Predictors of functioning in major depression

2017 ◽  
Vol 41 (S1) ◽  
pp. S325-S325
Author(s):  
M. Serra-Blasco ◽  
E. Aguilar ◽  
M. Vicent ◽  
G. Navarra ◽  
M.J. Portella ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Major Depression ◽  
Statistical Power ◽  
Rating Scale ◽  
Cognitive Domain ◽  
Neuropsychological Battery ◽  
Cognitive Difficulties ◽  
Mood Symptoms ◽  
Life Functioning ◽  
Competing Interest

IntroductionLife functioning difficulties are a relevant but undervalued consequence of major depression. Mood symptoms and cognitive deficits have a significant, and somehow independent, impact on them. Therefore, cognitive difficulties should be considered a potential target to improve patients’ functioning.AimsTo examine the degree in which objective and subjective cognition explain functional outcome.ObjectivesTo assess objective cognitive function (CF) with a neuropsychological battery and to measure subjective CF using measures of cognitive perception.MethodsNinety-nine patients with depression were assessed by age, sex and level of schooling. Depressive symptoms severity was measured by Hamilton Depression Rating Scale (HDRS-17). Objective CF consisted in the following cognitive domains: memory, attention, executive functioning and processing speed. Subjective CF was assessed with Perceived Deficit Questionnaire-Depression (PDQ-D). Functioning Assessment Short Test (FAST) was used to evaluate life functioning, excluding the cognitive domain. All the listed measures were included in a multiple regression analysis with FAST scores as dependent variable.ResultsThe regression model was significant (F1,98 = 67.484, P < 0.001) with an R of 0.825. The variables showing statistical power included (from higher to lower β-coefficient) HDRS-17 (β = 0.545, t = 8.453, P < 0.001), PDQ-D (β = 0.383, t = 6.047, P < 0.001) and DSST (β = −0.123, t = −1.998, P = 0.049).ConclusionsThe severity of depressive symptoms is the variable that best explains life functioning. Surprisingly, the second factor hindering it is the patients’ perception of their cognition. Current findings highlight the importance of correcting cognitive bias in order to improve functionality. However, results have to be taken cautiously as mood symptoms could partly explain the bias.Disclosure of interestThe authors have not supplied their declaration of competing interest.

A phase 2 trial of inhaled nitrous oxide for treatment-resistant major depression

2021 ◽  
Vol 13 (597) ◽  
pp. eabe1376
Author(s):  
Peter Nagele ◽  
Ben J. Palanca ◽  
Britt Gott ◽  
Frank Brown ◽  
Linda Barnes ◽  
...  
Keyword(s):  
Nitrous Oxide ◽  
Depressive Symptoms ◽  
Major Depression ◽  
Rating Scale ◽  
Similar Efficacy ◽  
Comparable Efficacy ◽  
Crossover Fashion ◽  
Phase 2 ◽  
Treatment Resistant ◽  
Phase 2 Trial

Nitrous oxide at 50% inhaled concentration has been shown to improve depressive symptoms in patients with treatment-resistant major depression (TRMD). Whether a lower concentration of 25% nitrous oxide provides similar efficacy and persistence of antidepressant effects while reducing the risk of adverse side effects is unknown. In this phase 2 clinical trial (NCT03283670), 24 patients with severe TRMD were randomly assigned in a crossover fashion to three treatments consisting of a single 1-hour inhalation with (i) 50% nitrous oxide, (ii) 25% nitrous oxide, or (iii) placebo (air/oxygen). The primary outcome was the change on the Hamilton Depression Rating Scale (HDRS-21). Whereas nitrous oxide significantly improved depressive symptoms versus placebo (P = 0.01), there was no difference between 25 and 50% nitrous oxide (P = 0.58). The estimated differences between 25% and placebo were −0.75 points on the HDRS-21 at 2 hours (P = 0.73), −1.41 points at 24 hours (P = 0.52), −4.35 points at week 1 (P = 0.05), and −5.19 points at week 2 (P = 0.02), and the estimated differences between 50% and placebo were −0.87 points at 2 hours (P = 0.69), −1.93 points at 24 hours (P = 0.37), −2.44 points at week 1 (P = 0.25), and −7.00 points at week 2 (P = 0.001). Adverse events declined substantially with dose (P < 0.001). These results suggest that 25% nitrous oxide has comparable efficacy to 50% nitrous oxide in improving TRMD but with a markedly lower rate of adverse effects.

