Anhedonia: a neglected symptom of psychopathology

1993 ◽  
Vol 23 (4) ◽  
pp. 957-966 ◽  
Author(s):  
Philip Snaith
Keyword(s):  
Depressive Disorders ◽  
Rating Scales ◽  
Antidepressant Drugs ◽  
Endogenous Depression ◽  
Depressive Illness ◽  
Point Of View ◽  
Psychiatric Research ◽  
Biological Research ◽  
The 1960S ◽  
Definition Of

SynopsisIn the last century psychopathologists attached importance to the concept of anhedonia, the loss of ability to experience pleasure. Its role in the diagnosis of melancholia was considered to be crucial. In the present century attention to anhedonia has faded, possibly because of the focus upon depressed mood as the pathognomonic feature of depressive disorders. Research on the symptomatology of endogenous depression did not include the concept; anhedonia was also lacking from the major instruments of psychiatric research, the depression rating scales,Attention was drawn to anhedonia by two authors: by Meehl in the 1960s and by Klein in the 1970s. Meehl considered anhedonia from the point of view of a personality defect predisposing to mental illness; and Klein regarded anhedonia to be a symptom of depressive illness and probably the best clinical marker predicting response to antidepressant drugs.In 1980 the revised DSM presented the concept of ‘loss of interest or pleasure’ as one of the two cardinal symptoms of major depression. Since then there has been a gradual recovery of emphasis although many systems confuse the two concepts of‘loss of interest’ and anhedonia. It is possible that anhedonia may provide the key to a more exact delineation of depressive disorders in biological research and in clinical practice. Further research will depend upon a more precise, cross-nationally agreed definition of the concept and the means of its assessment.

A Treatment Outline for Depressive Disorders

1983 ◽  
Vol 17 (2) ◽  
pp. 129-146 ◽  
Keyword(s):  
Quality Assurance ◽  
Treatment Outcome ◽  
Electroconvulsive Therapy ◽  
Depressive Disorders ◽  
Meta Analysis ◽  
Antidepressant Drugs ◽  
Endogenous Depression ◽  
Government Support ◽  
Sources Of Information ◽  
Quality Assurance Project

With College and Government support the Quality Assurance Project is developing a series of explicit and detailed treatment outlines of major psychiatric disorders for use in peer review. Three sources of information are used: a meta-analysis of the treatment outcome literature, the opinions of a sample of practising psychiatrists and the views of a panel of nominated experts. The present outline concerns the treatment of depressive disorders. The three sources of information were in agreement that tricyclic and allied antidepressants were the treatments of choice for endogenous depression and were also to be considered in persistent neurotic depressions. Electroconvulsive therapy was recommended in patients with endogenous depression who were severely ill, troubled by hallucinations and delusions or for whom the antidepressant drugs had not proven effective. The psychotherapies, both dynamic and behavioural, were regarded as the treatments of choice in neurotic depression.

scholarly journals Differentiated approach and indications for optimization of agomelatine therapy for endogenous depression

2019 ◽  
Vol 11 (2) ◽  
pp. 71-77
Author(s):  
L. I. Abramova ◽  
G. P. Panteleeva ◽  
I. Yu. Nikiforova ◽  
T. E. Novozhenova
Keyword(s):  
Depressive Disorders ◽  
Rating Scales ◽  
Rating Scale ◽  
Treatment Cycle ◽  
Endogenous Depression ◽  
Good Effect ◽  
Antidepressant Effect ◽  
Antidepressive Effect ◽  
Wide Range ◽  
Days Of Therapy

Objective: to develop and justify differentiated indications for the use of agomelatine (valdoxan) to treat the typological variants of endogenous depressions with varying severity on the basis of an analysis of its therapeutic efficacy.Patients and methods. An open prospective study was conducted using the clinical, psychopathological, and psychometric rating scales: the Hamilton Depression Rating Scale (HAMD-21); Udvalg for Kliniske Undersњgelser Scale (UKU); the Snaith-Hamilton Pleasure Scale (SHAPS) for assessing anhedonic disorders, and statistical methods. Examinations were made in 56 patients (mean age, 34.9 years) with moderate and severe endogenous depression within affective psychosis (n=42) and shift-like schizophrenia (n=14) (ICD-10 items F31.3–4; F32.1–2, and F33.1–2). The patients received a cycle treatment with agomelatine (valdoxan) 25–50 mg once a day in the evening for 4–8 weeks. The patients' status was evaluated over time on fixed days from a reduction in the mean total score (MTS) of the respective scales as insignificant (less than 19% reduction in disorders), moderate (20–49%), good (50–69%), and excellent (70% or more) effects. The effect of agomelatine was analyzed in two patient groups. The specific features of the antidepressive effect and its dynamics in the presence of endogenous depressions of different typologies (melancholic, anxious, and adynamic depressions) were studied in Group 1 (n=26); the effect of agomelatine on anhedonic endogenous depressions and manifestations of anhedonia in different mental activity areas (interests, social activity, emotional engagement and eating/drinking) was investigated in Group 2 (n=30).Results and discussion. There was a good tolerance and a high antidepressant activity of agomelatine during its treatment cycle for moderate and severe endogenous depressions. A significant improvement (an 84.4% reduction in HAMD-21 MTS) was noted in patients at 3 and 4 weeks of the treatment cycle and consistently persisted at a subsequent follow-up. Agomelatine showed a good effect (a 50% or more reduction in HAMD-21 MTS) just at 14 days of therapy. The drug was observed to have a balanced antidepressant effect, significant thymoleptic, stimulant, anxiolytic, and antianhedonic activities (reductions in the MTS of depressive disorders by 90.83, 84.9, 82.39, and 78.9%, respectively).Conclusion. The universal spectrum of the antidepressive effect of agomelatine, its good tolerability, high efficacy, and rapid improvement makes it the drug of choice in treating a wide range of psychopathological endogenous depressions: melancholic, apatho-adynamic, anxious, and anhedonic ones.

