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Sample records for montgomery asberg depression

  1. Agreement between hopelessness/helplessness and Montgomery-Asberg Depression Rating Scale in healthy individuals and in patients with benign breast disease and breast cancer: a prospective case-control study in Finland.

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    Eskelinen, Matti; Korhonen, Riika; Selander, Tuomas; Ollonen, Paula

    2015-04-01

    The relation between scoring for hopelessness/helplessness and the Montgomery-Asberg Depression Rating Scale (MADRS) in healthy study subjects (HSS) and in patients with benign breast disease (BBD) and breast cancer (BC) has not been compared in a prospective study. We, therefore, investigated hopelessness and helplessness scores versus the MADRS in 115 patients. In the Kuopio Breast Cancer Study, 115 women with breast symptoms were evaluated for hopelessness and helplessness, and for the MADRS before any diagnostic procedures were carried out. In the self-rating score (SRS), hopelessness/helplessness versus the MADRS were highly significantly positively correlated in the HSS, BBD and BC groups. In the SRS, the weighted kappa values for hopelessness/helplessness versus the MADRS in the HSS, BBD and BC groups were also statistically significant. There was also a significant positive correlation in the examiner-rating score (ERS) for hopelessness versus the MADRS in the HSS, BBD and BC groups and for helplessness versus the MADRS in the HSS, BBD and BC groups. The unweighted kappa values in the ERS for hopelessness versus the MADRS were statistically highly significant for the HSS, BBD and BC groups and those for helplessness versus the MADRS in the HSS and BBD groups were statistically significant. A new finding with clinical relevance in the present work is the agreement between hopelessness/helplessness scores and MADRS in the SRS and ERS. In the breast cancer diagnostic unit, the identification of hopeless/helpless persons is essential in suicide prevention and it is important to assess and treat hopelessness/helplessness even though an individual may report few depressive symptoms. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  2. Estudio de validación de la escala de depresión de Montgomery y Asberg.

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    Ricardo Martínez Gallardo

    1991-01-01

    Full Text Available Derivada del cuestionario psicopatológico C.P.R.S., aparece en 1979 la "Montgomery Asberg Depression Rating Scale" concebida por sus autores como un instrumento altamente sensible para detectar los cambios en la sintomatología depresiva de los pacientes. Validada por sus autores originales en Inglaterra y Suecia, presentamos en este artículo un estudio de validación realizado sobre 147 pacientes franceses hospitalizados y diagnosticados de un trastorno afectivo según el DSM III. Obtuvimos resultados similares a los estudios precedentes que confirman una validez superior (sensibilidad = 94%, especificidad = 75% y mal clasificados = 6%, una más alta fiabilidad interexaminadores (K = 0,41 KW = 0,81 y sobre todo una mayor sensibilidad al cambio (S = 0,64 y 0,59 que las escalas de Hamilton y Beck consideradas hasta ahora como de referencia en su género

  3. Validity and test–retest reliability of the Persian version of the Montgomery–Asberg Depression Rating Scale

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    Ahmadpanah M

    2016-03-01

    Full Text Available Mohammad Ahmadpanah,1 Meisam Sheikhbabaei,1 Mohammad Haghighi,1 Fatemeh Roham,1 Leila Jahangard,1 Amineh Akhondi,2 Dena Sadeghi Bahmani,3 Hafez Bajoghli,4 Edith Holsboer-Trachsler,3 Serge Brand3,5 1Behavioral Disorders and Substances Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Iran; 2Hamadan Educational Organization, Ministry of Education, Hamadan, Iran; 3Center for Affective, Stress, and Sleep Disorders, Psychiatric Clinics of the University of Basel, Basel, Switzerland; 4Iranian National Center for Addiction Studies (INCAS, Tehran University of Medical Sciences, Tehran, Iran; 5Department of Sport, Exercise and Health Science, Sport Science Section, University of Basel, Basel, Switzerland Background and aims: The Montgomery–Asberg Depression Rating Scale (MADRS is an expert’s rating tool to assess the severity and symptoms of depression. The aim of the present two studies was to validate the Persian version of the MADRS and determine its test–retest reliability in patients diagnosed with major depressive disorders (MDD. Methods: In study 1, the translated MADRS and the Hamilton Depression Rating Scale (HDRS were applied to 210 patients diagnosed with MDD and 100 healthy adults. In study 2,200 patients diagnosed with MDD were assessed with the MADRS in face-to-face interviews. Thereafter, 100 patients were assessed 3–14 days later, again via face-to-face-interviews, while the other 100 patients were assessed 3–14 days later via a telephone interview. Results: Study 1: The MADRS and HDRS scores between patients with MDD and healthy controls differed significantly. Agreement between scoring of the MADRS and HDRS was high (r=0.95. Study 2: The intraclass correlation coefficient (test–retest reliability was r=0.944 for the face-to-face interviews, and r=0.959 for the telephone interviews. Conclusion: The present data suggest that the Persian MADRS has high validity and excellent test–retest reliability over

  4. The structure of the Montgomery-Åsberg depression rating scale over the course of treatment for depression.

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    Quilty, Lena C; Robinson, Jennifer J; Rolland, Jean-Pierre; Fruyt, Filip De; Rouillon, Frédéric; Bagby, R Michael

    2013-09-01

    The Montgomery-Åsberg Depression Rating Scale (MADRS) is a widely used clinician-rated measure of depressive severity. Empirical support for the factor structure of the MADRS is mixed; further, the comparison of MADRS scores within and between patients requires the demonstration of consistent instrument properties. The objective of the current investigation was to evaluate MADRS factor structure as well as MADRS factorial invariance across time and gender. The MADRS was administered to 821 depressed outpatients participating in a large-scale effectiveness study of combined pharmacotherapy and psychotherapy for depression. Treatment outcome did not differ across treatment groups. Factor structure and invariance was evaluated via confirmatory factor analysis. A four-factor model consisting of Sadness, Negative Thoughts, Detachment and Neurovegetative symptoms demonstrated a good fit to the data. This four-factor structure was invariant across time and gender. A hierarchical model, in which these four factors served as indicators of a general depression factor, was also supported. A limitation of the current study is the lack of comprehensive characterization of patient clinical features; results need to be replicated in more severely depressed or treatment refractory patients. Overall, evidence supported the use of the MADRS total score as well as subscales focused on affective, cognitive, social and somatic aspects of depression in male and female outpatients. Copyright © 2013 John Wiley & Sons, Ltd.

  5. The impact of spirituality before and after treatment of major depressive disorder.

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    Peselow, Eric; Pi, Sarah; Lopez, Enrique; Besada, André; Ishak, Waguih William

    2014-03-01

    The authors sought to assess spirituality in depressed patients and evaluate whether the degree of initial depressive symptoms and response to pharmacotherapy treatment has a correlation with degree of spirituality and belief in God. Our participants included 84 patients who presented to a depression/anxiety clinic for naturalistic treatment of their depressive illness over the course of two years. All patients met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria for major depression, as confirmed by structured interviews using the Structured Clinical Interview for DSM-IV, and were treated with selective serotonin reuptake inhibitors for eight weeks. Patients were evaluated at baseline and after treatment using the Montgomery Asberg Depression Rating Scale, the Beck Hopelessness Scale, the Dysfunctional Attitude Scale, and the Spiritual Orientation to Life scale. At baseline, patients reporting greater spirituality had significantly lower measures of hopelessness, dysfunctional attitudes, and depressive symptoms. Those who believed in God had a greater mean change score than those who did not on the Montgomery Asberg Depression Rating Scale, the Beck Hopelessness Scale, and the Dysfunctional Attitude Scale, with the Montgomery Asberg Depression Rating Scale showing the greatest mean change score. Significant correlations were detected between the Spiritual Orientation to Life scale score and the Montgomery Asberg Depression Rating Scale, the Beck Hopelessness Scale, and the Dysfunctional Attitude Scale pre-scores, post-scores, and change scores. The findings suggest that greater spirituality is associated with less severe depression. Moreover, the degree to which the measures of depressive symptom severity, hopelessness, and cognitive distortions improved over the course of eight weeks was significantly greater for those patients who were more spiritual.

  6. The Hamilton Depression Scale (HAM-D) and the Montgomery-Åsberg Depression Scale (MADRS). A psychometric re-analysis of the European Genome-Based Therapeutic Drugs for Depression Study using Rasch analysis

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    Bech, Per; Allerup, Peter; Larsen, Erik Roj

    2014-01-01

    The objective of this re-analysis of the European Genome-Based Therapeutic Drugs for Depression Study (GENDEP) was to psychometrically test the unidimensionality of the full Montgomery Åsberg Depression Rating Scale (MADRS10) and the Hamilton Depression Scale (HAM-D17) versus their respective...... 2030 had to be supplemented with the Friedman two-way analysis of variance by ranks. The HAM-D6 but not the MADRS5 was accepted. It was therefore concluded that the HAM-D6 is a psychometrically valid outcome scale to measure change in clinical trials of antidepressants....

  7. New dopamine agonist pramipexole improves parkinsonism and depression in Parkinson's disease.

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    Harada, Toshihide; Ishizaki, Fumiko; Horie, Nobuko; Nitta, Yumiko; Yamada, Tohru; Sasaki, Tomohiro; Nagakane, Tomoomi; Yasumatsu, Yoshiteru; Nitta, Kohsaku; Katsuoka, Hiroyuki

    2011-12-01

    Previous studies have shown that pramipexole might have the potential to improve depressive symptoms in patients with Parkinson's disease. To provide more evidence, in five Japanese patients at Hoehn & Yahr stage 1-3 we evaluated the Unified Parkinson's Disease Rating Scale (UPDRS), Hamilton Depression Rating Scale (HAMD) and Montgomery Asberg Depression Rating Scale (MADRS) at our hospital. After the pramipexole treatment, each total score of UPDRS, HAMD and MADRS significantly decreased compared with that before the treatment. Our data indicate that pramipexole improves depressive symptoms in patients with Parkinson's disease.

  8. Efficacy of aripiprazole augmentation in Japanese patients with major depressive disorder: a subgroup analysis and Montgomery-Åsberg Depression Rating Scale and Hamilton Rating Scale for Depression item analyses of the Aripiprazole Depression Multicenter Efficacy study.

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    Ozaki, Norio; Otsubo, Tempei; Kato, Masaki; Higuchi, Teruhiko; Ono, Hiroaki; Kamijima, Kunitoshi

    2015-01-01

    Results from this randomized, placebo-controlled study of aripiprazole augmentation to antidepressant therapy (ADT) in Japanese patients with major depressive disorder (MDD) (the Aripiprazole Depression Multicenter Efficacy [ADMIRE] study) revealed that aripiprazole augmentation was superior to ADT alone and was well tolerated. In subgroup analyses, we investigated the influence of demographic- and disease-related factors on the observed responses. We also examined how individual symptom improvement was related to overall improvement in MDD. Data from the ADMIRE study were analyzed. Subgroup analyses were performed on the primary outcome measures: the mean change in the Montgomery-Åsberg Depression Rating Scale (MADRS) total score from the end of selective serotonin reuptake inhibitor (SSRI)/serotonin norepinephrine reuptake inhibitor (SNRI) treatment to the end of the randomized treatment. Changes in the MADRS total scores were consistently greater with aripiprazole than placebo in each of the subgroups. Efficacy was not related to sex, age, number of adequate ADT trials in the current episode, MDD diagnosis, number of depressive episodes, duration of the current episode, age at first depressive episode, time since the first depressive episode, type of SSRI/SNRI, or severity at the end of SSRI/SNRI treatment phase. Compared to placebo, aripiprazole resulted in significant and rapid improvement on seven of the 10 MADRS items, including sadness. These post-hoc analyses indicated that aripiprazole was effective for a variety of Japanese patients with MDD who had exhibited inadequate responses to ADT. Additionally, we suggest that aripiprazole significantly and rapidly improved the core depressive symptoms. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

  9. Items of the Montgomery-Åsberg Depression Rating Scale Associated With Response to Paroxetine Treatment in Patients With Major Depressive Disorder.

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    Tomita, Tetsu; Sato, Yasushi; Nakagami, Taku; Tsuchimine, Shoko; Kaneda, Ayako; Kaneko, Sunao; Nakamura, Kazuhiko; Yasui-Furukori, Norio

    2016-01-01

    In the present study, we investigated the association between the severity of each symptom evaluated by the Montgomery-Åsberg Depression Rating Scale (MADRS) at baseline and responsiveness to treatment in patients with major depressive disorder (MDD) to identify the items that predict treatment response. The patients received a diagnosis of MDD if they had a score greater than 20 points on the MADRS. Following admission, 120 patients were enrolled in the study, and 89 patients completed the study. For the first week, a 20-mg/d dose of paroxetine was administered; thereafter, the dose was increased to 40 mg/d. The MADRS was applied at baseline and after 1, 2, 4, and 6 weeks. We defined responders as patients with improvements in their MADRS scores of more than 50% after 6 weeks of treatment. A multiple regression analysis of MADRS scores at 6 weeks was performed to identify patients who responded to treatment. There was a significant difference between responders and nonresponders in the reported sadness (RS) score for all MADRS items. In the multiple logistic regression analysis, only the RS and concentration difficulties (C) scores showed a significant association with treatment response. Based on the results of χ tests, RS score cutoff values of 2/3 and 3/4 revealed significant differences in the responder rate. None of the cutoff values for the C score revealed significant differences. The RS score was significantly associated with responsiveness to paroxetine treatment for MDD, with higher RS scores predicting poor responses to treatment.

  10. Efficacy of vilazodone on anxiety symptoms in patients with major depressive disorder.

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    Thase, Michael E; Chen, Dalei; Edwards, John; Ruth, Adam

    2014-11-01

    Anxiety symptoms are prevalent in patients with major depressive disorder. A post-hoc analysis of two phase III trials was conducted to evaluate the efficacy of vilazodone on depression-related anxiety. Using the 17-item Hamilton Depression Rating Scale (HAMD17) Anxiety/Somatization subscale, patients were classified as anxious or nonanxious. Improvements in depressive symptoms were based on least squares mean changes in HAMD17 and Montgomery-Asberg Depression Rating Scale total scores. Anxiety symptoms in the anxious subgroup were evaluated using Hamilton Anxiety Rating Scale (HAMA) total and subscale (Psychic Anxiety, Somatic Anxiety) scores, HAMD17 Anxiety/Somatization subscale and item (Psychic Anxiety, Somatic Anxiety) scores, and the Montgomery-Asberg Depression Rating Scale Inner Tension item score. Most of the pooled study population [82.0% (708/863)] was classified with anxious depression. After 8 weeks of treatment, least squares mean differences between vilazodone and placebo for changes in HAMA total and HAMD17 Anxiety/Somatization subscale scores were -1.82 (95% confidence interval -2.81 to -0.83; Pmajor depressive disorder who exhibit somatic and/or psychic symptoms of anxiety.

  11. A Danish cost-effectiveness model of escitalopram in comparison with citalopram and venlafaxine as first-line treatments for major depressive disorder in primary care

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    Sørensen, Jan; Stage, Kurt B; Damsbo, Niels

    2007-01-01

    The objective of this study was to model the cost-effectiveness of escitalopram in comparison with generic citalopram and venlafaxine in primary care treatment of major depressive disorder (baseline scores 22-40 on the Montgomery-Asberg Depression Rating Scale, MADRS) in Denmark. A three-path dec......The objective of this study was to model the cost-effectiveness of escitalopram in comparison with generic citalopram and venlafaxine in primary care treatment of major depressive disorder (baseline scores 22-40 on the Montgomery-Asberg Depression Rating Scale, MADRS) in Denmark. A three...... in 2004 DDK. The expected overall 6-month remission rate was higher for escitalopram (64.1%) than citalopram (58.9%). From both perspectives, the total expected cost per successfully treated patient was lower for escitalopram (DKK 22,323 healthcare, DKK 72,399 societal) than for citalopram (DKK 25......,778 healthcare, DKK 87,786 societal). Remission rates and costs were similar for escitalopram and venlafaxine. Robustness of the findings was verified in multivariate sensitivity analyses. For patients in primary care, escitalopram appears to be a cost-effective alternative to (generic) citalopram, with greater...

  12. Pregabalin for the treatment of patients with generalized anxiety disorder with inadequate treatment response to antidepressants and severe depressive symptoms.

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    Olivares, José M; Álvarez, Enrique; Carrasco, José L; Pérez Páramo, María; López-Gómez, Vanessa

    2015-09-01

    To evaluate the effectiveness of pregabalin in patients with resistant generalized anxiety disorder (GAD) and severe depressive symptoms, we carried out a post-hoc analysis of a multicenter, prospective, and observational 6-month study. We included patients who were at least 18 years old, fulfilled the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) criteria for GAD, showed inadequate responses to previous courses of antidepressant treatment, had Montgomery-Asberg Rating Scale scores of at least 35, had not received pregabalin previously, and were prescribed pregabalin upon entry into this study. We included 1815 patients fulfilling the DSM-IV criteria for GAD, and 133 (7.3%) fulfilled the selection criteria for these analyses. Ninety-seven percent of the patients received pregabalin (mean dose: 222 mg/day) in combination with other psychotropics. The Hamilton Anxiety Scale total score was reduced by a mean of 20.3 points (95% confidence interval, 22.1-18.4) (57.2% reduction) at month 6. Pregabalin also ameliorated comorbid depressive symptoms, with a reduction in the mean score of the Montgomery-Asberg Rating Scale of 22.3 points (95% confidence interval, 24.2-20.4) (56.6% reduction). Our results suggest that pregabalin, as part of a combination regimen with antidepressants and/or benzodiazepines, might be effective for the treatment of patients with GAD who have shown inadequate response to previous antidepressants and have severe depressive symptoms.

  13. Combined treatment with sulpiride and paroxetine for accelerated response in patients with major depressive disorder.

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    Uchida, Hiroyuki; Takeuchi, Hiroyoshi; Suzuki, Takefumi; Nomura, Kensuke; Watanabe, Koichiro; Kashima, Haruo

    2005-12-01

    Although serotonin reuptake inhibitors are recommended as first-line agents for major depressive disorder, delayed onset of action is problematic, and faster effective treatment is needed. Sulpiride, a dopamine-mediated agent, has been reported to show faster antidepressant efficacy, and we examined the efficacy of adjunctive sulpiride in combination with paroxetine (PAX), compared with PAX alone, to clarify whether the combined treatment exerts faster effect. Forty-one major depressive disorder patients were enrolled in this 12-week open-label trial and were randomly assigned to a PAX (10-40 mg/d) or a PAX (10-40 mg/d) plus sulpiride (100 mg/d) group. Assessments included the Montgomery-Asberg Depression Rating Scale, the 17-item Hamilton Rating Scale for Depression, and the Zung Self-rating Depression Scale on an intent-to-treat basis, and safety was also monitored. Thirty-three patients completed the study. Both PAX + sulpiride and PAX treatments showed a mean reduction in the total Montgomery-Asberg Depression Rating Scale score of 34.4 to 5.6 and 32.2 to 10.4, respectively (P Depression Rating Scale, Hamilton Rating Scale for Depression, and Zung Self-rating Depression Scale scores between week 1 and the study end point (P < 0.05). Median times to response among responders alone for the combined treatment and monotherapy were 2 and 6 weeks, respectively. Both treatments were well tolerated, with no clinically significant differences in safety measures except for an elevation of prolactin in the combined treatment group. The combination treatment may be a safe and effective strategy for accelerating antidepressant response.

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

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    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 depressive disorder. Further studies are warranted to confirm the potential of this accessible agent to optimise

  15. Eicosapentaenoic acid as an add-on to antidepressant medication for co-morbid major depression in patients with diabetes mellitus

    DEFF Research Database (Denmark)

    Bot, M; Pouwer, F; Assies, Johanna

    2010-01-01

    . METHODS: In the VU University Medical Center, we conducted a 12-week, placebo-controlled, double-blind, parallel-group intervention study of E-EPA (1g/day) versus placebo in 25 diabetes patients meeting DSM-IV criteria for major depressive disorder, who were already using antidepressant medication......BACKGROUND: Depression is common in individuals with diabetes. The present study is the first randomized controlled trial to test the efficacy of omega-3 ethyl-eicosapentaenoic acid (E-EPA) as adjuvant to antidepressant medication in the treatment of depression in adults with diabetes mellitus....... The primary outcome was severity of depressive symptoms, assessed by the Montgomery Asberg Depression Rating Scale (MADRS) at baseline and 12-week follow-up at two-weekly intervals. Blood samples were collected at baseline and at 12-week follow-up to determine EPA levels in erythrocyte membranes. Data were...

  16. Apathy and depressive mood in nursing home patients with early-onset dementia.

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    Leontjevas, Ruslan; van Hooren, Susan; Waterink, Wim; Mulders, Ans

    2009-01-01

    The study explored whether apathy and depressive mood symptoms (DMS) are related to cognitive and functional features of dementia in 63 nursing home (NH) residents with early-onset dementia (EOD). All EOD residents from one NH (n = 41) and a random sample from another NH were assessed for depressive symptoms (Montgomery Asberg Depression Rating Scale [MADRS]), apathy (Neuropsychiatric Inventory [NPI]), global cognitive functions (Mini-Mental State Examination [MMSE]), activities of daily living (ADL, Minimum Data Set-Resident Assessment Instrument [MDS-RAI]), and overall dementia severity (Global Deterioration Scale [GDS]). DMS were not associated with apathy and dementia severity. Regression analyses adjusted for age, gender, the type of dementia, and DMS revealed that dementia severity measures accounted, respectively, for 14% (ADL), 13% (GDS), and 9% (MMSE) of the variance in apathy. In line with previous research in older patients, the higher apathy scores were associated with more cognitive and functional problems in EOD.

  17. Depressive symptoms and major depressive disorder in patients affected by subclinical hypothyroidism: a cross-sectional study.

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    Demartini, Benedetta; Ranieri, Rebecca; Masu, Annamaria; Selle, Valerio; Scarone, Silvio; Gambini, Orsola

    2014-08-01

    The relationship between subclinical hypothyroidism and depression is still controversial. Our objective was to compare the prevalence of depressive symptoms and major depressive disorder in a population of patients affected by subclinical hypothyroidism and a control group without thyroid disease. The authors enrolled 123 consecutive outpatients affected by subclinical hypothyroidism undergoing follow-up at the endocrinology department of San Paolo Hospital in Milan and 123 controls without thyroid disease under the charge of general physicians.All patients and controls underwent an evaluation by means of a psychiatric interview; Hamilton Rating Scale for Depression (HAM-D); Montgomery-Asberg Depression Rating Scale (MADRS); and serum thyroid stimulating hormone, free T4, and free T3 levels. Patients were also screened for thyroid peroxidase antibodies and thyroglobulin antibodies. Patients affected by subclinical hypothyroidism had a prevalence of depressive symptoms of 63.4% at HAM-D and 64.2% at MADRS; 22 patients (17.9%) had a diagnosis of depressive episode (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria). The control group had a prevalence of depressive symptoms of 27.6% at HAM-D and 29.3% at MADRS, and only seven controls had a diagnosis of depressive episode. The prevalence of depressive symptoms between these two groups was statistically different. This study underlines a strong association between subclinical hypothyroidism and depressive symptoms, which could have some important diagnostic and therapeutic implications in the clinical practice.

  18. A longitudinal study of differences in late and early onset geriatric depression: Depressive symptoms and psychosocial, cognitive, and neurological functioning

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    Sachs-Ericsson, Natalie; Corsentino, Elizabeth; Moxley, Jerad; Hames, Jennifer L.; Collins, Nicole; Sawyer, Kathryn; Selby, Edward A.; Joiner, Thomas; Zarit, Steven; Gotlib, Ian H.; Steffens, David C.

    2012-01-01

    Objectives Studies suggest early onset depression (EOD) is associated with a more severe course of the depressive disorder, while late onset depression (LOD) is associated with more cognitive and neuroimaging changes. This study examined if older adults with EOD, compared with those with LOD, would exhibit more severe symptoms of depression and, consistent with the glucocorticoid cascade hypothesis, have more hippocampal volume loss. A second goal was to determine if LOD, compared with EOD, would demonstrate more cognitive and neuroimaging changes. Method At regular intervals over a four year period non-demented, older, depressed adults were assessed on the Mini Mental Status Examination (MMSE) and the Montgomery-Asberg Depression Rating Scale (MADRS). They were also assessed on Magnetic Resonance Imaging (MRI). Results Compared with LOD, EOD had more depressive symptoms, more suicidal thoughts, and less social support. Growth curve analyses indicated that EOD demonstrated higher levels of residual depressive symptoms over time. The LOD group exhibited a greater decrement in cognitive scores. Contrary to the glucocorticoid cascade hypothesis, participants with EOD lost right hippocampal volume at a slower rate than did participants with LOD. Right cerebrum gray matter was initially smaller among participants with LOD. Conclusions EOD is associated with greater severity of depressive illness. LOD is associated with more severe cognitive and neurological changes. These differences are relevant to understanding cognitive impairment in geriatric depression. PMID:22934752

  19. A longitudinal study of differences in late- and early-onset geriatric depression: depressive symptoms and psychosocial, cognitive, and neurological functioning.

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    Sachs-Ericsson, Natalie; Corsentino, Elizabeth; Moxley, Jerad; Hames, Jennifer L; Rushing, Nicole C; Sawyer, Kathryn; Joiner, Thomas; Selby, Edward A; Zarit, Steven; Gotlib, Ian H; Steffens, David C

    2013-01-01

    Studies suggest early-onset depression (EOD) is associated with a more severe course of the depressive disorder, while late-onset depression (LOD) is associated with more cognitive and neuroimaging changes. This study examined if older adults with EOD, compared with those with LOD, would exhibit more severe symptoms of depression and, consistent with the glucocorticoid cascade hypothesis, have more hippocampal volume loss. A second goal was to determine if LOD, compared with EOD, would demonstrate more cognitive and neuroimaging changes. At regular intervals over a four-year period non-demented, older, depressed adults were assessed on the Mini-Mental Status Examination and the Montgomery-Asberg Depression Rating Scale. They were also assessed on magnetic resonance imaging. Compared with LOD, EOD had more depressive symptoms, more suicidal thoughts, and less social support. Growth curve analyses indicated that EOD demonstrated higher levels of residual depressive symptoms over time. The LOD group exhibited a greater decrement in cognitive scores. Contrary to the glucocorticoid cascade hypothesis, participants with EOD lost right hippocampal volume at a slower rate than did participants with LOD. Right cerebrum gray matter was initially smaller among participants with LOD. EOD is associated with greater severity of depressive illness. LOD is associated with more severe cognitive and neurological changes. These differences are relevant to understanding cognitive impairment in geriatric depression.

  20. 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

    DEFF Research Database (Denmark)

    Bech, Per; Lönn, Sara L; Overø, Kerstin F

    2010-01-01

    -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. RESULTS: All studies showed a statistically significant (P needed to treat approximately 4. Patients with residual symptoms (MADRS score...... > 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...

  1. The prolactin response to sulpiride in major depression: the role of the D2 receptor in depression.

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    Verbeeck, W J; Berk, M; Paiker, J; Jersky, B

    2001-06-01

    Multiple lines of investigations have implicated the role of the dopaminergic system in depression. The aim of the study was to characterise the Dopamine D2 receptor sensitivity status in depressed patients versus controls by means of a novel neuro-endocrine challenge test, the prolactin response to sulpiride. In this intervention, ten patients and ten age matched male volunteers were studied. The patients were diagnosed according to DSM-IV criteria, and Montgomery Asberg and Zung scales were done. There was no significant difference in baseline levels of prolactin between the depressed and control groups. Significantly higher prolactin levels after sulpiride challenge were however found in depressed patients than controls at all time points after sulpiride administration. This neuroendocrine challenge paradigm suggests that the prolactin response to sulpiride, a D2 receptor antagonist, is enhanced in depression, which suggests that this receptor might be supersensitive in depression compared to controls. This adds to the data implicating the dopaminergic system in the pathophysiology of depression, and suggests that dopaminergic mechanisms might be a target of therapeutic interest.

  2. Major depression: an illness with objective physical signs.

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    Gupta, Ramesh K

    2009-01-01

    Major depression is an illness with objective physical signs occurring with some consistency. These signs are retardation of movements and diminished gestures and expressions. The patient may appear tired, self-concerned, bored, and inattentive and display a loss of interest in the surroundings. Anxiety is a conspicuous and an integral element of affective state and may be expressed by severe restlessness and agitation. Muscle tension, wringing of hands, weeping and moaning, repeating over and over in a monotonous and stereotyped way phrases expressive of misery are all important clinical signs of major depression. Similarly tachycardia, dry tongue/mouth, sweaty palms and/or bodily extremities, cold clammy skin, pallor, pupillary dilatation, tremor, and the fluctuations in blood pressure with wide pulse pressure are all important and give away the underlying distress. These signs have formed an integral part of both the Hamilton Depression Rating Scale and the Montgomery-Asberg Depression Rating Scale as they have a positive correlation with the diagnosis and the severity of illness. Current practice of operational criteria does not help exclude patients with subjective perception of distress and also fails to make room for aetiopathogenesis. The DSM-IV does not include these physical signs as an integral part of the clinical picture of depression, consequently leaving the diagnosis of MDE to subjective criteria and perceptions. This could also explain a large placebo response in recent randomised controlled clinical trials.

  3. Administration of ketamine for unipolar and bipolar depression.

    Science.gov (United States)

    Kraus, Christoph; Rabl, Ulrich; Vanicek, Thomas; Carlberg, Laura; Popovic, Ana; Spies, Marie; Bartova, Lucie; Gryglewski, Gregor; Papageorgiou, Konstantinos; Lanzenberger, Rupert; Willeit, Matthäus; Winkler, Dietmar; Rybakowski, Janusz K; Kasper, Siegfried

    2017-03-01

    Clinical trials demonstrated that ketamine exhibits rapid antidepressant efficacy when administered in subanaesthetic dosages. We reviewed currently available literature investigating efficacy, response rates and safety profile. Twelve studies investigating unipolar, seven on bipolar depression were included after search in medline, scopus and web of science. Randomized, placebo-controlled or open-label trials reported antidepressant response rates after 24 h on primary outcome measures at 61%. The average reduction of Hamilton Depression Rating Scale (HAM-D) was 10.9 points, Beck Depression Inventory (BDI) 15.7 points and Montgomery-Asberg Depression Rating Scale (MADRS) 20.8 points. Ketamine was always superior to placebo. Most common side effects were dizziness, blurred vision, restlessness, nausea/vomiting and headache, which were all reversible. Relapse rates ranged between 60% and 92%. To provide best practice-based information to patients, a consent-form for application and modification in local language is included. Ketamine constitutes a novel, rapid and efficacious treatment option for patients suffering from treatment resistant depression and exhibits rapid and significant anti-suicidal effects. New administration routes might serve as alternative to intravenous regimes for potential usage in outpatient settings. However, long-term side effects are not known and short duration of antidepressant response need ways to prolong ketamine's efficacy.

  4. The effect of escitalopram on sleep problems in depressed patients.

    Science.gov (United States)

    Lader, M; Andersen, H F; Baekdal, T

    2005-07-01

    The results from three 8-week escitalopram studies in major depressive disorder are presented with respect to efficacy and the effect on sleep quality, both in the full population and the subpopulation of patients with sleep problems at baseline. Analysis of pooled data from these randomized, double-blind, placebo-controlled, studies in which citalopram was the active reference, showed a significant improvement for escitalopram-treated patients (n = 52.0) in the Montgomery-Asberg depression rating scale (MADRS) item 4 ('reduced sleep') scores at weeks 6 and 8 compared with placebo (n=398; p Escitalopram-treated patients with sleep problems (MADRS item 4 score > or = 4; n = 254) at baseline showed a statistically significant improvement in mean MADRS item 4 scores at weeks 4, 6 and 8 compared with patients treated with placebo (n = 191; p escitalopram treatment compared with citalopram at weeks 1, 4, 6 and 8 (observed cases) and endpoint (-2.45; last observation carried forward [LOCF]). Statistical significance in favour of escitalopram versus placebo treatment was found at all visits, including endpoint (-4.2; LOCF).Thus, these post-hoc analyses suggest that escitalopram has a significant beneficial effect compared with placebo or citalopram in reducing sleep disturbance in patients suffering from major depressive disorder. The effect of escitalopram in improving 'reduced sleep' scores was clearly seen in patients with more severe sleep disturbance at baseline. A further prospective study is needed to establish this useful clinical effect in insomniac depressives.

  5. Omega-3 Fatty Acids for Depression in Multiple Sclerosis: A Randomized Pilot Study.

    Directory of Open Access Journals (Sweden)

    Lynne Shinto

    Full Text Available Multiple sclerosis is the most common chronic disabling disease in the central nervous system in young to middle aged adults. Depression is common in multiple sclerosis (MS affecting between 50–60% of patients. Pilot studies in unipolar depression report an improvement in depression when omega-3 fatty acids are given with antidepressants. The objective of this study was to investigate whether omega-3 fatty acid supplementation, as an augmentation therapy, improves treatment-resistant major depressive disorder (MDD in people with MS. We performed a randomized, double-blind, placebo-controlled pilot study of omega-3 fatty acids at six grams per day over three months. The primary outcome was a 50% or greater improvement on the Montgomery-Asberg Depression Rating Scale (MADRS. Thirty-nine participants were randomized and thirty-one completed the 3-month intervention. Improvement on MADRS between groups was not significantly different at the 3-month end point with 47.4% in the omega-3 fatty acid group and 45.5% in the placebo group showing 50% or greater improvement (p = 0.30. Omega-3 fatty acids as an augmentation therapy for treatment-resistant depression in MS was not significantly different than placebo in this pilot trial. Omega-3 fatty acid supplementation at the dose given was well-tolerated over 3 months.ClinicalTrials.gov NCT00122954.

  6. Development of a brief validated geriatric depression screening tool: the SLU "AM SAD".

    Science.gov (United States)

    Chakkamparambil, Binu; Chibnall, John T; Graypel, Ernest A; Manepalli, Jothika N; Bhutto, Asif; Grossberg, George T

    2015-08-01

    Combining five commonly observed symptoms of late-life depression to develop a short depression screening tool with similar sensitivity and specificity as the conventional, more time-consuming tools. We developed the St. Louis University AM SAD (Appetite, Mood, Sleep, Activity, and thoughts of Death) questionnaire. The frequency of each symptom in the prior 2 weeks is quantified as 0, 1, or 2. Patients 65 years or older from our clinics were administered the AM SAD, the Geriatric Depression Scale (GDS-15), the Montgomery-Asberg Depression Rating Scale (MADRS), and the St. Louis University Mental Status Exam (SLUMS). 100 patients were selected. AM SAD correlation with GDS was 0.72 and MADRS 0.80. AM SAD yielded a sensitivity and specificity of 79% and 62% against diagnosis of depression; of 88% and 62% with GDS-15; and 92% and 71% with MADRS. The AM SAD can be reliably used as a short depression screening tool in patients with a SLUMS score of 20 or higher. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  7. Depression symptom ratings in geriatric patients with bipolar mania.

    Science.gov (United States)

    Sajatovic, Martha; Al Jurdi, Rayan; Gildengers, Ariel; Greenberg, Rebecca L; Tenhave, Thomas; Bruce, Martha L; Mulsant, Benoit; Young, Robert C

    2011-11-01

    Given the paucity of information available regarding standardized ratings of depression symptoms in bipolar manic states, and in particular those in older adults, we explored depression ratings in symptomatic participants in a multicenter study of treatment of bipolar I disorder in late life. Baseline data was obtained from the first 100 patients enrolled in an NIMH-funded, 9-week, randomized, double-blind RCT comparing treatment with lithium or valproate in patients of age 60 years and older with Type I Bipolar mania or hypomania. This multi-site study was conducted at six academic medical centers in the United States and enrolled inpatients and outpatients with a total Young Mania Rating Scale (YMRS) score of 18 or greater. Depressive symptoms were evaluated with the Hamilton Depression Rating Scale (HAM-D) and the Montgomery-Asberg Depression Rating Scale (MADRS). The criterion for at least moderate bipolar depressive symptoms was the European College of Neuropsychopharmacology (ECNP) Consensus Meeting definition of HAM-D 17 total score >20. Eleven percent of patients had mixed symptoms defined by depression scale severity according to ECNP criterion. In the overall sample, total scores on the two depression scales were highly correlated. Total YMRS scores of this mixed symptom group were similar to the remainder of the sample. These preliminary findings suggest that moderate to severe depressive symptoms occur in about one in ten bipolar manic elders. Future studies are needed to further evaluate symptom profiles, clinical correlates, and treatments for bipolar older adults with combined manic and depressive symptoms. Copyright © 2011 John Wiley & Sons, Ltd.

  8. A randomized, double-blind, placebo-controlled trial of desvenlafaxine succinate in the treatment of major depressive disorder.

    Science.gov (United States)

    Septien-Velez, Lucia; Pitrosky, Bruno; Padmanabhan, Sudharshan Krishna; Germain, Jean-Michel; Tourian, Karen A

    2007-11-01

    The antidepressant efficacy and safety of desvenlafaxine succinate (desvenlafaxine) were evaluated in a phase III, double-blind, placebo-controlled study. Outpatients with a primary diagnosis of major depressive disorder were treated with fixed once-daily doses of desvenlafaxine 200 or 400 mg for 8 weeks. The primary efficacy measure was change from baseline on the 17-item Hamilton Rating Scale for Depression. At the final on-therapy evaluation, adjusted mean change from baseline in 17-item Hamilton Rating Scale for Depression total score was greater for desvenlafaxine 200 and 400 mg/day vs. placebo. Both desvenlafaxine doses showed greater efficacy than placebo on the secondary efficacy measures, including the Clinical Global Impressions-Improvement scale scores, Montgomery-Asberg Depression Rating Scale scores, CGI-Severity, and 17-item Hamilton Rating Scale for Depression response rate. Desvenlafaxine 200 mg/day was also significantly better than placebo on remission, Visual Analog Scale-Pain Intensity overall scores, and some Visual Analog Scale-Pain Intensity subscale scores. Desvenlafaxine 400 mg/day was significantly better than placebo on selected Visual Analog Scale-Pain Intensity subscale scores. Most adverse events were mild or moderate in severity, and safety assessments revealed few clinically significant changes in vital signs, laboratory tests, and electrocardiogram results. These data provide support for the efficacy and safety of desvenlafaxine in the treatment of major depressive disorder.

  9. The association of suicide risk with negative life events and social support according to gender in Asian patients with major depressive disorder.

    Science.gov (United States)

    Park, Subin; Hatim Sulaiman, Ahmad; Srisurapanont, Manit; Chang, Sung-man; Liu, Chia-Yih; Bautista, Dianne; Ge, Lan; Choon Chua, Hong; Pyo Hong, Jin

    2015-08-30

    We investigated the associations between negative life events, social support, depressive and hostile symptoms, and suicide risk according to gender in multinational Asian patients with major depressive disorder (MDD). A total of 547 outpatients with MDD (352 women and 195 men, mean age of 39.58±13.21 years) were recruited in China, South Korea, Malaysia, Singapore, Thailand, and Taiwan. All patients were assessed with the Mini-International Neuropsychiatric Interview, the Montgomery-Asberg Depression Rating Scale, the Symptoms Checklist 90-Revised, the Multidimensional Scale of Perceived Social Support, and the List of Threatening Experiences. Negative life events, social support, depressive symptoms, and hostility were all significantly associated with suicidality in female MDD patients. However, only depressive symptoms and hostility were significantly associated with suicidality in male patients. Depression severity and hostility only partially mediated the association of negative life events and poor social support with suicidality in female patients. In contrast, hostility fully mediated the association of negative life events and poor social support with suicidality in male patients. Our results highlight the need of in-depth assessment of suicide risk for depressed female patients who report a number of negative life events and poor social supports, even if they do not show severe psychopathology.

  10. The Development of the Caregiving System among women with severe mental illness

    DEFF Research Database (Denmark)

    Røhder, Katrine

    , & Solomon, 2013). The development of psychopathology is assessed in pregnancy and at 4 and 16 weeks with The Positive and Negative Syndrome Scale (PANSS, Kay et al., 1989), The Montgomery Asberg Depression Rating Scale (MADRS, Montgomery and Asberg, 1979) and The Bech-Rafaelsen Mania Rating Scale (BRMRS...

  11. Screening for depression among community-dwelling elders: Usefulness of the center for epidemiologic studies depression scale

    Directory of Open Access Journals (Sweden)

    Sebind Kumar

    2016-01-01

    Full Text Available Context: Though common, depressive disorders often remain undetected in late life. Aim: To examine the usefulness of Center for Epidemiologic Studies Depression (CES-D for identifying depression among older people. Settings and Design: Community resident older people (aged 65 years or more, were evaluated by clinicians trained in psychiatry, as part of a cross-sectional study of late-life depression. Assessments were done in the community. Methods and Material: The participants were assigned ICD-10 diagnoses and assessed using Montgomery-Asberg Depression Rating Scale (MADRS and CES-D. A short version of CES-D with 10 items, translated to the local language Malayalam, was used. Statistical Analysis: The sensitivity and specificity of CES-D was evaluated against ICD-10 clinical diagnosis of depression. The correlation of CES-D and MADRS was assessed using Pearson correlation coefficient. Results: 220 consenting adults from 3 wards of the Panchayath were assessed. On analysis of the Receiver Operating Characteristic (ROC curve of CES-D scores in relation to clinical diagnosis, the large Area Under Curve (AUC showed efficient screening and a cut off score of 4 in CES-D had a sensitivity of 97.7% and a specificity of 79.1% for depression. There was also good correlation between the MADRS and CES-D scores (0.838. Conclusion: CES-D is a short simple scale which can be used by health care professionals for detecting depression in older people in primary care settings.

  12. Cognitive deficit and depressive symptoms in a community group of elderly people: a preliminary study

    Directory of Open Access Journals (Sweden)

    Claudia Silberman

    1995-12-01

    Full Text Available Since the number and proportion of old people increases worldwide, health professionals and systems should be made aware and prepared to deal with their problems. Cognitive deficit and symptoms of depression are commom among the elderly, and may occur in relation to various risk factors such as health conditions and psychosocial variables. In order to study cognitive deficit and the presence of signs and symptoms of depression, 62 elderly community subjects enrolled at a Community Health Unit in Porto Alegre, southern Brazil, were interviewed. They were evaluated by means of the Mini Mental State Exam, the Montgomery-Asberg Depression rating scale, and a questionnaire on health conditions, living arrangements and social variables. Higher levels of symptoms of depression were observed among subjects exposed to major risk factors for cerebrovascular diseases (diabetes and coronary disease, while impaired cognitive performance was seen among individuals who could not count on the presence of a confidant (social network variable. The results suggest that the early identification of major risk groups among old people can help to prevent institutionalization and keep individuals in the community.

  13. Cognitive deficit and depressive symptoms in a community group of elderly people: a preliminary study

    Directory of Open Access Journals (Sweden)

    Silberman Claudia

    1995-01-01

    Full Text Available Since the number and proportion of old people increases worldwide, health professionals and systems should be made aware and prepared to deal with their problems. Cognitive deficit and symptoms of depression are commom among the elderly, and may occur in relation to various risk factors such as health conditions and psychosocial variables. In order to study cognitive deficit and the presence of signs and symptoms of depression, 62 elderly community subjects enrolled at a Community Health Unit in Porto Alegre, southern Brazil, were interviewed. They were evaluated by means of the Mini Mental State Exam, the Montgomery-Asberg Depression rating scale, and a questionnaire on health conditions, living arrangements and social variables. Higher levels of symptoms of depression were observed among subjects exposed to major risk factors for cerebrovascular diseases (diabetes and coronary disease, while impaired cognitive performance was seen among individuals who could not count on the presence of a confidant (social network variable. The results suggest that the early identification of major risk groups among old people can help to prevent institutionalization and keep individuals in the community.

  14. Cost-effectiveness of escitalopram vs. citalopram in major depressive disorder.

    Science.gov (United States)

    Fantino, Bruno; Moore, Nicholas; Verdoux, Hélène; Auray, Jean-Paul

    2007-03-01

    Clinical trials have shown better efficacy of escitalopram over citalopram, and review-based economic models the cost-effectiveness of escitalopram vs. citalopram (brand and generic). No head-to-head clinical trial has, however, evaluated the cost-effectiveness of both drugs so far. The aim of this study was to assess the relative cost-effectiveness of escitalopram compared with citalopram in patients with major depressive disorder. An economic evaluation was conducted alongside a double-blind randomized clinical trial conducted by general practitioners and psychiatrists comparing fixed doses of escitalopram (20 mg/day) or citalopram (40 mg/day) over 8 weeks in ambulatory care patients with major depressive disorder (baseline Montgomery-Asberg Depression Rating Scale score > or =30). Resources use was recorded using a standardized form recording use of healthcare services and days of sick leave for the 2-month prestudy period and for the 8-week study period. Statistically significant improvements were observed in patients treated with escitalopram. Mean per-patient costs for the escitalopram group, compared with the citalopram group, were 41% lower (96 euro vs. 163 euro; Pescitalopram compared with citalopram recipients, assuming a parity price between escitalopram and citalopram. Bootstrapped distributions of the cost-effectiveness ratios also showed better effectiveness and lower costs for escitalopram compared with citalopram. Escitalopram is significantly more effective than citalopram, and is associated with lower healthcare costs. This prospective economic analysis demonstrated that escitalopram is a cost-effective first-line treatment option for major depressive disorder.

  15. Is combined treatment more effective than switching to monotherapy in patients with resistant depression? A retrospective study.

    Science.gov (United States)

    Bares, Martin; Novak, Tomas; Kopecek, Miloslav; Stopkova, Pavla; Sos, Peter

    2009-01-01

    The aim of this retrospective study was to compare the efficacy of combination therapy (combinations of antidepressants and various augmentations) and antidepressant monotherapy in the treatment of patients, who failed to respond at least to one previous antidepressant trial in the routine clinical practice. We reviewed chart documents of patients hospitalized at Prague Psychiatric Center for depressive disorder from June 2005 to June 2007 and finished at least 4 weeks of new treatment. Depressive symptoms and overall clinical status were assessed using Montgomery and Asberg Depression Rating Scale, Clinical Global Impression and Beck Depression Inventory - Short Form at the baseline and in the end of treatment. We identified 49 inpatients (24-combined treatment, 25-monotherapy), who were suitable for analyses. Both groups were equal in baseline characteristics and in the duration of index episode treatment. The combined treatment was superior to the monotherapy switch in the MADRS median score reduction (16 vs. 9 points, p=0.01). The combined group achieved higher response rate compared to monotherapy group (67% vs. 36%, p=0.05). Number need to treat for response was 3.3 (95% CI, 1.85-37.3). The findings of this study suggest that combined treatment is more efficacious than switch to monotherapy in the treatment of resistant depression.

  16. Cognitive deficit and depressive symptoms in a community group of elderly people: a preliminary study

    Directory of Open Access Journals (Sweden)

    Claudia Silberman

    1995-12-01

    Full Text Available Since the number and proportion of old people increases worldwide, health professionals and systems should be made aware and prepared to deal with their problems. Cognitive deficit and symptoms of depression are commom among the elderly, and may occur in relation to various risk factors such as health conditions and psychosocial variables. In order to study cognitive deficit and the presence of signs and symptoms of depression, 62 elderly community subjects enrolled at a Community Health Unit in Porto Alegre, southern Brazil, were interviewed. They were evaluated by means of the Mini Mental State Exam, the Montgomery-Asberg Depression rating scale, and a questionnaire on health conditions, living arrangements and social variables. Higher levels of symptoms of depression were observed among subjects exposed to major risk factors for cerebrovascular diseases (diabetes and coronary disease, while impaired cognitive performance was seen among individuals who could not count on the presence of a confidant (social network variable. The results suggest that the early identification of major risk groups among old people can help to prevent institutionalization and keep individuals in the community.Com o objetivo de avaliar déficit cognitivo e presença de sinais e sintomas depressivos, 62 idosos registrados numa Unidade de Saúde Comunitária em Porto Alegre/RS foram entrevistados em suas casas. Foram avaliados pelo Mini Exame do Estado Mental (Mini Mental State, pela escala de Montgomery-Asberg, e por um questionário sobre condições de saúde, moradia e outras variáveis de vínculos sociais. Níveis mais altos de sintomas depressivos foram observados entre os idosos expostos a fatores de risco maiores para doença cérebro-vascular (diabete e doença coronariana, enquanto que pior desempenho cognitivo foi encontrado nos sujeitos que não contavam com um confidente (variável da rede social. Os resultados sugeriram que a identificação precoce dos

  17. The burden of depressive symptoms in the long-term treatment of patients with schizophrenia.

    Science.gov (United States)

    Conley, Robert R; Ascher-Svanum, Haya; Zhu, Baojin; Faries, Douglas E; Kinon, Bruce J

    2007-02-01

    To prospectively measure the link between depressive symptoms and functional outcomes in the long-term treatment of people with schizophrenia. Data were drawn from a large, multi-site, 3-year, prospective, naturalistic, observational study, in which subjects with schizophrenia were assessed at enrollment and at 12-month intervals thereafter. Individuals who were "Depressed" (defined as a total score > or =16 on the Montgomery-Asberg Depression Rating Scale) at enrollment were compared to those "Non-depressed" on functional outcomes, using self-report measures, clinicians' ratings, and information from medical records. Statistical analyses included Generalized Estimation Equation and mixed regression analyses adjusted for individual characteristics. Longitudinal group comparisons across the 3-year study were augmented with a cross-sectional group comparison at enrollment. At enrollment, 39.4% (877/2228) of the participants were deemed Depressed. Across the 3-year study, the depressed cohort was significantly more likely than the Non-depressed to use relapse-related mental health services (emergency psychiatric services, sessions with psychiatrists); to be a safety concern (violent, arrested, victimized, suicidal); to have greater substance-related problems; and to report poorer life satisfaction, quality of life, mental functioning, family relationships, and medication adherence. Furthermore, changes in depressed status were associated with changes in functional outcomes. People with schizophrenia and concurrent depressive symptoms have poorer long-term functional outcomes compared to the Non-depressed. Their poorer quality of life, greater use of mental health services, and higher risk of involvement with law enforcement agencies underscore a need for special treatment interventions. Treatment of the non-psychotic dimensions of schizophrenia is a critical part of recovery.

  18. Early reduction in prefrontal theta QEEG cordance value predicts response to venlafaxine treatment in patients with resistant depressive disorder.

    Science.gov (United States)

    Bares, Martin; Brunovsky, Martin; Kopecek, Miloslav; Novak, Tomas; Stopkova, Pavla; Kozeny, Jiri; Sos, Peter; Krajca, Vladimir; Höschl, Cyril

    2008-08-01

    Previous studies of patients with unipolar depression have shown that early decrease of prefrontal EEG cordance in theta band can predict clinical response to various antidepressants. We have now examined whether decrease of prefrontal quantitative EEG (QEEG) cordance value after 1 week of venlafaxine treatment predicts clinical response to venlafaxine in resistant patients. We analyzed 25 inpatients who finished 4-week venlafaxine treatment. EEG data were monitored at baseline and after 1 week of treatment. QEEG cordance was computed at three frontal electrodes in theta frequency band. Depressive symptoms and clinical status were assessed using Montgomery-Asberg Depression Rating Scale (MADRS), Beck Depression Inventory-Short Form (BDI-S) and Clinical Global Impression (CGI). Eleven of 12 responders (reduction of MADRS >or=50%) and only 5 of 13 non-responders had decreased prefrontal QEEG cordance value after the first week of treatment (p=0.01). The decrease of prefrontal cordance after week 1 in responders was significant (p=0.03) and there was no significant change in non-responders. Positive and negative predictive values of cordance reduction for response were 0.7 and 0.9, respectively. The reduction of prefrontal theta QEEG cordance value after first week of treatment might be helpful in the prediction of response to venlafaxine.

  19. Double-blind, placebo-controlled evaluation of extended-release bupropion in elderly patients with major depressive disorder.

    Science.gov (United States)

    Hewett, K; Chrzanowski, W; Jokinen, R; Felgentreff, R; Shrivastava, R K; Gee, M D; Wightman, D S; O'Leary, M C; Millen, L S; Leon, M C; Briggs, M A; Krishen, A; Modell, J G

    2010-04-01

    Major depressive disorder in the elderly is associated with increased morbidity and reduced quality of life. This 10 week, placebo-controlled study investigated the efficacy and tolerability of extended-release bupropion (150-300 mg once daily) in depressed patients aged 65 years or older. The statistical assumptions necessary for the validity of the protocol-specified analysis of covariance were not met for the analysis of the primary outcome variable (Montgomery-Asberg Depression Rating Scale total score at Week 10, last observation carried forward). Alternative statistical methods used for the analysis of this variable demonstrated statistical significance. Statistically significant improvements were observed on the majority of secondary end points when compared with placebo, including the health outcome measures for motivation and energy, and life satisfaction and contentment. Adverse events were generally mild to moderate and similar between treatment groups. This study demonstrated that the extended-release bupropion is an effective, well-tolerated treatment for major depression in the elderly.

  20. Interest of targeting either cortical area Brodmann 9 or 46 in rTMS treatment for depression: a preliminary randomized study.

    Science.gov (United States)

    Trojak, Benoit; Meille, Vincent; Jonval, Lysiane; Schuffenecker, Nicolas; Haffen, Emmanuel; Schwan, Raymund; Bonin, Bernard; Chauvet-Gelinier, Jean-Christophe

    2014-12-01

    To assess the interest of specifically targeting Brodmann Areas (BA) 9 or 46 for rTMS treatment of depression. Patients with Treatment-Resistant Depression were randomly assigned to two treatment groups to receive either rTMS on BA 9 or on BA 46. Each patient underwent 10 sessions of 1Hz-rTMS for 2weeks. The Hamilton and Montgomery-Asberg Depression Rating Scales (HDRS, MADRS) were used under blind conditions to assess the therapeutic response (50% improvement). A Wilcoxon signed-rank test was used to compare the depression rating scales scores obtained before and after the 10 rTMS sessions for each of the two groups. The therapeutic results in the two groups were compared using the Mann-Whitney-Wilcoxon test. We also reported the effect sizes using Hedges's g. Fifteen patients were included. Stimulation of both BA 9 (n=7) and BA 46 (n=8) led to similar therapeutic responses in the two groups (with moderate effect size), such as the mean decrease in HDRS (BA 9: p=0.015; BA 46: p=0.010) and MADRS (BA 9: p=0.042; BA 46: p=0.038) scores. Our results do not come out in favor of one or the other BA. Stimulation of BA 9 and BA 46 appears to be equally effective in the treatment of depression. Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  1. Treatment patterns in major depressive disorder after an inadequate response to first-line antidepressant treatment

    Directory of Open Access Journals (Sweden)

    Garcia-Toro Mauro

    2012-09-01

    Full Text Available Abstract Background The aim of the study was to determine the most common pharmacological strategies used in the management of major depressive disorder (MDD after an inadequate response to first-line antidepressant treatment in clinical practice. Methods Multicenter, non-interventional study in adult outpatients with a DSM-IV-TR diagnosis of MDD and inadequate response to first-line antidepressant medication. Multiple logistic regression analyses were performed to identify independent factors associated with the adoption of a specific second-line strategy. Results A total of 273 patients were analyzed (mean age: 46.8 years, 67.8% female. Baseline mean Montgomery-Asberg Depression Rating Scale total score was 32.1 (95%CI 31.2-32.9. The most common strategies were: switching antidepressant medication (39.6%, augmentation (18.8%, and combination therapy (17.9%. Atypical antipsychotic drugs were the most commonly used agent for augmenting antidepressant effect. The presence of psychotic symptoms and the number of previous major depressive episodes were associated with the adoption of augmenting strategy (OR = 3.2 and 1.2, respectively. Conclusion The switch to another antidepressant agent was the most common second-line therapeutic approach. Psychiatrists chose augmentation based on a worse patients’ clinical profile (number of previous episodes and presence of psychotic symptoms.

  2. Oxytocin course over pregnancy and postpartum period and the association with postpartum depressive symptoms.

    Science.gov (United States)

    Jobst, Andrea; Krause, Daniela; Maiwald, Carina; Härtl, Kristin; Myint, Aye-Mu; Kästner, Ralph; Obermeier, Michael; Padberg, Frank; Brücklmeier, Benedikt; Weidinger, Elif; Kieper, Susann; Schwarz, Markus; Zill, Peter; Müller, Norbert

    2016-08-01

    During the postpartum period, women are at higher risk of developing a mental disorder such as postpartum depression (PPD), a disorder that associates with mother-infant bonding and child development. Oxytocin is considered to play a key role in mother-infant bonding and social interactions and altered oxytocin plasma concentrations were found to be associated with PPD. In the present study, we evaluated oxytocin plasma levels and depressive symptoms during pregnancy and the postpartum period in healthy women. We evaluated 100 women twice during pregnancy (weeks 35 and 38) and three times in the postpartum period (within 2 days and 7 weeks and 6 months after delivery) by measuring oxytocin plasma levels with enzyme-linked immunosorbent assay (ELISA) and assessing depressive symptoms with the Montgomery-Asberg Depression Rating Scale. Oxytocin plasma levels significantly increased from the 35th week of gestation to 6 months postpartum in all women. However, levels decreased from the 38th week of gestation to 2 days after delivery in participants with postpartum depressive symptoms, whereas they continuously increased in the group without postpartum depressive symptoms; the difference between the course of oxytocin levels in the two groups was significant (Δt2-t3: t = 2.14; p = 0.036*). Previous depressive episodes and breastfeeding problems predicted postpartum depressive symptoms. Our results indicate that alterations in the oxytocin system during pregnancy might be specific for women who develop postpartum depressive symptoms. Future studies should investigate whether oxytocin plasma levels might have predictive value in women at high risk for PPD.

  3. Depression, anxiety, and history of substance abuse among Norwegian inmates in preventive detention: Reasons to worry?

    Directory of Open Access Journals (Sweden)

    Værøy Henning

    2011-03-01

    Full Text Available Abstract Background Inmates on preventive detention are a small and select group sentenced to an indefinite term of imprisonment. Mood disorders and substance abuse are risk factors for inmate violence and recidivism, so the prevalence of depression, anxiety, and substance abuse was examined in this cohort using psychometric tests. Methods Completion of self-report questionnaires was followed by face-to-face clinical interviews with 26 of the 56 male inmates on preventive detention in Norway's Ila Prison. Substance abuse histories and information about the type of psychiatric treatment received were compiled. To assess anxiety and depression, the Hospital Anxiety and Depression Scale (HADS, the Clinical Anxiety Scale (CAS, and the Montgomery Asberg Depression Rating Scale (MADRS were used. Results Scores on the MADRS revealed that 46.1% of inmates had symptoms of mild depression. The HADS depression subscale showed that 19.2% scored above the cut-off for depression (κ = 0.57. The CAS anxiety score was above the cut-off for 30.7% of the subjects, while 34.6% also scored above the cut-off on the HADS anxiety subscale (κ = 0.61. Almost 70% of all these inmates, and more than 80% of those convicted of sex crimes, had a history of alcohol and/or drug abuse. Conclusions Mild anxiety and depression was found frequently among inmates on preventive detention. Likewise, the majority of the inmates had a history of alcohol and drug abuse. Mood disorders and substance abuse may enhance recidivism, so rehabilitation programs should be tailored to address these problems.

  4. Assessing the Association Between Electrical Stimulation Dose, Subsequent Cognitive Function and Depression Severity in Patients Receiving Bilateral Electroconvulsive Therapy for Major Depressive Disorder.

    Science.gov (United States)

    Sinclair, Jenny Elisabeth; Fernie, Gordon; Bennett, Daniel Mark; Reid, Ian Cameron; Cameron, Isobel Mary

    2016-09-01

    To assess the relationship between electrical stimulation administered to patients undergoing bilateral electroconvulsive therapy (ECT) and subsequent measures of cognitive function and depression severity. Stimulus dose titrated patients receiving bilateral ECT were assessed with the Cambridge Neuropsychological Test Automated Battery (CANTAB) Spatial Recognition Memory test and Montgomery Asberg Depression Rating Scale (MADRS) at baseline, after 4 ECT treatments and on course completion. Changes in CANTAB and MADRS scores were assessed in relation to electrical dosage, initial stimulus dose, and demographic variables using linear mixed models. Data pertained to 143 patients (mean age, 56.85 [SD, 14.94], 43% male). Median change in CANTAB score was -10% (-20% to 5%) after 4 ECT treatments and -10% (-20% to 5%) at course completion. Median change in MADRS score was -22 (-33 to -13) after 4 ECT treatments and -14 (-25 to -7) at course completion. Electrical dosage had no effect on CANTAB or MADRS change scores either after 4 treatments or course completion. Improvement in CANTAB score at end of course was associated with female sex (P treatments, improvement in CANTAB score was associated with younger age (P treatments). Electroconvulsive therapy has significant antidepressant and cognitive effects which are not associated with the total electrical dose administered. Other, unalterable variables, such as age and sex, have an influence on these effects.

  5. Early maladaptive schemas of emotional deprivation, social isolation, shame and abandonment are related to a history of suicide attempts among patients with major depressive disorders.

    Science.gov (United States)

    Ahmadpanah, Mohammad; Astinsadaf, Sommayyeh; Akhondi, Amineh; Haghighi, Mohammad; Sadeghi Bahmani, Dena; Nazaribadie, Marzieh; Jahangard, Leila; Holsboer-Trachsler, Edith; Brand, Serge

    2017-08-01

    Patients with psychiatric disorders have an exceptionally high risk of completed or attempted suicide. This holds particularly true for patients with major depressive disorders. The aim of the present study was to explore whether patients with major depressive disorders (MDD) and a history of suicide attempts differed in their early maladaptive schemas from patients with MDD but without such a history or from healthy controls. Ninety participants took part in the study. Of these, 30 were patients with MDD who had made a recent suicide attempt; 30 were patients with MDD but no suicide attempts, and 30 were gender- and age-matched healthy controls. Participants completed questionnaires covering socio-demographic characteristics and the Young Schema Questionnaire (YSQ- RE2R) to assess early maladaptive schemas. Experts rated patients' MDD with the Montgomery-Asberg Depression Rating Scale. Patients did not differ in experts' ratings of symptoms of depression. Compared to healthy controls, patients with MDD recorded higher scores on maladaptive schemas such as recognition seeking, negativity/pessimism, and insufficient self-control. Compared to patients without suicide attempts and healthy controls, those who had made a suicide attempt had higher scores on dimensions such as failure, mistrust, emotional inhibition, social isolation, and abandonment/instability. Compared to healthy controls, patients with MDD had more pronounced maladaptive schemas, but this was more marked in patients with a history of suicide attempts. The results suggest that suicide attempts and poorer psychological functioning are related. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2009-10-30

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

  7. Changes in the Temperament and Character Inventory dimensions after paroxetine treatment in patients with major depressive disorder.

    Science.gov (United States)

    Tomita, Tetsu; Kaneda, Ayako; Nakagami, Taku; Kaneko, Sunao; Yasui-Furukori, Norio

    2015-09-01

    Previous studies have reported changes in the dimensions of the Temperament and Character Inventory (TCI) after patients with major depressive disorder are treated. We aimed to investigate the changes in the TCI dimensions after paroxetine treatment in patients with major depressive disorder. Forty-eight patients were enrolled in this study and were treated with 10-40 mg/day of paroxetine for 6 weeks. The TCI was completed twice, at weeks 0 and 6. We used the Montgomery-Asberg Depression Rating Scale (MADRS) to evaluate patients. The participants were divided into three groups (responders, non-responders, and early responders) based on treatment response. The scores of each dimension of the TCI were compared before and after treatment using repeated-measures two-way analyses of variance. In the responders group (n = 24), no TCI dimension scores changed significantly during treatment, but the interaction between sex and MADRS score change was significantly associated with the results. In the non-responders group (n = 15), the self-directedness score increased significantly during the treatment period (p = 0.000), and the change in MADRS score significantly affected the results. In the early responders group (n = 9), no TCI dimension scores changed significantly during treatment. The results of the present study may reveal a possible correlation between paroxetine treatment and changes in personality traits. Copyright © 2015 John Wiley & Sons, Ltd.

