scholarly journals Relationship between Auditory Evoked Potentials and Circadian Preference in Patients with Major Depressive Episodes

2020 ◽  
Vol 10 (6) ◽  
pp. 370
Author(s):  
Young-Min Park
Keyword(s):  
Circadian Rhythm ◽  
Auditory Evoked Potentials ◽  
Age At Onset ◽  
Auditory Evoked Potential ◽  
Depression Severity ◽  
Major Depressive ◽  
Korean Version ◽  
Circadian Preference ◽  
Major Depressive Episodes ◽  
Depressive Episodes

Mood disorders often accompany circadian rhythm abnormalities. The serotonergic system (STS) is related to mood and circadian rhythm. This study aimed to test whether serotonergic neurotransmission, using the loudness dependence of auditory evoked potential (LDAEP), is associated with circadian preference in patients with major depressive disorder (MDD). Depression severity was assessed in 18–65-year-old outpatients (n = 48) using the Beck Depression Inventory scores and Hamilton Depression Rating Scale at baseline. Additionally, various scales, including the Korean version of the Composite Scale of Morningness (K-CSM), Korean version of the Mood Disorder Questionnaire (K-MDQ), and Korean version of the Childhood Trauma Questionnaire (K-CTQ), were used. LDAEP was also measured at baseline. The subjects were divided into three groups according to the circadian preference using total K-CSM scores (morningness (n = 10) vs intermediate (n = 19) vs. eveningness (n = 19)) and two groups according to median based on each K-CSM score, respectively (higher K-CSM (n = 25) vs. lower K-CSM (n = 23)). The bipolarity, suicidality, and age at onset differed among the three groups. Impulsivity, depression severity, suicidality, hopelessness, bipolarity, frequency of emotional abuse, and age at onset differed between the two group divisions. Thus, the STS might serve as the mediator between the circadian system and mood.

The olfactory deficits of depressed patients are restored after remission with venlafaxine treatment

2020 ◽  
pp. 1-9
Author(s):  
Romain Colle ◽  
Khalil El Asmar ◽  
Céline Verstuyft ◽  
Pierre-Marie Lledo ◽  
Françoise Lazarini ◽  
...  
Keyword(s):  
Antidepressant Treatment ◽  
Depression Severity ◽  
Major Depressive ◽  
Depressed Patients ◽  
Before And After ◽  
Major Depressive Episodes ◽  
Depressive Episodes ◽  
Drug Free ◽  
A Current ◽  
Psychophysical Test

Abstract Background It is unclear whether olfactory deficits improve after remission in depressed patients. Therefore, we aimed to assess in drug-free patients the olfactory performance of patients with major depressive episodes (MDE) and its change after antidepressant treatment. Methods In the DEP-ARREST-CLIN study, 69 drug-free patients with a current MDE in the context of major depressive disorder (MDD) were assessed for their olfactory performances and depression severity, before and after 1 (M1) and 3 (M3) months of venlafaxine antidepressant treatment. They were compared to 32 age- and sex-matched healthy controls (HCs). Olfaction was assessed with a psychophysical test, the Sniffin’ Sticks test (Threshold: T score; Discrimination: D score; Identification: I score; total score: T + D + I = TDI score) and Pleasantness (pleasantness score: p score; neutral score: N score; unpleasantness score: U score). Results As compared to HCs, depressed patients had lower TDI olfactory scores [mean (s.d.) 30.0(4.5) v. 33.3(4.2), p < 0.001], T scores [5.6(2.6) v. 7.4(2.6), p < 0.01], p scores [7.5(3.0) v. 9.8(2.8), p < 0.001)] and higher N scores [3.5(2.6) v. 2.1(1.8), p < 0.01]. T, p and N scores at baseline were independent from depression and anhedonia severity. After venlafaxine treatment, significant increases of T scores [M1: 7.0(2.6) and M3: 6.8(3.1), p < 0.01] and p scores [M1: 8.1(3.0) and M3: 8.4(3.3), p < 0.05] were evidenced, in remitters only (T: p < 0.01; P: p < 0.01). Olfaction improvement was mediated by depression improvement. Conclusions The olfactory signature of MDE is restored after venlafaxine treatment. This olfaction improvement is mediated by depression improvement.

