33 female, and 13 male, mean age 71.1) and 60 younger adults (40 female, and 20 male, mean age 44.5 years). All patients suffering from depressive disorders according to ICD-10. For evaluation and comparison of depressive symptomatology we used the HAM-D-17. The results analysed by the SPSS. The clinical manifestation of depression is different in the elderly. Elderly depressed patients compared with their younger counterparts, scored significantly less in Depressed mood, but significantly higher in Work and activities, Retardation, Somatic symptoms-general, Hypochondriasis, Insomnia-middle, Insomnia-late, Anxiety-somatic, and Somatic symptoms-gastrointestinal. On the other hand, younger patients scored significantly higher in Feelings of guilt, and Genital symptoms. Clinical presentation of depressive disorder is different in the elderly, depressed mood is often absent or masked. Anxiety, somatization, and hypochondriasis are more often present in the elderly depressed patients than in younger patients. The elderly people are also more likely than their younger counterparts to complain of insomnia.

  14. Bereavement and depression: possible changes to the diagnostic and statistical manual of mental disorders: a report from the Scientific Advisory Committee of the Association for Death Education and Counseling.

    Science.gov (United States)

    Balk, David E; Noppe, Illee; Sandler, Irwin; Werth, James

    2011-01-01

    The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) is being revised. A proposed revision hotly debated is to remove what is known as the exclusionary criterion and allow clinicians to diagnose a person with a major depressive episode within the early days and weeks following a death. The Executive Committee of the Association for Death Education and Counseling (ADEC) commissioned its Scientific Advisory Committee (SAC) to examine the debate over removing the exclusionary criterion and provide a written report. The DSM-IV-TR classifies bereavement as a clinical condition that is not a mental disorder. The exclusionary criterion states that within the first 2 months of the onset of bereavement a person should not be diagnosed as having major depression unless certain symptoms not characteristic of a normal grief reaction are present. We note these symptoms when discussing the exclusionary criterion. In the report we identify the features that comprise the exclusionary criterion, examine reasons (including research conclusions and clinical concerns) given for retaining and for eliminating the exclusionary criterion, offer extensive comments from experienced licensed clinicians about the issues involved, discuss diagnostic and treatment implications, and offer specific recommendations for ADEC to implement.

  15. An examination of the structure of posttraumatic stress disorder in relation to the anxiety and depressive disorders.

    Science.gov (United States)

    Forbes, David; Lockwood, Emma; Elhai, Jon D; Creamer, Mark; O'Donnell, Meaghan; Bryant, Richard; McFarlane, Alexander; Silove, Derrick

    2011-07-01

    The nature and structure of posttraumatic stress disorder (PTSD) has been the subject of much interest in recent times. This research has been represented by two streams, the first representing a substantive body of work which focuses specifically on the factor structure of PTSD and the second exploring PTSD's relationship with other mood and anxiety disorders. The present study attempted to bring these two streams together by examining structural models of PTSD and their relationship with dimensions underlying other mood and anxiety disorders. PTSD, anxiety and mood disorder data from 989 injury survivors interviewed 3-months following their injury were analyzed using a series of confirmatory factor analyses (CFA) to identify the optimal structural model. CFA analyses indicated that the best fitting model included PTSD's re-experiencing (B1-5), active avoidance (C1-2), and hypervigilance and startle (D4-5) loading onto a Fear factor (represented by panic disorder, agoraphobia and social phobia) and the PTSD dysphoria symptoms (numbing symptoms C3-7 and hyperarousal symptoms D1-3) loading onto an Anxious Misery/Distress factor (represented by depression, generalized anxiety disorder and obsessive compulsive disorder). The findings have implications for informing potential revisions to the structure of the diagnosis of PTSD and the diagnostic algorithm to be applied, with the aim of enhancing diagnostic specificity. Copyright © 2011 Elsevier B.V. All rights reserved.

  16. Autonomic nervous system and lipid metabolism: findings in anxious-depressive spectrum and eating disorders.

    Science.gov (United States)

    Pistorio, Elisabetta; Luca, Maria; Luca, Antonina; Messina, Vincenzo; Calandra, Carmela

    2011-10-28

    To correlate lipid metabolism and autonomic dysfunction with anxious-depressive spectrum and eating disorders. To propose the lipid index (LI) as a new possible biomarker. 95 patients and 60 controls were enrolled from the University Psychiatry Unit of Catania and from general practitioners (GPs). The patients were divided into four pathological groups: Anxiety, Depression, Anxious-Depressive Disorder and Eating Disorders [Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision (DSM-IV-TR) official/appendix criteria]. The levels of the cholesterol, triglycerides and apolipoproteins A and B were determined. The LI, for each subject, was obtained through a mathematical operation on the values of the cholesterol and triglycerides levels compared with the maximum cut-off of the general population. The autonomic functioning was tested with Ewing battery tests. Particularly, the correlation between heart rate variability (HRV) and lipid metabolism has been investigated. Pathological and control groups, compared among each other, presented some peculiarities in the lipid metabolism and the autonomic dysfunction scores. In addition, a statistically significant correlation has been found between HRV and lipid metabolism. Lipid metabolism and autonomic functioning seem to be related to the discussed psychiatric disorders. LI, in addition, could represent a new possible biomarker to be considered.

  17. Autonomic nervous system and lipid metabolism: findings in anxious-depressive spectrum and eating disorders

    Directory of Open Access Journals (Sweden)

    Messina Vincenzo

    2011-10-01

    Full Text Available Abstract Objective To correlate lipid metabolism and autonomic dysfunction with anxious-depressive spectrum and eating disorders. To propose the lipid index (LI as a new possible biomarker. Methods 95 patients and 60 controls were enrolled from the University Psychiatry Unit of Catania and from general practitioners (GPs. The patients were divided into four pathological groups: Anxiety, Depression, Anxious-Depressive Disorder and Eating Disorders [Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision (DSM-IV-TR official/appendix criteria]. The levels of the cholesterol, triglycerides and apolipoproteins A and B were determined. The LI, for each subject, was obtained through a mathematical operation on the values of the cholesterol and triglycerides levels compared with the maximum cut-off of the general population. The autonomic functioning was tested with Ewing battery tests. Particularly, the correlation between heart rate variability (HRV and lipid metabolism has been investigated. Results Pathological and control groups, compared among each other, presented some peculiarities in the lipid metabolism and the autonomic dysfunction scores. In addition, a statistically significant correlation has been found between HRV and lipid metabolism. Conclusions Lipid metabolism and autonomic functioning seem to be related to the discussed psychiatric disorders. LI, in addition, could represent a new possible biomarker to be considered.

  18. [A case of major depressive disorder barely distinguishable from narcissistic personality disorder].

    Science.gov (United States)

    Saito, Shinnosuke; Kobayashi, Toshiyuki; Kato, Satoshi

    2013-01-01

    The recent increase in cases of depression with a narcissistic tendency, especially among young individuals, has been pointed out. When the narcissistic tendency is conspicuous, patients may be treated for a personality disorder or pervasive developmental disorder, and not for a mood disorder. A case is described of a man in his late twenties who developed depression due to his failure in research work and job hunting, and, after a time, due to the break off of his engagement with his fiancée, manifested with narcissistic symptoms including an exaggerated opinion of himself, a sense of entitlement, interpersonal exploitation, lack of empathy, strong feelings of envy, and an extrapunitive tendency. He was regarded at the start of treatment as having narcissistic personality disorder. However, persevering treatment, mainly with supportive psychotherapy and pharmacotherapy including antidepressants (high dose of maprotiline combined with low dose of mirtazapine), sodium valprote and aripiprazole, finally improved not only his depressive symptoms, but also the symptoms regarded as a deriving from a personality disorder. He presented fierce anger and aggression regarded as a mixed state, and showed the rapid improvement in his depressive state after hospitalization, which we considered to show potential bipolarity. We diagnosed the patient with narcissistic depression, emphasizing the aspect which suggested a mood disorder, such as the episodic presence of narcissistic symptoms as long as a depressive state resided, his circular, recursive discourse, and his potential bipolarity. To accurately evaluate the aspect of mood disorders which patients appearing to show personality disorders have, it is considered useful to grasp a patient's condition from the viewpoint of a personality structure and viable dynamics. From a therapeutic standpoint, we suggest the importance of simple but persevering psychotherapy and a sufficient quantity of antidepressant medication for

  19. Analysis of mental disorders in tinnitus patients performed with Composite International Diagnostic Interview.

    Science.gov (United States)

    Zirke, N; Seydel, C; Arsoy, D; Klapp, B F; Haupt, H; Szczepek, A J; Olze, H; Goebel, G; Mazurek, B

    2013-10-01

    Known association between tinnitus and psychological distress prompted us to examine patients with chronic tinnitus by using the Composite International Diagnostic Interview (CIDI), which is a standardized and reliable method used for the diagnosis of mental disorders. One hundred patients with chronic tinnitus admitted to the Tinnitus Center, Charité-Universitätsmedizin Berlin, were included in this study. Data were collected between February 2008 and February 2009. Besides CIDI, the Tinnitus Questionnaire according to Goebel and Hiller, the Hospital Anxiety Depression Scale, and the General Anxiety Disorder-7 were used. Using CIDI, we have identified one or more mental disorders in 46 tinnitus patients. In that group, we found persistent affective disorders (37 %), anxiety disorders (32 %), and somatoform disorders (27 %). Those patients who had affective or anxiety disorders were more distressed by tinnitus and were more anxious and more depressed than tinnitus patients without mental disorders. Psychological impairment positively correlated with tinnitus distress: Patients with decompensated tinnitus had significantly more affective and anxiety disorders than patients with compensated tinnitus. In the present study, we have detected a high rate (almost half of the cases) of psychological disorders occurring in patients with chronic tinnitus. The patients diagnosed with psychological disorders were predominantly affected by affective and anxiety disorders. Psychological disorders were associated with severity of tinnitus distress. Our findings imply a need for routine comprehensive screening of mental disorders in patients with chronic tinnitus.

  20. Depression and smoking: a 5-year prospective study of patients with major depressive disorder.

    Science.gov (United States)

    Holma, Irina A K; Holma, K Mikael; Melartin, Tarja K; Ketokivi, Mikko; Isometsä, Erkki T

    2013-06-01

    Major depressive disorder (MDD) and smoking are major public health problems and epidemiologically strongly associated. However, the relationship between smoking and depression and whether this is influenced by common confounding factors remain unclear, in part due to limited longitudinal data on covariation. In the Vantaa Depression Study, psychiatric out- and inpatients with DSM-IV MDD and aged 20-59 years at were followed from baseline to 6 months, 18 months, and 5 years. We investigated course of depression, smoking, and comorbid alcohol-use disorders among the 214 patients (79.6% of 269) participating at least three time points; differences between smoking versus nonsmoking patients, and covariation of MDD, smoking, and alcohol-use disorders. Overall, 31.3% of the patients smoked regularly, 41.1% intermittently, and 27.6% never. Smokers were younger, had more alcohol-use disorders and Cluster B and C personality disorder symptoms, a higher frequency of lifetime suicide attempts, higher neuroticism, smaller social networks, and lower perceived social support than never smokers. Smoking and depression had limited longitudinal covariation. Depression, smoking, and alcohol-use disorders all exhibited strong autoregressive tendencies. Among adult psychiatric MDD patients, smoking is strongly associated with substance-use and personality disorders, which may confound research on the impact of smoking. Rather than depression or smoking covarying or predicting each other, depression, smoking, and alcohol-use disorders each have strong autoregressive tendencies. These findings are more consistent with common factors causing their association than either of the conditions strongly predisposing to the other. © 2013 Wiley Periodicals, Inc.

  1. Lifetime anxiety disorder and current anxiety symptoms associated with hastened depressive recurrence in bipolar disorder.

    Science.gov (United States)

    Shah, Saloni; Kim, Jane P; Park, Dong Yeon; Kim, Hyun; Yuen, Laura D; Do, Dennis; Dell'Osso, Bernardo; Hooshmand, Farnaz; Miller, Shefali; Wang, Po W; Ketter, Terence A

    2017-09-01

    To assess differential relationships between lifetime anxiety disorder/current anxiety symptoms and longitudinal depressive severity in bipolar disorder (BD). Stanford BD Clinic outpatients enrolled during 2000-2011 were assessed with the Systematic Treatment Enhancement Program for BD (STEP-BD) Affective Disorders Evaluation and followed with the STEP-BD Clinical Monitoring Form while receiving naturalistic treatment for up to two years. Baseline unfavorable illness characteristics/current mood symptoms and times to depressive recurrence/recovery were compared in patients with versus without lifetime anxiety disorder/current anxiety symptoms. Among 105 currently recovered patients, lifetime anxiety disorder was significantly associated with 10/27 (37.0%) demographic/other unfavorable illness characteristics/current mood symptoms/current psychotropics, hastened depressive recurrence (driven by earlier onset age), and a significantly (> two-fold) higher Kaplan-Meier estimated depressive recurrence rate, whereas current anxiety symptoms were significantly associated with 10/27 (37.0%) demographic/other unfavorable illness characteristics/current mood symptoms/current psychotropics and hastened depressive recurrence (driven by lifetime anxiety disorder), but only a numerically higher Kaplan-Meier estimated depressive recurrence rate. In contrast, among 153 currently depressed patients, lifetime anxiety disorder/current anxiety symptoms were not significantly associated with time to depressive recovery or depressive recovery rate. American tertiary BD clinic referral sample, open naturalistic treatment. Research is needed regarding differential relationships between lifetime anxiety disorder and current anxiety symptoms and hastened/delayed depressive recurrence/recovery - specifically whether lifetime anxiety disorder versus current anxiety symptoms has marginally more robust association with hastened depressive recurrence, and whether both have marginally more robust

  2. Dry Eye Disease in Patients with Newly Diagnosed Depressive Disorder.

    Science.gov (United States)

    Tiskaoglu, Nesime Setge; Yazıcı, Alper; Karlıdere, Tunay; Sari, Esin; Oguz, Elif Yilmaz; Musaoglu, Musa; Aslan, Seyda; Samet Ermiş, Sıtkı

    2017-05-01

    Psychiatric conditions and not just the treatments themselves might be involved in the pathophysiology of dry eye disease (DED). The aim of our study was to evaluate the association between depression and DED using objective and subjective tests in patients with newly diagnosed depressive disorder who were not using any medication which may help us to determine the sole effect of depression on dry eye. Thirty-six patients from the psychiatry clinic with a new diagnosis of depressive disorder and 32 controls were included in the study. All met the Diagnostic and Statistical Manual IV criteria for depression. Beck Depression Inventory (BDI) was used to measure depression severity and the State-Trait Anxiety Inventory (Stai1, Stai2) for concomitant anxiety symptoms. The Ocular Surface Disease Index (OSDI) and Visual Functioning Questionnaires (VFQ25) were completed and used to confirm diagnosis of DED in conjunction with the tear break up time (TBUT), ocular surface vital dye staining, and Schirmer's test. The comparison of depressive and control groups revealed significantly lower Schirmer (20.3 ± 9.9 vs. 25.7 ± 9.3 mm) and TBUT (7.8 ± 5.7 vs. 12.5 ± 7.8 s) scores with a consistently higher Oxford score (1.8 ± 3.2 vs. 0.2 ± 0.4) in the depressive group. Although the parameters were affected in the depressive group, this did not influence OSDI (86.1 ± 13.6 vs. 86.6 ± 13.3) and VFQ25 (30.8 ± 21.6 vs. 38.5 ± 29.1) scores. In both groups, the three psychological test scores (Stai1-2 and BDI) were correlated to each other but none of these tests were correlated to OSDI, VRQL, Schirmer, TBUT, and Oxford staining scores. Our study shows a definite association between depression and DED. We feel that it is important that psychiatrists take this into account especially while prescribing antidepressants which may aggravate dry eye signs.

  3. Diagnostic approaches to respiratory sleep disorders

    OpenAIRE

    Riha, Renata L.

    2015-01-01

    Sleep disordered breathing (SDB) comprises a number of breathing disturbances occurring during sleep including snoring, the obstructive sleep apnoea/hypopnea syndrome (OSAHS), central sleep apnoea (CSA) and hypoventilation syndromes. This review focuses on sleep disordered breathing and diagnostic approaches in adults, in particular clinical assessment and overnight assessment during sleep. Although diagnostic approaches to respiratory sleep disorders are reasonably straightforward, they do r...

  4. 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.

  5. Effects of Maternal Negativity and of Early and Recent Recurrent Depressive Disorder on Children’s False Belief Understanding

    Science.gov (United States)

    Rohrer, Lisa M.; Cicchetti, Dante; Rogosch, Fred A.; Toth, Sheree L.; Maughan, Angeline

    2015-01-01

    Research has shown that children of depressed mothers are at risk for problems in a variety of developmental domains; however, little is known about the effects of maternal depression on children’s emerging understanding of false beliefs. In this study, three false belief tasks were administered to five-year-old children whose mothers had either met criteria for major depressive disorder within the first 20 months of the child’s life (n = 91) or had never been depressed (n = 50). Significant difficulties in performance were found among the children of depressed mothers, especially those whose mothers had experienced early and recent recurrent depressive disorder. Regardless of diagnostic status, children whose mothers exhibited negativity during problem-solving tasks administered at an earlier developmental period also were less likely to demonstrate false belief understanding. These effects remained even after child verbal ability was controlled. PMID:21244156

  6. Salivary testosterone: associations with depression, anxiety disorders, and antidepressant use in a large cohort study.

    Science.gov (United States)

    Giltay, Erik J; Enter, Dorien; Zitman, Frans G; Penninx, Brenda W J H; van Pelt, Johannes; Spinhoven, Phillip; Roelofs, Karin

    2012-03-01

    Low circulating levels of testosterone have been associated with major depression, but there is more limited evidence for differences in patients with anxiety disorders. The use of selective serotonin reuptake inhibitors (SSRIs) and other antidepressants is associated with sexual side effects, warranting testing for interactions with testosterone. Data are from 722 male and 1380 female participants of The Netherlands Study of Depression and Anxiety (NESDA), who were recruited from the community, general practice care, and specialized mental health care. Depressive and anxiety diagnoses were assessed using the DSM-IV Composite International Diagnostic Interview. To smooth the episodic secretion, the four morning saliva samples per participant and the two evening samples were pooled before testosterone analysis. Morning median testosterone levels were 25.2 pg/ml in men and 16.2 pg/ml in women, with lower evening levels of 18.2 and 14.1 pg/ml, respectively. Significant determinants of testosterone levels were sex, age, time of the day, use of contraceptives, and smoking status. Female patients with a current (1-month) depressive disorder (effect size 0.29; P=0.002), generalized anxiety disorder (0.25; P=0.01), social phobia (0.30; Pdepressive disorder, generalized anxiety disorder, social phobia, and agoraphobia as compared to female controls. SSRIs may increase salivary testosterone in men and women. Copyright © 2011 Elsevier Inc. All rights reserved.

  7. Association among depressive disorder, adjustment disorder, sleep disturbance, and suicidal ideation in Taiwanese adolescent.

    Science.gov (United States)

    Chung, Ming-Shun; Chiu, Hsien-Jane; Sun, Wen-Jung; Lin, Chieh-Nan; Kuo, Chien-Cheng; Huang, Wei-Che; Chen, Ying-Sheue; Cheng, Hui-Ping; Chou, Pesus

    2014-09-01

    The aim of this study is to investigate the association among depressive disorder, adjustment disorder, sleep disturbance, and suicidal ideation in Taiwanese adolescent. We recruited 607 students (grades 5-9) to fill out the investigation of basic data and sleep disturbance. Psychiatrists then used the Mini International Neuropsychiatric Interview-Kid to interview these students to assess their suicidal ideation and psychiatric diagnosis. Multiple logistic regression with forward conditionals was used to find the risk factors for multivariate analysis. Female, age, depressive disorder, adjustment disorder, and poor sleep all contributed to adolescent suicidal ideation in univariate analysis. However, poor sleep became non-significant under the control of depressive disorder and adjustment disorder. We found that both depressive disorder and adjustment disorder play important roles in sleep and adolescent suicidal ideation. After controlling both depressive disorder and adjustment disorder, sleep disturbance was no longer a risk of adolescent suicidal ideation. We also confirm the indirect influence of sleep on suicidal ideation in adolescent. © 2013 Wiley Publishing Asia Pty Ltd.

  8. Social inequality in the prevalence of depressive disorders

    DEFF Research Database (Denmark)

    Andersen, I; Thielen, K; Nygaard, Else

    2009-01-01

    Uncertainties exist about the strength of the relation between socioeconomic position and depressive disorders. The aim of this study was to investigate the association between education, occupation, employment and income and depressive disorders measured as minor and major depression, as well as...

  9. Association of depressive disorders, depression characteristics and antidepressant medication with inflammation.

    Science.gov (United States)

    Vogelzangs, N; Duivis, H E; Beekman, A T F; Kluft, C; Neuteboom, J; Hoogendijk, W; Smit, J H; de Jonge, P; Penninx, B W J H

    2012-02-21

    Growing evidence suggests that immune dysregulation may be involved in depressive disorders, but the exact nature of this association is still unknown and may be restricted to specific subgroups. This study examines the association between depressive disorders, depression characteristics and antidepressant medication with inflammation in a large cohort of controls and depressed persons, taking possible sex differences and important confounding factors into account. Persons (18-65 years) with a current (N = 1132) or remitted (N = 789) depressive disorder according to DSM-IV criteria and healthy controls (N = 494) were selected from the Netherlands Study of Depression and Anxiety. Assessments included clinical characteristics (severity, duration and age of onset), use of antidepressant medication and inflammatory markers (C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α)). After adjustment for sociodemographics, currently depressed men, but not women, had higher levels of CRP (1.33 versus 0.92 mg l(-1), Pdepressed peers. Associations reduced after considering lifestyle and disease indicators--especially body mass index--but remained significant for CRP. After full adjustment, highest inflammation levels were found in depressed men with an older age of depression onset (CRP, TNF-α). Furthermore, inflammation was increased in men using serotonin-norepinephrine reuptake inhibitors (CRP, IL-6) and in men and women using tri- or tetracyclic antidepressants (CRP), but decreased among men using selective serotonin reuptake inhibitors (IL-6). In conclusion, elevated inflammation was confirmed in depressed men, especially those with a late-onset depression. Specific antidepressants may differ in their effects on inflammation.

  10. Impact of severity of personality disorder on the outcome of depression.

    Science.gov (United States)

    Kelly, Brendan D; Nur, Ula A; Tyrer, Peter; Casey, Patricia

    2009-06-01

    The influence of severity of personality disorder on outcome of depression is unclear. Four hundred and ten patients with depression in 9 urban and rural communities in Finland, Ireland, Norway, Spain and the United Kingdom, were randomised to individual problem-solving treatment (n=121), group sessions on depression prevention (n=106) or treatment as usual (n=183). Depressive symptoms were recorded at baseline, 6 and 12 months. Personality assessment was performed using the Personality Assessment Schedule and analysed by severity (no personality disorder, personality difficulty, simple personality disorder, complex personality disorder). Complete personality assessments were performed on 301 individuals of whom 49.8% had no personality disorder; 19.3% had personality difficulties; 13.0% had simple personality disorder; and 17.9% had complex personality disorder. Severity of personality disorder was correlated with Beck Depression Inventory (BDI) scores at baseline (Spearman's r=0.21; ppersonality disorder and treatment type for depression. While multi-variable analyses indicate that depressive symptoms at baseline are the strongest predictor of depressive symptoms at 6 and 12 months, the strong correlations between severity of personality disorder and depressive symptoms make it difficult to establish the independent effect of personality disorder on outcome of depression.

  11. [Internet dependency as a symptom of depressive mood disorders].

    Science.gov (United States)

    te Wildt, Bert T; Putzig, Inken; Zedler, Markus; Ohlmeier, Martin D

    2007-09-01

    In psychiatric contexts, the quick distribution of virtual techniques in private and professional everyday life gives rise to the question, if these can evoke a psychological addiction. Yet, the diagnostic assessment of internet or computer game dependency remains problematic. Within a study with 23 internet-dependent patients with significant psychological strain, 18 (77.8%) were diagnosed with a depressive mood disorder by thorough clinical examination and structured interviews. The presented work compares psychometric test results of the depressed subpopulation with healthy controls matched for age, sex and school education. In the Barrat Impulsiveness Scale patients with internet dependency scored significantly higher than the control group (p Internet Addiction Scale. Becks Depression Inventory and the Symptom-Checklist subscale for depression revealed significantly higher scores within the patient group as compared to controls (p internet dependent subjects showed significantly more pathological scores than the healthy subjects (p internet dependency can be understood as a novel psychopathology of well known psychiatric conditions, every psychiatrist should be able to detect and treat it adequately, as long as there is a willingness to deal with the contents and impacts of cyberspace. Especially with depressed patients, it seems to be crucial to include questions about media usage in psychiatric examination taking.

  12. Maternal bonding in mothers with postpartum anxiety disorder: the crucial role of subclinical depressive symptoms and maternal avoidance behaviour.

    Science.gov (United States)

    Tietz, A; Zietlow, A-L; Reck, C

    2014-10-01

    Hardly any research has examined the link between postpartum anxiety disorder and maternal bonding. This study examined if postpartum anxiety disorder and maternal bonding are related in the postpartum period. Thereby, subclinical depressive symptoms and specific aspects of an anxious symptomatology were also taken into consideration. The German sample of N = 78 mother-infant dyads is composed of n = 30 mothers with postpartum anxiety disorders but without major or minor depression according to the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) and n = 48 healthy mothers. Subjects were interviewed with the Structured Clinical Interview for DSM-IV Disorders at an average infant age of M = 4.1 months. Moreover, mothers filled out the Postpartum Bonding Questionnaire-16. The Anxiety Cognitions Questionnaire, the Body Sensations Questionnaire and the Mobility Inventory were chosen to assess different aspects of anxious symptomatology. To control for concurrent subclinical depressive symptoms, we used the German Edinburgh-Postnatal-Depression Scale. Mothers with postpartum anxiety disorder reported significantly lower bonding than healthy mothers. However, in a linear regression analysis, concurrent subclinical depressive symptoms and avoidance of anxiety-related situations in company explained 27 % of the overall variance in maternal bonding. The perceived lower bonding of mothers with anxiety disorder could be due to aspects of a concurrent subclinical depressive symptomatology. This notion emphasizes the need to target even mild depressive symptoms in the treatment of postpartum anxiety disorders. The outcomes also underline that the severity of anxious symptomatology, reflected by avoidance behaviour in company, puts the mother-infant bond at risk.

  13. Comorbid anxiety disorders alter the association between cardiovascular diseases and depression: the German National Health Interview and Examination Survey.

    Science.gov (United States)

    Tully, Phillip J; Baune, Bernhard T

    2014-05-01

    This study aims to examine whether specific anxiety disorder comorbidity alters the purported association between depression and specific cardiovascular diseases (CVDs). In 4,181 representative German participants of the general population, 12-month prevalence of psychiatric disorders was assessed through the Composite International Diagnostic Interview and CVDs by physician verified diagnosis. Adjusting for conventional risk factors logistic regression analyzed the association between CVDs (peripheral vascular disease (PVD), hypertension, cerebrovascular disease and heart disease) and combinations of comorbidity between depression and anxiety disorder types (panic disorder, specific phobia, social phobia and generalized anxiety). There were 770 cases of hypertension (18.4 %), 763 cases of cerebrovascular disease (18.2 %), 748 cases of PVD (17.9 %), and 1,087 cases of CVD (26.0 %). In adjusted analyses phobia comorbid with depression was associated with cerebrovascular disease (odds ratio (OR) 1.61; 95 % confidence interval (CI) 1.04-2.50) as was panic disorder (OR 2.89; 95 % CI 1.47-5.69). PVD was significantly associated with panic disorder (adjusted OR 2.97; 95 % CI 1.55-5.69). Panic disorder was associated with CVDs (adjusted OR 2.28; 95 % CI 1.09-4.77) as was phobia (adjusted OR 1.35; 95 % CI 1.04-1.78). Classification of anxiety and depression according to comorbidity groups showed discrete effects for panic disorder and specific phobia with CVDs, independent from covariates and depression.

  14. The impacts of migraine, anxiety disorders, and chronic depression on quality of life in psychiatric outpatients with major depressive disorder.

    Science.gov (United States)

    Hung, Ching-I; Wang, Shuu-Jiun; Yang, Ching-Hui; Liu, Chia-Yih

    2008-08-01

    Our purpose was to determine if migraine, anxiety comorbidities, and chronic depression were independently related to health-related quality of life (HRQoL) in outpatients with major depressive disorder (MDD). Consecutive psychiatric outpatients with MDD in a medical center were enrolled. MDD, chronic depression, and seven anxiety disorders were diagnosed using the Structured Clinical Interview for DSM-IV-TR. Migraine was diagnosed based on the International Classification of Headache Disorders, 2nd edition. The acute version of the Short-Form 36 and the Hamilton Depression Rating Scale (HAMD) were used to evaluate the HRQoL and the severity of depression, respectively. Multiple linear regressions were used to determine the independent factors related to HRQoL. There were 135 participants (34 men, 101 women) with MDD. Subjects with migraine, anxiety comorbidities, or chronic depression had higher HAMD scores and poor HRQoL. Migraine, specific phobia, and panic disorder were important and independent comorbidities predicting HRQoL. The impact of migraine on HRQoL, especially on bodily pain, was not inferior to those of some anxiety comorbidities or chronic depression. Future studies related to HRQoL of MDD should consider migraine and anxiety comorbidities simultaneously.

  15. Influence of personality on objective and subjective social support among patients with major depressive disorder: a prospective study.

    Science.gov (United States)

    Leskelä, Ulla; Melartin, Tarja; Rytsälä, Heikki; Jylhä, Pekka; Sokero, Petteri; Lestelä-Mielonen, Paula; Isometsä, Erkki

    2009-10-01

    Personality and social support (SS) influence risk for depression and modify its outcome through multiple pathways. The impact of personality dimensions neuroticism and extraversion on SS among patients with major depressive disorder (MDD) has been little studied. In the Vantaa Depression Study, we assessed neuroticism and extraversion with the Eysenck Personality Inventory, objective SS with the Interview Measure of Social Relationships, and subjective SS with the Perceived Social Support Scale-Revised at baseline, at 6 and 18 months among 193 major depressive disorder patients diagnosed according to the fourth edition of Diagnostic and Statistical Manual of Mental Disorders (DMS-IV). At all time-points, low neuroticism and high extraversion associated significantly with between-subject differences in levels of objective and subjective SS. Lower neuroticism (beta = 0.213, p = 0.003) and higher extraversion (beta = 0.159, p = 0.038) predicted greater within-subject change of subjective, but not objective SS. Thus, neuroticism and extraversion associated with the size of objective and subjective SS and predicted change of subjective SS. Modification of subjective SS, particularly, may indirectly influence future vulnerability to depression.