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

    Science.gov (United States)

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

    2015-01-01

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

  9. A double-blind, placebo-controlled study of the efficacy and safety of desvenlafaxine succinate in the treatment of major depressive disorder.

    Science.gov (United States)

    DeMartinis, Nicholas A; Yeung, Paul P; Entsuah, Richard; Manley, Amy L

    2007-05-01

    This study evaluated the efficacy and safety of desvenlafaxine succinate extended-release in major depressive disorder (MDD). Adult outpatients with DSM-IV-defined MDD were randomly assigned to desvenlafaxine 100 mg/day (N = 114), 200 mg/day (N = 116), or 400 mg/day (N = 113) or placebo (N = 118) for 8 weeks. Efficacy variables included change from baseline in the 17-item Hamilton Rating Scale for Depression (HAM-D(17), the primary efficacy measure), Clinical Global Impressions-Improvement scale (CGI-I), Montgomery-Asberg Depression Rating Scale, Clinical Global Impressions-Severity of Illness scale (CGI-S), rates of response (> or = 50% decrease from baseline HAM-D(17) score) and remission (HAM-D(17) score desvenlafaxine 100 mg/day (12.75) and 400 mg/day (12.50) were significantly lower than for placebo (15.31; p = .0038 and p = .0023, respectively); for desvenlafaxine 200 mg/day, the mean score was 13.31 (p = .0764). CGI-I and Montgomery-Asberg Depression Rating Scale results were significant for all groups; CGI-S results were significant with 100 mg/day and 400 mg/day. Response rates were significantly greater for desven-lafaxine 100 mg/day (51%) and 400 mg/day (48%) versus placebo (35%; p = .017 and p = .046, respectively); the response rate for desvenlafaxine 200 mg/day was 45% (p = .142). Remission rates were significantly greater for desvenlafaxine 400 mg/day (32%) versus placebo (19%; p = .035); remission rates were 30% for desvenlafaxine 100 mg/day (p = .093) and 28% for desvenlafaxine 200 mg/day (p = .126). Visual Analog Scale-Pain Intensity results were significant for desvenlafaxine 100 mg/day versus placebo (p = .002), but not for the higher doses. The most commonly reported adverse events were nausea, insomnia, somnolence, dry mouth, dizziness, sweating, nervousness, anorexia, constipation, asthenia, and abnormal ejaculation/orgasm. Desvenlafaxine is effective and well tolerated in the short-term treatment of MDD.

  10. Sy Montgomery: Part Indiana Jones and Part Emily Dickinson

    Science.gov (United States)

    Young, Terrell A.

    2008-01-01

    As important as accuracy may be to nonfiction writers, few have taken such risks as Sy Montgomery in gathering information for her articles, books, and films. In this profile article, Young recounts many of the risks and adventures Montgomery has taken for the sake of accurate and impassioned writing. Montgomery says, "I consider my books love…

  11. Sy Montgomery: Part Indiana Jones and Part Emily Dickinson

    Science.gov (United States)

    Young, Terrell A.

    2008-01-01

    As important as accuracy may be to nonfiction writers, few have taken such risks as Sy Montgomery in gathering information for her articles, books, and films. In this profile article, Young recounts many of the risks and adventures Montgomery has taken for the sake of accurate and impassioned writing. Montgomery says, "I consider my books love…

  12. Cognitive Disorders, Depressive Status and Chronic Complications of Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Tache Mirela

    2014-12-01

    Full Text Available Background and aims: Depression and cognitive disorders were reported more frequently in patients with diabetes mellitus (DM. Our aim was to analyze the association of cognitive disorders and depression association with chronic complications of DM in a group of Romanian patients. Materials and methods: The data was analyzed from 181 patients, with a mean age of 58,3 years to whom we applied the MMSE (Mini- Mental State Examination and MADRS (Montgomery-Asberg Depression Rating Scale questionnaires. We also analyzed the presence of chronic DM complications, HbA1c and lipid profile. Results: Most patients with type 2 diabetes mellitus (T2DM had mild cognitive impairment (92%, more common in the age group 50-59 years. Chronic macrovascular complications were present in 74.58%, while chronic microvascular complications were present in 61.87% of patients with T2DM who associated mild and moderate cognitive impairment (p = 0.013. The most common form of depression was mild depression (90.2%, present in most patients with DM, regardless of progression and type of treatment. MADRS depression test scores were statistically significant correlated with the presence of peripheral artery disease - PAD (p <0.001, ischemic heart disease - IHD (p <0.001 and chronic kidney disease - CKD (p =0.05. We did not find a statistically significant correlation with HbA1c and serum lipid values (p˃0,05. Conclusion: Chronic diabetes macrovascular complications (PAD, IHD and CKD were more frequently associated with cognitive disorders and depression in patients with T2DM independent of the degree of metabolic control.

  13. Cognitive Behavioral Analysis System of Psychotherapy versus Escitalopram in Chronic Major Depression.

    Science.gov (United States)

    Schramm, Elisabeth; Zobel, Ingo; Schoepf, Dieter; Fangmeier, Thomas; Schnell, Knut; Walter, Henrik; Drost, Sarah; Schmidt, Paul; Brakemeier, Eva-Lotta; Berger, Mathias; Normann, Claus

    2015-01-01

    A specific psychotherapy for chronic depression, the Cognitive Behavioral Analysis System of Psychotherapy (CBASP), was compared to escitalopram (ESC). Sixty patients with chronic major depression were randomized to 'CBASP' (22 sessions) or 'ESC plus clinical management' (ESC/CM) at two treatment sites. The primary outcome measure was the score on the Montgomery-Asberg Depression Rating Scale (MADRS) after 8 weeks of acute treatment assessed by blinded raters. In the case of nonimprovement (<20% reduction in the MADRS score), the other condition was augmented for the following 20 weeks of extended treatment. Secondary end points were, among others, depressive symptoms, remission (MADRS score of ≤9) and response rates (reduction of MADRS score of ≥50%) 28 weeks after randomization. An intent-to-treat analysis revealed that clinician-rated depression scores decreased significantly after 8 and 28 weeks with no significant differences between the groups. The response rates after 28 weeks of treatment were high (CBASP: 68.4%, ESC/CM: 60.0%), and the remission rates were moderate (CBASP: 36.8%, ESC/CM: 50.0%) with neither group being superior. Nonimprovers to the initial treatment caught up with the initial improvers in terms of depression scores and response and remission rates by the end of the treatment after being augmented with the respective other condition. CBASP and ESC/CM appear to be equally effective treatment options for chronically depressed outpatients. For nonimprovers to the initial treatment, it is efficacious to augment with medication in the case of nonresponse to CBASP and vice versa.

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

    Science.gov (United States)

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

    2014-01-01

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

  15. DID FIELD MARSHAL BERNARD MONTGOMERY (MONTGOMERY OF ALAMEIN) HAVE ASPERGER'S SYNDROME?

    OpenAIRE

    Fitzgerald, Michael

    2000-01-01

    In the present paper the evidence for Field Marshal Montgomery having Asperger's syndrome is examined. Biographies of Montgomery were examined to search for evidence that he met criteria for Asperger's syndrome - Gillberg (1991) and Asperger's disorder (APA.1994) and Anankastic personality disorder (WHO,1992). He demonstrates a qualitative impairment in social interaction and restricted repetitive and stereotyped patterns of behaviour, interests and activities. It can be concluded that he met...

  16. Effect of aerobic training on EEG alpha asymmetry and depressive symptoms in the elderly: a 1-year follow-up study

    Directory of Open Access Journals (Sweden)

    A.C. Deslandes

    2010-06-01

    Full Text Available The effect of physical exercise on the treatment of depressive elderly adults has not been investigated thus far in terms of changes in cortical hemispheric activity. The objective of the present study was to identify changes in depressive symptoms, quality of life, and cortical asymmetry produced by aerobic activity. Elderly subjects with a diagnosis of major depressive disorder (DSM-IV were included. Twenty patients (70% females, 71 ± 3 years were divided into an exercise group (pharmacological treatment plus aerobic training and a control group (undergoing pharmacological treatment in a quasi-experimental design. Pharmacological treatment was maintained stable throughout the study (antidepressants and anxiolytics. Subjects were evaluated by depression scales (Beck Depression Inventory, Hamilton Depression Rating Scale, Montgomery-Asberg Depression Rating Scale and the Short Form Health Survey-36, and electroencephalographic measurements (frontal and parietal alpha asymmetry before and after 1 year of treatment. After 1 year, the control group showed a decrease in cortical activity on the right hemisphere (increase of alpha power, which was not observed in the exercise group. The exercise group showed a significant decrease of depressive symptoms, which was not observed in the control group. This result was also accompanied by improved treatment response and remission rate after 1 year of aerobic exercise associated with treatment. This study provides support for the effect of aerobic training on alpha activity and on depressive symptoms in elderly patients. Exercise facilitates the treatment of depressive elderly adults, leading to clinical and physical improvement and protecting against a decrease in cortical activity.

  17. Longitudinal Changes in Depressive Circuitry in Response to Neuromodulation Therapy

    Science.gov (United States)

    Pathak, Yagna; Salami, Oludamilola; Baillet, Sylvain; Li, Zhimin; Butson, Christopher R.

    2016-01-01

    Background: Major depressive disorder (MDD) is a public health problem worldwide. There is increasing interest in using non-invasive therapies such as repetitive transcranial magnetic stimulation (rTMS) to treat MDD. However, the changes induced by rTMS on neural circuits remain poorly characterized. The present study aims to test whether the brain regions previously targeted by deep brain stimulation (DBS) in the treatment of MDD respond to rTMS, and whether functional connectivity (FC) measures can predict clinical response. Methods: rTMS (20 sessions) was administered to five MDD patients at the left-dorsolateral prefrontal cortex (L-DLPFC) over 4 weeks. Magnetoencephalography (MEG) recordings and Montgomery-Asberg depression rating scale (MADRS) assessments were acquired before, during and after treatment. Our primary measures, obtained with MEG source imaging, were changes in power spectral density (PSD) and changes in FC as measured using coherence. Results: Of the five patients, four met the clinical response criterion (40% or greater decrease in MADRS) after 4 weeks of treatment. An increase in gamma power at the L-DLPFC was correlated with improvement in symptoms. We also found that increases in delta band connectivity between L-DLPFC/amygdala and L-DLPFC/pregenual anterior cingulate cortex (pACC), and decreases in gamma band connectivity between L-DLPFC/subgenual anterior cingulate cortex (sACC), were correlated with improvements in depressive symptoms. Conclusions: Our results suggest that non-invasive intervention techniques, such as rTMS, modulate the ongoing activity of depressive circuits targeted for DBS, and that MEG can capture these changes. Gamma oscillations may originate from GABA-mediated inhibition, which increases synchronization of large neuronal populations, possibly leading to increased long-range FC. We postulate that responses to rTMS could provide valuable insights into early evaluation of patient candidates for DBS surgery. PMID

  18. Recognizing depression in patients with Parkinson’s disease: accuracy and specificity of two depression rating scale Reconhecimento de depressão em pacientes com doença de Parkinson: acurácia e especificidade de duas escalas de avaliação de depressão

    Directory of Open Access Journals (Sweden)

    Cláudia Débora Silberman

    2006-06-01

    Full Text Available This study aimed to find cut-off scores for the Montgomery-Asberg rating scale (MADRS and the Beck depression inventory (BDI that can relate to specific clinical diagnoses of depression in Parkinson´s disease (PD. Mild and moderate PD patients (n=46 were evaluated for depression according to the DSM IV criteria. All patients were assessed with the MADRS and the BDI. A "receiver operating characteristics" (ROC curve was obtained and the sensibility, specificity, positive and the negative predictive values were calculated for different cut-off scores of the MADRS and the BDI. The Kappa statistic was calculated for different cut-off scores to assess the agreement between the clinical judgment and both scales. Depression was present in 18 patients. MADRS cut-off scores of 6 and 10 showed Kappa 0.5 and 0.56, respectively. Specificity of cut-off score of 6 was 78.6% and of cut-off score of 10 was 96.4%. Kappa agreement of BDI cut-off scores of 10 and 18 were 0.36 and 0.62, respectively. Specificity was 60.7% for 10 and 92.9% for 18. Both rating scales show similar accuracy within the ROC curves (84.3% for MADRS and 79.7% for BDI. The MADRS and the BDI show a good accuracy and correlation to the clinical diagnosis when a cut-off score of 10 is used to MADRS and a cut-off score of 18 is used to BDI to recognize depression in mild to moderate PD patients. This may help clinicians to recognize depression in PD.Este estudo objetivou encontrar pontos de corte da escala de depressão de Montgomery-Asberg (MADRS e inventário de depressão de Beck (IDB que possam estar relacionados ao diagnóstico clínico específico de depressão na doença de Parkinson (DP. Os pacientes com DP leve e moderada (n= 46 foram avaliados para depressão de acordo com os critérios diagnósticos da DSM-IV. MADRS e IDB foram aplicadas em todos os pacientes. Uma curva "receiver operating characteristics" (ROC foi obtida calculando-se sensibilidade, especificidade, valores

  19. Effect of soothing-liver and nourishing-heart acupuncture on early selective serotonin reuptake inhibitor treatment onset for depressive disorder and related indicators of neuroimmunology: a randomized controlled clinical trial.

    Science.gov (United States)

    Liu, Yi; Feng, Hui; Mo, Yali; Gao, Jingfang; Mao, Hongjing; Song, Mingfen; Wang, Shengdong; Yin, Yan; Liu, Wenjuan

    2015-10-01

    To observe the effect of soothing-liver and nourishing-heart acupuncture on selective serotonin reuptake inhibitor (SSRIs) treatment effect onset in patients with depressive disorder and related indicators of neuroimmunology. Overall, 126 patients with depressive disorder were randomly divided into a medicine and acupuncture-medicine group using a random number table. Patients were treated for 6 consecutive weeks. The two groups were evaluated by the Montgomery-Asberg Depression Rating Scale (MADRS) and Side Effects Rating Scale (SERS) to assess the effect of the soothing-liver and nourishing-heart acupuncture method on early onset of SSRI treatment effect. Changes in serum 5-hydroxytryptamine (5-HT) and inflammatory cytokines before and after treatment were recorded and compared between the medicine group and the acupuncture-medicine group. The acupuncture-medicine group had significantly lower MADRS scores at weeks 1, 2, 4, and 6 after treatment compared with the medicine group (P treatment compared with the medicine group (P treatment, serum 5-HT in the acupuncture-medicine group was significantly higher compared with the medicine group (P 0.05). Anti-inflammatory cytokines IL-4 and IL-10 were significantly higher in the acupuncture-medicine group compared with the medicine group (P depressive disorder and can significantly reduce the adverse reactions of SSRIs. Moreover, acupuncture can enhance serum 5-HT and regulate the balance of pro-inflammatory cytokines and anti-inflammatory cytokines.

  20. Increase in PAS-induced neuroplasticity after a treatment course of intranasal ketamine for depression. Report of three cases from a placebo-controlled trial.

    Science.gov (United States)

    Gálvez, Verònica; Nikolin, Stevan; Ho, Kerrie-Anne; Alonzo, Angelo; Somogyi, Andrew A; Loo, Colleen K

    2017-02-01

    Animal studies suggest that neural plasticity may play a role in the antidepressant effects of a single ketamine dose. However, the potential effects of repeated ketamine treatments on human neuroplasticity are unknown. This pilot RCT study measured plasticity-induced changes before and after a ketamine course, in three treatment-resistant depressed subjects, who were randomized to receive 8 intranasal treatments of 100mg ketamine or 4.5mg midazolam. Mood ratings were performed by a trained blinded rater at baseline and 24h-48h after the ketamine course, using the Montgomery Asberg Depression Rating Scale (MADRS). Neuroplasticity was assessed in the motor cortex using a paired associative stimulation (PAS) paradigm at baseline and 24h-48h after the treatment course. No changes in current psychotropic medication or dosage were permitted for 4weeks prior to trial entry and throughout the trial. The subject receiving ketamine, but not those receiving midazolam, presented a marked increase in neural plasticity after the treatment course. However, mood changes were not associated with changes in neural plasticity. Pilot study with small sample size. Concomitant antidepressant medications taken. Plasticity was tested in the motor cortex only, thus the generalizability of these findings to other brain areas cannot be assumed. These results suggest that a course of intranasal ketamine may enhance synaptic plasticity in subjects with depression, but this was not associated with antidepressant effects. Further research on this topic is warranted. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Standardized clinical outcome rating scale for depression for use in clinical practice.

    Science.gov (United States)

    Zimmerman, Mark; Posternak, Michael A; Chelminski, Iwona; Friedman, Michael

    2005-01-01

    The integration of research into clinical practice to conduct effectiveness studies faces multiple obstacles. One obstacle is the burden of completing research measures of outcome. A simple, reliable, and valid measure that could be rated at every visit, incorporated into a clinician's progress note, and reflect the DSM-IV definition of a major depressive episode (including partial and full remission from the episode) would enhance the ability to conduct effectiveness research. The goal of the present study was to examine the reliability and validity of such a measure. Three hundred and three psychiatric outpatients who were being treated for a DSM-IV major depressive episode were rated on the Standardized Clinical Outcome Rating for Depression (SCOR-D), 17-item Hamilton Rating Scale for Depression, Montgomery-Asberg Depression Rating Scale, and the Global Assessment of Functioning. We examined the correlation between the SCOR-D and the other measures, and conducted an analyses of variance to compare mean values on these measures for each rating point on the SCOR-D. The inter-rater reliability of the SCOR-D dimensional ratings and categorical determination of remission were high. The SCOR-D was highly correlated with the other scales, and there were significant differences on the other measures of depression severity between each adjacent rating level of the SCOR-D. The SCOR-D is a brief standardized outcome measure linked to the DSM-IV approach toward defining remission that can be incorporated into routine clinical practice without adding undue burden to the treating clinician with some evidence of reliability and validity. This measure could make it more feasible to conduct effectiveness studies in clinical practice.

  2. Effects of PRX-00023, a novel, selective serotonin 1A receptor agonist on measures of anxiety and depression in generalized anxiety disorder: results of a double-blind, placebo-controlled trial.

    Science.gov (United States)

    Rickels, Karl; Mathew, Sanjay; Banov, Michael D; Zimbroff, Daniel L; Oshana, Scott; Parsons, Edward C; Donahue, Stephen R; Kauffman, Michael; Iyer, Ganesh R; Reinhard, John F

    2008-04-01

    PRX-00023, a serotonin 1A receptor agonist, was designed to provide high potency and selectivity for its target. To assess the possible therapeutic utility in anxiety, a randomized, double-blind, placebo-controlled trial was conducted in 311 subjects who met the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, for generalized anxiety disorder. All subjects underwent a 1-week placebo run-in and were randomized to receive once-daily capsules containing either PRX-00023 (80 mg/d) or placebo for an additional 8 weeks. The primary outcome measure was the Hamilton Anxiety Scale (HAM-A). The Montgomery-Asberg Depression Rating Scale was used as a secondary endpoint to measure depressive symptoms. Statistical testing was performed with analysis of covariance, between baseline and week 8, with baseline values as a covariate. The anxiolytic effect of PRX-00023, compared with placebo, showed trends across all anxiolytic measures but failed to reach significance on the primary endpoint (HAM-A total score). Among the components of the HAM-A total score, the anxious mood item was significantly different from placebo in the PRX-00023-treated group (-1.015 vs -0.748; P = 0.02). The scores of the Montgomery-Asberg Depression Rating Scale were significantly improved compared with placebo at week 8 (-4.5 vs -1.6; P = 0.0094 in the last observation carried forward analysis). PRX-00023 was well tolerated; of note, there were no drug-related serious adverse events, and more patients discontinued due to adverse events in the placebo group (2.9%) than in the PRX-00023 group (1.4%). The most common adverse event was headache, observed in 15.7% and 10.9% of PRX-00023- and placebo-treated patients, respectively. Furthermore, there was no evidence of impaired sexual function, as measured by the Massachusetts General Hospital Sexual Function Scale. Collectively, these results support further clinical investigation of higher doses of PRX-00023 in anxiety

  3. Qualitative changes in symptomatology as an effect of treatment with escitalopram in generalized anxiety disorder and major depressive disorder.

    Science.gov (United States)

    Lecrubier, Yves; Dolberg, Ornah T; Andersen, Henning F; Weiller, Emmauelle

    2008-04-01

    The purpose of this article is to examine the similarities and differences between patients with Major Depressive Disorder (MDD) versus Generalized Anxiety Disorder (GAD) versus MDD with anxiety symptoms. Data were analysed from all randomized double-blind clinical studies with escitalopram that measured symptoms using either Hamilton Anxiety Scale (HAMA) or Montgomery-Asberg Depression Rating Scale (MADRS). The contribution of each item of a scale to the total score was calculated before and after treatment, in remitters. Most single items of the HAMA contribute nearly equally in patients with GAD. In patients with MDD, four symptoms (i.e. anxious mood, tension, insomnia and concentration) contribute to most to the HAMA total score. In patients with GAD, three symptoms (tension, sleep and concentration) contribute two-thirds of the MADRS total score. In contrast, most MADRS items contribute equally to the total score in patients with MDD. After treatment to remission, the profile of residual symptoms MDD or GAD was similar to the symptom profile before treatment. Anxiety symptoms are very common in patients with MDD or GAD, and the symptomatic pattern is similar. In both disorders, the symptomatic pattern of residual symptoms is similar to the pattern of symptoms before treatment.

  4. General psychiatric or depressive symptoms were not predictive for mortality in a healthy elderly cohort in Southern Brazil

    Directory of Open Access Journals (Sweden)

    Maria Otilia Cerveira

    Full Text Available Abstract General psychiatric symptoms may interfere with the ability of individuals to take care of their health, to get involved with activities and develop social abilities, thereby increasing risk of death. Objective: To evaluate general psychiatric symptoms as predictive factors for mortality in a community elderly cohort in Southern Brazil. Methods: 345 healthy elderly, aged ³60 years, from the catchment area of Hospital de Clinicas de Porto Alegre were followed from 1996. Data for the present study were drawn from the period 1996-2004. General psychiatric symptoms (Self-Reporting Questionnaire - SRQ, depressive symptoms (Montgomery-Asberg depressive rating scale, and Mini Mental State Examination scores at baseline were included in the study. Socio-demographic, medical conditions, and functional capacity were also analyzed. The outcome was vital status at follow-up obtained from family members, hospital records and checked against official death registers. Results: Of the 345 baseline individuals, 246 were followed-up. The global mortality rate over the study period was 36.9% (N=90. Those who deceased during the period were older (73.5±7.5, more dependent overall, and more cognitively impaired than the living elderly (univariate analyses. In the logistic regression, only age (OR=0.93; p=0.003 and functional capacity (OR=0.22; p=0.007 remained significant in the final equation. Conclusion: Psychiatric symptoms presented no association with mortality in the present sample. Older age and functional incapacity were risk factors for mortality.

  5. Self-reported obstructive sleep apnea is associated with nonresponse to antidepressant pharmacotherapy in late-life depression.

    Science.gov (United States)

    Waterman, Lauren; Stahl, Sarah T; Buysse, Daniel J; Lenze, Eric J; Blumberger, Daniel; Mulsant, Benoit; Butters, Meryl; Gebara, Marie Anne; Reynolds, Charles F; Karp, Jordan F

    2016-12-01

    Obstructive sleep apnea (OSA) is frequently comorbid with late-life depression. The purpose of this project was to determine, using a sample of older adults with major depressive disorder, whether patient-reported diagnosis of OSA was associated with rate of response to venlafaxine. Participants from this multisite study were adults ≥60 years old (n = 468) with major depressive disorder and a Montgomery Asberg Depression Rating Scale (MADRS) score of ≥15. Depression response was the outcome variable, defined as a MADRS score of ≤10 for two consecutive assessments at the end of 12 weeks of open-label treatment with venlafaxine 300 mg/day. To assess OSA, participants were asked if they had been diagnosed with OSA using polysomnography. Eighty participants (17.1%) reported a diagnosis of OSA prior to baseline. Participants with OSA were more likely to be male, report greater impairment on measures of health, experience a longer duration of the index episode, and receive an adequate antidepressant trial prior to entering the study. During the 12 weeks of treatment, 40.8% responded to treatment with venlafaxine (43.6%, n = 169/388 of the no OSA group, and 27.5%, n = 22/80 of the OSA group). Participants without OSA were 1.79 times more likely to respond to treatment (HR: 1.79 [95%CI: 1.13-2.86], P < .05) compared to those with OSA. OSA may impair response to antidepressant pharmacotherapy in depressed older adults. Future studies of antidepressant response rates among depressed older adults with OSA should both prospectively diagnose OSA and monitor adherence to treatments such as continuous positive airway pressure. © 2016 Wiley Periodicals, Inc.

  6. Duloxetine and care management treatment of older adults with comorbid major depressive disorder and chronic low back pain: results of an open-label pilot study

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    Karp, Jordan F.; Weiner, Debra K.; Dew, Mary A.; Begley, Amy; Miller, Mark D.; Reynolds, Charles F.

    2010-01-01

    Objective: In older adults, major depressive disorder (MDD) and chronic low back pain (CLBP) are common and mutually exacerbating. We predicted that duloxetine pharmacotherapy and Depression and Pain Care Management (DPCM) would result in (1) significant improvement in MDD and CLBP and (2) significant improvements in health-related quality of life, anxiety, disability, self-efficacy, and sleep quality. Design and Intervention: Twelve week open-label study using duloxetine up to 120 mg/day + DPCM. Setting: Outpatient late-life depression research clinic. Patients: Thirty community-dwelling adults >60 years old. Outcome Measures: Montgomery Asberg Depression Rating Scale (MADRS) and McGill Pain Questionnaire-Short Form (MPQ-SF). Results: 46.7% (n = 14) of the sample had a depression remission. All subjects who met criteria for the depression remission also had a pain response. 93.3% (n = 28) had a significant pain response. Of the subjects who met criteria for a low back pain response, 50% (n = 14) also met criteria for the depression remission. The mean time to depression remission was 7.6 (SE = 0.6) weeks. The mean time to pain response was 2.8 (SE = 0.5) weeks. There were significant improvements in mental health-related quality of life, anxiety, sleep quality, somatic complaints, and both self-efficacy for pain management and for coping with symptoms. Physical health-related quality of life, back pain-related disability, and self-efficacy for physical functioning did not improve. Conclusions: Serotonin and norepinephrine reuptake inhibitors like duloxetine delivered with DPCM may be a good choice to treat these linked conditions in older adults. Treatments that target low self-efficacy for physical function and improving disability may further increase response rates. PMID:19750557

  7. Resilience and spirituality in patients with depression and their family members: A cross-sectional study.

    Science.gov (United States)

    Ozawa, Chisa; Suzuki, Takefumi; Mizuno, Yuya; Tarumi, Ryosuke; Yoshida, Kazunari; Fujii, Kazuhito; Hirano, Jinichi; Tani, Hideaki; Rubinstein, Ellen B; Mimura, Masaru; Uchida, Hiroyuki

    2017-08-01

    The degree and quality of resilience in patients with depression have never been investigated in the context of remission status, spirituality/religiosity, and family members' resilience levels, which was addressed in this study. This cross-sectional study recruited Japanese outpatients with depressive disorder according to ICD-10 and cohabitant family members who were free from psychiatric diagnoses. Resilience was assessed using the 25-item Resilience Scale (RS). Other assessments included the Montgomery-Asberg Depression Rating Scale (MADRS); the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT) and Kasen et al.'s (2012) scale for spirituality/religiosity; and the Rosenberg Self-Esteem Scale (RSES). One hundred outpatients with depression (mean±SD age, 50.8±14.5years; 44 men; MADRS total score 9.8±9.0) and 36 healthy family members (mean±SD age, 56.5±15.0years; 18 men) were included. Symptom severity, attendance at religious/spiritual services, and self-esteem were significantly associated with RS scores in the patient group. RS total scores were significantly higher in remitted patients compared to non-remitted patients (mean±SD, 112.3±17.1 vs. 84.8±27.7, pself-esteem or spirituality/religiosity may represent reinforcing elements. While caution is necessary in extrapolating these findings to other patient populations, our results suggest that resilience may be considered a state marker in depression. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Comparative efficacy of escitalopram in the treatment of major depressive disorder

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    Mazen K Ali

    2011-02-01

    Full Text Available Mazen K Ali, Raymond W LamDepartment of Psychiatry, University of British Columbia, and Mood Disorders Centre, University of British Columbia Hospital, Vancouver, CanadaBackground: Escitalopram is an allosteric selective serotonin reuptake inhibitor (SSRI with some indication of superior efficacy in the treatment of major depressive disorder. In this systematic review, we critically evaluate the evidence for comparative efficacy and tolerability of escitalopram, focusing on pooled and meta-analysis studies.Methods: A literature search was conducted for escitalopram studies that quantitatively synthesized data from comparative randomized controlled trials in MDD. Studies were excluded if they did not focus on efficacy, involved primarily subgroups of patients, or synthesized data included in subsequent studies. Outcomes extracted from the included studies were weighted mean difference or standard mean difference, response and remission rates, and withdrawal rate owing to adverse events.Results: The search initially identified 24 eligible studies, of which 12 (six pooled analysis and six meta-analysis studies met the criteria for review. The pooled and meta-analysis studies with citalopram showed significant but modest differences in favor of escitalopram, with weighted mean differences ranging from 1.13 to 1.73 points on the Montgomery Asberg Depression Rating Scale, response rate differences of 7.0%–8.3%, and remission rate differences of 5.1%–17.6%. Pooled analysis studies showed efficacy differences compared with duloxetine and with serotonin noradrenaline reuptake inhibitors combined, but meta-analysis studies did not. The effect sizes of the efficacy differences increased in the severely depressed patient subgroups.Conclusion: Based on pooled and meta-analysis studies, escitalopram demonstrates superior efficacy compared with citalopram and with SSRIs combined. Escitalopram shows similar efficacy to serotonin noradrenaline reuptake

  9. Effects of quetiapine on sleep architecture in patients with unipolar or bipolar depression

    Directory of Open Access Journals (Sweden)

    Laura Gedge

    2010-08-01

    Full Text Available Laura Gedge1, Lauren Lazowski1, David Murray2, Ruzica Jokic2,3, Roumen Milev2,31Centre for Neuroscience Studies, 2Department of Psychiatry, Queen’s University, Kingston, 3Providence Care-Mental Health Services, Kingston, Ontario, CanadaObjective: To determine the effect of adjunctive quetiapine therapy on the sleep architecture of patients with bipolar or unipolar depression.Methods: This is a prospective, single-blind, repeated measures polysomnographic study. Sleep architecture was analyzed by overnight polysomnography, and subjective sleep quality was measured using the Pittsburgh Sleep Quality Index. The Hamilton Rating Scale for Depression, Montgomery Asberg Depression Rating Scale, Young Mania Rating Scale, and Clinical Global Impression-Severity Scale were employed to quantify changes in illness severity with adjunctive quetiapine treatment. Polysomnographs and clinical measures were administered at baseline, after 2–4 days of treatment, and after 21–28 days of quetiapine treatment. The average dose of quetiapine was 155 mg, ranging from 100–200 mg.Results: Adjunctive quetiapine therapy did not significantly alter sleep efficiency, sleep continuity, or Pittsburgh Sleep Quality Index scores. Respiratory Disturbance Index and percentage of total time in rapid eye movement (REM sleep significantly decreased and the percentage of total time in non-REM sleep, and duration of Stage 2 and non-REM sleep significantly increased after 2–4 days of quetiapine treatment. Illness severity significantly decreased over time.Conclusions: Adjunctive quetiapine treatment alters sleep architecture in patients with major depressive disorder or bipolar disorder, which may partially explain its early antidepressant properties. Changes in sleep architecture are more robust and significant within two to four days of starting treatment.Keywords: quetiapine, sleep architecture, depression, bipolar disorder

  10. Posture-cognitive dual-tasking: A relevant marker of depression-related psychomotor retardation. An illustration of the positive impact of repetitive transcranial magnetic stimulation in patients with major depressive disorder.

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    Deschamps, Thibault; Sauvaget, Anne; Pichot, Anne; Valrivière, Pierre; Maroulidès, Maxime; Bois, Aurore; Bulteau, Samuel; Thomas-Ollivier, Véronique

    2016-12-01

    This study examined whether postural control variables, particularly the center-of-pressure (COP) velocity-based parameters, could be a relevant hallmark of depression-related psychomotor retardation (PMR). We first aimed at investigating the interplay between the PMR scores and the COP performance in patients with major depressive disorder (MDD), as compared to age-matched healthy controls; secondly, we focused on the impact of a repetitive transcranial magnetic stimulation (rTMS) treatment on depression, PMR scores and postural performance. 16 MDD patients, and a control group of 16 healthy adults, were asked to maintain quiet standing balance during two trials with or without vision, and while backward counting (dual task). All the position and velocity-based COP variables were computed. Before and after the rTMS session (n eligible MDD = 10), we assessed the depression level with the Montgomery-Asberg Depression Rating Scale (MADRS), the PMR scores with the French Retardation Rating Scale for Depression (ERD), and postural performance. Before the treatment, significant positive partial correlations were found between the pre-ERD scores and the velocity-based COP variables, especially in the dual-task conditions (p < 0.05). In contrast, there was no significant correlation between the post-ERD scores and any postural parameter after the treatment. The MADRS and ERD scores showed a significant decrease between before and after the rTMS intervention. For the first time, the findings clearly validated the view that the assessment of postural performance - easy to envisage in clinical settings-constitutes a reliable and objective marker of PMR in MDD patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. The Effect of Combination Antiviral Therapy in the Treatment of Hepatitis C on the Occurrence of Depressive Disorder in Patients Treated for Hepatitis C in the Republic of Srpska

    Science.gov (United States)

    Banjac, Visnja; Zivlak-Radulovic, Nera; Miskovic, Mirjana

    2016-01-01

    Background: The current standard treatment of chronic hepatitis C in Bosnia and Herzegovina consists of pegylated interferon alpha in combination with ribavirin. Interferon therapy has many psychiatric side effects, with depressive symptomatology being most prominent. The aim of the study was to establish the frequency and severity of depression in patients with chronic hepatitis C during two months of the aforementioned therapy. Subjects and Methods: The overall sample consisted of 46 subjects, divided into three subgroups, aged 18 to 65. The study population consisted of subjects treated for chronic hepatitis C (n = 15), subjects infected but not treated for chronic hepatitis C (n = 15), and healthy controls (n = 16). The assessment and level of depression were based on the Structural clinical interview (SCID), Montgomery-Asberg Depression Rating Scale and Zung Self-Rating Depression Scale. The assessments were conducted before interferon therapy (on the day 0), after 4 and 8 weeks of therapy. Results: Regarding its frequency, MADRS scoring showed that the number of depressed subjects receiving therapy increased after 8 weeks (46.7%). There was statistical significance between the subgroups after 4 and 8 weeks. Likewise, the ZUNG scale showed that the number of depressed subjects receiving therapy increased after 8 weeks (73.3%). There was statistical significance between the subgroups on the day 0, after 4 and 8 weeks. Conclusions: Depression was significantly more frequent in chronic hepatitis C subjects treated with interferon alpha in combination with ribavirin than in subjects in the group without therapy. Mild depression was most prevalent. PMID:27147788

  12. [Interest of scopolamine as a treatment of major depressive disorder].

    Science.gov (United States)

    Rigal, A; Mouchabac, S; Peretti, C S

    2016-12-01

    The number of patients with depression in the world is 350 millions according to estimates. The search for new treatments, particularly in forms of resistant depression, is necessary given the growing number of patients experiencing treatment failure and resistance. Scopolamine, an anticholinergic antimuscarinic molecule, is one of the treatments under evaluation. It falls within the assumptions of cholinergic disruption of the pathophysiology of depression, at different levels (genetic, receptorial [muscarinic and glutamate receptors], hormonal, synaptic…). In 2006, a pilot study made to evaluate the role of the cholinergic system in cognitive symptoms of depression found unexpected results regarding the antidepressant effect of scopolamine in depressive patients. Since that time other studies have been conducted to evaluate the benefits of treatment with intravenous injections of scopolamine. Our main objective was to evaluate the interest of scopolamine as an antidepressant treatment in depressed populations. We conducted a literature review with the aim of assessing the effectiveness of treatment with scopolamine in uni- and bipolar patients with depressive symptoms. The protocol consisted of two injection blocks (each block consisting of three injections spaced fifteen minutes apart within three to five days) of active ingredient or placebo crossover. The selected patients were between 18 and 45years and had the DSM-IV major depressive disorder or bipolar disorder criteria. Regarding the methods of measurement, the primary endpoint was the reduction in scores of the Montgomery Asberg Depression Rating Scale (MADRS) with a total response defined by a decrease of more than 50 % of the score and remission corresponding to a MADRS scoretreatment was well tolerated by patients with relatively mild and transient side effects the most common being the sensation of sleepiness that was also found in the placebo group. There were no serious side effects such as

  13. Do equivalent doses of escitalopram and citalopram have similar efficacy? A pooled analysis of two positive placebo-controlled studies in major depressive disorder.

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    Lepola, Ulla; Wade, Alan; Andersen, Henning Friis

    2004-05-01

    Escitalopram is the S-enantiomer of citalopram. In this study, we compared the efficacy of equivalent dosages of escitalopram and citalopram in the treatment of moderate to severe major depressive disorder (MDD), based on data from two, pooled, randomized, double-blind, placebo-controlled studies of escitalopram in which citalopram was the active reference. The primary efficacy parameter was the mean change from baseline in the Montgomery Asberg Depression Rating Scale (MADRS) total score. Significant differences in favour of escitalopram were observed for the MADRS [PEscitalopram separated from placebo at week 1 on the primary efficacy parameter, whereas citalopram first separated from placebo at week 6. An analysis of time to response showed that escitalopram-treated patients responded significantly faster to treatment than citalopram-treated patients (Pescitalopram than to citalopram (Pescitalopram-treated patients had a significant reduction in HAMD-17 total score at week 8 compared to citalopram-treated patients (P or = 30), escitalopram-treated patients showed greater improvement than citalopram-treated patients (PEscitalopram showed consistently superior efficacy compared to citalopram in the treatment of moderate to severe MDD on all efficacy parameters, and was similarly well tolerated.

  14. A Danish cost-effectiveness model of escitalopram in comparison with citalopram and venlafaxine as first-line treatments for major depressive disorder in primary care.

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    Sørensen, Jan; Stage, Kurt B; Damsbo, Niels; Le Lay, Agathe; Hemels, Michiel E

    2007-01-01

    The objective of this study was to model the cost-effectiveness of escitalopram in comparison with generic citalopram and venlafaxine in primary care treatment of major depressive disorder (baseline scores 22-40 on the Montgomery-Asberg Depression Rating Scale, MADRS) in Denmark. A three-path decision analytic model with a 6-month horizon was used. All patients started at the primary care path and were referred to outpatient or inpatient secondary care in the case of insufficient response to treatment. Model inputs included drug-specific probabilities derived from systematic literature review, ad-hoc survey and expert opinion. Main outcome measures were remission defined as MADRS escitalopram (64.1%) than citalopram (58.9%). From both perspectives, the total expected cost per successfully treated patient was lower for escitalopram (DKK 22,323 healthcare, DKK 72,399 societal) than for citalopram (DKK 25,778 healthcare, DKK 87,786 societal). Remission rates and costs were similar for escitalopram and venlafaxine. Robustness of the findings was verified in multivariate sensitivity analyses. For patients in primary care, escitalopram appears to be a cost-effective alternative to (generic) citalopram, with greater clinical benefit and cost-savings, and similar in cost-effectiveness to venlafaxine.

  15. Escitalopram dose-response revisited: an alternative psychometric approach to evaluate clinical effects of escitalopram compared to citalopram and placebo in patients with major depression.

    Science.gov (United States)

    Bech, Per; Tanghøj, Per; Cialdella, Philippe; Andersen, Henning Friis; Pedersen, Anders Gersel

    2004-09-01

    In continuation of a previous psychometric analysis of dose-response data for citalopram in depression, the corresponding study data for escitalopram is of interest, since escitalopram is the active enantiomer of citalopram and because citalopram was used as the active control. Revisiting those corresponding data, the psychometric properties of the Montgomery-Asberg Depression Scale (MADRS) and the Hamilton Depression Scale (HAMD) were investigated by focusing on the unidimensional HAMD6 and MADRS6. Effect sizes were calculated and compared for two dosages of escitalopram (10 mg and 20 mg daily) and between each of these two dosages and 40 mg citalopram daily. The results showed that the three depression scales MADRS6, MADRS10 and HAMD6 were psychometrically acceptable (coefficient of homogeneity of 0.40 or higher). In the severely depressed patients (MADRS10> or =30) a rather clear dose-response relationship for escitalopram was seen on all three scales after 6 and 8 wk of therapy. Thus, the effect size for 10 mg escitalopram ranged from 0.28 to 0.38 while the effect sizes for 20 mg escitalopram ranged from 0.57 to 0.77. This difference was statistically significant (pescitalopram and 40 mg citalopram was seen after 8 wk of therapy for MADRS10 (effect size 0.71 vs. 0.37). An item analysis identified 'suicidal thoughts' to be the most discriminating item in this respect. These results for the severely depressed patients were confirmed by the patients self-reported quality of life evaluation. When all included patients were analysed, however, no clear dose-response relationship was seen. In conclusion, a dose-response relationship for escitalopram was seen in the severely depressed patients on all outcome scales after 6 and 8 wk of treatment. After 8 wk of treatment 20 mg escitalopram was superior to 40 mg citalopram, but not after 2 wk of treatment.

  16. Increased depressive ratings in patients with hepatitis C receiving interferon-alpha-based immunotherapy are related to interferon-alpha-induced changes in the serotonergic system.

    Science.gov (United States)

    Bonaccorso, Stefania; Marino, Valentina; Puzella, Antonella; Pasquini, Massimo; Biondi, Massimo; Artini, Marco; Almerighi, Cristiana; Verkerk, Robert; Meltzer, Herbert; Maes, Michael

    2002-02-01

    There is now evidence that repeated administration of interferon-alpha (IFN-alpha) to patients with chronic active hepatitis and cancers induces depressive symptoms. There is also evidence that induction of the cytokine network modulates the serotonergic system and that major depression is related to activation of the cytokine network and disturbances in the serotonergic metabolism. The aims of this study were to examine the effects of IFN-alpha-based immunotherapy on the development of depressive symptoms in relation to its effects on plasma tryptophan and kynurenine and serum serotonin (5-HT). Eighteen patients affected by chronic active hepatitis C were treated with IFN-alpha (3-6 million units subcutaneously three to six times a week for 6 months) and had measurements of the previous parameters before starting immunotherapy and 2, 4, 16, and 24 weeks later. Severity of depression and anxiety were measured with the Montgomery-Asberg Depression Rating Scale (MADRS) and the Hamilton Rating Scale for Anxiety (HAM-A) scale, respectively. Immunochemotherapy with IFN-alpha (1) significantly increased the MADRS and HAM-A scores and serum kynurenine concentrations and (2) significantly reduced plasma tryptophan and serum 5-HT concentrations. IFN-alpha-based immunotherapy significantly increased the kynurenine per tryptophan quotient, which estimates the activity of indoleamine 2,3-dioxygenase, the major tryptophan-catabolizing enzyme, which is induced by IFNs. There are significant relationships between the IFN-alpha-induced changes in the MADRS score and serum kynurenine (positive) and 5-HT (negative) concentrations. Immunotherapy with IFN-alpha significantly increases the severity of depressive symptoms. The latter is related to changes in the serotonergic system, such as depletion of serum 5-HT and induction of the catabolism of tryptophan to kynurenine. It is suggested that the IFN-alpha-induced changes in the serotonergic turnover could play a role in the

  17. Safety and efficacy of oral escitalopram as continuation treatment of intravenous citalopram in patients with major depressive disorder.

    Science.gov (United States)

    Schmitt, Laurent; Tonnoir, Brigitte; Arbus, Christophe

    2006-01-01

    The objective of this open-label, multicentre study was to evaluate the safety and efficacy of treatment with escitalopram (10 or 20 mg/day) for 6 weeks following a switch from intravenous citalopram treatment (20 or 40 mg/day) in patients presenting with a major depressive episode. A total of 173 patients were included, 147 (85%) of whom completed the study. The mean Montgomery-Asberg Depression Rating Scale (MADRS) total score at inclusion (last citalopram dose) was 31.6 +/- 9.9. The MADRS score decreased to 23.4 +/- 10.5 after 3 days of oral treatment with escitalopram and was 12.7 +/- 9.3 at the end of the study. The scores on the Clinical Global Impression (CGI) and Patient Global Evaluation scales also improved: at the end of the study, the response rates were 67% on the MADRS (defined as >or=50% decrease from MADRS baseline score) and 68% on the CGI-I (defined as CGI-I depressive symptoms (anxiety: 9%; insomnia: 5%). In conclusion, escitalopram was well tolerated as a continuation treatment after switching from intravenous citalopram and reduced depressive symptoms in patients with a moderate to severe major depressive episode. (c) 2006 S. Karger AG, Basel.

  18. Perceptions of stigma and its correlates among patients with major depressive disorder: A multicenter survey from China.

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    Shi-Jie, Feng; Hong-Mei, Gao; Li, Wang; Bin-Hong, Wang; Yi-Ru, Fang; Gang, Wang; Tian-Mei, Si

    2017-09-01

    The stigma of major depressive disorder (MDD) is an important public health problem. This study evaluated stigma in MDD patients in China using explanatory model interview catalogue (EMIC) questionnaire and the demographic and clinical symptom factors associated with the stigma of these patients. A total of 158 MDD patients from domestic 3 mental health centers were surveyed. We used the EMIC questionnaire to assess stigma of these patients, Montgomery and Asberg depression rating scale (MADRS) to assess depressive severity, self-reporting inventory (SCL-90) to assess mental health level, Sheehan disability scale (SDS) to assess social function, and fatigue severity scale (FSS) to assess degree of fatigue. The stigma scores were significantly higher in the 18- to 30-year-old (z = 2.875, P = .024) and 31- to 40-year-old (z = 3.204, P = .008) groups than the 51- to 65-year-old group; in the full-time employment group than the retired group (z = 3.163, P = .016). The stigma scores exhibited significant negative correlation with age (r = -0.169, P = .034) but positive correlations with the scores of MADRS (r = .212, P = .007), total scores (r = .273, P = .001) and subscales of interpersonal sensitivity (r = .233, P = .003), depression (r = .336, P stigma. The age, employment status, fatigue, and depressive severity are closely associated with the perceived stigma of MDD patients and may be important factors considered for stigma interventions of MDD in China. © 2016 John Wiley & Sons Australia, Ltd.

  19. Low frequency (1-Hz), right prefrontal repetitive transcranial magnetic stimulation (rTMS) compared with venlafaxine ER in the treatment of resistant depression: a double-blind, single-centre, randomized study.

    Science.gov (United States)

    Bares, Martin; Kopecek, Miloslav; Novak, Tomas; Stopkova, Pavla; Sos, Peter; Kozeny, Jiri; Brunovsky, Martin; Höschl, Cyril

    2009-11-01

    Previous studies have shown effectiveness of repetitive transcranial magnetic stimulation (rTMS) in the treatment of depression. This double-blind study compared efficacy of l Hz rTMS over the right prefrontal dorsolateral cortex with venlafaxine ER in the treatment of resistant depression. A total of 60 inpatients with depressive disorder (DSM-IV criteria), who previously did not respond to at least one antidepressant treatment, were randomly assigned to 1 Hz rTMS with placebo and venlafaxine ER with sham rTMS for 4 weeks. The primary outcome measure was score change in the Montgomery-Asberg Depression Rating Scale (MADRS). We also used Clinical Global Impression (CGI) and Beck Depressive. Inventory-Short Form (BDI-SF). The response was defined as a >or=50% reduction of MADRS score. There were no significant differences between treatment groups in MADRS (p=0.38), BDI-SF (p=0.56) and CGI (p=0.17) scores from baseline to endpoint. Response rates for rTMS (33%) and venlafaxine (39%) as well as remission (MADRS scoredepressive symptomatology in patients with resistant depression comparable to venlafaxine ER. Larger sample sizes are required to confirm these results.

  20. Strategic nonviolent conflict: The Montgomery Bus Boycott

    Directory of Open Access Journals (Sweden)

    Fatih Balcı

    2011-07-01

    Full Text Available Nonviolent action emerges under the conditions of recognized an unacceptable political oppression and injustice. The people, who find the situation unacceptable, develop three ways of behavior. First, they exit the situation. Second, they engage in everyday forms of resistance. Third, they participate in political action which has two aspects: institutional and non-institutional. Institutional political action comprises of the regular political activities such as voting, taking part in legislative process, and joining political parties. Non-institutional political action, on the contrary, arises as either violent action or nonviolent action. This paper examines the emergence, progress, and spread of the Montgomery Bus Boycott as one of the leading examples of the nonviolent struggles in the last century.

  1. Strategic nonviolent conflict: The Montgomery Bus Boycott

    Directory of Open Access Journals (Sweden)

    Hüdaverdi Balcı

    2011-07-01

    Full Text Available Nonviolent action emerges under the conditions of recognized an unacceptable political oppression and injustice. The people, who find the situation unacceptable, develop three ways of behavior. First, they exit the situation. Second, they engage in everyday forms of resistance. Third, they participate in political action which has two aspects: institutional and non-institutional. Institutional political action comprises of the regular political activities such as voting, taking part in legislative process, and joining political parties. Non-institutional political action, on the contrary, arises as either violent action or nonviolent action. This paper examines the emergence, progress, and spread of the Montgomery Bus Boycott as one of the leading examples of the nonviolent struggles in the last century

  2. Dextromethorphan/quinidine pharmacotherapy in patients with treatment resistant depression: A proof of concept clinical trial.

    Science.gov (United States)

    Murrough, James W; Wade, Elizabeth; Sayed, Sehrish; Ahle, Gabriella; Kiraly, Drew D; Welch, Alison; Collins, Katherine A; Soleimani, Laili; Iosifescu, Dan V; Charney, Dennis S

    2017-08-15

    At least one-third of patients with major depressive disorder (MDD) have treatment-resistant depression (TRD), defined as lack of response to two or more adequate antidepressant trials. For these patients, novel antidepressant treatments are urgently needed. The current study is a phase IIa open label clinical trial examining the efficacy and tolerability of a combination of dextromethorphan (DM) and the CYP2D6 enzyme inhibitor quinidine (Q) in patients with TRD. Dextromethorphan acts as an antagonist at the glutamate N-methyl-d-aspartate (NMDA) receptor, in addition to other pharmacodynamics properties that include activity at sigma-1 receptors. Twenty patients with unipolar TRD who completed informed consent and met all eligibility criteria we enrolled in an open-label study of DM/Q up to 45/10mg by mouth administered every 12h over the course of a 10-week period, and constitute the intention to treat (ITT) sample. Six patients discontinued prior to study completion. There was no treatment-emergent suicidal ideation, psychotomimetic or dissociative symptoms. Montgomery-Asberg Depression Rating Scale (MADRS) score was reduced from baseline to the 10-week primary outcome (mean change: -13.0±11.5, t19=5.0, pproof-of-concept design. Herein we report acceptable tolerability and preliminary efficacy of DM/Q up to 45/10mg administered every 12h in patients with TRD. Future larger placebo controlled randomized trials in this population are warranted. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Usefulness of EQ-5D in Assessing Health Status in Primary Care Patients with Major Depressive Disorder

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    Nowicki Marie-Laure

    2004-05-01

    Full Text Available Abstract Objectives Major depressive disorder (MDD is a prevalent psychiatric disorder associated with impaired patient functioning and reductions in health-related quality of life (HRQL. The present study describes the impact of MDD on patients' HRQL and examines preference-based health state differences by patient features and clinical characteristics. Methods 95 French primary care practitioners recruited 250 patients with a DSM-IV diagnosis of MDD for inclusion in an eight-week follow-up cohort. Patient assessments included the Montgomery Asberg Depression Rating Scale (MADRS, the Clinical Global Impression of Severity (CGI, the Short Form-36 Item scale (SF-36, the Quality of Life Depression Scale (QLDS and the EuroQoL (EQ-5D. Results The mean EQ-5D utility at baseline was 0.33, and 8% of patients rated their health state as worse than death. There were no statistically significant differences in utilities by demographic features. Significant differences were found in mean utilities by level of disease severity assessed by CGI. The different clinical response profiles, assessed by MADRS, were also revealed by EQ-5D at endpoint: 0.85 for responders remitters, 0.72 for responders non-remitter, and 0.58 for non-responders. Even if HRQL and EQ-5D were moderately correlated, they shared only 40% of variance between baseline and endpoint. Conclusions Self-reported patient valuations for depression are important patient-reported outcomes for cost-effectiveness evaluations of new antidepressant compounds and help in further understanding patient compliance with antidepressant treatment.

  4. A randomized, double-blind, placebo-controlled trial of desvenlafaxine succinate in adult outpatients with major depressive disorder.

    Science.gov (United States)

    Liebowitz, Michael R; Yeung, Paul P; Entsuah, Richard

    2007-11-01

    This study evaluated the efficacy and tolerability of desvenlafaxine succinate (desvenlafaxine) in the treatment of major depressive disorder (MDD). In this 8-week, multicenter, randomized, double-blind, placebo-controlled trial, adult outpatients (aged 18-75 years) with a primary diagnosis of MDD (DSM-IV criteria) were randomly assigned to treatment with desvenlafaxine (100-200 mg/day) or placebo. The primary outcome measure was the 17-item Hamilton Rating Scale for Depression (HAM-D(17)) score at final on-therapy evaluation. The Clinical Global Impressions-Improvement scale (CGI-I) was the key secondary measure. Other secondary measures included the Montgomery-Asberg Depression Rating Scale (MADRS), Clinical Global Impressions-Severity of Illness scale, Visual Analog Scale-Pain Intensity (VAS-PI) overall and subcomponent scores, and HAM-D(17) response and remission rates. The study was conducted from June 2003 to May 2004. Of the 247 patients randomly assigned to treatment, 234 comprised the intent-to-treat population. Following titration, mean daily desvenlafaxine doses ranged from 179 to 195 mg/day. At endpoint, there were no significant differences in scores between the desvenlafaxine (N = 120) and placebo (N = 114) groups on the HAM-D(17) or CGI-I. However, the desvenlafaxine group had significantly greater improvement in MADRS scores (p = .047) and in VAS-PI overall pain (p = .008), back pain (p = .006), and arm, leg, or joint pain (p Desvenlafaxine was generally safe and well tolerated. In this study, it did not show significantly greater efficacy than placebo on the primary or key secondary efficacy endpoints, but it did demonstrate efficacy on an alternate depression scale and pain measure associated with MDD. ClinicalTrials.gov identifier NCT00063206.

  5. Depressants

    Science.gov (United States)

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

  6. Parcels and Land Ownership, Published in 2011, Montgomery County Government.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Parcels and Land Ownership dataset as of 2011. The extent of these data is generally Montgomery County, IA. This metadata was auto-generated through the Ramona...

  7. 76 FR 71909 - Television Broadcasting Services; Montgomery, AL

    Science.gov (United States)

    2011-11-21

    ... From the Federal Register Online via the Government Publishing Office FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 73 Television Broadcasting Services; Montgomery, AL AGENCY: Federal Communications Commission. ACTION: Final rule. SUMMARY: The Commission grants a petition for rulemaking filed by Channel...

  8. 76 FR 54188 - Television Broadcasting Services; Montgomery, AL

    Science.gov (United States)

    2011-08-31

    ... From the Federal Register Online via the Government Publishing Office FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 73 Television Broadcasting Services; Montgomery, AL AGENCY: Federal Communications... 73 Television, Television broadcasting. Federal Communications Commission. Barbara A. Kreisman,...

  9. Final Environmental Assessment for Temporary Aircraft Relocation to Maxwell Air Force Base 187th Fighter Wing Montgomery Regional Airport Montgomery, Alabama

    Science.gov (United States)

    2012-06-01

    Alabama. Mims, Donald L. Montgomery County Administrator, Montgomery, Alabama. Mueller, Heinz. Environmental Review Coordinator, U.S. Environmental...Mr. Donald L. Mims Montgomery County Administrator PO Box 1667 Montgomery, AL 36102-1667 Environmental Assessment for Temporary Aircraft...Experimental Study.” J. Acoust. Soc. Am., 82, 479-492. Frericks, R.R., B.L. Beeman , and A.H. Coulson. 1980. “Los Angeles Airport Noise and

  10. Negative Emotions and Suicidal Ideation during Psychosocial Treatments in Older Adults with Major Depression and Cognitive Impairment.

    Science.gov (United States)

    Kiosses, Dimitris N; Gross, James J; Banerjee, Samprit; Duberstein, Paul R; Putrino, David; Alexopoulos, George S

    2017-06-01

    To examine the relationship of negative emotions with suicidal ideation during 12 weeks of Problem Adaptation Therapy (PATH) versus Supportive Therapy of Cognitively Impaired Older Adults (ST-CI), hypothesizing that improved negative emotions are associated with reduced suicidal ideation, PATH improves negative emotions more than ST-CI, and improved negative emotions, rather than other depression symptoms, predict reduction in suicidal ideation. In a randomized controlled trial of two home-delivered psychosocial interventions, 74 older participants (65-95 years old) with major depressive disorder and cognitive impairment were recruited in collaboration with community agencies. The sample reported less intense feelings than suicidal intention. Interventions and assessments were conducted in participants' homes. PATH focuses on improving emotion regulation, whereas ST-CI focuses on nonspecific therapeutic factors, such as understanding and empathy. Improved negative emotions were measured as improvement in Montgomery Asberg's Depression Rating Scales' (MADRS) observer ratings of sadness, anxiety, guilt, hopelessness, and anhedonia. Suicidal ideation was assessed with the MADRS Suicide Item. MADRS Negative Emotions scores were significantly associated with suicidal ideation during the course of treatment (F[1,165] = 12.73, p = 0.0005). PATH participants had significantly greater improvement in MADRS emotions than ST-CI participants (treatment group by time: F[1,63.2] = 7.02, p = 0.0102). Finally, improved negative emotions, between lagged and follow-up interview, significantly predicted reduction in suicidal ideation at follow-up interview (F[1, 96] = 9.95, p = 0.0022). Findings thatimprovement in negative emotions mediates reduction in suicidal ideation may guide the development of psychosocial interventions for reduction of suicidal ideation (clinicaltrials.gov; NCT00368940). Copyright © 2017 American Association for Geriatric Psychiatry

  11. Is the Noradrenergic Symptom Cluster a Valid Construct in Adjunctive Treatment of Major Depressive Disorder?

    Science.gov (United States)

    Stauffer, Virginia L; Liu, Peng; Goldberger, Celine; Marangell, Lauren B; Nelson, Craig; Gorwood, Philip; Fava, Maurizio

    2017-03-01

    To identify symptoms potentially representative of a noradrenergic symptom cluster as possible predictors of response to the selective norepinephrine reuptake inhibitor (NRI) edivoxetine when used as monotherapy or adjunctive treatment in patients with DSM-IV-TR major depressive disorder (MDD). Pooled data from 4 adjunctive treatment trials (selective serotonin reuptake inhibitor [SSRI] + edivoxetine 6-18 mg/d vs SSRI + placebo; N = 2,066) and data from 1 monotherapy trial (edivoxetine 6-18 mg/d versus placebo; N = 495) were used to identify predictors of response related to noradrenergic symptoms using a resampling-based ensemble tree method. The trials were conducted from 2008 to 2013. In the pooled adjunctive trials, no subgroup was identified that demonstrated a greater edivoxetine-placebo treatment difference than the overall patient cohort. In the edivoxetine monotherapy trial, no subgroup showing greater mean edivoxetine-placebo differences on the Montgomery-Asberg Depression Rating Scale versus the overall patient cohort was identified; a subgroup (67%) with high b​aseline Massachusetts General Hospital Cognitive and Physical Functioning Questionnaire (CPFQ) total score (≥ 28) showed statistically significantly (P = .02) greater mean edivoxetine-placebo differences on the Sheehan Disability Scale versus the overall patient cohort, and subgroups with baseline CPFQ total score ≥ 28 (65%), CPFQ cognition dimension score ≥ 16 (63%), or CPFQ physical dimension score ≥ 13 (59%) showed statistically significantly (P ≤ .025) greater mean edivoxetine-placebo differences on the CPFQ total score versus the overall patient cohort. While we could not identify symptoms predictive of response to the selective NRI edivoxetine used as adjunctive treatment, impaired cognition and physical symptoms may predict greater improvement during monotherapy. ClinicalTrials.gov identifiers: NCT00840034, NCT01173601, NCT01187407, NCT01185340, NCT00795821.

  12. Effectiveness of the first French psychoeducational program on unipolar depression: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Ducasse, Déborah; Courtet, Philippe; Sénèque, Maude; Genty, Catherine; Picot, Marie-Christine; Schwan, Raymund; Olié, Emilie

    2015-11-17

    Major Depressive Disorder (MDD) is highly prevalent and was associated with greater morbidity, mortality (including suicide), and healthcare costs. By 2030, MDD will become the leading cause of disability in high-income countries. Notably, among patients with a previous experience of a major depressive episode, it was indeed estimated that up to 85 % of those patients will suffer from relapse. Two main factors were associated with a significantly higher risk of relapse: poor medication adherence and low self-efficacy in disease management. Interestingly, these issues could become the targets of psychoeducational programs for chronic diseases. Indded psychoeducational program for depression are recommended in international guidelines, but have not yet been proposed in France. We propose to evaluate the first French psychoeducational program for depression "ENVIE" in a multicenter randomized controlled trial. The group intervention will include 9 weekly sessions. Its aim is to educate patients on the latest knowledge on depression and effective treatments through didactic and interactive sessions. Patients will experiment the latest innovating psychological skills (from acceptance and commitment therapy) to cope with depressive symptoms and maintain motivation in behavioral activation. In total, 332 unipolar non-chronic (depression, without psychotic features, will be randomly allocated to the add-on ENVIE program (N = 166) or to a waiting list (N = 166). The follow-up will last 15 months and include 5 assessment visits. The primary endpoint will be the remission rate of the index episode at 15 months post-inclusion, defined by a Montgomery and Asberg Depression Rating Scale (MADRS) score ≤ 12 over an 8-week period, and without relapse during follow-up. We will also assess the response rate and relapse at 15 months post-inclusion, hospitalization rate and adherence to treatment during the follow-up period, quality of life and global functioning upon

  13. Depression CBT treatment gains among HIV-infected persons with a history of injection drug use varies as a function of baseline substance use.

