scholarly journals The association between suicide risk and self-esteem in Japanese university students with major depressive episodes of major depressive disorder

Author(s):  
Nobuyuki Mitsui ◽  
Satoshi Asakura ◽  
Yusuke Shimizu ◽  
Yutaka Fujii ◽  
Atsuhito Toyomaki ◽  
...  
2014 ◽  
Vol 205 (4) ◽  
pp. 268-274 ◽  
Author(s):  
Pim Cuijpers ◽  
Sander L. Koole ◽  
Annemiek van Dijke ◽  
Miquel Roca ◽  
Juan Li ◽  
...  

BackgroundThere is controversy about whether psychotherapies are effective in the treatment of subclinical depression, defined by clinically relevant depressive symptoms in the absence of a major depressive disorder.AimsTo examine whether psychotherapies are effective in reducing depressive symptoms, reduce the risk of developing major depressive disorder and have comparable effects to psychological treatment of major depression.MethodWe conducted a meta-analysis of 18 studies comparing a psychological treatment of subclinical depression with a control group.ResultsThe target groups, therapies and characteristics of the included studies differed considerably from each other, and the quality of many studies was not optimal. Psychotherapies did have a small to moderate effect on depressive symptoms against care as usual at the post-test assessment (g = 0.35, 95% CI 0.23–0.47; NNT = 5, 95% CI 4–8) and significantly reduced the incidence of major depressive episodes at 6 months (RR = 0.61) and possibly at 12 months (RR = 0.74). The effects were significantly smaller than those of psychotherapy for major depressive disorder and could be accounted for by non-specific effects of treatment.ConclusionsPsychotherapy may be effective in the treatment of subclinical depression and reduce the incidence of major depression, but more high-quality research is needed.


Author(s):  
W. Edward Craighead ◽  
Benjamin N. Johnson ◽  
Sean Carey ◽  
Boadie W. Dunlop

Behavior therapy, cognitive-behavioral therapy, and interpersonal psychotherapy have each been shown by at least two randomized controlled trials, as well as by numerous meta-analytic reports, to be effective psychosocial interventions for patients meeting criteria for major depressive disorder. All three psychosocial treatments have yielded substantial reductions in scores on the two major depression rating scales, significant decreases in percentage of patients meeting depression criteria at posttreatment, and substantial maintenance of effects well after treatment has ended. The data for outcomes of psychosocial and pharmacological interventions for major depressive episodes suggest that the two treatment modes are equally efficacious.


2008 ◽  
Vol 30 (2) ◽  
pp. 124-131 ◽  
Author(s):  
Lee Fu-I ◽  
Yuan Pang Wang

OBJECTIVE: To compare clinical characteristics of major depressive disorder symptoms between children and adolescents. METHOD: The subjects were 58 patients of a Child and Adolescent Affective Disorder Clinic consecutively admitted during a six-month period. Children aged 5-9 years old and adolescents from 10-17 years old currently meeting DSM-IV criteria diagnosis of major depressive disorder were chosen. Current MDD diagnosis and depressive psychopathology were assessed by a clinical interview and the Diagnostic Interview for Children and Adolescents-DSM-IV version. The Children’s Depression Rating Scale-Revised Version and the Children Global Assessment Scale rated the severity and global functioning of major depressive disorder. RESULTS: The most common depressive symptoms were: anhedonia (72.4%), depressed mood (72.4%), decreased concentration (62.1%), and irritability (58.6%). The intensity of depressive episodes of this sample ranged from mild to moderate. Fifty percent reported thoughts of death, and 29.3% presented a variety of psychotic symptoms. When compared with children, adolescents reported a significantly more depressed mood (p = 0.043), lower self-esteem (p = 0.002), and had more difficulty concentrating (p = 0.020). Female adolescents had lower self-esteem (p = 0.003), and male adolescents showed more decreased concentration (p = 0.016). CONCLUSION: This study suggests that age and gender differences might influence the clinical presentation of major depressive disorder in children and adolescents. Further studies with larger samples are needed.


