|
1
|
Liang P, Chen JJ, Yang X, Long R, Li Y, Wang ZL, Yang PL, Liang YD. Association and functional study of ATP6V1D and GPHN gene polymorphisms with depression in Chinese population. World J Psychiatry 2025; 15:102182. [DOI: 10.5498/wjp.v15.i4.102182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2024] [Revised: 01/20/2025] [Accepted: 02/18/2025] [Indexed: 03/25/2025] Open
Abstract
BACKGROUND Depression is a disease with a significant global social burden. Single nucleotide polymorphisms (SNPs) are correlated with the development of depression. This study investigates the relationship between polymorphisms in the GPHN and ATP6V1D gene promoter regions and susceptibility to depression in the Chinese population.
AIM To provide new insights into identifying SNPs for predicting depression in the Chinese population.
METHODS We conducted a case-control study involving 555 individuals with depression and 509 healthy controls. GPHN rs8020095 and ATP6V1D rs3759755, rs10144417, rs2031564, and rs8016024 in the promoter region were genotyped using next-generation sequencing. Dual luciferase reporter genes were employed to assess the transcriptional activity of promoter regions for each SNP genotype, with transcription factors binding to each site predicted using the JASPAR database.
RESULTS Compared to healthy controls, the ATP6V1D promoter rs10144417 AG genotype (P = 0.015), rs3759755 AC/CC genotype (P = 0.036), and GPHN gene rs8020095 GA and AA genotypes (GA: P = 0.028, GG: P = 0.025) were significantly associated with a lower prevalence of depression. Linked disequilibria were present in five SNPs, with the AGATA haplotype frequency in patients significantly lower than in healthy subjects (P = 0.023). Luciferase activity of the rs3759755-A recombinant plasmid was significantly higher than that of the rs3759755-C recombinant plasmid (P = 0.026), and the rs8020095-A recombinant plasmid activity was significantly higher than that of the rs8020095-G recombinant plasmid (P = 0.001). Transcription factors orthodenticle homeobox 2, orthodenticle homeobox 1, forkhead box L1, NK homeobox 3-1, and nuclear factor, interleukin 3 regulated demonstrated binding affinity with rs3759755A > C and rs8020095A > G.
CONCLUSION This study demonstrates that SNPs (rs3759755 and rs10144417) in the promoter region of the ATP6V1D and SNP (rs8020095) of GPHN are indeed associated with susceptibility to depression.
Collapse
Affiliation(s)
- Peng Liang
- Department of Basic Medicine, Chengdu Medical College, Chengdu 610500, Sichuan Province, China
| | - Jing-Jie Chen
- Department of Basic Medicine, Chengdu Medical College, Chengdu 610500, Sichuan Province, China
| | - Xue Yang
- Department of Geriatric Psychiatry, The First Psychiatric Hospital of Harbin, Harbin 150001, Heilongjiang Province, China
| | - Rui Long
- Department of Basic Medicine, Chengdu Medical College, Chengdu 610500, Sichuan Province, China
| | - Yue Li
- Department of Basic Medicine, Chengdu Medical College, Chengdu 610500, Sichuan Province, China
| | - Zi-Ling Wang
- Department of Basic Medicine, Chengdu Medical College, Chengdu 610500, Sichuan Province, China
| | - Ping-Liang Yang
- Department of Anesthesiology, The First Affiliated Hospital of Chengdu Medical College, Chengdu 610500, Sichuan Province, China
| | - Yun-Dan Liang
- Department of Basic Medicine, Chengdu Medical College, Chengdu 610500, Sichuan Province, China
| |
Collapse
|
|
2
|
Arnaud A, Benner J, Suthoff E, Werneburg B, Reinhart M, Sussman M, Kessler RC. The impact of early remission on disease trajectory and patient outcomes in major depression disorder (MDD): A targeted literature review and microsimulation modeling approach based on the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. J Affect Disord 2023; 325:264-272. [PMID: 36608852 DOI: 10.1016/j.jad.2022.12.147] [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: 12/21/2021] [Revised: 11/30/2022] [Accepted: 12/23/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND While literature has suggested that the duration of a major depressive episode (MDE) may affect both symptomatic and functional outcomes in major depressive disorder (MDD), study designs are limited in their ability to isolate a causal relationship. METHODS A targeted literature review was conducted using the MEDLINE database to assess whether there was an association between (1) shorter duration of an MDE, or (2) increased rapidity of symptom improvement, and MDD outcomes in adult patients. Given findings from the literature, we hypothesized that rapid symptom improvement could be associated with other longer-term clinical outcomes and used a previously-developed microsimulation model to test this hypothesis. The base case of the model replicated step-therapy treatment patterns, for 10,000 simulated patients, based on lines of therapy related to standard of care, observed remission rates, and observed time to relapse from the STAR*D study. In alternative scenario analyses, the step 1 remission rate was varied by +25 % and +50 % from the base case value to simulate the potential impact of improved earlier remission on disease trajectory and patient-level clinical outcomes. RESULTS The literature review (N = 35 studies) suggests a statistically significant relationship between the duration of MDE or early symptom improvement and MDD outcomes. The microsimulation model corroborated these findings and demonstrated that increasing the rate of remission in step 1 results in patients experiencing decreased number of treatment steps, faster time to remission, decreased rate of reaching treatment-resistant depression, and delayed time to relapse. LIMITATIONS Rates of relapse in STAR*D were deemed unreliable due to the high-loss of follow-up; rates of relapse for the MDD DTM were instead derived using parametric extrapolation methods (i.e., exponential, Weibull, log-logistic, Gaussian, log-normal, logistic). Adherence to treatment was assumed to be 100 %; however, non-adherence is expected to result in lower cumulative remission rates. CONCLUSION Findings from the literature, coupled with quantification through a novel microsimulation model, demonstrate the potential impact of increased remission on disease trajectory and patient outcomes in MDD. While additional analyses with the model may be warranted to explore the impact of novel interventions on population health, including long-term outcomes (i.e., 5-year follow-up, lifetime follow-up), efforts by clinicians to increase remission early in the disease trajectory may improve long-term outcomes.
