Presence of Irritability During Depressive Episodes in Bipolar Disorder

CNS Spectrums ◽  
2004 ◽  
Vol 9 (3) ◽  
pp. 227-231 ◽  
Author(s):  
Thilo Deckersbach ◽  
Roy H. Perlis ◽  
W. Gordon Frankle ◽  
Stephen M. Gray ◽  
Louisa Grandin ◽  
...  
Keyword(s):  
Depressive Episode ◽  
Major Depressive Episode ◽  
Massachusetts General Hospital ◽  
Bimodal Distribution ◽  
Significant Degree ◽  
Assessment Instrument ◽  
Major Depressive ◽  
Bipolar I Disorder ◽  
Dsm Iv ◽  
Depressive Episodes

ABSTRACTBackground:This study examined the prevalence of irritability in patients with bipolar I disorder during an episode of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) major depression who do not meet criteria for a mixed episode.Method:A chart review of 111 patients with bipolar I disorder treated at the Massachusetts General Hospital Bipolar Clinic between 1998 and 2000 identified 34 patients who met criteria for a DSM-IV major depressive episode in the absence of (1) mood elevation and/or (2) irritability associated with any additional above threshold DSM-IV symptoms of mania. Data gathered from the charts utilized prospective ratings made routinely at each clinic visit using the Clinical Monitoring Form (CMF), a structured assessment instrument which includes modified versions of the mood modules of the Structured Clinical Interview for DSM-IV. Data from these 34 patients were reviewed to determine the presence of irritability.Results:The frequency of abnormal irritability in these 34 patients followed a bimodal distribution: 26% of the patients showed abnormal irritability ≥75% of the time, compared with 68% of the patients with abnormal irritabihty ≤30% of the time. Of the high-irritability patients, psychomotor agitation was rated as definitely present to a significant degree in 44%. Talkativeness and distractibility were rated present but subthreshold in one patient each. All other symptoms of DSM-IV mania were absent.Conclusion:Approximately 25% of patients with bipolar I disorder who meet criteria for a DSM-IV major depressive episode also experienced substantial irritability in the absence of associated symptoms of mania. Our results suggest that abnormal irritability is not limited to mania or mixed states.

Empirical Investigation of Two Assumptions in the Diagnosis of DSM-IV Major Depressive Episode

2007 ◽  
Vol 41 (1) ◽  
pp. 17-23 ◽  
Author(s):  
Chika Sakashita ◽  
Tim Slade ◽  
Gavin Andrews
Keyword(s):  
Depressive Episode ◽  
Major Depressive Episode ◽  
Sleep Problems ◽  
Composite International Diagnostic Interview ◽  
Population Based ◽  
Diagnostic Interview ◽  
Major Depressive ◽  
Diagnostic Threshold ◽  
Dsm Iv ◽  
The Relationship

Objective: The aim of the current study was to examine two major assumptions behind the DSM-IV diagnosis of major depressive episode (MDE): that depression represents a distinct category defined by a valid symptom threshold, and that each depressive symptom contributes equally to the diagnosis. Methods: Data were from the Australian National Survey of Mental Health and Wellbeing. Participants consisted of a random population-based sample of 10 641 community volunteers, representing a response rate of 78%. DSM-IV diagnoses of MDE and other mental disorders were obtained using the Composite International Diagnostic Interview, version 2.0. Analyses were carried out on the subsample of respondents who endorsed either depressed mood or loss of interest (n =2137). Multivariate linear regression analyses examined the relationship between the number and type of symptoms and four independent measures of impairment. Results: The relationship between the number of depressive symptoms and the four measures of impairment was purely linear. Three individual symptoms (sleep problems, energy loss, and psychomotor disturbance) were all independent predictors of three of the four measures of impairment. Conclusions: Counting symptoms alone is limited in guiding a clear diagnostic threshold. The differential impact of individual symptoms on impairment suggests that impairment levels may be more accurately estimated by weighting the particular symptoms endorsed.

Is DSM-IV Bereavement Exclusion for Major Depressive Episode Relevant to Severity and Pattern of Symptoms?

