scholarly journals Depression with Mixed Features (for DSM-5): Distinguishing Indicators Imaginary Coherence EEG Rest

Psychiatry ◽  
2021 ◽  
Vol 19 (4) ◽  
pp. 61-75
Author(s):  
I. A. Lapin ◽  
T. A. Rogacheva ◽  
A. A. Mitrofanov ◽  
S. N. Mosolov
Keyword(s):  
Depressive Disorder ◽  
Healthy Subjects ◽  
Statistical Research ◽  
Significance Level ◽  
Dsm 5 ◽  
Bipolar Ii ◽  
Mixed Features ◽  
Symptom Complex ◽  
Mixed Traits ◽  
Statistical Trends

Background: The neuronal correlates of depression with mixed traits (according to DSM-5) at rest have not been studied. Objective: to determine the indicators of imaginary coherence of EEG-rest, which distinguish patients with depression with mixed features (according to DSM-5) from patients with depression without mixed features and healthy subjects, and also to trace the dependence of the identified neurophysiological characteristics on the diagnostic belonging of the symptom complex to bipolar II type or recurrent depressive disorder. Patients and methods: on a background free from drug therapy, 80 patients with depression with mixed features (XD; n = 40 — with bipolar II disorder (XB) and n = 40 — with recurrent depressive disorder (XR)), 80 patients with depression without mixed traits (TD; n = 40 — for bipolar II type (TB) and n = 40 — for recurrent depressive disorder (TR), as well as 80 healthy subjects (N). The study groups were matched by sex and age. The study used clinical-psychopathological, psychometric, neurophysiological and statistical research methods. According to the Kruskal–Wallis criterion for independent samples the parameters of imaginary coherence (modulo) of standard frequency ranges (delta (δ) — 0.5–4 Hz, theta (θ) — 4–8 Hz, alpha (α) — 8–13 Hz, beta-1 (β1) — 13–20 Hz, beta-2 (β2) — 20–30 Hz, gamma (γ) — 30–45 Hz) between pairs of 14 cutaneous standard EEG derivations (according to the “10–20” system) in three (XD, TD and N), and then in five (XB, XR, TB, TR and N) comparison groups. Post-hoc analysis was performed using the U-test. The significance level was adjusted according to the Bonferroni correction. Results: three indicators were identified: α-ICoh(C3–P4), β1-ICoh(C3–P3) and β2-ICoh(F3–C4). For all three parameters, the H-test values for the “Group” factor (n = 3 and n = 5) were highly significant. In this case, α-ICoh(C3– P4) — XD = TD, XD < N, TD < N; β1-ICoh(C3–P3) — XD < TD, XD < N; TD < N; β2-ICoh(F3–C4) — XD > TD; XD > N, TD > N. The groups of patients with XD within the framework of recurrent depressive and bipolar II disorders significantly differed in terms of β1- ICoh(C3–P3) — XR > XB. At the level of statistical trends, in type II bipolar disorder — XB > TB according to α-ICoh(C3–P4), and in recurrent depressive disorder — XR > TR according to β2-ICoh(F3–C4). Conclusion. Thus, depression with mixed features can be considered in terms of dysfunctional interactions of the left frontal, bilateral central and parietal cortical zones, depending on the diagnostic affiliation of the depressive symptom complex and reflecting violations of automatic and voluntary regulation of affect, cognitive and behavioral changes.

Measures of the DSM–5 mixed-features specifier of major depressive disorder

CNS Spectrums ◽  
2017 ◽  
Vol 22 (2) ◽  
pp. 196-202 ◽  
Author(s):  
Mark Zimmerman
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Antidepressant Medication ◽  
Reliability And Validity ◽  
Mixed States ◽  
Major Depressive ◽  
Manic Symptoms ◽  
Dsm 5 ◽  
Depressed Patients ◽  
Mixed Features

During the past two decades, a number of studies have found that depressed patients frequently have manic symptoms intermixed with depressive symptoms. While the frequency of mixed syndromes are more common in bipolar than in unipolar depressives, mixed states are also common in patients with major depressive disorder. The admixture of symptoms may be evident when depressed patients present for treatment, or they may emerge during ongoing treatment. In some patients, treatment with antidepressant medication might precipitate the emergence of mixed states. It would therefore be useful to systematically inquire into the presence of manic/hypomanic symptoms in depressed patients. We can anticipate that increased attention will likely be given to mixed depression because of changes in the DSM–5. In the present article, I review instruments that have been utilized to assess the presence and severity of manic symptoms and therefore could be potentially used to identify the DSM–5 mixed-features specifier in depressed patients and to evaluate the course and outcome of treatment. In choosing which measure to use, clinicians and researchers should consider whether the measure assesses both depression and mania/hypomania, assesses all or only some of the DSM–5 criteria for the mixed-features specifier, or assesses manic/hypomanic symptoms that are not part of the DSM–5 definition. Feasibility, more so than reliability and validity, will likely determine whether these measures are incorporated into routine clinical practice.

