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Sample records for patient-rated depression severity

  1. Determinants of patient-rated and clinician-rated illness severity in schizophrenia.

    Science.gov (United States)

    Fervaha, Gagan; Takeuchi, Hiroyoshi; Agid, Ofer; Lee, Jimmy; Foussias, George; Remington, Gary

    2015-07-01

    The contribution of specific symptoms on ratings of global illness severity in patients with schizophrenia is not well understood. The present study examined the clinical determinants of clinician and patient ratings of overall illness severity. This study included 1,010 patients with a DSM-IV diagnosis of schizophrenia who participated in the baseline visit of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study conducted between January 2001 and December 2004 and who had available symptom severity, side effect burden, cognition, and community functioning data. Both clinicians and patients completed the 7-point Clinical Global Impressions-Severity of Illness scale (CGI-S), the primary measure of interest in the present study. Symptoms were rated using the Positive and Negative Syndrome Scale and the Calgary Depression Scale for Schizophrenia, and functional status with the Quality of Life Scale. Neurocognition, insight, and medication-related side effects were also evaluated. Clinicians rated illness severity significantly higher than patients (P negative, disorganized, and depressive symptoms, as well as functional outcome (all P values enhance patient engagement in care and improve outcomes. ClinicalTrials.gov identifier: NCT00014001. © Copyright 2014 Physicians Postgraduate Press, Inc.

  2. [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. Copyright 2009 L'Encéphale. Published by Elsevier Masson SAS.. All rights reserved.

  3. Does recall period have an effect on cancer patients' ratings of the severity of multiple symptoms?

    Science.gov (United States)

    Shi, Qiuling; Trask, Peter C; Wang, Xin Shelley; Mendoza, Tito R; Apraku, Winifred A; Malekifar, Maggie; Cleeland, Charles S

    2010-08-01

    Choosing an appropriate recall period for symptom assessment in a clinical trial is dependent on the design and purpose of the trial. To examine the effects of recall on symptom severity ratings by comparing ratings made using 24-hour and seven-day recall periods of the MD Anderson Symptom Inventory (MDASI). Forty-two patients in their third to eighth week of chemoradiation rated their symptoms using the MDASI on two separate occasions (T1 and T2), one week apart. At T1, patients were randomly assigned to rate symptoms using either a 24-hour or a seven-day recall. At T2, patients rated symptoms using the recall period not used at their first visit. Comparing the 24-hour and seven-day recall periods, the correlation coefficient for total symptom severity was 0.888. All correlation coefficients for symptom severity items were >0.7 except for distress (r=0.67). The percentages of moderate to severe symptoms (rated >or=5) were consistent for both recall periods, with no significant difference between recall periods in the prevalence of moderate to severe symptoms. Cronbach alpha coefficients for both 24-hour and seven-day recalls were >0.8. Symptoms from both recall periods were more severe for patients with poorer performance status. Twenty patients were cognitively debriefed; 70% thought that the seven-day recall was "more appropriate" for the MDASI, but 85% did not think that recall period would influence their answers. This study demonstrated that the MDASI in a seven-day recall format has psychometric properties consistent with the 24-hour recall version, which may promote its use in future cancer clinical trials and may inform the choice of recall period when symptoms are outcome measures. Copyright (c) 2010 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  4. 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.

  5. Postpartum Depression After Mild and Severe Preeclampsia

    NARCIS (Netherlands)

    Hoedjes, Meeke; Berks, Durk; Vogel, Ineke; Franx, Arie; Bangma, Meike; Darlington, Anne-Sophie E.; Visser, Willy; Duvekot, Johannes J.; Habbema, J. Dik F.; Steegers, Eric A. P.; Raat, Hein

    2011-01-01

    Objective: To describe the prevalence of postpartum depressive symptoms after preeclampsia, to assess the extent to which the prevalence of postpartum depressive symptoms differs after mild and severe preeclampsia, and to investigate which factors contribute to such differences. Methods: Women

  6. The QUANTEC criteria for parotid gland dose and their efficacy to prevent moderate to severe patient-rated xerostomia.

    Science.gov (United States)

    Beetz, Ivo; Steenbakkers, Roel J H M; Chouvalova, Olga; Leemans, Charles R; Doornaert, Patricia; van der Laan, Bernard F A M; Christianen, Miranda E M C; Vissink, Arjan; Bijl, Henk P; van Luijk, Peter; Langendijk, Johannes A

    2014-05-01

    Recently, the Quantitative Analysis of Normal Tissue Effect in the Clinic (QUANTEC) Group defined dose-volume constraints for the parotid glands to avoid severe xerostomia. The aim of this study was to determine if application of these QUANTEC criteria also protected against moderate-to-severe patient-rated xerostomia. The study population consisted of 307 head and neck cancer patients treated with primary (chemo)radiotherapy, either with 3D-CRT (56%) or with IMRT (44%). All patients participated in a standard follow-up program in which radiation-induced toxicity and quality of life were prospectively assessed. Patients who met the QUANTEC criteria were classified as low risk and otherwise as high risk. In total, 41% of the patients (treated with 3D-CRT and IMRT) were classified as low risk patients. In the group treated with 3D-CRT and IMRT, it was possible to meet the QUANTEC criteria in 47% and 32% of the patients, respectively. Sparing the parotid glands with IMRT was considerably more difficult in patients with lymph node metastases and in patients with nasopharyngeal and oropharyngeal tumours. Low risk patients reported significantly less moderate-to-severe xerostomia than high risk patients. However, the predicted risk of elderly patients and patients with pre-existing minor patient-rated xerostomia at baseline was > 20%, even when the QUANTEC criteria were met. Significantly lower rates of radiation-induced patient-rated xerostomia were found among low risk patients treated according to the QUANTEC criteria, but these criteria do not completely protect against xerostomia. Particularly in elderly patients and patients already suffering from minor xerostomia at baseline, the QUANTEC criteria do not sufficiently protect against persistent, moderate-to-severe patient-rated xerostomia.

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

    DEFF Research Database (Denmark)

    Kessing, L.V.

    2008-01-01

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

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

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel

    2008-01-01

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

  9. Psychosocial factors predicting severity of depression among ...

    African Journals Online (AJOL)

    Background and Objectives: Depression as major psychological sequelea of the HIV/AIDS infection has continued to attract investigation. With few studies in Nigeria, it is unclear whether levels of perceived stigma, sexual risk behaviors, and anticipated discrimination are differentially associated with severity of depression.

  10. Impact of facial burns: relationship between depressive symptoms, self-esteem and scar severity.

    Science.gov (United States)

    Hoogewerf, Cornelis Johannes; van Baar, Margriet Elisabeth; Middelkoop, Esther; van Loey, Nancy Elisa

    2014-01-01

    This study assessed the role of self-reported facial scar severity as a possible influencing factor on self-esteem and depressive symptoms in patients with facial burns. A prospective multicentre cohort study with a 6 months follow-up was conducted including 132 patients with facial burns. Patients completed the Patient and Observer Scar Assessment Scale, the Rosenberg Self-esteem Scale and the Hospital Anxiety and Depression Scale. Structural Equation Modeling was used to assess the relations between depressive symptoms, self-esteem and scar severity. The model showed that patient-rated facial scar severity was not predictive for self-esteem and depressive symptoms six months post-burn. There was, however, a significant relationship between early depressive symptoms and both patient-rated facial scar severity and subsequent self-esteem. The variables in the model accounted for 37% of the variance in depressive symptoms six months post-burn and the model provided a moderately well-fitting representation of the data. The study suggests that self-esteem and depressive symptoms were not affected by self-reported facial scar severity but that earlier depressive symptoms were indicative for a more severe self-reported facial scar rating. Therefore, routine psychological screening during hospitalisation is recommended in order to identify patients at risk and to optimise their treatment. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Severity of depressive episodes according to ICD-10

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel

    2004-01-01

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

  12. Assessing depression related severity and functional impairment: the Overall Depression Severity and Impairment Scale (ODSIS.

    Directory of Open Access Journals (Sweden)

    Masaya Ito

    Full Text Available The Overall Depression Severity and Impairment Scale (ODSIS is a brief, five-item measure for assessing the frequency and intensity of depressive symptoms, as well as functional impairments in pleasurable activities, work or school, and interpersonal relationships due to depression. Although this scale is expected to be useful in various psychiatric and mental health settings, the reliability, validity, and interpretability have not yet been fully examined. This study was designed to examine the reliability, factorial, convergent, and discriminant validity of a Japanese version of the ODSIS, as well as its ability to distinguish between individuals with and without a major depressive disorder diagnosis.From a pool of registrants at an internet survey company, 2830 non-clinical and clinical participants were selected randomly (619 with major depressive disorder, 619 with panic disorder, 576 with social anxiety disorder, 645 with obsessive-compulsive disorder, and 371 non-clinical panelists. Participants were asked to respond to the ODSIS and conventional measures of depression, functional impairment, anxiety, neuroticism, satisfaction with life, and emotion regulation.Exploratory and confirmatory factor analysis of three split subsamples indicated the unidimensional factor structure of ODSIS. Multi-group confirmatory factor analysis showed invariance of factor loadings between non-clinical and clinical subsamples. The ODSIS also showed excellent internal consistency and test-retest intraclass correlation coefficients. Convergence and discriminance of the ODSIS with various measures were in line with our expectations. Receiver operating characteristic curve analyses showed that the ODSIS was able to detect a major depressive syndrome accurately.This study supports the reliability and validity of ODSIS in a non-western population, which can be interpreted as demonstrating cross-cultural validity.

  13. Maternal Depression and Youth Internalizing and Externalizing Symptomatology: Severity and Chronicity of Past Maternal Depression and Current Maternal Depressive Symptoms

    Science.gov (United States)

    O’Connor, Erin E.; Langer, David A.; Tompson, Martha C.

    2017-01-01

    Maternal depression is a well-documented risk factor for youth depression, and taking into account its severity and chronicity may provide important insight into the degree of risk conferred. This study explored the degree to which the severity/chronicity of maternal depression history explained variance in youth internalizing and externalizing symptoms above and beyond current maternal depressive symptoms among 171 youth (58% male) ages 8 to 12 over a span of three years. Severity and chronicity of past maternal depression and current maternal depressive symptoms were examined as predictors of parent-reported youth internalizing and externalizing symptomatology, as well as youth self-reported depressive symptoms. Severity and chronicity of past maternal depression did not account for additional variance in youth internalizing and externalizing symptoms at Time 1 beyond what was accounted for by maternal depressive symptoms at Time 1. Longitudinal growth curve modeling indicated that prior severity/chronicity of maternal depression predicted levels of youth internalizing and externalizing symptoms at each time point when controlling for current maternal depressive symptoms at each time point. Chronicity of maternal depression, apart from severity, also predicted rate of change in youth externalizing symptoms over time. These findings highlight the importance of screening and assessing for current maternal depressive symptoms, as well as the nature of past depressive episodes. Possible mechanisms underlying the association between severity/chronicity of maternal depression and youth outcomes, such as residual effects from depressive history on mother–child interactions, are discussed. PMID:27401880

  14. The Association between Physical Morbidity and Subtypes of Severe Depression

    DEFF Research Database (Denmark)

    Østergaard, Søren Dinesen; Petrides, Georgio; Dinesen, Peter Thisted

    2013-01-01

    Physical illness and depression are related, but the association between specific physical diseases and diagnostic subtypes of depression remains poorly understood. This study aimed to clarify the relationship between a number of physical diseases and the nonpsychotic and psychotic subtype...... of severe depression....

  15. Prevalence and Severity of Depression among Undergraduate ...

    African Journals Online (AJOL)

    Undergraduate Students in Karachi, Pakistan: A Cross. Sectional Study ... questionnaire to appraise the presence and extent of depression among the participants. Their socio- ..... and disability by cause 1990-2020: Global burden of disease ...

  16. Gender differences in depression severity and symptoms across depressive sub-types.

    Science.gov (United States)

    Parker, Gordon; Fletcher, Kathryn; Paterson, Amelia; Anderson, Josephine; Hong, Michael

    2014-01-01

    Lifetime rates of depression are distinctly higher in women reflecting both real and artefactual influences. Most prevalence studies quantifying a female preponderance have examined severity-based diagnostic groups such as major depression or dysthymia. We examined gender differences across three depressive sub-type conditions using four differing measures to determine whether any gender differences emerge more from severity or symptom prevalence, reflect nuances of the particular measure, or whether depressive sub-type is influential. A large clinical sample was recruited. Patients completed two severity-weighted depression measures: the Depression in the Medically Ill 10 (DMI-10) and Quick Inventory of Depressive Symptoms-Self-Report (QIDS-SR) and two measures weighting symptoms and illness correlates of melancholic and non-melancholic depressive disorders - the Severity of Depressive Symptoms (SDS) and Sydney Melancholia Prototype Index (SMPI). Analyses were undertaken of three diagnostic groups comprising those with unipolar melancholic, unipolar non-melancholic and bipolar depressive conditions. Women in the two unipolar groups scored only marginally (and non-significantly) higher than men on the depression severity measures. Women in the bipolar depression group, did however, score significantly higher than men on depression severity. On measures weighted to assessing melancholic and non-melancholic symptoms, there were relatively few gender differences identified in the melancholic and non-melancholic sub-sets, while more gender differences were quantified in the bipolar sub-set. The symptoms most commonly and consistently differentiating by gender were those assessing appetite/weight change and psychomotor disturbance. Our analyses of several measures and the minimal differentiation of depressive symptoms and symptom severity argues against any female preponderance in unipolar depression being contributed to distinctly by these depression rating measures

  17. Personal and Perceived Depression Stigma among Arab Adolescents: Associations with Depression Severity and Personal Characteristics.

    Science.gov (United States)

    Dardas, Latefa Ali; Silva, Susan G; Smoski, Moria J; Noonan, Devon; Simmons, Leigh Ann

    2017-10-01

    In Arab communities, the selection, utilization, and attitudes towards mental health services are substantially affected by existing mental illness stigma. However, little is known about how the stigma of depression manifests among Arab adolescents, which makes it difficult to design, implement, and disseminate effective anti-stigma interventions for this vulnerable population. Therefore, the purpose of this study was to determine levels of depression stigma among Arab adolescents. The specific aims were to (1) describe the severity of personal and perceived depression stigma among Arab adolescents and its relationship to severity of depression, and (2) determine characteristics associated with severity of depression stigma among Arab adolescents. This study was conducted in Jordan, a Middle Eastern Arab country. A nationally representative, school-based survey was utilized. A total of 2349 Jordanian adolescents aged 12-17 completed and returned the survey packets, which included measures on individual characteristics, depression severity, and depression stigma. The majority of the adolescents (88%) reported scores indicating moderate to high depression stigma. Adolescents reported higher rates of perceived stigma than personal stigma. Depression stigma was not significantly associated with severity of depression, but with adolescent's sex, age, region of residence, parents' education, and history of mental health problem. This is the first Arab study to isolate the influence of adolescent depression and personal characteristics on personal and perceived depression stigmas, and highlight the presence of these distinctions early in adolescence. Such distinction can inform the design and implementation of policies and interventions to reduce both personal and perceived stigma. The study provides important recommendations on when, how, and why to utilize school settings for anti-depression stigma interventions. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Tinnitus severity, depression, and the big five personality traits.

    Science.gov (United States)

    Langguth, B; Kleinjung, T; Fischer, B; Hajak, G; Eichhammer, P; Sand, P G

    2007-01-01

    A growing number of self-report measures for the evaluation of tinnitus severity has become available to research and clinical practice. This has led to an increased awareness of depression and personality as predictors of tinnitus severity in addition to loudness and other psychoacoustic measures. However, the net impact of personality dimensions on tinnitus ratings has not been investigated when the effect of depressed mood is controlled. In the present study, we demonstrate the role of the big five personality traits, 'Neuroticism', 'Extraversion', 'Openness', 'Agreeableness', and 'Conscientiousness', in affecting scores on two standard instruments for grading tinnitus-related complaints, the tinnitus handicap inventory (THI), and the tinnitus questionnaire (TQ). When 72 individuals with chronic tinnitus were examined, 'Agreeableness' negatively correlated with THI scores (p=.003), whereas the anxiety trait 'Neuroticism' correlated both with depressive symptomatology (ptrait anxiety and depression, low 'Agreeableness' was thus identified as a novel predictor of tinnitus severity on the THI.

  19. Severity of depression in hepatitis B and hepatitis C patients

    International Nuclear Information System (INIS)

    Qureshi, M.O.; Khokhar, N.; Shafqat, F.

    2012-01-01

    Objective: To assess and compare the severity of depression in chronic hepatitis B (CHB), chronic hepatitis C (CHC) and healthy subjects. Study Design: Comparative study. Place and Duration of Study: Shifa International Hospital, Islamabad from July 2011 to February 2012. Methodology:A total of 206 subjects were divided in three groups. Group-I (chronic hepatitis C, n = 95), group-II (chronic hepatitis B, n = 29) and group-III (healthy subjects, n = 82). They were matched for age, gender and socioeconomic status and were compared for frequency and severity of depression as measured by Hospital Anxiety and Depression Scale (HADS). Results: Some degree of depression was noted in all groups. Frequency of depression was 72.6% in group-I, 58.6% in group-II and 37.8% in group-III (p value < 0.001). Conclusion: Both CHC and CHB had high frequency of some degree of depression. Hepatitis C patients had more depressive features than CHB. It is worthwhile to do more close mental health observation in them. A multidisciplinary team including a psychiatric specialist can help in this approach. (author)

  20. Respecting the 'stages' of depression: Considering depression severity and readiness to seek help.

    Science.gov (United States)

    Lueck, Jennifer A

    2018-07-01

    Despite knowing the value of message customization, empirical results have failed to provide clear indicators of what make a depression help-seeking message effective. The present research examines stages of depression in response to a prominent communication strategy, gain versus loss framing, to inform possibilities for effective message customization. Two experimental studies were conducted with a student (N = 126) and U.S. adult (N = 738) sample that tested the effects of gain versus loss framing at different stages of depression. A persuasive gain-frame advantage was found for those with mild and severe depression, whereas a boomerang effect was found for both gain and loss framing among those with moderately severe depression. With regards to intention to seek help, neither gain nor loss framing was found to influence intentions. Stages of depression was a strong predictor, with strongest intentions to seek help observed among those with either minor or severe symptoms of depression. Effective health messaging must be matched with unique characteristics and needs of individuals at each 'stage' of depression in order to produce favorable outcomes. 'Stages' of depression should be known and carefully assessed before the creation and launch of communication interventions. Copyright © 2018 Elsevier B.V. All rights reserved.

  1. Predictability of depression severity based on posterior alpha oscillations.

    Science.gov (United States)

    Jiang, H; Popov, T; Jylänki, P; Bi, K; Yao, Z; Lu, Q; Jensen, O; van Gerven, M A J

    2016-04-01

    We aimed to integrate neural data and an advanced machine learning technique to predict individual major depressive disorder (MDD) patient severity. MEG data was acquired from 22 MDD patients and 22 healthy controls (HC) resting awake with eyes closed. Individual power spectra were calculated by a Fourier transform. Sources were reconstructed via beamforming technique. Bayesian linear regression was applied to predict depression severity based on the spatial distribution of oscillatory power. In MDD patients, decreased theta (4-8 Hz) and alpha (8-14 Hz) power was observed in fronto-central and posterior areas respectively, whereas increased beta (14-30 Hz) power was observed in fronto-central regions. In particular, posterior alpha power was negatively related to depression severity. The Bayesian linear regression model showed significant depression severity prediction performance based on the spatial distribution of both alpha (r=0.68, p=0.0005) and beta power (r=0.56, p=0.007) respectively. Our findings point to a specific alteration of oscillatory brain activity in MDD patients during rest as characterized from MEG data in terms of spectral and spatial distribution. The proposed model yielded a quantitative and objective estimation for the depression severity, which in turn has a potential for diagnosis and monitoring of the recovery process. Copyright © 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  2. Association Between Functional Dyspepsia And Severity Of Depression

    International Nuclear Information System (INIS)

    Jamil, O.; Sarwar, S.; Hussain, Z.; Fiaz, R. O.; Chaudary, R. D.

    2016-01-01

    Objective: To determine the association between functional dyspepsia and the severity of depression. Study Design: Cross-sectional study. Place and Duration of Study: Department of Medicine, King Edward Medical University/Mayo Hospital, Lahore, from September 2012 till January 2013. Methodology: After taking informed written consent, patients with symptoms of dyspepsia fulfilling the Rome III criteria were included in the study. All patients were evaluated for depression, using Hamilton depression rating scale (HDRS). Upper gastrointestinal endoscopy was done. Fischers' exact test and independent t-test were used for determining significance of association. Result: One hundred and one patients with mean age of 35.81 14.81) years and male to female ratio of 1.41:1 (54/47) were included. Predominant symptoms were early satiety (72.3 percentage), epigastric pain (65.3 percentage), bloating (49.5 percentage), postprandial fullness (40.6 percentage), and regurgitation (40.6 percentage). Alarm symptoms were positive in 44 (43.6 percentage) patients. Dyspepsia were classified as epigastric pain syndrome (EPS, 69.3 percentage), and postprandial distress syndrome (PDS, 30.7 percentage). Significantly more females had PDS (p=0.04), with positive endoscopic findings in EPS (p=0.03). Positive endoscopic findings noted were esophagitis in 21.8 percentage, and gastritis in 48.5 percentage patients. All patients except one had depression, mild in 22.8 percentage, moderate in 33.7 percentage, severe in 31.7 percentage, and very severe in 10.9 percentage patients. Severe depression was seen in 32 (45.7 percentage) patients with EPS and PDS; whereas very severe depression was in 11 (15.7 percentage) patients of EPS, while 11 (35.4 percentage) patients of PDS had severe depression but the difference was not significant. Conclusion: Functional dyspepsia is associated with depression, while positive endoscopic findings are more likely in patients with EPS. Very severe depression

  3. Disrupted reward circuits is associated with cognitive deficits and depression severity in major depressive disorder.

    Science.gov (United States)

    Gong, Liang; Yin, Yingying; He, Cancan; Ye, Qing; Bai, Feng; Yuan, Yonggui; Zhang, Haisan; Lv, Luxian; Zhang, Hongxing; Xie, Chunming; Zhang, Zhijun

    2017-01-01

    Neuroimaging studies have demonstrated that major depressive disorder (MDD) patients show blunted activity responses to reward-related tasks. However, whether abnormal reward circuits affect cognition and depression in MDD patients remains unclear. Seventy-five drug-naive MDD patients and 42 cognitively normal (CN) subjects underwent a resting-state functional magnetic resonance imaging scan. The bilateral nucleus accumbens (NAc) were selected as seeds to construct reward circuits across all subjects. A multivariate linear regression analysis was employed to investigate the neural substrates of cognitive function and depression severity on the reward circuits in MDD patients. The common pathway underlying cognitive deficits and depression was identified with conjunction analysis. Compared with CN subjects, MDD patients showed decreased reward network connectivity that was primarily located in the prefrontal-striatal regions. Importantly, distinct and common neural pathways underlying cognition and depression were identified, implying the independent and synergistic effects of cognitive deficits and depression severity on reward circuits. This study demonstrated that disrupted topological organization within reward circuits was significantly associated with cognitive deficits and depression severity in MDD patients. These findings suggest that in addition to antidepressant treatment, normalized reward circuits should be a focus and a target for improving depression and cognitive deficits in MDD patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Complex partial seizure with severe depression and conduct ...

    African Journals Online (AJOL)

    Complex partial seizure complicated by psychiatric comorbidities like depression and conduct disorder presents management challenges for both the physician and parents. The etiology of such psychiatric comorbidities may be related to the seizure or to several other unrelated risk factors. The psychiatric comorbidities and ...

  5. Predictability of depression severity based on posterior alpha oscillations

    NARCIS (Netherlands)

    Jiang, H.; Popov, T.; Jylänki, P.P.; Bi, K.; Yao, Z.; Lu, Q.; Jensen, O.; Gerven, M.A.J. van

    2016-01-01

    Objective: We aimed to integrate neural data and an advanced machine learning technique to predict individual major depressive disorder (MDD) patient severity. Methods: MEG data was acquired from 22 MDD patients and 22 healthy controls (HC) resting awake with eyes closed. Individual power spectra

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

    Science.gov (United States)

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

    2017-09-01

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

  7. Relationship between severity of depression symptoms and iron deficiency anemia in women with major depressive disorder

    Directory of Open Access Journals (Sweden)

    Seyed gholamreza Noorazar

    2015-11-01

    Full Text Available Introduction: Iron deficiency (ID is a common nutritional problem lead to many unintended consequences such as decrease energy, immune system problems, and neurological dysfunction. The most common psychological disorder is depression. A patient with ID anemia (IDA show signs and symptoms of behavioral and mood disorders like depression. Methods: In this study, 100 female patients with diagnosed major depression in years 2010 and 2011 were studied. In all patients standard Hamilton depression rating scale (HDRS was used to evaluate depression severity. Blood samples were taken for complete blood count difference analysis and evaluating anemia and in those with hemoglobin (Hb < 12 mg/dl, ferritin, and total iron binding capacity were checked to evaluate IDA. Results: Patients mean age was 36.34 ± 10.43 years old. Mean HDRS score was 32.20 ± 4.07. 19 had anemia, and among them 8% had IDA. Mean HDRS score in patients with IDA (33.37 ± 1.90 was higher than those without (32.09 ± 4.19, but the difference was not significant (P = 0.39. There was no difference between patients with and without anemia in HDRS score. The negative relation was observed between Hb levels, and HDRS score (Pearson correlation = -0.21, P = 0.03. Conclusion: We observed that the negative correlation between Hb levels and HDRS score. It demonstrates the effect of Hb decrease and anemia occurrence on depression severity; however, it needs more studies.

  8. Increase in work productivity of depressed individuals with improvement in depressive symptom severity.

    Science.gov (United States)

    Trivedi, Madhukar H; Morris, David W; Wisniewski, Stephen R; Lesser, Ira; Nierenberg, Andrew A; Daly, Ella; Kurian, Benji T; Gaynes, Bradley N; Balasubramani, G K; Rush, A John

    2013-06-01

    The authors sought to identify baseline clinical and sociodemographic characteristics associated with work productivity in depressed outpatients and to assess the effect of treatment on work productivity. Employed depressed outpatients 18-75 years old who completed the Work Productivity and Activity Impairment scale (N=1,928) were treated with citalopram (20-40 mg/day) in the Sequenced Treatment Alternatives to Relieve Depression study. For patients who did not remit after an initial adequate antidepressant trial (level 1), either a switch to sertraline, sustained-release bupropion, or extended-release venlafaxine or an augmentation with sustained-release bupropion or buspirone was provided (level 2). Participants' clinical and demographic characteristics and treatment outcomes were analyzed for associations with baseline work productivity and change in productivity over time. Education, baseline depression severity, and melancholic, atypical, and recurrent depression subtypes were all independently associated with lower benefit to work productivity domains. During level 1 treatment, work productivity in several domains improved with reductions in depressive symptom severity. However, these findings did not hold true for level 2 outcomes; there was no significant association between treatment response and reduction in work impairment. Results were largely confirmed when multiple imputations were employed to address missing data. During this additional analysis, an association was also observed between greater impairment in work productivity and higher levels of anxious depression. Patients with clinically significant reductions in symptom severity during initial treatment were more likely than nonresponders to experience significant improvements in work productivity. In contrast, patients who achieved symptom remission in second-step treatment continued to have impairment at work. Patients who have demonstrated some degree of treatment resistance are more prone to

  9. Relationship of severity of depression, anxiety and stress with severity of fibromyalgia.

    Science.gov (United States)

    Alok, R; Das, S K; Agarwal, G G; Salwahan, L; Srivastava, R

    2011-01-01

    Negative affects like depression, anxiety and stress are frequently observed in patients with fibromyalgia (FMS). Understanding the association between FMS and negative affects is likely to help in deciding the choice of treatment. The aim of this study was to determine the correlation between the severity of FMS with the severity of depression, anxiety and stress. Sixty patients with fibromyalgia and 60 healthy controls were included in the study. Fibromyalgia Impact Questionnaire Revised (FIQR), and Depression, Anxiety and Stress Scale (DASS21) were administered to both the groups. The mean age of study population was 40.4±9.9 and 36±8.7 for FMS and control groups respectively. Most of the patients were females (93.3%). In subjects without FMS, depression was seen in 5% and was significantly associated with all three components of FIQR (pdepression, anxiety and stress were found significantly associated with the severity of all three components of FIQR, namely pain, function and symptoms (pdepression, anxiety and stress and in FMS magnitude of negative affects is significantly correlated with FIQR. However, depression alone in absence of FMS can also give rise to all three components of FIQR.

  10. Efficacy of Desvenlafaxine Compared With Placebo in Major Depressive Disorder Patients by Age Group and Severity of Depression at Baseline.

    Science.gov (United States)

    Mosca, Daniel; Zhang, Min; Prieto, Rita; Boucher, Matthieu

    2017-04-01

    This post hoc meta-analysis evaluated the efficacy and safety of desvenlafaxine 50 and 100 mg versus placebo across age groups and severity of depression at baseline in patients with major depressive disorder. Data from placebo and desvenlafaxine 50-mg and 100-mg dose arms were pooled from 9 short-term, placebo-controlled, major depressive disorder studies (N = 4279). Effects of age (18-40 years, >40 to depression severity (mild, 17-item Hamilton Rating Scale for Depression total score [HAM-D17] ≤18; moderate, HAM-D17 >18 to depression and function compared with placebo for patients 18 to 40 years, older than 40 to younger than 55 years, and 55 to younger than 65 years, with no significant evidence of an effect of age. Desvenlafaxine significantly improved most measures of depression and function in moderately and severely depressed patients. There was a significant baseline severity by treatment interaction for HAM-D17 total score only (P = 0.027), with a larger treatment effect for the severely depressed group. Desvenlafaxine significantly improved depressive symptoms in patients younger than 65 years and in patients with moderate or severe baseline depression. Sample sizes were not adequate to assess desvenlafaxine efficacy in patients 65 years or older or with mild baseline depression.

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

    Science.gov (United States)

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

    2015-09-01

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

  12. Is postpartum depression a homogenous disorder: time of onset, severity, symptoms and hopelessness in relation to the course of depression.

    Science.gov (United States)

    Kettunen, Pirjo; Koistinen, Eeva; Hintikka, Jukka

    2014-12-10

    Postpartum depression (PPD) is a common illness, but due to the underlying processes and the diversity of symptoms, some variability is exhibited. The risk of postpartum depression is great if the mother has previously suffered from depression, but there is some evidence that a certain subgroup of women only experience depression during the postpartum period. The study group consisted of 104 mothers with postpartum major depression and a control group of 104 postpartum mothers without depression. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) was used for data collection. The severity of depression and other mental symptoms were assessed using several validated rating scales. A history of past depression (82%), including depression during pregnancy (42%) and during the postpartum period (53%), was very common in those with current PPD. Eighteen per cent of mothers with current PPD had previously not had any depressive episodes and four per cent had experienced depression only during the postpartum period. Therefore, pure PPD was rare. The onset of PPD was usually (84%) within six weeks of childbirth. Obsessive-compulsive symptoms, phobic anxiety, paranoid ideation, depressed mood, diminished pleasure/interest, decreased energy, and psychomotor agitation/retardation were common with all kinds of depression histories. Pure PPD was the most similar to the first depressive episode. Nevertheless, the severity of depression, the level of hopelessness, somatisation, interpersonal sensitivity, anxiety, hostility, psychoticism, sleep disturbance, and suicidal ideation were lower, appetite changed less, and concentration was better than in other recurrent depressions. According to this study, PPD is not a homogenous disorder. The time of onset, severity, symptoms, level of hopelessness, and the course of depression vary. Recurrent depression is common. All mothers must be screened during the sixth week postpartum at the latest. Screening alone is not

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

    Directory of Open Access Journals (Sweden)

    Rajamannar Ramasubbu, MD, FRCPC, MSc

    2016-01-01

    Conclusions: Binary linear SVM classifiers achieved significant classification of very severe depression with resting-state fMRI, but the contribution of brain measurements may have limited potential in differentiating patients with less severe depression from healthy controls.

  14. Differential relationship between depression severity and patients' perceived family functioning in women versus in men.

    Science.gov (United States)

    Febres, Jeniimarie; Rossi, Rita; Gaudiano, Brandon A; Miller, Ivan W

    2011-07-01

    Previous research suggests that depression and family functioning are related and that women and men may differ in how they respond to and cope with depression. Significantly less attention has been paid to whether sex moderates the relationship between family functioning and depression. In the current study, the relationship between depression severity and perceived family functioning, both generally and in specific areas, was examined in women and men (N = 117) hospitalized with major depression. The level of depression severity was not significantly different in men and in women. Correlations between depression severity and most domains of family functioning were significant and positive for men only. Furthermore, sex statistically moderated the associations between depression severity and family functioning in the areas of problem solving, communication, affective responsiveness, and behavior control. The implications for the assessment and treatment of family dysfunction in severely depressed patients are discussed.

  15. Likelihood of Suicidality at Varying Levels of Depression Severity: A Re-Analysis of NESARC Data

    Science.gov (United States)

    Uebelacker, Lisa A.; Strong, David; Weinstock, Lauren M.; Miller, Ivan W.

    2010-01-01

    Although it is clear that increasing depression severity is associated with more risk for suicidality, less is known about at what levels of depression severity the risk for different suicide symptoms increases. We used item response theory to estimate the likelihood of endorsing suicide symptoms across levels of depression severity in an…

  16. Cerebrospinal fluid D-serine concentrations in major depressive disorder negatively correlate with depression severity.

    Science.gov (United States)

    Ishiwata, Sayuri; Hattori, Kotaro; Sasayama, Daimei; Teraishi, Toshiya; Miyakawa, Tomoko; Yokota, Yuuki; Matsumura, Ryo; Nishikawa, Toru; Kunugi, Hiroshi

    2018-01-15

    D-serine is an endogenous co-agonist of N-methyl-D-aspartate receptor (NMDAR) and plays an important role in glutamate neurotransmission. Several studies suggested the possible involvement of D-serine related in the pathophysiology of psychiatric disorders including major depression disorders (MDD). We tried to examine whether cerebrospinal fluid (CSF) or plasma D-serine concentrations are altered in MDD and whether D-serine concentrations correlated with disease severity. 26 MDD patients and 27 healthy controls matched for age, sex and ethnicity were enrolled. We measured amino acids in these samples using by high-performance liquid chromatography with fluorometric detection. D-serine and L-serine, precursor of D-serine, levels in CSF or plasma were not significantly different in patients of MDD compared to controls. Furthermore, a significant correlation between D-serine levels in CSF and Hamilton Depression Rating Scale (HAMD)-17 score was observed (r = -0.65, p = 0.006). Furthermore, we found a positive correlation between CSF D-serine and HVA concentrations in MDD patients (r = 0.54, p = 0.007). CSF D-serine concentrations were correlated with those of plasma in MDD (r = 0.61, p = 0.01) but not in controls. In CSF, we also confirmed a significant correlation between D-serine and L-serine levels in MDD (r = 0.72, p depression severity and HVA concentrations and further investigation were required to reveal the effect of medication and disease heterogeneity. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. The role of early adversity and recent life stress in depression severity in an outpatient sample.

    Science.gov (United States)

    Vogt, Dominic; Waeldin, Sandra; Hellhammer, Dirk; Meinlschmidt, Gunther

    2016-12-01

    Pre-, peri-, and postnatal stress have frequently been reported to be associated with negative health outcomes during adult life. However, it is unclear, if these factors independently predict mental health in adulthood. We estimated potential associations between reports of pre-, peri-, and postnatal stress and depression severity in outpatients (N = 473) diagnosed with depression, anxiety or somatoform disorders by their family physician. We retrospectively assessed pre-, peri-, and postnatal stress and measured depression severity as well as recent life stress using questionnaires. First, we estimated if depression severity was predicted by pre-, peri- and/or postnatal stress using multiple regression models. Second, we compared pre- and postnatal stress levels between patient subgroups of different degrees of depression severity, performing multilevel linear modeling. Third, we analyzed if an association between postnatal stress and current depression severity was mediated by recent life stress. We found no associations of pre-, or perinatal stress with depression severity (all p > 0.05). Higher postnatal stress was associated with higher depression severity (p stress as compared to patients with none to minimal, or mild depression (all p life stress of the association between postnatal stress and depression severity (p stress predicted depression severity in adult life. This association was mediated by recent life stress. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Prevalence and Severity of Depression among People Living with ...

    African Journals Online (AJOL)

    The validated Patient Health, Duke University of North Carolina functional social support questionnaires were used as interviewer-administered tools. The study revealed 14.4% prevalence of depression, with the mild category (9.5%) as the predominant subtype. Factors associated with the risk of developing depression ...

  19. Mortality and life expectancy in persons with severe unipolar depression

    DEFF Research Database (Denmark)

    Laursen, Thomas Munk; Musliner, Katherine L; Benros, Michael E

    2016-01-01

    BACKGROUND: Depression is a common psychiatric disorder, with a lifetime prevalence of 10-15% in the Danish population. Although depression is associated with excess mortality, it is not yet understood how this affects life expectancy. Our aim was to examine mortality rates and life expectancy...... in patients with unipolar depression compared to the general population, and to assess the impact of comorbid somatic illness and substance abuse. METHODS: We followed a Danish population-based cohort from 1995-2013 (N=5,103,699). The cohort included all residents in Denmark during the study period. Mortality...... rate ratios (MRRs) and life expectancy in persons with unipolar depression were calculated using survival analysis techniques. RESULTS: The overall MRR was 2.07 (95% Confidence Interval (CI): 2.05-2.09) in people with a previous unipolar depression diagnosis compared to the general Danish population...

  20. Mindfulness, Quality of Life, and Severity of Depressive Symptoms Among Patients With Schizophrenia and Patients With Major Depressive Disorder.

    Science.gov (United States)

    Rayan, Ahmad Hussien Rateb

    2017-05-01

    The current study used a descriptive correlational design to examine the relationship between mindfulness and quality of life (QOL) among patients with schizophrenia (n = 160) and patients with major depressive disorder (MDD) (n = 161), controlling for demographic and clinical variables. Participants completed self-reported questionnaires regarding demographic variables, severity of depression, QOL, and mindfulness. Patients diagnosed with MDD had higher mindfulness scores than patients diagnosed with schizophrenia. Mindfulness scores were significantly associated with the severity of depression among participants. After controlling for the demographic variables and severity of depressive symptoms, mindfulness had a unique variance in QOL among patients with schizophrenia, but not among patients with MDD. The current study provides preliminary evidence regarding the role of mindfulness in improving depressive symptoms and the overall QOL among patients diagnosed with mental illness. [Journal of Psychosocial Nursing and Mental Health Services, 55(5), 40-50.]. Copyright 2017, SLACK Incorporated.

  1. Exercise and severe major depression: effect on symptom severity and quality of life at discharge in an inpatient cohort.

    Science.gov (United States)

    Schuch, F B; Vasconcelos-Moreno, M P; Borowsky, C; Zimmermann, A B; Rocha, N S; Fleck, M P

    2015-02-01

    Exercise is a potential treatment for depression. However, few studies have evaluated the role of adjunct exercise in the treatment of severely major depressed inpatients. The goal of this study was to evaluate the effects of add-on exercise on the usual treatment of severely depressed inpatients. Fifty participants were randomized to an exercise (exercise + usual treatment) or a control (usual treatment) group. Twenty-five patients were randomly allocated to each group. The participants in the exercise group performed three sessions per week throughout the hospitalization period, with a goal dose of 16.5 kcal/kg/week plus the usual pharmacological treatment. Depressive symptoms and the Quality of Life (QoL) of the participants were assessed at the baseline, the second week, and discharge. A significant group × time interaction was found for depressive symptoms and the physical and psychological domains of QoL. Differences between groups occurred at the second week and discharge with respect to depressive symptoms and the physical and psychological domains of QoL. There was no difference in the remission rate at discharge (48% and 32% for the exercise and control group, respectively). An NNT of 6.25 was found. No significant baseline characteristics predict remission at discharge. Add-on exercise is an efficacious treatment for severely depressed inpatients, improving their depressive symptoms and QoL. Initial acceptance of exercise remains a challenge. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. What predicts depression in cardiac patients: Sociodemographic factors, disease severity or theoretical vulnerabilities?

    OpenAIRE

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

    2011-01-01

    Depression is associated with increased cardiovascular risk in patients with acute coronary syndrome (ACS), but some argue that elevated depression is actually a marker of cardiovascular disease severity. Therefore, disease indices should be better predictors of depression than established theoretical causes of depression (interpersonal life events, reinforcing events, cognitive distortions, type D personality). However, little theory-based research has been conducted in this area. In a cross...

  3. Big Five personality and depression diagnosis, severity and age of onset in older adults.

    Science.gov (United States)

    Koorevaar, A M L; Comijs, H C; Dhondt, A D F; van Marwijk, H W J; van der Mast, R C; Naarding, P; Oude Voshaar, R C; Stek, M L

    2013-10-01

    Personality may play an important role in late-life depression. The aim of this study is to examine the association between the Big Five personality domains and the diagnosis, severity and age of onset of late-life depression. The NEO-Five Factor Inventory (NEO-FFI) was cross-sectionally used in 352 depressed and 125 non-depressed older adults participating in the Netherlands Study of Depression in Older Persons (NESDO). Depression diagnosis was determined by the Composite International Diagnostic Interview (CIDI). Severity of depression was assessed by the Inventory of Depressive Symptomatology (IDS). Logistic and linear regression analyses were applied. Adjustments were made for sociodemographic, cognitive, health and psychosocial variables. Both the presence of a depression diagnosis and severity of depression were significantly associated with higher Neuroticism (OR=1.35, 95% CI=1.28-1.43 and B=1.06, ppersonality measures. This study confirms an association between personality and late-life depression. Remarkable is the association found between high Openness and earlier age of depression onset. © 2013 Elsevier B.V. All rights reserved.

  4. Association between pain severity, depression severity, and use of health care services in Japan: results of a nationwide survey

    Directory of Open Access Journals (Sweden)

    Vietri J

    2015-03-01

    Full Text Available Jeffrey Vietri,1 Tempei Otsubo,2 William Montgomery,3 Toshinaga Tsuji,4 Eiji Harada5 1Health Outcomes Practice, Kantar Health, Milan, Italy; 2Tokyo Shinjuku Medical Center, Tokyo, Japan; 3Eli Lilly Australia Pty Ltd., West Ryde, Australia; 4Medical Affairs, Shionogi & Co., Ltd., Osaka, Japan; 5Eli Lilly Japan KK, Kobe, Japan Background: Depression is often associated with painful physical symptoms. Previous research has seldom assessed the relationship between the severity of physical symptoms and the severity of mental and emotional symptoms of depression or other health outcomes, and no such studies have been conducted previously among individuals with depression in Japan. The aim of this study was to assess the relationship between the severity of physical pain and depression and other outcomes among individuals in Japan diagnosed with depression.Methods: Data for individuals aged 18 and older in Japan who reported being diagnosed with depression and also reported physical pain were obtained from the Japan National Health and Wellness Survey. These respondents were characterized on sociodemographics and health characteristics, and the relationship between ratings of severity on pain in the last week and health outcomes were assessed using bivariate correlations and generalized linear models. Measures included the Patient Health Questionnaire for depression severity, Medical Outcomes Study 12-Item Short Form Survey Instrument for health-related quality of life, the Work Productivity and Activity Impairment for work and activity impairment, and 6-month report of health care use.Results: More severe physical pain in the past week was correlated with more severe depression, worse health-related quality of life, lower health utility, greater impairment at work, and more health care provider visits. These relationships remained significant after incorporating sociodemographics and health characteristics in the statistical models

  5. Plasma galanin is a biomarker for severity of major depressive disorder.

    Science.gov (United States)

    Wang, Yong-Jun; Yang, Yu-Tao; Li, Hui; Liu, Po-Zi; Wang, Chuan-Yue; Xu, Zhi-Qing David

    2014-01-01

    This study investigated the association between plasma galanin level and depression severity. The severity of depression symptoms of 79 patients with major depressive disorder (MDD; 52 women and 27 men, 71 patients in onset, 8 in remission) was assessed using the 17-item Hamilton Depression Rating Scale. Venous fasting blood samples (5 mL) were taken from the 79 MDD patients, 35 healthy siblings, and 19 healthy controls, and plasma samples were prepared. Galanin levels in the plasma were measured by radioimmunoassay. Plasma galanin in MDD patients was significantly higher than that of remission patients, healthy siblings, or healthy controls (P 0.05). There was a significant positive correlation between plasma galanin levels and depression severity in women MDD patients (r = 0.329, df = 42, P = 0.020), but not in men patients. Plasma galanin levels may be an important biomarker for depression severity, especially in female patients.

  6. Are severe depressive symptoms associated with infertility-related distress in individuals and their partners?

    DEFF Research Database (Denmark)

    Peterson, Brennan D.; Sejbæk, Camilla Sandal; Prritano, Matthew

    2014-01-01

    the individual and partner level. What is known already?: An infertility diagnosis, the stress of medical treatments and a prior history of depression are risk factors for future depression in those undergoing fertility treatments. Studies examining the impact of severe depressive symptoms on infertility-related......Study question: Are severe depressive symptoms in women and men associated with individual and dyadic infertility-related stress in couples undergoing infertility treatment? Summary answer: Severe depressive symptoms were significantly associated with increased infertility-related distress at both....../materials, setting, methods: Participants were consecutively referred patients undergoing a cycle of medically assisted reproduction treatment at five Danish public and private clinics specializing in treating fertility patients. Severe depressive symptoms were measured by the Mental Health Inventory 5 from...

  7. Mothers’ Depression and Stress, Severity of Autism among Children and Family Income

    OpenAIRE

    Athari, Pegah; Department of educational psychology, Faculty of Education Universiti Teknologi Malaysia; Ghaedi, Leila; Department of educational psychology, Faculty of Education Universiti Teknologi Malaysia

    2013-01-01

    This study was conducted to investigate the relationship between mothers’ depression and stress compared with severity of autism in children and the effect of family income on the relationship between these two latter variables. Levels of depression and stress among mothers (n=250) were measured based on Depression Anxiety and Stress Scale of 42 items (DASS¬-42). The severity of autism among children was assessed by Autism Behavior Checklist (ABC) according to children’s teachers reports (n=2...

  8. The prevalence and correlates of severe depression in a cohort of Mexican teachers.

    Science.gov (United States)

    Soria-Saucedo, Rene; Lopez-Ridaura, Ruy; Lajous, Martin; Wirtz, Veronika J

    2018-07-01

    Depression is among the 10 major causes of disability in Mexico. Yet, local contextual factors associated to the disorder remain poorly understood. We measured the impact of several factors on severe depression such as demographics, pharmacotherapy, multimorbidity, and unhealthy behaviors in Mexican teachers. A total of 43,845 Mexican female teachers from 12 Mexican states answered the Patient Health Questionnaire (PHQ9). Data were part the Mexican Teacher's Cohort prospective study, the largest ongoing cohort study in Latin America. Unadjusted and adjusted estimates assessed the impact of several contextual factors between severe versus mild-no depression cases. In total 7026 teachers (16%) had a PHQ9 score compatible with severe depression. From them, only 17% received psychotropics, compared to 60% for those with a formal diagnosis. Less than 5% of teachers with PHQ9 scores compatible with severe depression had a formal diagnosis. Adjusted analysis reported higher odds of pharmacotherapy, having ≥ 3 comorbidities, higher levels of couple, family and work stress, fewer hours of vigorous physical activity, higher alcohol consumption, and smoking as risk factors for severe depression. Also, rural residents of northern and center states appeared more severely depressed compared to their urban counterparts. On average, the PHQ9 scores differed by ~ 10 points between severe and mild-no depressed teachers. A cross-sectional design. Also, the study focused on female teachers between ages 25 and 74 years old, reducing the generalizability of the estimates. Under-diagnosis of clinical depression in Mexican teachers is concerning. Unhealthy behavior is associated with severe depression. The information collected in this study represents an opportunity to build prevention mechanisms of depression in high-risk subgroups of female educators and warrants improving access to mental care in Mexico. Copyright © 2018 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

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

    2016-07-01

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

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

    Science.gov (United States)

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

    2009-06-01

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

  11. Severe Intellectual Disability: Systematic Review of the Prevalence and Nature of Presentation of Unipolar Depression

    Science.gov (United States)

    Walton, Catherine; Kerr, Mike

    2016-01-01

    Background: The diagnosis of depression in severe and profound intellectual disability is challenging. Without adequate skills in verbal self-expression, standardized diagnostic criteria cannot be used with confidence. The purpose of this systematic review was to investigate the assessment and diagnosis of unipolar depression in severe and…

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

    Directory of Open Access Journals (Sweden)

    Chun-feng HU

    2013-12-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  14. Psychometric evaluation of the Major Depression Inventory (MDI) as depression severity scale using the LEAD (Longitudinal Expert Assessment of All Data) as index of validity

    DEFF Research Database (Denmark)

    Bech, Per; Timmerby, N; Martiny, K

    2015-01-01

    BACKGROUND: The Major Depression Inventory (MDI) was developed to cover the universe of depressive symptoms in DSM-IV major depression as well as in ICD-10 mild, moderate, and severe depression. The objective of this study was to evaluate the standardization of the MDI as a depression severity......-IV major depression. The conventional VAS scores for no, mild, moderate, and severe depression were used for the standardization of the MDI. RESULTS: The inter-correlation for the MDI with the clinician ratings (VAS, MES, HAM-D17 and HAM-D6) increased over the rating weeks in terms of Pearson coefficients....... After nine weeks of therapy the coefficient ranged from 0.74 to 0.83. Using the clinician-rated VAS depression severity scale, the conventional MDI cut-off scores for no or doubtful depression, and for mild, moderate and severe depression were confirmed. CONCLUSIONS: Using the VAS as index of external...

  15. Gender similarities in somatic depression and in DSM depression secondary symptom profiles within the context of severity and bereavement.

    Science.gov (United States)

    Thompson, Angus H; Bland, Roger C

    2018-02-01

    Most population studies report higher rates of depression among women than men, and some researchers have observed gender differences in depression symptoms overall, or in sub-groupings (e.g. somatic depression). However, gender symptom differences have been inconsistent, prompting this investigation of gender differences in secondary DSM symptom profiles in the context of bereavement status, age, and depression severity. Individuals with symptoms of core depression (flat affect or anhedonia) were selected from a large survey of adults in the Alberta, Canada workforce. Analyses involved the comparison of gender profiles across the seven DSM-IV secondary depressive symptoms plus a MANOVA of sex, bereavement, and age, with secondary symptoms comprising the dependent variable. Gender profiles were very similar, irrespective of depression severity or bereavement. Secondary symptoms were marginally more common among women and more frequent among bereaved young adults, but there was no evidence for a gender-related somatic factor. First, data were gathered only for persons in the workforce and thus may not be generalizable to, for example, stay-at-home parents or those with employment issues. Second, the focus here is restricted to DSM symptoms, leaving risk factors, social roles, and brain functioning for separate investigation. Third, inferences were drawn from associations between groups of persons, rather than between individuals, requiring caution when speculating about individual attributes. Gender differences in depression represent a difference in amount, not kind, suggesting that the range of depressive experiences is similar for men and women. There was no gender difference ascribable to somatic depression. Copyright © 2017 Elsevier B.V. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Shahzad M. Alikhan

    2013-01-01

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

  17. What predicts depression in cardiac patients: sociodemographic factors, disease severity or theoretical vulnerabilities?

    Science.gov (United States)

    Doyle, F; McGee, H M; Conroy, R M; Delaney, M

    2011-05-01

    Depression is associated with increased cardiovascular risk in acute coronary syndrome (ACS) patients, but some argue that elevated depression is actually a marker of cardiovascular disease severity. Therefore, disease indices should better predict depression than established theoretical causes of depression (interpersonal life events, reinforcing events, cognitive distortions, type D personality). However, little theory-based research has been conducted in this area. In a cross-sectional design, ACS patients (n = 336) completed questionnaires assessing depression and psychosocial vulnerabilities. Nested logistic regression assessed the relative contribution of demographic or vulnerability factors, or disease indices or vulnerabilities to depression. In multivariate analysis, all vulnerabilities were independent significant predictors of depression (scoring above threshold on any scale, 48%). Demographic variables accounted for vulnerabilities accounting for significantly more (pseudo R² = 0.16, χ²(change) = 150.9, df = 4, p vulnerabilities increased the overall variance explained to 22% (pseudo R² = 0.22, χ² = 58.6, df = 4, p vulnerabilities predicted depression status better than did either demographic or disease indices. The presence of these proximal causes of depression suggests that depression in ACS patients is not simply a result of cardiovascular disease severity.

  18. Genetic and environmental components of female depression as a function of the severity of the disorder.

    Science.gov (United States)

    Rusby, James S M; Tasker, Fiona; Cherkas, Lynn

    2016-10-01

    Both clinical care and genome-wide studies need to account for levels of severity in the etiology of depression. The purpose of the study is to estimate the genetic and environmental components of female depression as a function of the severity of the disorder. A genetic and environmental model analysis of depression incidence was made using the IOP Depression Severity Measure (IDSM). Details of lifetime depression incidence were obtained by questionnaire from twins on the DTR registry. Data from 1449 matched female twin pairs in the age range 19-85 years in four ordinal categories of increasing severity were employed in the analysis. Estimates of additive and dominance genetic components of 27% and 25% were found when all three levels of depression were included, and near zero and 33% when the recurrent/severe level was excluded. Shared environmental effects were not significant in either case, but the estimate for random environmental effects was greater when the severe level was excluded. These results suggest that the incidence of severe depression is associated with homozygotic alleles and the less severe with heterozygotic alleles. This is in accord with the finding that the hereditary component of severe depression is relatively high and that milder forms are more dependent on life-time environmental factors. Such conclusions have clinical implications for the diagnosis and treatment of the disorder by practicing psychiatrists. They also lead to the importance of focusing future genome-wide and linkage studies on those females with severe levels of depression if progress in identifying genetic risk loci is to be made.

  19. A comparison of the major depression inventory (MDI) and the beck depression inventory (BDI) in severely depressed patients

    DEFF Research Database (Denmark)

    Konstantinidis, Anastasios; Martiny, Klaus; Bech, Per

    2011-01-01

    We set out to examine the psychometric properties of the MDI in comparison to the BDI in a mixed group of patients with primary depression.......We set out to examine the psychometric properties of the MDI in comparison to the BDI in a mixed group of patients with primary depression....

  20. Symptoms of depression in survivors of severe sepsis: a prospective cohort study of older Americans.

    Science.gov (United States)

    Davydow, Dimitry S; Hough, Catherine L; Langa, Kenneth M; Iwashyna, Theodore J

    2013-09-01

    To examine if incident severe sepsis is associated with increased risk of subsequent depressive symptoms and to assess which patient characteristics are associated with increased risk of depressive symptoms. Prospective longitudinal cohort study. Population-based cohort of older U.S. adults interviewed as part of the Health and Retirement Study (1998-2006). A total of 439 patients who survived 471 hospitalizations for severe sepsis and completed at least one follow-up interview. Depressive symptoms were assessed with a modified version of the Center for Epidemiologic Studies Depression Scale. Severe sepsis was identified using a validated algorithm in Medicare claims. The point prevalence of substantial depressive symptoms was 28% at a median of 1.2 years before sepsis, and remained 28% at a median of 0.9 years after sepsis. Neither incident severe sepsis (relative risk [RR]: 1.00; 95% confidence interval [CI]: 0.73, 1.34) nor severe sepsis-related clinical characteristics were significantly associated with subsequent depressive symptoms. These results were robust to potential threats from missing data or alternative outcome definitions. After adjustment, presepsis substantial depressive symptoms (RR: 2.20; 95% CI: 1.66, 2.90) and worse postsepsis functional impairment (RR: 1.08 per new limitation; 95% CI: 1.03, 1.13) were independently associated with substantial depressive symptoms after sepsis. The prevalence of substantial depressive symptoms in severe sepsis survivors is high but is not increased relative to their presepsis levels. Identifying this large subset of severe sepsis survivors at increased risk for major depression, and beginning interventions before hospital discharge, may improve outcomes. Copyright © 2013 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  1. Pharmacological treatment of severely depressed patients: a meta-analysis comparing efficacy of mirtazapine and amitriptyline

    NARCIS (Netherlands)

    Kasper, S.; Zivkov, M.; Roes, K.C.B.; Pols, A.G.

    1997-01-01

    Efficacy data were available from 405 severely depressed patients (baseline 17-item Hamilton Rating Scale for Depression-HAMD scores ≤25) participating in randomized, double blind, amitriptyline-controlled studies of mirtazapine. Main efficacy variables were changes from baseline in the group mean

  2. Identifying depression severity risk factors in persons with traumatic spinal cord injury.

    Science.gov (United States)

    Williams, Ryan T; Wilson, Catherine S; Heinemann, Allen W; Lazowski, Linda E; Fann, Jesse R; Bombardier, Charles H

    2014-02-01

    Examine the relationship between demographic characteristics, health-, and injury-related characteristics, and substance misuse across multiple levels of depression severity. 204 persons with traumatic spinal cord injury (SCI) volunteered as part of screening efforts for a randomized controlled trial of venlafaxine extended release for major depressive disorder (MDD). Instruments included the Patient Health Questionnaire-9 (PHQ-9) depression scale, the Alcohol Use Disorders Identification Test (AUDIT), and the Substance Abuse in Vocational Rehabilitation-Screener (SAVR-S), which contains 3 subscales: drug misuse, alcohol misuse, and a subtle items scale. Each of the SAVR-S subscales contributes to an overall substance use disorder (SUD) outcome. Three proportional odds models were specified, varying the substance misuse measure included in each model. 44% individuals had no depression symptoms, 31% had mild symptoms, 16% had moderate symptoms, 6% had moderately severe symptoms, and 3% had severe depression symptoms. Alcohol misuse, as indicated by the AUDIT and the SAVR-S drug misuse subscale scores were significant predictors of depression symptom severity. The SAVR-S substance use disorder (SUD) screening outcome was the most predictive variable. Level of education was only significantly predictive of depression severity in the model using the AUDIT alcohol misuse indicator. Likely SUD as measured by the SAVR-S was most predictive of depression symptom severity in this sample of persons with traumatic SCI. Drug and alcohol screening are important for identifying individuals at risk for depression, but screening for both may be optimal. Further research is needed on risk and protective factors for depression, including psychosocial characteristics. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  3. Severe inbreeding depression in a wild wolf (Canis lupus) population.

    Science.gov (United States)

    Liberg, Olof; Andrén, Henrik; Pedersen, Hans-Christian; Sand, Håkan; Sejberg, Douglas; Wabakken, Petter; Kesson, Mikael; Bensch, Staffan

    2005-03-22

    The difficulty of obtaining pedigrees for wild populations has hampered the possibility of demonstrating inbreeding depression in nature. In a small, naturally restored, wild population of grey wolves in Scandinavia, founded in 1983, we constructed a pedigree for 24 of the 28 breeding pairs established in the period 1983-2002. Ancestry for the breeding animals was determined through a combination of field data (snow tracking and radio telemetry) and DNA microsatellite analysis. The population was founded by only three individuals. The inbreeding coefficient F varied between 0.00 and 0.41 for wolves born during the study period. The number of surviving pups per litter during their first winter after birth was strongly correlated with inbreeding coefficients of pups (R2=0.39, pwolf population.

  4. Effects of an Internet intervention (Deprexis on severe depression symptoms: Randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Björn Meyer

    2015-03-01

    Conclusions: These results replicate and extend previous findings by showing that Deprexis can facilitate symptomatic improvement over 3 months and, perhaps to a lesser degree, up until 6 months among adults with initially severe depression.

  5. Symptom severity, quality of sleep, and treatment adherence among patients suffering from schizophrenia and depression

    NARCIS (Netherlands)

    Bosch, M.P.C.; Waberg, J.; Noort, M.W.M.L. van den; Staudte, H.; Lim, S.; Egger, J.I.M.

    2016-01-01

    Aim: Treatment non-adherence is a common problem in patients suffering from schizophrenia and depression. This study investigated the possible relationships between symptom severity, quality of sleep, and treatment adherence. Methods: Thirty outpatients with schizophrenia and 58 outpatients with

  6. Central Adrenal Insufficiency and Diabetes Insipidus Misdiagnosed as Severe Depression

    Directory of Open Access Journals (Sweden)

    Naoki Hiroi

    2010-01-01

    Full Text Available A 68 year-old Japanese man, who had been suffering from immobilization and disuse syndrome, was admitted to our hospital for evaluation of polyuria with polyposia, hyponatremia and low blood pressure. His plasma osmolality was greater than that of his urine. His endocrinological examination revealed low levels of plasma adrenocorticotropic hormone (ACTH and cortisol, and a normal response of ACTH to the corticotrophin-releasing hormone (CRH challenge. Plasma ACTH did not increase with insulin loading. A low plasma vasopressin (AVP level and no response of AVP to a 5% saline administration were observed. We diagnosed central adrenal insufficiency with central diabetes insipidus. Six months after starting administration of hydrocortisone and 1-deamino-8D-arginine vasopressin, his psychological symptoms had improved, and 1.5 years after starting treatment, he was able to walk. In conclusion, it is not particularly rare for adrenal insufficiency to be misdiagnosed as depression. However, a correct early diagnosis is necessary, because, if adrenal insufficiency is not definitively diagnosed, the patient's quality of life diminishes markedly.

  7. [Association between health related quality of life and severity of depression in patients with major depressive disorder].

    Science.gov (United States)

    Cao, Yuping; Li, Wen; Shen, Jingjin; Zhang, Yalin

    2011-02-01

    To investigate the association between health related quality of life (HRQoL) and severity of depression in patients with major depressive disorder (MDD). Short Form 36 Health Survey Questionnaire (SF-36) was administered to 103 MDD patients at the baseline and 6-week follow-up. Hamilton Depression Rating for Depression (HAMD) and Clinical Global Impression (CGI) were administered at the baseline, 2- and 6-week follow-up, respectively. All SF-36 component scores in the 6-week follow-up were significantly higher than those at the baseline (Pphysical, general health, vitality, social functioning, role-emotion and mental health were significantly higher in the remission group than those in the non-remission group (Phealth transition was significantly associated with higher scores of HAMD and sleep disturbance at the baseline (Phealth and role-emotion were strongly associated with higher score of anxiety/somatization at the baseline (both Phealth was positively associated with reduction rate of cognitive disturbance at the 2-week endpoint (Phealth transition were positively associated with the reduction rate of sleep disturbance at the 2-week endpoint (both Pdepression was significantly associated with a worse HRQoL in patients with MDD. A 6-week antidepressant treatment may result in comparable HRQoL improvements. The components of HRQoL vary with severity of various symptoms of depression at the baseline and their early improvement after the treatment.

