The Symptomatology of Puerperal Illnesses

1981 ◽  
Vol 139 (2) ◽  
pp. 128-133 ◽  
Author(s):  
C. Dean ◽  
R. E. Kendell

SummaryWomen who had a psychiatric illness requiring hospital admission within 90 days of delivery were compared with a control group matched for age, Research Diagnostic Criteria diagnosis and year of admission. Those with a diagnosis of major depressive disorder differed significantly from non-puerperal controls in being more deluded or hallucinated, more labile and more disorientated. There was no difference between puerperal and control cases of major depressive or manic disorder with respect to treatment received, or responded to, or length of stay in hospital.

2018 ◽  
Vol 122 (2) ◽  
pp. 398-410 ◽  
Author(s):  
Marco Giannini ◽  
Pietro Pellegrini ◽  
Alessio Gori ◽  
Yura Loscalzo

This study aimed to develop a handwriting analysis protocol for assessing severe major depressive disorder, in order to evaluate whether graphological analysis could be considered an objective tool and hence if it could be useful for clinicians in their early diagnosis. We modified and improved the methodology described by Lorusso et al. by proposing different graphic indexes based both on the literature and on the observation of a preliminary sample of 13 handwritings of patients affected by major depressive disorder. Then, we recruited 80 participants, divided into two groups: clinical sample ( n = 44) and control group ( n = 36). We used Cohen's Kappa to evaluate the reliability of agreement among four professional graphologists and the consensus between the psychiatric assessment and the ratings given by the judges. We found satisfactory results. Using our protocol, we obtained higher values for Cohen’s Kappa as compared with Lorusso et al. The agreement among graphologists is K = .62, while the K values for the agreement between psychiatric assessment and graphologists range between .47 and .60. The substantial improvements obtained in comparison with Lorusso et al. are encouraging and support further attempts.


2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Arash Mohagheghi ◽  
Asghar Arfaie ◽  
Shahrokh Amiri ◽  
Masoud Nouri ◽  
Salman Abdi ◽  
...  

Introduction and Objective. Despite the effectiveness of electroconvulsive therapy (ECT) in treating major depressive disorder (MDD), its cognitive side effects make it less popular. This study investigated the impact of liothyronine on ECT-induced memory deficit in patients with MDD.Methodology. This is a double-blind clinical trial, in which 60 patients with MDD who were referred for ECT were selected. The diagnosis was based on the criteria of DSM-IV-TR. Patients were divided randomly into two groups to receive either liothyronine (50 mcg every morning) or placebo. After the assessment with Wechsler Memory Scale-Revised (WMS-R) before first session of ECT, posttests were repeated again, two months after the completion of ECT.Findings. By controlling the pretest scores, the mean scores of the experimental group were higher than the control group in delayed recall, verbal memory, visual memory, general memory, and attention/concentration scales (P<0.05).Conclusion. Liothyronine may prevent ECT-induced memory impairment in patients with MDD. This study has been registered in IRCT underIRCT201401122660N2.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mostafa S ElShaarawi ◽  
Ayman A Gaafar ◽  
Hisham S. Saad Eldin ◽  
Randa H Ali

Abstract Background Major depressive disorder (MDD) is a common psychiatric disorder that affects nearly 11.1-14.6 % of the population in their lifetime. Pathophysiology and brain imaging findings show that degenerative and inflammatory processes may play a role. Meta-analysis of voxel-based morphometry studies in MDD demonstrated significant gray matter loss. From anatomical and embryological perspectives, the retina can be considered a unique extension of the brain and is able to reflect axonal histopathology. Being unmyelinated, it can provide insight into the pathophysiological processes of diseases with a neurodegenerative element. Aim to compare retinal optical coherence tomography (OCT) parameters in a group of MDD patients with a healthy control group and to correlate OCT parameters with pattern electroretinography (PERG) parameters. Method a controlled cross sectional study was conducted on 30 MDD patients and 28 age and sex matched controls. Both groups had a full ophthalmological examination, OCT imaging and 7 patients and 11 controls have PERG recorded. Results Thinning of the superior retinal nerve fiber layer, thinning of most of the ganglion cell inner plexiform (GCIP) layer, thinning of most of the macular thickness and thinning of macular volume in both eyes were detected. There was a statistically significant positive correlation between the left GCIP layer and the amplitude of the N95 wave. Also a statistically significant negative correlation existed between MDD duration in years with the left eye's average volume of the outer ring of the macula. Conclusion Significant retinal changes were detected by OCT in MDD patients supporting the theory of neurodegeneration as a pathophysiology of MDD.


