Prescription analysis and cost of antidepressant drugs in major depressive disorder outpatients at the tertiary care hospital of Pakistan: a prospective approach

A multi-factorial illness that causes morbidity threatens life and affects the quality of life is the major depressive disorder (MDD). Serotonergic dysfunction is one of the most described theories of psychiatric symptoms. Several serotonergic genes have been reported in associated with MDD. Recent studies have suggested that serotonin transporter length polymorphic region (5HTTLPR), Tryptophan hydroxylase gene 1 (TPH1) and Tryptophan hydroxylase gene 2 (TPH2) are associated with MDD. In the present study, we have examined the possible correlation between serotonergic genes 5HTTLPR, TPH1 (A218C), and TPH2 (G703T) polymorphism in MDD patients in Coimbatore tertiary care hospital. Blood samples were collected from 245 major depressive disorder patients and 250 healthy volunteers belonging to the faculty of Karpagam College of Medical Science and Research. All the samples were analysed by PCR-RFLP method. The chi-square test has been used for comparing genotype and allele distribution of cases and controls. We observed the 5HTTLPR L/S genotype and allele frequencies (P=0.001and p= 0.001) and TPH2 (G703T) (P=0.0002 and P= 0.005) TPH1 (A218C) (P=0.48 and P=0.43) polymorphisms with MDD. We also observed higher homozygous genotype frequencies of the short allele of 5HTTLPR, the G allele of TPH2 G703T polymorphism in patients. In short, our preliminary study suggests that the 5HTTLPR L/S and TPH2 G703T gene polymorphism were associated with the MDD. Serotonergic genes polymorphism in MDD patients and control groups were compared. Further clinical trials are to be carried out to find the exact mechanisms of the serotonergic system in MDD.

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Predictors of Suicidal Ideation and Attempt among Patients with Major Depressive Disorder at a Tertiary Care Hospital, Puducherry

Journal of Neurosciences in Rural Practice ◽

10.1055/s-0040-1721558 ◽

2021 ◽

Vol 12 (01) ◽

pp. 122-128

Author(s):

Ralte Lalthankimi ◽

Padmavathi Nagarajan ◽

Vikas Menon ◽

Jeby Jose Olickal

Keyword(s):

Major Depressive Disorder ◽

Suicidal Ideation ◽

Depressive Disorder ◽

Rating Scale ◽

Tertiary Care ◽

Severe Depression ◽

Care Hospital ◽

Suicidal Behaviors ◽

Major Depressive ◽

Severity Of Depression

Abstract Objectives Mental disorders have a large impact on death by suicide. Hence, this study aims to determine the prevalence of suicidal behaviors among major depressive disorder (MDD) patients and the associated factors. Materials and Methods This cross-sectional analytical study was conducted among individuals aged 18 to 65 years, diagnosed with MDD in the Psychiatry Outpatient Department of a Tertiary Care Center, Puducherry during March to October 2019. Severity of depression was assessed using Hamilton Depression Rating Scale and Columbia-Suicide Severity Rating Scale was used to find the suicidal behaviors. Results For 166 participants in the study, mean (standard deviation) age was 40 (11) years and majority were females (76%). More than one-third (37%) had severe or very severe depression, and the prevalence of suicidal ideation, plan, and attempts were 83, 24, and 35%, respectively. After adjusting the covariates, the severity of depression and unemployment were significantly associated with suicidal attempts (adjusted prevalence ratios [aPR] = 11.4 and 1.9), and very severe depression was associated with suicidal ideation (aPR = 1.6). Among 140 individuals with suicidal ideation, 45 (32%) had an ideation frequency of 2 to 3 times/week, 69 (50%) had ideation for 1 hour, 36 (26%) could control ideation with little difficulty, and 12% had suicidal ideation mostly to end or stop their pain. Conclusion Suicidal ideation and attempts were significantly high in MDD patients, and the severity of depression was significantly associated with it. Early identification of high-risk suicidal behavior and implementation of effective preventive interventions are necessary to reduce death by suicide in these groups.

