scholarly journals How effective is a web-based mental health intervention (“deprexis”) if started at psychiatric routine inpatient treatment of major depressive disorder? A pragmatic parallel-group randomized controlled trial

2018 ◽  
Author(s):  
Udo Bonnet
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Outpatient Treatment ◽  
Daily Activity ◽  
Inpatient Treatment ◽  
Real Life ◽  
Well Being ◽  
Hospital Treatment ◽  
Hamilton Depression Scale ◽  
Major Depressive

Internet-based self-help-programs like “deprexis” have been increasingly shown to reduce depressive symptoms in non-clinical and adjunctive to outpatient treatment settings. But how about the effectiveness of “deprexis” if being blended into routine psychiatric hospital treatment of major depressive disorder (MDD)? To examine, sixty-nine adult MDD-inpatients were randomly assigned to a 12-week-period of treatment-as-usual (TAU, N=33) or TAU plus guided “deprexis” (TAU-PLUS, N=36). As usual in everyday clinical practice, patients could be discharged from the ward at any time when they felt sufficiently stabilized for outpatient treatment. Modified intention-to-treat analyses included thirty-two inpatients of each group. At week 12, TAU-PLUS-patients were significantly more improved (p=.03, d=.75) than TAU-patients citing the primary-outcome measure (Beck-Depression-Inventory-II). Furthermore, TAU-PLUS-patients showed greater daily activity in the Work-Productivity-and-Activity-Impairment-Questionnaire (p=.04, d=.70) and had been discharged earlier from inpatient treatment (p=.003). Additional outcome measures (i.e. Hamilton-Depression-Scale, Clinical-Global-Impression-Severity, WHO-Well-Being-Index) were not significantly different between the groups. Post-discharge, the TAU-PLUS-group reported a lower rate of post-hospital care (p=.01) and re-admissions (p=.04). The study was limited by lack of blinding of the primary investigator and strengthened by its pragmatic approach to involve real-life treatment conditions. To conclude, TAU plus “deprexis” was superior to TAU without “deprexis” to improve subjective depression-severity (BDI-II) and daily activity in patients having sought psychiatric inpatient MDD-treatment before. This beneficial effect appeared 12 weeks after inpatient “deprexis”-initiation, i.e. when the vast majority of patients were back in general practitioner care. Adjunctive “deprexis” was associated with earlier discharges and an advantage in post-hospital stabilization.

Twelve-month prevalence and disability of DSM-IV bipolar disorder in an Australian general population survey

2004 ◽  
Vol 34 (5) ◽  
pp. 777-785 ◽  
Author(s):  
P. B. MITCHELL ◽  
T. SLADE ◽  
G. ANDREWS
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
National Survey ◽  
Large Scale ◽  
Well Being ◽  
Major Depressive ◽  
Co Morbidity ◽  
Dsm Iv ◽  
Days Out Of Role

Background. There have been few large-scale epidemiological studies which have examined the prevalence of bipolar disorder. The authors report 12-month prevalence data for DSM-IV bipolar disorder from the Australian National Survey of Mental Health and Well-Being.Method. The broad methodology of the Australian National Survey has been described previously. Ten thousand, six hundred and forty-one people participated. The 12-month prevalence of euphoric bipolar disorder (I and II) – similar to the euphoric-grandiose syndrome of Kessler and co-workers – was determined. Those so identified were compared with subjects with major depressive disorder and the rest of the sample, on rates of co-morbidity with anxiety and substance use disorders as well as demographic features and measures of disability and service utilization. Polychotomous logistic regression was used to study the relationship between the three samples and these dependent variables.Results. There was a 12-month prevalence of 0·5% for bipolar disorder. Compared with subjects with major depressive disorder, those with bipolar disorder were distinguished by a more equal gender ratio; a greater likelihood of being widowed, separated or divorced; higher rates of drug abuse or dependence; greater disability as measured by days out of role; increased rates of treatment with medicines; and higher lifetime rates of suicide attempts.Conclusions. This large national survey highlights the marked functional impairment caused by bipolar disorder, even when compared with major depressive disorder.