  16. Self-help interventions for depressive disorders and depressive symptoms: a systematic review

    Directory of Open Access Journals (Sweden)

    Jorm Anthony F

    2008-08-01

    Full Text Available Abstract Background Research suggests that depressive disorders exist on a continuum, with subthreshold symptoms causing considerable population burden and increasing individual risk of developing major depressive disorder. An alternative strategy to professional treatment of subthreshold depression is population promotion of effective self-help interventions that can be easily applied by an individual without professional guidance. The evidence for self-help interventions for depressive symptoms is reviewed in the present work, with the aim of identifying promising interventions that could inform future health promotion campaigns or stimulate further research. Methods A literature search for randomised controlled trials investigating self-help interventions for depressive disorders or depressive symptoms was performed using PubMed, PsycINFO and the Cochrane Database of Systematic Reviews. Reference lists and citations of included studies were also checked. Studies were grouped into those involving participants with depressive disorders or a high level of depressive symptoms, or non-clinically depressed participants not selected for depression. A number of exclusion criteria were applied, including trials with small sample sizes and where the intervention was adjunctive to antidepressants or psychotherapy. Results The majority of interventions searched had no relevant evidence to review. Of the 38 interventions reviewed, the ones with the best evidence of efficacy in depressive disorders were S-adenosylmethionine, St John's wort, bibliotherapy, computerised interventions, distraction, relaxation training, exercise, pleasant activities, sleep deprivation, and light therapy. A number of other interventions showed promise but had received less research attention. Research in non-clinical samples indicated immediate beneficial effects on depressed mood for distraction, exercise, humour, music, negative air ionisation, and singing; while potential

  17. Diagnostic criteria for headache attributed to temporomandibular disorders

    DEFF Research Database (Denmark)

    Schiffman, Eric; Ohrbach, Richard; List, Thomas

    2012-01-01

    We assessed and compared the diagnostic accuracy of two sets of diagnostic criteria for headache secondary to temporomandibular disorders (TMD).......We assessed and compared the diagnostic accuracy of two sets of diagnostic criteria for headache secondary to temporomandibular disorders (TMD)....

  18. Depression and suicide risk of outpatients at specialized hospitals for substance use disorder: comparison with depressive disorder patients at general psychiatric clinics.

    Science.gov (United States)

    Matsumoto, Toshihiko; Matsushita, Sachio; Okudaira, Kenichi; Naruse, Nobuya; Cho, Tetsuji; Muto, Takeo; Ashizawa, Takeshi; Konuma, Kyohei; Morita, Nobuaki; Ino, Aro

    2011-12-01

    The present study used a self-reporting questionnaire to compare suicide risk in outpatients being treated for substance use disorder at specialized hospitals to suicide risk in outpatients being treated for depressive disorder at general psychiatric clinics. Although patients in both groups exhibited an equal severity of depression, the patients with drug use disorder had a higher suicide risk than those with depressive disorder. These findings indicate that drug-abusing patients at specialized hospitals may have a severe risk of committing suicide, suggesting that carefully assessing the comorbidity of depression with drug abuse may be required for preventing suicide in drug-abusing patients.

  19. Evidence for Broadening Criteria for Atypical Depression Which May Define a Reactive Depressive Disorder.

    Science.gov (United States)

    Silverstein, Brett; Angst, Jules

    2015-01-01

    Objective. Arguing that additional symptoms should be added to the criteria for atypical depression. Method. Published research articles on atypical depression are reviewed. Results. (1) The original studies upon which the criteria for atypical depression were based cited fatigue, insomnia, pain, and loss of weight as characteristic symptoms. (2) Several studies of DSM depressive criteria found patients with atypical depression to exhibit high levels of insomnia, fatigue, and loss of appetite/weight. (3) Several studies have found atypical depression to be comorbid with headaches, bulimia, and body image issues. (4) Most probands who report atypical depression meet criteria for "somatic depression," defined as depression associated with several of disordered eating, poor body image, headaches, fatigue, and insomnia. The gender difference in prevalence of atypical depression results from its overlap with somatic depression. Somatic depression is associated with psychosocial measures related to gender, linking it with the descriptions of atypical depression as "reactive" appearing in the studies upon which the original criteria for atypical depression were based. Conclusion. Insomnia, disordered eating, poor body image, and aches/pains should be added as criteria for atypical depression matching criteria for somatic depression defining a reactive depressive disorder possibly distinct from endogenous melancholic depression.

  20. Evidence for Broadening Criteria for Atypical Depression Which May Define a Reactive Depressive Disorder

    Directory of Open Access Journals (Sweden)

    Brett Silverstein

    2015-01-01

    Full Text Available Objective. Arguing that additional symptoms should be added to the criteria for atypical depression. Method. Published research articles on atypical depression are reviewed. Results. (1 The original studies upon which the criteria for atypical depression were based cited fatigue, insomnia, pain, and loss of weight as characteristic symptoms. (2 Several studies of DSM depressive criteria found patients with atypical depression to exhibit high levels of insomnia, fatigue, and loss of appetite/weight. (3 Several studies have found atypical depression to be comorbid with headaches, bulimia, and body image issues. (4 Most probands who report atypical depression meet criteria for “somatic depression,” defined as depression associated with several of disordered eating, poor body image, headaches, fatigue, and insomnia. The gender difference in prevalence of atypical depression results from its overlap with somatic depression. Somatic depression is associated with psychosocial measures related to gender, linking it with the descriptions of atypical depression as “reactive” appearing in the studies upon which the original criteria for atypical depression were based. Conclusion. Insomnia, disordered eating, poor body image, and aches/pains should be added as criteria for atypical depression matching criteria for somatic depression defining a reactive depressive disorder possibly distinct from endogenous melancholic depression.

  1. Trait and facet-level predictors of first-onset depressive and anxiety disorders in a community sample of adolescent girls.

    Science.gov (United States)

    Goldstein, Brandon L; Kotov, Roman; Perlman, Greg; Watson, David; Klein, Daniel N

    2017-09-20

    Individual differences in neuroticism, extraversion, and conscientiousness are associated with, and may predict onset of, internalizing disorders. These general traits can be parsed into facets, but there is a surprising paucity of research on facet risk for internalizing disorders. We examined general traits and facets of neuroticism, extraversion, and conscientiousness in predicting first onsets of depressive and anxiety disorders. A community sample of 550 adolescent females completed general and facet-level personality measures and diagnostic interviews. Interviews were re-administered 18 months later. First onsets of depressive disorders were predicted by neuroticism, extraversion, and conscientiousness. Facets predicting first onset of depression included depressivity (neuroticism facet) and lower positive emotionality and sociability (extraversion facets). First onsets of generalized anxiety disorder (GAD) were predicted by neuroticism, and particularly the facet of anxiousness. First onsets of social phobia were predicted at the facet level by anxiousness. First onsets of specific phobia were predicted by neuroticism, low conscientiousness, and all neuroticism facets. In multivariate analyses, first onsets of depression were uniquely predicted by depressivity, and onsets of GAD and social phobia were uniquely predicted by anxiousness over and above the general trait of neuroticism. General traits predict first onsets of depressive and anxiety disorders. In addition, more specific associations are evident at the facet level. Facets can refine our understanding of the links between personality and psychopathology risk, and provide finer-grained targets for personality-informed interventions.

  2. Help-Seeking by Young People with Depressive Disorders

    Science.gov (United States)

    Sawyer, Michael G.; Sawyer, Alyssa C. P.; La Greca, Annette M.

    2012-01-01

    Depressive disorders commonly occur for the first time during adolescence and often become a recurring source of distress and impairment. Unfortunately, only a small proportion of adolescents with depressive disorders receive help from professional services, and there is evidence that adolescents with higher levels of depressive symptoms may be…

  3. Comparison of self-stigma and quality of life in patients with depressive disorders and schizophrenia spectrum disorders – a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Holubova M

    2016-11-01

    important aspect linked to the QoL irrespective of the diagnostic category. Keywords: self-stigma, quality of life, depressive disorders, schizophrenia spectrum disorders

  4. Depressão e doença bipolar na infância e adolescência Bipolar disorder and depression in childhood and adolescence

    Directory of Open Access Journals (Sweden)

    Dênio Lima

    2004-04-01

    Full Text Available OBJETIVOS: Este estudo buscou a revisão da história, conceitos, categorias diagnósticas, epidemiologia, fatores genéticos e neurobiológicos, assim como fatores predisponentes e modalidades de tratamento desses transtornos. FONTES DOS DADOS: Foi realizada uma revisão extensa da literatura sobre depressão infantil e transtorno bipolar. SÍNTESE DOS DADOS: A depressão infantil e o transtorno bipolar estão associados a fatores genéticos, temperamento, eventos adversos da vida, divórcio, problemas acadêmicos, abuso físico e sexual e fatores neurobiológicos. O tratamento pode ser realizado, na maioria das vezes, com medicações e psicoterapia. CONCLUSÕES: São transtornos importantes, muitas vezes de difícil diagnóstico, que, uma vez reconhecidos e tratados, irão minorar o sofrimento de crianças e adolescentes. O pediatra poderá intervir orientando a família nos casos leves, mas deve ficar atento àqueles que necessitam de outros tipos de tratamento.OBJECTIVES: To provide a historical review of childhood depression and bipolar disorder, covering concepts, diagnostic categories, epidemiology, genetic and neurobiological aspects as well as predisposing factors and treatment modalities. SOURCES OF DATA: Extensive review of the literature on child depression and bipolar disorder. SUMMARY OF THE FINDINGS: Child depression and bipolar disorder are associated with genetic factors, mood, adverse life events, divorce, academic problems, physical and sexual abuse, and neurobiological factors. Treatment usually includes medication and psychotherapy. CONCLUSIONS: These are important childhood disorders whose diagnosis is often difficult. The identification and treatment of depression and bipolar disorder reduces the suffering of affected children and adolescents. The pediatrician can intervene by orienting the family in mild cases, but must be alert to cases requiring more aggressive treatment.

  5. Relationship of personality disorders to the course of major depressive disorder in a nationally representative sample.

    Science.gov (United States)

    Skodol, Andrew E; Grilo, Carlos M; Keyes, Katherine M; Geier, Timothy; Grant, Bridget F; Hasin, Deborah S

    2011-03-01

    The purpose of this study was to examine the effects of specific personality disorder comorbidity on the course of major depressive disorder in a nationally representative sample. Data were drawn from 1,996 participants in a national survey. Participants who met criteria for major depressive disorder at baseline in face-to-face interviews (in 2001-2002) were reinterviewed 3 years later (in 2004-2005) to determine persistence and recurrence. Predictors included all DSM-IV personality disorders. Control variables included demographic characteristics, other axis I disorders, family and treatment histories, and previously established predictors of the course of major depressive disorder. A total of 15.1% of participants had persistent major depressive disorder, and 7.3% of those who remitted had a recurrence. Univariate analyses indicated that avoidant, borderline, histrionic, paranoid, schizoid, and schizotypal personality disorders all elevated the risk for persistence. With axis I comorbidity controlled, all personality disorders except histrionic personality disorder remained significant. With all other personality disorders controlled, borderline and schizotypal disorders remained significant predictors. In final, multivariate analyses that controlled for age at onset of major depressive disorder, the number of previous episodes, duration of the current episode, family history, and treatment, borderline personality disorder remained a robust predictor of major depressive disorder persistence. Neither personality disorders nor other clinical variables predicted recurrence. In this nationally representative sample of adults with major depressive disorder, borderline personality disorder robustly predicted persistence, a finding that converges with recent clinical studies. Personality psychopathology, particularly borderline personality disorder, should be assessed in all patients with major depressive disorder, considered in prognosis, and addressed in treatment.

  6. Depression in university students: associations with impulse control disorders.

    Science.gov (United States)

    Leppink, Eric W; Lust, Katherine; Grant, Jon E

    2016-09-01

    The purpose of this study was to assess the implications of depression in a sample of university students, particularly relating to impulse control disorders. While previous studies have shown high rates of depression among university students, no study to date has assessed whether levels of depression show associations with the incidence of impulse control disorders in this population. In all, 6000 students participated in the College Student Computer Use Survey. A total of 1717 students completed the scales of interest for this analysis. Participants were assigned to groups based on depression scores: severe (N = 75), mild/moderate (N = 647) and none (N = 995). The three groups were assessed using analysis of variance (ANOVA) or chi-square test. A multinomial logistic regression analysis was used to elucidate associations between depression and impulse control disorder diagnoses. Groups differed across demographic, health and academic variables. The severe depression group reported higher rates of skin-picking disorder, compulsive sexual behaviour and compulsive buying. Results suggest a significant association between depression and impulse control disorders. One possibility is that a facet of impulsivity contributes to both problems, which could be important information for clinicians. Future studies will need to clarify the exact nature of the relationship between depression and impulse control disorders.

  7. Lifetime suicidal ideation and attempt in adults with full major depressive disorder versus sustained depressed mood.

    Science.gov (United States)

    Yoo, Hye Jin; Hong, Jin Pyo; Cho, Maeng Je; Fava, Maurizio; Mischoulon, David; Heo, Jung-Yoon; Kim, Kiwon; Jeon, Hong Jin

    2016-10-01

    Major depressive disorder (MDD) is a well-known risk factor for suicidality, but depressed mood has been used non-specifically to describe the emotional state. We sought to compare influence of MDD versus sustained depressed mood on suicidality. A total of 12,532 adults, randomly selected through the one-person-per-household method, completed a face-to-face interview using the Korean version of Composite International Diagnostic Interview (K-CIDI) and a questionnaire for lifetime suicidal ideation (LSI) and lifetime suicidal attempt (LSA). Of 12,361 adults, 565 were assessed as 'sustained depressed mood group' having depressed mood for more than two weeks without MDD (4.6%), and 810 adults were assessed as having full MDD (6.55%) which consisted of 'MDD with depressed mood group' (6.0%) and 'MDD without depressed mood group' (0.5%). The MDD with depressed mood group showed higher odds ratios for LSI and LSA than the sustained depressed mood group. Contrarily, no significant differences were found in LSI and LSA between the MDD group with and without depressed mood. MDD showed significant associations with LSI (AOR=2.83, 95%CI 2.12-3.78) and LSA (AOR=2.17, 95%CI 1.34-3.52), whereas sustained depressed mood showed significant associations with neither LSI nor LSA after adjusting for MDD and other psychiatric comorbidities. Interaction effect of sustained depressed mood with MDD was significant for LSI but not for LSA. Sustained depressed mood was not related to LSI and LSA after adjusting for psychiatric comorbidities, whereas MDD was significantly associated with both LSI and LSA regardless of the presence of sustained depressed mood. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Relationship of Personality Disorders to the Course of Major Depressive Disorder in a Nationally Representative Sample

    Science.gov (United States)

    Skodol, Andrew E.; Grilo, Carlos M.; Keyes, Katherine; Geier, Timothy; Grant, Bridget F.; Hasin, Deborah S.

    2011-01-01

    Objective The purpose of this study was to examine the effects of specific personality disorder co-morbidity on the course of major depressive disorder in a nationally-representative sample. Method Data were drawn from 1,996 participants in a national survey. Participants who met criteria for major depressive disorder at baseline in face-to-face interviews (2001–2002) were re-interviewed three years later (2004–2005) to determine persistence and recurrence. Predictors included all DSM-IV personality disorders. Control variables included demographic characteristics, other Axis I disorders, family and treatment histories, and previously established predictors of the course of major depressive disorder. Results 15.1% of participants had persistent major depressive disorder and 7.3% of those who remitted had a recurrence. Univariate analyses indicated that avoidant, borderline, histrionic, paranoid, schizoid, and schizotypal personality disorders all elevated the risk for persistence. With Axis I co-morbidity controlled, all but histrionic personality disorder remained significant. With all other personality disorders controlled, borderline and schizotypal remained significant predictors. In final, multivariate analyses that controlled for age at onset of major depressive disorder, number of previous episodes, duration of current episode, family history, and treatment, borderline personality disorder remained a robust predictor of major depressive disorder persistence. Neither personality disorders nor other clinical variables predicted recurrence. Conclusions In this nationally-representative sample of adults with major depressive disorder, borderline personality disorder robustly predicted persistence, a finding that converges with recent clinical studies. Personality psychopathology, particularly borderline personality disorder, should be assessed in all patients with major depressive disorder, considered in prognosis, and addressed in treatment. PMID:21245088

  9. Examination of cumulative effects of early adolescent depression on cannabis and alcohol use disorder in late adolescence in a community-based cohort.

    Science.gov (United States)

    Rhew, Isaac C; Fleming, Charles B; Vander Stoep, Ann; Nicodimos, Semret; Zheng, Cheng; McCauley, Elizabeth

    2017-11-01

    Although they often co-occur, the longitudinal relationship between depression and substance use disorders during adolescence remains unclear. This study estimated the effects of cumulative depression during early adolescence (ages 13-15 years) on the likelihood of cannabis use disorder (CUD) and alcohol use disorder (AUD) at age 18. Prospective cohort study of youth assessed at least annually between 6th and 9th grades (~ age 12-15) and again at age 18. Marginal structural models based on a counterfactual framework that accounted for both potential fixed and time-varying confounders were used to estimate cumulative effects of depressive symptoms over early adolescence. The sample originated from four public middle schools in Seattle, Washington, USA. The sample consisted of 521 youth (48.4% female; 44.5% were non-Hispanic White). Structured in-person interviews with youth and their parents were conducted to assess diagnostic symptom counts of depression during early adolescence; diagnoses of CUD and AUD at age 18 was based the Voice-Diagnostic Interview Schedule for Children. Cumulative depression was defined as the sum of depression symptom counts from grades 7-9. The past-year prevalence of cannabis and alcohol use disorder at the age 18 study wave was 20.9 and 19.8%, respectively. A 1 standard deviation increase in cumulative depression during early adolescence was associated with a 50% higher likelihood of CUD [prevalence ratio (PR) = 1.50; 95% confidence interval (CI) = 1.07, 2.10]. Although similar in direction, there was no statistically significant association between depression and AUD (PR = 1.41; 95% CI = 0.94, 2.11). Further, there were no differences in associations according to gender. Youth with more chronic or severe forms of depression during early adolescence may be at elevated risk for developing cannabis use disorder compared with otherwise similar youth who experience fewer depressive symptoms during early adolescence. © 2017 Society

  10. Cardiovascular disease in persons with depressive and anxiety disorders.

    Science.gov (United States)

    Vogelzangs, Nicole; Seldenrijk, Adrie; Beekman, Aartjan T F; van Hout, Hein P J; de Jonge, Peter; Penninx, Brenda W J H

    2010-09-01

    Associations between depression, and possibly anxiety, with cardiovascular disease have been established in the general population and among heart patients. This study examined whether cardiovascular disease was more prevalent among a large cohort of depressed and/or anxious persons. In addition, the role of specific clinical characteristics of depressive and anxiety disorders in the association with cardiovascular disease was explored. Baseline data from the Netherlands Study of Depression and Anxiety were used, including persons with a current (i.e. past year) or remitted DSM-IV depressive or anxiety disorder (N=2315) and healthy controls (N=492). Additional clinical characteristics (subtype, duration, severity, and psychoactive medication) were assessed. Cardiovascular disease (stroke and coronary heart disease) was assessed using algorithms based on self-report and medication use. Persons with current anxiety disorders showed an about three-fold increased prevalence of coronary heart disease (OR anxiety only=2.70, 95%CI=1.31-5.56; OR comorbid anxiety/depression=3.54, 95%CI=1.79-6.98). No associations were found for persons with depressive disorders only or remitted disorders, nor for stroke. Severity of depressive and anxiety symptoms--but no other clinical characteristics--most strongly indicated increased prevalence of coronary heart disease. Cross-sectional design. Within this large psychopathology-based cohort study, prevalence of coronary heart disease was especially increased among persons with anxiety disorders. Increased prevalence of coronary heart disease among depressed persons was largely owing to comorbid anxiety. Anxiety-alone as well as comorbid to depressive disorders-as risk indicator of coronary heart disease deserves more attention in both research and clinical practice. 2010 Elsevier B.V. All rights reserved.

  11. Eye Movement Indices in the Study of Depressive Disorder.

    Science.gov (United States)

    Li, Yu; Xu, Yangyang; Xia, Mengqing; Zhang, Tianhong; Wang, Junjie; Liu, Xu; He, Yongguang; Wang, Jijun

    2016-12-25

    Impaired cognition is one of the most common core symptoms of depressive disorder. Eye movement testing mainly reflects patients' cognitive functions, such as cognition, memory, attention, recognition, and recall. This type of testing has great potential to improve theories related to cognitive functioning in depressive episodes as well as potential in its clinical application. This study investigated whether eye movement indices of patients with unmedicated depressive disorder were abnormal or not, as well as the relationship between these indices and mental symptoms. Sixty patients with depressive disorder and sixty healthy controls (who were matched by gender, age and years of education) were recruited, and completed eye movement tests including three tasks: fixation task, saccade task and free-view task. The EyeLink desktop eye tracking system was employed to collect eye movement information, and analyze the eye movement indices of the three tasks between the two groups. (1) In the fixation task, compared to healthy controls, patients with depressive disorder showed more fixations, shorter fixation durations, more saccades and longer saccadic lengths; (2) In the saccade task, patients with depressive disorder showed longer anti-saccade latencies and smaller anti-saccade peak velocities; (3) In the free-view task, patients with depressive disorder showed fewer saccades and longer mean fixation durations; (4) Correlation analysis showed that there was a negative correlation between the pro-saccade amplitude and anxiety symptoms, and a positive correlation between the anti-saccade latency and anxiety symptoms. The depression symptoms were negatively correlated with fixation times, saccades, and saccadic paths respectively in the free-view task; while the mean fixation duration and depression symptoms showed a positive correlation. Compared to healthy controls, patients with depressive disorder showed significantly abnormal eye movement indices. In addition

  12. [Symptomatology and psychosocial adaptation in adolescents with depressive disorder and comorbid disruptive behaviour disorder].

    Science.gov (United States)

    Toupin, Jean; Le Corff, Yann; Pauzé, Robert

    2008-01-01

    To describe symptomatology and specific psychological, social, and academic adaptation in adolescents with depressive disorder and comorbid disruptive behaviour disorder, as well as their family situation. Using binomial logistic regressions, this study compares adolescents with depressive disorder and comorbid disruptive behaviour disorder (n=25) with adolescents with the same behaviour problems but no comorbid depressive disorder (n=99). Sex-specific interaction impacts are examined. While both groups have several similar characteristics, youth with a dual diagnosis have more oppositional symptoms and poorer self-esteem. Analyses show no interaction impact from sex variable. Adolescents in both groups would benefit from similar interventions regarding disruptive behaviour disorders and some related problems, such as using psychoactive drugs, socializing with delinquent peers, and difficulty functioning in school. Adolescents with a comorbid depressive disorder need special attention, given the more significant oppositional symptomatology and the poorer self-esteem.

  13. Cognitive hypnotherapy for major depressive disorder.

    Science.gov (United States)

    Alladin, Assen

    2012-04-01

    Since the publication of the special issue on cognitive hypnotherapy in the Journal of Cognitive Psychotherapy: An International Quarterly (1994), there have been major developments in the application of hypnosis to the treatment of depression. However, there is no "one-size-fits-all" treatment for depressive disorders as the conditions represent a complex set of heterogeneous symptoms, involving multiple etiologies. It is thus important for therapists to promote a multimodal approach to treating depressive disorders. This article describes cognitive hypnotherapy (CH), an evidence-based multimodal psychological treatment that can be applied to a wide range of depressed patients. CH combines hypnosis with cognitive behavior therapy as the latter provides the best integrative lodestone for assimilating empirically supported treatment techniques derived from various psychotherapies.

  14. Self-stigma in borderline personality disorder – cross-sectional comparison with schizophrenia spectrum disorder, major depressive disorder, and anxiety disorders

    Directory of Open Access Journals (Sweden)

    Grambal A

    2016-09-01

    Full Text Available Ales Grambal,1 Jan Prasko,1 Dana Kamaradova,1 Klara Latalova,1 Michaela Holubova,1,2 Marketa Marackova,1 Marie Ociskova,1 Milos Slepecky3 1Faculty of Medicine and Dentistry, Department of Psychiatry, Palacky University Olomouc, University Hospital Olomouc, Olomouc, 2Department of Psychiatry, Hospital Liberec, Liberec, Czech Republic; 3Faculty of Social Science and Health Care, Department of Psychology Sciences, Constantine the Philosopher University, Nitra, Slovak Republic Introduction: Self-stigma arises from one’s acceptance of societal prejudices and is common in psychiatric patients. This investigation compares the self-stigma of a sample of patients with borderline personality disorder (BPD, schizophrenia spectrum disorder (SCH, major depressive disorder (MDD, bipolar affective disorder (BAD, and anxiety disorders (AD and explores of the self-stigma with the subjective and objective measures of the severity of the disorder and demographic factors. Methods: The total of 184 inpatients admitted to the psychotherapeutic department diagnosed with BPD, SCH, MDD, BAP, and AD were compared on the internalized stigma of mental illness (ISMI scale. The ISMI-total score was correlated with the subjective and objective evaluation of the disorder severity (clinical global impression, and clinical and demographic factors. Results: The self-stigma levels were statistically significantly different among the diagnostic groups (BPD 71.15±14.74; SCH 63.2±13.27; MDD 64.09±12.2; BAD 62.0±14.21; AD 57.62±15.85; one-way analysis of variance: F=8.698, df=183; P<0.005. However after applying the Bonferroni’s multiple comparison test, the only significant difference was between the BPD patients and the patients with AD (P<0.001. Stepwise regression analysis showed that the strongest factors connected with the higher level of self-stigma were being without partner, the number of hospitalization, and the severity of the disorder. Conclusion: The BPD patients

  15. Short-term diagnostic stability among re-admitted psychiatric in ...

    African Journals Online (AJOL)

    Results: The commonest diagnoses at admission were schizophrenia spectrum disorders (47.4%) and bipolar spectrum disorders (30.7%). Overall diagnostic stability as measured by prospective consistency in this study was 72.8%.The most stable diagnostic category was Major Depressive Disorder (100% prospective ...

  16. Neurobiology of Major Depressive Disorder

    Directory of Open Access Journals (Sweden)

    Rosa Villanueva

    2013-01-01

    Full Text Available We survey studies which relate abnormal neurogenesis to major depressive disorder. Clinically, descriptive gene and protein expression analysis and genetic and functional studies revised here show that individual alterations of a complex signaling network, which includes the hypothalamic-pituitary-adrenal axis; the production of neurotrophins and growth factors; the expression of miRNAs; the production of proinflammatory cytokines; and, even, the abnormal delivery of gastrointestinal signaling peptides, are able to induce major mood alterations. Furthermore, all of these factors modulate neurogenesis in brain regions involved in MDD, and are functionally interconnected in such a fashion that initial alteration in one of them results in abnormalities in the others. We highlight data of potential diagnostic significance and the relevance of this information to develop new therapeutic approaches. Controversial issues, such as whether neurogenesis is the basis of the disease or whether it is a response induced by antidepressant treatments, are also discussed.

  17. Depression and eating disorders: treatment and course.

    Science.gov (United States)

    Mischoulon, David; Eddy, Kamryn T; Keshaviah, Aparna; Dinescu, Diana; Ross, Stephanie L; Kass, Andrea E; Franko, Debra L; Herzog, David B

    2011-05-01

    We examined the course of major depressive disorder (MDD) and predictors of MDD recovery and relapse in a longitudinal sample of women with eating disorders (ED). 246 Boston-area women with DSM-IV anorexia nervosa-restricting (ANR; n=51), AN-binge/purge (ANBP; n=85), and bulimia nervosa (BN; n=110) were recruited between 1987 and 1991 and interviewed using the Eating Disorders Longitudinal Interval Follow-up Evaluation (LIFE-EAT-II) every 6-12 months for up to 12 years. 100 participants had MDD at study intake and 45 developed MDD during the study. Psychological functioning and treatment were assessed. Times to MDD onset (1 week-4.3 years), recovery (8 weeks-8.7 years), and relapse (1 week-5.2 years) varied. 70% recovered from MDD, but 65% subsequently relapsed. ANR patients were significantly less likely to recover from MDD than ANBP patients (p=0.029). Better psychological functioning and history of MDD were associated with higher chance of MDD recovery. Higher baseline depressive severity and full recovery from ED were associated with greater likelihood of MDD relapse; increased weight loss was somewhat protective. Adequate antidepressant treatment was given to 72% of patients with MDD and generally continued after MDD recovery. Time on antidepressants did not predict MDD recovery (p=0.27) or relapse (p=0.26). Small ED diagnostic subgroups; lack of non-ED control group. The course of MDD in EDs is protracted; MDD recovery may depend on ED type. Antidepressants did not impact likelihood of MDD recovery, nor protect against relapse, which may impact on treatment strategies for comorbid MDD and EDs. Copyright © 2010 Elsevier B.V. All rights reserved.

  18. Nanotechnology based diagnostics for neurological disorders

    Energy Technology Data Exchange (ETDEWEB)

    Kurek, Nicholas S; Chandra, Sathees B., E-mail: schandra@roosevelt.edu [Department of Biological, Chemical and Physical Sciences, Roosevelt University, Chicago, IL (United States)

    2012-07-01

    Nanotechnology involves probing and manipulating matter at the molecular level. Nanotechnology based molecular diagnostics have the potential to alleviate the suffering caused by many diseases, including neurological disorders, due to the unique properties of nanomaterials. Most neurological illnesses are multifactorial conditions and many of these are also classified as neurobehavioral disorders. Alzheimer's disease, Parkinson's disease, Huntington disease, cerebral ischemia, epilepsy, schizophrenia and autism spectrum disorders like Rett syndrome are some examples of neurological disorders that could be better treated, diagnosed, prevented and possibly cured using nanotechnology. In order to improve the quality of life for disease afflicted people, a wide range of nanomaterials that include gold and silica nanoparticles, quantum dots and DNA along with countless other forms of nanotechnology have been investigated regarding their usefulness in advancing molecular diagnostics. Other small scaled materials like viruses and proteins also have potential for use as molecular diagnostic tools. Information obtained from nanotechnology based diagnostics can be stored and manipulated using bioinformatics software. More advanced nanotechnology based diagnostic procedures for the acquisition of even greater proteomic and genomic knowledge can then be developed along with better ways to fight various diseases. Nanotechnology also has numerous applications besides those related to biotechnology and medicine. In this article, we will discuss and analyze many novel nanotechnology based diagnostic techniques at our disposal today. (author)

  19. Nanotechnology based diagnostics for neurological disorders

    Energy Technology Data Exchange (ETDEWEB)

    Kurek, Nicholas S.; Chandra, Sathees B., E-mail: schandra@roosevelt.edu [Department of Biological, Chemical and Physical Sciences, Roosevelt University, Chicago, IL (United States)

    2012-07-01

    Nanotechnology involves probing and manipulating matter at the molecular level. Nanotechnology based molecular diagnostics have the potential to alleviate the suffering caused by many diseases, including neurological disorders, due to the unique properties of nanomaterials. Most neurological illnesses are multifactorial conditions and many of these are also classified as neurobehavioral disorders. Alzheimer's disease, Parkinson's disease, Huntington disease, cerebral ischemia, epilepsy, schizophrenia and autism spectrum disorders like Rett syndrome are some examples of neurological disorders that could be better treated, diagnosed, prevented and possibly cured using nanotechnology. In order to improve the quality of life for disease afflicted people, a wide range of nanomaterials that include gold and silica nanoparticles, quantum dots and DNA along with countless other forms of nanotechnology have been investigated regarding their usefulness in advancing molecular diagnostics. Other small scaled materials like viruses and proteins also have potential for use as molecular diagnostic tools. Information obtained from nanotechnology based diagnostics can be stored and manipulated using bioinformatics software. More advanced nanotechnology based diagnostic procedures for the acquisition of even greater proteomic and genomic knowledge can then be developed along with better ways to fight various diseases. Nanotechnology also has numerous applications besides those related to biotechnology and medicine. In this article, we will discuss and analyze many novel nanotechnology based diagnostic techniques at our disposal today. (author)

  20. Nanotechnology based diagnostics for neurological disorders

    International Nuclear Information System (INIS)

    Kurek, Nicholas S.; Chandra, Sathees B.

