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.

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.

Escitalopram orally-disintegrating tablets (ODT) in major depression treatment

2016 ◽  
Vol 33 (S1) ◽  
pp. S158-S158
Author(s):  
M. Polikowska ◽  
B. Łoza
Keyword(s):  
Major Depression ◽  
Depressive Disorders ◽  
Rating Scale ◽  
Treatment Compliance ◽  
Well Being ◽  
Dropout Rate ◽  
Global Improvement ◽  
Orally Disintegrating Tablets ◽  
Long Term Treatment ◽  
Significant Difference

IntroductionThe growing rate of depressive disorders causes needs for more effective and more innovative solutions. The modern patients’ challenges make them fail mostly in the treatment compliance. Some reports have described that escitalopram orally disintegrating tablets (ODT) induce faster response and lower dropout rate than oral standard tablets (OST), although both forms have equal bioavailability.AimWe tried to clarify effectiveness rates between escitalopram ODT and OST treatments in depressive patients.MethodAn open-label, 6-month, randomized, flexible-dose study was conducted for direct comparison of the effects of escitalopram ODT (N16) and OST (N15) on dropout rate and clinical outcomes in patients with major depression.ResultsOutcome measures included Hamilton Depression Rating Scale (HDRS), Drug Attitude Inventory-10 (DAI), Clinical Global Improvement Scale (CGI), and Psychological General Well-Being Scale (PGWB). The tolerability was assessed by the UKU scale. No significant difference was found in HDRS, CGI, PGWB and GAF between the two forms of tablets. No significant difference was found in any tolerability rates. However, dropout rate favored escitalopram ODT group (N5, 31.3%) vs escitalopram OST (N7, 47.0%). DAI-10 outcomes, both in patients’ general attitude and subjective feelings, were significantly improved in ODT group (P = 0.000), comparing with OST.DiscussionEscitalopram in its classical form (OST) has become a leader in a group of antidepressants, thanks to safety of use, efficacy and tolerability. In the ODT form, escitalopram can meet additional needs, both clinical and lifestyle. ODT may reduce dropout rate and costs of long-term treatment improving the patients’ compliance.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The problematic use of social networking sites associates with elevated symptoms in patients with major depressive disorder

2020 ◽  
Vol 66 (5) ◽  
pp. 496-503 ◽  
Author(s):  
Orkun Aydin ◽  
Fikret Poyraz Çökmüş ◽  
Kuzeymen Balikçi ◽  
Didem Sücüllüoğlu-Dikici ◽  
Pınar Ünal-Aydin
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Depressive Disorder ◽  
Social Networking ◽  
Rating Scale ◽  
Health Workers ◽  
Well Being ◽  
Social Networking Site ◽  
Analysis Of Covariance ◽  
Major Depressive

Background: Although excessive use of social networking site (SNS) is related to undesired effects on healthy individual’s psychological well-being, there is a huge gap in studies performed with individuals who suffer from various mental disorders. Aim: The main goal of this study is to examine the association between problematic utilization of SNSs and depressive symptoms across patients diagnosed with major depressive disorder (MDD). Methods: 111 patients diagnosed with MDD (diagnoses confirmed via the Structured Clinical Interview for DSM-5–Clinician Version (SCID-5/CV)) and 108 healthy controls (HCs) were recruited for the study. Montgomery–Asberg Depression Rating Scale (MADRS) and Bergen Social Media Addiction Scale (BSMAS) were administered by both MDD and HC groups. Group comparisons were estimated with multivariate analysis of covariance (MANCOVA) analyses. To identify the relationship between SNS addiction and depressive symptoms, the Pearson correlations were performed, and finally, we computed the multiple linear regression analyses to determine whether SNS addiction predicts depressive symptoms. Results: The results revealed that MDD group is more addicted to SNS relative to HC. In addition, depressive symptoms were significantly predicted by ‘relapse’ subdimension and the overall score of SNS addiction in the MDD group. Conclusion: Our study illustrated the detrimental effects of excessive SNSs usage on depressive symptoms in MDD particularly for the individuals in ‘relapse’ state of SNS addiction. The mental health workers should consider the usage patterns of SNSs in patients diagnosed with MDD during their clinical observation and management.

scholarly journals Antidepressant Prophylaxis Reduces Depression Risk but Does Not Improve Sustained Virological Response in Hepatitis C Patients Receiving Interferon Without Depression at Baseline: A Systematic Review and Meta-Analysis