    Science.gov (United States)

    Labbe, Allison K; O'Cleirigh, Conall M; Stein, Michael; Safren, Steven A

    2015-01-01

    Depression and substance use, the most common comorbidities with HIV, are both associated with poor treatment outcomes and accelerated HIV disease progression. Though previous research has demonstrated short-term and follow-up success for cognitive behavioral therapy for adherence and depression (CBT-AD) on depression outcomes among patients with HIV in care and among patients with HIV in active substance abuse treatment for injection drug use (IDU), there is little information regarding possible moderating effects of active use versus abstinence on depression treatment gains. The present study aimed to examine recent substance use at treatment initiation as a moderator of the acute and maintenance effects of CBT-AD on depression. We used data from a two-arm, randomized controlled trial (N = 89) comparing CBT-AD to enhanced treatment as usual in individuals in treatment for IDU. To test whether depression at time of presentation affected outcomes, repeated-measures ANOVAs were conducted for two time frames: (1) acute phase (baseline to post-treatment) (acute) and (2) maintenance phase (baseline to 12-month follow-up). To further examine maintenance of gains, we additionally looked at post-treatment to 12-month follow-up. Depression scores derived from the clinical global impression for severity and the Montgomery-Asberg depression rating scale (MADRS) served as the primary outcome variables. Acute (baseline post treatment) moderation effects were found for those patients endorsing active drug use at baseline in the CBT-AD condition, who demonstrated the greatest reductions in MADRS scores at post-treatment (F[1,76] = 6.78, p = .01) and follow-up (F[1,61] = 5.46, p = .023). Baseline substance use did not moderate differences from post-treatment to 12-month follow-up as depression treatment gains that occurred acutely from baseline to post-treatment were maintained across both patients engaged in substance use and abstainers. We conclude that CBT

  14. [Relationship of insight with depression and suicidal ideation in psychotic disorders].

    Science.gov (United States)

    Patelaros, E; Zournatzis, E; Kontstantakopoulos, G

    2015-01-01

    The associations of insight into psychosis (i.e., awareness of illness) with clinical variables have been examined by a great number of studies. Most of these studies revealed that the level of insight is negatively correlated with psychotic symptoms but positively correlated with depression and suicidal ideation. The aim of this study was to test these findings in a Greek sample of patients. Forty-three outpatients (30 men and 13 women) with schizophrenia or delusional disorder being followed up at the Mental Health Centre of Kavala took part in the study. Patients with bipolar or schizoaffective disorder were excluded. Patients' mean age was 40.7 years and the mean duration of illness was 18.67 years. All participants were under treatment and clinically stable at the time of the study. We used the Positive and Negative Syndrome Scale (PANSS) for the assessment of positive and negative symptoms, the Schedule for the Assessment of Insight-Expanded (SAI-E) to assess the insight into psychosis, and the Montgomery-Asberg Depression Rating Scale (MADRS) for the evaluation of depression recording separately the score for item 10 as an estimate of suicidal ideation. All the scales used have been adapted to Greek population. We used Spearman rho coefficient to assess the strength of correlations between the scales because the distributions of some scores were not normal. In order to assess the predictive value of insight for depression and suicidal ideation, we used hierarchical linear regression analysis. Correlation coefficients between SAI-E and the clinical scales of psychopathology, depression and suicide ideation was statistically significant at the pregression analysis showed that our model of positive and negative psychopathology and insight explained 47.4% of the variance of depression and 32.2% of the variance of suicidal ideation. The predictive value of insight was critically important, because only after the introduction of the SAI-E score in the analysis our

  15. Some improvements on RNS Montgomery modular multiplication

    Science.gov (United States)

    Bajard, Jean-Claude; Didier, Laurent-Stephane; Kornerup, Peter; Rico, Fabien

    2000-11-01

    In Residue Number Systems (RNS), an integer X is represented by its residues {x0,...,xn-1} modulo a base of relatively prime numbers {m0,...,mn-1}. Thus a large number can be represented as a set of small integers. Addition and multiplication can be easily parallelized, there is no carry propagation. The time is reduced to the evaluation of these operations with small numbers. This representation is useful in cryptography and digital signal processing. Furthermore, in these two domains, modular multiplication (A X B mod N) is frequently used. So, in 1998, we have presented in IEEE journal of transactions on computers, a new modular multiplication algorithm in RNS. This algorithm is based on the Montgomery algorithm, using the associated Mixed Radix representation, for the weighted digits. It was the first algorithm of this type. In this paper, we present two remarks. First, if we develop the different expressions due to the algorithm, we obtain some mathematical simplifications that allow us to suppress some Mixed Radix occurrence in the basic iteration simply with a new initialization of our variables. Thus, in this new version, the complexity of each basic iteration, becomes equivalent to two products of small integers instead of three. The second remark is that, most of the time, modular multiplications are done with the same modulo N. We can precompute some values and reduce the complexity of each basic iteration to one multiplication of two small integers. Thus, the basic iteration is three times faster, and the global computation, due to the initialization, is 8/5 time faster than the original version. Sometime after the last basic iteration a Mixed Radix conversion can be needed. Classical parallel methods are linear. We propose an algorithmic parallel algorithm for this translation from RNS to Mixed Radix. For this, we use a result that comes from an RNS division algorithm, we published in Journal of VLSI signal processing systems 1998. We obtain in a

  16. Efficacy and safety of desvenlafaxine 50 mg/d in a randomized, placebo-controlled study of perimenopausal and postmenopausal women with major depressive disorder.

    Science.gov (United States)

    Clayton, Anita H; Kornstein, Susan G; Dunlop, Boadie W; Focht, Kristen; Musgnung, Jeff; Ramey, Tanya; Bao, Weihang; Ninan, Philip T

    2013-10-01

    Evaluate the 8-week efficacy and safety of desvenlafaxine at the recommended dose of 50 mg/d in perimenopausal and postmenopausal women with major depressive disorder (MDD) based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. This phase 4, multicenter, parallel-group, randomized, double-blind, placebo-controlled study was conducted from June 30, 2010, to June 8, 2011. Patients received placebo or desvenlafaxine 50 mg/d (1:1 ratio; n = 217 in each group). The primary outcome measure was the change at week 8 in the 17-item Hamilton Depression Rating Scale (HDRS17) total score. Secondary outcome measures included change in the Sheehan Disability Scale (SDS), the Clinical Global Impressions-Improvement scale (CGI-I), the Montgomery-Asberg Depression Rating Scale (MADRS), and the Visual Analog Scale-Pain Intensity (VAS-PI). At end point, compared to placebo, desvenlafaxine was associated with a significantly greater decrease in HDRS17 total scores (last-observation-carried-forward analysis; adjusted mean change from baseline -9.9 vs -8.1, respectively; P = .004) and significant improvements on the CGI-I (P Desvenlafaxine was generally safe and well tolerated. Short-term treatment with desvenlafaxine 50 mg/d was effective for the treatment of MDD in perimenopausal and postmenopausal women, with significant benefits on pain and functional outcomes evident as early as week 2. The safety and tolerability of desvenlafaxine were consistent with data in other populations. ClinicalTrials.gov identifier: NCT01121484. © Copyright 2013 Physicians Postgraduate Press, Inc.

  17. A double-blind, placebo-controlled study of edivoxetine as an adjunctive treatment for patients with major depressive disorder who are partial responders to selective serotonin reuptake inhibitor treatment.

    Science.gov (United States)

    Ball, Susan; Dellva, Mary Anne; D'Souza, Deborah N; Marangell, Lauren B; Russell, James M; Goldberger, Celine

    2014-01-01

    This phase 2 study examined the efficacy and tolerability of edivoxetine, a highly selective norepinephrine reuptake inhibitor, as an adjunctive treatment for patients with major depressive disorder (MDD) who have a partial response to selective serotonin reuptake inhibitor (SSRI) treatment. Study design consisted of double-blind, 10-week therapy of adjunctive edivoxetine (6-18 mg once daily) or adjunctive placebo with SSRI. Inclusion/entry criteria included partial response to current SSRI by investigator opinion and a GRID 17-item Hamilton Rating Scale for Depression (HAMD17) total score ≥16. The primary efficacy measure was the Montgomery-Asberg Depression Rating Scale (MADRS). Safety measures included treatment-emergent adverse events (TEAE) and vital signs. For the primary evaluable population (n=63 for adjunctive edivoxetine and n=68 for adjunctive placebo), the treatment groups did not differ significantly on the primary outcome of change from baseline to week 8 in the MADRS total score; the effect size of edivoxetine treatment was 0.26. Significant treatment differences, favoring adjunctive edivoxetine (p≤.05), were shown for improvements in role functioning and the functional impact of fatigue. For the adjunctive edivoxetine randomized group (N=111), the most frequent TEAEs were hyperhidrosis (7.2%), nausea (7.2%), erectile dysfunction (6.3%) and testicular pain (6.3%). Hemodynamic changes were observed in blood pressure and pulse rate between treatment groups. Study was underpowered for an alpha 2-sided 0.05 significance level for the primary outcome. For patients with MDD who had a partial response to SSRIs, adjunctive edivoxetine treatment was not statistically superior to adjunctive placebo on the primary outcome measure. However, pending further study, improved functioning and remission rate suggest a potential role for edivoxetine for patients with depression. Copyright © 2014 Elsevier B.V. All rights reserved.

  18. No change in N-acetyl aspartate in first episode of moderate depression after antidepressant treatment: 1H magnetic spectroscopy study of left amygdala and left dorsolateral prefrontal cortex

    Directory of Open Access Journals (Sweden)

    Bajs Janović M

    2014-09-01

    Full Text Available Maja Bajs Janović,1,3 Petra Kalember,2 Špiro Janović,1,3 Pero Hrabač,2 Petra Folnegović Grošić,1 Vladimir Grošić,4 Marko Radoš,5 Neven Henigsberg2,61University Department of Psychiatry, Clinical Hospital Center Zagreb, Zagreb, 2Polyclinic Neuron, Croatian Institute for Brain Research, School of Medicine, University of Zagreb, Zagreb, 3University North, Varaždin, 4Psychiatric Hospital Sveti Ivan, Zagreb, 5University Department of Radiology, Clinical Hospital Center Zagreb, Zagreb, 6Psychiatric Clinic Vrapče, Zagreb, CroatiaBackground: The role of brain metabolites as biological correlates of the intensity, symptoms, and course of major depression has not been determined. It has also been inconclusive whether the change in brain metabolites, measured with proton magnetic spectroscopy, could be correlated with the treatment outcome. Methods: Proton magnetic spectroscopy was performed in 29 participants with a first episode of moderate depression occurring in the left dorsolateral prefrontal cortex and left amygdala at baseline and after 8 weeks of antidepressant treatment with escitalopram. The Montgomery-Asberg Depression Rating Scale, the Hamilton Rating Scale for Depression, and the Beck Depression Inventory were used to assess the intensity of depression at baseline and at the endpoint of the study. At endpoint, the participants were identified as responders (n=17 or nonresponders (n=12 to the antidepressant therapy. Results: There was no significant change in the N-acetyl aspartate/creatine ratio (NAA/Cr after treatment with antidepressant medication. The baseline and endpoint NAA/Cr ratios were not significantly different between the responder and nonresponder groups. The correlation between NAA/Cr and changes in the scores of clinical scales were not significant in either group. Conclusion: This study could not confirm any significant changes in NAA after antidepressant treatment in the first episode of moderate depression, or in

  19. Depression

    Science.gov (United States)

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

  20. Montgomery Point Lock and Dam, White River, Arkansas

    Science.gov (United States)

    2016-01-01

    accurate and economical engineering solutions to coastal and hydraulic problems. This will strengthen and improve design criteria, enhance... Fischer , and J. Mewes. 2011. Montgomery Point Lock and Dam HSR model, White River miles 4.0 – 0.0; Hydraulic sediment response model investigation

  1. Montgomery Community College Profile of Entering Freshmen, Fall 1971.

    Science.gov (United States)

    Gell, Robert L., Comp.

    This is a profile of 2,578 freshmen students at Montgomery College (Maryland), fall 1971. Data are presented in the following areas: (1) academic potentials, including ACT scores and high school grades; (2) goals and aspirations; (3) student personnel needs in the areas of housing, transportation, financial welfare, special programs, and…

  2. Rights of Passage: The Montgomery County Transition Initiative.

    Science.gov (United States)

    O'Toole, Thomas J.; Meissner, Margit

    1988-01-01

    A Montgomery County (Maryland) task force was jointly developed by the county executive and the school superintendent to consider the transition from school to work for disabled students. Recommendations were made which resulted in development of a transition planning/coordinating function and a model for planning transition services. (JDD)

  3. Sustained inflammation 1.5 years post-stroke is not associated with depression in elderly stroke survivors

    Directory of Open Access Journals (Sweden)

    Noonan K

    2013-01-01

    Full Text Available Kate Noonan,1,2 Sheila G Crewther,1,2 Leeanne M Carey,2,4 Michaela C Pascoe,5 Thomas Linden2,31School of Psychological Science, La Trobe University, Bundoora, Victoria, Australia; 2Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, Heidelberg, Victoria, Australia; 3Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden; 4Department of Occupational Therapy, School of Allied Health, La Trobe University, Bundoora, Victoria, Australia; 5Brain Sciences Institute, Swinburne University, Melbourne, AustraliaBackground: Depression is common in elderly stroke survivors and has been associated with systemic inflammation. We aimed to investigate an elderly population of Swedish stroke patients for evidence of sustained peripheral inflammation 18 months post-stroke and to identify if inflammation is associated with post-stroke depression at 18 months post-stroke.Methods: The Barthel Index was used to measure the level of impairment in activities of daily living at 3 days post-stroke. Serum concentrations of inflammation markers, ie, C-reactive protein and white cell count, were measured in 149 stroke patients (mean age 81 ± 5.33 years, 35% male at 18 months post-stroke, and a comparison was made with an age-matched sample of elderly Swedish individuals who had not suffered a stroke. At the same visit, clinical depression was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Third Edition-Revised criteria. Severity of depression was assessed using the Montgomery-Asberg Depression Rating Scale (MADRS.Results: Mean C-reactive protein and white cell count levels in stroke patients were significantly elevated at 18 months post-stroke compared with population probands. Disability scores were associated with MADRS depression scores, but C-reactive protein and white cell count were not.Conclusion: We found evidence for a sustained peripheral inflammatory response at 18 months

  4. The Montgomery College Student; A Profile of the Students Enrolled at Montgomery College During the Fall Semester of 1976.

    Science.gov (United States)

    Gell, Robert L.; And Others

    This document contains a descriptive analysis of the 13,984 students enrolled at Montgomery College for fall 1976, including full- and part-time, credit and non-credit, and day and evening students. Selected biographic and demographic variables were used to describe the student population. Analysis showed: (1) the mean age for all students was…

  5. Depression

    DEFF Research Database (Denmark)

    Kessing, Lars Veddel; Bukh, Jens Otto Drachmann

    2014-01-01

    The prevalence of depression is not clearly established, but estimated to 3-4% in a Danish questionnaire study. Lifetime's prevalences of 12-17% are reported in other community samples. In the current diagnostic system depression is defined categorically and operationally. It has been argued......, that these diagnostic criteria represent an oversimplification, which has blurred the concept of depression. We suggest a greater emphasis on the depressed mood as the core symptom of depression, which may increase the specificity of the diagnosis. Furthermore, basic principles for the treatment of depression...

  6. Depression

    DEFF Research Database (Denmark)

    Kessing, Lars Veddel; Bukh, Jens Drachmann

    2014-01-01

    , that these diagnostic criteria represent an oversimplification, which has blurred the concept of depression. We suggest a greater emphasis on the depressed mood as the core symptom of depression, which may increase the specificity of the diagnosis. Furthermore, basic principles for the treatment of depression......The prevalence of depression is not clearly established, but estimated to 3-4% in a Danish questionnaire study. Lifetime's prevalences of 12-17% are reported in other community samples. In the current diagnostic system depression is defined categorically and operationally. It has been argued...

  7. Efficacy, safety and tolerability of escitalopram in doses up to 50 mg in Major Depressive Disorder (MDD: an open-label, pilot study

    Directory of Open Access Journals (Sweden)

    Crawford Gordon M

    2011-03-01

    Full Text Available Abstract Background Escitalopram is licensed for use at doses up to 20 mg but is used clinically at higher doses. There is limited published data at higher doses and none in the treatment of Major Depressive Disorder (MDD. Methods This open-label, pilot study was designed to investigate the efficacy, safety and tolerability of escitalopram in doses up to 50 mg in MDD. It was conducted in 60 primary care patients with MDD who had not responded to adequate treatment with citalopram. Patients were treated with escalating doses of escitalopram up to 50 mg for up to 32 weeks until they achieved remission (Montgomery-Asberg Depression Rating Scale [MADRS] ≤8 or failed to tolerate the dose. Results Forty-two patients (70% completed the study. Twenty-one patients (35% achieved remission with 8 of the 21 patients (38% needing the 50 mg dose to achieve remission. Median time to remission was 24 weeks and median dose in remission was 30 mg. No significant safety issues were identified although tolerability appeared to decline above a dose of 40 mg with 26% of patients unable to tolerate 50 mg. Twelve (20% patients had adverse events leading to discontinuation. The most common adverse events were headache (35%, nausea, diarrhoea and nasopharyngitis (all 25%. Minor mean weight gain was found during the study, which did not appear to be dose-related. Half of the patients who completed the study chose to continue treatment with escitalopram rather than taper down the dose at 32 weeks. Conclusions Dose escalation with escitalopram above 20 mg may have a useful role in the management of patients with MDD, although further studies are needed to confirm this finding. Trial Registration ClinicalTrials.gov: NCT00785434

  8. The influence of 5-HTTLPR genotype on the association between the plasma concentration and therapeutic effect of paroxetine in patients with major depressive disorder.

    Directory of Open Access Journals (Sweden)

    Tetsu Tomita

    Full Text Available INTRODUCTION: The efficacy of treatment with selective serotonin reuptake inhibitors in patients with major depressive disorder (MDD can differ depending on the patient's serotonin transporter-linked polymorphic region (5-HTTLPR genotype, and the effects of varying plasma concentrations of drugs can also vary. We investigated the association between the paroxetine plasma concentration and clinical response in patients with different 5-HTTLPR genotypes. METHODS: Fifty-one patients were enrolled in this study. The Montgomery-Asberg Depression Rating Scale (MADRS was used to evaluate patients at 0, 1, 2, 4, and 6 weeks. The patients' paroxetine plasma concentrations at week 6 were measured using high-performance liquid chromatography. Additionally, their 5-HTTLPR polymorphisms (alleles S and L were analyzed using a polymerase chain reaction with specific primers. We divided the participants into two groups based on their L haplotype: the SS group and the SL and LL group. We performed single and multiple regression analyses to investigate the associations between MADRS improvement and paroxetine plasma concentrations or other covariates for each group. RESULTS: There were no significant differences between the two groups with regard to demographic or clinical data. In the SS group, the paroxetine plasma concentration was significantly negatively correlated with improvement in MADRS at week 6. In the SL and LL group, the paroxetine plasma concentration was significantly positively correlated with improvement in MADRS at week 6 according to the results of the single regression analysis; however, it was not significantly correlated with improvement in MADRS at week 6 according to the results of the multiple regression analysis. CONCLUSION: Among patients with MDD who do not respond to paroxetine, a lower plasma concentration or a lower oral dose of paroxetine might be more effective in those with the SS genotype, and a higher plasma concentration might

  9. Cognitive-behavioral therapy added to fluoxetine in major depressive disorder after 4 weeks of fluoxetine-treatment: 16-week open label study.

    Science.gov (United States)

    Maneeton, Narong; Thongkam, Annop; Maneeton, Benchalak

    2010-03-01

    Major depressive disorder (MDD) not responding to antidepressant treatment poses challenges in planning therapy and prognostic uncertainties. Adjunctive treatment to antidepressants with cognitive-behavioral therapy (CBT) may be useful for these patients. Determine the efficacy of CBT augmentation in patients with MDD not responding to fluoxetine. Ten patients diagnosed with MDD, by Diagnostic and Statistical Manual of Mental Disorders Fourth edition (DSM-IV) criteria between December 2007 and July 2008 were enrolled to the present study. All patients had taken fluoxetine at least 20 mg a day and for at least 4 weeks prior to consent. Baseline Montgomery Asberg Depression Rating Scale (MADRS) ratings were all moderate to severe (22-44 point). The maximum number of sessions of CBT was 16. Patients treated with CBT for at least 8 weeks were defined as the completed treatment group. Response was defined as a reduction in MADRS score by at least 50 percent from baseline and remission was defined as a reduction in score of 10 or less. Fluoxetine augmentation with CBT was a significantly effective treatment in patients with MDD not responding to 4 week-fluoxetine treatment alone according to MADRS, Clinical Global Impression-Severity of illness and the 9-item Patient Health Questionnaire, Thai Version (p < 0.001, p = 0.002 and 0.004 respectively). The overall response and remission rates were 100% and 70% respectively. The VAS satisfaction scores increased from baseline significantly (p < 0.001). Overall quality of life of all patients by WHOQOL-BREF was improved significantly (p < 0.001). Adding CBT to fluoxetine in patients with MDD who did not respond to 4 weeks treatment of fluoxetine had significantly more efficacy than previous fluoxetine treatment alone. With no control group, a randomized and controlled method might substantiate these promising preliminary findings.

  10. Depressants

    Science.gov (United States)

    ... judgment and mental functioning nausea and vomiting memory loss (depressants can cause users to have no memory of events that happened while they were under the influence) Long-Term Effects When people misuse depressants over a long ...

  11. Efficacy of an adjunctive brief psychodynamic psychotherapy to usual inpatient treatment of depression: rationale and design of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Ambresin Gilles

    2012-10-01

    Full Text Available Abstract Background A few recent studies have found indications of the effectiveness of inpatient psychotherapy for depression, usually of an extended duration. However, there is a lack of controlled studies in this area and to date no study of adequate quality on brief psychodynamic psychotherapy for depression during short inpatient stay exists. The present article describes the protocol of a study that will examine the relative efficacy, the cost-effectiveness and the cost-utility of adding an Inpatient Brief Psychodynamic Psychotherapy to pharmacotherapy and treatment-as-usual for inpatients with unipolar depression. Methods/Design The study is a one-month randomized controlled trial with a two parallel group design and a 12-month naturalistic follow-up. A sample of 130 consecutive adult inpatients with unipolar depression and Montgomery-Asberg Depression Rating Scale score over 18 will be recruited. The study is carried out in the university hospital section for mood disorders in Lausanne, Switzerland. Patients are assessed upon admission, and at 1-, 3- and 12- month follow-ups. Inpatient therapy is a manualized brief intervention, combining the virtues of inpatient setting and of time-limited dynamic therapies (focal orientation, fixed duration, resource-oriented interventions. Treatment-as-usual represents the best level of practice for a minimal treatment condition usually proposed to inpatients. Final analyses will follow an intention–to-treat strategy. Depressive symptomatology is the primary outcome and secondary outcome includes measures of psychiatric symptomatology, psychosocial role functioning, and psychodynamic-emotional functioning. The mediating role of the therapeutic alliance is also examined. Allocation to treatment groups uses a stratified block randomization method with permuted block. To guarantee allocation concealment, randomization is done by an independent researcher. Discussion Despite the large number of studies

  12. Depression

    DEFF Research Database (Denmark)

    Cizza, G; Ravn, Pernille; Chrousos, G P

    2001-01-01

    Existing studies of the relationship between depression and osteoporosis have been heterogeneous in their design and use of diagnostic instruments for depression, which might have contributed to the different results on the comorbidity of these two conditions. Nevertheless, these studies reveal...... a strong association between depression and osteoporosis. Endocrine factors such as depression-induced hypersecretion of corticotropin-releasing hormone and hypercortisolism, hypogonadism, growth hormone deficiency and increased concentration of circulating interleukin 6, might play a crucial role...... in the bone loss observed in subjects suffering from major depression....

  13. Depression

    DEFF Research Database (Denmark)

    Pouwer, Frans

    2017-01-01

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

  14. The Montgomery College Student; A Profile of the Students Enrolled at Montgomery College During the Fall Semester of 1975.

    Science.gov (United States)

    Gell, Robert L.; And Others

    Student enrollment for fall 1975 at Montgomery College totalled 13,907. This figure represents a rise of 1,278 from fall 1974, and a 4,372 rise from fall 1971, the first year for which comparative data are provided. This document provides a profile of the student body in terms of age, sex, race, marital status, residence status, country of origin,…

  15. Adjunctive treatment with transcranial magnetic stimulation in treatment resistant depression: a randomized, double-blind, sham-controlled study

    Directory of Open Access Journals (Sweden)

    Qiang LIU

    2011-02-01

    Full Text Available Background: High-frequency repetitive transcranial magnetic stimulation (rTMS to the left prefrontal cortex is a promising antidepressant treatment but the appropriate duration of treatment andits effect on cognitive symptoms in treatment resistant patients is uncertain.Hypotheis: Patients with treatment resistant depression on standard antidepressant medication who receive four weeks of adjunctive treatment with high-frequency rTMS to the left prefrontal cortex will have better clinical outcomes and better cognitive functioning than those who receive sham rTMS treatments.Methods: Thirty patients with treatment resistant depression (defined as failure to respond to two or more antidepressants of different classes administered for at least 6 weeks at or above two-thirds of the recommended maximum dose receiving selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors wererandomly assigned to receive adjundive treatment with either real rTMS (n=15 or sham rTMS (n=15 5 times a week for 4 conseculive weeks. Blinded pre-post evaluations were conducted using the 17-item Hamilton Depression Rating Scale (HAMD, the Montgomery-Asberg Depression Rating Scale (MADRS, the severity of illness measure from the Clinical Global Impression Rating scale(CGI-S, the Wechsler Adult Intelligence ScaIe (WAIS, the Wechsler Memory Scale (WMS, and the Wisconsjn Card Sorting Test(WC5T.Results:14 subjects from each group completed the study. There was no significant difference in the HAMD total scores between the two groups after 2 weeks of treatment but after 4 weeks of treatment the mean percentage drop in the HAMD total score was significantly greater in the real rTMS group (49%, SD=19% than in the sham rTMS group(29%, SD=25%, with a mean difference of 20% [95%CI=3%-37%;t26=2.42; P=0.023]. At 4 weeks the mean (SD reduction in the MADRS total score was also greater in the real rTMS group [47%(23% vs 16%(40

  16. Testosterone gel replacement improves sexual function in depressed men taking serotonergic antidepressants: a randomized, placebo-controlled clinical trial.

    Science.gov (United States)

    Amiaz, Revital; Pope, Harrison G; Mahne, Thomas; Kelly, John F; Brennan, Brian P; Kanayama, Gen; Weiser, Mark; Hudson, James I; Seidman, Stuart N

    2011-01-01

    Testosterone replacement is the most effective treatment for sexual dysfunction in hypogonadal men. Comorbid depression and antidepressant side effects may reduce its influence. The authors conducted a 6-week, double-blind, placebo-controlled clinical trial of testosterone gel versus placebo gel in men with major depressive disorder who were currently taking a serotonergic antidepressant and exhibited low or low-normal testosterone level. A total of 100 men were enrolled at 2 study sites (Boston, Massachusetts, USA, and Tel Aviv, Israel). The effects of testosterone augmentation on sexual functioning were determined using domain scores on the International Index of Erectile Function (IIEF). Complete pre- and posttrial IIEF data were available for 63 subjects. Men randomized to testosterone (n = 31) and placebo (n = 32) were similar in age, baseline testosterone levels, and baseline IIEF scores. At study termination, men randomized to placebo showed virtually no change from baseline in mean (95% CI) IIEF score (-0.7 [-6.5, 5.2]), whereas those receiving testosterone exhibited a substantial increase (15.8 [8.5, 23.1]). The estimated mean difference between groups was 16.8 [7.5, 26.1]; p = .001 by linear regression with adjustment for age and study site. There were also significant between-group differences in each of the 5 IIEF subscales, as well as on the single question involving ejaculatory ability (p ≤ .03 in all cases). Effect sizes in these comparisons remained little changed, and generally remained statistically significant, when we further adjusted for change in depression scores on the Montgomery Asberg Depression Rating Scale. It is notable that the subgroup of men with the highest baseline testosterone levels showed virtually the same improvement as those with lower levels, suggesting that the observed improvement was unlikely to be due simply to correction of hypogonadism alone. In depressed men with low or low-normal testosterone levels who continued

  17. Hypericum perforatum versus fluoxetine in the treatment of mild to moderate depression: a randomized double-blind trial in a Brazilian sample Hypericum perforatum versus fluoxetina no tratamento da depressão leve a moderada: estudo duplo-cego randomizado em uma amostra brasileira

    Directory of Open Access Journals (Sweden)

    Ricardo Alberto Moreno

    2006-03-01

    Full Text Available OBJETIVE: Hypericum perforatum has demonstrated antidepressant efficacy when compared to placebo, but comparisons with other antidepressants remain controversial. We assessed the efficacy and safety of Hypericum perforatum in comparison with fluoxetine, in a 8-week double-blind trial in patients with mild to moderate depression. METHOD: Seventy-two outpatients were randomly assigned to receive Hypericum perforatum 900 mg/day, fluoxetine 20 mg/day or placebo. Efficacy measures included the HAM-D21 scale, the Montgomery-Åsberg Rating Scale, and the Clinical Global Impression. Safety was assessed with the UKU Side Effect Rating Scale. RESULTS: Intention-to-treat analysis showed no differences between the mean scores of the three groups. In the analyses of observed cases, patients receiving Hypericum perforatum had the lowest remission rates (12%, p = 0.016 compared to fluoxetine (34.6% and placebo (45%. CONCLUSIONS: Hypericum perforatum was less efficacious than both fluoxetine and placebo. Both drugs were safe and well-tolerated. Larger trials are needed for definite conclusions.OBJETIVO: Hypericum perforatum demonstrou eficácia antidepressiva em comparação ao placebo, mas comparações com outros antidepressivos permanecem controversas. Avaliamos a eficácia e a tolerabilidade do Hypericum perforatum em comparação com fluoxetina e placebo, em um estudo duplo-cego de oito semanas em pacientes com depressão leve a moderada. MÉTODO: Setenta e dois pacientes ambulatoriais receberam aleatoriamente doses fixas de Hypericum perforatum 900 mg/dia, fluoxetina 20 mg/dia ou placebo. Medidas de eficácia incluíram a HAM-D21, Escala de Montgomery-Asberg e Impressão Clínica Global. A segurança foi avaliada por meio da Escala UKU de Efeitos Colaterais. RESULTADOS: A análise por intenção de tratar não demonstrou diferenças entre os três grupos. Na análise por casos observados, os pacientes que receberam Hypericum perforatum tiveram as menores

  18. Isomorphism and Generation of Montgomery-Form Elliptic Curves Suitable for Cryptosystems

    Institute of Scientific and Technical Information of China (English)

    LIU Duo; SONG Tao; DAI Yiqi

    2005-01-01

    Many efficient algorithms of Montgomery-form elliptic curve cryptology have been investigated recently. At present, there are no reported studies of the isomorphic class of the Montgomery-form elliptic curve over a finite field. This paper investigates the isomorphism of Montgomery-form elliptic curves via the isomorphism of Weierstrass-form elliptic curves and gives a table of (nearly) all the forms of Montgomery-form elliptic curves suitable for cryptographic usage. Then, an algorithm for generating a secure elliptic curve with Montgomery-form is presented. The most important advantages of the new algorithm are that it avoids the transformation from an elliptic curve's Weierstrass-form to its Montgomery-form, and that it decreases the probability of collision. So, the proposed algorithem is quicker, simpler, and more efficient than the old ones.

  19. Depression.

    Science.gov (United States)

    Strock, Margaret

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

  20. Depression

    DEFF Research Database (Denmark)

    Johansen, Jon O. J.

    2013-01-01

    Nyhederne er fulde af historier om depression. Overskrifter som: ’Danskerne propper sig med lykkepiller’ eller ‘depression er stadigvæk tabu’ går tit igen i dagspressen. Men hvor er nuancerne, og hvorfor gider vi læse de samme historier igen og igen? Måske er det fordi, vores egne forestillinger er...

  1. Final Environmental Assessment For Proposed Family Campground Expansion Maxwell Air Force Base, Montgomery County, Alabama

    Science.gov (United States)

    2013-03-27

    Agriculture and Industry 1445 Federal Dr Montgomery, AL 36107   Mr. George C. Speake, PE/LS Montgomery County Engineer PO Box 1667 Montgomery...Insecticide, Fungicide , and Rodenticide Act (FIFRA), or the Asbestos National Emissions Standards for Hazardous Air Pollutants (NESHAPs) under the...organizations and resources are available as well. 1) The US Department of Agriculture Forest Products Laboratory, in partnership with the University of

  2. Depression

    Science.gov (United States)

    ... Different people have different symptoms. Some symptoms of depression include: Persistent sad, anxious, or “empty” mood Feelings of hopelessness or pessimism Feelings of guilt, worthlessness, or helplessness ...

  3. Depression

    Science.gov (United States)

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

  4. The RSA Cryptoprocessor Hardware Implementation Based on Modified Montgomery Algorithm

    Institute of Scientific and Technical Information of China (English)

    CHEN Bo; WANG Xu; RONG Meng-tian

    2005-01-01

    RSA (Rivest-Shamir-Adleman)public-key cryptosystem is widely used in the information security area such as encryption and digital signature. Based on the modified Montgomery modular multiplication algorithm, a new architecture using CSA(carry save adder)was presented to implement modular multiplication. Compared with the popular modular multiplication algorithms using two CSA, the presented algorithm uses only one CSA, so it can improve the time efficiency of RSA cryptoprocessor and save about half of hardware resources for modular multiplication. With the increase of encryption data size n, the clock cycles for the encryption procedure reduce in T(n2) , compared with the modular multiplication algorithms using two CSA.

  5. Adjunctive atypical antipsychotic treatment for major depressive disorder: a meta-analysis of depression, quality of life, and safety outcomes.

    Science.gov (United States)

    Spielmans, Glen I; Berman, Margit I; Linardatos, Eftihia; Rosenlicht, Nicholas Z; Perry, Angela; Tsai, Alexander C

    2013-01-01

    Atypical antipsychotic medications are widely prescribed for the adjunctive treatment of depression, yet their total risk-benefit profile is not well understood. We thus conducted a systematic review of the efficacy and safety profiles of atypical antipsychotic medications used for the adjunctive treatment of depression. We included randomized trials comparing adjunctive antipsychotic medication to placebo for treatment-resistant depression in adults. Our literature search (conducted in December 2011 and updated on December 14, 2012) identified 14 short-term trials of aripiprazole, olanzapine/fluoxetine combination (OFC), quetiapine, and risperidone. When possible, we supplemented published literature with data from manufacturers' clinical trial registries and US Food and Drug Administration New Drug Applications. Study duration ranged from 4 to 12 wk. All four drugs had statistically significant effects on remission, as follows: aripiprazole (odds ratio [OR], 2.01; 95% CI, 1.48-2.73), OFC (OR, 1.42; 95% CI, 1.01-2.0), quetiapine (OR, 1.79; 95% CI, 1.33-2.42), and risperidone (OR, 2.37; 95% CI, 1.31-4.30). The number needed to treat (NNT) was 19 for OFC and nine for each other drug. All drugs with the exception of OFC also had statistically significant effects on response rates, as follows: aripiprazole (OR, 2.07; 95% CI, 1.58-2.72; NNT, 7), OFC (OR, 1.30, 95% CI, 0.87-1.93), quetiapine (OR, 1.53, 95% CI, 1.17-2.0; NNT, 10), and risperidone (OR, 1.83, 95% CI, 1.16-2.88; NNT, 8). All four drugs showed statistically significant effects on clinician-rated depression severity measures (Hedges' g ranged from 0.26 to 0.48; mean difference of 2.69 points on the Montgomery-Asberg Depression Rating Scale across drugs). On measures of functioning and quality of life, these medications produced either no benefit or a very small benefit, except for risperidone, which had a small-to-moderate effect on quality of life (g = 0.49). Treatment was linked to several adverse

  6. Efficient Reversible Montgomery Multiplier and Its Application to Hardware Cryptography

    Directory of Open Access Journals (Sweden)

    Noor M. Nayeem

    2009-01-01

    Full Text Available Problem Statement: Arithmetic Logic Unit (ALU of a crypto-processor and microchips leak information through power consumption. Although the cryptographic protocols are secured against mathematical attacks, the attackers can break the encryption by measuring the energy consumption. Approach: To thwart attacks, this study proposed the use of reversible logic for designing the ALU of a crypto-processor. Ideally, reversible circuits do not dissipate any energy. If reversible circuits are used, then the attacker would not be able to analyze the power consumption. In order to design the reversible ALU of a crypto-processor, reversible Carry Save Adder (CSA using Modified TSG (MTSG gates and architecture of Montgomery multiplier were proposed. For reversible implementation of Montgomery multiplier, efficient reversible multiplexers and sequential circuits such as reversible registers and shift registers were presented. Results: This study showed that modified designs perform better than the existing ones in terms of number of gates, number of garbage outputs and quantum cost. Lower bounds of the proposed designs were established by providing relevant theorems and lemmas. Conclusion: The application of reversible circuit is suitable to the field of hardware cryptography.

  7. Buying Renewable Electric Power in Montgomery County, Maryland

    Science.gov (United States)

    Cember, Richard P.

    2008-08-01

    From mid-August 2007 until mid-August 2008, my home electricity supply was 100% wind-generated. My experience in switching to wind-generated electric power may be of interest to fellow AGU members for three reasons. First, Montgomery County, Md., where I live, is one of the few jurisdictions in the United States that has both an electric power tax and a renewable energy credit. The county is therefore a case study in price-based public policy for greenhouse gas emissions control. Second, I was surprised by the comparatively small price difference (or ``price premium'') between wind-generated and conventionally generated power in the county, and I believe that Eos readers will be similarly surprised. Third, because so many U.S. federal agencies concerned with Earth science are based in the Washington, D. C., area, a high concentration of AGU members live in Montgomery County and may be personally interested in evaluating the price of reducing carbon dioxide emissions from the generation of their own residential electricity.

  8. The Employers. A Survey of Employers Who Have Hired Montgomery College Graduates.

    Science.gov (United States)

    Gell, Robert L.; Harkness, Suzanne C.

    This study was undertaken to assess employers' attitudes toward the educational preparation of Montgomery College graduates in their employ. Further, it was an effort to gain information from employers regarding what improvements they felt could be made in Montgomery's curriculum to better prepare students for their future occupations. The data…

  9. Depression.

    Science.gov (United States)

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

    2016-10-04

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

  10. Temporal filtering for Montgomery self-imaging under dispersive transmission.

    Science.gov (United States)

    Cuadrado-Laborde, Christian; Costanzo-Caso, Pablo A; Duchowicz, Ricardo; Sicre, Enrique E

    2007-08-01

    We present what we believe is a new method to introduce self-imaging properties under dispersive transmission of single or multiple light pulses with different temporal characteristics. By properly performing a temporal filtering into a given input signal it can produce an output signal having a spectral content satisfying the Montgomery condition, thereby allowing self-imaging of this signal under further dispersive transmission. An array of fiber loops performs the filtering operation on the input signal. We show some numerical simulations with a single light pulse as an input signal to verify the feasibility of the method and demonstrate the effects of the several involved parameters on both the pulse shape and the noise level.

  11. A NEW RSA CRYPTOSYSTEM HARDWARE IMPLEMENTATION BASED ON MONTGOMERY'S ALGORITHM

    Institute of Scientific and Technical Information of China (English)

    卢君明; 林争辉

    2002-01-01

    RSA public key crypto-system is a relatively safe technology, which is widely used in today's secure electronic communication. In this paper, a new implementation method to optimize a 1 024 bit RSA processor was presented. Basically, a fast modular multiplication architecture based on Montgomery's algorithm was proposed. Modular exponentiation algorithm scans encryption from right to left, so two modular multiplications can be processed parallel. The new architecture is also fit for an effective I/O interface. The time to calculate a modular exponentiation is about n2 clock cycles. The proposed architecture has a data rate of 93.7 kb/s for 1 024 bit work with a 100 MHz clock.

  12. Intraductal papilloma with bloody discharge from Montgomery's areolar tubercle examined by ductoscopy from the areola.

    Science.gov (United States)

    Sakai, Takehiko; Makita, Masujiro; Akiyama, Futoshi; Uehara, Kanou; Kasumi, Fujio; Horii, Rie; Sakamoto, Goi

    2006-01-01

    A patient with intraductal papilloma who had abnormal bloody discharge from Montgomery's areolar tubercle underwent mammary ductography, mammary ductoscopy from the tubercle, and microdochectomy.A 43-year-old woman who was being followed-up for left breast cancer noticed bloody discharge from Montgomery's areolar tubercle of the right breast. Because the discharge continued for 2 months, further examinations were conducted. Mammary ductoscopy of Montgomery's areolar tubercle showed a normal internal duct structure. The presence of yellowish superficial lesions suggested intraductal inflammation or superficial hyperplasia of the duct epithelium. Lavage cytology revealed benign papillary lesions. Since the discharge continued and we could not completely exclude malignancy, microdochectomy was performed. Histologically a lactiferous duct was connected to Montgomery's areolar tubercle and an intraductal papilloma was seen in part and considered to have caused the bloody discharge. Bloody discharge from Montgomery's areola tubercles is extremely rare, the present case was our first experience with ductoscopy of Montgomery's areolar tubercle out of 641 cases of mammary ductoscopy performed on patients with bloody nipple discharge from 1998 to 2004. In our case, Montgomery's areolar tubercles were connected to a lactiferous duct. Although there are a few breast carcinomas that cause bloody discharge and eruption of areola, areolar preservation should be performed with the knowledge that disease may also involve the areola through the lactiferous ducts.

  13. The discrimination and diagnosis for the depressive symptoms in patients with Schizophrenia- Comparison of the four assessment scales for depression%精神分裂症抑郁症状的识别与诊断——四种抑郁量表的比较

    Institute of Scientific and Technical Information of China (English)

    刘联琦; 周平; 郝军锋; 梁凤珍

    2012-01-01

    Objective To compare the diagnostic validity of 4 commonly used assessment scales for depression in schizophrenia. Methods The study population consisted of 100 schizophrenic patients who met CCMD-3 criteria for schizophrenia. Depression in the study subjects was defined by the CCMD - 3 criteria for a major depressive episode. The following 4 depression scales were assessed for their diagnostic validity as measures of depressive disorder in schizophrenia-, the Calgary Depression Scale for Schizophrenia (CDSS-C),the Montgomery-Asberg Depression Rating Scale ( MADRS) , the Hamilton Rating Scale for Depression (HAMD-24) ,and the depression subscale of the PANSS (PANSS-D). At the same time, we also undertook the negative subscale of the PANSS( PANSS-N) and the Rating Scale for Extrapyramidal Side Effects(RSESE). Results (1) There were 22 patients who met the CCMD-3 criteria for a major depressive episode among the 100 schizophrenia patients, so the incidence of depression was 22%. (2)The depression scales were found to be highly intercorrelated with each other. Of the 4 depression scales studied, only CDSS - C can discriminate between depression and a PANSS negative symptoms subscale score or negative item scores or a RSESE score. (3)The areas under the receiver operating characteristic curves of the CDSS-CMARDS,HAMD-24,and PANSS-D were 0. 933,0. 826, 0. 883 and 0. 887 respectively. The area under the receiver operating characteristic curve of the CDSS-C was significantly greater than those of MARDS, HAMD-24, and PANSS-D. Conclusions Our study suggests that the CDSS-C may provide optimal assessment on depression in patients with schizophrenia and is feasible to attempt to use in the clinic.%目的 比较四种抑郁量表对精神分裂症抑郁症状的诊断效能.方法 100例符合CCMD-3精神分裂症诊断标准的患者进入研究,以CCMD-3抑郁发作标准判断是否存在有抑郁症状,同时进行CDSS-C、MADRS、HAMD-24、PANSS及RSESE测评.结果 (1

  14. Partnership with Montgomery Schools trains teachers in water quality management exercises

    OpenAIRE

    Constantinescu, Ana

    2007-01-01

    High and middle school teachers from four Montgomery County (Va.) public schools will receive training in water quality management for their classroom instruction using the latest field measurement tools and techniques.

  15. Agreement for depression diagnosis between DSM-IV-TR criteria, three validated scales, oncologist assessment, and psychiatric clinical interview in elderly patients with advanced ovarian cancer

    Directory of Open Access Journals (Sweden)

    Rhondali W

    2015-07-01

    Anxiety Depression Scale, the distress thermometer, the mood thermometer, and OA. The interview guide for PCI was constructed from three validated scales: the GDS, the Hamilton Depression Rating Scale, and the Montgomery Asberg Depression Rating Scale (MADRS. The Diagnostic and Statistical Manual of Mental Disorders, fourth edition, revised (DSM criteria for depression were used as a gold standard.Results: Out of 109 patients enrolled at 21 centers, 99 (91% completed all the assessments. Patient characteristics were: mean age 78, performance status ≥2: 47 (47%. Thirty six patients (36% were identified as depressed by the PCI versus 15 (15% identified by DSM. We found moderate agreement for depression identification between DSM and GDS (κ=0.508 and PCI (κ=0.431 and high agreement with MADRS (κ=0.663. We found low or no agreement between DSM with the other assessment strategies, including OA (κ=-0.043. Identification according to OA (yes/no resulted in a false-negative rate of 87%. As a screening tool, GDS had the best sensitivity and specificity (94% and 80%, respectively.Conclusion: The use of validated tools, such as GDS, and collaboration between psychologists and oncologists are warranted to better identify emotional disorders in elderly women with AOC. Keywords: depression, elderly, cancer, screening, geriatric assessment

  16. Grecia: Nivel IV. Basado en el curso de estudios sociales de Montgomery County Public Schools. (Greece. Level 6. Based on the Montgomery County Public Schools Social Studies Program).

    Science.gov (United States)

    Maldonado, Marisol

    This curriculum unit, developed by the Montgomery County Public Schools, Maryland, was designed for use in an elementary level foreign language immersion program. It is geared toward the sixth grade social studies classroom. The unit includes instructional and performance objectives, necessary vocabulary lists, optional language structure…

  17. Coenzyme Q10 Effects on Creatine Kinase Activity and Mood in Geriatric Bipolar Depression

    Science.gov (United States)

    Forester, Brent P.; Zuo, Chun S.; Ravichandran, Caitlin; Harper, David G.; Du, Fei; Kim, Susan; Cohen, Bruce M.; Renshaw, Perry F.

    2015-01-01

    Introduction Despite the prevalence, associated comorbidities, and functional consequences of bipolar depression (BPD), underlying disease mechanisms remain unclear. Published studies of individuals with bipolar disorder implicate abnormalities in cellular energy metabolism. This study tests the hypotheses that the forward rate constant (kfor) of creatine kinase (CK) is altered in older adults with BPD and that CoEnzyme Q10 (CoQ10), known to have properties that enhance mitochondrial function, increases kfor in elderly individuals with BPD treated with CoQ10 compared with untreated age- and sex-matched controls. Methods Ten older adults (ages 55 and above) with Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition [DSM IV]) bipolar disorder, current episode depressed and 8 older controls underwent two 4 Tesla 31Phosphorus magnetic resonance spectroscopy (31PMRS) scans 8 weeks apart using a magnetization transfer (MT) acquisition scheme to calculate kfor. The BPD group was treated with open-label CoEnzyme Q10 400 mg/d titrated up by 400 mg/d every 2 weeks to a maximum of 1200 mg/d. The Montgomery Asberg Depression Rating Scale (MADRS) was used to measure depression symptom severity. Baseline kfor and changes in kfor were compared between individuals with BPD and controls, not receiving CoQ. Clinical ratings were compared across time and associated with kfor changes using repeated measures linear regression. Results The kfor of CK was non-significantly lower for BPD than healthy controls at baseline (BPD mean (standard deviation [SD]) = 0.19 (0.02), control mean (SD) = 0.20 (0.02), Wilcoxon rank sum exact P = .40). The kfor for both CoQ10-treated BPD and controls increased after 8 weeks (mean increase (SD) = 0.03 (0.04), Wilcoxon signed rank exact P = .01), with no significant difference in 8-week changes between groups (BPD mean change (SD) = 0.03 (0.03), control mean change (SD) = 0.03 (0.05), Wilcoxon rank sum exact P = .91). In an exploratory

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

    Directory of Open Access Journals (Sweden)

    Maneeton Narong

    2012-09-01

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

  19. Experience in using sulpiride in non-psychotic endogenous depressive-hypochondriacal disorders

    OpenAIRE

    2012-01-01

    Objective: to study the efficacy of sulpiride in different types of non-psychotic types of endogenous depressive-hypochondriacal syndrome. Patients and methods. Forty-seven patients (36 women and 11 men) with a depressive episode (n = 15), recurrent depressive disorder (n = 14), and slowly progressive schizophrenia (SPS) (n = 18) were examined clinically and using the psychometric scales: the Clinical Global Impression Scale; Montgomery-Esberg Depression Rating Scale (MADRS), the Hamilton Anx...

  20. Innovation, informed consent, health research and the Supreme Court: Montgomery v Lanarkshire - a brave new world?

    Science.gov (United States)

    Mchale, Jean V

    2017-10-01

    The Supreme Court decision in Montgomery v Lanarkshire ([2015] UKSC11) has been hailed as a landmark not least because the Court enshrines the doctrine of informed consent formally into English law for the first time in relation to medical treatment. This paper explores the decision in Montgomery. It examines what its implications may be in the future for the consent process in relation to health research and innovative treatment and whether it may prove a watershed moment leading to changing dialogues and expectations in relation to consent. First, the paper explores the concept of 'informed consent' in clinical research as seen through international, Council of Europe and EU instruments. Second, it considers how English law currently governs the provision of information to research participants in the context of clinical research. It questions whether such an approach will be sustainable in the future. Third, it discusses the decision of the UK Supreme Court in Montgomery v Lanarkshire and asks what might be the impact of this Supreme Court decision in the health research context. It asks whether Montgomery may result in new approaches to consent in health research and innovative treatment.

  1. 75 FR 82463 - Yuri I. Montgomery, Respondent; Final Decision and Order

    Science.gov (United States)

    2010-12-30

    ... product of U.S.-origin technology. Seventh, that Montgomery shall have an opportunity to request that the... involved that are subject to the Regulations are the foreign-produced direct product of U.S.-origin... submitted supported Respondent's assertion that he did not violate the EAR because the country of origin...

  2. The Myth of "Rosa Parks the Tired." Teaching about Rosa Parks and the Montgomery Bus Boycott.

    Science.gov (United States)

    Kohl, Herbert

    1993-01-01

    Retells the story of Rosa Parks and the Montgomery (Alabama) bus boycott to reflect more accurately the cultural and historical background of the boycott and the conscious decision made by Mrs. Parks. Accurate examination of the story actually enhances a child's ability to identify with the issues and the protagonists. (SLD)

  3. The Politics of Children's Literature: The Story of Rosa Parks and the Montgomery Bus Boycott.

    Science.gov (United States)

    Kohl, Herbert

    1991-01-01

    As commonly told to and read by children, the story of Rosa Parks and the Montgomery bus boycott fails to indicate Mrs. Parks' activist role or the degree of community organization and participation in the boycott. Telling what actually occurred allows children identify with people who make justice happen. (SLD)

  4. Review of Procurement Practices in the Montgomery County Public Schools. Final Report.

    Science.gov (United States)

    Touche Ross and Co., Washington, DC.

    Following a management summary and introduction, chapters 3 and 4 of this report present findings and recommendations related to the Montgomery County, Maryland, Public Schools process of procuring supplies and equipment (food supplies, fuel oil, warehouse supplies, and maintenance parts) and contractual services (data processing maintenance,…

  5. Conceptualizing an Agenda for Social Responsibility and Public Policy at Montgomery College. A Briefing Paper. Revised

    Science.gov (United States)

    Scott, Michelle T.

    2007-01-01

    The purpose of this briefing paper is to conceptualize a social responsibility and public policy agenda for Montgomery College. The briefing paper provides (a) a well researched perspective to embed a College culture to actualize social responsibility and public policy as institutional practices; (b) examines some of the opportunities and…

  6. The Graduates 1975. A Follow-up Study of the Students Who Graduated from Montgomery College.

    Science.gov (United States)

    Gell, Robert L.; And Others

    A questionnaire was mailed to all 1,020 students who graduated from Montgomery College during the 1974-75 academic year to determine the employment and educational circumstances of the graduates as well as to gather information regarding the graduates' attitudes toward their college experience. Usable responses were received from 635 (62%)…

  7. A Profile of the Faculty, Staff and Administrators of Montgomery College, Fall 1977.

    Science.gov (United States)

    Gell, Robert L.; Armstrong, David F.

    Faculty, staff, and administrators of the three campuses and central administration of Montgomery College are described in terms of their sex, racial group, residence, and salary levels. In addition, the profile of faculty members includes their years of service, age, rank and sex in each discipline, tenure, length of contract, academic…

  8. A Four Year Follow-Up of Non-Returning Students at Montgomery College.

    Science.gov (United States)

    Gell, Robert L.; And Others

    An annual survey of non-returning Montgomery College students from the years 1971 to 1973 was conducted in order to examine reasons for choosing to leave the college, identify trends, determine the status of students at the time of the survey, and assess the impact of their college experience on current activities. The 454 usable responses (20…

  9. Montgomery College Student Follow-up Study: First-Time Students, Fall 1972.

    Science.gov (United States)

    Gell, Robert L.; Armstrong, David F.

    As part of a state-wide longitudinal study of student goal attainment, Montgomery College surveyed 3,975 students in 1976 who had initially enrolled in fall of 1972. Sixty percent responded. Interviews with non-respondents showed that the academically able were more likely to respond, but that questionnaire item responses varied little. Data…

  10. Changes to the law on consent following Montgomery vs Lanarkshire Health Board.

    Science.gov (United States)

    Clearkin, Louis

    2016-06-01

    The Supreme Court's determination on Montgomery (AP) (Appellant) v Lanarkshire Health Board (Respondent) (Scotland) [2015] clarified UK law on consent. It is for the informed patient to determine which intervention, if any, they will undergo. All doctors must meet this standard and may need to reassess their practice to do so.

  11. Vilazodone in the treatment of major depressive disorder: efficacy across symptoms and severity of depression.

    Science.gov (United States)

    Khan, Arif; Sambunaris, Angelo; Edwards, John; Ruth, Adam; Robinson, Donald S

    2014-03-01

    Vilazodone is a potent selective serotonin reuptake inhibitor and serotonin 1A receptor partial agonist approved for the treatment of major depressive disorder in adults. To assess the efficacy of vilazodone across a range of symptoms and severities of depression, data from two phase III, 8-week, randomized, double-blind, placebo-controlled trials were pooled for analysis. Overall improvement in depressive symptoms measured using the Montgomery-Åsberg Depression Rating Scale (MADRS) and the 17-item Hamilton Depression Rating Scale was statistically significant (Pdepression subgroups, with no consistent pattern associated with depression severity. These findings support the efficacy of vilazodone across a broad range of depressive symptoms and severities for the treatment of major depressive disorder.

  12. 'Bolam' to 'Montgomery' is result of evolutionary change of medical practice towards 'patient-centred care'.

    Science.gov (United States)

    Lee, Albert

    2017-01-01

    The Supreme Court judgement in 'Montgomery v Lanarkshire Health Board' has caused a change in the law concerning the duty of doctors on disclosure of information to patients regarding risks. The law now requires a doctor to take reasonable care to ensure that the patient is aware of any material risks involved in any recommended treatment, and of any reasonable alternative or variant treatments. Are doctors totally removed from the protective shield even if the practice is accepted by a reasonable body of medical opinion previously laid down by 'Bolam' with the recent Supreme Court decision in the 'Montgomery' case? This paper questions whether the 'Bolam' principle needs to be discarded or re-interpreted in the modern context of health care. Adopting 'patient-centred' care to unfold the 'significant risks' attached to patients would align with the evolving changes in medical law. It should be the changing context of health care driving the evolving change of law.

  13. Milnacipran: recent findings in depression

    Directory of Open Access Journals (Sweden)

    Guest editors: Stuart Montgomery (London

    2010-08-01

    Full Text Available EDITORIAL FOREWORDPage 1   Milnacipran: recent findings in depression Stuart Montgomery (London, UK and Mike Briley (Castres, France REVIEWSPage 3   Suicidality: risk factors and the effects of antidepressants. The example of parallel reduction of suicidality and other depressive symptoms during treatment with the SNRI, milnacipran Philippe Courtet (Montpellier, FrancePage 9   Treatment of patients with comorbid depression and diabetes with metformin and milnacipran Peter Hofmann (Graz, AustriaPage 17  Antidepressant therapy with milnacipran and venlafaxine Lucilla Mansuy (Toulouse, FrancePage 23  Milnacipran: a unique antidepressant? Siegfried Kasper and Gerald Pail (Vienna, Austria This supplement is based on a symposium that took place at the 9th International Forum on Mood and Anxiety in Monte Carlo in November 2009 and is supported by an unconditional education grant from Pierre Fabre Médicament.

  14. 左旋多巴联合地昔帕明治疗帕金森患者抑郁症状的效果研究%Efficacy of Benserazide and Desipramine on the Improvement of Depressive Symptoms and Quality of Life in Patients with Parkinson's Disease

    Institute of Scientific and Technical Information of China (English)

    焦凤有

    2012-01-01

    Objective To explore the efficacy of Benserazide and Desipramine on depressive symptoms and the quality of life in patients with Parkinson's disease (PD). Methods 108 PD patients who had depressive symptoms were recruited from our hospital. All patients were randomized into two groups; treatment group (51 patients) and the control group (57 patients). Participants of treatment group had taken Desipramine and Benserazide, and control group had taken placebo and Benserazide.To evaluate the degree of improvement, depressive symptoms were measured with Montgomery asberg depression rating scale (MADRS) and the quality of life with PDQ-39 at day 14 and 30. Results The two groups have insignificant differences of scores of PDQ-39 and MADRS before and after 14 days treatment(P>0.05). But after 30 days treatment, the scores of PDQ-39 and MADRS in treatment group were significantly lower than those of control group (P<0.05). Compared with severe depression, Desipramine had a more favorable effects on mild and moderate depression(P<0.05). Conclusions Treatment wilh Desipramine combined with Benserazide can improve the depressive symptoms and the quality of life in patients in a short time, Desipramine had more favorable effects on mild and moderate depression patients.%目的 探讨左旋多巴联合地昔帕明改善帕金森病(PD)患者的抑郁症状及生活质量的效果.方法 将伴有严重抑郁的帕金森病患者108例随机分为治疗组(51例)和对照组(57例),治疗组服用地昔帕明和左旋多巴,对照组服用安慰剂及左旋多巴,于治疗14d和30 d后分别利用蒙哥马利抑郁量表(MADRS)和帕金森氏症生活品质问卷(PDQ-39)对两组患者抑郁症状和生活质量进行评估.结果 在治疗前及治疗14 d后,两组的MADRS和PDQ39评分差异均无统计学意义(P>0.05),但在治疗1个月后,治疗组的MADRS评分(33.33±4.07)及PDQ39评分(36.20±6.15)均显著低于对照组的(38.21±7.12)分和(42.53±9.61)

  15. Enhanced Montgomery Multiplication on DSP Architectures for Embedded Public-Key Cryptosystems

    Directory of Open Access Journals (Sweden)

    Gastaldo P

    2008-01-01

    Full Text Available Abstract Montgomery's algorithm is a popular technique to speed up modular multiplications in public-key cryptosystems. This paper tackles the efficient support of modular exponentiation on inexpensive circuitry for embedded security services and proposes a variant of the finely integrated product scanning (FIPS algorithm that is targeted to digital signal processors. The general approach improves on the basic FIPS formulation by removing potential inefficiencies and boosts the exploitation of computing resources. The reformulation of the basic FIPS structure results in a general approach that balances computational efficiency and flexibility. Experimental results on commercial DSP platforms confirm both the method's validity and its effectiveness.

  16. Quality assurance for radon exposure chambers at the National Air and Radiation Environmental Laboratory, Montgomery, Alabama

    Energy Technology Data Exchange (ETDEWEB)

    Semler, M.O.; Sensintaffar, E.L. [National Air and Radiation Environmental Laboratory, Montgomery, AL (United States)

    1993-12-31

    The Office of Radiation and Indoor Air, U.S. Environmental Protection Agency (EPA), operates six radon exposure chambers in its two laboratories, the National Air and Radiation Environmental Laboratory (NAREL) in Montgomery, Alabama, and the Las Vegas Facility, Las Vegas, Nevada. These radon exposure chambers are used to calibrate and test portable radon measuring instruments, test commercial suppliers of radon measurement services through the Radon Measurement Proficiency Program, and expose passive measurement devices to known radon concentrations as part of a quality assurance plan for federal and state studies measuring indoor radon concentrations. Both laboratories participate in national and international intercomparisons for the measurement of radon and are presently working with the National Institute of Standards and Technology (NIST) to receive a certificate of traceability for radon measurements. NAREL has developed an estimate of the total error in its calibration of each chamber`s continuous monitors as part of an internal quality assurance program. This paper discusses the continuous monitors and their calibration for the three chambers located in Montgomery, Alabama, as well as the results of the authors intercomparisons and total error analysis.

  17. Use of the radial forearm fasciocutaneous free flap and montgomery salivary bypass tube for pharyngoesophageal reconstruction.

    Science.gov (United States)

    Varvares, M A; Cheney, M L; Gliklich, R E; Boyd, J M; Goldsmith, T; Lazor, J; Baron, J C; Montgomery, W W

    2000-08-01

    Head and neck reconstructive surgeons involved in pharyngoesophageal reconstruction have several options available to repair the defect after partial or total laryngopharyngectomy. There is no uniform agreement among head and neck surgeons as to which of the most frequently used techniques offers the best results. A retrospective study was performed on 20 consecutive patients who had undergone reconstruction of the hypopharynx and cervical esophagus using a radial forearm free flap with Montgomery salivary bypass tube at the Massachusetts Eye and Ear Infirmary in Boston, Massachusetts, and St. Louis University, Department of Otolaryngology-Head and Neck Surgery between 1992 and 1996. This reconstruction was used for primary reconstruction after total or partial laryngopharyngectomy with cervical esophagectomy, partial pharyngectomy sparing the larynx, and for reconstruction of the stenotic neopharynx after laryngectomy. The overall rate of pharyngocutaneous fistula was 20%, and the rate of postoperative stricture was 10%. Of patients reconstructed with this technique, 85% were able to resume oral alimentation, whereas 15% remained G-tube dependent. Of the 18 patients who did not have their larynges remain intact, 6 were able to develop useful tracheoesophageal speech. The results of this study show that the radial forearm fasciocutaneous free flap in combination with the Montgomery salivary bypass tube is extremely useful for reconstruction of partial and circumferential defects of the hypopharynx and cervical esophagus.

  18. Airway management using laryngeal mask airway in insertion of the Montgomery tracheal tube for subglottic stenosis -A case report-.

    Science.gov (United States)

    Park, Jung Sun; Kwon, Young-Suk; Lee, Sangseock; Yon, Jun Heum; Kim, Dong Won

    2010-12-01

    The Montgomery tracheal tube (T-tube) is a device used as a combined tracheal stent and airway after laryngotracheoplasty for patients with tracheal stenosis. This device can present various challenges to anesthesiologists during its placement, including the potential for acute loss of the airway, inadequate administration of inhalation agents, and inadequacy of controlled mechanical ventilation. The present case of successful airway management used a laryngeal mask airway under total intravenous anesthesia with propofol and remifentanil in the insertion of a Montgomery T-tube in a tracheal resection and thyrotracheal anastomosis because of severe subglottic stenosis.

  19. Montgomery Blair Science, Mathematics and Computer Science Magnet Program: A Successful Model for Meeting the Needs of Highly Able STEM Learners

    Science.gov (United States)

    Stein, David; Ostrander, Peter; Lee, G. Maie

    2016-01-01

    The Magnet Program at Montgomery Blair High School is an application-based magnet program utilizing a curriculum focused on science, mathematics, and computer science catering to interested, talented, and eager to learn students in Montgomery County, Maryland. This article identifies and discusses some of the unique aspects of the Magnet Program…

  20. La Materia. Nivel II. Basado en el curso de estudios de Ciencia de Montgomery County Public Schools. (Matter. Level II. Based on the Montgomery County Public Schools Science Studies Program).

