Frequency, Clinical Associations, and Longitudinal Course of Major Depressive Disorder in Adults With Cerebral Glioma

2011 ◽  
Vol 29 (32) ◽  
pp. 4307-4312 ◽  
Author(s):  
Alasdair G. Rooney ◽  
Shanne McNamara ◽  
Mairi Mackinnon ◽  
Mary Fraser ◽  
Roy Rampling ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Functional Impairment ◽  
Odds Ratio ◽  
Previous History ◽  
Cerebral Glioma ◽  
Major Depressive ◽  
Longitudinal Course ◽  
Clinical Associations

Purpose There is a need for high-quality evidence regarding the frequency, independent clinical associations, and longitudinal course of depression in patients with cerebral glioma. Patients and Methods This was a twin-center, prospective, observational cohort study with 6-month follow-up. Consenting adults with a new diagnosis of cerebral glioma received the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition to diagnose major depressive disorder (MDD). Interviews occurred shortly after the start of radiotherapy (T1), with follow-up interviews 3 months later (T2) and 6 months later (T3). Independent associations between MDD and clinical variables were analyzed using logistic regression. Results One hundred fifty-five patients participated. The frequency of MDD was 13.5% ± 5.4% at T1 (n = 155); 14.8% ± 6.7% at T2 (n = 108); and 6.8% ± 5.3% at T3 (n = 88). Overall, 32 individuals were diagnosed with MDD during the study period (20.6% ± 6.4%). Inter-rater diagnostic agreement for MDD was good (κ = 0.81; 95% CI, 0.60 to 1.00). Independent predictors of MDD were functional impairment (odds ratio, 3.9; 95% CI, 1.5 to 10.8) and a previous history of depression (odds ratio, 2.7; 95% CI, 0.99 to 7.3). MDD persisted for at least 3 months in half of the patients with adequate follow-up, but many depressed patients also dropped out of the study as a result of clinical deterioration. Conclusion In this longitudinal study, one in five patients with glioma developed clinical depression in the 6 months after starting radiotherapy. Patients with functional impairment or previous depression were at higher risk. MDD often persisted for at least 3 months. Clinicians should seek and treat depression in adults with glioma.

scholarly journals Functional Impairment and Painful Physical Symptoms in Patients with Major Depressive Disorder Treated with Antidepressants: Real-World Evidence from the Middle East

2017 ◽  
Vol 13 (1) ◽  
pp. 145-155
Author(s):  
Jihyung Hong ◽  
Diego Novick ◽  
Maria Victoria Moneta ◽  
Ahmed El-Shafei ◽  
Héctor Dueñas ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Middle East ◽  
Depressive Disorder ◽  
Functional Impairment ◽  
Repeated Measures ◽  
Middle Eastern ◽  
Relative Size ◽  
Physical Symptoms ◽  
Major Depressive

Background:The Global Burden of Disease 2010 study reported the relative size of major depressive disorder (MDD) burden to be greater in the Middle East and North Africa than anywhere else. However, little research has been carried out to examine the comparative effectiveness of antidepressants in this region.Objective:To assess and compare functioning levels in Middle Eastern patients with MDD treated with either duloxetine or a selective serotonin reuptake inhibitor (SSRI), and to examine the impacts of depression-related pain on functioning by the type of treatment.Method:This post-hoc analysis, which focused on Middle Eastern patients, used data from a 6-month prospective observational study that included 1,549 MDD patients without sexual dysfunction. Levels of functional impairment and depression-related pain were assessed using the Sheehan Disability Scale (SDS) and the modified Somatic Symptom Inventory, respectively. A mixed model with repeated measures (MMRM) was employed.Results:The mean age of the patients was 37.3 (SD=8.4) years, and 34.6% were female. Patient functioning was, on average, moderately impaired at baseline, but improved substantially during follow-up in both the duloxetine (n=152) and the SSRI (n=123) cohorts. The MMRM results showed a lower level of functional impairment at 24 weeks in the duloxetine cohort than in the SSRI cohort (p<0.001). Pain severity at baseline was positively associated with functional impairment during follow-up only in the SSRI cohort (p=0.003).Conclusion:Duloxetine-treated MDD patients achieved better functioning than SSRI-treated patients. This treatment difference was partly driven by depression-related pain.

scholarly journals Factors associated with the onset of major depressive disorder in adults with type 2 diabetes living in 12 different countries: results from the INTERPRET-DD prospective study

2020 ◽  
Vol 29 ◽  
Author(s):  
C. E. Lloyd ◽  
N. Sartorius ◽  
H. U. Ahmed ◽  
A. Alvarez ◽  
S. Bahendeka ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Depressive Disorder ◽  
Life Events ◽  
Stressful Life Events ◽  
Regression Analyses ◽  
Major Depressive

