scholarly journals Algoneurodystrophy in a Patient with Major Depressive Disorder

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Virgínia Henriques ◽  
Sérgio Henriques
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Medical History ◽  
Psychiatric Illness ◽  
Correct Diagnosis ◽  
Conversion Disorder ◽  
Physical Symptoms ◽  
Major Depressive ◽  
The Right ◽  
Probable Diagnosis

Introduction. Not infrequently, in patients with a psychiatric illness who have concomitant physical symptoms, these symptoms are often wrongly attributed to a psychiatric illness. Consequently, there is a delay in establishing the correct diagnosis, which may have an impact on the prognosis of the disease. The authors aim to present a case report of a patient with a diagnosis of major depressive disorder and conversion disorder that was later correctly diagnosed with algoneurodystrophy. The authors intend to draw attention to the importance of a careful medical history and this entity. Case Presentation. A patient went to the emergency department multiple times with complaints of decreased strength and pain in the right upper limb, concomitantly with depressive symptoms. The patient was first diagnosed with conversion disorder and major depressive disorder. After the worsening of the clinical condition with the appearance of neuropathic pain and the exclusion of other organic pathologies, the probable diagnosis of algoneurodystrophy was made. At that time, the patient started treatment and a favorable clinical evolution was observed. Discussion. The clinical case highlights the importance of conducting a careful medical history in a patient with a psychiatric illness, so as not to mistakenly exclude the presence of an organic disease. The absence or delay in making a correct diagnosis can have adverse consequences in terms of the prognosis of the disease.

Somatic symptoms, drinking, and mental distress among Russian female patients with rheumatoid arthritis: A pilot study

2017 ◽  
Vol 41 (S1) ◽  
pp. S510-S510
Author(s):  
K. Yoshimasu ◽  
S. Takemura ◽  
E. Myasoedova ◽  
S. Myasoedova
Keyword(s):  
Rheumatoid Arthritis ◽  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Depressive Disorder ◽  
Protective Factor ◽  
Physical Symptoms ◽  
Stepwise Logistic Regression ◽  
Major Depressive ◽  
Drinking Habits ◽  
Drinking Status

IntroductionDrinking has been shown to be a protective factor against the risk of rheumatoid arthritis (RA). On the other hand, high prevalence of depressive symptoms has been observed among RA patients.ObjectiveTo evaluate the association between depressive symptoms and somatic factors as well as drinking habits in RA patients.MethodsDrinking habits and physical symptoms in 182 female RA outpatients in Ivanovo, Russia (average [standard deviation] of age, 62.0 [11.7] years), were investigated. Drinking status was classified as current drinkers (alcohol consumption within the previous 12 months) and others. Depressive symptoms were evaluated with MINI, HADS and CES-D questionnaires. Outcomes were (a) presence or history of major depressive disorder, presence of melancholic major depressive disorder, presence of dysthymia, or 1 point or greater of suicidal risk score in MINI, (b) 8 points or greater in HADS-depression, (c) 8 points or greater in HADS-anxiety, and (d) 16 points or greater in CES-D. Stepwise logistic regression was used to evaluate somatic factors associated with depressive symptoms, with age and drinking status included.ResultsDrinking was rather protective against depression, but did not reach statistical significance. Symptomatic parts in the extremities associated with the outcomes were shoulders for MINI, elbows and knees for HADS-depression, shoulders for HADS-anxiety, and hands, elbows and shoulders for CES-D. In the stepwise selection, some symptoms in the extremities were positively associated with the outcomes.ConclusionSymptoms chiefly in large joints contributed to depressive symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Augmentation Strategies for Patients with Major Depressive Disorder with an Inadequate Response to Antidepressant Monotherapy

2014 ◽  
Vol 60 (2) ◽  
pp. 61-66
Author(s):  
Th Moica ◽  
I Gabos Grecu ◽  
Marieta Gabos Grecu ◽  
Melinda Ferencz ◽  
Elena Gabriela Buicu ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Depressive Episode ◽  
Physical Symptoms ◽  
Inadequate Response ◽  
Recurrent Depression ◽  
Major Depressive ◽  
Incomplete Response ◽  
Augmentation Strategies ◽  
Wide Range

