Psychodramatic psychotherapy combined with pharmacotherapy in major depressive disorder: an open and naturalistic study

OBJETIVE: Recent literature has highlighted the role of psychotherapy in the treatment of major depressive disorder. Combined therapies comprising both psychotherapy and pharmacotherapy have presented the best results. Although several kinds of psychotherapies have been studied in the treatment of depressive disorders, there remains a lack of data on psychodramatic psychotherapy in the treatment of major depressive disorder. The objective of this study was to evaluate the impact of psychodramatic psychotherapy (in a sample of major depressive disorder patients. METHOD: This is an open, naturalistic, controlled, non-randomized study. Twenty major depressive disorder patients (according to the DSM-IV criteria), under pharmacological treatment for depression, with Hamilton Depression Scale total scores between 7 and 20 (mild to moderate depression), were divided into two groups. Patients in the psychotherapeutic group took part in 4 individual and 24 structured psychodramatic group sessions, whilst subjects in the control group did not participate in this psychodramatic psychotherapy. Both groups were evaluated with the Social Adjustment Scale - Self Report and the Hamilton Depression Scale. RESULTS: Psychotherapeutic group patients showed a significant improvement according to the Social Adjustment Scale - Self Report and the Hamilton Depression Scale scores at endpoint, compared to those of the control group. CONCLUSIONS: Results suggest that individual and group psychodramatic psychotherapy, associated to pharmacological treatment, provides good clinical benefits in the treatment of major depressive disorder.

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Efficacy of brief dynamic interpersonal therapy in patients with major depressive disorder: a prospective, multicenter randomized controlled trial protocol

10.21203/rs.2.24389/v1 ◽

2020 ◽

Author(s):

Lanlan Wang ◽

Qian Wang ◽

Wenhui Jiang ◽

Jianfeng Luo ◽

Jun Tong ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Major Depressive Disorder ◽

Depressive Disorder ◽

Controlled Trial ◽

Self Report ◽

Hamilton Depression Scale ◽

Major Depressive ◽

Interpersonal Therapy ◽

Randomized Controlled ◽

Multicenter Randomized Controlled Trial

Abstract Background : Dynamic Interpersonal Psychotherapy (DIT) is a brief manualized depression-focused intervention. This paper describes a study protocol of a multi-site, three-arm randomized controlled trial comparing medication plus DIT to medication alone and medication plus an active control psychotherapy in the treatment of major depressive disorder (MDD). Methods : 240 patients with MDD will be randomly allocated on a 1:1:1 basis to the treatment conditions, with 80 patients in each group. Patients will be assessed pre-and post-intervention and at 6- and 12-months follow-up with the 17-item Hamilton Depression Scale (HAMD-17) and Hamilton Anxiety Scale (HAMA-14) administered by blind evaluators, and the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder-7-item scale(GAD-7), side effect reaction scale (TESS), and The Self-Assessment Scale of the Overall Efficacy and Satisfaction of Patients (SASE). The primary outcome is change from baseline in HAMD-17 scores. Secondary outcomes include rates of response, remission and relapse, change from baseline in self-report depression and measures of anxious symptomatology, and subjective satisfaction of patients. Discussion: This will be the first multicentered RCT in China to assess the potential efficacy of psychotherapy for MDD. The study has the potential to inform clinical treatment guidelines for the treatment of MDD in China. Trial registration : ChiCTR，ChiCTR1800016970， Registered on July 5 th 2018 - Retrospectively registered, http://www.chictr.org.cn/showprojen.aspx?proj=28786 . Key words : Depression; Dynamic Interpersonal Therapy; Multicenter randomized controlled trial,

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Abnormalities in Electroencephalographic Microstates Among Adolescents With First Episode Major Depressive Disorder

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.775156 ◽

2021 ◽

Vol 12 ◽

Author(s):

Yuqiong He ◽

Qianting Yu ◽

Tingyu Yang ◽

Yaru Zhang ◽

Kun Zhang ◽

...

