Characteristics and outcome of methadone maintenance treatment (MMT) patients with depression

IntroductionComorbidity of depression and opioid addiction is highly prevalent, but their outcome in MMT is not consistent.ObjectivesTo compare between depressed and non-depressed MMT patients.MethodsHamilton depression scale scores (taken during a psychiatric assessment) were studied among MMT patients on admission or during treatment (cutoff for depression > 18).ResultsA total of 498 MMT patients were studied. Depression proportion was 22.5%, and 23.2% among 263 who were studied on admission; the depressed vs. non-depressed on admission did not differ in female proportion (19.7% vs. 25.6%), age of admission (43.2 ± 10.4), opiate use onset (21.8 ± 6.3) and education years (9.5 ± 2.8), but had higher proportion of cocaine (55.7% vs. 35.1%, P = 0.005), and benzodiazepine abuse (73.8% vs. 58.4%, P = 0.04). Retention was high and similar (80.3 vs. 82.9% P = 0.7) and of those who stayed one year, cocaine and benzodiazepine were still higher among the depressed patients (cocaine: 43.8% vs. 23.2%, P = 0.03; BDZ: 61.2% vs. 40%, P = 0.01). Compared to the non-depressed, among all study group (n = 498) the depressed patients presented higher proportion of rape history (25% vs. 9.5%, P = 0.001), of suicide attempts (43.8% vs. 25%, P = 0.001) with only a trend of shorter cumulative retention in MMT of mean 9.4y (95% CI 7.8–10.7) vs. 11.5 (95% CI 10.5–12.5, P = 0.07).ConclusionDespite cocaine and benzodiazepine abuse on admission, depressed succeeded similarly to the non-depressed in the first year retention in treatment. Intervention is recommended since admission, as their long-term retention seems to be shorter, later on, and their ability to discontinue cocaine and benzodiazepine abuse is clearly hampered.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Motor activity in depressed patients during therapeutic sleep deprivation

European Psychiatry ◽

10.1016/j.eurpsy.2009.11.004 ◽

2010 ◽

Vol 25 (8) ◽

pp. 465-467 ◽

Cited By ~ 3

Author(s):

T.U. Brückner ◽

M.H. Wiegand

Keyword(s):

Motor Activity ◽

Sleep Deprivation ◽

Depression Scale ◽

Mechanisms Of Action ◽

Activity Levels ◽

Hamilton Depression Scale ◽

Depressed Patients ◽

Bidirectional Relationship ◽

Dsm Iv ◽

Insight Into

AbstractProblemBoth sleep and motor activity have a bidirectional relationship with depression. The existing literature on motor activity during therapeutic sleep deprivation in depressed patients is inconsistent and fragmentary. In the present study we measured motor activity continuously during 40 hours of sleep deprivation in depressed patients.MethodThirty-four inpatients suffering from a major depression (DSM-IV) underwent sleep deprivation with a continuous waking period of 40 hours. Motor activity of the patients was continuously recorded using an actigraph on the non-dominant wrist. The effect of sleep deprivation was assessed by the Hamilton Depression Scale (six-item version), thus separating the group into responders and non-responders to sleep deprivation.ResultsWe found no significant differences in motor activity between responders and non-responders on the day before sleep deprivation. During the night, responders to sleep deprivation exhibited a higher motor activity and less periods of rest. On the day after sleep deprivation, responders exhibited a higher activity, too.ConclusionsMotor activity levels differ between the two groups, thus giving more insight into possible mechanisms of action of the therapeutic sleep deprivation. We suggest that higher motor activity during the night prevents naps and leads to better response to sleep deprivation.

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Method of assessment determines prevalence of suicidal ideation among patients with depression

European Psychiatry ◽

10.1016/j.eurpsy.2013.08.005 ◽

2014 ◽

Vol 29 (6) ◽

pp. 338-344 ◽

Cited By ~ 23

Author(s):

M. Vuorilehto ◽

H.M. Valtonen ◽

T. Melartin ◽

P. Sokero ◽

K. Suominen ◽

...

