Vegetative and Psychological Symptoms Associated with Depressed Mood over the First Two Years after Stroke

1997 ◽  
Vol 27 (2) ◽  
pp. 137-157 ◽  
Author(s):  
Sergio Paradiso ◽  
Tatsunobu Ohkubo ◽  
Robert G. Robinson
Keyword(s):  
Depressive Symptoms ◽  
Major Depression ◽  
Diagnostic Criteria ◽  
Depressed Mood ◽  
Psychological Symptoms ◽  
Median Number ◽  
Physical Illness ◽  
Depressed Patients ◽  
Self Confidence ◽  
Dsm Iv

Introduction: In patients with acute physical illness, symptoms used in the diagnosis of major depression such as sleep or appetite disturbance may be nonspecific for depression. This study was undertaken to examine the association of depressed mood with other depressive symptoms to determine which symptoms were most useful in the accurate diagnosis of major depression after stroke. Methods: Using a structured mental status examination, 142 patients with acute stroke were followed at three, six, twelve, and twenty-four months. Results: The median number of vegetative and psychological symptoms among patients with depressed mood was more than three times the respective rates among nondepressed patients at all time points over two years. Autonomic anxiety, morning depression, subjective anergia, worrying, brooding, loss of interest, hopelessness, and lack of self-confidence were significantly more frequent among depressed patients than nondepressed patients throughout the entire two-year period. Some symptoms such as anxious foreboding and loss of libido, as well as self-depreciation, feelings of guilt, and irritability were no longer significantly more common among depressed compared with nondepressed patients after six months. Standard DSM-IV diagnostic criteria and modified DSM-IV diagnostic criteria which included only specific symptoms of depression (i.e., symptoms which were significantly more frequent among depressed than nondepressed mood patients) yielded similar frequencies of major depression diagnosis. There were only a few patients (i.e., 2% to 3%) with depressive symptoms without a depressed mood (perhaps “masked” depressions). Conclusions: Vegetative and psychological depressive symptoms are significantly more common in depressed patients over the first two years after stroke and DSM-IV criteria do not overdiagnose major depression even in this population with chronic physical illness. The symptoms which characterize major depression appear to change between the subacute and chronic post-stroke periods.

Depression in Taiwanese patients with Alzheimer's disease determined by the National Institutes of Mental Health Provisional Criteria

2012 ◽  
Vol 24 (8) ◽  
pp. 1299-1305 ◽  
Author(s):  
Pai-Yi Chiu ◽  
David Steffens ◽  
Ping-Kun Chen ◽  
Ya-Chen Hsu ◽  
Hsiu-Tzu Huang ◽  
...  
Keyword(s):  
Mental Health ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Major Depression ◽  
Psychological Symptoms ◽  
Consecutive Series ◽  
Depressed Patients ◽  
Depression Subscale ◽  
Dsm Iv ◽  
Behavioral And Psychological Symptoms

ABSTRACTBackground: Depression is a common behavioral and psychological symptom of Alzheimer's disease (AD). The aims of the present study were to determine the rate of depression in Taiwanese patients with AD using the National Institutes of Mental Health Provisional Criteria for Depression in AD (NIMH-dAD criteria) and to investigate the association of depression with other behavioral and psychological symptoms.Methods: A consecutive series of 302 AD patients registered in a dementia clinic were investigated in this study. All patients met the criteria of the National Institute of Neurological Disorders and Stroke–Alzheimer's Disease and Related Disorders Association for probable AD. The rates of depression were determined according to the criteria of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders for major depression (DSM-IV), the International Classification of Diseases-9-Clinical Modification (ICD-9-CM) for neurotic depression, the depression subscale of the Neuropsychiatric Inventory (NPI), and the NIMH-dAD criteria. Depression severity was assessed using the 17-item Hamilton Depression Rating Scale. The rates of depression determined by the NIMH-dAD criteria were compared with the rates derived from each of the other instruments. Other behavioral and psychological symptoms were assessed using NPI. A behavioral neurologist or a geriatric psychiatrist interviewed all the patients.Results: Using the NIMH-dAD criteria, it was found that 90 (29.8%) of the AD patients had depression, and all depressive symptoms in NIMH-dAD were significantly higher among depressed patients. Among other depression instruments, the frequency of depression was lowest using the DSM-IV major depression criteria (9.3%) and highest with the NPI depression subscale (54%). Behavioral and psychological symptoms determined with NPI were significantly higher among depressed patients in all domains except euphoria.Conclusions: This is the first study of depression in Taiwanese patients with AD using the NIMH-dAD criteria. Our findings suggest that comorbid depression is high in Taiwanese patients with AD. It is clinically important to note the high frequency of most behavioral and psychological symptoms among depressed AD patients.

