The Unified Protocol for Major Depressive Disorder

2017 ◽  
pp. 67-85
Author(s):  
James F. Boswell ◽  
Laren R. Conklin ◽  
Jennifer M. Oswald ◽  
Matteo Bugatti
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Emotional Disorders ◽  
Clinical Case ◽  
Depressive Disorders ◽  
Major Depressive ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
High Level ◽  
Future Work

Major depressive disorder (MDD) can be a chronic, debilitating condition that for many individuals waxes and wanes over time. In addition, MDD and other unipolar depressive disorders demonstrate a high level of comorbidity with anxiety disorders. This chapter describes the application of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) to MDD and other unipolar depressive disorders. We first review research supporting the association between depression and higher-order constructs such as neuroticism. Next, we present a clinical case that, combined with module-specific recommendations, further illustrates how UP principles and strategies are implemented in the treatment of primary depression. Finally, we offer recommendations for future work involving the UP for major depression and other depressive disorders.

Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents

2017 ◽  
Author(s):  
Jill Ehrenreich-May ◽  
Sarah M. Kennedy ◽  
Jamie A. Sherman ◽  
Shannon M. Bennett ◽  
David H. Barlow
Keyword(s):  
Anxiety Disorder ◽  
Depressive Disorder ◽  
Emotional Disorders ◽  
Depressive Disorders ◽  
Separation Anxiety Disorder ◽  
Tic Disorders ◽  
Evidence Based ◽  
Evidence Based Treatment ◽  
Transdiagnostic Treatment ◽  
Unified Protocol

Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents: Workbook (UP-A) provides evidence-based treatment strategies to assist adolescent clients to function better in their lives. This treatment is designed for adolescents who are experiencing feelings of sadness, anxiety, worry, anger, or other emotions that get in the way of their ability to enjoy their lives and feel successful. The workbook is written for adolescents and guides them through each week of the program with education, activities, and examples that will help them to understand the role that emotions play in their behaviors every day. Adolescents are taught helpful strategies for dealing with uncomfortable emotions and will receive support in making choices that will move them closer to their long-term goals. The evidence-based treatment skills presented in the accompanying Therapist Guide may be applied by the therapist to adolescents with a wide variety of emotional disorders. The UP-A takes a transdiagnostic approach to the treatment of the emotional disorders. Some of the disorders that may be targeted include anxiety disorders (e.g., generalized anxiety disorder, social anxiety disorder, separation anxiety disorder, specific phobias, panic disorder, illness anxiety disorder, agoraphobia) and depressive disorders (e.g., persistent depressive disorder, major depressive disorder). This treatment is flexible enough for use with some trauma and stress-related disorders (including adjustment disorders), somatic symptom disorders, tic disorders, and obsessive-compulsive disorders. The transdiagnostic presentation of evidence-based intervention techniques within these treatments may be particularly useful for adolescents presenting with multiple emotional disorders or mixed/subclinical symptoms of several emotional disorders.

scholarly journals Investigating regions of shared genetic variation in attention deficit/hyperactivity disorder and major depressive disorder: a GWAS meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Victoria Powell ◽  
Joanna Martin ◽  
Anita Thapar ◽  
Frances Rice ◽  
Richard J. L. Anney
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Genetic Correlation ◽  
Attention Deficit ◽  
Meta Analysis ◽  
Major Depressive ◽  
Hyperactivity Disorder ◽  
High Level ◽  
Genomic Regions

AbstractAttention deficit/hyperactivity disorder (ADHD) demonstrates a high level of comorbidity with major depressive disorder (MDD). One possible contributor to this is that the two disorders show high genetic correlation. However, the specific regions of the genome that may be responsible for this overlap are unclear. To identify variants associated with both ADHD and MDD, we performed a meta-analysis of GWAS of ADHD and MDD. All genome wide significant (p < 5 × 10–8) SNPs in the meta-analysis that were also strongly associated (p < 5 × 10–4) independently with each disorder were followed up. These putatively pleiotropic SNPs were tested for additional associations across a broad range of phenotypes. Fourteen linkage disequilibrium-independent SNPs were associated with each disorder separately (p < 5 × 10–4) and in the cross-disorder meta-analysis (p < 5 × 10–8). Nine of these SNPs had not been highlighted previously in either individual GWAS. Evidence supported nine of the fourteen SNPs acting as eQTL and two as brain eQTL. Index SNPs and their genomic regions demonstrated associations with other mental health phenotypes. Through conducting meta-analysis on ADHD and MDD only, our results build upon the previously observed genetic correlation between ADHD and MDD and reveal novel genomic regions that may be implicated in this overlap.

