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Liu X, Liu S, Su F, Zhang W, Ke Y, Ming D. Neurophysiological Signatures of Major Depressive Disorder and Frontocentral Gamma Auditory Response Deficits. Depress Anxiety 2025; 2025:7390951. [PMID: 40225721 PMCID: PMC11918825 DOI: 10.1155/da/7390951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 12/08/2024] [Accepted: 01/13/2025] [Indexed: 04/15/2025] Open
Abstract
Background: Aberrant gamma oscillations in major depressive disorder (MDD) have attracted extensive attention, but evidence delineating such neural signatures is lacking. The auditory steady-state response (ASSR) elicited by periodic auditory stimuli is a robust probe of gamma oscillations. Here, we sought to characterize early transient auditory evoked responses (AEPs) and sustained gamma ASSRs in MDD, thereby identifying reliable neurophysiological signatures and providing preliminary interpretations of gamma auditory response deficits in MDD. Methods: Electroencephalographic data were obtained from 40 first-episode drug-naïve patients with MDD and 41 demographically matched healthy controls (HCs) during a 40-Hz ASSR paradigm, encompassing two periodic stimuli-chirp and click stimuli. Source analysis of transient AEPs was performed to identify generators involved in early information processing dysfunction. In addition, spectrotemporal and spatial characteristics of 40-Hz ASSRs were analyzed using event-related spectral perturbation, inter-trial phase coherence, and functional connectivity index. Results: Compared to HCs, patients showed a reduced P200 amplitude that was source-localized to the middle temporal gyrus, possibly reflecting an underlying impairment in the processes of early allocation or auditory information perception within the auditory pathways. Meanwhile, attenuated 40-Hz power and phase coherence, in conjunction with suppressed right frontotemporal and frontocentral connectivity, were observed in MDD, highlighting the multidimensional entrained gamma inhibition. Correlation analyses revealed that the decreased right frontocentral connectivity was strongly related to increased anxiety severity. Importantly, these abnormalities correlated with the patient's symptoms were only found with the chirp stimulus, suggesting that the chirp stimulus has tremendous potential to reveal specific neurophysiological signatures of MDD. Conclusions: Our data reveal impaired gamma auditory responses in first-episode drug-naïve patients with MDD and suggest that right frontocentral connectivity elicited by the chirp stimulus may represent a promising signature for predicting clinical symptoms.
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Affiliation(s)
- Xiaoya Liu
- Medical School of Tianjin University, Tianjin University, Tianjin, China
| | - Shuang Liu
- Medical School of Tianjin University, Tianjin University, Tianjin, China
| | - Fangyue Su
- College of Precision Instruments and Optoelectronics Engineering, Tianjin University, Tianjin, China
| | - Wenquan Zhang
- Medical School of Tianjin University, Tianjin University, Tianjin, China
| | - Yufeng Ke
- Medical School of Tianjin University, Tianjin University, Tianjin, China
| | - Dong Ming
- Medical School of Tianjin University, Tianjin University, Tianjin, China
- College of Precision Instruments and Optoelectronics Engineering, Tianjin University, Tianjin, China
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Ye Z, Zhang F, Cui R, Ye X, Tan M, Tao T, Zhang X. The effect of depression on non-suicidal self-injury and psychological status in adolescents with unipolar and bipolar disorders. BMC Psychol 2024; 12:743. [PMID: 39695873 DOI: 10.1186/s40359-024-02236-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2024] [Accepted: 11/27/2024] [Indexed: 12/20/2024] Open
Abstract
OBJECTIVE To investigate the effects of depression on non-suicidal self-injury (NSSI) and related psychological conditions in adolescents with unipolar disorder (UD) and bipolar disorder (BD), and to provide a basis for accurate prevention and intervention of NSSI behaviors in adolescents. METHODS This cross-sectional study collected data from adolescents aged 12-18 years with depressive episodes who exhibited NSSI behaviors and attended the psychiatric outpatient clinic of Huangshi City Psychiatric Specialized Hospital from 2018 to 2023. Depressive episodes were clinically diagnosed by two psychiatrists according to the ICD-10. RESULTS In terms of NSSI behavioral patterns and severity, adolescents with UD displayed more frequent behaviour of intentionally burning themselves with cigarettes and had more instances of self-inflicted suicidal thoughts that were not carried out compared to those with BD, and the differences between the two groups were statistically significant (P < 0.05). For psychological status, Nurses' Global Assessment of Suicide Risk (NGASR) scores were significantly higher in adolescents with BD than in those with UD (P < 0.05). There was a significant negative correlation between anxiety scores and the frequency of NSSI in adolescents with BD (P < 0.05); that is, the more anxious the adolescents with BD, the lower the frequency of NSSI. The NGASR scores of adolescents with UD and BD were significantly and positively correlated with the frequency of NSSI occurrences (P < 0.05); higher NGASR scores of adolescents with UD and BD corresponded with higher frequencies of NSSI. CONCLUSION The differences in NSSI behaviors between adolescents with UD and those with BD were statistically significant in terms of self-injury method and severity. Adolescents with UD experienced more severe consequences related to NSSI behaviors. Regarding psychological conditions, adolescents with BD are at a higher risk of suicide. An inverse relationship was observed between anxiety severity and the frequency of NSSI in adolescents with BD; severe anxiety was associated with lower NSSI frequency. Additionally, higher suicide risk was associated with a higher frequency of NSSI in adolescent patients with either UD or BD. Therefore, different prevention and intervention measures are needed to address NSSI behaviors in adolescents with UD and BD.
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Affiliation(s)
- Zhuofan Ye
- Department of Neurology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Department of Neurology, Guizhou Pronvincial People's Hospital, Guiyang, China
| | - Fanshi Zhang
- Department of Neurology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Ruxue Cui
- Department of Neurology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Department of Neurology, Guizhou Pronvincial People's Hospital, Guiyang, China
| | - Xixiang Ye
- Psychological Children's Ward, Mental Health Center of Huangshi, Hubei, China
| | - Mengqing Tan
- The Third Men's Ward, Mental Health Center of Huangshi, Hubei, China
| | - Tao Tao
- Department of Rehabilitation Medicine, Guizhou Provincial People's Hospital, Guiyang, China.
| | - Xiaozhi Zhang
- Psychological Children's Ward, Mental Health Center of Huangshi, Hubei, China.
- Daye Economic and Technological Development Zone, No.698 East Jinshan Road, Wangren Town, Huangshi, Hubei Province, 435111, China.
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Zhu L, Zheng L. Influence of White Sound on Sleep Quality, Anxiety, and Depression in Patients with Schizophrenia. Noise Health 2024; 26:97-101. [PMID: 38904807 PMCID: PMC11530119 DOI: 10.4103/nah.nah_116_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/23/2024] [Accepted: 02/23/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Patients with schizophrenia frequently experience issues such as poor sleep quality, anxiety, and depression. White sound has been identified as a potential therapeutic strategy to enhance sleep quality and alleviate negative emotions. This study aimed to investigate the effectiveness of white sound in improving sleep quality, anxiety, and depression among patients with schizophrenia. MATERIALS AND METHODS This retrospective analysis included clinical data from 212 patients with schizophrenia divided into two groups based on their treatment approach. Group C (control, without white sound, n = 106) received standard pharmacological treatments, while group W (white sound, n = 106) was exposed to white sound (40-50 dB) for 2 hours nightly at 9:00 pm. All patients were assessed using the Pittsburgh Sleep Quality Index (PSQI), Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), and Positive and Negative Syndrome Scale (PANSS) before and after 12 weeks of intervention. RESULTS After 12 weeks, group W showed significant improvements in sleep latency, sleep efficiency, and overall PSQI scores compared to group C (P < 0.05). Furthermore, the HAMD and HAMA scores were significantly lower in group W (P < 0.05), indicating reduced levels of anxiety and depression. The negative symptoms score was significantly lower in group W (P < 0.05) after treatment. CONCLUSION White sound shows promise in improving sleep quality, and alleviating anxiety and depression in patients with schizophrenia.
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Affiliation(s)
- Lingli Zhu
- Department of Psychology, The Third Hospital of Quzhou, Quzhou 324000, Zhejiang, China
| | - Lifeng Zheng
- Department of Psychology, The Third Hospital of Quzhou, Quzhou 324000, Zhejiang, China
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Dos Santos ERP, Coelho JCF, Ribeiro I, Sampaio F. Translation, cultural adaptation and evaluation of the psychometric properties of the Hamilton Anxiety Scale among a sample of Portuguese adult patients with mental health disorders. BMC Psychiatry 2023; 23:520. [PMID: 37468846 DOI: 10.1186/s12888-023-05010-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 07/07/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Only a few anxiety assessment tools that nurses may administer are validated forthe Portuguese population exist in the literature. Thus, this study aimed to translate and culturally adapt the Hamilton Anxiety Scale for the Portuguese population and assess its psychometric properties in a sample of adult people with mental health disorders. METHODS This psychometric study uses a convenience sample of adult patients with mental health disorders. RESULTS The confirmatory factor analysis confirmed the two factors of the original version of the tool. The internal consistency (Cronbach's alpha) was high, at .92, as well as the inter-rater reliability (intraclass correlation coefficient) (.91). CONCLUSIONS The validity and reliability of the instrument are supported. However, the Hamilton Anxiety Scale should be used cautiously in the Portuguese population because the correlation with the "Anxiety State" subscale of the State-Trait Anxiety Inventory is not statistically significant.
