Comorbidity of major depressive disorder and personality disorder increase the risk for suicide

2017 ◽  
Vol 41 (S1) ◽  
pp. S478-S479
Author(s):  
A. Mihai ◽  
M. Mihai ◽  
M.S. Mocan ◽  
C.I. Moga ◽  
E.V. Nistor ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Personality Disorder ◽  
Depressive Disorder ◽  
Suicide Attempts ◽  
Small Sample Size ◽  
Small Sample ◽  
Major Depressive ◽  
Significant Difference ◽  
Group A ◽  
Group B

IntroductionPersonality disorder (PD) with an associated diagnostic of major depressive disorder (MDD) is a common occurrence, being considered a factor of treatment resistant depression. In this study, we compare two groups of patients’ one group having Major Depressive Episode (MDD) and the other with MDD and PD as comorbidity.MethodsThis is an observational study of all patients admitted with diagnosis of MDD during one month period in an acute psychiatric hospital. Data collection is made using patients files. During one month period a total number of 105 MDD cases were recorded (group A-75 cases with MDD and group B-30 patients with PD and MDD). The diagnosis was recorded in files by a specialist psychiatrist. Data is analyzed using SPSS v.20.ResultsA significant difference is found when comparing age groups, mean age for group A being 60 years and for group B 35 years (P = 0.05). Regarding suicide attempts a higher prevalence is found in Group B (Group A 6.7%, Group B 20%) although with statistical relevance (P = 0.04). Study limitation: small sample size of group B does not allow analysis on different type of personality disorders, length of hospitalisation could be biased by the requirements of assurance company.ConclusionsThe risk of admission is higher at younger age in patients with MDD associated with PD then in MDD alone. The risk of suicide attempts is significantly higher in group of MDD associated with PD.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Efficacy of trial-based cognitive therapy, behavioral activation and treatment as usual in the treatment of major depressive disorder: preliminary findings from a randomized clinical trial

CNS Spectrums ◽  
2019 ◽  
Vol 25 (4) ◽  
pp. 535-544 ◽  
Author(s):  
Curt Hemanny ◽  
Clara Carvalho ◽  
Nina Maia ◽  
Daniela Reis ◽  
Ana Cristina Botelho ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Cognitive Therapy ◽  
Behavioral Activation ◽  
Behavioral Therapy ◽  
Small Sample Size ◽  
Dropout Rate ◽  
Small Sample ◽  
Major Depressive ◽  
Treatment As Usual

AbstractIntroduction.Major depressive disorder (MDD) is a prevalent, debilitating and disabling disorder, and its prevalence is increasing. Antidepressants (AD), cognitive-behavioral therapy (CBT) and behavioral activation (BA) are the main treatments for MDD. Trial-based cognitive therapy (TBCT) addresses and restructures dysfunctional negative core beliefs (CBs) and is a novel and promising approach.Objective.The aim of this study was to compare the efficacy of TBCT, BA and treatment as usual (TAU) in the treatment of MDD.Methods.A total of 76 patients with MDD were randomized into 1 of 3 groups and evaluated at baseline, after 6 weeks and at week 12 (final evaluation). The primary outcome was changing in HAM-D scores, and the secondary outcomes included scores on the BDI, CD-Quest, Sheehan Disability Scale (SDS) and WHOQOL.Results.Both TBCT and BA (which also included AD) were different from TAU (which included antidepressants alone) in reducing the HAM-D and BDI scores and other measures. TBCT and BA were different from TAU in the reduction of disability in SDS and WHOQOL physical domain scores. Besides limited by a small sample size, the dropout rate in the TAU arm was higher, and only 10 patients completed the 3 evaluations.Conclusion.This trial provides evidence that TBCT and BA combined with antidepressants were more efficacious than the TAU (drug alone) in reducing the severity of depressive symptoms and disability, showing that this combination can be useful for clinical practice.

