scholarly journals Arousing a wide range of emotions within educational virtual reality simulation about major depressive disorder affects knowledge retention

2021 ◽  
Author(s):  
Christos Hadjipanayi ◽  
Despina Michael-Grigoriou
Keyword(s):  
Virtual Reality ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Emotional Experience ◽  
Knowledge Retention ◽  
Emotional Impact ◽  
Body Ownership ◽  
Major Depressive ◽  
Head Mounted Display ◽  
Wide Range

AbstractThe experience of using an educational application, concerning a major depressive disorder simulation, could be anything but pleasant, so the challenges of creating such an application are ample. In this research, the effects of the emotional experience of the players, deriving from the positive ending of the virtual reality (VR) simulation’s embedded narrative or the lack of it, are evaluated. Alongside the investigation of a possible link between the emotional impact of the simulation and information retention, the overall effect of the application in relation to VR presence and body ownership is appraised. Thirty participants over 18 years old tested the application, using an Oculus Rift head-mounted display with a joystick, and their data were recorded by a pre- and a post-questionnaire. The 30 participants have been separated into groups of 15, where the positive ending was accessible to only one of the two groups. The group which experienced the positive ending reported a significant correlation of emotional impact and knowledge retention.

scholarly journals Efficacy of levomilnacipran extended-release in major depressive disorder: pooled analysis of 5 double-blind, placebo-controlled trials

CNS Spectrums ◽  
2014 ◽  
Vol 20 (2) ◽  
pp. 148-156 ◽  
Author(s):  
Stuart A. Montgomery ◽  
Carl P. Gommoll ◽  
Changzheng Chen ◽  
William M. Greenberg
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Extended Release ◽  
Rating Scale ◽  
Pooled Analysis ◽  
Major Depressive ◽  
Double Blind ◽  
Madrs Score ◽  
Wide Range ◽  
Remission Rates

Introduction/ObjectivePost hoc analyses were conducted to evaluate the efficacy of levomilnacipran extended-release (ER) in subgroups of patients with major depressive disorder (MDD).MethodsData were pooled from 5 completed Phase II/III studies. Patients were categorized by sex, age, MDD duration, recurrence of MDD, current episode duration, number of prior episodes, and baseline Montgomery–Åsberg Depression Rating Scale (MADRS) score. Efficacy was evaluated by MADRS least squares (LS) mean change from baseline, response (MADRS improvement ≥50%), and remission (MADRS ≤10).ResultsIn the pooled population, treatment with levomilnacipran ER versus placebo resulted in greater improvement in MADRS score (−15.8 versus −12.9; LS mean difference, −2.9; P < .001) and higher response rates (44.7% versus 34.5%; P < .001). Comparable treatment effects were found in most subgroups. Remission rates in the overall population were higher for levomilnacipran ER versus placebo (27.7% versus 21.5%; P < .05); notably high remission rates were seen in patients with baseline MADRS score < 30 (48.8% versus 28.9%; P < .001).DiscussionClinically meaningful improvements in depressive symptoms were found across subgroups, including statistically significant outcomes for both response and remission.ConclusionLevomilnacipran ER was efficacious across a wide range of MDD patients, including men and women, ages 18–78, with varying histories and symptom severity.

scholarly journals Augmentation Strategies for Patients with Major Depressive Disorder with an Inadequate Response to Antidepressant Monotherapy

2014 ◽  
Vol 60 (2) ◽  
pp. 61-66
Author(s):  
Th Moica ◽  
I Gabos Grecu ◽  
Marieta Gabos Grecu ◽  
Melinda Ferencz ◽  
Elena Gabriela Buicu ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Depressive Episode ◽  
Physical Symptoms ◽  
Inadequate Response ◽  
Recurrent Depression ◽  
Major Depressive ◽  
Incomplete Response ◽  
Augmentation Strategies ◽  
Wide Range

Abstract Introduction: Major depressive disorder is a chronic and debilitating disease characterized by a wide range of emotional and physical symptoms that coexist during a depressive episode and may reoccur at some point during the progression of the disease for the majority of patients. The purpose of the study was to investigate psychiatrists’ experience regarding the response to antidepressive treatment and their options regarding augmentation strategies in depression with incomplete response to antidepressant monotherapy. Method: We applied an 18-item questionnaire containing multiple choice questions to adult psychiatrists working in ambulatories, hospitals or mental health centers. Results: Fourty-two psychiatrists have agreed to answer the questionnaire. The majority of them were psychiatry specialists, between 35 and 49 years of age, working in an outpatient unit. For the majority of doctors, SSRIs (Serotonin Reuptake Inhibitors) proved to be the first line treatment both for the first depressive episode and for recurrent depression, followed by SNRI (Serotonin and Noradrenalin Reuptake Inhibitors). Regarding the duration of maintenance treatment for the patients who achieved complete remission after the first episode of depression, the results showed a wide spectrum from 4 to 9 months. Conclusions: Incomplete response to antidepressive monotherapy is very frequent both for the first depressive episode and for recurrent depression. Given the pharmacological profile that some atypical antipsychotic have, augmentation with atypical antipsychotics in patients with inadequate response to antidepressant monotherapy is a useful therapeutic strategy that should be considered.