    Science.gov (United States)

    Gerstman, M. Linda

    This curriculum unit is for use in an elementary school foreign language immersion program in Montgomery County, Maryland. The unit is geared toward the second grade science classroom. It includes instructional and performance objectives, vocabulary lists, optional language structure sections, illustrations, activities, evaluation suggestions, and…

  1. Seres Vivos. Nivel I. Basado en el curso de estudios de Ciencia de Montgomery County Public Schools. (Living Beings. Level 1. Based on the Montgomery County Public Schools Science Studies Program).

    Science.gov (United States)

    Senger, Graciela

    This curriculum unit, developed by the Montgomery County Public Schools, Maryland, was designed for use in the elementary level foreign language immersion program. It is geared toward the first grade science classroom. The unit includes instructional and performance objectives, necessary vocabulary lists, optional language structure sections,…

  2. Symptom predictors of response to electroconvulsive therapy in older patients with treatment-resistant depression

    Directory of Open Access Journals (Sweden)

    Tominaga K

    2011-07-01

    Full Text Available Keiichiro Tominaga¹, Mioto Okazaki¹, Hisashi Higuchi¹, Itaru Utagawa¹, Etsuko Nakamura², Noboru Yamaguchi¹¹Department of Neuropsychiatry, St Marianna University School of Medicine, Miyamae-ku, Kawasaki City, Kanagawa, ²Tsurukawa Sanatorium Hospital, Machida City, Tokyo, JapanBackground: Electroconvulsive therapy (ECT has been used for treatment-resistant depression. However, predictors of response to ECT have not been adequately studied using the Montgomery and Åsberg Depression Rating Scale, especially in older patients with treatment-resistant depression.Methods: This study included 18 Japanese patients who fulfilled the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision criteria for a diagnosis of major depressive disorder or bipolar disorder with a current major depressive episode, and met the definition of treatment-resistant depression outlined by Thase and Rush, scoring ≥21 on the Montgomery and Åsberg Depression Rating Scale. The three-factor model of the Montgomery and Åsberg Depression Rating Scale was used for analysis. Factor 1 was defined by three items, factor 2 by four items, and factor 3 by three items, representing dysphoria, retardation, and vegetative symptoms, respectively. ECT was performed twice a week for a total of six sessions using a Thymatron System IV device with the brief pulse technique. Clinical responses were defined on the basis of a ≥50% decrease in total pretreatment Montgomery and Åsberg Depression Rating Scale scores.Results: The mean pretreatment factor 2 score for responders (n = 7 was significantly lower than that for nonresponders (n = 11. Furthermore, a significant difference in mean factor 3 score between responders and nonresponders was observed one week after six sessions of ECT, indicating a time lag of response. No significant differences were observed for age, number of previous episodes, and duration of the current episode between responders and

  3. U.S. History and Modern World History Courses for English Speakers of Other Languages in Montgomery County Public Schools

    Science.gov (United States)

    Zhao, Huafang; Wade, Julie

    2014-01-01

    The Office of Shared Accountability (OSA) in Montgomery County (Maryland) Public Schools (MCPS) examined academic performance of English for Speakers of Other Languages (ESOL) students in U.S. History and Modern World History courses, as well as the course sequence in ESOL U.S. History and Modern World History. In MCPS, students who are not ESOL…

  4. The Employers II: A Survey of Employers Who Have Hired Career Program Graduates of Montgomery Community College.

    Science.gov (United States)

    Gell, Robert L.; Jones, Robert F.

    As part of a student follow-up system, a survey was conducted of employers of 1973-74 career program graduates of Montgomery College (MC). The survey was divided into three major areas: the value of an associate degree in the working world, an evaluation of the job preparation given to MC graduates, and suggestions for improvements in individual…

  5. The Employers IV: A Survey of Employers Who Have Hired Career Program Graduates of Montgomery Community College.

    Science.gov (United States)

    Gell, Robert L.; Armstrong, David F.

    In a survey of 374 career curriculum graduates of Montgomery Community College in 1976, 280 indicated they were working in jobs related to their college programs. Of these, 225 (80%) gave employer names and addresses and permission to contact them. Questionnaires drew responses of 159 employers to questions about skill levels of students, employee…

  6. The Employers III: A Survey of Employers Who Have Hired Career Program Graduates of Montgomery Community College.

    Science.gov (United States)

    Gell, Robert L.; And Others

    As part of a student follow-up system, a survey was conducted of employers of 1975 career program graduates of Montgomery Community College (MCC). The survey was designed to elicit responses in three major areas: the value of an associate degree in the working world, an evaluation of job preparation given to MCC graduates, and suggestions for…

  7. Follow-up of Students Who Entered Montgomery Community College Fall 1970. A Preliminary Analysis of Student Goals.

    Science.gov (United States)

    Gell, Robert L.

    As part of a statewide followup study of all students who entered a community college in the fall of 1970, a questionnaire was mailed in April 1974 to the 3,615 students who had entered Montgomery Community College in fall 1970. Twenty percent of the questionnaires were nondeliverable; thus, 2,890 students received the questionnaire, and of these,…

  8. A Follow-up Study of Freshmen Who Left Montgomery College After Just One Semester of Attendance.

    Science.gov (United States)

    Gell, Robert L.; And Others

    Students' reasons for leaving Montgomery College after one semester, dropout trends, current activities of nonreturnees, and the impact that the one semester had on their careers or course of action were elicited by questionnaires mailed to 389 students. A total of 120 usable questionnaires were returned. The data collected showed that: (1) the…

  9. 76 FR 71125 - Caddo Valley Railroad Company-Abandonment Exemption-in Clark, Pike, and Montgomery Counties, AR

    Science.gov (United States)

    2011-11-16

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF TRANSPORTATION Surface Transportation Board Caddo Valley Railroad Company--Abandonment Exemption--in Clark, Pike, and... distance of 32.2 miles, in Clark, Pike, and Montgomery Counties, Ark. (the line).\\1\\ The line...

  10. A Portrait of School District Crisis Management: Leadership Choices in Montgomery County during the Sniper Shootings of October 2002

    Science.gov (United States)

    Porter, Brian Joseph

    2010-01-01

    The actions of two assailants who shot and killed 10 people and wounded three others, including a student, in the region around Washington, D.C., in October 2002, provides the backdrop for a qualitative study of the emergency response by school district leaders in Montgomery County, Maryland. The study explores and describes the experiences of the…

  11. Depression (Major Depressive Disorder)

    Science.gov (United States)

    ... generally miserable or unhappy without really knowing why. Depression symptoms in children and teens Common signs and ... in normal activities, and avoidance of social interaction. Depression symptoms in older adults Depression is not a ...

  12. The future of professional hypnosis: comment on kirsch, mazzoni, and montgomery.

    Science.gov (United States)

    Frischholz, Edward J

    2015-01-01

    I believe the paper by Kirsch, Mazzoni, and Montgomery (this issue) should surprise about 95% of ASCH members (maybe only 93% of SCEH members) because the three facts espoused in their paper speciously seem to be 100% true. To paraphrase from their abstract: 1) nothing that can be produced by hypnotic induction plus suggestion cannot also be produced by suggestion alone; 2) administration of a hypnotic induction does not produce a meaningful increase in response to suggestion relative to suggestion alone; and 3) responsivity to suggestions are highly correlated to responsivity on the same measure when preceded by a hypnotic induction ceremony. In order to persuade that these propositions are true, several objections to them must be addressed. However, just because one's facts are true does not mean that one's interpretation of the facts and their interrelationships are also true. The ramifications of the above facts and their interrelationships for the future of professional hypnosis (experimental, clinical and forensic) are identified and discussed.

  13. Cognitive Functions and Depression in Patients with Irritable Bowel Syndrome

    Directory of Open Access Journals (Sweden)

    Per G. Farup

    2015-01-01

    Full Text Available Background. Irritable bowel syndrome (IBS is associated with depression and depression with impaired cognitive functions. The primary aim was to study associations between depression and cognitive functions in patients with IBS. Methods. IBS (according to the Rome III criteria, cognitive functions (evaluated with a set of neuropsychological tests, and depression (measured with Beck Depression Inventory II and Montgomery-Åsberg Depression Scale were analysed in patients with idiopathic depression and in patients with unspecified neurological symptoms. Results. 18 and 48 patients with a mean age of 47 and 45 years were included in the “Depression” and “Neurological” group, respectively. In the “Depression” group, the degree of depression was significantly higher in patients with IBS than in those without. Depression was associated with impaired cognitive function in 6 out of 17 neuropsychological tests indicating reduced set shifting, verbal fluency, attention, and psychomotor speed. IBS was statistically significantly associated with depression but not with any of the tests for cognitive functions. Conclusions. IBS was associated with depression but not with impaired cognitive functions. Since the idiopathic depression was associated with cognitive deficits, the findings could indicate that the depression in patients with IBS differs from an idiopathic depression.

  14. Editorial Foreword - Milnacipran: recent findings in depression

    Directory of Open Access Journals (Sweden)

    Stuart Montgomery

    2010-08-01

    Full Text Available Stuart Montgomery1, Mike Briley2 1Imperial College School of Medicine, London, England, UK; 2NeuroBiz Consulting and Communication, Castres, FranceMilnacipran: recent findings in depressionMilnacipran is a serotonin and norepinephrine reuptake inhibitor (SNRI which was first approved for the treatment of major depressive episodes in France in December 1996. It is currently marketed for this indication (as Ixel®, Toledomin®, Tivanyl® or Dalcipran® in over 45 countries worldwide including Japan. It was approved for the management of fibromyalgia in the US in 2009.This supplement, which is based on a symposium at the International Forum on Mood and Anxiety (IFMAD held in Monaco in November 2009, highlights several recent clinical studies with milnacipran in depression.

  15. Map showing radon potential of rocks and soils in Montgomery County, Maryland

    Science.gov (United States)

    Gundersen, L.C.; Reimer, G.M.; Wiggs, C.R.; Rice, C.A.

    1988-01-01

    This report summarizes the radon potential of Montgomery County in the context of its geology. Radon is a naturally occurring gas produced by the radioactive decay of uranium. Radon produced by uraniferous rocks and soils may enter a house through porous building materials and through openings in walls and floors. Radon gases has a tendency to move from the higher pressure commonly existing in the soil to the lower pressure commonly existing in the house. The U.S. Environmental Protection Agency (U.S. EPA, 1986a) estimates that elevated levels of indoor radon may be associated with 5,000 to 20,000 of the 130,000 lung cancer deaths per year. They also estimate that 8 to 12 percent of the homes in the United States will have annual average indoor radon levels exceeding 4 picoCuries per liter of air (pCi/L). Above this level, the U.S. EPA recommends homeowners take remedial action. May factors control the amount of radon which may enter a home from the geologic environment. Soil drainage, permeability, and moisture content effect the amount of radon that can be released from rocks and soils (known as the emmanation) and may limit or increase how far it can migrate. Well drained, highly permeable soils facilitate the movement of radon. Soils with water content in the 8 to 15 percent range enhance the emmanation of radon (Lindmark, 1985). Daily and seasonal variations in soil and indoor radon can be caused by meteorologic factors such as barometric pressure, temperature, and wind (Clements and Wilkening, 1974; Schery and other, 1984). Construction practices also inhibit or promote entry of radon into the home (U.S. EPA, 1986b). In general, however, geology controls the source and distribution of radon (Akerblom and Wilson, 1982; Gundersen and others, 1987, 1988; Sextro and others, 1987; U.S. EPA, 1983; Peake, 1988; Peake and Hess, 1988). The following sections describe: 1) the methods used to measure radon and equivalent uranium (eU) in soil; 2) the radon potential

  16. Role of Montgomery salivary stent placement during pharyngolaryngectomy, to prevent pharyngocutaneous fistula in high-risk patients.

    Science.gov (United States)

    Bondi, S; Giordano, L; Limardo, P; Bussi, M

    2013-01-01

    To evaluate the incidence of pharyngocutaneous fistula after pharyngolaryngectomy with and without a Montgomery salivary stent. Retrospective analysis of patients with factors that predispose to the development of pharyngocutaneous fistula (i.e. disease extending to the supraglottic region, base of the tongue or pyriform sinuses, and/or radiochemotherapy). Between 2002 and 2008, 85 pharyngolaryngectomies were performed in our clinic. Of these patients, 31 were at increased risk of fistula development, of whom 45 per cent developed fistulas post-operatively. This subgroup of 31 patients was compared with a second subgroup of 22 patients at high risk of fistula development, treated between 2009 and 2011 with pharyngolaryngectomy and with a Montgomery salivary stent placed in advance during closure of the neopharynx. Statistical analysis showed a significant reduction in the rate of fistula development, from 45 to 9 per cent (p fistula development.

  17. Depression - resources

    Science.gov (United States)

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

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

    Institute of Scientific and Technical Information of China (English)

    王健; 王刚; 马辛

    2014-01-01

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

  19. Groundwater environmental tracer data collected from the Chicot, Evangeline, and Jasper aquifers in Montgomery County and adjacent counties, Texas, 2008

    Science.gov (United States)

    Oden, Timothy D.

    2011-01-01

    The Gulf Coast aquifer system is the primary water supply for Montgomery County in southeastern Texas, including part of the Houston metropolitan area and the cities of Magnolia, Conroe, and The Woodlands Township, Texas. The U.S. Geological Survey, in cooperation with the Lone Star Groundwater Conservation District, collected environmental tracer data in the Gulf Coast aquifer system, primarily in Montgomery County. Forty existing groundwater wells screened in the Gulf Coast aquifer system were selected for sampling in Montgomery County (38 wells), Waller County (1 well), and Walker County (1 well). Groundwater-quality samples, physicochemical properties, and water-level data were collected once from each of the 40 wells during March-September 2008. Groundwater-quality samples were analyzed for dissolved gases and the environmental tracers sulfur hexafluoride, chlorofluorocarbons, tritium, helium-4, and helium-3/tritium. Water samples were collected and processed onsite using methods designed to minimize changes to the water-sample chemistry or contamination from the atmosphere. Replicate samples for quality assurance and quality control were collected with each environmental sample. Well-construction information and environmental tracer data for March-September 2008 are presented.

  20. Geochemical characterization of shallow ground water in the Eutaw aquifer, Montgomery, Alabama

    Science.gov (United States)

    Robinson, J.L.; Journey, C.A.

    2004-01-01

    Ground water samples were collected from 30 wells located in, or directly down gradient from, recharge areas of the Eutaw aquifer in Montgomery, Alabama. The major ion content of the water evolves from calcium-sodium-chloride- dominated type in the recharge area to calcium-bicarbonate-dominated type in the confined portion of the aquifer. Ground water in the recharge area was undersaturated with respect to aluminosilicate and carbonate minerals. Ground water in the confined portion of the aquifer was at equilibrium levels for calcite and potassium feldspar. Dissolved oxygen and nitrite-plus-nitrate concentrations decreased as ground water age increased; pH, iron, and sulfate concentrations increased as ground water age increased. Aluminum, copper, and zinc concentrations decreased as ground water age and pH increased. These relations indicate that nitrate, aluminum, copper, and zinc are removed from solution as water moves from recharge areas to the confined areas of the Eutaw aquifer. The natural evolution of ground water quality, which typically increases the pH and decreases the dissolved oxygen content, may be an important limiting factor to the migration of nitrogen based compounds and metals.

  1. Postpartum depression

    Science.gov (United States)

    Depression - postpartum; Postnatal depression; Postpartum psychological reactions ... behavioral therapy (CBT) and interpersonal therapy (IPT) are types of talk therapy that often help postpartum depression. ...

  2. Effects of 5-HT1A receptor agonists and L-5-HTP in Montgomery's conflict test.

    Science.gov (United States)

    Söderpalm, B; Hjorth, S; Engel, J A

    1989-01-01

    The effects of the pyrimidinyl-piperazines buspirone, gepirone, ipsapirone and their common metabolite 1-(2-pyrimidinyl)-piperazine (PmP) as well as of 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT) and L-5-hydroxytryptophan (L-5-HTP) were investigated in Montgomery's conflict test--an animal anxiety model based on the animal's inborn urge to explore a new environment and its simultaneous fear of elevated, open spaces. Subcutaneous buspirone (32-128 nmol/kg), gepirone (32-128 nmol/kg), ipsapirone (32-512 nmol/kg) and 8-OH-DPAT (50-200 nmol/kg), as well as intraperitoneal L-5-HTP (56 mumol/kg) produced anxiolytic-like effects. However, at higher doses the magnitude of these effects decreased and overall the dose-response curves displayed inverted U-shapes. The highest doses (2048 nmol/kg) of buspirone and of gepirone even decreased responding below control levels, possibly in part due to concomitant sedation/motor impairment. After L-5-HTP (448 mumol/kg) and PmP (512 nmol/kg) anxiogenic-like effects were observed. The results indicate that anxiolytic- and anxiogenic-like effects of drugs affecting central serotonergic neurotransmission can be obtained in a sensitive rat anxiety model which neither involves consummatory behavior nor punishment. The anxiolytic-like effects of these compounds may be due to their 5-HT1A agonistic properties. Moreover, the present data may provide support for a possible reciprocal association of presynaptic 5-HT1A receptors vs. postsynaptic 5-HT1A as well as 5-HT2 receptors with regard to anxiety.

  3. Evaluation of geophysical logs, Phase I, at Willow Grove Naval Air Station, Montgomery County, Pennsylvania

    Science.gov (United States)

    Conger, R.W.

    1997-01-01

    Between April and June 1997, the U.S. Navy contracted Brown and Root Environmental, Inc., to drill 20 monitor wells at the Willow Grove Naval Air Station in Horsham Township, Montgomery County, Pa. The wells were installed to monitor water levels and allow collection of water samples from shallow, intermediate, and deep water-bearing zones. Analysis of the samples will determine the horizontal and vertical distribution of any contaminated ground water migrating from known contaminant sources. Eight wells were drilled near the Fire Training Area (Site 5), five wells near the 9th Street Landfill (Site 3), four wells at the Antenna Field Landfill (Site 2), and three wells near Privet Road Compound (Site 1). Depths range from 73 to 167 feet below land surface. The U.S. Geological Survey conducted borehole-geophysical and borehole-video logging to identify water-bearing zones so that appropriate intervals could be screened in each monitor well. Geophysical logs were run on the 20 monitor wells and 1 existing well. Video logs were run on 16 wells. Caliper and video logs were used to locate fractures, inflections on fluid-temperature and fluid-resistivity logs were used to locate possible water-bearing fractures, and flowmeter measurements verified these locations. Single-point-resistance and natural-gamma logs provided information on stratigraphy. After interpretation of geophysical logs, video logs, and driller's notes, all wells were screened such that water-level fluctuations could be monitored and discrete water samples collected from one or more shallow and intermediate water-bearing zones in each borehole.

  4. The characteristics of rapid eye movement sleep of depressed patients and its correlation with severity degree of depression%抑郁症患者快动眼睡眠特征及其与抑郁水平的相关性

    Institute of Scientific and Technical Information of China (English)

    吕学玉; 刘艳骄; 汪卫东; 靖猛; 林颖娜; 王芳

    2011-01-01

    Objective To explore the characteristics of polysomnography (PSG) of depressed patients and the correlation between rapid eye movement (REM) and severity degree of depression. Methods Polysomnography was used to assess patients'sleep condition and Montgomery-Asberg depression scale (MADRS) was used to assess the severity degree of depression. 90 patients and 30 healthy controls were included. Results Compared to healthy controls,sleep progress of depressed patients changed as follow:prolonged sleep latency((25.2 ±15.25) minutes) ,lowered sleep efficiency(0.853 ±0.11) ;the architecture of sleep also changed:percentage of stage 1 increased( (27.7 ± 16.38) % ),percentage of REM sleep increased( (22. 8 ± 6. 1 ) % ) , percentage of stage 2 decreased ((40.2±11.3)%), percentage of slow wave sleep decreased ((11.8 ±9. 32)%); REM sleep significantly changed; decreased REM latency((79. 27 ±30. 44) minutes) , increased REM activity((129. 0 ±53. 12) u) .increased intensity of REM((36.7 ±14.0)u/min), increased REM density((159.2 ±57.2)u/min) were observed in depressed patients. There was no obvious correlation between the variance of REM and severity degree of depression. Conclusion There are a series of changes in sleep progress, architecture and REM sleep of depression and the change of REM sleep can be specified to diagnose depression. However,there is no causality between REM variance and severity of depression.%目的 探讨抑郁症患者多导睡眠图特征及快动眼睡眠(REM)变异度与抑郁严重程度是否存在相关性.方法 应用多导睡眠图对纳入的符合CCMD-3单项抑郁症诊断标准的患者90例进行整夜多导睡眠监测与蒙哥马利抑郁量表(MADRS)评定,并采用30例正常被试作为对照.结果 与正常对照组相比,抑郁症患者在睡眠进程方面的表现为睡眠潜伏期延长[(25.5±15.25)min],睡眠效率下降[(0.83±0.11)];睡眠结构方面,抑郁症患者1期睡眠百分比增加[(27.7±16.38)%)],REM

  5. 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

    DEFF Research Database (Denmark)

    Bech, Per; Lönn, Sara L; Overø, Kerstin F

    2010-01-01

    -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...

  6. Postpartum Depression

    Science.gov (United States)

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

  7. Caregiver Depression

    Science.gov (United States)

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

  8. "Cancer-Related Fatigue: A Systematic and Meta-Analytic Review of Nonpharmacological Therapies for Cancer Patients:" Correction to Kangas, Bovbjerg, and Montgomery (2008)

    Science.gov (United States)

    Kangas, Maria; Bovbjerg, Dana H.; Montgomery, Guy H.

    2009-01-01

    Reports an error in "Cancer-related fatigue: A systematic and meta-analytic review of non-pharmacological therapies for cancer patients" by Maria Kangas, Dana H. Bovbjerg and Guy H. Montgomery (Psychological Bulletin, 2008[Sep], Vol 134[5], 700-741). The URL to the Supplemental Materials for the article is listed incorrectly in two places in the…

  9. Grades--Scores--Predictions: A Study of the Efficiency of High School Grades and American College Test Scores in Predicting Academic Achievement at Montgomery College.

    Science.gov (United States)

    Gell, Robert L.; Bleil, David F.

    This report analyzes the relationship between high school grades, American College Test (ACT) scores, and first-semester college grades. Based on the Standard Research Service of the ACT program, 1,379 students in the fall 1969 freshman class of Montgomery College (Maryland) were studied. Measures of academic background used ACT scores in English,…

  10. Where Have All the Freshman Gone? A Follow-up Study of Students Who Left Montgomery Community College Prior to Graduation.

    Science.gov (United States)

    Gell, Robert L.; Bleil, David F.

    The purpose of this study was to discover what the nonreturning student does when he leaves Montgomery College and why he left prior to earning a degree. This report is the second phase of a total follow-up study conducted by the Office of Institutional Research. The first phase consisted of a study of what the 1970 graduates were doing four…

  11. Tentative Ten-Year Enrollment Projections, Fiscal Years 1978-1987. (A Supplement to the FY 1978 Capital and Operating Budgets of Montgomery Community College)

    Science.gov (United States)

    Gell, Robert L.; Armstrong, David F.

    The number of students expected to enroll in Montgomery College yearly through 1987 is projected on the basis of a model incorporating past trends, population projections, economic indicators, and other factors on which viable assumptions about the future can be based, into a system of linear equations expressed in matrix notation. The model…

  12. Topographic data of selected areas along the Alabama River near Montgomery, Alabama, collected using mobile terrestrial light detection and ranging (T-LiDAR) technology

    Science.gov (United States)

    Kimbrow, D.R.

    2014-01-01

    Topographic data at selected areas within the Alabama River flood plain near Montgomery, Alabama, were collected using a truck-mounted mobile terrestrial light detection and ranging system. These data were collected for inclusion in a flood inundation model developed by the National Weather Service in Birmingham, Alabama. Data are presented as ArcGIS point shapefiles with the extension .shp.

  13. Implementación eficiente de la multiplicación modular de Montgomery sobre hardware reconfigurable

    Directory of Open Access Journals (Sweden)

    Ander Torres López

    2013-10-01

    Full Text Available Este documento propone implementaciones tanto, software como hardware, sobre un FPGA de Xilinx, del algoritmo de multiplicación de Montgomery utilizando el método de Escaneo de Operandos por Separado (SOS, de sus siglas en inglés, que es una forma eficiente para calcular multiplicaciones modulares. La solución software ha sido desarrollada sobre la plataforma de procesamiento MicroBlaze y la de hardware se realizó utilizando directamente los recursos lógicos y dedicados de la FPGA. Los resultados se presentan con una comparación entre ambos casos en función de su rendimiento y el empleo de recursos.

  14. Estimated rates of groundwater recharge to the Chicot, Evangeline and Jasper aquifers by using environmental tracers in Montgomery and adjacent counties, Texas, 2008 and 2011

    Science.gov (United States)

    Oden, Timothy D.; Truini, Margot

    2013-01-01

    Montgomery County is in the northern part of the Houston, Texas, metropolitan area, the fourth most populous metropolitan area in the United States. As populations have increased since the 1980s, groundwater has become an important resource for public-water supply and industry in the rapidly growing area of Montgomery County. Groundwater availability from the Gulf Coast aquifer system is a primary concern for water managers and community planners in Montgomery County and requires a better understanding of the rate of recharge to the system. The Gulf Coast aquifer system in Montgomery County consists of the Chicot, Evangeline, and Jasper aquifers, the Burkeville confining unit, and underlying Catahoula confining system. The individual sand and clay sequences of the aquifers composing the Gulf Coast aquifer system are not laterally or vertically continuous on a regional scale; however, on a local scale, individual sand and clay lenses can extend over several miles. The U.S. Geological Survey, in cooperation with the Lone Star Groundwater Conservation District, collected groundwater-quality samples from selected wells within or near Montgomery County in 2008 and analyzed these samples for concentrations of chlorofluorocarbons (CFCs), sulfur hexafluoride (SF6), tritium (3H), helium-3/tritium (3He/3H), helium-4 (4He), and dissolved gases (DG) that include argon, carbon dioxide, methane, nitrogen and oxygen. Groundwater ages, or apparent age, representing residence times since time of recharge, were determined by using the assumption of a piston-flow transport model. Most of the environmental tracer data indicated the groundwater was recharged prior to the 1950s, limiting the usefulness of CFCs, SF6, and 3H concentrations as tracers. In many cases, no tracer was usable at a well for the purpose of estimating an apparent age. Wells not usable for estimating an apparent age were resampled in 2011 and analyzed for concentrations of major ions and carbon-14 (14C). At six of

  15. Tratamento homeopático da depressão: relato de série de casos Homeopathic treatment of depression: series of case report

    Directory of Open Access Journals (Sweden)

    Ubiratan Cardinalli Adler

    2008-01-01

    Full Text Available CONTEXTO: Não há estudos metodologicamente adequados sobre a eficácia da homeopatia na depressão. Relatos de casos clínicos são os primeiros degraus da evidência clínica, a caminho de estudos controlados. OBJETIOS: Relatar resultados preliminares do tratamento homeopático de pacientes com depressão no SUS de Jundiaí. MÉTODOS: Revisão dos prontuários dos casos novos, atendidos entre março e dezembro de 2006. O diagnóstico foi confirmado por entrevista estruturada. Os pacientes receberam homeopatia individualizada e a evolução foi avaliada pela escala de Montgomery & Åsberg (MADRS. RESULTADOS: Foram tratados 15 casos e observou-se resposta terapêutica (redução maior que 50% dos escores de depressão em 14 pacientes (93%, após uma média de sete semanas de tratamento; um paciente apresentou piora clínica e foi encaminhado ao tratamento convencional. O escore média (± dp na Escala de Avaliação de Depressão de Montgomery-Åsberg diminuiu de 24,9 (± 5,8 a 9,7 (± 8,2, p BACKGROUND: Evidence for the efficacy of homeopathy for depression is limited due to lack of clinical trials of high quality. Case reports are the first steps of clinical evidence, towards controlled trials. OBJECTIVES: To report preliminary results of homeopathic treatment of depression in Jundiai's public health system, Sao Paulo. METHODS: Review of the medical records of new patients, treated between March and December 2006. Their diagnosis was confirmed by a semi-structured interview. Patients received individualized homeopathy and their response was measured by the Montgomery & Åsberg depression scale (MADRS. RESULTS: Fifteen patients were treated and response (more than 50% decrease of MADRS scores was observed in 14 patients (93%, after an average of seven weeks of treatment; one patient had clinical worsening and was refered to conventional antidepressant therapy. The MADRS mean scores (± dp decreased from 24.9 (± 5.8 to 9.7 (± 8.2, p < .0001

  16. [Recited depression].

    Science.gov (United States)

    Barucci, M; Cossio, M

    1984-01-01

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

  17. Phase I Investigations at the Former CCC/USDA Grain Storage Facility in Montgomery City, Missouri, in 2010-2011

    Energy Technology Data Exchange (ETDEWEB)

    LaFreniere, Lorraine M. [Argonne National Lab. (ANL), Argonne, IL (United States). Environmental Science Division. Applied Geoscience and Environmental Restoration Program

    2012-11-01

    This report presents the technical findings of Phase I of Argonne’s studies. The Phase I field investigation was initiated on October 18, 2010. The work was conducted in accord with (1) the final site-specific Phase I Work Plan for Montgomery City (Argonne 2010; approved by the MDNR [2010]); (2) applicable Missouri regulations; and (3) the standard operating procedures, quality assurance/quality control (QA/QC) measures, and general health and safety policies outlined in the Master Work Plan (Argonne 2002) for operations in Kansas, which was reviewed by the MDNR and accepted for current use. A draft master plan specific to work in Missouri and a set of draft standard operating procedures are in review with the MDNR. The site-specific Work Plan for Montgomery City (Argonne 2010) (1) summarizes the pre-existing knowledge base for the Montgomery City investigation site compiled by Argonne and (2) describes the site-specific technical objectives and the intended scope of work developed for the first phase of the investigation. Three primary technical objectives were identified for the Phase I studies, as follows: 1. Update the presently identified inventory and status of private and public drinking water wells in the immediate vicinity of the former CCC/USDA grain storage facility, and sample the identified wells for volatile organic compounds (VOCs) and geochemical analyses. In conjunction with this effort, determine the present sources(s) of drinking water for all residents in an approximate 0.5-mi radius of the former CCC/USDA facility. 2. Investigate for possible evidence of a soil source of carbon tetrachloride contamination in the unconsolidated sediments beneath the former CCC/USDA facility that might affect the underlying bedrock aquifer units. 3. Obtain preliminary information on the site-specific lithologic and hydrologic characteristics of the unconsolidated sediments overlying bedrock at the former CCC/USDA grain storage location. Section 2 of this report

  18. Atypical Depression

    Science.gov (United States)

    ... satisfaction and control in your life Help ease depression symptoms such as hopelessness and anger As part of your treatment, it's important to also address other conditions that often accompany atypical depression, in particular anxiety and drug or alcohol use, ...

  19. Teen Depression

    Science.gov (United States)

    ... Depression is a real, treatable brain illness, or health problem. Depression can be caused by big transitions in life, stress, or changes in your body’s chemicals that affect your thoughts and moods. Even if you feel ...

  20. Postpartum Depression

    Science.gov (United States)

    ... do not need treatment. The symptoms of postpartum depression last longer and are more severe. You may ... treatment right away, often in the hospital. Postpartum depression can begin anytime within the first year after ...

  1. Depression Treatment

    Science.gov (United States)

    ... 3286 After hours (404) 639-2888 Contact Media Depression Treatment Recommend on Facebook Tweet Share Compartir On ... How Do I Know if I Am Experiencing Depression? The following questions may help you determine if ...

  2. Depression Screening

    Science.gov (United States)

    ... Centers Diseases + Condition Centers Mental Health Medical Library Depression Screening (PHQ-9) - Instructions The following questions are ... this tool, there is also text-only version . Depression Screening - Manual Instructions The following questions are a ...

  3. Knowledge of General Nutrition, Soy Nutrition, and Consumption of Soy Products: Assessment of a Sample Adult Population in Montgomery County, Virginia

    OpenAIRE

    1999-01-01

    KNOWLEDGE OF GENERAL NUTRITION, SOY NUTRITION, AND CONSUMPTION OF SOY PRODUCTS: ASSESSMENT OF A SAMPLE ADULT POPULATION IN MONTGOMERY COUNTY, VIRGINIA Lida Catherine Johnson (ABSTRACT) Nutrition education programs in the prevention of chronic diseases has flourished over the last 15 years. Investigators continue to demonstrate that soy consumption plays a role in decreasing chronic diseases such as cardiovascular disease, cancer, osteoporosis and problems regarding menopause....

  4. Antidepressant Effects of a Single Dose of Ayahuasca in Patients With Recurrent Depression: A SPECT Study.

    Science.gov (United States)

    Sanches, Rafael Faria; de Lima Osório, Flávia; Dos Santos, Rafael G; Macedo, Ligia R H; Maia-de-Oliveira, João Paulo; Wichert-Ana, Lauro; de Araujo, Draulio Barros; Riba, Jordi; Crippa, José Alexandre S; Hallak, Jaime E C

    2016-02-01

    Ayahuasca is an Amazonian botanical hallucinogenic brew which contains dimethyltryptamine, a 5-HT2A receptor agonist, and harmine, a monoamine-oxidase A inhibitor. Our group recently reported that ayahuasca administration was associated with fast-acting antidepressive effects in 6 depressive patients. The objective of the present work was to assess the antidepressive potentials of ayahuasca in a bigger sample and to investigate its effects on regional cerebral blood flow. In an open-label trial conducted in an inpatient psychiatric unit, 17 patients with recurrent depression received an oral dose of ayahuasca (2.2 mL/kg) and were evaluated with the Hamilton Rating Scale for Depression, the Montgomery-Åsberg Depression Rating Scale, the Brief Psychiatric Rating Scale, the Young Mania Rating Scale, and the Clinician Administered Dissociative States Scale during acute ayahuasca effects and 1, 7, 14, and 21 days after drug intake. Blood perfusion was assessed eight hours after drug administration by means of single photon emission tomography. Ayahuasca administration was associated with increased psychoactivity (Clinician Administered Dissociative States Scale) and significant score decreases in depression-related scales (Hamilton Rating Scale for Depression, Montgomery-Åsberg Depression Rating Scale, Brief Psychiatric Rating Scale) from 80 minutes to day 21. Increased blood perfusion in the left nucleus accumbens, right insula and left subgenual area, brain regions implicated in the regulation of mood and emotions, were observed after ayahuasca intake. Ayahuasca was well tolerated. Vomiting was the only adverse effect recorded, being reported by 47% of the volunteers. Our results suggest that ayahuasca may have fast-acting and sustained antidepressive properties. These results should be replicated in randomized, double-blind, placebo-controlled trials.

  5. 重复经颅磁刺激联合帕罗西汀治疗重性抑郁障碍%Repetitive transcranial magnetic stimulation in combination with paroxetine for major depressive disorder

    Institute of Scientific and Technical Information of China (English)

    房萌; 任艳萍; 刘辉; 周方; 王刚

    2014-01-01

    Objective To investigate the efficacy of repetitive transcranial magnetic stimulation( rTMS) in combination with paroxetine for major depressive disorder. Methods In a 6-week, randomized, double-blind, sham-controlled trial, 48 patients with major depressive disorder were randomly assigned to receive real or sham rTMS for 2 weeks. During the 6 weeks, paroxetine was used at a fixed dose of 20 mg per day for all participants. Seven sites were set to conduct assessment of efficacy and adverse events in this study. ResultsThe Montgomery-Asberg Depression Rating(MADRS), the 17-item Hamilton Depression Rating Scale(HAMD-17) and Hamilton Anxiety Rating Scale( HAMA) scores significantly decreased from baseline to the endpoint in both groups. No meaningful difference was observed between the two groups in general clinical effect. The mean time-to-onset was earlier by 3 days in Real group, but the difference was not significant. In the Real group, the scores of HAMD anxiety/somatic symptom factor significantly decreased on day10, 14 and 28; the scores of HAMA significantly decreased on day 10. The incidence of adverse events in both groups had no significant difference. Conclusion The combination of rTMS and paroxetine was effective and safe in treatment of MDD. The tendency of fast onset of effect was observed in the comprehensive intervention, which probably is beneficial to the patients with anxiety and somatic symptoms.%目的探讨重复经颅磁刺激( repetitive transcranial magnetic stimulation,rTMS)联合帕罗西汀对重性抑郁障碍( major depressive disorder,MDD)的疗效。方法本研究是一项为期6周的随机、双盲、伪刺激对照临床试验。48例MDD患者采用数字表法随机分为2组接受rTMS真(real)或伪(sham)刺激治疗2周,基线起同时合并固定剂量的帕罗西汀(20 mg/d),rTMS治疗结束后随访至6周末,随访期间帕罗西汀治疗剂量保持不变。设置7个访视点进行疗效评定和不良事件记录。结

  6. Tubo en T de Montgomery en el tratamiento de la estenosis isquémica laringotraqueal y traqueal Montgomery T-tube in the treatment of layngotracheal and tracheal ischemic stenosis

    Directory of Open Access Journals (Sweden)

    Edelberto Fuentes Valdés

    2008-06-01

    Full Text Available INTRODUCCIÓN. La colocación de un tubo en T es una alternativa segura en pacientes con estenosis isquémica laringotraqueal y traqueal, para quienes no está indicada la resección y anastomosis. El objetivo del presente estudio fue analizar los resultados obtenidos con esta prótesis. MÉTODOS. Se realizó un estudio prospectivo y descriptivo de 69 pacientes consecutivos, a quienes se colocó un tubo en T entre noviembre de 1991 y septiembre de 2002. Las variables estudiadas fueron promedio de edad, sexo, extensión de la estenosis, práctica de resección y localización de esta: subglótica o traqueal. Las variables de respuesta fueron las complicaciones y la recidiva. El análisis estadístico comprendió técnicas univariadas (prueba de Fisher y ji al cuadrado y multivariadas (modelo de regresión logística. RESULTADOS. El porcentaje de complicaciones fue 33,3 % y las más frecuentes comprendieron granulomas traqueales, infección local, fístula cervical tardía y obstrucción del tubo. El promedio de edad (p = 0,045 y la localización traqueal de la lesión (p = 0,035 se asociaron al fallo de la operación. Con el análisis multivariado se demostró la influencia del promedio de edad (p = 0,036 sobre la aparición de recidivas. Finalmente, 55 pacientes (80,9 % tuvieron resultados buenos o satisfactorios. CONCLUSIONES. El tubo en T de Montgomery fue útil cuando no estuvo indicada la resección y anastomosis término-terminal. En un grupo significativo de pacientes se pueden esperar resultados satisfactorios de su uso como tratamiento único.INTRODUCTION. The placement of a T-tube is a safe alternative in patients with laryngotracheal or tracheal ischemic stenosis for those who have not been indicated resection or anastomosis. The objective of the present study was to analyze the result obtained with this prosthesis. METHODS. A prospective and descriptive study of 69 consecutive patients that were placed a T-tube between November 1991

  7. Homocysteine as a potential biochemical marker for depression in elderly stroke survivors

    Directory of Open Access Journals (Sweden)

    Michaela C. Pascoe

    2012-04-01

    Full Text Available Background: Elderly stroke survivors have been reported to be at risk of malnutrition and depression. Vitamin B-related metabolites such as methylmalonic acid and homocysteine have been implicated in depression. Objective: We conducted a study exploring the relationship between homocysteine and post-stroke depression. Design: Three methodologies were used: Observational cohort study of elderly Swedish patients (n=149 1.5 years post-stroke, assessed using Diagnostic and Statistical Manual of Mental Disorders, Montgomery Åsberg Depression Rating Scale and serum blood levels of methylmalonic acid and homocysteine. Results: Homocysteine significantly correlated with depressive symptomatology in stroke survivors (β = 0.18*. Individuals with abnormal levels of methylmalonic acid and homocysteine were almost twice more likely to show depressive symptomatology than those with normal levels (depressive symptoms 22%; no depressive symptoms 12%. Comparison of methylmalonic acid and homocysteine levels with literature data showed fewer stroke survivors had vitamin deficiency than did reference individuals (normal range 66%; elevated 34%. Conclusions: Homocysteine is significantly associated with depressive symptomatology in elderly Swedish stroke survivors.

  8. Hippocampal volume in relation to clinical and cognitive outcome after electroconvulsive therapy in depression

    Science.gov (United States)

    Nordanskog, P; Larsson, M R; Larsson, E-M; Johanson, A

    2014-01-01

    Objective In a previous magnetic resonance imaging (MRI) study, we found a significant increase in hippocampal volume immediately after electroconvulsive therapy (ECT) in patients with depression. The aim of this study was to evaluate hippocampal volume up to 1 year after ECT and investigate its possible relation to clinical and cognitive outcome. Method Clinical and cognitive outcome in 12 in-patients with depression receiving antidepressive pharmacological treatment referred for ECT were investigated with the Montgomery–Asberg Depression Rating Scale (MADRS) and a broad neuropsychological test battery within 1 week before and after ECT. The assessments were repeated 6 and 12 months after baseline in 10 and seven of these patients, respectively. Hippocampal volumes were measured on all four occasions with 3 Tesla MRI. Results Hippocampal volume returned to baseline during the follow-up period of 6 months. Neither the significant antidepressant effect nor the significant transient decrease in executive and verbal episodic memory tests after ECT could be related to changes in hippocampal volume. No persistent cognitive side effects were observed 1 year after ECT. Conclusion The immediate increase in hippocampal volume after ECT is reversible and is not related to clinical or cognitive outcome. PMID:23745780

  9. Evaluation of geophysical logs, Phase II, at Willow Grove Naval Air Station Joint Reserve Base, Montgomery County, Pennsylvania

    Science.gov (United States)

    Conger, Randall W.

    1999-01-01

    Between March and April 1998, the U.S. Navy contracted Tetra Tech NUS Inc., to drill two monitor wells in the Stockton Formation at the Willow Grove Naval Air Station Joint Reserve Base, Horsham Township, Montgomery County, Pa. The wells MG-1634 and MG-1635 were installed to monitor water levels and sample contaminants in the shallow, intermediate, and deep water-producing zones of the fractured bedrock. Chemical analyses of the samples will help determine the horizontal and vertical distribution of any contaminated ground water migrating from known contaminant sources. Wells were drilled near the Fire Training Area (Site 5). Depths of all boreholes range from 69 to 149 feet below land surface. The U.S. Geological Survey conducted borehole geophysical logging and video surveys to identify water-producing zones in newly drilled monitor wells MG-1634 and MG-1635 and in wells MG-1675 and MG-1676. The logging was conducted from March 5, 1998, to April 16, 1998. This work is a continuation of the Phase I work. Caliper logs and video surveys were used to locate fractures; inflections on fluid-temperature and fluid-resistivity logs were used to locate possible water-producing fractures. Heatpulse-flowmeter measurements were used to verify the locations of water-producing or water-receiving zones and to measure rates of flow between water-bearing fractures. Single-point-resistance and natural-gamma logs provided information on stratigraphy. After interpretation of geophysical logs, video surveys, and driller's notes, wells MG-1634 and MG-1635 were screened such that water-levels fluctuations could be monitored and discrete water samples collected from one or more water-producing zones in each borehole.

  10. PreproNPY Pro7 protects against depression despite exposure to environmental risk factors.

    Science.gov (United States)

    Sjöholm, Louise K; Melas, Philippe A; Forsell, Yvonne; Lavebratt, Catharina

    2009-11-01

    There is extensive evidence, from both clinical cases and rodent models, for reduced levels of the widely expressed neuropeptide Y (NPY) in anxiety and depressive disorders. The rare allele of the Leu7Pro polymorphism in the signal peptide of preproNPY has been associated with higher processing into mature NPY, and higher NPY levels in plasma and cerebrospinal fluid. The Pro7 allele was proposed to protect against depression in a small Swedish clinical sample (Heilig M., Zachrisson O., Thorsell A., Ehnvall A., Mottagui-Tabar S., Sjögren M., Asberg M., Ekman R., Wahlestedt C., Agren H., 2004. Decreased cerebrospinal fluid neuropeptide Y (NPY) in patients with treatment refractory unipolar major depression: preliminary evidence for association with preproNPY gene polymorphism. J. Psychiatr. Res. 38, 113-121). Leu7Pro was analyzed in a large well-characterized longitudinal population-based sample of adult Swedes with data on life situation and life history, including 461 with depression diagnosis, 157 with anxiety diagnosis and 1514 healthy individuals with no symptom of psychopathology. Pro7 was rarer in depression cases than in healthy individuals (OR=2.7; P=0.0004). The protective effect of Pro7 was similar despite exposure to known environmental vulnerability factors. Pro7 appeared with similar effect size in those with an anxiety diagnosis, but this was not statistically significant (OR=2.3; P=0.06). The size of the anxiety sample and possibly some recall bias of childhood conditions. Pro7 allele of preproNPY protected against depression among Swedes. Pro7 is not common, but was found to exert its protective effect also in an environment-induced vulnerable state. This supports a protective effect of NPY in line with previous reports suggesting anxiolytic-like and antidepressant-like effects of NPY.

  11. Late Pregnancy Thyroid-Binding Globulin Predicts Perinatal Depression

    Science.gov (United States)

    Pedersen, Cort; Leserman, Jane; Garcia, Nacire; Stansbury, Melissa; Meltzer-Brody, Samantha; Johnson, Jacqueline

    2016-01-01

    Previously we found that late pregnancy total and free thyroxine (TT4, FT4) concentrations were negatively related to greater pre and/or postpartum depressive symptoms. In a much larger cohort, the current study examined whether these thyroid indices measured earlier in the third trimester (31-33 weeks) predict subsequent perinatal depression and anxiety ratings as well as syndromal depression. Thyroid-binding globulin (TBG) concentrations increase markedly during pregnancy and may be an index of sensitivity to elevated estrogen levels. TBG was examined in this study because prior findings suggest that postpartum depression is related to sensitivity to mood destabilization by elevated sex hormone concentrations during pregnancy. Our cohort was 199 euthyroid women recruited from a public health obstetrics clinic (63.8% Hispanic, 21.6% Black). After screening and blood draws for hormone measures at pregnancy weeks 31-33, subjects were evaluated during home visits at pregnancy weeks 35-36 as well as postpartum weeks 6 and 12. Evaluations included psychiatric interviews for current and life-time DSM-IV psychiatric history (M.I.N.I.-Plus), subject self-ratings and interviewer ratings for depression and anxiety (Edinburgh Postnatal Depression Scale, Montgomery-Ǻsberg Depression Rating Scale; Spielberger State-Trait Anxiety Inventory, Hamilton Anxiety Inventory), as well as a standardized interview to obtain life-time trauma history. Numerous covariates were included in all regression analyses. Trauma and major depression history were robustly significant predictors of depression and anxiety ratings over the study period when these variables were analyzed individually or in a combined model including FT4 or TBG (pdepression and anxiety ratings (pdepression history, were significant individual predictors of syndromal depression during the study period (pdepression history, FT4 and TBG generally were not significantly predictive of depression or anxiety ratings, and FT4

  12. White Matter Hyperintensities and the Course of Depressive Symptoms in Elderly People with Mild Dementia

    Directory of Open Access Journals (Sweden)

    Hogne Soennesyn

    2012-03-01

    Full Text Available Objectives: To explore the relationship between white matter hyperintensities (WMH and the prevalence and course of depressive symptoms in mild Alzheimer’s disease (AD and Lewy body dementia. Design: This is a prospective cohort study conducted in secondary care outpatient clinics in western Norway. Subjects: The study population consisted of 77 elderly people with mild dementia diagnosed according to standardised criteria. Methods: Structured clinical interviews and physical, neurological, psychiatric, and neuropsychological examinations were performed and routine blood tests were taken. Depression was assessed using the depression subitem of the Neuropsychiatric Inventory and the Montgomery-Åsberg Depression Rating Scale (MADRS. A standardised protocol for magnetic resonance imaging scan was used, and the volumes of WMH were quantified using an automated method, followed by manual editing. Results: The volumes of total and frontal deep WMH were significantly and positively correlated with baseline severity of depressive symptoms, and depressed patients had significantly higher volumes of total and frontal deep WMH than non-depressed patients. Higher volumes of WMH were also associated with having a high MADRS score and incident and persistent depression at follow-up. After adjustment for potential confounders, frontal deep WMH, in addition to prior depression and non-AD dementia, were still significantly associated with baseline depressive symptoms (p = 0.015, OR 3.703, 95% CI 1.294–10.593. Similar results emerged for total WMH. Conclusion: In elderly people with mild dementia, volumes of WMH, in particular frontal deep WMH, were positively correlated with baseline severity of depressive symptoms, and seemed to be associated with persistent and incident depression at follow-up. Further studies of the mechanisms that determine the course of depression in mild dementia are needed.

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

    Directory of Open Access Journals (Sweden)

    Iversen Valentina C

    2010-07-01

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

  14. Lithium carbonate combined paro west efficacy and safety of the treatment of depression research%碳酸锂联合帕罗西治疗抑郁症的有效性与安全性研究

    Institute of Scientific and Technical Information of China (English)

    武华侨

    2014-01-01

    Objective:To study the lithium carbonate combined paro west ef icacy and safety of the treatment of depression.Methods:Select 90 cases as the research object,in patients with refractory schizG ophrenia were randomly divided into observation group and control group 45 cases,control group treated with paroxetine,observation group with lithium carbonate with paroxetine therapy.After treatment with Hamilton depression scale (HAMD)and antidepressants adverse reaction scale (Asberg),to evaluate the two groups of curative ef ect and adverse reactions,respectively.Result:Six weeks,8 weeks afG ter treatment,the observation group of patients with HAMD deducted rate (33.54±10.36,10.36±17.38);Treatment was made in the group of eight weeks Asberg antidepressants adverse reaction scale score (4.63±2.02),tremor,gastrointestinal reaction and so on adverse drug reactions (13.33%),significantly lower than the control group.Conclusion:Lithium carbonate combined paro west depression good curative ef ect,high safety,worth clinical promotion.%目的:探讨研究碳酸锂联合帕罗西治疗抑郁症的有效性与安全性.方法:选取90例难治性精神分裂症患者为研究对象,随机分为观察组和对照组各45例,对照组采用帕罗西汀治疗,观察组采用碳酸锂联合帕罗西汀治疗.治疗后采用汉密尔顿抑郁量表(HAMD)和抗抑郁剂不良反应量表(Asberg),分别评定两组疗效和不良反应.结果:治疗6周、8周后,观察组患者 HAMD减分率(33.54±10.36、49.46±17.38);治疗8周察组Asberg抗抑郁剂不良反应量表评分(4.63±2.02)、发生震颤、胃肠道反应等药物不良反应(13.33%)明显低于对照组.结论:碳酸锂联合帕罗西治疗抑郁症疗效好,安全性高,值得临床推广.

  15. Adolescence depressions

    National Research Council Canada - National Science Library

    Matot, J P

    2009-01-01

    This article considers the depressive problematics emerging during adolescence in the frame of the transformations that characterize this period of life, with a focus on the interference of socio-cultural dimensions...

  16. Postpartum Depression

    DEFF Research Database (Denmark)

    Smith-Nielsen, Johanne

    Background: In three academic articles, this PhD thesis investigates maternal postpartum depression (PPD) as a risk factor for the infant-mother attachment and infant development. Previous studies have been contradictory with respect to the question of whether PPD can have long term effects...... on offspring. This may be due to not differing between when PPD is only occurring in the postpartum period and when effects are also due to ongoing or recurrent depression. However, it may also be due to viewing maternal depression as a unitary construct, and not considering underlying maternal psychological...... difficulties which may moderate potential adverse effects. The present thesis investigates two potential maternal moderators of risk:. Comorbid personality disorder and adult attachment insecurity. Moreover, the question of early environmental effects of PPD versus effects of later or ongoing depression...

  17. Final work plan : phase I investigation of potential contamination at the former CCC/USDA grain storage facility in Montgomery City, Missouri.

    Energy Technology Data Exchange (ETDEWEB)

    LaFreniere, L. M.; Environmental Science Division

    2010-08-16

    From September 1949 until September 1966, the Commodity Credit Corporation of the U.S. Department of Agriculture (CCC/USDA) leased property at the southeastern end of Montgomery City, Missouri, for the operation of a grain storage facility. During this time, commercial grain fumigants containing carbon tetrachloride were commonly used by the CCC/USDA and the private grain storage industry to preserve grain in their facilities. In January 2000, carbon tetrachloride was detected in a soil sample (220 {micro}g/kg) and two soil gas samples (58 {micro}g/m{sup 3} and 550 {micro}g/m{sup 3}) collected at the former CCC/USDA facility, as a result of a pre-CERCLIS site screening investigation (SSI) performed by TN & Associates, Inc., on behalf of the U.S. Environmental Protection Agency (EPA), Region VII (MoDNR 2001). In June 2001, the Missouri Department of Natural Resources (MoDNR) conducted further sampling of the soils and groundwater at the former CCC/USDA facility as part of a preliminary assessment/site inspection (PA/SI). The MoDNR confirmed the presence of carbon tetrachloride (at a maximum identified concentration of 2,810 {micro}g/kg) and chloroform (maximum 82 {micro}g/kg) in the soils and also detected carbon tetrachloride and chloroform (42.2 {micro}g/L and 58.4 {micro}g/L, respectively) in a groundwater sample collected at the former facility (MoDNR 2001). The carbon tetrachloride levels identified in the soils and groundwater are above the default target level (DTL) values established by the MoDNR for this contaminant in soils of all types (79.6 {micro}g/kg) and in groundwater (5.0 {micro}g/L), as outlined in Missouri Risk-Based Corrective Action (MRBCA): Departmental Technical Guidance (MoDNR 2006a). The corresponding MRBCA DTL values for chloroform are 76.6 {micro}g/kg in soils of all types and 80 {micro}g/L in groundwater. Because the observed contamination at Montgomery City might be linked to the past use of carbon tetrachloride-based fumigants at its

  18. Functional Correlates of childhood maltreatment and symptom severity during affective theory of mind tasks in chronic depression.

    Science.gov (United States)

    Hentze, Charlotte; Walter, Henrik; Schramm, Elisabeth; Drost, Sarah; Schoepf, Dieter; Fangmeier, Thomas; Mattern, Margarete; Normann, Claus; Zobel, Ingo; Schnell, Knut

    2016-04-30

    Among multiple etiological factors of depressive disorders, childhood maltreatment (CM) gains increasing attention as it confers susceptibility for depression and predisposes to chronicity. CM assumedly inhibits social-cognitive development, entailing interactional problems as observed in chronic depression (CD), especially in affective theory of mind (ToM). However, the extent of CM among CD patients varies notably as does the severity of depressive symptoms. We tested whether the extent of CM or depressive symptoms correlates with affective ToM functions in CD patients. Regional brain activation measured by functional magnetic resonance imaging during an affective ToM task was tested for correlation with CM, assessed by the Childhood Trauma Questionnaire (CTQ), and symptom severity, assessed by the Montgomery-Åsberg Depression Rating Scale (MADRS), in 25 unmedicated CD patients (mean age 41.52, SD 11.13). Amygdala activation during affective ToM correlated positively with CTQ total scores, while (para)hippocampal response correlated negatively with MADRS scores. Our findings suggest that differential amygdala activation in affective ToM in CD is substantially modulated by previous CM and not by the pathophysiological equivalents of current depressive symptoms. This illustrates the amygdala's role in the mediation of CM effects. The negative correlation of differential (para)hippocampal activation and depressive symptom severity indicates reduced integration of interactional experiences during depressive states.

  19. Aquifer tests and simulation of ground-water flow in Triassic sedimentary rocks near Colmar, Bucks and Montgomery Counties, Pennsylvania

    Science.gov (United States)

    Risser, Dennis W.; Bird, Philip H.

    2003-01-01

    This report presents the results of a study by the U.S. Geological Survey in cooperation with the U.S. Environmental Protection Agency to evaluate ground-water flow in Triassic sedimentary rocks near Colmar, in Bucks and Montgomery Counties, Pa. The study was conducted to help the U.S. Environmental Protection Agency evaluate remediation alternatives at the North Penn Area 5 Superfund Site near Colmar, where ground water has been contaminated by volatile organic solvents (primarily trichloroethene). The investigation focused on determining the (1) drawdown caused by separately pumping North PennWater Authority wells NP?21 and NP?87, (2) probable paths of groundwater movement under present-day (2000) conditions (with NP?21 discontinued), and (3) areas contributing recharge to wells if pumping from wells NP-21 or NP?87 were restarted and new recovery wells were installed. Drawdown was calculated from water levels measured in observation wells during aquifer tests of NP?21 and NP?87. The direction of ground-water flow was estimated by use of a three-dimensional ground-water-flow model. Aquifer tests were conducted by pumping NP?21 for about 7 days at 257 gallons per minute in June 2000 and NP?87 for 3 days at 402 gallons per minute in May 2002. Drawdown was measured in 45 observation wells during the NP?21 test and 35 observation wells during the NP?87 test. Drawdown in observation wells ranged from 0 to 6.8 feet at the end of the NP?21 test and 0.5 to 12 feet at the end of the NP?87 test. The aquifer tests showed that ground-water levels declined mostly in observation wells that were completed in the geologic units penetrated by the pumped wells. Because the geologic units dip about 27 degrees to the northwest, shallow wells up dip to the southeast of the pumped well showed a good hydraulic connection to the geologic units stressed by pumping. Most observation wells down dip from the pumping well penetrated units higher in the stratigraphic section that were not well

  20. Final work plan : phase I investigation of potential contamination at the former CCC/USDA grain storage facility in Montgomery City, Missouri.

    Energy Technology Data Exchange (ETDEWEB)

    LaFreniere, L. M.; Environmental Science Division

    2010-08-16

    From September 1949 until September 1966, the Commodity Credit Corporation of the U.S. Department of Agriculture (CCC/USDA) leased property at the southeastern end of Montgomery City, Missouri, for the operation of a grain storage facility. During this time, commercial grain fumigants containing carbon tetrachloride were commonly used by the CCC/USDA and the private grain storage industry to preserve grain in their facilities. In January 2000, carbon tetrachloride was detected in a soil sample (220 {micro}g/kg) and two soil gas samples (58 {micro}g/m{sup 3} and 550 {micro}g/m{sup 3}) collected at the former CCC/USDA facility, as a result of a pre-CERCLIS site screening investigation (SSI) performed by TN & Associates, Inc., on behalf of the U.S. Environmental Protection Agency (EPA), Region VII (MoDNR 2001). In June 2001, the Missouri Department of Natural Resources (MoDNR) conducted further sampling of the soils and groundwater at the former CCC/USDA facility as part of a preliminary assessment/site inspection (PA/SI). The MoDNR confirmed the presence of carbon tetrachloride (at a maximum identified concentration of 2,810 {micro}g/kg) and chloroform (maximum 82 {micro}g/kg) in the soils and also detected carbon tetrachloride and chloroform (42.2 {micro}g/L and 58.4 {micro}g/L, respectively) in a groundwater sample collected at the former facility (MoDNR 2001). The carbon tetrachloride levels identified in the soils and groundwater are above the default target level (DTL) values established by the MoDNR for this contaminant in soils of all types (79.6 {micro}g/kg) and in groundwater (5.0 {micro}g/L), as outlined in Missouri Risk-Based Corrective Action (MRBCA): Departmental Technical Guidance (MoDNR 2006a). The corresponding MRBCA DTL values for chloroform are 76.6 {micro}g/kg in soils of all types and 80 {micro}g/L in groundwater. Because the observed contamination at Montgomery City might be linked to the past use of carbon tetrachloride-based fumigants at its

  1. Antidepressant effects of a single dose of ayahuasca in patients with recurrent depression: a preliminary report

    Directory of Open Access Journals (Sweden)

    Flávia de L. Osório

    2015-03-01

    Full Text Available Objectives: Ayahuasca (AYA, a natural psychedelic brew prepared from Amazonian plants and rich in dimethyltryptamine (DMT and harmine, causes effects of subjective well-being and may therefore have antidepressant actions. This study sought to evaluate the effects of a single dose of AYA in six volunteers with a current depressive episode. Methods: Open-label trial conducted in an inpatient psychiatric unit. Results: Statistically significant reductions of up to 82% in depressive scores were observed between baseline and 1, 7, and 21 days after AYA administration, as measured on the Hamilton Rating Scale for Depression (HAM-D, the Montgomery-Åsberg Depression Rating Scale (MADRS, and the Anxious-Depression subscale of the Brief Psychiatric Rating Scale (BPRS. AYA administration resulted in nonsignificant changes in Young Mania Rating Scale (YMRS scores and in the thinking disorder subscale of the BPRS, suggesting that AYA does not induce episodes of mania and/or hypomania in patients with mood disorders and that modifications in thought content, which could indicate psychedelic effects, are not essential for mood improvement. Conclusions: These results suggest that AYA has fast-acting anxiolytic and antidepressant effects in patients with a depressive disorder.

  2. Antidepressant effects of a single dose of ayahuasca in patients with recurrent depression: a preliminary report.

    Science.gov (United States)

    Osório, Flávia de L; Sanches, Rafael F; Macedo, Ligia R; Santos, Rafael G dos; Maia-de-Oliveira, João P; Wichert-Ana, Lauro; Araujo, Draulio B de; Riba, Jordi; Crippa, José A; Hallak, Jaime E

    2015-01-01

    Ayahuasca (AYA), a natural psychedelic brew prepared from Amazonian plants and rich in dimethyltryptamine (DMT) and harmine, causes effects of subjective well-being and may therefore have antidepressant actions. This study sought to evaluate the effects of a single dose of AYA in six volunteers with a current depressive episode. Open-label trial conducted in an inpatient psychiatric unit. Statistically significant reductions of up to 82% in depressive scores were observed between baseline and 1, 7, and 21 days after AYA administration, as measured on the Hamilton Rating Scale for Depression (HAM-D), the Montgomery-Åsberg Depression Rating Scale (MADRS), and the Anxious-Depression subscale of the Brief Psychiatric Rating Scale (BPRS). AYA administration resulted in nonsignificant changes in Young Mania Rating Scale (YMRS) scores and in the thinking disorder subscale of the BPRS, suggesting that AYA does not induce episodes of mania and/or hypomania in patients with mood disorders and that modifications in thought content, which could indicate psychedelic effects, are not essential for mood improvement. These results suggest that AYA has fast-acting anxiolytic and antidepressant effects in patients with a depressive disorder.

  3. Music therapy modulates fronto-temporal activity in rest-EEG in depressed clients.

    Science.gov (United States)

    Fachner, Jörg; Gold, Christian; Erkkilä, Jaakko

    2013-04-01

    Fronto-temporal areas process shared elements of speech and music. Improvisational psychodynamic music therapy (MT) utilizes verbal and musical reflection on emotions and images arising from clinical improvisation. Music listening is shifting frontal alpha asymmetries (FAA) in depression, and increases frontal midline theta (FMT). In a two-armed randomized controlled trial (RCT) with 79 depressed clients (with comorbid anxiety), we compared standard care (SC) versus MT added to SC at intake and after 3 months. We found that MT significantly reduced depression and anxiety symptoms. The purpose of this study is to test whether or not MT has an impact on anterior fronto-temporal resting state alpha and theta oscillations. Correlations between anterior EEG, Montgomery-Åsberg Depression Rating Scale (MADRS) and the Hospital Anxiety and Depression Scale-Anxiety Subscale (HADS-A), power spectral analysis (topography, means, asymmetry) and normative EEG database comparisons were explored. After 3 month of MT, lasting changes in resting EEG were observed, i.e., significant absolute power increases at left fronto-temporal alpha, but most distinct for theta (also at left fronto-central and right temporoparietal leads). MT differed to SC at F7-F8 (z scored FAA, p effects on cortical activity in depression, suggesting an impact of MT on anxiety reduction.