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Affiliation(s)
| | - Joana Catarina Ferreira Coelho
- Portuguese Red Cross Northern Health School, Rua da Cruz Vermelha Cidacos-Apartado 1002, Oliveira de Azeméis, 3720-126, Portugal
- CINTESIS@RISE, Nursing School of Porto (ESEP), Rua Dr Plácido da Costa, Porto, 4200-450, Portugal
| | - Isilda Ribeiro
- CINTESIS@RISE, Nursing School of Porto (ESEP), Rua Dr Plácido da Costa, Porto, 4200-450, Portugal
- Nursing School of Porto, Rua Dr. António Bernardino de Almeida, 830, 844, 856, Porto, 4200-072, Portugal
| | - Francisco Sampaio
- CINTESIS@RISE, Nursing School of Porto (ESEP), Rua Dr Plácido da Costa, Porto, 4200-450, Portugal
- Nursing School of Porto, Rua Dr. António Bernardino de Almeida, 830, 844, 856, Porto, 4200-072, Portugal
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Guo G, Kong Y, Zhu Q, Wu Z, Zhang S, Sun W, Cheng Y, Fang M. Cerebral mechanism of Tuina analgesia in management of knee osteoarthritis using multimodal MRI: study protocol for a randomised controlled trial. Trials 2022; 23:694. [PMID: 35986403 PMCID: PMC9389761 DOI: 10.1186/s13063-022-06633-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 08/04/2022] [Indexed: 11/13/2022] Open
Abstract
Background The chronic pain of patients with knee osteoarthritis (KOA) seriously affects their quality of life and leads to heavy social and economic burden. As a nondrug therapy in Traditional Chinese Medicine (TCM), Tuina is generally recognised as safe and effective for reducing the chronic pain of KOA. However, the underlying central mechanisms of Tuina for improving the pain of KOA are not fully understood. Methods/design This study will be a randomised controlled trial with a parallel-group design. A total of 60 eligible participants will be assigned to the Tuina group or healthcare education group (Education group) at 1:1 ratio using stratified randomisation with gender and age as factors. The interventions of both groups will last for 30 min per session and be conducted twice each week for 12 weeks. This study will primarily focus on pain evaluation assessed by detecting the changes in brain grey matter (GM) structure, white matter (WM) structure, and the cerebral functional connectivity (FC) elicited by Tuina treatment, e.g., thalamus, hippocampus, anterior cingulate gyrus, S1, insula, and periaqueductal grey subregions (PAG). The two groups of patients will be evaluated by clinical assessments and multimodal magnetic resonance imaging (MRI) to observe the alterations in the GM, WM, and FC of participants at the baseline and the end of 6 and 12 weeks’ treatment and still be evaluated by clinical assessments but not MRI for 48 weeks of follow-up. The visual analogue scale of current pain is the primary outcome. The Short-Form McGill Pain Questionnaire, Western Ontario and McMaster Universities Osteoarthritis Index, 36-Item Short Form Health Survey, Hamilton Depression Scale, and Hamilton Anxiety Scale will be used to evaluate the pain intensity, pain feeling, pain emotion, clinical symptoms, and quality of life, respectively. MRI assessments, clinical data evaluators, data managers, and statisticians will be blinded to the group allocation in the outcome evaluation procedure and data analysis to reduce the risk of bias. The repeated measures analysis of variance (2 groups × 6 time points ANOVA) will be used to analyse numerical variables of the clinical and neuroimaging data obtained in the study. P<0.05 will be the statistical significance level. Discussion The results of this randomised controlled trial with clinical assessments and multimodal MRI will help reveal the influence of Tuina treatment on the potential morphological changes in cortical and subcortical brain structures, the white matter integrity, and the functional activities and connectivity of brain regions of patients with KOA, which may provide scientific evidence for the clinical application of Tuina in the management of KOA. Trial registration Chinese Clinical Trial Registry ChiCTR2000037966. Registered on Sep. 8, 2020. Dissemination The results will be published in peer-reviewed journals and disseminated through the study’s website, and conferences.
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Xia K, Han Y, Zhou L, Hu S, Rao R, Shan S, Hua L. Attention impairment in patients with cervical dystonia: An attention network test study. Front Psychol 2022; 13:952567. [PMID: 35992456 PMCID: PMC9386253 DOI: 10.3389/fpsyg.2022.952567] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/04/2022] [Indexed: 11/24/2022] Open
Abstract
Objective The purpose of this study was to investigate attentional network functional characteristics in patients with cervical dystonia (CD). Methods A total of 29 patients with CD and 26 healthy controls (HCs) were recruited. All subjects participated in the study and underwent the Attention Network Test (ANT), which evaluated the efficiencies of three independent attention networks (alerting, orienting, and executive control), as well as reaction time (RT) and accuracy. Results Significant differences between CD patients (9.86 ± 27.95 ms) and HCs (33.62 ± 23.41 ms) were observed in the alerting network (t = −3.40, p < 0.05). In contrast, the orienting network (t = 0.26, p = 0.79), executive control network (Z = −0.55, p = 0.58), total mean reaction time (t = −2.6, p = 0.79), and total accuracy rate (Z = −1.67, p = 0.09) showed no significant differences between the two groups. Conclusion Patients with CD showed a significant deficit in the alerting network. However, they did not show any deficits in the orienting or executive control network. In addition, the alerting, orienting, and executive control network functions of CD patients were all affected by the severity of torticollis, especially the alerting network function.
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Affiliation(s)
- Kun Xia
- Institute of Neurology, Anhui University of Chinese Medicine, Hefei, China
| | - Yongsheng Han
- Institute of Neurology, Anhui University of Chinese Medicine, Hefei, China
- Department of Neurology, Anhui Hospital of Integrated Traditional Chinese and Western Medicine, Hefei, China
- *Correspondence: Yongsheng Han,
| | - Lanlan Zhou
- Department of Neurology, The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, China
| | - Sheng Hu
- School of Medical Information Engineering, Anhui University of Traditional Chinese Medicine, Hefei, China
| | - Rao Rao
- Institute of Neurology, Anhui University of Chinese Medicine, Hefei, China
| | - Shu Shan
- Institute of Neurology, Anhui University of Chinese Medicine, Hefei, China
| | - Lei Hua
- Institute of Neurology, Anhui University of Chinese Medicine, Hefei, China
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Luo B, Lu Y, Qiu C, Dong W, Xue C, Zhang L, Liu W, Zhang W. Altered Spontaneous Neural Activity and Functional Connectivity in Parkinson's Disease With Subthalamic Microlesion. Front Neurosci 2021; 15:699010. [PMID: 34354566 PMCID: PMC8329380 DOI: 10.3389/fnins.2021.699010] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 06/28/2021] [Indexed: 11/13/2022] Open
Abstract
Background Transient improvement in motor symptoms are immediately observed in patients with Parkinson's disease (PD) after an electrode has been implanted into the subthalamic nucleus (STN) for deep brain stimulation (DBS). This phenomenon is known as the microlesion effect (MLE). However, the underlying mechanisms of MLE is poorly understood. Purpose We utilized resting state functional MRI (rs-fMRI) to evaluate changes in spontaneous brain activity and networks in PD patients during the microlesion period after DBS. Method Overall, 37 PD patients and 13 gender- and age-matched healthy controls (HCs) were recruited for this study. Rs-MRI information was collected from PD patients three days before DBS and one day after DBS, whereas the HCs group was scanned once. We utilized the amplitude of low-frequency fluctuation (ALFF) method in order to analyze differences in spontaneous whole-brain activity among all subjects. Furthermore, functional connectivity (FC) was applied to investigate connections between other brain regions and brain areas with significantly different ALFF before and after surgery in PD patients. Result Relative to the PD-Pre-DBS group, the PD-Post-DBS group had higher ALFF in the right putamen, right inferior frontal gyrus, right precentral gyrus and lower ALFF in right angular gyrus, right precuneus, right posterior cingulate gyrus (PCC), left insula, left middle temporal gyrus (MTG), bilateral middle frontal gyrus and bilateral superior frontal gyrus (dorsolateral). Functional connectivity analysis revealed that these brain regions with significantly different ALFF scores demonstrated abnormal FC, largely in the temporal, prefrontal cortices and default mode network (DMN). Conclusion The subthalamic microlesion caused by DBS in PD was found to not only improve the activity of the basal ganglia-thalamocortical circuit, but also reduce the activity of the DMN and executive control network (ECN) related brain regions. Results from this study provide new insights into the mechanism of MLE.
