scholarly journals A randomised controlled trial of Memory Flexibility training (MemFlex) to enhance memory flexibility and reduce depressive symptomatology in individuals with Major Depressive Disorder

2018 ◽  
Author(s):  
Caitlin Hitchcock ◽  
Siobhan Gormley ◽  
Catrin Rees ◽  
Evangeline Rodrigues ◽  
Julia Gillard ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Depressive Disorder ◽  
Autobiographical Memory ◽  
Depressive Symptomatology ◽  
Secondary Outcome ◽  
Major Depressive ◽  
Low Intensity ◽  
Memory Flexibility ◽  
Randomised Controlled

The published version of this paper is available through open access at https://doi.org/10.1016/j.brat.2018.08.008. Successful navigation within the autobiographical memory store is integral to daily cognition. Impairment in the flexibility of memory retrieval processes can thereby have a detrimental impact on mental health. This randomised controlled phase II trial (N=60) evaluated the potential of a novel, autobiographical memory-based intervention drawn from basic science – an autobiographical Memory Flexibility (MemFlex) training programme – which sought to ameliorate memory difficulties and improve symptoms of Major Depressive Disorder. MemFlex was compared to Psychoeducation (an evidence-based low-intensity intervention) to determine the likely range of effects on a primary cognitive target of memory flexibility at post-intervention, and co-primary clinical targets of self-reported depressive symptoms and depression diagnostic status at three month follow-up, in preparation for a later phase trial. Results demonstrated small-moderate effect sizes in favour of MemFlex for memory flexibility (d=0.34), self-reported depressive symptoms (d=0.24), and loss of depression diagnosis (OR=0.65), along with the secondary outcome of depression-free days (d=0.36). These results suggest that further development and definitive evaluation of MemFlex is warranted as an avenue to improving the low-intensity treatment of depression.

Network Analysis of Depressive Symptomatology in Elderly Patients with Major Depressive Disorder

2021 ◽  
Vol 17 ◽  
Author(s):  
Seon-Cheol Park
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Network Analysis ◽  
Depressive Disorder ◽  
Elderly Patients ◽  
Rating Scale ◽  
Depressive Symptomatology ◽  
Depressive Mood ◽  
Major Depressive ◽  
Using Data

Background: A novel psychopathological approach is the application of network analysis, as it is proposed that symptoms and their interconnections constitute a disease itself, rather than simply being components or outcome factors of disease. Objective: Using data from the Clinical Research Center for Depression (CRESCEND) Study, this study examined depressive symptoms in elderly patients with major depressive disorder using a network analysis approach. Methods: Among 135 elderly patients with major depressive disorder who were recruited from the CRESCEND study, we created a network based on individual items from the Hamilton Depression Rating Scale (HAMD), with the nodes being each item (symptom) and the edges being the strength of the association between the items (interconnection). By calculating measures of centrality of each of the nodes, we were able to determine which depressive symptoms were most central (influential) in the network. Results: The insight item was completely unconnected with other items and it was excluded in terms of network analysis. Thus, a network analysis of the 16 HAMD items estimated that the anxiety psychic item was the most central domain, followed by insomnia (middle of the night), depressive mood, and insomnia (early hours of the morning) items. On the contrary, the retardation item was the most poorly interconnected with the network. Conclusion: We suggest that our study makes a significant contribution to the literature because we have found that anxiety, depressed mood, and insomnia are most central to the network, indicating that they are the most influential symptoms in major depression in elderly individuals.

scholarly journals Effects of ketamine in electroconvulsive therapy for major depressive disorder: meta-analysis of randomised controlled trials

2020 ◽  
Vol 33 (3) ◽  
pp. e100117
Author(s):  
Xiao-Mei Li ◽  
Zhan-Ming Shi ◽  
Pei-Jia Wang ◽  
Hua Hu
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Depressive Disorder ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Major Depressive ◽  
Randomised Controlled ◽  
Grade Approach

