scholarly journals Status of Medications Prescribed for Psychiatric Disorders in Korean Pediatric and Adolescent Patients

Children ◽  
2022 ◽  
Vol 9 (1) ◽  
pp. 68
Author(s):  
In-Woo Jang ◽  
Ji-Eun Chang ◽  
Jongyoon Kim ◽  
Kiyon Rhew
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Anxiety Disorder ◽  
Depressive Disorder ◽  
Package Insert ◽  
Real World Data ◽  
Major Depressive ◽  
Tic Disorder ◽  
Adolescent Patients ◽  
Depressive Episodes

While mental health services for children are increasing, few psychiatric drugs have been approved for such use. We analyzed claim data from 19,557 South Korean pediatric and adolescent patients (<20 years) who were diagnosed with schizophrenia, bipolar disorder, major depressive disorder, anxiety disorder, attention deficit-hyperactivity disorder (ADHD), or a tic disorder. Among these diseases, depressive episodes were the most common, followed by an anxiety disorder, ADHD, bipolar disorder, tic disorder, and schizophrenia. For each disease, prescriptions were categorized as full-label (approved indication with pediatric dosing in the package insert (PI)), partial-label (approved indication without pediatric dosing in the PI), and contraindication (contraindicated for the specific pediatric age in the PI). For schizophrenia, major depressive disorder, and anxiety disorder, more than 50% of the patients were prescribed partial-labeled medications. Additionally, more than 5% of patients with major depressive disorder were prescribed medications that were contraindicated for their age group. Our findings reveal that children with full-labeled psychiatric conditions are commonly administered drugs that are not explicitly approved for either their disease state or age, including off-label and unlicensed drugs. To use pharmaceuticals more safely, expanding drug indications using real-world data are needed.

Uncomplicated Depression as Normal Sadness

2016 ◽  
pp. 82-94
Author(s):  
Jerome C. Wakefield ◽  
Allan V. Horwitz ◽  
Lorenzo Lorenzo-Luaces
Keyword(s):  
Major Depressive Disorder ◽  
Anxiety Disorder ◽  
Major Depression ◽  
General Population ◽  
Depressive Disorder ◽  
Generalized Anxiety Disorder ◽  
Research Program ◽  
Generalized Anxiety ◽  
Major Depressive ◽  
Depressive Episodes

About half of all individuals meet the criteria for DSM-defined major depressive disorder (MDD) by the age of 30. These and other considerations suggest that MDD criteria are too inclusive and apply to individuals who are not ill but are experiencing normal sadness. This chapter reviews a research program that attempts to address this issue by examining “uncomplicated depression,” a subcategory of MDD that is hypothesized to consist of false positive diagnoses in which normal sadness is misdiagnosed as MDD. Data on uncomplicated depression suggest that many individuals who currently meet the DSM criteria for MDD are at no greater risk for subsequent depressive episodes, attempting suicide, or development of generalized anxiety disorder than members of the general population. These data suggest that uncomplicated depression is normal sadness, not major depression, and should not be diagnosed as disordered. They thus indicate that current DSM criteria for MDD are overly inclusive.

Comparing the Phenomenology of Depressive Episodes in Bipolar I and II Disorder and Major Depressive Disorder Within Bipolar Disorder Pedigrees

2015 ◽  
Vol 76 (01) ◽  
pp. 32-39 ◽  
Author(s):  
Andrew Frankland ◽  
Ester Cerrillo ◽  
Dusan Hadzi-Pavlovic ◽  
Gloria Roberts ◽  
Adam Wright ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Major Depressive ◽  
Depressive Episodes

scholarly journals Comparison of depressive episodes in bipolar disorder and in major depressive disorder within bipolar disorder pedigrees

2011 ◽  
Vol 199 (4) ◽  
pp. 303-309 ◽  
Author(s):  
Philip B. Mitchell ◽  
Andrew Frankland ◽  
Dusan Hadzi-Pavlovic ◽  
Gloria Roberts ◽  
Justine Corry ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Clinical Features ◽  
Bipolar Depression ◽  
Bipolar Affective Disorder ◽  
Probabilistic Approach ◽  
Psychomotor Retardation ◽  
Major Depressive ◽  
Depressive Episodes

BackgroundAlthough genetic epidemiological studies have confirmed increased rates of major depressive disorder among the relatives of people with bipolar affective disorder, no report has compared the clinical characteristics of depression between these two groups.AimsTo compare clinical features of depressive episodes across participants with major depressive disorder and bipolar disorder from within bipolar disorder pedigrees, and assess the utility of a recently proposed probabilistic approach to distinguishing bipolar from unipolar depression. A secondary aim was to identify subgroups within the relatives with major depression potentially indicative of ‘genetic’ and ‘sporadic’ subgroups.MethodPatients with bipolar disorder types 1 and 2 (n = 246) and patients with major depressive disorder from bipolar pedigrees (n = 120) were assessed using the Diagnostic Interview for Genetic Studies. Logistic regression was used to identify distinguishing clinical features and assess the utility of the probabilistic approach. Hierarchical cluster analysis was used to identify subgroups within the major depressive disorder sample.ResultsBipolar depression was characterised by significantly higher rates of psychomotor retardation, difficulty thinking, early morning awakening, morning worsening and psychotic features. Depending on the threshold employed, the probabilistic approach yielded a positive predictive value ranging from 74% to 82%. Two clusters within the major depressive disorder sample were found, one of which demonstrated features characteristic of bipolar depression, suggesting a possible ‘genetic’ subgroup.ConclusionsA number of previously identified clinical differences between unipolar and bipolar depression were confirmed among participants from within bipolar disorder pedigrees. Preliminary validation of the probabilistic approach in differentiating between unipolar and bipolar depression is consistent with dimensional distinctions between the two disorders and offers clinical utility in identifying patients who may warrant further assessment for bipolarity. The major depressive disorder clusters potentially reflect genetic and sporadic subgroups which, if replicated independently, might enable an improved phenotypic definition of underlying bipolarity in genetic analyses.

