The period before hospitalization of patients with depressive disorders

2011 ◽  
Vol 26 (S2) ◽  
pp. 690-690
Author(s):  
E. Shmunk
Keyword(s):  
Psychiatric Hospital ◽  
Professional Training ◽  
Depressive Disorders ◽  
Rating Scale ◽  
Structured Interview ◽  
Interview Guide ◽  
Icd 10 ◽  
Gastrointestinal Complaints ◽  
First Time ◽  
Depressive Patients

IntroductionDepressive disorders (DD) are common and disabling. Patients with DD often have to do a long way before seeing a mental health specialist.ObjectivesTo investigate characteristics of the period before hospitalization to psychiatric hospital of patients with DD.AimsTo define clinical peculiarities of DD, investigations, treatment of depressive patients before hospitalization.MethodsThe RDC of ICD-10 and «Structured Interview Guide for the Hamilton Depression Rating Scale, Seasonal Affective Disorders Version» were used.ResultsAfter informed agreement 102 patients with DD for the first time admitted to the psychiatric hospital were examined. The average duration of DD before psychiatric examination was 19,1 months (up to 312 months). The average number of visits to primary care (PC) was 3,6 (up to 49), the average number of investigations was 2,4 (up to 8). The most part of visits to PC felt at patients with heart complaints (р = 0,02), the less to patients with loss of energy (р = 0,0007). With the prolongation of DD the number of investigations, medications in PC and absence days increased (r > 0,2, р < 0,05). Patients with heart and gastrointestinal complaints had more investigations (р = 0,01; р = 0,03). 38,2% of patients were prescribed tranquilizers and only 23,5% antidepressants, but 54,2% of them had suboptimal dossages.ConclusionsTo summarize, in real clinical practice patients with DD still haven’t enough opportunities for early diagnostics and treatment. Systematic recognition of patient with DD, professional training of PC doctors of different specialities are cruicial.

Anxiety Symptoms in Older Adults with Depression Are Associated with Suicidality

2018 ◽  
Vol 45 (3-4) ◽  
pp. 180-189 ◽  
Author(s):  
Anette Bakkane Bendixen ◽  
Knut Engedal ◽  
Geir Selbæk ◽  
Cecilie Bhandari Hartberg
Keyword(s):  
Older Adults ◽  
Cognitive Functioning ◽  
Depressive Disorders ◽  
Rating Scale ◽  
Medical Condition ◽  
Anxiety Symptoms ◽  
Clock Drawing Test ◽  
General Medical Condition ◽  
Icd 10 ◽  
Severity Of Depression

Objective: Anxiety symptoms are common in older adults with depression, but whether severe anxiety is associated with poorer outcomes of depression is unknown. The objective of the present study was to examine the association between severity of anxiety and severity of depression and physical illness, suicidality, and physical and cognitive functioning in older adults with depression. Methods: We included 218 older adults with diagnoses of a depressive disorder according to the ICD-10 criteria; their mean age (SD) was 75.6 (7.2), and 67.0% were women. The Geriatric Anxiety Inventory (GAI) was used to measure the severity of anxiety symptoms. The Montgomery-Aasberg Depression Rating Scale (MADRS) was used to assess the severity of depression. We obtained information on the level of functioning with the Physical Self-Maintenance Scale (PSMS) by Lawton and Brody and on cognition with the Mini-Mental State Examination (MMSE) and the Clock-Drawing Test (CDT). Physical health was determined based on information regarding falls and weight loss and an assessment of each patient’s general medical condition. The treating physician evaluated current suicidality in a comprehensive and standardized way. Results: Higher GAI scores were significantly associated with scores on the MADRS (β = 0.233, p = 0.002) and suicidality (β = 0.206, p = 0.006). Levels of physical or cognitive functioning were not associated with the GAI score. Conclusion: The severity of anxiety symptoms was associated with the severity of depression and suicidality in older adults with depressive disorders. The results could indicate a need to focus greater attention on the treatment of anxiety and suicidality in older patients with depression.

scholarly journals Development and reliability of a structured interview guide for the Montgomery-Åsberg Depression Rating Scale (SIGMA)

2008 ◽  
Vol 192 (1) ◽  
pp. 52-58 ◽  
Author(s):  
Janet B. W. Williams ◽  
Kenneth A. Kobak
Keyword(s):  
Clinical Trials ◽  
Treatment Efficacy ◽  
Interrater Reliability ◽  
Rating Scale ◽  
High Reliability ◽  
Intraclass Correlation ◽  
Structured Interview ◽  
Interview Guide ◽  
Test Retest Reliability ◽  
Improve Reliability

BackgroundThe Montgomery-Åsberg Depression Rating Scale (MADRS) is often used in clinical trials to select patients and to assess treatment efficacy. The scale was originally published without suggested questions for clinicians to use in gathering the information necessary to rate the items. Structured and semi-structured interview guides have been found to improve reliability with other scales.AimsTo describe the development and test-retest reliability of a structured interview guide for the MADRS (SIGMA).MethodA total of 162 test-retest interviews were conducted by 81 rater pairs. Each patient was interviewed twice, once by each rater conducting an independent interview.ResultsThe intraclass correlation for total score between raters using the SIGMA was r = 0.93, P < 0.0001. All ten items had good to excellent interrater reliability.ConclusionsUse of the SIGMA can result in high reliability of MADRS scores in evaluating patients with depression.