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Affiliation(s)
- Bei Luo
- Department of Functional Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yue Lu
- Department of Functional Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Chang Qiu
- Department of Functional Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Wenwen Dong
- Department of Functional Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Chen Xue
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Li Zhang
- Department of Geriatrics, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Weiguo Liu
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Wenbin Zhang
- Department of Functional Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
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Abstract
Wilson's disease patients with neurological symptoms have motor symptoms and cognitive deficits, including frontal executive, visuospatial processing, and memory impairments. Although the brain structural abnormalities associated with Wilson's disease have been documented, it remains largely unknown how Wilson's disease affects large-scale functional brain networks. In this study, we investigated functional brain networks in Wilson's disease. Particularly, we analyzed resting state functional magnetic resonance images of 30 Wilson's disease patients and 26 healthy controls. First, functional brain networks for each participant were extracted using an independent component analysis method. Then, a computationally efficient pattern classification method was developed to identify discriminative brain functional networks associated with Wilson's disease. Experimental results indicated that Wilson's disease patients, compared with healthy controls, had altered large-scale functional brain networks, including the dorsal anterior cingulate cortex and basal ganglia network, the middle frontal gyrus, the dorsal striatum, the inferior parietal lobule, the precuneus, the temporal pole, and the posterior lobe of cerebellum. Classification models built upon these networks distinguished between neurological WD patients and HCs with accuracy up to 86.9% (specificity: 86.7%, sensitivity: 89.7%). The classification scores were correlated with the United Wilson's Disease Rating Scale measures and durations of disease of the patients. These results suggest that Wilson's disease patients have multiple aberrant brain functional networks, and classification scores derived from these networks are associated with severity of clinical symptoms.
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Bascarane S, Kuppili PP, Menon V. Psychiatric Assessment and Management of Clients Undergoing Cosmetic Surgery: Overview and Need for an Integrated Approach. Indian J Plast Surg 2021; 54:8-19. [PMID: 33854274 PMCID: PMC8034989 DOI: 10.1055/s-0040-1721868] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background Psychiatric disorders are more common among people undergoing cosmetic procedures than the general population and evaluating mental health can be cumbersome for plastic surgeons. We aim to summarize the available literature in this regard and propose an integrated approach to psychiatric assessment and management of mental health issues among this group. Methods Electronic search of MEDLINE, Google Scholar, and PsycINFO databases was done to identify relevant peer-reviewed English language articles from inception till April 2020. Generated abstracts were screened for their eligibility. Included articles were grouped according to their thematic focus under the following headings; prevalence of psychiatric morbidity among clients posted for cosmetic surgery, assessment tools, and management of psychiatric morbidity in relation to undergoing cosmetic surgery. Results A total of 120 articles were reviewed. The prevalence of psychiatric disorder in patients undergoing cosmetic surgery was 4 to 57% for body dysmorphic disorder (BDD); the corresponding figures for depression, anxiety, and personality disorder were 4.8 to 25.8, 10.8 to 22, and 0 to 53%, respectively. A range of tools have been used to assess these disorders and specific measures are also available to assess clinical outcomes following surgery. Screening for these disorders is essential to prevent unnecessary surgical procedures, as well as to ensure timely management of the psychiatric comorbidity. Conclusion Psychiatric morbidity is a common concomitant in cosmetic surgery. A structured and integrated approach to evaluation and management of psychiatric morbidity will help to optimize postsurgical outcomes.
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Affiliation(s)
- Sharmi Bascarane
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Pooja P. Kuppili
- Senior Clinical Fellow, Penn Hospital Black Country Healthcare NHS Foundation Trust United Kingdom
| | - Vikas Menon
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
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Ivansic D, Besteher B, Gantner J, Guntinas-Lichius O, Pantev C, Nenadic I, Dobel C. Psychometric assessment of mental health in tinnitus patients, depressive and healthy controls. Psychiatry Res 2019; 281:112582. [PMID: 31586842 DOI: 10.1016/j.psychres.2019.112582] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 09/25/2019] [Accepted: 09/26/2019] [Indexed: 01/05/2023]
Abstract
Tinnitus describes the perception of a sound without external source and is characterized by high comorbidity, e.g. depression. In many studies, tinnitus patients were compared to healthy controls while a comorbid psychiatric diagnosis was an exclusion criterion. Consequently, patients with severe tinnitus and psychiatric comorbidity were often neglected. In the current study, we tried to fill this gap and compared four groups including two control groups: (1) chronic tinnitus patients with mild tinnitus distress (N = 37), (2) chronic tinnitus patients with severe tinnitus distress (N = 24), (3) patients suffering from depression, but no tinnitus (major depressive disorder, MDD; N = 23) and (4) healthy controls (N = 42). We assessed their clinical profile with clinical questionnaires concerning anxiety, depression and somatoform symptoms. Data were analyzed with a canonical discriminant analysis resulting in two factors. Factor 1 was called general psychopathology, because most questionnaires loaded highly on it. Regarding this factor, patients with severe tinnitus distress and MDD controls were impaired equally strong. Patients with mild tinnitus distress were more strongly affected than healthy controls. Both tinnitus groups reached higher values than the two control groups with regard to factor 2, called somatization. These results stress the presence of significant general psychopathology even in mild tinnitus.
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Affiliation(s)
- Daniela Ivansic
- Department of Otorhinolaryngology, Jena University Hospital, Stoystr. 3, 07740 Jena, Germany
| | - Bianca Besteher
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Julia Gantner
- Institute for Medical Statistics, Computer Science and Data Science, Jena University Hospital, Jena, Germany
| | | | - Christo Pantev
- Institute of Biomagnetism and Biosignalanalysis, University of Muenster, Germany
| | - Igor Nenadic
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg & Marburg University Hospital - UKGM, Marburg, Germany; Center for Mind, Brain and Behavior (CMBB), University of Marburg and Justus Liebig University Giessen, Marburg, Germany
| | - Christian Dobel
- Department of Otorhinolaryngology, Jena University Hospital, Stoystr. 3, 07740 Jena, Germany.
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Besteher B, Gaser C, Ivanšić D, Guntinas-Lichius O, Dobel C, Nenadić I. Chronic tinnitus and the limbic system: Reappraising brain structural effects of distress and affective symptoms. NEUROIMAGE-CLINICAL 2019; 24:101976. [PMID: 31494400 PMCID: PMC6734051 DOI: 10.1016/j.nicl.2019.101976] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 07/14/2019] [Accepted: 08/06/2019] [Indexed: 12/18/2022]
Abstract
Chronic tinnitus has been associated with brain structural changes in both the auditory system as well as limbic system. While there is considerable inconsistency across brain structural findings, growing evidence suggests that distress and other non-auditory symptoms modulate effects. In this study we addressed this issue, testing the hypothesis that limbic changes in tinnitus relate to both disease-related distress as well as co-morbid psychopathology. We obtained high-resolution structural magnetic resonance imaging (MRI) scans from a total of 125 subjects: 59 patients with bilateral chronic tinnitus (29 with a co-morbid psychiatric condition, 30 without), 40 healthy controls and 26 psychiatric controls with depression/anxiety disorders (without tinnitus). Voxel-based morphometry with the CAT12 software package was used to analyse data. First, we analysed data based on a 2 × 2 factorial design (tinnitus; psychiatric co-morbidity), showing trend-level effects for tinnitus in ROI analyses of the anterior cingulate cortex and superior/transverse temporal gyri, and for voxel-based analysis in the left parahippocampal cortex. Multiple regression analyses showed that the parahippocampal finding was mostly predicted by tinnitus rather than (dimensional) psychopathology ratings. Comparing only low-distress tinnitus patients (independent of co-morbid conditions) with healthy controls also showed reduced left parahippocampal grey matter. Our findings demonstrate that depression and anxiety (not only subjective distress) are major modulators of brain structural effects in tinnitus, calling for a stronger consideration of psychopathology in future neurobiological and clinical studies of tinnitus.
Chronic tinnitus is associated with high psychiatric co-morbidity and distress. Parahippocamal grey matter is associated with tinnitus rather than distress. Psychiatric co-morbidity modulates tinnitus-related structural patterns.