Collapse
|
|
3
|
Kubo K, Sakurai H, Tani H, Watanabe K, Mimura M, Uchida H. Predicting relapse from the time to remission during the acute treatment of depression: A re-analysis of the STAR*D data. J Affect Disord 2023; 320:710-715. [PMID: 36208688 DOI: 10.1016/j.jad.2022.09.162] [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: 04/30/2022] [Revised: 09/26/2022] [Accepted: 09/30/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Predicting relapse during maintenance treatment for depression is challenging. The objective of this analysis was to investigate the association between the time taken to achieve remission in the acute phase, and the subsequent relapse rate or time to relapse using the Sequenced Treatment Alternatives to Relieve Depression dataset. METHOD Data of 1296 outpatients with nonpsychotic depression who entered a 12-month naturalistic follow-up period after achieving remission with citalopram for up to 14 weeks were analyzed. One-way analysis of variance and the Jonckheere-Terpstra trend test were performed to compare the relapse rates and days to relapse during the follow-up period among those who achieved remission at weeks 2, 4, 6, 9, 12, and 14. Remission and relapse were defined as scores of ≤5 and ≥11, respectively, on the 16-Item Quick Inventory of Depressive Symptomatology and Self-Report. RESULTS The relapse rates were significantly different among those who achieved remission each week (F(5, 1087) = 4.995, p < 0.001). The lowest and highest relapse rates were observed in those who achieved remission at weeks 4 (25.7 %) and 12 (42.4 %), respectively, with a significant difference (p = 0.006). There was also a significant negative trend between the weeks taken to achieve remission and the days to relapse (z = -6.13, p < 0.001). CONCLUSIONS Patients with depression who show a faster response to antidepressant treatment are more likely to maintain remission in the long term. This finding suggests that, to prevent relapse, close attention should be paid to patients who require a relatively long time to achieve remission.
Collapse
Affiliation(s)
- Kaoruhiko Kubo
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Hitoshi Sakurai
- Department of Neuropsychiatry, Kyorin University Faculty of Medicine, Tokyo, Japan.
| | - Hideaki Tani
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Koichiro Watanabe
- Department of Neuropsychiatry, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Hiroyuki Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.
| |
Collapse
|
|
4
|
Zhu XQ, Mayes TL, Qi N, Feng L, Feng Y, Wu WY, Hu YD, Xiao L, Wang G. The effect of the time to remission on residual symptoms and functioning among depressive patients. J Affect Disord 2023; 320:667-673. [PMID: 36209781 DOI: 10.1016/j.jad.2022.10.006] [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: 05/05/2022] [Revised: 09/27/2022] [Accepted: 10/02/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVES To explore the effect of time to remission on residual symptoms, functioning and quality of life (QOL) of the patients with major depressive disorder (MDD). METHOD A total of 434 patients were enrolled from 16 sites of China. The Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR) and self-rating scales were assessed at baseline, and months 1, 3 and 6. Baseline remitters were defined as those subjects with a QIDS-SR score ≤ 5 at baseline. Later remitters was defined as those reaching remission one month (Month 1 remitters) or three month (Month 3 remitters) after baseline. Persistent non-remitters were defined as those with QIDS-SR score > 5 at all 3 assessments. A follow-up assessment was done at month 6 to examine outcomes. Cross-lagged models indicated QIDS-SR predicted social functioning and QOL. RESULTS Totally, 179 patients at baseline achieved remission. An additional 141 participants remitted at month 1 (n = 94) or month 3 (n = 47), and 63 patients were persistent non-remitters. There were significant differences between all groups on depression severity at baseline. QOL was similar for both late remitter groups, which was better than non-remitters, but lower than early-remitters. Late remitters and non-remitters showed significant differences on change of functioning and QOL (P < 0.001) at each visit. By 6 months, all remitting groups showed lower depression severity and better social functioning and QOL than persistent non-remitters. Cross-lagged models indicated QIDS-SR predicted social functioning and QOL. CONCLUSION We confirmed the association of earlier remission with a better quality of remission at early stage; but the time to remission does not affect future functioning and QOL.
Collapse
Affiliation(s)
- Xue-Quan Zhu
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Taryn L Mayes
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Na Qi
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Lei Feng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yuan Feng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Wen-Yuan Wu
- Department of Psychiatry, Tongji Hospital of Tongji University, Shanghai, China
| | - Yong-Dong Hu
- Department of Clinical Psychology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Le Xiao
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| | - Gang Wang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| |
Collapse
|
|
5
|
Wiersema C, Oude Voshaar RC, van den Brink RHS, Wouters H, Verhaak P, Comijs HC, Jeuring HW. Determinants and consequences of polypharmacy in patients with a depressive disorder in later life. Acta Psychiatr Scand 2022; 146:85-97. [PMID: 35435249 PMCID: PMC9321061 DOI: 10.1111/acps.13435] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 03/27/2022] [Accepted: 04/03/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Polypharmacy and late-life depression often congregate in the geriatric population. The primary objective is to identify determinants of polypharmacy in patients with depression, and second to examine polypharmacy in relation to various clinical phenotypes of depression and its course. METHODS A longitudinal observational study using data of the Netherlands Study of Depression in Older persons (NESDO) including 375 patients with depression ≥ 60 years and 132 non-depressed comparisons. Linear and logistic regression were used to analyze both polypharmacy (dichotomous: ≥5 medications) and number of prescribed drugs (continuous) in relation to depression, various clinical phenotypes, and depression course. RESULTS Polypharmacy was more prevalent among patients with depression (46.9%) versus non-depressed comparisons (19.7%). A lower level of education, lower cognitive functioning, and more chronic diseases were independently associated with polypharmacy. Adjusted for these determinants, polypharmacy was associated with a higher level of motivational problems, anxiety, pain, and an earlier age of onset. A higher number of drugs was associated with a worse course of late-life depression (OR = 1.24 [95% CI: 1.03-1.49], p = 0.022). CONCLUSION Older patients with depression have a huge risk of polypharmacy, in particular among those with an early onset depression. As an independent risk factor for chronic depression, polypharmacy needs to be identified and managed appropriately. Findings suggest that depression moderates polypharmacy through shared risk factors, including motivational problems, anxiety, and pain. The complex interaction with somatic health burden requires physicians to prescribe medications with care.
