scholarly journals Predictors and moderators of time to remission of major depression with interpersonal psychotherapy and SSRI pharmacotherapy

2010 ◽  
Vol 41 (1) ◽  
pp. 151-162 ◽  
Author(s):  
E. Frank ◽  
G. B. Cassano ◽  
P. Rucci ◽  
W. K. Thompson ◽  
H. C. Kraemer ◽  
...  
Keyword(s):  
Major Depression ◽  
Social Adjustment ◽  
Rating Scales ◽  
Unipolar Depression ◽  
Interpersonal Psychotherapy ◽  
Self Report ◽  
Medical Centers ◽  
Academic Medical ◽  
The Social ◽  
Psychomotor Activation

BackgroundAlthough many studies suggest that, on average, depression-specific psychotherapy and antidepressant pharmacotherapy are efficacious, we know relatively little about which patients are more likely to respond to one versus the other. We sought to determine whether measures of spectrum psychopathology are useful in deciding which patients with unipolar depression should receive pharmacotherapy versus depression-specific psychotherapy.MethodA total of 318 adult out-patients with major depression were randomly assigned to escitalopram pharmacotherapy or interpersonal psychotherapy (IPT) at academic medical centers at Pittsburgh, Pennsylvania and Pisa, Italy. Our main focus was on predictors and moderators of time to remission on monotherapy at 12 weeks.ResultsParticipants with higher scores on the need for medical reassurance factor of the Panic–Agoraphobic Spectrum Self-Report (PAS-SR) had more rapid remission with IPT and those with lower scores on the psychomotor activation factor of the Mood Spectrum Self-Report (MOODS-SR) experienced more rapid remission with selective serotonin reuptake inhibitor (SSRI) pharmacotherapy. Non-specific predictors of longer time to remission with monotherapy included several panic spectrum and mood spectrum factors and the Social Phobia Spectrum (SHY) total score. Higher baseline scores on the 17- and 25-item Hamilton Depression Rating Scales (HAMD-17 and HAMD-25) and the Work and Social Adjustment Scale (WSAS) also predicted a longer time to remission, whereas being married predicted a shorter time to remission.ConclusionsThis exploratory study identified several non-specific predictors but few moderators of psychotherapy versus pharmacotherapy outcome. It offers useful indicators of the characteristics of patients that are generally difficult to treat, but only limited guidance as to who benefits from IPT versus SSRI pharmacotherapy.

Yesterday a Learner, Today a Teacher Too: Residents as Teachers in 2000

PEDIATRICS ◽  
2000 ◽  
Vol 105 (Supplement_2) ◽  
pp. 238-241
Author(s):  
Elizabeth H. Morrison ◽  
Janet Palmer Hafler
Keyword(s):  
Medical Students ◽  
Rating Scales ◽  
Clinical Teaching ◽  
Teaching Skills ◽  
Learning Needs ◽  
Educational Benefits ◽  
Medical Centers ◽  
Resident Physicians ◽  
Academic Medical ◽  
Rigorous Research

Resident physicians spend numerous hours every week teaching medical students and fellow residents, and only rarely are they taught how to teach. They can, however, be taught to teach more effectively. Teaching skills improvement initiatives for residents are taking a more prominent place in the educational literature. Limited evidence now suggests that better resident teachers mean better academic performance by learners. A small but important body of research supports selected interventions designed to improve residents' teaching skills, but not all studies have demonstrated significant educational benefits for learners. An increasing number of valid and reliable instruments are available to assess residents' clinical teaching, including objective structured teaching examinations and rating scales. In all specialties, rigorous research in evidence-based teacher training for residents will help prepare academic medical centers to meet the diverse and changing learning needs of today's physicians-in-training.resident physicians, medical students, fellow residents, teaching, graduate medical education.

