The effectiveness of intravenous ketamine in adults with treatment-resistant major depressive disorder and bipolar disorder presenting with prominent anxiety: Results from the Canadian Rapid Treatment Center of Excellence

2020 ◽  
pp. 026988112095404
Author(s):  
Roger S McIntyre ◽  
Nelson B Rodrigues ◽  
Orly Lipsitz ◽  
Flora Nasri ◽  
Hartej Gill ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Depressive Symptomatology ◽  
Rapid Onset ◽  
Anxiety Symptoms ◽  
Self Report ◽  
Treatment Center ◽  
Treatment Resistant ◽  
Major Depressive

Background: Individuals meeting criteria for treatment-resistant depression (TRD) are differentially affected by high levels of anxiety symptoms. Aims: There is a need to identify the efficacy of novel rapid-onset treatments in adults with mood disorders and comorbid anxious-distress. Methods: This study included patients with treatment-resistant major depressive disorder (MDD) or bipolar disorder (BD) who were receiving intravenous (IV) ketamine treatment at a community-based clinic.Anxious-distress was proxied using items from the Quick Inventory of Depressive Symptomatology–Self Report 16-item (QIDS-SR16) and Generalized Anxiety Disorder 7-item (GAD7) scales. The difference in QIDS-SR16 total score, QIDS-SR16 suicidal ideation (SI) item and GAD7 score were analyzed between groups. Results: A total of 209 adults with MDD ( n = 177) and BD ( n = 26) were included in this analysis. From this sample, 94 patients (mean = 45 ± 13.9 years) met the criteria for anxious-distress. Individuals meeting the criteria for anxious-distress exhibited a significantly greater reduction in QIDS-SR16 total score following four infusions ( p = 0.02) when compared with patients not meeting the anxious-distress criteria. Both anxious-distressed and low-anxiety patients exhibited a significant reduction in SI ( p < 0.0001) following four infusions.Finally, there was a significantly greater reduction in anxiety symptoms in the anxious-distress group compared with the non–anxious distress group following three ( p = 0.02) and four infusions ( p < 0.001). Conclusion: Patients with TRD and prominent anxiety receiving IV ketamine exhibited a significant reduction in depressive, SI and anxiety symptoms.

The Quick Inventory of Depressive Symptomatology (Clinician and Self-Report Versions) in Patients With Bipolar Disorder

CNS Spectrums ◽  
2010 ◽  
Vol 15 (6) ◽  
pp. 367-373 ◽  
Author(s):  
Ira H. Bernstein ◽  
A. John Rush ◽  
Trisha Suppes ◽  
Yakasushi Kyotoku ◽  
Diane Warden
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Depressive Disorder ◽  
Depressive Symptomatology ◽  
Self Report ◽  
General Interest ◽  
Major Depressive ◽  
Sad Mood ◽  
Illness Phase

ABSTRACTIntroduction: The clinical and self-report versions of the Quick Inventory of Depressive Symptomatology (QIDS-C16 and QIDS-SR16) have been well studied in patients with major depressive disorder and in one recent study using patients with bipolar disorder. This article examines these measures in a second sample of 141 outpatients with bipolar disorder in different phases of the illness.Methods: At baseline, 61 patients were depressed and 30 were euthymic; at exit, 50 were depressed and 52 were euthymic. The remaining patients (at baseline or exit) were in either a manic or mixed phase and were pooled for statistical reasons.Results: Similar results were found for the QIDS-C16 and QIDS-SR16. Scores were reasonably reliable to the extent that variability within groups permitted. As expected, euthymic patients showed less depressive symptomatology than depressed patients. Sad mood and general interest were tne most discriminating symptoms between depressed and euthymic phases. Changes in illness phase (baseline to exit) were associated with substantial changes in scores. The relation of individual depressive symptoms to the overall level of depression was consistent across phases.Conclusion: Both the QIDS-SR16 and QIDS-C16 are suitable measures of depressive symptoms in patients with bipolar disorder.

scholarly journals Agomelatine: Its Role in the Management of Major Depressive Disorder

2012 ◽  
Vol 4 ◽  
pp. CMPsy.S7989 ◽  
Author(s):  
Daniel P. Cardinali ◽  
María F. Vidal ◽  
Daniel E. Vigo
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Circadian Rhythm ◽  
Depressive Disorder ◽  
Seasonal Affective Disorder ◽  
Rapid Onset ◽  
Depressive Illness ◽  
Melatonin Secretion ◽  
Major Depressive ◽  
Onset Of Action

