The Major Depressive Disorder Hierarchy: Rasch Analysis of 6 Items of the Hamilton Depression Scale Covering the Continuum of Depressive Syndrome

2017 ◽  
Vol 41 (S1) ◽  
pp. s244-s244
Author(s):  
L. Primo de Carvalho Alves ◽  
M. Pio de Almeida Fleck ◽  
A. Boni ◽  
N. Sica da Rocha
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Depressed Mood ◽  
Rasch Analysis ◽  
Rating Scale ◽  
Depression Scale ◽  
Psychomotor Retardation ◽  
Model Fit ◽  
Hamilton Depression Scale ◽  
Major Depressive

ObjectivesMelancholic features of depression (MFD) seem to be a unidimensional group of signs and symptoms. However, little importance has been given to the evaluation of what features are related to a more severe disorder. That is, what are the MFD that appear only in the most depressed patients. We aim to demonstrate how each MFD is related to the severity of the major depressive disorder.MethodsWe evaluated both the Hamilton depression rating scale (HDRS-17) and its 6-item melancholic subscale (HAM-D6) in 291 depressed inpatients using Rasch analysis, which computes the severity of each MFD. Overall measures of model fit were mean ( ± SD) of items and persons residual = 0 (± 1); low χ2 value; P > 0.01.ResultsFor the HDRS–17 model fit, mean (± SD) of item residuals = 0.35 (± 1.4); mean (± SD) of person residuals = –0.15 (± 1.09); χ2 = 309.74; P < 0.00001. For the HAM-D6 model fit, mean (± SD) of item residuals = 0.5 (± 0.86); mean (± SD) of person residuals = 0.15 (± 0.91); χ2 = 56.13; P = 0.196. MFD ordered by crescent severity were depressed mood, work and activities, somatic symptoms, psychic anxiety, guilt feelings, and psychomotor retardation.ConclusionsDepressed mood is less severe, while guilt feelings and psychomotor retardation are more severe MFD in a psychiatric hospitalization. Understanding depression, as a continuum of symptoms can improve the understanding of the disorder and may improve its perspective of treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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

SLEEP ◽  
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.

scholarly journals Counterfactual Thinking-Related Emotional Responses in Patients With Major Depressive Disorder

2021 ◽  
Vol 11 ◽  
Author(s):  
Qi Zheng ◽  
Mei Liao ◽  
Bangshan Liu ◽  
WenWen Ou ◽  
WenTao Chen ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Rating Scale ◽  
Demographic Data ◽  
Depression Scale ◽  
Counterfactual Thinking ◽  
Hamilton Depression Scale ◽  
Gambling Task ◽  
Major Depressive ◽  
Significant Difference

Objective: To explore the emotional characteristics of counterfactual thinking (CT)-related emotion responses in patients with major depressive disorder (MDD) via the “counterfactual thinking gambling task (CTGT).”Method: Twenty-five patients with MDD (the MDD group) and twenty-five healthy controls (the HC group) with matched demographic features were included. The 17-item Hamilton Depression Scale (HAMD) and the 14-item Hamilton Anxiety Rating Scale (HAMA) were used to assess the severity of depression and anxiety symptoms. The counterfactual thinking gambling task was applied to assess the situation-focused- and behavior-focused-CT-related emotion responses in the MDD group and the HC group.Results: There was no significant difference in general demographic data between the two groups (p &gt; 0.05). Compared with the HC group, the MDD group experienced higher levels of “disappointment” and lower levels of “joy” in the situation-focused CT paradigm (p &lt; 0.05). However, the experience of “regret” and “relief” in the behavior-focused CT paradigm were not significantly different between the two groups (p &gt; 0.05).Conclusions: MDD is associated with an impaired situation-focused-CT-related emotion responses, and is often accompanied by increased disappointment and decreased joy; however, behavior-focused-CT-related emotion responses are not significantly affected in MDD. This pattern may represent the characteristic CT-related emotion responses of MDD.

scholarly journals Abnormalities in Electroencephalographic Microstates Among Adolescents With First Episode Major Depressive Disorder

2021 ◽  
Vol 12 ◽  
Author(s):  
Yuqiong He ◽  
Qianting Yu ◽  
Tingyu Yang ◽  
Yaru Zhang ◽  
Kun Zhang ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Depression Scale ◽  
First Episode ◽  
Hamilton Depression Scale ◽  
Healthy Controls ◽  
Major Depressive ◽  
Hamd Score ◽  
Eeg Changes ◽  
Microstate Analysis