scholarly journals Indices of Change, Expectations, and Popularity of Biological Treatments for Major Depressive Disorder between 1988 and 2017: A Scientometric Analysis

2019 ◽  
Vol 16 (13) ◽  
pp. 2255 ◽  
Author(s):  
Bach X. Tran ◽  
Giang H. Ha ◽  
Giang T. Vu ◽  
Long H. Nguyen ◽  
Carl A. Latkin ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Grey Literature ◽  
Scientometric Analysis ◽  
Major Depressive ◽  
Wide Range ◽  
Biological Treatments ◽  
Meta Analyses ◽  
Positive Index

Background. Major Depressive Disorder (MDD) is the most common psychiatric disorder with high prevalence and disease burden. Biological treatments of MDD over the last several decades include a wide range of antidepressants and neurostimulation therapies. While recent meta-analyses have explored the efficacy and tolerability of antidepressants, the changing trends of biological treatments have not been evaluated. Our study measured the indices of change, expectations, and popularity of biological treatments of MDD between 1988 and 2017. Methods. We performed a scientometric analysis to identify all relevant publications related to biological treatments of MDD from 1988 to 2017. We searched the Web of Science websites for publications from 1 January 1988 to 31 December 2017. We included publications of fluoxetine, paroxetine, citalopram, sertraline, amitriptyline, fluvoxamine, escitalopram, venlafaxine, duloxetine, milnacipran, desvenlafaxine, levomilnacipran, clomipramine, nortriptyline, bupropion, trazodone, nefazodone, mirtazapine, agomelatine, vortioxetine, vilazodone, electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS), vagus nerve stimulation (VNS), deep brain stimulation (DBS), and transcranial direct current stimulation (tDCS). We excluded grey literature, conference proceedings, books/book chapters, and publications with low quality as well as publications not related to medicine or human health. The primary outcomes assessed were indices of change, expectations, and popularity. Results. Of 489,496 publications identified, we included 355,116 publications in this scientometric analysis. For the index of change, fluoxetine, sertraline and ECT demonstrated a positive index of change in 6 consecutive periods. Other neurostimulation therapies including rTMS, VNS, DBS and tDCS had shown a positive index of change since 1998. We calculated the index of change of popularity index (PI), which indicates that from 2013 to 2017, the number of publications on tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) were reduced by 85.0% and 81.3% respectively, as compared with the period 2008–2012. For the index of expectation, fluoxetine and ECT showed the highest index of expectations in six consecutive periods and remained the highest in 2013–2017. For popularity, the three antidepressants with highest PI were fluoxetine (4.01), paroxetine (2.09), and sertraline (1.66); the three antidepressants with lowest PI were desvenlafaxine (0.08), vilazodone (0.04) and levomilnacipran (0.03). Among neurostimulation therapies, ECT has the highest PI (2.55), and tDCS the lowest PI (0.14). The PI of SSRI remained the highest among all biological treatments of MDD in 2013–2017. In contrast, the PI of ECT was reduced by approximately 50% during the period 2008 to2012 than that in the period 2013 to 2017. Conclusions. This scientometric analysis represents comprehensive evidence on the popularity and change in prospects of biological treatments for MDD from 1988 to 2017. The popularity of SSRI peaked between 1998 and 2002, when their efficacy, tolerability and safety profile allowed them to replace the TCAs and MAOIs. While the newer neurostimulation therapies are gaining momentum, the popularity of ECT has sustained.

scholarly journals A Framework for Recruiting into a Remote Measurement Technologies (RMTs) study: Experiences from a major depressive disorder cohort

2021 ◽  
Author(s):  
Carolin Oetzmann ◽  
Katie White ◽  
Alina Ivan ◽  
Jessica Julie ◽  
Daniel Leightley ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Large Scale ◽  
Healthcare Research ◽  
Remote Measurement ◽  
Major Depressive ◽  
Successful Recruitment ◽  
Wide Range ◽  
The Uk ◽  
Common Barriers

The use of remote measurement technologies (RMTs) across mobile health (mHealth) studies is becoming increasingly popular, given their potential for high-frequency symptom monitoring outside of routine clinical appointments. However, many RMT studies fail to report on engagement and recruitment statistics, with the few who do citing a wide range of recruitment rates. There is a need for the standardisation of best practices for successful recruitment into RMT research, critical for both research validity and reproducibility. The current paper aims to create a framework for successful recruitment into RMT studies, reflecting on the experience of RADAR-MDD, a large-scale, multi-site prospective cohort study utilising RMT to explore the clinical course of people with major depressive disorder across the UK, Netherlands, and Spain. More specifically, the paper assesses four key strategies for successful recruitment, alongside a review of the common barriers to participation and how to avoid them. Finally, the strategies and barriers outlined are combined into a single model of recruitment, that can be used as a framework to inform future study design and evaluation. Such a model will be applicable to a variety of stakeholders using RMT in healthcare research and practice.