scholarly journals Association Between Frontal Alpha Asymmetry With Cognitive Symptoms, Depression Severity, and Insomnia

2021 ◽  
Vol 3 (4) ◽  
pp. 157-162
Author(s):  
Dae Yun Hwang ◽  
Yang Rae Kim ◽  
Young-Min Park
Keyword(s):  
Self Report ◽  
Analysis Of Covariance ◽  
Alpha Power ◽  
Depression Severity ◽  
Major Depressive ◽  
Absolute Power ◽  
Alpha Asymmetry ◽  
Frontal Alpha Asymmetry ◽  
Major Depressive Episodes ◽  
Depressive Episodes

Objective: Previous studies have compared depressive episodes between bipolar disorder (BD) and major depressive disorder (MDD) using quantitative electroencephalogram (QEEG); however, there are no distinct discriminating feature between them. Here, we used QEEG to directly compare the alpha asymmetry and absolute power of each band between patients with BD and MDD.Methods: Fifty in-patients with major depressive episodes between 2019 and 2021 were retrospectively enrolled. Self-reported questionnaires including the Beck Depression Inventory (BDI), Korean version of the Childhood Trauma Questionnaire, and Adult Attention-Deficit/Hyperactivity Disorder Self Report Scale (ASRS) were used to evaluate the symptoms. The absolute power of QEEG delta, theta, alpha, beta, high beta waves, and the Z-scores of frontal alpha asymmetry were collected. A t-test and Pearson’s correlation test were conducted using these data and based on these results, an analysis of covariance was conducted.Results: There were no significant differences between MDD and BD in QEEG power or alpha asymmetry. Patients with severe depression (BDI ≥29) had higher alpha power at FP1 (p=0.037), FP2 (p=0.028), F3 (p=0.047), F4 (p=0.016), and higher right frontal alpha asymmetry at F3–F4 (p=0.039). Adult patients with features consistent with ADHD (ASRS ≥4) had higher right frontal alpha asymmetry at F3–F4 (p=0.046). Patients with insomnia had higher left frontal alpha asymmetry at F3–F4 (p=0.003).Conclusion: QEEG limited the differential diagnosis of MDD and BD. However, frontal alpha asymmetry did exist in depression and affected cognitive impairment, insomnia, and depression severity in particular. Future studies with improved methodologies are needed for a better comparison.

Toward a validation of a new definition of agitated depression as a bipolar mixed state (mixed depression)

2004 ◽  
Vol 19 (2) ◽  
pp. 85-90 ◽  
Author(s):  
F. Benazzi ◽  
A. Koukopoulos ◽  
H.S. Akiskal
Keyword(s):  
Mixed State ◽  
Age At Onset ◽  
Signs And Symptoms ◽  
Mood Stabilizers ◽  
Major Depressive ◽  
Cross Sectional ◽  
History Of ◽  
Dsm Iv ◽  
Major Depressive Episodes ◽  
Depressive Episodes