2013 ◽  
Vol 27 (10) ◽  
pp. 575-581 ◽  
Author(s):  
Awad Al-Omari ◽  
Juthaporn Cowan ◽  
Lucy Turner ◽  
Curtis Cooper
Keyword(s):  
Depressive Symptoms ◽  
Hepatitis C ◽  
Antiviral Therapy ◽  
Sustained Virological Response ◽  
Risk Ratio ◽  
Virological Response ◽  
Randomized Clinical Trials ◽  
Rating Scale ◽  
Antiviral Treatment ◽  
Well Being

BACKGROUND: Depression complicates interferon-based hepatitis C virus (HCV) antiviral therapy in 10% to 40% of cases, and diminishes patient well-being and ability to complete a full course of therapy. As a consequence, the likelihood of achieving a sustained virological response (SVR [ie, permanent viral eradication]) is reduced.OBJECTIVE: To systematically review the evidence of whether preemptive antidepressant prophylaxis started before HCV antiviral initiation is beneficial.METHODS: Inclusion was restricted to randomized controlled trials in which prophylactic antidepressant therapy was started at least two weeks before the initiation of HCV antiviral treatment. Studies pertaining to patients with active or recent depressive symptoms before commencing HCV antiviral therapy were excluded. English language articles from 1946 to July 2012 were included. The MEDLINE, Embase and Cochrane Central databases were searched. Where possible, meta-analyses were conducted evaluating the effect of antidepressant prophylaxis on SVR and major depression as well as on Montgomery-Asberg Depression Rating Scale and Beck Depression Index scores at four, 12 and 24 weeks. The Cochrane Collaboration tool was used to assess bias risk.RESULTS: Six randomized clinical trials involving 522 patients met the inclusion criteria. Although the frequency of on-treatment clinical depression was decreased with antidepressant prophylaxis (risk ratio 0.60 [95% CI 0.38 to 0.93]; P=0.02; I2=24%), no benefit to SVR was identified (risk ratio 1.08 [95% CI 0.74 to 1.57]; P=0.69; I2=58%).CONCLUSION: This practice is not justified to improve SVR in populations free of active depressive symptoms leading up to HCV antiviral therapy.

scholarly journals Quality of life in isolated dystonia: non-motor manifestations matter

2021 ◽  
pp. jnnp-2020-325193 ◽  
Author(s):  
Johanna Junker ◽  
Brian D Berman ◽  
James Hall ◽  
Deena W Wahba ◽  
Valerie Brandt ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Social Anxiety ◽  
Physical Functioning ◽  
Rating Scale ◽  
Depression Scale ◽  
Standard Of Care ◽  
Well Being ◽  
Current Standard

ObjectiveTo evaluate the relationship between health-related quality of life (HR-QoL) and both physical and psychiatric factors in a large, international, multicentre cohort of patients with isolated dystonia, the Dystonia Coalition.MethodsNatural history data from 603 patients with isolated dystonia (median age 57 years (IQR: 48 to 64 years), 67.0% women) were prospectively acquired and analysed. HR-QoL (RAND 36-Item Health Survey), severity of depressive symptoms, generalised anxiety (Hospital Anxiety and Depression Scale) and social anxiety (Liebowitz Social Anxiety Scale) were assessed. Dystonia severity (Burke-Fahn-Marsden Dystonia Rating Scale) and dystonic tremor were examined. Statistical predictors of HR-QoL were calculated using saturated path analysis.ResultsReduced HR-QoL was strongly associated with the degree of depressive symptoms and generalised and social anxiety (8/8 RAND 36 subscales, p≤0.001). Increased dystonia severity was associated with worse physical functioning, physical and emotional role functioning and social functioning (all p≤0.001). The presence of tremor correlated with worse physical functioning and pain (all p≤0.006). Younger age was associated with reduced emotional well-being and vitality (all p≤0.006). There were no HR-QoL differences between sexes.ConclusionHR-QoL in isolated dystonia is strongly associated with psychiatric and physical features. While current standard of care focus on motor aspects of dystonia, comprehensive care should address both physical and mental aspects of health.

scholarly journals Breathing-focused Yoga as Augmentation for Unipolar and Bipolar Depression: A Randomized Controlled Trial: Le yoga axé sur la respiration comme traitement d’appoint pour la dépression unipolaire et bipolaire: Un essai randomisé contrôlé