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Depression Scale ◽

First Episode ◽

Hamilton Depression Scale ◽

Healthy Controls ◽

Major Depressive ◽

Hamd Score ◽

Eeg Changes ◽

Microstate Analysis

Background: Recent studies have reported changes in the electroencephalograms (EEG) of patients with major depressive disorder (MDD). However, little research has explored EEG differences between adolescents with MDD and healthy controls, particularly EEG microstates differences. The aim of the current study was to characterize EEG microstate activity in adolescents with MDD and healthy controls (HCs).Methods: A total of 35 adolescents with MDD and 35 HCs were recruited in this study. The depressive symptoms were assessed by Hamilton Depression Scale (HAMD) and Children's Depression Inventory (CDI), and the anxiety symptoms were assessed by Chinese version of DSM-5 Level 2-Anxiety-Child scale. A 64-channel EEG was recorded for 5 min (eye closed, resting-state) and analyzed using microstate analysis. Microstate properties were compared between groups and correlated with patients' depression scores.Results: We found increased occurrence and contribution of microstate B in MDD patients compared to HCs, and decreased occurrence and contribution of microstate D in MDD patients compared to HCs. While no significant correlation between depression severity (HAMD score) and the microstate metrics (occurrence and contribution of microstate B and D) differing between MDD adolescents and HCs was found.Conclusions: Adolescents with MDD showed microstate B and microstate D changes. The obtained results may deepen our understanding of dynamic EEG changes among adolescents with MDD and provide some evidence of changes in brain development in adolescents with MDD.

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Common and Specific Alterations of Amygdala Subregions in Major Depressive Disorder With and Without Anxiety: A Combined Structural and Resting-State Functional MRI Study

Frontiers in Human Neuroscience ◽

10.3389/fnhum.2021.634113 ◽

2021 ◽

Vol 15 ◽

Author(s):

Yao Yao Li ◽

Xiao kang Ni ◽

Ya feng You ◽

Yan hua Qing ◽

Pei rong Wang ◽

...

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Gray Matter Volume ◽

Functional Integration ◽

Depression Scale ◽

Neural Mechanism ◽

Anterior Cingulate ◽

Treatment Programs ◽

Hamilton Depression Scale ◽

Major Depressive

Anxious major depressive disorder is a common subtype of major depressive disorder; however, its unique neural mechanism is not well-understood currently. Using multimodal MRI data, this study examined common and specific alterations of amygdala subregions between patients with and without anxiety. No alterations were observed in the gray matter volume or intra-region functional integration in either patient group. Compared with the controls, both patient groups showed decreased functional connectivity between the left superficial amygdala and the left putamen, and between the right superficial amygdala and the bilateral anterior cingulate cortex and medial orbitofrontal cortex, while only patients with anxiety exhibited decreased activity in the bilateral laterobasal and superficial amygdala. Moreover, the decreased activity correlated negatively with the Hamilton depression scale scores in the patients with anxiety. These findings provided insights into the pathophysiologic processes of anxious major depressive disorder and may help to develop new and effective treatment programs.

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Impact of measurement frequency on self-reported depressive symptoms: An experimental study in a clinical setting

10.31234/osf.io/9v38z ◽

2020 ◽

Author(s):

Nicole Geschwind ◽

Martijn van Teffelen ◽

Elin Hammarberg ◽

Arnoud Arntz ◽

M.J.H. Huibers ◽

...

Keyword(s):

Major Depressive Disorder ◽

Depressive Symptoms ◽

Depressive Symptom ◽

Depressive Disorder ◽

Depressive Symptomatology ◽

Depression Scale ◽

Self Report ◽

Major Depressive ◽

Measurement Frequency ◽

Symptom Scores

Background: Previous research suggests a relationship between measurement frequency of self-reported depressive symptoms and change in depressive symptom scores for the Beck Depression Inventory II (BDI-II). The goal of the current study was to investigate the differential effects of weekly and monthly completion of the BDI-II and Quick Inventory of Depressive Symptomatology self-report (QIDS-SR). Methods: Seventy individuals diagnosed with major depressive disorder (MDD) waiting for treatment were randomly assigned to either completing BDI-II weekly, BDI-II monthly, QIDS-SR weekly, or QIDS-SR monthly for a duration of nine weeks. After nine weeks participants also completed the Zung depression scale once. Mixed multilevel regression modelling and Bayesian Statistical Analysis were used to test the relationship between the measurement frequency and depression scores, and to compare scores of the repeatedly completed instruments with the instrument completed only in week nine.Results: Measurement frequency was not related to BDI-II, QIDS-SR or Zung scores. However, depression scores declined in the weekly and monthly QIDS-SR (but not BDI-II) conditions, while Bayesian analyses indicated moderate support for equal depression scores on the Zung SDS.Limitations: Lack of a clinician-rated depression scale at week nine in addition to the self-report measure. Conclusion: In contrast to previous studies in non-clinical samples, our findings suggest that measurement frequency does not have an impact on scores of the BDI-II. Implications for clinical studies monitoring depressive symptom scores with self-report scales are discussed. Keywords: major depressive disorder; retest effects; measurement error; measurement frequency; Beck Depression Inventory; Quick Inventory of Depressive Symptomatology