2005 ◽  
Vol 186 (4) ◽  
pp. 314-318 ◽  
Author(s):  
T. Petteri Sokero ◽  
Tarja K. Melartin ◽  
Heikki J. Rytsälä ◽  
Ulla S. Leskelä ◽  
Paula S. Lestelä-Mielonen ◽  
...  

BackgroundThere are few prospective studies on risk factors for attempted suicide among psychiatric out- and in-patients with major depressive disorder.AimsTo investigate risk factors for attempted suicide among psychiatric out- and in-patients with major depressive disorder inthe city of Vantaa, Finland.MethodThe Vantaa Depression Study included 269 patients with DSM–IV major depressive disorder diagnosed using semi-structured interviews and followed up at 6- and 18-month interviews with a life chart.ResultsDuring the 18-month follow-up, 8% of the patients attempted suicide. The relative risk of an attempt was 2.50 during partial remission and 7.54 during a major depressive episode, compared with full remission (P<0.001). Numerous factors were associated with this risk, but lacking a partner, previous suicide attempts and total time spent in major depressive episodes were the most robust predictors.ConclusionsSuicide attempts among patients with major depressive disorder are strongly associated with the presence and severity of depressive symptoms and predicted by lack of partner, previous suicide attempts and time spent in depression. Reducing the time spent depressed is a credible preventive measure.


Author(s):  
Nicole Geschwind ◽  
Saara Martinmäki ◽  
Eric L. Garland

Positive emotions are vital to psychological well-being and enhance resilience against psychopathology. One of the psychiatric disorders most characterized by a lack of positive emotions is major depressive disorder. Despite the resilience-enhancing features of positive emotions and high rates of relapse for major depressive disorder, current recommended treatment forms do not pay much explicit attention to the stimulation of positive emotions. One evidence-based form of relapse prevention is mindfulness-based cognitive therapy. In mindfulness based cognitive therapy, participants train their capacity to intentionally guide their attention toward present-moment experience through daily practice, such as focusing on their own breath. Another important aspect of the training is the cultivation of an open, nonevaluative, curious, and mild orientation of mind. Many scholars have focused on the nonevaluative quality of mindful present-moment awareness as an antidote for reducing negative mental states. The question arises regarding which extent mindfulness-based therapies naturally enhance positive emotions. The current chapter first reviews the current evidence for positive emotions as a protective factor against the development of major depressive episodes and then examines the evidence for the idea that mindfulness practice may naturally facilitate the experience of positive emotions. The chapters ends by presenting a novel account detailing how the practice of mindfulness may result in increased positive emotions as well as translate into an increased sense of meaningfulness and purpose. Implications for enhancing the facilitation of positive emotions in mindfulness-based therapies are discussed.


2011 ◽  
Vol 26 (S2) ◽  
pp. 633-633
Author(s):  
B. Hartinger ◽  
C. Scharinger ◽  
K. Diers ◽  
C. Kasess ◽  
W. Huf ◽  
...  

IntroductionThe natural course of Major Depressive Disorder (MDD) encompasses the occurrence of alternating intervals of major depressive episodes and remission. While several abnormalities in neural circuits related to acute MDD have been identified, the neural mechanisms underlying stable remission remain obscure.ObjectivesAcute MDD is characterized by increased amygdala and subgenual anterior cingulate cortex (sACC) activation and decreased connectivity between the amygdala and the sACC. Consequently, we expect those regions to be affected during remission.AimsTo determine whether active counter-regulatory mechanisms are implicated in the maintenance of full remission once antidepressant treatment has been discontinued.MethodsFunctional and structural magnetic resonance imaging was used to measure brain activation and volume of the amygdala and the sACC. Images were obtained from 38 healthy subjects without any psychiatric life-time diagnosis and 38 gender-matched drug-free remitted MDD patients. Furthermore, correlation analyses were performed with clinical variables.ResultsPatients with rMDD exhibited lower activation in the amygdala and the sACC and increased functional coupling between the amygdala and sACC compared to controls. This connectivity was particularly pronounced in patients characterized by a long cumulated time of depressive episodes. Similarly, structural connectivity results showed increased association between the amygdala and sACC volume in rMDD patients compared to controls.ConclusionsRemitted MDD is related to neural alterations within a neural circuit encompassing the amygdala and the sACC compared to controls. These findings suggest active counter-regulatory mechanisms likely contributing to the maintenance of remission once treatment has been discontinued.