Reliability and validity of a structured interview guide for the Hamilton Anxiety Rating Scale (SIGH-A)

2001 ◽  
Vol 13 (4) ◽  
pp. 166-178 ◽  
Author(s):  
M. Katherine Shear ◽  
Joni Vander Bilt ◽  
Paola Rucci ◽  
Jean Endicott ◽  
Bruce Lydiard ◽  
...  
Keyword(s):  
Rating Scale ◽  
Reliability And Validity ◽  
Structured Interview ◽  
Interview Guide ◽  
Hamilton Anxiety Rating Scale ◽  
Hamilton Anxiety

scholarly journals Takotsubo Syndrome is Associated with Mood Disorders and Antidepressants Use, not with Anxiety and Impairment of Quality of Life Due to the Psychiatric Disorder

2018 ◽  
Vol 14 (1) ◽  
pp. 26-32 ◽  
Author(s):  
F. Sancassiani ◽  
Mauro G. Carta ◽  
Roberta Montisci ◽  
Antonio Preti ◽  
Sergio Machado ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Psychiatric Disorder ◽  
Mood Disorder ◽  
Mood Disorders ◽  
Depressive Disorders ◽  
Statistical Significance ◽  
Structured Interview ◽  
Icd 10 ◽  
Major Depressive Disorders

Background: The aim was to study the association between mood and anxiety disorders and the Tako-Tsubo Syndrome (TTS) and to determine the role of antidepressants and the impairment of quality of life due the comorbid psychiatric disorder. Methods: Case-control study: 19 consecutive patients (17 female) with TTS compared to 76 controls without TTS, were randomly selected from the database of a nationwide epidemiological study after matching (gender, age and residence) by controls. Psychiatric diagnoses were carried out according to the ICD-10 using semi-structured interview tools (ANTAS-SCID) administered by clinical staff. Quality of Life (Qol) was assessed by means of SF-12. Results: Only Major Depressive Disorders (MDD) showed higher frequencies in cases with statistical significance difference (p=0.014) as well as at least one Mood Disorder Diagnosis [MDD or BD] (p=0.002). The lifetime prevalence of at least one anxiety disorder with no comorbid mood disorder did not show a higher frequency in cases (p=0.57). The score at SF-12 in the TTS group was similar to those of controls (p=0.71)In the TTS group, the score at SF-12 in people with one mood or anxiety diagnosis (N=7) was similar to those without mood or anxiety diagnosis (p=0.75). The use of antidepressants was higher in TTS group (15.79% vs 1.31%; p=0.030). Conclusion: The study shows an association between TTS with depressive disorders and antidepressants use and does not confirm the association with anxiety syndromes. The study suggests the need to investigate the possible interactions between antidepressants use and mood disorders in studies with appropriate design and sample size.

scholarly journals Ischemic stroke and depression

2003 ◽  
Vol 9 (3) ◽  
pp. 429-439 ◽  
Author(s):  
DAVID W. DESMOND ◽  
ROBERT H. REMIEN ◽  
JOAN T. MORONEY ◽  
YAAKOV STERN ◽  
MARY SANO ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Rating Scale ◽  
Patient Characteristics ◽  
Structured Interview ◽  
Small Sample ◽  
Control Subjects ◽  
Functional Assessments ◽  
Interview Guide ◽  
History Of ◽  
Small Sample Sizes

Previous studies of depression after stroke have reported widely variable findings, possibly due to differences between studies in patient characteristics and methods for the assessment of depression, small sample sizes, and the failure to examine stroke-free reference groups to determine the base rate of depression in the general population. In an effort to address certain of those methodologic issues and further investigate the frequency and clinical determinants of depression after stroke, we administered the Structured Interview Guide for the Hamilton Depression Rating Scale (SIGH–D) and neurological, neuropsychological, and functional assessments to 421 patients (age = 71.5 ± 8.0 years) 3 months after ischemic stroke and 249 stroke-free control subjects (age = 70.8 ± 6.7 years). We required a SIGH–D total score > 11 for the identification of depression. We found that depression was less frequent (47/421 patients, or 11.2%, and 13/249 control subjects, or 5.2%), less severe, and less persistent in our stroke cohort than previously reported, possibly due to the underrepresentation of patients with a premorbid history of affective illness. Depression was associated with more severe stroke, particularly in vascular territories that supply limbic structures; dementia; and female sex. SIGH–D item analyses suggested that a reliance on nonsomatic rather than somatic symptoms would result in the most accurate diagnoses of depression after ischemic stroke. (JINS, 2003, 9, 429–439.)