MMN-Indexed Auditory Change Detection in Major Depressive Disorder

2020 ◽  
Vol 51 (6) ◽  
pp. 365-372 ◽  
Author(s):  
Jenna N. Bissonnette ◽  
Ashley M. Francis ◽  
Krista M. Hull ◽  
Jennifer Leckey ◽  
Laura Pimer ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Auditory Cortex ◽  
Change Detection ◽  
Community Dwelling ◽  
Major Depressive ◽  
Severity Scores ◽  
Wide Range ◽  
Related Potentials ◽  
Auditory Change Detection

In major depressive disorder (MDD), event-related potentials that are involved in auditory cortex function (i.e. N100 and P300) often have greater latencies and decreased amplitudes. The auditory mismatch negativity (MMN) is thought to be produced by generators in the auditory cortex, as well as the frontal lobes. Reports on differences in MMN in those with MDD have been varied. It was hypothesized that the wide range of results in the literature may be due to the use of different deviant types in eliciting the MMN. To attempt and explain these inconsistencies, the current study employed a multifeature MMN paradigm with 5 deviant tone types in community-dwelling participants with a diagnosis of MDD. We found those with MDD had higher MMN amplitudes following tones that deviated in intensity and location, but no difference in MMNs elicted by the other deivants (relative to unaffected controls). Location MMN deviants were negatively correlated with depression severity scores (i.e. larger MMN with greater severity). We also found longer MMN latencies following the pitch deviant. These results suggest the early auditory change detection process is altered in MDD, but only following certain types of auditory stimuli. Potential explanations for these findings, including high levels of anxiety and the influence of tryptophan are explored. Equally, the current report highlights the importance of using various deviant types when examining the MMN in clinical populations.

The potential of transcranial photobiomodulation therapy for treatment of major depressive disorder

2017 ◽  
Vol 28 (4) ◽  
pp. 441-453 ◽  
Author(s):  
Farzad Salehpour ◽  
Seyed Hossein Rasta
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Near Infrared ◽  
Treatment Protocol ◽  
Photobiomodulation Therapy ◽  
Infrared Light ◽  
Major Depressive ◽  
Atp Production ◽  
Beneficial Effects ◽  
Wide Range

AbstractMajor depressive disorder is a common debilitating mood disorder that affects quality of life. Prefrontal cortex abnormalities, an imbalance in neurotransmitters, neuroinflammation, and mitochondrial dysfunction are the major factors in the etiology of major depressive disorder. Despite the efficacy of pharmacotherapy in the treatment of major depressive disorder, 30%–40% of patients do not respond to antidepressants. Given this, exploring the alternative therapies for treatment or prevention of major depressive disorder has aroused interest among scientists. Transcranial photobiomodulation therapy is the use of low-power lasers and light-emitting diodes in the far-red to near-infrared optical region for stimulation of neuronal activities. This non-invasive modality improves the metabolic capacity of neurons due to more oxygen consumption and ATP production. Beneficial effects of transcranial photobiomodulation therapy in the wide range of neurological and psychological disorders have been already shown. In this review, we focus on some issue relating to the application of photobiomodulation therapy for major depressive disorder. There is some evidence that transcranial photobiomodulation therapy using near-infrared light on 10-Hz pulsed mode appears to be a hopeful technique for treatment of major depressive disorder. However, further studies are necessary to find the safety of this method and to determine its effective treatment protocol.

scholarly journals Using biomarkers to predict treatment response in major depressive disorder: evidence from past and present studies

2014 ◽  
Vol 16 (4) ◽  
pp. 539-544 ◽  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Treatment Response ◽  
Cortical Activation ◽  
Variable Response ◽  
Major Depressive ◽  
Distant Future ◽  
Wide Range ◽  
Research Findings ◽  
Predict Treatment Response