Predictors of Recovery From Major Depression Among Geriatric Psychiatry Inpatients: The Importance of Caregivers' Beliefs

1999 ◽  
Vol 11 (2) ◽  
pp. 149-157 ◽  
Author(s):  
Robin J. Casten ◽  
Barry W. Rovner ◽  
Yochi Shmuely-Dulitzki ◽  
Rona E. Pasternak ◽  
Rodney Pelchat ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Major Depression ◽  
Multivariate Analyses ◽  
Geriatric Psychiatry ◽  
Depression Treatment ◽  
Electroconvulsive Treatment ◽  
Caregiver Support ◽  
Important Relationship ◽  
Dsm Iv ◽  
Course Of Depression

Caregiver support is an important factor in recovery from depression among older patients. We examined whether caregivers' perceptions regarding patients' ability to control depressive symptoms were related to depression recovery. Depression treatment, demographics, number of depressive symptoms, and health were controlled. The sample comprised 51 geriatric psychiatry inpatients who met DSM-IV criteria for major depression and who had a primary caregiver. Depression was assessed at both admission and discharge. Caregivers were asked to indicate whether they believed their patient-relatives could control their depressive symptoms. At discharge, 33 patients (64.7%) were “remitted” and 18 (35.3%) were “nonremitted.” Multivariate analyses indicated that receiving electroconvulsive treatment, having fewer depressive symptoms caregivers perceived to be within patient control, and being female predicted depression remission at discharge. This study highlights the important relationship between family dynamics and course of depression.

Depression in Adults with Intellectual Disability. Part 2: A Pilot Study

1997 ◽  
Vol 31 (2) ◽  
pp. 243-251 ◽  
Author(s):  
Julian P. Davis ◽  
Fiona K. Judd ◽  
Helen Herrman
Keyword(s):  
Intellectual Disability ◽  
Depressive Disorder ◽  
Diagnostic Criteria ◽  
Patient Group ◽  
Depressive Disorders ◽  
Psychiatric Evaluation ◽  
Depressed Patients ◽  
Standard Assessment ◽  
Core Measure ◽  
Dsm Iv

Objectives: To identify adults with intellectual disability (ID) with a depressive disorder referred to a tertiary consultation clinic for psychiatric assessment; to investigate common presenting features of depression in adults with ID; to assess the utility of visual analogue scale (VAS) measures of emotion/behaviour, the CORE measure of psychomotor disturbance, and substitutive diagnostic criteria in the assessment of depressive disorders in this patient group. Method: Over a 6-month period 47 patients were seen for psychiatric evaluation. Patients in whom a diagnosis of depression was made were further assessed using: VAS measures of depression, irritability, verbal aggression, physical aggression, temper outbursts, regressed behaviour; CORE measure of psychomotor disturbance; and substitutive diagnostic criteria designed by the authors. Results: Ten patients were found to have a depressive disorder. Substitutive criteria resulted in a greater rate of diagnosis than standard DSM-IV criteria. The VAS measure of irritability was highly scored for all 10 depressed patients. All 10 depressed patients were assigned to the melancholic subgroup according to CORE score. Conclusions: Standard assessment measures and diagnostic criteria may require modification to enhance their utility in this patient group. Melancholic features require further investigation.

Depressed patients with incurable cancer: Which depressive symptoms do they experience?