Collapse
Affiliation(s)
- Carlijn Wiersema
- Department: University Center of Psychiatry, University of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | - Richard C. Oude Voshaar
- Department: University Center of Psychiatry, University of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | - Rob H. S. van den Brink
- Department: University Center of Psychiatry, University of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | - Hans Wouters
- Department of General PracticeUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | - Peter Verhaak
- Department of General PracticeUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands,Research Department, NIVEL, Netherlands Institute for Health Services ResearchUtrechtThe Netherlands
| | - Hannie C. Comijs
- Department Psychiatry, Amsterdam Public Health Research InstituteVU University Medical CenterAmsterdamThe Netherlands
| | - Hans W. Jeuring
- Department: University Center of Psychiatry, University of Groningen, University Medical Center GroningenGroningenThe Netherlands
| |
Collapse
|
|
6
|
Sherwood SN, Youngstrom JK, Findling RL, Youngstrom EA, Freeman AJ. Irritability Is Associated with Illness Severity and Anhedonia Is Associated with Functional Impairment Among Depressed Children and Adolescents. J Child Adolesc Psychopharmacol 2021; 31:531-537. [PMID: 34283918 DOI: 10.1089/cap.2021.0018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objectives: Irritability and anhedonia are cardinal symptoms of depression for children and adolescents. However, anhedonia may be more strongly associated with illness severity compared with irritability. The present study evaluated the impact of irritability and anhedonia on symptom severity and functional impairment among depressed children and adolescents. Methods: Participants were 383 children and adolescents presenting for outpatient treatment at a community mental health center or academic medical center. Children and adolescents were diagnosed with unipolar depression or bipolar disorder. Regression models predicted depression severity and functional impairment from irritability and anhedonia after covarying age, gender, depressive and hypomanic symptoms, and diagnosis. Results: Greater irritability and anhedonia were associated with more severe depression symptoms. Greater irritability, but not anhedonia, was associated with lower global functioning and family quality of life (QoL), and more externalizing problems. Greater anhedonia was associated with lower overall, emotional, self-esteem, and social QoL. Neither irritability nor anhedonia was associated with school or physical QoL, nonsuicidal self-injury, suicidal ideation, number of comorbid diagnoses, or internalizing problems. Conclusions: Irritability was associated with more markers of depression severity, whereas anhedonia was associated with indicators of functional impairment. This study used a cross-sectional observational design and therefore cannot provide information about cause and effect relationships between variables. Irritability and anhedonia were derived from their respective subscales of the General Behavior Inventory and included only caregiver-reported symptoms but not child- or adolescent-reported symptoms. Identifying the impact of specific symptoms of depression may assist clinicians in delivering more individualized interventions to target symptoms that result in greater impairment.
Collapse
Affiliation(s)
- Samantha N Sherwood
- Department of Psychology, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Jennifer K Youngstrom
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Robert L Findling
- Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Eric A Youngstrom
- Department of Psychology and Neuroscience and Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Andrew J Freeman
- Division of Child and Family Services, Nevada Department of Health and Human Services, Las Vegas, Nevada, USA
| |
Collapse
|
|
7
|
Ogunsakin RE, Olugbara OO, Moyo S, Israel C. Meta-analysis of studies on depression prevalence among diabetes mellitus patients in Africa. Heliyon 2021; 7:e07085. [PMID: 34095580 PMCID: PMC8165422 DOI: 10.1016/j.heliyon.2021.e07085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 12/30/2020] [Accepted: 05/13/2021] [Indexed: 12/12/2022] Open
Abstract
Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion or insulin action. It can be caused by the consumption of carbohydrate meals or medication side effects. Depression as a comorbid condition in an individual with diabetes is accountable for increased disability, mortality, and significant health problem in patients. As a continent, Africa does not have an overall estimation of depression prevalence among diabetes mellitus patients at a regional level. Consequently, this study's purpose was to use the meta-analysis method to summarize estimates of extant studies that have reported depression prevalence among patients with diabetes mellitus in Africa. The literature search method was executed to classify studies with reported depression prevalence with evidently designed inclusion and exclusion criteria. In total, 20 studies from sundry screened articles were appropriate for ultimate inclusion in the meta-analysis. Since substantial heterogeneity was expected, a random-effects meta-analysis was carried out using the number of cases with a total sample size to estimate the prevalence of diabetes mellitus at a regional level. The residual amount of heterogeneity was found to be high according to the statistics of τ2 = 0.06; I2 = 99.10%, chi-square = 2184.85, degree of freedom = 19 and P =< 0.001. The pooled depression prevalence was 40% within a 95% confidence interval of 29%–51%. The meta-regression analysis result showed that none of the included moderators contributed to the heterogeneity of studies. The result of effect size estimates against its standard error showed publication bias with a P-value of 0.001. The meta-analysis findings of this study have indicated that depression prevalence in Africa is still high. Reporting on numerous risk factors like socio-demographic characteristics were not possible in this study because of a lack of completeness in the included articles. Consequently, screening diabetes patients for comorbid depression with its associated risk factors is highly recommended.