Proposed DSM-5 mixed features are associated with greater likelihood of remission in out-patients with major depressive disorder

2012 ◽  
Vol 44 (7) ◽  
pp. 1361-1367 ◽  
Author(s):  
R. H. Perlis ◽  
C. Cusin ◽  
M. Fava
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Depressive Episode ◽  
Major Depressive Episode ◽  
Antidepressant Treatment ◽  
Adverse Outcomes ◽  
Self Report ◽  
Major Depressive ◽  
Dsm 5 ◽  
Mixed Features

BackgroundDraft DSM-5 criteria for a mixed major depressive episode have been proposed, but their predictive validity has not yet been established. We hypothesized that such symptoms would be associated with poorer antidepressant treatment outcomes.MethodWe examined outcomes among individuals with major depressive disorder participating in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study, an effectiveness study conducted at primary and specialty care centers in the USA. Mixed features were derived from the six self-report items of the mania subscale of the Psychiatric Diagnosis Screening Questionnaire. Primary analyses examined the association between the presence of at least two of these in the 6 months before study entry, and remission across up to four sequential treatment trials, as well as adverse outcomes.ResultsOf the 2397 subjects with a major depressive episode of at least 6 months' duration, 449 (18.7%) reported at least two mixed symptoms. The presence of such symptoms was associated with a greater likelihood of remission across up to four sequential treatments, which persisted after adjustment for potential confounding clinical and demographic variables (adjusted hazard ratio 1.16, 95% confidence interval 1.03–1.28). Two individual items, expansive mood and cheerfulness, were strongly associated with a greater likelihood of remission.ConclusionsProposed DSM-5 mixed state features were associated with a greater rather than a lesser likelihood of remission. While unexpected, this result suggests the potential utility of further investigation of depressive mixed states in major depression.

A clinically useful self-report measure of the DSM-5 mixed features specifier of major depressive disorder

2014 ◽  
Vol 168 ◽  
pp. 357-362 ◽  
Author(s):  
Mark Zimmerman ◽  
Iwona Chelminski ◽  
Diane Young ◽  
Kristy Dalrymple ◽  
Jennifer H. Martinez
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Self Report ◽  
Major Depressive ◽  
Dsm 5 ◽  
Mixed Features ◽  
Report Measure

Validating a two-dimensional bipolar spectrum model integrating DSM-5's mixed features specifier for Major Depressive Disorder

2017 ◽  
Vol 77 ◽  
pp. 89-99 ◽  
Author(s):  
Panagiotis Ferentinos ◽  
Konstantinos N. Fountoulakis ◽  
Cathryn M. Lewis ◽  
Evgenia Porichi ◽  
Dimitris Dikeos ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Two Dimensional ◽  
Bipolar Spectrum ◽  
Major Depressive ◽  
Dsm 5 ◽  
Mixed Features ◽  
Spectrum Model

scholarly journals Footnotes to Kraepelin: Changes in the classification of mood disorders with DSM-5

BJPsych Open ◽  
2017 ◽  
Vol 3 (3) ◽  
pp. e1-e3 ◽  
Author(s):  
Nicola J. Kalk ◽  
Allan H. Young
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Mood Disorders ◽  
Bipolar Affective Disorder ◽  
Major Depressive ◽  
Bipolar Ii Disorder ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Bipolar Ii

SummaryReliable diagnosis of mood disorders continues to pose a challenge. This is surprising because they have been recognised clinically since classical times. Mood disorders are also common: major depressive disorder affects nearly 300 million people worldwide and bipolar affective disorder nearly 60 million and they are a major cause of disability. Nonetheless, the reliability trials of the updated Diagnostic and Statistical Manual, Fifth Edition (DSM-5) found that the reliability of the diagnosis of major depressive disorder was in the 'questionable' range. Although the reliability of the diagnosis of bipolar I disorder in the same trials was 'good', the sample size of the individuals recruited to validate bipolar II disorder was insufficient to confirm reliability. As the epidemiological prevalences of bipolar I and bipolar II disorders are the same, this alone implies problems in its recognition. Here, we critically evaluate the most recent iteration of DSM mood disorder diagnoses in a historical light and set out the implications for clinical practice and research.