  4. Antidepressant effects, of magnetic seizure therapy and electroconvulsive therapy, in treatment-resistant depression.

    Science.gov (United States)

    Kayser, Sarah; Bewernick, Bettina H; Grubert, Christiane; Hadrysiewicz, Barbara L; Axmacher, Nikolai; Schlaepfer, Thomas E

    2011-05-01

    Major depression is a common mental health problem and associated with significant morbidity and mortality, including impaired social and physical functioning and increased risk for suicide. Electroconvulsive therapy (ECT) is highly efficacious in treatment-resistant depressive disorders, but cognitive side effects are frequently associated with the treatment. Magnetic seizure therapy (MST) is a form of convulsive therapy, using magnetic fields in order to induce therapeutic seizures. First studies suggested that cognitive side effects of MST, including postictal recovery time, are more benign than those resulting from ECT treatment. In this open-label study we tested the hypothesis that MST is associated with clinically significant antidepressant effects in treatment-resistant depression (TRD) as an add-on therapy to a controlled pharmacotherapy. Twenty patients suffering from TRD were randomly assigned to receive either MST or ECT starting from July 2006 until November 2008. Primary outcome measure was antidepressant response assessed by Montgomery Åsberg Depression Scale. Secondary outcome measures included Hamilton Depression Rating Scale, Hamilton Anxiety Scale, Beck Depression Inventory and 90-Item Symptom Checklist. Antidepressant response (improvement of 50% in MADRS ratings) was statistically significant and of similar size in both treatment groups. Cognitive side effects were observed in neither group. Characteristics in MST- and ECT-induced seizures were comparable, especially regarding ictal activity and postictal suppression. Thus, MST may be a potential alternative to ECT if efficacy and safety are validated in larger clinical trials.

  5. Predictors of functional improvement in employed adults with major depressive disorder treated with desvenlafaxine.

    Science.gov (United States)

    Lam, Raymond W; Endicott, Jean; Hsu, Ming-Ann; Fayyad, Rana; Guico-Pabia, Christine; Boucher, Matthieu

    2014-09-01

    We carried out a secondary analysis of a double-blind, placebo-controlled trial of desvenlafaxine for major depressive disorder (MDD) to explore the associations between depressive symptoms and subtypes, and functional outcomes, including work functioning. Employed outpatients with MDD were assigned randomly in a 2 : 1 ratio to receive desvenlafaxine 50 mg/day or placebo for 12 weeks. Analyses were carried out post-hoc with the intent-to-treat (ITT) sample (N=427) and a prospectively defined modified ITT sample (N=310), composed of patients with baseline 17-item Hamilton Rating Scale for Depression score of at least 20. Functional outcomes at week 12 included items and factors from the Montgomery-Åsberg Depression Rating Scale, Sheehan Disability Scale, and the Work Productivity and Activity Impairment questionnaire. In the modified ITT sample, but not in the ITT sample, desvenlafaxine-treated patients showed significantly greater improvement in several functional outcomes in the responder, nonanxious, and normal-energy patient subgroups. Improvement in the 17-item Hamilton Rating Scale for Depression total score at week 2 predicted change at week 12 in several functional outcomes. Functional improvement at 12 weeks was greater in subgroups of patients and was also significantly predicted by early improvement in depressive symptoms in employed patients with MDD treated with desvenlafaxine.

  6. Can Lupus Cause Depression?

    Science.gov (United States)

    ... lupus Living well with lupus Can lupus cause depression? Life with lupus can be challenging. With symptoms ... treatable illness called clinical depression. Symptoms of Clinical Depression People are considered clinically depressed when they have ...

  7. Older Adults and Depression

    Science.gov (United States)

    ... find more information? Reprints Share Older Adults and Depression Download PDF Download ePub Order a free hardcopy ... depression need treatment to feel better. Types of Depression There are several types of depression. The most ...

  8. Depression and Multiple Sclerosis

    Science.gov (United States)

    ... Symptoms Depression Share this page Facebook Twitter Email Depression Depression Fatigue Walking (Gait) Difficulties Numbness or Tingling ... away from addictive substances such as alcohol. Clinical depression It’s important to distinguish between mild, everyday “blues” — ...

  9. Discussion of “Response Surface Design Evaluation and Comparison” by C.M. Anderson-Cook, C.M. Borror, and D.C Montgomery

    Energy Technology Data Exchange (ETDEWEB)

    Piepel, Gregory F.

    2009-02-02

    The article “Response Surface Design Evaluation and Comparison” by C.M. Anderson-Cook, C.M. Borror, and D.C Montgomery is discussed. The discussion covers three issues. First, graphical methods for evaluating and comparing experimental designs should utilize the unscaled prediction variance (PV) rather than the scaled prediction variance (SPV). Using PV makes it easier for practitioners to see how prediction variance is decreased by designs with larger numbers of points, and to assess the “cost” of that decrease in a flexible manner. Using SPV confounds “prediction variance” and “cost” information in a pre-defined way, thus making design choice harder for practitioners. The second and third comments are that bias properties as well as variance properties of designs should be accounted for in constructing, evaluating, and comparing experimental designs.

  10. Correlates of current suicide risk among Thai patients with bipolar I disorder: findings from the Thai Bipolar Disorder Registry

    Directory of Open Access Journals (Sweden)

    Suttajit S

    2013-11-01

    Full Text Available Sirijit Suttajit,1 Suchat Paholpak,2 Somrak Choovanicvong,3 Khanogwan Kittiwattanagul,4 Wetid Pratoomsri,5 Manit Srisurapanont1On behalf of the Thai Bipolar Registry Group1Department of Psychiatry, Chiang Mai University, Chiang Mai, 2Department of Psychiatry, Khon Kaen University, Khon Kaen, 3Srithanya Hospital, Nonthaburi, 4Khon Kaen Rajanagarindra Psychiatric Hospital, Khon Kaen, 5Chachoengsao Hospital, Chachoengsao, ThailandBackground: The Thai Bipolar Disorder Registry was a prospective, multisite, naturalistic study conducted in 24 hospitals across Thailand. This study aimed to examine the correlates of current suicide risk in Thai patients with bipolar I disorder.Methods: Participants were adult inpatients or outpatients with bipolar disorder, based on the Diagnosis and Statistical Manual of Mental Disorders, fourth edition. All were assessed by using the Mini International Neuropsychiatric Interview (MINI, version 5. The severity of current suicide risk was determined by using the total score of the MINI suicidality module. Mood symptoms were assessed by using the Young Mania Rating Scale and the Montgomery Asberg Depression Rating Scale.Results: The data of 383 bipolar I disorder patients were included in the analyses. Of these, 363 (94.8% were outpatients. The mean (standard deviation of the MINI suicide risk score was 1.88 (5.0. The demographic/clinical variables significantly associated with the MINI suicide risk scores included age, number of overall previous episodes, the Young Mania Rating Scale score, the Montgomery Asberg Depression Rating Scale scores, and the Clinical Global Impression Severity of Illness Scale for Bipolar Disorder mania score, depression score, and overall score. The variables affecting the differences of suicide risk scores between or among groups were type of first mood episode, a history of rapid cycling, anxiety disorders, and alcohol use disorders. The stepwise multiple linear regression model revealed

  11. Clinical Study on Electro-acupuncture Treatment for 30 Cases of Mental Depression

    Institute of Scientific and Technical Information of China (English)

    韩毳; 李晓泓; 罗和春; 赵学英; 李学武

    2004-01-01

    To observe the clinical therapeutic effects of electro-acupuncture therapy for mental depression, 30 cases were treated by electro-acupuncture on Baihui (GV20), Yintang (EX-HN3) and the differential points.Maprotiline was used in the control group of 31 cases. After the treatment, the scores in HAMD for both groups were found to be obviously decreased as compared with those before the treatment (P<0.01),without significant between-group differences (P>0.05). The total effective rate in the treatment group was 96.7%, and that of the control group was 90.3%, showing no significant between-group differences (P>0.05). After the treatment, the two groups all showed obvious decrease in the TCM symptomatic integrals (P<0.01), with significant between-group differences (P<0.05), the integral of the treatment group showing obvious superiority to that of the control group. And the decrease of the Asberg scores testing the side effect of antidepressants of the treatment group was obviously superior to that of the control group. After the treatment, the cortisol (CORT) content and the endothelin-1 (ET-1) content of the two groups were all obviously decreased (P<0.01), and basically turned to normal, without significant between-group differences (P>0.05). Conclusion: Electro-acupuncture therapy can produce the same clinical therapeutic effect as that produced by the tetracyclic drug maprotiline, giving less side effect and better symptomatic improvement.

  12. Levomilnacipran for the treatment of major depressive disorder: a review

    Directory of Open Access Journals (Sweden)

    Asnis GA

    2015-01-01

    Full Text Available Gregory M Asnis,1,2 Margaret A Henderson21Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, 2Anxiety and Depression Clinic, Montefiore Medical Center, Bronx, New York, NY, USAAbstract: Levomilnacipran (LVM, Fetzima® was recently approved by the US Food and Drug Administration for the treatment of major depressive disorder. It is a unique dual neurotransmitter reuptake inhibitor. In contrast with other selective serotonin norepinephrine reuptake inhibitors, including duloxetine, venlafaxine, and desvenlafaxine, it has greater selectivity for inhibiting norepinephrine reuptake than serotonin reuptake. Our review focuses on the efficacy, safety, and tolerability data for five double-blind, placebo-controlled, short-term studies and two long-term studies. In the short-term studies, LVM was found to be more effective than placebo in reducing depression (Montgomery-Åsberg Depression Rating Scale scores as well as improving functional impairment (Sheehan Disability Scale scores. Long-term studies found LVM to be similarly effective but in the only placebo-controlled long-term study, LVM was not significantly superior to placebo. LVM is fairly well tolerated, with the most common adverse events being nausea, headache, dry mouth, hyperhidrosis, and constipation. Discontinuation rates were mildly increased in those being treated with LVM (9% versus placebo (3%. Adverse events were not dose-related except for urinary hesitancy and erectile dysfunction. LVM was weight neutral, was not toxic to the liver, and did not cause clinically significant QTc prolongation. Consistent with being a predominant potentiator of norepinephrine, pulse and blood pressure were significantly elevated by LVM but rarely induced tachycardia or hypertension. LVM is a relatively safe alternative antidepressant treatment with minimal drug–drug interactions. It is the only antidepressant that has in its labeling that it is not only effective in

  13. Effects of levomilnacipran ER on fatigue symptoms associated with major depressive disorder.

    Science.gov (United States)

    Freeman, Marlene P; Fava, Maurizio; Gommoll, Carl; Chen, Changzheng; Greenberg, William M; Ruth, Adam

    2016-03-01

    The aim of this study was to evaluate the effects of levomilnacipran extended-release (ER) on depression-related fatigue in adults with major depressive disorder. Post-hoc analyses of five phase III trials were carried out, with evaluation of fatigue symptoms based on score changes in four items: Montgomery-Åsberg Depression Rating Scale (MADRS) item 7 (lassitude), and 17-item Hamilton Depression Rating Scale (HAMD17) items 7 (work/activities), 8 (retardation), and 13 (somatic symptoms). Symptom remission was analyzed on the basis of score shifts from baseline to end of treatment: MADRS item 7 and HAMD17 item 7 (from ≥2 to ≤1); HAMD17 items 8 and 13 (from ≥1 to 0). The mean change in MADRS total score was analyzed in patients with low and high fatigue (MADRS item 7 baseline score symptom remission (no/minimal residual fatigue) on all fatigue-related items: lassitude (35 vs. 28%), work/activities (43 vs. 35%), retardation (46 vs. 39%), somatic symptoms (26 vs. 18%; all Psdepression-related fatigue in adult patients with major depressive disorder and was associated with remission of fatigue symptoms.

  14. Helping your teen with depression

    Science.gov (United States)

    Teen depression - helping; Teen depression - talk therapy; Teen depression - medicine ... teen the most. The most effective treatments for depression are: Talk therapy Antidepressant medicines If your teen ...

  15. The effectiveness of prefrontal theta cordance and early reduction of depressive symptoms in the prediction of antidepressant treatment outcome in patients with resistant depression: analysis of naturalistic data.

    Science.gov (United States)

    Bares, Martin; Novak, Tomas; Kopecek, Miloslav; Brunovsky, Martin; Stopkova, Pavla; Höschl, Cyril

    2015-02-01

    Current studies suggest that an early improvement of depressive symptoms and the reduction of prefrontal theta cordance value predict the subsequent response to antidepressants. The aim of our study was (1) to compare the predictive abilities of early clinical improvement defined as ≥ 20 % reduction in Montgomery and Åsberg Depression Rating Scale (MADRS) total score at week 1 and 2, and the decrease of prefrontal theta cordance at week 1 in resistant depressive patients and (2) to assess whether the combination of individual predictors yields more robust predictive power than either predictor alone. Eighty-seven subjects were treated (≥ 4 weeks) with various antidepressants chosen according to the judgment of attending psychiatrists. Areas under curve (AUC) were calculated to compare predictive effect of defined single predictors (≥ 20 % reduction in MADRS total score at week 1 and 2, and the decrease of cordance at week 1) and combined prediction models. AUCs of all three predictors were not statistically different (pair-wise comparison). The model combining all predictors yielded an AUC value 0.91 that was significantly higher than AUCs of each individual predictor. The results indicate that the combined predictor model may be a useful and clinically meaningful tool for the prediction of antidepressant response in patients with resistant depression.

  16. The efficacy of levomilnacipran ER across symptoms of major depressive disorder: a post hoc analysis of 5 randomized, double-blind, placebo-controlled trials.

    Science.gov (United States)

    McIntyre, Roger S; Gommoll, Carl; Chen, Changzheng; Ruth, Adam

    2016-10-01

    A post hoc analysis evaluated the effects of levomilnacipran ER on individual symptoms and symptom domains in adults with major depressive disorder (MDD). Data were pooled from 5 Phase III trials comprising 2598 patients. Effects on depression symptoms were analyzed based on change from baseline in individual Montgomery-Åsberg Depression Rating Scale (MADRS) item scores. A1dditional evaluations included resolution of individual symptoms (defined as a MADRS item score ≤1 at end of treatment) and concurrent resolution of all 10 MADRS items, all MADRS6 subscale items, and all items included in different symptom clusters (Dysphoria, Retardation, Vegetative Symptoms, Anhedonia). Significantly greater mean improvements were found on all MADRS items except Reduced Appetite with levomilnacipran ER treatment compared with placebo. Resolution of individual symptoms occurred more frequently with levomilnacipran ER than placebo for each MADRS item (all Pdepression symptoms and symptom domains.

  17. QEEG Theta Cordance in the Prediction of Treatment Outcome to Prefrontal Repetitive Transcranial Magnetic Stimulation or Venlafaxine ER in Patients With Major Depressive Disorder.

    Science.gov (United States)

    Bares, Martin; Brunovsky, Martin; Novak, Tomas; Kopecek, Miloslav; Stopkova, Pavla; Sos, Peter; Höschl, Cyril

    2015-04-01

    The aims of this double-blind study were to assess and compare the efficacy of quantitative electroencephalographic (QEEG) prefrontal theta band cordance in the prediction of response to 4-week, right, prefrontal, 1-Hz repetitive transcranial magnetic stimulation (rTMS) or venlafaxine ER in patients with major depressive disorder (MDD). Prefrontal QEEG cordance values of 50 inpatients (25 subjects in each group) completing 4 weeks of the study were obtained at baseline and after 1 week of treatment. Depressive symptoms were assessed using Montgomery-Åsberg Depression Rating Scale (MADRS) at baseline and at week 1 and 4. Treatment response was defined as a ≥50% reduction in baseline MADRS total score. All responders (n = 9) and 6 of 16 nonresponders in the rTMS group had reduced cordance at week 1 (P treatment, with comparable predictive efficacy for both therapeutic interventions. © EEG and Clinical Neuroscience Society (ECNS) 2014.

  18. Efficacy of escitalopram compared to citalopram: a meta-analysis.

    Science.gov (United States)

    Montgomery, Stuart; Hansen, Thomas; Kasper, Siegfried

    2011-03-01

    The aim of this review was to assess the clinical relevance of the relative antidepressant efficacy of escitalopram and citalopram by meta-analysis. Studies in major depressive disorder (MDD) with both escitalopram and citalopram treatment arms were identified. Adult patients had to meet DSM-IV criteria for MDD. The primary outcome measure was the treatment difference in Montgomery-Asberg Depression Rating Scale (MADRS) total score at week 8 (or last assessment if escitalopram, n=995; citalopram, n=1014). Escitalopram was significantly more effective than citalopram in overall treatment effect, with an estimated mean treatment difference of 1.7 points at week 8 (or last assessment if escitalopram. In this meta-analysis, the statistically significant superior efficacy of escitalopram compared to citalopram was shown to be clinically relevant.

  19. Investigations of groundwater system and simulation of regional groundwater flow for North Penn Area 7 Superfund site, Montgomery County, Pennsylvania

    Science.gov (United States)

    Senior, Lisa A.; Goode, Daniel J.

    2013-01-01

    Groundwater in the vicinity of several industrial facilities in Upper Gwynedd Township and vicinity, Montgomery County, in southeast Pennsylvania has been shown to be contaminated with volatile organic compounds (VOCs), the most common of which is the solvent trichloroethylene (TCE). The 2-square-mile area was placed on the National Priorities List as the North Penn Area 7 Superfund site by the U.S. Environmental Protection Agency (USEPA) in 1989. The U.S. Geological Survey (USGS) conducted geophysical logging, aquifer testing, and water-level monitoring, and measured streamflows in and near North Penn Area 7 from fall 2000 through fall 2006 in a technical assistance study for the USEPA to develop an understanding of the hydrogeologic framework in the area as part of the USEPA Remedial Investigation. In addition, the USGS developed a groundwater-flow computer model based on the hydrogeologic framework to simulate regional groundwater flow and to estimate directions of groundwater flow and pathways of groundwater contaminants. The study area is underlain by Triassic- and Jurassic-age sandstones and shales of the Lockatong Formation and Brunswick Group in the Mesozoic Newark Basin. Regionally, these rocks strike northeast and dip to the northwest. The sequence of rocks form a fractured-sedimentary-rock aquifer that acts as a set of confined to partially confined layers of differing permeabilities. Depth to competent bedrock typically is less than 20 ft below land surface. The aquifer layers are recharged locally by precipitation and discharge locally to streams. The general configuration of the potentiometric surface in the aquifer is similar to topography, except in areas affected by pumping. The headwaters of Wissahickon Creek are nearby, and the stream flows southwest, parallel to strike, to bisect North Penn Area 7. Groundwater is pumped in the vicinity of North Penn Area 7 for industrial use, public supply, and residential supply. Results of field investigations

  20. Patients' Experience of Winter Depression and Light Room Treatment

    Science.gov (United States)

    2017-01-01

    Background. There is a need for more knowledge on the effects of light room treatment in patients with seasonal affective disorder and to explore patients' subjective experience of the disease and the treatment. Methods. This was a descriptive and explorative study applying qualitative content analysis. A purposeful sample of 18 psychiatric outpatients with a major depressive disorder with a seasonal pattern and a pretreatment score ≥12 on the 9-item Montgomery-Åsberg Depression self-rating scale was included (10 women and 8 men, aged 24–65 years). All patients had completed light room treatment (≥7/10 consecutive weekdays). Data was collected two weeks after treatment using a semistructured interview guide. Results. Patients described a clear seasonal pattern and a profound struggle to adapt to seasonal changes during the winter, including deterioration in sleep, daily rhythms, energy level, mood, activity, and cognitive functioning. Everyday life was affected with reduced work capacity, social withdrawal, and disturbed relations with family and friends. The light room treatment resulted in a radical and rapid improvement in all the major symptoms with only mild and transient side effects. Discussion. The results indicate that light room treatment is essential for some patients' ability to cope with seasonal affective disorder.

  1. Patients’ Experience of Winter Depression and Light Room Treatment

    Directory of Open Access Journals (Sweden)

    Cecilia Rastad

    2017-01-01

    Full Text Available Background. There is a need for more knowledge on the effects of light room treatment in patients with seasonal affective disorder and to explore patients’ subjective experience of the disease and the treatment. Methods. This was a descriptive and explorative study applying qualitative content analysis. A purposeful sample of 18 psychiatric outpatients with a major depressive disorder with a seasonal pattern and a pretreatment score ≥12 on the 9-item Montgomery-Åsberg Depression self-rating scale was included (10 women and 8 men, aged 24–65 years. All patients had completed light room treatment (≥7/10 consecutive weekdays. Data was collected two weeks after treatment using a semistructured interview guide. Results. Patients described a clear seasonal pattern and a profound struggle to adapt to seasonal changes during the winter, including deterioration in sleep, daily rhythms, energy level, mood, activity, and cognitive functioning. Everyday life was affected with reduced work capacity, social withdrawal, and disturbed relations with family and friends. The light room treatment resulted in a radical and rapid improvement in all the major symptoms with only mild and transient side effects. Discussion. The results indicate that light room treatment is essential for some patients’ ability to cope with seasonal affective disorder.

  2. What is depression?

    DEFF Research Database (Denmark)

    Davidsen, Annette Sofie; Fosgerau, Christina Fogtmann

    2014-01-01

    The diagnosis of depression is defined by psychiatrists, and guidelines for treatment of patients with depression are created in psychiatry. However, most patients with depression are treated exclusively in general practice. Psychiatrists point out that general practitioners' (GPs') treatment of ...

  3. Sadness and Depression

    Science.gov (United States)

    ... What Happens in the Operating Room? Sadness and Depression KidsHealth > For Kids > Sadness and Depression A A ... big difference in your life. When Sadness Is Depression When you're in a sad mood, it ...

  4. Depression Strikes…Anyone

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Depression Depression Strikes… Anyone Winter 2017 Table of Contents Anyone can suffer from depression. And almost everyone has a friend or family ...

  5. Depression and College Students

    Science.gov (United States)

    ... depression and other mental health issues? Reference Share Depression and College Students Download PDF Download ePub Order ... Answers to college students’ frequently asked questions about depression Feeling moody, sad, or grouchy? Who doesn’t ...

  6. Sadness and Depression

    Science.gov (United States)

    ... dientes Video: Getting an X-ray Sadness and Depression KidsHealth > For Kids > Sadness and Depression Print A ... big difference in your life. When Sadness Is Depression When you're in a sad mood, it ...

  7. Postpartum Depression Facts

    Science.gov (United States)

    ... Where can I find more information? Share Postpartum Depression Facts Download PDF Download ePub Download Mobi Order ... for herself or her family. What is postpartum depression? Postpartum depression is a mood disorder that can ...

  8. Recognizing teen depression

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000648.htm Recognizing teen depression To use the sharing features on this page, ... life. Be Aware of the Risk for Teen Depression Your teen is more at risk for depression ...

  9. Men and Depression

    Science.gov (United States)

    ... in crisis? For more information Share Men and Depression Download PDF Download ePub Order a free hardcopy ... If so, you may have depression. What is depression? Everyone feels sad or irritable sometimes, or has ...

  10. Occurrence of Selected Pharmaceuticals, Personal-Care Products, Organic Wastewater Compounds, and Pesticides in the Lower Tallapoosa River Watershed near Montgomery, Alabama, 2005

    Science.gov (United States)

    Oblinger, Carolyn J.; Gill, Amy C.; McPherson, Ann K.; Meyer, Michael T.; Furlong, Edward T.

    2007-01-01

    Synthetic and natural organic compounds derived from agricultural operations, residential development, and treated and untreated sanitary and industrial wastewater discharges can contribute contaminants to surface and ground waters. To determine the occurrence of these compounds in the lower Tallapoosa River watershed, Alabama, new laboratory methods were used that can detect human and veterinary antibiotics; pharmaceuticals; and compounds found in personal-care products, food additives, detergents and their metabolites, plasticizers, and other industrial and household products in the environment. Well-established methods for detecting 47 pesticides and 19 pesticide degradates also were used. In all, 186 different compounds were analyzed by using four analytical methods. The lower Tallapoosa River serves as the water-supply source for more than 100,000 customers of the Montgomery Water Works and Sanitary Sewer Board. Source-water protection is a high priority for the Board, which is responsible for providing safe drinking water. The U.S. Geological Survey, in cooperation with the Montgomery Water Works and Sanitary Sewer Board, conducted this study to provide baseline data that could be used to assess the effects of agriculture and residential development on the occurrence of selected organic compounds in the lower Tallapoosa River watershed. Twenty samples were collected at 10 sites on the Tallapoosa River and its tributaries. Ten samples were collected in April 2005 during high base streamflow, and 10 samples were collected in October 2005 when base streamflow was low. Thirty-two of 186 compounds were detected in the lower Tallapoosa River watershed. Thirteen compounds, including atrazine, 2-chloro-4-isopropylamino-6-amino-s-triazine (CIAT), hexazinone, metalaxyl, metolachlor, prometryn, prometon, simazine, azithromycin, oxytetracycline, sulfamethoxazole, trimethoprim, and tylosin, had measurable concentrations above their laboratory reporting levels

  11. Various forms of depression

    OpenAIRE

    BENAZZI, FRANCO

    2006-01-01

    The current subtyping of depression is based on the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Text Revision (DSM-IV-TR) categorical division of bipolar and depressive disorders. Current evidence, however, supports a dimensional approach to depression, as a continuum/spectrum of overlapping disorders, ranging from bipolar I depression to major depressive disorder. Types of depression which have recently been the focus of most research will be reviewed ; bipolar II depressi...

  12. [Depressive symptoms and sexuality].

    Science.gov (United States)

    Porto, Robert

    2014-10-01

    The mutually reinforcing dyad of depressive symptoms and erectile dysfunction is scientifically established. The cure of depression improves sexual dysfunction (SD) and the treatment of SD induces improvement of depression. Most of anti-depressants induce negative sexual side effects that lead to non-compliance of these treatments. The knowledge of interrelation between depression, anti-depressants and sexuality is of great importance in clinical practice. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  13. Depressive symptoms as a predictor of quality of life in cerebral small vessel disease, acting independently of disability; a study in both sporadic SVD and CADASIL

    Science.gov (United States)

    Brookes, Rebecca L; Willis, Thomas A; Patel, Bhavini; Morris, Robin G; Markus, Hugh S

    2013-01-01

    Background Cerebral small vessel disease (SVD) causes lacunar stroke, and more recently has been implicated as a cause of depression. Factors causing reduced quality of life (QoL) in SVD, including the relative contributions of disability and depressive symptoms, remain uncertain. Hypothesis Depressive symptoms are a major predictor of reduced QoL in SVD, acting independently of disability. Methods The Stroke-Specific QoL scale was completed by 100 patients with SVD (lacunar stroke with MRI lacunar infarct) and 55 controls. We repeated the protocol in 40 patients with the young onset genetic form of SVD, CADASIL, and 35 controls. Disability (modified Rankin Scale), [instrumental] activities of daily living (IADL, ADL), cognition (Mini Mental State Examination) and depressive symptoms (Geriatric Depression Scale, Montgomery-Åsberg Depression Rating Scale) were measured. Results QoL was significantly lower in SVD than controls: mean (SD), 196.8 (35.2) versus 226.8(15.3), pSVD. They account for greater reduction than disability, and the association is independent of disability. This relationship may reflect the proposed causal association between white matter disease and depression. Treatment of depressive symptoms might significantly improve QoL in SVD. PMID:22364606

  14. Validation of the Brazilian Portuguese version of the Beck Depression Inventory-II in a community sample.

    Science.gov (United States)

    Gomes-Oliveira, Marcio Henrique; Gorenstein, Clarice; Lotufo Neto, Francisco; Andrade, Laura Helena; Wang, Yuan Pang

    2012-12-01

    The Beck Depression Inventory (BDI) is used worldwide for detecting depressive symptoms. This questionnaire has been revised (1996) to match the DSM-IV criteria for a major depressive episode. We assessed the reliability and the validity of the Brazilian Portuguese version of the BDI-II for non-clinical adults. The questionnaire was applied to 60 college students on two occasions. Afterwards, 182 community-dwelling adults completed the BDI-II, the Self-Report Questionnaire, and the K10 Scale. Trained psychiatrists performed face-to-face interviews with the respondents using the Structured Clinical Interview (SCID-I), the Montgomery-Åsberg Depression Scale, and the Hamilton Anxiety Scale. Descriptive analysis, signal detection analysis (Receiver Operating Characteristics), correlation analysis, and discriminant function analysis were performed to investigate the psychometric properties of the BDI-II. The intraclass correlation coefficient of the BDI-II was 0.89, and the Cronbach's alpha coefficient of internal consistency was 0.93. Taking the SCID as the gold standard, the cut-off point of 10/11 was the best threshold for detecting depression, yielding a sensitivity of 70% and a specificity of 87%. The concurrent validity (a correlation of 0.63-0.93 with scales applied simultaneously) and the predictive ability of the severity level (over 65% correct classification) were acceptable. The BDI-II is reliable and valid for measuring depressive symptomatology among Portuguese-speaking Brazilian non-clinical populations.

  15. Internet-based cognitive behavior therapy for patients with heart failure and depressive symptoms: A proof of concept study.

    Science.gov (United States)

    Lundgren, Johan; Andersson, Gerhard; Dahlström, Örjan; Jaarsma, Tiny; Köhler, Anita Kärner; Johansson, Peter

    2015-08-01

    The aim was (1) to describe the development of a guided internet-based CBT (ICBT) program adapted to patients with heart failure (HF) and (2) to evaluate the feasibility of the ICBT program in regard to depressive symptoms, the time used by health care providers to give feedback, and participants' perceptions of the ICBT program. A multi-professional team developed the program and seven HF patients with depressive symptoms were recruited to the study. The Patient Health Questionnaire-9 (PHQ-9) and the Montgomery Åsberg Depression Rating-Self-rating scale (MADRS-S) were used to measure depression, and patients were interviewed about their perceptions of the program. Based on research in HF and CBT, a nine-week program was developed. The median depression score decreased from baseline to the end of the study (PHQ-9: 11-8.5; MADRS-S: 25.5-16.5) and none of the depression scores worsened. Feedback from health care providers required approximately 3h per patient. Facilitating perceptions (e.g. freedom of time) and demanding perceptions (e.g. part of the program demanded a lot of work) were described by the patients. The program appears feasible and time-efficient. However, the program needs to be evaluated in a larger randomized study. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  16. Experience in using sulpiride in non-psychotic endogenous depressive-hypochondriacal disorders

    Directory of Open Access Journals (Sweden)

    Nina Arkadyevna Tyuvina

    2012-01-01

    Full Text Available Objective: to study the efficacy of sulpiride in different types of non-psychotic types of endogenous depressive-hypochondriacal syndrome. Patients and methods. Forty-seven patients (36 women and 11 men with a depressive episode (n = 15, recurrent depressive disorder (n = 14, and slowly progressive schizophrenia (SPS (n = 18 were examined clinically and using the psychometric scales: the Clinical Global Impression Scale; Montgomery-Esberg Depression Rating Scale (MADRS, the Hamilton Anxiety Rating Scale (HARS, and Udvalg for Kliniske Undersшgelser Side Effect Rating Scale. Sulpiride was given in an initial dose of50—100 mg/day; the dose was, if required, increased up to 400—600 mg/day. Results. After 2 months of treatment in the patients with affective disorders, the MADRS and HARS scores showed reductions from 28.7+2.3 to 14.3+1.7 and from 14.8+2.1 to 7.4+2.7, respectively. The reductions in the symptoms of depression and anxiety were 50.2 and 50.0%, respectively. In SPS, the mean MADRS and HARS scores decreased from 21.4+3.7 to 13.7ё1.8 and from 10.2+1.5 to 6.4+3.2, respectively. There were generally 40 and 37.3% reductions in the symptoms of depression and anxiety, respectively. Conclusion. In patients with affective disorders, the efficacy of sulpiride is predominantly due to its antidepressant and anti-anxiety activities in depressive-hypochondriacal syndrome and to its antipsychotic and activating activities in SPS.

  17. [Causes of depression].

    Science.gov (United States)

    Fernández, Francisco Alonso

    2011-01-01

    This paper describes four nosological categories of depressive disorder according to the fundamental or prime cause: endogen depression, situative depression, psychogen depression and somatogen (also pharmacogen or addictive) depression. Recent advances in neurobiology provide the commun pathogenic mechanism distribuited in neurochemical, neuroendocrine and neuroinmune factors, with at the end a cellular and molecular sequence beyond the synapse. There is an increased risk of depression multiplied by three or four in the elderly, obese, unemployed and inmigrant and it is very frequent in terminally ill patients with a pervasive desire for death. Finally, eight personalized preventive guidelines enable to decrease the individual risk of depression in more than a fifty per cent.

  18. Efficacy and safety of olanzapine/fluoxetine combination in the treatment of treatment-resistant depression: a meta-analysis of randomized controlled trials

    Science.gov (United States)

    Luan, Shuxin; Wan, Hongquan; Wang, Shijun; Li, He; Zhang, Baogang

    2017-01-01

    Background Whether olanzapine/fluoxetine combination (OFC) is superior to olanzapine or fluoxetine monotherapy in patients with treatment-resistant depression (TRD) remains controversial. Thus, we conducted this meta-analysis of randomized controlled trials (RCTs) to compare the efficacy and safety of OFC with olanzapine or fluoxetine monotherapy for patients with TRD. Materials and methods RCTs published in PubMed, Embase, Web of Science, and the ClinicalTrials.gov registry were systematically reviewed to assess the efficacy and safety of OFC. Outcomes included mean changes from baseline in Montgomery–Asberg Depression Rating Scale (MADRS), Clinical Global Impression-Severity (CGI-S), Hamilton Rating Scale for Anxiety (HAM-A), Brief Psychiatric Rating Scale (BPRS) scores, response rate, remission rate, and adverse events. Results were expressed with weighted mean difference (WMD) with 95% confidence intervals (CIs) and risk ratio (RR) with 95% CIs. Results A total of five RCTs with 3,020 patients met the inclusion criteria and were included in this meta-analysis. Compared with olanzapine or fluoxetine monotherapy, OFC was associated with greater changes from baseline in MADRS (WMD =−3.37, 95% CI: −4.76, −1.99; Pfluoxetine monotherapy in the treatment of patients with TRD. Our results provided supporting evidence for the use of OFC in TRD. However, considering the limitations in this study, more large-scale, well-designed RCTs are needed to confirm these findings. PMID:28280343

  19. Therapieresistente Depression

    Directory of Open Access Journals (Sweden)

    Holsboer-Trachsler E

    2006-01-01

    Full Text Available In der Behandlung einer Depression wird ein Nichtansprechen auf zwei adäquate Antidepressivatherapien während je 6–8 Wochen als Therapieresistenz bezeichnet. Da häufig zu geringe Dosierungen oder eine zu kurze Behandlungsdauer die Ursache für ein Nichtansprechen sind, sollte in einem ersten Schritt die medikamentöse Therapie hinsichtlich Dauer und Dosierung, eventuell unter Einbezug von Plasmaspiegelbestimmungen, überprüft und optimiert werden. Als pharmakologische Maßnahmen werden zunächst ein Wechsel des Antidepressivums und danach eine Kombination von verschiedenen Antidepressiva mit unterschiedlichem biochemischem Wirkungsansatz empfohlen. Zeigen beide nicht den gewünschten Erfolg, so sollte zusätzlich zur bestehenden Antidepressivabehandlung eine Augmentationstherapie, primär mit Lithium und/oder dem Schilddrüsenhormon T3, durchgeführt werden. Ein neuer, vielversprechender Behandlungsansatz ist eine Augmentationstherapie mit atypischen Neuroleptika. Als akut wirkende nichtpharmakologische Zusatzmaßnahme hat sich der partielle Schlafentzug bewährt. Weitere nichtpharmakologische Strategien umfassen Psychotherapie, Elektrokrampftherapie und Vagusnervstimulationsbehandlung.

  20. The change of QEEG prefrontal cordance as a response predictor to antidepressive intervention in bipolar depression. A pilot study.

    Science.gov (United States)

    Bares, Martin; Novak, Tomas; Brunovsky, Martin; Kopecek, Miloslav; Stopkova, Pavla; Krajca, Vladimir; Höschl, Cyril

    2012-02-01

    The aim of the study was to examine whether the change of quantitative EEG (QEEG) theta prefrontal cordance after one week of various antidepressive interventions predicts response to a 4-week treatment in patients with bipolar depression. We investigated 20 inpatients who completed a 4-week treatment. EEG data were monitored at baseline and after 1 week of treatment. QEEG cordance was computed at 3 frontal electrodes (Fp1, Fp2, Fz) in theta frequency band. Depressive symptoms and clinical status were assessed using Montgomery-Åsberg Depression Rating Scale (MADRS), Clinical Global Impression (CGI) and Young Mania Rating Scale (YMRS). Seven of 8 responders (reduction of MADRS ≥50%) and only 2 of 12 non-responders had decreased prefrontal theta cordance value after the first week of treatment (p = 0.02). The positive and negative predictive values of cordance reduction for response were 0.78 and 0.91, respectively. We also found significant differences in cordance value reductions between responders and non-responders after week 1 and higher baseline cordance in responders. The change in prefrontal theta cordance was associated with subsequent change in depressive symptoms and potentially might be a useful tool in the early detection of acute response to antidepressive interventions in bipolar depressed patients. Copyright © 2011 Elsevier Ltd. All rights reserved.

  1. Escitalopram for the management of major depressive disorder: a review of its efficacy, safety, and patient acceptability

    Directory of Open Access Journals (Sweden)

    Kirino E

    2012-12-01

    Full Text Available Eiji Kirino1,21Department of Psychiatry, Juntendo University Shizuoka Hospital, Shizuoka, Japan; 2Department of Psychiatry, Juntendo University School of Medicine, Tokyo, JapanAbstract: Escitalopram (escitalopram oxalate; Cipralex®, Lexapro® is a selective serotonin reuptake inhibitor (SSRI used for the treatment of major depressive disorder (MDD and anxiety disorder. This drug exerts a highly selective, potent, and dose-dependent inhibitory effect on the human serotonin transport. By inhibiting the reuptake of serotonin into presynaptic nerve endings, this drug enhances the activity of serotonin in the central nervous system. Escitalopram also has allosteric activity. Moreover, the possibility of interacting with other drugs is considered low. This review covers randomized, controlled studies that enrolled adult patients with MDD to evaluate the efficacy of escitalopram based on the Montgomery–Asberg Depression Rating Scale and the Hamilton Depression Rating Scale. The results showed that escitalopram was superior to placebo, and nearly equal or superior to other SSRIs (eg, citalopram, paroxetine, fluoxetine, sertraline and serotonin-noradrenaline reuptake inhibitors (eg, duloxetine, sustained-release venlafaxine. In addition, with long-term administration, escitalopram has shown a preventive effect on MDD relapse and recurrence. Escitalopram also showed favorable tolerability, and associated adverse events were generally mild and temporary. Discontinuation symptoms were milder with escitalopram than with paroxetine. In view of the patient acceptability of escitalopram, based on both a meta-analysis and a pooled analysis, this drug was more favorable than other new antidepressants. The findings indicate that escitalopram achieved high continuity in antidepressant drug therapy.Keywords: escitalopram, MDD, SSRI, allosteric action, discontinuation symptoms

  2. Efficacy and tolerability of vilazodone for major depressive disorder: evidence from phase III/IV randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Shi LG

    2016-11-01

    Full Text Available Ligen Shi,1,2 Jingyi Wang,1 Shenbin Xu,2 Yunrong Lu1 1Department of Psychiatry, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, 2Department of Neurosurgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China Abstract: Vilazodone is a new molecule approved for major depressive disorder (MDD. This report focuses on the efficacy and tolerability of vilazodone for MDD. MEDLINE, EMBASE, and Cochrane Library were searched. A total of 1,930 patients from four trials were included. A significant improvement in the Montgomery–Asberg Depression Rating Scale (MADRS total score was seen as early as week 2 (P<0.01 in vilazodone-treated patients. The results showed a higher rate of MADRS response with vilazodone compared with placebo (P<0.001. There were also greater improvements in the Hamilton Rating Scale for Anxiety as well as the Clinical Global Impressions (severity of illness and improvement of illness scores from baseline in vilazodone-treated patients compared to placebo patients (P<0.001. Discontinuation rates due to adverse events were higher with vilazodone than placebo (P=0.0002. The most common adverse events of vilazodone were vomiting, nausea, diarrhea, insomnia, somnolence, dizziness, and dry mouth (P<0.05. Treatment-related effects on sexual function were mild compared to placebo in men (P=0.03. In conclusion, 40 mg/day of vilazodone had a rapid onset of response and showed good improvement in anxiety symptoms as well as good tolerability during short-term treatment (8–10 weeks for MDD. Further studies should focus on the efficacy and tolerability of vilazodone over a longer duration and should utilize active comparators. Keywords: vilazodone, major depressive disorder, sexual dysfunction, anxiety

  3. [Depression in schizophrenia].

    Science.gov (United States)

    Rigaud, A S

    1991-03-01

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

  4. Prevalence of Type 2 Diabetes and Impaired Glucose Regulation with Associated Cardiometabolic Risk Factors and Depression in an Urbanizing Rural Community in Bangladesh: A Population-Based Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Bishwajit Bhowmik

    2012-12-01

    Full Text Available BackgroundTo determine the prevalence of type 2 diabetes (T2DM and impaired glucose regulation (impaired fasting glucose [IFG] and impaired glucose tolerance [IGT] in an urbanizing rural population of Bangladesh and associated cardiometabolic risk indicators and depression.MethodsA total of 2,293 subjects aged ≥20 years in an urbanizing rural Bangladeshi community were investigated. Socio-demographic and anthropometric details, blood pressure, fasting plasma glucose (FPG, 2 hours after 75 g plasma glucose (2hPG, glycosylated hemoglobin, fasting serum insulin and lipid profiles were studied. Presence of depressive symptoms using Montogomery-Asberg Depression Rating Scale was also assessed.ResultsThe prevalence of IFG, IGT, IFG+IGT, and T2DM were 3.4%, 4.0%, 1.2%, and 7.9%, respectively. The prevalence of T2DM and impaired glucose regulation differed between males and females, but, both increased with age in both sexes. FPG and 2hPG had positive correlation. Employing logistic regression, it was found that increased age, waist to hip ratio, systolic blood pressure, total cholesterol, triglycerides, and depression were independent risk indicators for diabetes. Both insulin resistance and β-cell deficiency were significantly related for causation of diabetes. Among the study population, 26.2% had general obesity, 39.8% central obesity, 15.5% hypertension, 28.7% dyslipidemia, 17.6% family history of diabetes, and 15.3% had depression. Physical inactivity and smoking habits were significantly higher in male.ConclusionRising prevalence of diabetes and impaired glucose regulation in this urbanizing rural population exist as a significant but hidden public health problem. Depression and other cardiometabolic risk indicators including obesity, hypertension, and dyslipdemia were also prevalent in this population.

  5. Predictive value of Pre-treatment Amygdala volume for Electroconvulsive Therapy Response in Severely Depressed Patients

    Directory of Open Access Journals (Sweden)

    Freek eTen Doesschate

    2014-11-01

    Full Text Available Background Electroconvulsive therapy (ECT is an effective treatment for patients with severe depression. Knowledge on factors predicting therapeutic response may help to identify patients who will benefit most from the intervention. Based on the neuroplasticity hypothesis, volumes of the amygdala and hippocampus are possible candidates for predicting treatment outcome. Therefore, this prospective cohort study examines the predictive value of amygdala and hippocampal volumes for the effectiveness of ECT.Methods Prior to ECT, 53 severely unipolar depressed patients (mean age 57±14 years; 40% [n=21] male received structural magnetic resonance imaging at 1.5 Tesla. Normalized amygdala and hippocampal volumes were calculated based on automatic segmentation by FreeSurfer. Regression analyses were used to test if the normalized volumes could predict the response to a course of ECT, based on the Montgomery-Åsberg Depression Rating Scale (MADRS scores. ResultsA larger amygdala volume independently and significantly predicted a lower post-ECT MADRS score (β = -0.347, P=0.013. The left amygdala volume had greater predictive value for treatment outcome relative to the right amygdala volume. Hippocampal volume had no independent predictive value.Conclusion A larger pretreatment amygdala volume predicted more effective ECT, independent of other known predictors. Almost all patients continued their medication during the study, which might have influenced the course of treatment in ways that were not taken into account.

  6. Plasma brain derived neurotrophic factor (BDNF) and response to ketamine in treatment-resistant depression.

    Science.gov (United States)

    Haile, C N; Murrough, J W; Iosifescu, D V; Chang, L C; Al Jurdi, R K; Foulkes, A; Iqbal, S; Mahoney, J J; De La Garza, R; Charney, D S; Newton, T F; Mathew, S J

    2014-02-01

    Ketamine produces rapid antidepressant effects in treatment-resistant depression (TRD), but the magnitude of response varies considerably between individual patients. Brain-derived neurotrophic factor (BDNF) has been investigated as a biomarker of treatment response in depression and has been implicated in the mechanism of action of ketamine. We evaluated plasma BDNF and associations with symptoms in 22 patients with TRD enrolled in a randomized controlled trial of ketamine compared to an anaesthetic control (midazolam). Ketamine significantly increased plasma BDNF levels in responders compared to non-responders 240 min post-infusion, and Montgomery-Åsberg Depression Rating Scale (MADRS) scores were negatively correlated with BDNF (r=-0.701, p = 0.008). Plasma BDNF levels at 240 min post-infusion were highly negatively associated with MADRS scores at 240 min (r = -0.897, p=.002), 24 h (r = -0.791, p = 0.038), 48 h (r = -0.944, p = 0.001) and 72 h (r = -0.977, p = 0.010). No associations with BDNF were found for patients receiving midazolam. These data support plasma BDNF as a peripheral biomarker relevant to ketamine antidepressant response.

  7. Memory training in depression

    NARCIS (Netherlands)

    Becker, E.S.; Vanderhasselt, M.A.; Vrijsen, J.N.

    2015-01-01

    Memory biases, that is, general memory impairments as well as specific mood-congruent memory biases, are important vulnerability factors in depression. Recently, computerized memory trainings have been developed to target these biases, reducing rumination and lightening depressive symptoms. This

  8. Depression and Suicide Risk

    Science.gov (United States)

    Depression and Suicide Risk (2014) Definition: A mood disorder that causes a persistent feeling of sadness and ... i Prevalence: 1. Ranges of lifetime risk for depression: from 6.7% overall to 40% in men, ...

  9. Depression and Pregnancy

    Science.gov (United States)

    ... best live chat Live Help Fact Sheets Share Depression Thursday, 01 September 2016 In every pregnancy, a ... risk. This sheet talks about whether exposure to depression may increase the risk for birth defects over ...

  10. Heart disease and depression

    Science.gov (United States)

    ... gov/ency/patientinstructions/000790.htm Heart disease and depression To use the sharing features on this page, ... a heart attack or heart surgery Signs of Depression It is pretty common to feel down or ...

  11. Learning about depression

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000325.htm Learning about depression To use the sharing features on this page, ... trigger or reason. What are the Signs of Depression? You may notice some or all of the ...

  12. Depression - stopping your medicines

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000570.htm Depression - stopping your medicines To use the sharing features ... prescription medicines you may take to help with depression, anxiety, or pain. Like any medicine, there are ...

  13. Depression and Pregnancy

    Science.gov (United States)

    ... best live chat Live Help Fact Sheets Share Depression Thursday, 01 September 2016 In every pregnancy, a ... risk. This sheet talks about whether exposure to depression may increase the risk for birth defects over ...

  14. Depression Disturbs Germany

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    The suicide of Robert Enke,the goalkeeper of the Germany national football team who had battled depression for years,stunned the country and cast depression into the national spotlight as a disturbing disease.

  15. Relationship between plasma concentrations of lamotrigine and its early therapeutic effect of lamotrigine augmentation therapy in treatment-resistant depressive disorder.

    Science.gov (United States)

    Kagawa, Shoko; Mihara, Kazuo; Nakamura, Akifumi; Nemoto, Kenji; Suzuki, Takeshi; Nagai, Goyo; Kondo, Tsuyoshi

    2014-12-01

    The relationship between plasma concentrations of lamotrigine and its therapeutic effects was prospectively studied on 34 (9 men and 25 women) inpatients with treatment-resistant depressive disorder during an 8-week treatment of lamotrigine augmentation using an open-study design. The subjects were depressed patients who had already shown insufficient response to at least 3 psychotropics, including antidepressants, mood stabilizers, and atypical antipsychotics. The diagnoses were major depressive disorder (n = 12), bipolar I disorder (n = 7), and bipolar II disorder (n = 15). The final doses of lamotrigine were 100 mg/d for 18 subjects who were not taking valproate and 75 mg/d for 16 subjects taking valproate. Depressive symptoms were evaluated by the Montgomery Åsberg Depression Rating Scale (MADRS) before and after the 8-week treatment. Blood sampling was performed at week 8. Plasma concentrations of lamotrigine were measured by high-performance liquid chromatography. There was a significant linear relationship between the plasma concentrations of lamotrigine and percentage improvements at week 8 (r = 0.418, P 12.7 μmol/L (11/15 versus 4/19, P treatment-resistant depressive disorder.

  16. Preventing Depression in Adults With Subthreshold Depression

    DEFF Research Database (Denmark)

    Buntrock, Claudia; Berking, Matthias; Smit, Filip

    2017-01-01

    BACKGROUND: Psychological interventions for the prevention of depression might be a cost-effective way to reduce the burden associated with depressive disorders. OBJECTIVE: To evaluate the cost-effectiveness of a Web-based guided self-help intervention to prevent major depressive disorder (MDD......) in people with subthreshold depression (sD). METHODS: A pragmatic randomized controlled trial was conducted with follow-up at 12 months. Participants were recruited from the general population via a large statutory health insurance company and an open access website. Participants were randomized to a Web......-based guided self-help intervention (ie, cognitive-behavioral therapy and problem-solving therapy assisted by supervised graduate students or health care professionals) in addition to usual care or to usual care supplemented with Web-based psycho-education (enhanced usual care). Depression-free years (DFYs...

  17. Depression in cerebrovascular diseases

    OpenAIRE

    Voskresenskaya, Tatyana

    2009-01-01

    The paper discusses the topical problem of depression in cerebrovascular diseases. It shows its possible causes, mechanisms of occurrence, clinical picture and negative impact on the course of cerebrovascular disease and recovery of neurological functions. There is a bilateral association between stroke and depression: on the one hand, stroke is a risk factor for the development of depression and, on the other, depression is a both direct and indirect risk factor for the development of stroke...

  18. [Multiple mechanisms of depression].

    Science.gov (United States)

    Liu, Chun-Lin; Ruan, Ke-Feng; Gao, Jun-Wei; Wu, Fei; Zhang, Ji-Quan

    2013-08-01

    Depression is a grievous mental disease with an increasing high morbidity year by year and a serious social harm. The pathogenesises of depression is complicated and involves with multi-mechanisms and multi-organs. Recent studies demondtrate that in the nerval system and endocrine system there are many types of neurotransmitters and hormones, as well as their receptors, involved in depression. This paper reviews the research progress of depression in recent years.

  19. Method of treating depression

    Energy Technology Data Exchange (ETDEWEB)

    Henn, Fritz

    2013-04-09

    Methods for treatment of depression-related mood disorders in mammals, particularly humans are disclosed. The methods of the invention include administration of compounds capable of enhancing glutamate transporter activity in the brain of mammals suffering from depression. ATP-sensitive K.sup.+ channel openers and .beta.-lactam antibiotics are used to enhance glutamate transport and to treat depression-related mood disorders and depressive symptoms.

  20. Method of treating depression

    Science.gov (United States)

    Henn, Fritz [East Patchogue, NY

    2012-01-24

    Methods for treatment of depression-related mood disorders in mammals, particularly humans are disclosed. The methods of the invention include administration of compounds capable of enhancing glutamate transporter activity in the brain of mammals suffering from depression. ATP-sensitive K.sup.+ channel openers and .beta.-lactam antibiotics are used to enhance glutamate transport and to treat depression-related mood disorders and depressive symptoms.

  1. Clinical Judgments of Depression.

    Science.gov (United States)

    Jackson, Douglas N.; And Others

    1986-01-01

    Investigated degree to which judges could simulate Basic Personality Inventory (BPI) responses of a clinically depressed patient group. Judgmental profiles of depressed patients indicated very high reliabilities across information conditions, a high association with actual profiles of clinically depressed patients, and differentiation from other…

  2. Depression (For Parents)

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old Depression KidsHealth > For Parents > Depression A A A What's ... to Help en español Comprender la depresión About Depression It's normal for kids to feel sad, down, ...

  3. Handling Depression | Smokefree 60+

    Science.gov (United States)

    Everyone feels blue now and then. It's a part of life. But if your feelings last more than few days and interfere with your normal daily activities, you may be suffering from depression. On this page: Symptoms of depression Who gets depressed and why?

  4. Depression and Aging.

    Science.gov (United States)

    Hamilton, Marshall, Ed.

    1982-01-01

    Contains four articles related to depression and aging. Compares normal adults with those having a major depressive disorder. Focuses on life satisfaction in the elderly, describing an individualized measure of life satisfaction. Describes similarities and differences between grief and depression. Contains a psychometric analysis of the Zung…

  5. Depression (For Parents)

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old Depression KidsHealth > For Parents > Depression Print A A A ... to Help en español Comprender la depresión About Depression It's normal for kids to feel sad, down, ...

  6. Measuring psychotic depression

    DEFF Research Database (Denmark)

    Østergaard, Søren Dinesen; Meyers, B S; Flint, A J

    Psychotic depression (PD) is a highly debilitating condition, which needs intensive monitoring. However, there is no established rating scale for evaluating the severity of PD. The aim of this analysis was to assess the psychometric properties of established depression rating scales and a number...... of new composite rating scales, covering both depressive and psychotic symptoms, in relation to PD....

  7. Measuring psychotic depression

    DEFF Research Database (Denmark)

    Østergaard, Søren Dinesen; Meyers, B S; Flint, A J

    Psychotic depression (PD) is a highly debilitating condition, which needs intensive monitoring. However, there is no established rating scale for evaluating the severity of PD. The aim of this analysis was to assess the psychometric properties of established depression rating scales and a number...... of new composite rating scales, covering both depressive and psychotic symptoms, in relation to PD....

  8. Therapeutics of postpartum depression.

    Science.gov (United States)

    Thomson, Michael; Sharma, Verinder

    2017-05-01

    Postpartum depression is a prevalent disorder affecting many women of reproductive age. Despite increasing public awareness, it is frequently underdiagnosed and undertreated leading to significant maternal morbidity and adverse child outcomes. When identified, postpartum depression is usually treated as major depressive disorder. Many studies have identified the postpartum as a period of high risk for first presentations and relapses of bipolar disorder. Areas covered: This article reviews the acute and prophylactic treatment of postpartum major depressive disorder, bipolar depression and major depressive disorder with mixed features. The safety of antidepressant and mood stabilizing medications in pregnancy and breastfeeding will also be reviewed. Expert commentary: Differentiating postpartum major depressive disorder and postpartum bipolar depression can be difficult given their clinical similarities but accurate identification is vital for initiating proper treatment. Antidepressants are the mainstay of drug treatment for postpartum major depressive disorder, yet randomized controlled trials have shown conflicting results. A paucity of evidence exists for the effectiveness of antidepressant prophylaxis in the prevention of recurrences of major depressive disorder. Mood stabilizing medications reduce the risk of postpartum bipolar depression relapse but no randomized controlled trials have examined their use in the acute or prophylactic treatment of postpartum bipolar depression.

  9. Importance of Depression in Diabetes.

    Science.gov (United States)

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

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

  10. Antidepressant monotherapy compared with combinations of antidepressants in the treatment of resistant depressive patients: a randomized, open-label study.

    Science.gov (United States)

    Bares, Martin; Novak, Tomas; Kopecek, Miloslav; Stopkova, Pavla; Cermak, Jan; Kozeny, Jiri; Höschl, Cyril

    2013-02-01

    This randomized, 6-week, open-label study compared efficacy of CAD and antidepressant monotherapies (ADM) that had been chosen according to clinical judgment of the attending psychiatrist. A total of 60 inpatients (intent-to-treat analysis) with depressive disorder (≥ 1 unsuccessful antidepressant treatment) were randomly assigned to the interventions. The responders who completed the acute phase of study, were evaluated for relapse within 2 months of follow-up treatment. The primary outcome measure was change in the Montgomery-Åsberg Depression Rating Scale (MADRS) and response was defined as a ≥ 50% reduction of MADRS score. Mean changes in total MADRS score from baseline to week 6 for patients in both treatment modalities were not different (ADM = 13.2 ± 8.6 points; CAD = 14.5 ± 9.5 points; P = 0.58). The analysis of covariance performed for significantly higher value of imipramine equivalent dose in CAD group showed only a non-significant between-group difference for total MADRS change (P = 0.17). There were also no differences between groups in response rate (ADM = 48%; CAD = 58%) and number of drop-outs in acute treatment as well as proportion of responders' relapses in the follow-up. Both treatment modalities produced clinically relevant reduction of depressive symptomatology in acute treatment of patients with resistant depression and their effect was comparable.

  11. Antidepressant monotherapy and combination of antidepressants in the treatment of resistant depression in current clinical practice: A retrospective study.

    Science.gov (United States)

    Bares, Martin; Novak, Tomas; Kopecek, Miloslav; Stopkova, Pavla; Höschl, Cyril

    2010-11-01

    Abstract Objectives. The aim of this study was to compare efficacy of antidepressant monotherapies and combinations of antidepressants in the treatment of resistant patients in current clinical practice. Methods. We reviewed chart documents of resistant depressive inpatients treated at least 4 weeks with a new treatment. Depressive symptoms and clinical status were assessed using Montgomery and Åsberg Depression Rating Scale (MADRS), Beck Depression Inventory-Short Form and Clinical Global Impression at the baseline, week 2 and in the end of treatment. Results. We identified 81 patients (27 with combinations and 51 with monotherapies) that were suitable for analyses. The combination group achieved higher reduction of MADRS score (14.6 vs 10.2 pts., p=0.02) and response rate (≥ 50% reduction of MADRS, 67% vs 39%, p=0.03). Number needed to treat for response was 4. Conclusions. Based on our results, we suggest that combination of antidepressants might be more effective than monotherapy in clinical practice.

  12. Analysis of potentially predictive factors of efficacy of adjunct extended-release quetiapine fumarate in patients with major depressive disorder.

    Science.gov (United States)

    Bauer, Michael; Thase, Michael E; Liu, Sherry; Earley, Willie; Eriksson, Hans

    2015-05-01

    Identification of predictors of treatment response in patients with major depressive disorder (MDD) may facilitate improved disease management. Data were pooled from two 6-week, double-blind, placebo-controlled studies of extended-release quetiapine (quetiapine XR; 150 or 300 mg/day) as adjunct to ongoing antidepressant therapy. Effects of psychiatric history and baseline demographic and disease characteristics on efficacy outcomes (Week 6 Montgomery Åsberg Depression Rating Scale [MADRS] total score reduction) were evaluated in population subgroups (quetiapine XR both doses pooled, n = 616; placebo, n = 303). Baseline Clinical Global Impressions-Severity (CGI-S) score and previous depressive episodes on Week 6 MADRS total score change, and baseline MADRS individual item scores on Week 6 change in CGI-Improvement score, were also evaluated. No major differences between responders and non-responders to quetiapine XR were observed for patient characteristics or demographic and disease characteristics. No suggestion of a predictive association was found between baseline CGI-S score, number of depressive episodes, and baseline MADRS item scores and efficacy outcomes. These analyses showed no major differences between responders and non-responders, and no predictive association between the parameters assessed and efficacy outcomes for adjunct quetiapine XR in patients with MDD and an inadequate response to prior antidepressant therapy.

  13. Lithium and Valproate Levels Do Not Correlate with Ketamine's Antidepressant Efficacy in Treatment-Resistant Bipolar Depression.

    Science.gov (United States)

    Xu, Annie J; Niciu, Mark J; Lundin, Nancy B; Luckenbaugh, David A; Ionescu, Dawn F; Richards, Erica M; Vande Voort, Jennifer L; Ballard, Elizabeth D; Brutsche, Nancy E; Machado-Vieira, Rodrigo; Zarate, Carlos A

    2015-01-01

    Ketamine and lithium both inhibit glycogen synthase kinase 3. In addition, lithium and ketamine have synergistic antidepressant-like effects at individually subeffective doses in rodents. We hypothesized that ketamine's antidepressant effects would be improved by therapeutic doses of lithium versus valproate and that serum lithium levels would positively correlate with ketamine's antidepressant efficacy. Thirty-six patients with treatment-resistant bipolar depression maintained on therapeutic-dose lithium (n = 23, 0.79 ± 0.15 mEq/L) or valproate (n = 13, 79.6 ± 12.4 mg/mL) received 0.5 mg/kg ketamine infusion in a randomized, double-blind, placebo-controlled, crossover trial. The primary depression outcome measure-the Montgomery-Åsberg Depression Rating Scale (MADRS)-was assessed before infusion and at numerous postinfusion time points. Both lithium (F 1,118 = 152.08, p lithium and valproate levels did not correlate with ketamine's antidepressant efficacy. Although the study was potentially underpowered, our results suggest that lithium may not potentiate ketamine's antidepressant efficacy in treatment-resistant bipolar depression.

  14. Understanding childhood depression.

    Science.gov (United States)

    Malhotra, Savita; Das, Partha Pratim

    2007-02-01

    Major depressive disorder in children is a severe and a chronically disabling disorder. This population appears to be a special group in terms of consequences of poor psychosocial and academic outcome and increased risk of substance abuse, and suicide. Studies have revealed several major findings in genetic, familial, psychological, and biological aspects of such depression, some of which have explored into the issue of its relationship with adult depression. Considerable advances have been made now in the area of childhood depression providing a better understanding of its nature. We review literature available on historical aspect, epidemiology, clinical characteristics, and aetiology of childhood depression.

  15. Depression in geriatric patients.

    Science.gov (United States)

    Abbas Asghar-Ali, A; Braun, U K

    2009-02-01

    While the most serious of depressive illnesses in the elderly is major depressive disorder, patients' quality of life can be significantly impacted by dysthmic disorder, sub-threshold depression (minor depression), or a depressive disorder due to a general medical condition, all of which have been shown to be more prevalent than major depression in the community dwelling population of older adults. Older adults are also more likely to develop grief reaction and frequently deal with issues of bereavement. This review will discuss the diagnoses of all relevant depressive diagnoses that primary care physicians are likely to encounter. Among the many different assessment tools that screen for depression the briefest instruments are a two-question screening tool recommended by the U.S. Preventive Services Task Force and, specifically developed for older adults, the Geriatric Depression Scale (GDS) that is available in a short 15- Yes/No-question version. Many medical illnesses are associated with depressive symptoms. The focus in this review is on dementing illnesses/cerebrovascular disease, dementia of the Alzheimer's type, and Parkinson disease. First-line pharmacological therapy of depression includes selective serotonin inhibitors (SSRIs), and serotonin-norepinephrine reuptake inhibitors (SNRIs). Side effects of particular drugs can often be geared towards achieving additional benefits, e.g. weight gain associated with the use of some SSRISs may be helpful for patients with dementia.

  16. Depression in adolescence

    Science.gov (United States)

    Thapar, Anita; Collishaw, Stephan; Pine, Daniel S; Thapar, Ajay K

    2012-01-01

    Unipolar depressive disorder in adolescence is common worldwide but often unrecognised. The incidence, notably in girls, rises sharply after puberty and, by the end of adolescence, the 1 year prevalence rate exceeds 4%. The burden is highest in low-income and middle-income countries. Depression is associated with sub stantial present and future morbidity, and heightens suicide risk. The strongest risk factors for depression in adolescents are a family history of depression and exposure to psychosocial stress. Inherited risks, developmental factors, sex hormones, and psychosocial adversity interact to increase risk through hormonal factors and associated perturbed neural pathways. Although many similarities between depression in adolescence and depression in adulthood exist, in adolescents the use of antidepressants is of concern and opinions about clinical management are divided. Effective treatments are available, but choices are dependent on depression severity and available resources. Prevention strategies targeted at high-risk groups are promising. PMID:22305766

  17. [Depression and neurological diseases].