Collapse
Affiliation(s)
- Ropo Ebenezer Ogunsakin
- ICT and Society Research Group, South Africa Luban Workshop, Durban University of Technology, Durban, South Africa
| | - Oludayo O Olugbara
- ICT and Society Research Group, South Africa Luban Workshop, Durban University of Technology, Durban, South Africa
| | - Sibusiso Moyo
- ICT and Society Research Group, South Africa Luban Workshop, Durban University of Technology, Durban, South Africa
| | - Connie Israel
- ICT and Society Research Group, South Africa Luban Workshop, Durban University of Technology, Durban, South Africa
| |
Collapse
|
|
8
|
Chireh B, Li M, D'Arcy C. Diabetes increases the risk of depression: A systematic review, meta-analysis and estimates of population attributable fractions based on prospective studies. Prev Med Rep 2019; 14:100822. [PMID: 30815337 PMCID: PMC6378921 DOI: 10.1016/j.pmedr.2019.100822] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 01/25/2019] [Accepted: 02/06/2019] [Indexed: 12/27/2022] Open
Abstract
We aim to examine the relationship between diabetes and depression risk in longitudinal cohort studies and by how much the incidence of depression in a population would be reduced if diabetes was reduced. Medline/PubMed, EMBASE, PsycINFO, and Cochrane Library databases were searched for English-language published literature from January 1990 to December 2017. Longitudinal studies with criteria for depression and self-report doctors' diagnoses or diagnostic blood test measurement of diabetes were assessed. Systematic review with meta-analysis synthesized the results. Study quality, heterogeneity, and publication bias were examined. Pooled odds ratios were calculated using random effects models. Population attributable fractions (PAFs) were used to estimate potential preventive impact. Twenty high-quality articles met inclusion criteria and were analyzed. The pooled odds ratio (OR) between diabetes and depression was 1.33 (95% CI, 1.18-1.51). For the various study types the ORs were as follows: prospective studies (OR 1.34, 95% CI 1.14-1.57); retrospective studies (OR 1.30, 95% CI 1.05-1.62); self-reported diagnosis of diabetes (OR 1.37, 95% CI 1.17-1.60); and diagnostic diabetes blood test (OR 1.25, 95% CI 1.04-1.52). PAFs suggest that over 9.5 million of global depression cases are potentially attributable to diabetes. A 10-25% reduction in diabetes could potentially prevent 930,000 to 2.34 million depression cases worldwide. Our systematic review provides fairly robust evidence to support the hypothesis that diabetes is an independent risk factor for depression while also acknowledging the impact of risk factor reduction, study design and diagnostic measurement of exposure which may inform preventive interventions.
Collapse
Affiliation(s)
- Batholomew Chireh
- University of Saskatchewan School of Public Health, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
| | - Muzi Li
- The Douglas Hospital Research Centre, 6875 boulevard LaSalle, Montreal H4H 1R3, Canada
| | - Carl D'Arcy
- University of Saskatchewan, Department of Psychiatry and, School of Public Health, 103 Hospital drive, Ellis Hall, Room 107, Saskatoon, SK S7N 0W8, Canada
| |
Collapse
|
|
9
|
Lam RW, Wajsbrot DB, Meier E, Pappadopulos E, Mackell JA, Boucher M. Effect of desvenlafaxine 50 mg and 100 mg on energy and lassitude in patients with major depressive disorder: A pooled analysis. J Psychopharmacol 2017; 31:1204-1214. [PMID: 28718346 DOI: 10.1177/0269881117719261] [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] [Indexed: 11/17/2022]
Abstract
Nine randomized, double-blind, placebo-controlled studies of major depressive disorder were pooled to evaluate the effects of desvenlafaxine 50- and 100-mg/d on energy and lassitude in adults with major depressive disorder ( n=4279). Changes from baseline to endpoint in 17-item Hamilton Rating Scale for Depression (HAM-D17) Work and Activities, Retardation, and Somatic Symptoms General items, HAM-D17 psychomotor retardation factor, and Montgomery-Åsberg Depression Rating Scale Lassitude item were analyzed with a mixed model for repeated measures analysis of variance. Associations between residual energy measures and functional impairment, based on the Sheehan Disability Scale, were modeled using stepwise multiple linear regression. Improvement from baseline was significantly greater for both desvenlafaxine doses versus placebo on all energy symptom outcomes at week 8 (all p⩽0.005). Both early improvement in HAM-D17 psychomotor retardation at week 2 and residual energy symptoms at week 8 were associated with Sheehan Disability Scale total score at week 8 (all p⩽0.001). Among Sheehan Disability Scale remitters and responders, the HAM-D17 psychomotor retardation score at week 8 was significantly lower with desvenlafaxine (both doses) than placebo. Desvenlafaxine 50 and 100 mg/d significantly improved energy and lassitude symptoms in patients with major depressive disorder. Both early improvement in energy and fewer residual energy symptoms were associated with functional improvement.