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A Study of Anxiety Disorders in Terms of Severity and Prevalence in Patients of Major Depressive Disorder in a Tertiary Care Centre

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol03-i11/476 ◽

2018 ◽

Vol 3 (11) ◽

Author(s):

Dr Richa Rani ◽

Neeru Bala ◽

Parshotam Dass Garg ◽

Aashish Bansal

Keyword(s):

Major Depressive Disorder ◽

Anxiety Disorder ◽

Depressive Disorder ◽

Anxiety Disorders ◽

Psychiatric Comorbidity ◽

Tertiary Care ◽

Care Hospital ◽

Major Depressive ◽

Compulsive Disorder ◽

Severe Anxiety

Background: Depression is a disorder of major public health importance. Over the last 50 years, large number of studies have been published from India addressing various aspects of depression. The objective of the current study was to study the socio-demographic characteristics and anxiety as co-morbidity in patients with major depressive disorder. Method: This was a cross sectional study conducted in tertiary care hospital in which 100 patients diagnosed with major depressive disorder, according to ICD-10 were assessed for presence of anxiety disorder as psychiatric Comorbidity using MINI and severity of anxiety was assessed using HAM-A. Results: Current study showed major depressive disorder is more common among females 59%, married 79%, housewife 50%, 61% had first episode of depression and 27% had family history of major depressive disorder. There was 48% presence of any anxiety disorder among total major depressive disorder patients. Among which 25% had generalized anxiety disorder, 9% obsessive compulsive disorder, 5% panic disorder, 4% agoraphobia, 4% post traumatic stress disorder and 1% social anxiety disorder among total patients with major depressive disorder. The maximum number of patients 43% had mild to moderate level of anxiety, 32% had mild anxiety, 19% had moderate to severe anxiety and 6% had severe anxiety. Conclusion: There is a high prevalence of anxiety disorders in major depressive disorder which is oftenly ignored because of symptom overlap between anxiety and major depression. This study is important because of increasing prevalence of psychiatric comorbidity among the patients of major depressive disorders lead to impaired functioning in patients with MDD. Therefore, monitoring of symptoms as well as functioning during the long-term management MDD could be crucial to achieve the functioning remission.

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Comparative Efficacy and Acceptability of 21 Antidepressant Drugs for the Acute Treatment of Adults With Major Depressive Disorder: A Systematic Review and Network Meta-Analysis

FOCUS The Journal of Lifelong Learning in Psychiatry ◽

10.1176/appi.focus.16407 ◽

2018 ◽

Vol 16 (4) ◽

pp. 420-429 ◽

Cited By ~ 20

Author(s):

Andrea Cipriani ◽

Toshi A Furukawa ◽

Georgia Salanti ◽

Anna Chaimani ◽

Lauren Z Atkinson ◽

...

Keyword(s):

Systematic Review ◽

Major Depressive Disorder ◽

Depressive Disorder ◽

Acute Treatment ◽

Meta Analysis ◽

Antidepressant Drugs ◽

Comparative Efficacy ◽

Major Depressive

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Depressive disorder among the breast cancer patients in outpatient department of a tertiary care hospital in Pakistan

European Psychiatry ◽

10.1016/s0924-9338(11)72383-5 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 677-677 ◽

Cited By ~ 1

Author(s):

R.U. Rahman ◽

A. Nisar ◽

N. Hussain ◽

I. Chaudhary

Keyword(s):

Breast Cancer ◽

Depressive Disorder ◽

Rating Scale ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Psychiatric Morbidity ◽