Suicidal Imagery in Borderline Personality Disorder and Major Depressive Disorder

2020 ◽  
Vol 34 (4) ◽  
pp. 546-564 ◽  
Author(s):  
Katharina Schultebraucks ◽  
Moritz Duesenberg ◽  
Martina Di Simplicio ◽  
Emily A. Holmes ◽  
Stefan Roepke
Keyword(s):  
Major Depressive Disorder ◽  
Borderline Personality Disorder ◽  
Suicidal Ideation ◽  
Personality Disorder ◽  
Depressive Disorder ◽  
Mental Imagery ◽  
Suicide Attempts ◽  
Borderline Personality ◽  
Major Depressive ◽  
Patient Groups

A better understanding of suicidal behavior is important to detect suicidality in at-risk populations such as patients with borderline personality disorder (BPD), posttraumatic stress disorder (PTSD), and major depressive disorder (MDD). Suicidal tendencies are clinically assessed by verbal thoughts rather than by specifically asking about mental images. This study examines whether imagery and verbal thoughts about suicide occur and differ between patients with BPD with and without comorbid PTSD compared to patients with MDD (clinical controls). All patient groups experienced suicide-related images. Patients with BPD with comorbid PTSD reported significantly more vivid images than patients with MDD. Severity of suicidal ideation, number of previous suicide attempts, and childhood traumata were significantly associated with suicidal imagery across all patient groups. The authors demonstrate for the first time that suicide-related mental imagery occurs in BPD and is associated with suicidal ideation. This finding highlights the importance of assessing mental imagery related to suicide in clinical practice.

What make suicide depressions different from non-suicide ones: A diffusion tensor imaging study

2017 ◽  
Vol 41 (S1) ◽  
pp. S351-S351
Author(s):  
H. Zhang ◽  
Z. Jia
Keyword(s):  
Major Depressive Disorder ◽  
White Matter ◽  
Suicidal Ideation ◽  
Depressive Disorder ◽  
Suicide Attempts ◽  
Diffusion Tensor ◽  
Imaging Study ◽  
Major Depressive ◽  
Significant Difference ◽  
Depressive Patients

IntroductionDepression is a common psychiatric disorder affecting many people globally, and the worst outcome is suicide. But its neurobiology is hardly understood.ObjectivesTo use DTI to characterize abnormalities of white matter (WM) integrity in major depressive disorder patients with suicide attempts or suicidal ideation.AimsPresent study aimed to give a more complete profile for the association of cerebral WM abnormalities with suicidal behavior in major depressive disorder patients by quantifying the suicidal ideation and behavior severity.MethodsThirteen depressive patients with suicide attempts (SA), 14 depressive patients with suicidal ideation but no suicide attempts (SI), 13 depressive patients without suicidal ideation or suicide attempts (NSD) and 40 healthy controls (HC) received MRI scans on a 3 T magnet. Whole brain voxel-based analysis of FA based on DTI was performed among the four groups using a threshold of P < 0.05 with FWE correction. FA values were extracted by Marsbar software to quantify the changes.ResultsThe four groups had significant differences of FA in the in the left splenium of corpus callosum (peak Z = 5.36 at −14, −36, 22). Quantify comparison revealed that SA had significant decreased FA value than SI, NSD, and HC. There was no significant difference among the other three groups, although there was a trend that SI and NSD had lower FA values than HC in this region.ConclusionsDepression and suicide are associated with microstructure abnormalities of the white matter and patients with suicide attempts may have severe cerebral alteration.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Suicide Risk in Patients with Somatization Disorder

Crisis ◽  
2004 ◽  
Vol 25 (1) ◽  
pp. 3-7 ◽  
Author(s):  
Andrea P. Chioqueta ◽  
Tore C. Stiles
Keyword(s):  
Major Depressive Disorder ◽  
Personality Disorder ◽  
Depressive Disorder ◽  
Suicide Risk ◽  
Suicide Attempts ◽  
Total Sample ◽  
Somatization Disorder ◽  
Principal Diagnosis ◽  
Psychiatric Outpatients ◽  
Major Depressive

Summary: The aim of the study was to assess suicide risk in psychiatric outpatients with and without somatization disorder. A total sample of 120 psychiatric outpatients was used in the study, 29 of whom met diagnostic criteria for somatization disorder. The results indicated that somatization disorder was significantly associated with suicide attempts even when the effects of both a comorbid major depressive disorder and a comorbid personality disorder were statistically controlled for. The results suggest that, although a patient meets the criteria for a principal diagnosis of major depressive disorder and/or a personality disorder, it is still of significant importance to decide whether or not the patient also meets the criteria for a somatization disorder in order to more optimally assess suicide risk. The findings highlight the fact that the potential for suicide in patients with somatization disorder should not be overlooked when a diagnosable depressive disorder or personality disorder is not present.

