scholarly journals Treatment of Depressive Conditions in Pregnancy

2018 ◽  
Vol 6 (11) ◽  
pp. 2079-2083
Author(s):  
Slavica Arsova ◽  
Stojan Bajraktarov ◽  
Kadri Hadzihamza ◽  
Viktor Isijanovski
Keyword(s):  
Depressive Disorder ◽  
Growth And Development ◽  
Antidepressant Treatment ◽  
Combined Treatment ◽  
Therapeutic Interventions ◽  
Behavioural Development ◽  
Icd 10 ◽  
Severity Of Depression ◽  
Depressive Episodes ◽  
Future Growth

BACKGROUND: Mother’s mental state during pregnancy is of substantial importance for the mother, but also for the infant and his/her future growth and development. Depressive maternal disorders during pregnancy have a significant influence on the development of the baby during pregnancy as well as on the future development and mother-baby relation, the breastfeeding process and care for the baby. AIM: This study aimed to determine the influence of SSRI antidepressant therapy and psychosocial and therapeutic interventions on depression during pregnancy. It was also our aim to determine the relation between severity of depression and sociodemographic characteristics. METHODS: The study included 40 women, with diagnosis F32 and F33 according to ICD 10, that is, with severe depressive disorder within depressive episodes or recurrent depressive disorder. Patients were evaluated at the beginning of the treatment and 3 months after antidepressant treatment. They were followed-up for two years. RESULTS: The results obtained have shown that a larger number of mothers treated with antidepressant medications, had normal childbirth with the unremarkable condition of both, the mother and the newborn baby. CONCLUSION: A well-combined treatment of maternal depression during pregnancy reduces the risk of postpartum depression, which is by itself a prerequisite for normal emotional and behavioural development of the child.

scholarly journals Depression in patients with refractory temporal lobe epilepsy

2011 ◽  
Vol 69 (5) ◽  
pp. 775-777 ◽  
Author(s):  
Eleonora Borges Gonçalves ◽  
Fernando Cendes
Keyword(s):  
Depressive Disorder ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Depressive Disorders ◽  
Antidepressant Treatment ◽  
International Classification Of Diseases ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
Major Depressive Episodes ◽  
Depressive Episodes

OBJECTIVE: To evaluate the comorbidity of depressive disorders in patients with refractory temporal lobe epilepsy (TLE). METHOD: We evaluated 25 consecutive patients with refractory TLE (16 women and 9 men), using semi-structured psychiatric interviews, according to the International Classification of Diseases (ICD-10), and the Beck Depression Inventory. RESULTS: Seventeen of 25 patients (68%) had depressive disorder: 6 with dysthymia, three with major depressive episodes and 8 with recurrent depressive disorders. Two (8%) were diagnosed with mixed anxiety and depression. Only 5 of 17 patients (29.4%) were previously diagnosed with depressive disorder and received prior antidepressant treatment. Duration of epilepsy was significantly higher in patients with depressive disorder (p=0.016), but there was no relationship between depression and seizure frequency. CONCLUSION: This study confirmed that depressive disorders are common and underdiagnosed in patients with TLE refractory to AEDs. Patients with longer duration of epilepsy are at higher risk of having depression.

The network structure of core depressive symptom-domains in major depressive disorder following antidepressant treatment: a randomized clinical trial

2020 ◽  
pp. 1-15
Author(s):  
Marcelo T. Berlim ◽  
Stephane Richard-Devantoy ◽  
Nicole Rodrigues dos Santos ◽  
Gustavo Turecki
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Graphical Models ◽  
Network Structure ◽  
Depressed Mood ◽  
Antidepressant Treatment ◽  
Therapeutic Interventions ◽  
Major Depressive ◽  
Cross Sectional ◽  
Symptom Domains