  8. Vulnerable narcissism is associated with severity of depressive symptoms in dysthymic patients.

    Science.gov (United States)

    Erkoreka, Leire; Navarro, Bárbara

    2017-11-01

    Pathological narcissism involves grandiose and vulnerable presentations. Narcissism, and specifically the vulnerable presentation, has been associated to depression, although empirical research studying this relationship is limited. Dysthymia is characterized by a greater treatment resistance and poorer prognosis than other chronic depressive disorders. The presence of dysfunctional personality traits may explain it. We aim to explore the association between vulnerable narcissistic traits and severity of depressive symptoms in a sample of dysthymic patients. To that end, 80 dysthymic outpatients were evaluated. The treating psychiatrist collected sociodemographic and clinical data and completed the Clinical Global Impression-Severity Scale. Patients completed the Beck Depression Inventory (BDI) and the Hypersensitive Narcissism Scale (HSNS), that respectively assess severity of depressive symptoms and vulnerable narcissism. We tested for potential confounders and conducted a regression analysis to explore whether severity of vulnerable narcissism was associated with greater depressive symptoms. HSNS was found to be the principal predictor of BDI, and along with age, accounted for 23% of the variance in BDI. An assessment of personality functioning is therefore recommended in chronically depressed patients that have been refractory to standard treatments. Psychotherapies that address personality disturbance should be included in the treatment when necessary. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Association between severity of depression and clinico-biochemical markers of polycystic ovary syndrome.

    Science.gov (United States)

    Enjezab, Behnaz; Eftekhar, Maryam; Ghadiri-Anari, Akram

    2017-11-01

    Polycystic ovary syndrome (PCOS), as the most common endocrine disorder among reproductive-aged women may lead to psychological morbidity. The present study set out to evaluate the severity of depression in PCOS and non-PCOS women and to evaluate correlation between depression score with body mass index, HOMA-IR, and testosterone level in every group (PCOS and non-PCOS women) in Yazd province. In this cross-sectional study, 62 women with PCOS and 61 non- PCOS subjects (20 to 40 years) who were attending Imam-Ali Clinic in Yazd, Iran from September 2014 through March 2015 participated. These persons completed the Beck Depression Short Inventory (BDI-S) Questionnaire. Frequency of depression in PCOD and healthy persons and correlation between depression severity with body mass index, HOMA-IR, testosterone level in PCOS and non- PCOS women were evaluated by ANOVA test and independent-samples t-test and Pearson correlation. P-value of less than 0.05 was considered as statistically significant. Data analyses were performed using SPSS version 16. Of 62 PCOS subjects, 40 (64.5%) were verified positive for depression, determined by the BDI-S Questionnaire. In the control group, 60.7% had depression. Mean±SE score of depression for PCOS and non-PCOS women were 7.47±5.54 and 7.57±5.77 respectively. There was no statistically significant correlation between body mass index, HOMA-IR, testosterone level with depression score in either group separately or together. We found considerable amounts of depression in our population. There is no correlation between body mass index, HOMA-IR, and testosterone level with depression score in our study.

  10. Symptom Profile and Severity in a Sample of Nigerians with Psychotic versus Nonpsychotic Major Depression

    Directory of Open Access Journals (Sweden)

    Increase Ibukun Adeosun

    2013-01-01

    Full Text Available The therapeutic strategies in managing patients with psychotic major depression (PMD differ from those with non-psychotic major depression (NMD, because of differences in clinical profile and outcome. However, there is underrecognition of psychotic symptoms in depressed patients. Previous studies in Western population suggest that certain symptom patterns, apart from psychosis which may be concealed, can facilitate the discrimination of PMD from NMD. These studies may have limited applicability to sub-Saharan Africa due to cross-cultural differences in the phenomenology of depression. This study compared the rates and severity of depressive symptoms in outpatients with PMD (n=129 and NMD (n=117 using the Structured Clinical Interview for Depression (SCID and Hamilton Depression Rating Scale (HAM-D. Patients with PMD had statistically significantly higher rates of suicidal ideation, suicidal attempt, psychomotor agitation, insomnia, and reduced appetite. Patients with NMD were more likely to manifest psychomotor retardation and somatic symptoms. PMD was associated with greater symptom severity. On logistic regression analysis, suicidal ideation, psychomotor disturbances, insomnia, and somatic symptoms were predictive of diagnostic status. The presence of these symptoms clusters may increase the suspicion of occult psychosis in patients with depression, thereby informing appropriate intervention strategies.

  11. Quantitative Susceptibility Mapping Reveals an Association between Brain Iron Load and Depression Severity

    Directory of Open Access Journals (Sweden)

    Shun Yao

    2017-08-01

    Full Text Available Previous studies have detected abnormal serum ferritin levels in patients with depression; however, the results have been inconsistent. This study used quantitative susceptibility mapping (QSM for the first time to examine brain iron concentration in depressed patients and evaluated whether it is related to severity. We included three groups of age- and gender-matched participants: 30 patients with mild-moderate depression (MD, 14 patients with major depression disorder (MDD and 20 control subjects. All participants underwent MR scans with a 3D gradient-echo sequence reconstructing for QSM and performed the 17-item Hamilton Depression Rating Scale (HDRS test. In MDD, the susceptibility value in the bilateral putamen was significantly increased compared with MD or control subjects. In addition, a significant difference was also observed in the left thalamus in MDD patients compared with controls. However, the susceptibility values did not differ between MD patients and controls. The susceptibility values positively correlated with the severity of depression as indicated by the HDRS scores. Our results provide evidence that brain iron deposition may be associated with depression and may even be a biomarker for investigating the pathophysiological mechanism of depression.

  12. Plasma sterols and depressive symptom severity in a population-based cohort.

    Directory of Open Access Journals (Sweden)

    Basar Cenik

    Full Text Available Convergent evidence strongly suggests major depressive disorder is heterogeneous in its etiology and clinical characteristics. Depression biomarkers hold potential for identifying etiological subtypes, improving diagnostic accuracy, predicting treatment response, and personalization of treatment. Human plasma contains numerous sterols that have not been systematically studied. Changes in cholesterol concentrations have been implicated in suicide and depression, suggesting plasma sterols may be depression biomarkers. Here, we investigated associations between plasma levels of 34 sterols (measured by mass spectrometry and scores on the Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR16 scale in 3117 adult participants in the Dallas Heart Study, an ethnically diverse, population-based cohort. We built a random forest model using feature selection from a pool of 43 variables including demographics, general health indicators, and sterol concentrations. This model comprised 19 variables, 13 of which were sterol concentrations, and explained 15.5% of the variation in depressive symptoms. Desmosterol concentrations below the fifth percentile (1.9 ng/mL, OR 1.9, 95% CI 1.2-2.9 were significantly associated with depressive symptoms of at least moderate severity (QIDS-SR16 score ≥10.5. This is the first study reporting a novel association between plasma concentrations cholesterol precursors and depressive symptom severity.

  13. Disengagement from tasks as a function of cognitive load and depressive symptom severity.

    Science.gov (United States)

    Bowie, Christopher R; Milanovic, Melissa; Tran, Tanya; Cassidy, Sarah

    2017-01-01

    Depression is associated with impairment in cognition and everyday functioning. Mechanisms of cognitive dysfunction in depression and the factors that influence strategic deployment of cognitive abilities in complex environments remain elusive. In this study we investigated whether depression symptom severity is associated with disengagement from a working memory task (Paced Auditory Serial Addition Task; PASAT) with parametric adjustment of task difficulty. 235 participants completed the Beck Depression Inventory, low and high cognitive load conditions of the PASAT, and quality of life. Cognitive disengagement was the sum of consecutive items in which participants did not proffer a response to the trial. Individuals with higher depression severity showed more cognitive disengagement on the high but not low cognitive load trial of the PASAT; they did not differ in number of correct responses. Increased disengagement from the low to high cognitive load was associated with more impaired quality of life. Depression severity is associated with increased disengagement from tasks as difficulty increases. These findings suggest the importance of measuring how cognitive skills are avoided in complex environments in addition to considering performance accuracy. Individuals with depressive symptoms might preferentially avoid cognitive tasks that are perceived as more complex in spite of intact ability.

  14. Rest-activity rhythm and sleep characteristics associated with depression symptom severity in strained dementia caregivers.

    Science.gov (United States)

    Smagula, Stephen F; Krafty, Robert T; Taylor, Briana J; Martire, Lynn M; Schulz, Richard; Hall, Martica H

    2017-12-01

    Depression is associated with disturbances to sleep and the 24-h sleep-wake pattern (known as the rest-activity rhythm: RAR). However, there remains a need to identify the specific sleep/RAR correlates of depression symptom severity in population subgroups, such as strained dementia caregivers, who are at elevated risk for major depressive disorder. We assessed the cross-sectional associations of sleep/RARs with non-sleep depression symptom severity among 57 (mean age: 74 years, standard deviation: 7.4) strained dementia caregivers who were currently without clinical depression. We derived sleep measures from polysomnography and actigraphy, modelled RARs using a sigmoidally transformed cosine curve and measured non-sleep depression symptom severity using the Hamilton Depression Rating Scale (HRDS) with sleep items removed. The following sleep-wake measures were associated with greater depression symptom severity (absolute Spearman's correlations ranged from 0.23 to 0.32): more time awake after sleep onset (WASO), higher RAR middle level (mesor), relatively shorter active periods (alpha), earlier evening settling time (down-mesor) and less steep RARs (beta). In multivariable analysis, high WASO and low RAR beta were associated independently with depression symptom severity. Predicted non-sleep HDRS means (95% confidence intervals) in caregivers with and without these characteristics were: normal WASO/beta = 3.7 (2.3-5.0), high WASO/normal beta = 5.5 (3.5-7.6), normal WASO/low beta = 6.3 (3.6-8.9) and high WASO/low beta = 8.1 (5.3-10.9). Thus, in our sample of strained caregivers, greater sleep fragmentation (WASO) and less sustained/sharply segregated resting and active periods (low RAR beta) correlate uniquely with depression symptom severity. Longitudinal studies are needed to establish whether these independent sleep-wake correlates of depression symptoms explain heightened depression risk in dementia caregivers. © 2017 European Sleep Research Society.

  15. Preoperative depression symptom severity and its impact on adherence to preoperative beta-blocker therapy.

    Science.gov (United States)

    Schonberger, Robert B; Feinleib, Jessica; Holt, Natalie; Dai, Feng; Brandt, Cynthia; Burg, Matthew M

    2014-12-01

    To test the association among depression symptoms, distressed personality type, and preoperative beta-blocker nonadherence and to estimate the prevalence of untreated major depression in this population. Prospective observational study. A veterans hospital. One hundred twenty patients on outpatient beta-blocker therapy presenting for surgery. The Patient Health Questionnaire (PHQ)-9, the D-Scale-14 (DS14), and Modified Morisky Scale (MMS) questionnaires. Of 99 participants who presented for surgery, the incidence of preoperative nonadherence was 14.1% (95% confidence interval 7%-21%), consistent with prior research. Nonadherence was 9.5% among those with no depression, 27.8% among those with mild depression, and 28.6% among those with moderate-to-severe depression (Cochran-Armitage test for trend p = 0.03). Distressed personality type was found in 35% of the cohort (95% confidence interval 26-45%) and was not associated with beta-blocker nonadherence (Fisher's exact test, p = 0.24). Among participants with symptoms of major depressive disorder (n = 25, 25.3%), more than half (n = 14, 56%) had no indication of depression listed at their most recent primary care visit. Patients with symptoms of depression on chronic beta-blocker therapy are susceptible to medication nonadherence on the day of surgery. Most surgical patients with symptoms of major depression lack a diagnosis of depression. Preoperative depression screening may thus (1) identify a population at increased risk of beta-blocker withdrawal, and (2) identify patients who may benefit from anesthesiologist-initiated referral for this treatable condition. Copyright © 2014 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2015-01-01

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

  17. Somebody to lean on: Social relationships predict post-treatment depression severity in adults.

    Science.gov (United States)

    Hallgren, Mats; Lundin, Andreas; Tee, Fwo Yi; Burström, Bo; Forsell, Yvonne

    2017-03-01

    Supportive social relationships can help protect against depression, but few studies have examined how social relationships influence the response to depression treatment. We examined longitudinal associations between the availability of social relationships and depression severity following a 12-week intervention. In total, 946 adults aged 18-71 years with mild-to-moderate depression were recruited from primary care centres across Sweden and treated for 12 weeks. The interventions included internet-based cognitive behavioural therapy (ICBT), 'usual care' (CBT or supportive counselling) and exercise. The primary outcome was the change in depression severity. The availability of social relationships were self-rated and based on the Interview Schedule for Social Interaction (ISSI). Prospective associations were explored using and logistic regression models. Participants with greater access to supportive social relationships reported larger improvements in depression compared to those with 'low' availability of relationships (β= -3.95, 95% CI= -5.49, -2.41, psocial relationships appear to play a key role in recovery from depression. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  18. Wake and light therapy for moderate-to-severe depression - a randomized controlled trial

    DEFF Research Database (Denmark)

    Kragh, M; Martiny, K; Videbech, P

    2017-01-01

    Objective: To examine the efficacy of using wake and light therapy as a supplement to standard treatment of hospitalized patients with depression. Method: In this randomized, controlled study, 64 patients with moderate-to-severe depression were allocated to standard treatment or to the intervention......, which additionally consisted of three wake therapy sessions in one week, 30-min daily light treatment and sleep time stabilization over the entire nine-week study period. Results: Patients in the wake therapy group had a significant decrease in depressive symptoms in week one as measured by HAM-D17, 17...

  19. Severe Intellectual Disability: Systematic Review of the Prevalence and Nature of Presentation of Unipolar Depression.

    Science.gov (United States)

    Walton, Catherine; Kerr, Mike

    2016-09-01

    The diagnosis of depression in severe and profound intellectual disability is challenging. Without adequate skills in verbal self-expression, standardized diagnostic criteria cannot be used with confidence. The purpose of this systematic review was to investigate the assessment and diagnosis of unipolar depression in severe and profound intellectual disability. The review aimed to examine the methods used to assess for depression. The secondary aim was to explore the frequency and symptoms of depression. The PRISMA (2009) Checklist for systematic review was followed, and a search of electronic databases was undertaken. Nine studies were included in the qualitative synthesis from over 2000 records identified. The quality of the studies was assessed and scored, with a wide range of results. Individual studies scored between 2 and 7 of a maximum possible score of 8. The diagnostic tools utilized by each of the studies were assessed and compared. In terms of the methods used to assess for depression, results were varied. This was due to the heterogeneous nature of the individual study designs. The Aberrant Behaviour Checklist consistently showed promise, in particular when combined with other instruments or clinical examination. Qualitative analysis of the selected studies has shown a wide variation in the quality of primary research in this field, with more required to make firm conclusions regarding the diagnosis, frequency and presentation of depression in severe and profound intellectual disability. © 2015 John Wiley & Sons Ltd.

  20. Maternal effects alter the severity of inbreeding depression in the offspring.

    Science.gov (United States)

    Pilakouta, Natalie; Smiseth, Per T

    2016-09-14

    A maternal effect is a causal influence of the maternal phenotype on the offspring phenotype over and above any direct effects of genes. There is abundant evidence that maternal effects can have a major impact on offspring fitness. Yet, no previous study has investigated the potential role of maternal effects in influencing the severity of inbreeding depression in the offspring. Inbreeding depression is a reduction in the fitness of inbred offspring relative to outbred offspring. Here, we tested whether maternal effects due to body size alter the magnitude of inbreeding depression in the burying beetle Nicrophorus vespilloides We found that inbreeding depression in larval survival was more severe for offspring of large females than offspring of small females. This might be due to differences in how small and large females invest in an inbred brood because of their different prospects for future breeding opportunities. To our knowledge, this is the first evidence for a causal effect of the maternal phenotype on the severity of inbreeding depression in the offspring. In natural populations that are subject to inbreeding, maternal effects may drive variation in inbreeding depression and therefore contribute to variation in the strength and direction of selection for inbreeding avoidance. © 2016 The Author(s).

  1. Relationship Between Depression and Perception of Pain Severity in Patients Admitted to General Surgery Ward

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    Mehdi Samadzadeh

    2016-11-01

    Full Text Available Background Depression is considered as the most common psychological problem in individuals. Patients with persistent pain usually suffer from depression, disturbance in interpersonal relations, fatigue, and reduced physical and psychological performance. Objectives The aim of this study was to survey the relationship between depression and perception of pain severity in patients admitted to general surgery ward. Methods This research was a cross-sectional descriptive study. The study population included patients admitted to general surgery ward at hospitals of Ardabil city during 2010 - 2011. The study sample consisted of 168 individuals (male and female who were selected by nonrandomized convenience sampling method. The data were collected using a questionnaire on demographic information, the Beck depression inventory (BDI, and Toren questionnaire on pain beliefs and perceptions. The SPSS software was used for statistical analysis. Results The highest frequency of participants had moderate depression (44.1% while the lowest frequency belonged to healthy individuals (4.2%. The score of depression was higher in men (23.21 ± 7.56 than women (19.19 ± 6.84 as the same as the score of pain perception (8.91 ± 2.34 vs. 7.95 ± 1.87, respectively. The results indicated that there was a positive significant relationship between depression and perception of pain severity (P ≤ 0.01. This means that patients who have a history of depression feel much more pain during hospitalization and after the surgery. Conclusions Depressed or anguished patients report more pain compared to healthy ones.

  2. Anaerobic muscle strengthening physical activity and depression severity among USA adults.

    Science.gov (United States)

    Cangin, Causenge; Harris, Randall; Binkley, Philip; Schwartzbaum, Judith; Focht, Brian

    2018-06-01

    We investigated the association between depression and anaerobic physical activity (while controlling aerobic physical activity), using a nationally representative sample of USA adults ( n  = 7354) who participated in the cross sectional National Health and Nutrition Examination Survey (NHANES, 1999-2006). We defined depression using the validated "Patient Health Questionnaire" (PHQ 9 ) scale of 0-27 as PHQ 9   ≥  10. Severity of depression was classified by clinically established PHQ 9 levels: mild (5-9), dysthymic (10-14), moderate (15-19), and major depression ( ≥ 20). We used logistic regression to estimate adjusted odds ratios of depression associated with distinct types of activity (only aerobic, only anaerobic, combined regime). We used multinomial logistic regression to examine associations of anaerobic activity with various severity levels of depression (mild, dysthymic, moderate, and major depression) with adjustment for aerobic activity. Women had higher prevalence of depression than men (8.4% versus 5.7%), whereas anaerobic muscle strengthening activity was more common in men than women (35% versus 24%). Adjusting for aerobic activity , anaerobic activity was inversely associated with depression (PHQ 9   ≥  10) in women under 50 (OR = 0.57; 95%CI = 0.41-0.81), all women (OR = 0.59; 0.43-0.80), men under 50 (OR = 0.85; 0.58-1.2), and all men (OR = 0.72; 0.51-1.01). Anaerobic activity was inversely associated with severity level of depressive symptoms in women and men. The combined regimen of anaerobic muscle strengthening activity and meeting the Physical Activity Guideline for America (PAGA) was related to the lowest odds ratio of depression in women (OR = 0.50; 95%CI = 0.33-0.75) and men (OR = 0.39; 95%CI = 0.23-0.62). Independent of aerobic physical activity, anaerobic muscle strengthening activity is significantly and inversely associated with depression among USA adults.

  3. Secondary depression in severe anxiety disorders: a population-based cohort study in Denmark

    Science.gov (United States)

    Meier, Sandra M; Petersen, Liselotte; Mattheisen, Manuel; Mors, Ole; Mortensen, Preben B; Laursen, Thomas M

    2016-01-01

    Summary Background Depression and anxiety disorders are highly comorbid conditions and a worldwide disease burden; however, large-scale studies delineating their association are scarce. In this retrospective study, we aimed to assess the effect of severe anxiety disorders on the risk and course of depression. Methods We did a population-based cohort study with prospectively gathered data in Denmark using data from three Danish population registers: The Danish Civil Registration System, the Danish Psychiatric Central Register, and the Danish National Hospital Registry. We selected the cohort from people born in Denmark between Jan 1, 1955, and Dec 31, 2002, who we followed up from Jan 1, 1994, to Dec 31, 2012. The cohort was restricted to individuals with known parents. First, we investigated the effect of specific anxiety diagnoses on risk of single depressive episodes and recurrent depressive disorder. Second, we investigated the effect of comorbid anxiety on risk of readmission for depression, adjusting for sex, age, calendar year, parental age, place at residence at time of birth, and the interaction of age with sex. Findings We included 3 380 059 individuals in our study cohort. The adjusted incidence rate ratio (IRR) for single depressive episodes was 3·0 (95% CI 2·8–3·1, pdepressive disorder was 5·0 (4·8–5·2) in patients with severe anxiety disorders compared with the general population. Compared with control individuals, the offspring of parents with anxiety disorders were more likely to be diagnosed with single depressive episodes (1·9, 1·8–2·0) or recurrent depressive disorder (2·1, 1·9–2·2). Comorbid anxiety increased the readmission rates in both patients with single depressive episodes and patients with recurrent depressive disorder. Interpretation Severe anxiety constitutes a significant risk factor for depression. Focusing on specific anxiety disorders might help to identify individuals at risk of depression, thereby providing new

  4. Relationship between Opium Abuse and Severity of Depression in Type 2 Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Sepehrmanesh Zahra

    2012-04-01

    Full Text Available BackgroundOpium use in diabetic populations is associated with major depressive disorder (MDD. This study was designed to investigate the relationship between opium use and severity of depression in Iranian diabetic patients.MethodsIn this case-control study, 642 type 2 diabetic patients were recruited from those presenting at two outpatient clinics at the Akhavan Hospital in Kashan, Iran; of them, 600 diabetic patients were included in the study and divided into two groups: opium-abusers (150 patients and non-opium-abusers (450 patients. Clinical and demographic information was obtained through a detailed questionnaire. Depression symptomalogy and severity were assessed with the Beck Depression Inventory (BDI, and a corresponding diagnosis was made based on the Diagnostic and Statistical Manual of Mental Disorders-IV, Text Revision, 2000 (DSM-IV TR criteria.ResultsThe mean depression score was higher in the opium abuse group than in the non-abuser group (29.27±1.44 vs. 18.29±1.31, P<0.001. In general, a significant association was found between opium abuse and depression among patients (odds ratio [OR], 4.54; 95% confidence interval [CI], 2.87 to 7.44; P=0.001. No significant relationship was found between dysthymia and opium abuse (OR, 0.68; 95% CI, 0.18 to 1.192; P=0.155, while MDD was significantly higher in the opium abuser group (OR, 7.32; 95% CI, 5.20 to 12.01; P<0.001.ConclusionDepression is more frequent in opium-dependent diabetic patients, and its severity is also greater. Given these findings, opium-dependent diabetic patients should be advised about the increased risks of depression and related comorbidities.

  5. Relationship of smartphone use severity with sleep quality, depression, and anxiety in university students.

    Science.gov (United States)

    Demirci, Kadir; Akgönül, Mehmet; Akpinar, Abdullah

    2015-06-01

    The usage of smartphones has increased rapidly in recent years, and this has brought about addiction. The aim of the current study was to investigate the relationship between smartphone use severity and sleep quality, depression, and anxiety in university students. In total, 319 university students (203 females and 116 males; mean age = 20.5 ± 2.45) were included in the study. Participants were divided into the following three groups: a smartphone non-user group (n = 71, 22.3%), a low smartphone use group (n = 121, 37.9%), and a high smartphone use group (n = 127, 39.8%). All participants were evaluated using the Pittsburgh Sleep Quality Index, Beck Depression Inventory, Beck Anxiety Inventory; moreover, participants other than those in the smartphone non-user group were also assessed with the Smartphone Addiction Scale. The findings revealed that the Smartphone Addiction Scale scores of females were significantly higher than those of males. Depression, anxiety, and daytime dysfunction scores were higher in the high smartphone use group than in the low smartphone use group. Positive correlations were found between the Smartphone Addiction Scale scores and depression levels, anxiety levels, and some sleep quality scores. The results indicate that depression, anxiety, and sleep quality may be associated with smartphone overuse. Such overuse may lead to depression and/or anxiety, which can in turn result in sleep problems. University students with high depression and anxiety scores should be carefully monitored for smartphone addiction.

  6. Relationship of Smartphone Use Severity with Sleep Quality, Depression, and Anxiety in University Students

    Science.gov (United States)

    Demi̇rci̇, Kadi̇r; Akgönül, Mehmet; Akpinar, Abdullah

    2015-01-01

    Background and Aims The usage of smartphones has increased rapidly in recent years, and this has brought about addiction. The aim of the current study was to investigate the relationship between smartphone use severity and sleep quality, depression, and anxiety in university students. Methods In total, 319 university students (203 females and 116 males; mean age = 20.5 ± 2.45) were included in the study. Participants were divided into the following three groups: a smartphone non-user group (n = 71, 22.3%), a low smartphone use group (n = 121, 37.9%), and a high smartphone use group (n = 127, 39.8%). All participants were evaluated using the Pittsburgh Sleep Quality Index, Beck Depression Inventory, Beck Anxiety Inventory; moreover, participants other than those in the smartphone non-user group were also assessed with the Smartphone Addiction Scale. Results The findings revealed that the Smartphone Addiction Scale scores of females were significantly higher than those of males. Depression, anxiety, and daytime dysfunction scores were higher in the high smartphone use group than in the low smartphone use group. Positive correlations were found between the Smartphone Addiction Scale scores and depression levels, anxiety levels, and some sleep quality scores. Conclusion The results indicate that depression, anxiety, and sleep quality may be associated with smartphone overuse. Such overuse may lead to depression and/or anxiety, which can in turn result in sleep problems. University students with high depression and anxiety scores should be carefully monitored for smartphone addiction. PMID:26132913

  7. Urinary free cortisol levels among depressed men and women: differential relationships to age and symptom severity?

    Science.gov (United States)

    Grant, M M; Friedman, E S; Haskett, R F; Riso, L P; Thase, M E

    2007-01-01

    Preclinical and clinical models of depression suggest sex differences may be mediated at least in part, by differences in hormonal modulation of hypothalamic-pituitary-adrenal (HPA) axis activity. Unraveling the consequences of moderating influences from the effect of sexual dimorphism will be vital to elaborating models of pathophysiology. The current study investigated urinary free cortisol (UFC) among younger adults with mild to moderate major depressive disorder to clarify the relationship with potential demographic and clinical moderators. Male patients had higher mean UFC levels than female patients. Moreover, significant interactions between age and severity were found among men, but not women. In contrast to prior findings, neither age nor severity effects on UFC levels were found among female patients. Conclusions from the current study are limited by the absence of cortisol data from matched controls. Thus it was not possible to disentangle sex differences in baseline physiology from that of pathophysiological differences tied specifically to depression. Despite several methodological limitations, the interactions between sex and both age and severity in this large sample of depressed patients are suggestive of differential pathophysiology for regulation of UFC excretion, and could reflect a neuroprotective effect for estrogen among younger depressed women.

  8. Depressive Symptom Severity and Community Collective Efficacy following the 2004 Florida Hurricanes.

    Directory of Open Access Journals (Sweden)

    Carol S Fullerton

    Full Text Available There is a lack of research investigating community-level characteristics, such as community collective efficacy, mitigating the impact of disasters on psychological health, specifically depression. We examined the association of community collective efficacy with depressive symptom severity in Florida public health workers (n = 2249 exposed to the 2004 hurricane season using a multilevel approach. Cross-sectional anonymous questionnaires were distributed electronically to all Florida Department of Health (FDOH personnel that assessed depressive symptom severity and collective efficacy nine months after the 2004 hurricane season. Analyses were conducted at the individual level and community level using zip codes. The majority of participants were female (81.9%, and ages ranged from 20 to 78 years (median = 49 years. The majority of participants (73.4% were European American, 12.7% were African American, and 9.2% were Hispanic. Using multilevel analysis, our data indicate that higher community-level and individual-level collective efficacy were associated with significantly lower depressive symptom severity (b = -0.09 [95% CI: -0.13, -0.04] and b = -0.09 [95% CI: -0.12, -0.06], respectively even after adjusting for individual sociodemographic variables, community socioeconomic characteristics, individual injury/damage, and community storm damage. Lower levels of depressive symptom severity were associated with communities with high collective efficacy. Our study highlights the possible importance of programs that enrich community collective efficacy for disaster communities.

  9. Mobile Phone Sensor Correlates of Depressive Symptom Severity in Daily-Life Behavior: An Exploratory Study

    Science.gov (United States)

    Saeb, Sohrab; Zhang, Mi; Karr, Christopher J; Schueller, Stephen M; Corden, Marya E; Kording, Konrad P

    2015-01-01

    Background Depression is a common, burdensome, often recurring mental health disorder that frequently goes undetected and untreated. Mobile phones are ubiquitous and have an increasingly large complement of sensors that can potentially be useful in monitoring behavioral patterns that might be indicative of depressive symptoms. Objective The objective of this study was to explore the detection of daily-life behavioral markers using mobile phone global positioning systems (GPS) and usage sensors, and their use in identifying depressive symptom severity. Methods A total of 40 adult participants were recruited from the general community to carry a mobile phone with a sensor data acquisition app (Purple Robot) for 2 weeks. Of these participants, 28 had sufficient sensor data received to conduct analysis. At the beginning of the 2-week period, participants completed a self-reported depression survey (PHQ-9). Behavioral features were developed and extracted from GPS location and phone usage data. Results A number of features from GPS data were related to depressive symptom severity, including circadian movement (regularity in 24-hour rhythm; r=-.63, P=.005), normalized entropy (mobility between favorite locations; r=-.58, P=.012), and location variance (GPS mobility independent of location; r=-.58, P=.012). Phone usage features, usage duration, and usage frequency were also correlated (r=.54, P=.011, and r=.52, P=.015, respectively). Using the normalized entropy feature and a classifier that distinguished participants with depressive symptoms (PHQ-9 score ≥5) from those without (PHQ-9 score mobile phone sensor data, including GPS and phone usage, provided behavioral markers that were strongly related to depressive symptom severity. While these findings must be replicated in a larger study among participants with confirmed clinical symptoms, they suggest that phone sensors offer numerous clinical opportunities, including continuous monitoring of at-risk populations with

  10. The prevalence and predictors of severe depression among the elderly in Malaysia.

    Science.gov (United States)

    Rashid, Abdul; Tahir, Ibrahim

    2015-03-01

    The population of Malaysia is relatively young, due to this there is a dearth in research conducted among the elderly especially relating to depression. The aim of this study is to determine the prevalence and the predictors of severe depression among the elderly in Malaysia. A sample of 2005 older adults randomly selected from the Penang State government's list of elderly receiving aid participated in the study. The Geriatric Depression Scale was used to screen for depression. Socio-demographic, social support, disease, functional and other factors were looked at as possible predictor variables. The prevalence of severe depression was 19.2 %. Indians (aOR = 2.0), being married (aOR = 10.5), widowed & divorced (aOR = 5.2), having poor (aOR = 2.7) or moderate social support (aOR = 2.7), having no one (aOR = 2.9), relatives (aOR = 2.3) or religious figures & others (aOR = 1.9) as compared to a spouse as a source of emotional support, feeling extremely lonely (aOR = 3.4), not socially active (aOR = 2.3), cognitively impaired (aOR 2.5), activities limited due to illness or disability (aOR = 1.6) and poor sleep quality (aOR = 3.6) were significant predictor variables. The prevalence of severe depression was high. It is pertinent that older adults, especially those with risk factors identified in this study be screened for depression at every opportunity.

  11. [Anxiety and polymorphism Val66Met of BDNF gene--predictors of depression severity in ischemic heart disease].

    Science.gov (United States)

    Golimbet, V E; Volel', B A; Kopylov, F Iu; Dolzhikov, A V; Korovaitseva, G I; Kasparov, S V; Isaeva, M I

    2015-01-01

    In a framework of search for early predictors of depression in patients with ischemic heart disease (IHD) we studied effect of molecular-genetic factors (polymorphism of brain-derived neirotrophic factor--BDNF), personality traits (anxiety, neuroticism), IHD severity, and psychosocial stressors on manifestations of depression in men with verified diagnosis of IHD. Severity of depression was assessed by Hamilton Depression Rating Scale 21-item (HAMD 21), anxiety and neuroticism were evaluated by the Spielberger State-Trait Anxiety Inventory and "Big Five" questionnaire, respectively. It wa shown that personal anxiety and ValVal genotype of BDNF gene appeared to be predictors of moderate and severe depression.

  12. Severe insomnia is associated with hypertriglyceridemia in women with major depression treated in psychiatry settings.

    Science.gov (United States)

    Costemale-Lacoste, Jean-François; Trabado, Séverine; Verstuyft, Céline; El Asmar, Khalil; Butlen-Ducuing, Florence; Colle, Romain; Ferreri, Florian; Polosan, Mircea; Haffen, Emmanuel; Balkau, Beverley; Falissard, Bruno; Feve, Bruno; Becquemont, Laurent; Corruble, Emmanuelle

    2017-08-01

    Hypertriglyceridemia (HTG) is a cardiovascular risk factor. In the general population, elevated fasting triglyceridemia (TG) is associated with insomnia. Since insomnia is a core symptom of Major Depressive Episodes (MDE), we studied the association of severe insomnia with HTG in major depression. We used the baseline data of the METADAP cohort, comprising 624 patients with a current MDE in a context of Major Depressive Disorder treated in psychiatry settings, without current alcohol use disorders. Patients were screened for severe insomnia, defined by a score of four or more on the three Hamilton Depression Rating Scale (HDRS) sleep items, and for HTG characterised by TG≥200mg/dL. Severe insomnia was observed in 335(54%) patients with a current MDE, of whom 234(70%) were women; 49(8%) patients had HTG, of whom 25(51%) were women. 69(11%) patients were treated with lipid-lowering drugs. Severe insomnia was associated with a higher frequency of HTG in the whole sample (9.9% vs 5.6%, p=0.046) and in the subgroup of women (9.0% vs 2.0%, p=0.002). Multivariate logistic regression analyses adjusted for age, education levels, BMI and total HDRS scores confirmed the association between severe insomnia and HTG in the whole sample (OR=2.02, 95%CI [1.00-4.08], p=0.05) as well as in the subgroup of women (OR=4.82, 95%CI [1.5-15.5], p=0.008). No association was shown in men. HTG should be systematically investigated in depressed patients with severe insomnia and particularly in women. Further studies are needed to explain the association we observed between severe insomnia and HTG. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Depression, anxiety and quality-of-life among relatives of patients with severe brain injury

    DEFF Research Database (Denmark)

    Norup, Anne; Welling, Karen-Lise; Qvist, Jesper

    2012-01-01

    Primary objective: To investigate the emotional well-being of relatives of patients with a severe brain injury in the acute setting, as well as risk factors associated with high anxiety and depression scores and impaired quality-of-life. Research design: Clinical convenience sample. Methods...

  14. Prediction of Response to Medication and Cognitive Therapy in the Treatment of Moderate to Severe Depression

    Science.gov (United States)

    Fournier, Jay C.; DeRubeis, Robert J.; Shelton, Richard C.; Hollon, Steven D.; Amsterdam, Jay D.; Gallop, Robert

    2009-01-01

    A recent randomized controlled trial found nearly equivalent response rates for antidepressant medications and cognitive therapy in a sample of moderate to severely depressed outpatients. In this article, the authors seek to identify the variables that were associated with response across both treatments as well as variables that predicted…

  15. Impact of facial burns: relationship between depressive symptoms, self-esteem and scar severity

    NARCIS (Netherlands)

    Hoogewerf, C.J.; van Baar, M.E.; Middelkoop, E.; van Loey, N.E.

    2014-01-01

    Objective: This study assessed the role of self-reported facial scar severity as a possible influencing factor on self-esteem and depressive symptoms in patients with facial burns. Method: A prospective multicentre cohort study with a 6 months follow-up was conducted including 132 patients with

  16. Impact of facial burns : relationship between depressive symptoms, self-esteem and scar severity

    NARCIS (Netherlands)

    Hoogewerf, Cornelis Johannes; van Baar, Margriet Elisabeth; Middelkoop, Esther; Van Loey, N.E.E.

    2014-01-01

    OBJECTIVE: This study assessed the role of self-reported facial scar severity as a possible influencing factor on self-esteem and depressive symptoms in patients with facial burns. METHOD: A prospective multicentre cohort study with a 6 months follow-up was conducted including 132 patients with

  17. Frequency, trends, and antecedents of severe maternal depression after three million U.S. births.

    Directory of Open Access Journals (Sweden)

    Urbano L França

    Full Text Available Postpartum depression carries adverse consequences for mothers and children, so widespread screening during primary care visits is recommended. However, the rates, timing, and factors associated with significant depressive episodes are incompletely understood.We examined the Healthcare Cost and Utilization Project (HCUP State Inpatient, Emergency Department, and Ambulatory Surgery and Services Databases from California (2005-2011 and Florida (2005-2012. Within 203 million records, we identified 3,213,111 births and all mothers who had hospital encounters for severe depression within 40 weeks following delivery. We identified 15,806 episodes of postpartum depression after 11,103 deliveries among 10,883 unique women, and calculated an overall rate of 36.7 depression- associated hospital visits per 10,000 deliveries. Upward trends were observed in both states, with combined five-year increases of 34%. First depressive events were most common within 30 days of delivery, but continued for the entire observation period. About half (1,661/3,325 of PPD first episodes occurred within 34 days of delivery, 70% (2,329/3,325 by the end of the second month, and 87% (2,893/3,325 before four-months of the delivery. Women with private insurance were less likely to have hospital encounters for depression than women with public insurance and women with depression were much more likely to have had some kind of hospital encounter at some time during their pregnancies. Rates of depression increased with the number of prenatal hospital encounters in a "dose-dependent" fashion: the rate of depression was 17.2/10,000 for women with no prenatal hospital visits, doubling for women with at least one encounter (34.9/10,000, and increasing 7-fold to 126/10,000 for women with three or more encounters during their pregnancies.Our findings suggest that (1 hospital encounters for post-partum depression are increasing, (2 screening should begin very early and continue for the

  18. Frequency, trends, and antecedents of severe maternal depression after three million U.S. births.

    Science.gov (United States)

    França, Urbano L; McManus, Michael L

    2018-01-01

    Postpartum depression carries adverse consequences for mothers and children, so widespread screening during primary care visits is recommended. However, the rates, timing, and factors associated with significant depressive episodes are incompletely understood. We examined the Healthcare Cost and Utilization Project (HCUP) State Inpatient, Emergency Department, and Ambulatory Surgery and Services Databases from California (2005-2011) and Florida (2005-2012). Within 203 million records, we identified 3,213,111 births and all mothers who had hospital encounters for severe depression within 40 weeks following delivery. We identified 15,806 episodes of postpartum depression after 11,103 deliveries among 10,883 unique women, and calculated an overall rate of 36.7 depression- associated hospital visits per 10,000 deliveries. Upward trends were observed in both states, with combined five-year increases of 34%. First depressive events were most common within 30 days of delivery, but continued for the entire observation period. About half (1,661/3,325) of PPD first episodes occurred within 34 days of delivery, 70% (2,329/3,325) by the end of the second month, and 87% (2,893/3,325) before four-months of the delivery. Women with private insurance were less likely to have hospital encounters for depression than women with public insurance and women with depression were much more likely to have had some kind of hospital encounter at some time during their pregnancies. Rates of depression increased with the number of prenatal hospital encounters in a "dose-dependent" fashion: the rate of depression was 17.2/10,000 for women with no prenatal hospital visits, doubling for women with at least one encounter (34.9/10,000), and increasing 7-fold to 126/10,000 for women with three or more encounters during their pregnancies. Our findings suggest that (1) hospital encounters for post-partum depression are increasing, (2) screening should begin very early and continue for the first year

  19. Health-related quality of life and symptom severity in Chinese patients with major depressive disorder.

    Science.gov (United States)

    Cao, Yuping; Li, Wen; Shen, Jingjin; Malison, Robert T; Zhang, Yalin; Luo, Xingguang

    2013-12-01

    Patients suffering from major depressive disorder (MDD) have been reported to have substantial long-lasting limitations in multiple domains of health-related quality of life (HRQoL). The thoughtful assessment of HRQoL and the impact of treatment response on HRQoL are emerging as important issues in the care of patients with major depressive disorder. One hundred and three patients meeting Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for MDD took fluoxetine (20 mg/d) for 6 weeks and were assessed by the Short Form 36 Health Survey (SF-36), the 17-item Hamilton Depression Rating (HAMD-17) and the Clinical Global Impression (CGI) scales. Relationships between SF-36 scores and depressive symptom severity and early change of these symptoms were tested. SF-36 component scores at week 6 were higher than those at baseline (all P ≤ 0.0058). Scores for general health were significantly higher in responders than non-responders (P = 0.0009). The overall HAMD-17 and CGI scores at 2- and 6-week follow-up were significantly lower than those at baseline (P ≤ 0.0001). Higher scores for anxiety/somatization were significantly associated with poorer SF-36 scores at baseline (P = 0.0001); role-physical scores at week 6 were positively correlated with reduction rate of anxiety/somatization in 2-week follow-up (P = 0.0002). Depressive symptom severity was associated with HRQoL in patients with MDD. HRQoL may vary with severity of depression and/or anxiety-somatization at baseline. Copyright © 2013 Wiley Publishing Asia Pty Ltd.

  20. A study on the prevalence of depression and the severity of depression in patients of chronic obstructive pulmonary disease in a semi-urban Indian population.

    Science.gov (United States)

    Agarwal, Abhishekl; Batra, Sakshi; Prasad, Rajendra; Verma, Anand; Jilani, Abdul Q; Kant, Surya

    2018-03-19

    Chronic obstructive pulmonary disease (COPD) is one of the few respiratory diseases which is associated with a number of comorbidities. Psychiatric disease like depression is a very important comorbidity of COPD because it decreases the feeling of wellbeing in the patient and also interferes with the compliance with medication thereby increasing the risk of hospitalization in the COPD patient. A cross-sectional study was done for two years in the department of pulmonary medicine at Era's Lucknow medical college and hospital, Lucknow. A total of 150 patients were enrolled for the study after a clinico-radiological screening for the diagnosis confirmed on spirometry. After the confirmation of the diagnosis of COPD in these patients, they were screened for depression using the PHQ-9 scale in our department of pulmonary medicine. The confirmation of the diagnosis of depression was done according to the ICD-10 guidelines for depression and the severity of depression was graded using HAM-D scale in the department of psychiatry at our institute. The most common age group enrolled in the study was 51-60 years of age (40.67%). One hundred and fifteen patients (76.7%) of the enrolled patients were smokers while the remaining 35 patients (23.3%) were non-smokers. Depression was found to be present in 46 out of the total 150 patients in the study. Thus, the prevalence of depression in our study was 30.67%. Depression was seen in COPD groups B,C and D. Out of the 46 patients of COPD with depression,18 had mild depression (39.13%), 26 had moderate depression (56.52%) and 2 had severe depression (4.35%). Hence, depression of all grades (i.e., mild, moderate and severe depression) is seen in COPD groups B, C and D.

  1. Dextroamphetamine sulfate provided quick relief of severe post-partum depression that was recalcitrant to standard antidepressants and psychotherapy.

    Science.gov (United States)

    Check, J H; Jaffe, A

    2017-01-01

    To determine if dextroamphetamine sulfate could improve symptoms of post-partum depression. A woman with severe post-partum depression that was resistant to standard antidepressant therapy and psychotherapy was treated with dextroamphetamine sulfate extended release capsules 15 mg/day. A quick and complete abrogation of the depression ensued along with improvement of migraine headaches, insomnia, and chronic fatigue. Dextr6amphetamine sulfate should be considered as a treatment modality for post-partum depression.

  2. The effects of exercise on oxidative stress (TBARS) and BDNF in severely depressed inpatients.

    Science.gov (United States)

    Schuch, Felipe Barreto; Vasconcelos-Moreno, Mirela Paiva; Borowsky, Carolina; Zimmermann, Ana Beatriz; Wollenhaupt-Aguiar, Bianca; Ferrari, Pamela; de Almeida Fleck, Marcelo Pio

    2014-10-01

    Exercise can be an effective treatment for depression. Although the efficacy of exercise is well established, little is known concerning the biological changes associated with the antidepressant effects of exercise. A randomized, controlled trial was conducted to evaluate the effects of adding exercise to the usual treatment on the thiobarbituric acid-reactive substances (TBARS) and brain-derived neurotrophic factor (BDNF) serum levels of severely depressed inpatients. Twenty-six participants were randomized to an exercise group (n=15, exercise+treatment as usual) or a control group (n=11, treatment as usual). The participants in the exercise group completed a targeted dose of 16.5 kcal/kg/week of aerobic exercise, three times per week, throughout their hospitalizations. The control group did not exercise during their hospitalizations. The mean hospitalization length was of 21.63 (4.5)×23.82 (5.7) days for exercise and control groups, respectively. The exercise group performed a median of nine sessions. After adjusting for previous tobacco use, a significant group×time interaction was found for TBARS serum levels (p=0.02). A post hoc Bonferroni test revealed differences between the exercise and control groups at discharge. A significant time effect (pexercise to the usual treatment of severely depressed inpatients decreases the TBARS serum levels of severely depressed inpatients after 3 weeks. Adding exercise had no additional effects on BDNF serum levels.

  3. Self-perceived personality characteristics in seasonal affective disorder and their implications for severity of depression.

    Science.gov (United States)

    Hjordt, Liv Vadskjær; Dam, Vibeke H; Ozenne, Brice; Hageman, Ida; Mc Mahon, Brenda; Mortensen, Erik Lykke; Knudsen, Gitte M; Stenbæk, Dea Siggaard

    2018-04-01

    The personality traits Neuroticism and Extraversion may be involved in the development of seasonal affective disorder (SAD). However, the impact of personality traits on SAD severity and whether such self-reported traits fluctuate with season is unknown. We investigated the association between Neuroticism, as acquired in a symptom-free phase and depression severity in individuals with SAD and seasonal changes in personality traits in individuals with SAD compared to healthy controls. Twenty-nine individuals diagnosed with SAD and thirty demographically matched controls completed the NEO Personality Inventory-Revised and the Major Depression Inventory twice: in summer when individuals with SAD were symptom-free, and in winter when they experienced SAD symptoms. In summer, the groups scored similarly on their personality traits, and the controls did not score any different in winter compared to summer. High scores on Neuroticism in summer was associated with more severe depressive symptoms in winter in SAD individuals. In winter, individuals with SAD scored higher on Neuroticism and lower on Extraversion, both compared to controls and to their own summer scores. Our results support that Neuroticism may represent a vulnerability marker related to SAD, and during a depressive episode Neuroticism and Extraversion may be sensitive markers of SAD pathology. Copyright © 2018 Elsevier B.V. All rights reserved.

  4. [Marital status and the severity of perinatal depression among pregnant women].

    Science.gov (United States)

    Podolska, Magdalena; Sipak-Szmigiel, Olimpia

    2010-01-01

    Cohabitation existing for ages in all human cultures is becoming more common since the 1960s due to complex changes in postmodern societies. These societies have made the phenomenon of cohabitation the object of adequate theoretical reflection. The aim of this work was to determine whether the marital status of pregnant women affects the severity of perinatal depression. We enrolled 117 gravida hospitalized in 2006 and 2007 at the Department of Maternal-Fetal Medicine, Pomeranian Medical University. The gestational age ranged from week 32 to 40. The clinical condition of each gravida was assessed during routine obstetric history taking. The Edinburgh Postnatal Depression Scale by Cox, Holden, and Sagovski was used as the screening test for perinatal depression. 1. The marital status of the gravida with emphasis on cohabitation is a significant correlate of perinatal depression and its risk. 2. Clinical examination should concentrate not only on the physical and medical condition but also on the psychosocial status of the patient as the predictor of perinatal depression. 3. All pregnant women living in informal partnerships should be offered psychological support.

  5. Association between shift work and severity of depressive symptoms among female nurses: the Korea Nurses' Health Study.

    Science.gov (United States)

    Lee, Hea Young; Kim, Mi Sun; Kim, OkSoo; Lee, Il-Hyun; Kim, Han-Kyoul

    2016-03-01

    To determine the prevalence of depression and the relationship between shift work and depression severity among female nurses in South Korea. Shift work has been associated with higher risks of depressive symptoms, but there is a dearth of research on nurses, particularly investigating the severity of depressive symptoms. Quantitative data including survey response from 9789 participants were analysed. Statistical analysis included descriptive, Spearman's correlation and multivariable ordinal logistic regression. The numbers of nurses according to the severity of depressive symptoms were 35.2% (n = 3445), 38.0% (n = 3716), 16.1% (n = 1578), 7.6% (n = 747) and 3.1% (n = 303) for normal, mild, moderate, severely moderate and severe level of depressive symptoms, respectively. After adjusting for sociodemographic and health behavioural factors, nurses who worked shifts had 1.519-times greater odds of experiencing a higher severity of depressive symptoms (OR = 1.519, CI = 1.380-1.674, P nurses who worked shifts and suggests that shift work may increase the severity of depressive symptoms among female nurses in South Korea. Nursing professionals, managers and health policy makers need to understand the factors influencing depressive symptoms and to use appropriate interventions based on the severity and not just the onset. © 2015 John Wiley & Sons Ltd.

  6. [The degree of asthma severity in children and the level of maternal anxiety and depression].

    Science.gov (United States)

    Witkowska-Płusa, Urszula

    2015-02-01

    Care for sick children most often falls to mothers, which may affect their mental state, causing the states of depression and anxiety. The aim of this study was to determine the relationship between the severity of asthma in children and the level of anxiety and depression in mothers, taking into account the importance of the material status of the family, the educational level of the mothers, the presence of critical events, as well as the coexistence of allergic diseases in other family members. The study included 60 mothers of children with bronchial asthma. Age of mothers in the investigated families was on average 37.28 +/- 6.24 years, and most had a high school education (55.0%) or higher (28.3%). 16.7% of mothers and 8.3% fathers suffered from asthma. 13.3% of mothers of children with asthma were brought child alone. To assess the level of anxiety the inventory for measuring state and trait anxiety (STAI - State Trait Anxiety Inventory) developed by Spielberger, Gorsuch'a and Lushene'a was applied. To determine the changes in depressive the Beck Depression Inventory (BDI - Beck Depression Inventory questionnaire) was used. The Student's t test was included for two independent populations and a comparison of the results obtained in the questionnaire for diagnosing the level of anxiety and depression. For other parameters the correlation coefficient r-Pearson rank and Kendall's tau were performed. Mothers of children with moderate asthma compared to mothers of children with mild asthma had higher levels of anxiety (both state and properties), and also a slightly higher level of depression. Maternal age was connected positively and moderately strongly with the number held by children (r = 0.380; p = 0.003) and age of a child with asthma (r = 0.613, p = 0.0005). The duration of the child's disease was associated positively and moderately strongly with the level of state anxiety mother (X-1) (r = 0.345; p = 0.007) and a bit less and also positively with the

  7. Depressive symptomatology in severe dementia in a European sample: prevalence, associated factors and prescription rate of antidepressants.

    Science.gov (United States)

    Giebel, Clarissa M; Sutcliffe, Caroline; Renom-Guiteras, Anna; Arve, Seija; Hallberg, Ingalill Rahm; Soto, Maria; Zabalegui, Adelaida; Hamers, Jan; Saks, Kai; Challis, David

    2015-04-01

    Depression is a common comorbid disorder of dementia. This study explores the prevalence of and factors associated with depressive symptomatology, and antidepressant prescription rates in severe dementia across eight European countries. In total, 414 people with severe dementia completed measures of cognition and quality of life (QoL), whilst carers completed proxy measures of activities of daily living (ADLs), depression, neuropsychiatric symptoms, QoL and comorbidity. Findings indicated that 30% of the sample had depression, whilst the highest and lowest prevalence of depression was reported in Germany and Finland, respectively. Lower QoL, the presence of pain and more frequent neuropsychiatric symptoms were associated with depressive symptomatology, whilst no significant relationship between impairment of ADLs, comorbidity, and depression emerged. Spain and Estonia had the highest and lowest rates of antidepressant prescribing, respectively, whilst Germany had the highest discrepancy between depressive symptomatology and prescription. The study highlights variations across countries in the prevalence of depressive symptomatology in severe dementia and prescription of antidepressants. Information about factors associated with depressive symptomatology may help to better identify and manage depression.

  8. HAM-D17 and HAM-D6 sensitivity to change in relation to desvenlafaxine dose and baseline depression severity in major depressive disorder

    DEFF Research Database (Denmark)

    Bech, P; Boyer, P; Germain, J-M

    2010-01-01

    INTRODUCTION: This retrospective analysis compared sensitivity to change on the 17-item and 6-item Hamilton Rating Scales For Depression (HAM-D (17) and HAM-D (6), respectively) in relation to antidepressant dose and baseline depression severity. METHODS: Data were derived from 6 randomized, double...

  9. A LONGITUDINAL-STUDY OF INTERACTION PATTERNS OF A PSYCHIATRIST AND SEVERELY DEPRESSED-PATIENTS BASED ON OBSERVED BEHAVIOR - AN ETHOLOGICAL APPROACH OF INTERPERSONAL THEORIES OF DEPRESSION

    NARCIS (Netherlands)

    BOUHUYS, AL; VANDENHOOFDAKKER, RH

    Observed behaviour of a psychiatrist interacting with severely depressed patients during an interview was related to the course of depression during hospitalization. The behavioural structure of such interaction could be described by 6 factors for the patients and 7 factors for the psychiatrist. The

  10. Using thermographic cameras to investigate eye temperature and clinical severity in depression

    Science.gov (United States)

    Maller, Jerome J.; George, Shefin Sam; Viswanathan, Rekha Puzhavakkathumadom; Fitzgerald, Paul B.; Junor, Paul

    2016-02-01

    Previous studies suggest that altered corneal temperature may be a feature of schizophrenia, but the association between major depressive disorder (MDD) and corneal temperature has yet to be assessed. The aim of this study is to investigate whether eye temperature is different among MDD patients than among healthy individuals. We used a thermographic camera to measure and compare the temperature profile across the corneas of 16 patients with MDD and 16 age- and sex-matched healthy subjects. We found that the average corneal temperature between the two groups did not differ statistically, although clinical severity correlated positively with right corneal temperature. Corneal temperature may be an indicator of clinical severity in psychiatric disorders, including depression.

  11. Self-perceived personality characteristics in seasonal affective disorder and their implications for severity of depression

    DEFF Research Database (Denmark)

    Hjordt, Liv Vadskjær; Dam, Vibeke H; Ozenne, Brice

    2018-01-01

    The personality traits Neuroticism and Extraversion may be involved in the development of seasonal affective disorder (SAD). However, the impact of personality traits on SAD severity and whether such self-reported traits fluctuate with season is unknown. We investigated the association between...... Neuroticism, as acquired in a symptom-free phase and depression severity in individuals with SAD and seasonal changes in personality traits in individuals with SAD compared to healthy controls. Twenty-nine individuals diagnosed with SAD and thirty demographically matched controls completed the NEO Personality...... Inventory-Revised and the Major Depression Inventory twice: in summer when individuals with SAD were symptom-free, and in winter when they experienced SAD symptoms. In summer, the groups scored similarly on their personality traits, and the controls did not score any different in winter compared to summer...

  12. Initial Severity and Differential Treatment Outcome in the National Institute of Mental Health Treatment of Depression Collaborative Research Program.

    Science.gov (United States)

    Elkin, Irene; And Others

    1995-01-01

    Random regression models were used to investigate the role of initial severity in the outcome of four treatments for major depression: cognitive behavioral therapy, interpersonal psychotherapy, imipramine plus clinical management, and placebo plus clinical management. Initial severity of depression and impairment of functioning significantly…

  13. Relationship of Smartphone Use Severity with Sleep Quality, Depression, and Anxiety in University Students

    OpenAIRE

    Demi?rci?, Kadi?r; Akg?n?l, Mehmet; Akpinar, Abdullah

    2015-01-01

    Background and Aims The usage of smartphones has increased rapidly in recent years, and this has brought about addiction. The aim of the current study was to investigate the relationship between smartphone use severity and sleep quality, depression, and anxiety in university students. Methods In total, 319 university students (203 females and 116 males; mean age = 20.5 ? 2.45) were included in the study. Participants were divided into the following three groups: a smartphone non-user group (n...

  14. [Poor self-esteem is correlated with suicide intent, independently from the severity of depression].

    Science.gov (United States)

    Perrot, C; Vera, L; Gorwood, P

    2018-04-01

    Suicide is a major Public Health concern, and low self-esteem might represent a major risk factor. Our main objective was to assess the correlation between self-esteem and suicide intent. More specifically, we aimed to examine the relationship between the different dimensions of self-esteem (total, general, familial, professional and social) and suicide intent. We also sought the role of depression in the relationship of self-esteem to suicide intent. This retrospective cross-sectional study was conducted at a suicide prevention department at the CMME (Sainte-Anne Hospital, Paris, France). We included patients aged 15 and older and admitted for suicide attempt over a 3-year period from January 2008 to December 2010. Self-esteem was assessed with the Coopersmith's Self-Esteem Inventory (SEI) scale that takes into account several domains of self-esteem. Subjects scoring over 5 points on the lie scale were excluded. Our primary endpoint was the correlation between self-esteem and suicide intent. Our secondary endpoint was the same correlation adjusted for depression severity (using the Hamilton scale). Suicide intent was estimated using Beck's Suicide Intentionality Scale (SIS). We examined the Pearson's correlation coefficients between self-esteem and suicide intent. These analyses were adjusted for the severity of depressive symptoms assessed with the Hamilton Depression Rating Scale (17 items). Overall, 132 patients were included. Suicide intent was correlated with total self-esteem (r=-0.227, P=0.009), social self-esteem (r=-0.331, Pself-esteem (r=-0.260, P=0.003). These results remained significant after adjusting for the level of depression for total score (r=-0.181, P=0.038), and the social (r=-0.282, P=0.001) and familial (r=-0.237, P=0.006) dimensions. Self-esteem (and especially social and familial dimensions) is likely to be associated with suicide intent, at least in part independently of the severity of depression, in a population of subjects

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

    Science.gov (United States)

    Mumma, Gregory H

    2002-10-01

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

  16. EEG alpha power as an intermediate measure between brain-derived neurotrophic factor Val66Met and depression severity in patients with major depressive disorder.

    Science.gov (United States)

    Zoon, Harriët F A; Veth, C P M; Arns, Martijn; Drinkenburg, W H I M; Talloen, Willem; Peeters, Pieter J; Kenemans, J L

    2013-06-01

    Major depressive disorder has a large impact on patients and society and is projected to be the second greatest global burden of disease by 2020. The brain-derived neurotrophic factor (BDNF) gene is considered to be one of the important factors in the etiology of major depressive disorder. In a recent study, alpha power was found to mediate between BDNF Met and subclinical depressed mood. The current study looked at a population of patients with major depressive disorder (N = 107) to examine the association between the BDNF Val66Met polymorphism, resting state EEG alpha power, and depression severity. For this purpose, repeated-measures analysis of variance, partial correlation, and multiple linear models were used. Results indicated a negative association between parietal-occipital alpha power in the eyes open resting state and depression severity. In addition, Met/Met patients showed lower global absolute alpha power in the eyes closed condition compared with Val-carriers. These findings are in accordance with the previously uncovered pathway between BDNF Val66Met, resting state EEG alpha power, and depression severity. Additional research is needed for the clarification of this tentative pathway and its implication in personalized treatment of major depressive disorder.

  17. Amygdala Activity During Autobiographical Memory Recall in Depressed and Vulnerable Individuals: Association With Symptom Severity and Autobiographical Overgenerality.

    Science.gov (United States)

    Young, Kymberly D; Siegle, Greg J; Bodurka, Jerzy; Drevets, Wayne C

    2016-01-01

    In healthy individuals, autobiographical memory recall is biased toward positive and away from negative events, while the opposite is found in depressed individuals. This study examined amygdala activity during autobiographical memory recall as a putative mechanism underlying biased memory recall and depressive symptoms in currently depressed adults and two vulnerable populations: individuals remitted from depression and otherwise healthy individuals at high familial risk of developing depression. Identification of such vulnerability factors could enable interception strategies that prevent depression onset. Sixty healthy control subjects, 45 unmedicated currently depressed individuals, 25 unmedicated remitted depressed individuals, and 30 individuals at high familial risk of developing depression underwent functional MRI while recalling autobiographical memories in response to emotionally valenced cue words. Amygdala reactivity and connectivity with anatomically defined amygdala regions were examined. During positive recall, depressed participants exhibited significantly decreased left amygdala activity and decreased connectivity with regions of the salience network compared with the other groups. During negative recall, control subjects had significantly decreased left amygdala activity compared with the other groups, while depressed participants exhibited increased amygdala connectivity with the salience network. In depressed participants, left amygdala activity during positive recall correlated significantly with depression severity (r values >-0.38) and percent of positive specific memories recalled (r values >0.59). The results suggest that left amygdala hyperactivity during negative autobiographical recall is a trait-like marker of depression, as both vulnerable groups showed activity similar to the depressed group, while amygdala hypoactivity during positive autobiographical recall is a state marker of depression manifesting in active disease. Treatments

  18. Individuals with more severe depression fail to sustain nucleus accumbens activity to preferred music over time.

    Science.gov (United States)

    Jenkins, Lisanne M; Skerrett, Kristy A; DelDonno, Sophie R; Patrón, Víctor G; Meyers, Kortni K; Peltier, Scott; Zubieta, Jon-Kar; Langenecker, Scott A; Starkman, Monica N

    2018-05-30

    We investigated the ability of preferred classical music to activate the nucleus accumbens in patients with Major depressive disorder (MDD). Twelve males with MDD and 10 never mentally ill male healthy controls (HC) completed measures of anhedonia and depression severity, and listened to 90-second segments of preferred classical music during fMRI. Compared to HCs, individuals with MDD showed less activation of the left nucleus accumbens (NAcc). Individuals with MDD showed attenuation of the left NAcc response in later compared to earlier parts of the experiment, supporting theories that MDD involves an inability to sustain reward network activation. Counter intuitively, we found that NAcc activity during early music listening was associated with greater depression severity. In whole-brain analyses, anhedonia scores predicted activity in regions within the default mode network, supporting previous findings. Our results support theories that MDD involves an inability to sustain reward network activation. It also highlights that pleasant classical music can engage critical neural reward circuitry in MDD. Copyright © 2018 Elsevier B.V. All rights reserved.

  19. Gender differences in severity, symptomatology and distribution of melancholia in major depression

    DEFF Research Database (Denmark)

    Hildebrandt, Malene Grubbe; Stage, Kurt Bjerregaard; Kragh-Soerensen, Per

    2003-01-01

    BACKGROUND: Studies of gender differences in the clinical presentation of depression have provided divergent results. This study aimed at analyzing gender differences in severity, symptomatology and distribution of melancholia in major depression. SAMPLING AND METHODS: The study comprised 930 in...... Scale from 1965 for melancholia (N1) in a subsample of patients (n = 439). A factor analysis on the HDS was performed. Non-parametric statistical tests were used and only gender differences greater than 20% were considered clinically relevant. RESULTS: The median on the HDS total score was 22...... and the median number of symptoms was 13 for both men and women. Presentation of specific symptoms was similar for men and women. The factor analysis revealed no gender differences, and neither did analyses on symptoms of Axes II and IV. According to the N1, 80% of the men and 66% of the women suffered from...

  20. Association of Beck Depression Inventory score and Temperament and Character Inventory-125 in patients with eating disorders and severe malnutrition

    OpenAIRE

    Tanaka, Satoshi; Yoshida, Keizo; Katayama, Hiroto; Kohmura, Kunihiro; Kawano, Naoko; Imaeda, Miho; Kato, Saki; Ando, Masahiko; Aleksic, Branko; Nishioka, Kazuo; Ozaki, Norio

    2015-01-01

    The authors investigated the association between personality and physical/mental status in malnourished patients with eating disorders. A total of 45 patients with anorexia nervosa, avoidant/restrictive food intake disorder, and other specified feeding or eating disorders were included and compared with 39 healthy controls. Personality characteristics and severity of depression were assessed using the Temperament and Character Inventory-125 and Beck?s Depression Inventory. Depression correlat...

