Prediction of ECT Response: Validation of a Refined Sign-Based (CORE) System for Defining Melancholia

1996 ◽  
Vol 169 (1) ◽  
pp. 68-74 ◽  
Author(s):  
Ian Hickie ◽  
Catherine Mason ◽  
Gordon Parker ◽  
Henry Brodaty
Keyword(s):  
Electroconvulsive Therapy ◽  
Affective Disorders ◽  
Rating System ◽  
Clinical Validity ◽  
Clinical Predictors ◽  
Core System ◽  
The Core ◽  
Best Response ◽  
Primary Affective Disorders ◽  
Psychotic Features

BackgroundThe clinical validity of melancholia has been argued on the basis of its capacity to predict response to electroconvulsive therapy (ECT). We have argued that a sign-based (CORE) rating system of psychomotor disturbance can identify patients with melancholia. Therefore, the clinical validity of the CORE system was tested here in terms of its capacity to predict response to ECT.MethodThe response of 81 patients with primary affective disorders to an individualised course of ECT was investigated. CORE scores and other clinical predictors were evaluated in terms of their capacity to predict effect size changes in symptoms and disability.ResultsCORE scores predicted ECT response, as did the presence of psychotic features. The combination of marked psychomotor change (high CORE scores) and psychotic features predicted the best response to ECT.ConclusionThis study supports the clinical validity of the CORE system for diagnosing melancholia.

Prediction of Response to Electroconvulsive Therapy

1990 ◽  
Vol 157 (1) ◽  
pp. 65-71 ◽  
Author(s):  
Ian Hickie ◽  
Brian Parsonage ◽  
Gordon Parker
Keyword(s):  
Predictive Validity ◽  
Electroconvulsive Therapy ◽  
Open Study ◽  
Depressive Disorders ◽  
Multivariate Analyses ◽  
Rating System ◽  
Prediction Of Response ◽  
Core System ◽  
The Core ◽  
Preliminary Study

In an open study of 35 depressed patients, psychomotor disturbance, assessed by the CORE rating system, significantly predicted response to ECT in patients with a ‘retarded’ but not those with an ‘agitated’ type of illness. In multivariate analyses, psychomotor disturbance was the sole predictor of response. This preliminary study suggests that the CORE system, which has been shown to differentiate endogenous and non-endogenous depressive disorders, has predictive validity in relation to ECT response.

scholarly journals Prediction of electroconvulsive therapy response and remission in major depression: meta-analysis

2018 ◽  
Vol 212 (2) ◽  
pp. 71-80 ◽  
Author(s):  
Linda van Diermen ◽  
Seline van den Ameele ◽  
Astrid M. Kamperman ◽  
Bernard C.G. Sabbe ◽  
Tom Vermeulen ◽  
...  
Keyword(s):  
Major Depression ◽  
Electroconvulsive Therapy ◽  
Meta Analysis ◽  
Therapy Response ◽  
Depression Severity ◽  
Clinical Predictors ◽  
Treatment Protocols ◽  
Prisma Statement ◽  
Severity Of Depression ◽  
Psychotic Features

BackgroundElectroconvulsive therapy (ECT) is considered to be the most effective treatment in severe major depression. The identification of reliable predictors of ECT response could contribute to a more targeted patient selection and consequently increased ECT response rates.AimsTo investigate the predictive value of age, depression severity, psychotic and melancholic features for ECT response and remission in major depression.MethodA meta-analysis was conducted according to the PRISMA statement. A literature search identified recent studies that reported on at least one of the potential predictors.ResultsOf the 2193 articles screened, 34 have been included for meta-analysis. Presence of psychotic features is a predictor of ECT remission (odds ratio (OR) = 1.47, P = 0.001) and response (OR = 1.69, P < 0.001), as is older age (standardised mean difference (SMD) = 0.26 for remission and 0.35 for response (P < 0.001)). The severity of depression predicts response (SMD = 0.19, P = 0.001), but not remission. Data on melancholic symptoms were inconclusive.ConclusionsECT is particularly effective in patients with depression with psychotic features and in elderly people with depression. More research on both biological and clinical predictors is needed to further evaluate the position of ECT in treatment protocols for major depression.Declaration of interestNone.

A Hormonal Component to Postnatal Depression

1993 ◽  
Vol 163 (3) ◽  
pp. 403-405 ◽  
Author(s):  
Brian Harris
Keyword(s):  
Thyroid Gland ◽  
Postnatal Depression ◽  
Affective Disorders ◽  
Depressive Illness ◽  
Thyroid Stimulating Hormone ◽  
Major Depressive ◽  
Thyrotrophin Releasing Hormone ◽  
Primary Affective Disorders ◽  
Psychotic Features ◽  
Tsh Levels

Disorders of the thyroid gland are associated with disorders of mood (Thomas et al, 1970; Van Uitert & Russakoff, 1979; Folks, 1984; Young, 1984; Jadresic, 1990). Both hypothyroid and hyperthyroid states can be associated with depression, which is sometimes accompanied by psychotic features such as delusions and hallucinations (Wilson & Jefferson, 1986). Similarly, primary affective disorders can be accompanied by changes in thyroid function, with low thyroid-stimulating hormone (TSH) levels and elevated thyroxine (T4) (Kirkegaard & Faber, 1980), and in major depressive illness there is often a blunted TSH response to thyrotrophin releasing hormone (TRH) (Prange et al, 1972; Loosen, 1987).