Major depressive disorder (MDD) is a heterogeneous condition with a variable response to a wide range of treatments. Despite intensive efforts, no biomarker has been identified to date that can reliably predict response or non-response to any form of treatment, nor has one been identified that can be used to identify those at high risk of developing treatment-resistant depression (ie, non-response to a sequence of treatments delivered for adequate duration and intensity). This manuscript reviews some past areas of research that have proved informative, such as studies using indexes of hypercortisolism or sleep disturbance, and more recent research findings using measures of inflammation and different indicators of regional cortical activation to predict treatment response. It is concluded that, although no method has yet been demonstrated to be sufficiently accurate to be applied in clinical practice, progress has been made. It thus seems likely that--at some point in the not-too-distant future--it will be possible to prospectively identify, at least for some MDD patients, the likelihood of response or non-response to cognitive therapy or various antidepressant medications.

scholarly journals Virtual Reality Behavioral Activation as an Intervention for Major Depressive Disorder: Case Report (Preprint)

2020 ◽  
Author(s):  
Margot Paul ◽  
Kim Bullock ◽  
Jeremy Bailenson
Keyword(s):  
Virtual Reality ◽  
Major Depressive Disorder ◽  
Case Report ◽  
Depressive Disorder ◽  
Rating Scales ◽  
Behavioral Activation ◽  
Self Report ◽  
Clinical Population ◽  
Depression Symptoms ◽  
Major Depressive

BACKGROUND Major depressive disorder (MDD) is a global problem with an increasing incidence and prevalence. There has additionally been an increase in depression due to the COVID-19 pandemic. Behavioral activation is considered an evidence-based treatment for MDD. However, there are many barriers that could hinder one’s ability to engage in behavioral activation, with COVID-19 “shelter-in-place” and social distancing orders being current and large impediments. Virtual reality (VR) has been successfully used to help treat a variety of mental health conditions, but it has not yet been used as a method of administering behavioral activation to a clinical population. Using VR to engage in behavioral activation could eliminate barriers that pandemic precautions place and help decrease symptoms of depression that are especially exacerbated in these times. OBJECTIVE The following case report examines the feasibility, acceptability, and tolerability of VR behavioral activation for an adult with MDD during a global pandemic. This participant was part of a larger pilot study, and the case serves as a description of the VR intervention. METHODS The participant engaged in a weekly 50-minute psychotherapy Zoom session for 4 weeks, in which a modified behavioral activation protocol was administered using a VR headset to simulate activities. Data on mood ratings, homework compliance, and headset use were obtained from the headset. Acceptability, tolerability, and depression symptoms were obtained using self-report rating scales. RESULTS The intervention was feasible, acceptable, and tolerable, as reported by this participant. The participant’s depressive symptoms decreased by five-points on the Patient Health Questionnaire-9 over a month, with a beginning score of 10 (moderate depression) and a final score of 5 (mild depression). CONCLUSIONS The implications of these findings for future research are discussed. CLINICALTRIAL ClinicalTrials.gov NCT04268316; http://clinicaltrials.gov/ct2/show/NCT04268316

Advances in digital psychiatry: Towards an extended definition of major depressive disorder symptomatology (Preprint)

2021 ◽  
Author(s):  
Nayra Anna Martin-Key ◽  
Dan-Mircea Mirea ◽  
Tony Olmert ◽  
Jason Cooper ◽  
Sung Yeon Sarah Han ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Clinical Decision Making ◽  
Clinical Symptoms ◽  
Model Performance ◽  
Emotional Instability ◽  
Major Depressive ◽  
Digital Assessment ◽  
Wide Range ◽  
Definition Of

BACKGROUND Diagnosing major depressive disorder (MDD) is challenging, with diagnostic manuals failing to capture the wide range of clinical symptoms that are endorsed by individuals with the condition. OBJECTIVE The aim of this study was to provide evidence for an extended definition of MDD symptomatology. METHODS Symptom data were collected via a digital assessment that was developed for the Delta Study [1]. Random forest classification with nested cross-validation was used to distinguish between individuals with MDD and those with subthreshold symptomatology of the disorder using i) disorder-specific symptoms and ii) transdiagnostic symptoms. The diagnostic performance of the Patient Health Questionnaire-9 (PHQ-9) was also examined. RESULTS A depression-specific model demonstrated good predictive performance when distinguishing between individuals with MDD (n = 64) and those with subthreshold depression (n = 140) (AUC = .89; sensitivity = 82.4%; specificity = 81.3%; accuracy = 81.6%). The inclusion of transdiagnostic symptoms of psychopathology, including symptoms of depression, generalized anxiety disorder, insomnia, emotional instability, and panic disorder, improved the model performance (AUC = .95; sensitivity = 86.5%; specificity = 90.8%; accuracy = 89.5%). The PHQ-9 was excellent at identifying MDD but over diagnosed the condition (sensitivity = 92.2%; specificity = 54.3%; accuracy = 66.2%). CONCLUSIONS Our findings are in line with the notion that current diagnostic practices may present an overly narrow conception of mental health. Further, our study provides proof-of-concept support for the clinical utility of a digital assessment to inform clinical decision-making in the evaluation of MDD.

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