scholarly journals Alcohol-Induced Psychotic Disorder and Depressive Disorder: a Dual Diagnosis Case Series

2021 ◽  
Vol 13 (5) ◽  
pp. 130-133
Author(s):  
A. Elbelushi ◽  
Z. Muravec ◽  
H. Masood ◽  
B. Masood
Keyword(s):  
Depressive Disorder ◽  
Psychotic Disorder ◽  
Dual Diagnosis ◽  
Clinical Global Impression ◽  
Rating Scale ◽  
Medication Compliance ◽  
Case Series ◽  
Prevalence Studies ◽  
Icd 10 ◽  
Drug Attitude

Alcohol-induced psychotic disorder (AIPD) is a diagnosis in the ICD 10. Previous studies of AIPD do not appear to have reported the co-morbid presence of depressive disorder in either prevalence studies or treatment studies. Five cases are presented with a dual diagnosis of AIPD and depressive disorder. These cases were assessed using the Brief Psychiatric Rating Scale (BPRS), Hamilton Depression Rating Scale (HDRS), Clinical Global Impression Severity score (CGI-S), Clinical Global Impression Improvement score (CGI-I), Drug Attitude Inventory 10 (DAI 10), Short Assessment Personality-Abbreviated Scale (SAPAS) and Modified Sainsbury Tool. Antidepressants and antipsychotics were chosen based on drug attitude scores from DAI 10. Cases demonstrate inpatient and outpatient treatment with good treatment outcomes after six months. Three cases demonstrate suicide risk. The majority did not have a personality disorder. These cases highlight the importance of treating a depressive disorder in AIPD and of tailored medication treatments for poor medication compliance.

Rapid amelioration of severe manic episodes with right unilateral ultrabrief pulse ECT: a case series of four patients

2016 ◽  
Vol 25 (1) ◽  
pp. 10-12 ◽  
Author(s):  
Alexey Sidorov ◽  
Prashanth Mayur
Keyword(s):  
Electroconvulsive Therapy ◽  
Clinical Global Impression ◽  
Treatment Efficacy ◽  
Rating Scale ◽  
Case Series ◽  
Inadequate Response ◽  
Young Mania ◽  
Dramatic Decrease ◽  
Current Case ◽  
Significant Clinical Improvement

Objective: The aim of this small case series is to describe four cases of severe mania, where ultrabrief pulse electroconvulsive therapy (ECT) was used as a primary mode of treatment. Methods: A retrospective file review was undertaken of four patients identified as having received ultrabrief pulse ECT for severe mania. The outcome measures for treatment efficacy were the Young Mania Rating Scale (YMRS) and Clinical Global Impression (CGI). Results: All the patients showed significant clinical improvement. A comparison of pre- and post-treatment YMRS and CGI scores showed a dramatic decrease in all four cases. However, one patient was shifted to brief pulse ECT due to inadequate response. Conclusions: Ultrabrief pulse ECT may be an effective treatment in cases of severe mania. Due to the very small number of cases in the current case series, no specific conclusions regarding efficacy may be drawn; however, larger, controlled studies would be indicated.

Adjunctive minocycline treatment for major depressive disorder: A proof of concept trial

2017 ◽  
Vol 51 (8) ◽  
pp. 829-840 ◽  
Author(s):  
Olivia M Dean ◽  
Buranee Kanchanatawan ◽  
Melanie Ashton ◽  
Mohammadreza Mohebbi ◽  
Chee Hong Ng ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Major Depressive Disorder ◽  
Confidence Interval ◽  
Depressive Disorder ◽  
Clinical Global Impression ◽  
Effect Size ◽  
Rating Scale ◽  
Controlled Trial ◽  
Major Depressive

