scholarly journals Irritability and Its Clinical Utility in Major Depressive Disorder: Prediction of Individual-Level Acute-Phase Outcomes Using Early Changes in Irritability and Depression Severity

2019 ◽  
Vol 176 (5) ◽  
pp. 358-366 ◽  
Author(s):  
Manish K. Jha ◽  
Abu Minhajuddin ◽  
Charles South ◽  
A. John Rush ◽  
Madhukar H. Trivedi
2020 ◽  
pp. 1-10
Author(s):  
V. H. Dam ◽  
D. S. Stenbæk ◽  
K. Köhler-Forsberg ◽  
C. Ip ◽  
B. Ozenne ◽  
...  

Abstract Background Cognitive disturbances are common and disabling features of major depressive disorder (MDD). Previous studies provide limited insight into the co-occurrence of hot (emotion-dependent) and cold (emotion-independent) cognitive disturbances in MDD. Therefore, we here map both hot and cold cognition in depressed patients compared to healthy individuals. Methods We collected neuropsychological data from 92 antidepressant-free MDD patients and 103 healthy controls. All participants completed a comprehensive neuropsychological test battery assessing hot cognition including emotion processing, affective verbal memory and social cognition as well as cold cognition including verbal and working memory and reaction time. Results The depressed patients showed small to moderate negative affective biases on emotion processing outcomes, moderate increases in ratings of guilt and shame and moderate deficits in verbal and working memory as well as moderately slowed reaction time compared to healthy controls. We observed no correlations between individual cognitive tasks and depression severity in the depressed patients. Lastly, an exploratory cluster analysis suggested the presence of three cognitive profiles in MDD: one characterised predominantly by disturbed hot cognitive functions, one characterised predominantly by disturbed cold cognitive functions and one characterised by global impairment across all cognitive domains. Notably, the three cognitive profiles differed in depression severity. Conclusion We identified a pattern of small to moderate disturbances in both hot and cold cognition in MDD. While none of the individual cognitive outcomes mapped onto depression severity, cognitive profile clusters did. Overall cognition-based stratification tools may be useful in precision medicine approaches to MDD.


2020 ◽  
Vol 24 (3) ◽  
pp. 815-824 ◽  
Author(s):  
Sahar Harati ◽  
Andrea Crowell ◽  
Yijian Huang ◽  
Helen Mayberg ◽  
Shamim Nemati

2012 ◽  
Vol 47 (3) ◽  
pp. 271-275 ◽  
Author(s):  
Nayereh Khoraminya ◽  
Mehdi Tehrani-Doost ◽  
Shima Jazayeri ◽  
Aghafateme Hosseini ◽  
Abolghassem Djazayery

Objective: To compare the therapeutic effects of vitamin D3 plus fluoxetine and fluoxetine alone in patients with major depressive disorder. Methods: In the present double-blind, randomized, placebo-controlled trial, 42 patients with a diagnosis of major depressive disorder based on DSM-IV criteria were randomly assigned into two groups to receive daily either 1500 IU vitamin D3 plus 20 mg fluoxetine or fluoxetine alone for 8 weeks. Depression severity was assessed at 2-week intervals using the 24-item Hamilton Depression Rating Scale (HDRS) as a primary outcome measure and the 21-item Beck Depression Inventory (BDI) as a secondary outcome measure. Serum 25(OH) vitamin D was measured at baseline and after intervention. Results: Forty patients completed the trial. A two-way repeated-measures analysis of variance showed that depression severity based on HDRS and BDI decreased significantly after intervention, with a significant difference between the two groups. The vitamin D + fluoxetine combination was significantly better than fluoxetine alone from the fourth week of treatment. Conclusions: In the present 8-week trial, the vitamin D + fluoxetine combination was superior to fluoxetine alone in controlling depressive symptoms.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Fraser W. Gaspar ◽  
Kerri Wizner ◽  
Joshua Morrison ◽  
Carolyn S. Dewa

Abstract Background Depression is the greatest contributor to worldwide disability. The purpose of this study was to understand the influence of antidepressant and psychotherapy treatment adherence on future work leaves for patients with major depressive disorder. Methods Patients with a newly diagnosed major depressive disorder (n = 26,256) were identified in IBM® Watson™ MarketScan® medical and disability claims databases. Antidepressant and psychotherapy adherence metrics were evaluated in the acute phase of treatment, defined as the 114 days following the depression diagnosis. Multiple variable Cox proportional hazards regression models evaluated the influence of antidepressant and/or psychotherapy adherence on future injury or illness work leaves. Results The majority of work leaves in the 2-year follow-up period occurred in the acute phase of treatment (71.2%). Among patients without a work leave in the acute phase and who received antidepressants and/or psychotherapy (n = 19,994), those who were adherent to antidepressant or psychotherapy treatment in the acute phase had a 16% (HR = 0.84, 95% CI = 0.77–0.91) reduced risk of a future work leave compared to treatment non-adherent patients. Patients who were non-adherent or adherent to antidepressant treatment had a 22% (HR = 1.22, 95% CI = 1.11–1.35) and 13% (HR = 1.13, 95% CI = 1.01–1.27) greater risk of a future work leave, respectively, than patients not receiving antidepressant treatment. Conversely, patients who were non-adherent or adherent to psychotherapy treatment had a 9% (HR = 0.91, 95% CI = 0.81–1.02) and 28% (HR = 0.72, 95% CI = 0.64–0.82) reduced risk of a future work leave, respectively, than patients not receiving psychotherapy treatment. Conclusions This analysis suggests that treatment adherence may reduce the likelihood of a future work leave for patients with newly diagnosed major depressive disorder. Psychotherapy appears more effective than antidepressants in reducing the risk of a future work leave.


2020 ◽  
Vol 57 (2) ◽  
pp. 168-192
Author(s):  
Natalie Paul ◽  
Carol Lotter ◽  
Werdie van Staden

Abstract Reflections of patients have not been studied qualitatively after a completed course of individual music therapy for a major depressive disorder (MDD) or an acute phase of a schizophrenia spectrum disorder (SSD). Our interpretivist study explored patient reflections through individual interviews with 15 hospitalized patients after a completed course of eight individual music therapy sessions that were flexibly structured in blended fashion utilizing a set of active and receptive music therapy methods. Our analyses yielded 8 themes, supported by 23 subthemes. These themes were grouped into three domains, capturing respectively participants’ praise for music therapy, the distress from which change emerged, and various perceived gains. Participants cast the perceived gains from music therapy in the wake of their distress. The domain of distress comprised two themes: distress before and during therapy, and a process of opening up and dealing with old wounds. The themes expressing their gains were: new perspectives, growing strong, emotional fulfillment, becoming socially closer and more adept, and becoming liberated and creatively inspired. These client perspectives on a completed course of music therapy augment the evidence base established in clinician terms of what matters as a potential gain from music therapy. These perspectives, furthermore, inform on the gains and the distress from which gains emerged, congruent with a strengths-oriented therapeutic pursuit in music therapy for an MDD or an acute phase of SSD. Music therapists in similar settings may draw on these perspectives in the planning and strengthening of a course of music therapy.


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