    2012-01-01

    Nanotechnology involves probing and manipulating matter at the molecular level. Nanotechnology based molecular diagnostics have the potential to alleviate the suffering caused by many diseases, including neurological disorders, due to the unique properties of nanomaterials. Most neurological illnesses are multifactorial conditions and many of these are also classified as neurobehavioral disorders. Alzheimer's disease, Parkinson's disease, Huntington disease, cerebral ischemia, epilepsy, schizophrenia and autism spectrum disorders like Rett syndrome are some examples of neurological disorders that could be better treated, diagnosed, prevented and possibly cured using nanotechnology. In order to improve the quality of life for disease afflicted people, a wide range of nanomaterials that include gold and silica nanoparticles, quantum dots and DNA along with countless other forms of nanotechnology have been investigated regarding their usefulness in advancing molecular diagnostics. Other small scaled materials like viruses and proteins also have potential for use as molecular diagnostic tools. Information obtained from nanotechnology based diagnostics can be stored and manipulated using bioinformatics software. More advanced nanotechnology based diagnostic procedures for the acquisition of even greater proteomic and genomic knowledge can then be developed along with better ways to fight various diseases. Nanotechnology also has numerous applications besides those related to biotechnology and medicine. In this article, we will discuss and analyze many novel nanotechnology based diagnostic techniques at our disposal today. (author)

  1. Validity of Center for Epidemiologic Studies Depression (CES-D scale in a sample of Iraq and Afghanistan Veterans

    Directory of Open Access Journals (Sweden)

    Ana R Quiñones

    2016-04-01

    Full Text Available Objectives: Optimal depression screening necessitates measurement tools that are valid across varied populations and in the presence of comorbidities. Methods: This study assessed the test properties of two versions of the Center for Epidemiologic Studies Depression scale against psychiatric diagnoses established by the Mini International Neuropsychiatric Interview among a clinical sample of US Veterans deployed during Operations Enduring Freedom, Iraqi Freedom, and New Dawn. Participants (N = 359 recruited from two Department of Veterans Affairs hospitals completed a clinical interview, structured diagnostic interview, and self-reported measures. Results: Based on diagnostic interview and the Diagnostic and Statistical Manual of Mental Disorders 4th Edition criteria, 29.5% of the sample met diagnostic criteria for major depressive disorder and 26.5% met diagnostic criteria for post-traumatic stress disorder. Both Center for Epidemiologic Studies Depression-20 and Center for Epidemiologic Studies Depression-10 scales performed well and almost identically against the Mini International Neuropsychiatric Interview-major depressive disorder in identifying Veterans with major depressive disorder (Center for Epidemiologic Studies Depression-20 area under the Receiver Operating Characteristic curve 91%; Center for Epidemiologic Studies Depression-10 area under the ROC curve 90%. Overall, higher cut points for the Center for Epidemiologic Studies Depression scales performed better in correctly identifying true positives and true negatives for major depressive disorder (Center for Epidemiologic Studies Depression-20 cut point 18+ sensitivity 92% specificity 72%; Center for Epidemiologic Studies Depression-10 cut point 10+ sensitivity 92% specificity 69%. Conclusions: The specificity of the Center for Epidemiologic Studies Depression scales was poor among Veterans with co-occurring post-traumatic stress disorder (13% and 16%. Veterans with post

  2. The history of generalized anxiety disorder as a diagnostic category.

    Science.gov (United States)

    Crocq, Marc-Antoine

    2017-06-01

    From the 19th century into the 20th century, the terms used to diagnose generalized anxiety included "pantophobia" and "anxiety neurosis." Such terms designated paroxysmal manifestations (panic attacks) as well as interparoxysmal phenomenology (the apprehensive mental state). Also, generalized anxiety was considered one of numerous symptoms of neurasthenia, a vaguely defined illness. Generalized anxiety disorder (GAD) appeared as a diagnostic category in the third edition of the Diagnostic and Statistical Manual of Mental Disorders ( DSM-III ) in 1980, when anxiety neurosis was split into GAD and panic disorder. The distinct responses these two disorders had to imipramine therapy was one reason to distinguish between the two. Since the revised DSM-III ( DSM-III-R ), worry about a number of life circumstances has been gradually emphasized as the distinctive symptom of GAD. Thus, a cognitive aspect of anxiety has become the core criterion of GAD. The validity of GAD as an independent category has been questioned from DSM-III up to preparation of DSM-5 . Areas of concern have included the difficulty to establish clear boundaries between GAD and (i) personality dimensions, (ii) other anxiety-spectrum disorders, and (iii) nonbipolar depression. The National Institute of Mental Health has recently proposed the Research Domain Criteria (RDoC), a framework destined to facilitate biological research into the etiology of mental symptoms. Within the RDoC framework, generalized anxiety might be studied as a dimension denominated "anxious apprehension" that would typically fit into the research domain called "negative valence systems" and the more specific construct termed "potential threat."

  3. [Benzodiazepine dependence and the risk of depression and anxiety disorders: seniors' health study].

    Science.gov (United States)

    Nkogho Mengue, P-G; Abdous, B; Berbiche, D; Preville, M; Voyer, P

    2014-06-01

    The objective of this study is to examine the relationship between benzodiazepine dependence and anxiety disorders and depression in people aged 65 years and over. We referred to the data from the study on the health of seniors, a survey of a representative sample of 707 benzodiazepine users living in the community in Quebec, Canada. Benzodiazepine dependence, anxiety disorders and depression were measured using self-reported questionnaires based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, fourth revised edition. Seniors have consumed an average daily dose of 6.1±7.6mg diazepam equivalent to an average of 205±130 days. The prevalence of benzodiazepine dependence has been estimated at 9.5%. This dependence increases the risk of minor depression for females (relative risk [RR]=4.36, confidence interval 95% [95% CI]=1.19 to 15.99). The results of this study suggest that the use of benzodiazepines is far from being optimal among seniors in Quebec. The proportion of seniors who develop an addiction is important. The results illustrate the need to develop and implement programs to improve the quality of benzodiazepine use among this population. Copyright © 2013 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

  4. Bipolar I disorder and major depressive disorder show similar brain activation during depression.

    Science.gov (United States)

    Cerullo, Michael A; Eliassen, James C; Smith, Christopher T; Fleck, David E; Nelson, Erik B; Strawn, Jeffrey R; Lamy, Martine; DelBello, Melissa P; Adler, Caleb M; Strakowski, Stephen M

    2014-11-01

    Despite different treatments and courses of illness, depressive symptoms appear similar in major depressive disorder (MDD) and bipolar I disorder (BP-I). This similarity of depressive symptoms suggests significant overlap in brain pathways underlying neurovegetative, mood, and cognitive symptoms of depression. These shared brain regions might be expected to exhibit similar activation in individuals with MDD and BP-I during functional magnetic resonance imaging (fMRI). fMRI was used to compare regional brain activation in participants with BP-I (n = 25) and MDD (n = 25) during a depressive episode as well as 25 healthy comparison (HC) participants. During the scans, participants performed an attentional task that incorporated emotional pictures. During the viewing of emotional images, subjects with BP-I showed decreased activation in the middle occipital gyrus, lingual gyrus, and middle temporal gyrus compared to both subjects with MDD and HC participants. During attentional processing, participants with MDD had increased activation in the parahippocampus, parietal lobe, and postcentral gyrus. However, among these regions, only the postcentral gyrus also showed differences between MDD and HC participants. No differences in cortico-limbic regions were found between participants with BP-I and MDD during depression. Instead, the major differences occurred in primary and secondary visual processing regions, with decreased activation in these regions in BP-I compared to major depression. These differences were driven by abnormal decreases in activation seen in the participants with BP-I. Posterior activation changes are a common finding in studies across mood states in participants with BP-I. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Perseverative thought: a robust predictor of response to emotional challenge in generalized anxiety disorder and major depressive disorder.

    Science.gov (United States)

    Ruscio, Ayelet Meron; Seitchik, Allison E; Gentes, Emily L; Jones, Jason D; Hallion, Lauren S

    2011-12-01

    Generalized anxiety disorder (GAD) and major depressive disorder (MDD) frequently co-occur, yet the reasons for their comorbidity remain poorly understood. In the present experiment, we tested whether a tendency to engage in negative, repetitive thinking constitutes a common risk process for the two disorders. A mixed sample of adults with comorbid GAD-MDD (n=50), GAD only (n=35), MDD only (n=34), or no lifetime psychopathology (n=35) was administered noncontingent failure and success feedback on consecutive performance tasks. Perseverative thought (PT), measured by negative thought intrusions during a baseline period of focused breathing, emerged as a powerful prospective predictor of responses to this experimental challenge. Participants reporting more frequent negative thought intrusions at baseline, irrespective of thought content or diagnostic status, exhibited a stronger negative response to failure that persisted even after subsequent success. Higher PT over the course of the experiment was associated with later behavioral avoidance, with negative affect and other traits closely linked to anxiety and depression, and with the presence and severity of GAD and MDD. These findings provide evidence for a broadly-defined PT trait that is shared by GAD and MDD and contributes to adverse outcomes in these disorders. Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. Social functioning in patients with depressive and anxiety disorders.

    Science.gov (United States)

    Saris, I M J; Aghajani, M; van der Werff, S J A; van der Wee, N J A; Penninx, B W J H

    2017-10-01

    Adaptive social functioning is severely impeded in depressive and anxiety disorders, even after remission. However, a comprehensive overview is still lacking. Using data from the Netherlands Study of Depression and Anxiety (NESDA), behavioural (network size, social activities, social support) and affective (loneliness, affiliation, perceived social disability) indicators of social functioning were analyzed in patients with anxiety (N = 540), depressive (N = 393), comorbid anxiety and depressive disorders ('comorbid', N = 748), remitted participants (N = 621), and healthy control subjects (N = 650). Analyses revealed an increasing trend of social dysfunction among patient groups, in patients with comorbid anxiety and depressive disorders, showing the most severe impairments, followed by depressed and anxious patients (P's social functioning indicators). Affective indicators showed the largest effect sizes (Cohen's d range from 0.13 to 1.76). We also found impairments in social functioning among remitted patients. Furthermore, perceived social disability among patients was predictive of still having a depressive and/or anxiety diagnosis 2 years later (P social functioning are impaired in patients with anxiety or depressive disorders and most in patients with comorbid disorders. After remission of affective psychopathology, residual impairments tend to remain, while social dysfunction in patients seems predictive of future psychopathology. © 2017The Authors. Acta Psychiatrica Scandinavica Published by John Wiley & Sons Ltd.

  7. Competitive memory training (COMET) for treating low self-esteem in patients with depressive disorders: a randomized clinical trial.

    Science.gov (United States)

    Korrelboom, Kees; Maarsingh, Maaike; Huijbrechts, Irma

    2012-02-01

    Self-esteem is a major concern in mood disorders. Low self-esteem is a symptom of depressive disorders and is considered by some to be a predictor for relapse, whereas high self-esteem seems to buffer against depression. Recently, Competitive Memory Training (COMET) has shown to be effective for the enhancement of self-esteem in several psychopathological conditions. The current study assesses whether COMET is also an effective intervention for patients with depressive disorders. Sixty-one patients with depressive disorders who were already in therapy in an outpatient mental health institution were randomly assigned to either eight group sessions of COMET in addition to their regular therapy (COMET + therapy as usual [TAU]: the experimental group) or to 8 weeks of ongoing regular therapy (TAU only: the control group). These latter (control) patients received COMET after their TAU only period. All patients in both groups that completed COMET were contacted 3 and 6 months later to assess whether the effects of COMET had remained stable. Compared to the patients who received TAU only, patients in the COMET + TAU condition showed significant improvement with large effect sizes on indices of self-esteem, depression, and depressive rumination. The therapeutic effects of COMET + TAU remained stable after 3 and 6 months on all outcome measures or improved even further. COMET for low self-esteem seems to be an efficacious trans-diagnostic intervention that can relatively easily be added to the regular treatment of patients with depressive disorders. © 2012 Wiley Periodicals, Inc.

  8. State-Dependent Differences in Emotion Regulation Between Unmedicated Bipolar Disorder and Major Depressive Disorder

    NARCIS (Netherlands)

    Rive, M.M.; Mocking, R.J.T.; Koeter, M.W.; Wingen, G. van; Wit, S.J. de; Heuvel, O.A. van den; Veltman, D.J.; Ruhe, H.G.; Schene, A.H.

    2015-01-01

    IMPORTANCE: Major depressive disorder (MDD) and bipolar disorder (BD) are difficult to distinguish clinically during the depressed or remitted states. Both mood disorders are characterized by emotion regulation disturbances; however, little is known about emotion regulation differences between MDD

  9. State-Dependent Differences in Emotion Regulation Between Unmedicated Bipolar Disorder and Major Depressive Disorder

    NARCIS (Netherlands)

    Rive, Maria M.; Mocking, Roel J. T.; Koeter, Maarten W. J.; van Wingen, Guido; de Wit, Stella J.; van den Heuvel, Odile A.; Veltman, Dick J.; Ruhe, Henricus G.; Schene, Aart H.

    IMPORTANCE Major depressive disorder (MDD) and bipolar disorder (BD) are difficult to distinguish clinically during the depressed or remitted states. Both mood disorders are characterized by emotion regulation disturbances; however, little is known about emotion regulation differences between MDD

  10. State-Dependent Differences in Emotion Regulation Between Unmedicated Bipolar Disorder and Major Depressive Disorder

    NARCIS (Netherlands)

    Rive, M.M.; Mocking, R.J.T.; Koeter, M.W.J.; van Wingen, G.; de Wit, S.J.; van den Heuvel, O.A.; Veltman, D.J.; Ruhe, H.G.; Schene, A.H.

    2015-01-01

    IMPORTANCE Major depressive disorder (MDD) and bipolar disorder (BD) are difficult to distinguish clinically during the depressed or remitted states. Both mood disorders are characterized by emotion regulation disturbances; however, little is known about emotion regulation differences between MDD

  11. Whiplash-associated disorders: who gets depressed? Who stays depressed?

    OpenAIRE

    Phillips, Leah A.; Carroll, Linda J.; Cassidy, J. David; Côté, Pierre

    2010-01-01

    Depression is common in whiplash-associated disorders (WAD). Our objectives were to identify factors associated with depressive symptomatology occurring in the initial stages of WAD, and to identify factors predicting the course of depressive symptoms. A population-based cohort of adults sustaining traffic-related WAD was followed at 6 weeks, 3, 6, 9, and 12 months. Baseline measures (assessed a median of 11 days post-crash) included demographic and collision-related factors, prior health, an...

  12. [Overgeneral autobiographical memory in depressive disorders].

    Science.gov (United States)

    Dutra, Tarcísio Gomes; Kurtinaitis, Laila da Camara Lima; Cantilino, Amaury; Vasconcelos, Maria Carolina Souto de; Hazin, Izabel; Sougey, Everton Botelho

    2012-01-01

    This article aims to review studies focusing on the relationship between overgeneral autobiographical memory and depressive disorders. Such characteristic has attracted attention because of its relationship with a poor ability to solve problems and to imagine the future, as well as with the maintenance and a poor prognosis of depression. Data were collected through a systematic search on LILACS, SciELO, MEDLINE, and IBECS databases, and also on the health sciences records of Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), a Brazilian journal database, focusing on articles published between 2000 and 2010. The following keywords were used: memória autobiográfica, supergeneralização da memória autobiográfica, and memória autobiográfica e depressão in Portuguese; and autobiographical memory, overgeneral autobiographical memory, and autobiographical memory and depression in English. Following application of exclusion criteria, a total of 27 studies were reviewed. Overgeneral autobiographical memory has been investigated in several depressive disorders. However, further longitudinal studies are required to confirm the relevant role of this cognitive characteristic in anamnesis and in the treatment of mood disorders.

  13. [Examination of the hereditary burden for the depressive disorder].

    Science.gov (United States)

    Svilar, Nenad; Latas, Vesna

    2008-01-01

    Depressive disorders represent a group of diseases of a very complex etiology. The onset of this disease is determined by genetic and psychosocial factors. The presence of psychiatric disorders in families affects the onset and severity of the depressive disorder in offspring. The aim of this study was to determine the existence of differences in socio-biographic and clinical parameters between a group of depressive patients who have first degree relatives with psychiatric disorders (G1) and a group of depressive patients who have no first degree relatives with psychiatric disorders (G2). A number of 57 hospitalized patients were included and divided in two groups. Parameters observed: socio-demographic and biographic data, severity of the clinical status, period of the disease. Data were collected by using a socio-demographic questionnaire, Clinical Global Impression-Severity Scale and Hamilton depressive disorder scale. It has been found that the patients from G1 have a significantly higher rate for the parameter "broken home", p=0.014. Also, there were significant differences for the parameters: early insomnia (p=0.026), genital symptoms (p=0.016), (more manifested in G1). The results of the multivariate regression analysis showed that patients from G1 having higher level of hereditary burden had a more severe clinical status on the day of the admission to hospital. The research showed the influence of aggregation of psychiatric disorders in families on the onset and severity of depressive disorders. The interaction of genetic and psychosocial factors has been confirmed in the etiology of depression.

  14. Comorbid Depressive Disorders in Anxiety-Disordered Youth: Demographic, Clinical, and Family Characteristics

    Science.gov (United States)

    O'Neil, Kelly A.; Podell, Jennifer L.; Benjamin, Courtney L.; Kendall, Philip C.

    2010-01-01

    Research indicates that depression and anxiety are highly comorbid in youth. Little is known, however, about the clinical and family characteristics of youth with principal anxiety disorders and comorbid depressive diagnoses. The present study examined the demographic, clinical, and family characteristics of 200 anxiety-disordered children and…

  15. Web-based tools can be used reliably to detect patients with major depressive disorder and subsyndromal depressive symptoms

    Directory of Open Access Journals (Sweden)

    Tsai Shih-Jen

    2007-04-01

    Full Text Available Abstract Background Although depression has been regarded as a major public health problem, many individuals with depression still remain undetected or untreated. Despite the potential for Internet-based tools to greatly improve the success rate of screening for depression, their reliability and validity has not been well studied. Therefore the aim of this study was to evaluate the test-retest reliability and criterion validity of a Web-based system, the Internet-based Self-assessment Program for Depression (ISP-D. Methods The ISP-D to screen for major depressive disorder (MDD, minor depressive disorder (MinD, and subsyndromal depressive symptoms (SSD was developed in traditional Chinese. Volunteers, 18 years and older, were recruited via the Internet and then assessed twice on the online ISP-D system to investigate the test-retest reliability of the test. They were subsequently prompted to schedule face-to-face interviews. The interviews were performed by the research psychiatrists using the Mini-International Neuropsychiatric Interview and the diagnoses made according to DSM-IV diagnostic criteria were used for the statistics of criterion validity. Kappa (κ values were calculated to assess test-retest reliability. Results A total of 579 volunteer subjects were administered the test. Most of the subjects were young (mean age: 26.2 ± 6.6 years, female (77.7%, single (81.6%, and well educated (61.9% college or higher. The distributions of MDD, MinD, SSD and no depression specified were 30.9%, 7.4%, 15.2%, and 46.5%, respectively. The mean time to complete the ISP-D was 8.89 ± 6.77 min. One hundred and eighty-four of the respondents completed the retest (response rate: 31.8%. Our analysis revealed that the 2-week test-retest reliability for ISP-D was excellent (weighted κ = 0.801. Fifty-five participants completed the face-to-face interview for the validity study. The sensitivity, specificity, positive, and negative predictive values for major

  16. Psychotherapy for Major Depressive Disorder and Generalized Anxiety Disorder: A Health Technology Assessment.

    Science.gov (United States)

    2017-01-01

    Major depressive disorder and generalized anxiety disorder are among the most commonly diagnosed mental illnesses in Canada; both are associated with a high societal and economic burden. Treatment for major depressive disorder and generalized anxiety disorder consists of pharmacological and psychological interventions. Three commonly used psychological interventions are cognitive behavioural therapy (CBT), interpersonal therapy, and supportive therapy. The objectives of this report were to assess the effectiveness and safety of these types of therapy for the treatment of adults with major depressive disorder and/or generalized anxiety disorder, to assess the cost-effectiveness of structured psychotherapy (CBT or interpersonal therapy), to calculate the budget impact of publicly funding structured psychotherapy, and to gain a greater understanding of the experiences of people with major depressive disorder and/or generalized anxiety disorder. We performed a literature search on October 27, 2016, for systematic reviews that compared CBT, interpersonal therapy, or supportive therapy with usual care, waitlist control, or pharmacotherapy in adult outpatients with major depressive disorder and/or generalized anxiety disorder. We developed an individual-level state-transition probabilistic model for a cohort of adult outpatients aged 18 to 75 years with a primary diagnosis of major depressive disorder to determine the cost-effectiveness of individual or group CBT (as a representative form of structured psychotherapy) versus usual care. We also estimated the 5-year budget impact of publicly funding structured psychotherapy in Ontario. Finally, we interviewed people with major depressive disorder and/or generalized anxiety disorder to better understand the impact of their condition on their daily lives and their experience with different treatment options, including psychotherapy. Interpersonal therapy compared with usual care reduced posttreatment major depressive disorder

  17. Migration from Mexico to the US and Subsequent Risk for Depressive and Anxiety Disorders: A Cross-National Study

    Science.gov (United States)

    Breslau, Joshua; Borges, Guilherme; Tancredi, Daniel; Saito, Naomi; Kravitz, Richard; Hinton, Ladson; Vega, William; Medina-Mora, Maria Elena; Aguilar-Gaxiola, Sergio

    2013-01-01

    Objective To test the hypothesized increase in risk for depressive and anxiety disorders following arrival in the US among Mexican-origin migrants. Method Data from surveys conducted in Mexico and the US were combined. The surveys were conducted separately, but used the same structured diagnostic interview. Discrete time survival models were specified to estimate the relative odds of first onset of depressive (major depressive episode, dysthymia) and anxiety (generalized anxiety disorder, social phobia, panic disorder, posttraumatic stress disorder) disorders among migrants after their arrival in the US compared with non-migrant Mexicans who have a migrant in their immediate family. Results After arrival in the US, migrants had signficantly higher risk for first onset of any depressive or anxiety disorder than non-migrant family members of migrants in Mexico (OR=1.4, 95% CI =1.04–1.94). Associations between migration and disorder varied across birth cohorts. Elevated risk among migrants relative to non-migrants was restricted to the two younger cohorts, those 18–25 or 26–35 years old at interview. In the most recent cohort, the association between migration and first onset of any depressive or anxiety disorder was particularly strong (OR=3.89, 95% CI=2.74–5.53). Conclusions This is the first study to compare risk for first onset of psychaitric disorder between representative samples of migrants in the US and non-migrants in Mexico. The findings are consistent with the hypothesized adverse effect of migration from Mexico to the US on the mental health of migrants, but only among migrants in recent birth cohorts. PMID:21464367

  18. Major Depressive Disorder Definition, Etiology and Epidemiology: A Review

    Directory of Open Access Journals (Sweden)

    Fatmagul Helvaci Celik

    2016-03-01

    Full Text Available Depression is one of the most common psychiatric disorders influencing the all population. Untreated depression may lead to early death and worsening in general health. Depression has several clinically distinct subtypes which are sometimes difficult to diagnose. Diagnosis and treatment of these disorders are of concern to physicians other than psychiatrists, because of their effect on course and prognosis of general medical diseases. This is a concise and up to date overview of the epidemiology,etiology physiopathology and diagnosis of major depressive disorder. [J Contemp Med 2016; 6(1.000: 51-66

  19. Exposure to maternal pre- and postnatal depression and anxiety symptoms: risk for major depression, anxiety disorders, and conduct disorder in adolescent offspring.

    Science.gov (United States)

    Glasheen, Cristie; Richardson, Gale A; Kim, Kevin H; Larkby, Cynthia A; Swartz, Holly A; Day, Nancy L

    2013-11-01

    This study evaluated whether exposure to maternal pre- or postnatal depression or anxiety symptoms predicted psychopathology in adolescent offspring. Growth mixture modeling was used to identify trajectories of pre- and postnatal depression and anxiety symptoms in 577 women of low socioeconomic status selected from a prenatal clinic. Logistic regression models indicated that maternal pre- and postnatal depression trajectory exposure was not associated with offspring major depression, anxiety, or conduct disorder, but exposure to the high depression trajectory was associated with lower anxiety symptoms in males. Exposure to medium and high pre- and postnatal anxiety was associated with the risk of conduct disorder among offspring. Male offspring exposed to medium and high pre- and postnatal anxiety had higher odds of conduct disorder than did males with low exposure levels. Females exposed to medium or high pre- and postnatal anxiety were less likely to meet conduct disorder criteria than were females with lower exposure. To the best of our knowledge, this is the first study to examine the effect of pre- and postnatal anxiety trajectories on the risk of conduct disorder in offspring. These results suggest new directions for investigating the etiology of conduct disorder with a novel target for intervention.

  20. Developmentally sensitive diagnostic criteria for mental health disorders in early childhood: the diagnostic and statistical manual of mental disorders-IV, the research diagnostic criteria-preschool age, and the diagnostic classification of mental health and developmental disorders of infancy and early childhood-revised.

    Science.gov (United States)

    Egger, Helen L; Emde, Robert N

    2011-01-01

    As the infant mental health field has turned its focus to the presentation, course, and treatment of clinically significant mental health disorders, the need for reliable and valid criteria for identifying and assessing mental health symptoms and disorders in early childhood has become urgent. In this article we offer a critical perspective on diagnostic classification of mental health disorders in young children. We place the issue of early childhood diagnosis within the context of classification of psychopathology at other ages and describe, in some detail, diagnostic classifications that have been developed specifically for young children, including the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC:0-3R; ZERO TO THREE, 2005), a diagnostic classification for mental health symptoms and disorders in infants, toddlers, and preschoolers. We briefly outline the role of diagnostic classification in clinical assessment and treatment planning. Last, we review the limitations of current approaches to the diagnostic classification of mental health disorders in young children. PsycINFO Database Record (c) 2010 APA, all rights reserved.

  1. Depressive and anxiety disorders in epilepsy: do they differ in their potential to worsen common antiepileptic drug-related adverse events?

    Science.gov (United States)

    Kanner, Andres M; Barry, John J; Gilliam, Frank; Hermann, Bruce; Meador, Kimford J

    2012-06-01

    To compare the effect of anxiety disorders, major depressive episodes (MDEs), and subsyndromic depressive episodes (SSDEs) on antiepileptic drug (AED)-related adverse events (AEs) in persons with epilepsy (PWE). The study included 188 consecutive PWE from five U.S. outpatient epilepsy clinics, all of whom underwent structured interviews (SCID) to identify current and past mood disorders and other current Axis I psychiatric diagnoses according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria. A diagnosis of SSDE was made in patients with total Beck Depression Inventory-II (BDI-II) scores >12 or the Centers of Epidemiologic Studies-Depression (CES-D) > 16 (in the absence of any DSM diagnosis of mood disorder. The presence and severity of AEs was measured with the Adverse Event Profile (AEP). Compared to asymptomatic patients (n = 103), the AEP scores of patients with SSDE (n = 26), MDE only (n = 10), anxiety disorders only (n = 21), or mixed MDE/anxiety disorders (n = 28) were significantly higher, suggesting more severe AED-related AEs. Univariate analyses revealed that having persistent seizures in the last 6 months and taking antidepressants was associated with more severe AEs. Post hoc analyses, however, showed that these differences were accounted for by the presence of a depressive and/or anxiety disorders. Depressive and anxiety disorders worsen AED-related AEs even when presenting as a subsyndromic type. These data suggest that the presence of psychiatric comorbidities must be considered in their interpretation, both in clinical practice and AED drug trials. Wiley Periodicals, Inc. © 2012 International League Against Epilepsy.

  2. The clinical features of double depression and major depressive disorder%双重抑郁症与抑郁症临床特征的研究

    Institute of Scientific and Technical Information of China (English)

    严保平; 杨老虎; 崔利军; 孙秀丽; 刘永桥; 李建峰; 韩彦超; 栗克清; 江琴普; 高良会

    2012-01-01

    目的 了解双重抑郁症与抑郁症患者的临床特征.方法 采用随机多级抽样方法,以美国精神障碍诊断与统计手册第4版-修订版( DSM-Ⅳ-TR)为诊断标准,以DSM-Ⅳ-TR轴Ⅰ障碍定式临床检查患者版为诊断工具,以河北省流行病学调查的399例抑郁症患者为研究对象,其中符合双重抑郁症诊断标准患者56例(双重抑郁症组),符合抑郁症诊断标准患者343例(单一抑郁症组);采用功能大体评定量表( GAF)评定患者的功能状况.结果 399例抑郁症患者中,双重抑郁症的检出率为14.04%.单一抑郁症组和双重抑郁症组均有较高的其他精神障碍的共病率,分别为39.94%和48.21%,2组比较差异无统计学意义(x2=1.361,P>0.05);均以共病未特定的焦虑障碍、特殊恐怖症、广泛性焦虑障碍、创伤后应激障碍、惊恐障碍、酒依赖/酒滥用等常见.双重抑郁症组患者精神运动性激越、优柔寡断、自杀未遂症状出现的频率均高于单一抑郁症组(P<0.05),2组均以忧郁特征为常见临床特征(>50%).2组GAF评分和疾病的严重程度比较差异无统计学意义(t=0.354,P>0.05;x2 =0.655,P>0.05).结论 抑郁症中双重抑郁症的比例不低,共病其他精神障碍均较常见,但双重抑郁症患者自杀的风险更高,做事情总是优柔寡断.%Objective To investigate the clinical features of double depression and major depressive disorder.Methods Using the multistage random sampling method and the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorder Fourth edition ( DSM-Ⅳ ) was used as diagnostic criteria and the Structured Clinical Interview for DSM-Ⅳ-TR Axis Ⅰ Disorders-Patient Edition ( SCID- Ⅰ /P) was used as diagnostic tools.In 399 cases with major depressive disorder,56 subjects were with double depression.The Global Assessment Functions (GAF) was used to evaluate the functional status.Result Both single and double

  3. Migration from Mexico to the United States and subsequent risk for depressive and anxiety disorders: a cross-national study.