2009 ◽  
Vol 70 (8) ◽  
pp. 1091-1097 ◽  
Author(s):  
Emmanuelle Corruble ◽  
Virginie-Anne Chouinard ◽  
Alexia Letierce ◽  
Philip A. P. M. Gorwood ◽  
Guy Chouinard
Keyword(s):  
Depressive Episode ◽  
Major Depressive Episode ◽  
Major Depressive ◽  
Dsm Iv

Work stress as a risk factor for major depressive episode(s)

2004 ◽  
Vol 35 (6) ◽  
pp. 865-871 ◽  
Author(s):  
JIANLI WANG
Keyword(s):  
Multivariate Analysis ◽  
Risk Factor ◽  
Major Depression ◽  
Work Stress ◽  
Depressive Episode ◽  
Major Depressive Episode ◽  
Working Population ◽  
Major Depressive ◽  
Major Depressive Episodes ◽  
Depressive Episodes

Background. Major depression is a prevalent mental disorder in the general population, with a multi-factorial etiology. However, work stress as a risk factor for major depression has not been well studied.Method. Using a longitudinal study design, this analysis investigated the association between the levels of work stress and major depressive episode(s) in the Canadian working population, aged 18 to 64 years. Data from the longitudinal cohort of the Canadian National Population Health Survey (NPHS) were used (n=6663). The NPHS participants who did not have major depressive episodes (MDE) at baseline (1994–1995 NPHS) were classified into four groups by the quartile values of the baseline work stress scores. The proportion of MDE of each group was calculated using the 1996–1997 NPHS data.Results. The first three quartile groups had a similar risk of MDE. Those who had a work stress score above the 75th percentile had an elevated risk of MDE (7·1%). Using the 75th percentile as a cut-off, work stress was significantly associated with the risk of MDE in multivariate analysis (odds ratio=2·35, 95% confidence interval 1·54–3·77). Other factors associated with MDE in multivariate analysis included educational level, number of chronic medical illnesses and child and adulthood traumatic events. There was no evidence of effect modification between work stress and selected sociodemographic, clinical and psychosocial variables.Conclusions. Work stress is an independent risk factor for the development of MDE in the working population. Strategies to improve working environment are needed to keep workers mentally healthy and productive.

scholarly journals Major depressive episode among university students in Southern Brazil

2020 ◽  
Vol 54 ◽  
pp. 11 ◽  
Author(s):  
Betina Daniele Flesch ◽  
Gbènankpon Mathias Houvèssou ◽  
Tiago Neuenfeld Munhoz ◽  
Anaclaudia Gastal Fassa
Keyword(s):  
University Students ◽  
Depressive Episode ◽  
Major Depressive Episode ◽  
Negative Impact ◽  
Multivariable Analysis ◽  
Prevalence Ratio ◽  
Southern Brazil ◽  
Major Depressive ◽  
Major Depressive Episodes ◽  
Depressive Episodes

INTRODUCTION: Depression is the leading cause of disability around the world, and it has been increasingly affecting young people. This study evaluates the prevalence and factors associated with major depression in university students, with emphasis on the influence of the academic field, chosen study area and the environment they are inserted. METHODS: A census of students who entered the university in the first semester of 2017 was held at a university in Southern Brazil. The outcome of major depressive episode was evaluated using the Patient Health Questionnaire-9, considered when the individual had five or more depressive symptoms for at least one week. Its prevalence was estimated, and the associated factors were examined by the hierarchical multivariable analysis using the Poisson regression model. RESULTS: A total of 32% (95% confidence interval 29.9–34.2) of university students presented a major depressive episode, and the problem was more frequent among women (prevalence ratio [PR] = 1.59); people aged 21 to 23 years (PR = 1.24); those with a family history of depression (PR = 1.27); minorities’ sexual orientation (homosexuals, PR = 1.64, and bisexuals, PR = 1.69); who lived with friends or colleagues (PR = 1.36); students in the area of applied social and human sciences (PR = 1.28), and linguistics, language and literature, and art (PR = 1.25). The worst academic performance (PR = 2.61), alcohol abuse (PR = 1.25), and illicit drug use (PR = 1.30) were also positively associated with major depressive episode. CONCLUSION: In addition to individual, family, and behavioral aspects, already described as risk factors for major depressive episodes in the general population, academic aspects also influence the occurrence of depression among university students. Considering the high prevalence of major depressive episode and its negative impact on health, public and institutional policies are necessary to focus on students’ mental health promotion and care.

Mean Beck Depression Inventory–II Scores by Severity of Major Depressive Episode

2001 ◽  
Vol 88 (3_suppl) ◽  
pp. 1075-1076 ◽  
Author(s):  
Robert A. Steer ◽  
Gregory K. Brown ◽  
Aaron T. Beck ◽  
William C. Sanderson
Keyword(s):  
Beck Depression Inventory ◽  
Depressive Episode ◽  
Major Depressive Episode ◽  
Major Depressive ◽  
Dsm Iv ◽  
The Mean

The Beck Depression Inventory–II total scores of 35 (14%) outpatients who were diagnosed with a mild DSM–IV Major Depressive Episode (MDE), 144 (55%) outpatients with a moderate MDE, and 81 (31%) outpatients with a severe MDE were compared. The mean BDI–II total scores were, respectively, 18 ( SD = 8, 99% CI 12–23), 27 ( SD = 10, 99% CI 24–29), and 34 ( SD = 10, 99% CI 30–37) ( F2,257 = 33.25, p < .001). The mean BDI–II total score of the outpatients with a severe specifier was significantly higher than the mean BDI–II total score of the outpatients with a moderate specifier which was, in turn, significantly higher than the mean BDI–II total score of the outpatients with a mild specifier.