Circadian rhythm abnormalities, as shown by sleep/wake cycle disturbances, constitute one the most prevalent signs of depressive illness; advances or delays in the circadian phase are documented in patients with major depressive disorder (MDD), bipolar disorder, and seasonal affective disorder (SAD). The disturbances in the amplitude and phase of rhythm in melatonin secretion that occur in patients with depression resemble those seen in chronobiological disorders, thus suggesting a link between disturbed melatonin secretion and depressed mood. Based on this, agomelatine, the first MT1/MT2 melatonergic agonist displaying also 5-HT2C serotonergic antagonism, has been introduced as an antidepressant. Agomelatine has been shown to be effective in several animal models of depression and anxiety and it has beneficial effects in patients with MDD, bipolar disorder, or SAD. Among agomelatine's characteristics are a rapid onset of action and a pronounced effectiveness for correcting circadian rhythm abnormalities and improving the sleep/wake cycle. Agomelatine also improves the 3 functional dimensions of depression—emotional, cognitive, and social—thus aiding in the full recovery of patients to a normal life.

The selective orexin-2 receptor antagonist seltorexant improves sleep: An exploratory double-blind, placebo controlled, crossover study in antidepressant-treated major depressive disorder patients with persistent insomnia

2019 ◽  
Vol 33 (2) ◽  
pp. 202-209 ◽  
Author(s):  
Sander Brooks ◽  
Gabriël E Jacobs ◽  
Peter de Boer ◽  
Justine M Kent ◽  
Luc Van Nueten ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Depressive Symptomatology ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Sleep Efficiency ◽  
Least Square ◽  
Self Report ◽  
Major Depressive ◽  
Double Blind

Background: Insomnia is common in patients with major depressive disorder. Although antidepressants improve mood, insomnia often persists as a result of physiological hyperarousal. The orexin-2 receptor is increasingly being recognized as a new target for the treatment of persistent insomnia in major depressive disorder . Aim: This exploratory study investigated the effects of seltorexant on objective sleep parameters and subjective depressive symptoms in antidepressant treated major depressive disorder patients with persistent insomnia. Methods: Twenty male and female patients received a single dose of 10, 20, 40 mg seltorexant and placebo with a washout period of seven days in a double-blind four-way crossover study. Effects on latency to persistent sleep, total sleep time and sleep efficiency were assessed with polysomnography. Subjective changes in mood were explored by the Quick Inventory of Depressive Symptomatology Self-Report. Safety was recorded and suicidal ideation and behavior were assessed with the Columbia Suicide Severity Rating Scale. Results: Latency to persistent sleep was significantly shorter for all doses of seltorexant compared to placebo. Placebo least square mean was 61.05 min with least square mean ratios treatment/placebo (80% confidence interval) of 0.32 (0.24–0.44), 0.15 (0.11–0.2) and 0.17 (0.12–0.23) 19.69, 9.2, 10.15 for 10, 20 and 40 mg seltorexant respectively, (all p<0.001). Total sleep time was significantly longer for all doses of seltorexant compared to placebo. Sleep efficiency was significantly improved. The Quick Inventory of Depressive Symptomatology Self-Report demonstrated a trend to mood-improvement for the 40 mg group. Conclusions: Seltorexant showed a statistically significant, dose-dependent decrease in latency to persistent sleep, and increase in total sleep time and sleep efficiency combined with a tendency toward subjectively improved mood.

scholarly journals The Quick Inventory of Depressive Symptomatology-Self-report: a psychometric evaluation in patients with asthma and major depressive disorder

2008 ◽  
Vol 100 (5) ◽  
pp. 433-438 ◽  
Author(s):  
E. Sherwood Brown ◽  
Michelle Murray ◽  
Thomas J. Carmody ◽  
Beth D. Kennard ◽  
Carroll W. Hughes ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Depressive Symptomatology ◽  
Psychometric Evaluation ◽  
Self Report ◽  
Major Depressive

scholarly journals Impact of measurement frequency on self-reported depressive symptoms: An experimental study in a clinical setting

2020 ◽  
Author(s):  
Nicole Geschwind ◽  
Martijn van Teffelen ◽  
Elin Hammarberg ◽  
Arnoud Arntz ◽  
M.J.H. Huibers ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Depressive Symptom ◽  
Depressive Disorder ◽  
Depressive Symptomatology ◽  
Depression Scale ◽  
Self Report ◽  
Major Depressive ◽  
Measurement Frequency ◽  
Symptom Scores