Collapse
|
|
10
|
Bressi C, Fronza S, Minacapelli E, Nocito EP, Dipasquale E, Magri L, Lionetti F, Barone L. Short-Term Psychodynamic Psychotherapy with Mentalization-Based Techniques in Major Depressive Disorder patients: Relationship among alexithymia, reflective functioning, and outcome variables - A Pilot study. Psychol Psychother 2017; 90:299-313. [PMID: 27801544 DOI: 10.1111/papt.12110] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Revised: 08/16/2016] [Indexed: 11/27/2022]
Abstract
OBJECTIVES In depressed patients, recent advances have highlighted impairment in mentalizing: identifying and interpreting one's own or other's mental states. Short-Term Psychodynamic Psychotherapy (STPP) has proven to be effective in reducing symptoms and improving relational/functional abilities in these subjects. Therefore, the first aim of our study was to evaluate effectiveness of STPP with Mentalization-Based Techniques (STMBP) on their clinical outcomes and the second, to investigate Reflective Functioning and alexithymia concerning treatment outcomes in depressed subjects. DESIGN A baseline evaluation of reflective functioning, alexithymia and depression was conducted before an STMBP treatment. Patients were re-tested successively after 40 weeks (T1) and in a follow-up after 1 year at the end of the treatment (T2). METHODS A total of 24 patients principally diagnosed with Major Depressive Disorder (MDD) underwent a STMBP conducted by two expert therapists. Global Assessment Functioning (GAF), Toronto Alexithymia Scale-20 (TAS-20) and Hamilton Depression Rating Scale (HAM-D) data were collected at the baseline (T0) by two clinical therapists, along with RF scores rated by two trained raters. HAM-D, TAS-20 and GAF follow-ups were conducted at the end of the treatment after 40 weeks (T1) and after 1-year follow-up (T2). RESULTS Results highlighted an improvement of both HAM-D and TAS-20 scores in our sample. Moreover, a negative correlation between RF and TAS-20 was found. Both HAM-D and RF at T0 influenced depressive outcomes at the end of the treatment. CONCLUSIONS Results confirmed the effectiveness of STMBP in MDD, suggesting also an inverse association between RF and alexithymia. PRACTITIONER POINTS Our study demonstrates how STMBP could be effective in MDD even after 40 sessions, maintaining its effect in a 1-year follow-up. STMBP improves subjective capability of reflecting on the mental states of oneself and others. Our intervention allows patients to orientate thoughts from inside to outside, reducing negative beliefs also in absence of a pharmacological therapy (during the follow-up).
Collapse
Affiliation(s)
- Cinzia Bressi
- Unit of Psychiatry, Homogenous Area of Mental Health, Psychotherapy Service, Department of Pathophysiology and Transplantation (DePT), Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, State University of Milan, Italy
| | - Silvia Fronza
- Homogenous Area of Mental Health, Psychotherapy Service, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Eleonora Minacapelli
- Homogenous Area of Mental Health, Psychotherapy Service, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Emanuela Paola Nocito
- Homogenous Area of Mental Health, Psychotherapy Service, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Elisabetta Dipasquale
- Homogenous Area of Mental Health, Psychotherapy Service, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Lorenzo Magri
- Homogenous Area of Mental Health, Psychotherapy Service, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Francesca Lionetti
- Psychology Section, Department of Brain and Behavioral Sciences, University of Pavia, Milan, Italy
| | - Lavinia Barone
- Psychology Section, Department of Brain and Behavioral Sciences, University of Pavia, Milan, Italy
| |
Collapse
|
|
11
|
Dawson EL, Caveney AF, Meyers KK, Weisenbach SL, Giordani B, Avery ET, Schallmo MP, Bahadori A, Bieliauskas LA, Mordhorst M, Marcus SM, Kerber K, Zubieta JK, Langenecker SA. Executive Functioning at Baseline Prospectively Predicts Depression Treatment Response. Prim Care Companion CNS Disord 2017; 19. [PMID: 28196313 DOI: 10.4088/pcc.16m01949] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Accepted: 10/19/2016] [Indexed: 10/20/2022] Open
Abstract
Objective Existing cognitive and clinical predictors of treatment response to date are not of sufficient strength to meaningfully impact treatment decision making and are not readily employed in clinical settings. This study investigated whether clinical and cognitive markers used in a tertiary care clinic could predict response to usual treatment over a period of 4 to 6 months in a sample of 75 depressed adults. Methods Patients (N = 384) were sequentially tested in 2 half-day clinics as part of a quality improvement project at an outpatient tertiary care center between August 2003 and September 2007; additional subjects evaluated in the clinic between 2007 and 2009 were also included. Diagnosis was according to DSM-IV-TR criteria and completed by residents and attending faculty. Test scores obtained at intake visits on a computerized neuropsychological screening battery were the Parametric Go/No-Go task and Facial Emotion Perception Task. Treatment outcome was assessed using 9-item Patient Health Questionnaire (PHQ-9) self-ratings at follow-up (n = 75). Usual treatment included psychotropic medication and psychotherapy. Decline in PHQ-9 scores was predicted on the basis of baseline PHQ-9 score and education, with neuropsychological variables entered in the second step. Results PHQ-9 scores declined by 46% at follow-up (56% responders). Using 2-step multiple regression, baseline PHQ-9 score (P ≤ .05) and education (P ≤ .01) were significant step 1 predictors of percent change in PHQ-9 follow-up scores. In step 2 of the model, faster processing speed with interference resolution (go reaction time) independently explained a significant amount of variance over and above variables in step 1 (12% of variance, P < .01), while other cognitive and affective skills did not. This 2-step model accounted for 28% of the variance in treatment change in PHQ-9 scores. Processing speed with interference resolution also accounted for 12% variance in treatment and follow-up attrition. Conclusions Use of executive functioning assessments in clinics may help identify individuals with cognitive weaknesses at risk for not responding to standard treatments.