1992 ◽  
Vol 20 (3) ◽  
pp. 199-212 ◽  
Author(s):  
Lyne Prud'homme ◽  
Pierre Barron

In light of Rational-Emotive Theory, this study was undertaken to determine the pattern of irrational beliefs underlying Major Depressive Disorder (MDD). A total of 126 subjects (50 males, 76 females) volunteered to participate. Patients clinically diagnosed with MDD (unipolar type) and a control group of non-depressed patients were solicited from the inpatient and outpatient facilities of several Ottawa and Montreal hospitals; the normal control group comprised students and civil servants. The subjects completed questionnaires to measure irrational belief endorsement (IBT, RBI) and symptom severity (STAI, BDI) and to verify the depression diganosis (IDD). Multivariate statistics were used to determine the pattern of beliefs which best discriminates between the MDD group, the psychiatric control group, and the normal controls. Discriminant analysis of the IBT revealed a pattern of four irrational beliefs generally known as demand for approval, frustration reactivity, anxious overconcern, and helplessness over past. The implications of such findings for RET theory are discussed.


1983 ◽  
Vol 142 (5) ◽  
pp. 498-504 ◽  
Author(s):  
A. Coppen ◽  
M. Abou-Saleh ◽  
P. Milln ◽  
M. Metcalfe ◽  
J. Harwood ◽  
...  

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


2020 ◽  
Vol 10 ◽  
pp. 204512532093855
Author(s):  
Jingjing Zhou ◽  
Jian Yang ◽  
Xuequan Zhu ◽  
Tarek Zghoul ◽  
Lei Feng ◽  
...  

Introduction: Major depressive disorder (MDD) is a common affective disorder. Currently established pharmacotherapies lack rapid clinical response, thereby limiting their ability to bring instant relief to patients. A series of clinical trials has demonstrated the antidepressant effects of scopolamine, yet few have studied the effects of add-on scopolamine to currently available antidepressants. It is not known whether conventional antidepressant treatment with a 3-day scopolamine injection could speed up oral antidepressant efficacy. The main focus of this study is to detect the capacity of the rapid-onset efficacy of such a treatment option. Methods and analysis: This study consisted of a single-centre, double-blind, three-arm randomized trial with a 4-week follow-up period. Sixty-six participants meeting entry criteria were randomly allocated to three treatment groups: a high-dose group, a low-dose group and a placebo control group. Psychiatric rating scales were administered at baseline and seven viewing points following the administration of intramuscular injections. The primary outcome measure was length of time from randomization (baseline) to early improvement. Results: Both primary and secondary outcome measures consistently showed no differences among the three groups. The cumulative response rate and the remission rate were 72.7% (48/66) and 47.0% (31/66). Intramuscular scopolamine treatment was relatively well tolerated. Two subjects with high-dose injections dropped out because of a drug-related side effect. Conclusion: Contrary to our prediction, we found that, compared to placebo (0.9% saline i.m.), scopolamine was not associated with a significantly faster antidepressant response rate. Trial registration: ClinicalTrials.gov, NCT03131050. Registered on 18 April 2017.


1982 ◽  
Vol 141 (4) ◽  
pp. 372-376 ◽  
Author(s):  
Ilana B. Glass ◽  
Stuart A. Checkley ◽  
Eric Shur ◽  
Sheila Dawling

SummaryEleven drug free patients meeting Research Diagnostic Criteria for Major Depressive Disorder have been treated with desipramine and given a clonidine infusion after 0, 1 and 3 weeks of treatment. The sedative and hypotensive effects of clonidine were significantly inhibited after three weeks of treatment with desipramine: a similar interaction was seen after one week of treatment although this just failed to reach statistical significance. The growth hormone (GH) response to clonidine was initially impaired, but increased significantly after one week of treatment. A significant reduction in the GH response occurred during the second and third weeks of treatment with desipramine. This last finding is interpreted as evidence of adaptive change of α2 adrenoceptors: the other changes can be explained by the known ability of desipramine to block the re-uptake of noradrenaline.


