scholarly journals Psychotic major depression: challenges in clinical practice and research

2018 ◽  
Vol 212 (3) ◽  
pp. 131-133 ◽  
Author(s):  
M. Heslin ◽  
A. H. Young

SummaryPsychotic major depression is an under-researched and under-identified disorder. We highlight the major challenges both in clinical practice and in conducting research with people with this disorder. We also suggest which major issues need addressing to move treatment and knowledge of this disorder forward.Declaration of interestM.H. and A.H.Y. both report grants from the National Institute for Health Research (NIHR).

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Meng-qi Wang ◽  
Ran-ran Wang ◽  
Yu Hao ◽  
Wei-feng Xiong ◽  
Ling Han ◽  
...  

Abstract Background Psychotic major depression (PMD) is a subtype of depression with a poor prognosis. Previous studies have failed to find many differences between patients with PMD and those with non-psychotic major depression (NMD) or schizophrenia (SZ). We compared sociodemographic factors (including season of conception) and clinical characteristics between patients with PMD, NMD, and schizophrenia. Our aim was to provide data to help inform clinical diagnoses and future etiology research. Methods This study used data of all patients admitted to Shandong Mental Health Center from June 1, 2016 to December 31, 2017. We analyzed cases who had experienced an episode of PMD (International Classification of Diseases, Tenth Revision codes F32.3, F33.3), NMD (F32.0–2/9, F33.0–2/9), and SZ (F20–20.9). Data on sex, main discharge diagnosis, date of birth, ethnicity, family history of psychiatric diseases, marital status, age at first onset, education, allergy history, and presence of trigger events were collected. Odds ratios (OR) were calculated using logistic regression analyses. Missing values were filled using the k-nearest neighbor method. Results PMD patients were more likely to have a family history of psychiatric diseases in their first-, second-, and third-degree relatives ([OR] 1.701, 95% confidence interval [CI] 1.019–2.804) and to have obtained a higher level of education (OR 1.451, 95% CI 1.168–1.808) compared with depression patients without psychotic features. Compared to PMD patients, schizophrenia patients had lower education (OR 0.604, 95% CI 0.492–0.741), were more often divorced (OR 3.087, 95% CI 1.168–10.096), had a younger age of onset (OR 0.934, 95% CI 0.914–0.954), less likely to have a history of allergies (OR 0.604, 95% CI 0.492–0.741), and less likely to have experienced a trigger event 1 year before first onset (OR 0.420, 95% CI 0.267–0.661). Season of conception, ethnicity, and sex did not differ significantly between PMD and NMD or schizophrenia and PMD. Conclusions PMD patients have more similarities with NMD patients than SZ patients in terms of demographic and clinical characteristics. The differences found between PMD and SZ, and PMD and NMD correlated with specificity of the diseases. Furthermore, allergy history should be considered in future epidemiological studies of psychotic disorders.


2021 ◽  
pp. 1-7
Author(s):  
Eshim S. Jami ◽  
Megan Pritchard ◽  
Hitesh Shetty ◽  
Robert Stewart ◽  
Allan H. Young ◽  
...  

Author(s):  
Carlo Marchesi ◽  
De Panfilis ◽  
Tonna ◽  
Paolo Ossola

2020 ◽  
pp. 139-148
Author(s):  
Joel Paris

Aggressive psychopharmacology describes the current practice of prescribing a large number of medications to patients with almost any mental disorder. While there is some evidence for this approach in severe and, persistent mental disorders, it has spread to common disorders, most particularly major depression. Clinical practice guidelines, which offer a wide range options for patients who are resistant to standard treatments, are being interpreted as promoting polypharmacy for a very broad group of patient. These practices have a surprisingly weak evidence base, and tend to take psychotherapy options off the table. Aggressive psychoharmacology is driven by overdiagnosis and is strongly encouraged by the pharmaceutical industry.


2002 ◽  
Vol 32 (11) ◽  
pp. 695-698
Author(s):  
Charles DeBattista ◽  
Joseph Belanoff

2019 ◽  
Vol 90 (3) ◽  
pp. e23.1-e23
Author(s):  
A Ansaripour ◽  
C Burford ◽  
J Hanrahan ◽  
A Korkor ◽  
K Ashkan ◽  
...  

ObjectivesResearch remains a foundation in advancing the field of neurosurgery. We explore attitudes and perceived barriers to conducting research in neurosurgery globally.DesignA 29-item questionnaire, consisting of multiple-choice questions, Likert scales and short answers.SubjectsClinicians at various stages of the Neurosurgical career.MethodsThe questionnaire was distributed through the Society of British Neurological Surgeons (SBNS) and European Association of Neurosurgical Societies (EANS).ResultsA total of 324 responses from 29 countries consisted of Clinical Fellows (n=26), Junior Trainees (n=48), Senior Trainees (n=46), Sub-specialty Fellows (n=18), Consultants (n=128) and Professors of Neurosurgery (n=58). Whilst 83% of participants believe research is a crucial aspect of a neurosurgeons’ career, only a third (33%) believed that neurosurgery as a speciality fosters a culture that promotes research. The top three perceived barriers to conducting research were lack of time (78%), insufficient access to funding (58%) and lack of mentorship (49%). Despite these, more than 87% of participants are interested in formal academic roles with 58% willing to interrupt clinical training to pursue research opportunities. The region of clinical practice had no correlation with respondents’ research output or their perceptions towards research barriers.ConclusionsThis study identified important barriers to research, elucidating which, allows the neurosurgical community to improve integration of research into clinical practice.


2007 ◽  
Vol 31 (1) ◽  
pp. 24 ◽  
Author(s):  
Kieran C O'Doherty

The question of what probability actually is has long been debated in philosophy and statistics. Although the concept of probability is fundamental to many applications in the health sciences, these debates are generally not well known to health professionals. This paper begins with an outline of some of the different interpretations of probability. Examples are provided of how each interpretation manifests in clinical practice. The discipline of genetic counselling (familial cancer) is used to ground the discussion. In the second part of the paper, some of the implications that different interpretations of probability may have in practice are examined. The main purpose of the paper is to draw attention to the fact that there is much contention as to the nature of the concept of probability. In practice, this creates the potential for ambiguity and confusion. This paper constitutes a call for deeper engagement with the ways in which probability and risk are understood in health research and practice.


2019 ◽  
Vol 30 (2) ◽  
pp. 167-181
Author(s):  
Stephanie Premji ◽  
Agnieszka Kosny ◽  
Basak Yanar ◽  
Momtaz Begum

Individuals who experience language barriers are largely excluded as participants from health research, resulting in gaps in knowledge that have implications for the development of equitable policies, tools, and strategies. Drawing on the existing literature and on their collective experience conducting occupational health research in contexts of language barriers, the authors propose a tool to assist qualitative researchers and representatives from funding agencies and ethics review boards with the meaningful consideration of language barriers in research. There remain gaps and debates with respect to the relevant ethical and methodological guidance set forth by funding agencies and institutions and proposed in the scientific literature. This article adds to knowledge in this area by contributing our experiences, observations, and recommendations, including around the issue of conducting research in contexts of more or less linguistic diversity.


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