2013 ◽  
Vol 11 (6) ◽  
pp. 491-501 ◽  
Author(s):  
Elisabeth Brenne ◽  
Jon Håvard Loge ◽  
Stein Kaasa ◽  
Ellen Heitzer ◽  
Anne Kari Knudsen ◽  
...  
Keyword(s):  
Palliative Care ◽  
Depressive Symptoms ◽  
Depressive Disorders ◽  
Social Withdrawal ◽  
Incurable Cancer ◽  
Cancer Symptoms ◽  
Depressed Patients ◽  
Symptom Experiences ◽  
Dsm Iv ◽  
Symptom Criteria

AbstractObjective:Diagnosing depressive disorders in palliative care is challenging because of the overlap between some depressive symptoms and cancer-related symptoms, such as loss of appetite and fatigue. In order to improve future assessment of depression in palliative care, depressive symptoms experienced by patients receiving pharmacological treatment for depression were assessed and compared to the American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) criteria for major depressive disorder.Method:Thirty Norwegian (n = 20) and Austrian (n = 10) patients with advanced cancer were included. Semistructured interviews on symptom experiences were conducted and transcribed verbatim. By the phenomenographic method, patients' symptom experiences were extracted and sorted by headings, first individually and then across patients. The patients subsequently rated 24 symptoms numerically including the DSM-IV depression criteria.Results:Lowered mood and a diminished motivational drive were prominent and reflected the two main DSM-IV symptom criteria. A relentless focus on their actual situation, restlessness, disrupted sleep, feelings of worthlessness, feelings of guilt, and thoughts of death as a solution were variably experienced. Appetite and weight changes, fatigue and psychomotor retardation were indistinguishable from cancer symptoms. All these symptoms reflected DSM-IV symptom criteria. Some major symptoms occurred that are not present in the DSM-IV symptom criteria: despair, anxiety, and social withdrawal. The numerical ratings of symptoms were mainly in accordance with the findings from the qualitative analysis.Significance of results:Despair, anxiety, and social withdrawal are common symptoms in depressed patients with incurable cancer, and, therefore, hypothesized as candidate symptom criteria. Other symptom criteria might need adjustment for improvement of relevance in this group of patients.

Dementia and Depression in Elderly Medical Inpatients

2000 ◽  
Vol 12 (1) ◽  
pp. 67-75 ◽  
Author(s):  
Emese Linka ◽  
György Bartkó ◽  
Tamás Agárdi ◽  
Katalin Kemény
Keyword(s):  
Depressive Symptoms ◽  
Major Depression ◽  
Rating Scale ◽  
Depressive Symptomatology ◽  
Total Sample ◽  
Semistructured Interview ◽  
High Prevalence ◽  
Medical Inpatients ◽  
Dsm Iv ◽  
Hamilton Rating Scale

The purpose of this study was to examine the prevalence and correlation of cognitive impairments, major depression, and depressive symptoms among elderly medical inpatients, and to compare the degree of depressive symptomatology as well as cognitive deterioration in possible vascular dementia and possible Alzheimer's disease. In a department of internal medicine, 100 (36 male, 64 female) 65-year-old or older patients were examined by a semistructured interview, and assessed by the Hachinski Ischemic Scale, the Hamilton Rating Scale for Depression (HDS), and the Modified Mini-Mental State (MMMS) Examination. In our total sample, the MMMS total score was (±SD) 76.0 ± 15.5 and the HDS total score was (±SD) 12.0 ± 6.1. Based on DSM-IV criteria, major depression was established in 11 patients. Deterioration of cognitive functions was seen in 66 patients; cognitive impairment was mild in 30 patients, moderate in 19, and severe in 17. Forty-six patients had mild depressive symptoms and 27 had severe depressive symptoms. In summary, a high prevalence of cognitive dysfunction and depressive symptomatology was detected in our study, illustrating the importance of psychiatric care in elderly medical inpatients.