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Gut Microbiome Composition Associated With Major Depressive Disorder and Sleep Quality

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.645045 ◽

2021 ◽

Vol 12 ◽

Author(s):

Qi Zhang ◽

Yajun Yun ◽

Huimei An ◽

Wenxuan Zhao ◽

Ting Ma ◽

...

Keyword(s):

Major Depressive Disorder ◽

Gut Microbiota ◽

Depressive Disorder ◽

Sleep Quality ◽

Critical Role ◽

Depression Scale ◽

Hamilton Depression Scale ◽

Major Depressive ◽

Severity Of Depression ◽

Insomnia Severity

The microbiota–gut–brain axis plays a critical role in the pathogenesis of major depressive disorder (MDD) and related subclinical symptoms. However, studies on the gut microbiota in MDD are inconsistent, and data on MDD's effects on sleep are lacking. This study aimed to analyze the gut microbiota composition and sleep quality of patients with MDD. We performed 16S rRNA sequencing of stool samples from 36 patients with MDD and 45 healthy controls (HC). Sleep quality was assessed using the Pittsburgh Sleep Quality Index, depressive severity with the Hamilton Depression Scale, and insomnia severity using the Insomnia Severity Index. Forty-eight microbiota targets showed significant differences between MDD and HC. In MDD, six microbiota targets were associated with the severity of depression, 11 with sleep quality, and 3 with sleep severity. At the genus level, Dorea was simultaneously related to depression and sleep quality, while Intestinibacter was more closely related to sleep problems. Coprococcus and Intestinibacter were associated with sleep quality independent of the severity of depression. In conclusion, the present findings enable a better understanding of the relationship between gut microbiota and MDD-related symptoms. Gut microbiota alterations may become potential biomarkers and/or treatment targets for sleep quality in MDD.

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Effects of agomelatine and mirtazapine on sleep disturbances in major depressive disorder: evidence from polysomnographic and resting-state functional connectivity analyses

SLEEP ◽

10.1093/sleep/zsaa092 ◽

2020 ◽

Vol 43 (11) ◽

Author(s):

Wei-Feng Mi ◽

Serik Tabarak ◽

Li Wang ◽

Su-Zhen Zhang ◽

Xiao Lin ◽

...

Keyword(s):

Major Depressive Disorder ◽

Functional Connectivity ◽

Depressive Disorder ◽

Sleep Disturbances ◽

Rating Scale ◽

Sleep Onset ◽

Depression Scale ◽

Hamilton Depression Scale ◽

Major Depressive ◽

Depressed Patients

Abstract To investigate effects of agomelatine and mirtazapine on sleep disturbances in patients with major depressive disorder. A total of 30 depressed patients with sleep disturbances, 27 of which completed the study, took agomelatine or mirtazapine for 8 weeks. Subjective scales were administered, and polysomnography was performed at baseline and at the end of week 1 and 8. Functional magnetic resonance imaging was performed at baseline and at the end of week 8. Compared with baseline, scores on the Hamilton Depression Scale, Hamilton Anxiety Scale, Pittsburgh Sleep Quality Index, Sleep Dysfunction Rating Scale, and Insomnia Severity Index after 8 weeks of treatment significantly decreased in both groups, with no significant differences between groups, accompanied by significant increases in total sleep time, sleep efficiency, and rapid eye movement (REM) sleep and significant decrease in wake after sleep onset. Mirtazapine treatment increased N3 sleep at week 1 compared with agomelatine treatment, but this difference disappeared at week 8. The increases in the percentage and duration of N3 sleep were positively correlated with increases in connectivity between right dorsal lateral prefrontal cortex (dlPFC) and right precuneus and between left posterior cingulate cortex and right precuneus in both groups, respectively. Functional connectivity (FC) between right dlPFC and left precuneus in mirtazapine group was higher compared with agomelatine group after 8 weeks of treatment. These findings indicated that both agomelatine and mirtazapine improved sleep in depressed patients, and the effect of mirtazapine was greater than agomelatine with regard to rapidly increasing N3 sleep and gradually improving FC in the brain.