Keyword(s):

Primary Care ◽

Suicidal Ideation ◽

Suicide Attempts ◽

Depression Scale ◽

Hamilton Depression Scale ◽

Predictive Values ◽

Primary Care Patients ◽

Sensitivity Specificity ◽

Method Of Assessment

AbstractBackgroundHow different ways of assessing suicidal ideation influence its prevalence, correlates and predictive validity among patients with major depressive disorder (MDD) remains unclear.MethodsWithin the Vantaa Primary Care Depression Study (PC-VDS, 91 patients) and the Vantaa Depression Study (VDS, 153 psychiatric out-and 41 inpatients), suicidal ideation was assessed with the Scale for Suicidal Ideation (SSI), Hamilton Depression Scale (HAM-D) item 3 and Beck Depression Inventory (BDI) item 9, and by asking whether patients had seriously considered suicide during the episode. The positive and negative predictive values (PPV, NPV) for suicide attempts during a six-month follow-up were investigated.ResultsDepending on the setting, 56–88% of patients had suicidal ideation in some of the assessments, but only 8–44% in all of them. Agreement ranged from negligible to moderate (kappa 0.06–0.64), being lowest among primary care patients. The correlates of suicidal ideation overlapped. No assessment had optimal sensitivity, specificity, PPV and NPV. Nevertheless, PPVs ranged up to 43%.ConclusionsWhich MDD patient is classified as having suicidal ideation depends strongly on the method of assessment, with the greatest variation likely in primary care. Differences in assessments may cause inconsistency in risk factors. Predicting suicide attempts is difficult, but not futile.

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Responsiveness of observer rating scales by analysis of number of days until improvement in patients with major depression

European Psychiatry ◽

10.1016/s0924-9338(98)80138-7 ◽

1998 ◽

Vol 13 (3) ◽

pp. 143-145 ◽

Cited By ~ 5

Author(s):

N Lauge ◽

K Behnke ◽

J Søgaard ◽

B Bahr ◽

P Bech

Keyword(s):

Major Depression ◽

Rating Scales ◽

Rating Scale ◽

Depressive Symptomatology ◽

Depression Scale ◽

Response To Treatment ◽

Hamilton Depression Scale ◽

Scale Scores ◽

Pre Treatment ◽

Treatment Onset

SummarySeveral well-known observer scales, including the Hamilton Depression Scale (HAM-D), Montgomery-Åsberg Scale (MADRS), Major Depression Rating Scale (MDS), Melancholia Scale (MES), and Inventory for Depressive Symptomatology (IDS) used for measuring severity of depressive states have been compared by their responsiveness in an open trial including patients treated with a combination of citalopram and mianserin. The patients fulfilled the Diagnostic and Statistical Manual (DSM)-IV criteria for major depressive episode, and all scored 18 or more on the HAM-D before treatment. Onset of antidepressant action was defined as an improvement of rating scale scores of 25% or more of pre-treatment scores. A response to treatment was defined as a reduction of 50% or more on the pre-treatment scores. The results showed that the number of treatment days until improvement was 11 to 13 with no difference between the scales. The days until response were between 18 and 21 with no difference between the scales. In conclusion, the depression scales were found to be equal in their ability to detect changes in depressive symptoms during treatment. The mean of days to response was 19 for the combination of citalopram and mianserin. This is similar to the response for the combination of fluoxetine and pinolol.

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Psychological Effect of Semi-permanent Tattooing Rehabilitation in Patients with Mastectomy in 12 Months Period

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1143 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S669-S669

Author(s):

P. Argitis ◽

P. Platari ◽

K. Gatsiou ◽

C. Chatzidai ◽

K. Paschalidis

Keyword(s):