FC10-02 - Ghrelin affects sleep, secretion of cortisol and growth hormone and psychopathology in patients with major depression

2011 ◽  
Vol 26 (S2) ◽  
pp. 1865-1865
Author(s):  
M. Kluge ◽  
P. Schüssler ◽  
M. Dresler ◽  
D. Schmidt ◽  
A. Yassouridis ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Depressive Symptoms ◽  
Major Depression ◽  
Rem Sleep ◽  
Rating Scale ◽  
Well Being ◽  
Somatotropic Axis ◽  
Healthy Humans ◽  
Antidepressant Effects ◽  
Time Awake

IntroductionGhrelin showed antidepressant-like effects in mice. Furthermore, ghrelin influences sleep and the activity of hypothalamic-pituitary-adrenal (HPA) and somatotropic axis in healthy humans as indicated by increased cortisol and growth hormone (GH) plasma levels. Both sleep and the activity of these endocrine axes are disturbed in depression.ObjectiveTo study the effect of ghrelin on psychopathology, sleep and secretion of cortisol and GH in patients with major depression.MethodsDepressive symptoms as assessed by a validated self rating scale (’Befindlichkeits-Skala’, [well-being scale]), secretion profiles of cortisol and GH and sleep-EEGs were determined in 14 unmedicated patients with major depression (7 women) twice, receiving 50 μg ghrelin or placebo at 2200, 2300, 0000, and 0100 hours.ResultsOverall, depressive symptoms did not change significantly after ghrelin administration (placebo: 37 ± 8; ghrelin: 33 ± 10, p = 0.178). However, there was an improvement at trend level in men (placebo: 36 ± 9 to ghrelin: 30 ± 9, p = 0.093) but not in women. In men, ghrelin was associated with less time awake (placebo: 149.0 ± 11.1; ghrelin: 88.0±12.2 min, p = 0.029) and more non-REM sleep (placebo: 263.2 ± 24.1; ghrelin: 304.9 ± 14.1 min, p = 0.027), in women with less REM sleep (placebo: 108.6 ± 15.7; ghrelin: 74.1 ± 13.8 min, p = 0.031) and longer REM latency (placebo: 49.9 ± 6.5; ghrelin: 85.6 ± 14.1 min, p = 0.019). In both sexes, ghrelin caused strong transient increases of GH and cortisol.ConclusionOur study may provide an initial indication that ghrelin can exert antidepressant effects in patients with major depression. Ghrelin strongly affected sleep and secretion of GH and cortisol in a partly different way as previously reported in healthy subjects.

Anhedonic brain while attending sexual and emotional pictures

2016 ◽  
Vol 33 (S1) ◽  
pp. S161-S161
Author(s):  
F. Von Duering
Keyword(s):  
Major Depression ◽  
Sexual Arousal ◽  
Rating Scale ◽  
Sexual Attraction ◽  
Affective State ◽  
Anterior Cingulate ◽  
Relevant Role ◽  
Depressive Symptom Severity ◽  
Emotional Pictures ◽  
Competing Interest

Anhedonia is defined as the inability to gain pleasure from normally pleasurable experiences and reduced sexual desire. Rees et al. (2007) showed that limbic and paralimbic areas are responsible for sexual arousal and that anhedonia is associated with frontolimbic inhibition. In major depression, reduced ventral striatum and increased ventral prefrontal cortex areas was associated with anhedonia(Gorwood, 2009). Walter et al. (2009) indicated that there is a deviation in the neuronal activation pattern of the pregenual anterior cingulate cortex in anhedonic depression which is related to a glutamergic deficit. Glutamate was suggested to play a relevant role in reward system (Birgner et al., 2005). ACC is a key involved in affective state and glutamate mediates ACC activation to sexual attraction(Wu et al., 2009). Thus, a glutamatergic deficit might be related to reduced hedonic effect specific to major depression. Using an attention modulation of emotional and sexual pictures, we investigate the role of anhedonia on the ventral and dorsal systems in healthy volunteers and patients with major depression. They undergo an expectancy task in a 7 T scanner and passively view sexual and emotional photographs and are asked to expect either high salient pictures or high erotic pictures. Half of these pictures are announced by an expectancy cue, whereas the other half are preceded by a fixation cross. Snaith-Hamilton-Pleasure-Scale and Hamilton Depression Rating Scale are employed to assess anhedonia and depressive symptom severity. Brain metabolites in the dorsal and pgACC are measured using MRS. We will show how anhedonia modulates the neural response to sexual arousal.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