  1. Differences in depression severity and frequency of relapses in opiate addicts treated with methadone or opiate blocker after detoxification

    OpenAIRE

    Jovanović Tatjana; Lazarević Dušan; Nikolić Gordana

    2012-01-01

    Background/Aim. Relapse of opiate dependence is a common occurrence after detoxification and introduction of opiate addicts in abstinence from opiates. Clinical evaluation showed that over 90% of opiate addicts exhibit depressive manifestations during detoxification, or develop post-detoxification depression. The aim of this study was to determine differences in the frequency of relapses, severity and course of depression during a of 6-month period, and previous patterns of use of opioi...

  2. The Direct and Interactive Effects of Neuroticism and Life Stress on the Severity and Longitudinal Course of Depressive Symptoms

    Science.gov (United States)

    Brown, Timothy A.; Rosellini, Anthony J.

    2011-01-01

    The direct and interactive effects of neuroticism and stressful life events (chronic and episodic stressors) on the severity and temporal course of depression symptoms were examined in 826 outpatients with mood and anxiety disorders, assessed on three occasions over a one-year period (intake, 6- and 12-month follow-ups). Neuroticism, chronic stress, and episodic stress were uniquely associated with intake depression symptom severity. A significant interaction effect indicated that the strength of the effect of neuroticism on initial depression severity increased as chronic stress increased. Although neuroticism did not have a significant direct effect on the temporal course of depression symptoms, chronic stress significantly moderated this relationship such that neuroticism had an increasingly deleterious effect on depression symptom improvement as the level of chronic stress over follow-up increased. In addition, chronic stress over follow-up (but not episodic stress) was uniquely predictive of less depression symptom improvement. Consistent with a stress generation framework, however, initial depression symptom severity was positively associated with chronic stress during follow-up. The results are discussed in regard to diathesis-stress conceptual models of emotional disorders and the various roles of stressful life events in the onset, severity, and maintenance of depressive psychopathology. PMID:21381799

  3. The role of empowerment and quality of life in depression severity among unemployed people with affective disorders receiving mental healthcare.

    Science.gov (United States)

    Johanson, Suzanne; Bejerholm, Ulrika

    2017-09-01

    Sick leave and unemployment are highly prevalent among people with affective disorders. Their depression severity is disabling and inversely related to having employment. No evidence-based vocational rehabilitation exists for this target group. Knowledge is therefore needed to understand the psychosocial factors that affect depression severity in order to develop new rehabilitation interventions. This study examined relationships between depression severity and empowerment, working life aspirations, occupational engagement, and quality of life in unemployed people with affective disorders receiving mental healthcare. In this cross-sectional study of 61 participants, instruments on psychosocial factors and questions on descriptive sociodemographic and clinical characteristics were administered. Descriptive, correlation, and regression statistics were applied. Correlation and regression analyses showed significant inverse relations between depression severity and empowerment and quality of life. The odds for more severe depression decreased with higher empowerment and quality of life. However, neither extent of engagement in daily life nor working life aspiration was related to depression severity. An empowerment approach and strategies, which support the quality of life, are needed in development of vocational rehabilitation interventions, and bridging of mental healthcare and vocational services. Implications for Rehabilitation Enhancing empowerment and quality life in the return to work process can decrease depression severity in unemployed people with affective disorder. There is a need to address work issues in addition to symptom reduction in primary and mental healthcare. Bridging the service and time gap between vocational rehabilitation and healthcare is recommended for mitigating long-term unemployment for people with affective disorders who want to work.

  4. Hormonal determinants of the severity of andropausal and depressive symptoms in middle-aged and elderly men with prediabetes.

    Science.gov (United States)

    Rabijewski, Michał; Papierska, Lucyna; Kuczerowski, Roman; Piątkiewicz, Paweł

    2015-01-01

    Andropausal and depressive symptoms are common in aging males and may be associated with hormone deficiency. We investigated the severity of andropausal and depressive symptoms, as well as their hormonal determinants, in 196 middle-aged and elderly men (age range: 40-80 years) with prediabetes (PD) and in 184 healthy peers. PD was diagnosed according to the definition of the American Diabetes Association. The severity of andropausal and depressive symptoms was assessed using the Aging Males' Symptoms Rating Scale and the Self-Rating Depression Scale. Total testosterone (TT), calculated free testosterone (cFT), dehydroepiandrosterone sulfate (DHEAS), and insulin-like growth factor 1 (IGF-1) were measured. The prevalence of andropausal syndrome in men with PD was significantly higher than that in healthy men (35% vs 11%, respectively). In men with PD aged 40-59 years, the severity of sexual, psychological, and all andropausal symptoms was greater than in healthy peers, while in elderly men (60-80 years), only the severity of psychological symptoms was greater than in healthy peers. The severity of depressive symptoms in the middle-aged men with PD was greater than in healthy peers, while the severity of depressive symptoms in elderly men with PD and healthy peers was similar. The higher prevalence of andropausal symptoms was independently associated with cFT and IGF-1 in middle-aged men and with TT and DHEAS in elderly men with PD. The more severe depression symptoms were associated with low TT and DHEAS in middle-aged men and with low cFT and DHEAS in elderly men with PD. In conclusion, the prevalence of andropausal symptoms, especially psychological, was higher in prediabetic patients as compared to healthy men, while the severity of depressive symptoms was higher only in middle-aged men with PD. Hormonal determinants of andropausal and depressive symptoms are different in middle-aged and elderly patients, but endocrine tests are necessary in all men with PD.

  5. PSYCHOMETRIC PROPERTY OF FATIGUE SEVERITY SCALE AND CORRELATION WITH DEPRESSION AND QUALITY OF LIFE IN CIRRHOTICS

    Directory of Open Access Journals (Sweden)

    Danusa ROSSI

    2017-10-01

    Full Text Available ABSTRACT BACKGROUND: Fatigue is a common complaint in cirrhotic patients and may be considered a debilitating symptom with negative impact on quality of life. Research on its etiology and treatment has been hampered by the lack of relevant and reproducible measures of fatigue. OBJECTIVE: To evaluate the psychometric properties of the Fatigue Severity Scale (FSS in cirrhotic patients and to correlate with depressive symptomatology and quality of life. METHODS: Cross-sectional study with a convenience sample of 106 cirrhotic patients, aged between 18 and 70 years, both genders, literate, pre and post liver transplantation in outpatient follow-up. Internal consistency, reproducibility, discriminant validity, criterion validity, construct validity, responsiveness criterion, depressive symptomatology and quality of life were evaluated through questionnaires between January and October 2015. RESULTS: The mean age was 54.75±9.9 years, 65.1% male and 32.1% of the sample had cirrhosis due to hepatitis C virus. The mean FSS score was 4.74±1.64. Cronbach’s alpha was 0.93, and the Intraclass Correlation Coefficient was 0.905 (95% CI: 0.813-0.952. For discriminant validity, FSS differentiated scores from different groups (P=0.009 and presented a correlation with the Modified Fatigue Impact Scale (r=0.606, P=0.002. FSS correlated significantly and positively with depressive symptomatology and correlated negatively with the SF-36 domains for construct validity. For responsiveness, no significant changes were observed in the fatigue scores in the pre and post-liver transplantation periods (P=0.327. CONCLUSION: FSS showed good psychometric performance in the evaluation of fatigue in patients with cirrhosis. Fatigue presented a strong correlation with depressive symptomatology and quality of life.

  6. Electro convulsive therapy in a pre-pubertal child with severe depression.

    Directory of Open Access Journals (Sweden)

    Russell P

    2002-10-01

    Full Text Available Electro Convulsive Therapy (ECT in pre-pubertal children is a controversial and underreported treatment. Even though the effectiveness and side effects of ECT in adolescents are comparable with those in adults, there is a pervasive reluctance to use ECT in children and adolescents. We report the case of a pre-pubertal child in an episode of severe depression with catatonic features, where a protracted course of ECT proved life-saving in spite of prolonged duration of seizures and delayed response to treatment. The case illustrates the safety and efficacy of ECT in children. Relevant literature is also reviewed along with the case report.

  7. Regional brain volumes, diffusivity, and metabolite changes after electroconvulsive therapy for severe depression

    DEFF Research Database (Denmark)

    Jørgensen, A.; Magnusson, P.; Hanson, Lars G.

    2016-01-01

    , and metabolite changes in 19 patients receiving ECT for severe depression. Other regions of interest included the amygdala, dorsolateral prefrontal cortex (DLPFC), orbitofrontal cortex, and hypothalamus. Patients received a 3T MR scan before ECT (TP1), 1 week (TP2), and 4 weeks (TP3) after ECT. Results......: Hippocampal and amygdala volume increased significantly at TP2 and continued to be increased at TP3. DLPFC exhibited a transient volume reduction at TP2. DTI revealed a reduced anisotropy and diffusivity of the hippocampus at TP2. We found no significant post-ECT changes in brain metabolite concentrations...

  8. A patient with autism and severe depression: medical and ethical challenges for an adolescent medicine unit.

    Science.gov (United States)

    Skinner, S Rachel; Ng, Cindy; McDonald, Ann; Walters, Tamara

    2005-10-17

    An adolescent with autism and intellectual disability presented with severe depression related to menstruation. Because of the complex medical, psychiatric and ethical issues involved, her care was coordinated by a hospital-based adolescent medicine unit. After trials of other therapies over an extended period and interdisciplinary and intersectoral case conferencing, it was decided that hysterectomy was the most appropriate management. This case highlights the complexity of adolescent health care in a tertiary hospital, the importance of intersectoral cooperation between hospital and community, and the integral role of interdisciplinary care of adolescent patients with chronic conditions.

  9. Quality of Life, Functioning, and Depressive Symptom Severity in Older Adults With Major Depressive Disorder Treated With Citalopram in the STAR*D Study.

    Science.gov (United States)

    Steiner, Alexander J; Recacho, Jennifer; Vanle, Brigitte; Dang, Jonathan; Wright, Stephanie M; Miller, Justin S; Kauzor, Kaitlyn; Reid, Mark; Bashmi, Luma E; Mirocha, James; Danovitch, Itai; IsHak, Waguih William

    2017-07-01

    Major depressive disorder (MDD) can substantially worsen patient-reported quality of life (QOL) and functioning. Prior studies have examined the role of age in MDD by comparing depressive symptom severity or remission rates between younger and older adults. This study examines these outcomes before and after SSRI treatment. On the basis of prior research, we hypothesized that older adults would have worse treatment outcomes in QOL, functioning, and depressive symptom severity and that nonremitters would have worse outcomes. A retrospective secondary data analysis was conducted from the National Institute of Mental Health-funded Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study (July 2001-September 2006). We analyzed data for 2,280 nonpsychotic adults with DSM-IV-TR-defined MDD who received citalopram monotherapy. Older adults were classified as adults aged 65 years and above. All subjects completed patient-reported QOL, functioning, and depressive symptom severity measures at entry and exit. Subjects included 106 older adults and 2,174 adults older adults and adults Older adults had smaller treatment effect sizes for all outcomes, particularly functioning. Conversely, mean change scores from entry to exit were equivalent across all outcomes. Remitters at exit had significantly better responses to treatment than nonremitters for the majority of outcomes. Findings suggest that older adults and younger adults have comparable treatment responses to citalopram monotherapy, with significant improvements in patient-reported depressive symptom severity, functioning, and QOL. ClinicalTrials.gov identifier: NCT00021528. © Copyright 2017 Physicians Postgraduate Press, Inc.

  10. The effect of self efficacy and meaning in life on posttraumatic stress disorder and depression severity among veterans.

    Science.gov (United States)

    Blackburn, Laura; Owens, Gina P

    2015-03-01

    The current study examined the relationships among combat exposure, presence of and search for meaning in life, general and social self-efficacy, and both posttraumatic stress disorder (PTSD) and depression symptom severity for a Veteran sample (N = 93). Participants completed an online survey comprising the Combat Exposure Scale, Meaning in Life Questionnaire, Self-Efficacy Scale, Depression subscale of the Depression, Anxiety, Stress Scales-21, and PTSD Checklist-Specific Stressor version. The majority of participants were male and Caucasian. Participants served in various service eras To determine factors that predicted PTSD and depression severity, separate hierarchical linear regressions were performed. In the final PTSD model, rank, combat exposure, and general self-efficacy were significant predictors, with officer rank, lower combat exposure, and higher general self-efficacy associated with lower PTSD severity. The interaction between combat exposure and general self-efficacy was also significant, with self-efficacy moderating the relationship between combat exposure and PTSD severity. For depression, rank, presence of meaning in life, and general self-efficacy were significant predictors in the model, with officer rank, higher presence of meaning in life, and general self-efficacy associated with lower depression severity. A focus on strengthening self-efficacy may assist with lower levels of PTSD and depression symptomatology after combat trauma. © 2014 Wiley Periodicals, Inc.

  11. Anxiety and depressive symptoms in primary caregivers of patients with severe depression. A snapshot from a military mental health care facility

    International Nuclear Information System (INIS)

    Javed, M.; Ayaz, S.B.; Ullah, A.; Matee, S.

    2015-01-01

    This study aimed at determining the frequency and severity of anxiety and depressive symptoms in primary caregivers of severely depressed patients and evaluate the impact of demographic factors. Methodology: It was a cross-sectional study conducted in the out-patient as well as the in-patient setting of Armed Forces institute of Mental Health, Rawalpindi, from September 2009 to May 2012. Through non-probability purposive sampling, primary caregivers of patients diagnosed with severe depression by consultant psychiatrists were included and scored by resident psychiatrists on Revised Beck Depression Inventory (BDI-II) and Beck Anxiety Inventory (BAI). Results: Of 316 caregivers (mean age: 37.75 ± 12.26 years), majority (52.8%) were females, married (70.6%), employed (58.5%), earned < Rs. 5,000 per month (40.5%) and literate from grade 1-5 (21.8%). Most of them were mothers (25.3%) of the patients and were the caregivers for less than one year (43.4%). The mean total BDI-II score was 17.29 ± 13.94.It was significantly high in subjects belonging to age group of < 44 years. The mean total BAI score was 14.44 ± 11.56 and it was not significantly related to any demographic factor. Conclusion: Caregivers of severely depressed patients suffered considerable levels of anxiety and depressive symptoms. Younger caregivers were at higher risk of developing depressive symptoms but the age did not significantly affect development of anxiety. Gender, marital status, employment status, monthly income, relationship with the patient, ethnicity based on provinces, educational level and duration of care giving did not appear to be significantly related to the development of anxiety or depressive symptoms in our sample. (author)

  12. The severity of Internet addiction risk and its relationship with the severity of borderline personality features, childhood traumas, dissociative experiences, depression and anxiety symptoms among Turkish university students.

    Science.gov (United States)

    Dalbudak, Ercan; Evren, Cuneyt; Aldemir, Secil; Evren, Bilge

    2014-11-30

    The aim of this study was to investigate the relationship of Internet addiction (IA) risk with the severity of borderline personality features, childhood traumas, dissociative experiences, depression and anxiety symptoms among Turkish university students. A total of 271 Turkish university students participated in this study. The students were assessed through the Internet Addiction Scale (IAS), the Borderline Personality Inventory (BPI), the Dissociative Experiences Scale (DES), the Childhood Trauma Questionnaire (CTQ-28), the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). The rates of students were 19.9% (n=54) in the high IA risk group, 38.7% (n=105) in the mild IA risk group and 41.3% (n=112) in the group without IA risk. Correlation analyses revealed that the severity of IA risk was related with BPI, DES, emotional abuse, CTQ-28, depression and anxiety scores. Univariate covariance analysis (ANCOVA) indicated that the severity of borderline personality features, emotional abuse, depression and anxiety symptoms were the predictors of IAS score, while gender had no effect on IAS score. Among childhood trauma types, emotional abuse seems to be the main predictor of IA risk severity. Borderline personality features predicted the severity of IA risk together with emotional abuse, depression and anxiety symptoms among Turkish university students. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  13. Severe water intoxication and secondary depressive syndrome in relation to delusional infestation

    Directory of Open Access Journals (Sweden)

    Lai J

    2016-02-01

    Full Text Available Jianbo Lai,1 Qiaoqiao Lu,1 Yi Xu,1,2 Shaohua Hu1,2 1Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 2The Key Laboratory of Mental Disorder’s Management in Zhejiang Province, Hangzhou, People’s Republic of China Abstract: This study presents a case of severe water intoxication in a female patient with delusional infestation. Self-induced excessive water ingestion is a rare medical condition, which has not been reported in patients with delusional infestation yet. The patient in this case study was a 60-year-old Chinese woman, who was admitted to our hospital because of a feeling of skin infestation. She suffered from loss of consciousness and generalized tonic–clonic seizure after drinking 12 L of water during bowel cleansing before colonoscopy. Sufficient laboratory and imaging examinations were performed to exclude other possible causes of severe hyponatremia, such as hypothyroidism, diabetes insipidus, and syndrome of inappropriate antidiuretic hormone. Besides, the cystic lesion in the posterior pituitary revealed by cranial magnetic resonance imaging was not accountable for her delusional symptoms as well as excessive drinking behavior. Her delusional symptoms were in complete remission with a combination of risperidone and aripiprazole. However, nearly 3 months after discharge, this patient suffered from depressed mood and was diagnosed with depressive syndrome, and even attempted suicide. This case highlights the possibility of self-induced water intoxication in patients with delusional infestation, inevitably adding to the complexity of the disease, and indicates the necessity of precautions for secondary psychotic or mood problems after symptomatological remission. Keywords: delusional infestation, depressive syndrome, suicide, water intoxication

  14. Depression

    Science.gov (United States)

    ... in the winter. Depression is one part of bipolar disorder. There are effective treatments for depression, including antidepressants, talk therapy, or both. NIH: National Institute of Mental Health

  15. Risk factors for suicide among 34,671 patients with psychotic and non-psychotic severe depression

    DEFF Research Database (Denmark)

    Leadholm, Anne Katrine K; Rothschild, Anthony J; Nielsen, Jimmi

    2014-01-01

    BACKGROUND: Severe unipolar depression is associated with increased risk of suicide, but it remains unknown whether the same risk factors are present in the non-psychotic (non-PD) and psychotic (PD) subtypes respectively. Therefore, this study aimed to identify risk factors for suicide in non......-PD and PD separately, and to investigate if the presence of psychotic symptoms is an independent risk factor for suicide in severe depression. METHODS: This register-based, nationwide, historical prospective cohort study used logistic regression analyses to ascertain risk factors for suicide among all...... adults diagnosed with severe depression at Danish psychiatric hospitals between January 1, 1994 and December 31, 2010. The risk for suicide was expressed as adjusted odds ratios (AOR). RESULTS: A total of 34,671 individuals with severe depression (non-PD: n=26,106 and PD: n=12,101) were included...

  16. Increased risk of severe depression in male partners of women with breast cancer

    DEFF Research Database (Denmark)

    Nakaya, Naoki; Saito-Nakaya, Kumi; Bidstrup, Pernille Envold

    2010-01-01

    BACKGROUND:: A few small studies published to date have suggested that major psychosocial problems develop in the partners of cancer patients; however, to the authors' knowledge, no studies to date have addressed their risk for severe depression. In a retrospective cohort study, the risk for hosp......BACKGROUND:: A few small studies published to date have suggested that major psychosocial problems develop in the partners of cancer patients; however, to the authors' knowledge, no studies to date have addressed their risk for severe depression. In a retrospective cohort study, the risk...... for hospitalization with an affective disorder of the male partners of women with breast cancer was investigated, using unbiased, nationwide, population-based information. METHODS:: Followed were 1,162,596 men born between 1925 and 1973 who were aged ≥30 years at study entry, resided in Denmark between 1994 and 2006......-related indicators obtained from national administrative and disease registers. RESULTS:: During the 13 years of follow-up, breast cancer was diagnosed in the partners of 20,538 men. On multivariable analysis, men whose partner was diagnosed with breast cancer were found to be at an increased risk of being...

  17. DEPRESSION MEDIATES THE RELATION OF INSOMNIA SEVERITY WITH SUICIDE RISK IN THREE CLINICAL SAMPLES OF U.S. MILITARY PERSONNEL.

    Science.gov (United States)

    Bryan, Craig J; Gonzales, Jacqueline; Rudd, M David; Bryan, AnnaBelle O; Clemans, Tracy A; Ray-Sannerud, Bobbie; Wertenberger, Evelyn; Leeson, Bruce; Heron, Elizabeth A; Morrow, Chad E; Etienne, Neysa

    2015-09-01

    A growing body of empirical research suggests insomnia severity is directly related to suicide ideation, attempts, and death in nonmilitary samples, even when controlling for depression and other suicide risk factors. Few studies have explored this relationship in U.S. military personnel. The present study entailed secondary data analyses examining the associations of insomnia severity with suicide ideation and attempts in three clinical samples: Air Force psychiatric outpatients (n = 158), recently discharged Army psychiatric inpatients (n = 168), and Army psychiatric outpatients (n = 54). Participants completed the Beck Scale for Suicide Ideation, the Beck Depression Inventory-II or Patient Health Questionnaire-9, the Insomnia Severity Index, and the Posttraumatic Stress Disorder Checklist at baseline; two samples also completed these measures during follow-up. Sleep disturbance was associated with concurrent (β's > 0.21; P's 0.39; P's suicide ideation in all three samples. When adjusting for age, gender, depression, and posttraumatic stress, insomnia severity was no longer directly associated with suicide ideation either concurrently (β's 0.200) or prospectively (β's 0.063), but depression was (β's > 0.22; P's depression mediated the relation of insomnia severity with suicide ideation. Across three clinical samples of military personnel, depression explained the relationship between insomnia severity and suicide risk. © 2015 Wiley Periodicals, Inc.

  18. Depression

    Science.gov (United States)

    ... reasons why a woman may have depression: Family history . Women with a family history of depression may be more at risk. But depression can also happen in women who don’t have a family history of depression. Brain changes. The brains of people ...

  19. One year follow-up of post-partum-onset depression: the role of depressive symptom severity and personality disorders.

    Science.gov (United States)

    Uguz, Faruk; Akman, Cemal; Sahingoz, Mine; Kaya, Nazmiye; Kucur, Rahim

    2009-06-01

    Long-term follow-up and risk factors of persistent post-partum depression (PPD) are fairly unknown compared with its prevalence in the developing countries. In this study, we did a follow-up measure of PPD and examined the factors, which were associated with PPD 1-year post-partum. Our sample comprised of 34 women. Depressive symptoms were assessed by the Edinburgh post-natal depression scale (EPDS) 6 weeks post-partum, and women with scores >12 on this scale was categorised as depressed. Personality disorders were determined at the same occasion by means of the Structured Clinical Interview for DSM-III-R personality disorders (SCID-II). One year post-partum EPDS was completed. The rate of PPD 1-year post-partum was 32.4%, and it was unrelated to age at assessment, primiparity, number of children, employment status, economical status and educational level. Women depressed 1-year post-partum had significantly higher basal scores of EPDS and more often also a diagnosis of any axis II disorder; and specifically dependent and obsessive-compulsive personality disorders. In our sample, the predictors of 1-year post-partum PPD were having higher basal score of EPDS and the existence of a personality disorder. This study suggests that women with PPD, scoring high in the EPDS scale 6 weeks post-partum and having a personality disorder, run a higher risk for depression at 1-year follow-up.

  20. Gender, negative life events and coping on different stages of depression severity: A cross-sectional study among Chinese university students.

    Science.gov (United States)

    Sun, Xiao-Jun; Niu, Geng-Feng; You, Zhi-Qi; Zhou, Zong-Kui; Tang, Yun

    2017-02-01

    The effects of gender, negative life events, and coping on depression have been well-documented. But depression is a heterogeneous syndrome of which the severity ranged from mild depression to major depression. This study aimed to investigate the specific effects of gender, negative life events, and coping on different stages of depression severity. A total of 5989 students (aged 16-25 years, M=20.85, SD=0.58), recruited from six universities in the central region of China using the stratified cluster sampling method, completed Life Events Questionnaire, Coping Response Inventory, and Beck Depression Inventory-Ⅱ. Among the participants, 708 (11.8%) students presented different severity levels of depression. Gender, negative life events, positive coping, and negative coping all had significant effects on depression. That is, the possibility of being depressed was significantly higher in female university students, or students who had more negative life events, more negative coping, or positive coping. In terms of the different stages of depression severity, all these factors had significant effects on the stage from non- depression to mild depression; only gender, negative life events and positive coping had significant effects on the stage from mild depression to moderate depression; only gender had a significant effect on the stage from moderate depression to major depression. The causal role of these factors on different stages of depression severity could not be inferred. Moreover, the participants were from a non-clinical population. The effects of gender, negative life events and coping varied in different stages of depression severity. The effects of life events and coping styles became insignificant with the increasing severity of depression, whereas the effect of gender remained significant. The results could provide guidance for the prevention, intervention, and treatment of depression. Copyright © 2016. Published by Elsevier B.V.

  1. Effect of Mirtazapine Treatment on Serum Levels of Brain-Derived Neurotrophic Factor and Tumor Necrosis Factor-α in Patients of Major Depressive Disorder with Severe Depression.

    Science.gov (United States)

    Gupta, Rachna; Gupta, Keshav; Tripathi, A K; Bhatia, M S; Gupta, Lalit K

    2016-01-01

    This study evaluated the clinical efficacy of mirtazapine and its effect on serum brain-derived neurotrophic factor (BDNF) and tumor necrosis factor-α (TNF-α) levels in patients of major-depressive disorder (MDD) with severe depression. Patients (aged 18-60) with MDD diagnosed by DSM-IV criteria, and Hamilton Rating Scale for Depression (HAM-D) score ≥25 were included (n = 30). Mirtazapine was given in the doses of 30 mg/day. All patients were followed up for 12 weeks for the evaluation of clinical efficacy, safety along with serum BDNF and TNF-α levels. HAM-D score at the start of treatment was 30.1 ± 1.92, which significantly (p depressed patients and treatment response is associated with an increase in serum BDNF and a decrease in serum TNF-α levels. © 2016 S. Karger AG, Basel.

  2. Association of different levels of depressive symptoms with symptomatology, overall disease severity, and quality of life in women with fibromyalgia.

    Science.gov (United States)

    Soriano-Maldonado, Alberto; Amris, Kirstine; Ortega, Francisco B; Segura-Jiménez, Víctor; Estévez-López, Fernando; Álvarez-Gallardo, Inmaculada C; Aparicio, Virginia A; Delgado-Fernández, Manuel; Henriksen, Marius; Ruiz, Jonatan R

    2015-12-01

    This study examined the associations of different levels of depression with pain, sleep quality, fatigue, functional exercise capacity, overall fibromyalgia (FM) severity, and health-related quality of life (HRQoL) in women with FM. A total of 451 women with FM participated in this cross-sectional study. Depressive symptoms (Beck Depression Inventory; BDI-II), pain intensity (numerical rating scale; NRS), pain sensitivity (algometry), sleep quality (Pittsburgh Sleep Quality Index), fatigue (Multidimensional Fatigue Inventory), functional exercise capacity (6-min walk test), FM severity (revised Fibromyalgia Impact Questionnaire), and HRQoL (SF-36) were assessed. Participants with severe depressive symptoms had significantly higher pain intensity (NRS = 1.1; 95 % CI 0.3-1.8), fatigue (12.6-units; 95 % CI 8.2-17.1) and overall FM severity (12.6-units; 95 % CI 11.4-23.7), as well as poorer sleep quality (3.2-units; 95 % CI 1.7-4.7) and mental component of HRQoL (-17.0-units; 95 % CI -21.0 to -12.9) than participants with minimal signs of depression. There was no association of signs of depression with pain sensitivity, exercise capacity, or the physical component of HRQoL (P > 0.05). These results extend current knowledge on the association of signs of depression with FM severity and quality of life in women with FM, and suggest that severity of depressive symptoms could potentially be a prognostic factor to be considered in future prospective intervention studies.

  3. Hyper-responsivity to losses in the anterior insula during economic choice scales with depression severity.

    Science.gov (United States)

    Engelmann, J B; Berns, G S; Dunlop, B W

    2017-12-01

    Commonly observed distortions in decision-making among patients with major depressive disorder (MDD) may emerge from impaired reward processing and cognitive biases toward negative events. There is substantial theoretical support for the hypothesis that MDD patients overweight potential losses compared with gains, though the neurobiological underpinnings of this bias are uncertain. Twenty-one unmedicated patients with MDD were compared with 25 healthy controls (HC) using functional magnetic resonance imaging (fMRI) together with an economic decision-making task over mixed lotteries involving probabilistic gains and losses. Region-of-interest analyses evaluated neural signatures of gain and loss coding within a core network of brain areas known to be involved in valuation (anterior insula, caudate nucleus, ventromedial prefrontal cortex). Usable fMRI data were available for 19 MDD and 23 HC subjects. Anterior insula signal showed negative coding of losses (gain > loss) in HC subjects consistent with previous findings, whereas MDD subjects demonstrated significant reversals in these associations (loss > gain). Moreover, depression severity further enhanced the positive coding of losses in anterior insula, ventromedial prefrontal cortex, and caudate nucleus. The hyper-responsivity to losses displayed by the anterior insula of MDD patients was paralleled by a reduced influence of gain, but not loss, stake size on choice latencies. Patients with MDD demonstrate a significant shift from negative to positive coding of losses in the anterior insula, revealing the importance of this structure in value-based decision-making in the context of emotional disturbances.

  4. Association of different levels of depressive symptoms with symptomatology, overall disease severity, and quality of life in women with fibromyalgia

    DEFF Research Database (Denmark)

    Soriano-Maldonado, Alberto; Amris, Kirstine; Ortega, Francisco B

    2015-01-01

    PURPOSE: This study examined the associations of different levels of depression with pain, sleep quality, fatigue, functional exercise capacity, overall fibromyalgia (FM) severity, and health-related quality of life (HRQoL) in women with FM. METHODS: A total of 451 women with FM participated.......4-23.7), as well as poorer sleep quality (3.2-units; 95 % CI 1.7-4.7) and mental component of HRQoL (-17.0-units; 95 % CI -21.0 to -12.9) than participants with minimal signs of depression. There was no association of signs of depression with pain sensitivity, exercise capacity, or the physical component of HRQo...... in this cross-sectional study. Depressive symptoms (Beck Depression Inventory; BDI-II), pain intensity (numerical rating scale; NRS), pain sensitivity (algometry), sleep quality (Pittsburgh Sleep Quality Index), fatigue (Multidimensional Fatigue Inventory), functional exercise capacity (6-min walk test), FM...

  5. Effect of prenatal mindfulness training on depressive symptom severity through 18-months postpartum: A latent profile analysis.

    Science.gov (United States)

    Felder, Jennifer N; Roubinov, Danielle; Bush, Nicole R; Coleman-Phox, Kimberly; Vieten, Cassandra; Laraia, Barbara; Adler, Nancy E; Epel, Elissa

    2018-02-28

    We examined whether prenatal mindfulness training was associated with lower depressive symptoms through 18-months postpartum compared to treatment as usual (TAU). A controlled, quasi-experimental trial compared prenatal mindfulness training (MMT) to TAU. We collected depressive symptom data at post-intervention, 6-, and 18-months postpartum. Latent profile analysis identified depressive symptom profiles, and multinomial logistic regression examined whether treatment condition predicted profile. Three depressive symptom severity profiles emerged: none/minimal, mild, and moderate. Adjusting for relevant covariates, MMT participants were less likely than TAU participants to be in the moderate profile than the none/minimal profile (OR = 0.13, 95% CI = 0.03-0.54, p = .005). Prenatal mindfulness training may have benefits for depressive symptoms during the transition to parenthood. © 2018 Wiley Periodicals, Inc.

  6. Odour recognition memory and odour identification in patients with mild and severe major depressive disorders.

    Science.gov (United States)

    Zucco, Gesualdo M; Bollini, Fabiola

    2011-12-30

    Olfactory deficits, in detection, recognition and identification of odorants have been documented in ageing and in several neurodegenerative and psychiatric conditions. However, olfactory abilities in Major Depressive Disorder (MDD) have been less investigated, and available studies have provided inconsistent results. The present study assessed odour recognition memory and odour identification in two groups of 12 mild MDD patients (M age 41.3, range 25-57) and 12 severe MDD patients (M age, 41.9, range 23-58) diagnosed according to DSM-IV criteria and matched for age and gender to 12 healthy normal controls. The suitability of olfactory identification and recognition memory tasks as predictors of the progression of MDD was also addressed. Data analyses revealed that Severe MDD patients performed significantly worse than Mild MDD patients and Normal controls on both tasks, with these last groups not differing significantly from one another. The present outcomes are consistent with previous studies in other domains which have shown reliable, although not conclusive, impairments in cognitive function, including memory, in patients with MDD, and highlight the role of olfactory identification and recognition tasks as an important additional tool to discriminate between patients characterised by different levels of severity of MDD. Copyright © 2011 Elsevier Ltd. All rights reserved.

  7. Improvement of depressive symptoms in patients with moderate-to-severe psoriasis treated with ustekinumab: an open label trial validated using beck depression inventory, Hamilton depression rating scale measures and 18fluorodeoxyglucose (FDG) positron emission tomography (PET).

    Science.gov (United States)

    Kim, Seong-Jang; Park, Min-Young; Pak, Kyoungjune; Han, Junhee; Kim, Gun-Wook; Kim, Hoon-Soo; Ko, Hyun-Chang; Kim, Moon-Bum; Kim, Byung-Soo

    2018-05-07

    Psoriasis is a chronic skin disease associated with psychiatric co-morbidities, especially depression. Early detection of psychological vulnerability in patients with psoriasis seems to be of great clinical importance and significantly impacts the quality of life of the patients. We sought to clarify the association between psoriasis and depressive symptoms in patients with moderate-to-severe psoriasis, and to determine the risk factors for depressive symptoms and analyze the effect of ustekinumab on the symptoms. We also aimed to evaluate the changes in glucose metabolism using 18 fluorodeoxyglucose (FDG) positron emission tomography (FDG-PET). Fifteen patients with moderate-to-severe psoriasis scheduled to be treated with ustekinumab were enrolled. At baseline and after achieving a 75% reduction in the Psoriasis Area and Severity Index (PASI) score (PASI75), all patients underwent a psychiatric interview and FDG-PET. Fifteen healthy volunteers were enrolled for comparison. Patients with moderate-to-severe psoriasis were more depressed than those in the control group were (p Inventory and Hamilton Depression Rating Scale psychiatric interviews (p < .05). However, FDG-PET of the brain showed no significant difference before and after PASI75 achievement using ustekinumab injection. Patients with moderate-to-severe psoriasis are at an increased risk for depressive symptoms, and treatment with ustekinumab may be beneficial. FDG-PET does not reflect the changes in depressive symptoms in such patients.

  8. Involvement of fractalkine and macrophage inflammatory protein-1 alpha in moderate-severe depression

    Directory of Open Access Journals (Sweden)

    Rosaria Alba Merendino

    2004-01-01

    Full Text Available MODERATE-severe depression (MSD is linked to overexpression of proinflammatory cytokines and chemokines. Fractalkine (FKN and macrophage inflammatory protein-1 alpha (MIP-1α are, respectively, members of CX3C and C-C chemokines, and both are involved in recruiting and activating mononuclear phagocytes in the central nervous system. We analysed the presence of FKN and MIP-1α in sera of untreated MSD patients and healthy donors. High FKN levels were observed in all MSD patients as compared with values only detectable in 26% of healthy donors. MIP-1α was measurable in 20% of patients, while no healthy donors showed detectable chemokine levels. In conclusion, we describe a previously unknown involvement of FKN in the pathogenesis of MSD, suggesting that FKN may represent a target for a specific immune therapy of this disease.

  9. The impact of depressive and bipolar symptoms on socioeconomic status, core symptoms, function and severity of fibromyalgia.

    Science.gov (United States)

    Gota, Carmen E; Kaouk, Sahar; Wilke, William S

    2017-03-01

    To evaluate the prevalence of depressive and bipolar symptoms in a cohort of consecutive fibromyalgia (FM) patients seen in a tertiary care center and to determine the relationship between depressive and manic symptoms with FM symptoms, socioeconomic status, severity and function. Three hundred and five FM patients were enrolled; demographic, clinical and questionnaire data were collected. Depressive symptoms were measured by the Patient Health Questionnaire (PHQ-9), manic symptoms by the Mood Disorders Questionnaire (MDQ). The FM cohort had the following characteristics: age 43.53 (11.7) years; 86.5% white; 82.7% female; PHQ-9 ≥ 10, 59.7%, mean 11.9 (7.3); no depression 11.4%, mild 29.1%, moderate 27.5%, moderate severe 17.7%, severe 14%; anxiety 41.6%; 21.3% had either an MDQ score ≥ 7 and/or reported a past diagnosis of bipolar disorder (BD). Increasing levels of depression severity, as well as a positive screen for BD were significantly associated with increasing prevalence and severity of FM symptoms, longer duration of morning stiffness, and increased severity of FM. Increasing levels of depression were significantly associated with increase in prevalence of reported past sexual abuse, and a decline in socioeconomic status, including higher disability and unemployment rates. Patients with severe FM disease activity, high load of symptoms, prolonged morning stiffness, increased disability, lower socioeconomic status and those who take a lot of medications for FM should be evaluated for depressive and manic symptoms. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  10. Hormonal determinants of the severity of andropausal and depressive symptoms in middle-aged and elderly men with prediabetes

    Directory of Open Access Journals (Sweden)

    Rabijewski M

    2015-08-01

    Full Text Available Michał Rabijewski,1 Lucyna Papierska,2 Roman Kuczerowski,1 Paweł Piątkiewicz11Department of Internal Diseases, Diabetology and Endocrinology, Medical University of Warsaw, 2Department of Endocrinology, Medical Centre for Postgraduate Education, Warsaw, PolandAbstract: Andropausal and depressive symptoms are common in aging males and may be associated with hormone deficiency. We investigated the severity of andropausal and depressive symptoms, as well as their hormonal determinants, in 196 middle-aged and elderly men (age range: 40–80 years with prediabetes (PD and in 184 healthy peers. PD was diagnosed according to the definition of the American Diabetes Association. The severity of andropausal and depressive symptoms was assessed using the Aging Males’ Symptoms Rating Scale and the Self-Rating Depression Scale. Total testosterone (TT, calculated free testosterone (cFT, dehydroepiandrosterone sulfate (DHEAS, and insulin-like growth factor 1 (IGF-1 were measured. The prevalence of andropausal syndrome in men with PD was significantly higher than that in healthy men (35% vs 11%, respectively. In men with PD aged 40–59 years, the severity of sexual, psychological, and all andropausal symptoms was greater than in healthy peers, while in elderly men (60–80 years, only the severity of psychological symptoms was greater than in healthy peers. The severity of depressive symptoms in the middle-aged men with PD was greater than in healthy peers, while the severity of depressive symptoms in elderly men with PD and healthy peers was similar. The higher prevalence of andropausal symptoms was independently associated with cFT and IGF-1 in middle-aged men and with TT and DHEAS in elderly men with PD. The more severe depression symptoms were associated with low TT and DHEAS in middle-aged men and with low cFT and DHEAS in elderly men with PD. In conclusion, the prevalence of andropausal symptoms, especially psychological, was higher in prediabetic

  11. Depression

    DEFF Research Database (Denmark)

    Kessing, Lars Veddel; Bukh, Jens Drachmann

    2014-01-01

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

  12. Depressants

    Science.gov (United States)

    ... For Teens / Depressants Print en español Depresores del sistema nervioso What They Are: Tranquilizers and other depressants ... of Use Notice of Nondiscrimination Visit the Nemours Web site. Note: All information on TeensHealth® is for ...

  13. Severity of complicated versus uncomplicated subthreshold depression: New evidence on the "Monotonicity Thesis" from the national comorbidity survey.

    Science.gov (United States)

    Wakefield, Jerome C; Schmitz, Mark F

    2017-04-01

    "Complicated" subthreshold depression (CsD) includes at least one of six pathosuggestive "complicated" symptoms: >6 months duration, marked role impairment, sense of worthlessness, suicidal ideation, psychotic ideation, and psychomotor retardation. "Uncomplicated" subthreshold depression (UsD) has no complicated features. Whereas studies show that complicated (CMDD) versus uncomplicated (UMDD) major depression differ substantially in severity and prognosis, UsD and CsD severity has not been previously compared. This study evaluates UsD and CsD pathology validator levels and examines whether the complicated/uncomplicated distinction offers incremental concurrent validity over the standard number-of-symptoms dimension as a depression severity measure. Using nationally representative community data from the National Comorbidity Survey, seven depression lifetime history subgroups were identified: one MDD screener symptom (n=1432); UsD (n=430); CsD (n=611); UMDD (n=182); and CMDD with 5-6 symptoms (n=518), 7 symptoms (n=217), and 8-9 symptoms (n=291). Severity was evaluated using five concurrent pathology validators: suicide attempt, interference with life, help seeking, hospitalization, and generalized anxiety disorder. CsD validator levels are substantially higher than both UsD and UMDD levels, and similar to mild CMDD, disconfirming the "monotonicity thesis" that severity increase with symptom number. Complicated/uncomplicated status predicts severity, and when complicatedness is controlled, number of symptoms no longer predicts validator levels. Diagnoses were based on respondents' fallible retrospective symptom reports during a lay-administered structured interview, which may not yield diagnoses comparable to clinicians' assessments. CsD is more severe than UsD and comparable to mild MDD. Complicated status more validly indicates depression severity than the standard number-of-symptoms measure. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Differences in depression severity and frequency of relapses in opiate addicts treated with methadone or opiate blocker after detoxification

    Directory of Open Access Journals (Sweden)

    Jovanović Tatjana

    2012-01-01

    Full Text Available Background/Aim. Relapse of opiate dependence is a common occurrence after detoxification and introduction of opiate addicts in abstinence from opiates. Clinical evaluation showed that over 90% of opiate addicts exhibit depressive manifestations during detoxification, or develop post-detoxification depression. The aim of this study was to determine differences in the frequency of relapses, severity and course of depression during a of 6-month period, and previous patterns of use of opioids in the two groups of opiate addicts treated by two different therapeutic modalities. Methods. The results of the two groups of opiate addicts were compared: the patients on substitution methadone treatment (M and the patients treated with opiate blocker naltrexone (B. In all the patients, clinical and instrumental evaluations confirmed depressive syndrome. Opioid relapses were diagnosed by the panel test for rapid detection of metabolites of opiates in urine. Then they were brought in connection with scores of depression and addiction variables. The Hamilton Depression Scale (HAMD and Zunge Depression Scale were the applied instruments for measuring the level of depression. All the subjects completed a questionnaire Pompidou (short version. Psychological measurements were carried out during a 6-month follow-up on three occasions. The presence of opiate metabolites in urine was controlled every two weeks. Results. Both groups of patients (M and B had high scores on HAMD during the study. The group on methadone had a strong depression in all three measurements. There was a drop in the level of depression in both experimental groups over time, which was accompanied by a decrease in the incidence of recurrence. In both tested groups the frequency of relapses was positively correlated with earlier addiction variables - intravenous application of opioids, the experience of overdose, the absence of immunization against hepatitis C and hepatitis C virus carriers

  15. [Differences in depression severity and frequency of relapses in opiate addicts treated with methadone or opiate blocker after detoxification].

    Science.gov (United States)

    Jovanović, Tatjana; Lazarević, Dusan; Nikolić, Gordana

    2012-04-01

    Relapse of opiate dependence is a common occurrence after detoxification and introduction of opiate addicts in abstinence from opiates. Clinical evaluation showed that over 90% of opiate addicts exhibit depressive manifestations during detoxification, or develop post-detoxification depression. The aim of this study was to determine differences in the frequency of relapses, severity and course of depression during a of 6-month period, and previous patterns of use of opioids in the two groups of opiate addicts treated by two different therapeutic modalities. The results of the two groups of opiate addicts were compared: the patients on substitution methadone treatment (M) and the patients treated with opiate blocker naltrexone (B). In all the patients, clinical and instrumental evaluations confirmed depressive syndrome. Opioid relapses were diagnosed by the panel test for rapid detection of metabolites of opiates in urine. Then they were brought in connection with scores of depression and addiction variables. The Hamilton Depression Scale (HAMD) and Zunge Depression Scale were the applied instruments for measuring the level of depression. All the subjects completed a questionnaire Pompidou (short version). Psychological measurements were carried out during a 6-month follow-up on three occasions. The presence of opiate metabolites in urine was controlled every two weeks. Both groups of patients (M and B) had high scores on HAMD during the study. The group on methadone had a strong depression in all three measurements. There was a drop in the level of depression in both experimental groups over time, which was accompanied by a decrease in the incidence of recurrence. In both tested groups the frequency of relapses was positively correlated with earlier addiction variables - intravenous application of opioids, the experience of overdose, the absence of immunization against hepatitis C and hepatitis C virus carriers. The opioid relapse behavior is associated with a

  16. Prediction of Parkinson's disease subsequent to severe depression: a ten-year follow-up study.

    Science.gov (United States)

    Walter, Uwe; Heilmann, Robert; Kaulitz, Lara; Just, Tino; Krause, Bernd Joachim; Benecke, Reiner; Höppner, Jacqueline

    2015-06-01

    Major depressive disorder (MDD) has been associated with an increased risk of subsequent Parkinson's disease (PD) in case-control and cohort studies. However, depression alone is unlikely to be a useful marker of prodromal PD due to its low specificity. In this longitudinal observational study, we assessed whether the presence of other potential markers of prodromal PD predicts the subsequent development of PD in MDD patients. Of 57 patients with severe MDD but no diagnosis of PD who underwent a structured interview, olfactory and motor investigation and transcranial sonography at baseline, 46 (36 women; mean age 54.9 ± 11.7 years) could be followed for up to 11 (median, 10) years. Three patients (2 women; age 64, 65 and 70 years) developed definite PD after 1, 7, and 9 years, respectively. The combined finding of mild asymmetric motor slowing, idiopathic hyposmia, and substantia nigra hyperechogenicity predicted subsequent PD in all patients who could be followed for longer than 1 year. Out of the whole study cohort, only the subjects with subsequent PD presented with the triad of asymmetric motor slowing, idiopathic hyposmia, and substantia nigra hyperechogenicity in combination with at least two out of four reportable risk factors (family history of PD, current non-smoker, non-coffee drinker, constipation) at baseline investigation. Post-hoc analysis revealed that additional rating of eye and eye-lid motor abnormalities might further improve the prediction of PD in larger cohorts. Findings of this pilot-study suggest that MDD patients at risk of subsequent PD can be identified using an inexpensive non-invasive diagnostic battery.

  17. 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....

  18. Flotation separation of arsenopyrite from several sulphide minerals with organic depressants

    Institute of Scientific and Technical Information of China (English)

    Wang Fuliang; Wang Ligang; Sun Chuanyao

    2008-01-01

    In this paper,the separation of arsenopyrite from chalcopyrite,pyrite,galena with organic depressants (guergum and sodium humic)was discussed,and the functioning mechanism of those organic depressants was dis-cussed.The experimental results of monomineral flotation indicated that both guergum and sodium humic have depress-ing effect on arsenopyrite in the presence of ethyl xanthate.Guergum and sodium humic showed different depressing a-bility to pyrite,chalcopyrite and galena,and the higher the pH value in pulp,the stronger the depressing ability.Ultra-violet-Visible Spectrophotometric study showed that the adsorption layer of xanthate on surface of minerals had been de-sorbed by the two organic depressants,and the selective desorption of the collector layer was found from different miner-als.The xanthate cover on minerals surface was set free when dosage of the organic depressants was high enough.For artificially-mixed minerals,the separation of arsenopyrite from other sulphides was successfully realized by controlling dosage of the organic depressants.And sodium humic had been used successfully to decrease arsenic content in sulphide concentr ates in a commercial Lead-Zinc concentrator.

  19. Predicting relapse in major depressive disorder using patient-reported outcomes of depressive symptom severity, functioning, and quality of life in the Individual Burden of Illness Index for Depression (IBI-D).

    Science.gov (United States)

    Ishak, Waguih William; Greenberg, Jared M; Cohen, Robert M

    2013-10-01

    Patients with Major Depressive Disorder (MDD) often experience unexpected relapses, despite achieving remission. This study examines the utility of a single multidimensional measure that captures variance in patient-reported Depressive Symptom Severity, Functioning, and Quality of Life (QOL), in predicting MDD relapse. Complete data from remitted patients at the completion of 12 weeks of citalopram in the STAR*D study were used to calculate the Individual Burden of Illness index for Depression (IBI-D), and predict subsequent relapse at six (n=956), nine (n=778), and twelve months (n=479) using generalized linear models. Depressive Symptom Severity, Functioning, and QOL were all predictors of subsequent relapse. Using Akaike information criteria (AIC), the IBI-D provided a good model for relapse even when Depressive Symptom Severity, Functioning, and QOL were combined in a single model. Specifically, an increase of one in the IBI-D increased the odds ratio of relapse by 2.5 at 6 months (β=0.921 ± 0.194, z=4.76, pDepressive Symptom Severity in the IBI-D is useful in assessing the full burden of illness and in adequately predicting relapse, in MDD. © 2013 Elsevier B.V. All rights reserved.

  20. 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

  1. Clinical and sociodemographic correlates of severe insomnia in psychotropic drug-free, Asian outpatients with major depressive disorder.

    Science.gov (United States)

    Srisurapanont, Manit; Likhitsathian, Surinporn; Chua, Hong Choon; Udomratn, Pichet; Chang, Sungman; Maneeton, Narong; Maneeton, Benchaluk; Chen, Chia-Hui; Shih-Yen Chan, Edwin; Bautista, Dianne; Bin Sulaiman, Ahmad Hatim

    2015-11-01

    Little has been known regarding the correlates of severe insomnia in major depressive disorder (MDD). This post-hoc analysis aimed to examine the sociodemographic and clinical correlates of severe insomnia in psychotropic drug-free, Asian adult outpatients with MDD. Participants were psychotropic drug-free patients with MDD, aged 18-65 years. By using the Symptom Checklist-90 Items, Revised (SCL-90-R), a score of 4 (severe distress) on any one of three insomnia items was defined as severe insomnia. Other measures included the Montgomery-Asberg Depression Rating Scale (MADRS), the Fatigue Severity Scale (FSS), the nine psychopathology subscales of SCL-90-R, the Physical and Mental Component Summaries of Short Form Health Survey (SF-36 PCS and SF-36 MCS), and the Sheehan Disability Scale (SDS). Of 528 participants, their mean age being 39.5 (SD=13.26) years, 64.2% were females, and 239 (45.3%) had severe insomnia. The logistic regression model revealed that low educational qualifications (less than secondary school completion), high SCL-90-R Depression scores, high SCL-90-R Anxiety scores, and low SF-36 PCS scores were independently correlated with severe insomnia (p'sdepression and anxiety severity, and poor physical health. These findings may implicate the treatment of comorbid MDD and severe insomnia, for example, sleep hygiene education, pharmacological treatment. Copyright © 2015 Elsevier B.V. All rights reserved.

  2. Disagreement between self-reported and clinician-ascertained suicidal ideation and its correlation with depression and anxiety severity in patients with major depressive disorder or bipolar disorder.

    Science.gov (United States)

    Gao, Keming; Wu, Renrong; Wang, Zuowei; Ren, Ming; Kemp, David E; Chan, Philip K; Conroy, Carla M; Serrano, Mary Beth; Ganocy, Stephen J; Calabrese, Joseph R

    2015-01-01

    To study the disagreement between self-reported suicidal ideation (SR-SI) and clinician-ascertained suicidal ideation (CA-SI) and its correlation with depression and anxiety severity in patients with major depressive disorder (MDD) or bipolar disorder (BPD). Routine clinical outpatients were diagnosed with the MINI-STEP-BD version. SR-SI was extracted from the 16 Item Quick Inventory of Depression Symptomatology Self-Report (QIDS-SR-16) item 12. CA-SI was extracted from a modified Suicide Assessment module of the MINI. Depression and anxiety severity were measured with the QIDS-SR-16 and Zung Self-Rating Anxiety Scale. Chi-square, Fisher exact, and bivariate linear logistic regression were used for analyses. Of 103 patients with MDD, 5.8% endorsed any CA-SI and 22.4% endorsed any SR-SI. Of the 147 patients with BPD, 18.4% endorsed any CA-SI and 35.9% endorsed any SR-SI. The agreement between any SR-SI and any CA-SI was 83.5% for MDD and 83.1% for BPD, with weighted Kappa of 0.30 and 0.43, respectively. QIDS-SR-16 score, female gender, and ≥4 year college education were associated with increased risk for disagreement, 15.44 ± 4.52 versus 18.39 ± 3.49 points (p = 0.0026), 67% versus 46% (p = 0.0783), and 61% versus 29% (p = 0.0096). The disagreement was positively correlated to depression severity in both MDD and BPD with a correlation coefficient R(2) = 0.40 and 0.79, respectively, but was only positively correlated to anxiety severity in BPD with a R(2) = 0.46. Self-reported questionnaire was more likely to reveal higher frequency and severity of SI than clinician-ascertained, suggesting that a combination of self-reported and clinical-ascertained suicidal risk assessment with measuring depression and anxiety severity may be necessary for suicide prevention. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. A pharmacoeconomic evaluation of escitalopram versus citalopram in the treatment of severe depression in the United Kingdom.

    Science.gov (United States)

    Wade, Alan G; Toumi, Idris; Hemels, Michiel E H

    2005-04-01

    Severe depression can increase the risk of psychiatric hospitalization, as well as inpatient and outpatient care; it may also lead to long-term absenteeism from work. However, the cost-effectiveness of antidepressant therapy for severe depression has been little studied. The aim of this work was to investigate the cost-effectiveness of escitalopram compared with citalopram in patients with severe depression (Montgomery-Asberg Depression Rating Scale [MADRS] total score > or = 30) in the United Kingdom. A probabilistic decision tree with a 6-month time horizon was adapted to the UK setting. The model incorporated clinical data, resource use directly related with care of severe depression, and lost productivity costs due to absenteeism. Primary results were remission (MADRS escitalopram instead of citalopram rendered a higher overall remission rate (relative difference, 10.3%) and first-line success rate (relative difference, 35.4%). The mean cost per successfully treated patient was 15.7% (146 British pounds) lower for escitalopram (786 British pounds [range, 702-876 British pounds]) compared with citalopram (932 British pounds [range, 843-1028 British pounds]) from the NHS perspective and 15.6% (238 British pounds) lower for escitalopram (1283 British pounds [range, 1157-1419 British pounds]) than for citalopram (1521 British pounds [range, 1383-1675 British pounds]) from the societal perspective. The mean cost per severely depressed patient treated (overall study group) was 32 British pounds lower for escitalopram (422 British pounds [range, 404-441 British pounds]) than citalopram (454 British pounds [range, 436-471 British pounds]) from an NHS perspective and 50 British pounds lower for escitalopram (690 British pounds [range, 665-714 British pounds]) than citalopram (740 British pounds [range, 715-767 British pounds]) from the societal perspective. Using multivariate sensitivity analyses, we found that, in 99.8% of the cases, escitalopram was dominant from both

  4. Depression in systemic lupus erythematosus, dependent on or independent of severity of disease

    NARCIS (Netherlands)

    van Exel, E.; Jacobs, J.; Korswagen, L.A.; Voskuyl, A.E.; Stek, M.L.; Dekker, J.; Bultink, I.E.M.

    2013-01-01

    Objectives: To estimate the prevalence of depression in subjects with systemic lupus erythematosus (SLE) in relation to the general population and to unravel the relation between depression and SLE disease characteristics. Methods: One hundred and two subjects with SLE (mean age 44.4 years) were

  5. Adverse psychosocial working conditions and risk of severe depressive symptoms. Do effects differ by occupational grade?

    NARCIS (Netherlands)

    Rugulies, Reiner; Aust, Birgit; Madsen, Ida E. H.; Burr, Hermann; Siegrist, Johannes; Bultmann, Ute

    Background: Depression is a major concern for public health. Both adverse working conditions and low socio-economic position are suspected to increase risk of depression. In a representative sample of the Danish workforce we investigated (i) whether adverse psychosocial working conditions, defined

  6. Hypercortisolemia Is Associated with Severity of Bone Loss and Depression in Hypothalamic Amenorrhea and Anorexia Nervosa

    OpenAIRE

    Lawson, Elizabeth A.; Donoho, Daniel; Miller, Karen K.; Misra, Madhusmita; Meenaghan, Erinne; Lydecker, Janet; Wexler, Tamara; Herzog, David B.; Klibanski, Anne

    2009-01-01

    Context: Anorexia nervosa (AN) and functional hypothalamic amenorrhea (HA) are associated with low bone density, anxiety, and depression. Women with AN and HA have elevated cortisol levels. Significant hypercortisolemia, as in Cushing’s disease, causes bone loss. It is unknown whether anxiety and depression and/or cortisol dysregulation contribute to low bone density in AN or HA.

  7. The Diagnosis of Depression in People with Severe Limitations in Intellectual Functioning

    Science.gov (United States)

    Scott, Haleigh; Havercamp, Susan M.

    2015-01-01

    People with intellectual disability (ID) were once considered immune to developing psychopathology, including affective disorders such as depression. Now research has shown that people with ID do suffer from depression, and the focus is on understanding how to best diagnose and provide treatment. Research has come a long way in adapting the…

  8. 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...

  9. Do continued antidepressants protect against dementia in patients with severe depressive disorder?

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Forman, Julie Lyng; Andersen, Per Kragh

    2011-01-01

    may decrease the risk of developing dementia in patients with depression. We investigated whether continued treatment with antidepressants is associated with a decreased rate of dementia in a population of patients discharged from psychiatric healthcare service with a diagnosis of depression. We used...... register data on all prescribed antidepressants in all patients discharged from psychiatric healthcare service with a diagnosis of depression and with subsequent diagnoses of dementia in Denmark from 1995 to 2005. A total of 37 658 patients with a diagnosis of depression at their first psychiatric contact......Studies on humans show that depressive disorder is associated with an increased risk of developing cognitive dysfunction, and animal studies suggest that antidepressants may have neuroprotective abilities. On the basis of these observations, it was hypothesized that treatment with antidepressants...

  10. Dissociative, depressive, and PTSD symptom severity as correlates of nonsuicidal self-injury and suicidality in dissociative disorder patients.

    Science.gov (United States)

    Webermann, Aliya R; Myrick, Amie C; Taylor, Christina L; Chasson, Gregory S; Brand, Bethany L

    2016-01-01

    The present study investigates whether symptom severity can distinguish patients diagnosed with dissociative identity disorder and dissociative disorder not otherwise specified with a recent history of nonsuicidal self-injury (NSSI) and suicide attempts from those patients without recent self-harm. A total of 241 clinicians reported on recent history of patient NSSI and suicide attempts. Of these clinicians' patients, 221 completed dissociative, depressive, and posttraumatic stress disorder symptomatology measures. Baseline cross-sectional data from a naturalistic and prospective study of dissociative disorder patients receiving community treatment were utilized. Analyses evaluated dissociative, depressive, and posttraumatic stress disorder symptom severity as methods of classifying patients into NSSI and suicide attempt groupings. Results indicated that dissociation severity accurately classified patients into NSSI and suicidality groups, whereas depression severity accurately classified patients into NSSI groups. These findings point to dissociation and depression severity as important correlates of NSSI and suicidality in patients with dissociative disorders and have implications for self-harm prevention and treatment.

  11. Establishing the cut-off score for remission and severity-ranges on the Psychotic Depression Assessment Scale (PDAS)

    DEFF Research Database (Denmark)

    Østergaard, Søren D; Rothschild, Anthony J; Flint, Alastair J

    2016-01-01

    BACKGROUND: The Psychotic Depression Assessment Scale (PDAS) is a rating scale dedicated to the measurement of severity in psychotic depression (PD). The aim of this study was to establish the PDAS cut-off for remission of PD as well as PDAS score-ranges for mild, moderate, and severe PD...... on the PDAS and the severity-ranges for mild, moderate, and severe PD were defined using the Clinical Global Impression - Severity scale (CGI-S) as reference by means of pair-wise receiver operating characteristic (ROC) analyses. Subsequently, it was tested whether remission on the PDAS could separate...... the effects of Olanzapine+Sertraline vs. Olanzapine+Placebo through an intention-to-treat, mixed-effects logistic regression of the data from STOP-PD. RESULTS: According to the ROC analyses, the ideal cut-off for remission of PD was a PDAS total score moderate...

  12. Parsing trait and state effects of depression severity on neurocognition: Evidence from a 26-year longitudinal study.

    Science.gov (United States)

    Sarapas, Casey; Shankman, Stewart A; Harrow, Martin; Goldberg, Joseph F

    2012-11-01

    Cognitive dysfunction in mood disorders falls along a continuum, such that more severe current depression is associated with greater cognitive impairment. It is not clear whether this association reflects transient state effects of current symptoms on cognitive performance, or persistent, trait-like differences in cognition that are related to overall disorder severity. We addressed this question in 42 unipolar and 47 bipolar participants drawn from a 26-year longitudinal study of psychopathology, using measures of attention/psychomotor processing speed, cognitive flexibility, verbal fluency, and verbal memory. We assessed (a) the extent to which current symptom severity and past average disorder severity predicted unique variance in cognitive performance; (b) whether cognitive performance covaried with within-individual changes in symptom severity; and (c) the stability of neurocognitive measures over six years. We also tested for differences among unipolar and bipolar groups and published norms. Past average depression severity predicted performance on attention/psychomotor processing speed in both groups, and in cognitive flexibility among unipolar participants, even after controlling for current symptom severity, which did not independently predict cognition. Within-participant state changes in depressive symptoms did not predict change in any cognitive domain. All domains were stable over the course of six years. Both groups showed generalized impairment relative to published norms, and bipolar participants performed more poorly than unipolar participants on attention/psychomotor processing speed. The results suggest a stable relationship between mood disorder severity and cognitive deficits. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

  13. Salience Network and Depressive Severities in Parkinson’s Disease with Mild Cognitive Impairment: A Structural Covariance Network Analysis

    Directory of Open Access Journals (Sweden)

    Ya-Ting Chang

    2018-01-01

    Full Text Available Purpose: In Parkinson’s disease with mild cognitive impairment (PD-MCI, we investigated the clinical significance of salience network (SN in depression and cognitive performance.Methods: Seventy seven PD-MCI patients that fulfilled multi-domain and non-amnestic subtype were included. Gray matter structural covariance networks were constructed by 3D T1-magnetic resonance imaging and seed based analysis. The patients were divided into two groups by psychiatric interviews and screening of Geriatric Depression Scale (GDS: PD-MCI with depression (PD-MCI-D or without depression (PD-MCI-ND. The seed or peak cluster volume, or the significant differences in the regression slopes in each seed-peak cluster correlation, were used to evaluate the significance with the neurobehavioral scores.Results: This study is the first to demonstrate that the PD-MCI-ND group presented a larger number of voxels of structural covariance in SN than the PD-MCI-D group. The right fronto-insular seed volumes and the peak cluster of left lingual gyrus showed significant inverse correlation with the Geriatric Depression Scale (GDS; r = -0.231, P = 0.046.Conclusions: This study is the first to validate the clinical significance of the SN in PD-MCI-D. The right insular seed value and the SN correlated with the severity of depression in PD-MCI.

