Prevalence, clinical features and prescription patterns of psychotropic medications for patients with psychotic depression in China

Author(s):  
Li-Min Xin ◽  
Yun-Ai Su ◽  
Feng Yan ◽  
Fu-De Yang ◽  
Gang Wang ◽  
...  
1989 ◽  
Vol 23 (3) ◽  
pp. 357-368 ◽  
Author(s):  
Gordon Parker ◽  
Dusan Hadzi-Pavlovic ◽  
Philip Boyce

We review the concept of endogenous depression historically and undertake quantitative analyses of representative factor analytic studies. We also report an empirical study, isolating symptoms and signs associated with a clinical diagnosis of psychotic/endogenous depression, made by a large number of clinical raters assessing 300 depressives. The quantitative analyses and the study of practising psychiatrists agreed in delineating depressive type and together suggest a more restricted construct of endogenous and psychotic depression than has been held historically. Key clinical features isolated were severity, retardation, delusions and paranoid features, non-reactivity and non-variability in mood, while vegetative features appeared to lack relevance.


1989 ◽  
Vol 23 (3) ◽  
pp. 357-368 ◽  
Author(s):  
Gordon Parker ◽  
Dusan Hadzi-Pavlovic ◽  
Philip Boyce

We review the concept of endogenous depression historically and undertake quantitative analyses of representative factor analytic studies. We also report an empirical study, isolating symptoms and signs associated with a clinical diagnosis of psychotic/endogenous depression, made by a large number of clinical raters assessing 300 depressives. The quantitative analyses and the study of practising psychiatrists agreed in delineating depressive type and together suggest a more restricted construct of endogenous and psychotic depression than has been held historically. Key clinical features isolated were severity, retardation, delusions and paranoid features, non-reactivity and non-variability in mood, while vegetative features appeared to lack relevance.


1977 ◽  
Vol 131 (6) ◽  
pp. 592-598 ◽  
Author(s):  
B. H. Anstee ◽  
J. J. Fleminger

During a ten year study, 10 per cent of patients at a general hospital in-patient unit had unsolved diagnostic problems at the time of discharge from hospital. These 132 cases were designated ‘uncertain’ and were followed up. Eighty-three patients were ultimately diagnosed, and 300 consecutive in-patients discharged from the same unit with a definite diagnosis were also studied. The clinical features and diagnoses of the two groups were compared. Special features associated with uncertainty were: a presenting complaint of pain; apathy without apparent mental or physical cause; hallucinosis or major paranoid symptoms without other good evidence of psychosis. Age was found to be relevant; compared with patients receiving confident diagnoses, those with uncertain diagnosis due to depressive psychosis were more often younger, while those due to neurosis or personality disorder tended to be older. Atypical psychotic depression was the condition most commonly associated with diagnostic doubt.


2020 ◽  
Author(s):  
Shiau-Shian Huang ◽  
Hsi-Han Chen ◽  
Jui Wang ◽  
Wei J. Chen ◽  
Hsi-Chung Chen ◽  
...  

Abstract Background: To investigate the risk of treatment-resistant depression (TRD) in patients with depression by examining their clinical features, early prescription patterns, and early and lifetime comorbidities. Methods: In total, 31,422 depressive inpatients were followed-up from diagnostic onset for more than 10-years. Patients were diagnosed with TRD if their antidepressant treatment regimen was altered ≥two times or if they were admitted after at least two different antidepressant treatments. Multiple Cox regression model were used to determine whether physical and psychiatric comorbidities, psychosis, and prescription patterns increased the risk of TRD by controlling for relevant demographic covariates. Survival analyses were performed for important TRD-associated clinical variables. Results: Females with depression (21.24%) were more likely to suffer from TRD than males (14.02%). Early anxiety disorders were more commonly observed in the TRD group than in the non-TRD group (81.48 vs. 58.96%, p<0.0001). Lifetime anxiety disorders had the highest population attributable fraction (42.87%). Seventy percent of patients with multiple psychiatric comorbidities developed TRD during follow-up. Cox regression analysis further identified that functional gastrointestinal disorders significantly increased TRD risk (aHR=1.19). Higher doses of antidepressants and benzodiazepines and Z drugs in the early course of major depressive disorder increased TRD risk (p<0.0001). Conclusion: Our findings indicate the need to monitor early comorbidities and polypharmacy patterns in patients with depression associated with elevated TRD risk.


2015 ◽  
Vol 25 (1) ◽  
pp. 9-17 ◽  
Author(s):  
Y.-T. Xiang ◽  
G. S. Ungvari ◽  
C. U. Correll ◽  
H. F. K. Chiu ◽  
N. Shinfuku

To date, antipsychotics remain the mainstay of treatment for schizophrenia and related disorders although other psychotropic medications and non-pharmaceutical interventions have been used adjunctively in some patients and settings. Regular surveys on access to and prescription patterns of psychotropic medications in clinical practice are an important and efficient way of examining the use and time trends of treatments in a given population and region. Unlike developed Western countries, Asian countries have not fully undergone deinstitutionalisation of the severely and chronically mentally ill, and community-based mental health services are still under-developed. As a result, a large number of psychiatric patients still receive treatments in psychiatric hospitals. Moreover, there have been very limited studies examining access to and prescription patterns of psychotropic medications for schizophrenia patients in Asian countries. In this paper, we focus on the only international project on the use of psychotropic medications in schizophrenia patients in selected East and Southeast Asian countries/territories summarising its major findings. Most of the first- and second-generation antipsychotics (FGAs and SGAs) are available in Asian countries, but the access to psychotropic medications is largely affected by socio-cultural and historical contexts, health insurance schemes, health care policy, medication cost and consumers’ preference across different countries/territories. Overall, the proportional use of FGAs, high dose antipsychotic treatment and antipsychotic polypharmacy have decreased, while the use of SGAs and antidepressants have increased and the utilisation of benzodiazepines and mood stabilisers has remained relatively stable over time. However, within these general trends, there is great inter-country variation regarding the psychotropic prescribing patterns and trends in Asian schizophrenia patients that also seems to differ from data in many Western countries.


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