Depression in Inpatients: Bipolar vs Unipolar

162 depressed inpatients were divided into three diagnostic groups to compare patterns of sociodemographic characteristics, psychopathology, and psychosocial: 35 had a single episode of major depression, 96 had recurrent major depression, and 31 had a bipolar disorder. Psychopathology and psychosocial functioning were measured by clinician-rated scales, Montgomery-Asberg Depression Rating Scale, Hamilton Rating Scale for Depression, Clinical Global Impression, and self-rating scales, Symptom Checklist-90, Social Support Questionnaire, Social Adjustment Scale. The three groups were comparable on sociodemographic variables, with the exception of education. Univariate analyses showed a similar social impairment as measured by Social Support Questionnaire, Social Adjustment Scale, and no significant differences were recorded for the psychopathology when the total test scores (Montgomery-Asberg Depression Rating Scale, Hamilton Rating Scale for Depression, Clinical Global Index, Symptom Checklist-90) were evaluated. Some differences emerged for single items in the Montgomery-Asberg Depression Rating Scale and Symptom Checklist-90. These findings suggest a substantial similarity among the three groups. Results are discussed in terms of the clinical similarities between unipolar and bipolar patients during a depressive episode as well as the limitations of cross-sectional study implies.

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Methylphenidate May Treat Apathy Independent of Depression

Annals of Pharmacotherapy ◽

10.1345/aph.1g352 ◽

2005 ◽

Vol 39 (11) ◽

pp. 1947-1949 ◽

Cited By ~ 25

Author(s):

Prasad R Padala ◽

Frederick Petty ◽

Subhash C Bhatia

Keyword(s):

Major Depression ◽

Treatment Regimen ◽

Rating Scales ◽

Rating Scale ◽

Case Summary ◽

Long Time ◽

History Of ◽

High Degree ◽

Hamilton Rating Scale

OBJECTIVE To report a case of apathy treated with methylphenidate in which improvement in apathy was independent of improvement of depression. CASE SUMMARY A 47-year-old woman with a 20-year history of recurrent major depression was diagnosed as having significant apathy with lack of initiative and motivation. Over the course of a 4-week treatment regimen with methylphenidate, her apathy, as measured by the Apathy Evaluation Scale, improved, with her score decreasing from 57 to 31. During this period, her depression, as assessed by the 21-item Hamilton Rating Scale for Depression, remained unchanged. DISCUSSION Our report of improvement of apathy with methylphenidate is consistent with other reports in the literature, although previous studies have not specifically used the rating scales to assess apathy. Even though this patient had experienced apathy for a long time, it had not been detected due to lack of direct questioning. In this case, as noted, the improvement of apathy was independent of improvement in depression. CONCLUSIONS A high degree of suspicion and specific inquiry is required for identification of apathy. Once detected, methylphenidate may be beneficial in its treatment, a strategy that may work independently of augmentation of antidepressants.

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Physical exercise for late-life major depression

The British Journal of Psychiatry ◽

10.1192/bjp.bp.114.150516 ◽

2015 ◽

Vol 207 (3) ◽

pp. 235-242 ◽

Cited By ~ 39

Author(s):

M. Belvederi Murri ◽

M. Amore ◽

M. Menchetti ◽

G. Toni ◽

F. Neviani ◽

...

Keyword(s):

Primary Care ◽

Major Depression ◽

Physical Exercise ◽

Primary Outcome ◽

Rating Scale ◽

Late Life ◽

Lower Intensity ◽

Progressive Exercise ◽

Primary Care Patients ◽

Hamilton Rating Scale

BackgroundInterventions including physical exercise may help improve the outcomes of late-life major depression, but few studies are available.AimsTo investigate whether augmenting sertraline therapy with physical exercise leads to better outcomes of late-life major depression.MethodPrimary care patients (>65 years) with major depression were randomised to 24 weeks of higher-intensity, progressive aerobic exercise plus sertraline (S+PAE), lower-intensity, non-progressive exercise plus sertraline (S+NPE) and sertraline alone. The primary outcome was remission (a score of $10 on the Hamilton Rating Scale for Depression).ResultsA total of 121 patients were included. At study end, 45% of participants in the sertraline group, 73% of those in the S+NPE group and 81% of those in the S+PAE group achieved remission (P = 0.001). A shorter time to remission was observed in the S+PAE group than in the sertraline-only group.ConclusionsPhysical exercise may be a safe and effective augmentation to antidepressant therapy in late-life major depression.

