scholarly journals Residual symptoms in patients with partial versus complete remission of a major depressive disorder episode: patterns of painful physical symptoms in depression

2016 ◽  
Vol Volume 12 ◽  
pp. 1599-1607 ◽  
Author(s):  
Levent Alev ◽  
Yoichi Satoi ◽  
Toshiaki Kikuchi ◽  
Koichiro Watanabe ◽  
Masaru Mimura ◽  
...  
2017 ◽  
Vol 41 (S1) ◽  
pp. S510-S510
Author(s):  
K. Yoshimasu ◽  
S. Takemura ◽  
E. Myasoedova ◽  
S. Myasoedova

IntroductionDrinking has been shown to be a protective factor against the risk of rheumatoid arthritis (RA). On the other hand, high prevalence of depressive symptoms has been observed among RA patients.ObjectiveTo evaluate the association between depressive symptoms and somatic factors as well as drinking habits in RA patients.MethodsDrinking habits and physical symptoms in 182 female RA outpatients in Ivanovo, Russia (average [standard deviation] of age, 62.0 [11.7] years), were investigated. Drinking status was classified as current drinkers (alcohol consumption within the previous 12 months) and others. Depressive symptoms were evaluated with MINI, HADS and CES-D questionnaires. Outcomes were (a) presence or history of major depressive disorder, presence of melancholic major depressive disorder, presence of dysthymia, or 1 point or greater of suicidal risk score in MINI, (b) 8 points or greater in HADS-depression, (c) 8 points or greater in HADS-anxiety, and (d) 16 points or greater in CES-D. Stepwise logistic regression was used to evaluate somatic factors associated with depressive symptoms, with age and drinking status included.ResultsDrinking was rather protective against depression, but did not reach statistical significance. Symptomatic parts in the extremities associated with the outcomes were shoulders for MINI, elbows and knees for HADS-depression, shoulders for HADS-anxiety, and hands, elbows and shoulders for CES-D. In the stepwise selection, some symptoms in the extremities were positively associated with the outcomes.ConclusionSymptoms chiefly in large joints contributed to depressive symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2014 ◽  
Vol 60 (2) ◽  
pp. 61-66
Author(s):  
Th Moica ◽  
I Gabos Grecu ◽  
Marieta Gabos Grecu ◽  
Melinda Ferencz ◽  
Elena Gabriela Buicu ◽  
...  

Abstract Introduction: Major depressive disorder is a chronic and debilitating disease characterized by a wide range of emotional and physical symptoms that coexist during a depressive episode and may reoccur at some point during the progression of the disease for the majority of patients. The purpose of the study was to investigate psychiatrists’ experience regarding the response to antidepressive treatment and their options regarding augmentation strategies in depression with incomplete response to antidepressant monotherapy. Method: We applied an 18-item questionnaire containing multiple choice questions to adult psychiatrists working in ambulatories, hospitals or mental health centers. Results: Fourty-two psychiatrists have agreed to answer the questionnaire. The majority of them were psychiatry specialists, between 35 and 49 years of age, working in an outpatient unit. For the majority of doctors, SSRIs (Serotonin Reuptake Inhibitors) proved to be the first line treatment both for the first depressive episode and for recurrent depression, followed by SNRI (Serotonin and Noradrenalin Reuptake Inhibitors). Regarding the duration of maintenance treatment for the patients who achieved complete remission after the first episode of depression, the results showed a wide spectrum from 4 to 9 months. Conclusions: Incomplete response to antidepressive monotherapy is very frequent both for the first depressive episode and for recurrent depression. Given the pharmacological profile that some atypical antipsychotic have, augmentation with atypical antipsychotics in patients with inadequate response to antidepressant monotherapy is a useful therapeutic strategy that should be considered.


2018 ◽  
Vol 49 (11) ◽  
pp. 1869-1878 ◽  
Author(s):  
Boadie W. Dunlop ◽  
Philip E. Polychroniou ◽  
Jeffrey J. Rakofsky ◽  
Charles B. Nemeroff ◽  
W. Edward Craighead ◽  
...  

AbstractBackgroundPersisting symptoms after treatment for major depressive disorder (MDD) contribute to ongoing impairment and relapse risk. Whether cognitive behavior therapy (CBT) or antidepressant medications result in different profiles of residual symptoms after treatment is largely unknown.MethodsThree hundred fifteen adults with MDD randomized to treatment with either CBT or antidepressant medication in the Predictors of Remission in Depression to Individual and Combined Treatments (PReDICT) study were analyzed for the frequency of residual symptoms using the Montgomery Asberg Depression Rating Scale (MADRS) item scores at the end of the 12-week treatment period. Separate comparisons were made for treatment responders and non-responders.ResultsAmong treatment completers (n= 250) who responded to CBT or antidepressant medication, there were no significant differences in the persistence of residual MADRS symptoms. However, non-responders treated with medication were significantly less likely to endorse suicidal ideation (SI) at week 12 compared with those treated with CBT (non-responders to medication: 0/54, 0%, non-responders to CBT: 8/30, 26.7%;p= .001). Among patients who terminated the trial early (n= 65), residual MADRS item scores did not significantly differ between the CBT- and medication-treated groups.ConclusionsDepressed adults who respond to CBT or antidepressant medication have similar residual symptom profiles. Antidepressant medications reduce SI, even among patients for whom the medication provides little overall benefit.