Cortisol and BDNF levels in depression within schizophrenia structure: approach to treating

2016 ◽  
Vol 14 (3) ◽  
pp. 12-17 ◽  
Author(s):  
Yulia S. Nikiforova ◽  
Galina E. Mazo
Keyword(s):  
Depressive Symptoms ◽  
Diagnostic Criteria ◽  
Structure Approach ◽  
Psychometric Methods ◽  
Depressed Patients ◽  
Icd 10 ◽  
Schizophrenic Patients

To evaluate the effect of depression on the level of cortisol and BDNF in patients with schizophrenia 25 inpatients, who met the diagnostic criteria for ICD-10 schizophrenia (F20), were examined. The examination included clinical, psychopathological, laboratory and psychometric methods. Patients were examined twice: at admission and after 6 weeks of treatment. It was found that the level of BDNF in schizophrenic patients with depressive symptoms was significantly lower than that of non-depressed patients, and the level of cortisol in patients with depression was significantly higher.

Screening for Depression in Medical Settings: The Case Against Specific Scales

2009 ◽  
Author(s):  
Fariba Babaei ◽  
Alex J. Mitchell
Keyword(s):  
Primary Care ◽  
Major Depression ◽  
Functional Disability ◽  
Somatic Symptoms ◽  
Physical Illness ◽  
Medical Illness ◽  
Comorbid Depression ◽  
Depressed Patients ◽  
Chronic Medical Illness ◽  
Lost Productivity

The prevailing view for detecting mood disorders in the presence of physical disease is to exclude somatic symptoms that might contaminate a diagnosis (See Parker and Hyatt, Chapter 10 for a presentation of this point of view). This chapter will examine whether this approach is beneficial, with a view to deciding whether new depression scales for each physical disorder (each excluding somatic symptoms) are required. There is a bidirectional relationship between depression and physical illness. New evidence suggests that among depressed individuals presenting in primary care, most have at least one comorbid psychiatric condition and at least one physical condition. At least 75% of elderly depressed patients in primary care also have a known physical illness, and in 30–50% this is of high severity. In one study only 10% of elderly depressed patients in primary care had pure depression with no comorbidity. Thus, comorbid depression should be considered ‘‘normal’’ in primary care. Some evidence suggests that those with comorbidity are less likely to have depression treatment initiated by their primary care practitioner. They are also less likely to recover from depression.9 Specific conditions such as speech disorders, arthritis, and dermatologic problems have been linked with worse outcomes of depression. The exact relationship of depression and comorbidities is complex. In one of the largest studies, Egede (2007) examined data from 30,801 adults captured in the 1999 Household National Health Interview Survey. The community prevalence of major depression was 4.7% in those without chronic medical illness but 7.7%, 9.8%, and 12% in those with one, two, or three or more chronic disorders, respectively (Fig. 11.1). Major depression was associated with significant increases in utilization, lost productivity, and functional disability. Patients with chronic medical illness and comorbid depression (and anxiety) also have significantly higher numbers of medical symptoms, even controlling for severity of disease. Around one in four people in the general population have functional disability, but in those with depression and medical comorbidity, at least three out of four have functional limitations.

Depressive Symptoms as Predictors of the Severity of Fatigue in Major Depression

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
P. Ferentinos ◽  
V. Kontaxakis ◽  
B. Havaki-Kontaxaki ◽  
D. Dikeos ◽  
G. Papadimitriou
Keyword(s):  
Factor Analysis ◽  
Depressive Symptoms ◽  
Major Depression ◽  
Multiple Regression ◽  
Depressed Mood ◽  
Rating Scale ◽  
Main Diagnosis ◽  
Factor Scores ◽  
Major Depressive ◽  
Somatic Anxiety

Objective:Fatigue in patients with major depression is understudied, although highly prominent. The objective of this study was to investigate the independent correlation of various depressive symptoms with the severity of fatigue in major depression.Methods:Eighty-one patients (70 female/11 male, 40 inpatients/41 outpatients), aged 23-65 years (mean 48.6±10.6), with a DSM-IV main diagnosis of Major Depressive Disorder (М.Ι.Ν.Ι. 5.0.0.) and currently in a Major Depressive Episode [17-item Hamilton Depression Rating Scale (HDRS) score ≥15], were studied. Patients with physical diseases or other fatigue-related conditions were excluded. The 14-item Fatigue Questionnaire (FQ) was used for the assessment of reported fatigue. Factor analysis of all HDRS items was performed. Pearson's correlations between the derived regression factor scores and the FQ score were calculated. Age, gender, and factor scores that significantly correlated with the FQ score entered a multiple regression analysis, with the FQ score as the dependent variable.Results:Factor analysis of HDRS items indicated a 6-factor structure (F1 ‘depressed mood’, F2 ‘middle/late insomnia and somatic anxiety’, F3 ‘anorexia/ weight loss’, F4 ‘general somatic symptoms’, F5 ‘anxiety/hypochondriasis’, F6 ‘early insomnia’). Only factors F1 (items 1,3,7,8), F2 (items 5,6,11) and F4 (items 13,14,17) were significantly correlated with the FQ score (p< 0.05). F1, F2 and F4 turned out to be significant predictors of FQ in the multiple regression, with standardised beta coefficients of 0.291, 0.290 and 0.278 (p< 0.05), respectively.Conclusions:Depressed mood, somatic anxiety, middle and late insomnia correlate independently with the severity of fatigue reported by patients with major depression.

