scholarly journals Relationship between childhood physical abuse and clinical severity of treatment-resistant depression in a geriatric population

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250148
Author(s):  
Antoine Yrondi ◽  
Christophe Arbus ◽  
Djamila Bennabi ◽  
Thierry D’Amato ◽  
Frank Bellivier ◽  
...  
Keyword(s):  
Depressive Symptom ◽  
Physical Abuse ◽  
Symptom Severity ◽  
Self Esteem ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
High Severity ◽  
Depressive Symptom Severity ◽  
Resistant Depression ◽  
Score Range

Introduction We assessed the correlation between childhood maltreatment (CM) and severity of depression in an elderly unipolar Treatment-Resistant Depression (TRD) sample. Methods Patients were enrolled from a longitudinal cohort (FACE-DR) of the French Network of Expert TRD Centres. Results Our sample included 96 patients (33% of the overall cohort) aged 60 years or above, with a mean age of 67.2 (SD = 5.7). The majority of the patients were female (62.5%). The Montgomery and Asberg Depression Rating Scale (MADRS) and Quick Inventory Depression Scale-Self Report (QIDS-SR) mean scores were high, 28.2 (SD = 7.49) [MADRS score range: 0–60; moderate severity≥20, high severity≥35] and 16.5 (SD = 4.94) [IDS-SR score range: 0–27; moderate severity≥11, high severity≥16], respectively. Mean self-esteem scores were 22.47 (SD = 6.26) [range 0–30]. In an age- and sex-adjusted model, we found a positive correlation between childhood trauma (CTQ scores) and depressive symptom severity [MADRS (β = 0.274; p = 0.07) and QIDS-SR (β = 0.302; p = 0.005) scores]. We detected a statistically significant correlation between physical abuse and depressive symptom severity [MADRS (β = 0.304; p = 0.03) and QIDS-SR (β = 0.362; p = 0.005) scores]. We did not observe any significant correlation between other types of trauma and depressive symptom severity. We showed that self-esteem (Rosenberg scale) mediated the effect of physical abuse (PA) on the intensity of depressive symptoms [MADRS: b = 0.318, 95% BCa C.I. [0.07, 0.62]; QIDS-SR: b = 0.177, 95% BCa C.I. [0.04, 0.37]]. Preacher & Kelly’s Kappa Squared values of 19.1% (k2 = 0.191) and 16% (k2 = 0.16), respectively for the two scales, indicate a moderate effect. Conclusion To our knowledge, this is the first study conducted in a geriatric TRD population documenting an association between childhood trauma (mainly relating to PA) and the intensity of depressive symptoms.

scholarly journals Relationship between Childhood Physical Abuse and Clinical Severity of Treatment-Resistant Depression in a Geriatric Population

2020 ◽  
Author(s):  
Antoine Yrondi ◽  
Christophe Arbus ◽  
Djamila Bennabi ◽  
Thierry D'Amato ◽  
Frank Bellivier ◽  
...  
Keyword(s):  
Depressive Symptom ◽  
Physical Abuse ◽  
Symptom Severity ◽  
Self Esteem ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
High Severity ◽  
Depressive Symptom Severity ◽  
Resistant Depression ◽  
Score Range

Abstract Background: We assessed the correlation between childhood maltreatment (CM) and severity of depression in an elderly unipolar Treatment-Resistant Depression (TRD) sample. Methods: Patients were enrolled from a longitudinal cohort (FACE-DR) of the French Network of Expert TRD Centres. Results: Our sample included 96 patients (33% of the overall cohort) aged 60 years or above, with a mean age of 67.2 (SD = 5.7). Most of the patients were female (62.5%). The Montgomery and Asberg Depression Rating Scale (MADRS) and Quick Inventory Depression Scale-Self Report (QIDS-SR) mean scores were high, 28.2 (SD = 7.49) [MADRS score range: 0-60; moderate severity≥20, high severity≥35] and 16.5 (SD=4.94) [IDS-SR score range: 0-27; moderate severity≥11, high severity≥16], respectively. Mean self-esteem scores were 22.47 (SD=6.26) [range 0-30]. In an age and sex-adjusted model, we found a positive correlation between childhood trauma (CTQ scores) and depressive symptom severity [MADRS (β=0.274; p=0.07) and QIDS-SR (β=0.302; p=0.005) scores]. We detected a statistically significant correlation between physical abuse and depressive symptom severity [MADRS (β=0.304; p=0.03) and QIDS-SR (β=0.362; p=0.005) scores]. We did not observe any significant correlation between other types of trauma and depressive symptom severity. We showed that self-esteem (Rosenberg scale) mediated the effect of physical abuse (PA) on the intensity of depressive symptoms [MADRS: b=0.318, 95% BCa C.I. [0.07, 0.62]; QIDS-SR: b=0.177, 95% BCa C.I. [0.04, 0.37]]. Preacher & Kelly’s Kappa Squared values of 19.1% (k2=0.191) and 16% (k2=0.16), respectively, indicate a moderate effect. Conclusion: To our knowledge, this is the first study conducted in a geriatric TRD population documenting an association between childhood trauma (mainly relating to PA) and the intensity of depressive symptoms.