Suicide behavior and subthreshold psychiatric disorders among children and adolescents

2011 ◽  
Vol 26 (S2) ◽  
pp. 265-265
Author(s):  
J. Balazs ◽  
G. Dallos ◽  
A. Kereszteny ◽  
J. Gadoros
Keyword(s):  
Psychiatric Disorders ◽  
Depressive Episode ◽  
Major Depressive Episode ◽  
Hospitalized Children ◽  
Major Depressive ◽  
Psychiatric Illnesses ◽  
Suicide Behavior ◽  
Child Psychiatric ◽  
Report Data ◽  
Dsm Iv

ObjectiveSuicide among adults have been associated to subthreshold psychiatric illnesses as well; however it is little known about the role of subthreshold mental disorders in suicide risk among children/adolescents.MethodsUsing the Mini International Neuropsychiatric Interview Kid the authors examined 105 hospitalized children/adolescents in the Vadaskert Child Psychiatric Hospital, Budapest. Current suicide behavior was defined as giving positive answer to any of the following questions: “In the past month did you: think you would be better off dead or wish you were dead? want to hurt yourself? think about killing yourself? attempt suicide?”ResultsWe report data on 105 hospitalized children/adolescents, 76 (72.4%) boys and 29 (27.6%) girls. The mean age of the subjects was 11.4 years (SD = 3.43, min: 5, max: 17). Current suicide behavior was present in 18 cases (17.1%). There were one person with current suicide behavior, who did not have any current DSM-IV disorder, but he/she had current subthreshold disorder. The majority (n = 16, 88.8%) of the children/adolescents with suicide behavior had both current subthreshold and DSM-IV disorders. Eight children/adolescents (44.4%) with current suicide behavior had current DSM-IV major depressive episode and further 5 children/adolescents (27,8%) had current subthreshold major depressive episode. The prevalence of DSM-IV and subthreshold major depressive episode was significantly higher among hospitalized children with suicide behavior (n = 18), than among hospitalized children without suicide behavior (n = 87) (X2 = 5,272, df = 1. p = 0,022).ConclusionsSubthreshold forms of pediatric psychiatric disorders need to be taken into account as well in suicide prevention.

Augmentation of Zonisamide in Poor or Non-responder Patients Treated with Duloxetine for Single or Recurrent Unipolar Major Depressive Episode

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
M. Fornaro ◽  
F. Bandini ◽  
C. Mattei ◽  
F. Battaglia ◽  
C. Ogliastro ◽  
...  
Keyword(s):  
Depressive Episode ◽  
Wave Amplitude ◽  
Rating Scales ◽  
Major Depressive Episode ◽  
Open Label ◽  
Major Depressive ◽  
Open Label Study ◽  
Wide Range ◽  
Axis I ◽  
Dsm Iv

Objectives:The aim of our ongoing study is to investigate the effectiveness of Zonisamide augmentation to Duloxetine in partial and non-responder patients in course of Unipolar Major Depressive Episode.Method:35 outpatients will be enrolled in a 12-weeks open-label study including both genders, 18 to 65 years old subjects. Unipolar Major Depressive Episode diagnosis will be performed at screening time using “Structured Clinical Interview for DSM-IV-Axis-I Disorders- Italian 1996 version” (SCID-I, First et al., 1996) and by a ≥14 total score for the “Quick Inventory of Depressive Symptomathology-Self Rated” (QIDS-SR, Rush et al., 2003). Patients will be repeatedly evaluated during the course of the study using a wide range of mood and anxiety rating scales and monitoring biomarkers such as electroretinogram b-wave amplitude, interleukins, flogosis and BDNF factors etc. At week 6, Duloxetine partial/non responders will be augmetated to Zonisamide and further evaluations of mentioned markers will be repeated. A “Fisher-test” or χ² analysis will be performed at the end of the study. Expected p will be ≤ 0,005.Hypothesis:We expect Zonisamide augmentation to be an effective treatment for SNRI-resistant Major Depression.

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