Objective: Conventional antidepressant treatments result in symptom remission in 30% of those treated for major depressive disorder, raising the need for effective adjunctive therapies. Inflammation has an established role in the pathophysiology of major depressive disorder, and minocycline has been shown to modify the immune-inflammatory processes and also reduce oxidative stress and promote neuronal growth. This double-blind, randomised, placebo-controlled trial examined adjunctive minocycline (200 mg/day, in addition to treatment as usual) for major depressive disorder. This double-blind, randomised, placebo-controlled trial investigated 200 mg/day adjunctive minocycline (in addition to treatment as usual) for major depressive disorder. Methods: A total of 71 adults with major depressive disorder ( Diagnostic and Statistical Manual of Mental Disorders–Fourth Edition) were randomised to this 12-week trial. Outcome measures included the Montgomery–Asberg Depression Rating Scale (primary outcome), Clinical Global Impression–Improvement and Clinical Global Impression–Severity, Hamilton Anxiety Rating Scale, Quality of Life Enjoyment and Satisfaction Questionnaire, Social and Occupational Functioning Scale and the Range of Impaired Functioning Tool. The study was registered on the Australian and New Zealand Clinical Trials Register: www.anzctr.org.au , #ACTRN12612000283875. Results: Based on mixed-methods repeated measures analysis of variance at week 12, there was no significant difference in Montgomery–Asberg Depression Rating Scale scores between groups. However, there were significant differences, favouring the minocycline group at week 12 for Clinical Global Impression–Improvement score – effect size (95% confidence interval) = −0.62 [−1.8, −0.3], p = 0.02; Quality of Life Enjoyment and Satisfaction Questionnaire score – effect size (confidence interval) = −0.12 [0.0, 0.2], p < 0.001; and Social and Occupational Functioning Scale and the Range of Impaired Functioning Tool score – 0.79 [−4.5, −1.4], p < 0.001. These effects remained at follow-up (week 16), and Patient Global Impression also became significant, effect size (confidence interval) = 0.57 [−1.7, −0.4], p = 0.017. Conclusion: While the primary outcome was not significant, the improvements in other comprehensive clinical measures suggest that minocycline may be a useful adjunct to improve global experience, functioning and quality of life in people with major depressive disorder. Further studies are warranted to confirm the potential of this accessible agent to optimise treatment outcomes.

Modafinil Augmentation of SSRI Therapy in Patients with Major Depressive Disorder and Excessive Sleepiness and Fatigue: A 12-Week, Open-label, Extension Study

CNS Spectrums ◽  
2006 ◽  
Vol 11 (2) ◽  
pp. 93-102 ◽  
Author(s):  
Michael E. Thase ◽  
Maurizio Fava ◽  
Charles DeBattista ◽  
Sanjay Arora ◽  
Rod J. Hughes
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Clinical Global Impression ◽  
Rating Scale ◽  
Extension Study ◽  
Dose Titration ◽  
Open Label ◽  
Major Depressive ◽  
Residual Symptoms ◽  
Excessive Sleepiness

AbstractIntroduction:Many patients with major depressive disorder (MDD) treated with selective serotonin reuptake inhibitors have residual symptoms (eg, persistent fatigue, excessive sleepiness) despite an overall antidepressant response. Placebo-controlled studies indicate that modafinil, a wake-promoting agent, may relieve residual symptoms.Methods:This 12-week, open-label, dose titration, extension study followed an 8-week placebo-controlled study of modafinil augmentation in patients with MDD. The dose was 100–400 mg/day. The median stable dose was 300 mg/day. Assessments were the Epworth Sleepiness Scale, Brief Fatigue Inventory, Clinical Global Impression of Improvement scale, 17-item Hamilton Rating Scale for Depression, and Montgomery-Åsberg Depression Rating Scale.Results:Of the 245 patients treated, 194 completed the study; 70% reported Clinical Global Impression of Improvement scale responses of “much improved” or “very much improved” between open-label baseline and final visit (previous randomized modafinil group: 74%; placebo group: 66%). When data were analyzed for four subsets of patients (former modafinil responders, placebo responders, modafinil nonresponders, and placebo nonresponders), improvements in scores on all outcome measures were at least twice as great among former modafinil and placebo nonresponders compared with responders. Most common adverse events were headache (18%), nausea (9%), and dizziness (7%); all were generally mild to moderate in severity.Conclusion:Twelve weeks of modafinil augmentation relieved excessive sleepiness, reduced fatigue, and improved patients' overall clinical condition, including mood.