Abstract Aims To examine the factors that are associated with changes in depression in people with type 2 diabetes living in 12 different countries. Methods People with type 2 diabetes treated in out-patient settings aged 18–65 years underwent a psychiatric assessment to diagnose major depressive disorder (MDD) at baseline and follow-up. At both time points, participants completed the Patient Health Questionnaire (PHQ-9), the WHO five-item Well-being scale (WHO-5) and the Problem Areas in Diabetes (PAID) scale which measures diabetes-related distress. A composite stress score (CSS) (the occurrence of stressful life events and their reported degree of ‘upset’) between baseline and follow-up was calculated. Demographic data and medical record information were collected. Separate regression analyses were conducted with MDD and PHQ-9 scores as the dependent variables. Results In total, there were 7.4% (120) incident cases of MDD with 81.5% (1317) continuing to remain free of a diagnosis of MDD. Univariate analyses demonstrated that those with MDD were more likely to be female, less likely to be physically active, more likely to have diabetes complications at baseline and have higher CSS. Mean scores for the WHO-5, PAID and PHQ-9 were poorer in those with incident MDD compared with those who had never had a diagnosis of MDD. Regression analyses demonstrated that higher PHQ-9, lower WHO-5 scores and greater CSS were significant predictors of incident MDD. Significant predictors of PHQ-9 were baseline PHQ-9 score, WHO-5, PAID and CSS. Conclusion This study demonstrates the importance of psychosocial factors in addition to physiological variables in the development of depressive symptoms and incident MDD in people with type 2 diabetes. Stressful life events, depressive symptoms and diabetes-related distress all play a significant role which has implications for practice. A more holistic approach to care, which recognises the interplay of these psychosocial factors, may help to mitigate their impact on diabetes self-management as well as MDD, thus early screening and treatment for symptoms is recommended.

Evaluation of psychosocial functioning in the acute treatment term of major depressive disorder: a 16-week multi-centered follow-up study

2021 ◽  
pp. 102883
Author(s):  
Neslihan ALTUNSOY ◽  
Didem SÜCÜLLÜOĞLU DİKİCİ ◽  
Fikret Poyraz ÇÖKMÜŞ ◽  
Hüseyin Murat ÖZKAN ◽  
Kadir AŞÇIBAŞI ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Psychosocial Functioning ◽  
Acute Treatment ◽  
Major Depressive ◽  
Follow Up Study

Prefrontal cortex function in remitted major depressive disorder

2012 ◽  
Vol 43 (6) ◽  
pp. 1219-1230 ◽  
Author(s):  
N. L. Nixon ◽  
P. F. Liddle ◽  
G. Worwood ◽  
M. Liotti ◽  
E. Nixon
Keyword(s):  
Major Depressive Disorder ◽  
Prefrontal Cortex ◽  
Depressive Disorder ◽  
Negative Feedback ◽  
Affective State ◽  
Recurrence Risk ◽  
Anterior Cingulate ◽  
Major Depressive ◽  
Negative Experience

BackgroundRecent models of major depressive disorder (MDD) have proposed the rostral anterior cingulate (rACC) and dorsomedial prefrontal cortex (dmPFC) as nexus sites in the dysfunctional regulation of cognitive-affective state. Limited evidence from remitted-state MDD supports these theories by suggesting that aberrant neural activity proximal to the rACC and the dmPFC may play a role in vulnerability to recurrence/relapse within this disorder. Here we present a targeted analysis assessing functional activity within these two regions of interest (ROIs) for groups with identified vulnerability to MDD: first, remitted, high predicted recurrence-risk patients; and second, patients suffering observed 1-year recurrence.MethodBaseline T2* images sensitive to blood oxygen level-dependent (BOLD) contrast were acquired from patients and controls during a Go/No-Go (GNG) task incorporating negative feedback, with 1-year patient follow-up to identify recurrence. BOLD contrast data for error commission (EC) and visual negative feedback (VNF) were used in an ROI analysis based on rACC and dmPFC coordinates from the literature, comparing patientsversuscontrols and recurrenceversusnon-recurrenceversuscontrol groups.ResultsAnalysis of patients (n = 20)versuscontrols (n = 20) showed significant right dmPFC [Brodmann area (BA) 9] hypoactivity within the patient group, co-localized during EC and VNF, with additional significant rACC (BA 32) hypoactivity during EC. The results from the follow-up analysis were undermined by small groups and potential confounders but suggested persistent right dmPFC (BA 9) hypoactivity associated with 1-year recurrence.ConclusionsConvergent hypoactive right dmPFC (BA 9) processing of VNF and EC, possibly impairing adaptive reappraisal of negative experience, was associated most clearly with clinically predicted vulnerability to MDD.

Hippocampal and Amygdala Changes in Patients With Major Depressive Disorder and Healthy Controls During a 1-Year Follow-Up

2004 ◽  
Vol 65 (4) ◽  
pp. 492-499 ◽  
Author(s):  
Thomas Frodl ◽  
Eva M. Meisenzahl ◽  
Thomas Zetzsche ◽  
Tom Höhne ◽  
Sandra Banac ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Healthy Controls ◽  
Major Depressive

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.

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