Background: Recent studies have reported changes in the electroencephalograms (EEG) of patients with major depressive disorder (MDD). However, little research has explored EEG differences between adolescents with MDD and healthy controls, particularly EEG microstates differences. The aim of the current study was to characterize EEG microstate activity in adolescents with MDD and healthy controls (HCs).Methods: A total of 35 adolescents with MDD and 35 HCs were recruited in this study. The depressive symptoms were assessed by Hamilton Depression Scale (HAMD) and Children's Depression Inventory (CDI), and the anxiety symptoms were assessed by Chinese version of DSM-5 Level 2-Anxiety-Child scale. A 64-channel EEG was recorded for 5 min (eye closed, resting-state) and analyzed using microstate analysis. Microstate properties were compared between groups and correlated with patients' depression scores.Results: We found increased occurrence and contribution of microstate B in MDD patients compared to HCs, and decreased occurrence and contribution of microstate D in MDD patients compared to HCs. While no significant correlation between depression severity (HAMD score) and the microstate metrics (occurrence and contribution of microstate B and D) differing between MDD adolescents and HCs was found.Conclusions: Adolescents with MDD showed microstate B and microstate D changes. The obtained results may deepen our understanding of dynamic EEG changes among adolescents with MDD and provide some evidence of changes in brain development in adolescents with MDD.

scholarly journals Psychodramatic psychotherapy combined with pharmacotherapy in major depressive disorder: an open and naturalistic study

2006 ◽  
Vol 28 (1) ◽  
pp. 40-43
Author(s):  
Elisabeth Maria Sene Costa ◽  
Rosilda Antonio ◽  
Márcia Britto de Macedo Soares ◽  
Ricardo Alberto Moreno
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Social Adjustment ◽  
Depression Scale ◽  
Self Report ◽  
Control Group ◽  
Hamilton Depression Scale ◽  
Major Depressive ◽  
The Social ◽  
Social Adjustment Scale

OBJETIVE: Recent literature has highlighted the role of psychotherapy in the treatment of major depressive disorder. Combined therapies comprising both psychotherapy and pharmacotherapy have presented the best results. Although several kinds of psychotherapies have been studied in the treatment of depressive disorders, there remains a lack of data on psychodramatic psychotherapy in the treatment of major depressive disorder. The objective of this study was to evaluate the impact of psychodramatic psychotherapy (in a sample of major depressive disorder patients. METHOD: This is an open, naturalistic, controlled, non-randomized study. Twenty major depressive disorder patients (according to the DSM-IV criteria), under pharmacological treatment for depression, with Hamilton Depression Scale total scores between 7 and 20 (mild to moderate depression), were divided into two groups. Patients in the psychotherapeutic group took part in 4 individual and 24 structured psychodramatic group sessions, whilst subjects in the control group did not participate in this psychodramatic psychotherapy. Both groups were evaluated with the Social Adjustment Scale - Self Report and the Hamilton Depression Scale. RESULTS: Psychotherapeutic group patients showed a significant improvement according to the Social Adjustment Scale - Self Report and the Hamilton Depression Scale scores at endpoint, compared to those of the control group. CONCLUSIONS: Results suggest that individual and group psychodramatic psychotherapy, associated to pharmacological treatment, provides good clinical benefits in the treatment of major depressive disorder.

Supplementation of n-3 Polyunsaturated Fatty Acids for Major Depressive Disorder: A Randomized, Double-Blind, 12-Week, Placebo-Controlled Trial in Korea

2015 ◽  
Vol 66 (2-3) ◽  
pp. 141-148 ◽  
Author(s):  
Yongsoon Park ◽  
Yoo-Sin Park ◽  
Seok Hyeon Kim ◽  
Dong Hoon Oh ◽  
Yong-Chon Park
Keyword(s):  
Fatty Acids ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Polyunsaturated Fatty Acids ◽  
Clinical Global Impression ◽  
Rating Scale ◽  
Depression Scale ◽  
Major Depressive ◽  
Double Blind ◽  
Pufa Supplementation

