Validity of the DSM-5 anxious distress specifier for major depressive disorder

Background: According to new studies, only 60% of depressed patients respond to pharmaceutical treatment while suffering from their side effects. Natural products as adjuvant or alternative therapies should be examined to find safer and more effective ways to cope with depression. Objective: To find out the potential benefits of a combined herbal drug based on Echium amoenum compared with citalopram in the treatment of Major Depressive Disorder. Design and Setting: In psychiatry clinics of Mashhad University of Medical Sciences, 50 patients who met the criteria for Major Depressive Disorder based on DSM-5 were studied in a parallel randomized controlled trial. Design and Setting: In psychiatry clinics of Mashhad University of Medical Sciences, 50 patients who met the criteria for Major Depressive Disorder based on DSM-5 were studied in a parallel randomized controlled trial. Intervention: Subjects were randomly assigned to receive Echium amoenum compound syrup (EACS) or citalopram tablet for 8 weeks. Outcome Measures: The efficacy of treatments and recurrence of disease were surveyed and compared according to Hamilton depression rating scale at weeks 0, 4, 8, 12. Results: Patients in both groups of citalopram and EACS showed remarkable reduction in scores of Hamilton questionnaire. At the eighth week of treatment, the mean scores in EACS group were significantly lower than citalopram group (p-value = 0.03). 52% of patients suffered from various complications in citalopram group while just 12% of patients in EACS group reported few complications. Conclusion: Clinical efficacy of this herbal drug was significantly higher than citalopram, and complications were also less and lower in EACS group. Further studies with larger groups and para-clinical assessments such as serologic tests and QEEG would improve our understanding of the impacts and mechanisms of EACS.

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Measures of the DSM–5 mixed-features specifier of major depressive disorder

CNS Spectrums ◽

10.1017/s1092852916000857 ◽

2017 ◽

Vol 22 (2) ◽

pp. 196-202 ◽

Cited By ~ 4

Author(s):

Mark Zimmerman

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Antidepressant Medication ◽

Reliability And Validity ◽

Mixed States ◽

Major Depressive ◽

Manic Symptoms ◽

Dsm 5 ◽

Depressed Patients ◽

Mixed Features

During the past two decades, a number of studies have found that depressed patients frequently have manic symptoms intermixed with depressive symptoms. While the frequency of mixed syndromes are more common in bipolar than in unipolar depressives, mixed states are also common in patients with major depressive disorder. The admixture of symptoms may be evident when depressed patients present for treatment, or they may emerge during ongoing treatment. In some patients, treatment with antidepressant medication might precipitate the emergence of mixed states. It would therefore be useful to systematically inquire into the presence of manic/hypomanic symptoms in depressed patients. We can anticipate that increased attention will likely be given to mixed depression because of changes in the DSM–5. In the present article, I review instruments that have been utilized to assess the presence and severity of manic symptoms and therefore could be potentially used to identify the DSM–5 mixed-features specifier in depressed patients and to evaluate the course and outcome of treatment. In choosing which measure to use, clinicians and researchers should consider whether the measure assesses both depression and mania/hypomania, assesses all or only some of the DSM–5 criteria for the mixed-features specifier, or assesses manic/hypomanic symptoms that are not part of the DSM–5 definition. Feasibility, more so than reliability and validity, will likely determine whether these measures are incorporated into routine clinical practice.

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Underlying Dimensions of DSM-5 Posttraumatic Stress Disorder and Major Depressive Disorder Symptoms

Psychological Injury and Law ◽

10.1007/s12207-013-9177-4 ◽

2013 ◽

Vol 6 (4) ◽

pp. 290-298 ◽

Cited By ~ 43

Author(s):

Tracey L. Biehn ◽

Jon D. Elhai ◽

Laura D. Seligman ◽

Marijo Tamburrino ◽

Cherie Armour ◽

...

Keyword(s):

Posttraumatic Stress Disorder ◽

Major Depressive Disorder ◽

Depressive Disorder ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Major Depressive ◽

Dsm 5

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Anhedonia in Schizophrenia and Major Depressive Disorder Clinical and Functional MRI Study

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2021/v33i1631010 ◽

2021 ◽

pp. 139-154

Author(s):