  14. Salience Network and Depressive Severities in Parkinson’s Disease with Mild Cognitive Impairment: A Structural Covariance Network Analysis

    Science.gov (United States)

    Chang, Ya-Ting; Lu, Cheng-Hsien; Wu, Ming-Kung; Hsu, Shih-Wei; Huang, Chi-Wei; Chang, Wen-Neng; Lien, Chia-Yi; Lee, Jun-Jun; Chang, Chiung-Chih

    2018-01-01

    Purpose: In Parkinson’s disease with mild cognitive impairment (PD-MCI), we investigated the clinical significance of salience network (SN) in depression and cognitive performance. Methods: Seventy seven PD-MCI patients that fulfilled multi-domain and non-amnestic subtype were included. Gray matter structural covariance networks were constructed by 3D T1-magnetic resonance imaging and seed based analysis. The patients were divided into two groups by psychiatric interviews and screening of Geriatric Depression Scale (GDS): PD-MCI with depression (PD-MCI-D) or without depression (PD-MCI-ND). The seed or peak cluster volume, or the significant differences in the regression slopes in each seed-peak cluster correlation, were used to evaluate the significance with the neurobehavioral scores. Results: This study is the first to demonstrate that the PD-MCI-ND group presented a larger number of voxels of structural covariance in SN than the PD-MCI-D group. The right fronto-insular seed volumes and the peak cluster of left lingual gyrus showed significant inverse correlation with the Geriatric Depression Scale (GDS; r = -0.231, P = 0.046). Conclusions: This study is the first to validate the clinical significance of the SN in PD-MCI-D. The right insular seed value and the SN correlated with the severity of depression in PD-MCI. PMID:29375361

  15. Salience Network and Depressive Severities in Parkinson's Disease with Mild Cognitive Impairment: A Structural Covariance Network Analysis.

    Science.gov (United States)

    Chang, Ya-Ting; Lu, Cheng-Hsien; Wu, Ming-Kung; Hsu, Shih-Wei; Huang, Chi-Wei; Chang, Wen-Neng; Lien, Chia-Yi; Lee, Jun-Jun; Chang, Chiung-Chih

    2017-01-01

    Purpose: In Parkinson's disease with mild cognitive impairment (PD-MCI), we investigated the clinical significance of salience network (SN) in depression and cognitive performance. Methods: Seventy seven PD-MCI patients that fulfilled multi-domain and non-amnestic subtype were included. Gray matter structural covariance networks were constructed by 3D T1-magnetic resonance imaging and seed based analysis. The patients were divided into two groups by psychiatric interviews and screening of Geriatric Depression Scale (GDS): PD-MCI with depression (PD-MCI-D) or without depression (PD-MCI-ND). The seed or peak cluster volume, or the significant differences in the regression slopes in each seed-peak cluster correlation, were used to evaluate the significance with the neurobehavioral scores. Results: This study is the first to demonstrate that the PD-MCI-ND group presented a larger number of voxels of structural covariance in SN than the PD-MCI-D group. The right fronto-insular seed volumes and the peak cluster of left lingual gyrus showed significant inverse correlation with the Geriatric Depression Scale (GDS; r = -0.231, P = 0.046). Conclusions: This study is the first to validate the clinical significance of the SN in PD-MCI-D. The right insular seed value and the SN correlated with the severity of depression in PD-MCI.

  16. Escitalopram is Associated with Reductions in Pain Severity and Pain Interference in Opioid Dependent Patients with Depressive Symptoms

    Science.gov (United States)

    Tsui, Judith I.; Herman, Debra S.; Kettavong, Malyna; Anderson, Bradley J.; Stein, Michael D.

    2011-01-01

    Pain is common among opioid dependent patients, yet pharmacologic strategies are limited. The aim of this study was to explore whether escitalopram, a selective serotonin reuptake inhibitor, was associated with reductions in pain. The study used longitudinal data from a randomized, controlled trial that evaluated the effects of escitalopram on treatment retention in patients with depressive symptoms who were initiating buprenorphine/naloxone for treatment of opioid dependence. Participants were randomized to take escitalopram 10mg or placebo daily. Changes in pain severity, pain interference and depression were assessed at 1, 2 and 3 months visits using the Visual Analog Scale, Brief Pain Inventory and the Beck Depression Inventory II, respectively. Fixed-effects estimator for panel regression models were used to assess the effects of intervention on changes in outcomes over time. Additional models were estimated to explore whether the intervention effect was mediated by within-person changes in depression. In this sample of 147 adults, we found that participants randomized to escitalopram had significantly larger reductions on both pain severity (b = −14.34, t = −2.66, p < .01) and pain interference (b = −1.20, t = −2.23, p < .05) between baseline and follow-up. After adjusting for within-subject changes in depression, the estimated effects of escitalopram on pain severity and pain interference were virtually identical to the unadjusted effects. In summary, this study of opioid-dependent patients with depressive symptoms found that treatment with escitalopram was associated with clinically meaningful reductions in pain severity and pain interference during the first three months of therapy. PMID:21924552

  17. Identification of emotions in mixed disgusted-happy faces as a function of depressive symptom severity.

    Science.gov (United States)

    Sanchez, Alvaro; Romero, Nuria; Maurage, Pierre; De Raedt, Rudi

    2017-12-01

    Interpersonal difficulties are common in depression, but their underlying mechanisms are not yet fully understood. The role of depression in the identification of mixed emotional signals with a direct interpersonal value remains unclear. The present study aimed to clarify this question. A sample of 39 individuals reporting a broad range of depression levels completed an emotion identification task where they viewed faces expressing three emotional categories (100% disgusted and 100% happy faces, as well as their morphed 50% disgusted - 50% happy exemplars). Participants were asked to identify the corresponding depicted emotion as "clearly disgusted", "mixed", or "clearly happy". Higher depression levels were associated with lower identification of positive emotions in 50% disgusted - 50% happy faces. The study was conducted with an analogue sample reporting individual differences in subclinical depression levels. Further research must replicate these findings in a clinical sample and clarify whether differential emotional identification patterns emerge in depression for different mixed negative-positive emotions (sad-happy vs. disgusted-happy). Depression may account for a lower bias to perceive positive states when ambiguous states from others include subtle signals of social threat (i.e., disgust), leading to an under-perception of positive social signals. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. The dental management of patients with severe depression disorder (Literature review

    Directory of Open Access Journals (Sweden)

    Nanan Nur’aeny

    2016-06-01

    Full Text Available World Health Organization (WHO in the year 2000 have identified major depressive disorder ranks as the fourth leading cause of death in the world. WHO also estimates that in 2020, the disorder will increase to second only to ischemic heart disease. People at high risk of first occurrence of depression are those who have a family history. Depression can happen to anyone and at all ages, ranging in age from children, young adults up to old age. This paper will discuss the literature review of an overview of depression and itsmanagement in dentistry. Patients with major depressive disorder may have abnormalities in the oral cavity affected by lack of oral hygiene as well as a manifestation of mental disorder and its treatment. Dental and oral management conducted in accordance with procedures and have to be carried out carefully especially to patients with mental disorders such as depression. Tooth decayed, gingivitis, xerostomia, oral candidiasis, oral lesion, and TMJ disorder are clinical findings in depressed patient, so as dentists may cooperate with psychiatrists in providing comprehensive treatment to improve quality of life of the patients.

  19. Depression increases in patients with Parkinson?s disease according to the increasing severity of the cognitive impairment

    Directory of Open Access Journals (Sweden)

    Marcos Hortes N. Chagas

    2014-06-01

    Full Text Available Objective : To test the hypothesis that severity of cognitive impairment modifies the association between depression and Parkinson’s disease (PD. Method : One-phase population-based door-to-door surveys. This is a secondary analysis of 1,451 people aged 65 years and older with cognitive impairment living in defined catchment areas. Depression was estimated according to ICD-10, self-reported PD, disability according to WHODAS-II and cognitive status according to the CSI-D. Results : The mean age of the sample was 79.3 years old and most (69% were women. Of the total sample, 16.1% had depression and it was significantly higher among participants with PD. There was an increase on the ORs of the association between depression and PD with decreased scores in the cognitive test (Adjusted OR from 0.98 to 8.04. Conclusion : The association between depression and PD increases with the severity of the cognitive impairment.

  20. A manual-based phenomenological art therapy for individuals diagnosed with moderate to severe depression (PATd): A randomized controlled study.

    Science.gov (United States)

    Blomdahl, Christina; Guregård, Suzanne; Rusner, Marie; Wijk, Helle

    2018-05-14

    This study investigated the effects of manual-based Phenomenological Art Therapy for individuals living with depression in addition to treatment as usual (PATd/TAU) compared with only treatment as usual (TAU) for individuals diagnosed with moderate to severe depression. 79 adults (men = 29.1%) were included in this randomized-controlled-trial (RCT), multicenter study in Sweden with an intention-to-treat design. Participants were randomized into either the PATd/TAU-group (n = 43) or TAU-group (n = 36). Data were collected at baseline and at end of treatment. The main outcomes were depression levels and self-esteem. Secondary outcomes were suicide ideation and sickness absence. The PATd/TAU-group showed a significant decrease of depression levels. The PATd/TAU-group returned to work to a higher degree than the TAU-group. Self-esteem significantly improved in both groups. Suicide ideation was unaffected. Manual-based PATd works as expected, being an effective treatment, and contributes to recovery for individuals with moderate to severe depression. This outcome needs to be confirmed and its long-term effects examined in further studies. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  1. Differential response to right unilateral ECT in depressed patients: impact of comorbidity and severity of illness [ISRCTN39974945

    Directory of Open Access Journals (Sweden)

    Wahlbeck Kristian

    2002-01-01

    Full Text Available Abstract Background Recent electroconvulsive therapy (ECT efficacy studies of right unilateral (RUL ECT may not apply to real life clinics with a wide range of patients with major depressive episodes. Methods The study included two groups of patients. In addition to a homogeneous group of patients with major depression according to DSM-IV criteria with severity of the major depressive episode > 16 scores on 17-item Hamilton Rating Scale for Depression (HDRS (Group 1, n = 16, we included a heterogeneous group of patients with less severe major depressive episodes or with a variety of comorbid conditions (Group 2, n = 24. We randomly assigned the patients to an RUL ECT treatment dosed at 5 or 2.5 times seizure threshold with an intent-to-treat design. The outcomes measured blindly were HDRS, number of treatments, and Mini-Mental State Examination (MMSE. The patients were considered to have responded to treatment if the improvement in HDRS score was at least 60% and they had a total score of less than ten. Results The Group 2 patients responded poorer (8% vs. 63%, and had more often simultaneous worsening in their MMSE scores than Group 1 patients. The differences in the outcomes between the two different doses of RUL ECT treatment were not statistically significant. Conclusions ECT effectiveness seems to be lower in real-life heterogeneous patient groups than in homogeneous patient samples used in experimental efficacy trials.

  2. Response inconsistency of patient-reported symptoms as a predictor of discrepancy between patient and clinician reported depression severity

    NARCIS (Netherlands)

    Conijn, J.M.; Emons, W.H.M.; Page, B.F.; Sijtsma, K.; van der Does, W.; Carlier, I.V.; Giltay, E.J.

    2018-01-01

    The aim of this study was to assess the extent to which discrepancy between self-reported and clinician-rated severity of depression are due to inconsistent self-reports. Response inconsistency threatens the validity of the test score. We used data from a large sample of outpatients (N = 5,959) who

  3. Association of different levels of depressive symptoms with symptomatology, overall disease severity, and quality of life in women with fibromyalgia

    NARCIS (Netherlands)

    Soriano-Maldonado, Alberto; Amris, Kirstine; Ortega, Francisco B; Segura-Jiménez, Víctor; Estévez-López, Fernando; Álvarez-Gallardo, Inmaculada C; Aparicio, Virginia A; Delgado-Fernández, Manuel; Henriksen, Marius; Ruiz, Jonatan R

    2015-01-01

    PURPOSE: This study examined the associations of different levels of depression with pain, sleep quality, fatigue, functional exercise capacity, overall fibromyalgia (FM) severity, and health-related quality of life (HRQoL) in women with FM. METHODS: A total of 451 women with FM participated in this

  4. Association of different levels of depressive symptoms with symptomatology, overall disease severity, and quality of life in women with fibromyalgia

    NARCIS (Netherlands)

    Soriano-Maldonado, A.; Amris, K.; Ortega, F.B.; Segura-Jimenez, V.; Estevez-Lopez, F.; Alvarez-Gallardo, I.C.; Aparicio, V.A.; Delgado-Fernandez, M.; Henriksen, M.; Ruiz, J.R.

    2015-01-01

    Purpose: This study examined the associations of different levels of depression with pain, sleep quality, fatigue, functional exercise capacity, overall fibromyalgia (FM) severity, and health-related quality of life (HRQoL) in women with FM. Methods: A total of 451 women with FM participated in this

  5. Severe depressive symptoms as predictor of disability pension : a 10-year follow-up study in Denmark

    NARCIS (Netherlands)

    Bultmann, Ute; Christensen, Karl B.; Burr, Hermann; Lund, Thomas; Rugulies, Reiner

    Are severe depressive symptoms prospectively associated with disability pension? To answer that question, we linked data from a representative sample of the Danish workforce with disability pension (DP) award data from the National Registry on Public Transfer Payments. Of the 5106 study

  6. Modification of Depression by COMT val[superscript 158]Met Polymorphism in Children Exposed to Early Severe Psychosocial Deprivation

    Science.gov (United States)

    Drury, Stacy S.; Theall, Katherine P.; Smyke, Anna T.; Keats, Bronya J. B.; Egger, Helen L.; Nelson, Charles A.; Fox, Nathan A.; Marshall, Peter J.; Zeanah, Charles H.

    2010-01-01

    Objective: To examine the impact of the catechol-O-methyltransferase (COMT) val[superscript 158]met allele on depressive symptoms in young children exposed to early severe social deprivation as a result of being raised in institutions. Methods: One hundred thirty six children from the Bucharest Early Intervention Project (BEIP) were randomized…

  7. 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...

  8. Posttraumatic Stress Disorder and Depression Symptom Severities Are Differentially Associated With Hippocampal Subfield Volume Loss in Combat Veterans.

    Science.gov (United States)

    Averill, Christopher L; Satodiya, Ritvij M; Scott, J Cobb; Wrocklage, Kristen M; Schweinsburg, Brian; Averill, Lynnette A; Akiki, Teddy J; Amoroso, Timothy; Southwick, Steven M; Krystal, John H; Abdallah, Chadi G

    2017-01-01

    Two decades of human neuroimaging research have associated volume reductions in the hippocampus with posttraumatic stress disorder. However, little is known about the distribution of volume loss across hippocampal subfields. Recent advances in neuroimaging methods have made it possible to accurately delineate 10 gray matter hippocampal subfields. Here, we apply a volumetric analysis of hippocampal subfields to data from a group of combat-exposed Veterans. Veterans (total, n = 68, posttraumatic stress disorder, n = 36; combat control, n = 32) completed high-resolution structural magnetic resonance imaging. Based on previously validated methods, hippocampal subfield volume measurements were conducted using FreeSurfer 6.0. The Clinician-Administered PTSD Scale assessed posttraumatic stress disorder symptom severity; Beck Depression Inventory assessed depressive symptom severity. Controlling for age and intracranial volume, partial correlation analysis examined the relationship between hippocampal subfields and symptom severity. Correction for multiple comparisons was performed using false discovery rate. Gender, intelligence, combat severity, comorbid anxiety, alcohol/substance use disorder, and medication status were investigated as potential confounds. In the whole sample, total hippocampal volume negatively correlated with Clinician-Administered PTSD Scale and Beck Depression Inventory scores. Of the 10 hippocampal subfields, Clinician-Administered PTSD Scale symptom severity negatively correlated with the hippocampus-amygdala transition area (HATA). Beck Depression Inventory scores negatively correlated with dentate gyrus, cornu ammonis 4 (CA4), HATA, CA2/3, molecular layer, and CA1. Follow-up analysis limited to the posttraumatic stress disorder group showed a negative correlation between Clinician-Administered PTSD Scale symptom severity and each of HATA, CA2/3, molecular layer, and CA4. This study provides the first evidence relating posttraumatic stress

  9. Associations among depression severity, painful physical symptoms, and social and occupational functioning impairment in patients with major depressive disorder: a 3-month, prospective, observational study

    Directory of Open Access Journals (Sweden)

    Harada E

    2017-09-01

    Full Text Available Eiji Harada,1 Yoichi Satoi,2 Atsushi Kuga,1 Hirofumi Tokuoka,1 Toshiaki Kikuchi,3 Koichiro Watanabe,4 Levent Alev,1 Masaru Mimura3 1Biomedicine, Medicines Development Unit Japan, Eli Lilly Japan K.K, Kobe, Japan; 2Statistical Science, Eli Lilly Japan K.K., Kobe, Japan; 3Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; 4Department of Neuropsychiatry, Kyorin University School of Medicine, Tokyo, Japan Purpose: To investigate associations among depression severity, painful physical symptoms (PPS, and social and occupational functioning impairment in patients with major depressive disorder (MDD who had achieved complete remission (CR or partial remission (PR after acute treatment.Patients and methods: This was a 12-week, multicenter, prospective, observational study. Patients with MDD treated with an antidepressant medication for the previous 12 weeks (±3 weeks who had achieved CR (defined as a 17-item Hamilton Rating Scale for Depression [HAM-D17] score ≤7 or PR (HAM-D17 score ≥8 and ≤8 were enrolled. Depression severity, PPS, and impairment in social and occupational functioning were assessed using the HAM-D17, the Brief Pain Inventory (Short Form (BPI-SF, and the Social and Occupational Functioning Assessment Scale (SOFAS, respectively, at enrollment (Week 12 and after 12 weeks (Week 24.Results: Overall, 323 Japanese patients with MDD were enrolled (CR n=158, PR n=165 and 288 patients completed the study (CR n=139, PR n=149. HAM-D17 and SOFAS scores were strongly and negatively correlated at enrollment (Week 12; P<0.0001 and Week 24 (P<0.0001. A weak negative correlation between the BPI-SF and SOFAS was observed at Week 24 (P=0.0011, but not at enrollment (P=0.164. Remission status at enrollment (CR or PR was associated with achieving normal social and occupational functioning (SOFAS score ≥80 at Week 24 in patients who had not achieved normal social and occupational functioning (SOFAS score <80 at

  10. Aspects of Additional Psychiatric Disorders in Severe Depression/Melancholia: A Comparison between Suicides and Controls and General Pattern

    Directory of Open Access Journals (Sweden)

    Ulrika Heu

    2018-06-01

    Full Text Available Objective: Additional and comorbid diagnoses are common among suicide victims with major depressive disorder (MDD and have been shown to increase the suicide risk. The aim of the present study was first, to investigate whether patients with severe depression/melancholia who had died by suicide showed more additional psychiatric disorders than a matched control group. Second, general rates of comorbid and additional diagnoses in the total group of patients were estimated and compared with literature on MDD. Method: A blind record evaluation was performed on 100 suicide victims with severe depression/melancholia (MDD with melancholic and/or psychotic features: MDD-M/P and matched controls admitted to the Department of Psychiatry, Lund, Sweden between 1956 and 1969 and monitored to 2010. Diagnoses in addition to severe depression were noted. Results: Less than half of both the suicides and controls had just one psychiatric disorder (47% in the suicide and 46% in the control group. The average number of diagnoses was 1.80 and 1.82, respectively. Additional diagnoses were not related to an increased suicide risk. Anxiety was the most common diagnosis. Occurrence of suspected schizophrenia/schizotypal or additional obsessive-compulsive symptoms were more common than expected, but alcohol use disorders did not appear very frequent. Conclusions: The known increased risk of suicide in MDD with comorbid/additional diagnoses does not seem to apply to persons with MDD-M/P (major depressive disorder-depression/Melancholia. Some diagnoses, such as schizophrenia/schizotypal disorders, were more frequent than expected, which is discussed, and a genetic overlap with MDD-M/P is proposed.

  11. Wernicke-Korsakoff syndrome in a patient with self-neglect associated with severe depression.

    Science.gov (United States)

    Cocksedge, Karen A; Flynn, Adrian

    2014-02-01

    Wernicke-Korsakoff syndrome is a neuropsychiatric disorder resulting from thiamine deficiency and commonly associated with chronic alcoholism, but we describe the first case report resulting from self-neglect associated with depression.

  12. Wernicke–Korsakoff syndrome in a patient with self-neglect associated with severe depression

    OpenAIRE

    Cocksedge, Karen A; Flynn, Adrian

    2014-01-01

    Lesson Wernicke–Korsakoff syndrome is a neuropsychiatric disorder resulting from thiamine deficiency and commonly associated with chronic alcoholism, but we describe the first case report resulting from self-neglect associated with depression.

  13. Wernicke–Korsakoff syndrome in a patient with self-neglect associated with severe depression

    Science.gov (United States)

    Flynn, Adrian

    2014-01-01

    Lesson Wernicke–Korsakoff syndrome is a neuropsychiatric disorder resulting from thiamine deficiency and commonly associated with chronic alcoholism, but we describe the first case report resulting from self-neglect associated with depression. PMID:25057374

  14. White Matter Hyperintensities and Cognitive Impairment During Electroconvulsive Therapy in Severely Depressed Elderly Patients

    NARCIS (Netherlands)

    Oudega, M.L.; van Exel, E.; Wattjes, M.P.; Comijs, H.C.; Scheltens, P.; Barkhof, F.; Eikelenboom, P.; Craen, A.J.M.; Beekman, A.T.F.; Stek, M.L.

    2014-01-01

    Objective: Transient cognitive impairment during electroconvulsive therapy (ECT) can be a reason to discontinue ECT in depressed elderly patients. We hypothesized that both white matter hyperintensities and medial temporal lobe atrophy contribute to transient cognitive impairment during ECT.

  15. Social support and employment status modify the effect of intimate partner violence on depression symptom severity in women: results from the 2006 Behavioral Risk Factor Surveillance System Survey.

    Science.gov (United States)

    Dougé, Nathalie; Lehman, Erik B; McCall-Hosenfeld, Jennifer S

    2014-01-01

    Depression and intimate partner violence (IPV) are significant health issues for U.S. women. Interaction effects between IPV and other psychosocial factors on the severity of depressive symptoms have not been fully explored. This study assessed effect modification, that is, how IPV interacts with sociodemographics, psychosocial factors and health risk behaviors, on the severity of depressive symptoms in women. We utilized cross-sectional data from female respondents (n = 16,106) of the 2006 Behavioral Risk Factors Surveillance Survey. Sociodemographics, psychosocial variables, and health risk behaviors determined to be significantly associated with depression were tested for interaction effects with IPV. Weighted ordinal logistic regression and predicted probabilities illustrated the effect of IPV status on depressive symptom severity, stratified by interaction effects. Recent and lifetime IPV exposure were associated with more severe depressive symptoms compared with no IPV exposure. IPV history interacted with employment status and social support on the severity of depressive symptoms in women. Overall, any IPV exposure was associated with more severe depressive symptoms among women with low social support and unemployment, although the effect of recent (versus lifetime) IPV was most pronounced among women with high social support or employed women. Social support and employment status interact with IPV on the severity of depressive symptoms in women. Therefore, social support or workplace interventions designed to improve depressive symptoms should examine IPV history. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  16. Is the Higher Number of Suicide Attempts in Bipolar Disorder vs. Major Depressive Disorder Attributable to Illness Severity?

    Science.gov (United States)

    Michaels, Matthew S; Balthrop, Tia; Pulido, Alejandro; Rudd, M David; Joiner, Thomas E

    2018-01-01

    The present study represents an early stage investigation into the phenomenon whereby those with bipolar disorder attempt suicide more frequently than those with unipolar depression, but do not tend to attempt suicide during mania. Data for this study were obtained from baseline measurements collected in a randomized treatment study at a major southwestern United States military medical center. We demonstrated the rarity of suicide attempts during mania, the higher frequency of suicide attempts in those with bipolar disorder compared to those with depression, and the persistence of effects after accounting for severity of illness. These results provide the impetus for the development and testing of theoretical explanations.

  17. Last Suicide Attempt before Completed Suicide in Severe Depression: An Extended Suicidal Process May Be Found in Men Rather Than Women.

    OpenAIRE

    Brådvik, Louise

    2013-01-01

    The objective of this study was to compare the time from last suicide attempt to suicide in men and women with major depressive disorder with melancholic and/or psychotic features. The case records of 100 suicide victims with severe depression were evaluated. All suicide attempts during the course of depression were noted. The time from last suicide attempt to suicide was compared as well as the occurrence of suicide attempt during the last depressive episode, by gender. Male suicide attempte...

  18. Postprandial oxytocin secretion is associated with severity of anxiety and depressive symptoms in anorexia nervosa.

    Science.gov (United States)

    Lawson, Elizabeth A; Holsen, Laura M; Santin, McKale; DeSanti, Rebecca; Meenaghan, Erinne; Eddy, Kamryn T; Herzog, David B; Goldstein, Jill M; Klibanski, Anne

    2013-05-01

    Anorexia nervosa, a psychiatric disorder characterized by self-induced starvation, is associated with endocrine dysfunction and comorbid anxiety and depression. Animal data suggest that oxytocin may have anxiolytic and antidepressant effects. We have reported increased postprandial oxytocin levels in women with active anorexia nervosa and decreased levels in weight-recovered women with anorexia nervosa compared to healthy controls. A meal may represent a significant source of stress in patients with disordered eating. We therefore investigated the association between postprandial oxytocin secretion and symptoms of anxiety and depression in anorexia nervosa. We performed a cross-sectional study of 35 women (13 women with active anorexia nervosa, 9 with weight-recovered anorexia nervosa, and 13 healthy controls). Anorexia nervosa was diagnosed according to DSM-IV-TR criteria. Serum oxytocin and cortisol and plasma leptin levels were measured fasting and 30, 60, and 120 minutes after a standardized mixed meal. The area under the curve (AUC) and, for oxytocin, postprandial nadir and peak levels were determined. Anxiety and depressive symptoms were assessed using the Spielberger State-Trait Anxiety Inventory (STAI) and Beck Depression Inventory II (BDI-II). The study was conducted from January 2009 to March 2011. In women with anorexia nervosa, oxytocin AUC and postprandial nadir and peak levels were positively associated with STAI trait and STAI premeal and postmeal state scores. Oxytocin AUC and nadir levels were positively associated with BDI-II scores. After controlling for cortisol AUC, all of the relationships remained significant. After controlling for leptin AUC, most of the relationships remained significant. Oxytocin secretion explained up to 51% of the variance in STAI trait and 24% of the variance in BDI-II scores. Abnormal postprandial oxytocin secretion in women with anorexia nervosa is associated with increased symptoms of anxiety and depression. This

  19. Antepartum depression severity is increased during seasonally longer nights: relationship to melatonin and cortisol timing and quantity.

    Science.gov (United States)

    Meliska, Charles J; Martínez, Luis F; López, Ana M; Sorenson, Diane L; Nowakowski, Sara; Kripke, Daniel F; Elliott, Jeffrey; Parry, Barbara L

    2013-11-01

    Current research suggests that mood varies from season to season in some individuals, in conjunction with light-modulated alterations in chronobiologic indices such as melatonin and cortisol. The primary aim of this study was to evaluate the effects of seasonal variations in darkness on mood in depressed antepartum women, and to determine the relationship of seasonal mood variations to contemporaneous blood melatonin and cortisol measures; a secondary aim was to evaluate the influence of seasonal factors on measures of melancholic versus atypical depressive symptoms. We obtained measures of mood and overnight concentrations of plasma melatonin and serum cortisol in 19 depressed patients (DP) and 12 healthy control (HC) antepartum women, during on-going seasonal variations in daylight/darkness, in a cross-sectional design. Analyses of variance showed that in DP, but not HC, Hamilton Depression Rating Scale (HRSD) scores were significantly higher in women tested during seasonally longer versus shorter nights. This exacerbation of depressive symptoms occurred when the dim light melatonin onset, the melatonin synthesis offset, and the time of maximum cortisol secretion (acrophase) were phase-advanced (temporally shifted earlier), and melatonin quantity was reduced, in DP but not HC. Serum cortisol increased across gestational weeks in both the HC and DP groups, which did not differ significantly in cortisol concentration. Nevertheless, serum cortisol concentration correlated positively with HRSD score in DP but not HC; notably, HC showed neither significant mood changes nor altered melatonin and cortisol timing or quantity in association with seasonal variations. These findings suggest that depression severity during pregnancy may become elevated in association with seasonally related phase advances in melatonin and cortisol timing and reduced melatonin quantity that occur in DP, but not HC. Thus, women who experience antepartum depression may be more susceptible than

  20. The Validity of Online Patient Ratings of Physicians: Analysis of Physician Peer Reviews and Patient Ratings.

    Science.gov (United States)

    McGrath, Robert J; Priestley, Jennifer Lewis; Zhou, Yiyun; Culligan, Patrick J

    2018-04-09

    Information from ratings sites are increasingly informing patient decisions related to health care and the selection of physicians. The current study sought to determine the validity of online patient ratings of physicians through comparison with physician peer review. We extracted 223,715 reviews of 41,104 physicians from 10 of the largest cities in the United States, including 1142 physicians listed as "America's Top Doctors" through physician peer review. Differences in mean online patient ratings were tested for physicians who were listed and those who were not. Overall, no differences were found between the online patient ratings based upon physician peer review status. However, statistical differences were found for four specialties (family medicine, allergists, internal medicine, and pediatrics), with online patient ratings significantly higher for those physicians listed as a peer-reviewed "Top Doctor" versus those who were not. The results of this large-scale study indicate that while online patient ratings are consistent with physician peer review for four nonsurgical, primarily in-office specializations, patient ratings were not consistent with physician peer review for specializations like anesthesiology. This result indicates that the validity of patient ratings varies by medical specialization. ©Robert J McGrath, Jennifer Lewis Priestley, Yiyun Zhou, Patrick J Culligan. Originally published in the Interactive Journal of Medical Research (http://www.i-jmr.org/), 09.04.2018.

  1. Screening for depression and assessing change in severity of depression. Is the Geriatric Depression Scale (30-.15- and 8- item versions) useful for both purposes in nursing home patients?

    NARCIS (Netherlands)

    Smalbrugge, M.; Jongenelis, L.; Pot, A.M.; Eefsting, J.A.; Beekman, A.T.F.

    2008-01-01

    The objectives of this study were to determine the ability of the 30-, 15- and 8-item versions of the GDS for screening and assessing change in severity of depression in nursing home patients. The GDS and the MADRS were administered to 350 elderly NH-patients by trained interviewers. The presence of

  2. Do continued antidepressants protect against dementia in patients with severe depressive disorder?

    Science.gov (United States)

    Kessing, Lars Vedel; Forman, Julie Lyng; Andersen, Per Kragh

    2011-11-01

    Studies on humans show that depressive disorder is associated with an increased risk of developing cognitive dysfunction, and animal studies suggest that antidepressants may have neuroprotective abilities. On the basis of these observations, it was hypothesized that treatment with antidepressants may decrease the risk of developing dementia in patients with depression. We investigated whether continued treatment with antidepressants is associated with a decreased rate of dementia in a population of patients discharged from psychiatric healthcare service with a diagnosis of depression. We used register data on all prescribed antidepressants in all patients discharged from psychiatric healthcare service with a diagnosis of depression and with subsequent diagnoses of dementia in Denmark from 1995 to 2005. A total of 37 658 patients with a diagnosis of depression at their first psychiatric contact and who were exposed to antidepressants after discharge were included in the study. A total of 2007 patients (5.3%) were subsequently diagnosed with dementia of any kind. The rate of dementia decreased during periods of two or more prescriptions of older antidepressants compared with the period of only one prescription of older antidepressants [relative risk (RR)=0.83 (95% confidence interval (CI)=0.70-0.98)]. This finding was replicated with Alzheimer's disease as the outcome [RR=0.66 (95% CI=0.47-0.94)] but not with dementia of other kinds as the outcome [RR=0.88 (95% CI=0.73-1.06)]. In contrast, during periods of continued use of selective serotonin reuptake inhibitors or newer nonselective serotonin reuptake inhibitors, the rate of dementia was not decreased, regardless of the subtype of dementia. It was concluded that continued long-term treatment with older antidepressants is associated with a reduced rate of dementia in patients treated in psychiatric healthcare settings, whereas continued treatment with other kinds of antidepressants is not. Methodological reasons for

  3. The impact of accepting biological changes during adolescence on the severity of depression symptoms

    Directory of Open Access Journals (Sweden)

    Radziwiłłowicz Wioletta

    2016-12-01

    Full Text Available The aim of the study was to establish whether any relation exists between depression symptoms and the extent to which adolescents accept the changes their bodies undergo (the physical changes they experience at different stages of growing up, and if the connection does exist - is it gender-related. Method: Data were collected from four sub-groups: younger girls (aged 12-13, older girls (aged 17-18, younger boys (aged 12-13, and older boys (aged 17-18. The participants were asked to complete questionnaires that allow to measure the subjective intensity of depression symptoms (BDI, the current stage of biological changes (the Tanner scale and whether these changes are accepted by the individual who experiences them (the original Feelings Towards the Body questionnaire. Results: The less adolescents accept the changes in their bodies, the higher depression symptoms they demonstrate. For younger girls, older girls and older boys, no links were established between levels of accepting bodily changes and early/late maturation (in comparison with the population of their peers. For younger boys, the later the stage of their development, the less likely they are to accept the changes in their bodies. Girls report more intense depression symptoms than boys do, but their levels of accepting changes that occur around puberty are significantly lower only when compared to those of older boys. Conclusions: Whether biological changes during puberty (mainly feelings of anxiety and shame related to the body are accepted or not, was proven to be a significant predictor of more intense depression symptoms.

  4. Symptoms of anxiety and depression are frequent in patients with acute hepatitis C and are not associated with disease severity.

    Science.gov (United States)

    Deterding, Katja; Grüner, Norbert; Buggisch, Peter; Galle, Peter R; Spengler, Ulrich; Hinrichsen, Holger; Berg, Thomas; Potthoff, Andrej; Grohennig, Anika; Koch, Armin; Diepolder, Helmut; Lüth, Stefan; Feyerabend, Sandra; Jung, Maria C; Rogalska-Taranta, Magdalena; Schlaphoff, Verena; Cornberg, Markus; Manns, Michael P; Wedemeyer, Heiner; Wiegand, Johannes

    2016-02-01

    Neuropsychiatric symptoms of hepatitis C virus (HCV) infection and during peginterferon α therapy have been investigated in the chronic stage of the infection, but have not been described during the acute phase of the disease so far. We therefore evaluated anxiety and depression in patients with acute hepatitis C by the Hospital Anxiety and Depression Scale (HADS) within a clinical trial. Data were analysed from the German Hep-Net Acute HCV-III study. Anxiety and depression were characterized by an anxiety (HADS-A) and a depression subscale (HADS-D). More than eight points in each subscale were considered clinically relevant. Data were prospectively collected at baseline, end of treatment and at the end of the study. At baseline, a HADS-A above eight points was observed significantly more frequently than a HADS-D above eight points [n=23/103 (22%) vs. n=12/103 (12%); P=0.041].A pathological HADS-A or HADS-D score did not correlate with age, sex, IL28B genotype, the probable mode of infection, HCV genotype or severity of disease as investigated by alanine aminotransferase and bilirubin levels.Antiviral therapy did not influence anxiety as 12/50 (24%) of patients had HADS-A above 8 at the end of therapy. The proportion of patients with HADS-D above eight points increased from 12% at baseline to 24% (n=12/50) at the end of therapy (P=0.06). HADS results were not associated with lost to follow-up or sustained virological response rates. HADS data in acute HCV infection indicate that anxiety and depression do not correlate with severity of the disease, mode of acquisition, lost to follow-up and sustained virological response rates.

  5. Modification of depression by COMT val158met polymorphism in children exposed to early severe psychosocial deprivation

    Science.gov (United States)

    Drury, Stacy S; Theall, Katherine P; Smyke, Anna T; Keats, Bronya JB; Egger, Helen L; Nelson, Charles A; Fox, Nathan A; Marshall, Peter J; Zeanah, Charles H

    2014-01-01

    Objective To examine the impact of the Catechol-O-Methyltransferase (COMT) val158met allele on depressive symptoms in young children exposed to early severe social deprivation as a result of being raised in institutions. Methods 136 children from the Bucharest Early Intervention Project (BEIP) were randomized before 31 months of age to either care as usual (CAU) in institutions or placement in newly created foster care (FCG). At 54 months of age, a psychiatric assessment using the Preschool Age Psychiatric Assessment (PAPA) was completed. DNA was collected and genotyped for the COMT val158met polymorphism. Multivariate analysis examined the relationship between COMT alleles and depressive symptoms. Results Mean level of depressive symptoms was lower among participants with the met allele compared to those with two copies of the val allele (p <0.05). Controlling for group and gender, the rate of depressive symptoms was significantly lower among participants with the met/met or the met/val genotype (adjusted relative risk (aRR) = 0.67, 95% CI = 0.45, 0.99) compared to participants with the val/val genotype, indicating an intermediate impact for heterozygotes consistent with the biological impact of this polymorphism. The impact of genotype within groups differed significantly. There was a significant protective effect of the met allele on depressive symptoms within the CAU group, however there was no relationship seen within the FCG group. Conclusions This is the first study, to our knowledge, to find evidence of a gene × environment interaction in the setting of early social deprivation. These results support the hypothesis that individual genetic differences may explain some of the variability in recovery amongst children exposed to early severe social deprivation. PMID:20403637

  6. The association of antidepressant and statin use with death and incident cardiovascular disease varies by depression severity.

    Science.gov (United States)

    May, Heidi T; Bair, Tami L; Reiss-Brennan, Brenda; Knight, Stacey; Anderson, Jeffrey L; Horne, Benjamin D; Brunisholz, Kimberly D; Muhlestein, Joseph B

    2017-09-01

    Depression has been reported to be associated with a greater risk of death and cardiovascular disease (CVD); however, the impact of antidepressants (ADM) on CVD risk remains controversial. Statin use is known to decrease CVD risk. Whether the use of these medications together affects CVD risk has not been studied. Patients (N = 26,828) completing the patient health questionnaire (PHQ-9), ≥40 years of age, without prior CVD, and no prior ADM use were studied. Depressive severity was categorized as none-mild (PHQ-9 score ≤14, n = 21,517) and moderate-severe (PHQ-9 score ≥15, n = 5311). Cox hazard regression was used to evaluate the association of no ADM/no statin use (n = 23,104 [86.1%]), ADM/no statin use (n = 877 [3.3%]), no ADM/statin use (n = 2627 [9.8%]), and ADM/statin use (n = 220 [.8%]) with major adverse cardiovascular events (MACE: death, CAD, stroke). Patients averaged 56 ± 12 years; 61% female. There were 1182 (4.4%) 3 year MACE events. The association of ADM and statin use with MACE varied by depressive symptom severity, with statin therapy associated with a decreased risk in the none-mild group (HR = .78, p = .007) and ADM in the moderate-high group (HR = 0.58, p = 0.02). Concomitant use of ADMs and statins did not appear to provide additive benefit.

  7. Homeopathic Individualized Q-Potencies versus Fluoxetine for Moderate to Severe Depression: Double-Blind, Randomized Non-Inferiority Trial

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    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

  8. Homeopathic Individualized Q-Potencies versus Fluoxetine for Moderate to Severe Depression: Double-Blind, Randomized Non-Inferiority Trial

    Science.gov (United States)

    Adler, U. C.; Paiva, N. M. P.; Cesar, A. T.; Adler, M. S.; Molina, A.; Padula, A. E.; Calil, H. M.

    2011-01-01

    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 outpatients

  9. Tonic immobility during sexual assault - a common reaction predicting post-traumatic stress disorder and severe depression.

    Science.gov (United States)

    Möller, Anna; Söndergaard, Hans Peter; Helström, Lotti

    2017-08-01

    Active resistance is considered to be the 'normal' reaction during rape. However, studies have indicated that similar to animals, humans exposed to extreme threat may react with a state of involuntary, temporary motor inhibition known as tonic immobility. The aim of the present study was to assess the occurrence of tonic immobility during rape and subsequent post-traumatic stress disorder and severe depression. Tonic immobility at the time of the assault was assessed using the Tonic Immobility Scale in 298 women who had visited the Emergency clinic for raped women within 1 month of a sexual assault. Information about the assault and the victim characteristics were taken from the structured clinical data files. After 6 months, 189 women were assessed regarding the development of post-traumatic stress disorder and depression. Of the 298 women, 70% reported significant tonic immobility and 48% reported extreme tonic immobility during the assault. Tonic immobility was associated with the development of post-traumatic stress disorder (OR 2.75; 95% CI 1.50-5.03, p = 0.001) and severe depression (OR 3.42; 95% CI 1.51-7.72, p = 0.003) at 6 months. Further, previous trauma history (OR 2.36; 95% CI 1.48-3.77, p stress disorder and severe depression. Knowledge of this reaction in sexual assault victims is important in legal matters and for healthcare follow up. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  10. Traumatic severity and trait resilience as predictors of posttraumatic stress disorder and depressive symptoms among adolescent survivors of the Wenchuan earthquake.

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    Liuhua Ying

    Full Text Available PURPOSE: To examine the associations between trauma severity, trait resilience, and posttraumatic stress disorder (PTSD and depressive symptoms among adolescent survivors of the Wenchuan earthquake, China. METHODS: 788 participants were randomly selected from secondary schools in the counties of Wenchuan and Maoxian, the two areas most severely affected by the earthquake. Participants completed four main questionnaires including the Child PTSD Symptom Scale, the Center for Epidemiologic Studies Depression Scale for Children, the Connor and Davidson's Resilience Scale, and the Severity of Exposure to Earthquake Scale. RESULTS: After adjusting for the effect of age and gender, four aspects of trauma severity (i.e., direct exposure, indirect exposure, worry about others, and house damage were positively associated with the severity of PTSD and depressive symptoms, whereas trait resilience was negatively associated with PTSD and depressive symptoms and moderated the relationship between subjective experience (i.e., worry about others and PTSD and depressive symptoms. CONCLUSIONS: Several aspects (i.e., direct exposure, indirect exposure, worry about others, and house damage of earthquake experiences may be important risk factors for the development and maintenance of PTSD and depression. Additionally, trait resilience exhibits the beneficial impact on PTSD and depressive symptoms and buffers the effect of subjective experience (i.e., worry about others on PTSD and depressive symptoms.

  11. Perceived mental health related stigma, gender, and depressive symptom severity in a psychiatric facility in South India.

    Science.gov (United States)

    Kulesza, Magdalena; Raguram, R; Rao, Deepa

    2014-06-01

    Few studies exist on the topic of gender associated with depression and mental health-related stigma coming out of non-Western countries such as India. We aimed to add to the literature by assessing these relationships among adults seeking psychiatric services in India. Participants were 60 individuals seeking care at a psychiatric clinic in Bangalore, India. The majority of participants were female with a mean age of 36 years (SD=9.75). Contrary to our prediction, there were no significant differences between men (M=28.96; SD=9.85) and women (M=33.03; SD=12.08) on depression severity, t(58)=1.42, p=.16. Yet, women (M=10.09, SD=8.23) reported significantly more perceived stigma than men (M=5.79, SD=5.86), t(58)=2.30, p=.02. While men and women seeking psychiatric services at the psychiatric clinic in India report similar levels of depression severity, women reported more perceived mental illness stigma. Having experienced regular forms of discrimination associated with female status in India, it may be the case that women are more attuned to other forms of stigma, such as mental health stigma investigated in the present study. Given the detrimental impact of stigma on treatment adherence and engagement in care, additional research is needed support this work, including research on interventions to reduce stigma and improve engagement in care. Copyright © 2014 Elsevier B.V. All rights reserved.

  12. Role of stress areas, stress severity, and stressful life events on the onset of depressive disorder: a case-control study.

    Science.gov (United States)

    Lueboonthavatchai, Peeraphon

    2009-09-01

    Although the stress and stressful life events are known as the precipitation of depressive disorder, the areas of stress and types of stressful life events found in depression are varied by different socio-cultural context. Identify the stress areas, stress severity, and types of stressful life events associated with the onset of depressive disorder in Thai depressed patients. Ninety depressed and ninety non-depressed subjects, aged above 18 years old, from the Department of Psychiatry, King Chulalongkorn Memorial Hospital, were recruited into the present study between July 2007 and January 2008. All subjects completed a demographic data form, and a 1-Year Life Stress Event Questionnaire. The association between the number of stressful life events, stress areas, stress severity, types of stressful life events, and the onset of depressive disorder were analyzed by independent t-test and chi-square test. Logistic regression was performed to identify the predictors of depressive disorder. Most of the subjects were young and middle-aged women, living in Bangkok and the central region. The depressed subjects experienced more stressful life events than the non-depressed subjects (5.81 +/- 3.19 vs. 3.24 +/- 2.80 events in one year) (p stress areas (health-related, family-related, financial, occupational, and social stress), and overall stress were associated with the onset of depressive disorder (p stress in all areas were at the higher risk of depressive disorder than those with the mild stress (p stress was the stress area highest associated with the depressive disorder (OR = 5.93, 95% CI = 2.33-16.92, p stressful life events associated with the onset of depressive disorder were the medical hospitalization, medical illness leading to missing work or disturbed daily routine, change in sleeping habits, absence of recreation, arguments with spouse, sexual difficulties with spouse, family financial problems, job loss, and trouble with boss (p stress was the significant

  13. Plasma Metabolites Predict Severity of Depression and Suicidal Ideation in Psychiatric Patients-A Multicenter Pilot Analysis.

    Science.gov (United States)

    Setoyama, Daiki; Kato, Takahiro A; Hashimoto, Ryota; Kunugi, Hiroshi; Hattori, Kotaro; Hayakawa, Kohei; Sato-Kasai, Mina; Shimokawa, Norihiro; Kaneko, Sachie; Yoshida, Sumiko; Goto, Yu-Ichi; Yasuda, Yuka; Yamamori, Hidenaga; Ohgidani, Masahiro; Sagata, Noriaki; Miura, Daisuke; Kang, Dongchon; Kanba, Shigenobu

    2016-01-01

    Evaluating the severity of depression (SOD), especially suicidal ideation (SI), is crucial in the treatment of not only patients with mood disorders but also psychiatric patients in general. SOD has been assessed on interviews such as the Hamilton Rating Scale for Depression (HAMD)-17, and/or self-administered questionnaires such as the Patient Health Questionnaire (PHQ)-9. However, these evaluation systems have relied on a person's subjective information, which sometimes lead to difficulties in clinical settings. To resolve this limitation, a more objective SOD evaluation system is needed. Herein, we collected clinical data including HAMD-17/PHQ-9 and blood plasma of psychiatric patients from three independent clinical centers. We performed metabolome analysis of blood plasma using liquid chromatography mass spectrometry (LC-MS), and 123 metabolites were detected. Interestingly, five plasma metabolites (3-hydroxybutyrate (3HB), betaine, citrate, creatinine, and gamma-aminobutyric acid (GABA)) are commonly associated with SOD in all three independent cohort sets regardless of the presence or absence of medication and diagnostic difference. In addition, we have shown several metabolites are independently associated with sub-symptoms of depression including SI. We successfully created a classification model to discriminate depressive patients with or without SI by machine learning technique. Finally, we produced a pilot algorithm to predict a grade of SI with citrate and kynurenine. The above metabolites may have strongly been associated with the underlying novel biological pathophysiology of SOD. We should explore the biological impact of these metabolites on depressive symptoms by utilizing a cross species study model with human and rodents. The present multicenter pilot study offers a potential utility for measuring blood metabolites as a novel objective tool for not only assessing SOD but also evaluating therapeutic efficacy in clinical practice. In addition

  14. Plasma Metabolites Predict Severity of Depression and Suicidal Ideation in Psychiatric Patients-A Multicenter Pilot Analysis.

    Directory of Open Access Journals (Sweden)

    Daiki Setoyama

    Full Text Available Evaluating the severity of depression (SOD, especially suicidal ideation (SI, is crucial in the treatment of not only patients with mood disorders but also psychiatric patients in general. SOD has been assessed on interviews such as the Hamilton Rating Scale for Depression (HAMD-17, and/or self-administered questionnaires such as the Patient Health Questionnaire (PHQ-9. However, these evaluation systems have relied on a person's subjective information, which sometimes lead to difficulties in clinical settings. To resolve this limitation, a more objective SOD evaluation system is needed. Herein, we collected clinical data including HAMD-17/PHQ-9 and blood plasma of psychiatric patients from three independent clinical centers. We performed metabolome analysis of blood plasma using liquid chromatography mass spectrometry (LC-MS, and 123 metabolites were detected. Interestingly, five plasma metabolites (3-hydroxybutyrate (3HB, betaine, citrate, creatinine, and gamma-aminobutyric acid (GABA are commonly associated with SOD in all three independent cohort sets regardless of the presence or absence of medication and diagnostic difference. In addition, we have shown several metabolites are independently associated with sub-symptoms of depression including SI. We successfully created a classification model to discriminate depressive patients with or without SI by machine learning technique. Finally, we produced a pilot algorithm to predict a grade of SI with citrate and kynurenine. The above metabolites may have strongly been associated with the underlying novel biological pathophysiology of SOD. We should explore the biological impact of these metabolites on depressive symptoms by utilizing a cross species study model with human and rodents. The present multicenter pilot study offers a potential utility for measuring blood metabolites as a novel objective tool for not only assessing SOD but also evaluating therapeutic efficacy in clinical practice. In

  15. Hypercortisolemia is associated with severity of bone loss and depression in hypothalamic amenorrhea and anorexia nervosa.

    Science.gov (United States)

    Lawson, Elizabeth A; Donoho, Daniel; Miller, Karen K; Misra, Madhusmita; Meenaghan, Erinne; Lydecker, Janet; Wexler, Tamara; Herzog, David B; Klibanski, Anne

    2009-12-01

    Anorexia nervosa (AN) and functional hypothalamic amenorrhea (HA) are associated with low bone density, anxiety, and depression. Women with AN and HA have elevated cortisol levels. Significant hypercortisolemia, as in Cushing's disease, causes bone loss. It is unknown whether anxiety and depression and/or cortisol dysregulation contribute to low bone density in AN or HA. Our objective was to investigate whether hypercortisolemia is associated with bone loss and mood disturbance in women with HA and AN. We conducted a cross-sectional study in a clinical research center. We studied 52 women [21 healthy controls (HC), 13 normal-weight women with functional HA, and 18 amenorrheic women with AN]. Serum samples were measured every 20 min for 12 h overnight and pooled for average cortisol levels. Bone mineral density (BMD) was assessed by dual-energy x-ray absorptiometry (DXA) at anteroposterior and lateral spine and hip. Hamilton Rating Scales for Anxiety (HAM-A) and Depression (HAM-D) were administered. BMD was lower in AN and HA than HC at all sites and lower in AN than HA at the spine. On the HAM-D and HAM-A, AN scored higher than HA, and HA scored higher than HC. Cortisol levels were highest in AN, intermediate in HA, and lowest in HC. HAM-A and HAM-D scores were associated with decreased BMD. Cortisol levels were positively associated with HAM-A and HAM-D scores and negatively associated with BMD. Hypercortisolemia is a potential mediator of bone loss and mood disturbance in these disorders.

  16. Depression, anxiety and obsessive-compulsive symptoms in relation to nutritional status and outcome in severe anorexia nervosa.

    Science.gov (United States)

    Mattar, Lama; Thiébaud, Marie-Raphaele; Huas, Caroline; Cebula, Christelle; Godart, Nathalie

    2012-12-30

    Depression, anxiety and obsessive-compulsive disorder are frequently reported to co-occur with anorexia nervosa (AN). There is clinical consensus that depressive symptoms and anxiety may in part be sequelae of malnutrition in AN. However, evidence-based data are still very rare. The present study among severe AN patients investigates links between these psychological variants and nutritional status at admission and subsequent to nutritional rehabilitation. Twenty-four women with AN diagnosed according to the Diagnostic and Statistical Manual IV (DSM-IV) were included prospectively and consecutively at hospitalisation. Nutritional status was assessed by body mass index (BMI). Several psychological aspects were assessed using various scales for depression, anxiety, social phobia, obsessive and eating behaviour symptoms. Follow-up weights and heights at 4-12 years after hospital discharge were measured in 18 patients. BMI and all the scores except the Yale-Brown obsessive-compulsive scale (Y-BOCS) showed significant improvement between admission and discharge. This study highlights the fact that some of the depressive and anxiety symptoms at least partially decrease with nutrition rehabilitation. The improvement in the scores on the psychometric scales between admission and discharge was not correlated with BMI improvement. Psychometric scores at admission and at discharge were not correlated with BMI at follow-up. BMI at follow-up was correlated with minimum lifetime BMI (r=0.486, P=0.04). Future studies should use a better indicator for nutritional status than BMI alone, and should also consider the initial degree of weight loss and the rate at which weight was lost. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  17. The effect of individual enabling and support on empowerment and depression severity in persons with affective disorders: outcome of a randomized control trial.

    Science.gov (United States)

    Porter, Susann; Bejerholm, Ulrika

    2018-01-30

    To evaluate the effect of Individual Enabling and Support (IES) on empowerment and depression severity as compared to Traditional Vocational Rehabilitation (TVR) in people with affective disorders at 12 months follow-up. Additionally, longitudinal changes within the intervention groups and the correlation over time between empowerment and depression severity were evaluated. A single-blind randomized controlled trial of two intervention groups, IES (n = 33) and TVR (n = 28), was performed with measurement points at baseline, 6, and 12 months. Individuals with affective disorders, including depression and bipolar disorder diagnoses were included. The Empowerment Scale and Montgomery-Åsberg Depression Self-Rating Scale were administered, and Intention-To-Treat analysis was applied. The study was registered with the trial number ISRCTN93470551. There was a statistically significant difference between the intervention groups on empowerment and depression severity at 12 months. Within-group analysis showed that IES-participants increased their perceived empowerment and decreased their depression severity between measurement points, this was not seen among TVR-participants. A moderate, inverse relationship was detected between empowerment and depression. IES is more effective in increasing empowerment and decreasing depression severity after a 12-month intervention than is TVR. This study was limited by a small sample size and larger trials in different contexts are needed.

  18. The joint association of depression and cognitive function with severe disability among community-dwelling older adults in Finland, Poland and Spain.

    Science.gov (United States)

    Olaya, Beatriz; Moneta, Maria Victoria; Koyanagi, Ai; Lara, Elvira; Miret, Marta; Ayuso-Mateos, José Luis; Chatterji, Somnath; Leonardi, Matilde; Koskinen, Seppo; Tobiasz-Adamczyk, Beata; Lobo, Antonio; Haro, Josep Maria

    2016-04-01

    To explore the joint association of depression and cognitive function with severe disability in nationally-representative samples of community-dwelling adults aged 50 years and older from Finland, Poland and Spain. Cross-sectional. Community-based. Population-based sample of 7987 non-institutionalized adults aged 50 and older. The outcome was severe disability, defined as ≥ 90th percentile of the 12-item version of the World Health Organization Disability Assessment Schedule (WHODAS 2.0). Past 12-month DSM-IV major depressive disorder was assessed with the depression module of the WHO Composite International Diagnostic Interview (CIDI). A global cognitive function score was obtained through neuropsychological tests. Product terms between depression and cognition were introduced in multivariable logistic regression models to test for interaction. Lower cognitive function and depression were both significantly associated with severe disability in all countries. A significant interaction was only found in Finland where the ORs (95% CIs) of depression for severe disability at the 25th (worse), 50th, and 75th (better) percentiles of cognitive function were 7.26 (4.28-12.32), 11.1 (6.7-18.38), and 17.56 (9.29-33.2), respectively. People with depression and cognitive decline are likely to benefit from the usual evidence-based treatments to reduce the burden of disability. However, in Finland, those with better cognitive function may benefit from more aggressive depression treatment. Future research is warranted to assess whether our results may be replicated.

  19. The Relationship between the Broader Autism Phenotype, Child Severity, and Stress and Depression in Parents of Children with Autism Spectrum Disorders

    Science.gov (United States)

    Ingersoll, Brooke; Hambrick, David Z.

    2011-01-01

    This study examined the relationship between child symptom severity, parent broader autism phenotype (BAP), and stress and depression in parents of children with ASD. One hundred and forty-nine parents of children with ASD completed a survey of parenting stress, depression, broader autism phenotype, coping styles, perceived social support, and…

  20. Short-Term Effects of Electroconvulsive Therapy on Subjective and Actigraphy-Assessed Sleep Parameters in Severely Depressed Inpatients

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    Alexander Hoogerhoud

    2015-01-01

    Full Text Available Background. Sleep disturbances are a key feature of major depression. Electroconvulsive treatment (ECT may improve polysomnography-assessed sleep characteristics, but its short-term effects on actigraphy-assessed and subjective sleep characteristics are unknown. We therefore aimed to assess the effects of ECT on subjective and objective sleep parameters in a proof-of-principle study. Methods. We assessed subjective and objective sleep parameters in 12 severely depressed patients up to 5 consecutive days during their ECT course, corresponding to a total of 43 nights (including 19 ECT sessions. The 12 patients were 83% female and on average 62 (standard deviation (SD 14 years old and had an average MADRS score of 40 at baseline (SD 21. Results. Subjective and objective sleep parameters were not directly affected by ECT. The subjective sleep efficiency parameter was similar on the day after ECT and other days. ECT did not affect the number of errors in the Sustained Attention to Response Task. Patients subjectively underestimated their total sleep time by 1.4 hours (P<0.001 compared to actigraphy-assessed sleep duration. Conclusion. ECT did not affect subjective and actigraphy-assessed sleep in the short term. Depressed patients profoundly underestimated their sleep duration.

  1. Antidepressant Therapy in Severe Depression May Have Different Effects on Ego-Dystonic and Ego-Syntonic Suicidal Ideation

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    Louise Brådvik

    2011-01-01

    Full Text Available The objective of the present study was to investigate whether ego-dystonic and ego-syntonic suicidal ideation occurred at different frequencies during antidepressant therapy. A blind evaluation has been performed on records of 100 suicides with a primary severe depression and 100 matched controls, admitted to the Department of Psychiatry, Lund, Sweden. Ego-dystonic suicidal ideation was more commonly reported during adequate treatment as compared to ego-syntonic ideation (P=.004. Men who committed suicide during adequate antidepressant therapy more often reported ego-dystonic suicidal ideation earlier in their lives compared with those who were not treated (P=.0377. This may indicate that treatment failure for ego-dystonic ideation was a precursor of their suicides. Consequently, ego-dystonic ideation seems to show a poorer response to antidepressant therapy as compared to ego-syntonic ideation, which may be more directly related to depression. Ego-dystonic ideation is proposed to be related to depressive psychosis.

  2. Parental bonding and self-esteem as predictors of severe depressive symptoms: a 10-year follow-up study of Norwegian physicians.

    Science.gov (United States)

    Grotmol, Kjersti S; Ekeberg, Øivind; Finset, Arnstein; Gude, Tore; Moum, Torbjørn; Vaglum, Per; Tyssen, Reidar

    2010-01-01

    Elevated rates of suicide and depression among physicians have been reported. The associations between perceived parental bonding and depressive symptoms have yet to be studied longitudinally in this occupational group. In a nationwide cohort, we sought to study parental bonding as a predictor for severe depressive symptoms and to determine whether self-esteem mediates this relationship. After graduation (T1), medical students (N = 631) were followed-up after 1 (T2), 4 (T3), and 10 (T4) years. There were no gender differences in mean depressive scores. Female physicians reported higher levels of care from their mothers (p self-esteem for both sexes.

  3. Alcohol-use disorder severity predicts first-incidence of depressive disorders

    NARCIS (Netherlands)

    Boschloo, L.; van den Brink, W.; Penninx, B.W.J.H.; Wall, M.M.; Hasin, D.S.

    2012-01-01

    Background Previous studies suggest that alcohol-use disorder severity, defined by the number of criteria met, provides a more informative phenotype than dichotomized DSM-IV diagnostic measures of alcohol use disorders. Therefore, this study examined whether alcohol-use disorder severity predicted

  4. Alcohol-use disorder severity predicts first-incidence of depressive disorders

    NARCIS (Netherlands)

    Boschloo, L.; van den Brink, W.; Penninx, B. W. J. H.; Wall, M. M.; Hasin, D. S.

    2012-01-01

    Background. Previous studies suggest that alcohol-use disorder severity, defined by the number of criteria met, provides a more informative phenotype than dichotomized DSM-IV diagnostic measures of alcohol use disorders. Therefore, this study examined whether alcohol-use disorder severity predicted

  5. Not urbanization level but socioeconomic, physical and social neighbourhood characteristics are associated with presence and severity of depressive and anxiety disorders

    NARCIS (Netherlands)

    Dekkers, J.E.C.; Generaal, Ellen; Timmermans, Erik J; Smit, J.H.; Penninx, B.W.J.H.

    2018-01-01

    BACKGROUND: Which neighbourhood factors most consistently impact on depression and anxiety remains unclear. This study examines whether objectively obtained socioeconomic, physical and social aspects of the neighbourhood in which persons live are associated with the presence and severity of

  6. Adult clonidine overdose: prolonged bradycardia and central nervous system depression, but not severe toxicity.

    Science.gov (United States)

    Isbister, Geoffrey K; Heppell, Simon P; Page, Colin B; Ryan, Nicole M

    2017-03-01

    There are limited reports of adult clonidine overdose. We aimed to describe the clinical effects and treatment of clonidine overdose in adults. This was a retrospective review of a prospective cohort of poisoned patients who took clonidine overdoses (>200 μg). Demographic information, clinical effects, treatment, complications (central nervous system and cardiovascular effects) and length of stay (LOS) were extracted from a clinical database or medical records. From 133 admissions for clonidine poisoning (1988-2015), no medical record was available in 14 and 11 took staggered ingestions. Of 108 acute clonidine overdoses (median age 27 years; 14-65 years; 68 females), 40 were clonidine alone ingestions and 68 were clonidine with co-ingestants. Median dose taken was 2100 μg (interquartile range [IQR]: 400-15,000 μg). Median LOS was 21h (IQR: 14-35 h) and there were no deaths. Glasgow coma score [GCS] central nervous system depression and bradycardia. Naloxone was not associated with improved outcomes.

  7. Depression severity and quality of life of qualified and unqualified patients with a mood disorder for a research study targeting anhedonia in a clinical sample.