Supplementation of n-3 Polyunsaturated Fatty Acids for Major Depressive Disorder: A Randomized, Double-Blind, 12-Week, Placebo-Controlled Trial in Korea

2015 ◽  
Vol 66 (2-3) ◽  
pp. 141-148 ◽  
Author(s):  
Yongsoon Park ◽  
Yoo-Sin Park ◽  
Seok Hyeon Kim ◽  
Dong Hoon Oh ◽  
Yong-Chon Park
Keyword(s):  
Fatty Acids ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Polyunsaturated Fatty Acids ◽  
Clinical Global Impression ◽  
Rating Scale ◽  
Depression Scale ◽  
Major Depressive ◽  
Double Blind ◽  
Pufa Supplementation

Background: Controversy over the efficacy of n-3 polyunsaturated fatty acids (PUFAs) in depression continues to this day. The present study investigated the hypothesis that n-3 PUFA supplementation reduces depressive symptoms in Korean patients with major depressive disorder. Methods: In a randomized, double-blind, placebo-controlled, 12-week, parallel-group trial, 35 patients with Center for Epidemiological Studies Depression Scale Korean version (CES-D-K) scores ≥25 and depression confirmed by a psychiatrist were assigned to take either 3 capsules of n-3 PUFAs (1,140 mg of EPA + 600 mg of DHA; n = 18) or placebo (olive oil + safflower oil; n = 17). Results: Supplementation with n-3 PUFAs significantly reduced Clinical Global Impression Improvement (CGI-I) scores as compared with intake of placebo using intention-to-treat analysis with last-observation-carried-forward after adjusting for energy, fat, and fish intake. However, the CES-D-K, Hamilton Depression Rating Scale-17, and Clinical Global Impression Scale scores did not significantly differ between the n-3 PUFA and placebo groups. After supplementation with n-3 PUFAs, the erythrocyte levels of n-3 PUFAs were significantly increased, but n-6 PUFA levels were decreased. Conclusions: n-3 PUFAs demonstrated an advantage over placebo that did not reach clinical significance, although CGI-I score was significantly decreased in the n-3 PUFA group as compared with the placebo group.

Depressive symptoms in patients with schizophrenia

2016 ◽  
Vol 33 (S1) ◽  
pp. S141-S142 ◽  
Author(s):  
T. Aladashvili
Keyword(s):  
Depressive Symptoms ◽  
Depressive Disorder ◽  
Rating Scale ◽  
Control Group ◽  
Schizophrenic Disorder ◽  
Inclusion Criteria ◽  
Wide Range ◽  
Icd 10 ◽  
Schizophrenic Patients ◽  
Hamilton Rating Scale

IntroductionDepression is common among patients with schizophrenia and is associated with a wide range of poor outcomes, including psychotic relapse and suicide. The aim of the study is to evaluate the presence of depressive symptoms in patients with schizophrenia and to compare depression intensity in schizophrenic patients and patients with depressive disorder.MethodsIn this cross sectional study were included 40 patients from both genders. Patients were divided in 2 groups: (1) examined group: 20 schizophrenic patients who presented depressive symptomatology. Depressive symptoms-evaluated with the 17-item Hamilton Rating Scale for Depression. Inclusion criteria: schizophrenic disorder by ICD-10 (F20.0-F20.9), total score higher than 7 on the HRSD-17 and age between 25 and 65; (2) control group: 20 patients with depressive disorder. Inclusion criteria: recurrent depressive disorder by ICD-10 (F33.0-F33.9), total score higher than 7 on the HRSD-17 and age between 25 and 65. Psychiatric rating scales for clinical evaluation of prominence of symptomatology: 17-item Hamilton Rating Scale for Depression (HRSD-17) and PANSS (Positive And Negative Syndrome Scale).ResultsThe prevalence of patients with depressive symptoms among the schizophrenic patients was 45% i.e. out of 20 evaluated patients with schizophrenia, 9 showed depressive symptoms. The total score in the remaining 11 patients on the HRSD-17 was lower than 7 and they were excluded. Difference between the two groups for gender difference was not statistically significant.ConclusionsThe percentage of patients with depressive symptoms among the patients with schizophrenic disorder was 45%. Schizophrenic patients more frequently presented mild and moderate depression in comparison to the control group. In the majority of subjects with schizophrenia and depressive symptoms positive schizophrenic symptomatology was predominant.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

scholarly journals Masses of the Sternoclavicular Area: Case Series and Review of the Literature