    Science.gov (United States)

    Breslau, Joshua; Borges, Guilherme; Tancredi, Daniel; Saito, Naomi; Kravitz, Richard; Hinton, Ladson; Vega, William; Medina-Mora, Maria Elena; Aguilar-Gaxiola, Sergio

    2011-04-01

    Migration is suspected to increase risk for depressive and anxiety disorders. To test the hypothesized increase in risk for depressive and anxiety disorders after arrival in the United States among Mexican migrants. We combined data from surveys conducted separately in Mexico and the United States that used the same diagnostic interview. Discrete time survival models were specified to estimate the relative odds of first onset of depressive disorders (major depressive episode and dysthymia) and anxiety disorders (generalized anxiety disorder, social phobia, panic disorder, and posttraumatic stress disorder) among migrants after their arrival in the United States compared with nonmigrant Mexicans who have a migrant in their immediate family. Population surveys in the United States and Mexico. Two thousand five hundred nineteen nonmigrant family members of migrants in Mexico and 554 Mexican migrants in the United States. First onset of any depressive or anxiety disorder. After arrival in the United States, migrants had a significantly higher risk for first onset of any depressive or anxiety disorder than did nonmigrant family members of migrants in Mexico (odds ratio, 1.42; 95% confidence interval, 1.04-1.94). Associations between migration and disorder varied across birth cohorts. Elevated risk among migrants relative to nonmigrants was restricted to the 2 younger cohorts (those aged 18-25 or 26-35 years at interview). In the most recent birth cohort, the association between migration and first onset of any depressive or anxiety disorder was particularly strong (odds ratio, 3.89; 95% confidence interval, 2.74-5.53). This is, to our knowledge, the first study to compare risk for first onset of psychiatric disorder between representative samples of migrants in the United States and nonmigrants in Mexico. The findings are consistent with the hypothesized adverse effect of migration from Mexico to the United States on the mental health of migrants, but only among

  4. Lifetime eating disorder comorbidity associated with delayed depressive recovery in bipolar disorder.

    Science.gov (United States)

    Balzafiore, Danielle R; Rasgon, Natalie L; Yuen, Laura D; Shah, Saloni; Kim, Hyun; Goffin, Kathryn C; Miller, Shefali; Wang, Po W; Ketter, Terence A

    2017-12-01

    Although eating disorders (EDs) are common in bipolar disorder (BD), little is known regarding their longitudinal consequences. We assessed prevalence, clinical correlates, and longitudinal depressive severity in BD patients with vs. without EDs. Outpatients referred to Stanford University BD Clinic during 2000-2011 were assessed with the Systematic Treatment Enhancement Program for BD (STEP-BD) affective disorders evaluation, and while receiving naturalistic treatment for up to 2 years, were monitored with the STEP-BD clinical monitoring form. Patients with vs. without lifetime EDs were compared with respect to prevalence, demographic and unfavorable illness characteristics/current mood symptoms and psychotropic use, and longitudinal depressive severity. Among 503 BD outpatients, 76 (15.1%) had lifetime EDs, which were associated with female gender, and higher rates of lifetime comorbid anxiety, alcohol/substance use, and personality disorders, childhood BD onset, episode accumulation (≥10 prior mood episodes), prior suicide attempt, current syndromal/subsyndromal depression, sadness, anxiety, and antidepressant use, and earlier BD onset age, and greater current overall BD severity. Among currently depressed patients, 29 with compared to 124 without lifetime EDs had significantly delayed depressive recovery. In contrast, among currently recovered (euthymic ≥8 weeks) patients, 10 with compared to 95 without lifetime EDs had only non-significantly hastened depressive recurrence. Primarily Caucasian, insured, suburban, American specialty clinic-referred sample limits generalizability. Small number of recovered patients with EDs limited statistical power to detect relationships between EDs and depressive recurrence. Further studies are warranted to explore the degree to which EDs impact longitudinal depressive illness burden in BD.

  5. Similar associations between personality dimensions and anxiety or depressive disorders in a population study of Turkish-Dutch, Moroccan-Dutch, and native Dutch subjects.

    Science.gov (United States)

    Schrier, Agnes C; de Wit, Matty A S; Krol, Anneke; Fassaert, Thijs J L; Verhoeff, Arnoud P; Kupka, Ralph W; Dekker, Jack; Beekman, Aartjan T F

    2013-05-01

    It is well established that personality traits are associated with anxiety and depressive disorders in Western populations, but it is not known whether this is true also for people from non-Western cultures. In this study, we examined whether ethnicity moderates the association between personality dimensions and anxiety or depressive disorders or symptoms. In a random urban population sample, stratified by ethnicity, in Amsterdam, the Netherlands, we interviewed 309 native Dutch subjects, 203 Turkish-Dutch subjects, and 170 Moroccan-Dutch subjects. Dimensions of personality were measured using the NEO Five-Factor Inventory. Anxiety and depressive disorders and symptom levels were assessed with the Composite International Diagnostic Interview and the Symptom Checklist-90-Revised. The association between personality factors and disorders or symptoms of anxiety and depression was very similar in the three ethnic groups: all show the typical profile of high neuroticism and low extraversion, agreeableness, and conscientiousness.

  6. Accuracy of automated classification of major depressive disorder as a function of symptom severity.

    Science.gov (United States)

    Ramasubbu, Rajamannar; Brown, Matthew R G; Cortese, Filmeno; Gaxiola, Ismael; Goodyear, Bradley; Greenshaw, Andrew J; Dursun, Serdar M; Greiner, Russell

    2016-01-01

    Growing evidence documents the potential of machine learning for developing brain based diagnostic methods for major depressive disorder (MDD). As symptom severity may influence brain activity, we investigated whether the severity of MDD affected the accuracies of machine learned MDD-vs-Control diagnostic classifiers. Forty-five medication-free patients with DSM-IV defined MDD and 19 healthy controls participated in the study. Based on depression severity as determined by the Hamilton Rating Scale for Depression (HRSD), MDD patients were sorted into three groups: mild to moderate depression (HRSD 14-19), severe depression (HRSD 20-23), and very severe depression (HRSD ≥ 24). We collected functional magnetic resonance imaging (fMRI) data during both resting-state and an emotional-face matching task. Patients in each of the three severity groups were compared against controls in separate analyses, using either the resting-state or task-based fMRI data. We use each of these six datasets with linear support vector machine (SVM) binary classifiers for identifying individuals as patients or controls. The resting-state fMRI data showed statistically significant classification accuracy only for the very severe depression group (accuracy 66%, p = 0.012 corrected), while mild to moderate (accuracy 58%, p = 1.0 corrected) and severe depression (accuracy 52%, p = 1.0 corrected) were only at chance. With task-based fMRI data, the automated classifier performed at chance in all three severity groups. Binary linear SVM classifiers achieved significant classification of very severe depression with resting-state fMRI, but the contribution of brain measurements may have limited potential in differentiating patients with less severe depression from healthy controls.

  7. Interpersonal psychotherapy (IPT) in major depressive disorder.

    Science.gov (United States)

    Brakemeier, Eva-Lotta; Frase, Lukas

    2012-11-01

    In this article, we will introduce interpersonal psychotherapy as an effective short-term treatment strategy in major depression. In IPT, a reciprocal relationship between interpersonal problems and depressive symptoms is regarded as important in the onset and as a maintaining factor of depressive disorders. Therefore, interpersonal problems are the main therapeutic targets of this approach. Four interpersonal problem areas are defined, which include interpersonal role disputes, role transitions, complicated bereavement, and interpersonal deficits. Patients are helped to break the interactions between depressive symptoms and their individual interpersonal difficulties. The goals are to achieve a reduction in depressive symptoms and an improvement in interpersonal functioning through improved communication, expression of affect, and proactive engagement with the current interpersonal network. The efficacy of this focused and structured psychotherapy in the treatment of acute unipolar major depressive disorder is summarized. This article outlines the background of interpersonal psychotherapy, the process of therapy, efficacy, and the expansion of the evidence base to different subgroups of depressed patients.

  8. Depressive Disorders in Primary Health Care

    OpenAIRE

    Vuorilehto, Maria

    2008-01-01

    The Vantaa Primary Care Depression Study (PC-VDS) is a naturalistic and prospective cohort study concerning primary care patients with depressive disorders. It forms a collaborative research project between the Department of Mental and Alcohol Research of the National Public Health Institute, and the Primary Health Care Organization of the City of Vantaa. The aim is to obtain a comprehensive view on clinically significant depression in primary care, and to compare depressive patients in prima...

  9. Comorbidity of Personality Disorders and Depression: Implications for Treatment.

    Science.gov (United States)

    Shea, M. Tracie; And Others

    1992-01-01

    Reviews studies of impact of comorbidity of personality disorders and depression on response to various forms of treatment. Notes that findings support belief that personality disorders are associated with poorer response to treatment for depression. Also notes that limited data available suggest that depression may be positive prognostic…

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

    Science.gov (United States)

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

    1985-05-01

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

  11. Sexual minority youth and depressive symptoms or depressive disorder: A systematic review and meta-analysis of population-based studies.

    Science.gov (United States)

    Lucassen, Mathijs Fg; Stasiak, Karolina; Samra, Rajvinder; Frampton, Christopher Ma; Merry, Sally N

    2017-08-01

    Research has suggested that sexual minority young people are more likely to have depressive symptoms or depressive disorder, but to date most studies in the field have relied on convenience-based samples. This study overcomes this limitation by systematically reviewing the literature from population-based studies and conducting a meta-analysis to identify whether depressive disorder and depressive symptoms are elevated in sexual minority youth. A systematic review and meta-analysis were conducted and informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement to determine if rates of depressive symptoms or depressive disorder differ for sexual minority youth, relative to heterosexual adolescents. MEDLINE, PsycINFO, EMBASE and ERIC databases were searched. Studies reporting depressive symptom data or the prevalence of depressive disorder in population-based samples of adolescents, which included sexual minority youth and heterosexual young people, were included in the review. A meta-analysis was conducted to examine differences between groups. Twenty-three articles met the inclusion criteria. The proportion of sexual minority youth in the studies ranged from 2.3% to 12%. Sexual minority youth reported higher rates of depressive symptoms and depressive disorder (odds ratio = 2.94, p depressive symptoms when compared to male sexual minority youth (standardized mean difference, d = 0.34, p depressive symptoms or depressive disorder was measured. There is robust evidence that rates of depressive disorder and depressive symptoms are elevated in sexual minority youth in comparison to heterosexual young people. Despite the elevated risk of depressive symptoms or depressive disorder for sexual minority youth, the treatment for this group of young people has received little attention.

  12. Increased error-related brain activity distinguishes generalized anxiety disorder with and without comorbid major depressive disorder.

    Science.gov (United States)

    Weinberg, Anna; Klein, Daniel N; Hajcak, Greg

    2012-11-01

    Generalized anxiety disorder (GAD) and major depressive disorder (MDD) are so frequently comorbid that some have suggested that the 2 should be collapsed into a single overarching "distress" disorder. Yet there is also increasing evidence that the 2 categories are not redundant. Neurobehavioral markers that differentiate GAD and MDD would be helpful in ongoing efforts to refine classification schemes based on neurobiological measures. The error-related negativity (ERN) may be one such marker. The ERN is an event-related potential component presenting as a negative deflection approximately 50 ms following an erroneous response and reflects activity of the anterior cingulate cortex. There is evidence for an enhanced ERN in individuals with GAD, but the literature in MDD is mixed. The present study measured the ERN in 26 GAD, 23 comorbid GAD and MDD, and 36 control participants, all of whom were female and medication-free. Consistent with previous research, the GAD group was characterized by a larger ERN and an increased difference between error and correct trials than controls. No such enhancement was evident in the comorbid group, suggesting comorbid depression may moderate the relationship between the ERN and anxiety. The present study further suggests that the ERN is a potentially useful neurobiological marker for future studies that consider the pathophysiology of multiple disorders in order to construct or refine neurobiologically based diagnostic phenotypes. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

  13. Autobiographical memory dysfunctions in depressive disorders.

    Science.gov (United States)

    Talarowska, Monika; Berk, Michael; Maes, Michael; Gałecki, Piotr

    2016-02-01

    Autobiographical memory (AM) is a ubiquitous human experience that belongs to long-term declarative memory. It plays interpersonal and intrapsychic functions. The main aim of this study is to present results of contemporary research on AM in recurrent depressive disorders. The available research literature suggests that AM dysfunctions are a precursor and risk factor for recurrent depressive disorders and that they also appear to be a consequence of depressive symptoms in a bidirectional and interacting manner. These data suggest that AM might be a viable therapeutic target for cognitive remediation strategies, given the impact of cognition on diverse clinical outcomes. © 2015 The Authors. Psychiatry and Clinical Neurosciences © 2015 Japanese Society of Psychiatry and Neurology.

  14. Ratio of mBDNF to proBDNF for Differential Diagnosis of Major Depressive Disorder and Bipolar Depression.

    Science.gov (United States)

    Zhao, Guoqing; Zhang, Chen; Chen, Jun; Su, Yousong; Zhou, Rubai; Wang, Fan; Xia, Weiping; Huang, Jia; Wang, Zuowei; Hu, Yingyan; Cao, Lan; Guo, Xiaoyun; Yuan, Chengmei; Wang, Yong; Yi, Zhenghui; Lu, Weihong; Wu, Yan; Wu, Zhiguo; Hong, Wu; Peng, Daihui; Fang, Yiru

    2017-09-01

    There is a high rate of misdiagnosis between major depressive disorder (MDD) and bipolar disorder (BD) in clinical practice. Our previous work provided suggestive evidence for brain-derived neurotrophic factor (BDNF) in differentiating BD from MDD. In this study, we aimed to investigate the role of mature BDNF (mBDNF) and its precursor (proBDNF) in distinguishing bipolar depression (BP) from MDD during acute depressive episode. A total of 105 participants, including 44 healthy controls, 37 MDD patients and 24 BP patients, were recruited. Enzyme-linked immunosorbent assay kits were applied to measure plasma mBDNF levels and proBDNF levels of all participants. Plasma mBDNF levels were significantly decreased in BP group than those in MDD group (P = 0.001) and healthy controls (P = 0.002). Significantly higher ratio of mBDNF to proBDNF (M/P) at baseline was showed in MDD group than those in BP group as well as in healthy controls (P = 0.000 and P = 0.000, respectively). The optimal model for discriminating BP was the M/P ratio (area under the ROC curve = 0.858, 95 % CI 0.753-0.963). Furthermore, the M/P ratio was restored to normal levels after antidepressants treatment in MDD group. In summary, our data demonstrated that both plasma mBDNF levels and M/P ratio were lower in BP compared with MDD. These findings further support M/P ratio as a potential differential diagnostic biomarker for BP among patients in depressive episodes.

  15. The clinical application of fMRI data in a single-patient diagnostic conundrum: Classifying brain response to experimental pain to distinguish between gastrointestinal, depressive and eating disorder symptoms.

    Science.gov (United States)

    Strigo, Irina A; Murray, Stuart B; Simmons, Alan N; Bernard, Rebecca S; Huang, Jeannie S; Kaye, Walter H

    2017-11-01

    Patients with eating disorders (EDs) often present with psychiatric comorbidity, and functional and/or organic gastrointestinal (GI) symptomatology. Such multidiagnostic presentations can complicate diagnostic practice and treatment delivery. Here we describe an adolescent patient who presented with mixed ED, depressive, and GI symptomatology, who had received multiple contrasting diagnoses throughout treatment. We used a novel machine learning approach to classify (i) the patient's functional brain imaging during an experimental pain paradigm, and (ii) patient self-report psychological measures, to categorize the diagnostic phenotype most closely approximated by the patient. Specifically, we found that the patient's response to pain anticipation and experience within the insula and anterior cingulate cortices, and patient self-report data, were most consistent with patients with GI pain. This work is the first to demonstrate the possibility of using imaging data, alongside supervised learning models, for purposes of single patient classification in those with ED symptomatology, where diagnostic comorbidity is common. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Intergenerational Transmission of Internalizing Problems: Effects of Parental and Grandparental Major Depressive Disorder on Child Behavior

    Science.gov (United States)

    Pettit, Jeremy W.; Olino, Thomas M.; Roberts, Robert E.; Seeley, John R.; Lewinsohn, Peter M.

    2008-01-01

    Effects of lifetime histories of grandparental (G1) and parental (G2) major depressive disorder (MDD) on children's (G3) internalizing problems were investigated among 267 G3 children (ages 2-18 years) who received Child Behavior Checklist (CBCL) ratings and had diagnostic data available on 267 biological G2 parents and 527 biological G1…

  17. Axis-I comorbidity in female patients with dissociative identity disorder and dissociative identity disorder not otherwise specified.

    Science.gov (United States)

    Rodewald, Frauke; Wilhelm-Göling, Claudia; Emrich, Hinderk M; Reddemann, Luise; Gast, Ursula

    2011-02-01

    The aim of this study was to investigate axis-I comorbidity in patients with dissociative identity disorder (DID) and dissociative disorder not otherwise specified (DDNOS). Using the Diagnostic Interview for Psychiatric Disorders, results from patients with DID (n = 44) and DDNOS (n = 22) were compared with those of patients with posttraumatic stress disorder (PTSD) (n = 13), other anxiety disorders (n = 14), depression (n = 17), and nonclinical controls (n = 30). No comorbid disorders were found in nonclinical controls. The average number of comorbid disorders in patients with depression or anxiety was 0 to 2. Patients with dissociative disorders averagely suffered from 5 comorbid disorders. The most prevalent comorbidity in DDNOS and DID was PTSD. Comorbidity profiles of patients with DID and DDNOS were very similar to those in PTSD (high prevalence of anxiety, somatoform disorders, and depression), but differed significantly from those of patients with depression and anxiety disorders. These findings confirm the hypothesis that PTSD, DID, and DDNOS are phenomenologically related syndromes that should be summarized within a new diagnostic category.

  18. Family history of mood disorder and characteristics of major depressive disorder: a STAR*D (sequenced treatment alternatives to relieve depression) study.

    Science.gov (United States)

    Nierenberg, Andrew A; Trivedi, Madhukar H; Fava, Maurizio; Biggs, Melanie M; Shores-Wilson, Kathy; Wisniewski, Stephen R; Balasubramani, G K; Rush, A John

    2007-01-01

    Clinicians routinely ask patients with major depressive disorder (MDD) about their family history. It is unknown, however, if patients who report a positive family history differ from those who do not. This study compared the demographic and clinical features of a large cohort of treatment-seeking outpatients with non-psychotic MDD who reported that they did or did not have at least one first-degree relative who had either MDD or bipolar disorder. Subjects were recruited for the STAR( *)D multicenter trial. Differences in demographic and clinical features for patients with and without a family history of mood disorders were assessed after correcting for age, sex, race, and ethnicity. Patients with a family history of mood disorder (n=2265; 56.5%) were more frequently women and had an earlier age of onset of depression, as compared to those without such a history (n=1740; 43.5%). No meaningful differences were found in depressive symptoms, severity, recurrence, depressive subtype, or daily function. Women were twice as likely as men to report a positive family history of mood disorder, and a positive family history was associated with younger age of onset of MDD in the proband. Consistent with prior research, early age of onset appears to define a familial and, by extension, genetic subtype of major depressive disorder.

  19. Psychotherapy for Major Depressive Disorder and Generalized Anxiety Disorder: A Health Technology Assessment

    Science.gov (United States)

    McMartin, Kristen; Gajic-Veljanoski, Olga; Wells, David; Higgins, Caroline; Walter, Melissa

    2017-01-01

    Background Major depressive disorder and generalized anxiety disorder are among the most commonly diagnosed mental illnesses in Canada; both are associated with a high societal and economic burden. Treatment for major depressive disorder and generalized anxiety disorder consists of pharmacological and psychological interventions. Three commonly used psychological interventions are cognitive behavioural therapy (CBT), interpersonal therapy, and supportive therapy. The objectives of this report were to assess the effectiveness and safety of these types of therapy for the treatment of adults with major depressive disorder and/or generalized anxiety disorder, to assess the cost-effectiveness of structured psychotherapy (CBT or interpersonal therapy), to calculate the budget impact of publicly funding structured psychotherapy, and to gain a greater understanding of the experiences of people with major depressive disorder and/or generalized anxiety disorder. Methods We performed a literature search on October 27, 2016, for systematic reviews that compared CBT, interpersonal therapy, or supportive therapy with usual care, waitlist control, or pharmacotherapy in adult outpatients with major depressive disorder and/or generalized anxiety disorder. We developed an individual-level state-transition probabilistic model for a cohort of adult outpatients aged 18 to 75 years with a primary diagnosis of major depressive disorder to determine the cost-effectiveness of individual or group CBT (as a representative form of structured psychotherapy) versus usual care. We also estimated the 5-year budget impact of publicly funding structured psychotherapy in Ontario. Finally, we interviewed people with major depressive disorder and/or generalized anxiety disorder to better understand the impact of their condition on their daily lives and their experience with different treatment options, including psychotherapy. Results Interpersonal therapy compared with usual care reduced

  20. 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.

  1. Young, single and not depressed: prevalence of depressive disorder among young women in rural Pakistan.

    Science.gov (United States)

    Rahman, Atif; Ahmed, Mansoor; Sikander, Siham; Malik, Abid; Tomenson, Barbara; Creed, Francis

    2009-09-01

    The prevalence of depression is very high among adult women in Pakistan but it is not known whether such a high prevalence occurs in younger women. We aimed to assess the prevalence and correlates of depression in 16 to 18-year old unmarried women in Pakistan. Population-based survey of all 16 to 18-year old unmarried women in one rural community in Rawalpindi District, Punjab, Pakistan. Depressive disorder and psychological distress were assessed using the Structured Clinical Interview for DSM-IV Disorders (SCID) and Self-Reporting Questionnaire (SRQ) respectively. 337 eligible women were identified of whom 321 (95%) were interviewed. Fourteen (4.4%) had depressive disorder; one third scored 9 or more on SRQ. On multivariate analysis a high SRQ score was associated with childhood experience of poverty, father's education, stressful life events, disturbed family relationships and mother's depression. The sample was derived from one rural community only and the results should be generalised with caution. Depressive disorder is not common in young women in rural Pakistan though distress appears common and is associated with early and recent adversity and family difficulties. These results suggest future work might aim to understand onset and prevent chronic depression.

  2. Association between toll-like receptors expression and major depressive disorder.

    Science.gov (United States)

    Hung, Yi-Yung; Kang, Hong-Yo; Huang, Kai-Wei; Huang, Tiao-Lai

    2014-12-15

    Accumulating evidences suggest that Toll-like receptors (TLRs) were involved in the pathophysiology of major depressive disorder. TLR4 was thought to be associated with major depressive disorder in animal model, but the others were still unknown. In order to examine TLR1-9 mRNA expression levels in peripheral blood and their relationships with the psychopathology of major depressive disorder, 30 patients with major depressive disorder were compared with 29 healthy controls. The 17-item Hamilton Depression Rating Scale (HAMD-17) was used to assess the severity of major depression. The mRNA expression levels of TLRs were examined in parallel with a housekeeping gene using real-time polymerase chain reaction (RT-PCR). Analysis of covariance with age and body mass index adjustment revealed a significantly higher expression of TLR3, 4, 5 and 7 mRNA but lower expression of TLR1 and 6 in patients with major depressive disorder as compared with healthy controls. Multiple linear regression analysis revealed that TLR4 was an independent risk factor relating to severity of major depression. These findings suggest that TLRs, especially TLR4, may be involved in the psychopathology of major depression. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  3. Korean Medication Algorithm for Depressive Disorders 2017: Third Revision

    Science.gov (United States)

    Seo, Jeong Seok; Wang, Hee Ryung; Woo, Young Sup; Park, Young-Min; Jeong, Jong-Hyun; Kim, Won; Shim, Se-Hoon; Lee, Jung Goo; Jon, Duk-In

    2018-01-01

    Objective In 2002, the Korean Society for Affective Disorders developed the guidelines for the treatment of major depressive disorder (MDD), and revised it in 2006 and 2012. The third revision of these guidelines was undertaken to reflect advances in the field. Methods Using a 44-item questionnaire, an expert consensus was obtained on pharmacological treatment strategies for MDD 1) without or 2) with psychotic features, 3) depression subtypes, 4) maintenance, 5) special populations, 6) the choice of an antidepressant (AD) regarding safety and adverse effects, and 7) non-pharmacological biological therapies. Recommended first, second, and third-line strategies were derived statistically. Results AD monotherapy is recommended as the first-line strategy for non-psychotic depression in adults, children/adolescents, elderly adults, patient with persistent depressive disorder, and pregnant women or patients with postpartum depression or premenstrual dysphoric disorder. The combination of AD and atypical antipsychotics (AAP) was recommended for psychotic depression in adult, child/adolescent, postpartum depression, and mixed features or anxious distress. Most experts recommended stopping the ongoing initial AD and AAP after a certain period in patients with one or two depressive episodes. As an MDD treatment modality, 92% of experts are considering electroconvulsive therapy and 46.8% are applying it clinically, while 86% of experts are considering repetitive transcranial magnetic stimulation but only 31.6% are applying it clinically. Conclusion The pharmacological treatment strategy in 2017 is similar to that of Korean Medication Algorithm for Depressive Disorder 2012. The preference of AAPs was more increased. PMID:29397669

  4. Impact of dissociation on treatment of depressive and anxiety spectrum disorders with and without personality disorders.

    Science.gov (United States)

    Prasko, Jan; Grambal, Ales; Kasalova, Petra; Kamardova, Dana; Ociskova, Marie; Holubova, Michaela; Vrbova, Kristyna; Sigmundova, Zuzana; Latalova, Klara; Slepecky, Milos; Zatkova, Marta

    2016-01-01

    The central goal of the study was to analyze the impact of dissociation on the treatment effectiveness in patients with anxiety/neurotic spectrum and depressive disorders with or without comorbid personality disorders. The research sample consisted of inpatients who were hospitalized in the psychiatric department and met the ICD-10 criteria for diagnosis of depressive disorder, panic disorder, generalized anxiety disorder, mixed anxiety-depressive disorder, agoraphobia, social phobia, obsessive compulsive disorder, posttraumatic stress disorder, adjustment disorders, dissociative/conversion disorders, somatoform disorder, or other anxiety/neurotic spectrum disorder. The participants completed these measures at the start and end of the therapeutic program - Beck Depression Inventory, Beck Anxiety Inventory, a subjective version of Clinical Global Impression-Severity, Sheehan Patient-Related Anxiety Scale, and Dissociative Experience Scale. A total of 840 patients with anxiety or depressive spectrum disorders, who were resistant to pharmacological treatment on an outpatient basis and were referred for hospitalization for the 6-week complex therapeutic program, were enrolled in this study. Of them, 606 were statistically analyzed. Data from the remaining 234 (27.86%) patients were not used because of various reasons (103 prematurely finished the program, 131 did not fill in most of the questionnaires). The patients' mean ratings on all measurements were significantly reduced during the treatment. Also, 67.5% reached at least minimal improvement (42.4% showed moderate and more improvement, 35.3% of the patients reached remission). The patients without comorbid personality disorder improved more significantly in the reduction of depressive symptoms than those with comorbid personality disorder. However, there were no significant differences in change in anxiety levels and severity of the mental issues between the patients with and without personality disorders. Higher

  5. Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis.

    Science.gov (United States)

    Vancampfort, Davy; Stubbs, Brendon; Mitchell, Alex J; De Hert, Marc; Wampers, Martien; Ward, Philip B; Rosenbaum, Simon; Correll, Christoph U

    2015-10-01

    Metabolic syndrome (MetS) and its components are highly predictive of cardiovascular diseases. The primary aim of this systematic review and meta-analysis was to assess the prevalence of MetS and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder, comparing subjects with different disorders and taking into account demographic variables and psychotropic medication use. The secondary aim was to compare the MetS prevalence in persons with any of the selected disorders versus matched general population controls. The pooled MetS prevalence in people with severe mental illness was 32.6% (95% CI: 30.8%-34.4%; N = 198; n = 52,678). Relative risk meta-analyses established that there was no significant difference in MetS prevalence in studies directly comparing schizophrenia versus bipolar disorder, and in those directly comparing bipolar disorder versus major depressive disorder. Only two studies directly compared people with schizophrenia and major depressive disorder, precluding meta-analytic calculations. Older age and a higher body mass index were significant moderators in the final demographic regression model (z = -3.6, p = 0.0003, r(2)  = 0.19). People treated with all individual antipsychotic medications had a significantly (ppeople with severe mental illness had a significantly increased risk for MetS (RR = 1.58; 95% CI: 1.35-1.86; p<0.001) and all its components, except for hypertension (p = 0.07). These data suggest that the risk for MetS is similarly elevated in the diagnostic subgroups of severe mental illness. Routine screening and multidisciplinary management of medical and behavioral conditions is needed in these patients. Risks of individual antipsychotics should be considered when making treatment choices. © 2015 World Psychiatric Association.

  6. Depression and hypochondriasis in family practice patients with somatization disorder.

    Science.gov (United States)

    Oxman, T E; Barrett, J

    1985-10-01

    The relationships specified in DSM-III between somatization disorder and depression, and somatization disorder and hypochondriasis require further validation and easier methods of detection for use by primary care physicians. The authors investigated hypochondriacal and depressive symptoms in 13 family practice outpatients with somatization disorder. Pain complaints and depressive symptomatology were present in over 75% of this group, while hypochondriacal symptoms were present in 38%. The mean score on the somatization scale of the Hopkins Symptom Check List (HSCL-90) was greater than that reported for any other group. These findings support the separation of somatization disorder and hypochondriasis and suggest the need for better delineation of depressive subtypes in somatization disorder. The somatization scale of the HSCL-90 should be a useful screen for somatization disorder in future research.

  7. Migraine symptomatology and major depressive disorder

    NARCIS (Netherlands)

    Ligthart, Lannie; Penninx, Brenda; Nyholt, Dale R.; Distel, Marijn A.; de Geus, Eco J. C.; Willemsen, Gonneke; Smit, Johannes H.; Boomsma, Dorret I.

    Introduction and objective: Migraine and major depressive disorder (MDD) frequently co-occur, but it is unclear whether depression is associated with a specific subtype of migraine. The objective of this study was to investigate whether migraine is qualitatively different in MDD patients (N = 1816)

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

    Science.gov (United States)

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

    2011-12-01

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

  9. Theory of mind impairment and its clinical correlates in patients with schizophrenia, major depressive disorder and bipolar disorder.

    Science.gov (United States)

    Wang, Yan-Yu; Wang, Yi; Zou, Ying-Min; Ni, Ke; Tian, Xue; Sun, Hong-Wei; Lui, Simon S Y; Cheung, Eric F C; Suckling, John; Chan, Raymond C K

    2017-11-06

    Although Theory of Mind (ToM) impairment has been observed in patients with a wide range of mental disorders, the similarity and uniqueness of these deficits across diagnostic groups has not been thoroughly investigated. We recruited 35 participants with schizophrenia (SCZ), 35 with bipolar disorder (BD), 35 with major depressive disorder (MDD), and 35 healthy controls in this study. All participants were matched in age, gender proportion and IQ estimates. The Yoni task, capturing both the cognitive and affective components of ToM at the first- and second-order level was administered. Repeated-measure ANOVA and MANOVA were conducted to compare the group differences in ToM performance. A network was then constructed with ToM performances, psychotic and depressive symptoms, and executive function as nodes exploring the clinical correlates of ToM. Overall, ToM impairments were observed in all patient groups compared with healthy controls, with patients with SCZ performing worse than those with BD. In second-order conditions, patients with SCZ and MDD showed deficits in both cognitive and affective conditions, while patients with BD performed significantly poorer in cognitive conditions. Network analysis showed that second-order affective ToM performance was associated with psychotic and depressive symptoms as well as executive dysfunction, while second-order affective ToM performance and negative symptoms showed relatively high centrality in the network. Patients with SCZ, MDD and BD exhibited different types and severity of impairments in ToM sub-components. Impairment in higher-order affective ToM appears to be closely related to clinical symptoms in both psychotic and affective disorders. Copyright © 2017. Published by Elsevier B.V.