Comparing Effectiveness of a Combined Herbal Drug Based on Echium Amoenum with Citalopram in the Treatment of Major Depressive Disorder

2019 ◽  
Vol 16 (2) ◽  
pp. 232-238 ◽  
Author(s):  
Majid Anushiravani ◽  
Ali A. Manteghi ◽  
Ali Taghipur ◽  
Mahdi Eslami
Keyword(s):  
Randomized Controlled Trial ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Controlled Trial ◽  
Herbal Drug ◽  
Medical Sciences ◽  
Major Depressive ◽  
Dsm 5 ◽  
Randomized Controlled ◽  
Echium Amoenum

Background: According to new studies, only 60% of depressed patients respond to pharmaceutical treatment while suffering from their side effects. Natural products as adjuvant or alternative therapies should be examined to find safer and more effective ways to cope with depression. Objective: To find out the potential benefits of a combined herbal drug based on Echium amoenum compared with citalopram in the treatment of Major Depressive Disorder. Design and Setting: In psychiatry clinics of Mashhad University of Medical Sciences, 50 patients who met the criteria for Major Depressive Disorder based on DSM-5 were studied in a parallel randomized controlled trial. Design and Setting: In psychiatry clinics of Mashhad University of Medical Sciences, 50 patients who met the criteria for Major Depressive Disorder based on DSM-5 were studied in a parallel randomized controlled trial. Intervention: Subjects were randomly assigned to receive Echium amoenum compound syrup (EACS) or citalopram tablet for 8 weeks. Outcome Measures: The efficacy of treatments and recurrence of disease were surveyed and compared according to Hamilton depression rating scale at weeks 0, 4, 8, 12. Results: Patients in both groups of citalopram and EACS showed remarkable reduction in scores of Hamilton questionnaire. At the eighth week of treatment, the mean scores in EACS group were significantly lower than citalopram group (p-value = 0.03). 52% of patients suffered from various complications in citalopram group while just 12% of patients in EACS group reported few complications. Conclusion: Clinical efficacy of this herbal drug was significantly higher than citalopram, and complications were also less and lower in EACS group. Further studies with larger groups and para-clinical assessments such as serologic tests and QEEG would improve our understanding of the impacts and mechanisms of EACS.

Depressive Disorders: Update on Diagnosis, Etiology, and Treatment

2018 ◽  
Author(s):  
Isabelle E. Bauer ◽  
Antonio L Teixeira ◽  
Marsal Sanches ◽  
Jair C. Soares
Keyword(s):  
Depressive Disorder ◽  
Depressive Disorders ◽  
Treatment Strategies ◽  
Premenstrual Dysphoric Disorder ◽  
Brain Volumes ◽  
Somatic Therapy ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
History Of ◽  
Persistent Depressive Disorder

This review discusses the changes in the diagnostic criteria for depressive disorders as outlined in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), and recent findings exploring the etiology of and treatment strategies for these disorders. Depressive disorders are typically characterized by depression in the absence of a lifetime history of mania or hypomania. New developments in the DSM-5 include the recognition of new types of depressive disorders, such as disruptive mood dysregulation disorder, persistent depressive disorder, premenstrual dysphoric disorder, and the addition of catatonic features as a specifier for persistent depressive disorder. These diagnostic changes have important implications for the prognosis and treatment of this condition. A thorough understanding of both the clinical phenotype and the biosignature of these conditions is essential to provide individualized, long-term, effective treatments to affected individuals.  This review contains 1 table and 52 references Key words: brain volumes, depressive disorders, DSM-5, hormones, inflammation, neuropeptides, somatic therapy, stress

Validity of the DSM-5 anxious distress specifier for major depressive disorder

2018 ◽  
Vol 36 (1) ◽  
pp. 31-38 ◽  
Author(s):  
Mark Zimmerman ◽  
Jacob Martin ◽  
Patrick McGonigal ◽  
Lauren Harris ◽  
Sophie Kerr ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Major Depressive ◽  
Dsm 5
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