Obese youths are not more likely to become depressed, but depressed youths are more likely to become obese

2013 ◽  
Vol 43 (10) ◽  
pp. 2143-2151 ◽  
Author(s):  
R. E. Roberts ◽  
H. T. Duong
Keyword(s):  
Depressive Symptoms ◽  
Major Depression ◽  
Weight Status ◽  
Reciprocal Effects ◽  
Age Group ◽  
Reciprocal Effect ◽  
Symptoms Of Depression ◽  
Increased Risk ◽  
Dsm Iv ◽  
Meta Analyses

BackgroundOverweight/obesity and depression are both major public health problems among adolescents. However, the question of a link between overweight/obesity and depression remains unresolved in this age group. We examined whether obesity increases risk of depression, or depression increases risk of obesity, or whether there is a reciprocal effect.MethodA two-wave prospective cohort study of adolescents aged 11–17 years at baseline (n = 4175) followed up a year later (n = 3134) sampled from the Houston metropolitan area. Overweight was defined as 95th percentile >body mass index (BMI) ⩽85th percentile and obese as BMI >95th percentile. Three indicators of depression were examined: any DSM-IV mood disorder, major depression, and symptoms of depression.ResultsData for the two-wave cohort indicated no evidence of reciprocal effects between weight and depression. Weight status predicted neither major depression nor depressive symptoms. However, mood disorders generally and major depression in particular increased risk of future obesity more than twofold. Depressed males had a sixfold increased risk of obesity. Females with depressive symptoms had a marginally increased risk of being overweight but not obese.ConclusionsOur findings, combined with those of recent meta-analyses, suggest that obese youths are not more likely to become depressed but that depressed youths are more likely to become obese.

scholarly journals Psychological features in panic disorder: a comparison with major depression

2002 ◽  
Vol 60 (3A) ◽  
pp. 553-557 ◽  
Author(s):  
Yasmin A. Almeida ◽  
Antonio E. Nardi
Keyword(s):  
Comparative Analysis ◽  
Major Depression ◽  
Panic Disorder ◽  
Object Relations ◽  
Anxiety Symptoms ◽  
Psychological Model ◽  
Depressed Patients ◽  
Dsm Iv ◽  
Psychological Features ◽  
Negative Impression

OBJECTIVE: We aim to evaluate the psychodymanic model for panic disorder (PD) formulated by Shear et al. (1993), comparing PD patients and major depression (MD) patients. METHOD: We evaluated these parameters in open interviews in 10 PD patients and 10 patients with MD (DSM-IV). The data were recorded on videotape and were examined by 5 diagnostic blind appraisers. RESULTS: The data allowed a comparative analysis that underscores the existence of a psychological model for PD vs MD: 1) the protracted symbiotic phase of development and the existence of problems with separation in PD patients; 2) patients with MD tended to have a particularly negative impression of relationship with the first objects; furthermore, they had remarkable experiences of loss; and 3) while the PD patients tended to be shy and inhibited in childhood, especially showing a clear difficulty in expressing aggressiveness, the depressed patients tended to disclose an impulsive aggressiveness from infancy to adulthood. CONCLUSION: Exposure to parental behaviours that augment fearfulness may result in disturbances in object relations and persistence of conflicts between dependence and independence may predispose to anxiety symptoms and fears of PD.

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