    Science.gov (United States)

    Piber, D; Hinkelmann, K; Gold, S M; Heesen, C; Spitzer, C; Endres, M; Otte, C

    2012-11-01

    In many neurological diseases a depressive syndrome is a characteristic sign of the primary disease or is an important comorbidity. Post-stroke depression, for example, is a common and relevant complication following ischemic brain infarction. Approximately 4 out of every 10 stroke patients develop depressive disorders in the course of the disease which have a disadvantageous effect on the course and the prognosis. On the other hand depression is also a risk factor for certain neurological diseases as was recently demonstrated in a meta-analysis of prospective cohort studies which revealed a much higher stroke risk for depressive patients. Furthermore, depression plays an important role in other neurological diseases with respect to the course and quality of life, such as Parkinson's disease, multiple sclerosis and epilepsy. This article gives a review of the most important epidemiological, pathophysiological and therapeutic aspects of depressive disorders as a comorbidity of neurological diseases and as a risk factor for neurological diseases.

  18. In Pursuit: Montgomery After Alamein

    Science.gov (United States)

    1991-05-01

    I vision th d ay. immediate threat of encirclement, having yielded Mersa Matruh, Sii 8arran2, and Bardia. Montgcmery ordered a temporary cause at the...the strength 51 and intentions of Panzer Armee Afrika. Rommel signaled on 8 December that he would pull back from the Mersa Brega-El Agheila position

  19. FLOODPLAIN, Montgomery COUNTY, VIRGINIA, USA

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — The Floodplain Mapping/Redelineation study deliverables depict and quantify the flood risks for the study area. The primary risk classifications used are the...

  20. HYDROLOGY, MONTGOMERY COUNTY, ALABAMA USA

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — Hydrology data include spatial datasets and data tables necessary for documenting the hydrologic procedures for estimating flood discharges for a flood insurance...

  1. HYDROLOGY, MONTGOMERY COUNTY, KENTUCKY USA

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — Hydrology data include spatial datasets and data tables necessary for documenting the hydrologic procedures for estimating flood discharges for a flood insurance...

  2. HYDROLOGY, MONTGOMERY COUNTY, ALABAMA USA

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — Hydrology data include spatial datasets and data tables necessary for documenting the hydrologic procedures for estimating flood discharges for a flood insurance...

  3. HYDRAULICS, MONTGOMERY COUNTY, ALABAMA, USA

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — Recent developments in digital terrain and geospatial database management technology make it possible to protect this investment for existing and future projects to...

  4. Impact of anxiety symptoms on outcomes of depression: an observational study in Asian patients

    Directory of Open Access Journals (Sweden)

    Novick D

    2016-04-01

    Full Text Available Diego Novick,1 William Montgomery,2 Jaume Aguado,3 Xiaomei Peng,4 Josep Maria Haro3 1Eli Lilly and Company, Windlesham, Surrey, UK; 2Eli Lilly Australia Pty Ltd, West Ryde, NSW, Australia; 3Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain; 4Eli Lilly and Company, Indianapolis, IN, USA Objective: To investigate the impact of anxiety symptoms on depression outcomes in Asian patients with major depressive disorder (MDD (n=714. Methods: The 17-item Hamilton Depression Scale (HAMD-17, overall severity, somatic symptoms, and quality of life (QOL (EuroQOL Questionnaire-5 Dimensions [EQ-5D] were assessed at baseline and 3 months. Anxiety was measured using items 10 and 11 from the HAMD-17. Linear, tobit, and logistic multiple regression models analyzed the impact of anxiety symptoms on outcomes. Baseline anxiety was related to age and the presence of pain symptoms at baseline. Results: Regression models showed that a higher level of anxiety was associated with a lower frequency of remission and lower QOL at 3 months. Patients with lower baseline anxiety symptoms had higher remission rates (odds ratio for each point of anxiety symptoms, 0.829 [95% confidence interval [CI]: 0.723–0.951]. Patients with higher levels of baseline anxiety had a lower QOL at 3 months (a decrease in EQ-5D tariff score for each point of anxiety symptoms, 0.023 [95% CI: 0.045–0.001]. Conclusion: In conclusion, the presence of anxiety symptoms negatively impacts the outcomes of depression. Keywords: depression, anxiety, Asia, observational, outcomes

  5. Acupuncture treatment modulates the corticostriatal reward circuitry in major depressive disorder.

    Science.gov (United States)

    Wang, Zengjian; Wang, Xiaoyun; Liu, Jian; Chen, Jun; Liu, Xian; Nie, Guangning; Jorgenson, Kristen; Sohn, Ki Cheul; Huang, Ruiwang; Liu, Ming; Liu, Bo; Kong, Jian

    2017-01-01

    Major depressive disorder (MDD) is a common disorder with a high prevalence and significant social and economic impacts. Nevertheless, the treatment of MDD is far from satisfactory. Acupuncture treatment has emerged as a promising method for treating MDD. However, the neural mechanism by which acupuncture reduces depressive symptoms is not fully understood. Studies have shown that the corticostriatal reward circuitry is associated with the pathophysiology of MDD; thus, we investigated the corticostriatal resting-state functional connectivity (rsFC) before and after real and sham acupuncture treatments combined with the antidepressant fluoxetine. Forty-six female major depressive patients were assigned to either verum acupuncture plus fluoxetine (n = 22) or sham acupuncture plus fluoxetine (n = 24) treatment for 8 weeks, and resting state functional magnetic resonance imaging (fMRI) data were collected before the first and after the last treatment sessions. The results showed that compared with sham acupuncture, the verum acupuncture group showed: (1) significantly increased rsFC between inferior ventral striatum and medial prefrontal cortex, ventral rostral putamen and amygdala/parahippocampus, as well as dorsal caudate and middle temporal gyrus; (2) significantly decreased rsFC between right ventral rostral putamen and right dorsolateral prefrontal cortex, and right dorsal caudate and bilateral cerebellar tonsil. The increased rsFC between the inferior ventral striatum and medial prefrontal cortex, ventral rostral putamen and amygdala/parahippocampus were significantly positively associated with decreased clinical scores (Montgomery-Åsberg Depression Rating Scale and Self-Rating Depression Scale scores) at the end of the eight-week treatment. Our findings suggest that acupuncture may achieve treatment effects by modulating the corticostriatal reward/motivation circuitry in MDD patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Physical activity patterns of people affected by depressive and anxiety disorders as measured by accelerometers: a cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Björg Helgadóttir

    Full Text Available Exercise can relieve both depressive and anxiety disorders and it is therefore of importance to establish movement patterns of mildly to moderately affected sufferers to estimate the treatment potential. The aim is to describe the physical activity patterns of people affected by mild to moderate depressive and/or anxiety symptoms using objective measures of physical activity.The design of the study was cross-sectional using data from 165 people aged 18-65 years, with mild to moderate depressive and/or anxiety disorder symptoms (scoring ≥ 10 on the PHQ-9. Diagnoses were made using Mini International Neuropsychiatric Interview (MINI and symptom severity was measured with the Montgomery-Åsberg Depression Rating Scale (MADRS. The participants wore accelerometers for a week to evaluate physical activity patterns.No statistically significant differences were detected between different diagnoses, though depressed participants tended to be less active and more sedentary. Only one-fifth of the sample followed public health guidelines regarding physical activity. Each one point increase in MADRS was associated with a 2.4 minute reduction in light physical activity, independent of moderate-to-vigorous physical activity and sedentary time. MADRS was positively associated with number of sedentary bouts.The physical activity pattern of people with depressive and/or anxiety disorders was characterized by large amounts of sedentary time and low fulfillment of physical activity guidelines. There is therefore a large treatment potential for this group by increasing exercise. The results suggest that instead of focusing exclusively on high intensity exercise for treating depressive and anxiety disorders, health care providers might encourage patients to reduce sedentary time by increasing light physical activity and decreasing the number of sedentary bouts, though further studies are needed that can determine directionality.

  7. Lurasidone for the Treatment of Major Depressive Disorder With Mixed Features: A Randomized, Double-Blind, Placebo-Controlled Study.

    Science.gov (United States)

    Suppes, Trisha; Silva, Robert; Cucchiaro, Josephine; Mao, Yongcai; Targum, Steven; Streicher, Caroline; Pikalov, Andrei; Loebel, Antony

    2016-04-01

    Accumulating evidence indicates that manic symptoms below the threshold for hypomania (mixed features) are common in individuals with major depressive disorder. This form of depression is often severe and is associated with an increased risk for recurrence, suicide attempts, substance abuse, and functional disability. This study evaluated the efficacy and safety of lurasidone in major depressive disorder with mixed features. Patients meeting DSM-IV-TR criteria for major depressive disorder who presented with two or three protocol-defined manic symptoms were randomly assigned to 6 weeks of double-blind treatment with either lurasidone at 20-60 mg/day (N=109) or placebo (N=100). Changes from baseline in Montgomery-Åsberg Depression Rating Scale score (MADRS; primary outcome measure) and Clinical Global Impressions severity subscale score (CGI-S; key secondary outcome measure) were evaluated using a mixed model for repeated-measures analysis. Lurasidone significantly improved depressive symptoms and overall illness severity, assessed by least squares mean change at week 6 in the MADRS and CGI-S scores: -20.5 compared with -13.0 (effect size, 0.80) and -1.8 compared with -1.2 (effect size, 0.60), respectively. Significant improvement in manic symptoms, assessed by the Young Mania Rating Scale, was also observed, in addition to other secondary efficacy endpoints. Rates of discontinuation due to adverse events were low. The most common adverse events were nausea (6.4% and 2.0% in the lurasidone and placebo groups, respectively) and somnolence (5.5% and 1.0%). Lurasidone was effective and well tolerated in this study involving patients with major depressive disorder associated with subthreshold hypomanic symptoms (mixed features).

  8. The study protocol of the Norwegian randomized controlled trial of electroconvulsive therapy in treatment resistant depression in bipolar disorder

    Directory of Open Access Journals (Sweden)

    Oedegaard Ketil J

    2010-02-01

    Full Text Available Abstract Background The treatment of depressive phases of bipolar disorder is challenging. The effects of the commonly used antidepressants in bipolar depression are questionable. Electroconvulsive therapy is generally considered to be the most effective treatment even if there are no randomized controlled trials of electroconvulsive therapy in bipolar depression. The safety of electroconvulsive therapy is well documented, but there are some controversies as to the cognitive side effects. The aim of this study is to compare the effects and side effects of electroconvulsive therapy to pharmacological treatment in treatment resistant bipolar depression. Cognitive changes and quality of life during the treatment will be assessed. Methods/Design A prospective, randomised controlled, multi-centre six- week acute treatment trial with seven clinical assessments. Follow up visit at 26 weeks or until remission (max 52 weeks. A neuropsychological test battery designed to be sensitive to changes in cognitive function will be used. Setting: Nine study centres across Norway, all acute psychiatric departments. Sample: n = 132 patients, aged 18 and over, who fulfil criteria for treatment resistant depression in bipolar disorder, Montgomery Åsberg Depression Rating Scale Score of at least 25 at baseline. Intervention: Intervention group: 3 sessions per week for up to 6 weeks, total up to 18 sessions. Control group: algorithm-based pharmacological treatment as usual. Discussion This study is the first randomized controlled trial that aims to investigate whether electroconvulsive therapy is better than pharmacological treatment as usual in treatment resistant bipolar depression. Possible long lasting cognitive side effects will be evaluated. The study is investigator initiated, without support from industry. Trial registration NCT00664976

  9. Is duloxetine's effect on painful physical symptoms in depression an indirect result of improvement of depressive symptoms? Pooled analyses of three randomized controlled trials.

    Science.gov (United States)

    Harada, Eiji; Tokuoka, Hirofumi; Fujikoshi, Shinji; Funai, Jumpei; Wohlreich, Madelaine M; Ossipov, Michael H; Iwata, Nakao

    2016-03-01

    In treating Major Depressive Disorder with associated painful physical symptoms (PPS), the effect of duloxetine on PPS has been shown to decompose into a direct effect on PPS and an indirect effect on PPS via depressive symptoms (DS) improvement. To evaluate the changes in relative contributions of the direct and indirect effects over time, we analyzed pooled data from 3 randomized double-blind studies comparing duloxetine 60 mg/d with placebo in patients with major depressive disorder and PPS. Changes from baseline in Montgomery-Åsberg Depression Rating Scale total and Brief Pain Inventory-Short Form average pain score were assessed over 8 weeks. Path analysis examined the (1) direct effect of treatment on PPS and/or indirect effect on PPS via DS improvement and (2) direct effect of treatment on DS and/or indirect effect on DS via PPS improvement. At week 1, the direct effect of duloxetine on PPS (75.3%) was greater than the indirect effect through DS improvement (24.7%) but became less (22.6%) than the indirect effect (77.4%) by week 8. Initially, the direct effect of duloxetine on PPS was markedly greater than its indirect effect, whereas later the indirect effect predominated. Conversely, at week 1, the direct effect of treatment on DS (46.4%) was less than the indirect effect (53.6%), and by week 8 it superseded (62.6%) the indirect effect (37.4%). Thus, duloxetine would relieve PPS directly in the initial phase and indirectly via improving DS in the later phase.

  10. Relationship between major depressive disorder and associated painful physical symptoms: analysis of data from two pooled placebo-controlled, randomized studies of duloxetine.

    Science.gov (United States)

    Robinson, Michael J; Sheehan, David; Gaynor, Paula J; Marangell, Lauren B; Tanaka, Yoko; Lipsius, Sarah; Ohara, Fumihiro; Namiki, Chihiro

    2013-11-01

    The aim of this study was to evaluate the relationship between painful physical symptoms (PPS) and outcomes in major depressive disorder (MDD). Post-hoc analysis of two identically designed 8-week trials compared the efficacy of 60 mg/day duloxetine (N=523) with that of placebo (N=532) in treating PPS associated with MDD. The Montgomery-Åsberg Depression Rating Scale (MADRS) total score, the Brief Pain Inventory (BPI) average pain score, and the Sheehan Disability Scale global functional impairment score assessed depression symptoms, pain, and functioning, respectively. Remission was defined as a MADRS score of 10 or less, and the BPI response subgroup was defined as a 50% or greater reduction from baseline. Path analyses assessed relationships among variables. Duloxetine-treated patients who had a 50% or greater reduction in BPI score at endpoint had higher rates of remission. Path analysis indicated that 16% of likelihood of remission in depression symptoms was because of the direct effect of treatment, 41% because of pain reduction, and 43% because of functional improvement. Path analysis also indicated that 51% of improvement in functioning was attributed to pain improvement and 43% to mood improvement. Results demonstrate that improvement in pain and mood contributes to functional improvement, and pain reduction and functional improvement increase the likelihood of remission of depressive symptoms with duloxetine treatment in patients with both MDD and PPS at baseline.

  11. Rapid resolution of suicidal ideation after a single infusion of an N-methyl-D-aspartate antagonist in patients with treatment-resistant major depressive disorder.

    Science.gov (United States)

    DiazGranados, Nancy; Ibrahim, Lobna A; Brutsche, Nancy E; Ameli, Rezvan; Henter, Ioline D; Luckenbaugh, David A; Machado-Vieira, Rodrigo; Zarate, Carlos A

    2010-12-01

    Suicidal ideation is a medical emergency, especially when severe. Little research has been done on pharmacologic interventions that could address this problem. Ketamine, an N-methyl-D-asparate antagonist, has been reported to have antidepressant effects within hours. We examined the effects of a single dose of ketamine on suicidal ideation in subjects with treatment-resistant major depressive disorder (MDD). Thirty-three subjects with DSM-IV-diagnosed MDD received a single open-label infusion of ketamine (0.5 mg/kg) and were rated at baseline and at 40, 80, 120, and 230 minutes postinfusion with the Scale for Suicide Ideation (SSI), the Montgomery-Åsberg Depression Rating Scale, the Hamilton Depression Rating Scale, and the Beck Depression Inventory. The study was conducted between October 2006 and January 2009. Suicidal ideation scores decreased significantly on the SSI as well as on the suicide subscales of other rating instruments within 40 minutes; these decreases remained significant through the first 4 hours postinfusion (P Depression, anxiety, and hopelessness were significantly improved at all time points (P < .001). Suicidal ideation in the context of MDD improved within 40 minutes of a ketamine infusion and remained improved for up to 4 hours postinfusion. Future studies with ketamine in suicidal ideation are warranted due to the potential impact on public health. clinicaltrials.gov Identifier: NCT00088699. © Copyright 2010 Physicians Postgraduate Press, Inc.

  12. Standardization of depression measurement

    DEFF Research Database (Denmark)

    Wahl, Inka; Löwe, Bernd; Bjørner, Jakob

    2014-01-01

    comparisons among included measures. Large differences were found in their measurement precision and range, providing a rationale for instrument selection. Published scale-specific threshold scores of depression severity showed remarkable consistencies across different questionnaires. CONCLUSION: An IRT-based......OBJECTIVES: To provide a standardized metric for the assessment of depression severity to enable comparability among results of established depression measures. STUDY DESIGN AND SETTING: A common metric for 11 depression questionnaires was developed applying item response theory (IRT) methods. Data...... instrument-independent metric for depression severity enables direct comparisons among established measures. The "common ruler" simplifies the interpretation of depression assessment by identifying key thresholds for clinical and epidemiologic decision making and facilitates integrative psychometric research...

  13. Depression and attachment problems.

    OpenAIRE

    Pettem, O; M. West; Mahoney, A; Keller, A.

    1993-01-01

    This study investigated the characteristics related to attachment of 42 depressed psychiatric patients and 42 non-depressed psychiatric controls. The depressed subjects demonstrated an anxious pattern of attachment, characterized by either intense care-seeking in relation to their attachment figure or angry withdrawal from their attachment figure when their desire for security was frustrated. The results are discussed in terms of Bowlby's attachment construct.

  14. Progress Report on the ISCR Pilot Test Conducted at the Former CCC/USDA Grain Storage Facility in Montgomery City, Missouri, as of April 2013

    Energy Technology Data Exchange (ETDEWEB)

    LaFreniere, Lorraine M. [Argonne National Lab. (ANL), Argonne, IL (United States). Environmental Science Division. Applied Geoscience and Environmental Restoration Program

    2013-06-01

    The Commodity Credit Corporation of the U.S. Department of Agriculture (CCC/USDA) is conducting an environmental investigation at the former CCC/USDA grain storage facility on the county fairgrounds in Montgomery City, Missouri, to evaluate contamination associated with the former use of grain fumigants containing carbon tetrachloride at the site. The CCC/USDA studies have identified carbon tetrachloride in the soils (primarily unconsolidated glacial tills) at concentrations that exceed the U.S. Environmental Protection Agency (EPA) regional screening level (RSL) values for this compound in residential soils (610 μg/kg) but are below the corresponding RSL for industrial soils (3,000 μg/kg). Concentrations of carbon tetrachloride greater than the EPA maximum contaminant level (MCL; 5.0 μg/L) for this contaminant in drinking water were also identified in the shallow groundwater (Argonne 2012). On the basis of these findings, remedial actions are considered necessary to mitigate the present and potential future impacts of the contamination. In cooperation with the Missouri Department of Natural Resources (MDNR), the CCC/USDA has initiated a field-scale pilot test to evaluate an in situ technology for treatment of the carbon tetrachloride contamination. In this approach, a chemical amendment consisting primarily of slow-release organic matter and zero-valent iron is employed to induce oxygen-depleted, chemically reducing conditions in the subsurface. These conditions foster the in situ chemical reduction (ISCR) of carbon tetrachloride and its degradation products (chloroform, methylene chloride, and chloromethane) via both inorganic and biologically mediated processes. The chemical amendment being used, EHC™, was developed by the Adventus Group, Freeport, Illinois, and is now manufactured and distributed by FMC Environmental Solutions, Philadelphia, Pennsylvania. With the approval of the MDNR (2012), the ISCR technology is being tested in two target areas

  15. Geophysical Logs, Aquifer Tests, and Water Levels in Wells in and Near the North Penn Area 7 Superfund Site, Upper Gwynedd Township, Montgomery County, Pennsylvania, 2002-2006

    Science.gov (United States)

    Senior, Lisa A.; Conger, Randall W.; Bird, Philip H.

    2008-01-01

    Ground water in the vicinity of several industrial facilities in Upper Gwynedd Township and Lansdale Borough, Montgomery County, Pa., is contaminated with several volatile organic compounds (VOCs). The 2-square-mile area was placed on the National Priorities List as the North Penn Area 7 Superfund Site by the U.S. Environmental Protection Agency (USEPA) in 1989. The U.S. Geological Survey (USGS) conducted geophysical logging, aquifer testing, water-level monitoring, and streamflow measurements in the vicinity of North Penn Area 7 from October 2002 through December 2006. This followed work that began in 2000 to assist the USEPA in developing an understanding of the hydrogeologic framework in the area as part of the USEPA Remedial Investigation. The study area is underlain by Triassic- and Jurassic-age sandstones, siltstones, and shales of the Lockatong Formation and the Brunswick Group. Regionally, these rocks strike northeast and dip to the northwest. The sequence of rocks form fractured-rock aquifers that act as a set of confined to semi-confined layered aquifers of differing permeabilities. The aquifers are recharged by precipitation and discharge to streams and wells. The Wissahickon Creek headwaters are less than 1 mile northeast of the study area. This stream flows southwest approximately parallel to strike and bisects North Penn Area 7. Ground water is pumped in the vicinity of North Penn Area 7 for industrial use and public supply. The USGS collected geophysical logs for 42 wells that ranged in depth from 40 to 477 ft. Aquifer-interval-isolation testing was done in 17 of the 42 wells, for a total of 122 zones tested. A multiple-well aquifer test was conducted by monitoring the response of 14 wells to pumping and shutdown of a 600-ft deep production well in November-December 2004. In addition, water levels were monitored continuously in four wells in the area from October 2002 through September 2006, and streamflow was measured quarterly at two sites on

  16. DEPRESSIVE DISORDERS IN EPILEPSY

    Directory of Open Access Journals (Sweden)

    Koralia Todorova

    2010-11-01

    Full Text Available Depressive disorders are the most frequent psychiatric comorbidity in epilepsy but very often remain unrecognized and untreated. We examined 103 epileptic patients, aged 18-60 years, 40 males and 63 females, for the presence of interictal depressive disorder. All subjects underwent clinical psychiatric examination, including evaluation on Hamilton Depression Rating Scale (HAM-D-17. A questionnaire for demographic and seizure-related variables was also completed. Concurrent depressive disorder (clinically presented according to ICD-10 diagnostic criteria affected 28.3% of all evaluated patients. Based on HAM-D-17 scores depression was defined as mild - 80% of all depressed patients, moderate - 17% and severe - 3%. Atypical presentation of interictal depressive disorder was frequent. Depression has a tremendous effect on one’s family, social and psychological functioning, even more than the actual seizure frequency and severity. Diagnostic difficulties come through the atypical mode of presentation of depressive disorders in epilepsy. Proper neuropsychiatric evaluation is essential for improving treatment and quality of life for patients with epilepsy.

  17. Depression after myocardial infarction.

    Science.gov (United States)

    Ziegelstein, R C

    2001-01-01

    Depression is an independent risk factor for increased postmyocardial infarction morbidity and mortality, even after controlling for the extent of coronary artery disease, infarct size, and the severity of left ventricular dysfunction. This risk factor takes on added significance when one considers that almost half of patients recovering from a myocardial infarction have major or minor depression and that major depression alone occurs in about one in five of these individuals. Despite the well-documented risk of depression, questions remain about the mechanism of the relationship between mood disturbance and adverse outcome. The link may be explained by an association with lower levels of social support, poor adherence to recommended medical therapy and lifestyle changes intended to reduce the risk of subsequent cardiac events, disturbances in autonomic tone, enhanced platelet activation and aggregation, and systemic immune activation. Unfortunately, questions about the pathophysiologic mechanism of depression in this setting are paralleled by uncertainties about the optimal treatment of depression for patients recovering from a myocardial infarction and by a lack of knowledge about whether treating depression lowers the associated increased mortality risk. Ongoing research studies will help to determine the benefits of psychosocial interventions and of antidepressant therapy for patients soon after myocardial infarction. Although the identification of depression as a risk factor may by itself be a reason to incorporate a comprehensive psychological evaluation into the routine care of patients with myocardial infarction, this practice should certainly become standard if studies show that treating depression reduces the increased mortality risk of these patients.

  18. Changes in interleukin-6 levels during electroconvulsive therapy may reflect the therapeutic response in major depression.

    Science.gov (United States)

    Järventausta, K; Sorri, A; Kampman, O; Björkqvist, M; Tuohimaa, K; Hämäläinen, M; Moilanen, E; Leinonen, E; Peltola, J; Lehtimäki, K

    2017-01-01

    Interleukin-6 (IL-6) has been reported to be elevated in major depressive disorder (MDD) but decreased by antidepressive medication. IL-6 levels are markedly elevated both after epileptic seizures and single electroconvulsive therapy (ECT) session, but long-term changes in IL-6 levels after ECT have not been studied. The correlation between immediate and long-term changes in proinflammatory cytokines and outcome after ECT was investigated. Thirty patients suffering from MDD participated in the study. IL-6, interleukin-1β (IL-1β) and interleukin-1 receptor antagonist (IL-1RA) levels were examined at baseline and at 2 and 4 h after the first, fifth and the last ECT sessions. The response to ECT was measured with Montgomery-Åsberg Depression Rating Scale (MADRS). ECT repeatedly caused an increase in IL-6 levels at the 4-h time point. However, the baseline IL-6 levels decreased among remitters, but not among non-remitters, towards the end of ECT. IL-1β levels were mostly below detectable level, and IL-1Ra levels did not change during and after ECT. ECT has distinct acute and long-term effects on IL-6 levels. Interestingly, the long-term effect of ECT on IL-6 seems to correlate with outcome, providing further evidence of the mechanism of action of ECT and supporting the inflammation theory in MDD. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Do concomitant pain symptoms in patients with major depression affect quality of life even when taking into account baseline depression severity?

    Directory of Open Access Journals (Sweden)

    Novick D

    2013-05-01

    Full Text Available Diego Novick,1 William Montgomery,2 Zbigniew Kadziola,3 Victoria Moneta,4 Xiaomei Peng,5 Roberto Brugnoli,6 Josep Maria Haro41Eli Lilly and Company, Windlesham, Surrey, UK; 2Eli Lilly Australia Pty Ltd, West Ryde, NSW, Australia; 3Eli Lilly Austria GmbH, Vienna, Austria; 4Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain; 5Eli Lilly and Company, Indianapolis, IN, USA; 6Università di Roma, “Sapienza,” Rome, ItalyBackground: Patients with major depressive disorder (MDD may suffer from concomitant pain symptoms. The aim of this study is to determine whether the presence of painful physical symptoms (PPS influences quality of life when taking into account baseline depression severity.Methods: Patients with a new or first episode of MDD (n = 909 were enrolled in a 3-month prospective observational study in East Asia. The Hamilton Depression Rating Scale, Clinical Global Impression-Severity score, Somatic Symptom Inventory, and EuroQoL questionnaire-5 Dimensions (EQ-5D and EQ-Visual Analogue Scale (EQ-VAS were assessed at baseline and 3 months’ follow-up. The presence of PPS was defined as a mean score of ≥2 on the Somatic Symptom Inventory pain-related items. Regression analyses determined predictors of quality of life at 3 months, adjusting for age, sex, depressive symptoms, overall severity, and quality of life at baseline.Results: PPS were present (PPS+ at baseline in 52% of patients. During the 3-month follow-up, EQ-VAS scores improved from 47.7 (standard deviation [SD] 20.6 to 72.5 (SD 20.4, and EQ-5D improved from 0.48 (SD 0.34 to 0.80 (SD 0.26. At 3 months, mean EQ-VAS was 66.4 (SD 21.2 for baseline PPS+ patients versus 78.5 (SD 17.6 for baseline PPS- patients, and mean EQ-5D was 0.71 (SD 0.29 versus 0.89 (SD 0.18. PPS+ at baseline was a significant predictor of quality of life at 3 months after adjusting for sociodemographic and baseline clinical variables

  20. Antidepressant response in major depressive disorder: a meta-regression comparison of randomized controlled trials and observational studies.

    Directory of Open Access Journals (Sweden)

    Florian Naudet

    Full Text Available BACKGROUND: To compare response to antidepressants between randomized controlled trials (RCTs and observational trials. METHODS AND FINDINGS: Published and unpublished studies (from 1989 to 2009 were searched for by 2 reviewers on Medline, the Cochrane library, Embase, clinicaltrials.gov, Current Controlled Trial, bibliographies and by mailing key organisations and researchers. RCTs and observational studies on fluoxetine or venlafaxine in first-line treatment for major depressive disorder reported in English, French or Spanish language were included in the main analysis. Studies including patients from a wider spectrum of depressive disorders (anxious depression, minor depressive episode, dysthymia were added in a second analysis. The main outcome was the pre-/post-treatment difference on depression scales standardised to 100 (17-item or 21-item Hamilton Rating Scale for Depression or Montgomery and Åsberg Rating Scale in each study arm. A meta-regression was conducted to adjust the comparison between observational studies and RCTs on treatment type, study characteristics and average patient characteristics. 12 observational studies and 109 RCTs involving 6757 and 11035 patients in 12 and 149 arms were included in the main analysis. Meta-regression showed that the standardised treatment response in RCTs is greater by a magnitude of 4.59 (2.61 to 6.56. Study characteristics were related to standardised treatment response, positively (study duration, number of follow-up assessments, outpatients versus inpatients, per protocol analysis versus intention to treat analysis or negatively (blinded design, placebo design. At patient level, response increased with baseline severity and decreased with age. Results of the second analysis were consistent with this. CONCLUSIONS: Response to antidepressants is greater in RCTs than in observational studies. Observational studies should be considered as a necessary complement to RCTs.

  1. Nutritional Aspects of Depression

    Directory of Open Access Journals (Sweden)

    Undine E. Lang

    2015-09-01

    Full Text Available Several nutrition, food and dietary compounds have been suggested to be involved in the onset and maintenance of depressive disorders and in the severity of depressive symptoms. Nutritional compounds might modulate depression associated biomarkers and parallel the development of depression, obesity and diabetes. In this context, recent studies revealed new mediators of both energy homeostasis and mood changes (i.e. IGF-1, NPY, BDNF, ghrelin, leptin, CCK, GLP-1, AGE, glucose metabolism and microbiota acting in gut brain circuits. In this context several healthy foods such as olive oil, fish, fruits, vegetables, nuts, legumes, poultry, dairy and unprocessed meat have been inversely associated with depression risk and even have been postulated to improve depressive symptoms. In contrast, unhealthy western dietary patterns including the consumption of sweetened beverage, refined food, fried food, processed meat, refined grain, and high fat diary, biscuits, snacking and pastries have been shown to be associated with an increased risk of depression in longitudinal studies. However, it is always difficult to conclude a real prospective causal relationship from these mostly retrospective studies as depressed individuals might also change their eating habits secondarily to their depression. Additionally specific selected nutritional compounds, e.g. calcium, chromium, folate, PUFAs, vitamin D, B12, zinc, magnesium and D-serine have been postulated to be used as ad-on strategies in antidepressant treatment. In this context, dietary and lifestyle interventions may be a desirable, effective, pragmatical and non-stigmatizing prevention and treatment strategy for depression. At last, several medications (pioglitazone, metformin, exenatide, atorvastatin, gram-negative antibiotics, which have traditionally been used to treat metabolic disorders showed a certain potential to treat depression in first randomized controlled clinical trials.

  2. Nutritional aspects of depression.

    Science.gov (United States)

    Lang, Undine E; Beglinger, Christoph; Schweinfurth, Nina; Walter, Marc; Borgwardt, Stefan

    2015-01-01

    Several nutrition, food and dietary compounds have been suggested to be involved in the onset and maintenance of depressive disorders and in the severity of depressive symptoms. Nutritional compounds might modulate depression associated biomarkers and parallel the development of depression, obesity and diabetes. In this context, recent studies revealed new mediators of both energy homeostasis and mood changes (i.e. IGF-1, NPY, BDNF, ghrelin, leptin, CCK, GLP-1, AGE, glucose metabolism and microbiota) acting in gut brain circuits. In this context several healthy foods such as olive oil, fish, fruits, vegetables, nuts, legumes, poultry, dairy and unprocessed meat have been inversely associated with depression risk and even have been postulated to improve depressive symptoms. In contrast, unhealthy western dietary patterns including the consumption of sweetened beverage, refined food, fried food, processed meat, refined grain, and high fat diary, biscuits, snacking and pastries have been shown to be associated with an increased risk of depression in longitudinal studies. However, it is always difficult to conclude a real prospective causal relationship from these mostly retrospective studies as depressed individuals might also change their eating habits secondarily to their depression. Additionally specific selected nutritional compounds, e.g. calcium, chromium, folate, PUFAs, vitamin D, B12, zinc, magnesium and D-serine have been postulated to be used as ad-on strategies in antidepressant treatment. In this context, dietary and lifestyle interventions may be a desirable, effective, pragmatical and non-stigmatizing prevention and treatment strategy for depression. At last, several medications (pioglitazone, metformin, exenatide, atorvastatin, gram-negative antibiotics), which have traditionally been used to treat metabolic disorders showed a certain potential to treat depression in first randomized controlled clinical trials.

  3. Negative attributional style, hopelessness depression and endogenous depression.

    Science.gov (United States)

    Joiner, T E

    2001-02-01

    The hopelessness theory of depression [Abramson, L. Y., Metalsky, G. I. & Alloy, L. B. (1989). Hopelessness depression: a theory-based subtype of depression. Psychological Review, 96, 358-372.] postulates that a negative attributional style represents a risk factor for a particular constellation of depressive symptoms, termed 'hopelessness depression'. Four studies tested the relation of negative attributional style to hopelessness depression symptoms versus endogenous depression symptoms. Despite the considerable overlap of hopelessness and endogenous depression symptoms, negative attributional style was more related to the former than the latter, consistent with hopelessness theory.

  4. Depression During and After Pregnancy

    Science.gov (United States)

    ... Depression during and after pregnancy fact sheet ePublications Depression during and after pregnancy fact sheet This information in Spanish (en español) Print this fact sheet Depression during and after pregnancy fact sheet (PDF, 260 ...

  5. Symptoms and Treatment of Depression

    Medline Plus

    Full Text Available ... 3 items) Institute Announcements (24 items) Symptoms and Treatment of Depression February 1, 2010 People with depression ... why it affects some people but not others. Treatments for depression do work. One type of effective ...

  6. St. John's Wort and Depression

    Science.gov (United States)

    ... W X Y Z St. John's Wort and Depression: In Depth Share: On This Page Introduction Key ... will help ensure coordinated and safe care. About Depression Depression is a medical condition that affects about ...

  7. Symptoms and Treatment of Depression

    Medline Plus

    Full Text Available ... 3 items) Institute Announcements (24 items) Symptoms and Treatment of Depression February 1, 2010 People with depression ... why it affects some people but not others. Treatments for depression do work. One type of effective ...

  8. Longitudinal Relationships of Religion with Posttreatment Depression Severity in Older Psychiatric Patients: Evidence of Direct and Indirect Effects

    Directory of Open Access Journals (Sweden)

    R. David Hayward

    2012-01-01

    Full Text Available Psychiatric patients (age 59+ were assessed before study treatment for major depressive disorder, and again after 3 months. Measures taken before study treatment included facets of religiousness (subjective religiosity, private prayer, worship attendance, and religious media use, social support, and perceived stress. Clinician-rated depression severity was assessed both before and after treatment using the Montgomery-Åsberg Depression Rating Scale (MADRS. Structural equation modeling was used to test a path model of direct and indirect effects of religious factors via psychosocial pathways. Subjective religiousness was directly related to worse initial MADRS, but indirectly related to better posttreatment MADRS via the pathway of more private prayer. Worship attendance was directly related to better initial MADRS, and indirectly related to better post-treatment MADRS via pathways of lower stress, more social support, and more private prayer. Private prayer was directly related to better post-treatment MADRS. Religious media use was related to more private prayer, but had no direct relationship with MADRS.

  9. Longitudinal relationships of religion with posttreatment depression severity in older psychiatric patients: evidence of direct and indirect effects.

    Science.gov (United States)

    Hayward, R David; Owen, Amy D; Koenig, Harold G; Steffens, David C; Payne, Martha E

    2012-01-01

    Psychiatric patients (age 59+) were assessed before study treatment for major depressive disorder, and again after 3 months. Measures taken before study treatment included facets of religiousness (subjective religiosity, private prayer, worship attendance, and religious media use), social support, and perceived stress. Clinician-rated depression severity was assessed both before and after treatment using the Montgomery-Åsberg Depression Rating Scale (MADRS). Structural equation modeling was used to test a path model of direct and indirect effects of religious factors via psychosocial pathways. Subjective religiousness was directly related to worse initial MADRS, but indirectly related to better posttreatment MADRS via the pathway of more private prayer. Worship attendance was directly related to better initial MADRS, and indirectly related to better post-treatment MADRS via pathways of lower stress, more social support, and more private prayer. Private prayer was directly related to better post-treatment MADRS. Religious media use was related to more private prayer, but had no direct relationship with MADRS.

  10. Testosterone and Depression

    Directory of Open Access Journals (Sweden)

    Şükrü Kartalcı

    2010-12-01

    Full Text Available Androgens have various effects on human body and mood. Testosterone, a hormone mainly secreted from testes and adrenals, is one of the most potent androgens. Multiple studies have found that testosterone plays a role in regulating sexual activity, libido, social behaviors, aggression, cognitive functions, sleep control and well-being in men and women. Testosterone deficiency in hypogonadic or elderly men leads to neuropsychiatric problems, such as fatigue, loss of libido, irritability, insomnia and depressive mood. Testosterone replacement therapy consistently reverses these sequel in men. On the other hand, hyperandrogenic states in women are related to aggression and antisocial behavior, which might lead to depressive mood. Low testosterone levels may also result in depression among oophorectomized women. Because of such effects, a relationship between testosterone and depression has long been an issue of speculation, but yet very few studies have addressed this relation. Along with clinical studies, experimental and epidemiological studies show that testosterone is related to depression in men and women. But studies of testosterone concentrations in depression have yielded inconsistent results reporting low as well as high testosterone levels associated with depression. In this article, the physiological and psychological effects of testosterone and evidence regarding its relationship to depressive disorders and possible gender differences have been reviewed.

  11. Depression in older adults.

    Science.gov (United States)

    Fiske, Amy; Wetherell, Julie Loebach; Gatz, Margaret

    2009-01-01

    Depression is less prevalent among older adults than among younger adults, but it can have serious consequences. More than half of cases represent a first onset in later life. Although suicide rates in the elderly are declining, they are still higher than in younger adults and are more closely associated with depression. Depressed older adults are less likely to endorse affective symptoms and more likely to display cognitive changes, somatic symptoms, and loss of interest than are depressed younger adults. Risk factors leading to the development of late-life depression likely comprise complex interactions among genetic vulnerabilities, cognitive diathesis, age-associated neurobiological changes, and stressful events. Insomnia is an often overlooked risk factor for late-life depression. We suggest that a common pathway to depression in older adults, regardless of which predisposing risks are most prominent, may be curtailment of daily activities. Accompanying self-critical thinking may exacerbate and maintain a depressed state. Offsetting the increasing prevalence of certain risk factors in late life are age-related increases in psychological resilience. Other protective factors include higher education and socioeconomic status, engagement in valued activities, and religious or spiritual involvement. Treatments including behavioral therapy, cognitive-behavioral therapy, cognitive bibliotherapy, problem-solving therapy, brief psychodynamic therapy, and life review/reminiscence therapy are effective but are too infrequently used with older adults. Preventive interventions including education for individuals with chronic illness, behavioral activation, cognitive restructuring, problem-solving skills training, group support, and life review have also received support.

  12. Depression Begets Depression: Comparing the Predictive Utility of Depression and Anxiety Symptoms to Later Depression

    Science.gov (United States)

    Keenan, Kate; Feng, Xin; Hipwell, Alison; Klostermann, Susan

    2009-01-01

    Background: The high comorbidity between depressive and anxiety disorders, especially among females, has called into question the independence of these two symptom groups. It is possible that childhood anxiety typically precedes depression in girls. Comparing of the predictive utility of symptoms of anxiety with the predictive utility of symptoms…

  13. [Hashimoto encephalitis and depression].

    Science.gov (United States)

    Veltman, E M; Rhebergen, D; van Exel, E; Stek, M L

    2015-01-01

    Hashimoto encephalitis (he) is an auto-immune disease, with 40-50% of patients developing psychopathology. This could require targeted treatment. HE and prednison could both cloud the identification of a concurrent depressive disorder. We saw a 78-year-old woman with he and a severe depression, and treated her succesfully with ect.

  14. Depression (For Teens)

    Science.gov (United States)

    ... these simple actions. They can have a powerful effect on mood and help with depression: eat healthy foods get the right amount of ... dance, and find creative self-expression through art, music, or journaling. ... and well-being. Depression can be treated if you take the right ...

  15. Sleep deprivation and depression

    NARCIS (Netherlands)

    Elsenga, Simon

    1992-01-01

    The association between depression and sleep disturbances is perhaps as old as makind. In view of the longstanding experience with this association it is amazing that only some 20 years ago, a few depressed patients attracted attention to the fact that Total Sleep Deprivation (TSD) had

  16. Sleep deprivation and depression

    NARCIS (Netherlands)

    Elsenga, Simon

    1992-01-01

    The association between depression and sleep disturbances is perhaps as old as makind. In view of the longstanding experience with this association it is amazing that only some 20 years ago, a few depressed patients attracted attention to the fact that Total Sleep Deprivation (TSD) had antidepressan

  17. CIRCADIAN RHYTMICITY AND DEPRESSION

    Directory of Open Access Journals (Sweden)

    Peter Pregelj

    2008-11-01

    There is a grooving evidence that dysfunction in circadian rhythm regulation andmelatonergic system function is involved in depression pathogenesis. It is known thatclinically used antidepressants have influence on melatonergic system, probably throughchanged ratio between melatonergic type 1 and 2 receptors. With the clinical use of newcompounds like agomelatine that directly regulates melatonergic system new opportunities in depression treatment emerged

  18. Depression - older adults

    Science.gov (United States)

    ... slowly than in younger adults. To better manage depression at home: Exercise regularly, if the provider says it is OK. Surround yourself with caring, positive people and do fun activities. ... signs of depression, and know how to react if these occur. ...

  19. Depression and ionizing radiation.

    Science.gov (United States)

    Loganovsky, K N; Vasilenko, Z L

    2013-01-01

    The objective of this at issue paper is the analysis of published data in correlation with the results of own research on the potential role of ionizing radiation in the genesis of depressive disorders. Depression is one of the most significant and long-term effect of the atomic bombings, nuclear testing and radiation emergences. The participants of the accident at the Chornobyl nuclear power plant increased prevalence of depression (18.0% and 13.1% in controls) and suicide rates. Depression is mainly observed in the structure of an organic mental disorder against cerebrovascular disease. The clinical pattern is dominated by asthenoadynamic and asthenoapathetic depression. Depressive disorders in radiation emergencies are multifactorial, that is the result of exposure to the complex psychogenic and radiological accident's factors, impact of traditional risk factors, somatic and neurological diseases, genetic predisposition, predisposition, etc. At the same time, exposure to ionizing radiation is a factor in the genesis of depression. This impact can be direct (to the Central Nervous System), and indirectly through the somatic and neurological abnormalities (multiorgan dysfunction) as well as by a variety of pathogenic mechanisms of ionizing radiation on the brain that have been discovered recently. It is strongly necessary analytical clinical and epidemiological studies with verification of depression and evidence-based establishment of the role of radiation and non-radiation risk factors. Loganovskyj K. N., Vasylenko Z. L., 2013.

  20. Cooperation and depressive symptoms.

    Science.gov (United States)

    Brendan Clark, C; Thorne, Christopher B; Hardy, Sonya; Cropsey, Karen L

    2013-09-25

    Deficits in pro-social cooperation are common in many individuals with mental illnesses such as depression. For decades, researchers have used economic game paradigms to compare cross-cultural cooperative behavior. However, research using economic games to assess cooperative behavior in clinical populations is in the early stages. We hypothesized that individuals with greater depressive symptoms would struggle to maintain reciprocity in iterative games, but not in single-iteration games measuring personal values. Participants (n=41) played four computer-based economic games (prisoner's dilemma, the public goods game, the ultimatum game, and the trust game) measuring different aspects of cooperation. Participants completed the Depression Anxiety and Stress Scale (DASS) and other measures of personality and demographics. Analyses assessed the relationships between game performance and psychological distress as measured by the DASS. Significant correlations were found between game performance and depressive symptoms, but not symptoms of anxiety or stress. Performance in the prisoner's dilemma and public goods game was significantly related to depression in a linear regression even when known associations with depressive affect such as age, gender, race, education, marital status, and neuroticism were controlled for. Depressive symptoms were associated with an inability to sustain reciprocal cooperation. Participants showed the predicted deficits in cooperation in these economic games. Economic games show the potential for assessing the social deficits associated with depressive symptoms. © 2013 Elsevier B.V. All rights reserved.

  1. Adolescent depression: a metasynthesis.

    Science.gov (United States)

    Dundon, Edith Emma

    2006-01-01

    Concerns about the adequate assessment and treatment of adolescent depression have been in the forefront of pediatric mental health literature in the recent past. While quantitative studies have provided valuable information, the voice of the adolescent has been lacking in the development of theory and treatment of this prevalent disorder. Using approach, a metasynthesis of six qualitative studies was conducted. This process revealed six themes that outline the course of adolescents who struggle with depression: (a) beyond the blues, (b) spiraling down and within, (c) breaking points, (d) seeing and being seen, (e) seeking solutions, and (f) taking control. Knowledge of the experience of adolescent depression will aid practitioners in recognition and early intervention for the increasing number of adolescents suffering with depression, as well as guide educational initiatives to provide needed information on the symptoms of depression and available resources for getting help.

  2. [Depression and suicide prevention].

    Science.gov (United States)

    Yamada, Mitsuhiko

    2007-09-01

    Suicide is a major public health problem and the number of suicide victims has exceeded 30,000 a year since 1998 in Japan. The rates of depression are extremely high in suicide victims. Social and environmental factors, such as the slow recovery of Japanese economy, could have a strong effect on depression and suicide, especially in middle-aged men. To reduce the number of suicide victims, we need to use both population-based and high-risk approaches, targeting individuals with high psychological and socioeconomic risks of suicide, especially depressed patients. On the other hand, the role of antidepressants in suicide prevention is a major question given the high prevalence of both depression and depression-related suicidality. Because treatment and prevention of suicide are complex and encompass many factors, success will need multi-sector collaboration.

  3. Depression following myocardial infarction

    DEFF Research Database (Denmark)

    Larsen, Karen Kjær

    2013-01-01

    Myocardial infarction (MI) is a severe life event that is accompanied by an increased risk of depression. Mounting evidence suggests that post-MI depression is associated with adverse outcomes, but the underlying mechanisms of this association remain unclear, and no previous studies have examined...... whether the mental burden of MI is so heavy that it increases the risk of suicide. Although post-MI depression is common and burdensome, the condition remains under-recognised and under-treated. The development of new strategies to improve the quality of care for people with post-MI depression requires...... thorough understanding of the mechanisms that influence the prognosis as well as knowledge of the present care provided. The purpose of this PhD thesis is accordingly subdivided into four specific aims: 1. To estimate the prevalence of depression in people with MI after three months, and to estimate...

  4. Measuring psychotic depression

    DEFF Research Database (Denmark)

    Østergaard, Søren Dinesen; Meyers, B S; Flint, A J

    2014-01-01

    OBJECTIVE: Psychotic depression (PD) is a highly debilitating condition, which needs intensive monitoring. However, there is no established rating scale for evaluating the severity of PD. The aim of this analysis was to assess the psychometric properties of established depression rating scales...... and a number of new composite rating scales, covering both depressive and psychotic symptoms, in relation to PD. METHOD: The psychometric properties of the rating scales were evaluated based on data from the Study of Pharmacotherapy of Psychotic Depression. RESULTS: A rating scale consisting of the 6-item......'s correlation coefficient between change in HAMD-BPRS11 and Clinical Global Impression - Improvement (CGI-I) scores = -0.74--0.78) and unidimensionality (Loevinger's coefficient of homogeneity = 0.41) in the evaluation of PD. The HAM-D6 fulfilled the same criteria, whereas the full 17-item Hamilton Depression...

  5. Depression and Political Participation*

    Science.gov (United States)

    Ojeda, Christopher

    2015-01-01

    In this paper, I propose that depression is a political phenomenon insofar as it has political sources and consequences. I then investigate one aspect of this argument—whether depression reduces participation. I hypothesize that individuals with depression lack the motivation and physical capacity to vote and engage in other forms of political participation due to somatic problems and feelings of hopelessness and apathy. Moreover, I examine how depression in adolescence can have downstream consequences for participation in young adulthood. The analyses, using both cross-sectional and longitudinal data, show that voter turnout and other forms of participation decrease as the severity of depressed mood increases. These findings are discussed in light of disability rights and potential efforts to boost participation among this group. PMID:26924857

  6. Depression and Political Participation.

    Science.gov (United States)

    Ojeda, Christopher

    2015-11-01

    In this paper, I propose that depression is a political phenomenon insofar as it has political sources and consequences. I then investigate one aspect of this argument-whether depression reduces participation. I hypothesize that individuals with depression lack the motivation and physical capacity to vote and engage in other forms of political participation due to somatic problems and feelings of hopelessness and apathy. Moreover, I examine how depression in adolescence can have downstream consequences for participation in young adulthood. The analyses, using both cross-sectional and longitudinal data, show that voter turnout and other forms of participation decrease as the severity of depressed mood increases. These findings are discussed in light of disability rights and potential efforts to boost participation among this group.

  7. [Severe depression : psychoanalysis].

    Science.gov (United States)

    Bouvet de la Maisonneuve, O

    2009-12-01

    The indication for psychoanalysis in severe depression is not clear. And yet, demands for this type of intervention are increasing, despite the absence of any form of consensus on the subject. Freud considered depression as a failure of analytical efforts and, based on this observation, revised his theory, in particular to include the notions of narcissism and the death drive. Many analysts have been reluctant to follow his teachings on this last point and provide depressed patients with analytical-type therapies aimed at restoring narcissism. Melanie Klein pushed Freud's ideas about depression even further and brought such therapies back to the heart of analytical practice. Jacques Lacan took the debate to another level by proposing an overhaul of the principles on which analysis has been based. Today, while following certain precautionary rules, true psychoanalyses can be proposed to patients with severe depression, whether of the bipolar, recurring or even neurotic type that can reach this level of severity.

  8. The noradrenaline metabolite MHPG is a candidate biomarker between the depressive, remission, and manic states in bipolar disorder I: two long-term naturalistic case reports

    Directory of Open Access Journals (Sweden)

    Kurita M

    2015-02-01

    Full Text Available Masatake Kurita,1–3 Satoshi Nishino,1,2 Yukio Numata,1 Yoshiro Okubo,3 Tadahiro Sato11Sato Hospital, Koutokukai, Nanyo, Yamagata, Japan; 2Department of Cellular Signaling, Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Miyagi, Japan; 3Department of Psychiatry and Behavioral Science, Graduate School of Medicine, Nippon Medical School, Bunkyo-ku, Tokyo, JapanBackground: Treatment of the depressive and manic states in bipolar disorder I (BDI is a challenge for psychiatrists. Despite the recognized importance of the switch phenomenon, the precise mechanisms underlying this process are yet to be shown. We conducted a naturalistic study in two BDI patients to determine whether biological markers (monoamine metabolites and brain-derived neurotrophic factor [BDNF] are associated with the switch between depressive and manic states.Case presentation and methods: Blood sampling and mood assessments were performed at 2-week intervals over a period of 2 (Case 1, n=72 and 6 (Case 2, n=183 years. Plasma concentrations of 3-methoxy-4-hydroxyphenylglycol (MHPG and homovanillic acid (HVA were analyzed by high-performance liquid chromatography with electrochemical detection. Plasma BDNF was assayed by sandwich ELISA (enzyme-linked immunosorbent assay.Results: MHPG had the highest standardized coefficient (β in the multiple regression analysis. We found a significant positive correlation between Young Mania Rating Scale scores and plasma MHPG levels (Case 1: р=0.429; Case 2: р=0.488, and a significant negative correlation between Montgomery–Asberg Depression Rating Scale scores and MHPG levels (Case 1: р=-0.542; Case 2: р=-0.465. Conversely, no significant correlation was found between the level of BDNF and the presence of a manic or depressive state, and although HVA had a slightly stronger correlation than MHPG, the levels of neither of these were found to significantly correlate with the symptoms.Conclusion: These data suggest

  9. Management of bipolar depression

    Directory of Open Access Journals (Sweden)

    Jae Seung Chang

    2011-01-01

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

  10. Borehole geophysical logging and aquifer-isolation tests conducted in well MG-1693 at North Penn Area 5 Superfund Site near Colmar, Montgomery County, Pennsylvania

    Science.gov (United States)

    Bird, Philip H.

    2006-01-01

    Borehole geophysical logging and aquifer-isolation (packer) tests were conducted in well MG-1693 (NP-87) at the North Penn Area 5 Superfund Site near Colmar, Montgomery County, Pa. Objectives of the study were to identify the depth and yield of water-bearing zones, occurrence of vertical borehole flow, and effects of pumping on water levels in nearby wells. Caliper, natural-gamma, single-point-resistance, fluid-temperature, fluid-resistivity, heatpulse-flowmeter, and borehole-video logs were collected. Vertical borehole-fluid movement direction and rate were measured under nonpumping conditions. The suite of logs was used to locate water-bearing fractures, determine zones of vertical borehole-fluid movement, and select depths to set packers. Aquifer-isolation tests were conducted to sample discrete intervals and to determine specific capacities of water-bearing zones and effects of pumping individual zones on water levels in two nearby monitor wells. Specific capacities of isolated zones during aquifer-isolation tests ranged from 0.03 to 3.09 (gal/min)/ft (gallons per minute per foot). Fractures identified by borehole geophysical methods as water-producing or water-receiving zones produced water when isolated and pumped. Water enters the borehole primarily through high-angle fractures at 416 to 435 ft bls (feet below land surface) and 129 to 136 ft bls. Water exits the borehole through a high-angle fracture at 104 to 107 ft bls, a broken casing joint at 82 ft bls, and sometimes as artesian flow through the top of the well. Thirteen intervals were selected for aquifer-isolation testing, using a straddle-packer assembly. The specific capacity of interval 1 was 2.09 (gal/min)/ft. The specific capacities of intervals 2, 3, and 4 were similar: 0.27, 0.30, and 0.29 (gal/min)/ft,respectively. The specific capacities of intervals 5, 6, 7, 8, and 10 were similar: 0.03, 0.04, 0.09, 0.09, and 0.04 (gal/min)/ft,respectively. Intervals 9, 11, and 12 each showed a strong

  11. The B-VITAGE trial: A randomized trial of homocysteine lowering treatment of depression in later life

    Directory of Open Access Journals (Sweden)

    van Bockxmeer Frank

    2010-01-01

    Full Text Available Abstract Background Depression is a leading cause of disability worldwide and depressive symptoms are common in later life. Observational evidence suggests that depression is more prevalent among people with high plasma homocysteine (tHcy, but the results of randomized trials to date have been unable to show that lowering tHcy through the supplementation of vitamins B6, B12 and folate benefits depressive symptoms. We designed the B-VITAGE trial to determine whether adjunctive treatment with vitamins B6, B12 and folate increases the efficacy of standard antidepressant treatment. Methods/Design The B-VITAGE trial is a 12-month randomized, double-blind, placebo-controlled trial of daily citalopram (20 to 40 mg plus B12(0.4 mg, B6 (25 mg and folic acid (2 mg or citalopram (20 to 40 mg plus placebo for the treatment of depression in later life. The trial aims to recruit over 300 older adults with major depression (DSM-IV and has been powered to detect the impact of an intervention associated with moderate effect size. Depressive symptoms will be rated with the Montgomery-Åsberg Depression Rating Scale (MADRS. The trial has two main outcomes of interest: a reduction of 50% or more in the MADRS total score between baseline and week 12 and the remission of the depressive episode at weeks 12, 26 and 52 according to DSM-IV criteria. We hypothesize that subjects randomly allocated to the vitamin arm of the study will be more likely to show a clinically significant improvement and achieve and maintain remission of symptoms at 12, 26 and 52 weeks. Secondary outcomes of interest include compliance with treatment, reduction in the severity of depressive symptoms, switching to different antidepressants, the use of non-pharmacological antidepressant treatments, response to treatment according to MTHFRC677T genotype, and changes in cognitive function over 52 weeks. Conclusions The results of this trial will clarify whether the systematic use of B

  12. Behandlingsresistent depression kan behandles

    DEFF Research Database (Denmark)

    Vinberg, Maj; Levinsen, Mette Frandsen; Kessing, Lars Vedel

    2011-01-01

    Depression is considered resistant when two treatment attempts with antidepressants from different classes fail to produce significant clinical improvement. In cases of treatment-resistant depression, it is recommended to reevaluate the diagnosis, clarify comorbidity, substance abuse and lack...... of compliance. Regarding treatment, evidence is sparse, but switching to a different antidepressant, and combination or augmentation with another agent, admission and treatment with ECT are the options. The choice of treatment must be based on the characteristics of the depression, the severity of treatment...

  13. Depression and erectile dysfunction.

    Science.gov (United States)

    Makhlouf, Antoine; Kparker, Ashay; Niederberger, Craig S

    2007-11-01

    Depression and erectile dysfunction (ED) clearly are associated. Although urologists and psychiatrists have long recognized that antidepressant medications affect erectile function negatively, the interplay between the two conditions remains underappreciated. Psychiatrists may be reluctant to question a patient in detail about ED, and urologists seldom perform a formal assessment of the presence of depression in patients who have ED. This article gives a quick overview of the relationship between these two conditions and provides the clinician with the knowledge required to effectively manage ED with comorbid depression.

  14. Neuroticism in remitted major depression

    DEFF Research Database (Denmark)

    Gade, Anders; Kristoffersen, Marius; Kessing, Lars Vedel

    2015-01-01

    BACKGROUND: The personality trait of neuroticism is strongly related to depression, but depression is etiologically heterogeneous. Late-onset depression (LOD) may be more closely related to vascular factors, and previous studies of neuroticism in LOD versus early-onset depression (EOD) have not b...

  15. Do You Have Major Depression?

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Depression Do You Have Major Depression? Past Issues / Fall 2009 Table of Contents Simple ... member may have major depression. —NIMH Types of Depression Just like other illnesses, such as heart disease, ...

  16. Vision in depressive disorder

    DEFF Research Database (Denmark)

    Bubl, E.; Tebartz Van Elst, L.; Ebert, D.

    2009-01-01

    Background. Reduced dopaminergic transmission has been implicated in the pathophysiology of major depression. Furthermore, dopaminergic neurotransmission plays an important role in the physiology of visual contrast sensitivity (CS). To test the hypothesis that altered dopaminergic neurotransmissi...

  17. Telomere length and depression

    DEFF Research Database (Denmark)

    Wium-Andersen, Marie Kim; Ørsted, David Dynnes; Rode, Line

    2016-01-01

    BACKGROUND: Depression has been cross-sectionally associated with short telomeres as a measure of biological age. However, the direction and nature of the association is currently unclear. AIMS: We examined whether short telomere length is associated with depression cross-sectionally as well...... as prospectively and genetically. METHOD: Telomere length and three polymorphisms, TERT, TERC and OBFC1, were measured in 67 306 individuals aged 20-100 years from the Danish general population and associated with register-based attendance at hospital for depression and purchase of antidepressant medication....... RESULTS: Attendance at hospital for depression was associated with short telomere length cross-sectionally, but not prospectively. Further, purchase of antidepressant medication was not associated with short telomere length cross-sectionally or prospectively. Mean follow-up was 7.6 years (range 0...

  18. Doxepin (Depression, Anxiety)

    Science.gov (United States)

    Doxepin is used to treat depression and anxiety. Doxepin is in a class of medications called tricyclic antidepressants. It works by increasing the amounts of certain natural substances in the brain ...

  19. [Depression and myocardial infaction].

    Science.gov (United States)

    Testuz, A

    2009-03-04

    Several works show an association between depression and the occurence of a first myocardial infarction. Depression after myocardial infarction seems to be a marker of poorer outcome, regardless of other risk factors or severity of the myocardial infarction. Dysautonomia and alteration of platelet activation are a few physiopathological changes shared by both affections, through which they might be related. Treatment of depression is not associated with better cardiovascular outcome, but selective serotonin reuptake inhibitors have been shown safe and efficient among patients with coronary heart disease. Cognitivo-comportemental approach and cardiovascular rehabilitation program after myocardial infarction also play a role in improving quality of life of the depressed patient with coronary heart disease.

  20. Depression (For Teens)

    Science.gov (United States)

    ... people overcome depression. Talk therapy works by helping people to: understand their emotions, put feelings into words, and feel understood and supported build the confidence to deal with life's struggles work out problems ...

  1. Depression in Older Adults

    Science.gov (United States)

    ... the Printable Report Election Year: Mental Health and Politics Glossary and Citations Prevalence Data Ranking Guidelines Ranking ... Mental Health. “The Many Dimensions of Depression in Women: Women at Risk,” Accessed June 1999. Netscape: http:// ...

  2. The psychoneuroimmunology of depression.

    Science.gov (United States)

    Leonard, Brian E; Myint, Ayemu

    2009-04-01

    Chronic stress, by initiating changes in the hypothalamic-pituitary-adrenal (HPA) axis and the immune system, acts as a trigger for anxiety and depression. There is experimental and clinical evidence that the rise in the concentration of pro-inflammatory cytokines and glucocorticoids, which occurs in a chronically stressful situation and also in depression, contribute to the behavioural changes associated with depression. A defect in serotonergic function is associated with these hormonal and immune changes. Neurodegenerative changes in the hippocampus, prefrontal cortex and amygdalae are the frequent outcome of the changes in the HPA axis and the immune system. Such changes may provide evidence for the link between chronic depression and dementia in later life.

  3. Depression and codependency in women.

    Science.gov (United States)

    Hughes-Hammer, C; Martsolf, D S; Zeller, R A

    1998-12-01

    Seven million American women are depressed, and 40 million Americans, primarily women, have been labeled as codependent. This study aimed to identify the prevalence of codependency in women undergoing treatment for depression, examine the relationship between codependency and depression, and determine which of the symptoms of codependency are most highly predictive of depression scores. Depression and codependency were measured in a sample of 105 depressed women by using the Beck Depression Inventory and the Codependency Assessment Tool. Descriptive statistics, Pearson's Product Moment Correlation, and multiple regression were used for analysis. Of these depressed women, 36% were moderately to severely codependent. Depression and codependency were strongly related, with the significant gamma = .92 (P codependency subscales, Low Self-Worth and Hiding Self correlate most strongly with depression; Other Focus/Self-Neglect added the least-independent--explanatory power. Thus, future research should be directed toward the relationship of codependency to power, alienation of self, and personality disorders.

  4. Identifying Depression on Twitter

    OpenAIRE

    Nadeem, Moin

    2016-01-01

    Social media has recently emerged as a premier method to disseminate information online. Through these online networks, tens of millions of individuals communicate their thoughts, personal experiences, and social ideals. We therefore explore the potential of social media to predict, even prior to onset, Major Depressive Disorder (MDD) in online personas. We employ a crowdsourced method to compile a list of Twitter users who profess to being diagnosed with depression. Using up to a year of pri...

