scholarly journals Trajectories of somatic drug utilization patterns in Major Depressive Disorder: A Study protocol for a Danish nationwide register study using Latent Class Analysis

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 1039
Author(s):  
Anne Marije Christina Overgaard Nielsen ◽  
Kristoffer Jarlov Jensen ◽  
Ramune Jacobsen ◽  
Pernille Herold Jeberg ◽  
Anna Birna Almarsdóttir ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Latent Class Analysis ◽  
Drug Utilization ◽  
Latent Class ◽  
Treatment Burden ◽  
Major Depressive ◽  
Utilization Patterns ◽  
Somatic Diseases ◽  
Over Time

Background: Major Depressive disorder (MDD) is a heterogeneous, multi-etiological disorder that is associated with chronic medical conditions and a high somatic treatment burden. A better understanding of the somatic diseases and treatment burden in MDD can be provided through a mapping of the somatic drug utilization patterns over time. The objective of this study is therefore to characterize the somatic drug profiles and their transitions over time (i.e. trajectories) among MDD patients.    Methods: This descriptive study will be a nationwide register-based study including all Danish patients with an incident MDD diagnosis between 2011 and 2015. Using Latent Class Analysis, we will identify homogenous MDD patient subgroups according to somatic drug utilization (i.e. drug profiles). The development in somatic drug profiles will be depicted in four different time intervals from three years prior to the MDD diagnosis to three years after the diagnosis. Patients will be assigned to the latent class (drug profile) to which they have the highest probability of belonging using modal assignment. The treatment trajectories will be performed by cross tabulating these assignments.  Discussion: Profiles and trajectories of somatic drug use will provide a new perspective on patterns of somatic drug burden in MDD patients. Moreover, identifying homogenous subgroups of MDD patients regarding somatic drug use can contribute to a deeper understanding of MDD etiology. In the future, this knowledge could help optimizing MDD treatment by studying if different antidepressants will show different efficacy and safety depending on the profiles and trajectories of somatic diseases.

scholarly journals Structure of major depressive disorder in adolescents and adults in the US general population

2012 ◽  
Vol 201 (2) ◽  
pp. 143-150 ◽  
Author(s):  
Femke Lamers ◽  
Marcy Burstein ◽  
Jian-ping He ◽  
Shelli Avenevoli ◽  
Jules Angst ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Latent Class Analysis ◽  
Representative Sample ◽  
Latent Class ◽  
Longitudinal Research ◽  
Class Analysis ◽  
Major Depressive ◽  
National Comorbidity Survey ◽  
Nationally Representative

BackgroundAlthough techniques such as latent class analysis have been used to derive empirically based subtypes of depression in adult samples, there is limited information on subtypes of depression in youth.AimsTo identify empirically based subtypes of depression in a nationally representative sample of US adolescents, and to test the comparability of subtypes of depression in adolescents with those derived from a nationally representative sample of adults.MethodRespondents included 912 adolescents and 805 adults with a 12-month major depressive disorder, selected from the National Comorbidity Survey Adolescent Supplement and the National Comorbidity Survey Replication samples respectively. Latent class analysis was used to identify subtypes of depression across samples. Sociodemographic and clinical correlates of derived subtypes were also examined to establish their validity.ResultsThree subtypes of depression were identified among adolescents, whereas four subtypes were identified among adults. Two of these subtypes displayed similar diagnostic profiles across adolescent and adult samples (P=0.43); these subtypes were labelled ‘severe typical’ (adults 45%, adolescents 35%) and ‘atypical’ (adults 16%, adolescents 26%). The latter subtype was characterised by increased appetite and weight gain.ConclusionsThe structure of depression observed in adolescents is highly similar to the structure observed in adults. Longitudinal research is necessary to evaluate the stability of these subtypes of depression across development.

scholarly journals Sexual Function during Bupropion or Paroxetine Treatment of Major Depressive Disorder