Depression in Inpatients: Bipolar vs Unipolar

2003 ◽  
Vol 92 (3) ◽  
pp. 1031-1039 ◽  
Author(s):  
Stella Dorz ◽  
Giuseppe Borgherini ◽  
Donatella Conforti ◽  
Caterina Scarso ◽  
Guido Magni
Keyword(s):  
Social Support ◽  
Major Depression ◽  
Social Adjustment ◽  
Rating Scales ◽  
Rating Scale ◽  
Social Impairment ◽  
Symptom Checklist ◽  
Bipolar Patients ◽  
Hamilton Rating Scale ◽  
Social Adjustment Scale

162 depressed inpatients were divided into three diagnostic groups to compare patterns of sociodemographic characteristics, psychopathology, and psychosocial: 35 had a single episode of major depression, 96 had recurrent major depression, and 31 had a bipolar disorder. Psychopathology and psychosocial functioning were measured by clinician-rated scales, Montgomery-Asberg Depression Rating Scale, Hamilton Rating Scale for Depression, Clinical Global Impression, and self-rating scales, Symptom Checklist-90, Social Support Questionnaire, Social Adjustment Scale. The three groups were comparable on sociodemographic variables, with the exception of education. Univariate analyses showed a similar social impairment as measured by Social Support Questionnaire, Social Adjustment Scale, and no significant differences were recorded for the psychopathology when the total test scores (Montgomery-Asberg Depression Rating Scale, Hamilton Rating Scale for Depression, Clinical Global Index, Symptom Checklist-90) were evaluated. Some differences emerged for single items in the Montgomery-Asberg Depression Rating Scale and Symptom Checklist-90. These findings suggest a substantial similarity among the three groups. Results are discussed in terms of the clinical similarities between unipolar and bipolar patients during a depressive episode as well as the limitations of cross-sectional study implies.

scholarly journals Psychodramatic psychotherapy combined with pharmacotherapy in major depressive disorder: an open and naturalistic study

2006 ◽  
Vol 28 (1) ◽  
pp. 40-43
Author(s):  
Elisabeth Maria Sene Costa ◽  
Rosilda Antonio ◽  
Márcia Britto de Macedo Soares ◽  
Ricardo Alberto Moreno
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Social Adjustment ◽  
Depression Scale ◽  
Self Report ◽  
Control Group ◽  
Hamilton Depression Scale ◽  
Major Depressive ◽  
The Social ◽  
Social Adjustment Scale

OBJETIVE: Recent literature has highlighted the role of psychotherapy in the treatment of major depressive disorder. Combined therapies comprising both psychotherapy and pharmacotherapy have presented the best results. Although several kinds of psychotherapies have been studied in the treatment of depressive disorders, there remains a lack of data on psychodramatic psychotherapy in the treatment of major depressive disorder. The objective of this study was to evaluate the impact of psychodramatic psychotherapy (in a sample of major depressive disorder patients. METHOD: This is an open, naturalistic, controlled, non-randomized study. Twenty major depressive disorder patients (according to the DSM-IV criteria), under pharmacological treatment for depression, with Hamilton Depression Scale total scores between 7 and 20 (mild to moderate depression), were divided into two groups. Patients in the psychotherapeutic group took part in 4 individual and 24 structured psychodramatic group sessions, whilst subjects in the control group did not participate in this psychodramatic psychotherapy. Both groups were evaluated with the Social Adjustment Scale - Self Report and the Hamilton Depression Scale. RESULTS: Psychotherapeutic group patients showed a significant improvement according to the Social Adjustment Scale - Self Report and the Hamilton Depression Scale scores at endpoint, compared to those of the control group. CONCLUSIONS: Results suggest that individual and group psychodramatic psychotherapy, associated to pharmacological treatment, provides good clinical benefits in the treatment of major depressive disorder.

Social adjustment in generalised anxiety disorder: a long-term placebo-controlled study of venlafaxine extended release

2004 ◽  
Vol 19 (5) ◽  
pp. 272-279 ◽  
Author(s):  
Patrice Boyer ◽  
Vincent Mahé ◽  
David Hackett
Keyword(s):  
Anxiety Disorder ◽  
Social Adjustment ◽  
Extended Release ◽  
Social Impairment ◽  
Self Report ◽  
Controlled Study ◽  
Generalised Anxiety Disorder ◽  
Short Term Treatment ◽  
The Social