    Science.gov (United States)

    Gao, Keming; Sweet, Jennifer; Su, Meilei; Calabrese, Joseph R

    2017-06-01

    To investigate the depression severity and quality of life of qualified and unqualified patients with a mood disorder for a research study based on anhedonia severity. Diagnosis of major depressive disorder (MDD) or bipolar disorder (BPD) was ascertained with the MINI International Neuropsychiatric Interview. The severity of depression was measured with the 16-item Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-16-SR), and Item 5, "feeling sad (sadness)," QIDS-16-SR Item 13, "change in general interest," was used to measure the severity of anhedonia. The quality of life was measured with the Quality of Life, Enjoyment and Satisfaction Questionnaire (Q-LES-Q). Of 96 patients with MDD and 147 with bipolar I or II disorder, the severity rating on sadness and anhedonia was similar. The severities of anhedonia and sadness were highly correlated with R 2 of ≥0.91. Without considering depressive severity, 55% of patients would be eligible for a study if≥mild anhedonia was used as a severity criterion, but only 26% of patients eligible for a study if≥moderate anhedonia was used without considering substance use and medical comorbidities. If patients with ≥ moderate overall depressive symptoms were considered, 88.1% of patients would be eligible if≥mild anhedonia was required for a study, and 45.2% of patients would be eligible for a study if≥moderate anhedonia was required. For those who were unqualified for the study based on≥moderate anhedonia, about 1/3 had≥moderate overall depressive symptoms and less than 40% of maximum possible scores of Q-LES-Q. If only patients in remission based on overall depressive symptom severity were considered for a study of anhedonia, no patient would be eligible for the study. Depressive mood and anhedonia are highly correlated. Screening patients with a mood disorder and an overall moderate depressive severity is a cost-effective approach for a study targeting anhedonia, especially for a study requiring

  8. "Black folk don't get no severe depression": Meanings and expressions of depression in a predominantly black urban neighborhood in Midwestern United States.

    Science.gov (United States)

    Alang, Sirry M

    2016-05-01

    Discrepancies exist between how some Black populations perceive depression and how depression is conceptualized within research and clinical settings. Based on a 12-month ethnography of mental health in a predominantly Black disadvantaged urban neighborhood in Midwestern United States, the current study identifies meanings and common ways of expressing depression among African Americans. Depression was often considered a sign of weakness rather than a health problem that might need medical attention. Associated emotions like sadness and hopelessness were inconsistent with notions of strength. Common indicators of depression included classic symptoms such as hopelessness, loss of sleep, and feeling worthless. However, expressions of depression such as anger, agitation, violent behavior, and a frantic search for social interaction that are inconsistent with DSM-V criteria were also common. These findings have implications for the clinical assessment of depression and for the measurement of depression in community surveys. In addition, the context and meaning of symptoms play an important role in determining whether experiences are indicative of depression. This paper underscores that the provision of patient-centered mental health care requires a better understanding of the conceptualization of disorders within specific contexts. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Evaluation of the impact of severity of itching symptoms on the level of depression in patients with allergic contact eczema (preliminary study

    Directory of Open Access Journals (Sweden)

    Małgorzata Czarny-Działak

    2014-06-01

    Full Text Available Introduction : Allergic contact dermatitis is one of the most frequent skin disorders in the general population as well as among people who work professionally. Allergic contact allergens are simple chemical compounds. The most common are nickel and fragrance substances. Aim of the research : To estimate if and how the degree of itching in allergic contact dermatitis influences the development of depression. Material and methods: The treatment was conducted on a group of 17 people with allergic contact dermatitis. Each person was treated in order to estimate the level of depression using Becks scale and the level of itching. Next, it was estimated if the level of itching had any influence on the development of depression. Results: All skin diseases, including allergic contact eczema affect the biological and psychosocial functioning, and the quality of human. Five patients out of 17 showed features of depression: 3 mild (2 men and 1 woman, which is the most common state of transition, and 2 (women moderately-severe depressive symptoms. Both patients with moderately-severe depressive symptoms had a significant degree of severity of pruritus. Conclusions: It was stated that the level of itching has no influence on the development of depression.

  10. Integrating family work into the treatment of young people with severe and complex depression: a developmentally focused model.

    Science.gov (United States)

    Rice, Simon; Halperin, Stephen; Blaikie, Simon; Monson, Katherine; Stefaniak, Rachel; Phelan, Mark; Davey, Christopher

    2018-04-01

    Although models of family intervention are clearly articulated in the child and early adolescent literature, there is less clarity regarding family intervention approaches in later adolescence and emerging adulthood. This study provides the rationale and intervention framework for a developmentally sensitive model of time-limited family work in the outpatient treatment of complex youth depression (15-25 years). Derived from current practice in the Youth Mood Clinic (YMC) at Orygen Youth Health, Melbourne, a stepped model of family intervention is discussed. YMC aims to provide comprehensive orientation, assessment and education to all families. For some, a family-based intervention, delivered either by the treating team or through the integration of a specialist family worker, offers an important adjunct in supporting the recovery of the young person. Developmental phases and challenges experienced by the young person with respect to family/caregiver involvement are discussed in the context of two case studies. A developmentally sensitive model is presented with particular attention to the developmental needs and preferences of young people. Formal evaluation of this model is required. Evaluation perspectives should include young people, caregivers, the broader family system (i.e. siblings) and the treating team (i.e. case manager, doctor and family worker) incorporating outcome measurement. Such work determines how best to apply a time-limited family-based intervention approach in strengthening family/caregiver relationships as part of the young person's recovery from severe and complex depression. © 2016 John Wiley & Sons Australia, Ltd.

  11. Alcohol use severity and depressive symptoms among late adolescent Hispanics: Testing associations of acculturation and enculturation in a bicultural transaction model.

    Science.gov (United States)

    Cano, Miguel Ángel; de Dios, Marcel A; Castro, Yessenia; Vaughan, Ellen L; Castillo, Linda G; Lorenzo-Blanco, Elma I; Piña-Watson, Brandy; Berger Cardoso, Jodi; Ojeda, Lizette; Cruz, Rick A; Correa-Fernandez, Virmarie; Ibañez, Gladys; Auf, Rehab; Molleda, Lourdes M

    2015-10-01

    Research has indicated that Hispanics have high rates of heavy drinking and depressive symptoms during late adolescence. The purpose of this study was to test a bicultural transaction model composed of two enthnocultural orientations (acculturation and enculturation); and stressful cultural transactions with both the U.S. culture (perceived ethnic discrimination) and Hispanic culture (perceived intragroup marginalization) to predict alcohol use severity and depressive symptoms among a sample of 129 (men=39, women=90) late adolescent Hispanics (ages 18-21) enrolled in college. Results from a path analysis indicated that the model accounted for 18.2% of the variance in alcohol use severity and 24.3% of the variance in depressive symptoms. None of the acculturation or enculturation domains had statistically significant direct effects with alcohol use severity or depressive symptoms. However, higher reports of ethnic discrimination were associated with higher reports of alcohol use severity and depressive symptoms. Similarly, higher reports of intragroup marginalization were associated with higher depressive symptoms. Further, both ethnic discrimination and intragroup marginalization functioned as mediators of multiple domains of acculturation and enculturation. These findings highlight the need to consider the indirect effects of enthnocultural orientations in relation to health-related outcomes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Perceived family social support buffers against the effects of exposure to rocket attacks on adolescent depression, aggression, and severe violence.

    Science.gov (United States)

    Shahar, Golan; Henrich, Christopher C

    2016-02-01

    The authors compared the protective effects of 3 sources of perceived social support-from family members, friends, and school personnel-on internalizing and externalizing symptoms in adolescents exposed to rocket attacks. Data were based on 362 Israeli adolescents (median age = 14), chronically exposed to rockets from the Gaza Strip, for whom robust effects of exposure on internalizing and externalizing symptoms were reported during the 2009-2010 period (Henrich & Shahar, 2013). New analyses revealed that perceived family social support assessed in 2009 buffered against the effect of exposure to rocket attacks on depression, aggression, and severe violence during 2009-2010. Findings are consistent with a human-ecological perspective exposure to political violence and encourage the employment of family-based preventive interventions in afflicted areas. (c) 2016 APA, all rights reserved).

  13. Marchiafava-Bignami disease with dementia: severe cerebral metabolic depression revealed by PET. Case report

    International Nuclear Information System (INIS)

    Pappata, S.; Chabriat, H.; Levasseur, M.; Legault-Demare, F.; Baron, J.C.

    1994-01-01

    The Cerebral Metabolic Rate of Glucose (CMRGlu) was measured with positron emission tomography and 18 F-FDG in a patient with Marchiafava-Bignami Disease (MBD)-related dementia. Despite MRI evidence of lesions essentially limited to the corpus callosum (CC), but consistent with the cognitive pattern of cortical dementia, the CMRGlu was markedly reduced in the frontal and temporo-parieto-occipital association cortices. Disruption of cortico-cortical networks crossing the CC presumably contributed to, but may not in and by itself explain, the severity of the clinical-metabolic findings in this patient. An additional role could be played by microscopic white matter lesions and/or neocortical neuronal loss, which have been occasionally observed in post-mortem studies of MBD patients. (authors)

  14. Physical appearance concerns are uniquely associated with the severity of steroid dependence and depression in anabolic-androgenic steroid users.

    Science.gov (United States)

    Griffiths, Scott; Jacka, Brendan; Degenhardt, Louisa; Murray, Stuart B; Larance, Briony

    2018-02-27

    Emerging research suggests that the sub-population of anabolic-androgenic steroid (AAS) users who experience physical appearance concerns may suffer greater psychological dysfunction than other sub-populations, including users with athletic or occupational concerns. Thus, among current AAS users, we sought to determine whether, and to what extent, social physique anxiety-an established measure of appearance concern-was associated with psychological dysfunction. Interviews were conducted with a sample of 74 male AAS users living in Australia. Users completed self-report instruments of the severity of AAS dependence, depression, hazardous and risky drinking, use of non-AAS illicit drugs, psychological side-effects due to AAS use and abnormal test results due to AAS use. Multivariate analyses revealed that greater social physique anxiety was uniquely associated with more severe symptoms of both AAS dependence and depression. Moreover, the effect size of these relationships was large. Social physique anxiety was not associated with hazardous or risky drinking, non-AAS illicit drug use, psychological side-effects or abnormal test results. Limitations notwithstanding, the study is consistent with the notion that AAS users who experience appearance concerns are at heightened risk of co-morbid psychological dysfunction. Given trends indicating an increase in the prevalence of AAS use in Australia and elsewhere, the findings suggest that health-care systems may need to consider prioritising the sub-population of AAS users who experience appearance concerns. Further investigation of the clinical syndrome of AAS dependence is required, including its relation to body image and eating disorders. © 2018 Australasian Professional Society on Alcohol and other Drugs.

  15. The association between food insecurity and depressive symptoms severity among pregnant women differs by social support category: a cross-sectional study.

    Science.gov (United States)

    Natamba, Barnabas K; Mehta, Saurabh; Achan, Jane; Stoltzfus, Rebecca J; Griffiths, Jeffrey K; Young, Sera L

    2017-07-01

    Common mental disorders, such as depression and anxiety, affect approximately 16% of pregnant women in low- and middle-income countries. Food insecurity (FI) has been shown to be associated with depressive symptoms. It has also been suggested that the association between FI and depressive symptoms is moderated by social support (SS); however, there is limited evidence of these associations among pregnant women living in low-income and middle-income countries. We studied the association between FI and depressive symptoms severity and assessed whether such an association varied among Ugandan pregnant women with low vs. high SS. Cross-sectional data were collected among 403 pregnant women in northern Uganda. SS was assessed using an eight-item version of the Duke-UNC functional SS scale. FI and depressive symptoms were assessed by, respectively, the individually focused FI scale and the Center for Epidemiologic Studies-Depression scale. Women were categorized into two SS groups, based on scoring category (adjusted beta (95%CI): 0.91 (0.55; 1.27)) than for women belonging to the high SS group (0.53 (0.28; 0.78)) (adjusted p value for interaction = 0.026). There is need for longitudinal or interventional studies among pregnant women living in northern Uganda or similar contexts to examine the temporal sequence of the associations among food insecurity, depressive symptoms severity and social support. © 2016 John Wiley & Sons Ltd. © 2016 John Wiley & Sons Ltd.

  16. Heterogeneity in 10-Year Course Trajectories of Moderate to Severe Major Depressive Disorder: A Danish National Register-Based Study.

    Science.gov (United States)

    Musliner, Katherine L; Munk-Olsen, Trine; Laursen, Thomas M; Eaton, William W; Zandi, Peter P; Mortensen, Preben B

    2016-04-01

    Evidence suggests that long-term trajectories of major depressive disorder (MDD) are heterogeneous. The Danish Psychiatric Central Research Register (DPCRR) provides a rare opportunity to examine patterns and correlates of long-term trajectories in a large sample of patients with moderate to severe MDD. To characterize patterns and correlates of 10-year course trajectories of MDD in the DPCRR. A cohort containing 11 640 individuals born in Denmark in 1955 or later with their first recorded MDD diagnosis in the DPCRR between 1995 and 2002 was established. Patients were followed for 10 years from the date of their initial MDD diagnosis. Data were obtained from Danish civil and psychiatric national registers in June 2013 and were analyzed from April 4, 2014, to December 17, 2015. Correlates of trajectory class membership were sex, characteristics of the first recorded MDD episode (ie, age, severity, inpatient treatment, and record of suicide attempt or self-harm), and psychiatric diagnoses in parents (ie, depression, bipolar disorder, schizophrenia-spectrum disorders, substance abuse, and anxiety or somatoform disorders). The outcome variable was past-year contact at a psychiatric hospital with a main diagnosis of MDD during each of the 10 years following the initial MDD diagnosis. Trajectories were modeled using latent class growth analysis. The sample included 11 640 individuals (7493 [64.4%] women) aged 18 to 48 years (mean [SD], 31.4 [7.3]) at their first recorded MDD diagnosis. Four trajectory classes were identified: brief contact (77.0%) (characterized by low probability of contact after 2 years); prolonged initial contact (12.8%) (characterized by high decreasing probability of contact during the first 5 years); later reentry (7.1%) (characterized by moderate probability of contact during the second 5 years); and persistent contact (3.1%) (characterized by high or moderate probability of contact throughout). Female sex (odds ratio [OR] range, 1

  17. Increased autoimmune activity against 5-HT: a key component of depression that is associated with inflammation and activation of cell-mediated immunity, and with severity and staging of depression.

    Science.gov (United States)

    Maes, Michael; Ringel, Karl; Kubera, Marta; Berk, Michael; Rybakowski, Janusz

    2012-02-01

    Depression is characterized by inflammation and cell-mediated immune (CMI) activation and autoimmune reactions directed against a multitude of self-epitopes. There is evidence that the inflammatory response in depression causes dysfunctions in the metabolism of 5-HT, e.g. lowering the 5-HT precursor tryptophan, and upregulating 5-HT receptor mRNA. This study has been undertaken to examine autoimmune activity directed against 5-HT in relation to CMI activation and inflammation. 5-HT antibodies were examined in major depressed patients (n=109) versus normal controls (n=35) in relation to serum neopterin and lysozyme, and plasma pro-inflammatory cytokines (PIC), i.e. interleukin-1 (IL-1) and tumor necrosis factor-α (TNFα). Severity of depression was assessed with the Hamilton Depression Rating Scale (HDRS) and severity of fatigue and somatic symptoms with the Fibromyalgia and Chronic Fatigue Syndrome (FF) Rating Scale. The incidence of anti-5-HT antibody activity was significantly higher in depressed patients (54.1%), and in particular in those with melancholia (82.9%), than in controls (5.7%). Patients with positive 5-HT antibodies showed increased serum neopterin and lysozyme, and plasma TNFα and IL-1; higher scores on the HDRS and FF scales, and more somatic symptoms, including malaise and neurocognitive dysfunctions. There was a significant association between autoimmune activity to 5-HT and the number of previous depressive episodes. The autoimmune reactions directed against 5-HT might play a role in the pathophysiology of depression and the onset of severe depression. The strong association between autoimmune activity against 5-HT and inflammation/CMI activation is explained by multiple, reciprocal pathways between these factors. Exposure to previous depressive episodes increases the incidence of autoimmune activity directed against 5-HT, which in turn may increase the likelihood to develop new depressive episodes. These findings suggest that sensitization

  18. Low serum levels of High-Density Lipoprotein cholesterol (HDL-c) as an indicator for the development of severe postpartum depressive symptoms

    Science.gov (United States)

    Ramachandran Pillai, Raji; Wilson, Anand Babu; Premkumar, Nancy R.; Kattimani, Shivanand; Sagili, Haritha

    2018-01-01

    Postpartum depression (PPD) is a psychiatric complication of childbirth affecting 10–20% of new mothers and has negative impact on both mother and infant. Serum lipid levels have been related to depressive disorders, but very limited literatures are available regarding the lipid levels in women with postpartum depression. The present study is aimed to examine the association of serum lipids with the development of postpartum depressive symptoms. This is a cross sectional study conducted at a tertiary care hospital in South India. Women who came for postpartum check-up at 6th week post-delivery were screened for PPD (September 2014-October 2015). Women with depressive symptoms were assessed using EPDS (Edinburgh Postnatal Depression Scale). The study involved 186 cases and 250 controls matched for age and BMI. Serum levels of lipid parameters were estimated through spectrophotometry and the atherogenic indices were calculated in all the subjects. Low serum levels of Total Cholesterol (TC) and High Density Lipoprotein cholesterol (HDL-c) were significantly low in PPD women with severe depressive symptoms. The study recorded a significant negative correlation between HDL-c and the EPDS score in PPD women (r = -0.140, p = 0.05). Interestingly, the study also observed a significant negative correlation between Body Mass Index (BMI) and EPDS scores in case group (r = -0.146, p = 0.047), whereas a positive correlation between the same in controls (r = 0.187, p = 0.004). Our study demonstrated that low levels of serum HDL-c is correlated with the development of severe depressive symptoms in postpartum women. Study highlights the role of lipids in the development of postpartum depressive symptoms. PMID:29444162

  19. Low serum levels of High-Density Lipoprotein cholesterol (HDL-c as an indicator for the development of severe postpartum depressive symptoms.

    Directory of Open Access Journals (Sweden)

    Raji Ramachandran Pillai

    Full Text Available Postpartum depression (PPD is a psychiatric complication of childbirth affecting 10-20% of new mothers and has negative impact on both mother and infant. Serum lipid levels have been related to depressive disorders, but very limited literatures are available regarding the lipid levels in women with postpartum depression. The present study is aimed to examine the association of serum lipids with the development of postpartum depressive symptoms. This is a cross sectional study conducted at a tertiary care hospital in South India. Women who came for postpartum check-up at 6th week post-delivery were screened for PPD (September 2014-October 2015. Women with depressive symptoms were assessed using EPDS (Edinburgh Postnatal Depression Scale. The study involved 186 cases and 250 controls matched for age and BMI. Serum levels of lipid parameters were estimated through spectrophotometry and the atherogenic indices were calculated in all the subjects. Low serum levels of Total Cholesterol (TC and High Density Lipoprotein cholesterol (HDL-c were significantly low in PPD women with severe depressive symptoms. The study recorded a significant negative correlation between HDL-c and the EPDS score in PPD women (r = -0.140, p = 0.05. Interestingly, the study also observed a significant negative correlation between Body Mass Index (BMI and EPDS scores in case group (r = -0.146, p = 0.047, whereas a positive correlation between the same in controls (r = 0.187, p = 0.004. Our study demonstrated that low levels of serum HDL-c is correlated with the development of severe depressive symptoms in postpartum women. Study highlights the role of lipids in the development of postpartum depressive symptoms.

  20. What Is Being Measured? A Comparison of Two Depressive Symptom Severity Instruments with a Depression Diagnosis in Low-Income High-Risk Mothers.

    Science.gov (United States)

    Yang, Jenny; Martinez, Maria; Schwartz, Todd A; Beeber, Linda

    2017-06-01

    Adequate assessment of depressive symptomatology is a necessary step toward decreasing income-related mental health treatment inequity. No studies have focused on comparing instruments used to detect depression in women from low-income backgrounds who are mothers of young children-a period of increased risk for depressive symptoms. To address this gap, two commonly used instruments (Center for Epidemiologic Studies Depression Scale [CES-D] and Hamilton Rating Scale for Depression [Hamilton]) were compared with a depression diagnosis (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [DSM-V]) in a sample (n = 251) of mothers from low-income backgrounds with children ranging from 1 to 54 months old. Diagnostic utility was examined in light of contextual factors associated with maternal depressive symptoms. In this sample, CES-D had better screening sensitivity and specificity than Hamilton. Our results suggest that Hamilton may underdiagnose cases of major depressive episodes (MDE) as defined by DSM-V among black and low-income mothers compared with CES-D. In addition, we identify items in CES-D, which do not contribute to alignment with DSM-V and are appropriate targets for future improvements. Our analysis identifies interpersonal relationships and mother's age as the primary risk factors, which differentiate between CES-D and Hamilton determinations versus MDE diagnosis. In addition, we find regional differences in CES-D and Hamilton. It is important to tailor the measure to the context, and a calibration sample should be considered for studies of sufficient size.

  1. Comparison of effects of bright light therapy alone or combined with fluoxetine on severity of depression, circadian rhythms, mood disturbance, and sleep quality, in patients with non-seasonal depression

    Directory of Open Access Journals (Sweden)

    Ağargün MY

    2013-06-01

    Full Text Available Mehmet Yücel Agargün,1 Gokben Hizli Sayar,2 Hüseyin Bulut,3 Oguz Tan21Medipol University, Department of Psychiatry, Istanbul, Turkey; 2Uskudar University, Neuropsychiatry Istanbul Hospital, Istanbul, Turkey; 3Büyükçekmece Government Hospital, Department of Psychiatry, Istanbul, TurkeyPurpose: To compare effects of bright light therapy (BLT alone or combined with the selective serotonin reuptake inhibitor (SSRI fluoxetine, on severity of depression, circadian rhythms, mood disturbance, and sleep quality, in patients with non-seasonal depression.Patients and methods: Drug-free patients who were administered 10,000 lux of BLT for 30 minutes for 7 days comprised the BLT group (n = 7, while patients who started fluoxetine as an add-on treatment day comprised the SSRI + BLT group (n = 8. The primary outcomes were severity of depression, measured using the Hamilton Depression Rating Scale (HAM-D and the Beck Depression Inventory (BDI; chronotype, measured using the Morningness Eveningness Questionnaire (MEQ; mood disturbance, measured using the Profile of Mood States (POMS survey; and sleep quality, measured using the Pittsburgh Sleep Quality Index (PSQI, before and after treatment in both groups.Results: All patients completed the study, and none reported obvious side effects. The mean onset age of depression was 26.1 years ± 5.3 years in the BLT group and 27 years ± 9.5 years in the SSRI + BLT group (P = 0.425. The number of past depressive episodes was 1.29 ± 0.76 in the BLT group, and 1.5 ± 0.8 in the SSRI + BLT group (P = 0.427. The difference between pre- and posttreatment scores revealed no significant difference between groups for the HAM-D scale, BDI, MEQ, POMS survey, and the PSQI.Conclusion: This study suggests that BLT is effective with respect to the severity of depression, circadian rhythms, mood disturbance, and sleep quality, in non-seasonal depression. However, there was no evidence in favor of adjunctive fluoxetine with BLT

  2. Intimate Partner Violence and Depression Symptom Severity among South African Women during Pregnancy and Postpartum: Population-Based Prospective Cohort Study.

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    Alexander C Tsai

    2016-01-01

    Full Text Available Violence against women by intimate partners remains unacceptably common worldwide. The evidence base for the assumed psychological impacts of intimate partner violence (IPV is derived primarily from studies conducted in high-income countries. A recently published systematic review identified 13 studies linking IPV to incident depression, none of which were conducted in sub-Saharan Africa. To address this gap in the literature, we analyzed longitudinal data collected during the course of a 3-y cluster-randomized trial with the aim of estimating the association between IPV and depression symptom severity.We conducted a secondary analysis of population-based, longitudinal data collected from 1,238 pregnant women during a 3-y cluster-randomized trial of a home visiting intervention in Cape Town, South Africa. Surveys were conducted at baseline, 6 mo, 18 mo, and 36 mo (85% retention. The primary explanatory variable of interest was exposure to four types of physical IPV in the past year. Depression symptom severity was measured using the Xhosa version of the ten-item Edinburgh Postnatal Depression Scale. In a pooled cross-sectional multivariable regression model adjusting for potentially confounding time-fixed and time-varying covariates, lagged IPV intensity had a statistically significant association with depression symptom severity (regression coefficient b = 1.04; 95% CI, 0.61-1.47, with estimates from a quantile regression model showing greater adverse impacts at the upper end of the conditional depression distribution. Fitting a fixed effects regression model accounting for all time-invariant confounding (e.g., history of childhood sexual abuse yielded similar findings (b = 1.54; 95% CI, 1.13-1.96. The magnitudes of the coefficients indicated that a one-standard-deviation increase in IPV intensity was associated with a 12.3% relative increase in depression symptom severity over the same time period. The most important limitations of our study

  3. Is the beck anxiety inventory a good tool to assess the severity of anxiety? A primary care study in The Netherlands study of depression and anxiety (NESDA

    Directory of Open Access Journals (Sweden)

    van der Feltz-Cornelis Christina M

    2011-07-01

    Full Text Available Abstract Background Appropriate management of anxiety disorders in primary care requires clinical assessment and monitoring of the severity of the anxiety. This study focuses on the Beck Anxiety Inventory (BAI as a severity indicator for anxiety in primary care patients with different anxiety disorders (social phobia, panic disorder with or without agoraphobia, agoraphobia or generalized anxiety disorder, depressive disorders or no disorder (controls. Methods Participants were 1601 primary care patients participating in the Netherlands Study of Depression and Anxiety (NESDA. Regression analyses were used to compare the mean BAI scores of the different diagnostic groups and to correct for age and gender. Results Patients with any anxiety disorder had a significantly higher mean score than the controls. A significantly higher score was found for patients with panic disorder and agoraphobia compared to patients with agoraphobia only or social phobia only. BAI scores in patients with an anxiety disorder with a co-morbid anxiety disorder and in patients with an anxiety disorder with a co-morbid depressive disorder were significantly higher than BAI scores in patients with an anxiety disorder alone or patients with a depressive disorder alone. Depressed and anxious patients did not differ significantly in their mean scores. Conclusions The results suggest that the BAI may be used as a severity indicator of anxiety in primary care patients with different anxiety disorders. However, because the instrument seems to reflect the severity of depression as well, it is not a suitable instrument to discriminate between anxiety and depression in a primary care population.

  4. Has the symptom severity inclusion requirement narrowed the definition of major depressive disorder in antidepressant efficacy trials?

    Science.gov (United States)

    Zimmerman, Mark; Walsh, Emily; Chelminski, Iwona; Dalrymple, Kristy

    2017-03-15

    The inclusion criteria of all placebo-controlled studies of antidepressants have required a minimum level of severity on standardized measures of symptoms of depression. In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project we examined the association between scores on the Hamilton Depression Rating Scale (HAMD) and the number of criteria met for MDD, as well as the impact of different HAMD cutoff scores on the distribution of the number of DSM-IV criteria met. We speculated that the use of a minimum symptom severity score (MSSS) for inclusion in an antidepressant efficacy trial (AETs) disproportionately excludes patients who are at or just above the diagnostic threshold for MDD, whereas patients who are well above the diagnostic threshold are not excluded. Seven hundred forty outpatients with current MDD were evaluated with a semi-structured diagnostic interview. We compared the distribution of DSM-IV MDD criteria scores in patients who scored at or above or below the 3 cutoff scores on the HAMD most commonly used for inclusion in an AET. The distribution of the number of DSM-IV MDD symptom criteria met was significantly associated with HAMD scores. Compared to patients scoring below 18 on the HAMD the patients scoring 18 and above were less likely to report 5 MDD criteria (13.9% vs. 43.7%, χ 2 =82.2, pconducted in a single outpatient practice in which the majority of patients were white, female, and had health insurance. Although the study was limited to a single site, a strength of the recruitment procedure was that the sample was not selected for participation in a treatment study, and exclusion and inclusion criteria did not reduce the representativeness of the patient groups. While there is not a perfect relationship between the HAMD score and the number of DSM MDD criteria present, the results of the current study suggest that HAMD scores can be thought of as a proxy for the number of DSM

  5. Persistent CSF but not Plasma HIV RNA, is Associated with Increased Risk of New-onset Moderate-to-Severe Depressive Symptoms; A Prospective Cohort Study

    Science.gov (United States)

    Hammond, Edward R.; Crum, Rosa M.; Treisman, Glenn J.; Mehta, Shruti H.; Clifford, David B.; Ellis, Ronald J.; Gelman, Benjamin B.; Grant, Igor; Letendre, Scott L.; Marra, Christina M; Morgello, Susan; Simpson, David M.; McArthur, Justin C.

    2016-01-01

    Major depressive disorder is the most common neuropsychiatric complication in human immunodeficiency virus (HIV) infections and is associated with worse clinical outcomes. We determined if detectable cerebrospinal fluid (CSF) HIV ribonucleic acid (RNA) at threshold ≥50 copies/ml is associated with increased risk of depression. The CNS HIV Anti-Retroviral Therapy Effects Research (CHARTER) cohort is a six-center US-based prospective cohort with bi-annual follow-up 674 participants. We fit linear mixed models (N=233) and discrete-time survival models (N=154; 832 observations), to evaluate trajectories of Beck Depression Inventory (BDI) II scores, and the incidence of new-onset moderate-to-severe depressive symptoms (BDI≥17) among participants, on combination antiretroviral therapy (cART), who were free of depression at study entry, and received a minimum of three CSF examinations over 2,496 person-months follow-up. Detectable CSF HIV RNA (threshold ≥50 copies/ml) at any visit was associated with a 4.7-fold increase in new-onset depression at subsequent visits adjusted for plasma HIV RNA and treatment adherence; hazard ratio (HR)=4.76, (95% CI: 1.58–14.3); P=0.006. Depression (BDI) scores were 2.53 points higher (95% CI: 0.47–4.60; P=0.02) over 6 months if CSF HIV RNA was detectable at a prior study visit in fully adjusted models including age, sex, race, education, plasma HIV RNA, duration and adherence of cART, and lifetime depression diagnosis by DSM-IV criteria. Persistent CSF but not plasma HIV RNA, is associated with an increased risk for new-onset depression. Further research evaluating the role of immune activation and inflammatory markers may improve our understanding of this association. PMID:26727907

  6. Relationship Between Adenosine - Induced ST Segment Depression During 99mTc-MIBI Scintigraphy and The Severity of Coronary Artery Disease

    International Nuclear Information System (INIS)

    Cho, Jung Ah; Choi, Jung Il; Kwak, Dong Suk

    1994-01-01

    Pharmacologic coronary vasodilation in conjunction with myocardial perfusion scintigraphy has become an alternative to dynamic exercise test for the diagnosis and risk stratification of coronary artery disease, especially in patients who are unable to perform adequate exercise. Dipyridamole and adenosine have been used for pharmacologic stress testing with myocardial perfusion imaging. Adenosine is a potent, coronary vasodilator with rapid onset of action, short half life, near maximal coronary vasodilation and less serious side effects. ST segment depression has been reported in about 7-15% of patients with coronary artery disease receiving dipyridamole in conjunction with myocardial perfusion imaging. The exact cause and clinical significance are not known. In order to evaluate the relationship between adenosine-induced ST segment depression during 99m Tc-MIBI myocardial perfusion scintigraphy and the severity of coronary artery disease, we performed 99m -MIBI imaging after intravenous infusion of adenosine in 120 patients with suspected coronary artery disease. Of the 120 patients, 28 also performed coronary angiography. There were 24 patients with ST segment depression during 99m Tc-MIIBI scintigraphy and 96 patients without ST segment depression. Adenosine was infused intravenously at a dose of 0.14 mg/kg per minute for 6 minutes and 99 MmTc-MIB1 was injected at 3 minute. We then compared the hemodynamic changes, side effects, scintigraphic and angiographic findings. Heart rate increased 90 ± 19 beats/minute in the group with ST depression compared with 80 ±16 beats/minute in the group without ST depression(p 9m Tc-MIBI images were abnormal in 23(96%) patients with ST segment depression and 66(69%) patients without ST segment depression(p 99m Tc-MIBI myocardial perfusion scintigraphy with intravenous adenosine is related to the severity of coronary artery disease.

  7. 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 ...

  8. 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 ...

  9. Predicting depression from illness severity in cardiovascular disease patients: self-efficacy beliefs, illness perception, and perceived social support as mediators.

    Science.gov (United States)

    Greco, A; Steca, P; Pozzi, R; Monzani, D; D'Addario, M; Villani, A; Rella, V; Giglio, A; Malfatto, G; Parati, G

    2014-04-01

    Many studies have investigated the relationships between cardiovascular diseases and patients' depression; nevertheless, few is still known as regard the impact of illness severity on depression and whether psychosocial variables mediate this association. The aim of this study is to investigate the putative mediating role of illness representations, self-efficacy beliefs, and perceived social support on the relationship between illness severity and depression. A total of 75 consecutive patients with cardiovascular disease (80 % men; mean age = 65.44, SD = 10.20) were enrolled in an Italian hospital. Illness severity was measured in terms of left ventricular ejection fraction, whereas psychological factors were assessed using self-report questionnaires. The relationship between left ventricular ejection fraction and depression was mediated by identity illness perception, self-efficacy beliefs in managing cardiac risk factors, and perceived social support. The treatment of depression in cardiovascular disease patients may therefore benefit from a psychological intervention focused on patients' illness representations, self-efficacy beliefs, and their perceived social support.

  10. The Healthy Activity Program (HAP), a lay counsellor-delivered brief psychological treatment for severe depression, in primary care in India: a randomised controlled trial.

    Science.gov (United States)

    Patel, Vikram; Weobong, Benedict; Weiss, Helen A; Anand, Arpita; Bhat, Bhargav; Katti, Basavraj; Dimidjian, Sona; Araya, Ricardo; Hollon, Steve D; King, Michael; Vijayakumar, Lakshmi; Park, A-La; McDaid, David; Wilson, Terry; Velleman, Richard; Kirkwood, Betty R; Fairburn, Christopher G

    2017-01-14

    Although structured psychological treatments are recommended as first-line interventions for depression, only a small fraction of people globally receive these treatments because of poor access in routine primary care. We assessed the effectiveness and cost-effectiveness of a brief psychological treatment (Healthy Activity Program [HAP]) for delivery by lay counsellors to patients with moderately severe to severe depression in primary health-care settings. In this randomised controlled trial, we recruited participants aged 18-65 years scoring more than 14 on the Patient Health Questionnaire 9 (PHQ-9) indicating moderately severe to severe depression from ten primary health centres in Goa, India. Pregnant women or patients who needed urgent medical attention or were unable to communicate clearly were not eligible. Participants were randomly allocated (1:1) to enhanced usual care (EUC) alone or EUC combined with HAP in randomly sized blocks (block size four to six [two to four for men]), stratified by primary health centre and sex, and allocation was concealed with use of sequential numbered opaque envelopes. Physicians providing EUC were masked. Primary outcomes were depression symptom severity on the Beck Depression Inventory version II and remission from depression (PHQ-9 score of better results than did EUC alone for the secondary outcomes of disability (adjusted mean difference -2·73 [-4·39 to -1·06]; p=0·001), days out of work (-2·29 [-3·84 to -0·73]; p=0·004), intimate partner physical violence in women (0·53 [0·29-0·96]; p=0·04), behavioural activation (2·17 [1·34-3·00]; pbetter than EUC alone was for patients with moderately severe to severe depression in routine primary care in Goa, India. HAP was readily accepted by this previously untreated population and was cost-effective in this setting. HAP could be a key strategy to reduce the treatment gap for depressive disorders, the leading mental health disorder worldwide. Wellcome Trust

  11. Measuring Severity of Anxiety and Depression in Patients with Inflammatory Bowel Disease: Low Concordance Between Patients and Male Gastroenterologists.

    Science.gov (United States)

    Janmohamed, Neha; Steinhart, A Hillary

    2017-07-01

    Studies have indicated that anxiety and depression are significant contributors to reporting of increased disease activity in patients with inflammatory bowel disease (IBD). Thus, for the appropriate clinical management of these patients, it is important that gastroenterologists are able to recognize these conditions. This study aimed to examine the level of agreement between gastroenterologists and patients with IBD for the presence of clinically significant anxiety and depression. Before consultation, patients completed the Hospital Anxiety and Depression Survey. After the consultation, the gastroenterologist recorded whether they believed the patient was anxious and depressed and if so, whether any further action had been taken. Seventy-five patients participated in this study, with a response rate of 88%. Self-reported questionnaires indicated that 31% and 11% of patients were identified as probable for having anxiety and depression, respectively. The level of agreement between the patient and gastroenterologist as to the presence of anxiety or depression was fair to moderate (kappa statistic 0.32 and 0.41, respectively). In only 50% of cases was further action taken by gastroenterologists during consultation for distressed patients, mostly in the form of a patient discussion. Agreement between gastroenterologists and IBD patients regarding the presence of clinically significant anxiety or depression was low, with no further action taken after consultation for 50% of patients who were identified by gastroenterologists as being anxious or depressed. This study highlights the need for educating gastroenterologists to improve their ability to identify IBD patient distress.

  12. The effects of co-morbidity in defining major depression subtypes associated with long-term course and severity.

    Science.gov (United States)

    Wardenaar, K J; van Loo, H M; Cai, T; Fava, M; Gruber, M J; Li, J; de Jonge, P; Nierenberg, A A; Petukhova, M V; Rose, S; Sampson, N A; Schoevers, R A; Wilcox, M A; Alonso, J; Bromet, E J; Bunting, B; Florescu, S E; Fukao, A; Gureje, O; Hu, C; Huang, Y Q; Karam, A N; Levinson, D; Medina Mora, M E; Posada-Villa, J; Scott, K M; Taib, N I; Viana, M C; Xavier, M; Zarkov, Z; Kessler, R C

    2014-11-01

    Although variation in the long-term course of major depressive disorder (MDD) is not strongly predicted by existing symptom subtype distinctions, recent research suggests that prediction can be improved by using machine learning methods. However, it is not known whether these distinctions can be refined by added information about co-morbid conditions. The current report presents results on this question. Data came from 8261 respondents with lifetime DSM-IV MDD in the World Health Organization (WHO) World Mental Health (WMH) Surveys. Outcomes included four retrospectively reported measures of persistence/severity of course (years in episode; years in chronic episodes; hospitalization for MDD; disability due to MDD). Machine learning methods (regression tree analysis; lasso, ridge and elastic net penalized regression) followed by k-means cluster analysis were used to augment previously detected subtypes with information about prior co-morbidity to predict these outcomes. Predicted values were strongly correlated across outcomes. Cluster analysis of predicted values found three clusters with consistently high, intermediate or low values. The high-risk cluster (32.4% of cases) accounted for 56.6-72.9% of high persistence, high chronicity, hospitalization and disability. This high-risk cluster had both higher sensitivity and likelihood ratio positive (LR+; relative proportions of cases in the high-risk cluster versus other clusters having the adverse outcomes) than in a parallel analysis that excluded measures of co-morbidity as predictors. Although the results using the retrospective data reported here suggest that useful MDD subtyping distinctions can be made with machine learning and clustering across multiple indicators of illness persistence/severity, replication with prospective data is needed to confirm this preliminary conclusion.

  13. Effectiveness of a discharge education program in reducing the severity of postpartum depression: a randomized controlled evaluation study.

    Science.gov (United States)

    Ho, Shiao-Ming; Heh, Shu-Shya; Jevitt, Cecilia M; Huang, Lian-Hua; Fu, Yu-Ying; Wang, Li-Lin

    2009-10-01

    The effectiveness of a hospital discharge education program including information on postnatal depression was evaluated to reduce psychological morbidity after childbirth. A randomized controlled trial (RCT) was conducted in a regional hospital in Taipei. Two hundred first-time mothers agreed to take part and were randomly allocated to an intervention group (n=100) or control group (n=100). The intervention group received discharge education on postnatal depression provided by postpartum ward nurses. The control group received general postpartum education. The main outcome measure was the Edinburgh Postnatal Depression Scale (EPDS) administered by postal questionnaire at six weeks and three months after delivery. Women who received discharge education intervention on postnatal depression were less likely to have high depression scores when compared to the control group at three months postpartum. A discharge educational intervention including postnatal depression information given to women during the postpartum stay benefits psychological well-being. A postpartum discharge education program including information on postnatal depression should be integrated into postpartum discharge care in general practice. 2009 Elsevier Ireland Ltd.

  14. Effect of variation in BDNF Val(66)Met polymorphism, smoking, and nicotine dependence on symptom severity of depressive and anxiety disorders

    NARCIS (Netherlands)

    Jamal, Mumtaz; Van der Does, Willem; Penninx, Brenda W. J. H.

    2015-01-01

    Background: Smoking, especially nicotine dependence is associated with more severe symptoms of depression and anxiety disorders. However, the mechanisms underlying this association are unclear. We investigated the effect of brain-derived neurotrophic factor (BDNF) VaI(66)Met polymorphism on the

  15. Does depression influence symptom severity in irritable bowel syndrome? Case study of a patient with irritable bowel syndrome and bipolar disorder.

    Science.gov (United States)

    Crane, Catherine; Martin, Maryanne; Johnston, Derek; Goodwin, Guy M

    2003-01-01

    Irritable bowel syndrome (IBS) is frequently associated with mood disorder. However, it is typically difficult to distinguish between disturbed mood as a causal agent and disturbed mood as a consequence of the experience of IBS. This report considers the association between mood and symptom severity in a patient with diarrhea-predominant IBS and stable, rapid cycling bipolar disorder with a predominantly depressive course. Such a case provides an important opportunity to determine the direction of the relationship between mood and IBS symptom severity because the fluctuations of mood in bipolar disorder are assumed to be driven largely by biological, rather than psychosocial, processes. The study was carried out prospectively, with ratings of mood and IBS symptom severity made daily by the patient for a period of almost 12 months. The patient experienced regular and substantial changes in mood as well as fluctuations in the level of IBS symptoms during the study period. Contrary to expectation, the correlation between mood and IBS symptom severity on the same day suggested that the patient experienced less severe IBS symptoms during periods of more severe depression. However, time series analysis revealed no significant association between these two processes when serial dependence within each series was controlled for. The unusual co-occurrence of IBS with bipolar disorder provides direct evidence to indicate that depression does not necessarily lead to an increase in the reported severity of IBS, at least in the context of bipolar disorder, and may under certain circumstances actually be associated with a reduction in the severity of IBS symptoms. Factors that might moderate the relationship between depression and symptom severity are discussed.

  16. Night-eating syndrome and the severity of self-reported depressive symptoms from the Korea Nurses' Health Study: analysis of propensity score matching and ordinal regression.

    Science.gov (United States)

    Kim, O-S; Kim, M S; Lee, J E; Jung, H

    2016-12-01

    The prevalence of night-eating syndrome (NES) and depression is increasing worldwide. Although nurses, in particular, are exposed to work in an environment of irregular eating, shift work, and stressful settings, limited research exist. In fact, the prevalence of NES among Korean nurses has never been reported. The aim of this study was to determine the prevalence of NES as well as the association between NES and severity of self-reported depressive symptoms among South Korean female nurses. The Korea Nurses' Health Study, following the protocols of the Nurses' Health Study led by the Harvard University, collected data on Korean female nurses. Survey responses from 3617 participants were included, and 404 responses were analyzed in this cross-sectional study using propensity score matching. Descriptive, Spearman's and Cramer's correlations, propensity score matching, and multivariable ordinal logistic regression were conducted as statistical analysis. The prevalence of both NES and self-reported depressive symptoms among Korean female nurses were higher compared with nurses in prior studies. Nurses with NES were 1.65 times more likely to have greater severity of depressive symptoms than those without NES (95% confidence interval [1.19-2.10], odds ratio = 1.65) after adjusting for covariates including sociodemographic characteristics, health behavioural factors, and shift work. This study suggests significant association between NES and the severity of self-reported depressive symptoms among Korean female nurses after adjusting for covariates. Policy makers and hospital managers need to develop strategies to reduce depression and NES among nurses for enhancement of nurses' mental and physical health as well as for improvement of care quality. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  17. Comprehensive eight-month intervention reduces weight and improves depression and anxiety levels in severe and morbid obesity

    Directory of Open Access Journals (Sweden)

    Alfonso Cofre-Lizama

    2017-04-01

    Conclusion: The comprehensive eight-month intervention had significant benefits for participants in weight loss and improved levels of anxiety and depression. For this reason, the intervention performed may be recommended for the treatment of this condition.

  18. The relationship of Internet addiction severity with Attention Deficit Hyperactivity Disorder symptoms in Turkish University students; impact of personality traits, depression and anxiety.

    Science.gov (United States)

    Dalbudak, Ercan; Evren, Cuneyt

    2014-04-01

    The aim of this study was to investigate the relationship of Internet addiction (IA) with Attention Deficit Hyperactivity Disorder (ADHD) symptoms while controlling the effect of personality traits, depression and anxiety symptoms in Turkish university students. A total of 271 university students participated in the present study. The students were assessed through the Internet Addiction Scale (IAS), the Wender Utah Rating Short Scale (WURS-25), the Turkish version of the Adult ADHD Self-Report Scale (ASRS), the Eysenck Personality Questionnaire Revised Abbreviated Form (EPQR-A), the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). According to IAS, participants were separated into three groups, namely, moderate/high, mild and without IA groups. The rates of groups were 19.9% (n=54), 38.7% (n=105) and 41.3% (n=112), respectively. Correlation analyses revealed that the severity of IAS is positively correlated with WURS-25, ASRS (total, inattention and hyperactivity/impulsivity subscales), neuroticism personality trait, depression and anxiety scores, whereas it is negatively correlated with extraversion personality trait. Hierarchical regression analysis indicated that depression and anxiety symptoms, introversion and neuroticism personality traits and the severity of ADHD symptoms (particularly hyperactivity/impulsivity symptoms) are the predictors for IAS score, respectively. The severity of ADHD symptoms has predicted the severity of IA even after controlling the effect of personality traits, depression and anxiety symptoms among Turkish university students. University students with severe ADHD symptoms, particularly hyperactivity/impulsivity symptoms may be considered as a risk group for IA. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. The Relation of Personality Traits Wth Depression Severity in Active and Non-Active Elderly Women in Tehran City

    OpenAIRE

    Mohammad Ali Aslankhani; Ahmad Farokhi; Parvane Shamsipour Dehkordi; Amir Shams; Mohammad Reza Ghasemian Moghaddam

    2010-01-01

    Objectives: The purpose of this study was to investigate the relation of personality traits with depression in active and non – active elderly women in Tehran city. Methods & Materials: The present research is descriptive–correlation. For this purpose, 188 elderly women (94 active and 94 non - active elders) in the age range of 63-82 in Tehran city availably selected as statistical sample. Measurement instrument were demographic questionnaire, Beck depression questionnaire and...

  20. The Relation of Personality Traits Wth Depression Severity in Active and Non-Active Elderly Women in Tehran City

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Aslankhani

    2010-07-01

    Full Text Available Objectives: The purpose of this study was to investigate the relation of personality traits with depression in active and non – active elderly women in Tehran city. Methods & Materials: The present research is descriptive–correlation. For this purpose, 188 elderly women (94 active and 94 non - active elders in the age range of 63-82 in Tehran city availably selected as statistical sample. Measurement instrument were demographic questionnaire, Beck depression questionnaire and NEO personality traits questionnaire. Data were analyzed using descriptive statistic (mean and standard deviation and inferential statistic (independent t test, Pearson correlation and Enter multi variant Regression. Results: Results showed that there was significant difference in personality traits and depression between active women with non-active women elders (P<0.05. Also, the result showed that significant correlation between depression score on neuroticism, extroversion, openness and conscientiousness in active women elders and conscientiousness and openness in non-active women elders (P<0.05. The results of multi variant regression also indicated that openness and extroversion variants in active elders and conscientiousness variant in non-active elders have linear relationship with criteria variant (depression and can predict its changes. Conclusion: Based on results of present research, sport and physical activity can be afforded the increase of positive personality traits (for example extroversion and openness and decrease of depression in women elders.

  1. Prefrontal cortex activation is associated with a discrepancy between self- and observer-rated depression severities of major depressive disorder: a multichannel near-infrared spectroscopy study.

    Science.gov (United States)

    Akashi, Hiroyuki; Tsujii, Noa; Mikawa, Wakako; Adachi, Toru; Kirime, Eiji; Shirakawa, Osamu

    2015-03-15

    Studies on major depressive disorder (MDD) show that the degree of correlation between the Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HAMD) varies widely. We aimed to determine whether this discrepancy reflects specific functional abnormalities in the frontotemporal cortex. Mildly depressed or euthymic patients with MDD (n=52), including 21 patients with MDD with the discrepancy, i.e., those with low HAMD17 scores (≤13) but high BDI-II scores (>28), and 31 patients without the discrepancy, i.e., those with low HAMD17 scores and low BDI-II scores (≤28), participated in the study along with 48 control subjects. Regional changes of oxygenated hemoglobin (oxy-Hb) levels during a verbal fluency task (VFT) were monitored using a 52-channel near-infrared spectroscopy (NIRS) device. In the frontotemporal regions, mean oxy-Hb changes induced by the VFT were significantly smaller in patients with MDD than in control subjects. In 5 channels within frontal regions, the increase in mean oxy-Hb levels was significantly greater in MDD patients with the BDI-HAMD discrepancy than in those without the discrepancy. In 6 channels within the frontal region of the patients with MDD, significant positive correlations were observed between mean oxy-Hb changes and BDI total scores (ρ=0.38-0.59; Pdepressed patients, particularly those with melancholia. The distinct pattern of activation of the prefrontal cortex suggests that MDD with the BDI-HAMD discrepancy is pathophysiologically different from MDD without the discrepancy. Copyright © 2014 Elsevier B.V. All rights reserved.

  2. The comparison of severity and prevalence of major depressive disorder, general anxiety disorder and eating disorders before and after bariatric surgery.

    Science.gov (United States)

    Matini, Diana; Ghanbari Jolfaei, Atefeh; Pazouki, Abdolreza; Pishgahroudsari, Mohadeseh; Ehtesham, Mehdi

    2014-01-01

    Severe obesity is highly co-morbid with psychiatric disorders and may have effect on the quality of life. This study aimed to compare severity and prevalence rate of depression, anxiety and eating disorders and quality of life in severe obese patients before and 6 months after the gastric bypass surgery. This was a prospective observational study which conducted at Hazarat Rasool-Akram Hospital in Tehran, 2012. Questionnaires included demographic questions, eating disorder Inventory (EDI), The Short Form Health Survey (SF-36) for quality of life, Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I) and Hamilton Rating Scale for Depression (HRSD) and anxiety (HRSA). Participants were interviewed two times, before surgery and six months after, to determine changes of the disorders. Patients with the history of bariatric surgery, individuals younger than 18 year old and those who disagreed to join the study were excluded. In assessing the eating disorder inventory-3rd version (EDI-3), Significant reduction in drive for thinness (DT) (p= 0.010), bulimia (B) (pdepression in HRSD (p= 0.311), prevalence of depression (p= 0.189) and prevalence of general anxiety disorder according to SCID (p=0.167) did not differ significantly, at this period. Although weight loss after bariatric surgery improved the physical component of quality of life, this improvement did not affect the mental aspect of life, depression and anxiety and it seems that these psychopathologies need attention and treatment in addition to weight loss treatments in patients with obesity.

  3. How is a specialist depression service effective for persistent moderate to severe depressive disorder?: a qualitative study of service user experience.

    Science.gov (United States)

    Thomson, Louise; Barker, Marcus; Kaylor-Hughes, Catherine; Garland, Anne; Ramana, Rajini; Morriss, Richard; Hammond, Emily; Hopkins, Gail; Simpson, Sandra

    2018-06-15

    A specialist depression service (SDS) offering collaborative pharmacological and cognitive behaviour therapy treatment for persistent depressive disorder showed effectiveness against depression symptoms versus usual community based multidisciplinary care in a randomised controlled trial (RCT) in specialist mental health services in England. However, there is uncertainty concerning how specialist depression services effect such change. The current study aimed to evaluate the factors which may explain the greater effectiveness of SDS compared to Treatment as Usual (TAU) by exploring the experience of the RCT participants. Qualitative audiotaped and transcribed semi-structured interviews were conducted 12-18 months after baseline with 21 service users (12 SDS, 9 TAU arms) drawn from all three sites. Inductive thematic analysis using a grounded approach contrasted the experiences of SDS with TAU participants. Four themes emerged in relation to service user experience: 1. Specific treatment components of the SDS: which included sub-themes of the management of medication change, explaining and developing treatment strategies, setting realistic expectations, and person-centred and holistic approach; 2. Individual qualities of SDS clinicians; 3. Collaborative team context in SDS: which included sub-themes of communication between healthcare professionals, and continuity of team members; 4. Accessibility to SDS: which included sub-themes of flexibility of locations, frequent consultation as reinforcement, gradual pace of treatment, and challenges of returning to usual care. The study uncovered important mechanisms and contextual factors in the SDS that service users experience as different from TAU, and which may explain the greater effectiveness of the SDS: the technical expertise of the healthcare professionals, personal qualities of clinicians, teamwork, gradual pace of care, accessibility and managing service transitions. Usual care in other specialist mental health

  4. Evaluating the efficacy of mixture of Boswellia carterii, Zingiber officinale, and Achillea millefolium on severity of symptoms, anxiety, and depression in irritable bowel syndrome patients.

    Science.gov (United States)

    Kazemian, Afarin; Toghiani, Ali; Shafiei, Katayoun; Afshar, Hamid; Rafiei, Rahmatollah; Memari, Mahnaz; Adibi, Peyman

    2017-01-01

    Irritable bowel syndrome (IBS) is the most prevalent functional gastrointestinal disorders (FGIDs) that affects in different aspects of life and patients experienced depression and anxiety more than others. There are several herbal medicines with positive effects in these patients. The aim of this study is to evaluate the effects of mixture of Boswellia carterii , Zingiber officinale , and Achillea Millefolium on severity of symptoms, anxiety, and depression in IBS patients. This clinical trial study was done in sixty IBS patients (with mild-to-moderate symptoms) divided into two case and control groups. Patients were assessed at the beginning, 1 month, and 3 months after by IBS-severity scoring system (IBS-SSS) and Hospital Anxiety and Depression Scale. IBS-SSS is used for quality of life evaluation too. Sixty IBS patients (with mild to moderate symptoms) with a mean age of 38.75 ± 11.74 participated that 55.4% of cases and 72.8% of controls were men. The most prevalent type of IBS was the mixed type of IBS. The mean score of abdominal pain severity and frequency, bloating score, and depression and anxiety score were decreased in patients administered herbal medication, but changes in these variables in controls were not statistically significant. The changes in quality of life score between cases and controls were significant in men ( P = 0.01) although it was not significant in women. A mixture of B. Carterii , Z. officinale , and A. millefolium is effective in eliminating IBS symptoms and its related depression and anxiety and using herbal medicine in IBS treatment is suggested.

  5. Dietary patterns, their covariates, and associations with severity of depressive symptoms among university students in Lebanon: a cross-sectional study.

    Science.gov (United States)

    Jaalouk, Doris; Matar Boumosleh, Jocelyne; Helou, Lea; Abou Jaoude, Maya

    2018-01-19

    The study aims to identify dietary patterns in university students in Lebanon, to determine their associations with socio-demographic, lifestyle, and stress factors, and to assess the link between identified dietary patterns and severity of depressive symptoms, controlling for multiple confounders. Four hundred and fifty-seven private university students were surveyed. Information about dietary intake, socio-demographic and lifestyle factors, physical activity, and depressive symptoms were collected by the 73-item food frequency questionnaire, background questionnaire, International Physical Activity Questionnaire-Short Form, and Patient Health Questionnaire (PHQ-9), respectively. Dietary patterns were identified by exploratory factor analysis. Multiple linear regression analyses were conducted to (1) identify covariates that were independently associated with dietary patterns and (2) examine the independent associations between each of the dietary patterns and severity of depressive symptoms. Five dietary patterns were identified: "traditional Lebanese", "Western fast food", "dairy", "Lebanese fast food" and "fruits". Higher scores of traditional Lebanese and fruits patterns were found to be associated with more meals per day, frequent breakfast consumption, and non-smoking. Higher Western fast food diet scores were shown to be associated with male gender, fewer meals per day, less frequent breakfast consumption, more frequent snacking, and alcohol consumption. Higher scores of the dairy pattern were found to be positively associated with hypertension, non-smoking, and frequency of alcohol consumption. Higher Lebanese fast food pattern scores were found to be associated with higher frequency of meal intake while watching TV and alcohol consumption. None of the five dietary patterns showed a significant association with severity of depressive symptoms after controlling for confounders. Severity of depressive symptoms showed no independent association with the

  6. Evaluating the efficacy of mixture of Boswellia carterii, Zingiber officinale, and Achillea millefolium on severity of symptoms, anxiety, and depression in irritable bowel syndrome patients

    Directory of Open Access Journals (Sweden)

    Afarin Kazemian

    2017-01-01

    Full Text Available Background: Irritable bowel syndrome (IBS is the most prevalent functional gastrointestinal disorders (FGIDs that affects in different aspects of life and patients experienced depression and anxiety more than others. There are several herbal medicines with positive effects in these patients. The aim of this study is to evaluate the effects of mixture of Boswellia carterii, Zingiber officinale, and Achillea Millefolium on severity of symptoms, anxiety, and depression in IBS patients. Materials and Methods: This clinical trial study was done in sixty IBS patients (with mild-to-moderate symptoms divided into two case and control groups. Patients were assessed at the beginning, 1 month, and 3 months after by IBS-severity scoring system (IBS-SSS and Hospital Anxiety and Depression Scale. IBS-SSS is used for quality of life evaluation too. Results: Sixty IBS patients (with mild to moderate symptoms with a mean age of 38.75 ± 11.74 participated that 55.4% of cases and 72.8% of controls were men. The most prevalent type of IBS was the mixed type of IBS. The mean score of abdominal pain severity and frequency, bloating score, and depression and anxiety score were decreased in patients administered herbal medication, but changes in these variables in controls were not statistically significant. The changes in quality of life score between cases and controls were significant in men (P = 0.01 although it was not significant in women. Conclusion: A mixture of B. Carterii, Z. officinale, and A. millefolium is effective in eliminating IBS symptoms and its related depression and anxiety and using herbal medicine in IBS treatment is suggested.

  7. Long-term course of severe depression: late remission and recurrence may be found in a follow-up after 38-53 years

    Directory of Open Access Journals (Sweden)

    Lisa Crona

    2012-07-01

    Full Text Available This study is a follow-up of inpatients diagnosed with severe depression/melancholia between 1956 and 1969. During this period, all inpatients at the Department of Psychiatry, University Hospital, Lund, were rated on a multidimensional diagnostic schedule on discharge. There were 471 patients born from 1920 onward. In the present follow-up, 2006 to 2010, 169 survivors could be traced. They were asked to participate in the study involving a telephone interview, in which a structured life chart was used. Of the patients contacted, 16 were ill or confused and 3 did not remember ever being depressed, leaving 150 who could participate. Seventy-five of these agreed to participate in the study. Long-term course of depression was evaluated by cluster analysis and compared to background variables, such as heredity for depression, perceived parental rearing behaviour, and treatment of index depressive episode. Using a cluster analysis the patients could be separated into six clusters describing the course: i single or few episodes followed by long-lasting remission; ii single or few episodes followed by long-lasting remission, although shorter; iii single or few episodes followed by late recurrence; iv single or few episodes, but more frequently ill, followed by late recurrence; v several episodes followed by lasting remission; vi chronic course of episodes. Remission or recurrence could there- fore occur even after more than a decade. In summary, there was a short-term course with or without recurrence or a chronic course with or without late remission. Heredity for depression was significantly related to a chronic course with or without late remission.

  8. How does illness severity influence depression, health satisfaction and life satisfaction in patients with cardiovascular disease? The mediating role of illness perception and self-efficacy beliefs.

    Science.gov (United States)

    Steca, P; Greco, A; Monzani, D; Politi, A; Gestra, R; Ferrari, G; Malfatto, G; Parati, G

    2013-01-01

    Numerous empirical studies have investigated the relationships between cardiovascular diseases (CVD) and patients' psychological well-being, with a focus almost exclusively on its dark side. Very little is known on the impact of illness severity on both negative and positive indicators of patients' well-being, as well as on the psychosocial variables that may mediate this association. Aim of the study was to investigate the impact of illness severity on depression as well as on health satisfaction and life satisfaction of patients undergoing a cardiovascular rehabilitation. It also aimed at testing the mediation of illness perception and self-efficacy beliefs in managing cardiac risk factors. The study involved 172 patients (mean age = 66.43 years; SD = 9.99 years; 76.2% men). Illness severity was measured in terms of left ventricular ejection fraction at discharge from the cardiology department, whereas all psychological dimensions were assessed one week later. Results showed significant relationships among illness severity, depression and health satisfaction that were fully mediated by illness perception and self-efficacy beliefs, but not significant relation between disease severity and life satisfaction (χ2 (1) = 2.30, p = n.s.). Overall, findings underline the importance of working on illness perception and self-efficacy beliefs to contrast depression and to improve health and life satisfaction in patients with CVD.

  9. Older age, higher perceived disability and depressive symptoms predict the amount and severity of work-related difficulties in persons with multiple sclerosis.

    Science.gov (United States)

    Raggi, Alberto; Giovannetti, Ambra Mara; Schiavolin, Silvia; Brambilla, Laura; Brenna, Greta; Confalonieri, Paolo Agostino; Cortese, Francesca; Frangiamore, Rita; Leonardi, Matilde; Mantegazza, Renato Emilio; Moscatelli, Marco; Ponzio, Michela; Torri Clerici, Valentina; Zaratin, Paola; De Torres, Laura

    2018-04-16

    This cross-sectional study aims to identify the predictors of work-related difficulties in a sample of employed persons with multiple sclerosis as addressed with the Multiple Sclerosis Questionnaire for Job Difficulties. Hierarchical linear regression analysis was conducted to identify predictors of work difficulties: predictors included demographic variables (age, formal education), disease duration and severity, perceived disability and psychological variables (cognitive dysfunction, depression and anxiety). The targets were the questionnaire's overall score and its six subscales. A total of 177 participants (108 females, aged 21-63) were recruited. Age, perceived disability and depression were direct and significant predictors of the questionnaire total score, and the final model explained 43.7% of its variation. The models built on the questionnaire's subscales show that perceived disability and depression were direct and significant predictors of most of its subscales. Our results show that, among patients with multiple sclerosis, those who were older, with higher perceived disability and higher depression symptoms have more and more severe work-related difficulties. The Multiple Sclerosis Questionnaire for Job Difficulties can be fruitfully exploited to plan tailored actions to limit the likelihood of near-future job loss in persons of working age with multiple sclerosis. Implications for rehabilitation Difficulties with work are common among people with multiple sclerosis and are usually addressed in terms of unemployment or job loss. The Multiple Sclerosis Questionnaire for Job Difficulties is a disease-specific questionnaire developed to address the amount and severity of work-related difficulties. We found that work-related difficulties were associated to older age, higher perceived disability and depressive symptoms. Mental health issues and perceived disability should be consistently included in future research targeting work-related difficulties.

  10. Electroconvulsive therapy in a physically restrained man with comorbid major depression, severe agoraphobia with panic disorder, and histrionic personality disorder.

    Science.gov (United States)

    Rapinesi, Chiara; Serata, Daniele; Del Casale, Antonio; Kotzalidis, Giorgio D; Romano, Silvia; Milioni, Mara; Capezzuto, Silvia; Carbonetti, Paolo; Angeletti, Gloria; Fensore, Claudio; Tatarelli, Roberto; Girardi, Paolo

    2012-03-01

    A 36-year-old man with comorbid panic disorder with agoraphobia, major depression, and histrionic personality disorder since age 21 was resistant to combined drug and psychotherapy treatment. His conditions had progressively worsened with time, causing him to withdraw socially and to simultaneously require continuous physical restraint, which further worsened his functioning. He spent almost 3 consecutive years in restraint, until he consented to receive bilateral ECT treatment. He improved after 13 sessions in all areas (social and role functioning, and panic, depressive, and histrionic symptoms) and is well 3 months later with a lithium-atypical antipsychotic combination.

