Network Analysis of Depressive Symptomatology in Elderly Patients with Major Depressive Disorder

Author(s):  
Seon-Cheol Park

Background: A novel psychopathological approach is the application of network analysis, as it is proposed that symptoms and their interconnections constitute a disease itself, rather than simply being components or outcome factors of disease. Objective: Using data from the Clinical Research Center for Depression (CRESCEND) Study, this study examined depressive symptoms in elderly patients with major depressive disorder using a network analysis approach. Methods: Among 135 elderly patients with major depressive disorder who were recruited from the CRESCEND study, we created a network based on individual items from the Hamilton Depression Rating Scale (HAMD), with the nodes being each item (symptom) and the edges being the strength of the association between the items (interconnection). By calculating measures of centrality of each of the nodes, we were able to determine which depressive symptoms were most central (influential) in the network. Results: The insight item was completely unconnected with other items and it was excluded in terms of network analysis. Thus, a network analysis of the 16 HAMD items estimated that the anxiety psychic item was the most central domain, followed by insomnia (middle of the night), depressive mood, and insomnia (early hours of the morning) items. On the contrary, the retardation item was the most poorly interconnected with the network. Conclusion: We suggest that our study makes a significant contribution to the literature because we have found that anxiety, depressed mood, and insomnia are most central to the network, indicating that they are the most influential symptoms in major depression in elderly individuals.

2014 ◽  
Vol 26 (5) ◽  
pp. 291-297 ◽  
Author(s):  
Salih Saygin Eker ◽  
Ebru Oztepe Yavasci ◽  
Sengul Cangur ◽  
Selcuk Kirli ◽  
Emre Sarandol

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.


2018 ◽  
Vol 268 ◽  
pp. 68-71 ◽  
Author(s):  
Jean-Arthur Micoulaud-Franchi ◽  
Mélanie Faugere ◽  
Sebastien Weibel ◽  
Catherine Faget ◽  
Christophe Lancon ◽  
...  

2020 ◽  
Vol 66 (5) ◽  
pp. 496-503 ◽  
Author(s):  
Orkun Aydin ◽  
Fikret Poyraz Çökmüş ◽  
Kuzeymen Balikçi ◽  
Didem Sücüllüoğlu-Dikici ◽  
Pınar Ünal-Aydin

Background: Although excessive use of social networking site (SNS) is related to undesired effects on healthy individual’s psychological well-being, there is a huge gap in studies performed with individuals who suffer from various mental disorders. Aim: The main goal of this study is to examine the association between problematic utilization of SNSs and depressive symptoms across patients diagnosed with major depressive disorder (MDD). Methods: 111 patients diagnosed with MDD (diagnoses confirmed via the Structured Clinical Interview for DSM-5–Clinician Version (SCID-5/CV)) and 108 healthy controls (HCs) were recruited for the study. Montgomery–Asberg Depression Rating Scale (MADRS) and Bergen Social Media Addiction Scale (BSMAS) were administered by both MDD and HC groups. Group comparisons were estimated with multivariate analysis of covariance (MANCOVA) analyses. To identify the relationship between SNS addiction and depressive symptoms, the Pearson correlations were performed, and finally, we computed the multiple linear regression analyses to determine whether SNS addiction predicts depressive symptoms. Results: The results revealed that MDD group is more addicted to SNS relative to HC. In addition, depressive symptoms were significantly predicted by ‘relapse’ subdimension and the overall score of SNS addiction in the MDD group. Conclusion: Our study illustrated the detrimental effects of excessive SNSs usage on depressive symptoms in MDD particularly for the individuals in ‘relapse’ state of SNS addiction. The mental health workers should consider the usage patterns of SNSs in patients diagnosed with MDD during their clinical observation and management.


CNS Spectrums ◽  
2010 ◽  
Vol 15 (6) ◽  
pp. 367-373 ◽  
Author(s):  
Ira H. Bernstein ◽  
A. John Rush ◽  
Trisha Suppes ◽  
Yakasushi Kyotoku ◽  
Diane Warden

ABSTRACTIntroduction: The clinical and self-report versions of the Quick Inventory of Depressive Symptomatology (QIDS-C16 and QIDS-SR16) have been well studied in patients with major depressive disorder and in one recent study using patients with bipolar disorder. This article examines these measures in a second sample of 141 outpatients with bipolar disorder in different phases of the illness.Methods: At baseline, 61 patients were depressed and 30 were euthymic; at exit, 50 were depressed and 52 were euthymic. The remaining patients (at baseline or exit) were in either a manic or mixed phase and were pooled for statistical reasons.Results: Similar results were found for the QIDS-C16 and QIDS-SR16. Scores were reasonably reliable to the extent that variability within groups permitted. As expected, euthymic patients showed less depressive symptomatology than depressed patients. Sad mood and general interest were tne most discriminating symptoms between depressed and euthymic phases. Changes in illness phase (baseline to exit) were associated with substantial changes in scores. The relation of individual depressive symptoms to the overall level of depression was consistent across phases.Conclusion: Both the QIDS-SR16 and QIDS-C16 are suitable measures of depressive symptoms in patients with bipolar disorder.


2020 ◽  
pp. 000486742096569
Author(s):  
Robson Zazula ◽  
Muhammad Ishrat Husain ◽  
Mohammadreza Mohebbi ◽  
Adam J Walker ◽  
Imran B Chaudhry ◽  
...  