Suicidal intent in people with major depression

2017 ◽  
Vol 41 (S1) ◽  
pp. s892-s892
Author(s):  
D. Shukla ◽  
A.Q. Jilani ◽  
P. Jaiswal ◽  
A. Nischal ◽  
R.A. Kallivayalil
Keyword(s):  
Major Depression ◽  
Rating Scale ◽  
Single Point ◽  
Severe Depression ◽  
Preventive Measure ◽  
Cross Sectional ◽  
Suicidal Intent ◽  
Suicidal Intention ◽  
Competing Interest ◽  
Socio Demographic Factors

BackgroundDepression is most common underlying contributor among cases of attempted/completed suicide. There is dearth of information regarding suicidal intent among people with depression and its relationship with hopelessness among Indians.ObjectiveTo evaluate and describe the intent of suicide in people with depression among north Indian population.MethodsThis cross-sectional single point, study was performed at the department of psychiatry, King George's Medical University, Lucknow, India. Cases were in the age group of 18–60 years with major depressive disorder as per DSM-IV TR criteria. Following tools e.g. Hamilton depression rating scale (HRS), Beck's hopelessness scale (BHS) and suicide intent questionnaire (SIQ) were used for assessment.ResultsSuicidal intent was observed among 68.1% (n = 49) of study sample (n = 72). There was no significant (P > 0.05) association of suicidal intent with socio-demographic factors except domicile status. Suicidal intent was common among people with moderate to severe depression and those with hopelessness. The hopelessness was present among 70.8% of subjects.ConclusionSuicidal intent is prevalent among people with major depression. Intervention at initial stage of suicidal intention would of importance for successful preventive measure. This emphasizes the need for evaluation of suicidal intent in cases of depression.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Concordance and Discrepancy Between Subjective and Objective Cognitive Assessment in Bipolar Disorder: What is Influencing this Discrepancy?

2017 ◽  
Vol 41 (S1) ◽  
pp. S207-S207
Author(s):  
F. Lima ◽  
T. Cardoso ◽  
C. Bonnin ◽  
A. Martinez-Aran ◽  
E. Vieta ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Cognitive Abilities ◽  
Cognitive Assessment ◽  
Rating Scale ◽  
False Negative ◽  
Cognitive Difficulties ◽  
Full Remission ◽  
Cognitive Measure ◽  
Competing Interest ◽  
Congruent Group

IntroductionEvidence has shown that some patients with bipolar disorder have a relatively accurate sense of their cognitive abilities, whereas others may overreported or underreported cognitive difficulties, which causes a discrepancy in this measures.ObjectivesTo investigate concordance and discrepancy between subjective and objective cognitive measures, as well as to identify factors that could influence this discrepancy.MethodsPatients who met DSM IV-TR criteria for bipolar disorder in partial or full remission (HDRS-17 score ≤ 12; YMRS score ≤ 7) were recruited from outpatient clinic at Barcelona and Porto Alegre. Objective cognitive assessment was performed by the Letter-Number Sequencing (LNS-WAIS III). Cognitive Complaints in Bipolar Disorder Rating Scale (COBRA) was used as a subjective cognitive measure.ResultsWere included 179 patients. We found a concordance between COBRA and LNS in 62 cases, and discrepancy in 117 cases (Fig. 1). The incongruent group (COBRA–and LNS + ) have less years of study (8.10 ± 4.01) than the incongruent group (COBRA+ and LNS–) (13.44 ± 4.05, P = 0.001), and than congruent group (COBRA–and NLS–) (13.75 ± 4.04, P = 0.003). Finally, the congruent group (COBRA+ and LNS + ) was the group with higher functioning impairment.ConclusionsA few number of false-negative cases were detected, suggesting that COBRA can be used as a screening instrument. A special attention should be provided for subjects with a few years of study, because possibly these subjects presents more difficulty in express its cognitive difficulties.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Dementia and Depression in Elderly Medical Inpatients

2000 ◽  
Vol 12 (1) ◽  
pp. 67-75 ◽  
Author(s):  
Emese Linka ◽  
György Bartkó ◽  
Tamás Agárdi ◽  
Katalin Kemény
Keyword(s):  
Depressive Symptoms ◽  
Major Depression ◽  
Rating Scale ◽  
Depressive Symptomatology ◽  
Total Sample ◽  
Semistructured Interview ◽  
High Prevalence ◽  
Medical Inpatients ◽  
Dsm Iv ◽  
Hamilton Rating Scale