2006 ◽  
Vol 51 (4) ◽  
pp. 234-242 ◽  
Author(s):  
Sidney H Kennedy ◽  
Kari A Fulton ◽  
R Michael Bagby ◽  
Andrea L Greene ◽  
Nicole L Cohen ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Sexual Function ◽  
Rating Scale ◽  
Primary Objective ◽  
Major Depressive ◽  
Double Blind ◽  
Significant Difference ◽  
To Receive ◽  
Over Time

Objective: The primary objective was to evaluate sexual function (SF) separately in men and women with major depressive disorder (MDD) before and during treatment with bupropion sustained release (SR) or paroxetine. The secondary objectives involved a comparative evaluation of the Sex Effects Scale (Sex FX) and the Investigator-Rated Sexual Desire and Functioning Scale (IRSD-F), as well as a comparison of antidepressant outcomes and an examination of the relation between level of depression and SF over time. Method: There were 141 patients (68 women and 73 men) who met DSM-IV criteria for a current major depressive episode. They were randomly assigned to receive bupropion SR (150 to 300 mg daily) or paroxetine (20 to 40 mg daily) under double-blind trial conditions. Patients were assessed at baseline and at 2, 4, 6, and 8 weeks with the 17-item Hamilton Depression Rating Scale (HDRS17), Sex FX, and IRSD-F. Results: Prior to treatment, women reported significantly lower SF on both the Sex FX and IRSD-F scales, compared with men. During treatment, there were no significant drug differences on measures of SF over time for women; however, men who were treated with paroxetine reported a worsening of SF, whereas bupropion SR did not significantly alter SF. Both bupropion SR and paroxetine produced clinically and statistically significant reductions in HDRS17 scores as well as comparable rates of response and remission. There was a statistically significant correlation between the 2 measures of SF at all visits. There was also a significant inverse relation between depression and SF in women, but not in men, irrespective of drug. Conclusion: According to the Sex FX scale, a significant difference in antidepressant-related sexual dysfunction was detected in men, but not women, during treatment with bupropion SR or paroxetine.

scholarly journals Patients With Type 2 Diabetes at Risk for Major Depressive Disorder Over Time

2011 ◽  
Vol 9 (2) ◽  
pp. 115-120 ◽  
Author(s):  
D. M. Naranjo ◽  
L. Fisher ◽  
P. A. Arean ◽  
D. Hessler ◽  
J. Mullan
Keyword(s):  
Type 2 Diabetes ◽  
At Risk ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Major Depressive ◽  
Over Time

Vascular Disease and Trajectories of Late-life Major Depressive Disorder in Secondary Psychiatric Care

2017 ◽  
Vol 41 (S1) ◽  
pp. s242-s242
Author(s):  
K. Musliner ◽  
T. Laursen ◽  
T. Munk-Olsen ◽  
X. Liu ◽  
P. Mortensen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Cerebrovascular Disease ◽  
Latent Class ◽  
Psychiatric Treatment ◽  
Psychiatric Hospitals ◽  
Late Life ◽  
Major Depressive ◽  
Related Risk

ObjectivesTo examine 5 years trajectories of secondary-treated late-life major depressive disorder (MDD), and evaluate whether pre-existing cerebrovascular disease and related risk factors are associated with more severe trajectories of late-life MDD.MethodsData were obtained from Danish registers. The sample included 11,184 adults ≥ 60 at index MDD diagnosis. Trajectories of in or outpatient contact at psychiatric hospitals for MDD over the 5 years period following index MDD diagnosis were modeled using latent class growth analysis. Risk factors included cerebrovascular disease, cardiovascular disease, hypertension, diabetes, and vascular dementia defined based on hospital diagnoses and prescription medications, demographic characteristics and characteristics of the index MDD diagnosis.ResultsThe final model included classes with consistently low (66%), high decreasing (19%), consistently high (9%) and moderate fluctuating (6%) probabilities of contact at a psychiatric hospital for MDD during the 5 year period following the index MDD diagnosis (Fig. 1). Older age, greater severity, inpatient treatment and > 12 antidepressant prescriptions within 5 years of the index MDD diagnosis predicted membership in more severe trajectory classes. Cerebrovascular disease and related risk factors were not associated with trajectory class membership.ConclusionsA substantial proportion (34%) of individuals diagnosed with MDD in late-life require specialized psychiatric treatment for extended periods of time. We found no evidence that cerebrovascular disease or related risk factors predicted course trajectories in secondary-treated late-life MDD.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Migraine symptomatology and major depressive disorder