AbstractThe objective of this analysis was to evaluate the short- (8 weeks) and long-term (24 weeks) efficacy of three fixed doses of venlafaxine extended release (ER) and placebo on the social adjustment of patients with generalised anxiety disorder (GAD). We analysed data from 544 outpatients who participated in a 24-week, double-blind, multicentre, parallel-group, placebo-controlled study conducted at 55 centres in five countries. All patients meet the DSM-IV criteria for GAD and were randomly assigned to receive venlafaxine ER 37.5, 75, and 150 mg or matched placebo administered orally once daily. Social adjustment was measured using the Social Adjustment Scale-Self Report, which explores social adaptation in the areas of work, social and leisure, extended family, primary relationship (marital), parental, and family unit. At baseline, the GAD patients had a high level of social dysfunction. Venlafaxine ER showed a dose-related improvement in social impairment during short-term treatment and in sustaining this improvement over the long-term. In the most severely socially impaired subgroup, placebo remission rates on the HAM-A were low, and the magnitude of the venlafaxine-placebo difference on the mean HAM-A total score was high, reaching more than 7 points. The benefits of venlafaxine ER treatment of GAD extend beyond that of improvement of anxiety symptoms to a significant improvement in the impairment of functioning that is associated with the illness.

Reliability, validity and standardization of the Japanese version of the Social Adjustment Scale-Self Report

2003 ◽  
Vol 57 (4) ◽  
pp. 441-446 ◽  
Author(s):  
Yuichiro Suzuki ◽  
Akio Sakurai ◽  
Toshinobu Yasuda ◽  
Hiroaki Harai ◽  
Toshinori Kitamura ◽  
...  
Keyword(s):  
Social Adjustment ◽  
Japanese Version ◽  
Self Report ◽  
The Social ◽  
Social Adjustment Scale

The Social Adjustment Scale-Self-Report: Psychometric Properties for Older Adults

2007 ◽  
Vol 101 (3) ◽  
pp. 920-926 ◽  
Author(s):  
Richard A. Zweig ◽  
Elihu Turkel
Keyword(s):  
Older Adults ◽  
Social Functioning ◽  
Social Adjustment ◽  
Psychiatric Symptoms ◽  
Brief Symptom Inventory ◽  
Community Dwelling ◽  
Self Report ◽  
The Social ◽  
Mixed Age ◽  
Social Adjustment Scale

To assess the reliability and validity of the Social Adjustment Scale-Self-Report for older adults, 129 community dwelling elderly ranging in age from 63 to 87 years ( M = 72.3 yr., SD = 5.0) were surveyed using a modified version of the scale. The average internal consistency of subscales was satisfactory (mean coefficient alpha = .62). Overall social functioning impairment (total score) was associated with measures of depression (Beck Depression Inventory, r = .58) and global psychiatric symptoms (Brief Symptom Inventory, r = .55). Older adults scored higher on Marital role, Family Unit role, and overall social functioning impairment compared to mixed-age adults assessed in previous research, and higher on marital role impairment but similarly on overall social functioning when compared with a mixed-age sample from primary care. The modified Social Adjustment Scale–Self-Report has acceptable psychometric characteristics for research use with older adults, and select subscales may account for findings of age-related differences.

Pre-Admission Adaptive Functioning as a Measure of Prognosis in Psychiatric Inpatients

1987 ◽  
Vol 21 (4) ◽  
pp. 539-544 ◽  
Author(s):  
Graham Mellsop ◽  
Kathryn Peace ◽  
Thakshan Fernando
Keyword(s):  
Interpersonal Relationships ◽  
Social Adjustment ◽  
Leisure Time ◽  
Adaptive Functioning ◽  
General Health Questionnaire ◽  
The Self ◽  
Self Report ◽  
Health Questionnaire ◽  
The Social ◽  
Social Adjustment Scale

This prospective study examined the concept of pre-admission adaptive functioning and its relationship with outcome. Pre-admission adaptive functioning was assessed by the self-report Social Adjustment Scale and the therapist rated Axis V of DSM-III. In addition, an instrument designed to look separately at the areas of interpersonal relationships, occupational functioning and use of leisure time was given to a subgroup. These measures were compared with outcome at six months as assessed by the General Health Questionnaire. Adaptive functioning proved to be a significant predictor of outcome, with the Social Adjustment Scale being a better predictor than Axis V for the whole group. In contrast, for patients with schizophrenia, the initial Axis V rating was the best predictor of the outcome score. Statistically significant correlations were found between the three areas of adaptive functioning for the group as a whole but, when examined by diagnosis, they proved to be statistically significant only in the schizophrenia sub-group, suggesting that it would be invaluable to rate the three areas separately in non-psychotic patients.

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