  10. Improving recognition of late life anxiety disorders in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition: observations and recommendations of the Advisory Committee to the Lifespan Disorders Work Group.

    Science.gov (United States)

    Mohlman, Jan; Bryant, Christina; Lenze, Eric J; Stanley, Melinda A; Gum, Amber; Flint, Alastair; Beekman, Aartjan T F; Wetherell, Julie Loebach; Thorp, Steven R; Craske, Michelle G

    2012-06-01

    Recognition of the significance of anxiety disorders in older adults is growing. The revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM) provides a timely opportunity to consider potential improvements to diagnostic criteria for psychiatric disorders for use with older people. The authors of this paper comprise the Advisory Committee to the DSM5 Lifespan Disorders Work Group, the purpose of which was to generate informative responses from individuals with clinical and research expertise in the field of late-life anxiety disorders. This paper reviews the unique features of anxiety in later life and synthesizes the work of the Advisory Committee. Suggestions are offered for refining our understanding of the effects of aging on anxiety and other disorders (e.g., mood disorders) and changes to the DSM5 criteria and text that could facilitate more accurate recognition and diagnosis of anxiety disorders in older adults. Several of the recommendations are not limited to the study of anxiety but rather are applicable across the broader field of geriatric mental health. DSM5 should provide guidelines for the thorough assessment of avoidance, excessiveness, and comorbid conditions (e.g., depression, medical illness, cognitive impairment) in anxious older adults. Copyright © 2011 John Wiley & Sons, Ltd.

  11. Fulfillment of the premenstrual dysphoric disorder criteria confirmed using a self-rating questionnaire among Japanese women with depressive disorders.

    Science.gov (United States)

    Miyaoka, Yoshiko; Akimoto, Yoshie; Ueda, Kayoko; Ujiie, Yuri; Kametani, Machiko; Uchiide, Yoko; Kamo, Toshiko

    2011-05-02

    Some women with depressive disorders experience severe premenstrual symptoms. However, there have been few studies in which premenstrual symptoms in women suffering from depressive disorders were assessed. In this study, we aimed to investigate premenstrual symptoms in women with depressive disorders using the premenstrual dysphoric disorder (PMDD) scale. We administered questionnaires to 65 Japanese female outpatients who had been diagnosed with a major depressive disorder or dysthymic disorder and to 303 healthy women as control subjects. The questionnaire consisted of items on demographics and the PMDD scale, which was modified from the premenstrual symptoms screening tool (PSST) developed by Steiner et al. (Arch Womens Ment Health 2003, 6:203-209). Twenty-eight women (43.1%) with depressive disorder fulfilled certain items of the PMDD scale. These women are considered to have coexisting PMDD and a depressive disorder, or to have premenstrual exacerbation (PME) of a depressive disorder. On the other hand, 18 women (5.9%) in the control group were diagnosed as having PMDD. The depressive disorder group who fulfilled the PMDD criteria had more knowledge of the term premenstrual syndrome (PMS) and took more actions to attenuate premenstrual symptoms than the control group with PMDD. Our findings demonstrated that the occurrence of severe premenstrual symptoms is much higher in women with depressive disorders than in healthy subjects. This is partially due to this group containing women with PME, but mainly due to it containing women with PMDD. The higher percentage of PMDD suggests similarity between PMDD and other depressive disorders. Furthermore, educating healthy Japanese women and women with depressive disorders about premenstrual symptoms and evidence-based treatment for them is necessary.

  12. Role of Comorbid Depression and Co-Occurring Depressive Symptoms in Outcomes for Anxiety-Disordered Youth Treated with Cognitive-Behavioral Therapy

    Science.gov (United States)

    O'Neil, Kelly A.; Kendall, Philip C.

    2012-01-01

    This study examined the role of comorbid depressive disorders (major depressive disorder or dysthymic disorder) and co-occurring depressive symptoms in treatment outcome and maintenance for youth (N = 72, aged 7-14) treated with cognitive-behavioral therapy for a principal anxiety disorder (generalized anxiety disorder, separation anxiety…

  13. The role of spousal loss in the development of depressive symptoms in the elderly - implications for diagnostic systems.

    Science.gov (United States)

    Sikorski, Claudia; Luppa, Melanie; Heser, Kathrin; Ernst, Annette; Lange, Carolin; Werle, Jochen; Bickel, Horst; Mösch, Edelgard; Wiese, Birgitt; Prokein, Jana; Fuchs, Angela; Pentzek, Michael; König, Hans-Helmut; Brettschneider, Christian; Scherer, Martin; Maier, Wolfgang; Weyerer, Siegfried; Riedel-Heller, Steffi G

    2014-06-01

    In the revised version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) the Mood Disorder Workgroup for DSM-V the bereavement exclusion criterion for the diagnosis of major depression has been eliminated. To investigate the impact of bereavement on the incidence of depression and depressive symptoms in the elderly. Participants over 75 years from the longitudinal German Study on Ageing, Cognition, and Dementia in Primary Care Patients (AgeCoDe) that were still married at baseline were investigated (n=1,193). Data from four follow-ups (time frame: 6 years) were investigated. The response rate at baseline was 50.3%. Three clinical endpoints were analyzed: depressive symptoms according to Geriatric Depression Scale (1) GDS≥6, (2) GDS≥10, and (3) Major Depression (MD). The effect of loss was investigated using random-effects regression models. Experiencing a loss of spouse was predictive of a higher incidence in GDS≥6 (OR 4.52, 95% CI 2.6-7.9) and 10 (OR 5.59, 95% CI 1.8-17.0) even after adjusting for age, gender, impairment at baseline, and GDS score at baseline. Associations with MD were not significant (OR 1.77, 96% CI 0.9-3.5). Older adults experiencing the loss of their spouse are more likely to display elevated levels of depressive symptoms, that may reach a concerning level of severity. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. Symptoms of social anxiety, depression, and stress in parents of children with social anxiety disorder.

    Science.gov (United States)

    Halldorsson, Brynjar; Draisey, Jenny; Cooper, Peter; Creswell, Cathy

    2018-06-01

    It has been suggested that elevated maternal social anxiety may play a disorder-specific role in maintaining childhood social anxiety disorder (SAD), but few studies have examined whether mothers of children with SAD are more socially anxious than mothers of children with other anxiety disorders (ANX). This study set out to examine whether symptoms of social anxiety were more severe amongst mothers of 7-12 year old children presenting for treatment with SAD (n = 260) compared to those presenting with ANX (n = 138). In addition, we examined whether there were differences between these two groups in terms of maternal and paternal general anxiety, depression, and stress. Parents of 7-12 year old children referred for treatment of SAD or ANX completed self-report questionnaire measures of emotional symptoms. Compared to mothers of children with ANX, mothers of children with SAD reported significantly higher levels of social anxiety, general anxiety, and depression. In addition, fathers of children with SAD reported significantly higher levels of anxiety, stress, and depression than fathers of children with ANX. This study is one of the few existing studies that have examined mothers' and fathers' psychopathology across different childhood anxiety disorders. Compared to parents of children with ANX, parents of children with SAD may have poorer mental health which may inhibit optimum child treatment outcomes for children with SAD. Thus, targeting parental psychopathology may be particularly important in the treatment of childhood SAD. Consideration of parental psychopathology may be particularly important in the treatment of childhood social anxiety disorder. Mothers of children with social anxiety disorder are more socially anxious than mothers of children with other anxiety disorders Fathers of children with social anxiety disorder are more anxious and depressed than fathers of children with other anxiety disorders Participants were predominantly of high

  15. Use of antipsychotics in the treatment of depressive disorders

    Institute of Scientific and Technical Information of China (English)

    Ping WANG; Tianmei SI

    2013-01-01

    There is a long history of using antipsychotic medications in the treatment of depressive disorders. Atypical antipsychotics, which have fewer side effects than traditional antipsychotics, have been used as monotherapy or adjunctively with antidepressants to treat depressive disorders with or without psychotic symptoms. The antidepressant effect of atypical antipsychotics involves regulation of monoamine, glutamate, gamma-aminobutyric acid (GABA), cortisol, and neurotrophic factors. To date, the United States Food and Drug Administration (USFDA) has approved aripiprazole and quetiapine slow-release tablets as adjunctive treatment for depressive disorders, and the combination of olanzapine and fluoxetine for the treatment of treatment-resistant depression. When using atypical antipsychotics in the treatment of depressed patients, clinicians need to monitor patients for the emergence of adverse effects including extrapyramidal symptoms (EPS), weight gain, and hyperglycemia.

  16. Maternal anxiety, depression and sleep disorders before and during pregnancy, and preschool ADHD symptoms in the NINFEA birth cohort study.

    Science.gov (United States)

    Vizzini, L; Popovic, M; Zugna, D; Vitiello, B; Trevisan, M; Pizzi, C; Rusconi, F; Gagliardi, L; Merletti, F; Richiardi, L

    2018-04-18

    Maternal mental disorders have been associated with the risk of attention-deficit/hyperactivity disorder (ADHD) in children. Within the context of a mother-child cohort, we examined whether maternal anxiety, depression and sleep disorders are associated with pre-school ADHD symptoms. The study included 3634 singletons from the Italian NINFEA (Nascita e INFanzia: gli Effetti dell'Ambiente') cohort. Maternal doctor-diagnosed anxiety, depression and sleep disorders before and during pregnancy were assessed from the questionnaires completed during pregnancy and 6 months after delivery. Mothers rated child ADHD symptoms at 4 years of age, according to the Diagnostic and Statistical Manual of Mental Disorders. Hyperactive-impulsive (ADHD-H), inattentive (ADHD-I) and total ADHD scores were analysed in the models adjusted for child's gender, first-born status, maternal age, education, alcohol consumption and smoking during pregnancy. The total ADHD score at age 4 was associated with maternal lifetime anxiety (17.1% percentage difference in score compared with never; 95% CI 7.3-27.9%), sleep disorders (35.7%; 95% CI 10.7-66.5%) and depression (17.5%; 95% CI 3.2-33.8%). Similar positive associations were observed also for ADHD-H and ADHD-I traits, with slightly attenuated associations between maternal sleep disorders and child ADHD-I score, and maternal depression and both ADHD scores. All the estimates were enhanced when the disorders were active during pregnancy and attenuated for disorders active only during the pre-pregnancy period. Maternal anxiety, depression and sleep disorders are associated with a relative increase in the number of ADHD-H, ADHD-I and total ADHD symptoms in preschoolers.

  17. Algorithm of Functional Musculoskeletal Disorders Diagnostics

    OpenAIRE

    Alexandra P. Eroshenko

    2012-01-01

    The article scientifically justifies the algorithm of complex diagnostics of functional musculoskeletal disorders during resort treatment, aimed at the optimal application of modern methods of physical rehabilitation (correction programs formation), based on diagnostic methodologies findings

  18. Psychosocial work factors, major depressive and generalised anxiety disorders: results from the French national SIP study.

    Science.gov (United States)

    Murcia, Marie; Chastang, Jean-François; Niedhammer, Isabelle

    2013-04-25

    Anxiety and depression are prevalent mental disorders in working populations. The risk factors of these disorders are not completely well known. Developing knowledge on occupational risk factors for mental disorders appears crucial. This study investigates the association between various classical and emergent psychosocial work factors and major depressive and generalised anxiety disorders in the French working population. The study was based on a national random sample of 3765 men and 3944 women of the French working population (SIP 2006 survey). Major Depressive Disorder (MDD) and Generalised Anxiety Disorder (GAD) were measured using a standardised diagnostic interview (MINI). Occupational factors included psychosocial work factors as well as biomechanical, physical, and chemical exposures. Adjustment variables included age, occupation, marital status, social support, and life events. Multivariate analysis was performed using logistic regression analysis. Low decision latitude, overcommitment, and emotional demands were found to be risk factors for both MDD-GAD among both genders. Other risk factors were observed: high psychological demands, low reward, ethical conflict, and job insecurity, but differences were found according to gender and outcome. Significant interaction terms were observed suggesting that low decision latitude, high psychological demands, and job insecurity had stronger effects on mental disorders for men than for women. Given the cross-sectional study design, no causal conclusion could be drawn. This study showed significant associations between classical and emergent psychosocial work factors and MDD-GAD. Preventive actions targeting various psychosocial work factors, including emergent factors, may help to reduce mental disorders at the workplace. Copyright © 2012 Elsevier B.V. All rights reserved.

  19. Anxiety, Depression and Post-Traumatic Stress Disorder after Earthquake.

    Science.gov (United States)

    Thapa, Prakash; Acharya, Lumeshor; Bhatta, Bhup Dev; Paneru, Suman Bhatta; Khattri, Jai Bahadur; Chakraborty, Prashant Kumar; Sharma, Rajasee

    2018-03-13

    Prevalence of anxiety, depression and post traumatic stress disorder is high after earthquake. The aim of the study is to study the prevalence and comorbidity of commonly occurring psychological symptoms in people exposed to Nepal mega earthquake in 2015 after a year of the event. A community based, cross sectional, descriptive study was carried out in Bhumlichaur area of Gorkha district, Nepal after around 14 months of the first major earthquake. We used self-reporting questionnaire 20, Post-traumatic stress disorder 8 and hospital anxiety and depression scale to screen for presence of symptoms of anxiety and depression or post-traumatic stress disorder in this population. The risk of having these disorders according to different socio-demographic variable was assessed by calculating odds ratio. All calculations were done using predictive and analytical software (PASW) version 16.0. A total of 198 participants were included in the final data analysis. The mean age of study participants was 35.13 years (SD=18.04). Borderline anxiety symptoms were found in 104 (52.5%) while significant anxiety symptoms were found in 40 (20%) of respondents. Borderline depressive symptoms were seen in 40 (20%) while significant depressive symptoms were seen in 16 (8%) of subjects. Around 27% (n= 53) of respondents were classified as having post-traumatic stress disorder. The prevalence of anxiety and depressive symptoms and post-traumatic stress disorder seems to be high even after one year in people exposed to earthquake.

  20. The NVL gene confers risk for both major depressive disorder and schizophrenia in the Han Chinese population.

    Science.gov (United States)

    Wang, Meng; Chen, Jianhua; He, Kuanjun; Wang, Qingzhong; Li, Zhiqiang; Shen, Jiawei; Wen, Zujia; Song, Zhijian; Xu, Yifeng; Shi, Yongyong

    2015-10-01

    NVL (nuclear VCP (valosin containing protein)/p97-Like), a member of the AAA-ATPase (ATPases associated with various cellular activities) family, encodes a novel hTERT (human telomerase reverse transcriptase)-interacting protein NVL2 which is a telomerase component essential for holoenzyme assembly. Previous researches have reported the impacts of telomerase activity on mental illness and the potential association between NVL and major depressive disorder. To validate the susceptibility of NVL to major depressive disorder, and to investigate the overlapping risk conferred by NVL for both major depressive disorder and schizophrenia, we analyzed 9 tag single nucleotide polymorphisms (tag SNPs) using TaqMan® technology, in 1045 major depressive disorder patients, 1235 schizophrenia patients and 1235 normal controls of Han Chinese origin. We found that rs10916583 (P(allele) = 0.020, P(genotype) = 0.028, OR = 1.156) and rs16846649 (adjusted P(allele) = 0.014, P(genotype) = 0.007, OR = 0.718) were associated with major depressive disorder, while rs10916583 (adjusted P(allele) = 1.08E-02, OR = 1.213), rs16846649 (adjusted P(allele) = 7.40E-06, adjusted P(genotype) = 8.07E-05, OR = 0.598) and rs10799541 (adjusted P(allele) = 8.10E-03, adjusted P(genotype) = 0.049, OR= 0.826) showed statistically significant association with schizophrenia after Bonferroni correction. Furthermore, rs10916583 (adjusted P(allele) = 9.00E-03, adjusted P(genotype) = 3.15E-02, OR = 1.187) and rs16846649 (adjusted P(allele) = 8.92E-06, adjusted P(genotype) = 8.84E-05, OR = 0.653) remained strongly associated with the analysis of combined cases of major depressive disorder and schizophrenia after Bonferroni correction. Our results indicated that the NVL gene may contain overlapping common genetic risk factors for major depressive disorder and schizophrenia in the Han Chinese population. The roles of NVL in telomerase biogenesis were also highlighted in psychiatric pathogenesis. The study on

  1. Major depressive and anxiety disorders in visually impaired older adults

    NARCIS (Netherlands)

    van der Aa, H.P.A.; Comijs, H.C.; Penninx, B.W.J.H.; van Rens, G.H.M.B.; van Nispen, R.M.A.

    2015-01-01

    PURPOSE. We assessed the prevalence of subthreshold depression and anxiety, and major depressive, dysthymic, and anxiety disorders (panic disorder, agoraphobia, social phobia, and general anxiety disorder) in visually impaired older adults and compared these estimates with those of normally sighted

  2. Perceived parental characteristics of patients with obsessive compulsive disorder, depression, and panic disorder.

    Science.gov (United States)

    Merkel, W T; Pollard, C A; Wiener, R L; Staebler, C R

    1993-01-01

    It has been hypothesized that parents of patients with obsessive compulsive disorder exhibit specific traits. 320 consecutive inpatient admissions who met criteria for OCD, depression, and panic disorder checked a list of adjectives to describe their parents. Patients with OCD were 1) less likely to perceive their mothers as disorganized than depressives, 2) more likely to perceive their mothers as overprotective than depressives and 3) less likely to perceive their fathers as demanding than patients with panic.

  3. Predictors of Response to Ketamine in Treatment Resistant Major Depressive Disorder and Bipolar Disorder

    Directory of Open Access Journals (Sweden)

    Carola Rong

    2018-04-01

    Full Text Available Objectives: Extant evidence indicates that ketamine exerts rapid antidepressant effects in treatment-resistant depressive (TRD symptoms as a part of major depressive disorder (MDD and bipolar disorder (BD. The identification of depressed sub-populations that are more likely to benefit from ketamine treatment remains a priority. In keeping with this view, the present narrative review aims to identify the pretreatment predictors of response to ketamine in TRD as part of MDD and BD. Method: Electronic search engines PubMed/MEDLINE, ClinicalTrials.gov, and Scopus were searched for relevant articles from inception to January 2018. The search term ketamine was cross-referenced with the terms depression, major depressive disorder, bipolar disorder, predictors, and response and/or remission. Results: Multiple baseline pretreatment predictors of response were identified, including clinical (i.e., Body Mass Index (BMI, history of suicide, family history of alcohol use disorder, peripheral biochemistry (i.e., adiponectin levels, vitamin B12 levels, polysomnography (abnormalities in delta sleep ratio, neurochemistry (i.e., glutamine/glutamate ratio, neuroimaging (i.e., anterior cingulate cortex activity, genetic variation (i.e., Val66Met BDNF allele, and cognitive functioning (i.e., processing speed. High BMI and a positive family history of alcohol use disorder were the most replicated predictors. Conclusions: A pheno-biotype of depression more, or less likely, to benefit with ketamine treatment is far from complete. Notwithstanding, metabolic-inflammatory alterations are emerging as possible pretreatment response predictors of depressive symptom improvement, most notably being cognitive impairment. Sophisticated data-driven computational methods that are iterative and agnostic are more likely to provide actionable baseline pretreatment predictive information.

  4. Fulfillment of the premenstrual dysphoric disorder criteria confirmed using a self-rating questionnaire among Japanese women with depressive disorders

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    Kametani Machiko

    2011-05-01

    Full Text Available Abstract Background Some women with depressive disorders experience severe premenstrual symptoms. However, there have been few studies in which premenstrual symptoms in women suffering from depressive disorders were assessed. In this study, we aimed to investigate premenstrual symptoms in women with depressive disorders using the premenstrual dysphoric disorder (PMDD scale. Methods We administered questionnaires to 65 Japanese female outpatients who had been diagnosed with a major depressive disorder or dysthymic disorder and to 303 healthy women as control subjects. The questionnaire consisted of items on demographics and the PMDD scale, which was modified from the premenstrual symptoms screening tool (PSST developed by Steiner et al. (Arch Womens Ment Health 2003, 6:203-209. Results Twenty-eight women (43.1% with depressive disorder fulfilled certain items of the PMDD scale. These women are considered to have coexisting PMDD and a depressive disorder, or to have premenstrual exacerbation (PME of a depressive disorder. On the other hand, 18 women (5.9% in the control group were diagnosed as having PMDD. The depressive disorder group who fulfilled the PMDD criteria had more knowledge of the term premenstrual syndrome (PMS and took more actions to attenuate premenstrual symptoms than the control group with PMDD. Conclusions Our findings demonstrated that the occurrence of severe premenstrual symptoms is much higher in women with depressive disorders than in healthy subjects. This is partially due to this group containing women with PME, but mainly due to it containing women with PMDD. The higher percentage of PMDD suggests similarity between PMDD and other depressive disorders. Furthermore, educating healthy Japanese women and women with depressive disorders about premenstrual symptoms and evidence-based treatment for them is necessary.

  5. Factor structure and clinical utility of the Beck depression inventory in patients with binge eating disorder and obesity.

    Science.gov (United States)

    Udo, Tomoko; McKee, Sherry A; Grilo, Carlos M

    2015-01-01

    The Beck Depression Inventory (BDI) is often used to assess depression symptoms, but its factor structure and its clinical utility have not been evaluated in patients with binge eating disorder (BED) and obesity. A total of 882 treatment-seeking obese patients with BED were administered structured interviews (Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis I Disorders) and completed self-report questionnaires. Exploratory and confirmatory factor analyses supported a brief 16-item BDI version with a three-factor structure (affective, attitudinal and somatic). Both 21- and 16-item versions showed excellent internal consistency (both α=0.89) and had significant correlation patterns with different aspects of eating disorder psychopathology; three factors showed significant but variable associations with eating disorder psychopathology. Area under the curves (AUC) for both BDI versions were significant in predicting major depressive disorder (MDD; AUC=0.773 [16-item], 73.5% sensitivity/70.2% specificity, AUC=0.769 [21-item], 79.5% sensitivity/64.1% specificity) and mood disorders (AUC=0.763 [16-item], 67.1% sensitivity/71.5% specificity, AUC=0.769 [21-item], 84.2% sensitivity/55.7% specificity). The 21-item BDI (cutoff score ≥16) showed higher negative predictive values (94.0% vs. 93.0% [MDD]; 92.4% vs. 88.3% [mood disorders]) than the brief 16-item BDI (cutoff score ≥13). Both BDI versions demonstrated moderate performance as a screening instrument for MDD/mood disorders in obese patients with BED. Advantages and disadvantages for both versions are discussed. A three-factor structure has potential to inform the conceptualization of depression features. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Effects of erythropoietin on depressive symptoms and neurocognitive deficits in depression and bipolar disorder

    DEFF Research Database (Denmark)

    Miskowiak, Kamilla W; Vinberg, Maj; Harmer, Catherine J

    2010-01-01

    BACKGROUND: Depression and bipolar disorder are associated with reduced neural plasticity and deficits in memory, attention and executive function. Drug treatments for these affective disorders have insufficient clinical effects in a large group and fail to reverse cognitive deficits. There is thus...... depression and reverses cognitive impairments in these patients and in patients with bipolar disorder in remission. METHODS/DESIGN: The trial has a double-blind, placebo-controlled, parallel-group design. 40 patients with treatment-resistant major depression and 40 patients with bipolar disorder in remission......) 1 in study 1 and, in study 2, verbal memory measured with the Rey Auditory Verbal Learning Test (RAVLT) 23. With inclusion of 40 patients in each study we obtain 86% power to detect clinically relevant differences between intervention and placebo groups on these primary outcomes. TRIAL REGISTRATION...

  7. Factors associated with a depressive disorder in Alzheimer's disease are different from those found for other dementia disorders.

    Science.gov (United States)

    Barca, Maria Lage; Engedal, Knut; Laks, Jerson; Selbaek, Geir

    2012-01-01

    This study explores factors associated with depression in Alzheimer's disease (AD) compared with mild cognitive impairment (MCI) and other dementia disorders. In a prospective study we included 195 patients: 31 with MCI, 112 with AD and 52 with other dementias. According to the ICD-10 and the DSM-IV criteria, 88 (44.1%) and 59 (30.3%), respectively, had a depressive disorder. An adjusted multiple regression analysis showed that previous depression (p depression in AD patients. Severity of dementia (p depressive disorder in a group of patients with frontotemporal dementia, vascular dementia, or dementia due to Lewy Body disease or Parkinson's disease. We found different factors associated with a depressive disorder in AD compared to those found for other dementia disorders.

  8. Familial and Clinical Correlates in Depressed Adolescents with Borderline Personality Disorder Traits

    Directory of Open Access Journals (Sweden)

    Jean Marc Guile

    2016-09-01

    Full Text Available Introduction: Chart review is a low-cost, but highly informative, method to describe symptoms, treatment and risk factors associated with Borderline Personality Disorder (BPD and to adapt screening and intervention to clinical reality. Previous chart review studies report more aggressiveness/anger and psychotic features in youths with BPD. They show that adverse family environment and parental psychopathology constitute important factors for BPD pathology. Objectives: To examine clinical characteristics of depressed BPD adolescents (12-17 years old outpatients according to gender and to explore variables which are associated with BPD traits. Methods: A retrospective chart review using the Child and Adolescent Version of the Retrospective Diagnostic Instrument for Borderlines was conducted on 30 depressed BPD adolescents with BPD traits and 28 non-BPD depressed patients without BPD traits. Participants who reached the C-DIB threshold for BPD were included in the BPD traits group. The Child and Adolescent Version of the Retrospective Diagnostic Interview for Borderlines was used to determine the presence of BPD. Comparisons analyses were performed using Pearson’s Chi-square test. Associated factors were determined using regression analyses. Results: BPD traits participants outpatients were characterised by higher family problems (parental psychopathology, parent disagreement/argument, parent-child relational problem, more aggressive symptoms, and higher rates of family intervention and hospitalisation. A number of familial factors (parental history of delinquency, substance use, or personality disorders, having siblings, parental disagreement/argument in boys were associated with BPD symptomatologytraits. Attention seeking and problematic functioning (does not adapt well to group activities were also associated with BPD traits. Discussion: Our study stresses the need to assess BPD traits in adolescent psychiatric evaluation, especially in

  9. Evaluating depressive symptoms in mania: a naturalistic study of patients with bipolar disorder

    Directory of Open Access Journals (Sweden)

    Young AH

    2015-04-01

    Full Text Available Allan H Young,1 Jonas Eberhard1,21Institute of Psychiatry, King’s College London, London, UK; 2Corporate Medical Affairs, H. Lundbeck A/S, Copenhagen, DenmarkObjective: This study aimed to evaluate patients with bipolar I disorder (BD-I who have mania with depressive symptoms and who meet the new “with mixed features” specifier of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5.Method: This prospective, multinational, naturalistic study surveyed psychiatrists and their patients with BD-I from October 2013 to March 2014. Eligible patients had BD-I, had a (current manic episode, and had experienced onset of a manic episode within the previous 3 months. Psychiatrists provided patient information on depressive symptoms (DSM-5 criteria; symptoms of anxiety, irritability, and agitation; suicide attempts; and physician satisfaction with treatment response. Data were stratified according to whether patients met the criteria for the BD-I “with mixed features” specifier of DSM-5 (≥3 depressive symptoms or not, and characteristics were compared between the two subgroups. Patients also self-reported on depressive symptoms using the Mini-International Neuropsychiatric Interview module questionnaire.Results: Overall, 34% of 1,035 patients met the criteria for BD-I “with mixed features,” exhibiting ≥3 depressive symptoms during their current manic episode. This correlated with the matched patient self-reports of depressive symptoms. During their current manic episode, BD-I patients “with mixed features” had more severe symptoms of anxiety, irritability, and agitation (average composite severity score of 4.1 vs 3.4, a higher incidence of suicide attempts (38% vs 9%, and more physician dissatisfaction with treatment response (22% vs 14%, compared to patients with 0–2 depressive symptoms (all P<0.05.Conclusion: This study found that patients with BD-I “with mixed features” (ie, ≥3 depressive symptoms

  10. Prevalence and correlates of major depressive disorder and dysthymia in an eleven-year follow-up--results from the Finnish Health 2011 Survey.

    Science.gov (United States)

    Markkula, Niina; Suvisaari, Jaana; Saarni, Samuli I; Pirkola, Sami; Peña, Sebastian; Saarni, Suoma; Ahola, Kirsi; Mattila, Aino K; Viertiö, Satu; Strehle, Jens; Koskinen, Seppo; Härkänen, Tommi

    2015-03-01

    Up-to-date epidemiological data on depressive disorders is needed to understand changes in population health and health care utilization. This study aims to assess the prevalence of major depressive disorder (MDD) and dysthymia in the Finnish population and possible changes during the past 11 years. In a nationally representative sample of Finns aged 30 and above (BRIF8901), depressive disorders were diagnosed with the Composite International Diagnostic Interview (M-CIDI) in 2000 and 2011. To account for nonresponse, two methods were compared: multiple imputation (MI) utilizing data from the hospital discharge register and from the interview in 2000 and statistical weighting. The MI-corrected 12-month prevalence of MDD was 7.4% (95% CI 5.7-9.0) and of dysthymia was 4.5% (95% CI 3.1-5.9), whereas the corresponding figures using weights were 5.4% (95% CI 4.7-6.1) for MDD and 2.0% (95% CI 1.6-2.4) for dysthymia. Women (OR 2.33, 95% CI 1.6-3.4) and unmarried people (OR 1.54, 95% CI 1.2-2.0) had a higher risk of depressive disorders. There was a significant increase in the prevalence of depressive disorders during the follow-up period from 7.3% in 2000 to 9.6% in 2011. Prevalences were two percentage points higher, on average, when using MI compared to weighting. Hospital treatments for depressive disorders and other mental disorders were strongly associated with nonparticipation. The CIDI response rate dropped from 75% in 2000 to 57% in 2011, but this was accounted for by MI and weighting. Depressive disorders are a growing public health concern in Finland. Non-participation of persons with severe mental disorders may bias the prevalence estimates of mental disorders in population-based studies. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. Repetitive transcranial magnetic stimulation for treatment of major depressive disorder with comorbid generalized anxiety disorder.

    Science.gov (United States)

    White, Daniela; Tavakoli, Sason

    2015-08-01

    Repetitive transcranial magnetic stimulation (rTMS) has shown promising results in treating individuals with behavioral disorders such as major depressive disorder (MDD), posttraumatic stress disorder, obsessive-compulsive disorder, and social anxiety disorder. A number of applications of rTMS to different regions of the left and right prefrontal cortex have been used to treat these disorders, but no study of treatment for MDD with generalized anxiety disorder (GAD) has been conducted with application of rTMS to both the left and right prefrontal cortex. We hypothesized that applying low-frequency rTMS to the right dorsolateral prefrontal cortex (DLPFC) before applying it to the left DLPFC for the treatment of depression would be anxiolytic in patients with MDD with GAD. Thirteen adult patients with comorbid MDD and GAD received treatment with rTMS in an outpatient setting. The number of treatments ranged from 24 to 36 over 5 to 6 weeks. Response was defined as a ≥ 50% reduction in symptoms from baseline, and remission was defined as a score of anxiety symptoms on the 7-item Generalized Anxiety Disorder (GAD-7) scale and depressive symptoms on the 21-item Hamilton Rating Scale for Depression (HAM-D-21). At the end of the treatment period, for the GAD-7 scale, 11 out of 13 (84.6%) patients' anxiety symptoms were in remission, achieving a score of depressive symptoms. In this small pilot study of 13 patients with comorbid MDD and GAD, significant improvement in anxiety symptoms along with depressive symptoms was achieved in a majority of patients after bilateral rTMS application.