BackgroundThe use of ketamine in electroconvulsive therapy (ECT) has been examined in the treatment of major depressive disorder (MDD); however, there has been no systematic review and meta-analysis of related randomised controlled trials (RCTs).AimTo examine the efficacy and safety of ketamine augmentation of ECT in MDD treatment.MethodsTwo reviewers searched Chinese (China National Knowledge Infrastructure and Wanfang) and English (PubMed, PsycINFO, Embase and Cochrane Library) databases from their inception to 23 July 2019. The included studies' bias risk was evaluated using the Cochrane risk of bias assessment tool. The primary outcome of this meta-analysis was improved depressive symptoms at day 1 after a single ECT treatment session. Data were pooled to calculate the standardised mean difference and risk ratio with their 95% CIs using RevMan V.5.3. We used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach to assess the whole quality of evidence.ResultsFour RCTs (n = 239) compared ketamine alone or ketamine plus propofol (n = 149) versus propofol alone (n = 90) in patients with MDD who underwent a single ECT session. Three RCTs were considered as unclear risk with respect to random sequence generation using the Cochrane risk of bias. Compared with propofol alone, ketamine alone and the combination of ketamine and propofol had greater efficacy in the treatment of depressive symptoms at days 1, 3 and 7 after a single ECT session. Moreover, compared with propofol alone, ketamine alone and the combination of ketamine and propofol were significantly associated with increased seizure duration and seizure energy index. Compared with propofol, ketamine alone was significantly associated with increased opening-eye time. Based on the GRADE approach, the evidence level of primary and secondary outcomes ranged from very low (26.7%, 4/15) to ‘low’ (73.3%, 11/15).ConclusionCompared with propofol, there were very low or low evidence levels showing that ketamine alone and the combination of ketamine and propofol appeared to rapidly improve depressive symptoms of patients with MDD undergoing a single ECT session. There is a need for high-quality RCTs.

The Quick Inventory of Depressive Symptomatology (Clinician and Self-Report Versions) in Patients With Bipolar Disorder

CNS Spectrums ◽  
2010 ◽  
Vol 15 (6) ◽  
pp. 367-373 ◽  
Author(s):  
Ira H. Bernstein ◽  
A. John Rush ◽  
Trisha Suppes ◽  
Yakasushi Kyotoku ◽  
Diane Warden
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Depressive Disorder ◽  
Depressive Symptomatology ◽  
Self Report ◽  
General Interest ◽  
Major Depressive ◽  
Sad Mood ◽  
Illness Phase

ABSTRACTIntroduction: The clinical and self-report versions of the Quick Inventory of Depressive Symptomatology (QIDS-C16 and QIDS-SR16) have been well studied in patients with major depressive disorder and in one recent study using patients with bipolar disorder. This article examines these measures in a second sample of 141 outpatients with bipolar disorder in different phases of the illness.Methods: At baseline, 61 patients were depressed and 30 were euthymic; at exit, 50 were depressed and 52 were euthymic. The remaining patients (at baseline or exit) were in either a manic or mixed phase and were pooled for statistical reasons.Results: Similar results were found for the QIDS-C16 and QIDS-SR16. Scores were reasonably reliable to the extent that variability within groups permitted. As expected, euthymic patients showed less depressive symptomatology than depressed patients. Sad mood and general interest were tne most discriminating symptoms between depressed and euthymic phases. Changes in illness phase (baseline to exit) were associated with substantial changes in scores. The relation of individual depressive symptoms to the overall level of depression was consistent across phases.Conclusion: Both the QIDS-SR16 and QIDS-C16 are suitable measures of depressive symptoms in patients with bipolar disorder.

scholarly journals Impact of measurement frequency on self-reported depressive symptoms: An experimental study in a clinical setting

