Original Research Article_Functional somatic symptoms in patients with major depressive disorder in a tertiary care hospital

A multi-factorial illness that causes morbidity threatens life and affects the quality of life is the major depressive disorder (MDD). Serotonergic dysfunction is one of the most described theories of psychiatric symptoms. Several serotonergic genes have been reported in associated with MDD. Recent studies have suggested that serotonin transporter length polymorphic region (5HTTLPR), Tryptophan hydroxylase gene 1 (TPH1) and Tryptophan hydroxylase gene 2 (TPH2) are associated with MDD. In the present study, we have examined the possible correlation between serotonergic genes 5HTTLPR, TPH1 (A218C), and TPH2 (G703T) polymorphism in MDD patients in Coimbatore tertiary care hospital. Blood samples were collected from 245 major depressive disorder patients and 250 healthy volunteers belonging to the faculty of Karpagam College of Medical Science and Research. All the samples were analysed by PCR-RFLP method. The chi-square test has been used for comparing genotype and allele distribution of cases and controls. We observed the 5HTTLPR L/S genotype and allele frequencies (P=0.001and p= 0.001) and TPH2 (G703T) (P=0.0002 and P= 0.005) TPH1 (A218C) (P=0.48 and P=0.43) polymorphisms with MDD. We also observed higher homozygous genotype frequencies of the short allele of 5HTTLPR, the G allele of TPH2 G703T polymorphism in patients. In short, our preliminary study suggests that the 5HTTLPR L/S and TPH2 G703T gene polymorphism were associated with the MDD. Serotonergic genes polymorphism in MDD patients and control groups were compared. Further clinical trials are to be carried out to find the exact mechanisms of the serotonergic system in MDD.

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Predictors of Suicidal Ideation and Attempt among Patients with Major Depressive Disorder at a Tertiary Care Hospital, Puducherry

Journal of Neurosciences in Rural Practice ◽

10.1055/s-0040-1721558 ◽

2021 ◽

Vol 12 (01) ◽

pp. 122-128

Author(s):

Ralte Lalthankimi ◽

Padmavathi Nagarajan ◽

Vikas Menon ◽

Jeby Jose Olickal

Keyword(s):

Major Depressive Disorder ◽

Suicidal Ideation ◽

Depressive Disorder ◽

Rating Scale ◽

Tertiary Care ◽

Severe Depression ◽

Care Hospital ◽

Suicidal Behaviors ◽

Major Depressive ◽

Severity Of Depression

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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A Study of Anxiety Disorders in Terms of Severity and Prevalence in Patients of Major Depressive Disorder in a Tertiary Care Centre

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol03-i11/476 ◽

2018 ◽

Vol 3 (11) ◽

Author(s):

Dr Richa Rani ◽

Neeru Bala ◽

Parshotam Dass Garg ◽

Aashish Bansal

Keyword(s):

Major Depressive Disorder ◽

Anxiety Disorder ◽

Depressive Disorder ◽

Anxiety Disorders ◽

Psychiatric Comorbidity ◽

Tertiary Care ◽

Care Hospital ◽

Major Depressive ◽

Compulsive Disorder ◽

Severe Anxiety

Background: Depression is a disorder of major public health importance. Over the last 50 years, large number of studies have been published from India addressing various aspects of depression. The objective of the current study was to study the socio-demographic characteristics and anxiety as co-morbidity in patients with major depressive disorder. Method: This was a cross sectional study conducted in tertiary care hospital in which 100 patients diagnosed with major depressive disorder, according to ICD-10 were assessed for presence of anxiety disorder as psychiatric Comorbidity using MINI and severity of anxiety was assessed using HAM-A. Results: Current study showed major depressive disorder is more common among females 59%, married 79%, housewife 50%, 61% had first episode of depression and 27% had family history of major depressive disorder. There was 48% presence of any anxiety disorder among total major depressive disorder patients. Among which 25% had generalized anxiety disorder, 9% obsessive compulsive disorder, 5% panic disorder, 4% agoraphobia, 4% post traumatic stress disorder and 1% social anxiety disorder among total patients with major depressive disorder. The maximum number of patients 43% had mild to moderate level of anxiety, 32% had mild anxiety, 19% had moderate to severe anxiety and 6% had severe anxiety. Conclusion: There is a high prevalence of anxiety disorders in major depressive disorder which is oftenly ignored because of symptom overlap between anxiety and major depression. This study is important because of increasing prevalence of psychiatric comorbidity among the patients of major depressive disorders lead to impaired functioning in patients with MDD. Therefore, monitoring of symptoms as well as functioning during the long-term management MDD could be crucial to achieve the functioning remission.