  5. Anxiety, depression, and insomnia.

    Science.gov (United States)

    Larzelere, Michele M; Wiseman, Pamela

    2002-06-01

    Evidence for alternative treatments for depression, anxiety, and insomnia are reviewed in this article. Treatment of depression with St. John's wort, L-tryptophan, 5-hydroxytryptophan, S-adenosylmethionine, dehydroepiandosterone, folate, exercise, acupuncture, and meditation are examined. Evidence for the efficacy of kava kava, exercise, relaxation therapies, and acupuncture in treatment anxiety is reviewed. The use of valerian, melatonin, chamomile, passionflower, exercise, acupuncture, and behavioral therapies (i.e., sleep restriction, stimulus control, relaxation, and sleep hygiene) for insomnia is discussed.

  6. [Depression in the workplace].

    Science.gov (United States)

    Mezerai, Mustapha; Dahane, Abdelkrim; Tachon, Jean-Paul

    2006-05-01

    Depression is the object of a dense literature, and synthesizing it is more of a utopian ideal rather than a concrete possibility. Several specific risk factors for mental health are found in the workplace: work overloads, defective communications, role conflicts, competitive climate, and tolerance of violence. At the same time, few preventive measures have been implemented against mental disorders at work, nor are many protective factors present. One worker in ten suffers from depression, anxiety, stress, or overwork. To be distinguished from "burnout", depressive symptoms must induce clinically significant suffering with substantial deterioration in functioning at work. For depression to be recognized as a workplace accident, the employee must show that it was triggered by an unforeseen and sudden event (or at least one certainly) due to or at work. The causal link between an event at work and the depression must be shown (in particular by expert medical testimony about stress factors and indicators of vulnerability to depression). Its recognition as an occupational disease can be based on the presence of psychosocial factors described by models of workplace stress and on its description by the occupational physician.

  7. Depression and Coronary Heart Disease

    OpenAIRE

    2012-01-01

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

  8. Quality of life, problem solving, focus of control and anger tendency in the patients with acne

    Directory of Open Access Journals (Sweden)

    Erman Bağcıoğlu

    2014-12-01

    Full Text Available Background and Design: In this study, we evaluated anxiety and depression levels, levels of problem solving, focus of control, tendency to anger and quality of life in patients with acne as well as the association between those parameters and the clinical features of acne. Materials and Methods: Fifty-two patients with mild to severe acne vulgaris and 46 healthy controls were enrolled. Acne severity was graded in all patients by a dermatologist. The Montgomery-Asberg Depression Rating Scale (MADRS, Hamilton Anxiety Rating Scale (HAM-A, Brief Symptom Inventory (BSI, Problem Solving Inventory (PSI, The State-Trait Anger Scale (STAS, Rotter’s Internal-External Focus of Control Scale (RIELCS and the Short Form 36-Item Health Survey (SF-36 were applied to all participants. Results: In our study, we found out that anxiety and depression scores were significantly higher in patients with acne vulgaris than in controls. In BSI, anxiety disorders, depression, interpersonal sensitivity, and paranoid thoughts scores were significantly higher in patients with acne than in controls. According to SF-36, physical role difficulty, general health and mental health scores were significantly lower in patients with acne. Conclusion: The results of our study support the previous findings suggesting that acne vulgaris leads to various psychiatric problems, such as depression and anxiety and, adversely affects quality of life of patients.

  9. Lurasidone for major depressive disorder with mixed features and irritability: a post-hoc analysis.

    Science.gov (United States)

    Swann, Alan C; Fava, Maurizio; Tsai, Joyce; Mao, Yongcai; Pikalov, Andrei; Loebel, Antony

    2017-04-01

    The aim of this post-hoc analysis was to evaluate the efficacy of lurasidone in treating major depressive disorder (MDD) with mixed features including irritability. The data in this analysis were derived from a study of patients meeting DSM-IV-TR criteria for unipolar MDD, with a Montgomery-Åsberg Depression Rating Scale (MADRS) total score ≥26, presenting with two or three protocol-defined manic symptoms, and who were randomized to 6 weeks of double-blind treatment with either lurasidone 20-60 mg/d (n=109) or placebo (n=100). We defined "irritability" as a score ≥2 on both the Young Mania Rating Scale (YMRS) irritability item (#5) and the disruptive-aggressive item (#9). Endpoint change in the MADRS and YMRS items 5 and 9 were analyzed using a mixed model for repeated measures for patients with and without irritability. Some 20.7% of patients met the criteria for irritability. Treatment with lurasidone was associated with a significant week 6 change vs. placebo in MADRS score in both patients with (-22.6 vs. -9.5, ptreatment with lurasidone was associated with significant week 6 changes vs. placebo in both the YMRS irritability item (-1.4 vs. -0.3, p=0.0012, ES=1.0) and the YMRS disruptive-aggressive item (-1.0 vs. -0.3, p=0.0002, ES=1.2). In our post-hoc analysis of a randomized, placebo-controlled, 6-week trial, treatment with lurasidone significantly improved depressive symptoms in MDD patients with mixed features including irritability. In addition, irritability symptoms significantly improved in patients treated with lurasidone.

  10. Efficacy of desvenlafaxine 50 mg compared with placebo in patients with moderate or severe major depressive disorder: a pooled analysis of six randomized, double-blind, placebo-controlled studies.

    Science.gov (United States)

    Papakostas, George I; Culpepper, Larry; Fayyad, Rana S; Musgnung, Jeff; Guico-Pabia, Christine J

    2013-11-01

    This study assessed the efficacy of desvenlafaxine 50 mg/day compared with placebo for treating moderate or severe major depressive disorder (MDD). Data were pooled from six double-blind, placebo-controlled, desvenlafaxine 50 mg/day fixed-dose studies in adults with MDD. The primary endpoint was improvement in 17-item Hamilton Rating Scale for Depression (HAM-D17) scores from baseline at week 8. HAM-D17 changes were evaluated in patients with moderate (18desvenlafaxine 50 mg, n=1150; placebo, n=1039). Of those, 694 (32%) patients had severe depression at baseline. Desvenlafaxine improved HAM-D17 scores versus placebo in patients with either moderate [desvenlafaxine, adjusted mean (±SE), -10.26±0.24; placebo, -8.87±0.26; Pdesvenlafaxine, -11.91±0.40; placebo, -9.85±0.42; Pdesvenlafaxine treatment compared with placebo (all P's≤0.029). Results were similar when baseline severity was defined by Montgomery-Åsberg Depression Rating Scale or Sheehan Disability Scale scores. Desvenlafaxine 50 mg/day significantly improved depressive symptoms regardless of severity at baseline and was effective in treating both moderate and severe MDD.

  11. Rapid response to methylphenidate as an add-on therapy to mirtazapine in the treatment of major depressive disorder in terminally ill cancer patients: a four-week, randomized, double-blinded, placebo-controlled study.

    Science.gov (United States)

    Ng, Chong Guan; Boks, Marco P M; Roes, Kit C B; Zainal, Nor Zuraida; Sulaiman, Ahmad Hatim; Tan, Seng Beng; de Wit, Niek J

    2014-04-01

    This is a 4 week, randomized, double-blind, placebo-controlled study to examine the effects of methylphenidate as add-on therapy to mirtazapine compared to placebo for treatment of depression in terminally ill cancer patients. It involved 88 terminally ill cancer patients from University of Malaya Medical Centre, Kuala Lumpur, Malaysia. They were randomized and treated with either methylphenidate or placebo as add on to mirtazapine. The change in Montgomery-Åsberg Depression Rating Scale (MADRS) score from baseline to day 3 was analyzed by linear regression. Changes of MADRS and Clinical Global Impression-Severity Scale (CGI-S) over 28 days were analyzed using mixed model repeated measures (MMRM). Secondary analysis of MADRS response rates, defined as 50% or more reduction from baseline score. A significantly larger reduction of Montgomery-Åsberg Depression Rating Scale (MADRS) score in the methylphenidate group was observed from day 3 (B=4.14; 95% CI=1.83-6.45). Response rate (defined as 50% or more reduction from baseline MADRS score) in the methylphenidate treated group was superior from day 14. Improvement in Clinical Global Impression-Severity Scale (CGI-S) was greater in the methylphenidate treated group from day 3 until day 28. The drop-out rates were 52.3% in the methylphenidate group and 59.1% in the placebo group (relative risk=0.86, 95%CI=0.54-1.37) due to cancer progression. Nervous system adverse events were more common in methylphenidate treated subjects (20.5% vs 9.1%, p=0.13). In conclusions, methylphenidate as add on therapy to mirtazapine demonstrated an earlier antidepressant response in terminally ill cancer patients, although at an increased risk of the nervous system side effects.

  12. Lifestyle medicine for depression.

    Science.gov (United States)

    Sarris, Jerome; O'Neil, Adrienne; Coulson, Carolyn E; Schweitzer, Isaac; Berk, Michael

    2014-04-10

    The prevalence of depression appears to have increased over the past three decades. While this may be an artefact of diagnostic practices, it is likely that there are factors about modernity that are contributing to this rise. There is now compelling evidence that a range of lifestyle factors are involved in the pathogenesis of depression. Many of these factors can potentially be modified, yet they receive little consideration in the contemporary treatment of depression, where medication and psychological intervention remain the first line treatments. "Lifestyle Medicine" provides a nexus between public health promotion and clinical treatments, involving the application of environmental, behavioural, and psychological principles to enhance physical and mental wellbeing. This may also provide opportunities for general health promotion and potential prevention of depression. In this paper we provide a narrative discussion of the major components of Lifestyle Medicine, consisting of the evidence-based adoption of physical activity or exercise, dietary modification, adequate relaxation/sleep and social interaction, use of mindfulness-based meditation techniques, and the reduction of recreational substances such as nicotine, drugs, and alcohol. We also discuss other potential lifestyle factors that have a more nascent evidence base, such as environmental issues (e.g. urbanisation, and exposure to air, water, noise, and chemical pollution), and the increasing human interface with technology. Clinical considerations are also outlined. While data supports that some of these individual elements are modifiers of overall mental health, and in many cases depression, rigorous research needs to address the long-term application of Lifestyle Medicine for depression prevention and management. Critically, studies exploring lifestyle modification involving multiple lifestyle elements are needed. While the judicious use of medication and psychological techniques are still advocated

  13. Poststroke depression: Diagnosis of depression, phenomenology and specificity of depressive symptoms

    Directory of Open Access Journals (Sweden)

    Rabi-Žikić Tamara

    2009-01-01

    Full Text Available The diagnosis of depression. Depressive disorder is nowadays diagnosed by the two widely used diagnostic systems - International Classification of Diseases of the World Health Organization, 10th revision and the Diagnostic and Statistical Manual Criteria of the American Psychiatric Organisation, 4th edition. The criteria for depressive disorder used in these two systems are almost identical. Poststroke depression. The diagnosis of depression may be difficult to establish in stroke patients, especially in patients with aphasia/dysphasia, anosognosia and other cognitive dysfunction. Major vs. minor poststroke depression, specificity and sensitivity of depressive symptoms: The phenomenology of major poststroke depression has been found to be similar to that of primary depression, and it appears that minor and major are not stages of the same continuum, but rather separate entities. Contrary to common opinion, non specific somatic symptoms do not hinder the diagnosis of poststroke depression and can be highly discriminative and crucial in the evaluation of poststroke depression. Validity of the poststroke depression diagnosis Studies have shown that a valid diagnosis of poststroke depression may be established successfully using structured or semi-structured neuropsychiatric interviews, according to the current Diagnostic and Statistical Manual Criteria. Conclusion. It appears that no new diagnostic tools specific for major depression in stroke patients are necessary. The existing diagnostic procedures will fail to diagnose or misdiagnose depression only in few stroke patients.

  14. Cost-effectiveness of lurasidone vs quetiapine extended-release (XR) in patients with bipolar depression.

    Science.gov (United States)

    Rajagopalan, Krithika; Meyer, Kellie; O'Day, Ken; Denno, Melissa; Loebel, Antony

    2015-01-01

    Bipolar disorder imposes a high economic burden on patients and society. Lurasidone and quetiapine extended-release (XR) are atypical antipsychotic agents indicated for monotherapy treatment of bipolar depression. Lurasidone is also indicated as adjunctive therapy with lithium or valproate for depressive episodes associated with bipolar disorder. The objective of this analysis was to estimate the cost-effectiveness of lurasidone and quetiapine XR in patients with bipolar depression. A cost-effectiveness model was developed to compare lurasidone to quetiapine XR. The model was based on a US third-party payer perspective over a 3-month time horizon. The effectiveness measure in the model was the percentage of patients achieving remission (Montgomery-Åsberg Depression Rating Scale [MADRS] total score ≤12 by weeks 6-8). The comparison of remission rates was made through an adjusted indirect treatment comparison of lurasidone and quetiapine XR pivotal trials using placebo as the common comparator. Resource utilization for remission vs no remission was estimated from published expert panel data, and resource costs were obtained from a retrospective database study of bipolar I depression patients. Drug costs were estimated using the mean dose from clinical trials and wholesale acquisition costs. Over the 3-month model time period, lurasidone and quetiapine XR patients, respectively, had similar mean numbers of emergency department visits (0.48 vs 0.50), inpatient days (2.1 vs 2.2), and office visits (9.3 vs 9.6). More lurasidone than quetiapine XR patients achieved remission (52.0% vs 43.2%) with slightly higher total costs ($4982 vs $4676), resulting in an incremental cost-effectiveness ratio of $3474 per remission. The probabilistic sensitivity analysis showed lurasidone had an 86% probability of being cost-effective compared to quetiapine XR at a willingness-to-pay threshold of $10,000 per remission. Lurasidone may be a cost-effective option when compared to

  15. Postpartum Blues and Postpartum Depression

    Directory of Open Access Journals (Sweden)

    Erdem Ö et al.

    2009-09-01

    Full Text Available Postpartum blues which is seen during the postpartum period is a transient psychological state. Most of the mothers experience maternity blues in postpartum period. It remains usually unrecognized by the others. Some sensitive families can misattribute these feelings as depression. In this article, we tried to review the characteristics of maternity blues and its differences from depression. We defined depression and presented the incidence and diagnostic criteria, of major depression as well as the risk factors and clinic findings of postpartum depression. Thus, especially at primary care we aimed to prevent misdiagnosis of both maternity blues and depression

  16. Depressive realism: effects of depression severity and interpretation time.

    Science.gov (United States)

    McKendree-Smith, N; Scogin, F

    2000-12-01

    This study examined the theory of depressive realism, which posits that depressed people often are more accurate in perceptions and judgments than nondepressed people. Two possible qualifications to this theory were examined: (1) severity of depression moderates the effect, and (2) length of processing time will impact the presence of bias in depressed people, that is, negative bias will develop over time. College students were presented with a bogus personality profile that actually consisted of items previously rated as neutral in desirability. Participants rated these profiles for desirability initially and then again three days later. Results indicated a significant effect of depression severity on desirability rating. Nondepressed and mildly depressed students found their profiles to be more positive than the moderately/severely depressed students, with both groups having scores in the positive range. However, those participants who were moderately/severely depressed showed a negative bias in their ratings. No support was found for the effect of different times of interpretation.

  17. Risk factors for antenatal depression, postnatal depression and parenting stress

    Directory of Open Access Journals (Sweden)

    Milgrom Jeannette

    2008-04-01

    Full Text Available Abstract Background Given that the prevalence of antenatal and postnatal depression is high, with estimates around 13%, and the consequences serious, efforts have been made to identify risk factors to assist in prevention, identification and treatment. Most risk factors associated with postnatal depression have been well researched, whereas predictors of antenatal depression have been less researched. Risk factors associated with early parenting stress have not been widely researched, despite the strong link with depression. The aim of this study was to further elucidate which of some previously identified risk factors are most predictive of three outcome measures: antenatal depression, postnatal depression and parenting stress and to examine the relationship between them. Methods Primipara and multiparae women were recruited antenatally from two major hoitals as part of the beyondblue National Postnatal Depression Program 1. In this subsidiary study, 367 women completed an additional large battery of validated questionnaires to identify risk factors in the antenatal period at 26–32 weeks gestation. A subsample of these women (N = 161 also completed questionnaires at 10–12 weeks postnatally. Depression level was measured by the Beck Depression Inventory (BDI. Results Regression analyses identified significant risk factors for the three outcome measures. (1. Significant predictors for antenatal depression: low self-esteem, antenatal anxiety, low social support, negative cognitive style, major life events, low income and history of abuse. (2. Significant predictors for postnatal depression: antenatal depression and a history of depression while also controlling for concurrent parenting stress, which was a significant variable. Antenatal depression was identified as a mediator between seven of the risk factors and postnatal depression. (3. Postnatal depression was the only significant predictor for parenting stress and also acted as a mediator

  18. Risk factors for antenatal depression, postnatal depression and parenting stress.

    Science.gov (United States)

    Leigh, Bronwyn; Milgrom, Jeannette

    2008-04-16

    Given that the prevalence of antenatal and postnatal depression is high, with estimates around 13%, and the consequences serious, efforts have been made to identify risk factors to assist in prevention, identification and treatment. Most risk factors associated with postnatal depression have been well researched, whereas predictors of antenatal depression have been less researched. Risk factors associated with early parenting stress have not been widely researched, despite the strong link with depression. The aim of this study was to further elucidate which of some previously identified risk factors are most predictive of three outcome measures: antenatal depression, postnatal depression and parenting stress and to examine the relationship between them. Primipara and multiparae women were recruited antenatally from two major hoitals as part of the beyondblue National Postnatal Depression Program 1. In this subsidiary study, 367 women completed an additional large battery of validated questionnaires to identify risk factors in the antenatal period at 26-32 weeks gestation. A subsample of these women (N = 161) also completed questionnaires at 10-12 weeks postnatally. Depression level was measured by the Beck Depression Inventory (BDI). Regression analyses identified significant risk factors for the three outcome measures. (1). Significant predictors for antenatal depression: low self-esteem, antenatal anxiety, low social support, negative cognitive style, major life events, low income and history of abuse. (2). Significant predictors for postnatal depression: antenatal depression and a history of depression while also controlling for concurrent parenting stress, which was a significant variable. Antenatal depression was identified as a mediator between seven of the risk factors and postnatal depression. (3). Postnatal depression was the only significant predictor for parenting stress and also acted as a mediator for other risk factors. Risk factor profiles for

  19. STUDY OF DEPRESSION IN SCHIZOPHRENIA

    Directory of Open Access Journals (Sweden)

    Dharmesh V

    2014-06-01

    Full Text Available : BACKGROUND: The presence of depression in schizophrenia has been recognized since the time of Kraepelin and Bleuler. Depressive symptoms associated with schizophrenia have received considerable attention in recent years. It has been suggested that patient may manifest depressive symptoms during the onset of psychotic symptoms, during course of chronic schizophrenia or after the psychotic symptoms has been abated. AIMS & OBJECTIVES: 1. To study the prevalence of depression in schizophrenia. 2. To study the correlation between depression and subtype of schizophrenia. MATERALS & METHODS: 50 consecutive patients suffering from schizophrenia according to DSM-IV criteria, who were brought to psychiatric OPD were selected for this study. Patients between 15-55years age were included in this study. HDRS (Hamilton depression rating scale was administered to all patients to assess severity of depression. RESULTS: Out of 50 patients suffering from schizophrenia, 44% of patients suffering from schizophrenia were depressed. In this study the most common symptoms of depression were depressed mood, loss of interest on pleasure, sleep disturbance, loss of energy/fatigue, psychomotor disturbance, suicidal thought or death wish, feeling of hopelessness. CONCLUSION: Depression is common in patients suffering from schizophrenia. The severity of depression was mild to moderate, no one had severe depression. It is more common in patients who are living in nuclear family, who are divorced, who have paranoid type of schizophrenia, who were not on antipsychotic medicine.

  20. Hopelessness, Depression, Suicidal Ideation, and Clinical Diagnosis of Depression.

    Science.gov (United States)

    Beck, Aaron T.; And Others

    1993-01-01

    Examined relevance of clinical diagnosis of depression for explaining discrepant relationships of hopelessness and depression with suicidal ideation. Administered Beck Depression Inventory, Hopelessness Scale, and Scale for Suicide Ideation to 1,306 patients with mood disorder and 488 patients without mood disorder. Found that hopelessness was 1.3…

  1. Symptoms and Treatment of Depression

    Medline Plus

    Full Text Available ... Opportunities & Announcements Funding Strategy for Grants Application Process Managing Grants Clinical Research Training Labs at NIMH Labs ... Symptoms and Treatment of Depression February 1, 2010 People with depression discuss how they got help. & ...

  2. Symptoms and Treatment of Depression

    Medline Plus

    Full Text Available ... Autism (13 items) Bipolar Disorder (2 items) Borderline Personality Disorder (3 items) Depression (28 items) Eating Disorders ( ... Autism (13 items) Bipolar Disorder (2 items) Borderline Personality Disorder (3 items) Depression (28 items) Eating Disorders ( ...

  3. Major depression with psychotic features

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000933.htm Major depression with psychotic features To use the sharing features on this page, please enable JavaScript. Major depression with psychotic features is a mental disorder in ...

  4. Symptoms and Treatment of Depression

    Medline Plus

    Full Text Available ... why. Scientists at the National Institute of Mental Health are studying brain images of people who suffer from depression trying to learn why it affects some people but not others. Treatments for depression ...

  5. Symptoms and Treatment of Depression

    Medline Plus

    Full Text Available ... suffer from depression trying to learn why it affects some people but not others. Treatments for depression do work. One type of effective psychotherapy is called cognitive behavioral therapy or CBT. ...

  6. Symptoms and Treatment of Depression

    Medline Plus

    Full Text Available ... a serious illness that affects many people. Symptoms can vary, but many depressed people lose interest in ... lot of weight. NARRATOR : A person with depression can feel irritable and restless, and have sleep problems. ...

  7. Executive Dysfunction in Geriatric Depression

    National Research Council Canada - National Science Library

    Lockwood, Kathryn A; Alexopoulos, George S; van Gorp, Wilfred G

    2002-01-01

    OBJECTIVE: The purpose of this study was to characterize the neuropsychological presentation of geriatric depression and to determine whether depression-related executive dysfunction is more pronounced during advanced age. METHOD...

  8. Facebook Bullying Can Cause Depression

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_160991.html Facebook Bullying Can Cause Depression Social media attacks have ' ... Sept. 15, 2016 (HealthDay News) -- Negative experiences on Facebook can increase the odds of depression in young ...

  9. Self-compassion in depression: associations with depressive symptoms, rumination, and avoidance in depressed outpatients.

    Science.gov (United States)

    Krieger, Tobias; Altenstein, David; Baettig, Isabelle; Doerig, Nadja; Holtforth, Martin Grosse

    2013-09-01

    Self-compassion involves being kind to oneself when challenged with personal weaknesses or hardship and has been claimed to be associated with resilience in various areas. So far, there are only a handful of studies that investigate self-compassion and its relation to clinical depression. Therefore, the principal goals of the present study were (a) to compare self-compassion in clinically depressed patients and never-depressed subjects, (b) to investigate self-compassion and its relation to cognitive-behavioral avoidance and rumination in depressed outpatients, and (c) to investigate rumination and avoidance as mediators of the relationship between self-compassion and depressive symptoms. One hundred and forty-two depressed outpatients and 120 never-depressed individuals from a community sample completed a self-report measure of self-compassion along with other measures. Results indicate that depressed patients showed lower levels of self-compassion than never-depressed individuals, even when controlled for depressive symptoms. In depressed outpatients, self-compassion was negatively related to depressive symptoms, symptom-focused rumination, as well as cognitive and behavioral avoidance. Additionally, symptom-focused rumination and cognitive and behavioral avoidance mediated the relationship between self-compassion and depressive symptoms. These findings extend previous research on self-compassion, its relation to depression, as well as processes mediating this relationship, and highlight the importance of self-compassion in clinically depressed patients. Since depressed patients seem to have difficulties adopting a self-compassionate attitude, psychotherapists are well advised to explore and address how depressed patients treat themselves.

  10. The efficacy and safety of 10 mg vortioxetine in the treatment of major depressive disorder: a meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Li G

    2016-02-01

    Full Text Available Guangjian Li, Xu Wang, Dihui Ma Department of Neurology and Neuroscience Center, First Hospital of Jilin University, Changchun, People’s Republic of China Background: Vortioxetine is an investigational multimodal antidepressant. We conducted this meta-analysis to assess the efficacy and safety of 10 mg vortioxetine in the treatment of major depressive disorder (MDD. Methods: Randomized controlled trials (RCTs published in PubMed, Web of Science, Embase, and ClinicalTrials.gov were systematically reviewed to assess the treatment effects and safety profiles of patients with MDD who were treated with 10 mg vortioxetine. The outcome measures included response rate, remission rate, changes from baseline in Montgomery–Asberg Depression Rating Scale (MADRS, Hamilton Rating Scale for Depression (24-items (HAM-D24, Clinical Global Impression-Severity (CGI-S, and Clinical Global Impression-Improvement (CGI-I scores. Results were expressed with risk ratio or weighted mean difference with 95% confidence intervals. Pooled results were calculated using a fixed-effects model or a random-effects model according to the heterogeneity among included trials. Results: Six RCTs with a total of 1,801 patients met the inclusion criteria and were included in this meta-analysis. The 10 mg vortioxetine dose significantly increased the response rate and remission rate in the treatment of MDD compared with placebo. Moreover, there was a statistically significant reduction from baseline in the MADRS, HAM-D24, CGI-S, and CGI-I scores with 10 mg vortioxetine vs placebo. The incidence of treatment-emergent adverse events such as nausea, vomiting, constipation, and hyperhidrosis was higher in the 10 mg vortioxetine group than in the placebo group. Conclusion: Vortioxetine 10 mg can significantly increase the response rate and remission rate, and reduce the MADRS, HAM-D24, CGI-S, and CGI-I scores in patients with MDD with an acceptable risk of treatment-emergent adverse

  11. Efficacy and tolerability of escitalopram in treatment of major depressive disorder with anxiety symptoms: a 24-week, open-label, prospective study in Chinese population

    Science.gov (United States)

    Jiang, Kaida; Li, Lingjiang; Wang, Xueyi; Fang, Maosheng; Shi, Jianfei; Cao, Qiuyun; He, Jincai; Wang, Jinan; Tan, Weihao; Hu, Cuili

    2017-01-01

    Background Significant anxiety symptoms are associated with poor clinical course and outcome in major depressive disorder (MDD). This single-arm, open-label study aimed to evaluate the efficacy and tolerability of escitalopram treatment in patients with MDD and anxiety symptoms. Methods Adult patients with MDD and anxiety symptoms (Montgomery–Asberg Depression Rating Scale [MADRS] ≥22 and Hamilton Anxiety Rating Scale [HAM-A] ≥14) were enrolled and received escitalopram (10–20 mg/day) treatment for 24 weeks. Symptom status was assessed by MADRS, 17-item-Hamilton Depression Rating Scale, HAM-A, and Clinical Global Impression Scale at baseline and the following visits. Quality of life was assessed by Short Form-12, and safety was evaluated by adverse events, laboratory investigations, vital signs, and physical findings. Results Overall, 200 of 318 (66.2%) enrolled patients completed the 24-week treatment. The remission (MADRS ≤10 and HAM-A ≤7) rate in the full analysis set (N=285) was 73.3% (95% confidence interval: 67.80, 78.38) at week 24. Mean (± standard deviation) MADRS total score was 33.4 (±7.13) and HAM-A score was 27.6 (±7.26) at baseline, which reduced to 6.6 (±10.18) and 6.0 (±8.39), respectively, at week 24. Patients with higher baseline depression and anxiety level took longer to achieve similar remission rates. Overall, 80 of the 302 (26.5%) patients included in the safety set reported at least 1 treatment-emergent adverse event (TEAE). Most frequently reported TEAEs (>2%) were headache (4.0%), nasopharyngitis (3.6%), nausea (3.0%), and dizziness (2.6%). Serious TEAEs were reported by 1.3% patients; no deaths were reported. Conclusion Escitalopram 10–20 mg/day was effective and well-tolerated in the long-term treatment of MDD with anxiety symptoms in adult Chinese population. PMID:28255239

  12. Exercise Against Depression.

    Science.gov (United States)

    Artal, Michal; Sherman, Carl

    1998-01-01

    Physical activity is useful for preventing and easing depression symptoms. When prescribing exercise as an adjunct to medication and psychotherapy, physicians must consider each patient's individual circumstances. Hopelessness and fatigue can make physical exercise difficult. A feasible, flexible, and pleasurable program has the best chance for…

  13. Clock genes in depression

    DEFF Research Database (Denmark)

    Christiansen, Sofie Laage; Bouzinova, Elena

    2017-01-01

    Data demonstrate that abnormal regulation of the circadian system can result in cardiovascular disease, metabolic syndrome, obesity, immune dysfunction, increased risk for cancer, reproductive complications, etc. It is highly individual among depressed patients and may be expressed as a phase adv...

  14. Genetic Determinants of Depression

    NARCIS (Netherlands)

    S. López León (Sandra)

    2008-01-01

    textabstractThe aim of the studies in this genetic epidemiological thesis was to investigate candidate genes that play a role in the etiology of depression and to obtain new insights about biological pathways that may be involved in this disorder. The introduction of the thesis presents a review of

  15. Depression and Caregiving

    Science.gov (United States)

    ... body techniques into your routine may help alleviate depression. Even 5 to 10 minutes of any of these techniques may be beneficial. These are some to try: Meditation Prayer Deep breathing Acupuncture Yoga Massage Listening to music Creating art Guided imagery Journaling Supplements: Herbal “over- ...

  16. Depression in general practice

    African Journals Online (AJOL)

    aspects of patients' lives to their condition more easily than psychiatrists. .... underdiagnose both dementia and depression in their elderly patients.20,21 A recent ... could lead to great improvement in the quality of life of many patients who ...

  17. Cognitive function assessment in idiopathic Parkinson's disease Avaliação da função cognitiva em doença de Parkinson idiopática

    Directory of Open Access Journals (Sweden)

    Mauro R. Piovezan

    2007-12-01

    Full Text Available Idiopathic Parkinson’s disease (PD is characterized by reduced nigrostriatal and cortical dopaminergic influence, with changes in movement and, subsequently, behavioral and cognitive disturbances. We studied cognitive impairment in Parkinson’s disease by assessing a group of 30 idiopathic Parkinson’s disease patients with an average age of 64.23 years (PG group and compared our findings with those for a control group of 30 patients (CG group. All the patients were submitted to the following assessments: motor function, using the UPDRS; staging, using the Hoehn-Yahr scales (PG group only; depression, using the Montgomery-Asberg scale; attention impairment; verbal fluency (FAR and animals; cognitive function, using the Mini Mental State Examination; visuospatial and executive functions; and clock drawing. In addition to altered motor function in PD patients, we found statistically significant differences between PD patients and controls in terms of cognitive function, verbal, executive and visuospatial functions, and attention deficits. Depression was more prevalent in the PG group.A doença de Parkinson idiopática (DP caracteriza-se pela redução da influência dopaminérgica nigroestriatal e cortical, com alterações em movimentos e posteriormente, comportamentais e cognitivas. Estudamos o comprometimento cognitivo de pacientes portadores de DP, avaliando 30 pacientes com doença de Parkinson idiopática (GP com média de idade de 64,23 anos e os comparamos com um grupo controle (GC de 30 pacientes. Todos os pacientes foram submetidos as seguintes avaliações: motora pela escala de UPDRS; estadiamento pela escala de Hoehn-Yahr (somente GP; depressão pela escala de Montgomery-Asberg; comprometimento da atenção; fluência verbal (FAR e animais; função cognitiva pelo Mini Exame do Estado Mental; funções visuoespaciais e executivas e desenho do relógio. Concluímos que na DP os pacientes apresentam além das alterações motoras

  18. Sadness, Depression, and Avoidance Behavior

    Science.gov (United States)

    Leventhal, Allan M.

    2008-01-01

    Research into genetic, psychosocial, and cognitive explanations for depression (biopsychosocial models) provides support for the role of these variables in the etiology of depression. Regularly identified as basic to depression is loss, and the experience of loss has been found to be more influential than genetic factors in the causation of…

  19. Male Depression: Understanding the Issues

    Science.gov (United States)

    Diseases and Conditions Depression (major depressive disorder) Male depression is a serious medical condition, but many men try to ignore it or refuse treatment. Learn the signs and symptoms — and what to do. By Mayo Clinic Staff Do you feel irritable, isolated or withdrawn? Do you find yourself working all ...

  20. Responding to a Student's Depression

    Science.gov (United States)

    Crundwell, R. Marc A.; Killu, Kim

    2010-01-01

    Although depression is classified as an adult mental health disorder, middle to late adolescence is the age when symptoms most commonly surface. If teachers can recognize the signs of depression in students, Crundwell and Killu assert, they can provide a supportive, flexible school environment that enables depressed students to learn and thrive.…

  1. Symptoms and Treatment of Depression

    Medline Plus

    Full Text Available ... 3 items) Institute Announcements (24 items) Symptoms and Treatment of Depression February 1, 2010 People with depression discuss how ... why it affects some people but not others. Treatments for depression do work. One type of effective psychotherapy is ...

  2. Symptoms and Treatment of Depression

    Medline Plus

    Full Text Available ... the road to recovery. Depression treatment can take time to work, so don't give up. Read more about depression on this Web page. If the symptoms fit, get help now. Share More Video and Audio about Depression Contact ...

  3. Depressive Realism: Wiser or Quieter?

    Science.gov (United States)

    Blanco, Fernando; Matute, Helena; Vadillo, Miguel A.

    2009-01-01

    Depressive realism consists of the lower personal control over uncontrollable events perceived by depressed as compared to nondepressed individuals. In this article, we propose that the realism of depressed individuals is caused not by an increased accuracy in perception, but by their more comprehensive exposure to the actual environmental…

  4. Overview of Depression

    Directory of Open Access Journals (Sweden)

    Ni Nyoman Wistya Tri Mayasari

    2013-11-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 Depression is a state of disorder tone generally feeling characterized by feelings of sadness, apathy, pessimism, and loneliness. Epidemiology of depression showed a lifetime prevalence of 7-12% for men and 20-25% for women. The reason for the prevalence differences between men and women not much can be explained, but biological factors and socio-cultural influences. In the depression is sadness lasts for days so that it can disrupt work, study, eat, sleep, and enjoyment. The cause of depression is not just one, but multifactorial. Most of the cause may arise from or the people themselves. Because it is not clear on anatomy, biochemistry, or physiology. To diagnose depression may use criteria of PPDGJ or using DSM-IV-TR /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  5. Cushing's syndrome masquerading as treatment resistant depression

    OpenAIRE

    Anil Kumar, B. N.; Sandeep Grover

    2016-01-01

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

  6. Plain Talk about Depression. Plain Talk Series.

    Science.gov (United States)

    Sargent, Marilyn

    Depression is defined as a "whole-body" illness, involving the body, mood, and thoughts. Three of the most prevalent types of depressive disorders are described: major depression, dysthymia, and bipolar disorders (formerly called manic-depressive illness). Eleven symptoms of depression and 10 symptoms of mania are listed. Causes of depression are…

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

    Science.gov (United States)

    Swann, Alan C

    2013-08-01

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

  8. Metacognitions and Mindful Attention Awareness in Depression: A Comparison Of Currently Depressed, Previously Depressed and Never Depressed Individuals.

    Science.gov (United States)

    Solem, Stian; Hagen, Roger; Wang, Catharina E A; Hjemdal, Odin; Waterloo, Knut; Eisemann, Martin; Halvorsen, Marianne

    2017-01-01

    The primary aim of the study was to test (1) how metacognition relates to the concept of mindful attention awareness, and (2) whether metacognitions or mindful attention awareness best predicted symptoms of depression. Data was collected from three samples: currently depressed (n = 37), previously depressed (n = 81) and never depressed controls (n = 50). There was a moderate correlation between mindful attention awareness and three of five metacognitive subscales. Both mindful attention awareness and metacognition were significantly correlated with depression severity scores after controlling for anxiety. The depressed group had significantly more dysfunctional metacognitions and less mindful attention awareness than the never depressed group. Negative beliefs about worry and mindful attention awareness were also significantly different in the previously depressed group compared with the never depressed. This suggests that metacognitions and mindful attention awareness can be vulnerability factors for depression. The results also indicated that anxiety symptoms and negative beliefs about worry were the most important factors in predicting depression. In conclusion, the study shows that metacognitions and mindful attention awareness are two related but separate constructs and that metacognitions emerged as the best predictor of depression. These results provide support for the metacognitive model of emotional disorders. Copyright © 2015 John Wiley & Sons, Ltd. Metacognitions and mindful attention awareness are related but separate constructs Both mindful attention awareness and metacognition are associated with depression Anxiety and negative beliefs about worry (metacognitions) are most important in predicting depression Addressing metacognitions in therapy should be considered in treatment of depression. Copyright © 2015 John Wiley & Sons, Ltd.

  9. A comparative study of escitalopram augmented with resperidone in the treatment of refractory depression%西酞普兰合并利培酮治疗难治性抑郁症的对照研究

    Institute of Scientific and Technical Information of China (English)

    范勇; 吴爱勤

    2009-01-01

    目的 探讨西酞普兰合并利培酮治疗难治性抑郁症的安全性和疗效.方法 将92例难治性抑郁症患者随机分为两组,研究组采用西酞普兰合并利培酮治疗,对照组单用西酞普兰治疗,两组分别在治疗后第2、4、8、12周末,采用汉密顿抑郁量表(HAMD)和临床总体印象量表(CGI)评定疗效,Asberg抗抑郁剂不良反应量表评定不良反应.结果 根据HAMD评分,两组8周末减分率分别为(31.85±12.78),(19.00±11.88),两组12周末减分率分别为(48.46±20.75),(29.54±16.85),两组间差异均具有显著性意义(P<0.05);根据CGI评分,两组8周末评分分别为(2.31±0.95)、(3.15±1.06),两组12周末评分分别为(2.00±1.00)、(2.92±1.19),两组间差异具有显著性意义(P<0.05);药物不良反应两组间无明显差异(P>0.05).结论 西酞普兰合并利培酮治疗难治性抑郁症的疗效好,不良反应无明显增加..%Objective To study the efficacy and side effects of escitalopram augmented with resperidone in treatment of refractory depression.Methods A total of 92 patients with refractory depression were randomly divided into study group with escitalopram augmented with resperidone and control group with escitalopram for treatment of 12 weeks.All subjects were assessed with Hamilton Rating Scale for Depression(HAMD),Clinical Global Impression(CGI),Asberg Rating Scale for Side Effects in end of 2th,4th,8th and 12th.Results The rates of decreased scores in HAMD between two groups in end of 8th week were(31.85±12.78),(19.00±11.88)and in end of 12th week were(48.46±20.75),(29.54±16.85).There were significant differences between two groups both in 8th and 12th weekend(P<0.05).In the end of 8th week the scores of CGI were(2.31±0.95) of study group,(3.15±1.06) of control group and in the end of 12th week(2.00±1.00)of study group,(2.92±1.19)of control group.There were significant differences between two groups(P<0.05).There were no significant differences

  10. Efficacy of extended release quetiapine fumarate monotherapy in elderly patients with major depressive disorder: secondary analyses in subgroups of patients according to baseline anxiety, sleep disturbance, and pain levels.

    Science.gov (United States)

    Montgomery, Stuart A; Altamura, A Carlo; Katila, Heikki; Datto, Catherine; Szamosi, Johan; Eriksson, Hans

    2014-03-01

    This study evaluated extended release quetiapine fumarate (quetiapine XR) monotherapy in elderly patients with major depressive disorder (MDD) according to baseline levels of anxiety, sleep disturbance, and pain. Post-hoc analyses of data from an 11-week (9-week randomized-treatment, 2-week post-treatment phase), double-blind, placebo-controlled study of quetiapine XR (50-300 mg/day) monotherapy in elderly (≥66 years) patients (n=338) with MDD were carried out. Outcomes included randomization to week 9 change in Montgomery Åsberg Depression Rating Scale (MADRS) score and week 9 response (≥50% MADRS score reduction) rates. Post-hoc analyses were carried out to assess subgroups of patients with MDD according to baseline levels in terms of the following: higher or lower anxiety (Hamilton Rating Scale for Anxiety total score≥20 or Depression sleep disturbance factor (items 4+5+6) score≥5 or depressive symptoms in elderly patients with MDD, irrespective of baseline levels of anxiety, sleep disturbance, and pain.

  11. Couple Discord and Depression in Couples during Couple Therapy and in Depressed Individuals during Depression Treatment

    Science.gov (United States)

    Atkins, David C.; Dimidjian, Sona; Bedics, Jamie D.; Christensen, Andrew

    2009-01-01

    The association between depression and relationship distress as well as the impact of treatment for the one on the other was examined across 2 treatment-seeking samples: individuals seeking treatment for depression (N = 120) and couples seeking marital therapy (N = 134 couples). Although there was a baseline association between depression and…

  12. Couple Discord and Depression in Couples during Couple Therapy and in Depressed Individuals during Depression Treatment

    Science.gov (United States)

    Atkins, David C.; Dimidjian, Sona; Bedics, Jamie D.; Christensen, Andrew

    2009-01-01

    The association between depression and relationship distress as well as the impact of treatment for the one on the other was examined across 2 treatment-seeking samples: individuals seeking treatment for depression (N = 120) and couples seeking marital therapy (N = 134 couples). Although there was a baseline association between depression and…

  13. Unipolar Depression in Paroxysmal Schizophrenia

    Directory of Open Access Journals (Sweden)

    Alexander S. Bobrov

    2013-12-01

    Full Text Available Based on the current study, the clinical characteristics of unipolar depression in the clinical picture of schizophrenia with the paroxysmal type of disease course are presented. Given the concomitant depression with phobic symptoms, the following clinical variants are marked: depression with generalized social phobia and/or anthropophobia and depression with generalized pathological body sensations and hypochondriacal phobias. In other words, we are talking about a necessity to allocate a special type of schizophrenia with affective structure episodes and comorbid neurosis-like symptoms. Information on the basic treatment strategy of schizophrenia with depressive structure episodes and comorbid neurosis-like symptoms in everyday psychiatric practice is also provided.

  14. Homeopathic Individualized Q-Potencies versus Fluoxetine for Moderate to Severe Depression: Double-Blind, Randomized Non-Inferiority Trial

    Directory of Open Access Journals (Sweden)

    U. C. Adler

    2011-01-01

    Full Text Available Homeopathy is a complementary and integrative medicine used in depression, The aim of this study is to investigate the non-inferiority and tolerability of individualized homeopathic medicines [Quinquagintamillesmial (Q-potencies] in acute depression, using fluoxetine as active control. Ninety-one outpatients with moderate to severe depression were assigned to receive an individualized homeopathic medicine or fluoxetine 20 mg day−1 (up to 40 mg day−1 in a prospective, randomized, double-blind double-dummy 8-week, single-center trial. Primary efficacy measure was the analysis of the mean change in the Montgomery & Åsberg Depression Rating Scale (MADRS depression scores, using a non-inferiority test with margin of 1.45. Secondary efficacy outcomes were response and remission rates. Tolerability was assessed with the side effect rating scale of the Scandinavian Society of Psychopharmacology. Mean MADRS scores differences were not significant at the 4th (P = .654 and 8th weeks (P = .965 of treatment. Non-inferiority of homeopathy was indicated because the upper limit of the confidence interval (CI for mean difference in MADRS change was less than the non-inferiority margin: mean differences (homeopathy-fluoxetine were −3.04 (95% CI −6.95, 0.86 and −2.4 (95% CI −6.05, 0.77 at 4th and 8th week, respectively. There were no significant differences between the percentages of response or remission rates in both groups. Tolerability: there were no significant differences between the side effects rates, although a higher percentage of patients treated with fluoxetine reported troublesome side effects and there was a trend toward greater treatment interruption for adverse effects in the fluoxetine group. This study illustrates the feasibility of randomized controlled double-blind trials of homeopathy in depression and indicates the non-inferiority of individualized homeopathic Q-potencies as compared to fluoxetine in acute treatment of

  15. Depression in Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Nasser Safaie

    2012-09-01

    Full Text Available Introduction: Depression is one of the Common psychological disorders. From the cognitive point of view, the unhealthy attitudes increase the severity of the depression. The aim of this study was to investigate depression and unhealthy attitudes in coronary patients hospitalized at Tabriz Shahid Madani Heart Center. Methods: One hundred twenty eight hospitalized patients having myocardial Infarctions were studied regarding unhealthy attitudes, severity of depression and demographic data. Results: The study showed a significant relation between unhealthy attitudes, BDI (Beck Depression Inventory and severe depression. Moreover, a significant relation existed between gender and depression (P=0.0001. In addition, the level of education increased the intensity of unhealthy attitudes (P=0.0001. Several researches in both outside and inside Iran support the idea. Conclusion: Based on present study and more other investigations, it can be suggested to provide the necessary elements and parameters such as antidepressant medication, psychologists, complementary treatment for coping with negative mood and its unwanted consequences.

  16. Ethnicity, music experience, and depression.

    Science.gov (United States)

    Werner, Paul D; Swope, Alan J; Heide, Frederick J

    2009-01-01

    The researchers studied differences in self-reported music experience and depression across ethnic groups, as well as differences in the relationship between music experience and depression across groups. College participants (78 African Americans, 111 Asian Americans, 218 Whites, and 87 in other ethnic groups) completed the Music Experience Questionnaire (MEQ) and the Center for Epidemiological Studies Depression scale. Statistically significant differences across groups were found on depression as well as on the MEQ factor for Subjective/Physical Reactions to music and on MEQ scales for Commitment to Music, Affective Reactions, Positive Psychotropic Effects, and Reactive Musical Behavior. A distinctive pattern of relationship was found between music variables and depression in the Asian American group, relative to the White and Other group. In particular, among Asian Americans there were negative correlations between depression and the MEQ Subjective/ Physical Reactions factor as well as the Affective Reactions scale. Implications were discussed for the literature on ethnicity and depression, music experience, and music therapy.

  17. Debunking the placebo effect in depression: the effect of patient and investigator expectation on escitalopram efficacy.

    Science.gov (United States)

    Nehama, Yael; Rabinowitz, Ilan; Baruch, Yehuda; Mandel, Amir; Lurie, Ido; Barak, Yoram

    2014-03-01

    In approximately half of the major depressive disorder (MDD) antidepressant trials published in the last decade, 30% or more of the patients assigned to the placebo arm showed clinically significant improvements. Attempts to reduce the placebo effect in a variety of ways have proven mostly unsuccessful. The aim of this study was to determine whether trial design has an effect on the efficacy outcome in a mock placebo versus escitalopram treatment of adult outpatients with MDD. An 8-week study was designed to evaluate the placebo effect on the response to fixed doses of escitalopram (10 and 20 mg/day) in patients with MDD. The variables affecting placebo response evaluated were as follows: patient expectation, rater expectation, three different outcome measures and the number of visits during the study. Investigators were blinded to the inclusion and exclusion criteria. Forty patients were randomized to receive what they and their treating physicians conceived of as double-blind treatment. The mean age of the patients in the group was 45.1 years, 19 women (47.5%) and 21 men. The mean change from baseline to week 8 in the Montgomery-Åsberg Depression Rating Scale total score was -13.7 for participants with 'monthly' visits and -12.9 for the 'fortnightly' group (P=0.75). In each group, 14/16 responders and their physicians thought that they were receiving active treatment. Of 22 nonresponsive patients, 17 thought that they had been receiving placebo. The pharmacological effect of escitalopram observed in the present study is almost identical to that observed in open-label studies, even when patients and clinicians are misled by the study design, placebo presence or raters' blindability.

  18. Depression and major depressive disorder in patients with Parkinson's disease.

    Science.gov (United States)

    Inoue, Takeshi; Kitagawa, Mayumi; Tanaka, Teruaki; Nakagawa, Shin; Koyama, Tsukasa

    2010-01-15

    The prevalence of depression in Parkinson's disease (PD) varies greatly. In this study, we investigated major depressive disorder (MDD) and depressive symptoms without MDD in patients with PD. The psychopathological characteristics of depressive symptoms were assessed by a psychiatric interview. A total of 105 Japanese patients with PD without dementia were included. The Japanese version of the Beck Depression Inventory-II (BDI-II) with a cutoff score of 13/14 was used to screen for depression. Using a structured interview, a comprehensive psychiatric evaluation of patients with BDI-II scores >13 (high BDI patients) was completed using the criteria of the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV-TR. Forty patients (38%) had a BDI-II >13, but 29 did not show any depressed mood. Five cases met the criteria for MDD (three current, two past) and one patient was diagnosed with minor depressive disorder. A slight depressed mood that was associated with worrying about PD was seen in 6 of 34 patients without any depressive disorder and fluctuated with aggravation of PD symptoms in two of these patients. For the diagnosis of MDD, the number of positive items from the DSM-IV-TR definition of MDD is most important and useful for differentiating MDD and non-MDD. The low-prevalence rate of MDD in our patient population suggests that PD may be a psychological stressor for MDD, but does not necessarily induce MDD.

  19. Validation of Standardized Questionnaires Evaluating Symptoms of Depression in Rheumatoid Arthritis Patients: Approaches to Screening for a Frequent Yet Underrated Challenge.

    Science.gov (United States)

    Englbrecht, Matthias; Alten, Rieke; Aringer, Martin; Baerwald, Christoph G; Burkhardt, Harald; Eby, Nancy; Fliedner, Gerhard; Gauger, Bettina; Henkemeier, Ulf; Hofmann, Michael W; Kleinert, Stefan; Kneitz, Christian; Krueger, Klaus; Pohl, Christoph; Roske, Anne-Eve; Schett, Georg; Schmalzing, Marc; Tausche, Anne-Kathrin; Peter Tony, Hans; Wendler, Joerg

    2017-01-01

    To validate standard self-report questionnaires for depression screening in patients with rheumatoid arthritis (RA) and compare these measures to one another and to the Montgomery-Åsberg Depression Rating Scale (MADRS), a standardized structured interview. In 9 clinical centers across Germany, depressive symptomatology was assessed in 262 adult RA patients at baseline (T0) and at 12 ± 2 weeks followup (T1) using the World Health Organization 5-Item Well-Being Index (WHO-5), the Patient Health Questionnaire (PHQ-9), and the Beck Depression Inventory II (BDI-II). The construct validity of these depression questionnaires (using convergent and discriminant validity) was evaluated using Spearman's correlations at both time points. The test-retest reliability of the questionnaires was evaluated in RA patients who had not undergone a psychotherapeutic intervention or received antidepressants between T0 and T1. The sensitivity and the specificity of the questionnaires were calculated using the results of the MADRS, a structured interview, as the gold standard. According to Spearman's correlation coefficients, all questionnaires met convergent validity criteria (ρ > |0.50|), with the BDI-II performing best, while correlations with age and disease activity for all questionnaires met the criteria for discriminant validity (ρ questionnaire to meet the predefined retest reliability criterion (ρ ≥ 0.70) was the BDI-II (rs  = 0.77), which also achieved the best results for both sensitivity and specificity (>80%) when using the MADRS as the gold standard. The BDI-II best met the predefined criteria, and the PHQ-9 met most of the validity criteria, with lower sensitivity and specificity. © 2016, American College of Rheumatology.

  20. Stress, externality, and depression.

    Science.gov (United States)

    Ganellen, R J; Blaney, P H

    1984-12-01

    Previous research has found mixed support for the possibility that locus of control moderates the effects of life stress on depression. Two methodological choices may have influenced previous findings: the use of a unidimensional rather than a multidimensional locus of control scale, and reliance on linear statistical methods using median splits. We attempted to correct these choices by using the Levenson IPC scale (1974) and multiple regression analyses in a female undergraduate population (N = 158). The results supported use of a multidimensional scale, since Stress, Internality, and Powerful Others were found to have main effects on depression whereas Chance interacted with life stress. The question of whether locus of control refers to responsibility for causing an event, i.e., self-blame, or belief in control over future events, i.e., coping behavior, was discussed.

  1. Bibliotherapy for depression.

    Science.gov (United States)

    Usher, Tegan

    2013-04-01

    Bibliotherapy can be used to treat mild to moderate depression or subthreshold depressive symptoms, as a sole or supplementary therapy. Bibliotherapy is a form of guided self-help. The patient works through a structured book, independently from the doctor. The role of the doctor is to support and motivate the patient as they continue through the book and to help clarify any questions or concerns the patient may have. Relevant books can be purchased or often borrowed from a library, with limited cost and good accessibility from a patient perspective. Patients need to have a reading age above 12 years and have a positive attitude toward self-help. Bibliotherapy has NHMRC Level 1 evidence of efficacy and no serious adverse effects have been reported. This article forms part of a series on non-drug treatments, which summarise the indications, considerations and the evidence, and where clinicians and patients can find further information.

  2. The Danish Depression Database

    DEFF Research Database (Denmark)

    Videbech, Poul Bror Hemming; Deleuran, Anette

    2016-01-01

    AIM OF DATABASE: The purpose of the Danish Depression Database (DDD) is to monitor and facilitate the improvement of the quality of the treatment of depression in Denmark. Furthermore, the DDD has been designed to facilitate research. STUDY POPULATION: Inpatients as well as outpatients...... as an evaluation of the risk of suicide are measured before and after treatment. Whether psychiatric aftercare has been scheduled for inpatients and the rate of rehospitalization are also registered. DESCRIPTIVE DATA: The database was launched in 2011. Every year since then ~5,500 inpatients and 7,500 outpatients...... have been registered annually in the database. A total of 24,083 inpatients and 29,918 outpatients have been registered. The DDD produces an annual report published on the Internet. CONCLUSION: The DDD can become an important tool for quality improvement and research, when the reporting is more...

  3. [Sulpiride and depression].

    Science.gov (United States)

    Lestynek, J L

    1983-09-22

    For many years the antidepressive or uninhibiting effect of sulpiride has been a subject of controversy. Following recent reports underscoring an antidepressive action of sulpiride with mood inversion, we have studied 17 patients with depression in order to build a personal opinion. With a daily dosage of 150 mg, a satisfactory response was recorded in overall pathology in 76.5% of cases, and in depressive manifestations in 82% of cases. Therefore, we believe that sulpiride does have an antidepressive action, which begins approximately on the tenth day of treatment, while the uninhibiting effect becomes noticeable on the fifth day. It is to be pointed out that, among the 12 patients who had failed to respond to prior therapy with tricyclic antidepressants, 10 responded very satisfactorily to sulpiride.

  4. Depression and Internal Medicine

    Directory of Open Access Journals (Sweden)

    Domenico Panuccio

    2013-05-01

    Full Text Available BACKGROUND Depression is 2-4 times more frequent in medically ill patients than in the general population, it significantly undermines the quality of life and makes prognosis worse in terms of morbidity and mortality. Nevertheless the majority of cases are not recognized or appropriately treated. A growing body of evidence suggests that mood disorders and many medical illnesses are linked in a bidirectional way by several biological mechanisms. Autonomic function changes, hyperactivity of the hypothalamic-pituitary-adrenal axis, increases in plasma cortisol, elevated levels of proinflammatory cytokines, increased platelet activation and hypercoagulability, all of them occur in patients with depression and all of them are causal factors in development and progression of atherothrombotic lesions or they are implicated in the pathogenesis of neoplasm and other illness such as chronic pain, chronic obstructive pulmonary disease, rheumatoid arthritis and so on. CONCLUSIONS Although antidepressant use has not been shown to reduce mortality rates in patients with medical illness, it alleviates depression, improves the quality of life and reduces morbidity. Clinicians should be aware of this association and should make an effort in detecting and treating not only biological illness but also mood disorders.

  5. Depression in Cancer Patients

    Directory of Open Access Journals (Sweden)

    Beyhan Bag

    2014-06-01

    Full Text Available It is not enough to consider treatment and care depression in the oncology that is the most common psychiatric illness in cancer patient affects of cancer treatment and the patient`s quality of life negatively, which is determined through researches in the field. With development of psycho-oncology it has been demonstrated to establish an important link between the cancer patient`s treatment as well as psycho-social support for the patient and psychiatric treatment and care for the if it is needed. With this connection between them it has been proposed to use of bio-psycho-social-model in cancer patient to improve their care. To achieve this goal, it is expected from medical personnel to realize patients psychosocial need und if he/she has a psychiatric disorders or syndromes. For the medical personnel that work in oncology services, it is inevitable to organize in order to raise the awareness of depression in the cancer patients. In the present study, it is focused on raising the awareness of depression in cancer patient for the medical personnel. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(2.000: 186-198

  6. The Danish Depression Database

    Directory of Open Access Journals (Sweden)

    Videbech P

    2016-10-01

    Full Text Available Poul Videbech,1 Anette Deleuran2 1Mental Health Centre Glostrup, Department of Clinical Medicine, University of Copenhagen, Glostrup, 2Psychiatric Centre Amager, Copenhagen S, Denmark Aim of database: The purpose of the Danish Depression Database (DDD is to monitor and facilitate the improvement of the quality of the treatment of depression in Denmark. Furthermore, the DDD has been designed to facilitate research. Study population: Inpatients as well as outpatients with depression, aged above 18 years, and treated in the public psychiatric hospital system were enrolled. Main variables: Variables include whether the patient has been thoroughly somatically examined and has been interviewed about the psychopathology by a specialist in psychiatry. The Hamilton score as well as an evaluation of the risk of suicide are measured before and after treatment. Whether psychiatric aftercare has been scheduled for inpatients and the rate of rehospitalization are also registered. Descriptive data: The database was launched in 2011. Every year since then ~5,500 inpatients and 7,500 outpatients have been registered annually in the database. A total of 24,083 inpatients and 29,918 outpatients have been registered. The DDD produces an annual report published on the Internet. Conclusion: The DDD can become an important tool for quality improvement and research, when the reporting is more complete. Keywords: quality assurance, suicide, somatic diseases, national database

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

    Science.gov (United States)

    Hattori, Hideyuki

    2009-04-01

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

  8. Depressive symptoms in neurodegenerative diseases.

    Science.gov (United States)

    Baquero, Miquel; Martín, Nuria

    2015-08-16

    Depressive symptoms are very common in chronic conditions. This is true so for neurodegenerative diseases. A number of patients with cognitive decline and dementia due to Alzheimer's disease and related conditions like Parkinson's disease, Lewy body disease, vascular dementia, frontotemporal degeneration amongst other entities, experience depressive symptoms in greater or lesser grade at some point during the course of the illness. Depressive symptoms have a particular significance in neurological disorders, specially in neurodegenerative diseases, because brain, mind, behavior and mood relationship. A number of patients may develop depressive symptoms in early stages of the neurologic disease, occurring without clear presence of cognitive decline with only mild cognitive deterioration. Classically, depression constitutes a reliable diagnostic challenge in this setting. However, actually we can recognize and evaluate depressive, cognitive or motor symptoms of neurodegenerative disease in order to establish their clinical significance and to plan some therapeutic strategies. Depressive symptoms can appear also lately, when the neurodegenerative disease is fully developed. The presence of depression and other neuropsychiatric symptoms have a negative impact on the quality-of-life of patients and caregivers. Besides, patients with depressive symptoms also tend to further decrease function and reduce cognitive abilities and also uses to present more affected clinical status, compared with patients without depression. Depressive symptoms are treatable. Early detection of depressive symptoms is very important in patients with neurodegenerative disorders, in order to initiate the most adequate treatment. We review in this paper the main neurodegenerative diseases, focusing in depressive symptoms of each other entities and current recommendations of management and treatment.

  9. Pulse Intravenous Clomipramine as an alternative antidepressant treatment to ECT: A pilot study

    Directory of Open Access Journals (Sweden)

    Maj-Liz Persson

    2007-12-01

    Full Text Available Background and Objectives: The aim of the study was to examine the antidepressant effect of a single pulse dose of intravenous clomipramine (200 mg i.v. followed by oral administration as an alternative method to electroconvulsive therapy. Methods: Twenty-one inpatients (8 male, 13 female with major depression were included. Depression severity was measured by Montgomery Asberg Rating Scale (MADRS and Clinical Global Impression severity scale (CGI-S before the pulse dose and 1 week after. The day after the pulse dose, the patient was medicated with 75 mg of oral clomipramine and from day two with 150 mg clomipramine daily. Results: The MADRS score dropped with 39% ± 22% and the CGI score with 28% ± 19% in one week. The improvement of the MADRS score after one week was 13.1 (C.I.9.5-17.0. CGI-ratings dropped from a mean of 5.5 (SD 1.2 to 3.9 (SD 1.1, an improvement of 28% ± 19%.(C.I. 1.0-2.1. Both improvements were significant (p<000.1. Conclusions: Single pulse dose clomipramine administration ameliorates depressive symptoms, and may be an alternative to ECT.

  10. Efficacy of brief interdisciplinary psychotherapeutic intervention for motor conversion disorder and nonepileptic attacks.

    Science.gov (United States)

    Hubschmid, M; Aybek, S; Maccaferri, G E; Chocron, O; Gholamrezaee, M M; Rossetti, A O; Vingerhoets, F; Berney, A

    2015-01-01

    The objective was to compare a brief interdisciplinary psychotherapeutic intervention to standard care as treatments for patients recently diagnosed with severe motor conversion disorder or nonepileptic attacks. This randomized controlled trial of 23 consecutive patients compared (a) an interdisciplinary psychotherapeutic intervention group receiving four to six sessions by a consultation liaison psychiatrist, the first and last sessions adding a neurological consultation and a joint psychiatric and neurological consultation, and (b) a standard care group. After intervention, patients were assessed at 2, 6 and 12 months with the Somatoform Dissociation Questionnaire (SDQ-20), Clinical Global Impression scale, Rankin scale, use of medical care, global mental health [Montgomery and Asberg Depression Rating Scale, Beck Depression Inventory, mental health component of Short Form (SF)-36] and quality of life (SF-36). We calculated linear mixed models. Our intervention brought a statistically significant improvement of physical symptoms [as measured by the SDQ-20 (P<.02) and the Clinical Global Impression scale (P=.02)] and psychological symptoms [better scores on the mental health component of the SF-36 (P<.05) and on the Beck Depression Inventory (P<.05)] and a reduction in new hospital stays after intervention (P<.05). A brief psychotherapeutic intervention taking advantage of a close collaboration with neurology consultants in the setting of consultation liaison psychiatry appears effective. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Recurrence of depressive disorders after interferon-induced depression

    Science.gov (United States)

    Chiu, W-C; Su, Y-P; Su, K-P; Chen, P-C

    2017-01-01

    Interferon alpha (IFN-α)-treated patients commonly develop depression during the therapy period. Although most IFN-α-induced depressive disorders achieve remission after IFN-α therapy, no studies have examined the long-term mood effects of IFN-α treatment. We conducted a 12-year population-based cohort study of hepatitis C virus (HCV)-infected patients who were older than 20 years and had received IFN-α therapy. The sample was obtained from the Taiwan National Health Insurance Research Database. The cohort included patients with and without IFN-α-induced depression, matched randomly by age, sex and depression history, at a ratio of 1:10. The follow-up started after the last administration of IFN-α and was designed to determine the incidence of recurrent depressive disorder after IFN-α therapy. A total of 156 subjects were identified as having IFN-α-induced depression and achieving full remission after IFN-α therapy. The overall incidence of recurrent depressive disorders among patients with and without IFN-α-induced depression was 56.8 (95% confidence interval (CI), 42.4–76.1) and 4.1 (95% CI, 2.9–5.8) cases, respectively, per 100 000 person-years, Pdepressive disorder were 13.5 (95% CI, 9.9–18.3) in the IFN-α-treated cohort and 22.2 (95% CI, 11.2–44.2) in the matched cohort for IFN-α-induced depression patients after adjusting for age, sex, income, urbanization and comorbid diseases. IFN-α-induced depression was associated with a high risk of recurrent depression. It was not a transient disease and might be considered an episode of depressive disorder. Continuation therapy might be considered, and further research is needed. PMID:28170005

  12. Risk factors for antenatal depression, postnatal depression and parenting stress

    OpenAIRE

    Leigh, Bronwyn; Milgrom, Jeannette

    2008-01-01

    Background Given that the prevalence of antenatal and postnatal depression is high, with estimates around 13%, and the consequences serious, efforts have been made to identify risk factors to assist in prevention, identification and treatment. Most risk factors associated with postnatal depression have been well researched, whereas predictors of antenatal depression have been less researched. Risk factors associated with early parenting stress have not been widely researched, despite the stro...