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Social Adjustment of Remitted Bipolar and Unipolar Out-patients

The British Journal of Psychiatry ◽

10.1192/bjp.159.2.239 ◽

1991 ◽

Vol 159 (2) ◽

pp. 239-244 ◽

Cited By ~ 84

Author(s):

F. Bauwens ◽

A. Tracy ◽

D. Pardoen ◽

M. Vander Elst ◽

J. Mendlewicz

Keyword(s):

Social Interactions ◽

Social Adjustment ◽

Leisure Activities ◽

Social Maladjustment ◽

Residual Symptoms ◽

The Social ◽

The Mean ◽

Bipolar Patients ◽

Normal Controls ◽

Social Adjustment Scale

Various areas of social adjustment were compared using the Social Adjustment Scale in 27 remitted bipolars, 24 remitted unipolars and 25 normal controls matched for age and sex. Scores for global adjustment and for social and leisure activities were significantly worse in patients than in controls. The maladjustment in social and leisure activities appeared only in ‘contact with friends' for bipolar patients and ‘diminished social interactions' for unipolar patients. Unipolar patients differed significantly from controls on the items investigating sexual adjustment. In unipolars, social maladjustment seemed to be independent of the course of the disease; in bipolars, it was partly related to the mean number of lifetime episodes and current residual symptoms.

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Use of Three Depression Scales for Evaluation of Pretreatment Severity and of Improvement after Treatment

Psychological Reports ◽

10.2466/pr0.2000.87.2.389 ◽

2000 ◽

Vol 87 (2) ◽

pp. 389-394 ◽

Cited By ~ 2

Author(s):

Carmen Senra Rivera ◽

Carolina RancañO Pérez ◽

Elizabeth Sánchez Cao ◽

Salomé Barba Sixto

Keyword(s):

Major Depression ◽

Tricyclic Antidepressants ◽

Rating Scale ◽

Severity Rating ◽

Four Levels ◽

Pretreatment Severity ◽

Castilian Spanish ◽

Depression Scales ◽

Hamilton Rating Scale ◽

Improvement Rating

We investigated the Castilian Spanish versions of three scales (the Hamilton Rating Scale for Depression, the Carroll Rating Scale for Depression, and the Montgomery-Asberg Depression Rating Scale) as to their suitability for classifying major depression patients in four levels of severity prior to treatment with tricyclic antidepressants, and also as to their suitability for classifying these patients in four improvement levels when administered posttreatment. Although the scales behaved quite similarly, each was most efficient at the task for which it had been designed, i.e., severity rating for the Hamilton and Carroll scales, improvement rating for the Montgomery-Asberg scale.

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Assessment and treatment of dysthymia. The development of the Cornell dysthymia rating scale

European Psychiatry ◽

10.1016/s0924-9338(97)89103-1 ◽

1997 ◽

Vol 12 (4) ◽

pp. 190-193 ◽

Cited By ~ 9

Author(s):

J Cohen

Keyword(s):