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Affiliation(s)
- Bianca Besteher
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany.
| | - Christian Gaser
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany; Department of Neurology, Jena University Hospital, Jena, Germany
| | - Daniela Ivanšić
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany
| | | | - Christian Dobel
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany; Department of Psychiatry and Psychotherapy, Philipps-University Marburg/Marburg University Hospital - UKGM, Marburg, Germany
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Wang Z, Zhang A, Zhao B, Gan J, Wang G, Gao F, Liu B, Gong T, Liu W, Edden RA. GABA+ levels in postmenopausal women with mild-to-moderate depression: A preliminary study. Medicine (Baltimore) 2016; 95:e4918. [PMID: 27684829 PMCID: PMC5265922 DOI: 10.1097/md.0000000000004918] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND It is increasingly being recognized that alterations of the GABAergic system are implicated in the pathophysiology of depression. This study aimed to explore in vivo gamma-aminobutyric acid (GABA) levels in the anterior cingulate cortex/medial prefrontal cortex (ACC/mPFC) and posterior-cingulate cortex (PCC) of postmenopausal women with depression using magnetic resonance spectroscopy (H-MRS). METHODS Nineteen postmenopausal women with depression and thirteen healthy controls were enrolled in the study. All subjects underwent H-MRS of the ACC/mPFC and PCC using the "MEGA Point Resolved Spectroscopy Sequence" (MEGA-PRESS) technique. The severity of depression was assessed by 17-item Hamilton Depression Scale (HAMD). Quantification of MRS data was performed using Gannet program. Differences of GABA+ levels from patients and controls were tested using one-way analysis of variance. Spearman correlation coefficients were used to evaluate the linear associations between GABA+ levels and HAMD scores, as well as estrogen levels. RESULTS Significantly lower GABA+ levels were detected in the ACC/mPFC of postmenopausal women with depression compared to healthy controls (P = 0.002). No significant correlations were found between 17-HAMD/14-HAMA and GABA+ levels, either in ACC/mPFC (P = 0.486; r = 0.170/P = 0.814; r = -0.058) or PCC (P = 0.887; r = 0.035/ P = 0.987; r = -0.004) in the patients; there is also no significant correlation between GABA+ levels and estrogen levels in patients group (ACC/mPFC: P = 0.629, r = -0.018; PCC: P = 0.861, r = 0.043). CONCLUSION Significantly lower GABA+ levels were found in the ACC/mPFC of postmenopausal women with depression, suggesting that the dysfunction of the GABAergic system may also be involved in the pathogenesis of depression in postmenopausal women.
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Affiliation(s)
- Zhensong Wang
- Shandong Medical Imaging Research Institute Affiliated to Shandong University
- No. 2 Affiliated Hospital of Shandong Traditional Chinese Medicine University
| | - Aiying Zhang
- Affiliated Eye Hospital of Shandong Traditional Chinese Medicine University
| | - Bin Zhao
- Shandong Medical Imaging Research Institute Affiliated to Shandong University
| | - Jie Gan
- No. 2 Affiliated Hospital of Shandong Traditional Chinese Medicine University
| | - Guangbin Wang
- Shandong Medical Imaging Research Institute Affiliated to Shandong University
- Correspondence: Guangbin Wang, Shandong Medical Imaging Research Institute Affiliated to Shandong University, No. 324, Jing-Wu Road, Jinan, China (e-mail: )
| | - Fei Gao
- Shandong Medical Imaging Research Institute Affiliated to Shandong University
| | - Bo Liu
- Qi Lu Hospital of Shandong University, Jinan, China
| | - Tao Gong
- Shandong Medical Imaging Research Institute Affiliated to Shandong University
| | - Wen Liu
- Shandong Medical Imaging Research Institute Affiliated to Shandong University
| | - Richard A.E. Edden
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine
- FM Kirby Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD
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Han Y, Cheng H, Toledo JB, Wang X, Li B, Han Y, Wang K, Fan Y. Impaired functional default mode network in patients with mild neurological Wilson's disease. Parkinsonism Relat Disord 2016; 30:46-51. [PMID: 27372239 DOI: 10.1016/j.parkreldis.2016.06.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Revised: 06/13/2016] [Accepted: 06/22/2016] [Indexed: 10/21/2022]
Abstract
Wilson's disease (WD) is an autosomal recessive metabolic disorder characterized by cognitive, psychiatric and motor signs and symptoms that are associated with structural and pathological brain abnormalities, in addition to liver changes. However, functional brain connectivity pattern of WD patients remains largely unknown. In the present study, we investigated functional brain connectivity pattern of WD patients using resting state functional magnetic resonance imaging. Particularly, we studied default mode network (DMN) using posterior cingulate cortex (PCC) based seed functional connectivity analysis and graph theoretic functional brain network analysis tools, and investigated the relationship between the DMN's functional connectivity pattern of WD patients and their attention functions examined using the attention network test (ANT). Our results demonstrated that WD patients had altered DMN's functional connectivity and lower local and global network efficiency compared with normal controls (NCs). In addition, the functional connectivity between left inferior temporal cortex and right lateral parietal cortex was correlated with altering function, one of the attention functions, across WD and NC subjects. These findings indicated that the DMN's functional connectivity was altered in WD patients, which might be correlated with their attention dysfunction.
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Affiliation(s)
- Yongsheng Han
- Institute of Neurology, Anhui University of Chinese Medicine, Hefei, Anhui Province, China
| | - Hewei Cheng
- Department of Biomedical Engineering, School of Bioinformatics, Chongqing University of Posts and Telecommunications, Chongqing, 400065, China
| | - Jon B Toledo
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Xun Wang
- Institute of Neurology, Anhui University of Chinese Medicine, Hefei, Anhui Province, China
| | - Bo Li
- Institute of Neurology, Anhui University of Chinese Medicine, Hefei, Anhui Province, China
| | - Yongzhu Han
- Institute of Neurology, Anhui University of Chinese Medicine, Hefei, Anhui Province, China
| | - Kai Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China.
| | - Yong Fan
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.
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14
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Rueckriegel SM, Baron M, Domschke K, Neuderth S, Kunze E, Kessler AF, Nickl R, Westermaier T, Ernestus RI. Trauma- and distress-associated mental illness symptoms in close relatives of patients with severe traumatic brain injury and high-grade subarachnoid hemorrhage. Acta Neurochir (Wien) 2015; 157:1329-36; discussion 1336. [PMID: 26105760 DOI: 10.1007/s00701-015-2470-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 06/03/2015] [Indexed: 01/12/2023]
Abstract
BACKGROUND Close relatives (CR) of patients with severe traumatic brain injury (TBI) and high-grade subarachnoid hemorrhage (SAH) suffer extraordinary distress during the treatment: Distress may lead to persisting mental illness symptoms within the spectrum of post-traumatic stress disorder (PTSD), anxiety disorders, and depression. The primary goal of this study was to determine the prevalence and severity of these symptoms in CR. The secondary goal was identification of associated factors. METHOD Standardized interviews were conducted with 53 CR (mean age of 57.7 ± 11.4 years) of patients with TBI °III (n = 27) and high-grade SAH H&H °III-V (n = 26) between 5 and 15 months after the event. The interviews contained a battery of surveys to quantify symptoms of PTSD, anxiety disorders, and depression, i.e., Impact of Event Scale (IES-R), 36-item Short-Form General Health Survey (SF-36), and Hospital Anxiety and Depression Scale (HADS). Fixed and modifiable possibly influencing factors were correlated. RESULTS Twenty-eight CR (53 %) showed IES-R scores indicating a probable diagnosis of PTSD. Twenty-five CR (47 %) showed an increased anxiety score and 18 (34 %) an increased depression score using HADS. Mean physical component summary of SF-36 was not abnormal (49.1 ± 9.1), whereas mean mental component summary was under average (41.0 ± 13.2), indicating a decreased quality of life caused by mental effects. Perception of the interaction quality with the medical staff and involvement into medical decisions correlated negatively with severity of mental illness symptoms. Evasive coping strategies were highly significantly associated with symptoms. CONCLUSIONS This study quantifies an extraordinarily high prevalence of mental illness symptoms in CR of patients with critical acquired brain injury due to SAH and TBI. Modifiable factors were associated with severity of mental illness symptoms. Prospective studies testing efficiency of early psychotherapeutic interventions are needed.
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Affiliation(s)
- Stefan Mark Rueckriegel
- Department of Neurosurgery, University Hospital Wuerzburg, Josef-Schneider-Strasse 11, 97080, Wuerzburg, Germany,
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15
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Han Y, Zhang F, Tian Y, Hu P, Li B, Wang K. Selective impairment of attentional networks of alerting in Wilson's disease. PLoS One 2014; 9:e100454. [PMID: 24949936 PMCID: PMC4065050 DOI: 10.1371/journal.pone.0100454] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 05/24/2014] [Indexed: 11/19/2022] Open
Abstract
Wilson's disease (WD) is typically affected by attention, which is one of the cognitive domains. The Attention Network Test (ANT) was developed to measure the functioning of the following three individual attentional networks: orienting, alerting, and executive control. The ANT has been used in a variety of neuropsychiatric conditions; however, it has not been used in WD. The aim of this study was to investigate the attentional function of WD patients, and 35 patients with early and moderate neurological WD, as well as 35 gender-, age-, and education-matched healthy controls performed the ANT. Remarkable differences between the patients and healthy controls were observed in the alerting network (p = 0.007) in contrast the differences in the orienting (p = 0.729) and executive control (p = 0.888) networks of visual attention. The mean reaction time in the ANT was significantly longer in the WD patients than in the controls (p<0.001, 0.001). In the WD patients, there was an effect specifically on the alerting domain of the attention network, whereas the orienting and executive control domains were not affected.