Amr Mohamad Elsarnagawy ◽

Rasha Ahmad Elshafeay ◽

Adel Abd-Elkarim Badawy ◽

Ehab Sayed Ramadan ◽

Gamal Ibrahim Shamma

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Assessment Tools ◽

P Value ◽

Major Depressive ◽

Dsm 5 ◽

Depressed Patients ◽

Schizophrenic Patients ◽

Group 2 ◽

Group 1

Background: Anhedonia, is defined as reduced capacity to gain pleasure from pleasurable experiences, is a key symptom of major depression. Several studies had investigated anhedonia in schizophrenia and major depressive disorder, using different psychometric and radiological assessment tools with controversy results in either severity of anhedonia or radiological findings. The aim of this study was to differentiate the nature of the issue of anhedonia in schizophrenia versus major depressive disorder; from clinical and brain function part of view, and to study different variables in this regard. Methods: This study was carried on 60 participants who were divided into three groups: Group 1: 20 schizophrenic patients, diagnosed according to DSM-5. The symptoms of schizophrenic patients must include anhedonia as a main symptom, Group 2: 20 patients with major depressive disorder according to DSM-5 criteria, and anhedonia was one of their prominent symptoms, Group 3: 20 control subjects. Results: Our results revealed statically significant differences between participants as regards age of onset, occupational career. Statically significant differences were found between 3 groups. Most of patients in group 1 lacks the interest for social activities and intimate relationships. Statically significant Difference was found between patients in both groups compared to controls. Striatal activity (mainly caudate) was significantly diminished in group 2 (P value <0.001) and group 1 (P value 0.002) relative to controls. Prefrontal activity (ventromedial area ''vmPFC'' and dorsolateral area ''DLPFC'') was increased significantly in group 2 more than control group (P value 0.034). Group 1 shows significantly decreased activation than controls (P value 0.019). Significant differences were found between group 1 and 2 (P value <0.001). Orbito-frontal activity was increased significantly in depressed patients more than group 1 (P <0.001) and controls (P =0.019). Conclusions: Anhedonia is a highly disabling symptom in patients with schizophrenia or MDD, associated with poor outcome. Depressed anhedonic patients have higher incidence of suicidal ideas, thoughts, and behavior. Depressed patients showed significant striatal hypoactivation associated with hyper activation of prefrontal and orbitofrontal areas. Schizophrenic patients showed diminished activation at striatal areas and frontal cortex. We fail to find significant correlation between severity of anhedonia in both patient groups and degree of fMRI activation in different brain areas involved in reward processing.

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MAJOR DEPRESSIVE DISORDER IN DSM-5: IMPLICATIONS FOR CLINICAL PRACTICE AND RESEARCH OF CHANGES FROM DSM-IV

Depression and Anxiety ◽

10.1002/da.22217 ◽

2013 ◽

Vol 31 (6) ◽

pp. 459-471 ◽

Cited By ~ 106

Author(s):

Rudolf Uher ◽

Jennifer L. Payne ◽

Barbara Pavlova ◽

Roy H. Perlis

Keyword(s):

Major Depressive Disorder ◽

Clinical Practice ◽

Depressive Disorder ◽

Major Depressive ◽

Dsm 5 ◽

Dsm Iv

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Questionable Agreement: The Experience of Depression and DSM-5 Major Depressive Disorder Criteria

The Journal of Medicine and Philosophy A Forum for Bioethics and Philosophy of Medicine ◽

10.1093/jmp/jhaa025 ◽

2020 ◽

Vol 45 (6) ◽

pp. 623-643

Author(s):

Abraham M Nussbaum

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Diagnostic Criteria ◽

Field Tests ◽

Mental Health Practitioners ◽

Major Depressive ◽

Dsm 5 ◽

Health Practitioners ◽

Classic Essay ◽

Depressive Episodes

Abstract Immediately before the release of DSM-5, a group of psychiatric thought leaders published the results of field tests of DSM-5 diagnostic criteria. They characterized the interrater reliability for diagnosing major depressive disorder by two trained mental health practitioners as of “questionable agreement.” These field tests confirmed an open secret among psychiatrists that our current diagnostic criteria for diagnosing major depressive disorder are unreliable and neglect essential experiences of persons in depressive episodes. Alternative diagnostic criteria exist, but psychiatrists rarely encounter them, forestalling the discipline’s epistemological crisis. In Alsadair MacIntyre’s classic essay, such crises occur in science when a person encounters a rival schemata that is incompatible with their current schemata and subsequently constructs a narrative that allows them to reconstruct their own tradition. In search of rival schemata that are in conversation with their own tradition, psychiatric practitioners can utilize alternative diagnostic criteria like the Cultural Formulation Interview, embrace an epistemologically humble psychiatry, and attend to the narrative experience of a person experiencing a depressive episode.

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Proposed DSM-5 mixed features are associated with greater likelihood of remission in out-patients with major depressive disorder

Psychological Medicine ◽

10.1017/s0033291712000281 ◽

2012 ◽

Vol 44 (7) ◽

pp. 1361-1367 ◽

Cited By ~ 15

Author(s):

R. H. Perlis ◽

C. Cusin ◽

M. Fava

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Depressive Episode ◽

Major Depressive Episode ◽

Antidepressant Treatment ◽

Adverse Outcomes ◽

Self Report ◽

Major Depressive ◽

Dsm 5 ◽

Mixed Features

BackgroundDraft DSM-5 criteria for a mixed major depressive episode have been proposed, but their predictive validity has not yet been established. We hypothesized that such symptoms would be associated with poorer antidepressant treatment outcomes.MethodWe examined outcomes among individuals with major depressive disorder participating in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study, an effectiveness study conducted at primary and specialty care centers in the USA. Mixed features were derived from the six self-report items of the mania subscale of the Psychiatric Diagnosis Screening Questionnaire. Primary analyses examined the association between the presence of at least two of these in the 6 months before study entry, and remission across up to four sequential treatment trials, as well as adverse outcomes.ResultsOf the 2397 subjects with a major depressive episode of at least 6 months' duration, 449 (18.7%) reported at least two mixed symptoms. The presence of such symptoms was associated with a greater likelihood of remission across up to four sequential treatments, which persisted after adjustment for potential confounding clinical and demographic variables (adjusted hazard ratio 1.16, 95% confidence interval 1.03–1.28). Two individual items, expansive mood and cheerfulness, were strongly associated with a greater likelihood of remission.ConclusionsProposed DSM-5 mixed state features were associated with a greater rather than a lesser likelihood of remission. While unexpected, this result suggests the potential utility of further investigation of depressive mixed states in major depression.

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