P01-331-Family functioning of adolescents with a major depressive disorder – a comparative study

2011 ◽  
Vol 26 (S2) ◽  
pp. 333-333
Author(s):  
M.L. Perereira ◽  
D.L. Nunes Peçanha ◽  
I.A. Santos Bordin
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Family Functioning ◽  
Psychiatric Disorders ◽  
Family Income ◽  
Well Being ◽  
Occupational Activity ◽  
Major Depressive ◽  
The Family ◽  
Depressive Episodes

IntroductionPsychiatric disorders occur in a complex context of human relations in its social and psychological aspects. Family functioning is closely related to physical and psychological well-being of family members and its impairment affects the family as a whole.ObjectivesTo evaluate family functioning in two groups of adolescents (13–18 years): cases (with major depressive disorder) and controls (with no DSM-IV psychiatric disorders based on the Brazilian version of the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime/K-SADS-PL).MethodFamilies of cases (N = 9) and controls (N = 9) were matched by adolescent's age, gender and education, number and age of siblings, parental marital status and occupational activity, and family income. An experienced systemic family therapist applied the Structured Family Interview to each family. Nine dimensions of family functioning were evaluated: communication, rules, roles, leadership, conflict, aggressiveness, affect, individuation and integration. Session transcripts were independently evaluated by two other systemic family therapists blind to the family case-control category.ResultsRaters scored all interview items using a standardized coding system (overall agreement = 83.5%). Cases exhibited lower mean scores in seven family dimensions, specially affect (p = 0.0078). Differences were not found regarding rules and leadership.ConclusionDifficulty in expressing affect in parent-child relationships was the main characteristic of families with a depressive adolescent. Improvement of family functioning can contribute to minimize the negative influence of psychosocial and family factors on the reoccurrence, and severity of depressive episodes among depressed adolescents.

The problematic use of social networking sites associates with elevated symptoms in patients with major depressive disorder

2020 ◽  
Vol 66 (5) ◽  
pp. 496-503 ◽  
Author(s):  
Orkun Aydin ◽  
Fikret Poyraz Çökmüş ◽  
Kuzeymen Balikçi ◽  
Didem Sücüllüoğlu-Dikici ◽  
Pınar Ünal-Aydin
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Depressive Disorder ◽  
Social Networking ◽  
Rating Scale ◽  
Health Workers ◽  
Well Being ◽  
Social Networking Site ◽  
Analysis Of Covariance ◽  
Major Depressive

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.

scholarly journals Efficacy of vortioxetine on the physical symptoms of major depressive disorder

2018 ◽  
Vol 32 (10) ◽  
pp. 1086-1097 ◽  
Author(s):  
Michael Cronquist Christensen ◽  
Ioana Florea ◽  
Annika Lindsten ◽  
David S Baldwin
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Gastrointestinal Symptoms ◽  
Physical Symptoms ◽  
Anxiety Symptoms ◽  
Hamilton Depression Scale ◽  
Short Term ◽  
Major Depressive ◽  
Symptoms Of Depression ◽  
Long Term Treatment

Background: Efficacy has been proven for vortioxetine in short-term and long-term treatment of major depressive disorder (MDD), with broad beneficial effects on emotional, physical and cognitive symptoms. Limited specific data on the effects of vortioxetine on depression-related physical symptoms have been published. Methods: A meta-analysis was carried out of five short-term multinational, double-blind, placebo-controlled studies. These studies were conducted in a total of 2105 adult MDD outpatients (18–75 years) with a major depressive episode of ⩾3 months’ duration. Only patients treated with a dose of 5 or 10 mg vortioxetine (therapeutic doses) or placebo were included in this analysis. Efficacy assessment of vortioxetine on the physical symptoms of depression included all items of the Hamilton Depression Scale (HAM-D) assessing physical symptoms, and all somatic items in the Hamilton Anxiety Scale (HAM-A). A subgroup analysis in MDD patients with coexisting anxiety symptoms (i.e. those with a HAM-A ⩾20 at baseline) was also performed. Results: A significant improvement ( p<0.05) of vortioxetine versus placebo was observed on all HAM-D items measuring physical symptoms, except for the somatic gastrointestinal symptoms and loss of weight items. Significant effects were also observed on the HAM-A somatic items: general somatic symptoms, gastrointestinal symptoms, and autonomic symptoms. In patients with a high baseline level of anxiety, a significant effect of vortioxetine was also observed on the physical symptoms of depression. Conclusions: These analyses indicate that patients with MDD, including those with a high level of anxiety symptoms, have significant improvements in MDD-associated physical symptoms when treated with vortioxetine.