2020 ◽  
pp. 070674372094053
Author(s):  
Arun V. Ravindran ◽  
Martha S. McKay ◽  
Tricia da Silva ◽  
Claudia Tindall ◽  
Tiffany Garfinkel ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Rating Scale ◽  
Bipolar Depression ◽  
Controlled Trial ◽  
Well Being ◽  
Mood Stabilizers ◽  
Adjunctive Treatment ◽  
Residual Symptoms ◽  
Significant Difference ◽  
Bipolar Patients

Objective: Patients with depression frequently experience persistent residual symptoms even with optimal interventions. These patients often use complementary treatments, including yoga, as a preferred alternative or adjunctive treatment. There is evidence for the benefit of yoga for depression, but this has not been rigorously evaluated, particularly in bipolar depression. We aimed to determine the feasibility and benefit of manualized breathing-focused yoga in comparison to psychoeducation as augmentation to pharmacotherapy for improving residual symptoms of depression in unipolar and bipolar patients. Methods: Using a randomized single-blind crossover design, 72 outpatients with unipolar or bipolar depression were augmented with the two 8-week interventions at separate times, as add-ons to current first-line antidepressants and mood stabilizers. The primary outcome measure was the Montgomery-Åsberg Depression Rating Scale (MADRS). Due to the high dropout of participants after crossover at Week 8, analysis focused on between-group comparisons of yoga and psychoeducation during the initial 8 weeks of the study. Results: There was a significant decline in depressive symptoms, as measured by the MADRS, following 8 weeks of yoga. However, there was no significant difference in MADRS ratings between intervention groups. Similar improvements in self-rated depressive symptoms and well-being were also observed across time. Conclusions: Both yoga and psychoeducation may improve residual symptoms of unipolar and bipolar depression as add-on to medications. In-class group sessions and long study durations may reduce feasibility for this population. Larger trials with parallel group design and shorter duration may be more feasible.

scholarly journals Elderly people´s definition of quality of life

2003 ◽  
Vol 25 (1) ◽  
pp. 31-39 ◽  
Author(s):  
Flávio M F Xavier ◽  
Marcos P T Ferraz ◽  
Norton Marc ◽  
Norma U Escosteguy ◽  
Emílio H Moriguchi
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Elderly People ◽  
Rating Scale ◽  
Life Quality ◽  
Well Being ◽  
Elderly Subjects ◽  
Negative Experience ◽  
Positive Quality

OBJECTIVES: Senescence for some elderly people is a phase of with development and satisfaction, whereas for others is a negative stage of life. The determinants of a good quality of life in old age vary from person to person. The aims of this study were to identify: 1) the prevalence of octogenarian people who evaluate their current life as being mainly characterized by a positive quality and 2) which were the domains that they identified as being the determinants of this positive quality. A same parallel study was conducted with subjects who evaluated senescence as a preponderantly negative experience. METHODS: A random and representative sample of 35% of the octogenarian people, living residing in the community, was selected among the dwellers of the city of Veranópolis, state of Rio Grande do Sul. A semi-structured questionnaire on quality of life quality was applied as well as the scale of depressive symptoms Geriatric Depression Scale (GDS) and the index of general health Cumulative Illness Rating Scale (CIRS). RESULTS: Slightly more than half of the studied sample (57%) defined their current quality of life with positive evaluations, whereas 18% presented a negative evaluation of it. A group 0f 25% defined their current lives as neutral or having both values (positive and negative). Those who were dissatisfied presented more health problems according to the CIRS and more depressive symptoms when evaluated by the GDS. Satisfied subjects ones had different reasons to justify this state, however, the dissatisfied had mainly the lack of health as a reason for their suffering. The main source of reported daily well-being was the involvement with rural or domestic activities. Among the interviewed, lack of health was the main source for not presenting well-being, although there was interpersonal variability regarding what each subject considered as loss of health. CONCLUSION: Possibly, for the elderly subjects a negative quality of life is equivalent to loss of health and a positive life quality is equivalent to a greater range of categories such as activity, income, social life and relationship with the family, categories which differed from subject to subject. Therefore, health seems to be a good indicator of negative quality of life, though an insufficient indicator of successful elderliness.

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.

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.

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