Abstract Introduction: Major depressive disorder is a chronic and debilitating disease characterized by a wide range of emotional and physical symptoms that coexist during a depressive episode and may reoccur at some point during the progression of the disease for the majority of patients. The purpose of the study was to investigate psychiatrists’ experience regarding the response to antidepressive treatment and their options regarding augmentation strategies in depression with incomplete response to antidepressant monotherapy. Method: We applied an 18-item questionnaire containing multiple choice questions to adult psychiatrists working in ambulatories, hospitals or mental health centers. Results: Fourty-two psychiatrists have agreed to answer the questionnaire. The majority of them were psychiatry specialists, between 35 and 49 years of age, working in an outpatient unit. For the majority of doctors, SSRIs (Serotonin Reuptake Inhibitors) proved to be the first line treatment both for the first depressive episode and for recurrent depression, followed by SNRI (Serotonin and Noradrenalin Reuptake Inhibitors). Regarding the duration of maintenance treatment for the patients who achieved complete remission after the first episode of depression, the results showed a wide spectrum from 4 to 9 months. Conclusions: Incomplete response to antidepressive monotherapy is very frequent both for the first depressive episode and for recurrent depression. Given the pharmacological profile that some atypical antipsychotic have, augmentation with atypical antipsychotics in patients with inadequate response to antidepressant monotherapy is a useful therapeutic strategy that should be considered.

Dexamethasone Suppression Test in Depression and other Psychiatric Illness

1983 ◽  
Vol 142 (5) ◽  
pp. 498-504 ◽  
Author(s):  
A. Coppen ◽  
M. Abou-Saleh ◽  
P. Milln ◽  
M. Metcalfe ◽  
J. Harwood ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Affective Disorders ◽  
Psychiatric Illness ◽  
Dexamethasone Suppression Test ◽  
Major Depressive ◽  
Abnormal Response ◽  
Suppression Test ◽  
Dexamethasone Suppression ◽  
Normal Controls

SummaryThe prevalence of an abnormal response to the dexamethasone suppression test (DST) was examined in 119 in-patients suffering from a major depressive disorder and in 79 normal controls. Only 11 per cent of controls showed an abnormal DST as against 70 per cent of depressed patients. The specificity of the DST was examined by testing patients with other psychiatric disorders. Abnormal responses were found in one-fifth of a sample of schizophrenics, over one-quarter of abstinent alcoholics, two-fifths of neurotics (including neurotic depressives) and almost half of senile dements. Abnormal DST was also found in 33 per cent of patients receiving prophylactic lithium for recurrent affective disorders.

scholarly journals Efficacy of vortioxetine on the physical symptoms of major depressive disorder

2018 ◽  
Vol 32 (10) ◽  
pp. 1086-1097 ◽  
Author(s):  
Michael Cronquist Christensen ◽  
Ioana Florea ◽  
Annika Lindsten ◽  
David S Baldwin
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Gastrointestinal Symptoms ◽  
Physical Symptoms ◽  
Anxiety Symptoms ◽  
Hamilton Depression Scale ◽  
Short Term ◽  
Major Depressive ◽  
Symptoms Of Depression ◽  
Long Term Treatment

Background: Efficacy has been proven for vortioxetine in short-term and long-term treatment of major depressive disorder (MDD), with broad beneficial effects on emotional, physical and cognitive symptoms. Limited specific data on the effects of vortioxetine on depression-related physical symptoms have been published. Methods: A meta-analysis was carried out of five short-term multinational, double-blind, placebo-controlled studies. These studies were conducted in a total of 2105 adult MDD outpatients (18–75 years) with a major depressive episode of ⩾3 months’ duration. Only patients treated with a dose of 5 or 10 mg vortioxetine (therapeutic doses) or placebo were included in this analysis. Efficacy assessment of vortioxetine on the physical symptoms of depression included all items of the Hamilton Depression Scale (HAM-D) assessing physical symptoms, and all somatic items in the Hamilton Anxiety Scale (HAM-A). A subgroup analysis in MDD patients with coexisting anxiety symptoms (i.e. those with a HAM-A ⩾20 at baseline) was also performed. Results: A significant improvement ( p<0.05) of vortioxetine versus placebo was observed on all HAM-D items measuring physical symptoms, except for the somatic gastrointestinal symptoms and loss of weight items. Significant effects were also observed on the HAM-A somatic items: general somatic symptoms, gastrointestinal symptoms, and autonomic symptoms. In patients with a high baseline level of anxiety, a significant effect of vortioxetine was also observed on the physical symptoms of depression. Conclusions: These analyses indicate that patients with MDD, including those with a high level of anxiety symptoms, have significant improvements in MDD-associated physical symptoms when treated with vortioxetine.

scholarly journals Abnormal Default-Mode Network Homogeneity in Melancholic and Nonmelancholic Major Depressive Disorder at Rest