  12. The Hospital Anxiety and Depression Scale (HADS) and the 9-item Patient Health Questionnaire (PHQ-9) as screening instruments for depression in patients with cancer

    DEFF Research Database (Denmark)

    Hartung, Tim J; Friedrich, Michael; Johansen, Christoffer

    2017-01-01

    all major tumor sites and treatment settings. The PHQ-9 and HADS-D were assessed and compared in terms of diagnostic accuracy and receiver operating characteristic (ROC) curves for Diagnostic and Statistical Manual of Mental Disorders, 4th edition diagnosis of major depressive disorder using......BACKGROUND: Depression screening in patients with cancer is recommended by major clinical guidelines, although the evidence on individual screening tools is limited for this population. Here, the authors assess and compare the diagnostic accuracy of 2 established screening instruments......: the depression modules of the 9-item Patient Health Questionnaire (PHQ-9) and the Hospital Anxiety and Depression Scale (HADS-D), in a representative sample of patients with cancer. METHODS: This multicenter study was conducted with a proportional, stratified, random sample of 2141 patients with cancer across...

  13. Algorithm of Functional Musculoskeletal Disorders Diagnostics

    Directory of Open Access Journals (Sweden)

    Alexandra P. Eroshenko

    2012-04-01

    Full Text Available The article scientifically justifies the algorithm of complex diagnostics of functional musculoskeletal disorders during resort treatment, aimed at the optimal application of modern methods of physical rehabilitation (correction programs formation, based on diagnostic methodologies findings

  14. Evaluating depressive symptoms in mania: a naturalistic study of patients with bipolar disorder

    Science.gov (United States)

    Young, Allan H; Eberhard, Jonas

    2015-01-01

    Objective This study aimed to evaluate patients with bipolar I disorder (BD-I) who have mania with depressive symptoms and who meet the new “with mixed features” specifier of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). Method This prospective, multinational, naturalistic study surveyed psychiatrists and their patients with BD-I from October 2013 to March 2014. Eligible patients had BD-I, had a (current) manic episode, and had experienced onset of a manic episode within the previous 3 months. Psychiatrists provided patient information on depressive symptoms (DSM-5 criteria); symptoms of anxiety, irritability, and agitation; suicide attempts; and physician satisfaction with treatment response. Data were stratified according to whether patients met the criteria for the BD-I “with mixed features” specifier of DSM-5 (≥3 depressive symptoms) or not, and characteristics were compared between the two subgroups. Patients also self-reported on depressive symptoms using the Mini-International Neuropsychiatric Interview module questionnaire. Results Overall, 34% of 1,035 patients met the criteria for BD-I “with mixed features,” exhibiting ≥3 depressive symptoms during their current manic episode. This correlated with the matched patient self-reports of depressive symptoms. During their current manic episode, BD-I patients “with mixed features” had more severe symptoms of anxiety, irritability, and agitation (average composite severity score of 4.1 vs 3.4), a higher incidence of suicide attempts (38% vs 9%), and more physician dissatisfaction with treatment response (22% vs 14%), compared to patients with 0–2 depressive symptoms (all P<0.05). Conclusion This study found that patients with BD-I “with mixed features” (ie, ≥3 depressive symptoms during a manic episode), suffered, on average, from a greater burden of disease than patients with pure mania. Improved identification of these patients may help to optimize

  15. Evaluating depressive symptoms in mania: a naturalistic study of patients with bipolar disorder.

    Science.gov (United States)

    Young, Allan H; Eberhard, Jonas

    2015-01-01

    This study aimed to evaluate patients with bipolar I disorder (BD-I) who have mania with depressive symptoms and who meet the new "with mixed features" specifier of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). This prospective, multinational, naturalistic study surveyed psychiatrists and their patients with BD-I from October 2013 to March 2014. Eligible patients had BD-I, had a (current) manic episode, and had experienced onset of a manic episode within the previous 3 months. Psychiatrists provided patient information on depressive symptoms (DSM-5 criteria); symptoms of anxiety, irritability, and agitation; suicide attempts; and physician satisfaction with treatment response. Data were stratified according to whether patients met the criteria for the BD-I "with mixed features" specifier of DSM-5 (≥3 depressive symptoms) or not, and characteristics were compared between the two subgroups. Patients also self-reported on depressive symptoms using the Mini-International Neuropsychiatric Interview module questionnaire. Overall, 34% of 1,035 patients met the criteria for BD-I "with mixed features," exhibiting ≥3 depressive symptoms during their current manic episode. This correlated with the matched patient self-reports of depressive symptoms. During their current manic episode, BD-I patients "with mixed features" had more severe symptoms of anxiety, irritability, and agitation (average composite severity score of 4.1 vs 3.4), a higher incidence of suicide attempts (38% vs 9%), and more physician dissatisfaction with treatment response (22% vs 14%), compared to patients with 0-2 depressive symptoms (all Pmixed features" (ie, ≥3 depressive symptoms during a manic episode), suffered, on average, from a greater burden of disease than patients with pure mania. Improved identification of these patients may help to optimize treatment outcomes.

  16. Subthreshold Depressive Disorder in Adolescents: Predictors of Escalation to Full-Syndrome

    Science.gov (United States)

    Klein, Daniel N.; Shankman, Stewart A.; Lewinsohn, Peter M.; Seeley, John R.

    2009-01-01

    The risk for the onset of full-syndrome depressive disorders from the subtreshold depressive disorder in adolescents is found to be at 67 percent. The variables that predict the progression to the full onset are: severity of depressive symptoms, medical conditions/ symptoms, history of suicidal ideation, history of anxiety disorder, and familial…

  17. Health-related quality of life and symptom severity in Chinese patients with major depressive disorder.

    Science.gov (United States)

    Cao, Yuping; Li, Wen; Shen, Jingjin; Malison, Robert T; Zhang, Yalin; Luo, Xingguang

    2013-12-01

    Patients suffering from major depressive disorder (MDD) have been reported to have substantial long-lasting limitations in multiple domains of health-related quality of life (HRQoL). The thoughtful assessment of HRQoL and the impact of treatment response on HRQoL are emerging as important issues in the care of patients with major depressive disorder. One hundred and three patients meeting Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for MDD took fluoxetine (20 mg/d) for 6 weeks and were assessed by the Short Form 36 Health Survey (SF-36), the 17-item Hamilton Depression Rating (HAMD-17) and the Clinical Global Impression (CGI) scales. Relationships between SF-36 scores and depressive symptom severity and early change of these symptoms were tested. SF-36 component scores at week 6 were higher than those at baseline (all P ≤ 0.0058). Scores for general health were significantly higher in responders than non-responders (P = 0.0009). The overall HAMD-17 and CGI scores at 2- and 6-week follow-up were significantly lower than those at baseline (P ≤ 0.0001). Higher scores for anxiety/somatization were significantly associated with poorer SF-36 scores at baseline (P = 0.0001); role-physical scores at week 6 were positively correlated with reduction rate of anxiety/somatization in 2-week follow-up (P = 0.0002). Depressive symptom severity was associated with HRQoL in patients with MDD. HRQoL may vary with severity of depression and/or anxiety-somatization at baseline. Copyright © 2013 Wiley Publishing Asia Pty Ltd.

  18. Depression as a systemic syndrome: mapping the feedback loops of major depressive disorder.

    Science.gov (United States)

    Wittenborn, A K; Rahmandad, H; Rick, J; Hosseinichimeh, N

    2016-02-01

    Depression is a complex public health problem with considerable variation in treatment response. The systemic complexity of depression, or the feedback processes among diverse drivers of the disorder, contribute to the persistence of depression. This paper extends prior attempts to understand the complex causal feedback mechanisms that underlie depression by presenting the first broad boundary causal loop diagram of depression dynamics. We applied qualitative system dynamics methods to map the broad feedback mechanisms of depression. We used a structured approach to identify candidate causal mechanisms of depression in the literature. We assessed the strength of empirical support for each mechanism and prioritized those with support from validation studies. Through an iterative process, we synthesized the empirical literature and created a conceptual model of major depressive disorder. The literature review and synthesis resulted in the development of the first causal loop diagram of reinforcing feedback processes of depression. It proposes candidate drivers of illness, or inertial factors, and their temporal functioning, as well as the interactions among drivers of depression. The final causal loop diagram defines 13 key reinforcing feedback loops that involve nine candidate drivers of depression. Future research is needed to expand upon this initial model of depression dynamics. Quantitative extensions may result in a better understanding of the systemic syndrome of depression and contribute to personalized methods of evaluation, prevention and intervention.

  19. The dental management of patients with severe depression disorder (Literature review

    Directory of Open Access Journals (Sweden)

    Nanan Nur’aeny

    2016-06-01

    Full Text Available World Health Organization (WHO in the year 2000 have identified major depressive disorder ranks as the fourth leading cause of death in the world. WHO also estimates that in 2020, the disorder will increase to second only to ischemic heart disease. People at high risk of first occurrence of depression are those who have a family history. Depression can happen to anyone and at all ages, ranging in age from children, young adults up to old age. This paper will discuss the literature review of an overview of depression and itsmanagement in dentistry. Patients with major depressive disorder may have abnormalities in the oral cavity affected by lack of oral hygiene as well as a manifestation of mental disorder and its treatment. Dental and oral management conducted in accordance with procedures and have to be carried out carefully especially to patients with mental disorders such as depression. Tooth decayed, gingivitis, xerostomia, oral candidiasis, oral lesion, and TMJ disorder are clinical findings in depressed patient, so as dentists may cooperate with psychiatrists in providing comprehensive treatment to improve quality of life of the patients.

  20. The prevalence and illness characteristics of DSM-5-defined "mixed feature specifier" in adults with major depressive disorder and bipolar disorder: Results from the International Mood Disorders Collaborative Project.

    Science.gov (United States)

    McIntyre, Roger S; Soczynska, Joanna K; Cha, Danielle S; Woldeyohannes, Hanna O; Dale, Roman S; Alsuwaidan, Mohammad T; Gallaugher, Laura Ashley; Mansur, Rodrigo B; Muzina, David J; Carvalho, Andre; Kennedy, Sidney H

    2015-02-01

    A substantial proportion of individuals with mood disorders present with sub-syndromal hypo/manic features. The objective of this analysis was to evaluate the prevalence and illness characteristics of the Diagnostic and Statistical Manual Version-5 (DSM-5) - defined mixed features specifier (MFS) in adults with major depressive disorder (MDD) and bipolar disorder (BD). Data from participants who met criteria for a current mood episode as part of MDD (n=506) or BD (BD-I: n=216, BD-II: n=130) were included in this post-hoc analysis. All participants were enrolled in the International Mood Disorders Collaborative Project (IMDCP): a collaborative research platform at the Mood Disorders Psychopharmacology Unit, University of Toronto and the Cleveland Clinic, Cleveland, Ohio. Mixed features specifier was operationalized as a score ≥ 1 on 3 or more select items on the Young Mania Rating Scale (YMRS) or ≥ 1 on 3 select items of the Montgomery Åsberg Depression Rating Scale (MADRS) or Hamilton Depression Rating Scale (HAMD-17) during an index major depressive episode (MDE) or hypo/manic episode, respectively. A total of 26.0% (n=149), 34.0% (n=65), and 33.8% (n=49) of individuals met criteria for MFS during an index MDE as part of MDD, BD-I and BD-II, respectively. Mixed features specifier during a hypo/manic episode was identified in 20.4% (n=52) and 5.1% (n=8) in BD-I and BD-II participants, respectively. Individuals with MDE-MFS as part of BD or MDD exhibited a more severe depressive phenotype (p=0.0002 and pdefined MFS is common during an MDE as part of MDD and BD. The presence of MFS identifies a subgroup of individuals with greater illness complexity and possibly a higher rate of cardiovascular comorbidity. The results herein underscore the common occurrence of MFS in adults with either BD or MDD. Moreover, the results of our analysis indicate that adults with mood disorders and MFS have distinct clinical characteristics and comorbidity patterns. Copyright

  1. Alcohol-use disorder severity predicts first-incidence of depressive disorders

    NARCIS (Netherlands)

    Boschloo, L.; van den Brink, W.; Penninx, B.W.J.H.; Wall, M.M.; Hasin, D.S.

    2012-01-01

    Background Previous studies suggest that alcohol-use disorder severity, defined by the number of criteria met, provides a more informative phenotype than dichotomized DSM-IV diagnostic measures of alcohol use disorders. Therefore, this study examined whether alcohol-use disorder severity predicted

  2. Alcohol-use disorder severity predicts first-incidence of depressive disorders

    NARCIS (Netherlands)

    Boschloo, L.; van den Brink, W.; Penninx, B. W. J. H.; Wall, M. M.; Hasin, D. S.

    2012-01-01

    Background. Previous studies suggest that alcohol-use disorder severity, defined by the number of criteria met, provides a more informative phenotype than dichotomized DSM-IV diagnostic measures of alcohol use disorders. Therefore, this study examined whether alcohol-use disorder severity predicted

  3. Multiple comorbidities of 21 psychological disorders and relationships with psychosocial variables: a study of the online assessment and diagnostic system within a web-based population.

    Science.gov (United States)

    Al-Asadi, Ali M; Klein, Britt; Meyer, Denny

    2015-02-26

    While research in the area of e-mental health has received considerable attention over the last decade, there are still many areas that have not been addressed. One such area is the comorbidity of psychological disorders in a Web-based sample using online assessment and diagnostic tools, and the relationships between comorbidities and psychosocial variables. We aimed to identify comorbidities of psychological disorders of an online sample using an online diagnostic tool. Based on diagnoses made by an automated online assessment and diagnostic system administered to a large group of online participants, multiple comorbidities (co-occurrences) of 21 psychological disorders for males and females were identified. We examined the relationships between dyadic comorbidities of anxiety and depressive disorders and the psychosocial variables sex, age, suicidal ideation, social support, and quality of life. An online complex algorithm based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision, was used to assign primary and secondary diagnoses of 21 psychological disorders to 12,665 online participants. The frequency of co-occurrences of psychological disorders for males and females were calculated for all disorders. A series of hierarchical loglinear analyses were performed to examine the relationships between the dyadic comorbidities of depression and various anxiety disorders and the variables suicidal ideation, social support, quality of life, sex, and age. A 21-by-21 frequency of co-occurrences of psychological disorders matrix revealed the presence of multiple significant dyadic comorbidities for males and females. Also, for those with some of the dyadic depression and the anxiety disorders, the odds for having suicidal ideation, reporting inadequate social support, and poorer quality of life increased for those with two-disorder comorbidity than for those with only one of the same two disorders. Comorbidities of

  4. Risk Factors for Depression in Children and Adolescents with High Functioning Autism Spectrum Disorders

    Science.gov (United States)

    De-la-Iglesia, Myriam; Olivar, José-Sixto

    2015-01-01

    The objective of our study was to examine, discuss, and provide proposals on diagnostic comorbidity of depression in children and adolescents with high functioning autism spectrum disorder (HFASD) in the following aspects. (1) Prevalence. It was concluded that there are an elevated depression rate and the need for longitudinal studies to determine prevalence and incidence based on functioning level, autistic symptoms, gender, age, type of depression, prognosis, duration, and treatment. (2) Explicative Hypotheses and Vulnerability. The factors that present the greatest specific risk are higher cognitive functioning, self-awareness of deficit, capacity for introspection, stressful life events, adolescence, quality of social relationships, and alexithymia. (3) Risk of Suicide. The need for control and detection of suicidal tendencies and bullying is emphasised. (4) Depressive Symptoms. Indicators for early detection are proposed and their overlap with HFASD is analysed, examining the assessment techniques used and arguing that specific adapted tests are needed. PMID:26413564

  5. A Cerebellar Framework for Predictive Coding and Homeostatic Regulation in Depressive Disorder.

    Science.gov (United States)

    Schutter, Dennis J L G

    2016-02-01

    Depressive disorder is associated with abnormalities in the processing of reward and punishment signals and disturbances in homeostatic regulation. These abnormalities are proposed to impair error minimization routines for reducing uncertainty. Several lines of research point towards a role of the cerebellum in reward- and punishment-related predictive coding and homeostatic regulatory function in depressive disorder. Available functional and anatomical evidence suggests that in addition to the cortico-limbic networks, the cerebellum is part of the dysfunctional brain circuit in depressive disorder as well. It is proposed that impaired cerebellar function contributes to abnormalities in predictive coding and homeostatic dysregulation in depressive disorder. Further research on the role of the cerebellum in depressive disorder may further extend our knowledge on the functional and neural mechanisms of depressive disorder and development of novel antidepressant treatments strategies targeting the cerebellum.

  6. 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.

  7. Childhood Gender Identity...Disorder? Developmental, Cultural, and Diagnostic Concerns

    Science.gov (United States)

    Dragowski, Eliza A.; Scharron-del Rio, Maria R.; Sandigorsky, Amy L.

    2011-01-01

    Childhood gender identity development is reviewed in the context of biological, environmental, cultural, and diagnostic factors. With the upcoming 5th revision of the "Diagnostic and Statistical Manual of Mental Disorders," the authors offer a critical consideration of childhood gender identity disorder, along with proposed diagnostic changes.…

  8. Child behavior checklist profiles in adolescents with bipolar and depressive disorders.

    Science.gov (United States)

    Kweon, Kukju; Lee, Hyun-Jeong; Park, Kee Jeong; Joo, Yeonho; Kim, Hyo-Won

    2016-10-01

    We aimed to evaluate the Child Behavior Checklist (CBCL) profiles in youths with bipolar and depressive disorders. Seventy-four subjects with a mean age of 14.9±1.6years (36 boys) with mood disorders and their parents were recruited from September 2011 to June 2013 in the Department of Psychiatry, Asan Medical Center, Seoul, Korea. Diagnosis of mood disorder and comorbid psychiatric disorder was confirmed by child psychiatrists using the Schedule for Affective Disorders and Schizophrenia for School Age Children - Present and Lifetime version (K-SADS-PL). The parents of the subjects completed the Parent General Behavior Inventory-10-item Mania Scale (P-GBI-10M), Parent-version of Mood Disorder Questionnaire (P-MDQ), ADHD rating scale (ARS) and CBCL. The adolescents completed the 76-item Adolescent General Behavior Inventory (A-GBI), Beck Depression Inventory (BDI), and Adolescent-version of Mood Disorder Questionnaire (A-MDQ). When adjusted for gender and the comorbidity with ADHD, the Withdrawn and Anxious/Depressed subscale scores of the CBCL were higher in subjects with bipolar disorder than in those with depressive disorder. Higher scores of A-GBI Depressive subscale, A-MDQ and BDI were shown in subjects with bipolar disorder than in those with depressive disorder. There was no significant difference on CBCL-DP, P-GBI-10M, P-MDQ, A-GBI Hypomanic/Biphasic subscale and ARS between two groups. All eight subscales of the CBCL positively correlated with the P-GBI-10M and P-MDQ scores, and seven of all eight subscales of the CBCL positively correlated with A-GBI Depressive and Hypomanic/Biphasic subscales. The BDI score was positively associated with the Withdrawn, Somatic Complaints, Anxious/Depressed, and Social Problems subscale scores. CBCL-DP score was strongly correlated with manic/hypomanic symptoms measured by P-GBI-10M and P-MDQ (r=0.771 and 0.826). This study suggests that the CBCL could be used for measuring mood symptoms and combined psychopathology

  9. Psychosocial Interventions in Depressive Disorders

    Directory of Open Access Journals (Sweden)

    Ceyda Basogul

    2015-03-01

    Full Text Available In the last ten years, improvements in effective psychosocial interventions in the prevention and treatment of depression are remarkable. The World Health Organization stated that major depression affects children, adults and the elderly and is the leading cause of approximately 12% of all disabilities around the World. Medical expenses, loss of workforce, suicide risk, the risk of relapse or recurrence are taken into account, depression is an issue that needs to be handled with utmost care for health care workers especially psychiatric nurses. The purpose of this literature review is to examine psychosocial interventions and effectiveness of these interventions for depressive disorders shows a gradual increase in prevalence in worlwide. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2015; 7(1: 1-15

  10. Diagnostic imaging in fertility disorders

    International Nuclear Information System (INIS)

    Winfield, A.C.; Fleischer, A.C.

    1987-01-01

    Some 10%-15% of married couples are affected by a fertility disorder. The number of infertile couples seeking medical assistance has increased dramatically in the past decade. The roles of diagnostic imaging with radiography and US (conventional and transvaginal) is emphasized in the assessment of couples with fertility disorders and an unexpectedly higher incidence of fetal wastage secondary to unsuspected uterine anomalies. The most frequently utilized radiographic examination in infertile patients is hysterosalpingography (HSG). Techniques and complications of HSG are illustrated. The normal anatomy, variants, and congenital anomalies of the uterus and fallopian tubes are demonstrated, as are the numerous abnormalities such as filling defects of the uterine cavity, synechiae, effects of maternal diethylstilbestrol exposure, inflammatory tubal disease, and the more common HSG findings following uterine and tubal surgery. The role of diagnostic imaging in male infertility, including vasography and varicocele detection, are addressed. Conventional and transvaginal US in the management of gynecologic fertility disorders are examined, with an emphasis on follicular monitoring, guided follicular aspirations, endometrial evaluations, and evaluation of other disorders (such as endometriosis) associated with infertility

  11. Depression/anxiety disorder and amygdala

    International Nuclear Information System (INIS)

    Iidaka, Tetsuya

    2007-01-01

    Described and discussed are neuro-imaging studies on the amygdala (Am) concerning its volume, neuro-active drug effect on it and its response to repulsive and attractive stress-evoked character/temperament tests in patients mainly with major depression (MD) and anxiety disorder (AD), by functional MRI (fMRI) and positron emission tomography (PET). A recent trend of volumetry of Am is the voxel-based morphometry by MRI, of which results are still controversial in MD. In contrast, many studies by PET and fMRI using neuro-active drugs have revealed that Am activity in MD is stimulated, and this hyperactivity can be improved by anti-depressive drugs. In addition, difference of activities is suggested in Am left and right hemispheres. The hyperactivity in Am has been reported also in AD and phobic disorders, of which symptoms are conceivably expressed by the sensitivity changes in the cerebral limbic system involving Am. The author considers the central region responsible for the depressive mood is present around cortex of anteroinferior genu of corpus callosum where neuro-network with Am is dense. (R.T.)

  12. Depressed Adolescents and Comorbid Psychiatric Disorders: Are There Differences in the Presentation of Depression?

    Science.gov (United States)

    Small, David Marc; Simons, Anne D.; Yovanoff, Paul; Silva, Susan G.; Lewis, Cara C.; Murakami, Jessica L.; March, John

    2008-01-01

    Patterns and correlates of comorbidity, as well as differences in manifest depressive profiles were investigated in a sample of depressed adolescents. A sub-sample of the youth were characterized as belonging to either a "Pure" depression group, an "Internalizing" group (depression and co-occurring internalizing disorders), or an "Externalizing"…

  13. Impact of dissociation on treatment of depressive and anxiety spectrum disorders with and without personality disorders

    Directory of Open Access Journals (Sweden)

    Prasko J

    2016-10-01

    Full Text Available Jan Prasko,1 Ales Grambal,1 Petra Kasalova,1 Dana Kamardova,1 Marie Ociskova,1 Michaela Holubova,1,2 Kristyna Vrbova,1 Zuzana Sigmundova,1 Klara Latalova,1 Milos Slepecky,3 Marta Zatkova3 1Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University in Olomouc, University Hospital Olomouc, Olomouc, 2Psychiatric Department, Hospital Liberec, Liberec, Czech Republic; 3Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, Slovak Republic Objective: The central goal of the study was to analyze the impact of dissociation on the treatment effectiveness in patients with anxiety/neurotic spectrum and depressive disorders with or without comorbid personality disorders.Methods: The research sample consisted of inpatients who were hospitalized in the psychiatric department and met the ICD-10 criteria for diagnosis of depressive disorder, panic disorder, generalized anxiety disorder, mixed anxiety–depressive disorder, agoraphobia, social phobia, obsessive compulsive disorder, posttraumatic stress disorder, adjustment disorders, dissociative/conversion disorders, somatoform disorder, or other anxiety/neurotic spectrum disorder. The participants completed these measures at the start and end of the therapeutic program – Beck Depression Inventory, Beck Anxiety Inventory, a subjective version of Clinical Global Impression-Severity, Sheehan Patient-Related Anxiety Scale, and Dissociative Experience Scale.Results: A total of 840 patients with anxiety or depressive spectrum disorders, who were resistant to pharmacological treatment on an outpatient basis and were referred for hospitalization for the 6-week complex therapeutic program, were enrolled in this study. Of them, 606 were statistically analyzed. Data from the remaining 234 (27.86% patients were not used because of various reasons (103 prematurely finished the program, 131 did not fill in most of the

  14. Rumination mediates the relationship between overgeneral autobiographical memory and depression in patients with major depressive disorder.

    Science.gov (United States)

    Liu, Yansong; Yu, Xinnian; Yang, Bixiu; Zhang, Fuquan; Zou, Wenhua; Na, Aiguo; Zhao, Xudong; Yin, Guangzhong

    2017-03-21

    Overgeneral autobiographical memory has been identified as a risk factor for the onset and maintenance of depression. However, little is known about the underlying mechanisms that might explain overgeneral autobiographical memory phenomenon in depression. The purpose of this study was to test the mediation effects of rumination on the relationship between overgeneral autobiographical memory and depressive symptoms. Specifically, the mediation effects of brooding and reflection subtypes of rumination were examined in patients with major depressive disorder. Eighty-seven patients with major depressive disorder completed the 17-item Hamilton Depression Rating Scale, Ruminative Response Scale, and Autobiographical Memory Test. Bootstrap mediation analysis for simple and multiple mediation models through the PROCESS macro was applied. Simple mediation analysis showed that rumination significantly mediated the relationship between overgeneral autobiographical memory and depression symptoms. Multiple mediation analyses showed that brooding, but not reflection, significantly mediated the relationship between overgeneral autobiographical memory and depression symptoms. Our results indicate that global rumination partly mediates the relationship between overgeneral autobiographical memory and depressive symptoms in patients with major depressive disorder. Furthermore, the present results suggest that the mediating role of rumination in the relationship between overgeneral autobiographical memory and depression is mainly due to the maladaptive brooding subtype of rumination.

  15. Sex Differences and Depression in Puerto Rico.

    Science.gov (United States)

    Canino, Glorisa J.; And Others

    1987-01-01

    Examined sex differences in rates of depressive disorders and depressive symptomatology, as measured by the Diagnostic Interview Schedule, for an island-wide probability sample of Puerto Rico. Found depression significantly more prevalent among women than men. Discusses risk factors from a sex-role and cultural perspective. (Author/KS)

  16. Mental state decoding impairment in major depression and borderline personality disorder: meta-analysis.

    Science.gov (United States)

    Richman, Mara J; Unoka, Zsolt

    2015-12-01

    Patients with major depression and borderline personality disorder are characterised by a distorted perception of other people's intentions. Deficits in mental state decoding are thought to be the underlying cause of this clinical feature. To examine, using meta-analysis, whether mental state decoding abilities in patients with major depression and borderline personality disorder differ from those of healthy controls. A systematic review of 13 cross-sectional studies comparing Reading in the Mind of the Eyes Test (RMET) accuracy performance of patients with major depression or borderline personality disorder and healthy age-matched controls (n = 976). Valence scores, where reported, were also assessed. Large significant deficits were seen for global RMET performance in patients with major depression (d = -0.751). The positive RMET valence scores of patients with depression were significantly worse; patients with borderline personality disorder had worse neutral scores. Both groups were worse than controls. Moderator analysis revealed that individuals with comorbid borderline personality disorder and major depression did better than those with borderline personality disorder alone on accuracy. Those with comorbid borderline personality disorder and any cluster B or C personality disorder did worse than borderline personality disorder alone. Individuals with both borderline personality disorder and major depression performed better then those with borderline personality disorder without major depression for positive valence. These findings highlight the relevance of RMET performance in patients with borderline personality disorder and major depression, and the importance of considering comorbidity in future analysis. © The Royal College of Psychiatrists 2015.

  17. Marketing Masked Depression: Physicians, Pharmaceutical Firms, and the Redefinition of Mood Disorders in the 1960s and 1970s.

    Science.gov (United States)

    Gerber, Lucie; Gaudillière, Jean-Paul

    2016-01-01

    This article investigates the redefinition of depression that took place in the early 1970s. Well before the introduction of the third edition of the Diagnostic and Statistical Manual of Mental Disorders, this rather rare and severe psychiatric disorder hitherto treated in asylums was transformed into a widespread mild mood disorder to be handled by general practitioners. Basing itself on the archives of the Swiss firm Ciba-Geigy, the article investigates the role of the pharmaceutical industry in organizing this shift, with particular attention paid to research and scientific marketing. By analyzing the interplay between the firm, elite psychiatrists specializing in the study of depression, and general practitioners, the article argues that the collective construction of the market for first-generation antidepressants triggered two realignments: first, it bracketed etiological issues with multiple classifications in favor of a unified symptom-oriented approach to diagnosis and treatment; second, it radically weakened the differentiation between antidepressants, neuroleptics, and tranquilizers. The specific construction of masked depression shows how, in the German-speaking context, issues of ambulatory care such as recognition, classification, and treatment of atypical or mild forms of depression were reshaped to meet commercial as well as professional needs.

  18. The GSK3B gene confers risk for both major depressive disorder and schizophrenia in the Han Chinese population.

    Science.gov (United States)

    Chen, Jianhua; Wang, Meng; Waheed Khan, Raja Amjad; He, Kuanjun; Wang, Qingzhong; Li, Zhiqiang; Shen, Jiawei; Song, Zhijian; Li, Wenjin; Wen, Zujia; Jiang, Yiwen; Xu, Yifeng; Shi, Yongyong; Ji, Weidong

    2015-10-01

    Glycogen synthease kinase-3B is a key gene encoding a protein kinase which is abundant in brain, and is involved in signal transduction cascades of neuronal cell development and energy metabolism. Previous researches proposed GSK3B as a potential region for schizophrenia. To validate the susceptibility of GSK3B to major depressive disorder, and to investigate the overlapping risk conferred by GSK3B for mental disorders, we performed a large-scale case-control study, analyzed 6 tag single nucleotide polymorphisms using TaqMan® technology in 1,045 major depressive disorder patients, 1,235 schizophrenia patients and 1,235 normal controls of Han Chinese origin. We found rs334535 (Pallele=2.79E-03, Pgenotype=5.00E-03, OR=1.429) and rs2199503 (Pallele=0.020, Pgenotype= 0.040, OR=1.157) showed association with major depressive disorder before Bonferroni correction. rs6771023 (adjusted Pallele=1.64E-03, adjusted Pgenotype=6.00E-03, OR=0.701) and rs2199503 (adjusted Pallele=0.001, adjusted Pgenotype=0.002, OR=1.251) showed significant association with schizophrenia after Bonferroni correction. rs2199503 (adjusted Pallele=1.70E-03, adjusted Pgenotype=0.006, OR=1.208) remained to be significant in the combined cases of major depressive disorder and schizophrenia after Bonferroni correction. Further validations of our findings in samples with larger scale are suggested, and functional genomic study is needed to elucidate the role of GSK3B in signal pathway and psychiatric disorders. Our results provide evidence that the GSK3B gene could be a promising region which contains genetic risk for both major depressive disorder and schizophrenia in the Han Chinese population. The study on variants conferring overlapping risk for multiple psychiatric disorders could be tangible pathogenesis support and clinical or diagnostic references. Copyright © 2015. Published by Elsevier B.V.