Quality Of Life ◽

Body Image ◽

Sexual Activity ◽

Rating Scale ◽

Cancer Type ◽

Body Image Scale ◽

Scale Scores ◽

Competing Interest ◽

One Year

IntroductionBreast cancer is the most common cancer type in Greek women as more than 4000 new cases are diagnosed every year. Seventy percent of those patents performs a type mastectomy. The breast has a societal and social connotation of femininity, motherhood, and sexuality.BackgroundSeveral studies support the existence of the relationship between psychological problems and mastectomy surgery. Body image and feminine self-concept also seems to influence quality of life of those women, considering the breast association of femininity, motherhood, and sexuality. During this study, we try to investigate how a non-psychiatric intervention might influence the mental state and the quality of life of those women.MaterialA clinical interview was performed in 53 women with partial or total mastectomy before 3 and 52 weeks after the rehabilitation with the method of semi-permanent tattooing.MethodsData were collected during the personal interviews, using Hamilton anxiety rating scale (Ham-A), body image scale and sexual activity questionnaire.ResultsModerate levels of anxiety were identified before the rehabilitation, associated with poor body image scale scores and sexual difficulties. Both Ham-A and body image score ameliorated after 3 weeks with unchanged sexual behaviour. One year after rehabilitation, anxiety scale score raises close to initial values, body image remains unchanged, comparing with the 3rd week interview and significant improvement noticed in sexual activity.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Individual level prediction of emerging suicide events in the pharmacologic treatment of bipolar disorder

10.1101/2021.01.13.20246603 ◽

2021 ◽

Author(s):

Sean X. Luo ◽

Adam Ciarleglio ◽

Hanga Galfalvy ◽

Michael Grunebaum ◽

Leo Sher ◽

...

Keyword(s):

Bipolar Disorder ◽

Variable Selection ◽

Suicidal Behavior ◽

Predictive Models ◽

Suicide Attempts ◽

Bipolar Depression ◽

Depression Scale ◽

Hamilton Depression Scale ◽

Pharmacologic Treatment ◽

Survival Trees

AbstractBackgroundPatients with bipolar disorder have a high lifetime risk of suicide. Predicting, preventing and managing suicidal behavior are major goals in clinical practice. Changes in suicidal thoughts and behavior are common in the course of treatment of bipolar disorder.MethodsUsing a dataset from a randomized clinical trial of bipolar disorder treatment (N=98), we tested predictors of future suicidal behavior identified through a review of literature and applied marginal variable selection and machine learning methods. The performance of the models was assessed using the optimism-adjusted C statistic.ResultsNumber of prior hospitalizations, number of prior suicide attempts, current employment status and Hamilton Depression Scale were identified as predictors and a simple logistic regression model was constructed. This model was compared with a model incorporating interactions with treatment group assignment, and more complex variable selection methods (LASSO and Survival Trees). The best performing models had average optimism-adjusted C-statistics of 0.67 (main effects only) and 0.69 (Survival Trees). Incorporating medication group did not improve prediction performance of the models.ConclusionsThese results suggest that models with a few predictors may yield a clinically meaningful way to stratify risk of emerging suicide events in patients who are undergoing pharmacologic treatment for bipolar disorder.Significance StatementThis study aims to find out whether suicide events that occur during the pharmacological treatment of bipolar disorder, a severe psychiatric disorder that is highly associated with suicide behavior, can be predicted. Using existing methods, we developed and compared several predictive models. We showed that these models performed similarly to predictive models of other outcomes, such as treatment efficacy, in unipolar and bipolar depression. This suggests that suicide events during bipolar disorder may be a feasible target for individualized interventions in the future.

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Therapeutic efficacy of original anticonvulsant meta-chloro-benzhydrylurea (m-ch-BHU) in the treatment of patients with a compulsive craving for alcohol

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1084 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S317-S318

Author(s):

T. Shushpanova ◽

N. Bokhan ◽

A. Mandel ◽

V. Lebedeva

Keyword(s):