Major Depression ◽

Rating Scale ◽

Pharmacologic Treatment ◽

Statistical Manual ◽

Diagnostic And Statistical Manual ◽

Insidious Onset ◽

Assessment And Treatment ◽

Depressive Personality ◽

Hamilton Rating Scale

SummaryThe understanding and classification of persistently depressed mood has undergone many changes since the term ‘dysthymia’ was first used nearly 150 years ago. Originally it was applied to both melancholia and mania; later it was applied to depressive personality. The Diagnostic and Statistical Manual (DSM)-III in 1980 and in subsequent updates classified dysthymia as a mood disorder, characterized by a frequently insidious onset and a course that is chronic and unremitting. The assessment of clinical response in the pharmacologic treatment of dysthymia has been more difficult than that for major depression. The Hamilton Rating Scale for Depression, among others, is oriented towards episodic rather than chronic states of depression. A new rating scale, the Cornell Dysthymia Rating Scale, has been developed to better assess milder symptomatology in chronically depressed patients. Early studies suggest its utility, but further validation of the scale is needed in patients with dysthymia and without major depression.

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Suicidal Ideation in Parkinson's Disease

CNS Spectrums ◽

10.1017/s109285290002040x ◽

2009 ◽

Vol 14 (8) ◽

pp. 431-436 ◽

Cited By ~ 21

Author(s):

Arthur Kummer ◽

Francisco Cardoso ◽

Antonio Lucio Teixeira

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Suicidal Ideation ◽

Major Depression ◽

Attempted Suicide ◽

Rating Scale ◽

Suicide Attempts ◽

Disease Onset ◽

Mini Mental Status Exam ◽

Hamilton Rating Scale

ABSTRACTObjective: To assess the frequency of suicidal ideation and suicide attempts in patients with Parkinson's disease.Methods: The Mini International Neuropsychiatric Interview (MINI), Beck Depression Inventory (BDI), and Hamilton Rating Scale for Depression (HAM-D) were administered to 90 consecutive, non-demented Parkinson's disease patients. They were also submitted to a complete neurologic examination which included brief cognitive batteries, the Mini Mental Status Exam, and Frontal Assessment Battery. We analyzed the scores of the section of the MINI related to the risk of suicide as well as the specific questions of BDI and HAM-D concerning suicidal ideation.Results: No patient had ever attempted suicide. According to MINI, suicidal ideation was present in 13 patients (14.4%) with Parkinson's disease. All instruments assessed the risk of suicide in a similar way. Suicidal ideation was associated only with lower age (P=.022), lower age of Parkinson's disease onset (P=.021), panic disorder (P=.004), social anxiety disorder (P=.007), and major depression (P<.001). Logistic regression analysis indicated that major depression was the main predictor of suicidal ideation.Conclusion: Suicide attempts seem to be uncommon in Parkinson's disease, despite the fact that the rates of suicidal ideation are possibly elevated. Depression seems to be the most important predictor of suicidal ideation in Parkinson's disease.

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Tolerability and Efficacy of Vortioxetine Versus SSRIs in Elderly With Major Depression. Study Protocol of the VESPA Study: A Pragmatic, Multicentre, Open-Label, Parallel-Group, Superiority, Randomized Trial

10.21203/rs.2.19503/v2 ◽

2020 ◽

Author(s):

Giovanni Ostuzzi ◽

Chiara Gastaldon ◽

Angelo Barbato ◽

Barbara D’Avanzo ◽

Mauro Tettamanti ◽

...

Keyword(s):