What face familiarity feelings say about the lateralization of specific entities within the core system

2019 ◽  
Vol 42 ◽  
Author(s):  
Guido Gainotti
Keyword(s):  
Temporal Lobe ◽  
Memory System ◽  
Core System ◽  
The Core ◽  
Memory Traces ◽  
Specific Memory ◽  
Target Article ◽  
Temporal Structures ◽  
The Right

Abstract The target article carefully describes the memory system, centered on the temporal lobe that builds specific memory traces. It does not, however, mention the laterality effects that exist within this system. This commentary briefly surveys evidence showing that clear asymmetries exist within the temporal lobe structures subserving the core system and that the right temporal structures mainly underpin face familiarity feelings.

A survey of some FORTRAN implementations of the Core System

1978 ◽  
Vol 12 (4) ◽  
pp. 67-73 ◽  
Author(s):  
Peter Bono ◽  
Margaret Polisher
Keyword(s):  
Core System ◽  
The Core

scholarly journals Neuroleptic malignant syndrome: a case responding to electroconvulsive therapy plus bupropion

2018 ◽  
Author(s):  
Quintí Foguet-Boreu ◽  
Montse Coll-Negre ◽  
Montse Serra-Millàs ◽  
Miquel Cavalleria-Verdaguer
Keyword(s):  
Neuroleptic Malignant Syndrome ◽  
Electroconvulsive Therapy ◽  
Potential Role ◽  
Caucasian Woman ◽  
Concomitant Treatment ◽  
Pharmacological Treatments ◽  
Severe Motor ◽  
Autonomic Instability ◽  
History Of ◽  
Psychotic Features

Neuroleptic malignant syndrome (NMS) is a severe motor syndrome occurring as a consequence of neuroleptic treatment. We present a case of a 67-year-old Caucasian woman with a history of a major depressive disorder with psychotic features. During her third hospital admission, symptoms of autonomic instability, hyperpyrexia, severe extrapyramidal side effects, and delirium appeared, suggesting NMS due to concomitant treatment with risperidone and quetiapine, among other drugs. Despite several consecutive pharmacological treatments (lorazepam, bromocriptine and amantadine) and prompt initiation of electroconvulsive therapy (ECT), clinical improvement was observed only after combining bupropion with ECT. The symptoms that had motivated the admission gradually remitted and the patient was discharged home. Bupropion increases dopaminergic activity in both the nucleus accumbens and the prefrontal cortex. Therefore, from a physiopathological standpoint, bupropion has a potential role in treating NMS. However, there is scarce evidence supporting this approach and therefore future cases should be carefully considered.

scholarly journals Basic concepts of depression

2008 ◽  
Vol 10 (3) ◽  
pp. 279-289 ◽  
Keyword(s):  
Bipolar Disorder ◽  
Affective Disorders ◽  
Life Stress ◽  
Endogenous Depression ◽  
Modern Concept ◽  
Reactive Depression ◽  
The Core ◽  
Broad Concept ◽  
Basic Concepts ◽  
The 1960S

This paper reviews concepts of depression, including history and classification. The original broad concept of melancholia included all forms of quiet insanity. The term depression began to appear in the nineteenth century, as did the modern concept of affective disorders, with the core disturbance now viewed as one of mood. The 1980s saw the introduction of defined criteria into official diagnostic schemes. The modern separation into unipolar and bipolar disorder was introduced following empirical research by Angst and Perris in the 1960s. The partially overlapping distinctions between psychotic and neurotic depression, and between endogenous and reactive depression, started to generate debate in the 1920s, with considerable multivariate research in the 1960s. The symptom element in endogenous depression currently survives in melancholia or somatic syndrome. Life stress is common in various depressive pictures. Dysthymia, a valuable diagnosis, represents a form of what was regarded earlier as neurotic depression. Other subtypes are also discussed.

scholarly journals Clinical Predictors of Short-Term Outcome in Electroconvulsive Therapy

1999 ◽  
Vol 44 (2) ◽  
pp. 158-163 ◽  
Author(s):  
Raymond W Lam ◽  
Simon Bartley ◽  
Lakshmi N Yatham ◽  
Edwin M Tam ◽  
Athanasios P Zis
Keyword(s):  
Electroconvulsive Therapy ◽  
Clinical Predictors ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome

Long-Term Risk of Developing Dementia After Electroconvulsive Therapy for Affective Disorders

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Simon Hjerrild ◽  
Johnny Kahlert ◽  
Poul-Erik Buchholtz ◽  
Raben Rosenberg ◽  
Poul Videbech
Keyword(s):  
Electroconvulsive Therapy ◽  
Affective Disorders

Which Depressed Patients will Respond to Electroconvulsive Therapy?

1989 ◽  
Vol 154 (1) ◽  
pp. 8-17 ◽  
Author(s):  
Allan I. F. Scott
Keyword(s):  
Effective Treatment ◽  
Clinical Features ◽  
Electroconvulsive Therapy ◽  
Physiological Responses ◽  
Depressive Illness ◽  
Seizure Threshold ◽  
Posterior Pituitary ◽  
Clinical Predictors ◽  
Depressed Patients ◽  
Wide Range

A small yet significant minority of contemporary patients with endogenous depressive illness who are treated with electroconvulsive therapy (ECT) gain little or no benefit. It is argued that the use of clinical features alone may not improve the ability to predict outcome after ECT. Many biological measures have been used to attempt to identify depressed patients for whom ECT would be an effective treatment, but none has yet been shown to be superior to clinical predictors. Depressed patients show a wide range of physiological responses to the first treatment of a course of ECT. Of these physiological responses, estimations of seizure threshold and of the release of posterior pituitary peptides merit further investigation as putative predictors of recovery.

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