scholarly journals Is cognitive dysfunction involved in difficult-to-treat depression? Characterizing resistance from a cognitive perspective

2020 ◽  
Vol 63 (1) ◽  
Author(s):  
Clara López-Solà ◽  
Marta Subirà ◽  
Maria Serra-Blasco ◽  
Muriel Vicent-Gil ◽  
Guillem Navarra-Ventura ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Depressive Symptom ◽  
Verbal Memory ◽  
Symptom Severity ◽  
Memory Impairment ◽  
Increased Risk ◽  
Depressive Symptom Severity ◽  
Resistant Depression ◽  
Staging Model ◽  
Mental Health Unit

Abstract Background. This study aimed to identify clinical and cognitive factors associated with increased risk for difficult-to-treat depression (DTD) or treatment-resistant depression (TRD). Methods. A total of 229 adult outpatients with major depression were recruited from the mental health unit at a public hospital. Participants were subdivided into resistant and nonresistant groups according to their Maudsley Staging Model score. Sociodemographic, clinical, and cognitive (objective and subjective measures) variables were compared between groups, and a logistic regression model was used to identify the factors most associated with TRD risk. Results. TRD group patients present higher verbal memory impairment than the nonresistant group irrespective of pharmacological treatment or depressive symptom severity. Logistic regression analysis showed that low verbal memory scores (odds ratio [OR]: 2.02; 95% confidence interval [CI]: 1.38–2.95) together with high depressive symptom severity (OR: 1.29; CI95%: 1.01–1.65) were associated with TRD risk. Conclusions. Our findings align with neuroprogression models of depression, in which more severe patients, defined by greater verbal memory impairment and depressive symptoms, develop a more resistant profile as a result of increasingly detrimental neuronal changes. Moreover, our results support a more comprehensive approach in the evaluation and treatment of DTD in order to improve illness course. Longitudinal studies are warranted to confirm the predictive value of verbal memory and depression severity in the development of TRD.

scholarly journals Body dysmorphic disorder and self-esteem: a meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nora Kuck ◽  
Lara Cafitz ◽  
Paul-Christian Bürkner ◽  
Laura Hoppen ◽  
Sabine Wilhelm ◽  
...  
Keyword(s):  
Depressive Symptom ◽  
Symptom Severity ◽  
Body Dysmorphic Disorder ◽  
Meta Analysis ◽  
Negative Relationship ◽  
Self Esteem ◽  
Sample Type ◽  
Healthy Controls ◽  
Partial Correlations ◽  
Depressive Symptom Severity

Abstract Objective Body dysmorphic disorder (BDD) is associated with low self-esteem. The aim of this meta-analysis was to examine the strength of the cross-sectional relationship between BDD symptom severity and global self-esteem in individuals with BDD, mentally healthy controls, community or student samples, and cosmetic surgery patients. Moreover, the role of depressive symptom severity in this relationship and other moderating factors were investigated. Methods A keyword-based literature search was performed to identify studies in which BDD symptoms and global self-esteem were assessed. Random effects meta-analysis of Fisher’s z-transformed correlations and partial correlations controlling for the influence of depressive symptom severity was conducted. In addition to meta-analysis of the observed effects, we corrected the individual correlations for variance restrictions to address varying ranges of BDD symptom severity across samples. Results Twenty-five studies with a total of 6278 participants were included. A moderately negative relationship between BDD symptom severity and global self-esteem was found (r = −.42, CI = [−.48, −.35] for uncorrected correlations, r = −.45, CI = [−.51, −.39] for artifact-corrected correlations). A meta-analysis of partial correlations revealed that depressive symptom severity could partly account for the aforementioned relationship (pr = −.20, CI = [−.25, −.15] for uncorrected partial correlations, pr = −.23, CI = [−.28, −.17] for artifact-corrected partial correlations). The sample type (e.g., individuals with BDD, mentally healthy controls, or community samples) and diagnosis of BDD appeared to moderate the relationship only before artifact correction of effect sizes, whereas all moderators were non-significant in the meta-analysis of artifact-corrected correlations. Conclusions The findings demonstrate that low self-esteem is an important hallmark of BDD beyond the influence of depressive symptoms. It appears that negative evaluation in BDD is not limited to appearance but also extends to other domains of the self. Altogether, our findings emphasize the importance of addressing self-esteem and corresponding core beliefs in prevention and treatment of BDD.

