scholarly journals Frequency and correlates of comorbid psychiatric illness in patients with heroin use disorder admitted to Stikland Opioid Detoxification Unit, South Africa

2014 ◽  
Vol 20 (3) ◽  
pp. 6 ◽  
Author(s):  
Lisa Dannatt ◽  
Karen Jacqueline Cloete ◽  
Martin Kidd ◽  
Lize Weich
Keyword(s):  
South Africa ◽  
Substance Use ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Psychiatric Illness ◽  
World Health ◽  
Major Depressive ◽  
Heroin Use ◽  
Heroin Use Disorder ◽  
Opioid Detoxification

<p><strong>Background</strong>. There is a lack of studies addressing the frequency and correlates of comorbidities among heroin users admitted for treatment in South Africa (SA). Objective. To assess the frequency and correlates of psychiatric comorbidity among patients with heroin use disorder admitted to the Opioid Detoxification Unit at Stikland Hospital in the Western Cape, SA.</p><p><strong>Method.</strong> Participants (<em>N</em>=141) were assessed for psychiatric illness (Mini International Neuropsychiatric Interview), comorbid substance use disorders (World Health Organization’s Alcohol Smoking Substance Involvement Screening Tool), and legal and social problems (Maudsley Addiction Profile). Demographic, personal, psychiatric and substance-use history, in addition to mental state examination on admission, were collected from the case notes.</p><p><strong>Results.</strong> The largest group of patients (<em>n</em>=56, 40%) had not been abstinent from heroin use since drug debut, and most had been arrested for drug-related activities (<em>n</em>=117, 83%) and had family conflicts related to use <em>(n</em>=135, 96%). Nicotine was the most common comorbid substance of dependence (<em>n</em>=137, 97%) and methamphetamine was the most common comorbid substance abused (<em>n</em>=73, 52%). The most common comorbid psychiatric illness was previous substance-induced psychosis (<em>n</em>=42, 30%) and current major depressive disorder (<em>n</em>=37, 26%). Current major depressive disorder was significantly associated with females (p=0.03), intravenous drug use (<em>p</em>=0.03), alcohol use (<em>p</em>=0.02), and a higher number of previous rehabilitation attempts (<em>p</em>=0.008).</p><p><strong>Conclusion.</strong> Patients with heroin use disorders present with high rates of psychiatric comorbidities, which underscores the need for substance treatment services with the capacity to diagnose and manage these comorbidities.</p>

scholarly journals Circadian Functioning and Quality of Life in Substance Use Disorder Patients With and Without Comorbid Major Depressive Disorder

2021 ◽  
Vol 12 ◽  
Author(s):  
Iman Hashemzadeh ◽  
Julia E. Marquez-Arrico ◽  
Kosar Hashemzadeh ◽  
José Francisco Navarro ◽  
Ana Adan
Keyword(s):  
Quality Of Life ◽  
Substance Use ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Sleep Quality ◽  
Substance Use Disorder ◽  
World Health ◽  
Major Depressive ◽  
Clinical Variables

Aim: Although a relationship between circadian disruption and development of several psychiatric disorders, such as major depressive disorder (MDD) and substance use disorder (SUD), has been observed, knowledge on this area is scarce yet. Therefore, this study aims to analyze the circadian functioning and quality of life (QOL) in SUD patients with and without comorbid MDD, two highly prevalent clinical entities with difficult therapeutic management.Methods: One hundred sixty-three male patients under treatment, 81 with SUD and 82 with SUD comorbid major depressive disorder (SUD + MDD), were evaluated. For the circadian functioning assessment, we calculated Social Jet Lag (SJL) and used the reduced Morningness–Eveningness Questionnaire (rMEQ) and the Pittsburgh Sleep Quality Index (PSQI). QOL was measured using the shortened version of the World Health Organization's Quality of Life Questionnaire (WHOQOL-BREF). We collected sociodemographic and clinical variables to evaluate their possible influence on the circadian functioning. Intergroup differences among the variables were examined by different analyses of covariance (ANCOVA and MANCOVA). The possible relationships of quantitative clinical variables with rMEQ, PSQI, and WHOQOL-BREF were explored using bivariate correlation analysis.Results: Lower SJL appears in the SUD + MDD group compared with SUD. The intermediate-type was more prevalent in the SUD group, while a higher percentage of morning-type patients was found in the SUD + MDD. Sleep quality (including latency and daytime dysfunction) was worse for SUD + MDD patients than for SUD even after controlling age and age of SUD onset variables. Last, QOL was poorer in patients with SUD + MDD and, for them, psychological health had a negative relationship with SJL and severity of depression.Conclusions: Our data support and extend previous findings indicating that SUD + MDD is associated with worse clinical characteristics, more sleep problems, and poorer QOL than SUD patients. These results underline the importance of a precise assessment of these measurements in future studies conducted in SUD patients with/without MDD comorbidity that could be considered from a therapeutic point of view.