The purpose of this study was to examine the prevalence and correlation of cognitive impairments, major depression, and depressive symptoms among elderly medical inpatients, and to compare the degree of depressive symptomatology as well as cognitive deterioration in possible vascular dementia and possible Alzheimer's disease. In a department of internal medicine, 100 (36 male, 64 female) 65-year-old or older patients were examined by a semistructured interview, and assessed by the Hachinski Ischemic Scale, the Hamilton Rating Scale for Depression (HDS), and the Modified Mini-Mental State (MMMS) Examination. In our total sample, the MMMS total score was (±SD) 76.0 ± 15.5 and the HDS total score was (±SD) 12.0 ± 6.1. Based on DSM-IV criteria, major depression was established in 11 patients. Deterioration of cognitive functions was seen in 66 patients; cognitive impairment was mild in 30 patients, moderate in 19, and severe in 17. Forty-six patients had mild depressive symptoms and 27 had severe depressive symptoms. In summary, a high prevalence of cognitive dysfunction and depressive symptomatology was detected in our study, illustrating the importance of psychiatric care in elderly medical inpatients.

scholarly journals Personality Trait Predictive Utility and Stability in Transcranial Magnetic Stimulation (rTMS) for Major Depression: Dissociation of Neuroticism and Self-Criticism

2019 ◽  
Vol 65 (4) ◽  
pp. 264-272 ◽  
Author(s):  
Daniel C. Kopala-Sibley ◽  
Gabrielle B. Chartier ◽  
Shiv Bhanot ◽  
Jaeden Cole ◽  
Peter Y. Chan ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Transcranial Magnetic Stimulation ◽  
Major Depression ◽  
Magnetic Stimulation ◽  
Rating Scale ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Meta Analysis ◽  
Small Sample ◽  
Antidepressant Response ◽  
Critical Patients

Background: Cost-efficient and non-invasive predictors of antidepressant response to repetitive transcranial magnetic stimulation (rTMS) are required. The personality vulnerabilities—neuroticism and self-criticism—are associated with antidepressant outcomes in other modalities; however, self-criticism has not been examined in response to rTMS, and the literature on neuroticism and rTMS is inconsistent. Methods: This naturalistic, 4-week study involved daily dorsolateral prefrontal cortex (DLFPC) rTMS for major depression (15 unipolar, 2 bipolar). Participants completed the Big Five Inventory (neuroticism) and the Depressive Experiences Questionnaire (self-criticism) at baseline and at the end of treatment. Changes in depressive symptoms, as rated by the clinician, were quantified using the 21-item Hamilton Depression Rating Scale. Given the inconsistencies in data regarding the stability of neuroticism in patients receiving rTMS, we performed a systematic review and quantitative meta-analysis of trials examining rTMS and neuroticism. Results: rTMS significantly improved depressive symptoms, and this was predicted by higher levels of self-criticism but not neuroticism. Self-criticism was stable over the 4 weeks of rTMS; however, neuroticism decreased, and this was not related to decreases in depressive symptoms. Our quantitative meta-analysis of 4 rTMS trials in major depression ( n = 52 patients) revealed decreases in neuroticism, with a moderate effect size. Limitations: Our results are limited by a small sample size, and the absence of a sham-rTMS group. Our meta-analysis included only 4 trials. Conclusion: Highly self-critical patients appear to benefit more from rTMS than less self-critical patients. Neuroticism, a conceptually similar but distinct personality domain, does not appear to predict antidepressant response, yet this vulnerability factor for depression decreases after rTMS.

Neuropsychological performance of HIV-1 infected men with major depression

1997 ◽  
Vol 3 (5) ◽  
pp. 457-463 ◽  
Author(s):  
KATHY J. GOGGIN ◽  
SIDNEY ZISOOK ◽  
ROBERT K. HEATON ◽  
J. HAMPTON ATKINSON ◽  
SANDRA MARSHALL ◽  
...  
Keyword(s):  
Major Depression ◽  
Drug Use ◽  
Rating Scale ◽  
Memory Test ◽  
Neuropsychological Impairment ◽  
Neuropsychological Battery ◽  
Psychiatric Interview ◽  
Severity Of Depression ◽  
Clinically Significant ◽  
Hiv 1

