586. Using Anxiety and Depressive Subtypes to Predict Electrocortical Processing of Distracting Pictures

BackgroundClinical and aetiological heterogeneity have impeded our understanding of depression.AimsTo evaluate differences in psychiatric and somatic course between people with depression subtypes that differed clinically (severity) and aetiologically (melancholic v. atypical).MethodData from baseline, 2-, 4- and 6-year follow-up of The Netherlands Study of Depression and Anxiety were used, and included 600 controls and 648 people with major depressive disorder (subtypes: severe melancholic n = 308; severe atypical n = 167; moderate n = 173, established using latent class analysis).ResultsThose with the moderate subtype had a significantly better psychiatric clinical course than the severe melancholic and atypical subtype groups. Suicidal thoughts and anxiety persisted longer in those with the melancholic subtype. The atypical subtype group continued to have the highest body mass index and highest prevalence of metabolic syndrome during follow-up, although differences between groups became less pronounced over time.ConclusionsCourse trajectories of depressive subtypes mostly ran parallel to each other, with baseline severity being the most important differentiator in course between groups.

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Major depressive subtypes and treatment response

Biological Psychiatry ◽

10.1016/s0006-3223(96)00440-4 ◽

1997 ◽

Vol 42 (7) ◽

pp. 568-576 ◽

Cited By ~ 157

Author(s):

Maurizio Fava ◽

Lisa A. Uebelacker ◽

Jonathan E. Alpert ◽

Andrew A. Nierenberg ◽

Joel A. Pava ◽

...

Keyword(s):

Treatment Response ◽

Major Depressive ◽

Depressive Subtypes

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Depressive subtypes and efficacy of antidepressive pharmacotherapy

The World Journal of Biological Psychiatry ◽

10.1080/15622970510030036 ◽

2005 ◽

Vol 6 (sup2) ◽

pp. 31-37 ◽

Cited By ~ 10

Author(s):

José L. Ayuso-Gutiérrez

Keyword(s):

Depressive Subtypes

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Gender differences in response to differing antidepressant drug classes: two negative studies

Psychological Medicine ◽

10.1017/s0033291703007918 ◽

2003 ◽

Vol 33 (8) ◽

pp. 1473-1477 ◽

Cited By ~ 51

Author(s):

G. PARKER ◽

K. PARKER ◽

M.-P. AUSTIN ◽

P. MITCHELL ◽

H. BROTCHIE

Keyword(s):

Gender Differences ◽

Antidepressant Drug ◽

Antidepressant Drugs ◽

Replication Studies ◽

Drug Classes ◽

Younger Age ◽

Gender And Age ◽

The Us ◽

Depressive Subtypes ◽

Ssri Medication

Background. A recent US study presented data suggesting that depressed women are more likely to respond to selective serotonin reuptake inhibitor (SSRI) than tricyclic (TCA) antidepressant drug therapies. We have undertaken replication studies in two independent databases.Method. We have examined for gender differences in SSRI and TCA antidepressant response in both retrospective and prospective naturalistic uncontrolled studies, and in subsets of melancholic and non-melancholic depressed subjects. As the US study had indicated that women under the age of 40 years were particularly likely to show a differential response to SSRIs, we examined for age, gender and interactional effects. In addition, we examined for differential SSRI and TCA responsiveness in a subset of patients who had received drugs from both classes.Results. We failed to find evidence of women having a preferential response to SSRI medication or, conversely, of men having a superior response to TCA medication. Older age, however, was associated with a superior TCA response and younger age with a superior SSRI response.Conclusion. As few studies have examined for differential gender and age effects in response to narrow action and broad action antidepressant drugs across major depressive subtypes, gender differential effects remain to be established.

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Impaired In Vivo Immune Responses in Patients with Melancholia

The British Journal of Psychiatry ◽

10.1192/bjp.162.5.651 ◽

1993 ◽

Vol 162 (5) ◽

pp. 651-657 ◽

Cited By ~ 61

Author(s):

Ian Hickie ◽

Catherine Hickie ◽

Andrew Lloyd ◽

Derrick Silove ◽

Denis Wakefield

Keyword(s):

Immune Responses ◽

Delayed Type Hypersensitivity ◽

Cell Mediated Immunity ◽

Melancholic Depression ◽

Skin Responses ◽

Severity Of Depression ◽

Depressive Subtypes ◽

Control Study

Previous attempts to establish a relationship between impaired cell-mediated immunity (CMI) and major mood disorders have been limited by a failure to explore the relevance of depressive subcategories or to assess CMI by in vivo methods. In this case-control study CMI was assessed in 57 patients with major depression (31 with melancholic, 26 with non-melancholic disorders), and in age- and sex-matched controls by both in vitro and in vivo immunological techniques. Compared with control subjects and patients with non-melancholic depression, patients with melancholia demonstrated reduced in vivo CMI as assessed by delayed-type hypersensitivity (DTH) skin responses. Although increasing age, severity of depression, hospital admission for treatment, and reported weight loss are correlates of melancholia, none of these factors alone, or in combination, accounted for the differences in DTH responses observed between the two depressive subtypes. These data suggest that impaired CMI in vivo may be limited to those with melancholic disorders. At this stage the factors which account for this effect are unclear.

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Neural Network Subtyping of Depression

Australian & New Zealand Journal of Psychiatry ◽

10.3109/00048679809113124 ◽

1998 ◽

Vol 32 (5) ◽

pp. 687-694 ◽

Cited By ~ 3

Author(s):

Tony M. Florio ◽

Gordon Parker ◽

Marie-Paule Austin ◽

Ian Hickie ◽

Philip Mitchell ◽

...

Keyword(s):

Neural Network ◽

Clinical Decision Making ◽

Linear Models ◽

Function Analysis ◽

Clinical Decision ◽

Linear Analysis ◽

Linear Discriminant ◽

Non Linear ◽

Depressive Subtypes ◽

Definition Of

Objective: To examine the applicability of a neural network classification strategy to examine the independent contribution of psychomotor disturbance (PMD) and endogeneity symptoms to the DSM-III-R definition of melancholia. Method: We studied 407 depressed patients with the clinical dataset comprising 17 endogeneity symptoms and the 18-item CORE measure of behaviourally rated PMD. A multilayer perceptron neural network was used to fit non-linear models of varying complexity. A linear discriminant function analysis was also used to generate a model for comparison with the non-linear models. Results: Models (linear and non-linear) using PMD items only and endogeneity symptoms only had similar rates of successful classification, while non-linear models combining both PMD and symptom scores achieved the best classifications. Conclusions: Our current non-linear model was superior to a linear analysis, a finding which may have wider application to psychiatric classification. Our non-linear analysis of depressive subtypes supports the binary view that melancholic and non-melancholic depression are separate clinical disorders rather than different forms of the same entity. This study illustrates how non-linear modelling with neural networks is a potentially fruitful approach to the study of the diagnostic taxonomy of psychiatric disorders and to clinical decision-making.

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