  19. Predicting the onset of major depressive disorder and dysthymia in older adults with subthreshold depression: a community based study

    NARCIS (Netherlands)

    Cuijpers, P.; Beekman, A.T.F.; Smit, H.F.E.; Deeg, D.J.H.

    2006-01-01

    Background: It is well-established that the incidence of major depressive disorder is increased in subjects with subthreshold depression. A new research area focuses on the possibilities of preventing the onset of major depressive disorders in subjects with subthreshold depression. An important

  20. 5 Hz Repetitive transcranial magnetic stimulation for posttraumatic stress disorder comorbid with major depressive disorder.

    Science.gov (United States)

    Carpenter, Linda L; Conelea, Christine; Tyrka, Audrey R; Welch, Emma S; Greenberg, Benjamin D; Price, Lawrence H; Niedzwiecki, Matthew; Yip, Agustin G; Barnes, Jennifer; Philip, Noah S

    2018-08-01

    Standard clinical protocols for repetitive transcranial magnetic stimulation (rTMS) for major depressive disorder (MDD) apply 10 Hz pulses over left prefrontal cortex, yet little is known about the effects of rTMS in more diagnostically complex depressed patients. Posttraumatic stress disorder (PTSD) is commonly comorbid with MDD, and while rTMS has been shown to alleviate PTSD symptoms in preliminary studies, ideal parameters remain unclear. We conducted a prospective, open-label study of 5 Hz rTMS for patients with comorbid PTSD + MDD and hypothesized stimulation would reduce symptoms of both disorders. Outpatients (N = 40) with PTSD + MDD and at least moderate global severity were enrolled. 5 Hz rTMS included up to 40 daily sessions followed by a 5-session taper. Symptoms were measured using the PTSD Checklist (PCL-5) and Inventory of Depressive Symptomatology, Self-Report (IDS-SR). Baseline-to-endpoint changes were analyzed. The intent-to-treat population included 35 participants. Stimulation significantly reduced PTSD symptoms (PCL-5 baseline mean ± SD score 52.2 ± 13.1 versus endpoint 34.0 ± 21.6; p < .001); 23 patients (48.6%) met a pre-defined categorical PTSD response criteria. MDD symptoms also improved significantly (IDS-SR, baseline 47.8 ± 11.9 to endpoint 30.9 ± 18.9; p < .001); 15 patients (42.9%) demonstrated categorical response and 12 (34.3%) remitted. PTSD and MDD symptom change was highly correlated (r = 0.91, p < .001). Unblinded single-arm study, with modest sample size. Significant and clinically meaningful reductions in both MDD and PTSD symptoms were observed following stimulation. The preliminary efficacy of 5 Hz rTMS for both symptom domains in patients with comorbid disorders supports future controlled studies. Copyright © 2018 Elsevier B.V. All rights reserved.

  1. Does temperamental instability support a continuity between bipolar II disorder and major depressive disorder?

    Science.gov (United States)

    Benazzi, F

    2006-06-01

    The current categorical split of mood disorders in bipolar disorders and depressive disorders has recently been questioned. Two highly unstable personality features, i.e. the cyclothymic temperament (CT) and borderline personality disorder (BPD), have been found to be more common in bipolar II (BP-II) disorder than in major depressive disorder (MDD). According to Kraepelin, temperamental instability was the "foundation" of his unitary view of mood disorders. The aim was to assess the distributions of the number of CT and borderline personality items between BP-II and MDD. Finding no bi-modal distribution (a "zone of rarity") of these items would support a continuity between the two disorders. an outpatient psychiatry private practice. Interviewer: A senior clinical and mood disorder research psychiatrist. A consecutive sample of 138 BP-II and 71 MDD remitted outpatients. Assessment instruments: The structured clinical interview for DSM-IV Axis I Disorders-Clinician Version (SCID-CV), the SCID-II Personality Questionnaire for self-assessing borderline personality traits (BPT) by patients, the TEMPS-A for self-assessing CT by patients. Interview methods: Patients were interviewed with the SCID-CV to diagnose BP-II and MDD, and then patients self-assessed the questions of the Personality Questionnaire relative to borderline personality, and the questions of the TEMPS-A relative to CT. As clinically significant distress or impairment of functioning is not assessed by the SCID-II Personality Questionnaire, a diagnosis of BPD could not be made, but BPT could be assessed (i.e. all BPD items but not the impairment criterion). The distribution of the number of CT and BPT items was studied by Kernel density estimate. CT and BPT items were significantly more common in BP-II versus MDD. The Kernel density estimate distributions of the number of CT and BPT items in the entire sample had a normal-like shape (i.e. no bi-modality). The expected finding, on the basis of previous

  2. 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.

  3. Computer therapy for the anxiety and depressive disorders is effective, acceptable and practical health care: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Gavin Andrews

    Full Text Available BACKGROUND: Depression and anxiety disorders are common and treatable with cognitive behavior therapy (CBT, but access to this therapy is limited. OBJECTIVE: Review evidence that computerized CBT for the anxiety and depressive disorders is acceptable to patients and effective in the short and longer term. METHOD: Systematic reviews and data bases were searched for randomized controlled trials of computerized cognitive behavior therapy versus a treatment or control condition in people who met diagnostic criteria for major depression, panic disorder, social phobia or generalized anxiety disorder. Number randomized, superiority of treatment versus control (Hedges g on primary outcome measure, risk of bias, length of follow up, patient adherence and satisfaction were extracted. PRINCIPAL FINDINGS: 22 studies of comparisons with a control group were identified. The mean effect size superiority was 0.88 (NNT 2.13, and the benefit was evident across all four disorders. Improvement from computerized CBT was maintained for a median of 26 weeks follow-up. Acceptability, as indicated by adherence and satisfaction, was good. Research probity was good and bias risk low. Effect sizes were non-significantly higher in comparisons with waitlist than with active treatment control conditions. Five studies comparing computerized CBT with traditional face-to-face CBT were identified, and both modes of treatment appeared equally beneficial. CONCLUSIONS: Computerized CBT for anxiety and depressive disorders, especially via the internet, has the capacity to provide effective acceptable and practical health care for those who might otherwise remain untreated. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12610000030077.

  4. Cognitive styles in depressed children with and without comorbid conduct disorder.

    Science.gov (United States)

    Schepman, Karen; Fombonne, Eric; Collishaw, Stephan; Taylor, Eric

    2014-07-01

    Little is known about patterns of cognitive impairment in depression comorbid with conduct disorder. The study included clinically depressed children with (N = 23) or without conduct disorder (N = 29), and controls without psychiatric disorder (N = 37). Cognitive biases typical of depression and patterns of social information processing were assessed. Both depressed groups had substantially higher rates of negative cognitive distortions, attributional biases and ruminative responses than non-depressed children. Children in the comorbid group made more hostile attributions and suggested more aggressive responses for dealing with threatening social situations, whilst children with depression only were more likely to be unassertive. Depression has a number of similar depressotypic cognitive biases whether or not complicated by conduct disorder, and may be potentially susceptible to similar interventions. The results also highlight the importance of recognising social information processing deficits when they occur and targeting those too, especially in comorbid presentations. Copyright © 2014. Published by Elsevier Ltd.

  5. Visuospatial planning in unmedicated major depressive disorder and bipolar disorder : distinct and common neural correlates

    NARCIS (Netherlands)

    Rive, M. M.; Koeter, M. W. J.; Veltman, D. J.; Schene, A. H.; Ruhe, H. G.

    Background Cognitive impairments are an important feature of both remitted and depressed major depressive disorder (MDD) and bipolar disorder (BD). In particular, deficits in executive functioning may hamper everyday functioning. Identifying the neural substrates of impaired executive functioning

  6. [Depressive disorder and issues related to DiabetIMSS beneficiaries].

    Science.gov (United States)

    Fu-Espinosa, Mario; Trujillo-Olivera, Laura Elena

    2013-01-01

    Diabetes mellitus type 2 (DM2) is the leading cause of death in people from 15 to 64 years in Mexico, and other regions in the world. For the chronic nature of diabetes and complications caused by inadequate metabolic control, patients may have mood disorders such as depression. Several studies have demonstrated higher prevalence of depression in diabetic patients than in general population. Our objective: is to determine prevalence and factors associated with depressive disorder in patients with type 2 diabetes mellitus enrolled in DiabetIMSS during 2010. Analytical study with random probability sampling. The analysis included prevalence, odds ratios with 95% confidence intervals. The Center Epidemiological Studies Depression Instrument was used. Prevalence of depression was 32.7% at 95% CI = 26.4-38.9%), 67.3% for women, 32.7 % for men; good metabolic control was 51.9%, CI = 95% (45.13-58.66%). We found a higher prevalence of depressive disorders than in the general population, no statistical association with glycemic control, keeping a greater proportion of women as well as the main aspect of depression associated with the perception of emotional support. We discuss DiabetIMSS program effectiveness.

  7. Genetic association between NRG1 and schizophrenia, major depressive disorder, bipolar disorder in Han Chinese population.

    Science.gov (United States)

    Wen, Zujia; Chen, Jianhua; Khan, Raja Amjad Waheed; Song, Zhijian; Wang, Meng; Li, Zhiqiang; Shen, Jiawei; Li, Wenjin; Shi, Yongyong

    2016-04-01

    Schizophrenia, major depressive disorder, and bipolar disorder are three major psychiatric disorders affecting around 0.66%, 3.3%, and 1.5% of the Han Chinese population respectively. Several genetic linkage analyses and genome wide association studies identified NRG1 as a susceptibility gene of schizophrenia, which was validated by its role in neurodevelopment, glutamate, and other neurotransmitter receptor expression regulation. To further investigate whether NRG1 is a shared risk gene for major depressive disorder, bipolar disorder as well as schizophrenia, we performed an association study among 1,248 schizophrenia cases, 1,056 major depression cases, 1,344 bipolar disorder cases, and 1,248 controls. Totally 15 tag SNPs were genotyped and analyzed, and no population stratification was found in our sample set. Among the sites, rs4236710 (corrected Pgenotye  = 0.015) and rs4512342 (Pallele  = 0.03, Pgenotye  = 0.045 after correction) were associated with schizophrenia, and rs2919375 (corrected Pgenotye  = 0.004) was associated with major depressive disorder. The haplotype rs4512342-rs6982890 showed association with schizophrenia (P = 0.03 for haplotype "TC" after correction), and haplotype rs4531002-rs11989919 proved to be a shared risk factor for both major depressive disorder ("CC": corrected P = 0.009) and bipolar disorder ("CT": corrected P = 0.003). Our results confirmed that NRG1 was a shared common susceptibility gene for major mental disorders in Han Chinese population. © 2016 Wiley Periodicals, Inc.

  8. Relapse prevention and residual symptoms: a closer analysis of placebo-controlled continuation studies with escitalopram in major depressive disorder, generalized anxiety disorder, social anxiety disorder, and obsessive-compulsive disorder.

    Science.gov (United States)

    Bech, Per; Lönn, Sara L; Overø, Kerstin F

    2010-02-01

    Analyses of data from 4 relapse-prevention studies with escitalopram were conducted in order to compare patients with and without residual symptoms with regard to relapse rates and global illness during double-blind, 24-week continuation periods. Clinical Global Impressions-Severity of Illness scores and relapse status in 4 studies published from 2005 to 2007, 1 each in major depressive disorder (MDD), generalized anxiety disorder, social anxiety disorder, and obsessive-compulsive disorder (OCD), were analyzed using mixed-effects model repeated measures as a function of Montgomery-Asberg Depression Rating Scale (MADRS) scores on items 1, 3, and 7 at randomization. All studies showed a statistically significant (P 0) and without residual symptoms (MADRS score = 0) at the start of continuation treatment were defined by how patients scored on 3 core items of the MADRS: depressed mood (observed), inner or psychic tension, and lassitude. At randomization, patients with a residual symptom were globally more ill than patients without such a symptom. Patients who did not continue active treatment worsened, even if they were initially free of a residual symptom. In contrast, patients who continued receiving escitalopram remained stable or further improved, regardless of residual symptoms or diagnosis. No clear picture emerged regarding whether patients with residual symptoms had a higher relapse rate. The presence of residual symptoms is associated with significantly worse overall illness severity in all 4 diagnostic groups and with a higher (although not significantly) risk of relapse for patients with MDD or OCD. The greatest difference in all of the studies was between patients treated with escitalopram (relapse rates ~ 20%) and placebo (relapse rates of about 50%). Copyright 2010 Physicians Postgraduate Press, Inc.

  9. Diagnostic depressive symptoms of the mixed bipolar episode.

    Science.gov (United States)

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

    2000-03-01

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

  10. A longitudinal examination of stress generation in depressive and anxiety disorders.

    Science.gov (United States)

    Uliaszek, Amanda A; Zinbarg, Richard E; Mineka, Susan; Craske, Michelle G; Griffith, James W; Sutton, Jonathan M; Epstein, Alyssa; Hammen, Constance

    2012-02-01

    The current study compared two competing theories of the stress generation model of depression (stress causation vs. stress continuation) using interview-based measures of episodic life stress, as well as interpersonal and noninterpersonal chronic life stress. We also expanded on past research by examining anxiety disorders as well as depressive disorders. In addition, we examined the role of neuroticism and extraversion in these relationships. Participants were 627 adolescents enrolled in a two-site, longitudinal study of risk factors for depressive and anxiety disorders. Baseline and follow-up assessments were approximately one year apart. Results supported the stress causation theory for episodic stress generation for anxiety disorders, with neuroticism partially accounting for this relationship. The stress causation theory was also supported for depression, but only for more moderate to severe stressors; neuroticism partially accounted for this relationship as well. Finally, we found evidence for interpersonal and noninterpersonal chronic life stress continuation in both depressive and anxiety disorders. The present findings have implications regarding the specificity of the stress generation model to depressive disorders, as well as variables involved in the stress generation process. PsycINFO Database Record (c) 2012 APA, all rights reserved.

  11. Examining the Application of the DC-IA-A Diagnostic Criteria for Internet Addiction Disorder in At-Risk College Students.

    Science.gov (United States)

    Hsu, Wen-Yu; Chang, Shan-Mei; Chiu, Nan-Ying; Lin, Sunny S J; Tseng, Yin-Hsing

    2015-01-01

    Internet addiction disorder is a relatively new condition, and the criteria for its diagnosis have been developed only over the last several years. The criteria for Internet addiction remain controversial. We strive to further elucidate the clinical validity of the diagnostic criteria for Internet addiction. To test items of the diagnostic criteria for Internet addiction among adolescents, we conducted a clinical interview study of college students based on longitudinal data on their risky use of the Internet. Forty-one high-risk cases were selected from a 3-year 5-time point longitudinal survey of 716 college freshmen. We examined disputes relevant to symptoms and impairment in the DC-IA-A (Diagnostic Criteria for Internet Addiction among Taiwanese Adolescents). Of the 41 cases, 21 were diagnosed with Internet addiction via a psychiatric interview. In the Internet addiction disorder group, 23.8% of cases had a diagnosis of depression, whereas only 15.0% of the cases in the non-Internet addiction group had a diagnosis of depression. Two major criteria (A8 and A3) had low incidences in these high-risk college students and thus did not help provide a differential diagnosis between the groups. We suggest that A8, 'excessive effort spent on activities necessary to obtain access to the Internet', should be omitted, and that A3, 'tolerance: a marked increase in the duration of Internet use needed to achieve satisfaction', should be modified. A1 and A9 should be discussed regarding their role in the diagnosis of Internet addiction disorder. Additional well-designed studies examining the diagnostic criteria and the relationship between factors are needed. © 2015 S. Karger AG, Basel.

  12. The Relationship between Major Depressive Disorder and Personality Traits.

    Directory of Open Access Journals (Sweden)

    Sara Bensaeed

    2014-03-01

    Full Text Available The aim of this study was to compare the clinical temperaments and characters of Iranian patients with Major Depressive Disorder (MDD with healthy controls.The study participants included 47 outpatients with Major Depressive Disorder (MDD and 120 normal controls with no psychiatric disorders. Sampling method was convenience. The MDD patients were diagnosed as MDD by a psychiatrist using the Persian structured clinical interview for axis I disorders (SCID-I, and they completed at least 8 weeks of antidepressant treatment. All the patients filled out the Persian version of the Temperament and Character Inventory (TCI. Data were analyzed using SPSS version 17, Chi square, T test and Multiple Regression. The level of significance was set at 5%.The present study demonstrates a link between depression and lower persistence (p≤0.001, self-directedness (p≤0.001 and cooperativeness (p≤0.001 scores. A negative correlation between age and Harm Avoidance (p≤0.001 was observed in both groups.Lower scores of persistence (P, self-directedness (SD and cooperativeness (CO were observed in patients with depression more than controls even in the remission phase which could indicate a relationship between these traits and depression.

  13. The two-year incidence of depression and anxiety disorders in spousal caregivers of persons with dementia: who is at the greatest risk?

    Science.gov (United States)

    Joling, Karlijn J; van Marwijk, Harm W J; Veldhuijzen, Aaltje E; van der Horst, Henriëtte E; Scheltens, Philip; Smit, Filip; van Hout, Hein P J

    2015-03-01

    Caregivers of persons with dementia play an important and economically valuable role within society, but many may do so at a considerable cost to themselves. Knowing which caregivers have the highest risk of developing a mental disorder may contribute to better support of ultra-high-risk groups with preventive interventions. This study aims to describe the incidence of depression and anxiety disorders in caregivers and to identify its significant predictors. Prospective cohort study with a follow-up of 24 months. 181 spousal caregivers of persons with dementia without a clinical depression or anxiety disorder at baseline. Memory clinics, case management services, and primary care settings in the Netherlands. The onset of depression and anxiety was measured every 3 months with the MINI International Neuropsychiatric Interview, a structured diagnostic instrument for DSM-IV mental disorders. Potential predictors were assessed at baseline. 60% of the caregivers developed a depressive and/or anxiety disorder within 24 months: 37% a depression, 55% an anxiety disorder, and 32% both disorders. Sub-threshold depressive symptoms (Wald χ2=6.20, df=1, OR: 3.2, 95% CI: 1.28-8.03, p=0.013) and poor self-reported health of the caregiver (Wald χ2=5.56, df=1, OR: 1.17, 95% CI: 1.03-1.34, p=0.018) at baseline were significant predictors of disorder onset. Spousal caregivers of persons with dementia have a high risk to develop a mental disorder. Indicators related to the caregiver's (mental) health rather than environmental stressors such as patient characteristics or interruption of caregivers' daily activities predict disorder onset and can be used to identify caregivers for whom supporting preventive interventions are indicated. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  14. Prevalence and Risk Factors for Depressive Disorders in Adults with Intellectual Disability.

    Science.gov (United States)

    Meins, Wolfgang

    1993-01-01

    Evaluation of 798 adults with intellectual disability in German residential facilities and group homes revealed that subjects did not seem especially vulnerable to depressive disorders. Almost 5% were identified with depressive disorder. Those with depressive disorders experienced reduced social support. Age, epilepsy, and etiology did not show…

  15. Prevalence and predictors of post-stroke mood disorders: A meta-analysis and meta-regression of depression, anxiety and adjustment disorder.

    Science.gov (United States)

    Mitchell, Alex J; Sheth, Bhavisha; Gill, John; Yadegarfar, Motahare; Stubbs, Brendon; Yadegarfar, Mohammad; Meader, Nick

    2017-07-01

    To ascertain the prevalence and predictors of mood disorders, determined by structured clinical interviews (ICD or DSM criteria) in people after stroke. Major electronic databases were searched from inception to June 2016 for studies involving major depression (MDD), minor depression (MnD), dysthymia, adjustment disorder, any depressive disorder (any depressive disorder) and anxiety disorders. Studies were combined using both random and fixed effects meta-analysis and results were stratified as appropriate. Depression was examined on 147 occasions from 2days to 7years after stroke (mean 6.87months, N=33 in acute, N=43 in rehabilitation and N=69 in the community/outpatients). Across 128 analyses involving 15,573 patients assessed for major depressive disorder (MDD), the point prevalence of depression was 17.7% (95% CI=15.6% to 20.0%) 0.65 analyses involving 9720 patients determined MnD was present in 13.1% in all settings (95% CI=10.9% to 15.8%). Dysthymia was present in 3.1% (95% CI=2.1% to 5.3%), adjustment disorder in 6.9% (95% CI=4.6 to 9.7%) and anxiety in 9.8% (95% CI=5.9% to 14.8%). Any depressive disorder was present in 33.5% (95% CI=30.3% to 36.8%). The relative risk of any depressive disorder was higher following left (dominant) hemisphere stroke, aphasia, and among people with a family history and past history of mood disorders. Depression, adjustment disorder and anxiety are common after stroke. Risk factors are aphasia, dominant hemispheric lesions and past personal/family history of depression but not time since stroke. Copyright © 2017. Published by Elsevier Inc.

  16. Gilles de la Tourette Syndrome, Depression, Depressive Illness, and Correlates in a Child and Adolescent Population.

    Science.gov (United States)

    Rizzo, Renata; Gulisano, Mariangela; Martino, Davide; Robertson, Mary May

    2017-04-01

    Gilles de la Tourette syndrome (GTS) and depression are both common disorders. It has been suggested that depression occurs in 13%-76% GTS patients. Despite this, there are few studies into the specific relationships and correlates between the two disorders. There is only some consensus as to the precise relationship between the two disorders. We undertook the study to investigate the relationship between depressive symptomatology and the core clinical features of GTS in a well-characterized clinical population of youth with this disorder. Our aim was to verify the association between depression and comorbid obsessive-compulsive disorder and explore further other potential associations highlighted in some, but not all, of the studies focused on this topic. Our results demonstrated that (1) the GTS patients were significantly older than the controls, (2) the GTS patients were significantly more depressed than controls, (3) depression was associated with tic severity, (4) the Diagnostic Confidence Index scores were higher in GTS patients without depression, (5) anxiety, attention-deficit/hyperactivity disorder (ADHD), conduct disorder (CD), and behavioral problems were significantly associated with depression, and (6) finally, patients with GTS and depression have a positive family history of depression. However, obsessionality (CY-BOCS) did not differentiate between depressed and not depressed GTS patients. Depression is common in patients with GTS and occurs significantly more in GTS than in controls. Depression is significantly associated with GTS factors such as tic severity, comorbidity with ADHD, and the presence of coexistent anxiety, CDs, and behavior problems. Depression is importantly significantly associated with a positive family history of depression. Intriguingly, depression in our sample was not related to obsessionality.

  17. examining the relationship between anxiety disorders and depression

    African Journals Online (AJOL)

    Enrique

    It is meaningful to distinguish anxiety and depression both as symptoms and as syndromes ... disorder). Anxiety, as a symptom, is a feeling of apprehension caused by anticipation of danger ... disorder. In medical disorders or substance-.

  18. A Comparison of Sexual Dysfunctions in Female Patients with Major Depressive Disorder and Panic Disorder

    OpenAIRE

    Tonguç Demir Berkol; Süheyla Doðan Bulut; Esra Alataþ; Dicle Görkem; Esra Çavdar; Ýlker Özyýldýrým

    2014-01-01

    Objective: The aim of this study is assessment of sexual dysfunction in female patients with major depressive disorder and panic disorder and compare the two groups. Methods: Total 76 female patients with primary diagnosis of major depressive disorder ( 46 patients) and panic disorder ( 30 patients) according to DSM-IV, who is sexually active and not use psychotropic medication were inclued. Sociodemographic data aqcusition form and the Arizona Sexual Experiences Scale (ASEX) were adminis...

  19. Risk of developing depressive disorders following rheumatoid arthritis: a nationwide population-based study.

    Directory of Open Access Journals (Sweden)

    Shu-Li Wang

    Full Text Available BACKGROUND & AIMS: To evaluate the risk of depressive disorders among rheumatoid arthritis (RA by using the Taiwan National Health Insurance Research Database (NHIRD. METHODS: We conducted a retrospective study of a matched cohort of 18 285 participants (3 657 RA patients and 14 628 control patients who were selected from the NHIRD. Patients were observed for a maximum of 10 years to determine the rates of newly diagnosed depressive disorders, and Cox regression was used to identify the risk factors associated with depressive disorders in RA patients. RESULTS: During the 10-year follow-up period, 205 (11.2 per 1000 person-years RA patients and 384 (5.1 per 1000 person-years control patients were diagnosed with depressive disorders. In RA patients, most depressive disorders (n = 163, 80% developed with five years of being diagnosed with RA. The incidence risk ratio of depressive disorders between RA patients and control patients was 2.20 (95% confidence interval [CI], 1.84-2.61, P<.001. After adjusting for age, sex, and comorbidities, RA patients were 2.06 times more likely to develop depressive disorders (95% CI, 1.73-2.44, P<.001 compared with the control patients. Hyperthyroidism (HR = 1.67 was an independent risk factor for depressive disorders in patients with RA. CONCLUSIONS: The likelihood of developing depressive disorders is greater among RA patients than among patients without RA. Symptoms of depression should be sought in patients with RA.

  20. Regional Brain Volume in Depression and Anxiety Disorders

    NARCIS (Netherlands)

    van Tol, Marie-Jose; van der Wee, Nic J. A.; van den Heuvel, Odile A.; Nielen, Marjan M. A.; Demenescu, Liliana R.; Aleman, Andre; Renken, Remco; van Buchem, Mark A.; Zitman, Frans G.; Veltman, Dick J.

    2010-01-01

    Context: Major depressive disorder (MDD), panic disorder, and social anxiety disorder are among the most prevalent and frequently co-occurring psychiatric disorders in adults and may have, at least in part, a common etiology. Objective: To identify the unique and shared neuro-anatomical profile of

  1. Regional brain volume in depression and anxiety disorders

    NARCIS (Netherlands)

    van Tol, Marie-José; van der Wee, Nic J. A.; van den Heuvel, Odile A.; Nielen, Marjan M. A.; Demenescu, Liliana R.; Aleman, André; Renken, Remco; van Buchem, Mark A.; Zitman, Frans G.; Veltman, Dick J.

    2010-01-01

    CONTEXT: Major depressive disorder (MDD), panic disorder, and social anxiety disorder are among the most prevalent and frequently co-occurring psychiatric disorders in adults and may have, at least in part, a common etiology. OBJECTIVE: To identify the unique and shared neuroanatomical profile of

  2. Symptom Similarities and Differences in Anxiety and Depressive Disorders

    Directory of Open Access Journals (Sweden)

    Dilek Sirvanli Ozen

    2010-04-01

    Full Text Available The question if there is a valid distinction between depression and anxiety disorders remains controversial. These two disorders have various overlaps in the symptomatology and sometimes it is difficult to make a clear diagnosis. The difficulty in making a definite diagnosis destined researchers to determine the differences and the similarities between anxiety and depression. The negative affect which has multiple dimensions such as low self-esteem, negative mood and negative cognitions is seen as the common factor in both disorders. The positive affect which has been defined as the harmony and satisfaction with others and milieu, is regarded as the discriminating factor for the diagnosis of depression. Further research has characterized somatic arousal as the third dimension, a candidate to be the discriminating factor for anxiety disorders. Although phenotypic models appear to find a solution for this problem the facts that negative affect dimension is more loaded compared to the other two dimensions and predominance of negative affect on several symptom patterns prevent researchers to reach a conclusive results regarding the differences between these two disorders. In this review article, symptom similarities and differences of anxiety and depressive disorders are discussed within the frame of phenotypic models and some alternative ideas are provided for possible changes in upcoming versions of classification systems.

  3. Depression, anxiety, and somatoform disorders: vague or distinct categories in primary care? Results from a large cross-sectional study.

    Science.gov (United States)

    Hanel, Gertraud; Henningsen, Peter; Herzog, Wolfgang; Sauer, Nina; Schaefert, Rainer; Szecsenyi, Joachim; Löwe, Bernd

    2009-09-01

    Depression, anxiety, and somatization are the most frequently observed mental disorders in primary health care. Our main objective was to draw on the often neglected general practitioners' (GPs) perspective to investigate what characterizes these three common mental diagnoses with regard to creating more suitable categories in the DSM-V and ICD-11. We collected independent data from 1751 primary care patients (participation rate=77%) and their 32 treating GPs in Germany. Patients filled out validated patient self-report measures for depression (PHQ-9), somatic symptom severity (PHQ-15), and illness anxiety (Whiteley-7), and questions regarding coping and attribution of illness. GPs' clinical diagnoses and associated features were assessed. Patients diagnosed by their GPs with depression, anxiety, and/or somatoform disorders were significantly older, less educated, and more often female than the reference group not diagnosed with a mental disorder. They had visited the GP more often, had a longer duration of symptoms, and were more often under social or financial stress. Among the mental disorders diagnosed by the GPs, depression (OR=4.4; 95% CI=2.6 to 7.5) and comorbidity of somatoform, depressive, and anxiety disorders (OR=9.5; 95% CI=4.6 to 19.4) were associated with the largest degrees of impairment compared to the reference group. Patients diagnosed as having a somatoform/functional disorder only had mildly elevated impairment on all dimensions (OR=2.0; 95% CI=1.4 to 2.7). Similar results were found for the physicians' attribution of psychosocial factors for cause and maintenance of the disease, difficult patient-doctor relationship, and self-assessed mental disorder. In order to make the DSM-V and ICD-11 more suitable for primary care, we propose providing appropriate diagnostic categories for (1) the many mild forms of mental syndromes typically seen in primary care; and (2) the severe forms of comorbidity between somatoform, depressive, and/or anxiety

  4. Elevated serum levels of malondialdehyde and cortisol are associated with major depressive disorder: A case-control study

    Science.gov (United States)

    Islam, Md Reazul; Ahmed, Imtiaz; Moktadir, Abdullah Al; Nahar, Zabun; Islam, Mohammad Safiqul; Shahid, Shelina Fatema Binte; Islam, Sheikh Nazrul; Islam, Md Saiful; Hasnat, Abul

    2018-01-01

    Objectives: Major depressive disorder is diagnosed on the basis of patient’s self-reported experiences, behavior reported by relatives, and a mental status examination, and yet we do not have any reliable biomarker for this. Mood-regulating pathways are affected by oxidative injury to lipids and cortisol is released into the blood due to stimulation of corticotrophin receptors in the adrenal cortex. Here, we aimed to determine serum levels of malondialdehyde and cortisol in major depressive disorder patients and controls. Methods: We collected blood samples from 247 major depressive disorder patients and 248 controls. Serum levels of malondialdehyde and cortisol were measured by ultraviolet spectrophotometry and enzyme-linked immunosorbent assay kit, respectively. Results: We found malondialdehyde levels were significantly higher in patients than controls, with mean ± standard deviation at 4.49 ± 1.37 and 2.87 ± 0.82 µmol/L, respectively, p < 0.001. Cortisol levels were also found significantly higher in patients than controls, with mean ± SD at 19.22 ± 1.64 and 17.37 ± 1.34 µg/dL, respectively, p < 0.001. Significant negative correlation was observed between serum levels of malondialdehyde and cortisol in patients (r =−0.170, p = 0.021). Receiver operating characteristic analysis showed good diagnostic value for malondialdehyde and cortisol, with the area under the curve at 0.853 and 0.819, respectively. Conclusion: The present study suggests that increased serum levels of malondialdehyde and cortisol are strongly associated with major depressive disorder. We believe elevations of malondialdehyde and cortisol in serum level arise independently and they could serve as biomarkers for major depressive disorder. PMID:29770218

  5. Depression and Anxiety Disorders among Hospitalized Women with Breast Cancer.

    Directory of Open Access Journals (Sweden)

    Neomi Vin-Raviv

    Full Text Available To document the prevalence of depression and anxiety disorders, and their associations with mortality among hospitalized breast cancer patients.We examined the associations between breast cancer diagnosis and the diagnoses of anxiety or depression among 4,164 hospitalized breast cancer cases matched with 4,164 non-breast cancer controls using 2006-2009 inpatient data obtained from the Nationwide Inpatient Sample database. Conditional logistic regression models were used to compute odds ratios (ORs and 95% confidence intervals (CI for the associations between breast cancer diagnosis and diagnoses of anxiety or depression. We also used binary logistic regression models to examine the association between diagnoses of depression or anxiety, and in-hospital mortality among breast cancer patients.We observed that breast cancer cases were less likely to have a diagnosis of depression (OR=0.63, 95% CI: 0.52-0.77, and less likely to have a diagnosis of anxiety (OR=0.68, 95% CI: 0.52-0.90 compared with controls. This association remained after controlling for race/ethnicity, residential income, insurance and residential region. Breast cancer patients with a depression diagnosis also had lower mortality (OR=0.69, 95% CI: 0.52-0.89 compared with those without a depression diagnosis, but there was no significant difference in mortality among those with and without anxiety diagnoses.Diagnoses of depression and anxiety in breast cancer patients were less prevalent than expected based on our analysis of hospitalized breast cancer patients and matched non-breast cancer controls identified in the NIS dataset using ICD-9 diagnostic codes. Results suggest that under-diagnosis of mental health problems may be common among hospitalized women with a primary diagnosis of breast cancer. Future work may fruitfully explore reasons for, and consequences of, inappropriate identification of the mental health needs of breast cancer patients.