Cephalalgia ◽  
2010 ◽  
Vol 30 (9) ◽  
pp. 1073-1081 ◽  
Author(s):  
Lannie Ligthart ◽  
Brenda WJH Penninx ◽  
Dale R Nyholt ◽  
Marijn A Distel ◽  
Eco JC de Geus ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Latent Class ◽  
Disease Process ◽  
Major Depressive ◽  
Qualitative Comparison ◽  
Symptom Profiles ◽  
Migraine Prevalence ◽  
Similar Disease ◽  
Migrainous Headache

Introduction and objective: Migraine and major depressive disorder (MDD) frequently co-occur, but it is unclear whether depression is associated with a specific subtype of migraine. The objective of this study was to investigate whether migraine is qualitatively different in MDD patients ( N = 1816) and non-depressed controls ( N = 3428). Methods: Migraine symptom data were analyzed using multi-group Latent Class Analysis, and a qualitative comparison was made between the symptom profiles of MDD patients and controls, while allowing for differences in migraine prevalence and severity between groups. Results: In both groups, three migrainous headache classes were identified, which differed primarily in terms of severity. Both mild and severe migrainous headaches were two to three times more prevalent in MDD patients. Migraine symptom profiles showed only minor qualitative differences in the MDD and non-MDD groups: in the severe migrainous headache class, significant differences were observed only in the prevalence of aggravation by physical activity (83% and 91% for the non-MDD and MDD groups, respectively) and aura (42% vs. 53%, respectively). Conclusion: The similar overall symptom profiles observed in the MDD and non-MDD subjects suggest that a similar disease process may underlie migraine in both groups.

scholarly journals Subtypes of Depression: Latent Class Analysis in Spanish Old People with Depressive Symptoms

Life ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. 70
Author(s):  
Sergio Pérez-Belmonte ◽  
Laura Galiana ◽  
Patricia Sancho ◽  
Amparo Oliver ◽  
José M. Tomás
Keyword(s):  
Older Adults ◽  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Depressive Disorder ◽  
Latent Class ◽  
Public Health Problem ◽  
Subsequent Treatment ◽  
Depression Symptoms ◽  
Major Depressive ◽  
Important Public Health Problem

Major depressive disorder (MDD) is one of the most disabling disorders and the one that most contributes to disability. When it occurs in older people, it is an additional burden to their potential physical and cognitive deficiencies, making MDD an important public health problem that supposes a large investment in health. There is a clear lack of consistency between the subtypes of depression found in the literature, ranging from two to seven classes, with three being the most commonly found non-melancholic, melancholic and psychotic, or putative psychotics. The aim of this research is to add knowledge to the profiles of depressive symptoms in a representative sample of older Spanish people, and to study the possible relationship of these symptom profiles with variables that have traditionally been related to depression. Spanish data from the sixth wave of SHARE were used, with 612 Spanish older adults living in Spain. A routine of several LCAs with a different number of classes was performed to answer this first aim to classify Spanish adults with depression symptoms. The results pointed out the presence of three different classes among the participants in the study: psychosomatic (11.12%), melancholic (14.21%), and anhedonic (74.67%). This work represents a step forward to understand the heterogeneity of major depressive disorder, facilitating the diagnosis, and subsequent treatment of older adults.

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