AbstractPurposeAs psychotic agitated depression is now a well-described form of mixed state during the course of bipolar I disorder, we sought to investigate the diagnostic validity of a new definition for agitated (mixed) depression in bipolar II (BP-II) and major depressive disorder (MDD).Materials and methodsThree hundred and thirty six consecutive outpatients presenting with major depressive episodes (MDE) but without history of mania were evaluated with the Structured Clinical Interview for DSM-IV when presenting for the treatment of MDE. On the basis of history of hypomania they were assigned to BP-II (n = 206) vs. MDD (n = 130). All patients were also examined for hypomania during the current MDE. Mixed depression was operationally defined by the coexistence of a MDE and at least two of the following excitatory signs and symptoms as described by Koukopoulos and Koukopoulos (Koukopoulos A, Koukopoulos A. Agitated depression as a mixed state and the problem of melancholia. In: Akiskal HS, editor. Bipolarity: beyond classic mania. Psychiatr Clin North Am 1999;22:547–64): inner psychic tension (irritability), psychomotor agitation, and racing/crowded thoughts. The validity of mixed depression was investigated by documenting its association with BP-II disorder and with external variables distinguishing it from unipolar MDD (i.e., younger age at onset, greater recurrence, and family history of bipolar disorders). We analyzed the data with multivariate regression (STATA 7).ResultsMDE plus psychic tension (irritability) and agitation accounted for 15.4%, and MDE plus agitation and crowded thoughts for 15.1%. The highest rate of mixed depression (38.6%) was achieved with a definition combining MDE with psychic tension (irritability) and crowded thoughts: 23.0% of these belonged to MDD and 76.9% to BP-II. Moreover, any of these permutations of signs and symptoms defining mixed depression was significantly and strongly associated with external validators for bipolarity. The mixed irritable-agitated syndrome depression with racing-crowded thoughts was further characterized by distractibility (74–82%) and increased talkativeness (25–42%); of expansive behaviors from the criteria B list for hypomania, only risk taking occurred with some frequency (15–17%).ConclusionsThese findings support the inclusion of outpatient-agitated depressions within the bipolar spectrum. Agitated depression is validated herein as a dysphorically excited form of melancholia, which should tip clinicians to think of such a patient belonging to or arising from a bipolar substrate. Our data support the Kraepelinian position on this matter, but regrettably this is contrary to current ICD-10 and DSM-IV conventions. Cross-sectional symptomatologic hints to bipolarity in this mixed/agitated depressive syndrome are virtually absent in that such patients do not appear to display the typical euphoric/expansive characteristics of hypomania—even though history of such behavior may be elicited by skillful interviewing for BP-II. We submit that the application of this diagnostic entity in outpatient practice would be of considerable clinical value, given the frequency with which these patients are encountered in such practice and the extent to which their misdiagnosis as unipolar MDD could lead to antidepressant monotherapy, thereby aggravating it in the absence of more appropriate treatment with mood stabilizers and/or atypical antipsychotics.

What is the role of conventional antidepressants in the treatment of major depressive episodes with Mixed Features Specifier?

CNS Spectrums ◽  
2016 ◽  
Vol 22 (2) ◽  
pp. 120-125 ◽  
Author(s):  
Gianni L. Faedda ◽  
Ciro Marangoni
Keyword(s):  
Clinical Trials ◽  
Unipolar Depression ◽  
Preliminary Evidence ◽  
Major Depressive ◽  
Pharmacological Management ◽  
Diagnostic And Statistical Manual ◽  
Mixed Features ◽  
Effective Use ◽  
Major Depressive Episodes ◽  
Depressive Episodes

The newly introduced Mixed Features Specifier of Major Depressive Episode and Disorder (MDE/MDD) is especially challenging in terms of pharmacological management. Prior to the publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, the symptoms of the mixed features specifier were intradepressive hypomanic symptoms, always and only associated with bipolar disorder (BD).Intradepressive hypomanic symptoms, mostly referred to as depressive mixed states (DMX), have been poorly characterized, and their treatment offers significant challenges. To understand the diagnostic context of DMX, we trace the nosological changes and collocation of intradepressive hypomanic symptoms, and examine diagnostic and prognostic implications of such mixed features.One of the reasons so little is known about the treatment of DMX is that depressed patients with rapid cycling, substance abuse disorder, and suicidal ideation/attempts are routinely excluded from clinical trials of antidepressants. The exclusion of DMX patients from clinical trials has prevented an assessment of the safety and tolerability of short- and long-term use of antidepressants. Therefore, the generalization of data obtained in clinical trials for unipolar depression to patients with intradepressive hypomanic features is inappropriate and methodologically flawed.A selective review of the literature shows that antidepressants alone have limited efficacy in DMX, but they have the potential to induce, maintain, or worsen mixed features during depressive episodes in BD. On the other hand, preliminary evidence supports the effective use of some atypical antipsychotics in the treatment of DMX.

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