Measurement issues in postpartum depression part 2: Assessment of somatic symptoms using the Hamilton Rating Scale for Depression

2003 ◽  
Vol 6 (1) ◽  
pp. 59-64 ◽  
Author(s):  
L. E. Ross ◽  
S. E. Gilbert Evans ◽  
E. M. Sellers ◽  
M. K. Romach
CNS Spectrums ◽  
2009 ◽  
Vol 14 (S4) ◽  
pp. 1-8
Author(s):  
David M. Clarke ◽  
Ahmad Hatim ◽  
Brian Ho ◽  
Jiyang Pan ◽  
Chee Ng ◽  
...  

It is a commonly held belief among mental health care providers that patients from the Western Pacific region with major depressive disorder (MDD) and anxiety disorders disproportionately present with somatic symptoms as opposed to emotional symptoms. Cultural norms, such as the stigma associated with psychiatric disorders, may lead members of this population to ignore the emotional aspects of these disorders or deny the presence of psychological symptoms. Empirical support is provided by the lower prevalence of these disorders in some Western Pacific nations in relation to the rest of the world. For example, MDD rates in India (9%), Japan (2%), China (2% to 4%), Malaysia (8%) and Australia (3%) are generally lower than rates in the United States (16%) and worldwide (10%). These discrepancies may be the result of missed diagnoses. Misdiagnosis is related to the increased somatization of MDD symptoms in these populations. As defined by the WHO, the Western Pacific region consists of 37 countries with a total population of 1.8 billion people (1.3 billion in China alone) with diverse cultural backgrounds and demographic profiles, which makes the issue of cultural effects on MDD diagnosis more complex.Patients with MDD or anxiety disorders worldwide often present with somatic symptoms, which frequently accompany psychological symptoms. For example, in a recent report of pooled data from Canada, scores on the Somatic Symptoms Inventory, the 17-item Hamilton Rating Scale for Depression (HAM-D17), and the Hamilton Rating Scale for Anxiety (HAM-A) were used to evaluate the association between somatic symptoms and MDD. Of the 2,191 patients randomly enrolled in the study, 78% reported moderate-to-severe fatigue and weakness. Painful physical symptoms commonly occur in patients with anxiety disorders as well. In a European study, painful physical symptoms were reported by 28% of those without anxiety disorders and 45% of those with anxiety disorders.


Diseases ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 52
Author(s):  
Muneeza Ali ◽  
Alifiya Aamir ◽  
Mufaddal Najmuddin Diwan ◽  
Hashir Ali Awan ◽  
Irfan Ullah ◽  
...  

Postpartum depression (PPD) is defined as the onset of major depressive disorder in mothers, occurring during pregnancy or within 4 weeks post-delivery. With 7% of pregnancy-related death in the United States owing to mental health conditions, including PPD, and a global prevalence of 12%, PPD is a growing public health concern. In 2019, the Food and Drug Administration (FDA) approved brexanolone, an exogenous analog of allopregnanolone, as the first ever drug to be specifically indicated for treating patients with PPD. This approval was preceded by an open-label study and three randomized placebo-controlled trials, each assessing the safety, tolerability, and efficacy of brexanolone, using mean Hamilton Rating Scale for Depression (HAM-D) score reduction as the primary outcome. In each randomized controlled trial, the drug was administered as an intravenous infusion given over 60 h. Enrolled participants were followed up on days 7 and 30 to evaluate the sustained effect. A statistically significant reduction in mean HAM-D score compared to placebo was observed in all three studies, supporting brexanolone’s use in treating moderate-to-severe PPD. Therefore, this article attempts to briefly review the pharmacology of brexanolone, evaluate the latest available clinical data and outcomes concerning its use, reevaluate its position as a ‘breakthrough’ in managing PPD, and review the cost-related barriers to its worldwide standardized use.