Background: Previous research suggests a relationship between measurement frequency of self-reported depressive symptoms and change in depressive symptom scores for the Beck Depression Inventory II (BDI-II). The goal of the current study was to investigate the differential effects of weekly and monthly completion of the BDI-II and Quick Inventory of Depressive Symptomatology self-report (QIDS-SR). Methods: Seventy individuals diagnosed with major depressive disorder (MDD) waiting for treatment were randomly assigned to either completing BDI-II weekly, BDI-II monthly, QIDS-SR weekly, or QIDS-SR monthly for a duration of nine weeks. After nine weeks participants also completed the Zung depression scale once. Mixed multilevel regression modelling and Bayesian Statistical Analysis were used to test the relationship between the measurement frequency and depression scores, and to compare scores of the repeatedly completed instruments with the instrument completed only in week nine.Results: Measurement frequency was not related to BDI-II, QIDS-SR or Zung scores. However, depression scores declined in the weekly and monthly QIDS-SR (but not BDI-II) conditions, while Bayesian analyses indicated moderate support for equal depression scores on the Zung SDS.Limitations: Lack of a clinician-rated depression scale at week nine in addition to the self-report measure. Conclusion: In contrast to previous studies in non-clinical samples, our findings suggest that measurement frequency does not have an impact on scores of the BDI-II. Implications for clinical studies monitoring depressive symptom scores with self-report scales are discussed. Keywords: major depressive disorder; retest effects; measurement error; measurement frequency; Beck Depression Inventory; Quick Inventory of Depressive Symptomatology

Dimensions of anxiety in Major depressive disorder and their use in predicting antidepressant treatment outcome: an iSPOT-D report

2019 ◽  
Vol 50 (6) ◽  
pp. 1032-1042 ◽  
Author(s):  
Taylor A. Braund ◽  
Donna M. Palmer ◽  
Leanne M. Williams ◽  
Anthony W. F. Harris
Keyword(s):  
Major Depressive Disorder ◽  
Treatment Outcome ◽  
Depressive Disorder ◽  
Clinical Features ◽  
Rating Scale ◽  
Depressive Symptomatology ◽  
Antidepressant Treatment ◽  
Anxiety Symptoms ◽  
Major Depressive ◽  
Somatic Anxiety

AbstractBackgroundMajor depressive disorder (MDD) commonly co-occurs with clinically significant levels of anxiety. However, anxiety symptoms are varied and have been inconsistently associated with clinical, functional, and antidepressant treatment outcomes. We aimed to identify and characterise dimensions of anxiety in people with MDD and their use in predicting antidepressant treatment outcome.Method1008 adults with a current diagnosis of single-episode or recurrent, nonpsychotic, MDD were assessed at baseline on clinical features and cognitive/physiological functioning. Participants were then randomised to one of three commonly prescribed antidepressants and reassessed at 8 weeks regarding symptom change, as well as remission and response, on the 17-item Hamilton Rating Scale Depression (HRSD17) and the 16-item Quick Inventory of Depressive Symptomatology (QIDS-SR16). Exploratory factor analysis was used on items from scales assessing anxiety symptoms, and resulting factors were assessed against clinical features and cognitive/physiological functioning. Factors were also assessed on their ability to predict treatment outcome.ResultsThree factors emerged relating to stress, cognitive anxiety, and somatic anxiety. All factors showed high internal consistency, minimal cross-loadings, and unique clinical and functional profiles. Furthermore, only higher somatic anxiety was associated with poorer QIDS-SR16 remission, even after adjusting for covariates and multiple comparisons.ConclusionsAnxiety symptoms in people with MDD can be separated onto distinct factors that differentially respond to treatment outcome. Furthermore, these factors do not align with subscales of established measures of anxiety. Future research should consider cognitive and somatic symptoms of anxiety separately when assessing anxiety in MDD and their use in predicting treatment outcome.

scholarly journals Predictors of Response to Ketamine in Treatment Resistant Major Depressive Disorder and Bipolar Disorder

2018 ◽  
Vol 15 (4) ◽  
pp. 771 ◽  
Author(s):  
Carola Rong ◽  
Caroline Park ◽  
Joshua Rosenblat ◽  
Mehala Subramaniapillai ◽  
Hannah Zuckerman ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Treatment Resistant ◽  
Major Depressive ◽  
Predictors Of Response
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