scholarly journals Body dysmorphic disorder and self-esteem: A meta-analysis

2020 ◽  
Author(s):  
Nora Kuck ◽  
Lara Cafitz ◽  
Paul - Christian Bürkner ◽  
Laura Nosthoff-Horstmann ◽  
Sabine Wilhelm ◽  
...  
Keyword(s):  
Depressive Symptom ◽  
Symptom Severity ◽  
Body Dysmorphic Disorder ◽  
Meta Analysis ◽  
Negative Relationship ◽  
Self Esteem ◽  
Sample Type ◽  
Healthy Controls ◽  
Partial Correlations ◽  
Depressive Symptom Severity

ObjectiveThe aim of this meta-analysis was to examine the strength of the cross-sectional relationship between body dysmorphic disorder (BDD) symptom severity and global self-esteem in individuals with BDD, mentally healthy controls, community or student samples, and cosmetic surgery patients. Moreover, the role of depressive symptom severity in this relationship and other moderating factors were investigated. MethodsA keyword-based literature search was performed to identify studies in which BDD symptoms and global self-esteem were assessed. Random effects meta-analysis of Fisher’s z-transformed correlations and partial correlations controlling for the influence of depressive symptom severity was conducted. In addition to meta-analysis of the observed effects, we corrected the individual correlations for variance restrictions to address varying ranges of BDD symptom severity across samples. ResultsTwenty-five studies with a total of 6149 participants were included. A moderately negative relationship between BDD symptom severity and global self-esteem was found (r = -.42, CI = [-.48, -.35] for uncorrected correlations, r = -.45, CI = [-.51, -.39] for artifact-corrected correlations). A meta-analysis of partial correlations revealed that depressive symptom severity could partly account for the aforementioned relationship (pr = -.2, CI = [-.25, -.15] for uncorrected partial correlations, pr = -.23, CI = [-.28, -.17] for artifact-corrected partial correlations). The sample type (e.g., individuals with BDD, mentally healthy controls, or community samples) and diagnosis of BDD appeared to moderate the relationship only before artifact correction of effect sizes, whereas all moderators were non-significant in the meta-analysis of artifact-corrected correlations. ConclusionsThe findings demonstrate that low self-esteem is an important hallmark of BDD beyond the influence of depressive symptoms. It appears that negative evaluation in BDD is not limited to appearance but also extends to other domains of the self. Altogether, our findings emphasize the importance of addressing self-esteem and corresponding core beliefs in prevention and treatment of BDD.

Multimodal Therapy of Treatment Resistant Depression: A Study and Analysis

2005 ◽  
Vol 35 (1) ◽  
pp. 27-39 ◽  
Author(s):  
Noreen Bannan
Keyword(s):  
Multimodal Therapy ◽  
Self Esteem ◽  
Treatment Resistant Depression ◽  
Pharmacological Treatments ◽  
Treatment Resistant ◽  
Psychological Therapies ◽  
Therapeutic Trials ◽  
History Of ◽  
Resistant Depression

Objective: To demonstrate through the use of a case study, the application of cognitive psychotherapy in the treatment of resistant depression. Method: The case of a woman with an 18-month history of resistant depression associated with low self-esteem, guilt and shame, who failed to respond to three therapeutic trials of antidepressants is described. A detailed description of a CBT intervention over 12 sessions is given. Result: Clear improvements on assessments of mood and hopelessness, along with overall improvements in social and occupational functioning were noted. Conclusion: These improvements were attributed to a combination of CBT and pharmacotherapy, where pharmacotherapy alone failed to alleviate symptoms. A concise literature review revealed relatively few published trials of psychological treatments, and a lack of clear guidelines on pharmacological treatments. More research is needed to explore the efficacy of psychological therapies for treatment resistant depression.

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