1976 ◽  
Vol 128 (2) ◽  
pp. 141-145 ◽  
Author(s):  
Ashley H. Robins

SummaryForty-five patients with parkinsonism were carefully matched for age and sex with 45 chronically disabled control patients with a significantly more severe grade of physical handicap. Depression was measured by the Hamilton Rating Scale, and it was found that the parkinsonian group was very significantly more depressed than the control group (p < 0.0001). Depression scores in both groups were unaffected by the patient's sex or by the severity of the disability. Analysis of the individual ratings of the Hamilton Scale showed that parkinsonian patients had significantly higher scores on items relating to suicide, work and interests, retardation, psychic anxiety, general somatic symptoms, and loss of insight. It was concluded that patients with parkinsonism suffer a degree of depression which cannot be solely a reaction to the stress of physical disability. This finding is discussed with reference to the monoamine hypothesis of depressive illness.


2019 ◽  
Author(s):  
Pablo Rodrigo Guzman Cortez ◽  
Matias Marzocchi ◽  
Neus Freixa Fontanals ◽  
Mercedes Balcells-Olivero

BACKGROUND Computerized mental health interventions have shown evidence of their potential benefit for mental health outcomes in young users. All of the studied interventions available in the review and scientific literature can be classified as "serious games". Serious games are computerized interventions designed from the start with the objective of improving specific desired health outcomes. Moreover, there are reports of users experiencing subjective benefits in mental health after playing specific commercial games. These were games not intentionally made with a therapeutic objective in the design process. An example is the videogame "Journey", first released for the Playstation 3 console in 2012 which won "Game of the Year" in the 2013 D.I.C.E awards. The creator of the game describes the game as a short, 2-3-hour narrative experience in which the player goes through the "Hero's Journey" following a classic 3-part structure. There were more than 100 testimonials from players describing how the game helped them cope with psychological or personal issues. Some of them explicitly described recovering from depressive episodes through playing the game. OBJECTIVE To conduct a pilot test of the efficacy of the videogame Journey in reducing depressive symptoms in an acute impatient setting METHODS Depressive symptomatology was measured before and after the intervention using the Hamilton Rating Scale for Depression (HRSD) The intervention was conducted in an isolated room using a Playstation 3 console with the videogame "Journey" developed by Thatgamecompany. No internet access was allowed. The game was played over the course of 4 30-45 min sessions in a two week period. RESULTS The initial score in the Hamilton Rating Scale for Depression (HRSD) was 30, indicating a very severe depression. After the intervention the HRSD score was 10, showing a mild depression. CONCLUSIONS The Videogame Journey, a commercial game first available for the Playstation 3 console in 2012, was not created as a serious game with potential health benefits. Our pilot test is the first case report of a commercial game showing a potential effect in reducing depressive symptoms, which is consistent with the previous informal reports of users online.


2021 ◽  
pp. 263183182110311
Author(s):  
Adarsh Tripathi ◽  
Dhirendra Kumar ◽  
Sujita Kumar Kar ◽  
PK Dalal ◽  
Anil Nischal

Background: Erectile dysfunction (ED) is one of the most common psychosexual disorders in clinical practice, and it results in significant distress, interpersonal impairments, poor quality of life, and marital disharmony. However, there is limited research on ED in India. Therefore, this study aimed to assess the sociodemographic and clinical profile of patients presenting with ED. Method: Cross-sectional evaluation of patients with ED presenting to the psychosexual outpatient department (OPD) of psychiatry department in a tertiary care hospital was done on structured clinical pro forma, Mini-International Neuropsychiatric Interview, International Index of Erectile Function-5, Arizona Sexual Experience, Hamilton rating scale for depression, and Hamilton rating scale for anxiety. Results: The sample included 102 patients. The mean age was 33.38 years. The majority of the patients were married (81.4%), Hindu (82.4%), residing in a rural area (60.8%), and belonging to a nuclear family (62.7%). The majority of the patients had a moderate level of ED (50%) followed by mild-to-moderate ED (26.5%) and severe ED (23.5%). Premature ejaculation (46.1%) and depression (28.4%) were the most common sexual and psychiatric comorbidities. Obesity was common (62.7%), and only a minority had other metabolic dysfunction, namely dyslipidemia (7.8%), diabetes (5.9%), and hypertension (4.9%). Tobacco dependence and alcohol dependence were present in 37.3% and 6.9% cases, respectively. Conclusion: Young adults with moderate-to-severe ED were present for treatment at a tertiary center. Comorbidities of other sexual disorders, psychiatric disorders, and substance use are commonly encountered in such patients. Promotion of early help-seeking should be encouraged. Clinicians should thoroughly assess even the young patients for other sexual, psychiatric, and medical comorbidities.