Major Depression ◽

Randomized Trial ◽

Selective Serotonin Reuptake Inhibitors ◽

Rating Scales ◽

Rating Scale ◽

The Elderly ◽

Tolerability Profile ◽

Open Label ◽

Parallel Group

Abstract Introduction. Depression is a highly prevalent condition in the elderly, with a vast impact on quality of life, life expectancy, and medical outcomes. Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed agents in this condition and, although generally safe, tolerability issues cannot be overlooked. Vortioxetine is an antidepressant with a novel mechanism of action. Based on available studies, it may have a promising tolerability profile in the elderly, as it does not adversely affect psychomotor or cognitive performance, and does not alter cardiovascular and endocrine parameters. The present study aims to assess the tolerability profile of vortioxetine in comparison with the SSRIs considered as a single group in elderly participants with depression. The rate of participants withdrawing from treatment due to adverse events after six months of follow-up will be the primary outcome. Methods and analysis. This is a pragmatic, multicentre, open-label, parallel-group, superiority, randomized trial funded by the Italian Medicines Agency (AIFA - Agenzia Italiana del Farmaco ). Thirteen Italian Community Psychiatric Services will consecutively enrol elderly participants suffering from an episode of major depression over a period of 12 months. Participants will be assessed at baseline and after 1, 3 and 6 months of follow-up. At each time point, the following validated rating scales will be administered: Montgomery–Åsberg Depression Rating Scale (MADRS), Antidepressant Side-Effect Checklist (ASEC), EuroQual 5 Dimensions (EQ-5D), Short Blessed Test (SBT), and Charlson Age-Comorbidity Index (CACI). Outcome assessors and the statistician will be masked to treatment allocation. A total of 358 participants (179 in each group) will be enrolled. Ethics and dissemination. This study will fully adhere to the ICH E6 Guideline for Good Clinical Practice. Participants’ data will be managed and safeguarded according to the European Data Protection Regulation 2016/679. An external Ethical Advisory Board will help guarantee high ethical standards. Trial registration number. EudraCT number: 2018-001444-66; Clinicaltrials.gov: NCT03779789, first submitted on December 12, 2018 and first posted on December 19 th trial status: protocol version 1.5; 09/06/2018. Recruitment started on February 2019 and it is ongoing. It is expected to end approximately on September 30 th 2021.

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Tolerability and Efficacy of Vortioxetine Versus SSRIs in Elderly with Major Depression. Study Protocol of the Vespa Study: A Pragmatic, Multicentre, Open-Label, Parrallel-Group, Superiority, Randomized Trial

10.21203/rs.2.19503/v1 ◽

2019 ◽

Author(s):

Giovanni Ostuzzi ◽

Chiara Gastaldon ◽

Angelo Barbato ◽

Barbara D’Avanzo ◽

Mauro Tettamanti ◽

...

Keyword(s):

Major Depression ◽

Randomized Trial ◽

Selective Serotonin Reuptake Inhibitors ◽

Rating Scales ◽

Rating Scale ◽

Good Clinical Practice ◽

The Elderly ◽

Tolerability Profile ◽

Open Label

Abstract Introduction. Depression is a highly prevalent condition in the elderly, with a vast impact on quality of life, life expectancy, and medical outcomes. Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed agents in this condition and, although generally safe, tolerability issues cannot be overlooked. Vortioxetine is an antidepressant with a novel mechanism of action. Based on available studies, it may have a promising tolerability profile in the elderly, as it does not adversely affect psychomotor or cognitive performance, and does not alter cardiovascular and endocrine parameters. The present study aims to assess the tolerability profile of vortioxetine in comparison with the SSRIs considered as a single group in elderly participants with depression. The rate of participants withdrawing from treatment due to adverse events after six months of follow-up will be the primary outcome. Methods and analysis. This is a pragmatic, multicentre, open-label, parallel-group, superiority, randomized trial funded by the Italian Medicines Agency (AIFA - Agenzia Italiana del Farmaco). Thirteen Italian Community Psychiatric Services will consecutively enrol elderly participants suffering from an episode of major depression over a period of 12 months. Participants will be assessed at baseline and after 1, 3 and 6 months of follow-up. At each time point, the following validated rating scales will be administered: Montgomery–Åsberg Depression Rating Scale (MADRS), Antidepressant Side-Effect Checklist (ASEC), EuroQual 5 Dimensions (EQ-5D), Short Blessed Test (SBT), and Charlson Age-Comorbidity Index (CACI). Outcome assessors and the statistician will be masked to treatment allocation. A total of 358 participants (179 in each group) will be enrolled. Ethics and dissemination. This study will fully adhere to the ICH E6 Guideline for Good Clinical Practice. Participants’ data will be managed and safeguarded according to the European Data Protection Regulation 2016/679. An external Ethical Advisory Board will help guarantee high ethical standards. Trial registration number. EudraCT number: 2018-001444-66; Clinicaltrials.gov: NCT03779789, first submitted on December 12, 2018 and first posted on December 19th trial status: protocol version 1.5; 09/06/2018. Recruitment started on February 2019 and it is ongoing. It is expected to end approximately on September 30th 2021.