scholarly journals Duloxetine in the prevention of relapse of major depressive disorder

2006 ◽  
Vol 188 (4) ◽  
pp. 346-353 ◽  
Author(s):  
David G. Perahia ◽  
Inmaculada Gilaberte ◽  
Fujun Wang ◽  
Curtis G. Wiltse ◽  
Stacy A. Huckins ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Well Being ◽  
Life Outcomes ◽  
Major Depressive ◽  
Noradrenaline Reuptake ◽  
The Usa ◽  
Time To Relapse ◽  
Depressive Episodes ◽  
Prevention Of Relapse

BackgroundRelapse rates may be as high as 50% in people with major depressive disorder (MDD) previously treated to remission.AimsDuloxetine, an inhibitor of serotonin and noradrenaline reuptake that is licensed in Europe, the USA and elsewhere for the treatment of depressive episodes, was evaluated with regard to its efficacy, safety and tolerability in the prevention of relapse of MDD.MethodAdult out-patients with MDD received duloxetine (60 mg daily) for 12 weeks (n=533). Patients who responded to the drug were then randomised to duloxetine (60 mgdaily) (n=136) or placebo (n=142) for 26 weeks. The primary measure of efficacy was time to relapse.ResultsPatients who received duloxetine (60 mg daily) experienced significantly longer times to relapse of MDD, and better efficacy global well-being, and quality-of-life outcomes compared with patients who received placebo. It should be noted that adverse events which occur in discontinuation may mimic some signs of depressive relapse, and were not specifically elicited in this study.ConclusionsDuloxetine (60 mg daily) is effective in the prevention of relapse of MDD during continuation treatment.

scholarly journals Major depressive disorder with religious struggle and completed suicide after hair transplantation

2017 ◽  
Vol 5 ◽  
pp. 2050313X1770074
Author(s):  
Mehmet Emin Ceylan ◽  
Barış Önen Ünsalver ◽  
Alper Evrensel
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Protective Factor ◽  
Religious Involvement ◽  
Well Being ◽  
Psychological Needs ◽  
Psychiatric Evaluation ◽  
Major Depressive ◽  
Hair Transplantation ◽  
Religious Struggle

Objectives: Psychological outcomes of aesthetic surgical procedures like hair transplantation are mostly positive including decreased anxiety, depression and social phobia and increased general well-being, self-efficacy and self-esteem. However, some patients may suffer from post-surgical depression and post-surgical increased suicide rates have been reported for breast augmentation patients. Difficulty adapting to the new image, unfulfilled psychological needs expected to be met by the surgery, side effects of the surgery like tissue swelling or bruising, uncontrolled pain, presence of body dysmorphic disorder and previous history of mood disorder may be some of the risk factors for post-surgical depression. Methods: Here, we present a case without prior psychiatric history who developed major depressive disorder after hair transplantation and died of suicide. Results: He started experiencing religious struggle related to his decision about the hair transplant which he interpreted as acting against God’s will. While religious involvement has been reported to be a protective factor against depression, spiritual struggle, which includes religious guilt, has been described as an important risk factor for depression, hopelessness and suicidality which might explain the severity of depression in our patient. Conclusions: This case highlights the importance of a detailed psychiatric evaluation and exploration of religious concerns of any patient before any type of aesthetic surgery. Major depressive disorder is a treatable condition; however, mild depression can go unnoticed. Religious belief and related religious practices affect an individual’s personal health attitudes; therefore, we think that every physician is needed to explore the religious concerns of any patient during any medical examination or surgical procedure. Relevant religious authorities should be consulted when necessary.