1999 ◽  
Vol 11 (1) ◽  
pp. 34-37 ◽  
Author(s):  
I.P.A.M. Huijbrechts ◽  
P.M.J. Haffmans ◽  
K. Jonker ◽  
A. van Dijke ◽  
E. Hoencamp

SummaryAlthough the Hamilton Rating Scale for Depression (HRSD) is the most frequently used rating scale for quantifying depressive states, it has been criticized for its reliability and its usability in clinical practice. This criticism is less applying to the Montgomery-Asberg Depression Rating Scale (MADRS). Goal of the present study is to investigate the reliability and validity, and clinical relationship between the HRSD and the MADRS. For 60 out-patients with diagnosed depression (DSM IV296.2x, 296.3x, 300.40 and 311.00), the HRSD and MADRS were scored at baseline and 6 weeks later by an independent rater according to a structured interview. Also the Clinical Global Impression (CGI) was assessed by a psychiatrist. Satisfying agreement was found between the totalscores (r= .75, p>.000 en r=.92, p>.000 respectively, at baseline and 6 weeks later). Furthermore agreement was found between the items of both scales, and these agree with the clinical impression. The reliability of the MADRS is more stable than the reliability of the HRSD (α = .6367 and α =.8900 vs α = .2193 and α = .8362 at baseline and at endpoint respectively). Considering the ease of scoring both scales in one interview and the widely international use of the HRSD, scoring both the HRSD and the MADRS to measure the severity of a depression seems to be an acceptabel covenant.


2000 ◽  
Vol 58 (4) ◽  
pp. 1025-1029 ◽  
Author(s):  
ALEXANDRE MARTINS VALENÇA ◽  
ANTONIO EGIDIO NARDI ◽  
ISABELLA NASCIMENTO ◽  
MARCO A. MEZZASALMA ◽  
FABIANA L. LOPES ◽  
...  

OBJECTIVE: To assess the effectiveness of clonazepam, in a fixed dose (2 mg/day), compared with placebo in the treatment of panic disorder patients. METHOD: 24 panic disorder patients with agoraphobia were randomly selected. The diagnosis was obtained using the structured clinical interview for DSM-IV . All twenty-four subjects were randomly assigned to either treatment with clonazepam (2 mg/day) or placebo, during 6 weeks. Efficacy assessments included: change from baseline in the number of panic attacks; CGI scores for panic disorder; Hamilton rating scale for anxiety; and panic associated symptoms scale. RESULTS: At the therapeutic endpoint, only one of 9 placebo patients (11.1%) were free of panic attacks, compared with 8 of 13 (61.5%) clonazepam patients (Fisher exact test; p=0,031). CONCLUSION: the results provide evidence for the efficacy of clonazepam in panic disorder patients.


2007 ◽  
Vol 27 (5) ◽  
pp. 531-534 ◽  
Author(s):  
Toshi A. Furukawa ◽  
Tatsuo Akechi ◽  
Hideki Azuma ◽  
Toru Okuyama ◽  
Teruhiko Higuchi

1982 ◽  
Vol 140 (6) ◽  
pp. 558-565 ◽  
Author(s):  
Peter Berner ◽  
Bernd Küfferle

For a foreign observer who has been trained in German and French psychopathology, British psychiatry is very attractive at first glance for a number of reasons. Its eclectic and principally non-theoretical approach (Cooper, 1975), characterized by an open acceptance of foreign concepts and by the tendency to question traditional structures and hypotheses and to test them by means of statistical methods, appears most impressive. The substantial contribution British authors have made toward the development of structured tools in psychopathology, like for instance the Present State Examination or the Hamilton Rating Scale in order to facilitate such a statistical evaluation, which reflects clearly the inheritance of Sir Francis Galton, is also a cause of sincere admiration. The European observer realizes furthermore that the British approach is rooted mainly in continental, especially in German, clinical psychiatry, and is not as heavily influenced by psychodynamic theories as, for instance, the American schools were, at least until recently. This provides him with a comfortable feeling of familiarity and he is not inclined to question certain British tenets until his involvement progresses and he becomes aware of the comparative lack of attention paid by British schools to some of the fundamentals of continental psychopathology.


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