2020 ◽  
pp. oemed-2020-106660
Author(s):  
Christian Hakulinen ◽  
Petri Böckerman ◽  
Laura Pulkki-Råback ◽  
Marianna Virtanen ◽  
Marko Elovainio

ObjectivesTo examine employment and earnings trajectories before and after the first sickness absence period due to major depressive disorder (MDD).MethodsAll individuals (n=158 813) in Finland who had a first sickness absence period (lasting longer than 9 days) due to MDD between 2005 and 2015 were matched with one randomly selected individual of the same age and gender with no history of MDD. Employment status and earnings were measured using register-based data annually from 2005 to 2015. Generalised estimating equations were used to examine the trajectories of employment and earnings before and after MDD diagnosis in men and women separately.ResultsSickness absence due to MDD was associated with increased probability of non-employment during and after the year of the first sickness absence period. In men, but not in women, the probability of being employed was lower 5 years before the sickness absence period due to MDD. When compared with the individuals in the control group, men had around 34% and women 15% lower earnings 1 year, and 40% and 23%, respectively, 5 years, after the first sickness absence period due to MDD. More severe MDD and longer duration of sickness absence period were associated with lower probability of being employed.ConclusionsSickness absence due to MDD was associated with considerable reduction in employment and earnings losses. For men and individuals with more severe MDD, this reduction was before the first sickness period. This supports a reciprocal association between employment and earnings with MDD.


2007 ◽  
Vol 13 (3) ◽  
pp. 5
Author(s):  
A M Dikobe ◽  
C W Van Staden ◽  
S Reif ◽  
M Bornman

<p><strong>Background.</strong> Symptoms of partial androgen deficiency in ageing men (PADAM) overlap considerably with those of major depressive disorder. The relationship between these conditions is complicated by the usual age-related decline in serum testosterone concentrations.</p><p><strong>Objectives.</strong> To test the hypothesis that depressed men above 45 years of age have lower serum testosterone concentrations than age-matched controls.</p><p><strong>Method.</strong> Serum testosterone fractions of 20 men above the age of 45 years suffering from a major depressive disorder were compared with those of 20 healthy men. An age-matched controlled design was used to account for the usual age-related decline in serum testosterone concentrations.</p><p><strong>Results.</strong> Testosterone concentrations of men suffering from a major depressive disorder were statistically significantly lower than those of an age-matched control group without depression. Conclusion. The role of testosterone deficiency in depressed men needs to be examined further in order for appropriate treatment options to be developed.</p>


2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
N. Zivkovic ◽  
G. Djokic ◽  
D. Pavicevic ◽  
V. Ilic

Major depressive disorder (MDD) is common and severe affective disorder with sleep disturbances and non-bizarre delusions which are organized in permanent and unshakeable delusional system. Neurobiological basis of MDD is still completely unknown, but significant role has serotoninergic and noradrenergic neuronal systems. Escitalopram is highly potent and highly selective serotonin re-uptake inhibitor.Purpose of this study was to estimate efficacy of the escitalopram in treatment of sleep disturbances in MDD.Methods:This prospective clinical study included 95 patients diagnosed by ICD-10 criteria for MDD, who are randomly divided into control (30 patients) and experimental group (65 patients). Patients were observed for 6 months in hospital and outpatients conditions, according to specially designed protocol, which included Hamilton Depression Rating Scale (HAMD) and Leeds Sleeping Evaluation Questionnaire (LSEQ). Control group was treated with maprotiline (75-150 mg/24h) and experimental group with escitalopram (10-20 mg/24h).Results:Escitalopram therapy influenced on HAMD score with high statistical significance vs. maprotiline, p=0.000. Escitalopram therapy improves LSEQ score after 6 months in comparison to maprotiline therapy with high statistical significance p=0.000. Percentage of adverse effects is significantly lower in escitalopram (10.76%) than in maprotiline (26.67%) group.Conclusion:Escitalopram has significantly better efficacy and lower adverse effects rate in treatment of depressive symptoms and sleep disturbances in MDD patients comparing to maprotiline.


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