Background: Controversy over the efficacy of n-3 polyunsaturated fatty acids (PUFAs) in depression continues to this day. The present study investigated the hypothesis that n-3 PUFA supplementation reduces depressive symptoms in Korean patients with major depressive disorder. Methods: In a randomized, double-blind, placebo-controlled, 12-week, parallel-group trial, 35 patients with Center for Epidemiological Studies Depression Scale Korean version (CES-D-K) scores ≥25 and depression confirmed by a psychiatrist were assigned to take either 3 capsules of n-3 PUFAs (1,140 mg of EPA + 600 mg of DHA; n = 18) or placebo (olive oil + safflower oil; n = 17). Results: Supplementation with n-3 PUFAs significantly reduced Clinical Global Impression Improvement (CGI-I) scores as compared with intake of placebo using intention-to-treat analysis with last-observation-carried-forward after adjusting for energy, fat, and fish intake. However, the CES-D-K, Hamilton Depression Rating Scale-17, and Clinical Global Impression Scale scores did not significantly differ between the n-3 PUFA and placebo groups. After supplementation with n-3 PUFAs, the erythrocyte levels of n-3 PUFAs were significantly increased, but n-6 PUFA levels were decreased. Conclusions: n-3 PUFAs demonstrated an advantage over placebo that did not reach clinical significance, although CGI-I score was significantly decreased in the n-3 PUFA group as compared with the placebo group.

scholarly journals Common and Specific Alterations of Amygdala Subregions in Major Depressive Disorder With and Without Anxiety: A Combined Structural and Resting-State Functional MRI Study

2021 ◽  
Vol 15 ◽  
Author(s):  
Yao Yao Li ◽  
Xiao kang Ni ◽  
Ya feng You ◽  
Yan hua Qing ◽  
Pei rong Wang ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Gray Matter Volume ◽  
Functional Integration ◽  
Depression Scale ◽  
Neural Mechanism ◽  
Anterior Cingulate ◽  
Treatment Programs ◽  
Hamilton Depression Scale ◽  
Major Depressive

Anxious major depressive disorder is a common subtype of major depressive disorder; however, its unique neural mechanism is not well-understood currently. Using multimodal MRI data, this study examined common and specific alterations of amygdala subregions between patients with and without anxiety. No alterations were observed in the gray matter volume or intra-region functional integration in either patient group. Compared with the controls, both patient groups showed decreased functional connectivity between the left superficial amygdala and the left putamen, and between the right superficial amygdala and the bilateral anterior cingulate cortex and medial orbitofrontal cortex, while only patients with anxiety exhibited decreased activity in the bilateral laterobasal and superficial amygdala. Moreover, the decreased activity correlated negatively with the Hamilton depression scale scores in the patients with anxiety. These findings provided insights into the pathophysiologic processes of anxious major depressive disorder and may help to develop new and effective treatment programs.

scholarly journals Gut Microbiome Composition Associated With Major Depressive Disorder and Sleep Quality

2021 ◽  
Vol 12 ◽  
Author(s):  
Qi Zhang ◽  
Yajun Yun ◽  
Huimei An ◽  
Wenxuan Zhao ◽  
Ting Ma ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Gut Microbiota ◽  
Depressive Disorder ◽  
Sleep Quality ◽  
Critical Role ◽  
Depression Scale ◽  
Hamilton Depression Scale ◽  
Major Depressive ◽  
Severity Of Depression ◽  
Insomnia Severity

The microbiota–gut–brain axis plays a critical role in the pathogenesis of major depressive disorder (MDD) and related subclinical symptoms. However, studies on the gut microbiota in MDD are inconsistent, and data on MDD's effects on sleep are lacking. This study aimed to analyze the gut microbiota composition and sleep quality of patients with MDD. We performed 16S rRNA sequencing of stool samples from 36 patients with MDD and 45 healthy controls (HC). Sleep quality was assessed using the Pittsburgh Sleep Quality Index, depressive severity with the Hamilton Depression Scale, and insomnia severity using the Insomnia Severity Index. Forty-eight microbiota targets showed significant differences between MDD and HC. In MDD, six microbiota targets were associated with the severity of depression, 11 with sleep quality, and 3 with sleep severity. At the genus level, Dorea was simultaneously related to depression and sleep quality, while Intestinibacter was more closely related to sleep problems. Coprococcus and Intestinibacter were associated with sleep quality independent of the severity of depression. In conclusion, the present findings enable a better understanding of the relationship between gut microbiota and MDD-related symptoms. Gut microbiota alterations may become potential biomarkers and/or treatment targets for sleep quality in MDD.