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A model for the evaluation of spirituality and resilience in major depressive disorder

Psihiatru ro ◽

10.26416/psih.58.3.2019.2532 ◽

2019 ◽

Vol 3 (1) ◽

pp. 40-44

Author(s):

Emilia-Cristina Popescu ◽

Doina Cozman

Keyword(s):

Major Depressive Disorder ◽

Major Depression ◽

Depressive Disorder ◽

Suicide Risk ◽

Depression Scale ◽

Public Health Problem ◽

Control Group ◽

Major Depressive ◽

Psychiatric Interview ◽

Area Of Interest

Depression is an important public health problem at the moment. There are data that can influence the spiritual spirit and resilience on major depression, can be studied imposingly and to cope with a Romanian population. The study will evaluate the spirituality, resilience, symptoms and severity of depression and suicide risk on a sample of adult patients diagnosed with major depression. The control group will consist of participants without psychiatric background, comparable as age and sex with the first group. Patients will undergo a structured psychiatric interview (M.I.N.I. – International Neuropsychiatric Interview), will complete a demographic questionnaire and will assessed with a depression scale, suicide risk scale, resilience and spirituality scale. Spirituality and religiosity become an area of interest for the study of depression protective factors. The present paper may propose to demonstrate the beneficial influence of the spirituality on the symptoms of major depression and the reduction of suicide risk in major depressive disorder. If the study will find a statistically significant correlation between spirituality and suicide risk reduction, it will emphasize the importance of spirituality in the evolution of psychiatric patients and it may change their approach and management.

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Major depression, temperament, and social support as psychosocial mechanisms of the intergenerational transmission of parenting styles

Development and Psychopathology ◽

10.1017/s0954579421000420 ◽

2021 ◽

pp. 1-15

Author(s):

Eyal Abraham ◽

Allison M. Letkiewicz ◽

Priya J. Wickramaratne ◽

Maya Bunyan ◽

Milenna T. van Dijk ◽

...

Keyword(s):

Social Support ◽

Parenting Styles ◽

Social Adjustment ◽

Parenting Practices ◽

Self Report ◽

Major Depressive ◽

The Social ◽

Intergenerational Continuity ◽

Successive Generations ◽

Social Adjustment Scale

Abstract In this three-generation longitudinal study of familial depression, we investigated the continuity of parenting styles, and major depressive disorder (MDD), temperament, and social support during childrearing as potential mechanisms. Each generation independently completed the Parental Bonding Instrument (PBI), measuring individuals’ experiences of care and overprotection received from parents during childhood. MDD was assessed prospectively, up to 38 years, using the semi-structured Schedule for Affective Disorders and Schizophrenia (SADS). Social support and temperament were assessed using the Social Adjustment Scale – Self-Report (SAS-SR) and Dimensions of Temperament Scales – Revised, respectively. We first assessed transmission of parenting styles in the generation 1 to generation 2 cycle (G1→G2), including 133 G1 and their 229 G2 children (367 pairs), and found continuity of both care and overprotection. G1 MDD accounted for the association between G1→G2 experiences of care, and G1 social support and temperament moderated the transmission of overprotection. The findings were largely similar when examining these psychosocial mechanisms in 111 G2 and their spouses (G2+S) and their 136 children (G3) (a total of 223 pairs). Finally, in a subsample of families with three successive generations (G1→G2→G3), G2 experiences of overprotection accounted for the association between G1→G3 experiences of overprotection. The results of this study highlight the roles of MDD, temperament, and social support in the intergenerational continuity of parenting, which should be considered in interventions to “break the cycle” of poor parenting practices across generations.

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Can BDNF and IL-2 be indicators for the diagnosis in schizophrenic patients with depressive symptoms?