  11. Is it possible to evaluate true prophylactic efficacy of antidepressants in severely ill patients with recurrent depression?

    DEFF Research Database (Denmark)

    Licht, Rasmus W; Martiny, Klaus Per Juul

    2013-01-01

    BACKGROUND: We compared citalopram and clomipramine against placebo with respect to recurrence prevention as opposed to relapse prevention in patients with recurrent depression, independently of any acute response to the test drug(s). METHODS: Patients with recurrent depressive disorder...... and achieved sustained response. Out of these, only 59 patients (34%) could be randomised to placebo (n=22), citalopram (n=19) or clomipramine (n=22), with protocol violation and/or non-consent being the major reasons for non-randomisation. There were no between-group differences in outcome; almost half...

  12. High prevalence of moderate and severe depressive and anxiety symptoms in polycystic ovary syndrome: a systematic review and meta-analysis.

    Science.gov (United States)

    Cooney, Laura G; Lee, Iris; Sammel, Mary D; Dokras, Anuja

    2017-05-01

    Do women with polycystic ovary syndrome (PCOS) have an increased prevalence of moderate and severe depressive and anxiety symptoms compared with control women, and do these symptoms correlate with age, BMI, testosterone, hirsutism or insulin resistance (IR)? Women with PCOS have significantly increased odds of moderate and severe depressive and anxiety symptoms, independent of obesity, and the symptoms are weakly associated with age, BMI, elevated testosterone, hirsutism and IR. Previous studies have reported that women with PCOS have an increased prevalence of mild depressive and anxiety symptoms or an increase in mean depression and anxiety scores, although these scores are usually within the normal range. Thus, it is therefore not clear whether these findings are clinically significant. The prevalence of moderate and severe depressive and anxiety symptoms, which require follow-up and would benefit from treatment, is not known in this population. A comprehensive systematic review (SR) was performed up to January 2016 and included 30 cross-sectional studies, representing 3050 subjects with PCOS and 3858 controls, from 10 different countries. The meta-analysis (MA) on depressive symptoms included 18 studies and the MA on anxiety symptoms included 9 studies. A separate SR identified 15 studies for the meta-regression examining the associations with PCOS-related symptoms or comorbidities. All studies included adult women with PCOS, defined by the National Institutes of Health or Rotterdam criteria, and a control group without PCOS. Ovid, Embase, PsychInfo and Cochrane were searched up to January 2016. Included studies used a validated screening tool to compare the prevalence or mean scores of depressive and/or anxiety symptoms. Random effects MA was used to estimate the pooled odds ratio (OR) of depressive and anxiety symptoms. Sensitivity analyses of methodological characteristics and a meta-regression of the pooled standardized mean difference (SMD) to evaluate

  13. The effects of co-morbidity in defining major depression subtypes associated with long-term course and severity

    NARCIS (Netherlands)

    Wardenaar, K. J.; van Loo, H. M.; Cai, T.; Fava, M.; Gruber, M. J.; Li, J.; de Jonge, P.; Nierenberg, A. A.; Petukhova, M. V.; Rose, S.; Sampson, N. A.; Schoevers, R. A.; Wilcox, M. A.; Alonso, J.; Bromet, E. J.; Bunting, B.; Florescu, S. E.; Fukao, A.; Gureje, O.; Hu, C.; Huang, Y. Q.; Karam, A. N.; Levinson, D.; Medina Mora, M. E.; Posada-Villa, J.; Scott, K. M.; Taib, N. I.; Viana, M. C.; Xavier, M.; Zarkov, Z.; Kessler, R. C.

    2014-01-01

    Background. Although variation in the long-term course of major depressive disorder (MDD) is not strongly predicted by existing symptom subtype distinctions, recent research suggests that prediction can be improved by using machine learning methods. However, it is not known whether these

  14. Up-regulation of leucocytes genes implicated in telomere dysfunction and cellular senescence correlates with depression and anxiety severity scores.

    Directory of Open Access Journals (Sweden)

    Jean-Raymond Teyssier

    Full Text Available BACKGROUND: Major depressive disorder (MDD is frequently associated with chronic medical illness responsible of increased disability and mortality. Inflammation and oxidative stress are considered to be the major mediators of the allostatic load, and has been shown to correlate with telomere erosion in the leucocytes of MDD patients, leading to the model of accelerated aging. However, the significance of telomere length as an exclusive biomarker of aging has been questioned on both methodological and biological grounds. Furthermore, telomeres significantly shorten only in patients with long lasting MDD. Sensitive and dynamic functional biomarkers of aging would be clinically useful to evaluate the somatic impact of MDD. METHODOLOGY: To address this issue we have measured in the blood leucocytes of MDD patients (N=17 and controls (N=16 the expression of two genes identified as robust biomarkers of human aging and telomere dysfunction: p16(INK4a and STMN1. We have also quantified the transcripts of genes involved in the repair of oxidative DNA damage at telomeres (OGG1, telomere regulation and elongation (TERT, and in the response to biopsychological stress (FOS and DUSP1. RESULTS: The OGG1, p16(INK4a, and STMN1 gene were significantly up-regulated (25 to 100% in the leucocytes of MDD patients. Expression of p16(INK4a and STMN1 was directly correlated with anxiety scores in the depression group, and that of p16(INK4a, STMN and TERT with the depression and anxiety scores in the combined sample (MDD plus controls. Furthermore, we identified a unique correlative pattern of gene expression in the leucocytes of MDD subjects. CONCLUSIONS: Expression of p16(INK4 and STMN1 is a promising biomarker for future epidemiological assessment of the somatic impact of depressive and anxious symptoms, at both clinical and subclinical level in both depressive patients and general population.

  15. The relationship between the severity of asthma and comorbidites with anxiety and depressive disorders Relação entre a gravidade da asma e comorbidade com transtornos de ansiedade e depressão

    Directory of Open Access Journals (Sweden)

    Alexandre M Valença

    2006-09-01

    Full Text Available OBJECTIVE: There is evidence that asthma is associated with increased frequency of psychiatric symptoms and mental disorders. Our aim was to assess the frequency of anxiety and depressive disorders in a sample of asthmatic outpatients and observe if there is any relationship between this comorbidity and the severity of asthma. METHOD: Sixty-two consecutive patients of two outpatient asthma clinics located in university hospitals were evaluated. Psychiatric diagnoses were assessed with the Mini-International Neuropsychiatric Interview 4.4 Version. RESULTS: Twenty-seven patients (43.5% met criteria for at least one psychiatric diagnosis. The most frequent diagnoses were major depression (24%, generalized anxiety disorder (20.9% and panic disorder/agoraphobia spectrum disorders (17.7%. We found no significant differences in the prevalence of anxiety disorders and depression between the groups with mild/moderate and severe asthma. Despite the high frequency of depression and anxiety disorders, only 4 (6.5% patients were under psychiatric treatment and 13 (20.9% patients were taking benzodiazepines. Twelve of 15 (80% patients who reported present use of psychotropic medication were not under psychiatric treatment at the moment of the study. CONCLUSIONS: Our results support the high morbidity of anxiety and depressive disorders in asthmatic patients, independent of the severity of asthma.OBJETIVO: Existem evidências de que a asma está associada a um aumento da presença de sintomas psiquiátricos e de transtornos mentais. O objetivo do presente estudo é o de averiguar a freqüência de transtornos de ansiedade e depressão em uma amostra de pacientes asmáticos ambulatoriais e observar se há relação deste tipo de comorbidade com a gravidade da asma. MÉTODO: Sessenta e dois pacientes consecutivos de dois ambulatórios universitários especializados em asma foram examinados. Os diagnósticos psiquiátricos foram obtidos em entrevista com a

  16. Self-reported perinatal depressive symptoms and postnatal symptom severity after treatment with antidepressants in pregnancy: a cross-sectional study across 12 European countries using the Edinburgh Postnatal Depression Scale

    Directory of Open Access Journals (Sweden)

    Lupattelli A

    2018-06-01

    postnatal depressive symptoms by severity across multiple countries and the association between antidepressant treatment in pregnancy and postnatal symptom severity. Materials and methods: This was a multinational web-based study conducted across 12 European countries (n=8069. Uniform data collection was ensured via an electronic questionnaire. Pregnant women at any gestational week and mothers of children with <1 year of age could participate. We used the Edinburgh Postnatal Depression Scale (EPDS to measure the prevalence of antenatal and postnatal depressive symptoms according to severity, which were corrected by survey weight adjustment (descriptive analysis. Within mothers with a psychiatric disorder (n=173, we estimated the association between antidepressant treatment in pregnancy and postnatal depressive symptom severity, as standardized EPDS mean scores, via the inverse probability of treatment weight (association analysis. Results: In the descriptive analysis (n=8069, the period prevalence of moderate-to-very severe depressive symptoms was higher in the western and eastern regions relative to the northern region, both in the antenatal period (6.8%–7.5% vs 4.3% and in the postnatal period (7.6% vs 4.7%. One in two mothers with psychiatric disorders used an antidepressant in pregnancy (86 of 173. In the association analysis, women medicated at any time during pregnancy (adjusted β=−0.34, 95% confidence interval [CI] =−0.66, −0.02 had a significant postnatal symptom severity reduction compared with the nonmedicated counterpart. This effect was larger (β=−0.74, 95% CI =−1.24, −0.24 when the analysis was restricted to mothers within 6 months after childbirth. Conclusion: The prevalence of self-reported antenatal and postnatal depressive symptoms differs across European countries. Among women with psychiatric disorders, those who had been on treatment with antidepressants during pregnancy were less likely to report postnatal depressive symptoms

  17. Optimal duration of combined psychotherapy and pharmacotherapy for patients with moderate and severe depression: A meta-analysis

    DEFF Research Database (Denmark)

    Møldrup, Claus; Østergaard, Svetlana

    2011-01-01

    Background: To investigate the most effective duration of combined psychotherapy and pharmacotherapy for achieving remission and preventing relapse in depressive patients compared to pharmacotherapy alone. Methods: A systematic review of English articles using PubMed, EMBASE, Web of Science...... demonstrated a higher risk for relapse compared to those receiving combined treatment. Limitations: we restricted our search to only English language publications. Studies investigating relapse or recurrence rates are often of small size. Conclusion: Pharmacotherapy enhanced with psychotherapy is associated...

  18. Relationship between the clinical global impression of severity for schizoaffective disorder scale and established mood scales for mania and depression.

    Science.gov (United States)

    Turkoz, Ibrahim; Fu, Dong-Jing; Bossie, Cynthia A; Sheehan, John J; Alphs, Larry

    2013-08-15

    This analysis explored the relationship between ratings on HAM-D-17 or YMRS and those on the depressive or manic subscale of CGI-S for schizoaffective disorder (CGI-S-SCA). This post hoc analysis used the database (N=614) from two 6-week, randomized, placebo-controlled studies of paliperidone ER versus placebo in symptomatic subjects with schizoaffective disorder assessed using HAM-D-17, YMRS, and CGI-S-SCA scales. Parametric and nonparametric regression models explored the relationships between ratings on YMRS and HAM-D-17 and on depressive and manic domains of the CGI-S-SCA from baseline to the 6-week end point. A clinically meaningful improvement was defined as a change of 1 point in the CGI-S-SCA score. No adjustment was made for multiplicity. Multiple linear regression models suggested that a 1-point change in the depressive domain of CGI-S-SCA corresponded to an average 3.6-point (SE=0.2) change in HAM-D-17 score. Similarly, a 1-point change in the manic domain of CGI-S-SCA corresponded to an average 5.8-point (SE=0.2) change in YMRS score. Results were confirmed using local and cumulative logistic regression models in addition to equipercentile linking. Lack of subjects scoring over the complete range of possible scores may limit broad application of the analyses. Clinically meaningful score changes in depressive and manic domains of CGI-S-SCA corresponded to approximately 4- and 6-point score changes on HAM-D-17 and YMRS, respectively, in symptomatic subjects with schizoaffective disorder. Copyright © 2013 Elsevier B.V. All rights reserved.

  19. Changes in regional cerebral blood flow correlate with symptoms of depression, severity of fatigue, and sleep disorders in 99mTc-ECD SPECT study in 45 workers

    International Nuclear Information System (INIS)

    Koyama, Fumihiko; Matsuura, Naoyuki; Kageyama, Junichi; Otsuki, Kenro

    2010-01-01

    We performed single photon emission computed tomography ( 99m Tc-ECD SPECT) of the brain in 25 workers suffering from major depression (22 males and 3 females at the average age of 47.5±7.7 standard deviation (S.D.) years and all patients were right handed) and identified frontal lobe hypoperfusion in 18 cases using the easy Z-score Imaging System (eZIS). During the remission period, which was within ten months of therapy, we observed normalization of the frontal cerebral perfusion in 75% of the patients. In further evaluation of the cerebral blood flow after the addition of 20 healthy volunteer workers (18 males and 2 females at the average age 47.1±9.8 S.D. years and all were right handed) as a control group, reduced cerebral blood flow in the dorsal area, which is supposed to be correlated to the severity of the feeling of fatigue estimated based on the self-rating depression scale (SDS), was demonstrated by statistical parametric mapping (SPM). The severity of the fatigue of all workers was estimated using a self-rating checklist disseminated by the Japan Ministry of Health, Labor, and Welfare, which pertains to the accumulation of fatigue due to labor. In the SPM analysis, limbic hypoperfusion, which is correlated to the total severity of fatigue in all worker cases, was estimated based on the reduction in the cerebral blood flow in the lower part of the temporal lobe. We also estimated the severity of insomnia in 21 cases (8 depressive, the 8 remitted and 5 controls), referred to as the Insomnia Score in this study, using the Structured Interview Guide for the Hamilton Depression Rating Scale (SIGH-D). The severity of the insomnia statistically correlates with frontoparietal hypoperfusion, and this region is situated very close to the region correlated to the feeling of fatigue expressed by the patients in the SDS. Accordingly, prolonged sleep disturbance due to, for instance, overwork may result in easy fatigability and a pre-depressive state which are

  20. Assessment of Depression in Dementia Patients: Association of Caregiver Mood with Depression Ratings.

    Science.gov (United States)

    Teri, Linda; Truax, Paula

    1994-01-01

    Primary caregivers (n=41) of memory-impaired patients rated a standardized stimulus of depression and their actual patient. They were able to correctly identify depression in both. Further, their mood was unassociated with video ratings and only moderately associated with patient ratings. The findings support reliance on caregiver input.…

  1. Comparison of chemokines (CCL-5 and SDF-1), chemokine receptors (CCR-5 and CXCR-4) and IL-6 levels in patients with different severities of depression.

    Science.gov (United States)

    Ogłodek, Ewa A; Szota, Anna; Just, Marek J; Moś, Danuta; Araszkiewicz, Aleksander

    2014-10-01

    Depression can be perceived as a psychoneuroimmunological disorder in which cytokines affecting the body's neurochemical and neuroendocrine functions play an important role. Among cytokines, chemokines participating in activation of the inflammatory response are considered to be crucial. 160 men and women were enrolled in the study. 120 of them were diagnosed with various types of depression. The mean age was 45.2 ± 4.5 years (range: 19-47 years). The control group consisted of 40 healthy individuals. The average age in this group was 42.4 ± 4.1 years. Plasma levels of chemokines and their receptors (CCL-5 - RANTES and CXCR-5, SDF-1 and CXCR-4), as well as of IL-6, were assessed by ELISA. There was an increase in SDF-1 and CCL-5 levels in women and men with different severities of depression, versus the control group. Also, an increase in the IL-6 levels, CXCR4 and CCR-5 receptors was observed in both women and men with all types of depression. Levels of SDF-1 and CCL-5 chemokines, as well as of CCR-5 and CXCR4 chemokine receptors, were higher in women than in men. The results of this study indicate the need for assessment of CCL-5 and SDF-1 chemokines levels, as they are likely markers of developing depression. Early measurement of these chemokines levels may be helpful in choosing the best pharmacotherapy. Copyright © 2014 Institute of Pharmacology, Polish Academy of Sciences. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  2. Fiber tract-specific white matter lesion severity Findings in late-life depression and by AGTR1 A1166C genotype.

    Science.gov (United States)

    Taylor, Warren D; Zhao, Zheen; Ashley-Koch, Allison; Payne, Martha E; Steffens, David C; Krishnan, Ranga R; Hauser, Elizabeth; MacFall, James R

    2013-02-01

    Past work demonstrated that late-life depression is associated with greater severity of ischemic cerebral hyperintense white matter lesions, particularly frontal lesions. However, these lesions are also associated with other neuropsychiatric deficits, so these clinical relationships may depend on which fiber tracts are damaged. We examined the ratio of lesion to nonlesioned white matter tissue within multiple fiber tracts between depressed and nondepressed elders. We also sought to determine if the AGTR1 A1166C and BDNF Val66Met polymorphisms contributed to vulnerability to lesion development in discrete tracts. The 3T structural MR images and blood samples for genetic analyses were acquired on 54 depressed and 37 nondepressed elders. Lesion maps were created through an automated tissue segmentation process and applied to a probabilistic white matter fiber tract atlas allowing for identification of the fraction of the tract occupied by lesion. The depressed cohort exhibited a significantly greater lesion ratio only in the left upper cingulum near the cingulate gyrus (F((1,86)) = 4.62, P = 0.0344), supporting past work implicating cingulate dysfunction in the pathogenesis of depression. In the 62 Caucasian subjects with genetic data, AGTR1 C1166 carriers exhibited greater lesion ratios across multiple tracts including the anterior thalamic radiation and inferior fronto-occipital fasciculus. In contrast, BDNF Met allele carriers exhibited greater lesion ratios only in the frontal corpus callosum. Although these findings did not survive correction for multiple comparisons, this study supports our hypothesis and provides preliminary evidence that genetic differences related to vascular disease may increase lesion vulnerability differentially across fiber tracts. Copyright © 2011 Wiley Periodicals, Inc.

  3. A randomized controlled comparison of electroconvulsive therapy and repetitive transcranial magnetic stimulation in severe and resistant nonpsychotic major depression.

    Science.gov (United States)

    Grunhaus, Leon; Schreiber, Shaul; Dolberg, Ornah T; Polak, Dana; Dannon, Pinhas N

    2003-02-15

    Studies published over the past few years suggest that transcranial magnetic stimulation (TMS) may have significant antidepressant actions. In a previous report, we compared electroconvulsive therapy (ECT) and repetitive TMS (rTMS) and found ECT to be superior for psychotic major depression (MD); however, ECT and rTMS had similar results in nonpsychotic MD. We now report on a controlled randomized comparison of ECT and rTMS in patients with nonpsychotic MD. Forty patients with nonpsychotic MD referred for ECT were included. Electroconvulsive therapy was performed according to established protocols. Repetitive TMS was performed over the left dorsolateral prefrontal cortex at 90% motor threshold. Patients were treated with 20 sessions (five times per week for 4 weeks) of 10-Hz treatments (1200 pulses per treatment-day) at 90% motor threshold. Response to treatment was defined as a decrease of at least 50% in the Hamilton Rating Scale for Depression (HRSD) score, with a final HRSD equal or less than 10 points and a final Global Assessment of Function Scale rating of 60 or more points. The overall response rate was 58% (23 out of 40 patients responded to treatment). In the ECT group, 12 responded and eight did not; in the rTMS group, 11 responded and nine did not (chi2 =.10, ns). Thus, patients responded as well to either ECT or rTMS. This study adds to the growing literature supporting an antidepressant effect for rTMS. This study is particularly relevant because it suggests that rTMS and ECT reach similar results in nonpsychotic major depressive disorder.

  4. Major depressive disorder and suicide risk among adult outpatients at several general hospitals in a Chinese Han population.

    Science.gov (United States)

    Li, Haiyan; Luo, Xinni; Ke, Xiaoyin; Dai, Qing; Zheng, Wei; Zhang, Chanjuan; Cassidy, Ryan M; Soares, Jair C; Zhang, XiangYang; Ning, Yuping

    2017-01-01

    Somatic complaints are often the presenting symptoms of major depressive disorder (MDD) in the outpatient context, because this may go unrecognized. It is well understood that MDD carries an increased risk of suicide. This study aimed to identify the risk factors and association with both MDD and suicidality among Han Chinese outpatients. A multicenter study was carried out in 5189 outpatient adults (≥18 years old) in four general hospitals in Guangzhou, China. The 1392 patients who had the Patient Health Questionnaire-9 (PHQ-9) score ≥ 5, indicating depressive symptoms were offered an interview with a psychiatrist by the Mini International Neuropsychiatric Interview (MINI); 819 patients consented and completed the MINI interview. MINI module B was used to assess suicidality. Stepwise binary logistic models were used to estimate the relationship between a significant risk factor and suicide or MDD. According to with or without MDD, the secondary analysis was performed using the logistic regression model for the risk of suicidility. The current prevalence of MDD and the one month prevalence of suicidality were 3.7% and 2.3% respectively. The odds ratio of suicidality in women was more than twice that in men (OR = 2.62; 95% CI 1.45-4.76). Other risk factors which were significantly associated with suicidality were: living alone, higher education, self-reported depression, getting psychiatric diagnoses (MDD, anxiety disorders, and bipolar disorders). Significant risk factors for MDD were also noticed, such as comorbid anxiety disorders, self-reported anxiety, insomnia, suicidal ideation. It's a cross-sectional study in outpatient clinics using self-report questionnaires. This study provides valuable data about the risk factors and association of MDD and suicide risk in adult outpatients in Han Chinese. Those factors allow better the employment of preventative measures.

  5. Serum BDNF levels in relation to illness severity, suicide attempts, and central serotonin activity in patients with major depressive disorder: a pilot study.

    Science.gov (United States)

    Park, Young-Min; Lee, Bun-Hee; Um, Tae Hyun; Kim, Sollip

    2014-01-01

    The aim of this study was to test the hypothesis that serum levels of brain-derived neurotrophic factor (BDNF) are correlated with the loudness dependence of auditory evoked potentials (LDAEP). The question of whether there is a difference in BDNF levels between depressive patients according to their illness severity, history of suicide attempts, and central serotonin activity was also addressed. A sample of 51 patients who met the criteria for major depressive disorder following diagnosis using axis I of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders - text revision comprised the study subjects. The patients were stratified into two subgroups based on their illness severity, history of suicide attempts, and their LDAEP values. The LDAEP was evaluated by measuring the auditory event-related potentials, and serum BDNF was measured using blood sampling before beginning medication with serotonergic agents. There was no difference in serum BDNF levels between the two patient subgroups. The subgroup with moderate-to-severe depression (n = 16) was reanalyzed after stratifying it into two subgroups according to LDAEP and BDNF values (dichotomized at the medians into low and high). The high-LDAEP subgroup had higher serum BDNF levels and total Barratt Impulsiveness Scale score than the low-LDAEP subgroup (p = 0.03 and 0.036, respectively). Serum BDNF levels were positively correlated with LDAEP and total Beck Hopelessness Scale (BHS) score (r = 0.56, p = 0.025, and r = 0.59, p = 0.016, respectively). The high-BDNF subgroup had a higher LDAEP and total BHS score than the low-BDNF subgroup (p = 0.046 and p = 0.011, respectively). This is the first study to demonstrate a relationship between the BDNF level and LDAEP in Asian depressive patients. Intriguingly, the high-BDNF subgroup (divided according to illness severity) exhibited a more severe psychopathology on some psychometric rating scales, a finding that

  6. The effect of core clinician interpersonal behaviours on depression.

    Science.gov (United States)

    Barnicot, K; Wampold, B; Priebe, S

    2014-01-01

    It is well-established that core clinician interpersonal behaviours are important when treating depression, but few studies have evaluated whether outcome is determined by clinicians׳ general behaviour rather than by the perception of the individual being treated. In the NIMH TDCRP, 157 patients rated their clinician׳s genuineness, positive regard, empathy and unconditional regard during cognitive behavioural therapy, interpersonal therapy or clinical management with placebo. The association between averaged ratings for each of 27 clinicians and their patients׳ self- and observer-rated depression outcomes was evaluated, adjusting for the deviation of individual patient ratings from the average for their clinician and other potential confounders. Clinicians in the clinical management condition were rated on average as less genuine and less empathic than those in the psychotherapy conditions. Clinicians׳ average genuineness, positive regard and empathy were significantly associated with lower depression severity during treatment, but not with recovery from depression, after adjusting for the deviation of the individual patient׳s rating of their clinician from the average for that clinician, treatment condition and baseline depression severity. Clinician unconditional regard was not significantly associated with outcome. Using averaged ratings of clinician behaviour likely reduced statistical power. Clinicians׳ ability to demonstrate genuineness, positive regard and empathy may represent a stable personal characteristic that influences the treatment of depression beyond the individual clinician-patient relationship or an individual patient׳s perception of their clinician. However, clinicians׳ ability to demonstrate these behaviours may be poorer when delivering an intervention without a specific rationale or treatment techniques. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. Hopelessness, defeat, and entrapment in posttraumatic stress disorder: their association with suicidal behavior and severity of depression.

    Science.gov (United States)

    Panagioti, Maria; Gooding, Patricia A; Tarrier, Nicholas

    2012-08-01

    Research has shown an increased frequency of suicidal behaviors in those with PTSD, but few studies have investigated the factors that underlie the emergence of suicidal behavior in PTSD. Two theories of suicide, the Cry of Pain and the Schematic Appraisal Model of Suicide, propose that feelings of hopelessness, defeat, and entrapment are core components of suicidality. This study aimed to examine the association between suicidal behavior and hopelessness, defeat, and entrapment in trauma victims with and without a PTSD diagnosis. The results demonstrated that hopelessness, defeat, and entrapment were significantly positively associated with suicidal behavior in those with PTSD. Hopelessness and defeat were also significantly positively associated with suicidal behavior in trauma victims without PTSD. In those with PTSD, the relationship between suicidal behavior and hopelessness and entrapment remained significant after controlling for comorbid depression. The findings provide support for the contemporary theories of suicidality and have important clinical implications.

  8. Changes in regional cerebral blood flow correlate with symptoms of depression and severity of fatigue in 99mTc-ECD SPECT study in 45 workers

    International Nuclear Information System (INIS)

    Koyama, Fumihiko; Hojo, Kei; Otsuki, Kenro; Yamamoto, Haruyoshi

    2008-01-01

    We performed single photon emission computed tomography ( 99m Tc-ECD SPECT) of the brain in 25 workers suffering from major depression (22 males and 3 females at the average age of 47.5±7.7 standard deviation (S.D.) years and all patients were right handed) and identified frontal lobe hypoperfusion in 18 cases using the easy Z-score Imaging System (eZIS). During the remission period, which was within ten months of therapy, we observed normalization of the frontal cerebral perfusion in 75% of the patients. In further evaluation of the cerebral blood flow after the addition of 20 healthy volunteer workers (18 males and 2 females at the average age 47.1±9.8 S.D. years and all were right handed) as a control group, reduced cerebral blood flow in the dorsal area of the frontal lobe, which is supposed to be correlated to the severity of the feeling of fatigue estimated based on the self-rating depression scale (SDS), was demonstrated by statistical parametric mapping (SPM). The severity of the fatigue of all workers was estimated using a self-rating checklist disseminated by the Japan Ministry of Health, Labor, and Welfare, which pertains to the accumulation of fatigue due to labor. In the SPM analysis, limbic hypoperfusion, which is correlated to the total severity of fatigue in all worker cases, was estimated based on the reduction in the cerebral blood flow in the lower part of the temporal lobe. Accordingly, the accumulation of fatigue due to, for instance, over work may result in easy fatigue and a pre-depressive state, which are associated with a reduction in the cerebral blood flow. This research is a part of the research and development and the dissemination projects related to the 13 fields of occupational injuries and illnesses of the Japan Labor Health and Welfare Organization. (author)

  9. Major depression

    Science.gov (United States)

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

  10. Treadmill exercise attenuates the severity of physical dependence, anxiety, depressive-like behavior and voluntary morphine consumption in morphine withdrawn rats receiving methadone maintenance treatment.

    Science.gov (United States)

    Alizadeh, Maryam; Zahedi-Khorasani, Mahdi; Miladi-Gorji, Hossein

    2018-05-30

    This study was designed to examine whether treadmill exercise would attenuate the severity of physical dependence, methadone-induced anxiety, depression and voluntary morphine consumption in morphine withdrawn rats receiving methadone maintenance treatment (MMT). The rats were chronically treated with bi-daily doses (10 mg/kg, at 12 h intervals) of morphine for 14 days. The exercising rats receiving MMT were forced to run on a motorized treadmill for 30 days during morphine withdrawal. Then, rats were tested for the severity of morphine dependence, the elevated plus-maze (EPM), sucrose preference test (SPT) and voluntary morphine consumption using a two-bottle choice (TBC) paradigm. The results showed that naloxone- precipitated opioid withdrawal signs were decreased in exercising morphine-dependent rats receiving MMT than sedentary rats. Also, the exercising morphine-dependent rats receiving MMT exhibited an increased time on open arms, preference for sucrose and a lower morphine preference ratio than sedentary rats. We conclude that treadmill exercise decreased the severity of physical dependence, anxiety/depressive-like behaviors and also the voluntary morphine consumption in morphine withdrawn rats receiving MMT. Thus, exercise may benefit in the treatment of addicts during MMT. Copyright © 2018. Published by Elsevier B.V.

  11. Severe depression with Cotard’s phenomenon: treatment of a capacitated patient within the United Kingdom’s Mental Health Act 2007

    Directory of Open Access Journals (Sweden)

    Simon B. Menezes

    2013-02-01

    Full Text Available Treatment of Cotard’s syndrome with electroconvulsive therapy (ECT has been seen to be an effective treatment option when pharmacological options are not successful. Recent changes in the Mental Health Act 2007 used within the United Kingdom has resulted in clinicians unable to prescribe treatment for patients who have capacity but are not providing consent for treatment. We report a case of a patient in the UK with Cotard’s phenomenon and severe depression, where the only effective treatment of ECT was restricted due to changes in mental health law. The role of maintenance ECT as well as the ethical dilemma faced is discussed.

  12. A tool for sexual minority mental health research: The Patient Health Questionnaire (PHQ-9) as a depressive symptom severity measure for sexual minority women in Viet Nam.

    Science.gov (United States)

    Nguyen, Trang Quynh; Bandeen-Roche, Karen; Bass, Judith K; German, Danielle; Nguyen, Nam Thi Thu; Knowlton, Amy R

    In a context with limited attention to mental health and prevalent sexual prejudice, valid measurements are a key first step to understanding the psychological suffering of sexual minority populations. We adapted the Patient Health Questionnaire as a depressive symptom severity measure for Vietnamese sexual minority women, ensuring its cultural relevance and suitability for internet-based research. Psychometric evaluation found that the scale is mostly unidimensional and has good convergent validity, good external construct validity, and excellent reliability. The sample's high endorsement of scale items emphasizes the need to study minority stress and mental health in this population.

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

    Science.gov (United States)

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

    2002-09-01

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

  14. Depressive Disorders

    Science.gov (United States)

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

    2017-01-01

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

  15. Postpartum Depression

    Science.gov (United States)

    ... professionals for help. With support and treatment, new mothers with depression can go on to be healthy, happy parents. ... or two, talk to your doctor. A new mother who feels like giving up, who feels that life is not ... depression can last for several months or even longer ...

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

    International Nuclear Information System (INIS)

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

    2017-01-01

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

  17. Severe tremor after cotrimoxazole-induced elevation of venlafaxine serum concentrations in a patient with major depressive disorder.

    Science.gov (United States)

    Geber, Christian; Ostad Haji, Elnaz; Schlicht, Konrad; Hiemke, Christoph; Tadić, André

    2013-06-01

    : We describe a female patient who was an extensive metabolizer of cytochrome P450 isoenzyme (CYP) 2D6 and an intermediate metabolizer of CYP2C19 (genotype: CYP2C19 *1/*2). She exhibited high serum concentrations of venlafaxine and O-desmethylvenlafaxine and developed severe tremor after comedication with cotrimoxazole (sulfamethazole/trimethoprim). Venlafaxine is mainly metabolized by O- and N-demethylation. O-demethylation is catalyzed by the highly polymorphic CYP2D6 and N-demethylation by several enzymes, CYP2C19, CYP2C9, and CYP3A4. The observed overall pharmacokinetic effect was most probably the result of decreased N-demethylation of venlafaxine by (1) reduced expression of CYP2C19 due to a genetic deficit and (2) inhibition of CYP2C9 by cotrimoxazole.

  18. Longer Nature-Based Rehabilitation May Contribute to a Faster Return to Work in Patients with Reactions to Severe Stress and/or Depression.

    Science.gov (United States)

    Grahn, Patrik; Pálsdóttir, Anna María; Ottosson, Johan; Jonsdottir, Ingibjörg H

    2017-10-27

    The global burden of depression and stress-related mental disorders is substantial, and constitutes a major need for effective rehabilitation. Can nature-based rehabilitation help people return to work? To study if the length of a nature-based rehabilitation program affects the outcome with regard to return to work one year after the onset of the program, in a group of patients with long-term reactions to severe stress and/or depression. A prospective, quasi-experimental study comparing results from 8-, 12-, and 24-week periods of rehabilitation. The rehabilitation of 106 participants was carried out by a multimodal rehabilitation team in a specially designed rehabilitation garden. Return to work data were collected before the intervention and one year after the start of rehabilitation. In addition, data were collected regarding self-assessed occupational competence, personal control, and sense of coherence. As many as 68% of the participants returned to work or participated in job training or work-oriented measures, full- or part-time, after one year. Participants with a longer period of rehabilitation reported better results on occupational competence, and were more likely to participate in paid work, full-time or part-time, one year after rehabilitation. Study outcomes indicate that a longer rehabilitation period in a rehabilitation garden increases the possibility of a return to paid work.

  19. Longer Nature-Based Rehabilitation May Contribute to a Faster Return to Work in Patients with Reactions to Severe Stress and/or Depression

    Science.gov (United States)

    Grahn, Patrik; Pálsdóttir, Anna María; Ottosson, Johan; Jonsdottir, Ingibjörg H.

    2017-01-01

    The global burden of depression and stress-related mental disorders is substantial, and constitutes a major need for effective rehabilitation. Can nature-based rehabilitation help people return to work? Objective: To study if the length of a nature-based rehabilitation program affects the outcome with regard to return to work one year after the onset of the program, in a group of patients with long-term reactions to severe stress and/or depression. Methods: A prospective, quasi-experimental study comparing results from 8-, 12-, and 24-week periods of rehabilitation. The rehabilitation of 106 participants was carried out by a multimodal rehabilitation team in a specially designed rehabilitation garden. Return to work data were collected before the intervention and one year after the start of rehabilitation. In addition, data were collected regarding self-assessed occupational competence, personal control, and sense of coherence. As many as 68% of the participants returned to work or participated in job training or work-oriented measures, full- or part-time, after one year. Participants with a longer period of rehabilitation reported better results on occupational competence, and were more likely to participate in paid work, full-time or part-time, one year after rehabilitation. Study outcomes indicate that a longer rehabilitation period in a rehabilitation garden increases the possibility of a return to paid work. PMID:29076997

  20. Longer Nature-Based Rehabilitation May Contribute to a Faster Return to Work in Patients with Reactions to Severe Stress and/or Depression

    Directory of Open Access Journals (Sweden)

    Patrik Grahn

    2017-10-01

    Full Text Available The global burden of depression and stress-related mental disorders is substantial, and constitutes a major need for effective rehabilitation. Can nature-based rehabilitation help people return to work? Objective: To study if the length of a nature-based rehabilitation program affects the outcome with regard to return to work one year after the onset of the program, in a group of patients with long-term reactions to severe stress and/or depression. Methods: A prospective, quasi-experimental study comparing results from 8-, 12-, and 24-week periods of rehabilitation. The rehabilitation of 106 participants was carried out by a multimodal rehabilitation team in a specially designed rehabilitation garden. Return to work data were collected before the intervention and one year after the start of rehabilitation. In addition, data were collected regarding self-assessed occupational competence, personal control, and sense of coherence. As many as 68% of the participants returned to work or participated in job training or work-oriented measures, full- or part-time, after one year. Participants with a longer period of rehabilitation reported better results on occupational competence, and were more likely to participate in paid work, full-time or part-time, one year after rehabilitation. Study outcomes indicate that a longer rehabilitation period in a rehabilitation garden increases the possibility of a return to paid work.

  1. Depression associated with dementia.

    Science.gov (United States)

    Gutzmann, H; Qazi, A

    2015-06-01

    Depression and cognitive disorders, including dementia and mild cognitive impairment, are common disorders in old age. Depression is frequent in dementia, causing distress, reducing the quality of life, exacerbating cognitive and functional impairment and increasing caregiver stress. Even mild levels of depression can significantly add to the functional impairment of dementia patients and the severity of psychopathological and neurological impairments increases with increasing severity of depression. Depressive symptoms may be both a risk factor for, as well as a prodrome of dementia. Major depressive syndrome of Alzheimer's disease may be among the most common mood disorders of older adults. Treating depression is therefore a key clinical priority to improve the quality of life both of people with dementia as well as their carergivers. Nonpharmacological approaches and watchful waiting should be attempted first in patients who present with mild to moderate depression and dementia. In cases of severe depression or depression not able to be managed through nonpharmacological means, antidepressant therapy should be considered.

  2. A naturalistic study of high-dose unilateral ECT among severely depressed inpatients: how does it work in the clinical practice?

    OpenAIRE

    Alves, Lucas P. C.; Freire, Thiago F. V.; Fleck, Marcelo P. A.; Rocha, Neusa S.

    2016-01-01

    Background Naturalistic studies can be useful tools to understand how an intervention works in the real clinical practice. This study aims to investigate the outcomes in a naturalistically treated depressed inpatients cohort, who were referred, or not, to unilateral ECT. Methods Depressed adults according to MINI admitted in a psychiatric unit were divided in unilateral ECT treated and non-ECT treated. Main outcomes were: depression improvement in Hamilton Rating Scale for Depression (HDRS-17...

  3. [Age 89 years, depression, fall with pelvic fracture, severe confusion - serotonin syndrome : Differential diagnosis, importance of CYP450 and economic considerations].

    Science.gov (United States)

    Weinrebe, W; Moutaouakil, A; Risz, K; Martin, M; Jeckelmann, K; Goetz, S

    2017-04-18

    A case study of an 89-year-old patient is reported, who was admitted to hospital because of immobility due to pain. After the cause of the pain could initially be clarified and treated, the further clinical course in this very old woman showed an alarming symptom complex of agitation, confusion and cognitive deterioration, which took on grave forms. The work-up of this case showed a typical constellation of pain and depression in old age; however, the pharmaceutical treatment in this case is not atypical and could lead to a severe serotonin syndrome. The interaction, diagnostics, differential diagnosis, pharmacological, functional, codification and economic aspects of the course of the disease are discussed.

  4. Antibody to endotoxin core glycolipid reverses reticuloendothelial system depression in an animal model of severe sepsis and surgical injury

    Energy Technology Data Exchange (ETDEWEB)

    Aldridge, M.C.; Chadwick, S.J.; Cheslyn-Curtis, S.; Rapson, N.; Dudley, H.A.

    1987-10-01

    To study the effect of severe sepsis on the function of the reticuloendothelial system (RES) we have measured the clearance kinetics and organ distribution of both low-dose technetium tin colloid (TTC) and /sup 75/selenomethionine-labelled E. coli in rabbits 24 hours after either sham laparotomy or appendix devascularization. Sepsis resulted in similar delayed blood clearance and reduced liver (Kupffer cell) uptake of both TTC and E. coli. To investigate the ability of polyclonal antibody to E. coli-J-5 (core glycolipid) to improve RES function in the same model of sepsis, further animals were pretreated with either core glycolipid antibody or control serum (10 ml IV) 2 hours before induction of sepsis. TTC clearance kinetics were determined 24 hours later. Antibody pretreated animals showed: a reduced incidence of bacteremia; normalization of the rate of blood clearance and liver uptake of TTC; and a 'rebound' increase in splenic uptake of TTC. We conclude that antibody to E. coli-J-5 enhances bacterial clearance by the RES.

  5. Antibody to endotoxin core glycolipid reverses reticuloendothelial system depression in an animal model of severe sepsis and surgical injury

    International Nuclear Information System (INIS)

    Aldridge, M.C.; Chadwick, S.J.; Cheslyn-Curtis, S.; Rapson, N.; Dudley, H.A.

    1987-01-01

    To study the effect of severe sepsis on the function of the reticuloendothelial system (RES) we have measured the clearance kinetics and organ distribution of both low-dose technetium tin colloid (TTC) and 75 selenomethionine-labelled E. coli in rabbits 24 hours after either sham laparotomy or appendix devascularization. Sepsis resulted in similar delayed blood clearance and reduced liver (Kupffer cell) uptake of both TTC and E. coli. To investigate the ability of polyclonal antibody to E. coli-J-5 (core glycolipid) to improve RES function in the same model of sepsis, further animals were pretreated with either core glycolipid antibody or control serum (10 ml IV) 2 hours before induction of sepsis. TTC clearance kinetics were determined 24 hours later. Antibody pretreated animals showed: a reduced incidence of bacteremia; normalization of the rate of blood clearance and liver uptake of TTC; and a 'rebound' increase in splenic uptake of TTC. We conclude that antibody to E. coli-J-5 enhances bacterial clearance by the RES

  6. Cross-cultural adaptation and reliability and validity of the Dutch Patient-Rated Tennis Elbow Evaluation (PRTEE-D)

    NARCIS (Netherlands)

    van Ark, Mathijs; Zwerver, Johannes; Diercks, Ronald L; van den Akker-Scheek, Inge

    2014-01-01

    Background: Lateral Epicondylalgia (LE) is a common injury for which no reliable and valid measure exists to determine severity in the Dutch language. The Patient-Rated Tennis Elbow Evaluation (PRTEE) is the first questionnaire specifically designed for LE but in English. The aim of this study was

  7. The natural history of new-onset heart failure with a severely depressed left ventricular ejection fraction: implications for timing of implantable cardioverter-defibrillator implantation.

    Science.gov (United States)

    Teeter, William A; Thibodeau, Jennifer T; Rao, Krishnasree; Brickner, M Elizabeth; Toto, Kathleen H; Nelson, Lauren L; Mishkin, Joseph D; Ayers, Colby R; Miller, Justin G; Mammen, Pradeep P A; Patel, Parag C; Markham, David W; Drazner, Mark H

    2012-09-01

    Guidelines recommend that patients with new-onset systolic heart failure (HF) receive a trial of medical therapy before an implantable cardiac defibrillator (ICD). This strategy allows for improvement of left ventricular ejection fraction (LVEF), thereby avoiding an ICD, but exposes patients to risk of potentially preventable sudden cardiac death during the trial of medical therapy. We reviewed a consecutive series of patients with HF of <6 months duration with a severely depressed LVEF (<30%) evaluated in a HF clinic (N = 224). The ICD implantation was delayed with plans to reassess LVEF approximately 6 months after optimization of β-blockers. Mortality was ascertained by the National Death Index. Follow-up echocardiograms were performed in 115 of the 224 subjects. Of these, 50 (43%) had mildly depressed or normal LVEF at follow-up ("LVEF recovery") such that an ICD was no longer indicated. In a conservative sensitivity analysis (using the entire study cohort, whether or not a follow-up echocardiogram was obtained, as the denominator), 22% of subjects had LVEF recovery. Mortality at 6, 12, and 18 months in the entire cohort was 2.3%, 4.5%, and 6.8%, respectively. Of 87 patients who tolerated target doses of β-blockers, only 1 (1.1%) died during the first 18 months. Patients with new-onset systolic HF have both a good chance of LVEF recovery and low 6-month mortality. Achievement of target β-blocker dose identifies a very low-risk population. These data support delaying ICD implantation for a trial of medical therapy. Copyright © 2012 Mosby, Inc. All rights reserved.

  8. 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 ...

  9. Functional Neurosurgery in the Treatment of Severe Obsessive Compulsive Disorder and Major Depression: Overview of Disease Circuits and Therapeutic Targeting for the Clinician

    Science.gov (United States)

    Shah, Dhwani B.; Pesiridou, Angeliki; Baltuch, Gordon H.; Malone, Donald A.; O’Reardon, John P.

    2008-01-01

    Over the past 20 years, there has been a concerted effort to expand our understanding of the neural circuitry involved in the pathogenesis of psychiatric disorders. Distinct neuronal circuits and networks have been implicated in obsessive compulsive disorder (OCD) and major depressive disorder (MDD) involving feedback loops between the cortex, striatum, and thalamus. When neurosurgery is used as a therapeutic tool in severe OCD and MDD, the goal is to modulate specific targets or nodes within these networks in an effort to produce symptom relief. Currently, four lesioning neurosurgical procedures are utilized for treatment refractory OCD and MDD: cingulotomy, capsulotomy, subcaudate tractotomy, and limbic leucotomy. Deep brain stimulation (DBS) is a novel neurosurgical approach that has some distinct advantages over lesioning procedures. With DBS, the desired clinical effect can be achieved by reversible, high frequency stimulation in a nucleus or at a node in the circuit without the need to produce an irreversible lesion. Recent trials of deep brain stimulation in both OCD and MDD at several neuroanatomical targets have reported promising early results in highly refractory patients and with a good safety profile. Future definitive trials in MDD and OCD are envisaged. PMID:19727257

  10. Further Evidence that Severe Scores in the Aggression/Anxiety-Depression/Attention Subscales of Child Behavior Checklist (Severe Dysregulation Profile) Can Screen for Bipolar Disorder Symptomatology: A Conditional Probability Analysis

    Science.gov (United States)

    Uchida, Mai; Faraone, Stephen V; Martelon, MaryKate; Kenworthy, Tara; Woodworth, K Yvonne; Spencer, Thomas; Wozniak, Janet; Biederman, Joseph

    2014-01-01

    Background Previous work shows that children with high scores (2 SD, combined score ≥ 210) on the Attention Problems, Aggressive Behavior, and Anxious-Depressed (A-A-A) subscales of the Child Behavior Checklist (CBCL) are more likely than other children to meet criteria for bipolar (BP)-I disorder. However, the utility of this profile as a screening tool has remained unclear. Methods We compared 140 patients with pediatric BP-I disorder, 83 with attention deficit hyperactivity disorder (ADHD), and 114 control subjects. We defined the CBCL-Severe Dysregulation profile as an aggregate cutoff score of ≥ 210 on the A-A-A scales. Patients were assessed with structured diagnostic interviews and functional measures. Results Patients with BP-I disorder were significantly more likely than both control subjects (Odds Ratio [OR]: 173.2; 95% Confidence Interval [CI], 21.2 to 1413.8; P < 0.001) and those with ADHD (OR: 14.6; 95% CI, 6.2 to 34.3; P < 0.001) to have a positive CBCL-Severe Dysregulation profile. Receiver Operating Characteristics analyses showed that the area under the curve for this profile comparing children with BP-I disorder against control subjects and those with ADHD was 99% and 85%, respectively. The corresponding positive predictive values for this profile were 99% and 92% with false positive rates of < 0.2% and 8% for the comparisons with control subjects and patients with ADHD, respectively. Limitations Non-clinician raters administered structured diagnostic interviews, and the sample was referred and largely Caucasian. Conclusions The CBCL-Severe Dysregulation profile can be useful as a screen for BP-I disorder in children in clinical practice. PMID:24882182

  11. The Clinical Correlates of Reported Childhood Sexual Abuse: An Association between Age at Trauma Onset and Severity of Depression and PTSD in Adults

    Science.gov (United States)

    Schoedl, Aline Ferri; Costa, Mariana Cadrobbi Pupo; Mari, Jair J.; Mello, Marcelo Feijo; Tyrka, Audrey R.; Carpenter, Linda L.; Price, Lawrence H.

    2010-01-01

    This study investigated the relationship between the age of self-reported sexual abuse occurrence and the development of post-traumatic stress disorder and/or depressive symptoms in adulthood. Subjects were evaluated for the presence of post-traumatic stress disorder and/or depressive symptoms as well as for a self-reported history of sexual abuse…

  12. Mechanical dispersion is associated with poor outcome in heart failure with a severely depressed left ventricular function and bundle branch blocks.

    Science.gov (United States)

    Stankovic, Ivan; Janicijevic, Aleksandra; Dimic, Aleksandra; Stefanovic, Milica; Vidakovic, Radosav; Putnikovic, Biljana; Neskovic, Aleksandar N

    2018-03-01

    Bundle branch blocks (BBB)-related mechanical dyssynchrony and dispersion may improve patient selection for device therapy, but their effect on the natural history of this patient population is unknown. A total of 155 patients with LVEF ≤ 35% and BBB, not treated with device therapy, were included. Mechanical dyssynchrony was defined as the presence of either septal flash or apical rocking. Contraction duration was assessed as time interval from the electrocardiographic R-(Q-)wave to peak longitudinal strain in each of 17 left ventricular segments. Mechanical dispersion was defined as either the standard deviation of all time intervals (dispersion SD ) or as the difference between the longest and shortest time intervals (dispersion delta ). Patients were followed for cardiac mortality during a median period of 33 months. Mechanical dyssynchrony was not associated with survival. More pronounced mechanical dispersion delta was found in patients with dyssynchrony than in those without. In the multivariate regression analysis, patients' functional class, diabetes mellitus and dispersion delta were independently associated with mortality. Mechanical dispersion, but not dyssynchrony, was independently associated with mortality and it may be useful for risk stratification of patients with heart failure (HF) and BBB. Key Messages Mechanical dispersion, measured by strain echocardiography, is associated with poor outcome in heart failure with a severely depressed left ventricular function and bundle branch blocks. Mechanical dispersion may be useful for risk stratification of patients with heart failure and bundle branch blocks.

  13. Testing a machine-learning algorithm to predict the persistence and severity of major depressive disorder from baseline self-reports.

    Science.gov (United States)

    Kessler, R C; van Loo, H M; Wardenaar, K J; Bossarte, R M; Brenner, L A; Cai, T; Ebert, D D; Hwang, I; Li, J; de Jonge, P; Nierenberg, A A; Petukhova, M V; Rosellini, A J; Sampson, N A; Schoevers, R A; Wilcox, M A; Zaslavsky, A M

    2016-10-01

    Heterogeneity of major depressive disorder (MDD) illness course complicates clinical decision-making. Although efforts to use symptom profiles or biomarkers to develop clinically useful prognostic subtypes have had limited success, a recent report showed that machine-learning (ML) models developed from self-reports about incident episode characteristics and comorbidities among respondents with lifetime MDD in the World Health Organization World Mental Health (WMH) Surveys predicted MDD persistence, chronicity and severity with good accuracy. We report results of model validation in an independent prospective national household sample of 1056 respondents with lifetime MDD at baseline. The WMH ML models were applied to these baseline data to generate predicted outcome scores that were compared with observed scores assessed 10-12 years after baseline. ML model prediction accuracy was also compared with that of conventional logistic regression models. Area under the receiver operating characteristic curve based on ML (0.63 for high chronicity and 0.71-0.76 for the other prospective outcomes) was consistently higher than for the logistic models (0.62-0.70) despite the latter models including more predictors. A total of 34.6-38.1% of respondents with subsequent high persistence chronicity and 40.8-55.8% with the severity indicators were in the top 20% of the baseline ML-predicted risk distribution, while only 0.9% of respondents with subsequent hospitalizations and 1.5% with suicide attempts were in the lowest 20% of the ML-predicted risk distribution. These results confirm that clinically useful MDD risk-stratification models can be generated from baseline patient self-reports and that ML methods improve on conventional methods in developing such models.

  14. Relationship between the body image and level of pain, functional status, severity of depression, and quality of life in patients with fibromyalgia syndrome.

    Science.gov (United States)

    Akkaya, Nuray; Akkaya, Semih; Atalay, Nilgun Simsir; Balci, Ceyhan Sengul; Sahin, Fusun

    2012-06-01

    The aims were to investigate how the body image is affected in fibromyalgia syndrome (FMS) in comparison to healthy people, as well as to explore the relationship of the body image with the level of pain, functional status, severity of depression, and quality of life (QoL). Demographic variables, symptoms of fibromyalgia, and number of fibromyalgia tender points for 51 patients with FMS and 41 control subjects were recorded. All patients were asked to mark the level of pain on visual analogue scale (VAS). Six-minute walking test was recorded for functional assessment. The impact of the disease was evaluated by fibromyalgia impact questionnaire (FIQ). All patients were asked to complete body image scale (BIS), Beck depression inventory (BDI), and short form-36 (SF-36). There were no differences between groups with regard to demographic variables (p>0.05). Mean VAS was 7.5±1.4 for the patients with FMS and 0.3±0.4 for control subjects (p<0.05). Mean FIQ was 70.8±13.2 and 8.2±9.6 for the FMS and control groups, respectively (p<0.05). Mean BIS and BDI were 106.5±24.0 and 20.2±11.2 for FMS group and 66.3±23.4 and 3.4±4.0 for control group, respectively (p<0.05). SF-36 subscores were found to be significantly lower in patients with FMS than control subjects (p<0.05), except for the social function subscore. BIS score had significant relationships both with VAS (r=0.843) and FIQ (r=0.290) in patients with FMS (p<0.05). There were significant relationships between BIS scores and SF-36 pain (r= -0.288), energy/vitality (r= -0.519), mental health (r= -0.442), and general health (r= -0,492) subscores (p<0.05). Body image was associated with VAS in the multivariate linear regression analysis. The results of the present study indicate that body image is disturbed in patients with FMS compared to control subjects. For the evaluation of the level of pain, impact of the disease, and QoL in patients with FMS, it would be useful to consider the relationship of the

  15. Relationship between the prefrontal function and the severity of the emotional symptoms during a verbal fluency task in patients with major depressive disorder: a multi-channel NIRS study.

    Science.gov (United States)

    Liu, Xiaomin; Sun, Gaoxiang; Zhang, Xiaoqian; Xu, Bo; Shen, Chenyu; Shi, Lujie; Ma, Xiangyun; Ren, Xiajin; Feng, Kun; Liu, Pozi

    2014-10-03

    Multi-channel near-infrared spectroscopy (NIRS) is a noninvasive and low-cost functional neuroimaging technique in psychiatric research, and it has been wildly used for detecting the spatiotemporal characteristics of brain activity. In order to evaluate the clinical value of NIRS data in the assistant diagnosis of major depressive disorder (MDD), prefrontal cortex (PFC) hemoglobin concentration exchange of 30 MDD patients combined with anxious and obsessive-compulsive symptom was detected by NIRS under voice fluency task (VFT), then the relationship between the severity of depressive, anxious and obsessive-compulsive symptom assessed by Hamilton Rating Scale for Depression (HAMD), Hamilton Anxiety Rating Scale (HAMA) and Yale-Brown Obsessive Compulsive Scale (Y-BOCS) with NIRS data in PFC was analyzed. Hypoactivation in lateral and lower PFC of MDD patients was confirmed in this study. Furthermore, Spearman correlation found that oxy-hemoglobin concentration ([oxy-Hb]) exchange in right-lateral PFC was associated with the severity of anxiety, while bilateral PFC and antero-medial PFC were associated with severity of depression. Meanwhile, no statistical correlation was observed on the severity of obsessive-compulsive symptom. The results prompted that MDD patients with anxiety and obsession-compulsion symptom showed a PFC hypoactivation state in NIRS. Furthermore, the function of right-lateral PFC was associated with anxiety symptom, while bilateral PFC and antero-medial PFC were associated with depression symptom. Different from depression and anxiety, obsession-compulsion may have a different biological character in PFC function. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Efficacy of individualized homeopathic treatment and fluoxetine for moderate to severe depression in peri- and postmenopausal women (HOMDEP-MENOP): study protocol for a randomized, double-dummy, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Macías-Cortés, Emma del Carmen; Aguilar-Faisal, Leopoldo; Asbun-Bojalil, Juan

    2013-04-23

    The perimenopausal period refers to the interval when women's menstrual cycles become irregular and is characterized by an increased risk of depressive symptoms. Use of homeopathy to treat depression is widespread but there is a lack of clinical trials about its efficacy in depression in peri- and postmenopausal women. Previous trials suggest that individualized homeopathic treatments improve depression. In classical homeopathy, an individually selected homeopathic remedy is prescribed after a complete case history of the patient. The aim of this study is to assess the efficacy and safety of the homeopathic individualized treatment versus placebo or fluoxetine in peri- and postmenopausal women with moderate to severe depression. A randomized, placebo-controlled, double-blind, double-dummy, three-arm trial with a six-week follow-up study was designed. The study will be conducted in a public research hospital in Mexico City (Juárez de México Hospital) in the outpatient service of homeopathy. One hundred eighty nine peri- and postmenopausal women diagnosed with major depression according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (moderate to severe intensity) will be included. The primary outcome is change in the mean total score among groups on the 17-item Hamilton Rating Scale for Depression after the fourth and sixth week of treatment. Secondary outcomes are: Beck Depression Inventory change in mean score, Greene's Scale change in mean score, response and remission rates and safety. Efficacy data will be analyzed in the intention-to-treat population. To determine differences in the primary and secondary outcomes among groups at baseline and weeks four and six, data will be analyzed by analysis of variance for independent measures with the Bonferroni post-hoc test. This study is the first trial of classical homeopathy that will evaluate the efficacy of homeopathic individualized treatment using C-potencies versus placebo or

  17. Study protocol for examining job strain as a risk factor for severe unipolar depression in an individual participant meta-analysis of 14 European cohorts

    DEFF Research Database (Denmark)

    Madsen, Ida E H; Hannerz, Harald; Nyberg, Solja T

    2013-01-01

    scales that do not necessarily correspond to clinically diagnosed depression. In addition, a meta-analysis from 2008 indicated publication bias in the field. METHODS: This study protocol describes the planned design and analyses of an individual participant data meta-analysis, to examine whether job...... using random effects meta-analysis. DISCUSSION: The planned analyses will help clarify whether job strain is associated with an increased risk of clinically diagnosed unipolar depression. As the analysis is based on pre-planned study protocols and an individual participant data meta-analysis, the pooled......BACKGROUND: Previous studies have shown that gainfully employed individuals with high work demands and low control at work (denoted "job strain") are at increased risk of common mental disorders, including depression. Most existing studies have, however, measured depression using self-rated symptom...

  18. 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/depression/ ...

  19. 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....

  20. Depression (Major Depressive Disorder)

    Science.gov (United States)

    ... your mood. Chronic pain causes a number of problems that can lead to depression, such as trouble sleeping and stress. Disabling pain can cause low self-esteem due to work, legal or financial issues. Depression ...

  1. Study protocol for examining job strain as a risk factor for severe unipolar depression in an individual participant meta-analysis of 14 European cohorts [v2; ref status: indexed, http://f1000r.es/30q

    Directory of Open Access Journals (Sweden)

    Ida E. H. Madsen

    2014-02-01

    Full Text Available Background: Previous studies have shown that gainfully employed individuals with high work demands and low control at work (denoted “job strain” are at increased risk of common mental disorders, including depression. Most existing studies have, however, measured depression using self-rated symptom scales that do not necessarily correspond to clinically diagnosed depression. In addition, a meta-analysis from 2008 indicated publication bias in the field.   Methods: This study protocol describes the planned design and analyses of an individual participant data meta-analysis, to examine whether job strain is associated with an increased risk of clinically diagnosed unipolar depression based on hospital treatment registers.  The study will be based on data from approximately 120,000 individuals who participated in 14 studies on work environment and health in 4 European countries. The self-reported working conditions data will be merged with national registers on psychiatric hospital treatment, primarily hospital admissions. Study-specific risk estimates for the association between job strain and depression will be calculated using Cox regressions. The study-specific risk estimates will be pooled using random effects meta-analysis.   Discussion: The planned analyses will help clarify whether job strain is associated with an increased risk of clinically diagnosed unipolar depression. As the analysis is based on pre-planned study protocols and an individual participant data meta-analysis, the pooled risk estimates will not be influenced by selective reporting and publication bias. However, the results of the planned study may only pertain to severe cases of unipolar depression, because of the outcome measure applied.

  2. Study protocol for examining job strain as a risk factor for severe unipolar depression in an individual participant meta-analysis of 14 European cohorts [v1; ref status: indexed, http://f1000r.es/1yz

    Directory of Open Access Journals (Sweden)

    IPD-Work Consortium

    2013-11-01

    Full Text Available Background: Previous studies have shown that gainfully employed individuals with high work demands and low control at work (denoted “job strain” are at increased risk of common mental disorders, including depression. Most existing studies have, however, measured depression using self-rated symptom scales that do not necessarily correspond to clinically diagnosed depression. In addition, a meta-analysis from 2008 indicated publication bias in the field.   Methods: This study protocol describes the planned design and analyses of an individual participant data meta-analysis, to examine whether job strain is associated with an increased risk of clinically diagnosed unipolar depression based on hospital treatment registers.  The study will be based on data from approximately 120,000 individuals who participated in 14 studies on work environment and health in 4 European countries. The self-reported working conditions data will be merged with national registers on psychiatric hospital treatment, primarily hospital admissions. Study-specific risk estimates for the association between job strain and depression will be calculated using Cox regressions. The study-specific risk estimates will be pooled using random effects meta-analysis.   Discussion: The planned analyses will help clarify whether job strain is associated with an increased risk of clinically diagnosed unipolar depression. As the analysis is based on pre-planned study protocols and an individual participant data meta-analysis, the pooled risk estimates will not be influenced by selective reporting and publication bias. However, the results of the planned study may only pertain to severe cases of unipolar depression, because of the outcome measure applied.

  3. Severe depression is associated with increased microglial quinolinic acid in subregions of the anterior cingulate gyrus: Evidence for an immune-modulated glutamatergic neurotransmission?

    Directory of Open Access Journals (Sweden)

    Mawrin Christian

    2011-08-01

    Full Text Available Abstract Background Immune dysfunction, including monocytosis and increased blood levels of interleukin-1, interleukin-6 and tumour necrosis factor α has been observed during acute episodes of major depression. These peripheral immune processes may be accompanied by microglial activation in subregions of the anterior cingulate cortex where depression-associated alterations of glutamatergic neurotransmission have been described. Methods Microglial immunoreactivity of the N-methyl-D-aspartate (NMDA glutamate receptor agonist quinolinic acid (QUIN in the subgenual anterior cingulate cortex (sACC, anterior midcingulate cortex (aMCC and pregenual anterior cingulate cortex (pACC of 12 acutely depressed suicidal patients (major depressive disorder/MDD, n = 7; bipolar disorder/BD, n = 5 was analyzed using immunohistochemistry and compared with its expression in 10 healthy control subjects. Results Depressed patients had a significantly increased density of QUIN-positive cells in the sACC (P = 0.003 and the aMCC (P = 0.015 compared to controls. In contrast, counts of QUIN-positive cells in the pACC did not differ between the groups (P = 0.558. Post-hoc tests showed that significant findings were attributed to MDD and were absent in BD. Conclusions These results add a novel link to the immune hypothesis of depression by providing evidence for an upregulation of microglial QUIN in brain regions known to be responsive to infusion of NMDA antagonists such as ketamine. Further work in this area could lead to a greater understanding of the pathophysiology of depressive disorders and pave the way for novel NMDA receptor therapies or immune-modulating strategies.