2011 ◽  
Vol 199 (1) ◽  
pp. 3-4 ◽  
Author(s):  
Allan H. Young ◽  
Holly MacPherson

SummaryMajor depressive episodes are common in bipolar disorder, which consequently may be misdiagnosed as major depressive disorder. Improved detection of bipolar disorder rests upon better ascertainment of a history of hypomania. Antidepressants are of dubious benefit in bipolar disorder and more accurate diagnosis of depression would promote better treatment.


2017 ◽  
Vol 41 (1) ◽  
pp. 111-114 ◽  
Author(s):  
K. Riihimäki ◽  
M. Vuorilehto ◽  
E. Isometsä

AbstractBackgroundMost practice guidelines recommend maintenance antidepressant treatment for recurrent major depressive disorder. However, the degree to which such guidance is actually followed in primary health care has remained obscure. We investigated the provision of maintenance antidepressant treatment within a representative primary care five-year cohort study.MethodsIn the Vantaa Primary Care Depression Study, a stratified random sample of 1119 adult patients was screened for depression using the Prime-MD. Depressive and comorbid psychiatric disorders were diagnosed using SCID-I/P and SCID-II interviews. Of the 137 patients with depressive disorders, 82% completed the prospective five-year follow-up. A graphic life chart enabling evaluation of the longitudinal course of episodes plus duration of pharmacotherapies was used. In accordance with national guidelines, an indication for maintenance treatment was defined to exist after three or more lifetime major depressive episodes (MDEs); maintenance treatment was to commence four months after onset of full remission.ResultsOf the cohort patients, 34% (46/137) had three or more lifetime MDEs, thus indicating the requirement for maintenance pharmacotherapy. Of these, half (54%, 25/46) received maintenance treatment, for only 29% (489/1670) of the months indicated.ConclusionsIn this cohort of depressed primary care patients, half of patients with indications for maintenance treatment actually received it, and only for a fraction of the time indicated. Antidepressant maintenance treatment for the prevention of recurrences is unlikely to be subject to large-scale actualization as recommended, which may significantly undermine the potential public health benefits of treatment.


2015 ◽  
Vol 24 (6) ◽  
pp. 473-475 ◽  
Author(s):  
S. B. Patten

The heterogeneity of clinical syndromes subsumed by diagnostic criteria for major depressive disorder (MDD) is regarded by some as a reason to abandon or modify the criteria. However, heterogeneity may be unavoidable because of the biopsychosocial complexity of depression. MDD may be characterised by complexities that cannot be distilled down to any brief set of diagnostic criteria. Psychiatrists and psychiatric epidemiologists may need to revise their expectations of this diagnosis in order to avoid over-estimating its ability to guide the selection of treatments and prediction of prognosis. An opposing perspective is that of reification, in which the diagnosis is viewed as being more real than it really is. The concept of rheostasis may help to explain some features of this condition, such as why major depressive episodes sometimes seem understandable or even adaptive (e.g. in the context of bereavement) whereas at other times such episodes are inexplicable and maladaptive.


2021 ◽  
pp. 216770262199208
Author(s):  
Renee J. Thompson ◽  
Natasha H. Bailen ◽  
Tammy English

The emotional experiences of people with major depressive disorder (MDD) are characterized by emotional disturbances. We examined whether these patterns characterize people with MDD in remission. Participants included individuals who had experienced at least two major depressive episodes (remitted-MDD group; n = 80), had current MDD (current-MDD group; n = 48), or were control participants ( n = 87). Participants reported their momentary affect five times per day for 14 days, from which we computed the mean (i.e., intensity), standard deviation (i.e., variability), and autocorrelation (i.e., inertia). Negative affect (NA) intensity and variability, but not inertia, differed between groups; the current-MDD group had the highest levels, the control group had the lowest, and the remitted-MDD group fell in between. Differences in NA variability held after accounting for mean NA. The only significant group difference for positive affect (PA) was that PA intensity was lower in the current-MDD group compared with the other two groups. Emotional disturbances of participants with remitted MDD appear limited to NA.


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