Affective Disorders ◽

Therapeutic Efficacy ◽

Clinical Manifestations ◽

Depression Scale ◽

Alcohol Withdrawal Syndrome ◽

Alcohol Addiction ◽

Hamilton Depression Scale ◽

Symptom Complex ◽

Competing Interest ◽

Clinical Description

IntroductionThe problem of the treatment of alcohol addiction is very difficult due to the reoccurrence of relapses. One of the major concepts of the formation of alcohol addiction is the concept of epileptic origin of compulsive craving for alcohol.ObjectiveWe investigated therapeutic efficacy of long-term dosing of original anticonvulsant (m-ch-BHU) on symptoms of alcohol withdrawal syndrome (AWS) in patients with a compulsive craving for alcohol.MethodsSixty-eight male alcoholic patients aged from 24 to 53 years with different levels of alcohol abuse were examined. Type of course of alcoholism in examined patients was of middle-progressing character. Clinical evaluation of state of patients was carried out with traditional clinical description. Quantitative characterization was conducted according to Hamilton Anxiety Scale and Hamilton Depression Scale. m-ch-BHU was administered to alcoholic patients at dose from 300 mg a day during 21 days against the background of conventional medication as well as in post-withdrawal period under various degrees of severity of affective disorders.ResultsAmong affective disorders dysphoric symptoms have a marked tropism for m-ch-BHU. Of the other clinical manifestations in the structure of AWS cerebral diencephalic paroxysms, cardiovascular and myofascial symptoms have the most pronounced sensitivity to the drug. In patients with complicated forms of alcoholism application of m-ch-BHU is effective also in phase of remission in spontaneously arising symptom complex of neurovegetative manifestations of primary pathological craving for ethanol called “dry abstinence”.ConclusionsOur data allows recommending the use of m-ch-BHU under outpatient conditions as an anti-recurrent and preventive agent.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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A Controlled Study of Repetitive Transcranial Magnetic Stimulation as a Treatment of Depression in the Elderly

International Psychogeriatrics ◽

10.1017/s1041610201007608 ◽

2001 ◽

Vol 13 (2) ◽

pp. 225-231 ◽

Cited By ~ 95

Author(s):

Facundo Manes ◽

Ricardo Jorge ◽

Maria Morcuende ◽

Toru Yamada ◽

Sergio Paradiso ◽

...

Keyword(s):

Transcranial Magnetic Stimulation ◽

Treatment Response ◽

Magnetic Stimulation ◽

Repetitive Transcranial Magnetic Stimulation ◽

Depression Scale ◽

The Elderly ◽

Controlled Study ◽

Hamilton Depression Scale ◽

Treatment Of Depression ◽

Scale Scores

Rapid transcranial magnetic stimulation (rTMS) applied to the left dorsal lateral frontal cortex has been shown to produce antidepressant effects. Older depressed patients, however, in one study showed a lower response rate than younger patients. The current study examined treatment response in 20 depressed, treatment-refractory patients (mean age 60.7 ± 9.8 years) given five sessions of rTMS at 20 Hz for 2 seconds over 20 trains at 80% of motor threshold or identical placebo stimulation, after patients had been withdrawn from their antidepressants. There were no significant differences in Hamilton Depression Scale scores either before or after treatment at 7 days' follow-up. There were three responders to active treatment and three to sham treatment and responders had significantly greater frontal lobe volume than nonresponders (p=.03). These findings suggest that the stimulation parameters used in this study were probably insufficient to produce treatment response and that frontal atrophy may interfere with the effectiveness of rTMS.

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Clinical symptomatology and empathy in schizophrenia: Which relationship?

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.237 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S141-S141

Author(s):

R. Trabelsi ◽

J. Mrizak ◽

A. Arous ◽

H. Ben Ammar ◽

A. Khalifa ◽

...

Keyword(s):

Depression Scale ◽

Cognitive Empathy ◽

Clinical State ◽

Psychotic Symptoms ◽

Significant Feature ◽

Affective Empathy ◽

Scale Scores ◽

Empathy Deficits ◽

Affective Components ◽

Competing Interest

IntroductionThe impairment of cognitive and affective empathy among patients with schizophrenia (SCZ) may represent a significant feature of the illness. However, the relationship between those impairment and dimensions of psychosis remains unclear.ObjectivesTo explore whether cognitive and affective empathy are associated with severety of different psychotic symptoms.MethodsCognitive and affective empathy were evaluated in 58 patients with stable schizophrenia with the Questionnaire of Cognitive and Affective Empathy (QCAE) comprising five subscales intended to assess cognitive and affective components of empathy. Symptomatology evaluation comprised the Positive and Negative Syndrome Scale (PANSS), the Calgary Depression Scale for Schizophrenia (CDSS) and the Clinical Global Impressions Scale Improvement and severity (CGI).ResultsPatients with better cognitive empathy had less total CDSS scores (P = 0.036, r = −0.449) and lower CGI-severity scale scores (P = 0.01, r = −0.536). Patients with better affective empathy had lower scores (which means a better improvement) at the CGI-improvement scale (P = 0.03, r = −0.461).ConclusionsOur results suggest that empathy with its different component is not totally independent of the clinical state of the patient. Further studies are required to confirm whether empathy deficits are state or trait aspects of SCZ.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Dermal reactivity and resilience in a sample of depressed patients

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.2232 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S598-S598

Author(s):

I. Coppola ◽

E. Gattoni ◽

C. Gramaglia ◽

S. Di Marco ◽

C. Delicato ◽

...