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Affiliation(s)
- Yongsheng Han
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, PR China
- Institute of Neurology, Anhui University of Chinese Medicine, Hefei, Anhui Province, PR China
| | - Fangfang Zhang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, PR China
| | - Yanghua Tian
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, PR China
| | - Panpan Hu
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, PR China
| | - Bo Li
- Institute of Neurology, Anhui University of Chinese Medicine, Hefei, Anhui Province, PR China
| | - Kai Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, PR China
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16
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Koszycki D, Bilodeau C, Raab-Mayo K, Bradwejn J. A multifaith spiritually based intervention versus supportive therapy for generalized anxiety disorder: a pilot randomized controlled trial. J Clin Psychol 2013; 70:489-509. [PMID: 24114846 PMCID: PMC4282333 DOI: 10.1002/jclp.22052] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES We have previously reported that a multifaith spiritually based intervention (SBI) may have efficacy in the treatment of generalized anxiety disorder (GAD). This randomized pilot trial tested whether the SBI had greater efficacy than a nonspecific control condition in GAD. METHOD Twenty-three participants with GAD of at least moderate severity were randomized to 12 individual sessions of the SBI (n = 11) or supportive psychotherapy (SP)--our control condition (n = 12). RESULTS Intent-to-treat analysis revealed the SBI fared better than SP in decreasing blind clinician ratings of anxiety and illness severity and self-report worry and intolerance of uncertainty, with large between-group effect sizes. The SBI also produced greater changes in spiritual well-being. Results remained the same when supplementary analyses were performed on the completer sample. Treatment gains were maintained at 3-months follow-up. CONCLUSIONS This small pilot trial demonstrates that a nondenominational SBI has greater efficacy than a rigorous control in improving symptoms of GAD and enhancing spiritual well-being. These results are encouraging and further research on the efficacy of the SBI and its underlying mechanisms is warranted.
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Affiliation(s)
- Diana Koszycki
- Faculty of Education (Counselling), University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine (Psychiatry), University of Ottawa, Ottawa, Ontario, Canada; Institut de Recherche de l'Hôpital Montfort, Ottawa, Ontario, Canada
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17
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Filipović BF, Randjelovic T, Ille T, Markovic O, Milovanović B, Kovacevic N, Filipović BR. Anxiety, personality traits and quality of life in functional dyspepsia-suffering patients. Eur J Intern Med 2013; 24:83-6. [PMID: 22857883 DOI: 10.1016/j.ejim.2012.06.017] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Revised: 06/26/2012] [Accepted: 06/29/2012] [Indexed: 02/06/2023]
Abstract
BACKGROUND Psychosocial stressors either acute or more sustained frequently precede the onset and exacerbation of the symptoms of the functional dyspepsia (FD). Depressive mood and quality of life have been already reported for interference in functional dyspepsia suffering patients. METHODS The examination were performed on 60 FD patients (30 females and 30 males), aged 20-79 years, 60 peptic ulcer subjects and 60 healthy volunteers in which we have investigate levels of anxiety and depression, personality traits and quality of life. RESULT According to the Hamilton Depression and Anxiety Rating Scales, the population with FD had the average score which classified them into the group of patients with the moderate depression (20.57 ± 4.45). Personality traits estimation based on data obtained by the Eysenck personality questionnaire revealed higher neuroticism scores in the group with functional dyspepsia. Both parameters, level of the neuroticism and anxiety level, expressed highly significant level of mutual concordance. Patients with functional dyspepsia reported a greater adverse impact of symptoms of emotional distress and food and drink problems. CONCLUSION Results are indicating that the depression and anxiety level is the highest in patients with functional dyspepsia and that anxiety level corroborates with the neuroticism level from the Eysenck scale. Psychological disturbances are influencing the quality of life mostly in patients with dyspepsia in the form of emotional distress and the problem with the food and beverage intake.
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18
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Effect of estrogen replacement therapy on symptoms of depression and anxiety in non-depressive menopausal women: a randomized double-blind, controlled study. Arch Womens Ment Health 2011; 14:479-86. [PMID: 22016254 DOI: 10.1007/s00737-011-0241-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2011] [Accepted: 10/03/2011] [Indexed: 12/17/2022]
Abstract
The efficacy of estrogen replacement therapy (ERT) for mood disturbances associated with menopause has yet to be firmly established. The objective of this study was to investigate the efficacy of ERT for improving mood and anxiety of non-depressive postmenopausal women. This double-blind, randomized, placebo-controlled study involved two treatment groups: one receiving conjugated equine estrogens (CEEs; 0.625 mg/day) and the other placebo, for six cycles of 28 days each. Subjects were hysterectomized, healthy, non-depressive (according to Schedule for Affective Disorders and Schizophrenia, Life Time Version [SADS-L]) women. Depressive and anxiety symptoms were assessed with the Beck Depression Inventory (BDI), and the Hamilton Anxiety Scale (HAMA), respectively. The Profile of Mood States (POMS) and other scales were used to characterize symptoms. In both groups, BDI scores were significantly lower at cycles 1, 2, 3, and 6, compared with baseline assessments (p<0.01). Anxiety scores for both groups significantly improved from cycle 3 to study endpoint. The only significant difference favoring the active group occurred at cycle 1. POMS scores were significantly improved at the end of cycles 1, 2, 3 and 6 among treated subjects and at the end of cycles 2, 3, and 6 among placebo subjects. ERT is not associated with improvements in mood or anxiety symptoms in non-depressive, hysterectomized, postmenopausal women.
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19
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Mimura C, Nishioka M, Sato N, Hasegawa R, Horikoshi R, Watanabe Y. A Japanese scale to assess anxiety severity: development and psychometric evaluation. Int J Psychiatry Med 2011; 41:29-45. [PMID: 21495520 DOI: 10.2190/pm.41.1.d] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This study developed a Japanese self-rating anxiety scale, the Himorogi Self-rating Anxiety Scale (HSAS), and tested psychometric properties of its use in Japanese psychiatric patients. METHODS The process of developing the scale consisted of an intensive literature review, assessment of existing instruments, and detailed discussion on the content of the newly developed scale. Data for psychometric evaluation were collected from 419 outpatients of psychiatric clinics. The Hamilton Rating Scale for Anxiety Interview Guide (HAMA-IG) and the Sheehan Patient Rated Anxiety Scale (SPRAS) were used as standards against which the HSAS was compared. RESULTS Confirmatory factor analysis revealed a unifactorial nature for the HSAS and fewer insignificant items in the HSAS than the HAMA-IG and the SPRAS. Cronbach's alpha and test-retest coefficients indicated sufficient reliability. High correlation with the HAMA-IG and the SPRAS indicated evidence of convergence for the HSAS. ROC analysis showed high ability to distinguish between the presence and absence or remission of anxiety. Analysis of descriptive data suggested a larger dynamic range for the HSAS than the HAMA-IG and the SPRAS. CONCLUSIONS The HSAS is a brief scale to assess anxiety severity, demonstrating evidence of good psychometric properties. It is recommended for use in research and clinical practice.
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20
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Gjerris A, Rafaelsen OJ, Sørensen AS, Bryld EB, Lykke-Olesen L, Werdelin L, Rehfeld JF. Cholecystokinin and other neuropeptides in the cerebrospinal fluid (CSF) in psychiatric disorders. ACTA ACUST UNITED AC 2009. [DOI: 10.3109/08039488509101956] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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21
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Leentjens AFG, Dujardin K, Marsh L, Martinez-Martin P, Richard IH, Starkstein SE, Weintraub D, Sampaio C, Poewe W, Rascol O, Stebbins GT, Goetz CG. Anxiety rating scales in Parkinson's disease: critique and recommendations. Mov Disord 2009; 23:2015-25. [PMID: 18792121 DOI: 10.1002/mds.22233] [Citation(s) in RCA: 162] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Anxiety syndromes are common in patients with Parkinson's disease (PD) with up to 30% suffering from panic disorder, and up to 11% from generalized anxiety disorder (GAD). Anxiety is associated with increased subjective motor symptoms, more severe gait problems, dyskinesias, freezing, and on/off fluctuations. Anxiety has a negative impact on health related quality of life and is strongly associated with depressive syndromes. Since a variety of anxiety scales have been used in PD patients, the Movement Disorder Society commissioned a task force to assess the clinimetric properties of these scales in PD. A systematic review was conducted to identify anxiety scales that have either been validated or used in patients with PD. Six anxiety rating scales were identified. These were the Beck anxiety inventory, the hospital anxiety and depression scale, the Zung self-rating anxiety scale and anxiety status inventory, the Spielberger state trait anxiety inventory, and the Hamilton anxiety rating scale. In addition, Item 5 (anxiety) of the neuropsychiatric inventory was included in the review. No scales met the criteria to be "recommended," and all scales were classified as "suggested." Essential clinimetric information is missing for all scales. Because several scales exist and have been used in PD, the task force recommends further studies of these instruments. If these studies show that the clinimetric properties of existing scales are inadequate, development of a new scale to assess anxiety in PD should be considered.