Association of Short-term Particulate Matter Exposure with Suicide Death Among Major Depressive Disorder Patients: A Time-Stratified Case-Crossover Analysis

2021 ◽  
Author(s):  
In Young Hwang ◽  
Daein Choi ◽  
Jihoon Andrew Kim ◽  
Seulggie Choi ◽  
Jooyoung Chang ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Particulate Matter ◽  
Depressive Disorder ◽  
Short Term ◽  
Major Depressive ◽  
Suicide Death ◽  
Case Crossover ◽  
Crossover Analysis ◽  
High Level ◽  
Particulate Matter Exposure

Abstract Objective: There is growing evidence that suggests a potential association between particulate matter (PM) and suicide. However, it is unclear that PM exposure and suicide death among major depressive disorder (MDD) patients, a high-risk group for suicide.Methods: We investigated the risk of suicide among 1,046,169 newly-diagnosed MDD patients from 2004 to 2015 within the Korean National Health Insurance Service (NHIS) database. We identified 3,372 suicide cases from January 1, 2015, to December 31, 2017, within the death statistics database of the Korean National Statistical Office. PMs with diameter less than 2.5 μm (PM2.5), less than 10 μm (PM10), and 2.5 μm to 10 μm (PM2.5-10) were considered, which were provided from the National Ambient Air Monitoring System in South Korea. Time-stratified case-crossover analysis was performed to investigate the association of particulate matter exposure to suicide events.Results: The risk of suicide was significantly high upon the high level of exposure to PM2.5-10, PM10 on lag 1 (p for trend = 0.044, 0.035, respectively). A similar association was observed in the multi-day lag model (lag 0-3). Increasing exposure to PM 2.5 was not associated with increased suicide risk.Conclusions: Short-term exposure to a high level of PM2.5-10 and PM10 was associated with an elevated risk for suicide among MDD patients, while PM2.5 did not. There is a clear dose-response relationship between short-term coarse particle exposures with suicide death among Major Depressive Disorder patients. This result will be used as an essential basis for consideration when establishing an air pollution alarm system and implementing a suicide prevention program for reducing adverse health outcomes by PM.

The Unified Protocol for Eating Disorders

2017 ◽  
pp. 150-163
Author(s):  
Christina L. Boisseau ◽  
James F. Boswell
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Emotional Disorders ◽  
Clinical Case ◽  
Case Examples ◽  
Transdiagnostic Treatment ◽  
Unified Protocol ◽  
Outpatient Settings

This chapter describes the application of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) to eating disorders, including anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder, and other specified feeding or eating disorders. We focus on the five core treatment modules, highlighting aspects of each one that are particularly relevant to eating disorders and discuss the evidence supporting their use. Next, using clinical case examples from both residential and outpatient settings, we illustrate how each of these core modules can be applied to the treatment of eating disorders. Finally, we provide recommendations for future applications of the UP in this population.

A simpler definition of major depressive disorder

2009 ◽  
Vol 40 (3) ◽  
pp. 451-457 ◽  
Author(s):  
M. Zimmerman ◽  
J. N. Galione ◽  
I. Chelminski ◽  
J. B. McGlinchey ◽  
D. Young ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Somatic Symptoms ◽  
Structured Interview ◽  
Major Depressive ◽  
Medically Ill ◽  
Treatment Providers ◽  
Dsm Iv ◽  
Definition Of ◽  
High Level

BackgroundThe DSM-IV symptom criteria for major depressive disorder (MDD) are somewhat lengthy, with many studies showing that treatment providers have difficulty recalling all nine symptoms. Moreover, the criteria include somatic symptoms that are difficult to apply in patients with medical illnesses. In a previous report, we developed a briefer definition of MDD that was composed of the mood and cognitive symptoms of the DSM-IV criteria, and found high levels of agreement between the simplified and full DSM-IV definitions. The goal of the present study was to replicate these findings in another large sample of psychiatric out-patients and to extend the findings to other patient samples.MethodWe interviewed 1100 psychiatric out-patients and 210 pathological gamblers presenting for treatment and 1200 candidates for bariatric surgery. All patients were interviewed by a diagnostic rater who administered a semi-structured interview. We inquired about all symptoms of depression for all patients.ResultsIn all three samples high levels of agreement were found between the DSM-IV and the simpler definition of MDD. Summing across all 2510 patients, the level of agreement between the two definitions was 95.5% and the κ coefficient was 0.87.ConclusionsAfter eliminating the four somatic criteria from the DSM-IV definition of MDD, a high level of concordance was found between this simpler definition and the original DSM-IV classification. This new definition offers two advantages over the current DSM-IV definition – it is briefer and it is easier to apply with medically ill patients because it is free of somatic symptoms.