2018 ◽  
Vol 32 (10) ◽  
pp. 1086-1097 ◽  
Author(s):  
Michael Cronquist Christensen ◽  
Ioana Florea ◽  
Annika Lindsten ◽  
David S Baldwin

Background: Efficacy has been proven for vortioxetine in short-term and long-term treatment of major depressive disorder (MDD), with broad beneficial effects on emotional, physical and cognitive symptoms. Limited specific data on the effects of vortioxetine on depression-related physical symptoms have been published. Methods: A meta-analysis was carried out of five short-term multinational, double-blind, placebo-controlled studies. These studies were conducted in a total of 2105 adult MDD outpatients (18–75 years) with a major depressive episode of ⩾3 months’ duration. Only patients treated with a dose of 5 or 10 mg vortioxetine (therapeutic doses) or placebo were included in this analysis. Efficacy assessment of vortioxetine on the physical symptoms of depression included all items of the Hamilton Depression Scale (HAM-D) assessing physical symptoms, and all somatic items in the Hamilton Anxiety Scale (HAM-A). A subgroup analysis in MDD patients with coexisting anxiety symptoms (i.e. those with a HAM-A ⩾20 at baseline) was also performed. Results: A significant improvement ( p<0.05) of vortioxetine versus placebo was observed on all HAM-D items measuring physical symptoms, except for the somatic gastrointestinal symptoms and loss of weight items. Significant effects were also observed on the HAM-A somatic items: general somatic symptoms, gastrointestinal symptoms, and autonomic symptoms. In patients with a high baseline level of anxiety, a significant effect of vortioxetine was also observed on the physical symptoms of depression. Conclusions: These analyses indicate that patients with MDD, including those with a high level of anxiety symptoms, have significant improvements in MDD-associated physical symptoms when treated with vortioxetine.


2018 ◽  
Vol 262 ◽  
pp. 469-476 ◽  
Author(s):  
Gianluca Serafini ◽  
Jacopo Nebbia ◽  
Nicolò Cipriani ◽  
Claudia Conigliaro ◽  
Denise Erbuto ◽  
...  

2010 ◽  
Vol 28 (2) ◽  
pp. 137-144 ◽  
Author(s):  
Nadia Iovieno ◽  
Adrienne van Nieuwenhuizen ◽  
Alisabet Clain ◽  
Lee Baer ◽  
Andrew A. Nierenberg

2020 ◽  
Vol 8 (1) ◽  
pp. 41-47
Author(s):  
Umme Salma Talukder ◽  
Hossain Tameem Bin Anayet ◽  
Samjhana Mandal ◽  
MM Jalal Uddin ◽  
Fahmida Ahmed ◽  
...  

Major Depressive Disorder (MDD) is one of the most common psychiatric illnesses. The effect of depression on one’s physical health is well-known, which can include anything from weight gain or loss to chronic illnesses such as heart disease, kidney or gastrointestinal problems. Provided the increasing prevalence of patients suffering from End Stage Renal Disease (ESRD) and receiving hemodialysis treatment, it is important to investigate how MDD affects the outcome of their treatment. The incidence of depression in dialysis patients ranges from 10% to 66% in various studies, with prevalence reaching as high as 100%. The purpose of this article is to find the prevalence and severity of major depressive disorder in dialysis patients as well as to describe the possible pathways MDD worsens the dialysis outcome. Our study population consisted of 51 End Stage Renal Disease (ESRD) patients sampled from the Department of Nephrology at BIRDEM General Hospital. Neurocognitive, physical symptoms, the severity of MDD and presence of comorbid conditions including diabetics and hypertension, were measured in our study. The ESRD patient sample consisted 47.7% moderately depressed patients, 34% severely depressed, 11.4% mild and 6.8% with minimal MDD patients. Analogous to Hypertension and Diabetic patients with depression, the number of Chronic Kidney Disease (CKD) patients with mostly moderate severe depression increased with the duration of the disease. The article explains a myriad of biologic, behavioral, genetic and social factors underlying the association of depression and adverse medical outcomes in patients with CKD and ESRD. Moreover, neuroimaging data is required for further discussion on relationship between Depression and CKD. The implication of this study is to emphasize the importance of dialysis patients’ overall health and to serve as a pretext for further research into depression in dialysis patients. Bangladesh Crit Care J March 2020; 8(1): 41-47


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