  4. The efficacy of antidepressants on overall well-being and self-reported depression symptom severity in youth: a meta-analysis.

    Science.gov (United States)

    Spielmans, Glen I; Gerwig, Katherine

    2014-01-01

    Recent meta-analyses of the efficacy of second-generation antidepressants for youth have concluded that such drugs possess a statistically significant advantage over placebo in terms of clinician-rated depressive symptoms. However, no meta-analysis has included measures of quality of life, global mental health, self-esteem, or autonomy. Further, prior meta-analyses have not included self-reports of depressive symptoms. Studies were selected through searching Medline, PsycINFO, and the Cochrane Central Register for Controlled Trials databases as well as GlaxoSmithKline's online trial registry. We included self-reports of depressive symptoms and pooled measures of quality of life, global mental health, self-esteem, and autonomous functioning as a proxy for overall well-being. We found a nonsignificant difference between second-generation antidepressants and placebo in terms of self-reported depressive symptoms (k = 6 trials, g = 0.06, p = 0.36). Further, pooled across measures of quality of life, global mental health, self-esteem, and autonomy, antidepressants yielded no significant advantage over placebo (k = 3 trials, g = 0.11, p = 0.13). Though limited by a small number of trials, our analyses suggest that antidepressants offer little to no benefit in improving overall well-being among depressed children and adolescents. © 2014 S. Karger AG, Basel.

  5. Individualized homeopathic treatment and fluoxetine for moderate to severe depression in peri- and postmenopausal women (HOMDEP-MENOP study: a randomized, double-dummy, double-blind, placebo-controlled trial.

    Directory of Open Access Journals (Sweden)

    Emma Del Carmen Macías-Cortés

    Full Text Available Perimenopausal period refers to the interval when women's menstrual cycles become irregular and is characterized by an increased risk of depression. Use of homeopathy to treat depression is widespread but there is a lack of clinical trials about its efficacy in depression in peri- and postmenopausal women. The aim of this study was to assess efficacy and safety of individualized homeopathic treatment versus placebo and fluoxetine versus placebo in peri- and postmenopausal women with moderate to severe depression.A randomized, placebo-controlled, double-blind, double-dummy, superiority, three-arm trial with a 6 week follow-up study was conducted. The study was performed in a public research hospital in Mexico City in the outpatient service of homeopathy. One hundred thirty-three peri- and postmenopausal women diagnosed with major depression according to DSM-IV (moderate to severe intensity were included. The outcomes were: change in the mean total score among groups on the 17-item Hamilton Rating Scale for Depression, Beck Depression Inventory and Greene Scale, after 6 weeks of treatment, response and remission rates, and safety. Efficacy data were analyzed in the intention-to-treat population (ANOVA with Bonferroni post-hoc test.After a 6-week treatment, homeopathic group was more effective than placebo by 5 points in Hamilton Scale. Response rate was 54.5% and remission rate, 15.9%. There was a significant difference among groups in response rate definition only, but not in remission rate. Fluoxetine-placebo difference was 3.2 points. No differences were observed among groups in the Beck Depression Inventory. Homeopathic group was superior to placebo in Greene Climacteric Scale (8.6 points. Fluoxetine was not different from placebo in Greene Climacteric Scale.Homeopathy and fluoxetine are effective and safe antidepressants for climacteric women. Homeopathy and fluoxetine were significantly different from placebo in response definition only

  6. Individualized homeopathic treatment and fluoxetine for moderate to severe depression in peri- and postmenopausal women (HOMDEP-MENOP study): a randomized, double-dummy, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Macías-Cortés, Emma Del Carmen; Llanes-González, Lidia; Aguilar-Faisal, Leopoldo; Asbun-Bojalil, Juan

    2015-01-01

    Perimenopausal period refers to the interval when women's menstrual cycles become irregular and is characterized by an increased risk of depression. Use of homeopathy to treat depression is widespread but there is a lack of clinical trials about its efficacy in depression in peri- and postmenopausal women. The aim of this study was to assess efficacy and safety of individualized homeopathic treatment versus placebo and fluoxetine versus placebo in peri- and postmenopausal women with moderate to severe depression. A randomized, placebo-controlled, double-blind, double-dummy, superiority, three-arm trial with a 6 week follow-up study was conducted. The study was performed in a public research hospital in Mexico City in the outpatient service of homeopathy. One hundred thirty-three peri- and postmenopausal women diagnosed with major depression according to DSM-IV (moderate to severe intensity) were included. The outcomes were: change in the mean total score among groups on the 17-item Hamilton Rating Scale for Depression, Beck Depression Inventory and Greene Scale, after 6 weeks of treatment, response and remission rates, and safety. Efficacy data were analyzed in the intention-to-treat population (ANOVA with Bonferroni post-hoc test). After a 6-week treatment, homeopathic group was more effective than placebo by 5 points in Hamilton Scale. Response rate was 54.5% and remission rate, 15.9%. There was a significant difference among groups in response rate definition only, but not in remission rate. Fluoxetine-placebo difference was 3.2 points. No differences were observed among groups in the Beck Depression Inventory. Homeopathic group was superior to placebo in Greene Climacteric Scale (8.6 points). Fluoxetine was not different from placebo in Greene Climacteric Scale. Homeopathy and fluoxetine are effective and safe antidepressants for climacteric women. Homeopathy and fluoxetine were significantly different from placebo in response definition only. Homeopathy, but

  7. Type-D personality but not depression predicts severity of anxiety in heart failure patients at 1-year follow-up

    DEFF Research Database (Denmark)

    Schiffer, Angélique A; Pedersen, Susanne S.; Broers, Herman

    2008-01-01

    Chronic heart failure (CHF) is a debilitating condition associated with poor outcome, including increased anxiety. However, anxiety and its determinants have not yet been studied systematically in CHF. We examined whether type-D personality and depressive symptoms would predict clinically signifi...

  8. Interpersonal discrimination and depressive symptomatology: examination of several personality-related characteristics as potential confounders in a racial/ethnic heterogeneous adult sample

    Science.gov (United States)

    2013-01-01

    Background Research suggests that reports of interpersonal discrimination result in poor mental health. Because personality characteristics may either confound or mediate the link between these reports and mental health, there is a need to disentangle its role in order to better understand the nature of discrimination-mental health association. We examined whether hostility, anger repression and expression, pessimism, optimism, and self-esteem served as confounders in the association between perceived interpersonal discrimination and CESD-based depressive symptoms in a race/ethnic heterogeneous probability-based sample of community-dwelling adults. Methods We employed a series of ordinary least squares regression analyses to examine the potential confounding effect of hostility, anger repression and expression, pessimism, optimism, and self-esteem between interpersonal discrimination and depressive symptoms. Results Hostility, anger repression, pessimism and self-esteem were significant as possible confounders of the relationship between interpersonal discrimination and depressive symptoms, together accounting for approximately 38% of the total association (beta: 0.1892, p interpersonal discrimination remained a positive predictor of depressive symptoms (beta: 0.1176, p personality characteristics in the association between reports of interpersonal discrimination and mental health, our results suggest that personality-related characteristics may serve as potential confounders. Nevertheless, our results also suggest that, net of these characteristics, reports of interpersonal discrimination are associated with poor mental health. PMID:24256578

  9. Differences in Depression, Posttraumatic Stress Disorder, and Lifetime Trauma Exposure in Formerly Abused Women with Mild versus Moderate to Severe Chronic Pain

    Science.gov (United States)

    Humphreys, Janice; Cooper, Bruce A.; Miaskowski, Christine

    2010-01-01

    Although associations between intimate partner violence, chronic pain, depression, posttraumatic stress disorder (PTSD), and lifetime trauma exposure are well known, previous studies are limited by their recruitment of women from shelters. These relationships were explored with a community-based sample of formerly abused women ( N = 84).…

  10. The effect of gender, age, and symptom severity in late-life depression on the risk of all-cause mortality: The Bambuí Cohort Study of Aging

    Science.gov (United States)

    Diniz, Breno S.; Reynolds, Charles F.; Butters, Meryl A.; Dew, Mary Amanda; Firmo, Josélia O. A.; Lima-Costa, Maria Fernanda; Castro-Costa, Erico

    2014-01-01

    Background Increased mortality risk and its moderators is an important, but still under recognized, negative outcome of Late-Life Depression (LLD). Therefore, we aimed to evaluate whether LLD is a risk factor for all-cause mortality in a population-based study with over ten years of follow-up, and addressed the moderating effect of gender and symptom severity on mortality risk. Methods This analysis used data from the Bambuí Cohort Study of Aging. The study population comprised 1.508 (86.5%) of all eligible 1.742 elderly residents. Depressive symptoms were annually evaluated by the GHQ-12, with scores of 5 or higher indicating clinically significant depression. From 1997 to 2007, 441 participants died during 10,648 person-years of follow-up. We estimated the hazard ratio for mortality risk by Cox regression analyses. Results Depressive symptoms were a risk factor for all-cause mortality after adjusting for confounding lifestyle and clinical factors (adjusted HR=1.24 CI95% [1.00–1.55], p=0.05). Mortality risk was significantly elevated in men (adjusted HR=1.45 CI95% [1.01 – 2.07], p=0.04), but not in women (adjusted HR=1.13 CI95% [0.84 – 1.48], p=0.15). We observed a significant interaction between gender and depressive symptoms on mortality risk ((HR= 1.72 CI95% [1.18 – 2.49], p=0.004). Conclusion The present study provides evidence that LLD is a risk factor for all-cause mortality in the elderly, especially in men. The prevention and adequate treatment of LLD may help to reduce premature disability and death among elders with depressive symptoms. PMID:24353128

  11. Effects of IL1B single nucleotide polymorphisms on depressive and anxiety symptoms are determined by severity and type of life stress.

    Science.gov (United States)

    Kovacs, David; Eszlari, Nora; Petschner, Peter; Pap, Dorottya; Vas, Szilvia; Kovacs, Peter; Gonda, Xenia; Juhasz, Gabriella; Bagdy, Gyorgy

    2016-08-01

    Interleukin-1β is one of the main mediators in the cross-talk between the immune system and the central nervous system. Higher interleukin-1β levels are found in mood spectrum disorders, and the stress-induced expression rate of the interleukin-1β gene (IL1B) is altered by polymorphisms in the region. Therefore we examined the effects of rs16944 and rs1143643 single nucleotide polymorphisms (SNPs) within the IL1B gene on depressive and anxiety symptoms, as measured by the Brief Symptom Inventory, in a Hungarian population sample of 1053 persons. Distal and proximal environmental stress factors were also included in our analysis, namely childhood adversity and recent negative life-events. We found that rs16944 minor (A) allele specifically interacted with childhood adversity increasing depressive and anxiety symptoms, while rs1143643's minor (A) allele showed protective effect against depressive symptoms after recent life stress. The genetic main effects of the two SNPs were not significant in the main analysis, but the interaction effects remained significant after correction for multiple testing. In addition, the effect of rs16944 A allele was reversed in a subsample with low-exposure to life stress, suggesting a protective effect against depressive symptoms, in the post hoc analysis. In summary, both of the two IL1B SNPs showed specific environmental stressor-dependent effects on mood disorder symptoms. We also demonstrated that the presence of exposure to childhood adversity changed the direction of the rs16944 effect on depression phenotype. Therefore our results suggest that it is advisable to include environmental factors in genetic association studies when examining the effect of the IL1B gene. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  12. Development and initial evaluation of blended cognitive behavioural treatment for major depression in routine specialized mental health care

    DEFF Research Database (Denmark)

    Kooistra, L. C.; Ruwaard, J.; Wiersma, J. E.

    2016-01-01

    the costs of mental health care, by reducing treatment duration and/or therapist contact. However, knowledge on blended care for depression is still limited. Objectives: To develop a blended cognitive behavioural treatment (bCBT) for depressed patients in an outpatient specialized mental health care centre...... with depressed patients (n = 9) in specialized mental health care. Patients' clinical profiles were established based on pre-treatment diagnostic information and patient self-reports on clinical measures. Patient treatment adherence rates were explored, together with patient ratings of credibility and expectancy...... the potential to be a valuable treatment option for patients with severe depression in specialized mental health care settings. Further exploration of the effectiveness of our bCBT protocol by means of a randomized controlled trial is warranted. © 2016 The Authors....

  13. Patient-rated health status predicts prognosis following percutaneous coronary intervention with drug-eluting stenting

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; Versteeg, Henneke; Denollet, Johan

    2011-01-01

    In patients treated with percutaneous coronary intervention (PCI) with the paclitaxel-eluting stent, we examined whether patient-rated health status predicts adverse clinical events.......In patients treated with percutaneous coronary intervention (PCI) with the paclitaxel-eluting stent, we examined whether patient-rated health status predicts adverse clinical events....

  14. Evidence that psychotic symptoms are prevalent in disorders of anxiety and depression, impacting on illness onset, risk, and severity--implications for diagnosis and ultra-high risk research.

    Science.gov (United States)

    Wigman, Johanna T W; van Nierop, Martine; Vollebergh, Wilma A M; Lieb, Roselind; Beesdo-Baum, Katja; Wittchen, Hans-Ullrich; van Os, Jim

    2012-03-01

    It is commonly assumed that there are clear lines of demarcation between anxiety and depressive disorders on the one hand and psychosis on the other. Recent evidence, however, suggests that this principle may be in need of updating. Depressive and/or anxiety disorders, with no previous history of psychotic disorder, were examined for the presence of psychotic symptoms in a representative community sample of adolescents and young adults (Early Developmental Stages of Psychopathology study; n = 3021). Associations and consequences of psychotic symptomatology in the course of these disorders were examined in terms of demographic distribution, illness severity, onset of service use, and risk factors. Around 27% of those with disorders of anxiety and depression displayed one or more psychotic symptoms, vs 14% in those without these disorders (OR 2.23, 95% CI 1.89-2.66, P illness course (P symptoms (P illness behavior (P illness (P disorders of anxiety and depression is common and a functionally and etiologically highly relevant feature, reinforcing the view that psychopathology is represented by a network or overlapping and reciprocally impacting dimensional liabilities.

  15. Correlation between depression and burden observed in informal caregivers of people suffering from dementia with time spent on caregiving and dementia severity

    DEFF Research Database (Denmark)

    Gregersen, Rikke

    2016-01-01

    The aim of thestudy is to compare data on the examined populationof informal caregivers of people sufferingfrom dementia with previous studies, aswell as to assess the correlation between (i) depressiondetermined on the basis of the Centerfor Epidemiologic Studies Depression Scaleand (ii) caregiver...... dementia fromdifferent backgrounds were evaluated usingthe Zarit Caregiver Burden Scale and the Centerfor Epidemiologic Studies DepressionScale. Demographic data about the time devotedto caregiving and the number of hoursspend on caregiving weekly were gathered. Thetype of dementia and its stage were...... registeredusing the Global Deterioration Scale (GDS).With the aid of the Statistica StatSoft program,mutual correlations between the parameterswere measured. The study was conducted withinthe framework of AAL UnderstAID – a platformthat supports and helps to understandand assist caregivers in the care...

  16. Standardization of depression measurement

    DEFF Research Database (Denmark)

    Wahl, Inka; Löwe, Bernd; Bjørner, Jakob

    2014-01-01

    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...... of 33,844 adults were used for secondary analysis including routine assessments of 23,817 in- and outpatients with mental and/or medical conditions (46% with depressive disorders) and a general population sample of 10,027 randomly selected participants from three representative German household surveys....... RESULTS: A standardized metric for depression severity was defined by 143 items, and scores were normed to a general population mean of 50 (standard deviation = 10) for easy interpretability. It covers the entire range of depression severity assessed by established instruments. The metric allows...

  17. The effects of perceived torture controllability on symptom severity of posttraumatic stress, depression and anger in refugees and asylum seekers: A path analysis.

    Science.gov (United States)

    Le, Lillian; Morina, Naser; Schnyder, Ulrich; Schick, Matthis; Bryant, Richard A; Nickerson, Angela

    2018-03-23

    Torture is associated with greater psychopathology, however, the specific mechanisms underlying the effects of torture remain unclear. Research suggests that the perceived uncontrollable nature of, rather than the exposure to, torture, influences the development of psychological disorders. Perceived distress during torture has also been shown to influence psychological outcomes. This cross-sectional study explored the relationship between perceived torture controllability, emotions (i.e., anger and fear) during torture, and current posttraumatic stress (PTS), depression and anger symptoms, controlling for the effects of post-migration living difficulties. Data were collected from 108 refugees and asylum seekers in treatment at two psychiatric clinics in Zurich, Switzerland. Path analyses revealed negative correlations between PTS, depression and anger symptoms, and perceived torture controllability, and positive correlations with anger and fear during torture. Furthermore, the effects of perceived torture controllability on PTS and depression symptoms were mediated by fear during torture, and on anger symptoms via anger during torture. This was over and above the effects of post-migration living difficulties on psychological symptoms. The study provides preliminary evidence that perceived uncontrollability and distress during torture might be significant risk factors for current mental health of torture survivors. These findings may have implications for informing interventions for torture survivors. Copyright © 2018 Elsevier B.V. All rights reserved.

  18. Mood self-assessment in bipolar disorder: a comparison between patients in mania, depression, and euthymia

    Directory of Open Access Journals (Sweden)

    Rafael de Assis da Silva

    2013-01-01

    Full Text Available BACKGROUND: Some studies indicate that mood self-assessment is more severely impaired in patients with bipolar disorder in a manic episode than in depression. OBJECTIVES: To investigate variations in mood self-assessment in relation to current affective state in a group of individuals with bipolar disorder. METHODS: A total of 165 patients with a diagnosis of bipolar disorder type I or type II had their affective state assessed using the Clinical Global Impressions Scale for use in bipolar illness (CGI-BP, the Positive and Negative Syndrome Scale (PANSS, and the Global Assessment of Functioning (GAF. In addition, participants completed a self-report visual analog mood scale (VAMS. Patients were divided into three groups (euthymia, mania, and depression and compared with regard to VAMS results. RESULTS: Manic patients rated their mood similarly to patients in euthymia in 14 out of 16 items in the VAMS. By contrast, depressed patients rated only two items similarly to euthymic patients. CONCLUSION: Patients with bipolar disorder in mania, but not those in depression, poorly evaluate their affective state, reinforcing the occurrence of insight impairment in the manic syndrome.

  19. Ansiedad y depresión en fumadores mexicanos y su relación con el grado de adicción Anxiety and depression in Mexican smokers, and their relationship with the severity of addiction

    Directory of Open Access Journals (Sweden)

    Eryka del Carmen Urdapilleta-Herrera

    2010-01-01

    Full Text Available Objetivo. Determinar la asociación entre el grado de adicción (GA y patrón de consumo de tabaco (PCT con la ansiedad y depresión en fumadores que quieren dejar de fumar (FQDF. Material y métodos. En 495 sujetos que acudieron a un programa para dejar de fumar se determinó la ansiedad (inventario IDARE y depresión (cuestionario BECK, el GA (cuestionario de Fagerström y PCT (paquetes-año. Resultados. El GA>= a 6 puntos se asoció con niveles de ansiedad altos [RM=1.94, (IC95%1.02-3.72, p= a 21 paquetes año, se asoció con ansiedad rasgo media; [RM=3.19 (IC95%1.94-5.25, pObjective. To determine the relationship between the degree of addiction (DA and pattern of tobacco consumption (PTC with anxiety and depression in smokers who want to quit smoking. Material and Methods. At admission to a smoking cessation program 495 smokers were surveyed to determine anxiety (IDARE Test, depression (Beck Inventory Test, DA (Fagerström Test and PTC (pack-years. Results. DA>= 6 points was associated with high anxiety levels RM=1.94, (IC95%1.02-3.72, p<0.04]; and with symptoms of severe depression; [RM=2.24, (IC95%1.00-4.99, p<0.04]. The PCT equal or greater than 21 pack-year, was associated with moderate anxiety; [RM=3.19 (IC95%1.94-5.25, p<.00]; high anxiety; [RM=3.36 (IC95% 1.66-6-80, p<.00]; with moderate depressive symptoms; [RM=3.14, (IC95% 1.75-5-62, p<.00] and severe depressive symptoms; [RM=9.85, (IC95% 3.30-29.37, p<.00]. Conclusion. A significant association exists in smokers having high GA and PCT, with moderate and high anxiety and depressive symptoms that should be considered during interventions to quit.

  20. Three and six-month outcome following courses of either ECT or rTMS in a population of severely depressed individuals--preliminary report.

    Science.gov (United States)

    Dannon, Pinhas N; Dolberg, Ornah T; Schreiber, Shaul; Grunhaus, Leon

    2002-04-15

    Recent studies have strengthened the claim that repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for major depression. The longitudinal outcome of TMS-treated patients, however, has not been described. We report on the 3- and 6-month outcomes of a group of patients treated with either electroconvulsive therapy (ECT) (n = 20) or (rTMS) (n = 21). Patients diagnosed with major depressive disorder with or without psychotic features referred for ECT were randomly assigned to receive either ECT or rTMS. Forty-one patients who responded to either treatment constituted the sample. Patients were followed on a monthly basis and outcomes were determined with the Hamilton Rating Scale for Depression-17 items (HRSD) and the Global Assessment of Functioning (GAF) scales. Medications were routinely prescribed. There were no differences in the 6-month relapse rate between the groups. Overall, 20% of the patients relapsed (four from the ECT group and four from the rTMS group). Patients reported equally low and not significantly different scores in the HRSD (ECT group 8.4 +/- 5.6 and TMS group 7.9 +/- 7.1) and the GAF (ECT group 72.8 +/- 12 and TMS group 77.8 +/- 17.1) at the 6-month follow up. Patients treated with rTMS do as well as those treated with ECT at the 3- and 6-month follow-up points. These data suggest that the clinical gains obtained with rTMS last at least as long as those obtained with ECT.

  1. Unilateral versus bilateral irradiation in squamous cell head and neck cancer in relation to patient-rated xerostomia and sticky saliva

    NARCIS (Netherlands)

    Jellema, Anke Petra; Slotman, Ben J.; Doornaert, Patricia; Leemans, C. Rene; Langendijk, Johannes A.

    2007-01-01

    Background and purpose: To investigate the association between radiation technique with patient-rated moderate and severe xerostomia and sticky saliva. Materials and methods: One hundred and fifty patients treated with bilateral or unilateral irradiation for head and neck cancer were included. The

  2. Insomnia severity and its relationship with demographics, pain features, anxiety, and depression in older adults with and without pain: cross-sectional population-based results from the PainS65+cohort

    OpenAIRE

    Dragioti, Elena; Levin, Lars-Åke; Bernfort, Lars; Larsson, Britt; Gerdle, Björn

    2017-01-01

    Background: Insomnia is a major cause of concern in the elderly with and without pain. This study set out to examine the insomnia and its correlates in a large sample of community adults aged amp;gt;= 65 years. Methods: A cross-sectional postal survey was completed by 6205 older individuals (53.8% women; mean age = 76.2 years; SD = 7.5). The participants also completed the Insomnia Severity Index (ISI) and questionnaires assessing pain intensity, pain spreading, anxiety, depression, and basic...

  3. 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 ...

  4. Depression FAQs

    Science.gov (United States)

    Depression affects about 15 million American adults every year. Women are more likely to get depression than men. In general, about one out of every four women will get depression at some point in her life.

  5. Depression Screening

    Science.gov (United States)

    ... Depression Screening Substance Abuse Screening Alcohol Use Screening 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 ...

  6. Depression in Hemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Badema Čengić

    2010-04-01

    Full Text Available Depression is the most frequent psychological complication of haemodialysis (HD patients (pts and has been associated with impaired Quality of Life (QoL. The aim of our study was to investigate the prevalence of depression in HD pts in relation to sociodemographic factors and the relationship between depression and QoL.200 pts from Clinic for haemodialysis in Sarajevo, B&H were participating in the study. Mean age was S7,26±13,78 years and mean HD duration was 64’26±58,18 months. From the test material we applied BDI and SF-36.51% of our pts have shown depression (BDI>11 in various degrees (30%-mild depression, 8,5%-moderate depression and 12,5%-severe depression. As we could expect, the most emphasized symptoms of depression were somatic symptoms. 55,5% of pts have shown QoL lower then average. Sociodemographic data such as gender, marital status and HD duration did not influence significantly on pt’s QoL and occurrence of depression (p>0,05. As the age of the pts increased, level of depression increased too and QoL significantly decreased (p<0,05. Employed pts have shown significantly better QoL and lower level of depression in relation to unemployed pts (p<0,05. As the educational level of pts increased, QoL increased too and level of depression significantly decreased (p<0,05. Pts in 1st HD shift were significantly more depressed and have significantly worse mental health in compare to pts in 3rd HD shift (p<0,05. Our results showed a high prevalence of depressive symptoms among the study group that was linked to trend of poor QoL.

  7. 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.

  8. 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. © 2015 The Author(s) Published by S

  9. Experiences of depression

    DEFF Research Database (Denmark)

    Rønberg, Mette

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

  10. 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.

  11. Nature-assisted rehabilitation for reactions to severe stress and/or depression in a rehabilitation garden: long-term follow-up including comparisons with a matched population-based reference cohort.

    Science.gov (United States)

    Währborg, Peter; Petersson, Ingemar F; Grahn, Patrik

    2014-03-01

    To determine the effect of a nature-assisted rehabilitation programme in a group of patients with reactions to severe stress and/or mild to moderate depression. Changes in sick-leave status and healthcare consumption in these patients were compared with those in a matched population-based reference cohort (treatment as usual). Retrospective cohort study with a matched reference group from the general population. A total of 118 participants referred to a nature-assisted rehabilitation programme, and 678 controls recruited from the Skåne Health Care Register. For both groups, information on sick leave was extracted from the National Social Insurance Register and on healthcare consumption data from the Skåne Health Care Register. The interventional rehabilitation programme was designed as a multimodal programme involving professionals from horticulture and medicine. The programme was conducted in a rehabilitation garden, designed especially for this purpose. A significant reduction in healthcare consumption was noted among participants in the programme compared with the reference population. The main changes were a reduction in outpatient visits to primary healthcare and a reduction in inpatient psychiatric care. No significant difference in sick-leave status was found. A structured, nature-based rehabilitation programme for patients with reactions to severe stress and/or depression could be beneficial, as reflected in reduced healthcare consumption.

  12. Severity of the aggression/anxiety-depression/attention child behavior checklist profile discriminates between different levels of deficits in emotional regulation in youth with attention-deficit hyperactivity disorder.

    Science.gov (United States)

    Biederman, Joseph; Petty, Carter R; Day, Helen; Goldin, Rachel L; Spencer, Thomas; Faraone, Stephen V; Surman, Craig B H; Wozniak, Janet

    2012-04-01

    We examined whether severity scores (1 SD vs 2 SDs) of a unique profile of the Child Behavior Checklist (CBCL) consisting of the Anxiety/Depression, Aggression, and Attention (AAA) scales would help differentiate levels of deficits in children with attention-deficit hyperactivity disorder (ADHD). Subjects were 197 children with ADHD and 224 without ADHD. We defined deficient emotional self-regulation (DESR) as an aggregate cutoff score of >180 but siblings. In contrast, the CBCL-DESR was associated with higher rates of comorbid disruptive behavior, anxiety disorders, and impaired interpersonal functioning compared with other ADHD children. Severity scores of the AAA CBCL profiles can help distinguish 2 groups of emotional regulation problems in children with ADHD.

  13. Six-month follow-up of patient-rated outcomes in a randomized controlled trial of exercise training during breast cancer chemotherapy.

    Science.gov (United States)

    Courneya, Kerry S; Segal, Roanne J; Gelmon, Karen; Reid, Robert D; Mackey, John R; Friedenreich, Christine M; Proulx, Caroline; Lane, Kirstin; Ladha, Aliya B; Vallance, Jeffrey K; Liu, Qi; Yasui, Yutaka; McKenzie, Donald C

    2007-12-01

    Few exercise trials in cancer patients have reported longer-term follow-up. Here, we report a 6-month follow-up of exercise behavior and patient-rated outcomes from an exercise trial in breast cancer patients. Breast cancer patients initiating adjuvant chemotherapy (n = 242) were randomly assigned to usual care (n = 82), resistance exercise training (RET; n = 82), or aerobic exercise training (AET; n = 78) for the duration of their chemotherapy. At 6-month follow-up, participants were mailed a questionnaire that assessed quality of life, self-esteem, fatigue, anxiety, depression, and exercise behavior. Two hundred one (83.1%) participants provided 6-month follow-up data. Adjusted linear mixed-model analyses showed that, at 6-month follow-up, the RET group reported higher self-esteem [adjusted mean difference, 1.6; 95% confidence interval (95% CI), 0.1-3.2; P = 0.032] and the AET group reported lower anxiety (adjusted mean difference, -4.7; 95% CI, -0.0 to -9.3; P = 0.049) compared with the usual care group. Moreover, compared with participants reporting no regular exercise during the follow-up period, those reporting regular aerobic and resistance exercise also reported better patient-rated outcomes, including quality of life (adjusted mean difference, 9.5; 95% CI, 1.2-17.8; P = 0.025). Improvements in self-esteem observed with RET during breast cancer chemotherapy were maintained at 6-month follow-up whereas reductions in anxiety not observed with AET during breast cancer chemotherapy emerged at 6-month follow-up. Moreover, adopting a combined aerobic and resistance exercise program after breast cancer chemotherapy was associated with further improvements in patient-rated outcomes. Exercise training during breast cancer chemotherapy may result in some longer-term and late effects for selected patient-rated outcomes.

  14. [Primary headache and depression].

    Science.gov (United States)

    Gesztelyi, Gyöngyi

    2004-11-28

    Primary headaches--mainly tension-type headache and migraine--affect a significant portion of the population. Depression is also highly prevalent. The co-existence of a primary headache and depression in the same patient therefore might be a coincidence due to the high prevalence of these conditions, but there might be a causal relationship between them, or headaches and depression might have a common background. This review of the literature summarizes the features of the relationship between primary headaches and depression. Depression is more prevalent in headache patients than in the headache-free population. Prospective epidemiological studies suggest a common genetic, biochemical or environmental background behind primary headaches and depression. This theory is supported by the role of the same neurotransmitter systems (mostly serotonin and dopamine) in headaches as well as in depression. Comorbid depression is associated with female gender, higher age, and higher frequency of headaches. Most depression inventories--questionnaires used to screen for the severity of depressive symptoms--contain transdiagnostic items, therefore their use in their original form is limited in organic diseases: due to the somatic items they might overestimate the severity of depression. When examining a headache patient special attention should be paid to the recognition of comorbid depression. The diagnosis of suspected mood disorder could be supported by using simple screening methods, such as the original or the abbreviated versions of standard depression inventories, but the final diagnosis of major depression needs psychiatric evaluation. Quality of life of the headache patient is affected not only by the characteristics of pain (frequency, duration, severity) but also by the disability caused by headache and the associating mood disorder. Recognizing coexisting mood disorder and disability helps to make the best treatment choice for the acute and preventive treatment of

  15. 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...... by statistical hypothesis testing....

  16. POST TRAUMATIC STRESS DISORDERS (PTSD WITH SEVERE DEPRESSION SYMPTOMS WITH ACUTE PSYCHOTIC IN PATIENT WITH HISTORY AS A PEDOPHILE VICTIMS AND DOMESTIC VIOLENCE IN 22 YEARS OLD MAN : A CASE REPORT

    Directory of Open Access Journals (Sweden)

    I Ketut Agus Indra Adhiputra

    2014-02-01

    Full Text Available Post traumatic stress disorders (PTSD is a disorder that is fairly common in thecommunity. Every event in the life will have its own meaning in later, especially eventsthat occur in childhood. Data in the U.S. showed 60% men and 50% women have atraumatic experience, which develops into PTSD approximately 6.7% of the entirepopulation. While data from the Indonesian National Commission of Women, since 20072010there has been 91311 cases of sexual violence against women, as well as cases ofchild sexual abuse reported to reach 250 cases. Presenting symptoms can range fromanxiety disorders, depression, until psychotic. The severity of symptoms depends on eachself-defense mechanism thus the PTSD symptoms are very diverse.

  17. Measuring psychotic depression

    DEFF Research Database (Denmark)

    Østergaard, S D; 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...

  18. Depression following myocardial infarction

    DEFF Research Database (Denmark)

    Larsen, Karen Kjær

    2013-01-01

    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...... between post-MI depression and new cardiovascular events or death, taking potential mediators into account (Paper III); 4. To examine the association between MI and suicide (Paper IV). Two different study designs were employed: a population-based cohort study using data obtained from registers......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...

  19. Self-reported pain severity, quality of life, disability, anxiety and depression in patients classified with 'nociceptive', 'peripheral neuropathic' and 'central sensitisation' pain. The discriminant validity of mechanisms-based classifications of low back (±leg) pain.

    LENUS (Irish Health Repository)

    Smart, Keith M

    2012-04-01

    Evidence of validity is required to support the use of mechanisms-based classifications of pain clinically. The purpose of this study was to evaluate the discriminant validity of \\'nociceptive\\' (NP), \\'peripheral neuropathic\\' (PNP) and \\'central sensitisation\\' (CSP) as mechanisms-based classifications of pain in patients with low back (±leg) pain by evaluating the extent to which patients classified in this way differ from one another according to health measures associated with various dimensions of pain. This study employed a cross-sectional, between-subjects design. Four hundred and sixty-four patients with low back (±leg) pain were assessed using a standardised assessment protocol. Clinicians classified each patient\\'s pain using a mechanisms-based classification approach. Patients completed a number of self-report measures associated with pain severity, health-related quality of life, functional disability, anxiety and depression. Discriminant validity was evaluated using a multivariate analysis of variance. There was a statistically significant difference between pain classifications on the combined self-report measures, (p = .001; Pillai\\'s Trace = .33; partial eta squared = .16). Patients classified with CSP (n = 106) reported significantly more severe pain, poorer general health-related quality of life, and greater levels of back pain-related disability, depression and anxiety compared to those classified with PNP (n = 102) and NP (n = 256). A similar pattern was found in patients with PNP compared to NP. Mechanisms-based pain classifications may reflect meaningful differences in attributes underlying the multidimensionality of pain. Further studies are required to evaluate the construct and criterion validity of mechanisms-based classifications of musculoskeletal pain.

  20. Depression (PDQ)

    Science.gov (United States)

    ... Data Conducting Clinical Trials Statistical Tools and Data Terminology Resources NCI Data Catalog Cryo-EM NCI's Role ... that may also cause depression. There are many medical conditions that can cause depression. Medical conditions that ...

  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. Off-pump coronary artery bypass surgery in selected patients is superior to the conventional approach for patients with severely depressed left ventricular function

    Science.gov (United States)

    Caputti, Guido Marco; Palma, José Honório; Gaia, Diego Felipe; Buffolo, Enio

    2011-01-01

    OBJECTIVES: Patients with coronary artery disease and left ventricular dysfunction have high mortality when kept in clinical treatment. Coronary artery bypass grafting can improve survival and the quality of life. Recently, revascularization without cardiopulmonary bypass has been presented as a viable alternative. The aim of this study is to compare patients with left ventricular ejection fractions of less than 20% who underwent coronary artery bypass graft with or without cardiopulmonary bypass. METHODS: From January 2001 to December 2005, 217 nonrandomized, consecutive, and nonselected patients with an ejection fraction less than or equal to 20% underwent coronary artery bypass graft surgery with (112) or without (off-pump) (105) the use of cardiopulmonary bypass. We studied demographic, operative, and postoperative data. RESULTS: There were no demographic differences between groups. The outcome variables showed similar graft numbers in both groups. Mortality was 12.5% in the cardiopulmonary bypass group and 3.8% in the off-pump group. Postoperative complications were statistically different (cardiopulmonary bypass versus off-pump): total length of hospital stay (days)—11.3 vs. 7.2, length of ICU stay (days)—3.7 vs. 2.1, pulmonary complications—10.7% vs. 2.8%, intubation time (hours)—22 vs. 10, postoperative bleeding (mL)—654 vs. 440, acute renal failure—8.9% vs. 1.9% and left-ventricle ejection fraction before discharge—22% vs. 29%. CONCLUSION: Coronary artery bypass grafting without cardiopulmonary bypass in selected patients with severe left ventricular dysfunction is valid and safe and promotes less mortality and morbidity compared with conventional operations. PMID:22189729

  3. Off-pump coronary artery bypass surgery in selected patients is superior to the conventional approach for patients with severely depressed left ventricular function

    Directory of Open Access Journals (Sweden)

    Guido Marco Caputti

    2011-01-01

    Full Text Available OBJECTIVES: Patients with coronary artery disease and left ventricular dysfunction have high mortality when kept in clinical treatment. Coronary artery bypass grafting can improve survival and the quality of life. Recently, revascularization without cardiopulmonary bypass has been presented as a viable alternative. The aim of this study is to compare patients with left ventricular ejection fractions of less than 20% who underwent coronary artery bypass graft with or without cardiopulmonary bypass. METHODS: From January 2001 to December 2005, 217 nonrandomized, consecutive, and nonselected patients with an ejection fraction less than or equal to 20% underwent coronary artery bypass graft surgery with (112 or without (off-pump (105 the use of cardiopulmonary bypass. We studied demographic, operative, and postoperative data. RESULTS: There were no demographic differences between groups. The outcome variables showed similar graft numbers in both groups. Mortality was 12.5% in the cardiopulmonary bypass group and 3.8% in the off-pump group. Postoperative complications were statistically different (cardiopulmonary bypass versus off-pump: total length of hospital stay (days-11.3 vs. 7.2, length of ICU stay (days-3.7 vs. 2.1, pulmonary complications-10.7% vs. 2.8%, intubation time (hours-22 vs. 10, postoperative bleeding (mL-654 vs. 440, acute renal failure-8.9% vs. 1.9% and left-ventricle ejection fraction before discharge-22% vs. 29%. CONCLUSION: Coronary artery bypass grafting without cardiopulmonary bypass in selected patients with severe left ventricular dysfunction is valid and safe and promotes less mortality and morbidity compared with conventional operations.

  4. Teen Depression

    Science.gov (United States)

    What is depression in teens? Teen depression is a serious medical illness. It's more than just a feeling of being sad or "blue" for a few days. It is ... trouble focusing and have no motivation or energy. Depression can make you feel like it is hard ...

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

    Directory of Open Access Journals (Sweden)

    Brett Silverstein

    2015-01-01

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

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

    Science.gov (United States)

    Silverstein, Brett; Angst, Jules

    2015-01-01

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

  7. 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...

  8. Depression and obstructive sleep apnea.

    Science.gov (United States)

    Hobzova, Milada; Prasko, Jan; Vanek, Jakub; Ociskova, Marie; Genzor, Samuel; Holubova, Michaela; Grambal, Ales; Latalova, Klara

    2017-10-01

    Obstructive sleep apnea (OSA), is described as intermittent interruptions or reductions in airflow which are initiated by an incomplete or complete collapse of the upper airways despite respiratory effort. When left untreated, OSA is connected with comorbid conditions, such as cardiovascular and metabolic illnesses. The PubMed database was used to examine papers published until April 2017 using the subsequent terms: "obstructive sleep apnea" or "obstructive sleep apnoea" and "depression" in successive combination with "CPAP (continuous positive airway pressure)", "therapy", "pharmacotherapy", "psychotherapy", "cognitive behavioral therapy" or "quality of life". After assessment for the suitability, 126 articles were chosen. The numerous evidence of a connection between OSA and depressive symptoms, as well as depressive disorder, were found. This connection may be directly or indirectly linked due to the participation of some OSA mediators consequences such as obesity, hypertension, and the decreased quality of life. Patients with the comorbid major depression and OSA reported more severe and longer episodes of depression. Nevertheless, the information on the effect of the treatment of OSA using CPAP on the depressive symptoms was limited. Still, the current state of the art suggests that this treatment decreases the severity of the comorbid depressive symptoms. It is important to evaluate the symptoms of depression in the patients with OSA. On the other side, a psychiatrist should not just treat the depression, as it is also important to screen individuals at high risk of OSA when assessing patients for depressive disorder, especially those with depression resistant to treatment.

  9. Depression Screening and Patient Outcomes in Cancer : A Systematic Review

    NARCIS (Netherlands)

    Meijer, Anna; Roseman, Michelle; Milette, Katherine; Coyne, James C.; Stefanek, Michael E.; Ziegelstein, Roy C.; Arthurs, Erin; Leavens, Allison; Palmer, Steven C.; Stewart, Donna E.; de Jonge, Peter; Thombs, Brett D.

    2011-01-01

    Background: Several practice guidelines recommend screening for depression in cancer care, but no systematic reviews have examined whether there is evidence that depression screening benefits cancer patients. The objective was to evaluate the potential benefits of depression screening in cancer

  10. Psychosocial Factors Predicting Severity of Depression Among ...

    African Journals Online (AJOL)

    2017-03-06

    Mar 6, 2017 ... treatment-seeking HIV/AIDS patients: A multi-site Nigerian study. Niger J. Clin Pract 2017 .... the role played by self-esteem, HIV-related stigma, and anticipated ..... could serve as a measure of treatment adherence and help.

  11. Depression and cardiovascular disease.

    Science.gov (United States)

    Elderon, Larkin; Whooley, Mary A

    2013-01-01

    Approximately one out of every five patients with cardiovascular disease (CVD) suffers from major depressive disorder (MDD). Both MDD and depressive symptoms are risk factors for CVD incidence, severity and outcomes. Great progress has been made in understanding potential mediators between MDD and CVD, particularly focusing on health behaviors. Investigators have also made considerable strides in the diagnosis and treatment of depression among patients with CVD. At the same time, many research questions remain. In what settings is depression screening most effective for patients with CVD? What is the optimal screening frequency? Which therapies are safe and effective? How can we better integrate the care of mental health conditions with that of CVD? How do we motivate depressed patients to change health behaviors? What technological tools can we use to improve care for depression? Gaining a more thorough understanding of the links between MDD and heart disease, and how best to diagnose and treat depression among these patients, has the potential to substantially reduce morbidity and mortality from CVD. Published by Elsevier Inc.

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

    Science.gov (United States)

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

    2008-06-01

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

  13. [Programmes against depression].

    Science.gov (United States)

    Taleb, M; Rouillon, F; Hegerl, U; Hamdani, N; Gorwood, Ph

    2006-01-01

    Depressive disorders represent a major public health concern, regarding their high frequency and their important cost. Depression impair the quality of life more than any other disease, sometimes leading to suicidal ideas or behavior. Indeed, 50% of patients with severe major depression commit suicide. Numerous studies showed that depressive disorders are frequently not recognised, and regularly untreated. In France, where at least 3 millions of inhabitants are concerned, 38% of depressed patients are not using any health system. When they are asking for care, the majority of depressed patients visit their general practitioner (51%), whereas less than 10% visit a psychiatrist. Even when the diagnostic is correct, the treatment prescribed is not systematically relevant. The treatment is, for example, frequently proposed for a too short period, and sometimes the prescribed product does not have proven antidepressive efficacy. Furthermore, as incorrect informations are frequently given to patients, and as there is a general biased judgement about psychotropic drugs in the general population, the compliance is usually poor for antidepressive treatment. Therefore, only a small minority of depressed patients benefits from an adequate care. Public health information methodological asserts. To improve this situation, delivering simple and clear-cut recommendations cannot be considered as sufficiently effective, and public health interventions are required. Different programs improving the recognition of depressive disorders have already been tested in some countries with encouraging results. These programs are based on information campaigns given to the public, and the training of general practitioners about the management of depressive disorders. The "Defeat Depression" campaign in Great-Britain and the "National Depression Screening Day" in the United-States of America may represent informative examples. Restricting these programs to general practitioners only is

  14. Major Depressive Disorder

    Directory of Open Access Journals (Sweden)

    G Grobler

    2013-08-01

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

  15. Is Chronic Inflammation a Possible Cause of Obesity-Related Depression?

    OpenAIRE

    Olszanecka-Glinianowicz, Magdalena; Zahorska-Markiewicz, Barbara; Kocełak, Piotr; Janowska, Joanna; Semik-Grabarczyk, Elżbieta; Wikarek, Tomasz; Gruszka, Wojciech; Dąbrowski, Piotr

    2009-01-01

    Adult obesity has been associated with depression, especially in women. Whether depression leads to obesity or obesity causes depression is unclear. Chronic inflammation is observed in obesity and depression. In 63 obese women without additional diseases depression level was assessed with the Beck's questionnaire. After evaluation of depression level study group was divided into groups according to the mood status (A—without depression, B—mild depression, and C—severe depression), and serum c...

  16. Gender Differences in Rating Stressful Events, Depression, and Depressive Cognition.

    Science.gov (United States)

    Sowa, Claudia J.; Lustman, Patrick J.

    1984-01-01

    Administered the Life Stress Questionnaire, the Beck Depression Inventory, and the Automatic Thought Questionnaire to 140 students. Results showed significant sex differences. Men reported more stressful life change, but women rated the impact of stressors more severely and had higher depression. Men exhibited greater distortions in cognitive…

  17. Depressed gut? The microbiota-diet-inflammation trialogue in depression

    NARCIS (Netherlands)

    Koopman, Margreet; El Aidy, Sahar; Daniels, Judith

    Purpose of reviewAccording to the WHO reports, around 350 million people worldwide suffer from depression. Despite its high prevalence, the complex interaction of multiple mechanisms underlying depression still needs to be elucidated.Recent findingsOver the course of the last few years, several

  18. Depression in hemodialysis patients

    International Nuclear Information System (INIS)

    Anees, M.; Barki, H.; Masood, M.

    2008-01-01

    To measure the frequency of depression and its risk factors in patients under going hemodialysis. It is a cross-sectional prospective study conducted at Hemodialysis unit of Shalamar Hospital and Shaikh Zayed Hospital, Lahore from 1/sup st/ January 2006 to 30/sup th/ April 2006. All patients getting regular hemodialysis for more than three months were included. Beck's Depression Inventory- II (BDI-II; adapted in Urdu) was administered on all the patients who were able to read or understand it. Blood sample were drawn at the same time for routine hematological, biochemical parameters and viral markers (Anti HCV and HbsAg). Diagnosis was made as per Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM IV) for correlation of psychological variables with clinical, hematological and biochemical parameters. Eighty nine patients were enrolled which included fifty two (58.4%) were male and seventy seven (86.5%) were married. Major causes of renal failure were diabetes, hypertension and chronic glomerulonephrotis. Duration of dialysis was from 03 to 49 months with mean of 19.64 +- 11.7 months. Severity of depression was categorized in to mild, moderate and severe on the basis of BDI score. Majority of the patients fifty (56.1%) were moderately to severely depressed and there was no gender difference in the prevalence of depression. Majority of patients undergoing hemodialysis were depressed. Major risk factors for depression were marital status, illiteracy, number of children, socioeconomic factors, gender, hypertension and hypoalbuminemia. Patients with anemia, hyponatremia and hyperkalemia had suicidal tendency. Patients with hepatitis C and disturbed liver function have strong correlation with psychological parameters. (author)

  19. Why don't you try harder? An investigation of effort production in major depression.

    Directory of Open Access Journals (Sweden)

    Marie-Laure Cléry-Melin

    Full Text Available Depression is mainly characterized as an emotional disorder, associated with reduced approach behavior. It remains unclear whether the difficulty in energising behavior relates to abnormal emotional states or to a flattened response to potential rewards, as suggested by several neuroimaging studies. Here, we aimed to demonstrate a specific incentive motivation deficit in major depression, independent of patients' emotional state. We employed a behavioral paradigm designed to measure physical effort in response to both emotional modulation and incentive motivation. Patients did exert more effort following emotionally arousing pictures (whether positive or negative but not for higher monetary incentives, contrary to healthy controls. These results show that emotional and motivational sources of effort production are dissociable in pathological conditions. In addition, patients' ratings of perceived effort increased for high incentives, whereas controls' ratings were decreased. Thus, depressed patients objectively behave as if they do not want to gain larger rewards, but subjectively feel that they try harder. We suggest that incentive motivation impairment is a core deficit of major depression, which may render everyday tasks abnormally effortful for patients.

  20. 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...

  1. Depression, women, and the workplace.

    Science.gov (United States)

    Wollersheim, J P

    1993-01-01

    , such as cognitive-behavioral and interpersonal therapy, have demonstrated effectiveness in treating depression. For mild depression, pharmacotherapy is likely to be the treatment of choice. In cases in which the depressive symptomatology is moderate to severe, a combination of drug therapy and psychotherapy is likely to be the most effective treatment and to provide the best prophylaxis. Drug therapy seems particularly effective in promoting rapid reduction of vegetative and physical symptoms. Psychotherapy enhances coping skills at home and at work and also focuses on problem-solving, relationship difficulties, and dealing with stressors. In the area of prevention, occupational health practitioners currently can have the greatest impact in secondary prevention.(ABSTRACT TRUNCATED AT 400 WORDS)

  2. Depressive realism and clinical depression.

    Science.gov (United States)

    Carson, Richard C; Hollon, Steven D; Shelton, Richard C

    2010-04-01

    Depressive realism suggests that depressed individuals make more accurate judgments of control than their nondepressed counterparts. However, most studies demonstrating this phenomenon were conducted in nonclinical samples. In this study, psychiatric patients who met criteria for major depressive disorder underestimated control in a contingent situation and were consistently more negative in their judgments than were nondepressed controls. Depressed patients were less likely than their nondepressed counterparts to overestimate control in a noncontingent situation, but largely because they perceived receiving less reinforcement. Depressed patients were no more likely to use the appropriate logical heuristic to generate their judgments of control than their nondepressed counterparts and each appeared to rely on different primitive heuristics. Depressed patients were consistently more negative than their nondepressed counterparts and when they did appear to be more "accurate" in their judgments of control (as in the noncontingent situation) it was largely because they applied the wrong heuristic to less accurate information. These findings do not support the notion of depressive realism and suggest that depressed patients distort their judgments in a characteristically negative fashion. 2009 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    Carroll, Linda J.; Cassidy, J. David; Côté, Pierre

    2010-01-01

    Depression is common in whiplash-associated disorders (WAD). Our objectives were to identify factors associated with depressive symptomatology occurring in the initial stages of WAD, and to identify factors predicting the course of depressive symptoms. A population-based cohort of adults sustaining traffic-related WAD was followed at 6 weeks, 3, 6, 9, and 12 months. Baseline measures (assessed a median of 11 days post-crash) included demographic and collision-related factors, prior health, and initial post-crash pain and symptoms. Depressive symptomatology was assessed at baseline and at each follow-up using the Centre for Epidemiological Studies Depression Scale (CES-D). We included only those who participated at all follow-ups (n = 3,452; 59% of eligible participants). Using logistic regression, we identified factors associated with initial (post-crash) depression. Using multinomial regression, we identified baseline factors predicting course of depression. Courses of depression were no depression; initial depression that resolves, recurs or persists, and later onset depression. Factors associated with initial depression included greater neck and low back pain severity, greater percentage of body in pain, numbness/tingling in arms/hand, dizziness, vision problems, post-crash anxiety, fracture, prior mental health problems, and poorer general health. Predictors of persistent depression included older age, greater initial neck and low back pain, post-crash dizziness, vision and hearing problems, numbness/tingling in arms/hands, anxiety, prior mental health problems, and poorer general health. Recognition of these underlying risk factors may assist health care providers to predict the course of psychological reactions and to provide effective interventions. PMID:20127261

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

    Science.gov (United States)

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

    2018-04-01

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

  5. Gender differences in major depressive disorder : Results from the Netherlands study of depression and anxiety

    NARCIS (Netherlands)

    Schuch, Jerome J. J.; Roest, Annelieke M.; Nolen, Willem A.; Penninx, Brenda W. J. H.; de Jonge, Peter

    Background: Although an overall gender difference in prevalence of major depressive disorder (MDD) has been well established, several questions concerning gender differences in the clinical manifestation of depression remain. This study aims to identify gender differences in psychopathology,

  6. The Effects of Hospital-Level Factors on Patients' Ratings of Physician Communication.

    Science.gov (United States)

    Al-Amin, Mona; Makarem, Suzanne C

    2016-01-01

    The quality of physician-patient communication influences patient health outcomes and satisfaction with healthcare delivery. Yet, little is known about contextual factors that influence physicians' communication with their patients. The main purpose of this article is to examine organizational-level factors that influence patient perceptions of physician communication in inpatient settings. We used the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey and American Hospital Association data to determine patients' ratings of physician communication at the hospital level, and to collect information about hospital-level factors that can potentially influence physician communication. Our sample consisted of 2,756 hospitals. We ran a regression analysis to determine the predictors of poor physician communication, measured as the percentage of patients in a hospital who reported that physicians sometimes or never communicated well. In our sample of hospitals, this percentage ranged between 0% and 21%, with 25% of hospitals receiving poor ratings from more than 6% of patients. Three organizational factors had statistically significant negative associations with physician communication: for-profit ownership, hospital size, and hospitalists providing care in the hospital, On the other hand, the number of full-time-equivalent physicians and dentists per 10,000 inpatient days, physician ownership of the hospital, Medicare share of inpatient days, and public ownership were positively associated with patients' ratings of physician communication. Physician staffing levels are an understudied area in healthcare research. Our findings indicate that physician staffing levels affect the quality of physician communication with patients. Moreover, for-profit and larger hospitals should invest more in physician communication given the role that HCAHPS plays in value-based purchasing.

  7. Depression in the Workplace

    Science.gov (United States)

    ... You are here Home » Depression In The Workplace Depression In The Workplace Clinical depression has become one ... will die by suicide vi . Employees' Attitudes Towards Depression Often times a depressed employee will not seek ...

  8. Genetics Home Reference: depression

    Science.gov (United States)

    ... Share: Email Facebook Twitter Home Health Conditions Depression Depression Printable PDF Open All Close All Enable Javascript to view the expand/collapse boxes. Description Depression (also known as major depression or major depressive ...

  9. An Overview of Depression among Transgender Women

    Directory of Open Access Journals (Sweden)

    Beth Hoffman

    2014-01-01

    Full Text Available Rates of depression are higher in transgender women than in the general population, warranting an understanding of the variables related to depression in this group. Results of the literature review of depression in transgender women reveal several variables influencing depression, including social support, violence, sex work, and gender identity. The theoretical constructs of minority stress, coping, and identity control theory are explored in terms of how they may predict depression in transgender women. Depression and depressive symptoms have been used to predict high-risk sexual behaviors with mixed results. The implications of the findings on treating depression in transgender women include taking into account the stress of transition and the importance of supportive peers and family. Future studies should explore a model of depression and high-risk behaviors in transgender women.

  10. 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...

  11. Pharmacoeconomics of antidepressants in moderate-to-severe depressive disorder in Colombia Farmacoeconomía de antidepresivos en trastornos de depresión moderada e intensa en Colombia

    Directory of Open Access Journals (Sweden)

    Márcio Machado

    2008-10-01

    Full Text Available OBJECTIVE: To compare three antidepressant drugs from different classes used in treating moderate-to-severe major depressive disorder (MDD in Colombian adults. METHODS: Based on expert input, a decision-tree model was adapted for Colombia to analyze data over 6 months from the government-payer perspective. The cost-effectiveness of amitriptyline, fluoxetine, and venlafaxine was determined. The clinical outcome was remission of depression (a score OBJETIVO: Comparar tres medicamentos antidepresivos de diferentes clases empleados para tratar trastornos depresivos mayores moderados e intensos en adultos colombianos. MÉTODOS: A partir de los aportes de expertos se adaptó un modelo de árbol de decisión para Colombia a fin de analizar los datos de seis meses desde la perspectiva del gobierno como pagador de los servicios. Se determinó la relación costo-efectividad de la amitriptilina, la fluoxetina y la venlafaxina. El desenlace clínico fue la remisión de la depresión (una puntuación <7 en la escala de depresión de Hamilton o <12 en la escala de valoración de la depresión de Montgomery-Åsberg después de 8 semanas de tratamiento. Los datos clínicos se obtuvieron de la literatura especializada y los costos, de las listas habituales de precios de Colombia. Se realizaron análisis de sensibilidad simples y multifactoriales para probar la robustez de los modelos. RESULTADOS: Los costos del tratamiento por paciente (en dólares estadounidenses de 2007 fueron: US$ 1 618 para la venlafaxina, US$ 1 207 para la fluoxetina y US$ 1 068 para la amitriptilina. Las tasas de remisión general fueron 73,1%, 64,1% y 71,3%, respectivamente. La amitriptilina tuvo un menor costo y una mayor remisión que la fluoxetina. La razón de rentabilidad incremental de la venlafaxina sobre la amitriptilina fue de US$ 31 595. El inductor de costos (cost driver del modelo fue el valor de adquisición de la venlafaxina, que representó 53,4% del total del costo por

  12. 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

  13. Burnout does not help predict depression among French school teachers.

    Science.gov (United States)

    Bianchi, Renzo; Schonfeld, Irvin Sam; Laurent, Eric

    2015-11-01

    Burnout has been viewed as a phase in the development of depression. However, supportive research is scarce. We examined whether burnout predicted depression among French school teachers. We conducted a 2-wave, 21-month study involving 627 teachers (73% female) working in French primary and secondary schools. Burnout was assessed with the Maslach Burnout Inventory and depression with the 9-item depression module of the Patient Health Questionnaire (PHQ-9). The PHQ-9 grades depressive symptom severity and provides a provisional diagnosis of major depression. Depression was treated both as a continuous and categorical variable using linear and logistic regression analyses. We controlled for gender, age, and length of employment. Controlling for baseline depressive symptoms, linear regression analysis showed that burnout symptoms at time 1 (T1) did not predict depressive symptoms at time 2 (T2). Baseline depressive symptoms accounted for about 88% of the association between T1 burnout and T2 depressive symptoms. Only baseline depressive symptoms predicted depressive symptoms at follow-up. Similarly, logistic regression analysis revealed that burnout symptoms at T1 did not predict incident cases of major depression at T2 when depressive symptoms at T1 were included in the predictive model. Only baseline depressive symptoms predicted cases of major depression at follow-up. This study does not support the view that burnout is a phase in the development of depression. Assessing burnout symptoms in addition to "classical" depressive symptoms may not always improve our ability to predict future depression.

  14. Direct and indirect influences of childhood abuse on depression symptoms in patients with major depressive disorder.

    Science.gov (United States)

    Hayashi, Yumi; Okamoto, Yasumasa; Takagaki, Koki; Okada, Go; Toki, Shigeru; Inoue, Takeshi; Tanabe, Hajime; Kobayakawa, Makoto; Yamawaki, Shigeto

    2015-10-14

    It is known that the onset, progression, and prognosis of major depressive disorder are affected by interactions between a number of factors. This study investigated how childhood abuse, personality, and stress of life events were associated with symptoms of depression in depressed people. Patients with major depressive disorder (N = 113, 58 women and 55 men) completed the Beck Depression Inventory-II (BDI-II), the Neuroticism Extroversion Openness Five Factor Inventory (NEO-FFI), the Child Abuse and Trauma Scale (CATS), and the Life Experiences Survey (LES), which are self-report scales. Results were analyzed with correlation analysis and structural equation modeling (SEM), by using SPSS AMOS 21.0. Childhood abuse directly predicted the severity of depression and indirectly predicted the severity of depression through the mediation of personality. Negative life change score of the LES was affected by childhood abuse, however it did not predict the severity of depression. This study is the first to report a relationship between childhood abuse, personality, adulthood life stresses and the severity of depression in depressed patients. Childhood abuse directly and indirectly predicted the severity of depression. These results suggest the need for clinicians to be receptive to the possibility of childhood abuse in patients suffering from depression. SEM is a procedure used for hypothesis modeling and not for causal modeling. Therefore, the possibility of developing more appropriate models that include other variables cannot be excluded.

  15. Acupuncture for depression.

    Science.gov (United States)

    Smith, Caroline A; Armour, Mike; Lee, Myeong Soo; Wang, Li-Qiong; Hay, Phillipa J

    2018-03-04

    Depression is recognised as a major public health problem that has a substantial impact on individuals and on society. People with depression may consider using complementary therapies such as acupuncture, and an increasing body of research has been undertaken to assess the effectiveness of acupuncture for treatment of individuals with depression. This is the second update of this review. To examine the effectiveness and adverse effects of acupuncture for treatment of individuals with depression.To determine:• Whether acupuncture is more effective than treatment as usual/no treatment/wait list control for treating and improving quality of life for individuals with depression.• Whether acupuncture is more effective than control acupuncture for treating and improving quality of life for individuals with depression.• Whether acupuncture is more effective than pharmacological therapies for treating and improving quality of life for individuals with depression.• Whether acupuncture plus pharmacological therapy is more effective than pharmacological therapy alone for treating and improving quality of life for individuals with depression.• Whether acupuncture is more effective than psychological therapies for treating and improving quality of life for individuals with depression.• Adverse effects of acupuncture compared with treatment as usual/no treatment/wait list control, control acupuncture, pharmacological therapies, and psychological therapies for treatment of individuals with depression. We searched the following databases to June 2016: Cochrane Common Mental Disorders Group Controlled Trials Register (CCMD-CTR), Korean Studies Information Service System (KISS), DBPIA (Korean article database website), Korea Institute of Science and Technology Information, Research Information Service System (RISS), Korea Med, Korean Medical Database (KM base), and Oriental Medicine Advanced Searching Integrated System (OASIS), as well as several Korean medical journals

  16. Does Excision of Heterotopic Ossification of the Elbow Result in Satisfactory Patient-Rated Outcomes?

    Science.gov (United States)

    Sandeep, K N; Suresh, G; Gopisankar, B; Abhishek, N; Sujiv, A

    2017-03-01

    Treatment of heterotopic ossification (HO) of the elbow is challenging and fraught with complications. Patients who sustain direct trauma to the elbow joint, the central nervous system, and thermal burns are at increased risk for development of HO. There is a paucity of studies and reports on patient's self-evaluation after the excision of the heterotopic ossification. This retrospective study assessed outcomes after excision of heterotopic ossification around the elbow in a cohort of ten patients operated from 2012 to 2015. The outcome assessment was done by the Mayo Elbow Performance index (MEPI) and the American Shoulder and Elbow Surgeons-Elbow score (ASES-E scores). The mean follow-up was 18.11 months after the operation. The Mayo Elbow Performance Score was excellent in two elbows, good in six and fair in two. The mean gain in flexion-extension arc after excision of HO was 80 degrees. All of the patients had residual flexion deformity postoperatively. Eight of the nine patients were able to do activities requiring flexion at final follow-up. Excision of HO around the elbow is associated with satisfactory patient-rated outcomes in spite of failure to regain full range of motion.

  17. 'Do you think you suffer from depression?' Reevaluating the use of a single item question for the screening of depression in older primary care patients

    DEFF Research Database (Denmark)

    Ayalon, Liat; Goldfracht, Margalit; Bech, Per

    2010-01-01

    OBJECTIVES: The majority of older adults seek depression treatment in primary care. Despite impressive efforts to integrate depression treatment into primary care, depression often remains undetected. The overall goal of the present study was to compare a single item screening for depression...... to existing depression screening tools. METHODS: A cross sectional sample of 153 older primary care patients. Participants completed several depression-screening measures (e.g. a single depression screen, Patient Health Questionnaire-9, Major Depression Inventory, Visual Analogue Scale). Measures were......: An easy way to detect depression in older primary care patients would be asking the single question, 'do you think you suffer from depression?'...