A further assessment of decision-making in anorexia nervosa

2015 ◽  
Vol 30 (1) ◽  
pp. 121-127 ◽  
Author(s):  
C. Adoue ◽  
I. Jaussent ◽  
E. Olié ◽  
S. Beziat ◽  
F. Van den Eynde ◽  
...  
Keyword(s):  
Decision Making ◽  
Major Depressive Disorder ◽  
Anorexia Nervosa ◽  
Depressive Disorder ◽  
Cognitive Processes ◽  
Depressive Disorders ◽  
Iowa Gambling Task ◽  
Learning Task ◽  
Adult Women ◽  
Major Depressive

AbstractObjective:Anorexia nervosa (AN) may be associated with impaired decision-making. Cognitive processes underlying this impairment remain unclear, mainly because previous assessments of this complex cognitive function were completed with a single test. Furthermore, clinical features such as mood status may impact this association. We aim to further explore the hypothesis of altered decision-making in AN.Method:Sixty-three adult women with AN and 49 female controls completed a clinical assessment and were assessed by three tasks related to decision-making [Iowa Gambling Task (IGT), Balloon Analogue Risk Task (BART), Probabilistic Reversal Learning Task (PRLT)].Results:People with AN had poorer performance on the IGT and made less risky choices on the BART, whereas performances were not different on PRLT. Notably, AN patients with a current major depressive disorder showed similar performance to those with no current major depressive disorder.Conclusion:These results tend to confirm an impaired decision making-process in people with AN and suggest that various cognitive processes such as inhibition to risk-taking or intolerance of uncertainty may underlie this condition Furthermore, these impairments seem unrelated to the potential co-occurent major depressive disorders.

Cognitive Therapy versus Medication in the Treatment of Moderate to Severe Depression

2018 ◽  
Author(s):  
Daniel Barron ◽  
Robert Ostroff
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Cognitive Therapy ◽  
Study Design ◽  
Clinical Case ◽  
Severe Depression ◽  
Major Depressive ◽  
Study Intervention ◽  
Landmark Study

This chapter provides a summary of a landmark study on major depressive disorder. Is paroxetine or cognitive therapy more effective in treating patients with moderate to severe major depressive disorder? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.

Suicide

2014 ◽  
Author(s):  
Kelly C. Cukrowicz ◽  
Erin K. Poindexter
Keyword(s):  
Risk Factors ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Suicidal Behavior ◽  
Depressive Disorders ◽  
Suicide Ideation ◽  
Time Of Death ◽  
Major Depressive ◽  
Self Injury ◽  
Recent Treatment

Suicide is a significant concern for clinicians working with clients experiencing major depressive disorder (MDD). Previous research has indicated that MDD is the diagnosis more frequently associated with suicide, with approximately two-thirds of those who die by suicide suffering from depression at the time of death by suicide. This chapter reviews data regarding the prevalence of suicidal behavior among those with depressive disorders. It then reviews risk factors for suicide ideation, self-injury, and death by suicide. Finally, the chapter provides an empirical overview of treatment studies aimed at decreasing risk for suicide, as well as an overview of several recent treatment approaches showing promise in the reduction of suicidal behavior.

The Use of Art Therapy in Complex Treatment on the Quality of Remission in Patients with Melancholy in Major Depressive Disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. s777-s777 ◽  
Author(s):  
H. Kozhyna ◽  
V. Korostiy ◽  
S. Hmain ◽  
V. Mykhaylov
Keyword(s):  
Quality Of Life ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Art Therapy ◽  
Depressive Disorders ◽  
Combined Treatment ◽  
Control Group ◽  
Complex Treatment ◽  
Major Depressive

IntroductionAccording to studies done in recent years regarding the treatment of patients with melancholy in major depressive disorder, a shift of interest from studies evaluating the effectiveness of therapy to the study of remission is seen. Despite significant progress in the development of pharmacotherapy of depressive disorders, difficulty in achieving rapid reduction in depressive symptoms and stable remission in patients with melancholic depression necessitated the search for new approaches to the treatment of this pathology.AimsEvaluating the effectiveness of art therapy in treatment in patients with melancholy in major depressive disorder on the quality of remission.MethodsThe study involved 135 patients – 60 male and 75 female patients aged from 18 to 30 years old. The main group of patients apart the combined treatment also participated in group art therapy with the use of drawing techniques, while the control group – statutory standard therapy.ResultsThe results of the use of art therapy in complex treatment in patients with major depressive disorder is detected primarily in reducing of the level of anxiety at the early stages of treatment (60% of patients have noticed decreasing of melancholic state), as well as improving the quality of life in remission period.ConclusionThese results support the use of art therapy in treatment in patients with melancholy in major depressive disorder during period of active treatment, and after achieving clinical remission contributes to achieving and maintaining high-quality and stable remission with full restoration of quality of life and social functioning.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Novel Treatments for Major Depressive Disorder

CNS Spectrums ◽  
2009 ◽  
Vol 14 (S5) ◽  
pp. 11-13
Author(s):  
R. Bruce Lydiard
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Depressive Disorders ◽  
Antidepressant Treatment ◽  
Major Depressive ◽  
Novel Treatments ◽  
Treatment Alternatives

Data from a variety of studies, including the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study, have shown that fewer patients achieve remission from symptoms of major depressive disorder (MDD) and other depressive disorders after taking the first-prescribed antidepressant treatment than was expected. The goal of treatment is true remission: the complete absence of symptoms. Achieveing less than true remission is associated with MDD recurrence and continued impairment.

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