scholarly journals Theta burst stimulation for the acute treatment of major depressive disorder: A systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jeffrey D. Voigt ◽  
Andrew F. Leuchter ◽  
Linda L. Carpenter
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Rating Scale ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
High Frequency Stimulation ◽  
Theta Burst Stimulation ◽  
Burst Stimulation ◽  
Major Depressive ◽  
Significant Difference ◽  
Theta Burst

AbstractPatients with major depressive disorder (MDD) may be refractory to or have contraindications that preclude treatment with antidepressant pharmacotherapies. Alternative therapies such as repetitive transcranial magnetic stimulation (rTMS) continue to evolve, and include theta burst stimulation (TBS), which has advantages over conventional rTMS. The aim of this study was to identify and meta-analyze efficacy data from all randomized controlled trials (RCTs) investigating TBS as a treatment for MDD. Published reports of RCTs (January 1, 2010 to October 23, 2020) were identified via systematic searches in computerized databases, followed by review of individual reports for inclusion. Inclusion criteria included primary diagnosis of MDD ≥ 1 week duration of therapy with ≥10 sessions, and treatment with any form of TBS. The Cochrane GRADE methodology and PRISMA criteria were used for evaluation of individual trials. Data from ten RCTs were included, representing 667 patients. Of these, 8 RCTs compared TBS to sham treatment and one compared TBS to standard rTMS (i.e., high frequency stimulation over left dorsolateral prefrontal cortex [HFL]). Quality of evidence assessment yielded high confidence in the finding of TBS being superior to sham on response measured by the Hamilton Depression Rating Scale (HRSD) (RR = 2.4; 95% CI: 1.27 to 4.55; P = 0.007; I2 = 40%). Comparison of HRSD response rates for TBS versus rTMS produced no statistically significant difference (RR = 1.02; 95% CI: 0.85 to 1.23; P = 0.80; I2 = 0%). The incidence of adverse events between TBS and rTMS was not statistically different. The findings of a positive effect of TBS vs. sham, and noninferiority of TBS vs. standard HFL rTMS support the continued development of TBS to treat depression.

Resequencing three candidate genes discovers seven potentially deleterious variants susceptibility to major depressive disorder and suicide attempts in Chinese

Gene ◽  
2017 ◽  
Vol 603 ◽  
pp. 34-41 ◽  
Author(s):  
Shitao Rao ◽  
Cherry She Ting Leung ◽  
Macro Hb Lam ◽  
Yun Kwok Wing ◽  
Mary Miu Yee Waye ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Candidate Genes ◽  
Suicide Attempts ◽  
Major Depressive

Augmentation strategies in the treatment of major depressive disorder

2016 ◽  
Vol 33 (S1) ◽  
pp. S407-S407
Author(s):  
S. Bise ◽  
B. Kurtovic ◽  
D. Begic ◽  
O. Cemalovic
Keyword(s):  
Major Depressive Disorder ◽  
Combination Therapy ◽  
Depressive Disorder ◽  
Mood Stabilizers ◽  
Augmentation Therapy ◽  
Major Depressive ◽  
Augmentation Strategies ◽  
Significant Difference ◽  
Augmentation Strategy ◽  
Competing Interest

Augmentation strategies for the treatment of Major depressive disorder (MDD) are needed when patients with MDD have a partial, or not responded to antidepressant monotherapy. The focus of augmentation therapy has been combining an antidepressant (AD) medication with another AD. Atypical antipsychotics (AAP) are becoming commonly used to augment antidepressants. Beyond AD and AAP, alternative augmentation strategies include mood stabilizers (MS).AimTo analyze the characteristics of therapy in patients with diagnosis of MDD and to investigate the frequency of augmentation therapy.MethodStudy included 28 patients hospitalized during one year with MDD diagnosis. Statistical analysis was performed with x2 and t-test.ResultAmong patients with MDD there were 18 (64.28%) women with an average age 57.5 and 10 (35.71%) men with an average age 53.5. Of the 28 patients with MDD, 25 (89.28%) were treated with a combination therapy, and monotherapy in the remaining 3 patients (10.71%). Of 25 patients with augmentation strategy treatment, 22 (88%) used two medications and the remaining 3 (12%) tree psychotropic medications (AAP, AD, MS). The most frequent combinations were a combination of AD and AAP (17 patients, 68%). Beyond that frequent combination were AD and MS (6 patients, 24%). Two patients used combination two AAP, and one patient with two AD and one patients used AAP and MS.ConclusionAugmentation strategy is often used in patients with MDD. There is no significant difference in the use combination therapy based on gender and age.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Alteration of Transthyretin and Thyroxine-Binding Globulin in Major Depressive Disorder: Multiple Reaction Monitoring-Based Proteomic Analysis