Collapse
Affiliation(s)
- Erica L Dawson
- Department of Psychiatry, University of Michigan Medical Center, Ann Arbor, Michigan, USA
| | - Angela F Caveney
- Department of Psychiatry, University of Michigan Medical Center, Ann Arbor, Michigan, USA
| | - Kortni K Meyers
- Department of Psychiatry, University of Michigan Medical Center, Ann Arbor, Michigan, USA
| | - Sara L Weisenbach
- Department of Psychiatry, University of Michigan Medical Center, Ann Arbor, Michigan, USA
| | - Bruno Giordani
- Department of Psychiatry, University of Michigan Medical Center, Ann Arbor, Michigan, USA
| | - Erich T Avery
- Department of Psychiatry, University of Michigan Medical Center, Ann Arbor, Michigan, USA
| | - Michael-Paul Schallmo
- Department of Psychiatry, University of Michigan Medical Center, Ann Arbor, Michigan, USA
| | - Armita Bahadori
- Department of Psychiatry, University of Michigan Medical Center, Ann Arbor, Michigan, USA
| | - Linas A Bieliauskas
- Department of Psychiatry, University of Michigan Medical Center, Ann Arbor, Michigan, USA
| | - Matthew Mordhorst
- Department of Psychiatry, University of Michigan Medical Center, Ann Arbor, Michigan, USA
| | - Sheila M Marcus
- Department of Psychiatry, University of Michigan Medical Center, Ann Arbor, Michigan, USA
| | - Kevin Kerber
- Department of Psychiatry, University of Michigan Medical Center, Ann Arbor, Michigan, USA
| | - Jon-Kar Zubieta
- Department of Psychiatry, University of Michigan Medical Center, Ann Arbor, Michigan, USA
| | - Scott A Langenecker
- Department of Psychiatry, The University of Illinois at Chicago, 1601 W Taylor Ave, Chicago, 60612. .,Department of Psychiatry, University of Michigan Medical Center, Ann Arbor, Michigan, USA
| |
Collapse
|
|
12
|
van der Veen DC, van Zelst WH, Schoevers RA, Comijs HC, Voshaar RCO. Comorbid anxiety disorders in late-life depression: results of a cohort study. Int Psychogeriatr 2015; 27:1157-65. [PMID: 25370017 DOI: 10.1017/s1041610214002312] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Comorbid anxiety disorders are common in late-life depression and negatively impact treatment outcome. This study aimed to examine personality characteristics as well as early and recent life-events as possible determinants of comorbid anxiety disorders in late-life depression, taking previously examined determinants into account. METHODS Using the Composite International Diagnostic Interview (CIDI 2.0), we established comorbid anxiety disorders (social phobia (SP), panic disorder (PD), generalized anxiety disorder (GAD), and agoraphobia (AGO)) in 350 patients (aged ≥60 years) suffering from a major depressive disorder according to DSM-IV-TR criteria within the past six months. Adjusted for age, sex, and level of education, we first examined previously identified determinants of anxious depression: depression severity, suicidality, partner status, loneliness, chronic diseases, and gait speed in multiple logistic regression models. Subsequently, associations were explored with the big five personality characteristics as well as early and recent life-events. First, multiple logistic regression analyses were conducted with the presence of any anxiety disorder (yes/no) as dependent variable, where after analyses were repeated for each anxiety disorder, separately. RESULTS In our sample, the prevalence rate of comorbid anxiety disorders in late-life depression was 38.6%. Determinants of comorbid anxiety disorders were a lower age, female sex, less education, higher depression severity, early traumatization, neuroticism, extraversion, and conscientiousness. Nonetheless, determinants differed across the specific anxiety disorders and lumping all anxiety disorder together masked some determinants (education, personality). CONCLUSIONS Our findings stress the need to examine determinants of comorbid anxiety disorder for specific anxiety disorders separately, enabling the development of targeted interventions within subgroups of depressed patients.
Collapse
Affiliation(s)
- D C van der Veen
- University of Groningen,University Medical Center Groningen,Center for Psychiatry & Interdisciplinary Center of Psychiatric Epidemiology,Groningen,the Netherlands
| | - W H van Zelst
- University of Groningen,University Medical Center Groningen,Center for Psychiatry & Interdisciplinary Center of Psychiatric Epidemiology,Groningen,the Netherlands
| | - R A Schoevers
- University of Groningen,University Medical Center Groningen,Center for Psychiatry & Interdisciplinary Center of Psychiatric Epidemiology,Groningen,the Netherlands
| | - H C Comijs
- Department for Psychiatry,EMGO Institute for Health and Care Research / Institute for Neurosciences,VU University,Amsterdam,the Netherlands
| | - R C Oude Voshaar
- University of Groningen,University Medical Center Groningen,Center for Psychiatry & Interdisciplinary Center of Psychiatric Epidemiology,Groningen,the Netherlands
| |
Collapse
|
|
13
|
Citrome L, Gommoll CP, Tang X, Nunez R, Mathews M. Evaluating the efficacy of vilazodone in achieving remission in patients with major depressive disorder: post-hoc analyses of a phase IV trial. Int Clin Psychopharmacol 2015; 30:75-81. [PMID: 25396353 PMCID: PMC4314104 DOI: 10.1097/yic.0000000000000056] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 10/06/2014] [Indexed: 11/26/2022]
Abstract
The aim of this study was to evaluate the efficacy of vilazodone using different definitions of remission. Post-hoc analyses were carried out using data from an 8-week, multicenter, randomized, double-blind, placebo-controlled trial of vilazodone 40 mg/day in adults with major depressive disorder (NCT01473394). The primary efficacy endpoint was a mean change in the Montgomery-Åsberg Depression Rating Scale (MADRS) total score; additional measures included the Clinical Global Impressions-Severity (CGI-S) and Hamilton Rating Scale for Anxiety (HAMA) scores. In addition to treatment response (MADRS≥50% improvement), post-hoc analyses were carried out for remission of depressive symptoms [MADRS score≤10; MADRS≤5 (complete remission)], anxiety symptoms (HAMA≤7), and combined depression and anxiety symptoms (MADRS/HAMA≤10/≤7), as well as for overall symptom severity (CGI-S=1). Odds ratios (ORs) and numbers needed to treat (NNTs) were also calculated. Significant outcomes were obtained with vilazodone versus placebo for MADRS response (50.6 vs. 33.3%, OR=2.04, P<0.001, NNT=6), remission (34.0 vs. 21.8%, OR=1.82, P=0.003, NNT=9), and complete remission (18.2 vs. 8.3%, OR=2.42, P=0.002, NNT=11). More patients receiving vilazodone rather than placebo also met remission criteria for HAMA (48.8 vs. 35.2%, OR=1.82, P=0.002, NNT=8), MADRS/HAMA (32.1 vs. 20.4%, OR=1.83, P=0.004, NNT=9), and CGI-S (24.1 vs. 11.5%, OR=2.41, P<0.001, NNT=8). Treatment with vilazodone 40 mg/day may help adult patients with major depressive disorder achieve remission of depression and/or anxiety symptoms.