  13. Risk factors for antenatal depression, postnatal depression and parenting stress

    OpenAIRE

    Milgrom Jeannette; Leigh Bronwyn

    2008-01-01

    Abstract Background Given that the prevalence of antenatal and postnatal depression is high, with estimates around 13%, and the consequences serious, efforts have been made to identify risk factors to assist in prevention, identification and treatment. Most risk factors associated with postnatal depression have been well researched, whereas predictors of antenatal depression have been less researched. Risk factors associated with early parenting stress have not been widely researched, despite...

  14. Risk factors for antenatal depression, postnatal depression and parenting stress

    OpenAIRE

    Milgrom Jeannette; Leigh Bronwyn

    2008-01-01

    Abstract Background Given that the prevalence of antenatal and postnatal depression is high, with estimates around 13%, and the consequences serious, efforts have been made to identify risk factors to assist in prevention, identification and treatment. Most risk factors associated with postnatal depression have been well researched, whereas predictors of antenatal depression have been less researched. Risk factors associated with early parenting stress have not been widely researched, despite...

  15. Risk factors for antenatal depression, postnatal depression and parenting stress

    OpenAIRE

    Leigh, Bronwyn; Milgrom, Jeannette

    2008-01-01

    Background Given that the prevalence of antenatal and postnatal depression is high, with estimates around 13%, and the consequences serious, efforts have been made to identify risk factors to assist in prevention, identification and treatment. Most risk factors associated with postnatal depression have been well researched, whereas predictors of antenatal depression have been less researched. Risk factors associated with early parenting stress have not been widely researched, despite the stro...

  16. [Lipids, depression and suicide].

    Science.gov (United States)

    Colin, A; Reggers, J; Castronovo, V; Ansseau, M

    2003-01-01

    Polyunsatured fatty acids are made out of a hydrocarbonated chain of variable length with several double bonds. The position of the first double bond (omega) differentiates polyunsatured omega 3 fatty acids (for example: alpha-linolenic acid or alpha-LNA) and polyunsatured omega 6 fatty acids (for example: linoleic acid or LA). These two classes of fatty acids are said to be essential because they cannot be synthetised by the organism and have to be taken from alimentation. The omega 3 are present in linseed oil, nuts, soya beans, wheat and cold water fish whereas omega 6 are present in maize, sunflower and sesame oil. Fatty acids are part of phospholipids and, consequently, of all biological membranes. The membrane fluidity, of crucial importance for its functioning, depends on its lipidic components. Phospholipids composed of chains of polyunsatured fatty acids increase the membrane fluidity because, by bending some chains, double bonds prevent them from compacting themselves perfectly. Membrane fluidity is also determined by the phospholipids/free cholesterol ratio, as cholesterol increases membrane viscosity. A diet based on a high proportion of essential polyunsatured fatty acids (fluid) would allow a higher incorporation of cholesterol (rigid) in the membranes to balance their fluidity, which would contribute to lower blood cholesterol levels. Brain membranes have a very high content in essential polyunsatured fatty acids for which they depend on alimentation. Any dietary lack of essential polyunsatured fatty acids has consequences on cerebral development, modifying the activity of enzymes of the cerebral membranes and decreasing efficiency in learning tasks. The prevalence of depression seems to increase continuously since the beginning of the century. Though different factors most probably contribute to this evolution, it has been suggested that it could be related to an evolution of alimentary patterns in the Western world, in which polyunsatured omega 3

  17. Evaluation of borehole geophysical logging, aquifer-isolation tests, distribution of contaminants, and water-level measurements at the North Penn Area 5 Superfund Site, Bucks and Montgomery counties, Pennsylvania

    Science.gov (United States)

    Bird, Philip H.; Conger, Randall W.

    2002-01-01

    Borehole geophysical logging and aquiferisolation (packer) tests were conducted at the North Penn Area 5 Superfund site in Bucks and Montgomery Counties, Pa. Caliper, naturalgamma, single-point-resistance, fluid-temperature, fluid-resistivity, heatpulse-flowmeter, and digital acoustic-televiewer logs and borehole television surveys were collected in 32 new and previously drilled wells that ranged in depth from 68 to 302 feet. Vertical borehole-fluid movement direction and rate were measured with a high-resolution heatpulse flowmeter under nonpumping conditions. The suite of logs was used to locate water-bearing fractures, determine zones of vertical borehole- fluid movement, select depths to set packers, and locate appropriate screen intervals for reconstructing new wells as monitoring wells. Aquifer-isolation tests were conducted in four wells to sample discrete intervals and to determine specific capacities of discrete water-bearing zones. Specific capacities of isolated zones during packer testing ranged from 0.12 to 15.30 gallons per minute per foot. Most fractures identified by borehole geophysical methods as water-producing or water-receiving zones produced water when isolated and pumped. The acoustic-televiewer logs define two basic fracture sets, bedding-plane partings with a mean strike of N. 62? E. and a mean dip of 27? NW., and high-angle fractures with a mean strike of N. 58? E. and a mean dip of 72? SE. Correlation of heatpulse-flowmeter data and acoustic-televiewer logs showed 83 percent of identified water-bearing fractures were high-angle fractures.

  18. [Memory processes in endogenous depression].

    Science.gov (United States)

    Radziwiłłowicz, W; Radziwiłłowicz, P

    1998-01-01

    The thesis aims to answer the questions about the profile of mental ability in endogenous depression and to decide whether self-estimation of depressive symptoms influences the results achieved by patients in memory tests. Fifty six patients suffering from endogenous depression have been examined. The following methods have been applied: Mini Mental State Examination, Benton Visual Retention Test, Beck Depression Inventory, hold tests: Vocabulary, Information, Comprehension and Digit Span of Wechsler Adult Intelligence Scale (WAIS), Rey-Osterrieth Complex Figure, Auditory Verbal Learning Test, DCS Weidlich. General status of cognitive functions correlates with the profile of specific kinds of memory results, particularly with delayed memory. Self-estimation of depressive symptoms intensity is mostly influenced by memory capacity, visuomotorial factor, functions of perception and lingual factor. High correlation between verbal and non verbal learning shows uniform influence of depression on the process of learning.

  19. Depression and social problem solving.

    Science.gov (United States)

    Marx, E M; Williams, J M; Claridge, G C

    1992-02-01

    Twenty depressed patients with major depressive disorder, 20 nondepressed matched control subjects, and 17 patients with anxiety disorders were compared in different measures of social problem solving. Problem solving was assessed with the Means-Ends Problem-Solving Test (Study 1), the solution of personal problems, and a problem-solving questionnaire (Study 2). Results showed that, as predicted, depressed subjects suffered from a deficit in problem solving in all three measures. The majority of these deficits were also displayed by the clinical control group rather than being specific to a diagnosis of depression. However, depressed subjects produced less effective solutions than did normal and clinical control subjects. The results suggest that depressed and anxious patients may have difficulties at different stages of the problem-solving process.

  20. Poverty and adolescent depressive symptoms.

    Science.gov (United States)

    Butler, Amy C

    2014-01-01

    Longitudinal data on non-Hispanic White children from the Panel Study of Income Dynamics (N = 1,056) were used to examine whether the relationship between poverty (early childhood poverty, poverty persistence, and current poverty) and adolescent depressive symptoms (measured by the Children's Depression Inventory and the Internalizing Index) can be explained by the mother's own childhood depression and family characteristics measured during the child's first year of life. Associations between poverty and depressive symptoms among adolescents were explained by mother's childhood depression and whether the adolescent had lived with both parents during the first year of life. The findings highlight the need for appropriate treatment of childhood depression so as to reduce the adverse consequences in adulthood and for the next generation.

  1. Depression og/eller apokalypse

    DEFF Research Database (Denmark)

    Frantzen, Mikkel Krause; Bjering, Jens Christian Borrebye

    2015-01-01

    The article sets out by investigating how depression is represented in Lars von Trier´s disaster movie Melancholia with the specific intent to detach mental illness from classic, somewhat romantic notions of metaphoric and epistemological connections between psychopathology and deeper “truths......” about the world. Employing what one could call a symptomatological view on the depression of the main protagonist Justine, the article concludes that her depression should be seen as a temporal disorder in the sense that she lacks the ability to project and plan a future. From here, the article turns...... to Eve Kosofsky Sedgwick´s concept of a “reparative praxis” as a possible ethico-practical way out of the depressive situation, arguing that such a reparative praxis is exactly what ends up pulling Justine out of her depression and enabling her to act. In a concluding step, the article relates depression...

  2. Gender, Anxiety, and Depressive Symptoms

    Science.gov (United States)

    Chaplin, Tara M.; Gillham, Jane E.; Seligman, Martin E. P.

    2009-01-01

    Does anxiety lead to depression more for girls than for boys? This study prospectively examines gender differences in the relationship between anxiety and depressive symptoms in early adolescence. One hundred thirteen 11- to 14-year-old middle school students complete questionnaires assessing depressive symptoms and three dimensions of anxiety (worry and oversensitivity, social concerns and concentration, and physiological anxiety) as well as total anxiety symptoms at an initial assessment and 1 year later. Total anxiety and worry and oversensitivity symptoms are found to predict later depressive symptoms more strongly for girls than for boys. There is a similar pattern of results for social concerns and concentration symptoms, although this does not reach statistical significance. Physiological anxiety predicts later depressive symptoms for both boys and girls. These findings highlight the importance of anxiety for the development of depression in adolescence, particularly worry and oversensitivity among girls. PMID:19756209

  3. Subthreshold Symptoms of Depression in Preadolescent Girls Are Stable and Predictive of Depressive Disorders

    Science.gov (United States)

    Keenan, Kate; Hipwell, Alsion; Feng, Xin; Babinski, Dara; Hinze, Amanda; Rischall, Michal; Henneberger, Angela

    2008-01-01

    Symptoms of depression are investigated among 232 preadolescent girls to study if they were predictive and stable of depression. Findings show that early symptoms of depression among preadolescent girls predict depressive disorders. Implications for preventive measures are discussed.

  4. The increasing burden of depression

    Directory of Open Access Journals (Sweden)

    Lépine J-P

    2011-05-01

    Full Text Available Jean-Pierre Lépine1, Mike Briley21Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris Unité INSERM 705 CNRS UMR 8206, Université Paris Diderot, Paris, France; 2NeuroBiz Consulting and Communication, Castres, FranceAbstract: Recent epidemiological surveys conducted in general populations have found that the lifetime prevalence of depression is in the range of 10% to 15%. Mood disorders, as defined by the World Mental Health and the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, have a 12-month prevalence which varies from 3% in Japan to over 9% in the US. A recent American survey found the prevalence of current depression to be 9% and the rate of current major depression to be 3.4%. All studies of depressive disorders have stressed the importance of the mortality and morbidity associated with depression. The mortality risk for suicide in depressed patients is more than 20-fold greater than in the general population. Recent studies have also shown the importance of depression as a risk factor for cardiovascular death. The risk of cardiac mortality after an initial myocardial infarction is greater in patients with depression and related to the severity of the depressive episode. Greater severity of depressive symptoms has been found to be associated with significantly higher risk of all-cause mortality including cardiovascular death and stroke. In addition to mortality, functional impairment and disability associated with depression have been consistently reported. Depression increases the risk of decreased workplace productivity and absenteeism resulting in lowered income or unemployment. Absenteeism and presenteeism (being physically present at work but functioning suboptimally have been estimated to result in a loss of $36.6 billion per year in the US. Worldwide projections by the World Health Organization for the year 2030 identify unipolar major depression as the leading cause of disease burden

  5. Childhood depression: a systematic review

    Directory of Open Access Journals (Sweden)

    Lima NNR

    2013-09-01

    Full Text Available Nádia Nara Rolim Lima,1 Vânia Barbosa do Nascimento,1 Sionara Melo Figueiredo de Carvalho,1 Luiz Carlos de Abreu,1,3 Modesto Leite Rolim Neto,2 Aline Quental Brasil,2 Francisco Telésforo Celestino Junior,2 Gislene Farias de Oliveira,2 Alberto Olavo Advíncula Reis3 1Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil; 2Departamento de Medicina. Universidade Federal do Ceará, UFC, Barbalha, Ceará, Brazil; 3Departamento de Saúde Materno Infantil, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil Abstract: As an important public health issue, childhood depression deserves special attention, considering the serious and lasting consequences of the disease to child development. Taking this into consideration, the present study was based on the following question: what practical contributions to clinicians and researchers does the current literature on childhood depression have to offer? The objective of the present study was to conduct a systematic review of articles regarding childhood depression. To accomplish this purpose, a systematic review of articles on childhood depression, published from January 1, 2010 to November 24, 2012, on MEDLINE and SciELO databases was carried out. Search terms were “depression” (medical subject headings [MeSH], “child” (MeSH, and "childhood depression" (keyword. Of the 180 retrieved studies, 25 met the eligibility criteria. Retrieved studies covered a wide range of aspects regarding childhood depression, such as diagnosis, treatment, prevention and prognosis. Recent scientific literature regarding childhood depression converge to, directly or indirectly, highlight the negative impacts of depressive disorders to the children's quality of life. Unfortunately, the retrieved studies show that childhood depression commonly grows in a background of vulnerability and poverty, where individual and familiar needs

  6. Personality in recovered depressed elderly.

    Science.gov (United States)

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

    1992-01-01

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

  7. Predicting depressive symptoms in unemployed

    Directory of Open Access Journals (Sweden)

    Marić Zorica

    2005-01-01

    Full Text Available In this study we review recent research literature focused on relationship between unemployment and depression, and theories emphasizing the mechanisms by which unemployment may contribute to increased levels of depression. Our research investigated depressive symptomatology and its predictors among unemployed people (N = 453 varying in length of unemployment. Results showed that self - mastery, self - esteem, financial strain, gender, intensity of job - seek behavior and length on unemployment were significant predictors of depressive symptoms. Results are discussed in light of current theories of unemployment and mental health and recommendations are made for practice.

  8. Emotional maltreatment and depression: prospective prediction of depressive episodes.

    Science.gov (United States)

    Liu, Richard T; Alloy, Lauren B; Abramson, Lyn Y; Iacoviello, Brian M; Whitehouse, Wayne G

    2009-01-01

    Most research to date on the role of maltreatment experiences in depression has focused on physical and sexual maltreatment. However, several researchers have theorized that emotional maltreatment may be more strongly linked to depression. Furthermore, prospective studies in this area are lacking. This study addressed these issues by examining whether experiences of current emotional maltreatment predicted the development of new prospective episodes of major (MD) or minor depression (MiD), and the subtype of hopelessness depression (HD) in young adults. It also assessed whether current emotional maltreatment from peers and from authority figures separately predicted the occurrence of depressive episodes. One hundred and sixty-five participants from the Cognitive Vulnerability to Depression Project were followed prospectively for 2.5 years. Current emotional maltreatment and new depressive episodes were assessed with life event and diagnostic interviews administered every 6 weeks. Greater overall emotional maltreatment predicted shorter time to onset of new MD, MiD, and HD episodes. Peer- and authority-perpetrated emotional maltreatment separately predicted shorter time to development of new HD episodes. Greater emotional maltreatment in young adults prospectively predicts onset of depression, particularly HD. These findings highlight the importance of adult emotional maltreatment experiences in determining targets for prevention and treatment. (c) 2009 Wiley-Liss, Inc.

  9. Effects of clomipramine treatment on cerebrospinal fluid monoamine metabolites and platelet sup 3 H-imipramine binding and serotonin uptake and concentration in major depressive disorder

    Energy Technology Data Exchange (ETDEWEB)

    Maartensson, B.; Waegner, A.; Aasberg, M. (Department of Psychiatry and Psychology, Karolinska Hospital, Stockholm (Sweden)); Beck, O.; Brodin, K. (Department of Clinical Pharmacology, Karolinska Hospital, Stockholm (Sweden)); Monterio, D. (Department of Clinical Pharmacology, Huddinge Hospital, Karolinska Institute, Stockholm (Sweden))

    1991-01-01

    In an open study of 12 inpatients who met the DSM-III criteria for a major depressive episode, the effects of clomipramine (CI) on the monoamine metabolites 5-hydroxyindoleacetic acid (5-HIAA), homovanillic acid (HVA), 4-hydroxy-3-methoxyphenyl glycol (HMPG) in cerebrospinal fluid (CSF) were measured simultaneously with the effects on {sup 3}H-imipramine binding, serotonin (5-HT) uptake and 5-HT concentration in platelets after 3 and 6 weeks of treatment. Drug (CI and desmethylclomipramine) plasma concentrations were determined. The concentrations of 5-HIAA and HMPG decreased substantially, and the concentration of HVA remained unchanged. There was also a large and significant reduction of the number of imipramine binding sites (B{sub max}) and of the platelet 5-HT concentration. The 5-HT uptake was not measurable aftet 3 weeks of treatment. None of the parameters changed significantly between weeks 3 and 6. There were no significant correlations between antidepressant effect (measured by the Montgomery-Aasberg Depression Rating Scale) and plasma drug concentrations, although a tendency to a significant correlation between antidepressant effect and CI was observed at 3 weeks. There were no significant intercorrelations between the different 5-HT parameters and no other significant correlations between the biochemical measures and clinical outcome. (author).

  10. Narcolepsy and depression Narcolepsia e depressão

    Directory of Open Access Journals (Sweden)

    Carla Adda

    1997-09-01

    Full Text Available Narcolepsy main symptoms include excessive daytime sleepiness and cataplexy. Its chronic course is accompanied by psychosocial impairment added to the difficulties and side effects of stimulants and tricyclics long term use. Depressive complaints are occasionally reported. The aim of this paper was to evaluate objectively the possibility of depression in a sample of 12 narcoleptics (7F;5 M, with mean age of 53 years (12 years SD, using the Beck Depression Inventory (BDI and the Hamilton Rating Scale for Depression (HAM-D. The results showed absence of depressive disorder in 75.0% of the cases according to BDI (or 58.3% according to HAM-D. The remaining patients had mild depression (only one patient presented major depression. The findings showed no correlation between narcolepsy and major depression.Narcolepsia é um distúrbio do sono caracterizado por sonolência diurna excessiva e ataques de cataplexia. Sendo crônico, traz uma série de dificuldades psicossociais às quais se aliam aquelas geradas pelos efeitos colaterais dos estimulantes e tricíclicos utilizados. Queixas depressivas são encontradas ocasionalmente. Esta pesquisa buscou verificar objetivamente a ocorrência de depressão em narcolépticos. Foi avaliado um grupo de 12 pacientes narcolépticos (7F; 5M com média de idade de 53 anos (DP 12 usando-se como instrumentos o Inventário de Beck para Depressão (BDI e a Escala Hamilton de Depressão (HAM-D. Os resultados demonstraram ausência de distúrbio depressivo em 75.0% dos pacientes avaliados pelo BDI e em 58.3% pela HAM-D. Os demais escores evidenciaram depressão leve ou disforia; depressão maior foi encontrada em apenas um caso. Tais achados não sugerem correlação entre narcolepsia e depressão.

  11. Validation of the Brazilian Portuguese version of the Beck Depression Inventory-II in a community sample Validação da versão brasileira em português do Inventário de Depressão de Beck-II numa amostra da comunidade

    Directory of Open Access Journals (Sweden)

    Marcio Henrique Gomes-Oliveira

    2012-12-01

    Full Text Available BACKGROUND: The Beck Depression Inventory (BDI is used worldwide for detecting depressive symptoms. This questionnaire has been revised (1996 to match the DSM-IV criteria for a major depressive episode. We assessed the reliability and the validity of the Brazilian Portuguese version of the BDI-II for non-clinical adults. METHODS: The questionnaire was applied to 60 college students on two occasions. Afterwards, 182 community-dwelling adults completed the BDI-II, the Self-Report Questionnaire, and the K10 Scale. Trained psychiatrists performed face-to-face interviews with the respondents using the Structured Clinical Interview (SCID-I, the Montgomery-Åsberg Depression Scale, and the Hamilton Anxiety Scale. Descriptive analysis, signal detection analysis (Receiver Operating Characteristics, correlation analysis, and discriminant function analysis were performed to investigate the psychometric properties of the BDI-II. RESULTS: The intraclass correlation coefficient of the BDI-II was 0.89, and the Cronbach's alpha coefficient of internal consistency was 0.93. Taking the SCID as the gold standard, the cut-off point of 10/11 was the best threshold for detecting depression, yielding a sensitivity of 70% and a specificity of 87%. The concurrent validity (a correlation of 0.63-0.93 with scales applied simultaneously and the predictive ability of the severity level (over 65% correct classification were acceptable. CONCLUSION: The BDI-II is reliable and valid for measuring depressive symptomatology among Portuguese-speaking Brazilian non-clinical populations.OBJETIVOS: O Inventário de Depressão de Beck (IDB é utilizado mundialmente para detectar sintomas depressivos. Este questionário foi revisado (1996 para se adequar aos critérios do DSM-IV para episódio depressivo maior. Avaliamos a confiabilidade e validade da versão I em português-brasileiro do IDB-I em uma amostra não clínica de adultos. MÉTODOS: O questionário foi aplicado em duas

  12. [Neurobiology of depression].

    Science.gov (United States)

    Braus, D F

    2010-03-01

    Basic and clinical neurosciences have effectively advanced research on aetiology, pathogenesis and therapy options of psychiatric disorders. The objectives of the present short review were to summarise the key findings regarding the neurobiology of major depressive disorder (MDD) on the gene, cell as well as system level. Consistent with structural findings, which report alterations in regions of emotionally relevant networks of the brain in depressive disorders, findings of functional studies point to changes in an ordered interaction of ventral-limbic and dorsal-neocortical regions of the brain. Genetic and stress vulnerabilities as well as social rhythm disrupting interact to initiate a cascade of neurobiological alterations that disrupt this dynamic system. On the cellular level, monoamine as well as glutamate neurotransmission, circadian rhythm disturbance, glucocorticoids, inflammatory cytokines and brain-derived growth factors are relevant mediators of these pathological alterations. Progressive effects of recurrent and chronic MDD may then lead to further structural and functional abnormalities. Thus, treatment providers are directed to recog-nise that the factors that may initiate an MDD episode and those that maintain the illness are likely to be different. Given these long-term consequences, an essential objective of treatment must be to restore as early as possible normative functioning and prevent further neurobiological structural alterations.

  13. Fractalkine depresses cardiomyocyte contractility.

    Directory of Open Access Journals (Sweden)

    David Taube

    Full Text Available BACKGROUND: Our laboratory reported that male mice with cardiomyocyte-selective knockout of the prostaglandin E2 EP4 receptor sub-type (EP4 KO exhibit reduced cardiac function. Gene array on left ventricles (LV showed increased fractalkine, a chemokine implicated in heart failure. We therefore hypothesized that fractalkine is regulated by PGE2 and contributes to depressed contractility via alterations in intracellular calcium. METHODS: Fractalkine was measured in LV of 28-32 week old male EP4 KO and wild type controls (WT by ELISA and the effect of PGE2 on fractalkine secretion was measured in cultured neonatal cardiomyocytes and fibroblasts. The effect of fractalkine on contractility and intracellular calcium was determined in Fura-2 AM-loaded, electrical field-paced cardiomyocytes. Cardiomyocytes (AVM from male C57Bl/6 mice were treated with fractalkine and responses measured under basal conditions and after isoproterenol (Iso stimulation. RESULTS: LV fractalkine was increased in EP4 KO mice but surprisingly, PGE2 regulated fractalkine secretion only in fibroblasts. Fractalkine treatment of AVM decreased both the speed of contraction and relaxation under basal conditions and after Iso stimulation. Despite reducing contractility after Iso stimulation, fractalkine increased the Ca(2+ transient amplitude but decreased phosphorylation of cardiac troponin I, suggesting direct effects on the contractile machinery. CONCLUSIONS: Fractalkine depresses myocyte contractility by mechanisms downstream of intracellular calcium.

  14. The Experience of Depression

    Directory of Open Access Journals (Sweden)

    Katharina Weitkamp

    2016-05-01

    Full Text Available There is a lack of research in health psychology on the subjective experience of adolescents with mental health disorders. The aim of this study was to explore the experience of depression and the journey into therapy of young people (YP diagnosed with depression. Semi-structured interviews were carried out with six YP (5 female, aged 15–19. Interviews were analyzed using Interpretative Phenomenological Analysis. The following four key themes were identified: “Suffering is experienced as overwhelming,” “An experience of loneliness and isolation,” “Struggling to understand the suffering,” and “Therapy as a last resort.” Reasons for a delay in accessing treatment were not knowing what is “normal,” the feeling that they have to deal with it by themselves, and/or the lack of a caring adult who supports the YP in getting help. The findings suggest the ongoing importance of reducing stigma and promoting mental health education for YP as well as parents, school staff, and health professionals.

  15. Depression--Medicines To Help You

    Science.gov (United States)

    ... For Consumers Consumer Information by Audience For Women Depression--Medicines To Help You Share Tweet Linkedin Pin ... medicines for depression. Important Warnings about Medicines for Depression Children and teens who take antidepressants may be ...

  16. Alzheimer's or Depression: Could It Be Both?

    Science.gov (United States)

    Alzheimer's or depression: Could it be both? Alzheimer's and depression have some similar symptoms. Proper treatment improves quality of life. By Mayo Clinic Staff Early Alzheimer's disease and depression share many ...

  17. How Do Fundamental Christians Deal with Depression?

    Science.gov (United States)

    Spinney, Douglas Harvey

    1991-01-01

    Provides explanation of developmental dynamics in experience of fundamental Christians that provoke reactive depression. Describes depressant retardant defenses against depression that have been observed in Christian fundamental subculture. Suggests four counseling strategies for helping fundamentalists. (Author/ABL)

  18. Adjunctive Lanicemine (AZD6765) in Patients with Major Depressive Disorder and History of Inadequate Response to Antidepressants: A Randomized, Placebo-Controlled Study

    Science.gov (United States)

    Sanacora, Gerard; Johnson, Michael R; Khan, Arif; Atkinson, Sarah D; Riesenberg, Robert R; Schronen, Juan P; Burke, Michael A; Zajecka, John M; Barra, Luis; Su, Hong-Lin; Posener, Joel A; Bui, Khanh H; Quirk, Michael C; Piser, Timothy M; Mathew, Sanjay J; Pathak, Sanjeev

    2017-01-01

    The objective of this study was to investigate the efficacy and safety of adjunctive lanicemine (NMDA channel blocker) in the treatment of major depressive disorder (MDD) over 12 weeks. This phase IIb, randomized, parallel-arm, double-blind, placebo-controlled study was conducted at 49 centers in four countries between December 2011 and August 2013 in 302 patients aged 18–70 years, meeting criteria for single episode or recurrent MDD and with a history of inadequate treatment response. Patients were required to be taking an allowed antidepressant for at least four weeks prior to screening. Patients were randomized equally to receive 15 double-blind intravenous infusions of adjunctive lanicemine 50 mg, lanicemine 100 mg, or saline over a 12-week course, in addition to ongoing antidepressant. The primary efficacy end point was change in Montgomery-Åsberg Depression Rating Scale (MADRS) total score from baseline to week 6. Secondary efficacy outcome variables included change in MADRS score from baseline to week 12, response and remission rates, and changes in Clinical Global Impression scale, Quick Inventory of Depressive Symptomology Self-Report score, and Sheehan Disability Scale score. Of 302 randomized patients, 240 (79.5%) completed treatment. Although lanicemine was generally well tolerated, neither dose was superior to placebo in reducing depressive symptoms on the primary end point or any secondary measures. There was no significant difference between lanicemine and placebo treatment on any outcome measures related to MDD. Post hoc analyses were performed to explore the possible effects of trial design and patient characteristics in accounting for the contrasting results with a previously reported trial. PMID:27681442

  19. Creativity, depression, and circannual variation.

    Science.gov (United States)

    Sitton, S C; Hughes, R B

    1995-12-01

    Verbal creativity has been linked to personal and family histories of bipolar depression. The present studies investigated the relationship between creativity and atypical symptoms of bipolar depression such as seasonal mood variations. Although more creative individuals, as measured by scores on the Remote Associates Test and a writing sample, perceived seasonal fluctuations in their creativity, no significant differences in performance were found.

  20. PSYCHOLOGICAL CORRELATES OF POSTPARTUM DEPRESSION

    Directory of Open Access Journals (Sweden)

    Anida Fazlagić

    2011-12-01

    Full Text Available Manual of Mental Disorders (DSM-IV, postpartum depression may include any nonpsychotic depressive disorder during the first four weeks of postpartum, according to research criteria during the first year after birth. The exact cause of postpartum depression is not yet known, and most researchers believe that postpartum depression is a bio-psycho-social problem. So far, the biological aspect of the disease is explained by changing the levels of estrogen and progesterone during pregnancy, and by decrease of hormone levels after birth. Psychological correlates are often associated with low selfesteem, pessimism as a personality trait, bad strategies of coping with stress, mood swings and emotional reactions. The social aspect of the disease is associated with the existential conditions of pregnant woman, support of partners and education level. This paper will include issues like hereditary causes and possible psychological factors of postpartum depression prevention. Nowadays, it is estimated that on average 15% of women, regardless of the pregnancy outcome, are suffering from postpartum depression. However, this information includes only those women who were diagnosed with postpartum depression and who themselves reported about it. Almost every woman receives basic care during pregnancy to prevent complications in the physiological level. This paper has shown possible psychological factors of postpartum depression prevention, the impact of optimism, self-esteem and coping skills.

  1. What Caused the Great Depression?

    Science.gov (United States)

    Caldwell, Jean; O'Driscoll, Timothy G.

    2007-01-01

    Economists and historians have struggled for almost 80 years to account for the American Great Depression, which began in 1929 and lasted until the early years of World War II. In this article, the authors discuss three major schools of thought on the causes of the Great Depression and the long failure of the American economy to return to full…

  2. Symptoms and Treatment of Depression

    Medline Plus

    Full Text Available ... Borderline Personality Disorder (3 items) Depression (27 items) Eating Disorders (9 items) Panic Disorder (1 item) Post-Traumatic ... Borderline Personality Disorder (3 items) Depression (27 items) Eating Disorders (9 items) Panic Disorder (1 item) Post-Traumatic ...

  3. Perfectionism, Shame, and Depressive Symptoms

    Science.gov (United States)

    Ashby, Jeffrey S.; Rice, Kenneth G.; Martin, James L.

    2006-01-01

    The authors examined the relationship between depression, maladaptive perfectionism, and shame. Regression analyses were used to replicate a model in which maladaptive perfectionism was negatively associated with self-esteem and positively associated with symptoms of depression, with self-esteem mediating the effects of maladaptive perfectionism…

  4. Vågenterapi mod depression

    DEFF Research Database (Denmark)

    Kragh, Mette; Videbech, Poul

    2015-01-01

    Patients admitted with depression are highly tormented and many are suicidal. Standard treatment does not offer full effect until after several weeks. Wake therapy is a method that may reduce depressive symptoms within days. In this paper, the literature regarding wake therapy is reviewed...

  5. Symptoms and Treatment of Depression

    Medline Plus

    Full Text Available ... to recovery. Depression treatment can take time to work, so don't give up. Read more about depression on this Web page. If the symptoms fit, get help now. ... of Scientific Meetings Information about NIMH RePORTER : Research Portfolio Online ...

  6. Vågenterapi mod depression

    DEFF Research Database (Denmark)

    Kragh, Mette; Videbech, Poul

    2015-01-01

    Patients admitted with depression are highly tormented and many are suicidal. Standard treatment does not offer full effect until after several weeks. Wake therapy is a method that may reduce depressive symptoms within days. In this paper, the literature regarding wake therapy is reviewed...

  7. Symptoms and Treatment of Depression

    Medline Plus

    Full Text Available ... at the National Institute of Mental Health are studying brain images of people who suffer from depression trying to learn why it affects some people but not others. Treatments for depression do work. One type of effective psychotherapy is called cognitive ...

  8. Perfectionism, Shame, and Depressive Symptoms

    Science.gov (United States)

    Ashby, Jeffrey S.; Rice, Kenneth G.; Martin, James L.

    2006-01-01

    The authors examined the relationship between depression, maladaptive perfectionism, and shame. Regression analyses were used to replicate a model in which maladaptive perfectionism was negatively associated with self-esteem and positively associated with symptoms of depression, with self-esteem mediating the effects of maladaptive perfectionism…

  9. State depression: Mood or syndrome?

    Directory of Open Access Journals (Sweden)

    Novović Zdenka

    2007-01-01

    Full Text Available A State Depression Scale was developed in order to register variations of depressive mood. The Scale has satisfactory reliability, as shown by its internal homogeneity and temporal stability. Concurrent validity of the Scale indicated that the Scale correlates with a POMS-D scale (r = 0.41; p < 0.00, and with the Depressive Personality Scale (r = 0.36; p < 0.00. Divergent validity of the Scale was tested by Scale's correlation with the two measures of state anxiety (STAI-S and POMS-A and was shown to be unsatisfactory since it was as high as the Scale's correlation with scales of depressive affect. Principal Component Analysis extracted four factors: two broader factors, which included depressive-affective contents combined with anxious and depressive-cognitive symptoms, respectively; and another two factors which related to motivational and behavioral characteristics. Sensitivity of the Scale was tested in an experimental setting involving induction of depressive and euphoric mood. The Scale showed high ability to register changes following induction of depressive mood. .

  10. Symptoms and Treatment of Depression

    Medline Plus

    Full Text Available ... Borderline Personality Disorder (3 items) Depression (28 items) Eating Disorders (9 items) Panic Disorder (1 item) Post-Traumatic ... Borderline Personality Disorder (3 items) Depression (28 items) Eating Disorders (9 items) Panic Disorder (1 item) Post-Traumatic ...

  11. Optimal management of perimenopausal depression

    Directory of Open Access Journals (Sweden)

    Barbara L Parry

    2010-06-01

    Full Text Available Barbara L ParryDepartment of Psychiatry, University of California, San Diego, USAAbstract: Only recently has the perimenopause become recognized as a time when women are at risk for new onset and recurrence of major depression. Untreated depression at this time not only exacerbates the course of a depressive illness, but also puts women at increased risk for sleep disorders, cardiovascular disease, diabetes, and osteoporosis. Although antidepressant medication is the mainstay of treatment, adjunctive therapy, especially with estrogen replacement, may be indicated in refractory cases, and may speed the onset of antidepressant action. Many, but not all, studies, report that progesterone antagonizes the beneficial effects of estrogen. Although some antidepressants improve vasomotor symptoms, in general they are not as effective as estrogen alone for relieving these symptoms. Estrogen alone, however, does not generally result in remission of major depression in most (but not all studies, but may provide benefit to some women with less severe symptoms if administered in therapeutic ranges. The selective serotonin reuptake inhibitors (SSRIs in addition to estrogen are usually more beneficial in improving mood than SSRIs or estrogen treatment alone for major depression, whereas the selective norepinephrine and serotonin reuptake inhibitors do not require the addition of estrogen to exert their antidepressant effects in menopausal depression. In addition to attention to general health, hormonal status, and antidepressant treatment, the optimal management of perimenopausal depression also requires attention to the individual woman’s psychosocial and spiritual well being.Keywords: menopause, depression, management

  12. Effects of transurethral resection of prostate on the quality of life of patients with benign prostatic hyperplasia.

    LENUS (Irish Health Repository)

    O'Sullivan, MartinJ

    2012-02-03

    BACKGROUND: This article investigated the effects of transurethral resection of prostate on quality of life (QOL) and urinary symptoms in patients with benign prostatic hyperplasia (BPH). STUDY DESIGN: In a prospective study, 30 patients without significant comorbidities undergoing transurethral resection of prostate for BPH were studied. Patients completed four validated questionnaires: the International Prostate Symptom Score and the associated QOL index because urinary symptoms, the Montgomery and Asberg Depression Rating Scale, the McGill Pain Questionnaire, and the QOL questionnaire Short Form-36. These were completed preoperatively, on the first postoperative day, on discharge from hospital, and at 1 and 3 months postoperatively. RESULTS: The QOL of patients who undergo transurethral resection of prostate for BPH had significantly improved at 3 months after their operation. The International Prostate Symptom Score scores at 1 month (9.3+\\/-4.6) and 3 months (5.4+\\/-5.6) were less than they were preoperatively (19.9+\\/-7.1). The QOL index because urinary symptoms was less at 1 month (2.4+\\/-1.9) and at 3 months postoperatively (1.5+\\/-1.4) in comparison with the preoperative scores (4.5+\\/-1.2). The Montgomery and Asberg Depression Rating Scale scores at 1 month (5.4+\\/-6.8) and 3 months (4.9+\\/-6.5) were less than they were preoperatively (9.2+\\/-8.3). The McGill Pain Questionnaire sensory and pain rating index scores were less at 3 months than they were preoperatively (p=0.02 and p<0.02 respectively). The McGill Pain Questionnaire affective score was less at 1 month than it was preoperatively (p<0.03). The McGill Pain Questionnaire evaluative scores were less than the preoperative score at all times postoperatively. The role physical (p=0.007), bodily pain (p=0.006), social function (p=0.007), and physical component summary (p=0.007) subsections of the Short Form-36 were greater at 3 months postoperatively when compared with the preoperative scores

  13. [Depression: diagnosis, treatment and course].

    Science.gov (United States)

    Stuppäck, Christoph

    2011-12-01

    Depressions are very common mental diseases. The diagnosis is made by psychopathology criteria and the course of the disorder. There is a growing body to the knowledge about etiology and treatment of depression - neuro-imaging, neuroplasticity, CREB and BDNF are all modified by antidepressants treatment and/or psychotherapy. As differential diagnoses, depressive syndromes on the basis of organic diseases but also burn-out syndromes may play a role, different therapeutic efforts are necessary. The treatment of depression consists of psychopharmacological and psychotherapeutic strategies, combinations of both are useful. Many psychopharmacological substances with differing mechanisms of action are available - combinations of antidepressants with complementing mechanisms are possible. The course of depressions is mainly influenced by "working therapies". Comorbid somatic diseases and their successful treatment are of relevance for the long term course.

  14. Dysfunctional Reward Processing in Depression

    Science.gov (United States)

    Admon, Roee; Pizzagalli, Diego A.

    2015-01-01

    Anhedonia - diminished pleasure and/or decreased reactivity to pleasurable stimuli - is a core feature of depression that frequently persists after treatment. As a result, extensive effort has been directed towards characterizing the psychological and biological processes that mediate dysfunctional reward processing in depression. Reward processing can be parsed into sub-components that include motivation, reinforcement learning, and hedonic capacity, which, according to preclinical and neuroimaging evidence, involve partially dissociable brain systems. In line with this, recent findings indicate that behavioral impairments and neural abnormalities in depression vary across distinct reward-related constructs. Ultimately, improved understanding of precise reward-related dysfunctions in depression promises to improve diagnostic and therapeutic efforts in depression. PMID:26258159

  15. Depression following acute coronary syndrome

    DEFF Research Database (Denmark)

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

    2016-01-01

    PURPOSE: Depression is common following acute coronary syndrome, and thus, it is important to provide knowledge to improve prevention and detection of depression in this patient group. The objectives of this study were to examine: (1) whether indicators of stressors and coping resources were risk...... factors for developing depression early and later after an acute coronary syndrome and (2) whether prior depression modified these associations. METHODS: The study was a register-based cohort study, which includes 87,118 patients with a first time diagnosis of acute coronary syndrome during the period.......8 % developed a recurrent depression. Most patient characteristics (demographic factors, socioeconomic status, psychosocial factors, health-related behavioural factors, somatic comorbidities, and severity of acute coronary syndrome) were significantly associated with increased HRs for both early and later...

  16. Study on treatment effect of amisulpride combined sertraline in the elderly depression%氨磺必利合并舍曲林治疗老年期抑郁症的对照研究

    Institute of Scientific and Technical Information of China (English)

    王志强; 董昆仑; 杨碧秀; 陈新宇; 王国强

    2014-01-01

    目的:探讨氨磺必利联合舍曲林对老年期抑郁症的治疗作用。方法采用随机开放对照研究,将符合《中国精神障碍分类与诊断标准(第3版)》(CCMD-3)的60例老年期抑郁症的患者随机分为研究组(氨磺必利联合舍曲林治疗组)与对照组(单纯舍曲林治疗组),分别在治疗前及治疗后第2、4、6、8周末,采用汉密尔顿抑郁量表(HAMD)、临床总体印象量表(CGI-GI)评定疗效,采用Asberg抗抑郁剂副反应量表(SERS)评定两组的药物副反应。结果研究组HAMD评分在治疗后2周末、4周末、6周末以及8周末与治疗前比较差异有统计学意义( P0.05)。结论氨磺必利联合舍曲林对老年期抑郁症的疗效优于单一应用舍曲林治疗,安全性好。%Objective To study treatment effect of low dose Amisulpride combined Sertraline in the elderly depression. Meth-ods Employed open label extension study to randomized controlled trial, 60 patients ( no less than 60 years old) met with CCMD-3 for Depression criteria were divided into research group (treated with ow dose Amisulpride combined Sertraline ,n=30) and control group (treated with Sertraline,n=30) randomly. All subjects were assessed with Hamilton Rating Scale for Depression(HAMD),Clin-ical Global Impression(CGI-GI),Asberg Rating Scale for Side Effects before treatment and after 2,4,6 and 8 week treatment. Resu-lts There is significant HAMD difference between before treatment and after 2,4,6 and 8 week treatment in research group(P0. 05). Conclusion Treatment with low dose Amisulpride combined Sertraline for depression in the elderly is safe and treatment effect is better than that of Sertraline.

  17. Amantadine for weight gain associated with olanzapine treatment.

    Science.gov (United States)

    Deberdt, Walter; Winokur, Andrew; Cavazzoni, Patrizia A; Trzaskoma, Quynh N; Carlson, Christopher D; Bymaster, Frank P; Wiener, Karen; Floris, Michel; Breier, Alan

    2005-01-01

    Patients with schizophrenia (Sch), schizoaffective, schizophreniform, or bipolar (BP) I disorders [Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV)]; not manic or acutely psychotic [Brief Psychiatric Rating Scale (BPRS) total score or =5% of their initial body weight were examined to determine whether amantadine could attenuate weight gain or promote weight loss. Olanzapine (Olz; 5-20 mg/day) was co-administered with double-blind treatment of 100-300 mg/day amantadine (Olz+Amt, n=60) or placebo (Olz+Plc, n=65). Visit-wise analysis of weight showed that weight change from baseline [last-observation-carried-forward (LOCF)] in the Olz+Amt group was significantly different from the Olz+Plc group at weeks 8 (P=0.042), 12 (P=0.029), and 16 (primary endpoint, mean+/-S.D.: -0.19+/-4.58 versus 1.28+/-4.26 kg, P=0.045). Mean BPRS total score, positive subscale, and anxiety-depression scores improved comparably in both groups, and Montgomery-Asberg Depression Rating Scale (MADRS) total score improved in the Olz+Amt group. Overall, amantadine was safe, was well tolerated, and attenuated weight gain or promoted weight loss in some patients who had gained weight during olanzapine therapy.

  18. Mean Deviation of Inter-rater Scoring (MDIS): a simple tool for introducing conformity into groups of clinical investigators.

    Science.gov (United States)

    Bourin, Michel; Deplanque, Dominique; Zins-Ritter, Marcel

    2004-07-01

    In spite of considerable progress over the past decade, training investigators for inter-rater reliability for clinical trials remains a major problem. The aim of the present study was to promote a new tool to increase data homogeneity by introducing conformity into groups of clinical investigators. The investigators scoring grid we are proposing-the Mean Deviation of Inter-rater Scoring (MDIS)-involves the calculation of the score deviation for each investigator relative to the median score of an expert group who had evaluated the same videotape-recorded clinical case. Whatever the scale, the score deviation is calculated as the absolute deviation value from the median score obtained by the experts for each item. The MDIS value is then evaluated from all the scores given by an investigator by dividing the total sum of the previously defined values by the number of items of the scale. Some examples from practice are given using several rating scales: (i) Hamilton Anxiety Rating Scale; (ii) Hamilton Depression Rating Scale; (iii) Montgomery Asberg Depression Rating Scale; and (iv) Positive And Negative Symptoms Scale. Finally, such a method could also be employed by experts to evaluate the quality of videotape-recorded clinical cases used in clinical trials, as well as by teachers to evaluate initial or continuous medical training.

  19. Psychiatric morbidity, pain perception, and functional status of chronic pain patients in palliative care

    Directory of Open Access Journals (Sweden)

    V Rajmohan

    2013-01-01

    Full Text Available Context: Psychological factors, such as that exist when we experience pain, can profoundly alter the strength of pain perception. Aim: The study aims to estimate the prevalence of psychiatric disorders, and its association with perception of pain and functional status in chronic patients in palliative care. Materials and Methods: The sample was selected via simple randomisation and post consent were assessed using (1 a semi- structured questionnaire to elicit socio-demographic information and medical data (2 Brief Pain Inventory (3 ICD-10 Symptom Checklist (4 ICD-10-Diagnostic Criteria for Research (DCR (5 Montgomery Asberg Depression Rating Scale (MADRS (6 Covi Anxiety Rating Scale (7 Karnofsky Performance Status Scale. Data was analysed using independent sample t test and chi square test. Results: The psychiatric morbidity was 67% with depression and adjustment disorders being the major diagnosis. There was a significant association between psychiatric morbidity pain variables (P = 0.000. Psychiatric morbidity significantly impaired activity, mood, working, walk, sleep, relationship, and enjoyment. There was no association between aetiology of pain, type of cancer, treatment for primary condition and treatment for pain and psychiatric morbidity. The functional status of cancer patients was also poorer in patients with psychiatric morbidity (P = 0.008. Conclusion: There is a high prevalence of psychiatric illness in chronic pain patients of any aetiology. Psychiatric morbidity is associated with increased pain perception, impairment in activity and poor functional status.

  20. Evaluation of reliability and validity of the Chinese version of personal and social performance scale%个人和社会功能量表在抑郁症中的适用性研究

    Institute of Scientific and Technical Information of China (English)

    田涛; 卢卫红; 易正辉; 乔颖

    2012-01-01

    目的 检测个人和社会功能量表(Personal and Social Performance scale,PSP)在抑郁症患者中的信度和效度,了解PSP在抑郁症中的适用性.方法 在全国6个精神卫生中心收集84例门诊抑郁症患者.所有的病例进行PSP、Montgomery- Asberg抑郁量表(Montgomery- Asberg Depression Rating Scale,MADRS)、大体社会功能量表(Global Assessment of Functioning Scale,GAF)评定,分析PSP在抑郁症患者中的内部一致性、与GAF的一致性以及与MADRS的相关性.另外,6例抑郁症病例在首次评定后的1周进行再次评定用以PSP重测一致性的检验.结果 PSP的内部一致性Cronbach α系数为0.760,PSP总分与GAF评分具有良好的正相关(r=0.906,P<0.01),与MADRS总分呈负相关,具有统计学意义(r=-0.652,P<0.01),重测一致性的kappa值为0.945(n=6,P=0.01).结论 PSP是一个操作简单、稳定性高的评估工具,可用于抑郁症患者社会功能的评估.量表中d维度(冲动和攻击行为)对整个量表的权重大,在抑郁症患者中与总分相关性欠佳.%Objective To investigate the reliability and validity of Chinese version of Personal and Social perfomance scale (PSP - CHN) in depression patients. Methods 84 depression outpatients were enrolled from 6 mental health hospitals around the country. All participants were assessed in Global Assessment of Functioning Scale (GAF) to investigate the validity of PSP -CHN, and were assessed in Montgomery-Asberg Depression Rating Scale (MADRS) to analyses the correlation. One week after the first PSP interview, the second PSP interview was conducted to assess the test-retest reliability in 6 depression patients. Results The internal consistency of PSP (Cronbach a is 0. 760) was high. The total score of Chinese version of PSP had a good positive correlation with the GAF score (r=0. 906) and good negative correlations with MADRS (r= -0. 652, P<0. 01). Furthermore, the test-retest reliability of Chinese version of PSP (kappa=0

  1. Hemodynamic changes in depressive patients

    Institute of Scientific and Technical Information of China (English)

    MA Ying; LI Hui-chun; ZHENG Lei-lei; YU Hua-liang

    2006-01-01

    Objective: This study is aimed at exploring the relationship between hemodynamic changes and depressive and anxious symptom in depression patients. Methods: The cardiac function indices including the left stroke index (LSI), ejection fraction (EF), heart rate (HR), diastolic pressure mean (DPM), systolic pressure mean (SPM), left ventricle end-diastolic volume (LVDV), effective circulating volume (ECV), resistance total mean (RTM) and blood flow smooth degree (BFSD) were determined in 65 patients with major depressive disorders and 31 healthy normal controls. The clinical symptoms were assessed with Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA). Results: In patients with depression without anxiety,LSI, EF, LVDV, DPM, SPM, ECV, BFSD were significantly lower than those in controls, while RTM was higher than that in controls. Patients with comorbidity of depression and anxiety showed decreased LVDV, ECV, BFSD, and increased HR in comparison with the controls. The anxiety/somatization factor score positively correlated with LSI, EF, LVDV, but negatively correlated with RTM. There was negative correlation between retardation factor score and DPM, SPM, LVDV. Conclusion: The study indicated that there are noticeable changes in left ventricle preload and afterload, blood pressure, peripheral resistance, and microcirculation in depressive patients, and that the accompanying anxiety makes the changes more complicated.

  2. Depressive symptomatology in hospitalised children

    Directory of Open Access Journals (Sweden)

    M. Rangaka

    1993-05-01

    Full Text Available This study was undertaken to determine the extent and nature of depressive symptoms exhibited by black South African children during hospitalisation for orthopaedic procedures. Social factors associated with the risk for depression, in response to hospitalisation, were also examined. Pre- and post-test assessments were conducted on a sample of 30 children aged between 6 and 12 years. The assessment entailed a structured interview, together with the following psychometric instruments: A Global Mood Scale, a Depressive Symptoms Checklist, a Hospital Fears Rating Scale and a Self Report Depression Rating Scale. A large proportion of the children were rated by ward sisters as showing high levels of depressive symptomatology two weeks after admission to hospital. As expected, discrepancies were found between adult and child self-ratings of depression. The results of this study indicate that hospitalisation for orthopaedic child patients is associated with the development of depressive symptomatology. It is suggested that emphasis be placed on the development of supportive programmes and procedures aimed at maximising children's coping responses to hospitalisation, particularly for children who find themselves Isolated from their communities and families, as a result of both centralised health services and poor socio-economic conditions.

  3. Metabolic syndrome and major depression.

    Science.gov (United States)

    Marazziti, Donatella; Rutigliano, Grazia; Baroni, Stefano; Landi, Paola; Dell'Osso, Liliana

    2014-08-01

    Major depression is associated with a 4-fold increased risk for premature death, largely accounted by cardiovascular disease (CVD). The relationship between depression and CVD is thought to be mediated by the so-called metabolic syndrome (MeS). Epidemiological studies have consistently demonstrated a co-occurrence of depression with MeS components, ie, visceral obesity, dyslipidemia, insulin resistance, and hypertension. Although the exact mechanisms linking MeS to depression are unclear, different hypotheses have been put forward. On the one hand, MeS could be the hallmark of the unhealthy lifestyle habits of depressed patients. On the other, MeS and depression might share common alterations of the stress system, including the hypothalamus-pituitary-adrenal (HPA) axis, the autonomic nervous system, the immune system, and platelet and endothelial function. Both the conditions induce a low grade chronic inflammatory state that, in turn, leads to increased oxidative and nitrosative (O&NS) damage of neurons, pancreatic cells, and endothelium. Recently, neurobiological research revealed that peripheral hormones, such as leptin and ghrelin, which are classically involved in homeostatic energy balance, may play a role in mood regulation. Metabolic risk should be routinely assessed in depressed patients and taken into account in therapeutic decisions. Alternative targets should be considered for innovative antidepressant agents, including cytokines and their receptors, intracellular inflammatory mediators, glucocorticoids receptors, O&NS pathways, and peripheral mediators.

  4. Anomia in major depressive state.

    Science.gov (United States)

    Georgieff, N; Dominey, P F; Michel, F; Marie-Cardine, M; Dalery, J

    1998-02-27

    Anomia, or word finding difficulty, is a frequent clinical symptom of the depressive state. This study investigates naming and lexicalization processes (or word production processes) in 11 depressive patients (major depressive state), through a picture naming task of 53 images corresponding to low frequency words. Depressives showed significantly more anomia and made more naming errors (semantically related substitution words) than control subjects. Tip-of-the-tongue (TOT) states, which correspond to an impairment at a later stage of phonological encoding with partial activation of phonological shape, remained rare in depressives despite the increase of lexicalization difficulties observed. Anomia observed in depressives could thus be related to an impairment at the early stage of lexicalization or word production processes (pre-phonological item selection and access, or storage of the semantic lexical item in Working Memory for further phonological encoding), without lexical-semantic disorganization. We discuss the relationship between such an elementary speech production disorder and cognitive impairments demonstrated in the depressive state (deficit of effortful and attentional processes, impairment in activation or initiation of cognitive processes and responses).

  5. Routine screening for postpartum depression.

    Science.gov (United States)

    Georgiopoulos, A M; Bryan, T L; Wollan, P; Yawn, B P

    2001-02-01

    Postpartum depression (PPD) is a common and often overlooked condition. Validated screening tools for PPD exist but are not commonly used. We present the 1-year outcome of a project to implement universal PPD screening at the 6-week postpartum visit. Universal screening with the Edinburgh Postnatal Depression Scale (EPDS) was implemented in all community postnatal care sites. One-year outcome assessments (diagnosis and treatment of PPD) were completed for a sample of the women screened using medical record review of all care they received during the first year postpartum. Sixty-eight (20%) of the 342 women whose medical records were reviewed had been given a documented diagnosis of postpartum depression, resulting in an estimated population rate of 10.7%. Depression was diagnosed in 35% of the women with elevated EPDS scores (> or =10) compared with 5% of the women with low EPDS scores (<10) in the first year postpartum. Treatment was provided for all women diagnosed with depression, including drug therapy for 49% and counseling for 78%. Four women were hospitalized for depression. Some degree of suicidal ideation was noted on the EPDS by 48 women but acknowledged in the chart of only 10 women, including 1 with an immediate hospitalization. The rate of diagnosis of postpartum depression in this community increased from 3.7% before the routine use of EPDS screening to 10.7% following screening. A high EPDS score was predictive of a diagnosis of postpartum depression, and the implementation of routine EPDS screening at 6 weeks postpartum was associated with an increase in the rate of diagnosed postpartum depression in this community.

  6. HYDRAULICS, MONTGOMERY COUNTY, MISSISSIPPI AND INCORPORATED AREAS

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — Recent developments in digital terrain and geospatial database management technology make it possible to protect this investment for existing and future projects to...

  7. Dummy metadata TERRAIN, Montgomery County, Pennsylvania

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — Terrain data includes digital elevation models, LIDAR derived contours, LIDAR three-dimensional spot elevations and breaklines, field surveyed ground elevations and...

  8. Strategic nonviolent conflict: The Montgomery Bus Boycott

    OpenAIRE

    Fatih Balcı; Hudaverdi Balcı

    2011-01-01

    Nonviolent action emerges under the conditions of recognized an unacceptable political oppression and injustice. The people, who find the situation unacceptable, develop three ways of behavior. First, they exit the situation. Second, they engage in everyday forms of resistance. Third, they participate in political action which has two aspects: institutional and non-institutional. Institutional political action comprises of the regular political activities such as voting, taking part in legisl...

  9. DCS Survey Submission for Montgomery County, AL

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — Survey data includes spatial datasets and data tables necessary to digitally represent data collected in the survey phase of the study. (Source: FEMA Guidelines and...

  10. MAXHELP: Needs Assessment in the Montgomery Community

    Science.gov (United States)

    1984-04-01

    science oriented students. 2. Try to improve. 3. Not familiar with facilities. 4. Need gramar a hands on computer learning geared to go as fast as...Show values clarification film to teachers and administrators. 33. I’d like for the language arts teachers to use the " English as a Second Languages...to begin having computers to work with in their classes. Hands on is the best teachers. 6. Word processing. 7. Use of computers to teach English

  11. Can we vaccinate against depression?

    Science.gov (United States)

    Rook, Graham A W; Raison, Charles L; Lowry, Christopher A

    2012-05-01

    Major depression is common in the context of autoimmune and inflammatory diseases and is frequently associated with persistently raised levels of proinflammatory cytokines and other markers of inflammation, even in the absence of another diagnosable immune pathology to account for these findings. Therefore immunoregulation-inducing vaccines or manipulations of the gut microbiota might prevent or treat depression. These strategies are already undergoing clinical trials for chronic inflammatory disorders, such as allergies, autoimmunity and inflammatory bowel disease. In this article, we summarize data suggesting that this approach might be effective in depression and encourage the initiation of clinical vaccination trials in this disorder.

  12. Predictivity of Early Depressive Symptoms for Post-Stroke Depression.

    Science.gov (United States)

    Lewin-Richter, A; Volz, M; Jöbges, M; Werheid, K

    2015-08-01

    Depression is a frequent complication after stroke. However, little is known about the predictive value of early self-reported depressive symptoms (DS) for later development of post-stroke depression (PSD) 6 months after discharge. Using a prospective longitudinal design, we investigated the prevalence of DS and examined their predictive value for depressive disorders 6 months after stroke while statistically controlling major established PSD risk factors. During inpatient rehabilitation, 96 stroke patients were screened for DS. After 6 months, 71 patients were attainable for a follow-up. DS was assessed using the 15-item Geriatric Depression Scale (GDS-15). At follow-up a telephone interview that included the Structured Clinical Interview for Psychiatric Disorders (SCID), which is based on DSM-IV criteria, and the GDS-15 was conducted. Patients with major depression (MD) at the follow-up were considered to have PSD. Regression analyses were conducted to examine the influence of early DS on PSD after 6 months while controlling for age, premorbid depression, and functional and cognitive impairments. The percentage of patients who scored above the GDS-15 cut-off for clinically relevant DS increased significantly, from 37% to 44%, after 6 months. According to the SCID, 27% of stroke patients fulfilled the criteria for MD, and another 16% fulfilled those for minor depression. Logistic regression showed that DS at baseline significantly predicted PSD at follow-up (odds ratio: 1.43; 95% CI: 1.15-1.8). Self-reported DS during inpatient rehabilitation are predictive for PSD 6 months after discharge. Assessment of early DS contributes to identifying stroke patients at risk for PSD, thereby facilitating prevention and treatment.

  13. Clinical effectiveness of usual care with or without antidepressant medication for primary care patients with minor or mild-major depression: a randomized equivalence trial

    Directory of Open Access Journals (Sweden)

    van Dyck Richard

    2007-12-01

    Full Text Available Abstract Background Minor and mild-major depression are highly prevalent in primary care. There is insufficient evidence for the effectiveness of antidepressants in the treatment of minor and mild-major depression. We compared the effectiveness of usual primary care treatment, with or without antidepressants, in minor and mild-major depression. Methods A pragmatic patient-randomized equivalence trial with 52 weeks follow-up was conducted in The Netherlands. In total, 59 primary care physicians (PCPs recruited and treated 181 adult patients with minor or mild-major depression. Patients were randomized to four consultations within 3 months of usual care plus antidepressants (UCandAD or usual care alone (UCnoAD. The Montgomery Åsberg Depression Rating Scale (MADRS was used to assess changes in severity of depressive symptoms. The predefined equivalence margin was set at five points. Multilevel analysis was used to analyze the data. Secondary outcome measures were the Short-Form 36 (SF-36, and the Client Satisfaction Questionnaire (CSQ-8. Results Patients received on average 3.0 (SD 1.4 15-min consultations within 3 months with (n = 85 or without paroxetine (n = 96. Equivalence of UCandAD and UCnoAD was demonstrated in the intention-to-treat analyses as well as the per-protocol analysis after 6 weeks, but not at 13, 26 and 52 weeks follow-up. No statistical differences in effectiveness between treatment groups were found in the intention-to-treat analysis. No differences in the physical and mental functioning (SF-36 were found between the treatment groups. Patients allocated to UCandAD were slightly more satisfied with their treatment at 13 weeks follow-up (but not at 52 weeks follow-up than patients allocated to UCnoAD. Preliminary analyses suggested that subgroups such as patients with mild-major (instead of a minor depression might benefit from antidepressant treatment. Patients who were assigned to their preferred treatment (in particular to

  14. Diagnosing Depression in Chronic Pain Patients: DSM-IV Major Depressive Disorder vs. Beck Depression Inventory (BDI)

    OpenAIRE

    Peter Knaster; Ann-Mari Estlander; Hasse Karlsson; Jaakko Kaprio; Eija Kalso

    2016-01-01

    Background Diagnosing depression in chronic pain is challenging due to overlapping somatic symptoms. In questionnaires, such as the Beck Depression Inventory (BDI), responses may be influenced more by pain than by the severity of depression. In addition, previous studies have suggested that symptoms of negative self-image, a key element in depression, are uncommon in chronic pain-related depression. The object of this study is to assess the relationship of the somatic and cognitive-emotional ...

  15. Depression in Older Persons with Mobility Limitations

    NARCIS (Netherlands)

    Milaneschi, Yuri; Penninx, Brenda W. J. H.

    2014-01-01

    The impact of depression on physical disability is undisputed. There is convincing evidence that depression increases the subsequent risk for physical disability and, in turn, physical disability results in increased depressive symptoms. Moreover, depression affects also the earlier stages of the di

  16. Recurrence in Major Depression: A Conceptual Analysis

    Science.gov (United States)

    Monroe, Scott M.; Harkness, Kate L.

    2011-01-01

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

  17. Patient specific modelling in diagnosing depression

    DEFF Research Database (Denmark)

    Ottesen, Johnny T.

    2015-01-01

    Depression is a very common disease. Approximately 10% of people in the Western world experience severe depression during their lifetime and many more experience a mild form of depression. It is commonly believed that depression is caused by malfunctions in the biological system constituted...

  18. Managing Depression during the Menopausal Transition

    Science.gov (United States)

    Pearson, Quinn M.

    2010-01-01

    The menopausal transition is associated with both first onset of depression and recurrent depression. Risk factors include vasomotor symptoms, a history of premenstrual dysphoria, postpartum depression, major depression, and sleep disturbances. Hormone replacement therapy, complementary and alternative medicine approaches, and counseling…

  19. Managing Depression during the Menopausal Transition

    Science.gov (United States)

    Pearson, Quinn M.

    2010-01-01

    The menopausal transition is associated with both first onset of depression and recurrent depression. Risk factors include vasomotor symptoms, a history of premenstrual dysphoria, postpartum depression, major depression, and sleep disturbances. Hormone replacement therapy, complementary and alternative medicine approaches, and counseling…

  20. Detecting Depression in Elderly Medical Inpatients.

    Science.gov (United States)

    Rapp, Stephen R.; And Others

    1988-01-01

    Used Research Diagnostic Criteria to assess base rate of detection of depression in 150 elderly medical inpatients by nonpsychiatric physicians, and evaluated psychometric properties of screening instruments to assess depression. Found detection of depression by house staff extremely low (8.7 percent). Beck Depression Inventory (BDI), BDI…