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Affiliation(s)
- Albert F G Leentjens
- Department of Psychiatry, Maastricht University Hospital, Maastricht, the Netherlands.
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22
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Bech P. Rating scales for mood disorders: applicability, consistency and construct validity. Acta Psychiatr Scand Suppl 2007; 345:45-55. [PMID: 3067540 DOI: 10.1111/j.1600-0447.1988.tb08567.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Rating scales for mood disorders have been reviewed with special reference to their consistency, applicability, and validity. Diagnostic scales with a biometric reference to antidepressants have been developed on the basis of the Newcastle Scales. This Diagnostic Melancholia Scale (DMS) includes two dimensions, one measuring endogenous depression, and one measuring reactive depression. These dimensions were found not to be mutually exclusive as 30% of the depressed patients scored high on both dimensions. Scales measuring outcomes of treatment were subdivided into (a) scales measuring disability of clinical depression (melancholia), anxiety, and mania, (b) scales measuring distress as a construct of side-effects during treatment, and (c) scales measuring discomfort or quality of life. Disability, distress and discomfort should be separately validated as they reflect different aspects of outcome of treatment. Self-rating scales have their main applicability in the measurement of discomfort.
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Affiliation(s)
- P Bech
- Department of Psychiatry, Frederiksborg General Hospital, Hillerød, Denmark
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23
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Filipović BR, Filipović BF, Kerkez M, Milinić N, Randelović T. Depression and anxiety levels in therapy-naïve patients with inflammatory bowel disease and cancer of the colon. World J Gastroenterol 2007; 13:438-43. [PMID: 17230615 PMCID: PMC4065901 DOI: 10.3748/wjg.v13.i3.438] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To assess whether depression and anxiety are more expressed in patients with the first episode of inflammatory bowel disease (IBD) than in individuals with newly discovered cancer of the colon (CCa).
METHODS: A total of 32 patients with IBD including 13 males and 19 females, aged 27 to 74, and 30 patients with CCa including 20 males and 10 females, aged 39-78, underwent a structured interview, which comprised Hamilton’s Depression Rating Inventory, Hamilton’s Anxiety Rating Inventory and Paykel’s Stressful Events Rating Scale.
RESULTS: Patients of the IBD group expressed both depression and anxiety. Depressive mood, sense of guilt, psychomotor retardation and somatic anxiety were also more pronounced in IBD patients. The discriminant function analysis revealed the total depressive score was of high importance for the classification of a newly diagnosed patient into one of the groups.
CONCLUSION: Newly diagnosed patients with IBD have higher levels of depression and anxiety. Moreover, a psychiatrist in the treatment team is advisable from the beginning.
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Bech P, Lunde M, Bech-Andersen G, Lindberg L, Martiny K. Psychiatric outcome studies (POS): does treatment help the patients? A Popperian approach to research in clinical psychiatry. Nord J Psychiatry 2007; 61 Suppl 46:4-34. [PMID: 17365777 DOI: 10.1080/08039480601151238] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- P Bech
- Psychiatric Research Unit, Frederiksborg General Hospital, 48, Dyrehavevej, DK-3400 Hillerød, Denmark.
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25
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Rozzini L, Ghianda D, Vicini Chilovi B, Padovani A, Trabucchi M. Peripheral oedema related to quetiapine therapy : a case report. Drugs Aging 2005; 22:183-4. [PMID: 15733023 DOI: 10.2165/00002512-200522020-00007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Luca Rozzini
- Geriatric Research Group, Brescia, ItalyDepartment of Neurology, University of Brescia, Brescia, Italy.
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Chou KR, Chen R, Lee JF, Ku CH, Lu RB. The effectiveness of nicotine-patch therapy for smoking cessation in patients with schizophrenia. Int J Nurs Stud 2004; 41:321-30. [PMID: 14967189 DOI: 10.1016/j.ijnurstu.2003.07.001] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2003] [Revised: 06/30/2003] [Accepted: 07/14/2003] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to determine the effectiveness of nicotine-patch therapy for smoking cessation in patients with schizophrenia. This was a longitudinal study and sixty-eight schizophrenic patients were assigned to 8 weeks of a nicotine-patch therapy program or a control group. The generalized estimating equation analysis revealed that there were significant reductions in the subjects' nicotine dependence (Fagerstrom Tolerance Questionnaire), the number of cigarettes per day, and CO levels over an 8-week period of nicotine-patch therapy and 3-month follow-up. The point-prevalence rates of abstinence from smoking were an abstinence of 26.9% at 8 weeks and 26.9% at a 3-month follow-up. At the 3-month follow-up, the rate of continuous smoking abstinence in the nicotine-patch group was 23.1%.
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Affiliation(s)
- Kuei-Ru Chou
- National Defense Medical Center, School of Nursing, Nei-Hu, Taipei 114, Taiwan, ROC.
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27
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Paile-Hyvärinen M, Wahlbeck K, Eriksson JG. Quality of life and metabolic status in mildly depressed women with type 2 diabetes treated with paroxetine: a single-blind randomised placebo controlled trial. BMC FAMILY PRACTICE 2003; 4:7. [PMID: 12747810 PMCID: PMC165418 DOI: 10.1186/1471-2296-4-7] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2003] [Accepted: 05/14/2003] [Indexed: 11/23/2022]
Abstract
BACKGROUND Depression is prevalent in people with type 2 diabetes and affects both glycemic control and overall quality of life. The aim of this trial was to evaluate the effect of the antidepressant paroxetine on metabolic control, quality of life and mental well-being in mildly depressed women with type 2 diabetes. METHODS We randomised 15 mildly depressed women with non-optimally controlled type 2 diabetes to a 10-week single-blind treatment with either paroxetine 20 mg per day or placebo. Primary efficacy measurements were glycemic control and quality of life. Glycosylated hemoglobin A1c (GHbA1c) was used as a measure of glycemic control. Quality of life was evaluated using RAND-36. Mental state was assessed using two clinician-rated scoring instruments, Hamilton's Anxiety Scale (HAM-A) and Montgomery-Asberg's Depression Rating Scale (MADRS), and a patient-rated scoring instrument, Beck's Depression Inventory (BDI). RESULTS At the end of the study no significant difference between groups in improvement of quality of life was found. A trend towards a superior improvement in glycemic control was found in the paroxetine group (p = 0.08). A superior increase in sex-hormone-binding-globuline (SHBG) levels was evidenced in the paroxetine group (p = 0.01) as a sign of improved insulin sensitivity. There was also a trend for superior efficacy of paroxetine in investigator-rated anxiety and depression. This notion was supported by a trend for superior decrease of serum cortisol levels in the paroxetine group (p = 0.06). CONCLUSION Paroxetine has a beneficial effect on measures of insulin sensitivity and may improve glycemic control. Larger studies of longer duration are needed to verify the benefits of paroxetine in type 2 diabetes. While waiting for more conclusive evidence it seems sensible to augment standard care of type 2 diabetes with paroxetine even in patients who do not fulfil routine psychiatric criteria for initiation of antidepressant drug treatment.
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Affiliation(s)
- Maria Paile-Hyvärinen
- Department of Psychiatry, University of Helsinki, Lapinlahti Hospital, P.O.Box 320, FIN-00029 HUCH, Helsinki, Finland
- National Public Health Institute, Mannerheimintie 166, FIN-00300 Helsinki, Finland
| | - Kristian Wahlbeck
- National Research and Development Centre for Welfare and Health (STAKES), P.O.Box 220, FIN-00531 Helsinki, Finland
- Vaasa Central Hospital, Vaasa, Finland
| | - Johan G Eriksson
- National Public Health Institute, Mannerheimintie 166, FIN-00300 Helsinki, Finland
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Neu P, Kiesslinger U, Schlattmann P, Reischies FM. Time-related cognitive deficiency in four different types of depression. Psychiatry Res 2001; 103:237-47. [PMID: 11549411 DOI: 10.1016/s0165-1781(01)00286-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Mild cognitive impairment often occurs in depressive illness. But it is unknown whether the occurrence or severity of cognitive deficits has diagnostic specificity. It is of interest to investigate whether there are time-related differences in cognitive functions characteristic of different kinds of depressive diagnoses, and therefore whether such differences might help to distinguish between types of depressive disorder. Eighty inpatients with a DSM-IV depressive episode (unipolar, bipolar, dysthymic and schizoaffective disorder, depressive type) were assessed with a series of neuropsychological tests at the beginning and at the end of their hospital stays. A group of 62 matched healthy controls were assessed with the same series of tests at comparable intervals. The diagnostic sub-groups could not be distinguished by cognitive parameters in the time-course. At the time of admission the inpatient group had a worse performance than the control group. After a significant decrease of their mean depression score, the patients still continued to show an outcome worse than the controls. We conclude that the variation of cognitive dysfunction with time in depression seems to be a phenomenon which does not depend on the kind of depressive sub-diagnosis. The results indicate that cognitive deficits might persist longer than the period of illness, but this seems to be true for all depressive sub-diagnoses.