  6. Clinicians' emotional responses and Psychodynamic Diagnostic Manual adult personality disorders: A clinically relevant empirical investigation.

    Science.gov (United States)

    Gazzillo, Francesco; Lingiardi, Vittorio; Del Corno, Franco; Genova, Federica; Bornstein, Robert F; Gordon, Robert M; McWilliams, Nancy

    2015-06-01

    The aim of this study is to explore the relationship between level of personality organization and type of personality disorder as assessed with the categories in the Psychodynamic Diagnostic Manual (PDM; PDM Task Force, 2006) and the emotional responses of treating clinicians. We asked 148 Italian clinicians to assess 1 of their adult patients in treatment for personality disorders with the Psychodiagnostic Chart (PDC; Gordon & Bornstein, 2012) and the Personality Diagnostic Prototype (PDP; Gazzillo, Lingiardi, & Del Corno, 2012) and to complete the Therapist Response Questionnaire (TRQ; Betan, Heim, Zittel-Conklin, & Westen, 2005). The patients' level of overall personality pathology was positively associated with helpless and overwhelmed responses in clinicians and negatively associated with positive emotional responses. A parental and disengaged response was associated with the depressive, anxious, and dependent personality disorders; an exclusively parental response with the phobic personality disorder; and a parental and criticized response with narcissistic disorder. Dissociative disorder evoked a helpless and parental response in the treating clinicians whereas somatizing disorder elicited a disengaged reaction. An overwhelmed and disengaged response was associated with sadistic and masochistic personality disorders, with the latter also associated with a parental and hostile/criticized reaction; an exclusively overwhelmed response with psychopathic patients; and a helpless response with paranoid patients. Finally, patients with histrionic personality disorder evoked an overwhelmed and sexualized response in their clinicians whereas there was no specific emotional reaction associated with the schizoid and the obsessive-compulsive disorders. Clinical implications of these findings were discussed. (c) 2015 APA, all rights reserved).

  7. Beta-Arrestin1 Levels in Mononuclear Leukocytes Support Depression Scores for Women with Premenstrual Dysphoric Disorder.

    Science.gov (United States)

    Alam, Farzana; Nayyar, Sanket; Richie, William; Archibong, Anthony; Nayyar, Tultul

    2015-12-22

    Depression is very common in reproductive women particularly with premenstrual dysphoric disorder (PMDD), which is a severe form of premenstrual syndrome (PMS). Beta-arrestins were previously implicated in the pathophysiology, diagnosis and treatment for mood disorders. This study examined whether a measurement for beta-arrestin1 levels in peripheral blood mononuclear leukocytes (PBMC), could aid to distinguish between PMDD and PMS. Study participants (n = 25) were non-pregnant women between 18-42 years of age with the symptoms of PMS/PMDD, but not taking any antidepressants/therapy and at the luteal phase of menstruation. The levels of beta-arrestin1 protein in the PBMCs were determined by ELISA using human beta-arrestin1 kit. The beta-arrestin1 levels were compared with the Hamilton Depression Rating Scale scores among these women. The magnitude of the different parameters for Axis 1 mental disorders were significantly higher and beta arrestin1 protein levels in PBMCs were significantly lower in women with PMDD as compared to PMS women. The reduction in beta arrestin1 protein levels was significantly correlated with the severity of depressive symptoms. Beta-arrestin1 measurements in women may potentially serve for biochemical diagnostic purposes for PMDD and might be useful as evidence-based support for questionnaires.

  8. Beta-Arrestin1 Levels in Mononuclear Leukocytes Support Depression Scores for Women with Premenstrual Dysphoric Disorder

    Directory of Open Access Journals (Sweden)

    Farzana Alam

    2015-12-01

    Full Text Available Depression is very common in reproductive women particularly with premenstrual dysphoric disorder (PMDD, which is a severe form of premenstrual syndrome (PMS. Beta-arrestins were previously implicated in the pathophysiology, diagnosis and treatment for mood disorders. This study examined whether a measurement for beta-arrestin1 levels in peripheral blood mononuclear leukocytes (PBMC, could aid to distinguish between PMDD and PMS. Study participants (n = 25 were non-pregnant women between 18–42 years of age with the symptoms of PMS/PMDD, but not taking any antidepressants/therapy and at the luteal phase of menstruation. The levels of beta-arrestin1 protein in the PBMCs were determined by ELISA using human beta-arrestin1 kit. The beta-arrestin1 levels were compared with the Hamilton Depression Rating Scale scores among these women. The magnitude of the different parameters for Axis 1 mental disorders were significantly higher and beta arrestin1 protein levels in PBMCs were significantly lower in women with PMDD as compared to PMS women. The reduction in beta arrestin1 protein levels was significantly correlated with the severity of depressive symptoms. Beta-arrestin1 measurements in women may potentially serve for biochemical diagnostic purposes for PMDD and might be useful as evidence-based support for questionnaires.

  9. Whiplash-associated disorders: who gets depressed? Who stays depressed?

    Science.gov (United States)

    Carroll, Linda J.; Cassidy, J. David; Côté, Pierre

    2010-01-01

    Depression is common in whiplash-associated disorders (WAD). Our objectives were to identify factors associated with depressive symptomatology occurring in the initial stages of WAD, and to identify factors predicting the course of depressive symptoms. A population-based cohort of adults sustaining traffic-related WAD was followed at 6 weeks, 3, 6, 9, and 12 months. Baseline measures (assessed a median of 11 days post-crash) included demographic and collision-related factors, prior health, and initial post-crash pain and symptoms. Depressive symptomatology was assessed at baseline and at each follow-up using the Centre for Epidemiological Studies Depression Scale (CES-D). We included only those who participated at all follow-ups (n = 3,452; 59% of eligible participants). Using logistic regression, we identified factors associated with initial (post-crash) depression. Using multinomial regression, we identified baseline factors predicting course of depression. Courses of depression were no depression; initial depression that resolves, recurs or persists, and later onset depression. Factors associated with initial depression included greater neck and low back pain severity, greater percentage of body in pain, numbness/tingling in arms/hand, dizziness, vision problems, post-crash anxiety, fracture, prior mental health problems, and poorer general health. Predictors of persistent depression included older age, greater initial neck and low back pain, post-crash dizziness, vision and hearing problems, numbness/tingling in arms/hands, anxiety, prior mental health problems, and poorer general health. Recognition of these underlying risk factors may assist health care providers to predict the course of psychological reactions and to provide effective interventions. PMID:20127261

  10. Effects of erythropoietin on depressive symptoms and neurocognitive deficits in depression and bipolar disorder

    Directory of Open Access Journals (Sweden)

    Paulson Olaf B

    2010-10-01

    Full Text Available Abstract Background Depression and bipolar disorder are associated with reduced neural plasticity and deficits in memory, attention and executive function. Drug treatments for these affective disorders have insufficient clinical effects in a large group and fail to reverse cognitive deficits. There is thus a need for more effective treatments which aid cognitive function. Erythropoietin (Epo is involved in neuroplasticity and is a candidate for future treatment of affective disorders. The investigators have demonstrated that a single dose of Epo improves cognitive function and reduces neurocognitive processing of negative emotional information in healthy and depressed individuals similar to effects seen with conventional antidepressants. The current study adds to the previous findings by investigating whether repeated Epo administration has antidepressant effects in patients with treatment resistant depression and reverses cognitive impairments in these patients and in patients with bipolar disorder in remission. Methods/design The trial has a double-blind, placebo-controlled, parallel-group design. 40 patients with treatment-resistant major depression and 40 patients with bipolar disorder in remission are recruited and randomised to receive weekly infusions of Epo (Eprex; 40,000 IU or saline (NaCl 0.9% for 8 weeks. Randomisation is stratified for age and gender. The primary outcome parameters for the two studies are: depression severity measured with the Hamilton Depression Rating Scale 17 items (HDRS-17 1 in study 1 and, in study 2, verbal memory measured with the Rey Auditory Verbal Learning Test (RAVLT 23. With inclusion of 40 patients in each study we obtain 86% power to detect clinically relevant differences between intervention and placebo groups on these primary outcomes. Trial registration The trial is approved by the Local Ethics Committee: H-C-2008-092, Danish Medicines Agency: 2612-4020, EudraCT: 2008-04857-14, Danish Data Agency

  11. The influence of thoughts of death and suicidal ideation on the course of depression in older depressed patients

    NARCIS (Netherlands)

    Bogers, I.; Zuidersma, M.; Boshuisen, M.L.; Comijs, H.C.; Oude Voshaar, R.C.

    2017-01-01

    OBJECTIVE: Thoughts of death are not regularly included in diagnostic instruments and rarely examined separately from thoughts of suicide. This exploratory study examined whether thoughts of death and thoughts of suicide affect the course of late-life depressive disorders. METHODS: In 378 depressed

  12. The influence of thoughts of death and suicidal ideation on the course of depression in older depressed patients

    NARCIS (Netherlands)

    Bogers, Ista C H M; Zuidersma, Marij; Boshuisen, Marjolein L; Oude Voshaar, Richard C

    OBJECTIVE: Thoughts of death are not regularly included in diagnostic instruments and rarely examined separately from thoughts of suicide. This exploratory study examined whether thoughts of death and thoughts of suicide affect the course of late-life depressive disorders. METHODS: In 378 depressed

  13. Symptoms of depression as possible markers of bipolar II disorder.

    Science.gov (United States)

    Benazzi, Franco

    2006-05-01

    Underdiagnosis and misdiagnosis of bipolar-II disorder (BP-II) as a major depressive disorder (MDD) are frequently reported. The study aim was to find which symptoms of depression could be possible cross-sectional markers of BP-II, in order to reduce underdiagnosing BP-II. Consecutive 379 BP-II and 271 MDD major depressive episode (MDE) outpatients were interviewed with the Structured Clinical Interview for DSM-IV, the Hypomania Interview Guide, and the Family History Screen, by a senior psychiatrist in a private practice. Inside-MDE hypomanic symptoms (elevated mood and increased self-esteem always absent by definition) were systematically assessed. Mixed depression was defined as an MDE plus 3 or more inside-MDE hypomanic symptoms, a definition validated by Akiskal and Benazzi. The MDE symptoms significantly more common in BP-II versus MDD were weight gain, increased eating, hypersomnia, psychomotor agitation, worthlessness, and diminished ability to concentrate. The inside-MDE hypomanic symptoms significantly more common in BP-II were distractibility, racing/crowded thoughts, irritability, psychomotor agitation, more talkativeness, increased risky and goal-directed activities. Multiple logistic regression showed that hypersomnia, racing/crowded thoughts, irritability, and psychomotor agitation were independent predictors of BP-II. Irritability had the most balanced combination of sensitivity and specificity predicting BP-II. Psychomotor agitation had the highest specificity but the lowest sensitivity. Racing/crowded thoughts had the highest sensitivity but the lowest specificity. These symptoms had a similar positive predictive value (PPV) for BP-II, which was around 70% (PPV is more clinically useful than sensitivity and specificity), which in turn was similar to the PPV of mixed depression and atypical depression (two diagnostic clinical markers of BP-II). All possible combinations of these symptoms had a PPV similar to that of the individual symptoms. The

  14. The diagnosis and management of depression in the era of the DSM-5

    African Journals Online (AJOL)

    Depressive disorders comprise a range of conditions that can be viewed along many dimensions. The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) introduced several changes to the chapter on depressive disorders largely informed by advances in neuroscience, clinical and public health ...

  15. [Depression and Anxiety Disorders and Associated Factors in the Adolescent Colombian Population, 2015 National Mental Health Survey].

    Science.gov (United States)

    Gómez-Restrepo, Carlos; Bohórquez, Adriana; Tamayo Martínez, Nathalie; Rondón, Martín; Bautista, Nubia; Rengifo, Herney; Medina Rico, Mauricio

    2016-12-01

    There was a prevalence of mental disorders of 17% in adolescents in the past year. These tended to be chronic and their appearance at this age is associated with a worse prognosis than those in adulthood. To determine the prevalence and mental factors associated with major depression and anxiety disorders. Data were obtained from the IV National Mental Health Survey representing 5 regions. A structured computerised survey was conducted using the Computer Assisted Personal Interview-Composite International Diagnostic Interview-Adolescent Version (CAPI-CIDI-A), focused on the most common depression and anxiety disorders. It included a sample of 1754 adolescents between 12 and 17 years old. The prevalence of any disorder at some point in life was 7.2% (95%CI, 5.8-8.9). The most common disorder corresponded to social phobia manifested sometime in life in 4.8% (95%CI, 3.7-6.2). Less frequent were panic disorder in girls (0.2%; 95% CI, 0.1-1.0) and other bipolar disorders in boys (0.2%; 95%CI, 0.1-0.7). Among the associated factors of suffering from any disorder were, being female (OR=2.1), having little family support (OR=2.0), having witnessed at least one traumatic event (OR=2.6), and having had a previous suicide attempt (OR=3.4). Participation in at least one group was a protective factor (OR=0.5). Mental disorders of anxiety and depression represent a major burden of disease for Colombia. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  16. Study Rate of Major Depression in Children and Adolescents with Tourette\\'s Disorder

    Directory of Open Access Journals (Sweden)

    Nasrin Amiri

    2005-01-01

    Full Text Available Objective: Tourette disorder composed of history of multiple motor tics and at least a vocal tic during a period of such disorder. Many reports have investigated in co– morbid major depressive disorder, and studies signify such importance of early diagnosis and treatment. So diagnosis of major depressive disorder when it is comorbid with Tourette disorder considered to be important in our society as well. Materials & Methods: 30 cases of Tourette disorder who refferred to a child psychiatry center were studied during a period of one year in a descriptive. Cross sectional study. At the same time” 30 cases matched by age and sex were chosen as our control group from Tehran public schools. There were 25 boys and 5 girls in each group “with age rang of 8 to 18 years. A semistructural questionnaire of kiddy Schedule for Affective Disorder and Schizophrenia was used to investigate the presence of major depressive disorder in both groups. Statistical tests including MC- Nemar exact test were used for statistical analysis. Results: 23/3% of Tourette group patients were diagnosed as major depressive while 3.3% of the control group was diagnosed as major depressive disorder” . Conclusion: As given the high association rate for Tourette disorder and major depressive disorder. It is suggested to investigate all cases of Tourette disorder for possible major depressive disorder.

  17. Risk of developing major depressive disorder and anxiety disorders among adolescents and adults with atopic dermatitis: a nationwide longitudinal study.

    Science.gov (United States)

    Cheng, Chih-Ming; Hsu, Ju-Wei; Huang, Kai-Lin; Bai, Ya-Mei; Su, Tung-Ping; Li, Cheng-Ta; Yang, Albert C; Chang, Wen-Han; Chen, Tzeng-Ji; Tsai, Shih-Jen; Chen, Mu-Hong

    2015-06-01

    Previous cross-sectional studies have suggested a comorbid association between atopic dermatitis (AD) and depressive disorder as well as anxiety disorders, but the temporal relationship was not determined. Using the Taiwan National Health Insurance Research Database, 8208 AD patients aged 12 and older without psychiatric history and age-/sex-matched (1:1) controls between 1998 and 2008 were enrolled in our study and followed to the end of 2011. Subjects who developed major depression, any depressive disorder, and anxiety disorders during the follow-up were identified. The Cox regression analysis after adjusting for demographic data and atopic comorbidities demonstrated that patients with AD had an elevated risk of developing major depression (hazard ratio [HR]: 6.56, 95% confidence interval [CI]: 3.64-11.84), any depressive disorder (HR: 5.44, 95% CI: 3.99-7.44), and anxiety disorders (HR: 3.57, 95% CI: 2.55-4.98). Stratified by age group, both adolescents and adults with AD were prone to developing major depression (HR: 4.26, 95% CI: 1.39-13.13; HR: 7.56, 95% CI: 3.75-15.23), any depressive disorder (HR: 4.38, 95% CI: 2.09-9.18; HR: 5.66, 95% CI: 4.01-7.99), and anxiety disorders (HR: 5.40, 95% CI: 2.02-14.39; HR: 3.36, 95% CI: 2.38-4.80). AD in both adolescence and adulthood increased the risk of developing major depression, any depressive disorder, and anxiety disorders in later life. Further studies would be required to clarify the possible underlying mechanism between AD and depression as well as anxiety disorders. Copyright © 2015 Elsevier B.V. All rights reserved.

  18. Delusional disorder-jealous type: how inclusive are the DSM-IV diagnostic criteria?

    Science.gov (United States)

    Easton, Judith A; Shackelford, Todd K; Schipper, Lucas D

    2008-03-01

    Delusional disorder-jealous type is a new diagnostic category in the Diagnostic and Statistical Manual for Disorders, Fourth Edition, Text Revision (DSM-IV-TR; American Psychiatric Association, 2000) in which delusions concerning a partner's infidelity must be present. Therefore, patients who experience a jealousy disorder, but do not experience delusions will not fit the diagnostic criteria. Using a database of 398 case histories of jealousy disorders reported in the literature from 1940-2002, we examined the percentage of these cases that met the diagnostic criteria for delusional disorder-jealous type. Only 4% of the cases met all diagnostic criteria. This is the first systematic comparison of the prevalence of these disorders. The results provide evidence that the diagnostic criteria are not inclusive, as most individuals suffering with a jealousy disorder were excluded from the diagnosis.

  19. Adaptation of Vanderbilt Attention Deficit Hyperactivity Disorder Diagnostic Parent Scale in Turkish

    Directory of Open Access Journals (Sweden)

    Tüba KÜÇÜK DOĞAROĞLU

    2013-12-01

    Full Text Available The purpose of this study is to adaptation of Vanderbilt Attention Deficit and Hyperactivity Disorder Diagnostic Parent Rating Scale (Vanderbilt ADHD PRS to Turkish. This study was done 343 mother whose children with DEHB and 7 – 9 years old. Gender of mothers’ children is 132 girls and 211 boys. Age of children is that 82 children are 7 years old, 141 children are 8 years old and 120 children are 9 years old. Datas are gathering by Vanderbilt ADHD PRS and data form. Validity and reliability of scale was examined exploratory factor analysis and Cronbach Alpha. Results reveal that adaptation of Vanderbilt ADHD PRS to Turkish included 45 items which had 4 factors (inattention / hyperactivity / oppositional and conduct disorder / depression – anxiety. Results indicated that adaptation of Vanderbilt ADHD PRS to Turkish is valid and reliable scale

  20. Panic disorder in patients with chronic heart failure.

    Science.gov (United States)

    Müller-Tasch, Thomas; Frankenstein, Lutz; Holzapfel, Nicole; Schellberg, Dieter; Löwe, Bernd; Nelles, Manfred; Zugck, Christian; Katus, Hugo; Rauch, Bernhard; Haass, Markus; Jünger, Jana; Remppis, Andrew; Herzog, Wolfgang

    2008-03-01

    Our objective was to assess the prevalence of panic disorder, its influence on quality of life (QoL), and the presence of further anxiety and depressive comorbid disorders in outpatients with chronic heart failure (CHF). In a cross-sectional study, anxiety and depressive disorders were diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnostic criteria in patients with CHF who were aged > or =18 years and had New York Heart Association (NYHA) Functional Classes I-IV, using the Patient Health Questionnaire. Health-related QoL was evaluated using the Short-Form 36 Health Survey (SF-36). Of the 258 participating patients, 24 (9.3%) fulfilled diagnostic criteria for panic disorder. Seven of these (29.2%) were diagnosed with comorbid anxiety disorders, 11 (47.3%) were diagnosed with comorbid depressive disorder, and 5 (20.8%) were diagnosed with other anxiety disorders and any depressive disorder. Female gender [odds ratio (OR)=3.1; 95% confidence interval (95% CI)=1.2-7.8; P=.02] and a lower level of education (OR=0.3; 95% CI=0.1-0.9; P=.04) were associated with the presence of panic disorder. In patients with panic disorder, QoL was significantly more restricted on all subscales of the SF-36 as compared to those without panic disorder, even when age, gender, and NYHA functional class were controlled for (P=.05 to <.01). Approximately 1 of 10 patients with CHF suffers from panic disorder, many of whom also have additional anxiety or depressive comorbid disorders. Female gender and a low level of education are positively associated with the presence of panic disorder. QoL is severely limited by the presence of panic disorder. Diagnosis of mental disorders and treatment offers for affected patients should be available in patient care.

  1. Sex Differences in Serum Markers of Major Depressive Disorder in the Netherlands Study of Depression and Anxiety (NESDA).

    Science.gov (United States)

    Ramsey, Jordan M; Cooper, Jason D; Bot, Mariska; Guest, Paul C; Lamers, Femke; Weickert, Cynthia S; Penninx, Brenda W J H; Bahn, Sabine

    2016-01-01

    Women have a consistently higher prevalence of major depressive disorder (MDD) than men. Hypotheses implicating hypothalamic-pituitary -adrenal, -gonadal, and -thyroid axes, immune response, genetic factors, and neurotransmitters have emerged to explain this difference. However, more evidence for these hypotheses is needed and new explanations must be explored. Here, we investigated sex differences in MDD markers using multiplex immunoassay measurements of 171 serum molecules in individuals enrolled in the Netherlands Study of Depression and Anxiety (NMDD = 231; Ncontrol = 365). We found 28 sex-dependent markers of MDD, as quantified by a significant interaction between sex and log2-transformed analyte concentration in a logistic regression with diagnosis (MDD/control) as the outcome variable (pdepression to males and females and have important implications for the development of diagnostic biomarker tests for MDD. More studies are needed to validate these results, investigate a broader range of biological pathways, and integrate this data with brain imaging, genetic, and other relevant data.

  2. Is alexithymia a risk factor for major depression, personality disorder, or alcohol use disorders? A prospective population-based study.

    Science.gov (United States)

    Honkalampi, Kirsi; Koivumaa-Honkanen, Heli; Lehto, Soili M; Hintikka, Jukka; Haatainen, Kaisa; Rissanen, Teemu; Viinamäki, Heimo

    2010-03-01

    Disagreements concerning the stability of alexithymia and its ability to predict subsequent psychiatric disorders prevail. The aim of this 7-year follow-up study was to examine whether alexithymia predicts subsequent major depression, personality disorder, or alcohol use disorders in a population-based sample. The four-phase Kuopio Depression Study (KUDEP) was conducted in the eastern part of Central Finland. The study population (aged 25-64, n=2050) was randomly selected from the National Population Register. Data were collected in 1998, 1999, and 2001. In 2005, a subsample (n=333, 43 were excluded) of the 3-year follow-up population (1998-2001) was gathered and their diagnoses of mental disorders were confirmed by the Structure Clinical Interview for DSM-IV Axis I (SCID-I). Alexithymia was measured using the Toronto Alexithymia Scale (TAS-20) and depressive symptoms using the Beck Depression Inventory (BDI-21). For both of these measures, two groups were formed based on the median of their sum score (summing the 1998, 1999, and 2001 scores). Logistic regression analyses were performed. BDI sum scores, but not those of TAS, were associated with subsequent major depressive disorder, personality disorder, and alcohol use disorders in 2005. The BDI sum scores explained 35.7% of the variation in concurrent TAS sum scores. Alexithymia did not predict diagnoses of major depressive disorder, personality disorder, or alcohol use disorders. Alexithymia was closely linked to concurrent depressive symptoms. Thus, depressive symptoms may act as a mediator between alexithymia and psychiatric morbidity. Copyright 2010 Elsevier Inc. All rights reserved.

  3. RSA fluctuation in major depressive disorder.

    Science.gov (United States)

    Rottenberg, Jonathan; Clift, April; Bolden, Sarah; Salomon, Kristen

    2007-05-01

    Cardiac vagal control, as measured by indices of respiratory sinus arrhythmia (RSA), has been investigated as a marker of impaired self-regulation in mental disorders, including depression. Past work in depressed samples has focused on deficits in resting RSA levels, with mixed results. This study tested the hypothesis that depression involves abnormal RSA fluctuation. RSA was measured in depressed and healthy control participants during rest and during two reactivity tasks, each followed by a recovery period. Relative to controls, depressed persons exhibited lower resting RSA levels as well as less RSA fluctuation, primarily evidenced by a lack of task-related vagal suppression. Group differences in RSA fluctuation were not accounted for by differences in physical health or respiration, whereas group differences in resting RSA level did not survive covariate analyses. Depression may involve multiple deficits in cardiac vagal control.

  4. Major Depressive Disorder, Obsessive-Compulsive Disorder, and Generalized Anxiety Disorder: Do the Sexual Dysfunctions Differ?

    OpenAIRE

    Kendurkar, Arvind; Kaur, Brinder

    2008-01-01

    Objectives: Major depressive disorder (MDD), obsessive-compulsive disorder (OCD), and generalized anxiety disorder (GAD) are known to have significant impact on sexual functioning. They have been studied individually. Therefore, this study was planned to compare the sexual dysfunction between MDD, OCD, and GAD with healthy subjects as controls.

  5. The association of childhood trauma and personality disorders with chronic depression: A cross-sectional study in depressed outpatients.

    Science.gov (United States)

    Klein, Jan Philipp; Roniger, Antje; Schweiger, Ulrich; Späth, Christina; Brodbeck, Jeannette

    2015-06-01

    Chronic depression has often been associated with childhood trauma. There may, however, be an interaction between personality pathology, childhood trauma, and chronic depression. This interaction has not yet been studied. This retrospective analysis is based on 279 patients contacted for a randomized trial in an outpatient psychotherapy center over a period of 18 months from 2010 to 2012. Current diagnoses of a personality disorder and presence of chronic depression were systematically assessed using the Structured Clinical Interview for DSM-IV. Retrospective reports of childhood trauma were collected using the short form of the Childhood Trauma Questionnaire (CTQ-SF). DSM-IV-defined chronic depression was the primary outcome. The association between chronic depression, childhood trauma, and personality disorders was analyzed using correlations. Variables that had at least a small effect on correlation analysis were entered into a series of logistic regression analyses to determine the predictors of chronic depression and the moderating effect of childhood trauma. The presence of avoidant personality disorder, but no CTQ-SF scale, was associated with the chronicity of depression (odds ratio [OR] = 2.20, P = .015). The emotional abuse subscale of the CTQ-SF did, however, correlate with avoidant personality disorder (OR = 1.15, P = .000). The level of emotional abuse had a moderating effect on the effect of avoidant personality disorder on the presence of chronic depression (OR = 1.08, P = .004). Patients who did not suffer from avoidant personality disorder had a decreased rate of chronic depression if they retrospectively reported more severe levels of emotional abuse (18.9% vs 39.7%, respectively). The presence of avoidant personality pathology may interact with the effect of childhood trauma in the development of chronic depression. This has to be confirmed in a prospective study. ClinicalTrials.gov identifier: NCT01226238. © Copyright 2015 Physicians

  6. The effects of mental health parity on spending and utilization for bipolar, major depression, and adjustment disorders.

    Science.gov (United States)

    Busch, Alisa B; Yoon, Frank; Barry, Colleen L; Azzone, Vanessa; Normand, Sharon-Lise T; Goldman, Howard H; Huskamp, Haiden A

    2013-02-01

    The Mental Health Parity and Addiction Equity Act requires insurance parity for mental health/substance use disorder and general medical services. Previous research found that parity did not increase mental health/substance use disorder spending and lowered out-of-pocket spending. Whether parity's effects differ by diagnosis is unknown. The authors examined this question in the context of parity implementation in the Federal Employees Health Benefits (FEHB) Program. The authors compared mental health/substance use disorder treatment use and spending before and after parity (2000 and 2002, respectively) for two groups: FEHB enrollees diagnosed in 1999 with bipolar disorder, major depression, or adjustment disorder (N=19,094) and privately insured enrollees unaffected by the policy in a comparison national sample (N=10,521). Separate models were fitted for each diagnostic group. A difference-in-difference design was used to control for secular time trends and to better reflect the specific impact of parity on spending and utilization. Total spending was unchanged among enrollees with bipolar disorder and major depression but decreased for those with adjustment disorder (-$62, 99.2% CI=-$133, -$11). Out-of-pocket spending decreased for all three groups (bipolar disorder: -$148, 99.2% CI=-$217, -$85; major depression: -$100, 99.2% CI=-$123, -$77; adjustment disorder: -$68, 99.2% CI=-$84, -$54). Total annual utilization (e.g., medication management visits, psychotropic prescriptions, and mental health/substance use disorder hospitalization bed days) remained unchanged across all diagnoses. Annual psychotherapy visits decreased significantly only for individuals with adjustment disorders (-12%, 99.2% CI=-19%, -4%). Parity implemented under managed care improved financial protection and differentially affected spending and psychotherapy utilization across groups. There was some evidence that resources were preferentially preserved for diagnoses that are typically more

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

    Science.gov (United States)

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

    2017-09-01

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

  8. 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...

  9. Severity of depressive episodes during th