scholarly journals Characteristics of Neuropsychiatric Mobile Health Trials: Cross-Sectional Analysis of Studies Registered on ClinicalTrials.gov

10.2196/16180 ◽  
2020 ◽  
Vol 8 (8) ◽  
pp. e16180
Author(s):  
Mia Tova Minen ◽  
Julia Frederica Reichel ◽  
Pallavi Pemmireddy ◽  
Elizabeth Loder ◽  
John Torous
Keyword(s):  
Substance Use ◽  
Major Depressive Disorder ◽  
Alzheimer Disease ◽  
Depressive Disorder ◽  
Alcohol Use Disorders ◽  
Opioid Use ◽  
Major Depressive ◽  
High Burden ◽  
Opioid Use Disorders ◽  
Neuropsychiatric Conditions

Background The development of mobile health (mHealth) technologies is progressing at a faster pace than that of the science to evaluate their validity and efficacy. Under the International Committee of Journal Medical Editors (ICMJE) guidelines, clinical trials that prospectively assign people to interventions should be registered with a database before the initiation of the study. Objective The aim of this study was to better understand the smartphone mHealth trials for high-burden neuropsychiatric conditions registered on ClinicalTrials.gov through November 2018, including the number, types, and characteristics of the studies being conducted; the frequency and timing of any outcome changes; and the reporting of results. Methods We conducted a systematic search of ClinicalTrials.gov for the top 10 most disabling neuropsychiatric conditions and prespecified terms related to mHealth. According to the 2016 World Health Organization Global Burden of Disease Study, the top 10 most disabling neuropsychiatric conditions are (1) stroke, (2) migraine, (3) major depressive disorder, (4) Alzheimer disease and other dementias, (5) anxiety disorders, (6) alcohol use disorders, (7) opioid use disorders, (8) epilepsy, (9) schizophrenia, and (10) other mental and substance use disorders. There were no date, location, or status restrictions. Results Our search identified 135 studies. A total of 28.9% (39/135) of studies evaluated interventions for major depressive disorder, 14.1% (19/135) of studies evaluated interventions for alcohol use disorders, 12.6% (17/135) of studies evaluated interventions for stroke, 11.1% (15/135) of studies evaluated interventions for schizophrenia, 8.1% (11/135) of studies evaluated interventions for anxiety disorders, 8.1% (11/135) of studies evaluated interventions for other mental and substance use disorders, 7.4% (10/135) of studies evaluated interventions for opioid use disorders, 3.7% (5/135) of studies evaluated interventions for Alzheimer disease or other dementias, 3.0% (4/135) of studies evaluated interventions for epilepsy, and 3.0% (4/135) of studies evaluated interventions for migraine. The studies were first registered in 2008; more than half of the studies were registered from 2016 to 2018. A total of 18.5% (25/135) of trials had results reported in some publicly accessible location. Across all the studies, the mean estimated enrollment (reported by the study) was 1078, although the median was only 100. In addition, across all the studies, the actual reported enrollment was lower, with a mean of 249 and a median of 80. Only about a quarter of the studies (35/135, 25.9%) were funded by the National Institutes of Health. Conclusions Despite the increasing use of health-based technologies, this analysis of ClinicalTrials.gov suggests that only a few apps for high-burden neuropsychiatric conditions are being clinically evaluated in trials.