2020 ◽  
Author(s):  
Hye In Woo ◽  
Jisook Park ◽  
Shinn-Won Lim ◽  
Doh Kwan Kim ◽  
Soo-Youn Lee
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Proteomic Analysis ◽  
Antidepressant Treatment ◽  
Multiple Reaction Monitoring ◽  
Reaction Monitoring ◽  
Healthy Individuals ◽  
Major Depressive ◽  
Thyroxine Binding Globulin ◽  
Significant Difference

Abstract Background: Major depressive disorder (MDD), common mental disorder, lacks objective diagnostic and prognosis biomarkers. The objective of this study was to perform proteomic analysis to identify proteins with changed expression levels after antidepressant treatment and investigate differences in protein expression between MDD patients and healthy individuals.Methods: A total of 111 proteins obtained from literature review were subjected to multiple reaction monitoring (MRM)-based protein quantitation. Finally, seven proteins were quantified for plasma specimens of 10 healthy controls and 78 MDD patients (those at baseline and at 6 weeks after antidepressant treatment of either selective serotonin reuptake inhibitors (SSRIs) or mirtazapine). Results: Among 78 MDD patients, 35 patients were treated with SSRIs and 43 patients were treated with mirtazapine. Nineteen (54.3%) and 16 (37.2%) patients responded to SSRIs and mirtazapine, respectively. Comparing MDD patients with healthy individuals, alteration of transthyretin was observed in MDD (p = 0.026). There was no significant difference in protein levels related to SSRIs treatment. Plasma thyroxine-binding globulin (TBG) was different between before and after mirtazapine treatment only in responders (p = 0.007).Conclusions: In proteomic analysis of plasma specimens from MDD patients, transthyretin and TBG levels were altered in MDD and changed after antidepressant treatment.

scholarly journals Analgesic efficacy of meloxicam with or without a buprenorphine patch in cats after ovariohysterectomy

2018 ◽  
Vol 63 (No. 6) ◽  
pp. 279-286
Author(s):  
SY Heo ◽  
SJ Kim ◽  
NS Kim
Keyword(s):  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Small Sample Size ◽  
Analgesic Efficacy ◽  
Small Sample ◽  
Visual Analogue Scale Pain ◽  
Pain Scores ◽  
Analogue Scale Pain ◽  
Group A ◽  
Group B

The purpose of this prospective double blind clinical study was to evaluate the analgesic efficacy of meloxicam with/without a buprenorphine patch for pain management after ovariohysterectomy in cats. Cats were randomly divided into two groups: ten cats were treated with meloxicam s.c. after ovariohysterectomy (Group A), and eight cats were treated with s.c. meloxicam and a 20 µg/h buprenorphine transdermal patch (Group B). For patch treatment, the cat’s hair was clipped on the left side in the thoracic area. Pain scores were assessed at 0.5, 1, 2, 4, 6, 8, 24 and 30 h post-ovariohysterectomy extubation. To evaluate postoperative pain, 4A-VET pain scale and visual analogue scale pain scores were used. In addition, blood was collected from all cats to determine the cortisol levels at –2 h and at 0.5, 4, 6 and 24 h after extubation. The 4A-VET scores for Group B were significantly lower at 1, 4, 6, 8, 24 and 30 h than the scores for Group A. The visual analogue scale pain scores for Group B were significantly lower at 4, 6, 24 and 30 h than the scores for Group A. Serum cortisol concentrations were not significantly different between Groups A and B at any of the measured intervals. There was a significant positive correlation between postoperative visual analogue scale and 4A-VET pain scores in both groups. Our results should be subject to careful interpretation as the study was limited by its small sample size and by observer subjectivity.

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