This study sought to determine if human immunodeficiency virus–type 1 (HIV-1) infected depressed men were more likely to be neuropsychologically impaired than their nondepressed counterparts. Subjects were 47 HIV-1 infected men who met DSM–III–R criteria for current major depressive disorder (MDD) and 47 HIV-1 infected nondepressed male controls (M age = 34.2 years) equated on HIV-1 disease severity, demographics, and drug use. The psychiatric interview included the Structured Clinical Inventory for the DSM–III–R, and Hamilton Rating Scale for Depression. The neuropsychological battery included tests covering 8 functional domains based on an expanded Halstead-Reitan Battery. The medical assessment included a history and physical examination, immunologic staging, and evaluation of prescription and recreational drug use. Prevalence of global neuropsychological impairment in the two groups (depressed vs. control) did not differ [53% vs. 38% respectively; χ2(1, N = 94) = 2.11, p > .05]. While syndromically depressed patients performed less well than nondepressed individuals on memory tests [delayed retention portions of the Story Memory Test: F(1,91) = 5.34, p < .05; and Figure Memory Test: F(1,90) = 4.16, p < .05], the majority of depressed participants (64%) did not have clinically impaired memory. No relationship between neuropsychological impairment and severity of depression was observed. The results suggest that, while HIV-1 infected men with major depression may perform more poorly than nondepressed men on some aspects of memory tasks, they are not more likely to evidence clinically significant neurocognitive impairment. (JINS, 1997, 3, 457–463.)

The outcome of elderly patients presenting with depressive symptoms

1997 ◽  
Vol 14 (1) ◽  
pp. 8-12 ◽  
Author(s):  
Heidi Lee ◽  
Brian A Lawlor
Keyword(s):  
Depressive Symptoms ◽  
Major Depression ◽  
Personality Disorder ◽  
Elderly Patients ◽  
Rating Scale ◽  
The Other ◽  
Comorbid Anxiety ◽  
Good Outcome ◽  
Depressed Group ◽  
Anxiety Depression

AbstractObjective: To examine the treatment of and outcome for elderly patients presenting with depressive symptoms.Method: 100 consecutive elderly patients presenting to an old age psychiatric service with depressed mood were studied, 51 met DSM-III-R criteria for major depression and 49 met criteria for a range of other diagnoses. Demographic details, psychiatric history and clinical examination including Hamilton Depression Rating Scale, Mini-Mental State Examination and Cumulative Illness Rating Scale scores were recorded at first presentation. Treatment of index episode was recorded and outcome assessed at time of follow up (mean of 19.1 ± 9.1 months later).Results: 57% of the major depressives and 41% of the other diagnoses had a good outcome. Within the other diagnoses group 30% of the comorbid anxiety/depression patients and none of the patients with dysthymia or personality disorder had a good outcome. In the major depression group there was no clear association between outcome and any clinical or demographic measure. Within the other diagnoses group a good outcome was significantly associated with being younger, having had more psychiatric admissions and being less likely to require benzodiazepine treatment (p < 0.05). The two groups received similar treatment except that the other diagnoses group were more likely to have had psychotherapy and the major depressed patients to have had ECT (trend) than the major depressed group.Conclusions: The outcome for patients with major depression is similar to that found in previous studies. Patients with depressive syndromes associated with dysthymia, personality disorder, or comorbid anxiety/depression respond poorly to conventional treatments of depression.

Heart rate variability in adolescent major depression

2011 ◽  
Vol 26 (S2) ◽  
pp. 361-361 ◽  
Author(s):  
I. Tonhajzerova ◽  
I. Ondrejka ◽  
Z. Turianikova ◽  
L. Chladekova ◽  
K. Javorka ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Depressive Symptoms ◽  
Major Depression ◽  
Rating Scale ◽  
Autonomic Regulation ◽  
Cardiac Complications ◽  
Nonlinear Methods ◽  
Cardiac Autonomic Regulation ◽  
Linear And Nonlinear

IntroductionImpaired cardiac autonomic regulation is likely important contributor to a potential cardiac complications in major depression. The knowledge regarding the depression effect on cardiac regulation in adolescent age is limited. Aim was to study short-term heart rate variability (HRV) as an index of cardiac autonomic control in never-treated major depressive disorder (MDD) adolescent patients using linear and nonlinear methods related to depressive symptoms severity.MethodsWe have examined 20 MDD girls and 20 healthy age-matched girls at the age from 15 to 18 years. The ECG was recorded in three positions: supine - orthostasis - supine. The HRV was analyzed using linear (time and frequency analysis) and novel nonlinear (symbolic dynamics, time assymetry) methods. The severity of depressive symptoms was evaluated using the scales Montgomery-Asberg Depression Rating Scale (MADRS) and Children’s Depression Inventory (CDI).ResultsSeveral HRV linear and nonlinear parameters were significantly reduced in MDD group compared to controls in supine rest and during orthostasis. The HRV nonlinear analysis indices significantly correlated with depressive symptoms severity.ConclusionsLinear and nonlinear analyses revealed reduced magnitude and complexity of the HRV indicating impaired neurocardiac regulation in adolescent major depression. In addition, new approach of HRV analysis using nonlinear methods provided important information about depressive symptoms severity and cardiac autonomic regulation relations.

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