Can BDNF and IL-2 be indicators for the diagnosis in schizophrenic patients with depressive symptoms?

2014 ◽  
Vol 26 (5) ◽  
pp. 291-297 ◽  
Author(s):  
Salih Saygin Eker ◽  
Ebru Oztepe Yavasci ◽  
Sengul Cangur ◽  
Selcuk Kirli ◽  
Emre Sarandol
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Depressive Disorder ◽  
Rating Scale ◽  
Depressive Symptomatology ◽  
Interleukin 2 ◽  
Depression Scale ◽  
Control Group ◽  
Major Depressive ◽  
Serum Bdnf

ObjectiveThe aim of the current study is to determine whether serum levels of brain-derived neurotrophic factor (BDNF) and interleukin-2 (IL-2) can be biological indicators for the diagnosis of schizophrenia in patients with depressive symptoms.MethodForty-seven patients (11 patients diagnosed with schizophrenia, 16 patients diagnosed with schizophrenia and comorbid depression and 20 patients diagnosed with major depressive disorder) and 20 healthy subjects were enrolled. The Positive and Negative Symptoms Scale, the Calgary Depression Scale for Schizophrenia and the Hamilton Depression Rating Scale were used for assessment. The serum BDNF and IL-2 levels of all the subjects were studied.ResultsDecreased levels of serum BDNF and increased levels of serum IL-2 were found in the patients diagnosed with either schizophrenia, schizophrenia with depression, or major depressive disorder (p = 0.049, p = 0.010; p = 0.001 and p = 0.044; p = 0.027, p = 0.003; respectively) compared with control group. There were no significant differences between the patient groups in their serum BDNF and IL-2 levels.ConclusionsThe present study suggests that neurotrophic factors and immune system changes are involved in the pathogenesis of schizophrenia with or without depressive symptomatology. However, the data do not clarify whether depressive symptoms in schizophrenia occur as a dimension of schizophrenia or as symptoms of major depression that is comorbid with schizophrenia.

Association of glucocorticoid receptor polymorphisms with the susceptibility to major depressive disorder and treatment responses in Korean depressive patients

2009 ◽  
Vol 21 (1) ◽  
pp. 11-17 ◽  
Author(s):  
Hwa-Young Lee ◽  
Rhee-Hun Kang ◽  
Sang-Woo Han ◽  
Jong-Woo Paik ◽  
Hun Soo Chang ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Glucocorticoid Receptor ◽  
Genetic Polymorphisms ◽  
Antidepressant Treatment ◽  
Depression Scale ◽  
Therapeutic Effects ◽  
Hamilton Depression Scale ◽  
Stress Reactions ◽  
Major Depressive

Objective:Major depressive disorder (MDD) is closely related to stress reactions and serotonin probably underpins the pathophysiology of MDD. Alterations of the hypothalamic-pituitary-adrenal axis at the gene level have reciprocal consequences on serotonin neurotransmission. Glucocorticoid receptor (GR) polymorphisms affect glucocorticoid sensitivity, which is associated with cortisol feedback effects. Therefore, we hypothesised that GR polymorphisms are associated with the susceptibility to MDD and predict the treatment response.Method:Ninety-six subjects with a minimum score of 17 on the 21-item Hamilton Depression Scale (HAMD) at baseline were enrolled into the present study. The genotypes of GR (N363S, ER22/23EK, Bcl1, and TthIII1 polymorphisms) were analysed. The HAMD score was again measured after 1, 2, 4 and 8 weeks of antidepressant treatment to detect whether the therapeutic effects differed with the GR genotype.Results:Our subjects carried no N363S or ER22/23EK genetic polymorphisms and three types of Bcl1 and TthIII1 genetic polymorphisms. The C/C genotype and C allele at Bcl1 polymorphism were more frequent in MDD patients than in normal controls (p < 0.01 and p = 0.01, respectively). The genotype distributions did not differ significantly between responders and non-responders.Conclusion:These results suggest that GR polymorphism cannot predict the therapeutic response after antidepressant administration. However, GR polymorphism (Bcl1) might play a role in the pathophysiology of MDD. Future studies should check this finding in larger populations with different characteristics.

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