Beyond the monoamine hypothesis: mechanisms, molecules and methods

2002 ◽  
Vol 17 (S3) ◽  
pp. 294s-299s ◽  
Author(s):  
I. Hindmarch
Keyword(s):  
Tricyclic Antidepressants ◽  
Rating Scales ◽  
Stress Disorder ◽  
Antidepressant Drugs ◽  
Antidepressant Activity ◽  
Hippocampal Volume ◽  
Depressive Illness ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Noradrenaline Levels

SummaryThe first effective antidepressants (monoamine oxidase inhibitors and tricyclic antidepressants) relied on their ability to augment serotonin and noradrenaline levels at the synapse. Forty years later, the same biological model led to the supremacy of the serotonergic hypothesis to explain not only the pathophysiology of depressive illness, but also the neuropharmacological basis for obsessive compulsive disorder, phobias, posttraumatic stress disorder, and even generalized anxiety disorder. It could be argued that the blinkered view of depression as a solely serotonergic phenomenon has not only restrained and limited research into other potential systems, but has also slowed down the discovery of putative antidepressant drugs. While some might argue that the hypothalamic-pituitary-adrenal (HPA) axis explains an individual’s sensitivity to depression, there are others who equally claim that the most likely explanations are to be found in the neuropsychopharmacology of the immune system or even through reductions in hippocampal volume. There is a richness of possibilities regarding the mechanisms for antidepressant activity embracing theoretical, pharmacological and clinical data. However, the methods by which putative antidepressants are assessed and their clinical efficacy demonstrated are not always robust. That current clinical comparisons of antidepressants rarely show major differences in efficacy between existing molecules could be taken as an indication that “all drugs are the same” or perhaps, more insightfully, as an indication that the ubiquitous Hamilton depression (HAM-D) rating scales are not sensitive to inter-drug differences, even though pronounced pharmacodynamic differences between molecules are easily demonstrated. Any advances in the development of new antidepressants will have to find not only original compounds but also unique psychometric tests by which the drugs can be assessed in a sensitive, reliable, and valid manner.

scholarly journals Proposal of Methodology for Technical Inspection and Rehabilitation Intervention for Multi-family Building of the 60’s in Portugal

2020 ◽  
Author(s):  
Inês Marcelino ◽  
João Lanzinha
Keyword(s):  
Point Of View ◽  
Thermal Regulation ◽  
Second Phase ◽  
Existing Buildings ◽  
Technical Inspection ◽  
The Common ◽  
Family Building ◽  
The 1960S ◽  
Definition Of

The rehabilitation of old buildings has been increasing over the last few years due to the lack of maintenance and there is an advanced degradation of the Portuguese built park. This sector of the civil construction has as objective the full reutilization of the existing buildings maintaining its identity. Since Portugal has a large percentage of buildings where it is possible to identify constructive times that accompanied the implementation of different trends and technological evolutions, defining differentiated strategies for intervention. The 1960s deserve some prominence in Portugal because it is composed of a significant set of buildings with reticulated structure in reinforced concrete and without concerns from the point of view of thermal behaviour, which are now inhabited mainly by elderly people, often residing alone. The following work aims to present a methodology proposal and apply it to a case study. The proposed methodology includes the detailed inspection of a building from the 60s in Covilhã, the consultation of residents and the definition of intervention proposals based on the main nonconformities detected. In the first stage, a detailed analysis of the existing situation is proposed, which includes a technical inspection report on the common parts and the different fractions of the building and a survey of residents in order to know their opinions and expectations regarding the work to be carried out. In the second phase we propose a set of measurements, the realization thermograms and the thermal analysis of the different habitable fractions of the building based on the current thermal regulation. After analysing all the data collected, the intervention proposals are defined according to the needs of the building and the residents, in a phased way and with the aim of creating better accessibility, comfort and use conditions.