Dexamethasone Suppression Test in Depression and other Psychiatric Illness

1983 ◽  
Vol 142 (5) ◽  
pp. 498-504 ◽  
Author(s):  
A. Coppen ◽  
M. Abou-Saleh ◽  
P. Milln ◽  
M. Metcalfe ◽  
J. Harwood ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Affective Disorders ◽  
Psychiatric Illness ◽  
Dexamethasone Suppression Test ◽  
Major Depressive ◽  
Abnormal Response ◽  
Suppression Test ◽  
Dexamethasone Suppression ◽  
Normal Controls

SummaryThe prevalence of an abnormal response to the dexamethasone suppression test (DST) was examined in 119 in-patients suffering from a major depressive disorder and in 79 normal controls. Only 11 per cent of controls showed an abnormal DST as against 70 per cent of depressed patients. The specificity of the DST was examined by testing patients with other psychiatric disorders. Abnormal responses were found in one-fifth of a sample of schizophrenics, over one-quarter of abstinent alcoholics, two-fifths of neurotics (including neurotic depressives) and almost half of senile dements. Abnormal DST was also found in 33 per cent of patients receiving prophylactic lithium for recurrent affective disorders.

scholarly journals Major depressive disorder in different age groups and quality of life

2017 ◽  
Vol 28 (2) ◽  
pp. 58-61 ◽  
Author(s):  
Umme Salma Talukder ◽  
MM Jalal Uddin ◽  
Niaz Mohammad Khan ◽  
Md Mostarshid Billah ◽  
Tufayel Ahmed Chowdhury ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Age Groups ◽  
World Health ◽  
Age Group ◽  
Major Depressive ◽  
World Health Organization Quality ◽  
Quality Of Life Scale

Major Depressive Disorder (MDD) is a significant public health problem due to its impact on the quality of life. The aim of the study was to determine the presentation of depression in different age group and quality of life among the respondents. This was a descriptive cross sectional study conducted from May, 2012 to February, 2013 among 65 patients aged 18 to 65 years with major depressive disorder in both outpatient and inpatient departments of National Institute of Mental Health (NIMH), Dhaka by using convenient sampling technique. Diagnostic and Statistical Manual of Mental Disorders- Text version (DSM-IV-TR), Beck Depression Inventory and World Health Organization Quality of Life Scale, Brief version (WHOQOL-BREF) were used to diagnose depressive disorder, to measure severity of depressive illness and Quality of Life (QOL) respectively. Level of depression was compared with the QOL. Quality of life deteriorated in patients with depression. Presence and level of depression was compared in different age groups of depressed patients. The results showed that most of the depressed people (17) were found in the age group of 21-25 years and most of the patients were severely depressed which was thirty nine (39). The study revealed that young people were mostly depressed and their quality of life was decreasing. lt needs further study to explore more information about pattern of presentation of depression and its effect on the quality of life.Bang J Psychiatry Dec 2014; 28(2): 58-61

Predictors of 1-year outcomes of major depressive disorder among individuals with a lifetime diagnosis: a population-based study

2011 ◽  
Vol 42 (2) ◽  
pp. 327-334 ◽  
Author(s):  
J. L. Wang ◽  
S. B. Patten ◽  
S. Currie ◽  
J. Sareen ◽  
N. Schmitz
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Longitudinal Studies ◽  
Psychosocial Factors ◽  
Composite International Diagnostic Interview ◽  
Population Based ◽  
World Health ◽  
Major Depressive ◽  
Factors Associated ◽  
Lifetime Diagnosis

BackgroundExamining predictors of the outcomes of major depressive disorder (MDD) is important for clinical practice and population health. There are few population-based longitudinal studies on this topic. The objectives of this study were to (1) estimate the proportions of persistent and recurrent MDD among those with MDD over 1 year, and (2) identify demographic, socio-economic, workplace psychosocial and clinical factors associated with the outcomes.MethodFrom a population-based longitudinal study of the working population, participants with a lifetime diagnosis of MDD were selected (n=834). They were classified into two groups: those with and those without current MDD. The proportions of 1-year persistence and recurrence of MDD were estimated. MDD was assessed by the World Health Organization (WHO) Composite International Diagnostic Interview, CIDI-Auto 2.1, by telephone.ResultsThe proportions of persistent and recurrent MDD in 1 year were 38.5% [95% confidence interval (CI) 31.1–46.5] and 13.3% (95% CI 10.2–17.1) respectively. Long working hours, negative thinking and having co-morbid social phobia were predictive of persistence of MDD. Perceived work–family conflict, the severity of a major depressive episode and symptoms of depressed mood were significantly associated with the recurrence of MDD.ConclusionsClinical and psychosocial factors are important in the prognosis of MDD. The factors associated with persistence and recurrence of MDD may be different. More large longitudinal studies on this topic are needed so that clinicians may predict potential outcomes based on the clinical profile and provide interventions accordingly. They may also take clinical action to change relevant psychosocial factors to minimize the chance of persistence and/or recurrence of MDD.