Collapse
Affiliation(s)
- Leslie Citrome
- Department of Psychiatry and Behavioral Sciences, New York Medical College, Valhalla, New York
| | | | - Xiongwen Tang
- Forest Research Institute, Jersey City, New Jersey, USA
| | - Rene Nunez
- Forest Research Institute, Jersey City, New Jersey, USA
| | - Maju Mathews
- Forest Research Institute, Jersey City, New Jersey, USA
| |
Collapse
|
|
14
|
Katzman MA, Anand L, Furtado M, Chokka P. Food for thought: understanding the value, variety and usage of management algorithms for major depressive disorder. Psychiatry Res 2014; 220 Suppl 1:S3-14. [PMID: 25539872 DOI: 10.1016/s0165-1781(14)70002-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 10/11/2014] [Indexed: 12/28/2022]
Abstract
By 2020, depression is projected to be among the most important contributors to the global burden of disease. A plethora of data confirms that despite the availability of effective therapies, major depressive disorder continues to exact an enormous toll; this, in part, is due to difficulties reaching complete remission, as well as the specific associated costs of both the disorder's morbidity and mortality. The negative effects of depression include those on patients' occupational functioning, including absenteeism, presenteeism, and reduced opportunities for educational and work success. The use of management algorithms has been shown to improve treatment outcomes in major depressive disorder and may be less costly than "usual care" practices. Nevertheless, many patients with depression remain untreated. As well, even those who are treated often continue to experience suboptimal quality of life. As such, the treatment algorithms in this article may improve outcomes for patients suffering with depression. This paper introduces some of the principal reasons underlying these treatment gaps and examines measures or recommendations that might be changed or strengthened in future practice guidelines to bridge them.
Collapse
Affiliation(s)
- Martin A Katzman
- START Clinic for Mood and Anxiety Disorders, Toronto, ON, Canada; Northern Ontario School of Medicine, Thunder Bay, ON, Canada; Department of Psychology, Lakehead University, Thunder Bay, ON, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Adler Graduate Professional School, Toronto, ON, Canada.
| | - Leena Anand
- START Clinic for Mood and Anxiety Disorders, Toronto, ON, Canada
| | - Melissa Furtado
- START Clinic for Mood and Anxiety Disorders, Toronto, ON, Canada
| | - Pratap Chokka
- University of Alberta, Edmonton, AB, Canada; Chokka Center for Integrative Health, Edmonton, AB, Canada
| |
Collapse
|
|
15
|
Persistence of chronic major depression: a national prospective study. J Affect Disord 2013; 151:306-12. [PMID: 23866303 DOI: 10.1016/j.jad.2013.06.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 06/07/2013] [Accepted: 06/08/2013] [Indexed: 11/22/2022]
Abstract
BACKGROUND Chronic major depressive disorder (CMDD) is highly prevalent and associated with high personal and societal cost. Identifying risk factors for persistence and remission of CMDD may help in developing more effective treatment and prevention interventions. METHODS Prospective cohort study of individuals participating in the National Epidemiologic Survey on Alcohol and Related Conditions (Wave 1; n=43,093) and its 3-year follow-up (Wave 2; n=34,653) who met a diagnosis of CMDD at the Wave 1 assessment. RESULTS Among the 504 respondents who met criteria for present CMDD at Wave 1, only 63 (11.52%) of them continued to meet criteria of CMDD. A history of childhood sexual abuse, earlier onset of MDD, presence of comorbidity and a history of treatment-seeking for depression predicted persistence of CMDD three years after the baseline evaluation. LIMITATIONS Our sample is limited to adults, our follow-up period was only three-years and the diagnosis of CMDD at baseline was retrospective. CONCLUSIONS CMDD shows high rates of remission within three years of baseline assessment, although some specific risk factors predict a persistent course. Given the high personal and societal cost associated with CMDD, there is a need to develop and disseminate effective interventions for CMDD.