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Meiqi Yan ◽  
Xilong Cui ◽  
Feng Liu ◽  
Huabing Li ◽  
Renzhi Huang ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Middle Temporal Gyrus ◽  
Support Vector ◽  
Healthy Controls ◽  
Major Depressive ◽  
Middle Temporal ◽  
Inferior Temporal Gyrus ◽  
Medial Frontal Gyrus ◽  
The Right

Background. Melancholic depression has been assumed as a severe type of major depressive disorder (MDD). We aimed to explore if there were some distinctive alterations in melancholic MDD and whether the alterations could be used to discriminate the melancholic MDD and nonmelancholic MDD. Methods. Thirty-one outpatients with melancholic MDD, thirty-three outpatients with nonmelancholic MDD, and thirty-two age- and gender-matched healthy controls were recruited. All participants were scanned by resting-state functional magnetic resonance imaging (fMRI). Imaging data were analyzed with the network homogeneity (NH) and support vector machine (SVM) methods. Results. Both patient groups exhibited increased NH in the right PCC/precuneus and right angular gyrus and decreased NH in the right middle temporal gyrus compared with healthy controls. Compared with nonmelancholic patients and healthy controls, melancholic patients exhibited significantly increased NH in the bilateral superior medial frontal gyrus and decreased NH in the left inferior temporal gyrus. But merely for melancholic patients, the NH of the right middle temporal gyrus was negatively correlated with TEPS total and contextual anticipatory scores. SVM analysis showed that a combination of NH values in the left superior medial frontal gyrus and left inferior temporal gyrus could distinguish melancholic patients from nonmelancholic patients with accuracy, sensitivity, and specificity of 79.66% (47/59), 70.97% (22/31), and 89.29%(25/28), respectively. Conclusion. Our findings showed distinctive network homogeneity alterations in melancholic MDD which may be potential imaging markers to distinguish melancholic MDD and nonmelancholic MDD.

scholarly journals Brain SPECT perfusion and PET metabolism as discordant biomarkers in major depressive disorder

2020 ◽  
Author(s):  
Maud Tastevin ◽  
Laurent Boyer ◽  
Theo Korchia ◽  
Guillaume Fond ◽  
Christophe Lançon ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Temporal Cortex ◽  
Brain Perfusion ◽  
Pathological Process ◽  
Brain Spect ◽  
Treatment Resistant ◽  
Major Depressive ◽  
The Right ◽  
Depressive Episodes

Abstract Background: Brain SPECT perfusion and PET metabolism have been, most often interchangeably, proposed to study the underlying pathological process in major depressive disorder (MDD). The objective of this study was to specify similarities and inconsistencies between these two biomarkers according to global characteristics of the disease. We conducted a retrospective study in 16 patients suffering from treatment-resistant MDD who underwent, during the same current episode, a cerebral perfusion SPECT with 99mTc-HMPAO and a metabolic PET with 18F-FDG. Whole-brain voxel-based SPM(T) maps were generated in correlation with the number of depressive episodes and in correlation with the depression duration, separately for the two exams (p-voxel<0.001 uncorrected, k>20). Results: No significant correlations were found between brain metabolism and either the number of depressive episodes or the duration of the disease, even at an uncorrected p-voxel<0.005. On the other hand, the increased number of depressive episodes was correlated with decreased perfusion of the right middle frontal cortex, the right anterior cingulum cortex, the right insula, the right medial temporal cortex and the left precuneus. The increased depression duration was correlated with decreased perfusion of the right anterior cingulum cortex. Conclusions: This preliminary study demonstrates more significant results with brain perfusion compared with glucose metabolism in treatment-resistant MDD, highlighting the value of brain SPECT despite less favourable instrumentation detection compared to PET.

scholarly journals An Observational Study on Depressive Illness in Hemodialysis Recipients: A Review on its Association and Prognostication

2020 ◽  
Vol 8 (1) ◽  
pp. 41-47
Author(s):  
Umme Salma Talukder ◽  
Hossain Tameem Bin Anayet ◽  
Samjhana Mandal ◽  
MM Jalal Uddin ◽  
Fahmida Ahmed ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Physical Symptoms ◽  
Diabetic Patients ◽  
Dialysis Patients ◽  
Major Depressive ◽  
Stage Renal Disease ◽  
End Stage