The Genetics of Depression and Manic-Depressive Disorder

1989 ◽  
Vol 155 (3) ◽  
pp. 294-304 ◽  
Author(s):  
Peter McGuffin ◽  
Randy Katz
Keyword(s):  
Depressive Disorder ◽  
Family Environment ◽  
Depressive Disorders ◽  
Familial Aggregation ◽  
Unipolar Depression ◽  
Endogenous Depression ◽  
Depressive Illness ◽  
Manic Depressive Illness ◽  
Familial Predisposition ◽  
Manic Depressive

Depressive disorders are more common in the relatives of depressed probands than in the population at large, and there is compelling evidence that the familial aggregation of bipolar disorder and severe unipolar depression is at least partly due to genetic factors. However, the evidence concerning ‘non-endogenous' depression is less clear, and family environment probably plays a stronger role. Much current research is focused on two areas: firstly, the mode of inheritance of manic-depressive illness, with the use of molecular biological techniques to detect and localise major genes; and secondly, the ways in which familial predisposition and environmental insults combine to produce depressive disorder.

Understanding functional illiteracy from a policy, adult education, and cognition point of view: Towards a joint referent framework

2019 ◽  
Vol 30 (2) ◽  
pp. 109-122
Author(s):  
Aleksandar Bulajić ◽  
Miomir Despotović ◽  
Thomas Lachmann
Keyword(s):  
Adult Education ◽  
Operational Definition ◽  
Literacy Skills ◽  
Point Of View ◽  
Industrialized Countries ◽  
Functional Illiteracy ◽  
Scale Levels ◽  
Components Of Reading ◽  
The One ◽  
Definition Of

Abstract. The article discusses the emergence of a functional literacy construct and the rediscovery of illiteracy in industrialized countries during the second half of the 20th century. It offers a short explanation of how the construct evolved over time. In addition, it explores how functional (il)literacy is conceived differently by research discourses of cognitive and neural studies, on the one hand, and by prescriptive and normative international policy documents and adult education, on the other hand. Furthermore, it analyses how literacy skills surveys such as the Level One Study (leo.) or the PIAAC may help to bridge the gap between cognitive and more practical and educational approaches to literacy, the goal being to place the functional illiteracy (FI) construct within its existing scale levels. It also sheds more light on the way in which FI can be perceived in terms of different cognitive processes and underlying components of reading. By building on the previous work of other authors and previous definitions, the article brings together different views of FI and offers a perspective for a needed operational definition of the concept, which would be an appropriate reference point for future educational, political, and scientific utilization.

Ways and Voices in the Psychoanalysis of Links According to Enrique Pichon-Rivière

2016 ◽  
Vol 6 (2) ◽  
Author(s):  
Rosa Jaitin
Keyword(s):  
Couple Therapy ◽  
Clinical Observation ◽  
Clinical Work ◽  
The Core ◽  
The Social ◽  
The 1960S ◽  
Definition Of ◽  
Relationship Of ◽  
The Voice ◽  
Different Levels

This article covers several stages of the work of Pichon-Rivière. In the 1950s he introduced the hypothesis of "the link as a four way relationship" (of reciprocal love and hate) between the baby and the mother. Clinical work with psychosis and psychosomatic disorders prompted him to examine how mental illness arises; its areas of expression, the degree of symbolisation, and the different fields of clinical observation. From the 1960s onwards, his experience with groups and families led him to explore a second path leading to "the voices of the link"—the voice of the internal family sub-group, and the place of the social and cultural voice where the link develops. This brought him to the definition of the link as a "bi-corporal and tri-personal structure". The author brings together the different levels of the analysis of the link, using as a clinical example the process of a psychoanalytic couple therapy with second generation descendants of a genocide within the limits of the transferential and countertransferential field. Body language (the core of the transgenerational link) and the couple's absences and presence during sessions create a rhythm that gives rise to an illusion, ultimately transforming the intersubjective link between the partners in the couple and with the analyst.

Dosimetry and optimization in digital radiography based on the contrast-detail resolution

2018 ◽  
Vol 6 (3) ◽  
Author(s):  
Wilson Otto Gomes Batista ◽  
Alexandre Gomes De Carvalho
Keyword(s):  
Image Quality ◽  
Inverse Image ◽  
Point Of View ◽  
Complete Analysis ◽  
Portable Devices ◽  
Evaluation Tool ◽  
Air Kerma ◽  
Direct Radiography ◽  
Definition Of ◽  
Entrance Surface Air Kerma