Depression Scale ◽

Outpatient Department ◽

Care Hospital ◽

Had Scale

ObjectivesTo determine the frequency of Depressive Disorder among patients with breast cancer in an outpatient department of a tertiary care hospital in Pakistan.BackgroundCancer not only affects body physically but can also affect the mind in the form of psychiatric disorder. Proper identification and treatment of these conditions can be beneficial and cost-effective.MethodologyThis cross-sectional descriptive study was conducted on patients of breast cancer attending OPD of oncology department of Civil Hospital Karachi. The sample consisted of ninety three diagnosed patients of breast cancer who were screened for psychiatric morbidity through Hospital Anxiety and Depression Scale (HAD Scale). Screened patients were interviewed and diagnosed as depressive disorder according to ICD criteria. The level of depression in these diagnosed patients was quantified through ZUNG'S Depression Rating Scale.ResultsEighty two percent (n = 76) of the sample (n = 93) were found to have psychiatric morbidity on HAD scale. Out of these screened sample sixty percent (n = 46) were found to be depressed on Zung self rating depression scale. Majority of these patients were suffering from mild to moderate depression. Half of the female in this sample were undergone mastectomy that was not found to have any statistically significant impact on psychiatric morbidity of the patient.ConclusionThis study shows high prevalence of depression in patients with breast cancer. The health professional involve in care of breast cancer should screen routinely their patients for symptoms of depression.

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Efficacy and Safety of Escitalopram in First Episode of Major Depressive Disorder - A Tertiary Care Indian Center Experience

Journal of Depression & Anxiety ◽

10.4172/2167-1044.1000324 ◽

2018 ◽

Vol 07 (04) ◽

Cited By ~ 1

Author(s):

Mayur G Patel ◽

Vishal K Patel ◽

Deepak S Tiwari ◽

Viral R Shah ◽

Dhruv S Patel ◽

...

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Tertiary Care ◽

First Episode ◽

Efficacy And Safety ◽

Major Depressive

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An epidemiological study to assess the mental health status of pregnant women in a tertiary care hospital, Srinagar, Jammu and Kashmir, India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20172355 ◽

2017 ◽

Vol 6 (6) ◽

pp. 2580

Author(s):

Bilal Ur Rehman ◽

Javid Ahmad ◽

Rauf Ur Rashid Kaul ◽

Mohammad Kaleem ul Haque

Keyword(s):

Mental Health ◽

Developing Countries ◽

Health Status ◽

Depressive Disorder ◽

Pregnant Women ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Antenatal Clinic ◽

Mental Health Status ◽

Care Hospital

Background: Pregnancy is a major psychological, as well as physiological event; women may find themselves unable to cope with additional demands of pregnancy. Mental illness during pregnancy-whether anxiety, depression or more severe psychiatric disorders-can have a significant negative impact on a mother and her baby. Poor psychological health has been associated with low birth weight, premature birth, perinatal and infant death, postnatal depression, as well as long term behavioural and psychological impacts on the child. Depressive disorders are a common source of disability among women. Mental health problems during pregnancy and postpartum periods are one of the alarming health issue among women. Community-based epidemiological data on antenatal depression from developing countries is scarce. This study was conducted to assess the mental health status of pregnant women attending antenatal clinic of tertiary care hospital, SKIMS, Srinagar (J and K).Methods: A cross sectional study was conducted over a period of six months from 1stSeptember 2016 to 28th February 2017 among randomly selected pregnant women attending antenatal clinic of tertiary care hospital, SKIMS, Srinagar. A total of 200 pregnant women formed the study subjects. Data was collected by interviewing the pregnant women using pre-designed, pre-tested, semi-structured questionnaire. Data was analysed using Statistical Programme for the social science (SPSS) version 19.0.Results: Amongst the study population, prevalence of depressive disorder was 26%. The depression was significantly increasing with advancing pregnancy and advancing age. Socio-economic status and depression was associated statistically significant (p=0.024). Women with bad relationship with in laws had significantly more depression compared to those who had good relationship with in laws (P=0.0037). The association between parity and depressive disorder was statistically insignificant(P=0,7144).Conclusions: When we care for mother we care for two live and live without psychological consideration is completely materialistic. A depressive symptom occurs commonly during 2nd and 3rd trimester of pregnancy, drawing attention to a need to screen for depression during antenatal care. Maternal health policies, a priority in developing countries, must integrate maternal depression as a disorder of public health importance. Intervention should target women in the early antenatal period.

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