scholarly journals Efficacy of brief dynamic interpersonal therapy in patients with major depressive disorder: a prospective, multicenter randomized controlled trial protocol

2020 ◽  
Author(s):  
Lanlan Wang ◽  
Qian Wang ◽  
Wenhui Jiang ◽  
Jianfeng Luo ◽  
Jun Tong ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Controlled Trial ◽  
Self Report ◽  
Hamilton Depression Scale ◽  
Major Depressive ◽  
Interpersonal Therapy ◽  
Randomized Controlled ◽  
Multicenter Randomized Controlled Trial

Abstract Background : Dynamic Interpersonal Psychotherapy (DIT) is a brief manualized depression-focused intervention. This paper describes a study protocol of a multi-site, three-arm randomized controlled trial comparing medication plus DIT to medication alone and medication plus an active control psychotherapy in the treatment of major depressive disorder (MDD). Methods : 240 patients with MDD will be randomly allocated on a 1:1:1 basis to the treatment conditions, with 80 patients in each group. Patients will be assessed pre-and post-intervention and at 6- and 12-months follow-up with the 17-item Hamilton Depression Scale (HAMD-17) and Hamilton Anxiety Scale (HAMA-14) administered by blind evaluators, and the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder-7-item scale(GAD-7), side effect reaction scale (TESS), and The Self-Assessment Scale of the Overall Efficacy and Satisfaction of Patients (SASE). The primary outcome is change from baseline in HAMD-17 scores. Secondary outcomes include rates of response, remission and relapse, change from baseline in self-report depression and measures of anxious symptomatology, and subjective satisfaction of patients. Discussion: This will be the first multicentered RCT in China to assess the potential efficacy of psychotherapy for MDD. The study has the potential to inform clinical treatment guidelines for the treatment of MDD in China. Trial registration : ChiCTR，ChiCTR1800016970， Registered on July 5 th 2018 - Retrospectively registered, http://www.chictr.org.cn/showprojen.aspx?proj=28786 . Key words : Depression; Dynamic Interpersonal Therapy; Multicenter randomized controlled trial,

scholarly journals Abnormalities in Electroencephalographic Microstates Among Adolescents With First Episode Major Depressive Disorder

2021 ◽  
Vol 12 ◽  
Author(s):  
Yuqiong He ◽  
Qianting Yu ◽  
Tingyu Yang ◽  
Yaru Zhang ◽  
Kun Zhang ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Depression Scale ◽  
First Episode ◽  
Hamilton Depression Scale ◽  
Healthy Controls ◽  
Major Depressive ◽  
Hamd Score ◽  
Eeg Changes ◽  
Microstate Analysis

Background: Recent studies have reported changes in the electroencephalograms (EEG) of patients with major depressive disorder (MDD). However, little research has explored EEG differences between adolescents with MDD and healthy controls, particularly EEG microstates differences. The aim of the current study was to characterize EEG microstate activity in adolescents with MDD and healthy controls (HCs).Methods: A total of 35 adolescents with MDD and 35 HCs were recruited in this study. The depressive symptoms were assessed by Hamilton Depression Scale (HAMD) and Children's Depression Inventory (CDI), and the anxiety symptoms were assessed by Chinese version of DSM-5 Level 2-Anxiety-Child scale. A 64-channel EEG was recorded for 5 min (eye closed, resting-state) and analyzed using microstate analysis. Microstate properties were compared between groups and correlated with patients' depression scores.Results: We found increased occurrence and contribution of microstate B in MDD patients compared to HCs, and decreased occurrence and contribution of microstate D in MDD patients compared to HCs. While no significant correlation between depression severity (HAMD score) and the microstate metrics (occurrence and contribution of microstate B and D) differing between MDD adolescents and HCs was found.Conclusions: Adolescents with MDD showed microstate B and microstate D changes. The obtained results may deepen our understanding of dynamic EEG changes among adolescents with MDD and provide some evidence of changes in brain development in adolescents with MDD.

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