Keyword(s):

Depressive Disorders ◽

Attempted Suicide ◽

Suicide Attempts ◽

Bipolar Depression ◽

Response To Treatment ◽

Depressed Patients ◽

Resilience Scale ◽

History Of ◽

Competing Interest ◽

The Impact

BackgroundMental disorders are considered a risk factor for suicide: for example, the lifetime risk of suicide is estimated to be 4%–8% in people with mood disorders. The literature suggests that a history of suicide attempts is significantly related to electrodermal hyporeactivity and that patients with violent suicide attempters exhibit faster habituation of the electrodermal response to repeated neutral tones than patients with non-violent attempts. The impact of depressive symptoms on suicidal ideation may be moderated by resilience. Resilience refers to the ability to maintain o regain mental health despite experiencing adversity. In bipolar and depressive disorders, resilience may influence severity of episodes, frequency of relapse and response to treatment.AimThe objective of our study was to assess the possible correlation among attempted suicide, resilience and dermal reactivity in a sample of depressed patients.MethodsWe recruited patients with depressive disorders and bipolar depression; data about socio-demographic, clinical features, severity of attempted suicide and suicidal risk were gathered. Patients filled in the Resilience Scale for Adult (RSA). Moreover, for each patient we performed the Edor test in order to assess dermal reactivity.ResultsData collection is still ongoing. We expect to find lower levels of resilience in those patients who are hyporeactive and attempted suicide. Moreover, we hypothesize that suicide attempts in the group of hyporeactive patients would be characterized by planning and greater severity. Clinical implications will be discussed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Effects of agomelatine and mirtazapine on sleep disturbances in major depressive disorder: evidence from polysomnographic and resting-state functional connectivity analyses

SLEEP ◽

10.1093/sleep/zsaa092 ◽

2020 ◽

Vol 43 (11) ◽

Author(s):

Wei-Feng Mi ◽

Serik Tabarak ◽

Li Wang ◽

Su-Zhen Zhang ◽

Xiao Lin ◽

...

Keyword(s):

Major Depressive Disorder ◽

Functional Connectivity ◽

Depressive Disorder ◽

Sleep Disturbances ◽

Rating Scale ◽

Sleep Onset ◽

Depression Scale ◽

Hamilton Depression Scale ◽

Major Depressive ◽

Depressed Patients

Abstract To investigate effects of agomelatine and mirtazapine on sleep disturbances in patients with major depressive disorder. A total of 30 depressed patients with sleep disturbances, 27 of which completed the study, took agomelatine or mirtazapine for 8 weeks. Subjective scales were administered, and polysomnography was performed at baseline and at the end of week 1 and 8. Functional magnetic resonance imaging was performed at baseline and at the end of week 8. Compared with baseline, scores on the Hamilton Depression Scale, Hamilton Anxiety Scale, Pittsburgh Sleep Quality Index, Sleep Dysfunction Rating Scale, and Insomnia Severity Index after 8 weeks of treatment significantly decreased in both groups, with no significant differences between groups, accompanied by significant increases in total sleep time, sleep efficiency, and rapid eye movement (REM) sleep and significant decrease in wake after sleep onset. Mirtazapine treatment increased N3 sleep at week 1 compared with agomelatine treatment, but this difference disappeared at week 8. The increases in the percentage and duration of N3 sleep were positively correlated with increases in connectivity between right dorsal lateral prefrontal cortex (dlPFC) and right precuneus and between left posterior cingulate cortex and right precuneus in both groups, respectively. Functional connectivity (FC) between right dlPFC and left precuneus in mirtazapine group was higher compared with agomelatine group after 8 weeks of treatment. These findings indicated that both agomelatine and mirtazapine improved sleep in depressed patients, and the effect of mirtazapine was greater than agomelatine with regard to rapidly increasing N3 sleep and gradually improving FC in the brain.

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