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Affiliation(s)
- P Neu
- Department of Psychiatry, Freie Universität Berlin, Eschenallee 3, 14050, Berlin, Germany.
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29
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Abstract
This study investigated symptoms of anxiety in two samples of clinic outpatients diagnosed with Alzheimer's disease (AD). Clinician and caregiver reports were obtained using standardized measures to characterize a broad array of anxiety symptoms. Anxiety symptoms were reported for a substantial proportion of subjects, regardless of whether clinician or caregiver ratings were used. Anxious or worried appearance was most common (68% to 71%), followed by fearfulness, tension, restlessness, and fidgeting (37% to 57%). Sleep disturbance and various somatic symptoms were less common (8% to 34%). Although anxiety symptoms were prevalent, only 5% to 6% of subjects met Diagnostic and Statistical Manual of Mental Disorders criteria for the diagnosis of generalized anxiety disorder. In both samples, anxiety symptoms were associated with depression, behavioral disturbances, and increased cognitive impairment. Study findings support a high occurrence of anxiety in patients with dementia, and treatments for anxiety might therefore be helpful in reducing the psychiatric burden of AD.
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Affiliation(s)
- L Ferretti
- Children's Hospital of Buffalo, Washington, USA
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30
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Serretti A, Jori MC, Casadei G, Ravizza L, Smeraldi E, Akiskal H. Delineating psychopathologic clusters within dysthymia: a study of 512 out-patients without major depression. J Affect Disord 1999; 56:17-25. [PMID: 10626776 DOI: 10.1016/s0165-0327(99)00056-7] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND The literature indicates that emotional-cognitive symptoms are much more characteristic of dysthymia than the vegetative and psychomotor symptoms of major depression, yet this is insufficiently emphasized in the official criteria listed in the criteria of the American Psychiatric Association. Furthermore, as previous studies have examined these symptoms more in relation to prevalence than to possible symptom aggregation, in the present analyses we address both aspects. METHODS In two multicenter collaborative trials, 512 out-patients meeting the symptom criteria of DSM-III-R dysthymia but without major depression were recruited. In this respect they conformed to the conceptual framework of ICD-10 which tends to restrict dysthymia to a subthreshold depression without excursion into severe depressive episodes. The Montgomery Asberg Depression Rating Scale (MADRS) and the Hamilton Anxiety Rating Scale (HAM-A) were used to assess depressive and anxiety symptoms. RESULTS Symptoms most frequently observed, besides depressed mood (100% by definition), were 'low energy or fatigue' (96%) and 'poor concentration or indecisiveness' (88%), followed by 'low self-esteem' (80%), 'insomnia or hypersomnia' (77%), 'poor appetite or overeating' (69%) and 'feeling of hopelessness' (42%). Interestingly, in the subjects with fewer than five symptoms, the most frequent were low energy or fatigue (93%), poor concentration or indecisiveness (79%) and low self-esteem (77%), the other symptoms being present in no more than half the sample. MADRS factor analysis identified two main factors: the first consisting of apparent and reported sadness, and the second concentration difficulties and lassitude. HAM-A factor analysis identified two factors clearly differentiating somatic and psychic symptoms. LIMITATIONS Because suicidal patients were excluded on the ground of human subject concerns, our sample is representative of the milder range of symptomatology within the spectrum of dysthymia. This may in part explain the low prevalence of neurovegetative symptoms. CONCLUSION Despite this, the present study involves the largest sample of pure dysthymia ever studied. Our results indicate that dysthymic disorder appears to primarily involve psychologic symptoms. The psychological symptoms themselves seem to cluster into sadness versus mental fatigue; as for anxiety symptoms, they appear divisible into somatic and psychic clusters, with the latter prevailing in dysthymia. Dysthymia proper, dominated by negative affectivity, might be distinguishable from a 'neurasthenic' subform dominated by low energy or 'deficit' symptoms at mental and physical levels.
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Affiliation(s)
- A Serretti
- Istituto Scientifico Ospedale San Raffaele, Department of Neurospychiatric Sciences, University of Milan School of Medicine, Italy.
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31
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Abstract
BACKGROUND The findings published to date on convergent validity of the BRMS are mainly concerned with the correlation with other observer-rating scales for depression. In many studies on the evaluation of therapeutic interventions self-rating scales are used in connection with observer-rating scales. Therefore, findings on the relations among instruments of both groups are necessary in order to justify the combination of a particular observer-rating scale with a particular self-rating scale. In the ICD-10 three different degrees of severity of depressive episodes are distinguished. No data on the discriminant validity of the BRMS with respect to this new diagnostic classification are available till now. METHODS 45 depressed inpatients were assessed with two observer-rating scales (BRMS and DEPRES of the AMDP system) and two self-rating scales (BDI and DS). RESULTS The discriminant validity with reference to the three degrees of severity of depressive episodes as defined in ICD-10 is at r = 0.80 very high. The convergent validity of the BRMS is high at r = 0.70, related to the DEPRES. The correlations between the BRMS and the BDI as well as the DS were clearly lower, at 0.53 and 0.32 each. CONCLUSIONS The only moderate convergent validity between self-rating and observer-rating scales is a strong argument for a multi-methodological approach in the context of therapy evaluation.
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Affiliation(s)
- M Smolka
- Department of Psychiatry, Free University of Berlin, Germany.
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32
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Clark DB, Donovan JE. Reliability and validity of the Hamilton Anxiety Rating Scale in an adolescent sample. J Am Acad Child Adolesc Psychiatry 1994; 33:354-60. [PMID: 8169180 DOI: 10.1097/00004583-199403000-00009] [Citation(s) in RCA: 97] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Although generalized anxiety is an important clinical problem among adolescents, there are no interview procedures to provide a global anxiety rating that have demonstrated reliability and validity for this population. The Hamilton Anxiety Rating Scale (HARS) is a general measure of anxiety that was developed for adults. The purpose of this study was to determine the reliability and validity of the HARS when used with adolescents. METHOD The sample consisted of 257 adolescents aged 12 to 18 years from both clinical and community sources. The HARS interviews and ratings were conducted as part of an extensive psychiatric and medical assessment. Psychiatric diagnoses were determined by structured interview. Other questionnaire measures of anxiety were also obtained. RESULTS The interrater reliability and internal consistency of the HARS were acceptable in this adolescent sample and were comparable to results reported for adults. The HARS exhibited good construct validity, showing statistically significant relationships with independent self-report measures of generalized anxiety and other anxiety variables. The factor structure of the HARS also was found to be similar to that found earlier with adults. CONCLUSIONS These results demonstrate that the HARS is a reliable and valid measure for the assessment of global anxiety in the adolescent population.
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Affiliation(s)
- D B Clark
- Pittsburgh Adolescent Alcohol Research Center, Department of Psychiatry, University of Pittsburgh School of Medicine, PA 15213
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33
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Larsen JK, Gjerris A, Holm P, Anderson J, Bille A, Christensen EM, Høyer E, Jensen H, Mejlhede A, Langagergaard A. Moclobemide in depression: a randomized, multicentre trial against isocarboxazide and clomipramine emphasizing atypical depression. Acta Psychiatr Scand 1991; 84:564-70. [PMID: 1792931 DOI: 10.1111/j.1600-0447.1991.tb03196.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Moclobemide was compared with isocarboxazide and clomipramine in patients with depression. A total of 167 outpatients were allocated to daily treatment with 300 mg moclobemide, 30 mg isocarboxazide or 150 mg clomipramine for 6 weeks. Moclobemide was slightly inferior to clomipramine, whereas isocarboxazide had an intermediate position. There was no interaction between treatment and atypical or nonatypical depression. Anticholinergic symptoms and orthostatic hypotension were most pronounced in the clomipramine group.