2021 ◽  
Vol 15 ◽  
pp. 117955652110216
Author(s):  
Parisa Oviedo ◽  
Morgan Bliss
Keyword(s):  
English Language ◽  
Pediatric Patients ◽  
Tertiary Care ◽  
Case Series ◽  
Review Of The Literature ◽  
Incision And Drainage ◽  
Surgical Interventions ◽  
Ganglion Cysts ◽  
Icd 10 ◽  
Bronchogenic Cysts

Objective: Masses of the sternoclavicular area are rare, and are not well described in the literature. We aim to present a series of patients with masses in this location and to review all reported English language cases of sternoclavicular masses in pediatric patients. Methods: This is a case series of pediatric patients with masses of the sternoclavicular area presenting to a tertiary care pediatric hospital from 2010 through 2017. Data was collected by using ICD-9 and ICD-10 codes to query the electronic medical record. Chart review included age at presentation, mass characteristics, medical and surgical interventions, and pathology results. A review of the literature was then performed. Results: Ten patients with masses overlying the sternoclavicular area were identified. Four patients presented with abscess and were treated with incision and drainage. Three of these patients were then treated with staged excision once infection cleared. Two additional patients were treated with primary excision. Four patients were treated with observation. The most common histopathologic finding was epidermoid. One patient was found to have a dermoid cyst, and 1 had a congenital cartilaginous rest. Conclusion: Epidermoids and dermoids are the most common masses overlying the sternoclavicular area. Controversy remains regarding the embryologic origin of sternoclavicular masses. The differential for masses in this area also includes branchial remnants, bronchogenic cysts, ganglion cysts, or septic arthritis.

scholarly journals Predictors of Suicidal Ideation and Attempt among Patients with Major Depressive Disorder at a Tertiary Care Hospital, Puducherry

2021 ◽  
Vol 12 (01) ◽  
pp. 122-128
Author(s):  
Ralte Lalthankimi ◽  
Padmavathi Nagarajan ◽  
Vikas Menon ◽  
Jeby Jose Olickal
Keyword(s):  
Major Depressive Disorder ◽  
Suicidal Ideation ◽  
Depressive Disorder ◽  
Rating Scale ◽  
Tertiary Care ◽  
Severe Depression ◽  
Care Hospital ◽  
Suicidal Behaviors ◽  
Major Depressive ◽  
Severity Of Depression

Abstract Objectives Mental disorders have a large impact on death by suicide. Hence, this study aims to determine the prevalence of suicidal behaviors among major depressive disorder (MDD) patients and the associated factors. Materials and Methods This cross-sectional analytical study was conducted among individuals aged 18 to 65 years, diagnosed with MDD in the Psychiatry Outpatient Department of a Tertiary Care Center, Puducherry during March to October 2019. Severity of depression was assessed using Hamilton Depression Rating Scale and Columbia-Suicide Severity Rating Scale was used to find the suicidal behaviors. Results For 166 participants in the study, mean (standard deviation) age was 40 (11) years and majority were females (76%). More than one-third (37%) had severe or very severe depression, and the prevalence of suicidal ideation, plan, and attempts were 83, 24, and 35%, respectively. After adjusting the covariates, the severity of depression and unemployment were significantly associated with suicidal attempts (adjusted prevalence ratios [aPR] = 11.4 and 1.9), and very severe depression was associated with suicidal ideation (aPR = 1.6). Among 140 individuals with suicidal ideation, 45 (32%) had an ideation frequency of 2 to 3 times/week, 69 (50%) had ideation for 1 hour, 36 (26%) could control ideation with little difficulty, and 12% had suicidal ideation mostly to end or stop their pain. Conclusion Suicidal ideation and attempts were significantly high in MDD patients, and the severity of depression was significantly associated with it. Early identification of high-risk suicidal behavior and implementation of effective preventive interventions are necessary to reduce death by suicide in these groups.