  18. Depressed gut? The microbiota-diet-inflammation trialogue in depression.

    Science.gov (United States)

    Koopman, Margreet; El Aidy, Sahar

    2017-09-01

    According to the WHO reports, around 350 million people worldwide suffer from depression. Despite its high prevalence, the complex interaction of multiple mechanisms underlying depression still needs to be elucidated. Over the course of the last few years, several neurobiological alterations have been linked to the development and maintenance of depression. One basic process that seems to link many of these findings is inflammation. Chronic inflammation has been associated with both biological factors such as excessive neurotransmitter concentrations as well as psychological processes such as adult stress reactivity and a history of childhood trauma. As a balanced microbial community, modulated by diet, is a key regulator of the host physiology, it seems likely that gut microbiota plays a role in depression. The review summarizes the existent literature on this emerging research field and provides a comprehensive overview of the multifaceted links between the microbiota, diet, and depression. Several pathways linking early life trauma, pharmacological treatment effects, and nutrition to the microbiome in depression are described aiming to foster the psychotherapeutic treatment of depressed patients by interventions targeting the microbiota.

  19. 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” — ...

  20. Depression in Older Adults

    Science.gov (United States)

    ... here Home » Depression In Older Adults: More Facts Depression In Older Adults: More Facts Depression affects more ... combination of both. [8] Older Adult Attitudes Toward Depression: According to a Mental Health America survey [9] ...

  1. Depression and Caregiving

    Science.gov (United States)

    ... FCA - A A + A You are here Home Depression and Caregiving Order this publication Printer-friendly version ... a more serious depression over time. Symptoms of Depression People experience depression in different ways. Some may ...

  2. Depression and Suicide Risk

    Science.gov (United States)

    ... due to another medical disorder Relationship Between Depression & Suicide: 1. Depression is the psychiatric diagnosis most commonly associated with ... of patients with treated depression eventually die by suicide. xiv 4. Depression is present in at least 50 percent of ...

  3. 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

  4. Depressive disorders and the menopause transition.

    Science.gov (United States)

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

    2012-02-01

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

  5. Postpartum Depression

    Science.gov (United States)

    ... or guilty. These emotions can affect a woman’s self-esteem and how she deals with stress. Fatigue—Many ... FAQs Exercise After Pregnancy (FAQ131) Depression (FAQ106) Patient Education FAQs Resources & Publications Committee Opinions Practice Bulletins Patient ...

  6. Equipping African American Clergy to Recognize Depression.

    Science.gov (United States)

    Anthony, Jean Spann; Morris, Edith; Collins, Charles W; Watson, Albert; Williams, Jennifer E; Ferguson, Bʼnai; Ruhlman, Deborah L

    2016-01-01

    Many African Americans (AAs) use clergy as their primary source of help for depression, with few being referred to mental health providers. This study used face-to-face workshops to train AA clergy to recognize the symptoms and levels of severity of depression. A pretest/posttest format was used to test knowledge (N = 42) about depression symptoms. Results showed that the participation improved the clergy's ability to recognize depression symptoms. Faith community nurses can develop workshops for clergy to improve recognition and treatment of depression.

  7. Genetik og stressende livsbegivenheder interagerer ved depression

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Bukh, Jens Otto Drachmann

    2013-01-01

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

  8. Do Physicians Respond to Web-Based Patient Ratings? An Analysis of Physicians' Responses to More Than One Million Web-Based Ratings Over a Six-Year Period.

    Science.gov (United States)

    Emmert, Martin; Sauter, Lisa; Jablonski, Lisa; Sander, Uwe; Taheri-Zadeh, Fatemeh

    2017-07-26

    Physician-rating websites (PRWs) may lead to quality improvements in case they enable and establish a peer-to-peer communication between patients and physicians. Yet, we know little about whether and how physicians respond on the Web to patient ratings. The objective of this study was to describe trends in physicians' Web-based responses to patient ratings over time, to identify what physician characteristics influence Web-based responses, and to examine the topics physicians are likely to respond to. We analyzed physician responses to more than 1 million patient ratings displayed on the German PRW, jameda, from 2010 to 2015. Quantitative analysis contained chi-square analyses and the Mann-Whitney U test. Quantitative content techniques were applied to determine the topics physicians respond to based on a randomly selected sample of 600 Web-based ratings and corresponding physician responses. Overall, physicians responded to 1.58% (16,640/1,052,347) of all Web-based ratings, with an increasing trend over time from 0.70% (157/22,355) in 2010 to 1.88% (6377/339,919) in 2015. Web-based ratings that were responded to had significantly worse rating results than ratings that were not responded to (2.15 vs 1.74, PWeb to patient ratings differ significantly from nonresponders regarding several characteristics such as gender and patient recommendation results (PWeb to patient ratings. This is likely because of (1) the low awareness of PRWs among physicians, (2) the fact that only a few PRWs enable physicians to respond on the Web to patient ratings, and (3) the lack of an active moderator to establish peer-to-peer communication. PRW providers should foster more frequent communication between the patient and the physician and encourage physicians to respond on the Web to patient ratings. Further research is needed to learn more about the motivation of physicians to respond or not respond to Web-based patient ratings. ©Martin Emmert, Lisa Sauter, Lisa Jablonski, Uwe Sander

  9. Cross-cultural adaptation and reliability and validity of the Dutch Patient-Rated Tennis Elbow Evaluation (PRTEE-D).

    Science.gov (United States)

    van Ark, Mathijs; Zwerver, Johannes; Diercks, Ronald L; van den Akker-Scheek, Inge

    2014-08-11

    Lateral Epicondylalgia (LE) is a common injury for which no reliable and valid measure exists to determine severity in the Dutch language. The Patient-Rated Tennis Elbow Evaluation (PRTEE) is the first questionnaire specifically designed for LE but in English. The aim of this study was to translate into Dutch and cross-culturally adapt the PRTEE and determine reliability and validity of the PRTEE-D (Dutch version). The PRTEE was cross-culturally adapted according to international guidelines. Participants (n = 122) were asked to fill out the PRTEE-D twice with a one week interval to assess test-retest reliability. Internal consistency of the PRTEE-D was determined by calculating Crohnbach's alphas for the questionnaire and subscales. Intraclass Correlation Coefficients (ICC) were calculated for the overall PRTEE-D score, pain and function subscale and individual questions to determine test-retest reliability. Additionally, the Disabilities for the Arm, Shoulder and Hand questionnaire (DASH) and Visual Analogue Scale (VAS) pain scores were obtained from 30 patients to assess construct validity; Spearman's correlation coefficients were calculated between the PRTEE-D (subscales) and DASH and VAS-pain scores. The PRTEE was successfully cross-culturally adapted into Dutch (PRTEE-D). Crohnbach's alpha for the first assessment of the PRTEE-D was 0.98; Crohnbach's alpha was 0.93 for the pain subscale and 0.97 for the function subscale. ICC for the PRTEE-D was 0.98; subscales also showed excellent ICC values (pain scale 0.97 and function scale 0.97). A significant moderate correlation exists between PRTEE-D and DASH (0.65) and PRTEE-D and VAS pain (0.68). The PRTEE was successfully cross-culturally adapted and this study showed that the PRTEE-D is reliable and valid to obtain an indication of severity of LE. An easy-to-use instrument for practitioners is now available and this facilitates comparing Dutch and international research data.

  10. An experimental investigation of emotional reasoning processes in depression.

    Science.gov (United States)

    Berle, David; Moulds, Michelle L

    2013-09-01

    depressed individuals were only mildly clinically depressed precluding conclusions about individuals with more severe levels of depression. © 2013 The British Psychological Society.

  11. Reproducibility and validity of patient-rated assessment of speech, swallowing, and saliva control in Parkinson’s Disease

    NARCIS (Netherlands)

    Machiel Zwarts; Johanna Kalf; Bastiaan Bloem; George Borm; Marten Munneke; Bert de Swart

    2012-01-01

    To report on the development and psychometric evaluation of the Radboud Oral Motor Inventory for Parkinson's Disease (ROMP), a newly developed patient-rated assessment of speech, swallowing, and saliva control in patients with Parkinson's disease (PD). To evaluate reproducibility, 60 patients

  12. Depression in CADASIL patients

    Directory of Open Access Journals (Sweden)

    Lačković Maja

    2014-01-01

    Full Text Available Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL is a hereditary neurological disease accompanied by recurrent ischemic events, characterized by the presence of psychiatric disorders. The aim of this study was to examine the occurrence of depression and its severity among patients with CADASIL. Sixteen patients with diffuse white matter changes on MRI and clinical signs suggesting CADASIL were included in the study. Definitive diagnosis of CADASIL was obtained by electron microscopic analysis of skin biopsies. Testing of the patients’ affective status was primarily devoted to detecting depression. Electron microscopic examinations of all skin biopsies revealed numerous granular osmiophilic material (GOM deposits embedded into the basal lamina around altered or degenerated vascular smooth muscle cells (VSMCs. Clinical symptoms of depression were present in a great number of examined CADASIL patients. The frequency of depression was higher than previously reported. Psychiatric disturbances might also represent the onset of CADASIL, especially in young patients, and should be evaluated by differential diagnosis. [Projekat Ministarstva nauke Republike Srbije, br. 41002

  13. Gender Differences among Patients with a Single Depressive Episode

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  14. Biological differences between melancholic and nonmelancholic depression subtyped by the CORE measure

    Directory of Open Access Journals (Sweden)

    Spanemberg L

    2014-08-01

    Full Text Available Lucas Spanemberg,1,2 Marco Antonio Caldieraro,1 Edgar Arrua Vares,1 Bianca Wollenhaupt-Aguiar,3,4 Márcia Kauer-Sant’Anna,3,4 Sheila Yuri Kawamoto,1 Emily Galvão,3–5 Gordon Parker,6,7 Marcelo P Fleck1,8 1Mood Disorders Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, 2Department of Psychiatry, Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul, 3INCT Translational Medicine, Hospital de Clínicas de Porto Alegre, 4Bipolar Disorders Program and Laboratory of Molecular Psychiatry, Universidade Federal do Rio Grande do Sul, 5Centro Universitário Metodista, Porto Alegre, Brazil; 6School of Psychiatry, University of New South Wales, 7Black Dog Institute, Sydney, NSW, Australia; 8Neuromodulation Research Clinic, Douglas Mental Health University Institute, Montréal, ON, Canada Background: The purpose of this study was to compare melancholic patients rated by the CORE measure of observable psychomotor disturbance with nonmelancholic and control subjects across a set of biomarkers.Methods: Depressed patients were classified as melancholic or nonmelancholic by using the CORE measure. Both groups of patients, as well as control subjects, were compared for a set of clinical and laboratory measures. Serum levels of brain-derived neurotrophic factor, of two markers of oxidative stress (protein carbonyl content [PCC] and thiobarbituric acid reactive substances [TBARS], and of several immunity markers (interleukin [IL]-2, IL-4, IL-6, IL-10, IL-17, tumor necrosis factor-alpha, and interferon-gamma were analyzed. Results: Thirty-three depressed patients and 54 healthy controls were studied. Depressive patients showed higher IL-4, IL-6, and PCC values than healthy controls. Thirteen (39% of the depressed patients were assigned as melancholic by the CORE measure. They generated lower interferon-gamma (compared with nonmelancholic depressed patients and TBARS (compared with both the

  15. Dendritic Spines in Depression: What We Learned from Animal Models

    OpenAIRE

    Qiao, Hui; Li, Ming-Xing; Xu, Chang; Chen, Hui-Bin; An, Shu-Cheng; Ma, Xin-Ming

    2016-01-01

    Depression, a severe psychiatric disorder, has been studied for decades, but the underlying mechanisms still remain largely unknown. Depression is closely associated with alterations in dendritic spine morphology and spine density. Therefore, understanding dendritic spines is vital for uncovering the mechanisms underlying depression. Several chronic stress models, including chronic restraint stress (CRS), chronic unpredictable mild stress (CUMS), and chronic social defeat stress (CSDS), have ...

  16. Gilles de la Tourette Syndrome, Depression, Depressive Illness, and Correlates in a Child and Adolescent Population.

    Science.gov (United States)

    Rizzo, Renata; Gulisano, Mariangela; Martino, Davide; Robertson, Mary May

    2017-04-01

    Gilles de la Tourette syndrome (GTS) and depression are both common disorders. It has been suggested that depression occurs in 13%-76% GTS patients. Despite this, there are few studies into the specific relationships and correlates between the two disorders. There is only some consensus as to the precise relationship between the two disorders. We undertook the study to investigate the relationship between depressive symptomatology and the core clinical features of GTS in a well-characterized clinical population of youth with this disorder. Our aim was to verify the association between depression and comorbid obsessive-compulsive disorder and explore further other potential associations highlighted in some, but not all, of the studies focused on this topic. Our results demonstrated that (1) the GTS patients were significantly older than the controls, (2) the GTS patients were significantly more depressed than controls, (3) depression was associated with tic severity, (4) the Diagnostic Confidence Index scores were higher in GTS patients without depression, (5) anxiety, attention-deficit/hyperactivity disorder (ADHD), conduct disorder (CD), and behavioral problems were significantly associated with depression, and (6) finally, patients with GTS and depression have a positive family history of depression. However, obsessionality (CY-BOCS) did not differentiate between depressed and not depressed GTS patients. Depression is common in patients with GTS and occurs significantly more in GTS than in controls. Depression is significantly associated with GTS factors such as tic severity, comorbidity with ADHD, and the presence of coexistent anxiety, CDs, and behavior problems. Depression is importantly significantly associated with a positive family history of depression. Intriguingly, depression in our sample was not related to obsessionality.

  17. Predicting Comorbidities, Nutritional Status, and Neuropsychological Performance of Depressed and Nondepressed Geriatric Communities: A Comparative Study

    Directory of Open Access Journals (Sweden)

    Lai Kuan Lee

    2012-12-01

    Conclusion: This study found that less exercise is an independent predictor of depressive symptomatology. Cognition-enhancing interventions are needed for the at-risk elderly with depressive symptoms in order to prevent the progression to severe depression.

  18. [Is the diagnosis 'depression' still useful?].

    Science.gov (United States)

    Terluin, Berend; Oud, Marian J T

    2012-01-01

    The DSM diagnosis of depression is based solely on the presence of symptoms, without taking into account the context in which these symptoms have occurred. For this reason, the DSM diagnosis does not distinguish between sadness as a normal reaction to a painful loss and pathologically depressive reactions that are disproportionate to personal life events and circumstances. According to a group of mental health expert general practitioners, a true depressive disorder is characterized by a depression that has acquired a life of its own and is hard to control. This depression is severe, and is recognized by the patient as alien to his or her character. Loss of the ability to experience pleasure in ordinary things (anhedonia) and thoughts about death as an alternative for the torment experienced are often present. We recommend the diagnosis of depression be reserved for clearly pathologically depressive reactions that are also recognized as such by the patient.

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

    DEFF Research Database (Denmark)

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

    2009-01-01

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

  20. Associations of depression and depressive symptoms with preeclampsia: results from a Peruvian case-control study

    Directory of Open Access Journals (Sweden)

    Garcia Pedro

    2007-09-01

    Full Text Available Abstract Background Preeclampsia involves endothelial dysfunction, platelet dysfunction/activation and sympathetic over-activity similar to cardiovascular disorders (CVD. Depression, an independent risk factor for progression of CVD, was found to be associated with an increased risk of preeclampsia among Finnish women. We examined the relation between depression/depressive symptoms and preeclampsia risk among Peruvian women. Methods The study included 339 preeclamptic cases and 337 normotensive controls. Depression and depressive symptoms during pregnancy were assessed using the Patient Health Questionnaire (PHQ-9. Odds ratios (OR and 95% confidence intervals (CI were estimated from logistic regression models. Results The prevalence of moderate depression was 11.5% among cases and 5.3% among controls. The corresponding figures for moderate-severe depression were 3.5% for cases and 2.1% for controls. Compared with non-depressed women, those with moderate depression had a 2.3-fold increased risk of preeclampsia (95% CI: 1.2–4.4, while moderate-severe depression was associated with a 3.2-fold (95% CI: 1.1–9.6 increased risk of preeclampsia. Associations of each of the 9-items of the PHQ-9 depression screening module with preeclampsia risk were also observed. Conclusion Our findings are consistent with the only other published report on this topic. Collectively, available data support recent calls for expanded efforts to study and address depression among pregnant women.

  1. [Depressive realism: happiness or objectivity].

    Science.gov (United States)

    Birinci, Fatih; Dirik, Gülay

    2010-01-01

    Realism is described as objective evaluations and judgments about the world; however, some research indicates that judgments made by "normal" people include a self-favored, positive bias in the perception of reality. Additionally, some studies report that compared to normal people, such cognitive distortions are less likely among depressive people. These findings gave rise to the depressive realism hypothesis. While results of several studies verify the notion that depressive people evaluate reality more objectively, other studies fail to support this hypothesis. Several causes for these inconsistent findings have been proposed, which can be characterized under 3 headings. One proposed explanation suggests that what is accepted as "realistic" in these studies is not quite objective and is in fact ambiguous. According to another perspective, the term "depressive" used in these studies is inconsistent with the criteria of scientific diagnostic methods. Another suggests that the research results can only be obtained under the specific experimental conditions. General negativity and limited processing are popular approaches used for explaining the depressive realism hypothesis. Nowadays, the debate over this hypothesis continues. The present review focuses on frequently cited research related to depressive realism and discusses the findings.

  2. Depressive and bipolar disorders

    DEFF Research Database (Denmark)

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

    2005-01-01

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

  3. 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 ...

  4. Early onset depression: the relevance of anxiety.

    Science.gov (United States)

    Parker, G; Wilhelm, K; Asghari, A

    1997-01-01

    The aim of this study was to determine risk factors that may differentiate early onset from late onset depression. A non-clinical cohort that had been assessed from 1978 to 1993 at 5 yearly intervals and that had a high prevalence rate of lifetime depression took part in the study. We established an appropriate age cut-off to distinguish early onset (i.e. before 26 years) of major and of minor depression, and examined the relevance of a number of possible determinants of early onset depression assessed over the life of the study. Despite several dimensional measures of depression, self-esteem and personality being considered, they generally failed (when assessed early in the study) to discriminate subsequent early onset depression, with the exception of low masculinity scores being a weak predictor of major and/or minor depression. Early onset depression was strongly predicted, however, by a lifetime episode of a major anxiety disorder, with generalised anxiety being a somewhat stronger and more consistent predictor than panic disorder, agoraphobia and minor anxiety disorders (ie social phobia, simple phobia). The possibility that anxiety may act as a key predispositional factor to early onset depression and to a greater number of depressive episodes is important in that clinical assessment and treatment of any existing anxiety disorder may be a more efficient and useful strategy than focussing primarily on the depressive disorder.

  5. Depression in paediatric chronic fatigue syndrome.

    Science.gov (United States)

    Bould, Helen; Collin, Simon M; Lewis, Glyn; Rimes, Katharine; Crawley, Esther

    2013-06-01

    To describe the prevalence of depression in children with chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME) and investigate the relationship between depression in CFS/ME and clinical symptoms such as fatigue, disability, pain and school attendance. Cross-sectional survey data using the Hospital Anxiety and Depression Scale (HADS) collected at assessment. Specialist paediatric CFS/ME service in the South West. Children aged 12-18 years with CFS/ME. Depression was defined as scoring >9 on the HADS depression scale. 542 subjects had complete data for the HADS and 29% (156/542) (95% CI 25% to 33%) had depression. In a univariable analysis, female sex, poorer school attendance, and higher levels of fatigue, disability, pain, and anxiety were associated with higher odds of depression. Age of child and duration of illness were not associated with depression. In a multivariable analysis, the factors most strongly associated with depression were disability, with higher scores on the physical function subscale of the 36 item Short Form (SF-36). Depression is commonly comorbid with CFS/ME, much more common than in the general population, and is associated with markers of disease severity. It is important to screen for, identify and treat depression in this population.

  6. Stability and change in levels of depression and personality: a follow-up study of postpartum depressed mothers that were hospitalized in a mother-infant unit.

    Science.gov (United States)

    Vliegen, Nicole; Luyten, Patrick; Besser, Avi; Casalin, Sara; Kempke, Stefan; Tang, Eileen

    2010-01-01

    This prospective longitudinal study investigated the role of the personality dimensions of dependency and self-criticism in the course of depressive symptoms in a sample of inpatient severely postpartum depressed mothers (n = 55). Depressive symptoms and personality were measured during hospitalization and on average 3 1/2 years later. In line with previous research, a considerable subgroup of mothers (39%) reported moderate to severe symptoms of depression at time 2. In addition, although these mothers did not exhibit more depressive episodes during follow-up period compared with mothers with a less chronic course of depression, their depressive episodes were considerably longer, and they had higher levels of severity of depression as well as of dependency and self-criticism at Time 1. Finally, self-criticism, but not dependency, assessed at Time 1, predicted both depression diagnosis and levels of depression at follow-up, supporting a vulnerability model positing that self-criticism confers vulnerability for depression over time.

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

    Science.gov (United States)

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

    2013-05-01

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

  8. The Role of Occupational Voice Demand and Patient-Rated Impairment in Predicting Voice Therapy Adherence.

    Science.gov (United States)

    Ebersole, Barbara; Soni, Resha S; Moran, Kathleen; Lango, Miriam; Devarajan, Karthik; Jamal, Nausheen

    2018-05-01

    Examine the relationship among the severity of patient-perceived voice impairment, perceptual dysphonia severity, occupational voice demand, and voice therapy adherence. Identify clinical predictors of increased risk for therapy nonadherence. A retrospective cohort study of patients presenting with a chief complaint of persistent dysphonia at an interdisciplinary voice center was done. The Voice Handicap Index-10 (VHI-10) and the Voice-Related Quality of Life (V-RQOL) survey scores, clinician rating of dysphonia severity using the Grade score from the Grade, Roughness Breathiness, Asthenia, and Strain scale, occupational voice demand, and patient demographics were tested for associations with therapy adherence, defined as completion of the treatment plan. Classification and Regression Tree (CART) analysis was performed to establish thresholds for nonadherence risk. Of 166 patients evaluated, 111 were recommended for voice therapy. The therapy nonadherence rate was 56%. Occupational voice demand category, VHI-10, and V-RQOL scores were the only factors significantly correlated with therapy adherence (P demand are significantly more likely to be nonadherent with therapy than those with high occupational voice demand (P 40 is a significant cutoff point for predicting therapy nonadherence (P demand and patient perception of impairment are significantly and independently correlated with therapy adherence. A VHI-10 score of ≤9 or a V-RQOL score of >40 is a significant cutoff point for predicting nonadherence risk. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  9. Exercise for patients with major depression

    DEFF Research Database (Denmark)

    Krogh, Jesper; Hjorthøj, Carsten; Speyer, Helene

    2017-01-01

    in participants diagnosed with depression. Primary outcomes were depression severity, lack of remission and serious adverse events (eg, suicide) assessed at the end of the intervention. Secondary outcomes were quality of life and adverse events such as injuries, as well as assessment of depression severity......Objectives To assess the benefits and harms of exercise in patients with depression. Design Systematic review Data sources Bibliographical databases were searched until 20 June 2017. Eligibility criteria and outcomes Eligible trials were randomised clinical trials assessing the effect of exercise...... and lack of remission during follow-up after the intervention. Results Thirty-five trials enrolling 2498 participants were included. The effect of exercise versus control on depression severity was -0.66 standardised mean difference (SMD) (95% CI -0.86 to -0.46; p

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

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel

    2005-01-01

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

  11. Postpartum Depression - Multiple Languages

    Science.gov (United States)

    ... Русский (Russian) Bilingual PDF Health Information Translations Postpartum Depression - English PDF Postpartum Depression - Русский (Russian) PDF Postpartum Depression - English MP3 ...

  12. Major Depression Among Adults

    Science.gov (United States)

    ... Depressive Episode Among Adolescents Data Sources Share Major Depression Definitions Major depression is one of the most ... Bethesda, MD 20892-9663 Follow Us Facebook Twitter YouTube Google Plus NIMH Newsletter NIMH RSS Feed NIMH ...

  13. 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 ...

  14. Sadness and Depression

    Science.gov (United States)

    ... Videos for Educators Search English Español Sadness and Depression KidsHealth / For Kids / Sadness and Depression Print en ... big difference in your life. When Sadness Is Depression When you're in a sad mood, it ...

  15. 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 ...

  16. 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 ...

  17. Prevalence of restless legs symptoms according to depressive symptoms and depression type: a cross-sectional study.

    Science.gov (United States)

    Auvinen, Piritta; Mäntyselkä, Pekka; Koponen, Hannu; Kautiainen, Hannu; Korniloff, Katariina; Ahonen, Tiina; Vanhala, Mauno

    2018-01-01

    Restless legs syndrome is a sensorimotor disorder and it is associated with several other diseases especially mental illnesses. To analyze the relationship between the symptoms of restless legs syndrome and the severity of depressive symptoms and the prevalence of restless legs symptoms in depression subtypes. A cross-sectional study of primary care patients in the Central Finland Hospital District. The prevalence of restless legs symptoms was studied in 706 patients with increased depressive symptoms and 426 controls without a psychiatric diagnosis by using a structured questionnaire. The depressive symptoms were evaluated with the Beck Depression Inventory (BDI) and the psychiatric diagnosis was confirmed by means of a diagnostic interview (Mini-International Neuropsychiatric Interview). The subjects with increased depressive symptoms were divided into three groups (subjects with depressive symptoms without a depression diagnosis, melancholic depression and non-melancholic depression). In the whole study population, the prevalence of restless legs symptoms increased with the severity of depressive symptoms. The prevalence of restless legs symptoms was highest in the melancholic and non-melancholic depressive patients (52 and 46%, respectively) and then in subjects with depressive symptoms without a depression diagnosis (43.4%), but the prevalence was also substantial (24.6%) in subjects without a psychiatric diagnosis. Restless legs symptoms are very common in primary care among subjects with depression, regardless of the depression type. The prevalence of restless legs symptoms increased with increasing severity of depressive symptoms, regardless of the diagnosis. These findings should be considered in clinical evaluation and treatment of patients visiting their physician due to restless legs or depressive symptoms.

  18. A review of depression research in malaysia.

    Science.gov (United States)

    Ng, C G

    2014-08-01

    Depression is a debilitating illness and has become a leading cause of morbidity globally. We aim to summarise the evidence available in regard to the prevalence, type of assessment tools used and treatment options for depression in Malaysia. Two hundred and forty seven articles related to depression were found in a search through a database dedicated to indexing all original data relevant to medicine published in Malaysia between the years 2000-2013. Fifty seven articles were selected and reviewed on the basis of clinical relevance and future research implications. Findings were summarised, categorised and presented according to prevalence of depression, depression in women, depression in clinical condition, assessment tools, and treatment of depression. The prevalence of depression in Malaysia was estimated to be between 8 and 12%. The figures were higher among women of low socio-economic background or those with comorbid medical condition. The common assessment tools used in Malaysia include Beck Depression Inventory (BDI), Depression, Anxiety and Stress Scale (DASS), Patient Health Questionnaire 9 (PHQ-9) and Hospital Anxiety and Depression Scale (HADS). They were translated into the Malay language and their psychometric properties were established. Both pharmacological treatment and psychotherapy were commonly used in Malaysia, and were highly recommended in local clinical practice guidelines. There are discrepancies in the reported rates of depression in Malaysia and this needs to be addressed. There were lack of studies looking into the depression among subgroups in Malaysia especially in the male population. There were several instruments available for assessment of depression in Malaysia but their suitability for the local setting need further research. Both pharmacotherapy and psychotherapy were recommended in the local treatment guideline in Malaysia. With the emergence of generic medication, we need to compare their clinical efficacy and tolerability

  19. Verbal learning in marijuana users seeking treatment: a comparison between depressed and non-depressed samples.

    Science.gov (United States)

    Roebke, Patrick V; Vadhan, Nehal P; Brooks, Daniel J; Levin, Frances R

    2014-07-01

    Both individuals with marijuana use and depressive disorders exhibit verbal learning and memory decrements. This study investigated the interaction between marijuana dependence and depression on learning and memory performance. The California Verbal Learning Test-Second Edition (CVLT-II) was administered to depressed (n = 71) and non-depressed (n = 131) near-daily marijuana users. The severity of depressive symptoms was measured by the self-rated Beck Depression Inventory (BDI-II) and the clinician-rated Hamilton Depression Rating Scale (HAM-D). Multivariate analyses of covariance statistics (MANCOVA) were employed to analyze group differences in cognitive performance. Pearson's correlation coefficients were calculated to examine the relative associations between marijuana use, depression and CVLT-II performance. Findings from each group were compared to published normative data. Although both groups exhibited decreased CVLT-II performance relative to the test's normative sample (p marijuana-dependent subjects with a depressive disorder did not perform differently than marijuana-dependent subjects without a depressive disorder (p > 0.05). Further, poorer CVLT-II performance was modestly associated with increased self-reported daily amount of marijuana use (corrected p depressive symptoms (corrected p > 0.002). These findings suggest an inverse association between marijuana use and verbal learning function, but not between depression and verbal learning function in regular marijuana users.

  20. Depression and anxiety in hypothyroidism.

    Science.gov (United States)

    Demet, M M; Ozmen, B; Deveci, A; Boyvada, S; Adiguzel, H; Aydemir, O

    2003-09-01

    The aim of the study was to determine the prevalence and severity of depression and anxiety in patients with hypothyroidism and to compare this with euthyroid patients. Thirty patients with hypothyroidism and 30 euthyroid controls attending the Endocrinology outpatient department of Celal Bayar University, Medical Faculty were included in the study. The hormonal screening was done by immunoassay and haemagglutination methods. Then, for psychiatric assessment, Hospital Anxiety and Depression Scale (HAD), Hamilton Depression Rating Scale (HAM-D), and Hamilton Anxiety Rating Scale (HAM-A) were used. There was no difference between the two groups in terms of demographic features. Total scores obtained from the scales used in the study did not differ significantly (p > 0.05). The frequency of items of both HAM-D and HAM-A did not show any differences in the two groups. By Wilks' Lambda discriminant analysis, depressive mood (HAM-D#1) was found to be the discriminating feature between the hypothyroid group and the euthyroid group. Therefore, depression and anxiety were not outstanding features in hypothyrodism. However, depression was more significant in the hypothyroid than euthyroid group.

  1. Cost of depression in Europe.

    Science.gov (United States)

    Sobocki, Patrik; Jönsson, Bengt; Angst, Jules; Rehnberg, Clas

    2006-06-01

    there is no earlier cost-of-illness study conducted on depression in Europe, it is, however, difficult to evaluate the validity of our results for individual countries and thus further research is needed. The cost of depression poses a significant economic burden to European society. The simulation model employed shows good predictability of the cost of depression in Europe and is a novel approach to estimate the cost-of-illness in Europe. IMPLICATIONS FOR HEALTH CARE PROVISION AND POLICIES: Health and social care policy and commissioning must be evidence-based. The empirical results from this study confirm previous findings, that depression is a major concern to the economic welfare in Europe which has consequences to both healthcare providers and policy makers. One important way to stop this explosion in cost is through increased research efforts in the field. Moreover, better detection, prevention, treatment and patient management are imperatives to reduce the burden of depression and its costs. Mental healthcare policies and better access to healthcare for mentally ill are other challenges to improve for Europe. This study has identified several research gaps which are of interest for future research. In order to better understand the impact of depression to European society long-term prospective epidemiology and cost-of-illness studies are needed. In particular data is lacking for Central European countries. On the basis of our findings, further economic evaluations of treatments for depression are necessary in order to ensure a cost-effective use of European healthcare budgets.

  2. Severe hyponatremia associated with escitalopram

    Directory of Open Access Journals (Sweden)

    Gautam Rawal

    2017-01-01

    Full Text Available Hyponatremia is a rare but potentially fatal complication of selective serotonin reuptake inhibitor (SSRI therapy with only limited cases of escitalopram as the causative drug. We report the case of a 54-year-old hypertensive female who was admitted to the hospital with seizure episode and subsequently diagnosed to have severe hyponatremia due to SSRI-induced syndrome of inappropriate antidiuretic hormone (SIADH with the cause attributed to the short history of intake of escitalopram for depression. All SSRIs, including escitalopram, can cause SIADH and should be used with caution in the depressive patients with regular monitoring of electrolytes, especially in the elderly.

  3. Insulin pen needles: effects of extra-thin wall needle technology on preference, confidence, and other patient ratings.

    Science.gov (United States)

    Aronson, Ronnie; Gibney, Michael A; Oza, Kunjal; Bérubé, Julie; Kassler-Taub, Kenneth; Hirsch, Laurence

    2013-07-01

    black; and 89.8% had type 2 DM. Nearly 99% used a single PN: 8 mm, 49.5%; 5 mm, 24.1%; 6 mm, 14.4%; and 4 mm, 12.0%. Patients rated the XTW PNs (mean [95% CI]) as preferable by a mean of 31.9 mm (27.2-36.6), P preferred overall, rated as requiring less time and less thumb force to inject, and providing greater confidence in completing a full dose compared with usual PNs in this group of patients with type 1 or type 2 DM. ClinicalTrials.gov identifier: NCT01852136. Copyright © 2013 The Authors. Published by EM Inc USA.. All rights reserved.

  4. Late onset depression: A recent update

    Directory of Open Access Journals (Sweden)

    Ananya Mahapatra

    2015-01-01

    Full Text Available Late onset depression has recently emerged as a serious mental health issue in the geriatric population with significant public health implications. It is often challenging to diagnose and treat this entity. Various theories have been postulated to elucidate the etiology of late onset depression, but a unifying hypothesis is lacking. Although the vascular hypothesis is most researched; a complex interaction of multiple vulnerability factors is the current focus of attention. Numerous psychosocial variables have been implicated to play a significant role in predicting the onset and severity of late-life depression. Phenomenological differences have been delineated from depression occurring at a younger age, but the findings are equivocal. A better understanding of the natural trajectory of depression in the elderly is required for early diagnosis and effective treatment. This review attempts to summarize the current status of evidence regarding epidemiology, etiology, clinical features, and treatment options available for late-onset depression.

  5. Maternal Depression and Parent Management Training Outcomes.

    Science.gov (United States)

    Dempsey, Jack; McQuillin, Samuel; Butler, Ashley M; Axelrad, Marni E

    2016-09-01

    This study examines the impact of maternal depression on reductions in children's behavior problems severity following implementation of the Brief Behavioral Intervention-a brief, manualized parent management training treatment. The parents of 87 children aged 2-6 years of age received parent management training at a metropolitan hospital. Parents of participants completed measures of externalizing behavior and maternal depression. The association between pre-post treatment change in externalizing behavior and maternal depression was examined using an autoregressive cross-lagged model. Results showed that self-reported maternal depressive symptoms at pre-treatment negatively influenced the overall magnitude of reduction of reported externalizing behaviors in children following treatment. Results indicate that aspects of family functioning not specifically targeted by parent management training, such as maternal depression, significantly affect treatment outcomes. Clinicians providing parent management training may benefit from assessing for maternal depression and modifying treatment as indicated.

  6. Stress, depression and hippocampal damage

    Indian Academy of Sciences (India)

    and exacerbation of psychiatric disorders like depression and post-traumatic stress disorder (PTSD) (Sapolsky 1996). Amongst the prime targets of stress in the brain ... discrete stages of development, the DG retains the ability to exhibit neurogenesis throughout adulthood in several species, including rodents, primates and ...

  7. Aetiology of Depression: Insights from epidemiological and genetic research

    NARCIS (Netherlands)

    O. Story-Jovanova (Olivera)

    2018-01-01

    markdownabstractThis thesis includes several population-based studies that explore the aetiology of depression, with a specific interest on biological factors, genetics and epigenetics, and physical health factors for depression. Unravelling the aetiology of depression could potentially answer some

  8. Bone density and depression in premenopausal South African ...

    African Journals Online (AJOL)

    In a comparison of women (4 of the 40 i.e. “control” subjects) with negligible symptoms of depression and the five patients with severe recurrent major depression- BMD, depression, saliva cortisol and bone turnover markers were measured and compared. Pro-inflammatory status (IL-1 and TNF-alpha) was investigated in ...

  9. The Prevalence of Depression among patients and its detection by ...

    African Journals Online (AJOL)

    Background Little information is available on the prevalence of depression in Malawi in primary health care settings and yet there is increased number of cases of depression presenting at tertiary level in severe form. Aim The aim of the study was to determine the prevalence of depression among patients and its detection ...

  10. Prevalence of depression: Comparisons of different depression definitions in population-based samples of older adults.

    Science.gov (United States)

    Sjöberg, Linnea; Karlsson, Björn; Atti, Anna-Rita; Skoog, Ingmar; Fratiglioni, Laura; Wang, Hui-Xin

    2017-10-15

    Depression prevalence in older adults varies largely across studies, which probably reflects methodological rather than true differences. This study aims to explore whether and to what extent the prevalence of depression varies when using different diagnostic criteria and rating scales, and various samples of older adults. A population-based sample of 3353 individuals aged 60-104 years from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K) were examined in 2001-2004. Point prevalence of depression was estimated by: 1) diagnostic criteria, ICD-10 and DSM-IV-TR/DSM-5; 2) rating scales, MADRS and GDS-15; and 3) self-report. Depression prevalence in sub-samples by dementia status, living place, and socio-demographics were compared. The prevalence of any depression (including all severity grades) was 4.2% (moderate/severe: 1.6%) for ICD-10 and 9.3% (major: 2.1%) for DSM-IV-TR; 10.6% for MADRS and 9.2% for GDS-15; and 9.1% for self-report. Depression prevalence was lower in the dementia-free sample as compared to the total population. Furthermore, having poor physical function, or not having a partner were independently associated with higher depression prevalence, across most of the depression definitions. The response rate was 73.3% and this may have resulted in an underestimation of depression. Depression prevalence was similar across all depression definitions except for ICD-10, showing much lower figures. However, independent of the definition used, depression prevalence varies greatly by dementia status, physical functioning, and marital status. These findings may be useful for clinicians when assessing depression in older adults and for researchers when exploring and comparing depression prevalence across studies. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Depressive symptoms and early retirement intentions among Danish eldercare workers

    DEFF Research Database (Denmark)

    Nexo, Mette Andersen; Borg, Vilhelm; Sejbaek, Camilla Sandal

    2015-01-01

    BACKGROUND: Depression increases the risk of disability pension and represents a health related strain that pushes people out of the labour market. Although early voluntary retirement is an important alternative to disability pension, few studies have examined whether depressive symptoms incur...... early voluntary retirement. This study examined whether depressive symptoms and changes in depressive symptoms over time were associated with early retirement intentions. METHODS: We used a cross-sectional (n = 4041) and a prospective (n = 2444) population from a longitudinal study on employees...... of the Danish eldercare sector. Depressive symptoms were measured by the Major Depression Inventory and the impact of different levels of depressive symptoms (severe, moderately severe, moderate, mild and none) and changes in depressive symptoms (worsened, improved, unaffected) on early retirement intentions...

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

    Directory of Open Access Journals (Sweden)

    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.

  13. Depression After Heart Attack

    Science.gov (United States)

    ... Can Be Done to Reduce the Impact of Depression on My Mental and Physical Health? There is some good news here. Depression is ... Can Be Done to Reduce the Impact of Depression on My Mental and Physical Health? What Can I Do About the Depression I’ ...

  14. A cluster randomized trial of standard quality improvement versus patient-centered interventions to enhance depression care for African Americans in the primary care setting: study protocol NCT00243425

    Directory of Open Access Journals (Sweden)

    Ghods Bri K

    2010-02-01

    Full Text Available Abstract Background Several studies document disparities in access to care and quality of care for depression for African Americans. Research suggests that patient attitudes and clinician communication behaviors may contribute to these disparities. Evidence links patient-centered care to improvements in mental health outcomes; therefore, quality improvement interventions that enhance this dimension of care are promising strategies to improve treatment and outcomes of depression among African Americans. This paper describes the design of the BRIDGE (Blacks Receiving Interventions for Depression and Gaining Empowerment Study. The goal of the study is to compare the effectiveness of two interventions for African-American patients with depression--a standard quality improvement program and a patient-centered quality improvement program. The main hypothesis is that patients in the patient-centered group will have a greater reduction in their depression symptoms, higher rates of depression remission, and greater improvements in mental health functioning at six, twelve, and eighteen months than patients in the standard group. The study also examines patient ratings of care and receipt of guideline-concordant treatment for depression. Methods/Design A total of 36 primary care clinicians and 132 of their African-American patients with major depressive disorder were recruited into a cluster randomized trial. The study uses intent-to-treat analyses to compare the effectiveness of standard quality improvement interventions (academic detailing about depression guidelines for clinicians and disease-oriented care management for their patients and patient-centered quality improvement interventions (communication skills training to enhance participatory decision-making for clinicians and care management focused on explanatory models, socio-cultural barriers, and treatment preferences for their patients for improving outcomes over 12 months of follow

  15. Prevalence of Depression in Postmenopausal Women

    Directory of Open Access Journals (Sweden)

    Afshari

    2015-07-01

    Full Text Available Background Every woman during different stages of her growth faces various crises, and one of these crises, menopause, may create different problems. In modern societies, psychological disorders and particularly depression is one of the problems of menopausal women. Objectives This study aimed to evaluate the prevalence of depression in postmenopausal women referred to selected health centers of Ahvaz in 2014. Patients and Methods This study was cross-sectional study. In this study, 1280 postmenopausal women aged between 40 and 65 years old who were referred to selected health centers of Ahvaz in 2014 were randomly enrolled. Hamilton depression scale and demographic questionnaire were used for gathering information. Data were analyzed using SPSS software. To analyze the data, descriptive statistics and analytical statistics (Independent t test, ANOVA, Pearson correlation and logistic regression were carried out (CI 95%. Results The mean ± SD score of depression for the subjects was 9.37 ± 4.62. The results showed that 59.8% of the 1280 samples were depressed; in particular, 39.8% had mild depression, 16% moderate depression, and 4% severe depression. There is a significant and inverse relation between variables of age, exposure to cigarette smoking, and the relationship with their spouses and the level of their depression, so higher age, more exposure to smoking, and better relation with their husbands, lead to the less depression. The results showed that the level of education is associated with depression. The highest rate of depression was in illiterate women; the finding also showed that there is a relationship between income and the severity of depression (Regression Log. T test showed that the mean depression level of employed postmenopausal women is higher than housewives postmenopausal women, and this difference is statistically significant (P < 0.001. Conclusions A significant percentage of women in their menopause experience

  16. NTCP models for patient-rated xerostomia and sticky saliva after treatment with intensity modulated radiotherapy for head and neck cancer: The role of dosimetric and clinical factors

    International Nuclear Information System (INIS)

    Beetz, Ivo; Schilstra, Cornelis; Schaaf, Arjen van der; Heuvel, Edwin R. van den; Doornaert, Patricia; Luijk, Peter van; Vissink, Arjan; Laan, Bernard F.A.M. van der; Leemans, Charles R.; Bijl, Henk P.; Christianen, Miranda E.M.C.; Steenbakkers, Roel J.H.M.; Langendijk, Johannes A.

    2012-01-01

    Purpose: The purpose of this multicentre prospective study was to develop multivariable logistic regression models to make valid predictions about the risk of moderate-to-severe patient-rated xerostomia (XER M6 ) and sticky saliva 6 months (STIC M6 ) after primary treatment with intensity modulated radiotherapy (IMRT) with or without chemotherapy for head and neck cancer (HNC). Methods and materials: The study population was composed of 178 consecutive HNC patients treated with IMRT. All patients were included in a standard follow up programme in which acute and late side effects and quality of life were prospectively assessed, prior to, during and after treatment. The primary endpoints were XER M6 and STIC M6 as assessed by the EORTC QLQ-H and N35 after completing IMRT. Organs at risk (OARs) potentially involved in salivary function were delineated on planning-CT, including the parotid, submandibular and sublingual glands and the minor glands in the soft palate, cheeks and lips. Patients with moderate-to-severe xerostomia or sticky saliva, respectively, at baseline were excluded. The optimal number of variables for a multivariate logistic regression model was determined using a bootstrapping method. Results: Eventually, 51.6% of the cases suffered from XER M6 . The multivariate analysis showed that the mean contralateral parotid gland dose and baseline xerostomia (none vs. a bit) were the most important predictors for XER M6 . For the multivariate NTCP model, the area under the receiver operating curve (AUC) was 0.68 (95% CI 0.60–0.76) and the discrimination slope was 0.10, respectively. Calibration was good with a calibration slope of 1.0. At 6 months after IMRT, 35.6% of the cases reported STIC M6 . The mean contralateral submandibular gland dose, the mean sublingual dose and the mean dose to the minor salivary glands located in the soft palate were most predictive for STIC M6 . For this model, the AUC was 0.70 (95% CI 0.61–0.78) and the discrimination slope

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

    Science.gov (United States)

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

    2007-01-01

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

  18. Emotion regulation predicts symptoms of depression over five years.

    Science.gov (United States)

    Berking, Matthias; Wirtz, Carolin M; Svaldi, Jennifer; Hofmann, Stefan G

    2014-06-01

    Deficits in emotion regulation have been identified as an important risk and maintaining factor for depression. The aim of this study was to examine the long-term effects of emotion regulation on symptoms of depression. Moreover, we investigated which specific emotion regulation skills were associated with subsequent symptoms of depression. Participants were 116 individuals (78% women, average age 35.2 years) who registered for an online-based assessment of depression and its risk-factors and reported at least some symptoms of depression. Successful application of emotion regulation skills and depressive symptom severity were assessed twice over a 5-year period. We utilized cross-lagged panel analyses to assess whether successful skills application would be negatively associated with subsequent depressive symptom severity. Cross-lagged panel analyses identified successful skills application as a significant predictor for depressive symptom severity even when controlling for the effects of initial symptoms of depression. A comparison of the effect sizes for different emotion regulation skills on subsequent depressive symptoms suggests that most of the skills included have similar predictive value. These findings provide preliminary evidence for the hypotheses that deficits in emotion regulation may contribute to the development of depression and that interventions systematically enhancing adaptive emotion regulation skills may help prevent and treat depressive symptoms. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Depression. Does it affect the comprehension of receptive skills?

    Science.gov (United States)

    Rashtchi, Mojgan; Zokaee, Zahra; Ghaffarinejad, Ali R; Sadeghi, Mohammad M

    2012-07-01

    To compare the comprehension of depressed and non-depressed male and female Iranian learners of English as a Foreign Language (EFL) in receptive skills, and to investigate whether inefficiency in learning English could be due to depression. We selected 126 boys and 96 girls aged between 15 and 18 by simple random sampling from 2 high schools in Kerman, Iran to examine whether there was any significant relationship between depression and comprehension of receptive skills in males and females. We undertook this descriptive, correlational study between January and May 2011 in Kerman, Iran. After administration of the Beck Depression Inventory (BDI), we found that 93 students were non-depressed, 65 had minimal depression, 48 mild depression, and 16 suffered from severe depression. The correlation between participants` scores on listening and reading test with depression level indicated a significant relationship between depression and comprehension of both listening, and reading. Males had higher scores in both reading and listening. In listening, there was no significant difference among the levels of depression and males and females. Regarding the reading skill, there was no significant difference among levels of depression; however, the reading comprehension of males and females differed significantly. Learners who show a deficiency in receptive skills should be examined for the possibility of suffering from some degree of depression.

  20. Attributional Style and Depression in Multiple Sclerosis

    Science.gov (United States)

    Arnett, Peter A.

    2013-01-01

    Several etiologic theories have been proposed to explain depression in the general population. Studying these models and modifying them for use in the multiple sclerosis (MS) population may allow us to better understand depression in MS. According to the reformulated learned helplessness (LH) theory, individuals who attribute negative events to internal, stable, and global causes are more vulnerable to depression. This study differentiated attributional style that was or was not related to MS in 52 patients with MS to test the LH theory in this population and to determine possible differences between illness-related and non-illness-related attributions. Patients were administered measures of attributional style, daily stressors, disability, and depressive symptoms. Participants were more likely to list non-MS-related than MS-related causes of negative events on the Attributional Style Questionnaire (ASQ), and more-disabled participants listed significantly more MS-related causes than did less-disabled individuals. Non-MS-related attributional style correlated with stress and depressive symptoms, but MS-related attributional style did not correlate with disability or depressive symptoms. Stress mediated the effect of non-MS-related attributional style on depressive symptoms. These results suggest that, although attributional style appears to be an important construct in MS, it does not seem to be related directly to depressive symptoms; rather, it is related to more perceived stress, which in turn is related to increased depressive symptoms. PMID:24453767

  1. Falls and depression in older people.

    Science.gov (United States)

    Turcu, Alin; Toubin, Sandrine; Mourey, France; D'Athis, Philippe; Manckoundia, Patrick; Pfitzenmeyer, Pierre

    2004-01-01

    Depression is one of the most common risk factors for falls, but links between falls and depression are still unclear. Few studies have examined the relationship between depression and gait alteration, which may increase the risk of fall. This study aims to assess a possible relationship between depression, postural and gait abnormalities, and falls. We conducted a 1-year prospective study on patients >/=70 years who were admitted to a geriatric unit for 'spontaneous' unexplained falls. Patients were tested for depression using the 30-item Geriatric Depression Scale (GDS). Their motor performances were assessed using the Mini Motor Test (MMT), which is an easy direct-observation test, validated in France, for assessment of frail old people who present with severe postural and gait impairment. This scale is composed of 4 categories of items: (1) abilities in bed; (2) quality of the sitting position; (3) abilities in the standing position, and (4) quality of gait. Sixty-nine patients were included. Depression was found in 46 patients (66.7%). The MMT score was higher in the non-depressed fallers (NDF) group (GDS 10; p predispose to falls. In clinical practice, more attention should be given to old fallers concerning diagnosis and treatment of associated depression. Copyright 2004 S. Karger AG, Basel

  2. Depression after CABG: a prospective study

    Directory of Open Access Journals (Sweden)

    Joana Kátya Veras Rodrigues Sampaio Nunes

    2013-12-01

    Full Text Available INTRODUCTION: Depression during or shortly after hospitalization elevated two to three times the risk of mortality or nonfatal cardiac events, significantly increasing the morbidity and mortality of these patients. OBJECTIVE: To assess the impact of revascularization on symptoms of depression in patients with coronary artery disease. METHODS: A prospective cohort study of 57 patients of both sexes undergoing coronary artery bypass grafting between June 2010 and June 2011. We used the SF-36 to assess quality of life, and the Beck Depression Inventory to detect depressive symptoms, applied preoperatively and six months. RESULTS: The prevalence of patients aged 60-69 years was 22 patients (38.60%, 39 men (68.42%, 26 described themselves as mixed race (45.61%, 16 literate (28.07 % and 30 married (52.63%. The beck depression inventory score demonstrated increased after revascularization: 15 patients mild (26.32% at time zero to 17 (29.82% after. And with moderate, seven patients (12.28% before and 10 (17.54% after. In the categories of individuals with decreased minimum degree of 32 (56.14% to 28 (49.12%, and severe of three (5.26% for two (3.51% patients. Association was observed between beck depression inventory, gender, age, lifestyle, comorbidities and quality of life. CONCLUSION: There was a high prevalence of elevated beck depression inventory scores, lowest scores of depressive symptoms among men and association between the improvement of quality of life scores and beck depression inventory.

  3. Early Maladaptive Schemas in Depressed Women and Its Relationship with Depression

    Directory of Open Access Journals (Sweden)

    Hacer Bolat KONUKÇU

    2013-07-01

    Full Text Available Objective: Objective: Schemas are deep enduring cognitive structures that are the source of dysfunctional cognitions, emotions and behaviors, activate after critical incidents in depression. A subset of schemas called Early Maladaptive Schemas (EMS which are hyphotised to arise from early traumatic and adverse life events are also claimed to be related with not only personality disorders but also mood disorders. In this study we aimed to investigate the relationship between early maladaptive schemas and depression and relationship between schema scores and depression severity in depressed women and compare it with non-depressed controls.Methods: 40 women attending to an outpatient psychiatry clinic and 30 healthy controls participated. All participants were assessed with SCID-1. Data were obtained by using a Sociodemographic Questionnaires, Young Schema Questionnaire-Short Form 3 (YSQ and Beck Depression Inventory (BDI.Results: All except one (enmeshment/undeveloped self maladaptive schema scores of depressed women were higher than controls. BDI was correlated to some schema and schema domain scores in both depressed and control groups but the correlations were stronger in control group. Mean emotional deprivation, negativism, abandonment and instability, failure EMS scores showed the highest difference between two groups. The schema domains most related to depression symptom severity were disconnection and rejection, impaired autonomy and performance.Conclusions: Almost all early maladaptive schemas are related to depression, and some schemas are related to depression symptom severity but these correlations are weaker in control group. This may mean that EMS are stable and mood independent structures. Although other schemas are related to depression, mostly related EMS in women might be emotional deprivation schema. These schemas may also overlap with Beck’s unlovability core belief or sociotropy dimension

  4. Longitudinal Association of Dementia and Depression.

    Science.gov (United States)

    Snowden, Mark B; Atkins, David C; Steinman, Lesley E; Bell, Janice F; Bryant, Lucinda L; Copeland, Catherine; Fitzpatrick, Annette L

    2015-09-01

    Depression is an important precursor to dementia, but less is known about the role dementia plays in altering the course of depression. We examined whether depression prevalence, incidence, and severity are higher in those with dementia versus those with mild cognitive impairment (MCI), or normal cognition. Prospective cohort study using the longitudinal Uniform Data Set of the National Alzheimer's Coordinating Center (2005-2013). 34 Alzheimer Disease research centers. 27,776 subjects with dementia, MCI, or normal cognition. Depression status was determined by a clinical diagnosis of depression within the prior 2 years and by a Geriatric Depression Scale-Short Form score >5. Rates of depression were significantly higher in subjects with MCI and dementia compared with those with normal cognition at index visit. Controlling for demographics and common chronic conditions, logistic regression analysis revealed elevated depression in those with MCI (OR: 2.40 [95% CI: 2.25, 2.56]) or dementia (OR: 2.64 [95% CI: 2.43, 2.86]) relative to those with normal cognition. In the subjects without depression at the index visit (N = 18,842), those with MCI and dementia had higher probabilities of depression diagnosis 2 years post index visit than those with normal cognition: MCI = 21.7%, dementia = 24.7%, normal cognition = 10.5%. MCI and dementia were associated with significantly higher rates of depression in concurrent as well as prospective analyses. These findings suggest that efforts to effectively engage and treat older adults with dementia will need also to address co-occurring depression. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  5. The Latent Symptom Structure of the Beck Depression Inventory-II in Outpatients with Major Depression

    Science.gov (United States)

    Quilty, Lena C.; Zhang, K. Anne; Bagby, R. Michael

    2010-01-01

    The Beck Depression Inventory-II (BDI-II) is a self-report instrument frequently used in clinical and research settings to assess depression severity. Although investigators have examined the factor structure of the BDI-II, a clear consensus on the best fitting model has not yet emerged, resulting in different recommendations regarding how to best…

  6. Depression and anxiety in multiple system atrophy.

    Science.gov (United States)

    Zhang, L-Y; Cao, B; Zou, Y-T; Wei, Q-Q; Ou, R-W; Zhao, B; Wu, Y; Shang, H-F

    2018-01-01

    It has been noticed that the patients with multiple system atrophy (MSA) can accompany with depression and anxiety. This study aimed to establish the incidence and determinants of depression and anxiety symptoms in Chinese MSA patients. A total of 237 MSA patients were enrolled in the study. Neuropsychological assessment was performed using Hamilton Depression Rating Scale-24 items and Hamilton Anxiety Rating Scale. We found that 62.0% and 71.7% patients had at least mild depression and anxiety symptoms, respectively. The severity of depression of MSA patients was associated with lower educational years (P=.024), longer disease duration (Panxiety was associated with increased disease duration (Panxiety were female gender, longer disease duration, and disease severity. Depression and anxiety symptoms are common in patients with MSA. Neurologists should pay attention to depression and anxiety in patients with MSA, especially in female patients and those with longer disease duration and severe disease condition. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. The relationship between depression and periodontal diseases.

    Science.gov (United States)

    Hwang, S H; Park, S G

    2018-03-01

    A cross-sectional study was conducted to investigate whether depression is associated with periodontal diseases in a representative sample of South Korean adults Methods: We used data from the sixth Korea National Health and Nutrition Examination Survey (KNHANES VI), conducted in 2014. We included in this study 4328 participants aged over 20 years (1768 males and 2560 females). Depression was assessed with the Patient Health Questionnaire (PHQ-9) and history of physician-diagnosed depression. Periodontal diseases were assessed a gingival bleeding, calculus and periodontal pockets. The data were analyzed using the chi-square test and multiple logistic regression. People with any periodontal diseases tended to be old, male, married, low income, poor education, blue-collar occupation, diabetes mellitus, hypertension, overweight, smoking, not using dental floss or interdental brush in univariate analysis. Neither self-reported nor diagnosed depression was associated with the presence of any or severe periodontal disease in the total sample. In participants aged 20-29 years only, the presence of any periodontal disease was associated with self-reported depression (OR, 2.031; 95% CI, 1.011-4.078). In the same age group, the presence of severe periodontal disease was associated with both self-reported depression (OR, 6.532; 95% CI, 2.190-19.483) and diagnosed depression (OR, 7.729; 95% CI, 1.966-30.389). Self-reported depression was significantly associated with the presence of any or severe periodontal disease, and diagnosed depression was significantly associated with severe periodontal diseases only in participants aged 20-29 years. Copyright© 2018 Dennis Barber Ltd.

  8. Eating styles in major depressive disorder: Results from a large-scale study

    NARCIS (Netherlands)

    Paans, N.P.G.; Bot, M.; Strien, T. van; Brouwer, I.A.; Visser, M.; Penninx, B.W.J.H.

    2018-01-01

    Depressed persons have been found to present disturbances in eating styles, but it is unclear whether eating styles are different in subgroups of depressed patients. We studied the association between depressive disorder, severity, course and specific depressive symptom profiles and unhealthy eating

  9. Eating styles in major depressive disorder : Results from a large-scale study

    NARCIS (Netherlands)

    Paans, Nadine P G; Bot, Mariska; van Strien, Tatjana; Brouwer, Ingeborg A; Visser, Marjolein; Penninx, Brenda W J H

    Depressed persons have been found to present disturbances in eating styles, but it is unclear whether eating styles are different in subgroups of depressed patients. We studied the association between depressive disorder, severity, course and specific depressive symptom profiles and unhealthy eating

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

    Science.gov (United States)

    Vandeputte, Melissa; de Weerd, Al

    2003-07-01

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

  11. "Facebook depression?" social networking site use and depression in older adolescents.

    Science.gov (United States)

    Jelenchick, Lauren A; Eickhoff, Jens C; Moreno, Megan A

    2013-01-01

    To evaluate the association between social networking site (SNS) use and depression in older adolescents using an experience sample method (ESM) approach. Older adolescent university students completed an online survey containing the Patient Health Questionnaire-9 depression screen (PHQ) and a week-long ESM data collection period to assess SNS use. Participants (N = 190) included in the study were 58% female and 91% Caucasian. The mean age was 18.9 years (standard deviation = .8). Most used SNSs for either 2 hours (n = 16, 8%). The mean PHQ score was 5.4 (standard deviation = 4.2). No associations were seen between SNS use and either any depression (p = .519) or moderate to severe depression (p = .470). We did not find evidence supporting a relationship between SNS use and clinical depression. Counseling patients or parents regarding the risk of "Facebook Depression" may be premature. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  12. Does radiation dose to the salivary glands and oral cavity predict patient-rated xerostomia and sticky saliva in head and neck cancer patients treated with curative radiotherapy?

    International Nuclear Information System (INIS)

    Jellema, Anke Petra; Doornaert, Patricia; Slotman, Ben J.; Rene Leemans, C.; Langendijk, Johannes A.

    2005-01-01

    Background and Purpose: To investigate the association between the mean salivary gland and oral cavity dose, with patient-rated moderate and severe xerostomia and sticky saliva. Patients and methods: One hundred and fifty-seven patients treated with bilateral irradiation for head and neck cancer were included. The parotid and submandibular glands and the oral cavity were delineated on plannings-CT scans. At baseline and 6 and 12 months self-reported xerostomia and sticky saliva were assessed using the EORTC QLQ-H and N35 questionnaire. Results: At 6 months a significant association between the mean parotid (MD par ) and mean submandibular dose (MD subm ) and xerostomia was observed (OR-MD par : 1.17; P=0.002 and OR-MD subm : 1.08; P=0.02). Between MD par and MD subm , a significant interaction term was present. No significant association was found with the oral cavity dose. Xerostomia was reversible depending on MD par and MD subm . Considering Sticky saliva, a significant association was found at 6 and 12 months with MD subm (OR: 1.03; P par and MD subm influence the risk of xerostomia in irradiated patients at 6 months. This probability as a function of the mean parotid dose significantly depended on the mean dose in the submandibular glands. Sticky saliva mainly depends on MD subm

  13. Unilateral versus bilateral irradiation in squamous cell head and neck cancer in relation to patient-rated xerostomia and sticky saliva

    International Nuclear Information System (INIS)

    Jellema, Anke Petra; Slotman, Ben J.; Doornaert, Patricia; Leemans, C. Rene; Langendijk, Johannes A.

    2007-01-01

    Background and purpose: To investigate the association between radiation technique with patient-rated moderate and severe xerostomia and sticky saliva. Materials and methods: One hundred and fifty patients treated with bilateral or unilateral irradiation for head and neck cancer were included. The salivary glands and the oral cavity were delineated on plannings-CT scans. Xerostomia and sticky saliva were assessed using the EORTC QLQ-H and N35 questionnaire at baseline and 6 and 12 months. Results: At 6 months a significant association between radiation technique and the mean parotid dose (MD parb ) and xerostomia was observed (Odds ratio (OR)-technique: 2.55; p = 0.04 and OR-MD parb : 1.04; p = 0.009). Considering the individual salivary glands, only the mean dose in the contralateral parotid gland (MD parcl ) is associated with xerostomia (OR: 1.04; p parb influence the risk of xerostomia in irradiated patients. Of all individual salivary glands, only MD parcl is of utmost importance for xerostomia. The shift in the P50 observed for xerostomia suggests that sparing of the contralateral parotid gland is compensated by hyperfunction of the contralateral parotid gland

  14. Sensitivity and specificity of the Major Depression Inventory in outpatients

    Directory of Open Access Journals (Sweden)

    Noteboom Annemieke

    2007-08-01

    Full Text Available Abstract Background The Major Depression Inventory (MDI is a new, brief, self-report measure for depression based on the DSM-system, which allows clinicians to assess the presence of a depressive disorder according to the DSM-IV, but also to assess the severity of the depressive symptoms. Methods We examined the sensitivity, specificity, and psychometric qualities of the MDI in a consecutive sample of 258 psychiatric outpatients. Of these patients, 120 had a mood disorder (70 major depression, 49 dysthymia. A total of 139 subjects had a comorbid axis-I diagnosis, and 91 subjects had a comorbid personality disorder. Results Crohnbach's alpha of the MDI was a satisfactory 0.89, and the correlation between the MDI and the depression subscale of the SCL-90 was 0.79 (p Conclusion The MDI is an attractive, brief depression inventory, which seems to be a reliable tool for assessing depression in psychiatric outpatients.