Major Depressive Disorder (MDD) is one of the most common psychiatric illnesses. The effect of depression on one’s physical health is well-known, which can include anything from weight gain or loss to chronic illnesses such as heart disease, kidney or gastrointestinal problems. Provided the increasing prevalence of patients suffering from End Stage Renal Disease (ESRD) and receiving hemodialysis treatment, it is important to investigate how MDD affects the outcome of their treatment. The incidence of depression in dialysis patients ranges from 10% to 66% in various studies, with prevalence reaching as high as 100%. The purpose of this article is to find the prevalence and severity of major depressive disorder in dialysis patients as well as to describe the possible pathways MDD worsens the dialysis outcome. Our study population consisted of 51 End Stage Renal Disease (ESRD) patients sampled from the Department of Nephrology at BIRDEM General Hospital. Neurocognitive, physical symptoms, the severity of MDD and presence of comorbid conditions including diabetics and hypertension, were measured in our study. The ESRD patient sample consisted 47.7% moderately depressed patients, 34% severely depressed, 11.4% mild and 6.8% with minimal MDD patients. Analogous to Hypertension and Diabetic patients with depression, the number of Chronic Kidney Disease (CKD) patients with mostly moderate severe depression increased with the duration of the disease. The article explains a myriad of biologic, behavioral, genetic and social factors underlying the association of depression and adverse medical outcomes in patients with CKD and ESRD. Moreover, neuroimaging data is required for further discussion on relationship between Depression and CKD. The implication of this study is to emphasize the importance of dialysis patients’ overall health and to serve as a pretext for further research into depression in dialysis patients. Bangladesh Crit Care J March 2020; 8(1): 41-47

scholarly journals Punding Behavior as a Red Flag for Dementia in a Patient With Depression: Case Report

2021 ◽  
Vol 12 ◽  
Author(s):  
Arnaud Pouchon ◽  
Clément Dondé ◽  
Mircea Polosan
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Brain Mri ◽  
Brain Perfusion ◽  
Normal Brain ◽  
Major Depressive ◽  
Red Flag ◽  
Neuropsychological Evaluations ◽  
Oriented Activity ◽  
The Right

Punding is defined as a stereotypic, complex, repetitive, and non-goal-oriented activity. This behavior has been observed in Parkinson's disease and chronic amphetamine users. However, in general, punding behavior is largely under-diagnosed. Here, we describe a rare case of a 53-year-old woman showing punding behavior during major depressive disorder with atypical clinical features suggestive of a frontal syndrome. Neuropsychological evaluations mainly reported deficits in executive functioning. Brain MRI and lumbar puncture were normal. Brain perfusion SPECT showed hypoperfusion predominating in the right frontal and parietooccipital lobes, and a slight hypoperfusion in subthalamic nucleus including the posterior area of right striatum. We diagnosed this case as a frontotemporal dementia. Punding behavior could be a red flag for dementia in patients with major depressive disorder.

scholarly journals Prevalence of Mental Disorders in Nepal: Findings from the Pilot Study

2019 ◽  
Vol 17 (2) ◽  
pp. 141-147 ◽  
Author(s):  
Anjani Kumar Jha ◽  
Saroj Prasad Ojha ◽  
Sushma Dahal ◽  
Pawan Sharma ◽  
Sagun Ballav Pant ◽  
...  
Keyword(s):  
Mental Health ◽  
Major Depressive Disorder ◽  
Pilot Study ◽  
Mental Disorders ◽  
Depressive Disorder ◽  
Health Survey ◽  
Conversion Disorder ◽  
Major Depressive ◽  
Mental Health Survey ◽  
National Mental Health

Background: The global prevalence of mental disorders is high and has an increasing trend. In Nepal, there is dearth in literature on prevalence of mental disorders based on national representative sample. In this study, we aim to present the findings on the prevalence of mental disorders from the pilot study of National Mental Health Survey, Nepal. Methods: A cross-sectional study was conducted among 1647 participants aged 13 years and above in three districts of Nepal: Dhanusha, Bhaktapur and Dolakha each representing three ecological regions. Mini International Neuropsychiatric Interview (MINI) standard version 7.0.2 for DSM-5 was used for adults (aged 18 years and above), and kid version of the same tool was used for children (aged 13-17 years) in Nepali language. Separate sets of questions were added for epilepsy and dissociative conversion disorder that were not in the Mini International Neuropsychiatric Interview tool. Prevalence of assessed mental disorders was reported separately for adults and children.Results: The current prevalence of mental disorders among adults and children were 13.2% and 11.2% respectively. Substance use disorder, dissociative conversion disorder, major depressive disorder, alcohol use disorder and psychotic disorder were common among adults. Similarly, psychotic disorder, agoraphobia, major depressive disorder, and anxiety disorders were common among children. Current suicidality was present among 10.9% adults and 8.7% children.Conclusions: Our findings from the pilot study have given insight into the prevalence of different mental disorders in the survey areas. These findings can be utilized for planning the National Mental Health Survey, Nepal. Keywords: Mental disorders; mental health survey; MINI; Nepal; pilot study.

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