2020 ◽  
Author(s):  
Nicole Geschwind ◽  
Martijn van Teffelen ◽  
Elin Hammarberg ◽  
Arnoud Arntz ◽  
M.J.H. Huibers ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Depressive Symptom ◽  
Depressive Disorder ◽  
Depressive Symptomatology ◽  
Depression Scale ◽  
Self Report ◽  
Major Depressive ◽  
Measurement Frequency ◽  
Symptom Scores

Background: Previous research suggests a relationship between measurement frequency of self-reported depressive symptoms and change in depressive symptom scores for the Beck Depression Inventory II (BDI-II). The goal of the current study was to investigate the differential effects of weekly and monthly completion of the BDI-II and Quick Inventory of Depressive Symptomatology self-report (QIDS-SR). Methods: Seventy individuals diagnosed with major depressive disorder (MDD) waiting for treatment were randomly assigned to either completing BDI-II weekly, BDI-II monthly, QIDS-SR weekly, or QIDS-SR monthly for a duration of nine weeks. After nine weeks participants also completed the Zung depression scale once. Mixed multilevel regression modelling and Bayesian Statistical Analysis were used to test the relationship between the measurement frequency and depression scores, and to compare scores of the repeatedly completed instruments with the instrument completed only in week nine.Results: Measurement frequency was not related to BDI-II, QIDS-SR or Zung scores. However, depression scores declined in the weekly and monthly QIDS-SR (but not BDI-II) conditions, while Bayesian analyses indicated moderate support for equal depression scores on the Zung SDS.Limitations: Lack of a clinician-rated depression scale at week nine in addition to the self-report measure. Conclusion: In contrast to previous studies in non-clinical samples, our findings suggest that measurement frequency does not have an impact on scores of the BDI-II. Implications for clinical studies monitoring depressive symptom scores with self-report scales are discussed. Keywords: major depressive disorder; retest effects; measurement error; measurement frequency; Beck Depression Inventory; Quick Inventory of Depressive Symptomatology

scholarly journals Quality of Life Impacts of Bright Light Treatment, Fluoxetine, and the Combination in Patients with Nonseasonal Major Depressive Disorder: A Randomized Clinical Trial

2020 ◽  
pp. 070674372093647
Author(s):  
Emma Morton ◽  
Erin E. Michalak ◽  
Anthony Levitt ◽  
Robert D. Levitan ◽  
Amy Cheung ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Depressive Disorder ◽  
Repeated Measures ◽  
Short Form ◽  
Bright Light ◽  
Secondary Outcome ◽  
Major Depressive

Objective: Bright light therapy is increasingly recommended (alone or in combination with antidepressant medication) to treat symptoms of nonseasonal major depressive disorder (MDD). However, little is known about its impacts on quality of life (QoL), a holistic, patient-valued outcome. Methods: This study utilizes secondary outcome data from an 8-week randomized, controlled, double blind trial comparing light monotherapy ( n = 32), fluoxetine monotherapy ( n = 30), and the combination of these ( n = 27) to placebo ( n = 30). QoL was assessed using the Quality of Life Enjoyment and Satisfaction Questionnaire Short Form (Q-LES-Q-SF). Treatment-related differences in QoL improvements were assessed using a repeated measures analysis of variance. The influence of potential predictors of QoL (demographic variables and change in depressive symptoms) were investigated via hierarchical linear regression. Results: Q-LES-Q-SF scores significantly improved across all treatment conditions; however, no significant differences were observed between treatment arms. QoL remained poor relative to community norms by the end of the trial period: Across conditions, 70.6% of participants had significantly impaired QoL at the 8-week assessment. Reduction in depressive scores was a significant predictor of improved QoL, with the final model accounting for 54% of variance in QoL change scores. Conclusion: The findings of this study emphasize that improvement in QoL and reduction in depressive symptoms in MDD, while related, cannot be taken to be synonymous. Adjunctive therapies may be required to address unmet QoL needs in patients with MDD receiving antidepressant or light therapies. Further research is required to explore additional predictors of QoL in order to better refine treatments for MDD.

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