Acta Neuropsychiatrica ◽

10.1017/neu.2014.13 ◽

2014 ◽

Vol 26 (5) ◽

pp. 291-297 ◽

Cited By ~ 6

Author(s):

Salih Saygin Eker ◽

Ebru Oztepe Yavasci ◽

Sengul Cangur ◽

Selcuk Kirli ◽

Emre Sarandol

Keyword(s):

Major Depressive Disorder ◽

Depressive Symptoms ◽

Depressive Disorder ◽

Rating Scale ◽

Depressive Symptomatology ◽

Interleukin 2 ◽

Depression Scale ◽

Control Group ◽

Major Depressive ◽

Serum Bdnf

ObjectiveThe aim of the current study is to determine whether serum levels of brain-derived neurotrophic factor (BDNF) and interleukin-2 (IL-2) can be biological indicators for the diagnosis of schizophrenia in patients with depressive symptoms.MethodForty-seven patients (11 patients diagnosed with schizophrenia, 16 patients diagnosed with schizophrenia and comorbid depression and 20 patients diagnosed with major depressive disorder) and 20 healthy subjects were enrolled. The Positive and Negative Symptoms Scale, the Calgary Depression Scale for Schizophrenia and the Hamilton Depression Rating Scale were used for assessment. The serum BDNF and IL-2 levels of all the subjects were studied.ResultsDecreased levels of serum BDNF and increased levels of serum IL-2 were found in the patients diagnosed with either schizophrenia, schizophrenia with depression, or major depressive disorder (p = 0.049, p = 0.010; p = 0.001 and p = 0.044; p = 0.027, p = 0.003; respectively) compared with control group. There were no significant differences between the patient groups in their serum BDNF and IL-2 levels.ConclusionsThe present study suggests that neurotrophic factors and immune system changes are involved in the pathogenesis of schizophrenia with or without depressive symptomatology. However, the data do not clarify whether depressive symptoms in schizophrenia occur as a dimension of schizophrenia or as symptoms of major depression that is comorbid with schizophrenia.

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Association of glucocorticoid receptor polymorphisms with the susceptibility to major depressive disorder and treatment responses in Korean depressive patients

Acta Neuropsychiatrica ◽

10.1111/j.1601-5215.2008.00342.x ◽

2009 ◽

Vol 21 (1) ◽

pp. 11-17 ◽

Cited By ~ 11

Author(s):

Hwa-Young Lee ◽

Rhee-Hun Kang ◽

Sang-Woo Han ◽

Jong-Woo Paik ◽

Hun Soo Chang ◽

...

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Glucocorticoid Receptor ◽

Genetic Polymorphisms ◽

Antidepressant Treatment ◽

Depression Scale ◽

Therapeutic Effects ◽

Hamilton Depression Scale ◽

Stress Reactions ◽

Major Depressive

Objective:Major depressive disorder (MDD) is closely related to stress reactions and serotonin probably underpins the pathophysiology of MDD. Alterations of the hypothalamic-pituitary-adrenal axis at the gene level have reciprocal consequences on serotonin neurotransmission. Glucocorticoid receptor (GR) polymorphisms affect glucocorticoid sensitivity, which is associated with cortisol feedback effects. Therefore, we hypothesised that GR polymorphisms are associated with the susceptibility to MDD and predict the treatment response.Method:Ninety-six subjects with a minimum score of 17 on the 21-item Hamilton Depression Scale (HAMD) at baseline were enrolled into the present study. The genotypes of GR (N363S, ER22/23EK, Bcl1, and TthIII1 polymorphisms) were analysed. The HAMD score was again measured after 1, 2, 4 and 8 weeks of antidepressant treatment to detect whether the therapeutic effects differed with the GR genotype.Results:Our subjects carried no N363S or ER22/23EK genetic polymorphisms and three types of Bcl1 and TthIII1 genetic polymorphisms. The C/C genotype and C allele at Bcl1 polymorphism were more frequent in MDD patients than in normal controls (p < 0.01 and p = 0.01, respectively). The genotype distributions did not differ significantly between responders and non-responders.Conclusion:These results suggest that GR polymorphism cannot predict the therapeutic response after antidepressant administration. However, GR polymorphism (Bcl1) might play a role in the pathophysiology of MDD. Future studies should check this finding in larger populations with different characteristics.

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