Collapse
|
|
16
|
Romera I, Pérez V, Ciudad A, Caballero L, Roca M, Polavieja P, Gilaberte I. Residual symptoms and functioning in depression, does the type of residual symptom matter? A post-hoc analysis. BMC Psychiatry 2013; 13:51. [PMID: 23398902 PMCID: PMC3575400 DOI: 10.1186/1471-244x-13-51] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Accepted: 01/30/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The degrees to which residual symptoms in major depressive disorder (MDD) adversely affect patient functioning is not known. This post-hoc analysis explored the association between different residual symptoms and patient functioning. METHODS Patients with MDD who responded (≥50% on the 17-item Hamilton Rating Scale for Depression; HAMD-17) after 3 months of treatment (624/930) were included. Residual core mood-symptoms (HAMD-17 core symptom subscale ≥1), residual insomnia-symptoms (HAMD-17 sleep subscale ≥1), residual anxiety-symptoms (HAMD-17-anxiety subscale ≥1), residual somatic-symptoms (HAMD-17 Item 13 ≥1), pain (Visual Analogue Scale ≥30), and functioning were assessed after 3 months treatment. A stepwise logistic regression model with normal functioning (Social and Occupational Functioning Assessment Scale ≥80) as the dependent variable was used. RESULTS After 3 months, 59.5% of patients (371/624) achieved normal functioning and 66.0% (412/624) were in remission. Residual symptom prevalence was: core mood symptoms 72%; insomnia 63%; anxiety 78%; and somatic symptoms 41%. Pain reported in 18%. Factors associated with normal functioning were absence of core mood symptoms (odds ratio [OR] 8.7; 95% confidence interval [CI], 4.6-16.7), absence of insomnia symptoms (OR 1.8; 95% CI, 1.2-2.7), episode length (4-24 weeks vs. ≥24 weeks [OR 2.0; 95% CI, 1.1-3.6]) and better baseline functioning (OR 1.0; 95% CI, 1.0-1.1). A significant interaction between residual anxiety symptoms and pain was found (p = 0.0080). CONCLUSIONS Different residual symptoms are associated to different degrees with patient functioning. To achieve normal functioning, specific residual symptoms domains might be targeted for treatment.
Collapse
Affiliation(s)
- Irene Romera
- Department of Clinical Research Lilly, S.A. Avenida de la Industria 30, 28108, Alcobendas, Spain.
| | - Víctor Pérez
- Department of Psychiatry, Hospital Santa Creu i Sant Pau, Autonomous University of Barcelona / CIBERSAM, Barcelona, Spain
| | - Antonio Ciudad
- Department of Clinical Research Lilly, S.A. Avenida de la Industria 30, 28108, Alcobendas, Spain
| | - Luis Caballero
- Department of Psychiatry, Hospital Puerta de Hierro, Madrid, Spain
| | - Miguel Roca
- Department of Psychiatry, Joan March Hospital, Rediapp, Palma de Mallorca, Spain
| | - Pepa Polavieja
- Department of Clinical Research Lilly, S.A. Avenida de la Industria 30, 28108, Alcobendas, Spain
| | - Inmaculada Gilaberte
- Department of Clinical Research Lilly, S.A. Avenida de la Industria 30, 28108, Alcobendas, Spain
| |
Collapse
|
|
17
|
Gili M, Roca M, Armengol S, Asensio D, Garcia-Campayo J, Parker G. Clinical patterns and treatment outcome in patients with melancholic, atypical and non-melancholic depressions. PLoS One 2012; 7:e48200. [PMID: 23110213 PMCID: PMC3482206 DOI: 10.1371/journal.pone.0048200] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Accepted: 09/21/2012] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To assess sociodemographic, clinical and treatment factors as well as depression outcome in a large representative clinical sample of psychiatric depressive outpatients and to determine if melancholic and atypical depression can be differentiated from residual non-melancholic depressive conditions. SUBJECTS/MATERIALS AND METHOD A prospective, naturalistic, multicentre, nationwide epidemiological study of 1455 depressive outpatients was undertaken. Severity of depressive symptoms was assessed by the Hamilton Depression Rating Scale (HDRS) and the Self Rated Inventory of Depressive Symptomatology (IDS-SR(30)). IDS-SR(30) defines melancholic and atypical depression according to DSM-IV criteria. Assessments were carried out after 6-8 weeks of antidepressant treatment and after 14-20 weeks of continuation treatment. RESULTS Melancholic patients (16.2%) were more severely depressed, had more depressive episodes and shorter episode duration than atypical (24.7%) and non-melancholic patients. Atypical depressive patients showed higher rates of co-morbid anxiety disorders and substance abuse. Melancholic patients showed lower rates of remission. CONCLUSION Our study supports a different clinical pattern and treatment outcome for melancholic and atypical depression subtypes.
Collapse
Affiliation(s)
- Margalida Gili
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS), University of Balearic Islands, Palma de Mallorca, Spain.
| | | | | | | | | | | |
Collapse
|
|
18
|
Gili M, Luciano JV, Bauzá N, Aguado J, Serrano MJ, Armengol S, Roca M. Psychometric properties of the IDS-SR30 for the assessment of depressive symptoms in Spanish population. BMC Med Res Methodol 2011; 11:131. [PMID: 21936925 PMCID: PMC3188477 DOI: 10.1186/1471-2288-11-131] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Accepted: 09/21/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Due to the high prevalence of depression, it is clinically relevant to improve the early identification and assessment of depressive episodes. The main objective of the present study was to examine the psychometric properties of the IDS-SR30 (Self-rated Inventory of Depressive Symptomatology) in a large Spanish sample of depressive patients. METHODS This prospective, naturalistic, multicenter, nationwide epidemiological study conducted in Spain included 1595 adult patients (65.3% females) with a DSM-IV Major Depressive Disorder (MDD. IDS-SR30 and the Hamilton Depression Rating Scale (HDRS, 21 items)were administered to the sample. Data was collected during 2 routine visits. The second assessment was carried out after 10 ± 2 weeks after first assessment. RESULTS The IDS-SR30 showed good internal consistency (α = 0.94) and high item total correlations (≥ 0.50) were found in 70% of the items. The convergent validity was 0.85. Results of the principal component analysis (PCA) and confirmatory factor analyses (CFA) showed that a three factor model (labelled mood/cognition, anxiety/somatic and sleep) is adequate for the current sample. CONCLUSIONS The Spanish version of the IDS-SR30 seems a reliable, valid and useful tool for measuring depression symptomatology in Spanish population.
Collapse
Affiliation(s)
- Margalida Gili
- Institut Universitari d'Investigació en Ciències de la Salut, University of Balearic Islands, Cra, de Valldemossa, Palma de Mallorca 07122, Spain.
| | | | | | | | | | | | | |
Collapse
|