Differences Among Major Depressive Disorder With and Without Co-occurring Substance Use Disorders and Substance-Induced Depressive Disorder

2012 ◽  
Vol 73 (06) ◽  
pp. 865-873 ◽  
Author(s):  
Carlos Blanco ◽  
Analucía A. Alegría ◽  
Shang-Min Liu ◽  
Roberto Secades-Villa ◽  
Luisa Sugaya ◽  
...  
Keyword(s):  
Substance Use ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Substance Use Disorders ◽  
Major Depressive

CORRECTION: "Text Messaging Versus Email Messaging to Support Patients With Major Depressive Disorder: Protocol for a Randomized Hybrid Type II Effectiveness-Implementation Trial" (Preprint)

2021 ◽  
Author(s):  
Vincent Agyapong ◽  
Medard Adu ◽  
Reham Shalaby ◽  
Ejemai Eboreime ◽  
Adegboyega Sapara ◽  
...  
Keyword(s):  
Mental Health ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Text Messaging ◽  
World Health ◽  
Depression Symptoms ◽  
Type Ii ◽  
Major Depressive ◽  
Hybrid Type ◽  
Study Results

BACKGROUND Background: Major depressive disorder (MDD) accounts for 40.5% of disability-adjusted life-years caused by mental and substance use disorders. Barriers such as stigma and financial and physical access to care have been reported, highlighting the need for innovative, accessible, and cost-effective psychological interventions. The effectiveness of supportive SMS text messaging in alleviating depression symptoms has been proven in clinical trials, but this approach can only help those with mobile phones. OBJECTIVE Objective: This paper presents the protocol for a study that will aim to evaluate the feasibility, comparative effectiveness, and user satisfaction of daily supportive email messaging as an effective strategy compared to daily supportive text messaging as part of the treatment of patients with MDD. METHODS Methods: This trial will be carried out using a hybrid type II implementation-effectiveness design. This design evaluates the effectiveness of an implementation strategy or intervention, while also evaluating the implementation context associated with the intervention. Patients with MDD receiving usual care will be randomized to receive either daily supportive email messaging or daily supportive text messaging of the same content for 6 months. The Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7 and the 5-item World Health Organization Well-Being Index will be used to evaluate the effectiveness of both strategies. The implementation evaluation will be guided by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework, as well as the Consolidated Framework for Implementation Research. All outcome measures will be analyzed using descriptive and inferential statistics. Qualitative data will be analyzed using thematic analysis. RESULTS Results: Data collection for this trial began in April 2021. We expect the study results to be available within 18 months of study commencement. The results will shed light on the feasibility, acceptability, and effectiveness of using automated emails as a strategy for delivering supportive messages to patients with MDD in comparison to text messaging. CONCLUSIONS Conclusions: The outcome of this trial will have a translational impact on routine patient care and access to mental health, as well as potential support mental health policy decision-making for health care resource allocation CLINICALTRIAL Trial Registration: ClinicalTrials.gov NCT04638231; https://clinicaltrials.gov/ct2/show/NCT04638231 International Registered Report Identifier (IRRID): DERR1-10.2196/29495

Modulating the serotonin system in the treatment of major depressive disorder

CNS Spectrums ◽  
2014 ◽  
Vol 19 (S1) ◽  
pp. 54-68 ◽  
Author(s):  
Debbi Ann Morrissette ◽  
Stephen M. Stahl
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Psychiatric Illness ◽  
Atypical Antipsychotics ◽  
Treatment Resistance ◽  
Major Depressive ◽  
Serotonin System ◽  
And Behavior ◽  
5Ht Receptors

Learning Objective: Discuss the theory of modulation of receptor activity or the blockade of the reuptake of multiple neurotransmitter systems for the future treatment of MDD.Major depressive disorder (MDD) is a serious and often crippling psychiatric illness with a high risk of relapse and treatment resistance. In this article, we discuss the role of the serotonergic system in MDD including our current understanding of how various serotonin (5HT) receptors modulate monoamine neurotransmission and behavior. We also discuss how pharmacologic interventions, including novel and existing antidepressants and atypical antipsychotics, may be utilized to adjust serotonergic neurotransmission and provide more effective treatments for patients with MDD.

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