Cognitive characteristics of unipolar (major depressive disorder) and bipolar depression

2016 ◽  
Vol 33 (S1) ◽  
pp. S374-S374 ◽  
Author(s):  
B. Suciu ◽  
R. Paunescu ◽  
I. Miclutia
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Cognitive Deficits ◽  
Bipolar Depression ◽  
Cognitive Domain ◽  
Global Functioning ◽  
Major Depressive ◽  
Cognitive Domains ◽  
Depressive Episodes

IntroductionImpairment in cognitive performance is an important characteristic in many psychiatric illnesses, such as Bipolar Disorder and Major Depressive Disorder. Initially, cognitive dysfunctions were considered to be present only in acute depressive episodes and to improve after symptoms recovered. Reports have described persistent cognitive deficits even after significant improvement of depressive symptoms.Aims/ObjectivesWe wanted to understand the dimension of cognitive impairment in unipolar and bipolar depression and also to underline the differences between cognitive profiles of patients diagnosed within the two mentioned disorders.MethodThis review examined recent literature about unipolar and bipolar depression.ResultsBoth depressed patients presented cognitive deficits in several cognitive domains. Different aspects of attention were altered in both patients but impairment in shifting attention appeared specific to unipolar disorder while impaired sustained attention was particular for bipolar disorder. Both types of patients showed memory deficits that were associated with poor global functioning. Two recent studies described that bipolar depressed subjects were more impaired across all cognitive domains than unipolar depressed subjects on tests assessing verbal memory, verbal fluency, attention and executive functions. The most consistently deficits were displayed on measures of executive functioning – such as tasks requiring problem solving, planning, decision making – suggesting that this cognitive domain is a trait-marker for depression.ConclusionsCognitive deficits are present in both disorders during a depressive episode but they display slightly different patterns of impairment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Clinical Features of Patients With Major Depressive Disorder and Bipolar Disorder Depressive Episodes With Mixed Features 

2021 ◽  
Author(s):  
Hong Wang ◽  
Yan-Xia Xiao ◽  
Jing-Ge Du ◽  
Xia Du ◽  
Lin Chen
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Marital Status ◽  
Clinical Features ◽  
Protective Factor ◽  
Onset Age ◽  
Major Depressive ◽  
Mixed Features ◽  
Depressive Episodes

Abstract Background: To investigate the clinical phenomenology and clinical features of the new concept of major depressive disorder and bipolar disorder depressive episodes with mixed features.Methods: A total of 357 patients with major depressive disorder or bipolar disorder depressive episodes were assessed, we compared the differences of clinical features with or without mixed features.Results: According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria, the overall prevalence of mixed features was 9.52% (34/357) in major depressive disorder and bipolar disorder depressive episodes; specifically, the prevalence was 6.0% in major depressive disorder and 23.3% in bipolar disorder depressive episodes. Compared with the non-mixed features group, the mixed features group had more single individuals (P=0.002), earlier onset age (P=0.003), more patients with an onset age <25 years (P=0.001), and more previous incidences and prior hospitalizations (P<0.001, P=0.004, respectively), and fewer melancholic features (P=0.013).Logistic regression analysis showed that marital status (OR=0.237) and previous incidence (OR=1.478) was associated with mixed features.Conclusion: It indicates that previous incidence may be a risk factor of in patients with major depressive disorder and bipolar disorder depressive episodes with mixed features, and marital status may be a protective factor.

Are major depression and bipolar disorder neuropsychologically distinct? A meta-analysis of comparative studies

2017 ◽  
Vol 39 ◽  
pp. 17-26 ◽  
Author(s):  
C. Samamé ◽  
A.G. Szmulewicz ◽  
M.P. Valerio ◽  
D.J. Martino ◽  
S.A. Strejilevich
Keyword(s):  
Bipolar Disorder ◽  
Major Depressive Disorder ◽  
Major Depression ◽  
Depressive Disorder ◽  
Verbal Memory ◽  
Comparative Studies ◽  
Negative Impact ◽  
Cognitive Outcomes ◽  
Major Depressive ◽  
Depressive Episodes

AbstractBackgroundNeuropsychological deficits are present in both major depression and bipolar disorder. So far, however, reports directly comparing these mood disorders with regard to cognitive outcomes have been scant and yielded inconsistent results. This work aims to combine the findings of comparative studies of cognition in major depression and bipolar disorder in order to explore whether these neuropsychiatric conditions present with distinct cognitive features.MethodsThe main online databases were extensively searched to retrieve reports assessing neurocognitive functioning in two groups of mood disorder patients, one with major depressive disorder and another with bipolar disorder, both in the same phase of illness. Between-group effect sizes for cognitive variables were obtained from selected studies and pooled by means of meta-analytic procedures.ResultsDuring euthymia, a significant overall effect size (Hedges’g = 0.64, P < 0.001) favoring major depressive disorder was found for verbal memory as assessed with list learning tests, whereas no significant between-group differences were found for the remaining variables analyzed. During depressive episodes, similar cognitive outcomes were observed between groups.ConclusionAt present, it is not possible to postulate specific neuropsychological profiles for major depression and bipolar disorder in light of available evidence. It remains to be ascertained whether the differences found for verbal memory constitute an expression of distinct underlying mechanisms or whether they are best explained by sample characteristics or differential exposure to variables with a negative impact on cognition.

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