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Depressive disorder among the breast cancer patients in outpatient department of a tertiary care hospital in Pakistan

European Psychiatry ◽

10.1016/s0924-9338(11)72383-5 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 677-677 ◽

Cited By ~ 1

Author(s):

R.U. Rahman ◽

A. Nisar ◽

N. Hussain ◽

I. Chaudhary

Keyword(s):

Breast Cancer ◽

Depressive Disorder ◽

Rating Scale ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Psychiatric Morbidity ◽

Depression Scale ◽

Outpatient Department ◽

Care Hospital ◽

Had Scale

ObjectivesTo determine the frequency of Depressive Disorder among patients with breast cancer in an outpatient department of a tertiary care hospital in Pakistan.BackgroundCancer not only affects body physically but can also affect the mind in the form of psychiatric disorder. Proper identification and treatment of these conditions can be beneficial and cost-effective.MethodologyThis cross-sectional descriptive study was conducted on patients of breast cancer attending OPD of oncology department of Civil Hospital Karachi. The sample consisted of ninety three diagnosed patients of breast cancer who were screened for psychiatric morbidity through Hospital Anxiety and Depression Scale (HAD Scale). Screened patients were interviewed and diagnosed as depressive disorder according to ICD criteria. The level of depression in these diagnosed patients was quantified through ZUNG'S Depression Rating Scale.ResultsEighty two percent (n = 76) of the sample (n = 93) were found to have psychiatric morbidity on HAD scale. Out of these screened sample sixty percent (n = 46) were found to be depressed on Zung self rating depression scale. Majority of these patients were suffering from mild to moderate depression. Half of the female in this sample were undergone mastectomy that was not found to have any statistically significant impact on psychiatric morbidity of the patient.ConclusionThis study shows high prevalence of depression in patients with breast cancer. The health professional involve in care of breast cancer should screen routinely their patients for symptoms of depression.

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Efficacy and Safety of Escitalopram in First Episode of Major Depressive Disorder - A Tertiary Care Indian Center Experience

Journal of Depression & Anxiety ◽

10.4172/2167-1044.1000324 ◽

2018 ◽

Vol 07 (04) ◽

Cited By ~ 1

Author(s):

Mayur G Patel ◽

Vishal K Patel ◽

Deepak S Tiwari ◽

Viral R Shah ◽

Dhruv S Patel ◽

...

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Tertiary Care ◽

First Episode ◽

Efficacy And Safety ◽

Major Depressive

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Validation of the Depression and Somatic Symptoms Scale by comparison with the Short Form 36 scale among psychiatric outpatients with major depressive disorder

Depression and Anxiety ◽

10.1002/da.20464 ◽

2009 ◽

Vol 26 (6) ◽

pp. 583-591 ◽

Cited By ~ 17

Author(s):

Ching-I Hung ◽

Shuu-Jiun Wang ◽

Chia-Yih Liu

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Short Form ◽

Somatic Symptoms ◽

Psychiatric Outpatients ◽

Major Depressive ◽

Short Form 36

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A simpler definition of major depressive disorder

Psychological Medicine ◽

10.1017/s0033291709990572 ◽

2009 ◽

Vol 40 (3) ◽

pp. 451-457 ◽

Cited By ~ 26

Author(s):

M. Zimmerman ◽

J. N. Galione ◽

I. Chelminski ◽

J. B. McGlinchey ◽

D. Young ◽

...

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Somatic Symptoms ◽

Structured Interview ◽

Major Depressive ◽

Medically Ill ◽

Treatment Providers ◽

Dsm Iv ◽

Definition Of ◽

High Level

BackgroundThe DSM-IV symptom criteria for major depressive disorder (MDD) are somewhat lengthy, with many studies showing that treatment providers have difficulty recalling all nine symptoms. Moreover, the criteria include somatic symptoms that are difficult to apply in patients with medical illnesses. In a previous report, we developed a briefer definition of MDD that was composed of the mood and cognitive symptoms of the DSM-IV criteria, and found high levels of agreement between the simplified and full DSM-IV definitions. The goal of the present study was to replicate these findings in another large sample of psychiatric out-patients and to extend the findings to other patient samples.MethodWe interviewed 1100 psychiatric out-patients and 210 pathological gamblers presenting for treatment and 1200 candidates for bariatric surgery. All patients were interviewed by a diagnostic rater who administered a semi-structured interview. We inquired about all symptoms of depression for all patients.ResultsIn all three samples high levels of agreement were found between the DSM-IV and the simpler definition of MDD. Summing across all 2510 patients, the level of agreement between the two definitions was 95.5% and the κ coefficient was 0.87.ConclusionsAfter eliminating the four somatic criteria from the DSM-IV definition of MDD, a high level of concordance was found between this simpler definition and the original DSM-IV classification. This new definition offers two advantages over the current DSM-IV definition – it is briefer and it is easier to apply with medically ill patients because it is free of somatic symptoms.

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