Contrast-detail (C-D) curves are useful in evaluating the radiographic image quality in a global way. The objective of the present study was to obtain the C-D curves and the inverse image quality figure. Both of these parameters were used as an evaluation tool for abdominal and chest imaging protocols. The C-D curves were obtained with the phantom CDRAD 2.0 in computerized radiography and the direct radiography systems (including portable devices). The protocols were 90 and 102 kV in the range of 2 to 20 mAs for the chest and 80 kV in the range of 10 to 80 mAs for the abdomen. The incident air kerma values were evaluated with a solid state sensor. The analysis of these C-D curves help to identify which technique would allow a lower value of the entrance surface air kerma, Ke, while maintaining the image quality from the point of view of C-D detectability. The results showed that the inverse image quality figure, IQFinv, varied little throughout the range of mAs, while the value of Ke varied linearly directly with the mAs values. Also, the complete analysis of the curves indicated that there was an increase in the definition of the details with increasing mAs. It can be concluded that, in the transition phase for the use of the new receptors, it is necessary to evaluate and adjust the practised protocols to ensure, at a minimum, the same levels of the image quality, taking into account the aspects of the radiation protection of the patient.

DIRECTIONS OF ASSOCIATIVE IDENTIFICATION OF PERSONAL NAMES

2019 ◽  
Vol 18 (28) ◽  
pp. 118-128
Author(s):  
Olena Karpenko ◽  
Tetiana Stoianova
Keyword(s):  
Proper Names ◽  
Mental Lexicon ◽  
Point Of View ◽  
Sound Symbolism ◽  
Personal Names ◽  
Communicative Process ◽  
Proper Name ◽  
Definition Of ◽  
Scientific Value ◽  
The Brain

The article is devoted to the study of personal names from a cognitive point of view. The study is based on the cognitive concept that speech actually exists not in the speech, not in linguistic writings and dictionaries, but in consciousness, in the mental lexicon, in the language of the brain. The conditions for identifying personal names can encompass not only the context, encyclopedias, and reference books, but also the sound form of the word. In the communicative process, during a free associative experiment, which included a name and a recipient’s mental lexicon. The recipient was assigned a task to quickly give some association to the name. The aggregate of a certain number of reactions of different recipients forms the associative field of a proper name. The associative experiment creates the best conditions for identifying the lexeme. The definition of a monosemantic personal name primarily includes the search of what it denotes, while during the process of identifying a polysemantic personal name recipients tend have different reactions. Scientific value is posed by the effect of the choice of letters for the name, sound symbolism, etc. The following belong to the generalized forms of identification: usage of a hyperonym; synonyms and periphrases or simple descriptions; associations denoting the whole (name stimulus) by reference to its part (associatives); cognitive structures such as “stimulus — association” and “whole (stimulus) — part (associative)”; lack of adjacency; mysterious associations. The topicality of the study is determined by its perspective to identify the directions of associative identification of proper names, which is one of the branches of cognitive onomastics. The purpose of the study is to identify, review, and highlight the directions of associative identification of proper names; the object of the research is the names in their entirety and variety; its subject is the existence of names in the mental lexicon, which determines the need for singling out the directions for the associative identification of the personal names.

DEFINITION OF THE PUBLIC SECURITY AND ORDERLINESS ENSURING MECHANISM IN UKRAINE

2018 ◽  
Vol 1 (11) ◽  
pp. 155-163
Author(s):  
Marina Aleksandrovna Kalievskaya
Keyword(s):  
Human Rights ◽  
Development Strategy ◽  
State Policy ◽  
The State ◽  
Point Of View ◽  
Public Security ◽  
National Priority ◽  
Institu Tions ◽  
Protection Of Human Rights ◽  
Definition Of

In this article, a model of the mechanism of ensuring public security and orderliness in accordance with the principles and tasks of the relevant institu- tions in public administration, taking into account resources, technologies, mea- sures for the state policy implementation in the spheres of ensuring the protection of human rights and freedoms, the interests of society and the state, combating crime, maintaining public security and order. It was found that ensuring public security and order in Ukraine is a mechanism for the implementation of national goals of state policy in the areas of ensuring the protection of human rights and freedoms, the interests of society and the state, combating crime, maintaining public security and order, by defining tasks according to certain principles. The idea is that if one considers the state policy in the spheres of ensuring the protec- tion of human rights and freedoms, the interests of society and the state, combat- ing crime, maintaining public security and order as a national priority (purpose, task), then the mechanism of ensuring public security and order in Ukraine needs coordination with the state development strategy. From the point of view of the implementation of the state policy in the areas of ensuring the protection of hu- man rights and freedoms, the interests of society and the state, combating crime, maintaining public security and order, the mechanism of ensuring public security and order in Ukraine can be considered as the main system providing intercon- nection such elements as institutions (implementing the specified state policy), resources (human resources, logistical, natural and so on, with the help of which it is possible to implement state policy), technologies (skills, knowledge, means and so on the implementation of state policy), measures (action plans), as well as external (internal) threats.

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