scholarly journals Cerliponase Alfa for the Treatment of Atypical Phenotypes of CLN2 Disease: A Retrospective Case Series

2020 ◽  
pp. 088307382097799
Author(s):  
Eva Wibbeler ◽  
Raymond Wang ◽  
Emily de los Reyes ◽  
Nicola Specchio ◽  
Paul Gissen ◽  
...  
Keyword(s):  
Treatment Duration ◽  
Chart Review ◽  
Rating Scale ◽  
Neuronal Ceroid Lipofuscinosis ◽  
Case Series ◽  
Language Function ◽  
Retrospective Case ◽  
Function Loss ◽  
Clinical Rating Scale

Background: The classic phenotype of CLN2 disease (neuronal ceroid lipofuscinosis type 2) typically manifests between ages 2 and 4 years with a predictable clinical course marked by epilepsy, language developmental delay, and rapid psychomotor decline. Atypical phenotypes exhibit variable time of onset, symptomatology, and/or progression. Intracerebroventricular-administered cerliponase alfa (rhTPP1 enzyme) has been shown to stabilize motor and language function loss in patients with classic CLN2 disease, but its impact on individuals with atypical phenotypes has not been described. Methods: A chart review was conducted of 14 patients (8 male, 6 female) with atypical CLN2 phenotypes who received cerliponase alfa. Pre- and posttreatment CLN2 Clinical Rating Scale Motor and Language (ML) domain scores were compared. Results: Median age at first presenting symptom was 5.9 years. First reported symptoms were language abnormalities (6 [43%] patients), seizures (4 [29%]), ataxia/language abnormalities (3 [21%]), and ataxia alone (1 [7%]). Median age at diagnosis was 10.8 years. ML score declined before treatment in 13 (93%) patients. Median age at treatment initiation was 11.7 years; treatment duration ranged from 11 to 58 months. From treatment start, ML score remained stable in 11 patients (treatment duration 11-43 months), improved 1 point in 1 patient after 13 months, and declined 1 point in 2 patients after 15 and 58 months, respectively. There were 13 device-related infections in 8 patients (57%) and 10 hypersensitivity reactions in 6 (43%). Conclusions: Cerliponase alfa is well tolerated and has the potential to stabilize motor and language function in patients with atypical phenotypes of CLN2 disease.

Depression Severity Is Related to Less Gross Body Movement: A Motion Energy Analysis

2021 ◽  
pp. 1-7
Author(s):  
Anna Sandmeir ◽  
Désirée Schoenherr ◽  
Uwe Altmann ◽  
Christoph Nikendei ◽  
Henning Schauenburg ◽  
...  
Keyword(s):  
Depressive Disorder ◽  
Energy Analysis ◽  
Rating Scale ◽  
Body Movement ◽  
Psychomotor Retardation ◽  
Diagnostic Interview ◽  
Depression Severity ◽  
Depressed Patients ◽  
Motion Energy ◽  
Objectively Measured

Psychomotor retardation is a well-known clinical phenomenon in depressed patients that can be measured in various ways. This study aimed to investigate objectively measured gross body movement (GBM) during a semi-structured clinical interview in patients with a depressive disorder and its relation with depression severity. A total of 41 patients with a diagnosis of depressive disorder were assessed both with a clinician-rated interview (Hamilton Depression Rating Scale) and a self-rating questionnaire (Beck Depression Inventory-II) for depression severity. Motion energy analysis (MEA) was applied on videos of additional semi-structured clinical interviews. We considered (partial) correlations between patients’ GBM and depression scales. There was a significant, moderate negative correlation between both measures for depression severity (total scores) and GBM during the diagnostic interview. However, there was no significant correlation between the respective items assessing motor symptoms in the clinician-rated and the patient-rated depression severity scale and GBM. Findings imply that neither clinician ratings nor self-ratings of psychomotor symptoms in depressed patients are correlated with objectively measured GBM. MEA thus offers a unique insight into the embodied symptoms of depression that are not available via patients’ self-ratings or clinician ratings.

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