Background: Randomized controlled clinical trials that have investigated minocycline as an adjunctive treatment for major depressive disorder have proved promising. Data from two studies were pooled to evaluate more definitively whether the addition of minocycline to standard treatment for major depressive disorder leads to an improvement of depressive symptoms when compared with placebo. Methods: Both studies were multi-site, double-blinded, placebo-controlled trials of minocycline 200 mg/day added to treatment as usual during a 12-week period. The primary outcome measure was change in depressive symptoms (Montgomery–Asberg Depression Rating Scale in Dean et al. and Hamilton Depression Rating Scale in Husain et al.). Secondary outcomes were change in depression severity (Montgomery–Asberg Depression Rating Scale for Dean et al. and 9-item Patient Health Questionnaire in Husain et al.), anxiety severity (Hamilton Anxiety Rating Scale in Dean et al. and Generalized Anxiety Disorder 7-item scale in Husain et al.) and functional status, which were also evaluated as potential mediators on the primary outcome. Results: A total of 112 participants were included in the pooled data (Dean et al., n = 71; Husain et al., n = 41). A significant change from baseline to week 12 was noted in depressive symptoms – differential change (Placebo vs Minocycline): 9.0, 95% confidence interval = [4.2, 13.9], Cohen’s D (95% confidence interval): 0.71 [0.29, 1.14], p < 0.001 – anxiety severity – differential change (Placebo vs Minocycline): 0.38, confidence interval = [0.00, 0.75], Cohen’s D (95% confidence interval): 0.41 [0.00, 0.82], p = 0.050) and functional status – differential change (Placebo vs Minocycline): 1.0, 95% confidence interval = [0.4, 1.5], Cohen’s D (95% confidence interval): 0.76 [0.34, 1.19], p = 0.001). Duration of illness, current use of benzodiazepine and pain medication were identified as moderators, whereas functional status as a mediator/predictor. Conclusion: The improvement of depressive symptoms, anxiety severity and functional status is promising and suggests that minocycline has potential as an adjunctive treatment for major depressive disorder. However, further studies are warranted to confirm therapeutic effects of minocycline in major depressive disorder. Trial registrations: NCT02263872, registered October 2014, and ACTRN12612000283875, registered March 2012.


2020 ◽  
Author(s):  
Nicole Geschwind ◽  
Martijn van Teffelen ◽  
Elin Hammarberg ◽  
Arnoud Arntz ◽  
M.J.H. Huibers ◽  
...  

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


2018 ◽  
Author(s):  
Caitlin Hitchcock ◽  
Siobhan Gormley ◽  
Catrin Rees ◽  
Evangeline Rodrigues ◽  
Julia Gillard ◽  
...  

The published version of this paper is available through open access at https://doi.org/10.1016/j.brat.2018.08.008. Successful navigation within the autobiographical memory store is integral to daily cognition. Impairment in the flexibility of memory retrieval processes can thereby have a detrimental impact on mental health. This randomised controlled phase II trial (N=60) evaluated the potential of a novel, autobiographical memory-based intervention drawn from basic science – an autobiographical Memory Flexibility (MemFlex) training programme – which sought to ameliorate memory difficulties and improve symptoms of Major Depressive Disorder. MemFlex was compared to Psychoeducation (an evidence-based low-intensity intervention) to determine the likely range of effects on a primary cognitive target of memory flexibility at post-intervention, and co-primary clinical targets of self-reported depressive symptoms and depression diagnostic status at three month follow-up, in preparation for a later phase trial. Results demonstrated small-moderate effect sizes in favour of MemFlex for memory flexibility (d=0.34), self-reported depressive symptoms (d=0.24), and loss of depression diagnosis (OR=0.65), along with the secondary outcome of depression-free days (d=0.36). These results suggest that further development and definitive evaluation of MemFlex is warranted as an avenue to improving the low-intensity treatment of depression.


2019 ◽  
Vol 50 (6) ◽  
pp. 1032-1042 ◽  
Author(s):  
Taylor A. Braund ◽  
Donna M. Palmer ◽  
Leanne M. Williams ◽  
Anthony W. F. Harris

AbstractBackgroundMajor depressive disorder (MDD) commonly co-occurs with clinically significant levels of anxiety. However, anxiety symptoms are varied and have been inconsistently associated with clinical, functional, and antidepressant treatment outcomes. We aimed to identify and characterise dimensions of anxiety in people with MDD and their use in predicting antidepressant treatment outcome.Method1008 adults with a current diagnosis of single-episode or recurrent, nonpsychotic, MDD were assessed at baseline on clinical features and cognitive/physiological functioning. Participants were then randomised to one of three commonly prescribed antidepressants and reassessed at 8 weeks regarding symptom change, as well as remission and response, on the 17-item Hamilton Rating Scale Depression (HRSD17) and the 16-item Quick Inventory of Depressive Symptomatology (QIDS-SR16). Exploratory factor analysis was used on items from scales assessing anxiety symptoms, and resulting factors were assessed against clinical features and cognitive/physiological functioning. Factors were also assessed on their ability to predict treatment outcome.ResultsThree factors emerged relating to stress, cognitive anxiety, and somatic anxiety. All factors showed high internal consistency, minimal cross-loadings, and unique clinical and functional profiles. Furthermore, only higher somatic anxiety was associated with poorer QIDS-SR16 remission, even after adjusting for covariates and multiple comparisons.ConclusionsAnxiety symptoms in people with MDD can be separated onto distinct factors that differentially respond to treatment outcome. Furthermore, these factors do not align with subscales of established measures of anxiety. Future research should consider cognitive and somatic symptoms of anxiety separately when assessing anxiety in MDD and their use in predicting treatment outcome.


2021 ◽  
Vol 12 (01) ◽  
pp. 122-128
Author(s):  
Ralte Lalthankimi ◽  
Padmavathi Nagarajan ◽  
Vikas Menon ◽  
Jeby Jose Olickal

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.


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