scholarly journals OP0215 FUNCTIONAL ABILITIES IMPROVEMENT IN RHEUMATOID ARTHRITIS PATIENTS WITH DEPRESSIVE AND ANXIETY DISORDERS TREATED WITH BIOLOGIC DMARDS AND/OR ANTIDEPRESSANTS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 133.1-134
Author(s):  
A. Abramkin ◽  
T. Lisitsyna ◽  
D. Veltishchev ◽  
O. Seravina ◽  
O. Kovalevskaya ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Depressive Disorders ◽  
Functional Disability ◽  
Rating Scale ◽  
Functional Limitations ◽  
Health Assessment ◽  
Structured Interview ◽  
Functional Abilities ◽  
Biologic Dmards ◽  
Group 1

Background:Anxiety and depressive disorders (ADD) significantly increase functional limitations in patients with rheumatoid arthritis (RA). Successful psychopharmacotherapy (PPT) of ADD can potentially improve the functional abilities of RA-patients.Objectives:To compare changes in functional disability of RA patients with comorbid ADD treated with conventional disease-modifying antirheumatic drugs (cDMARDs) alone or in combination with biologic DMARDs (bDMARDs) and/or PPT.Methods:128 RA-patients (pts) were enrolled, 86% were women with a mean age of 47,4±11,3 (M±SD) yrs. All patients met the full ACR/EULAR 2010 criteria for RA. Functional limitations were assessed using Health Assessment Questionnaire (HAQ), mean HAQ was 1,42±0,78 at baseline. 69,4% RA-pts were already taking prednisone (9 [5; 10] mg/day (Me (25%; 75%)), 84,4% - cDMARDs, 7,8% - bDMARDs (anti-TNF-α – 6,3%, rituximab – 1,6%). ADD were diagnosed by psychiatrist in 123 (96,1%) of RA-pts in accordance with ICD-10 in semi-structured interview. Severity of depression and anxiety was evaluated with Montgomery–Asberg Depression Rating Scale (MADRS) and Hamilton Anxiety Rating Scale (HAM-A). RA-pts with ADD were divided into the following treatment groups: 1 – сDMARDs (n=39), 2 – сDMARDs + PPT (sertraline or mianserine) (n=43), 3 – сDMARDs + bDMARDs (n=32), 4 – сDMARDs + bDMARDs + PPT (sertraline or mianserine) (n=9). Biologics treatment duration varied from 1 to 6 years, antidepressants – from 6 to 96 weeks.Results:HAQ scores were high in all 4 groups at baseline and after five years remained high in all groups except group 2 with the lowest endpoint scores among 4 groups (table 1). To measure changes in HAQ scores between groups we compared the differences between baseline and endpoint HAQ scores (Δ HAQ = endpoint HAQ – baseline HAQ) (table 2). The table shows an improvement in HAQ scores in groups 2 and 3, no significant changes in group 4 and a worsening of HAQ scores in group 1. HAQ scores in groups 2 and 3 significantly improved compared to group 1.Table 1Mean HAQ scores in RA patients with ADD at baseline and after 5 years, by groups.GroupsAt baseline (n=128)After 5 years (n=83)P between time points1 (cDMARDs), n=391,39±0,751,61±0,7>0,052 (сDMARDs + PPT), n=431,42±0,90,85±0,660,0113 (сDMARDs + bDMARDs), n=321,58±0,761,36±0,71>0,054 (сDMARDs + bDMARDs + PPT), n=91,38±0,831,49±0,26>0,05P between groups>0,05P2-1<0,001;P2-3=0,023P2-4=0,015Table 2.Differences between baseline and 5-years endpoint HAQ scores, by groupsсDMARDs, n=24сDMARDs + PPT, n=29сDMARDs + bDMARDs, n=21сDMARDs + bDMARDs +PPT, n=9p1234Δ HAQ0,23±0,49-0,3±0,42-0,28±0,940±0,82P1-2=0,002;P1-3=0,033Conclusion:Functional abilities measured by HAQ scores significantly improved in RA-patients with ADD receiving cDMARDs in combination with bDMARDs or PPT compared to cDMARDs only. The lowest HAQ scores were observed in patients receiving cDMARDs in combination with PPT.Disclosure of Interests:None declared

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