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Affiliation(s)
- J K Larsen
- Department of Psychiatry, Frederiksberg Hospital, Denmark
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34
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Bech P. Psychometric developments of the Hamilton scales: the spectrum of depression, dysthymia, and anxiety. PSYCHOPHARMACOLOGY SERIES 1990; 9:72-9. [PMID: 2204923 DOI: 10.1007/978-3-642-75373-2_9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- P Bech
- Frederiksborg General Hospital, Department of Psychiatry, Hillerød, Denmark
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35
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Maier W, Bech P. Measuring the efficacy of psychotropic drugs: clinical symptoms and rating scales. PSYCHOPHARMACOLOGY SERIES 1990; 8:105-20. [PMID: 2198558 DOI: 10.1007/978-3-642-75370-1_8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- W Maier
- Psychiatrische Klinik der Universítät Mainz, FRG
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36
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Plenge P, Mellerup ET, Gjerris A. Imipramine binding in depressive patients diagnosed according to different criteria. Acta Psychiatr Scand 1988; 78:156-61. [PMID: 2851919 DOI: 10.1111/j.1600-0447.1988.tb06315.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
3H-imipramine binding to platelet membranes, Bmax and KD, was measured in depressed patients, who were divided into endogenous and non-endogenous depression according to three different criteria, the ICD-9, the Newcastle I and the Newcastle II rating scales. Two groups served as controls, a group of healthy volunteers and a group of psychiatric patients suffering from schizophrenia or senile dementia. No significant differences were found in either Bmax or in KD among the different groups of patients and the control groups.
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Affiliation(s)
- P Plenge
- Psychochemistry Institute, Rigshospitalet, Copenhagen, Denmark
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37
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Maier W, Buller R, Philipp M, Heuser I. The Hamilton Anxiety Scale: reliability, validity and sensitivity to change in anxiety and depressive disorders. J Affect Disord 1988; 14:61-8. [PMID: 2963053 DOI: 10.1016/0165-0327(88)90072-9] [Citation(s) in RCA: 613] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The Hamilton Anxiety Scale (HAM-A) was tested for reliability and validity in two different samples, one sample (n = 97) defined by anxiety disorders, the other sample (n = 101) defined by depressive disorders. The reliability and the concurrent validity of the HAM-A and its subscales proved to be sufficient. Internal validity tested by latent structure analysis was insufficient. The major problems with the HAM-A are that (1) anxiolytic and antidepressant effects cannot be clearly distinguished; (2) the subscale of somatic anxiety is strongly related to somatic side effects. The applicability of the HAM-A in anxiolytic treatment studies is therefore limited. More specific anxiety scales are needed.
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Affiliation(s)
- W Maier
- Department of Psychiatry, University of Mainz, F.R.G
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38
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Gjerris A, Werdelin L, Gjerris F, Sørensen PS, Rafaelsen OJ, Alling C. CSF-amine metabolites in depression, dementia and in controls. Acta Psychiatr Scand 1987; 75:619-28. [PMID: 2441573 DOI: 10.1111/j.1600-0447.1987.tb02846.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Lumbar CSF concentration of 5-HIAA, MHPG, and HVA were measured in patients with depression, dementia due to normal pressure hydrocephalus (NPH) and in controls. Moreover, ventricular concentrations of the metabolites were measured in patients with NPH. It was aimed to match patients and controls for age, sex, and body height. Non-parametric statistics were used throughout the study. No differences in lumbar concentrations of CSF 5-HIAA, MHPG and HVA were found between the different diagnostic groups. A ventriculo-lumbar gradient of 5-HIAA and HVA being 4:1 and 5:1, respectively, was found in patients with NPH. No correlation between the difference in ventricular and lumbar concentrations and body height was found, suggesting that body height may be an inaccurate measure for the rostro-caudal gradient. Moreover, no correlation between ventricular and lumbar levels of 5-HIAA and HVA was seen.
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39
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Gjerris A, Sørensen AS, Rafaelsen OJ, Werdelin L, Alling C, Linnoila M. 5-HT and 5-HIAA in cerebrospinal fluid in depression. J Affect Disord 1987; 12:13-22. [PMID: 2437171 DOI: 10.1016/0165-0327(87)90056-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
CSF 5-HT and 5-HIAA were measured in endogenously depressed patients (ICD-9) (n = 23) and controls (n = 11). Distribution of sex, age and body height was similar in the two groups. Non-parametric statistics were used. In depressed patients CSF 5-HT concentrations were found to be higher (P less than or equal to 0.01) than in controls. A further classification of the depressed patients by the Newcastle Scale showed that the highest values were found in the endogenous group compared to the non-endogenous group (P less than or equal to 0.02). CSF 5-HIAA was found to be equal in the two groups, even when pairs matched for height were compared. No relation between clinical recovery due to drug treatment and changes in CSF 5-HT was seen. Our data support a possible involvement of 5-HT in the biology of depression, but the anatomical and functional levels of a serotonin derangement are still unknown.
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40
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Davidson J, Turnbull CD, Strickland R, Miller R, Graves K. The Montgomery-Asberg Depression Scale: reliability and validity. Acta Psychiatr Scand 1986; 73:544-8. [PMID: 3751660 DOI: 10.1111/j.1600-0447.1986.tb02723.x] [Citation(s) in RCA: 198] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The Montgomery-Asberg Depression Scale was evaluated in 44 depressed inpatients. All items of the scale occurred frequently in the sample; the scale exhibited construct validity (internal homogeneity) and concurrent validity relative to the Hamilton Depression Scale and the concepts of endogenous and nonendogenous depression. Sleep disturbance, reduced appetite, and suicidal thoughts, correlated poorly with the remainder of the scale. Reasons for this finding are discussed. Inter-rater reliability was demonstrated between a psychiatrist and a nurse on individual item and total scale scores.
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41
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Rafaelsen OJ, Gjerris A. Neuropeptides in the cerebrospinal fluid (CSF) in psychiatric disorders. Prog Neuropsychopharmacol Biol Psychiatry 1985; 9:533-8. [PMID: 3937176 DOI: 10.1016/0278-5846(85)90013-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Concentrations of vasoactive intestinal polypeptide (VIP), cholecystokinin (CCK) and gastrin in the cerebrospinal fluid (CSF) was studied in patients with endogenous depression, non-endogenous depression, mania, schizophrenia and a control group. All patients were classified according to various diagnostic systems. In the group of non-endogenously depressed patients CSF-VIP levels (median 16 pmol/l) were found significantly lowered compared to controls (median = 32 pmol/l) and endogenous depression (26 pmol/l). Going through the non-endogenous group it appeared that the low CSF-VIP was due to a group of patients with a former diagnosis of endogenous depression or a present diagnosis of possible endogenous depression. Moreover, this group was clinically characterized by 'dysphoric/hysterical features', 'reversed diurnal variation' (i.e. worst in the evening), and 'lack of clearly circumscribed episode'. In many aspects this group seems similar to the atypical depressions described as monoamineoxidase responders. Concerning CSF-CCK and CSF-gastrin no significant differences between the examined groups were demonstrated.
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42
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Gjerris A, Rafaelsen OJ, Vendsborg P, Fahrenkrug J, Rehfeld JF. Vasoactive intestinal polypeptide decreased in cerebrospinal fluid (CSF) in atypical depression. Vasoactive intestinal polypeptide, cholecystokinin and gastrin in CSF in psychiatric disorders. J Affect Disord 1984; 7:325-37. [PMID: 6241214 DOI: 10.1016/0165-0327(84)90054-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Vasoactive intestinal polypeptide (VIP), cholecystokinin (CCK) and gastrin in the cerebrospinal fluid (CSF) were studied in patients with endogenous depression, non-endogenous depression, mania, schizophrenia and a control group. All patients were classified according to ICD-9 and the group of depressions was further classified according to the Newcastle Rating Scales for depression (Carney et al. 1965) (N-I). In the group of non-endogenously depressed patients, CSF-VIP levels (median 16 pmol/l) were found to be significantly lower than those of controls (median = 32 pmol/l) and endogenous depressives (36 pmol/l). In the non-endogenous group, it appeared that the low CSF-VIP was due to a group of patients who, during a past or present depressive episode, had been diagnosed as suffering from endogenous depression. Moreover, this group was clinically characterized by 'dysphoric/hysterical features', 'reversed diurnal variation' (i.e. worse in the evening), and 'lack of clearly circumscribed episodes'. In many aspects this group seems similar to the atypical depressives described as monoamine oxidase inhibitor responders. Concerning CSF-CCK and CSF-gastrin, no significant differences between the examined groups were demonstrated.
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43
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Bech P, Gjerris A, Andersen J, Bøjholm S, Kramp P, Bolwig TG, Kastrup M, Clemmesen L, Rafaelsen OJ. The Melancholia Scale and the Newcastle Scales. Item-combinations and inter-observer reliability. Br J Psychiatry 1983; 143:58-63. [PMID: 6882994 DOI: 10.1192/bjp.143.1.58] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The reliability of the total scores on three rating scales (Melancholia Scale and the two Newcastle Scales) and the algorithms leading to the Feighner, Research Diagnostic Criteria, and the DSM-III subtypes of depression have been compared. The degree of inter-observer agreements for the various item-combinations was significantly higher than would be expected by chance. The average agreement for each assessment system ranged from 80 to 93 per cent. This 7 to 20 per cent lack of total agreement probably reflects the limitation of clinical assessments including the influence of halo effects.
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