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Narcolepsy and depression

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x1997000300012 ◽

1997 ◽

Vol 55 (3A) ◽

pp. 423-426 ◽

Cited By ~ 11

Author(s):

Carla Adda ◽

Beatriz Lefèvre ◽

Rubens Reimão

Keyword(s):

Side Effects ◽

Major Depression ◽

Depressive Disorder ◽

Excessive Daytime Sleepiness ◽

Rating Scale ◽

Mild Depression ◽

Psychosocial Impairment ◽

Chronic Course ◽

Hamilton Rating Scale

Narcolepsy main symptoms include excessive daytime sleepiness and cataplexy. Its chronic course is accompanied by psychosocial impairment added to the difficulties and side effects of stimulants and tricyclics long term use. Depressive complaints are occasionally reported. The aim of this paper was to evaluate objectively the possibility of depression in a sample of 12 narcoleptics (7F;5 M), with mean age of 53 years (12 years SD), using the Beck Depression Inventory (BDI) and the Hamilton Rating Scale for Depression (HAM-D). The results showed absence of depressive disorder in 75.0% of the cases according to BDI (or 58.3% according to HAM-D). The remaining patients had mild depression (only one patient presented major depression). The findings showed no correlation between narcolepsy and major depression.

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Predictors and moderators of time to remission of major depression with interpersonal psychotherapy and SSRI pharmacotherapy

Psychological Medicine ◽

10.1017/s0033291710000553 ◽

2010 ◽

Vol 41 (1) ◽

pp. 151-162 ◽

Cited By ~ 66

Author(s):

E. Frank ◽

G. B. Cassano ◽

P. Rucci ◽

W. K. Thompson ◽

H. C. Kraemer ◽

...

Keyword(s):

Major Depression ◽

Social Adjustment ◽

Rating Scales ◽

Unipolar Depression ◽

Interpersonal Psychotherapy ◽

Self Report ◽

Medical Centers ◽

Academic Medical ◽

The Social ◽

Psychomotor Activation

BackgroundAlthough many studies suggest that, on average, depression-specific psychotherapy and antidepressant pharmacotherapy are efficacious, we know relatively little about which patients are more likely to respond to one versus the other. We sought to determine whether measures of spectrum psychopathology are useful in deciding which patients with unipolar depression should receive pharmacotherapy versus depression-specific psychotherapy.MethodA total of 318 adult out-patients with major depression were randomly assigned to escitalopram pharmacotherapy or interpersonal psychotherapy (IPT) at academic medical centers at Pittsburgh, Pennsylvania and Pisa, Italy. Our main focus was on predictors and moderators of time to remission on monotherapy at 12 weeks.ResultsParticipants with higher scores on the need for medical reassurance factor of the Panic–Agoraphobic Spectrum Self-Report (PAS-SR) had more rapid remission with IPT and those with lower scores on the psychomotor activation factor of the Mood Spectrum Self-Report (MOODS-SR) experienced more rapid remission with selective serotonin reuptake inhibitor (SSRI) pharmacotherapy. Non-specific predictors of longer time to remission with monotherapy included several panic spectrum and mood spectrum factors and the Social Phobia Spectrum (SHY) total score. Higher baseline scores on the 17- and 25-item Hamilton Depression Rating Scales (HAMD-17 and HAMD-25) and the Work and Social Adjustment Scale (WSAS) also predicted a longer time to remission, whereas being married predicted a shorter time to remission.ConclusionsThis exploratory study identified several non-specific predictors but few moderators of psychotherapy versus pharmacotherapy outcome. It offers useful indicators of the characteristics of patients that are generally difficult to treat, but only limited guidance as to who benefits from IPT versus SSRI pharmacotherapy.

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