Abstract Background Network analysis (NA) conceptualizes psychiatric disorders as complex dynamic systems of mutually interacting symptoms. Major depressive disorder (MDD) is a heterogeneous clinical condition, and very few studies to date have assessed putative changes in its psychopathological network structure in response to antidepressant (AD) treatment. Methods In this randomized trial with adult depressed outpatients (n = 151), we estimated Gaussian graphical models among nine core MDD symptom-domains before and after 8 weeks of treatment with either escitalopram or desvenlafaxine. Networks were examined with the measures of cross-sectional and longitudinal structure and connectivity, centrality and predictability as well as stability and accuracy. Results At baseline, the most connected MDD symptom-domains were fatigue–cognitive disturbance, whereas at week 8 they were depressed mood–suicidality. Overall, the most central MDD symptom-domains at baseline and week 8 were, respectively, fatigue and depressed mood; in contrast, the most peripheral symptom-domain across both timepoints was appetite/weight disturbance. Furthermore, the psychopathological network at week 8 was significantly more interconnected than at baseline, and they were also structurally dissimilar. Conclusion Our findings highlight the utility of focusing on the dynamic interaction between depressive symptoms to better understand how the treatment with ADs unfolds over time. In addition, depressed mood, fatigue, and cognitive/psychomotor disturbance seem to be central MDD symptoms that may be viable targets for novel, focused therapeutic interventions.

May duration of untreated illness influence the long-term course of major depressive disorder?

2008 ◽  
Vol 23 (2) ◽  
pp. 92-96 ◽  
Author(s):  
A. Carlo Altamura ◽  
Bernardo Dell'Osso ◽  
Serena Vismara ◽  
Emanuela Mundo
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Antidepressant Treatment ◽  
Age At Onset ◽  
Major Depressive ◽  
Chi Square ◽  
Duration Of Untreated Illness ◽  
Course Variables ◽  
Depressive Episodes

AbstractThe aim of this naturalistic study was to investigate the possible influence of the duration of untreated illness (DUI) on the long-term course of Major Depressive Disorder (MDD). One hundred and thirteen patients with recurrent MDD, according to DSM-IV-TR criteria, followed up for 5 years, were selected, interviewed and their clinical charts were reviewed. The DUI was defined as the interval between the onset of the first depressive episode and the first adequate antidepressant treatment. The sample was divided into two groups according to the DUI: one group with a DUI ≤ 12 months (n = 75), and the other with a DUI > 12 months (n = 38). The main demographic and clinical course variables were compared between the two groups using Student's t-tests or chi-square tests. Patients with a longer DUI showed an earlier age at onset (t = 2.82, p = 0.006) and a longer duration of illness (t = 3.20, p = 0.002) compared to patients with a shorter DUI. In addition, the total number of depressive episodes occurring before the first antidepressant treatment was higher in the group with a longer DUI (t = −2.223, p < 0.03). Even though limited by the retrospective nature of the study, these preliminary findings would suggest that a longer DUI may negatively influence the course of MDD. Larger prospective studies are warranted to further investigate the role of the DUI within MDD.

scholarly journals Recent advances in predicting responses to antidepressant treatment

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 619 ◽  
Author(s):  
Thomas Frodl
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Targeted Therapies ◽  
Antidepressant Treatment ◽  
Inflammation Markers ◽  
Major Depressive ◽  
The Past ◽  
Recent Advances ◽  
The World ◽  
Depressive Episodes

Major depressive disorder is one of the leading causes of disability in the world since depression is highly frequent and causes a strong burden. In order to reduce the duration of depressive episodes, clinicians would need to choose the most effective therapy for each individual right away. A prerequisite for this would be to have biomarkers at hand that would predict which individual would benefit from which kind of therapy (for example, pharmacotherapy or psychotherapy) or even from which kind of antidepressant class. In the past, neuroimaging, electroencephalogram, genetic, proteomic, and inflammation markers have been under investigation for their utility to predict targeted therapies. The present overview demonstrates recent advances in all of these different methodological areas and concludes that these approaches are promising but also that the aim to have such a marker available has not yet been reached. For example, the integration of markers from different systems needs to be achieved. With ongoing advances in the accuracy of sensing techniques and improvement of modelling approaches, this challenge might be achievable.

scholarly journals Severity of depressive episodes during the course of depressive disorder

2008 ◽  
Vol 192 (4) ◽  
pp. 290-293 ◽  
Author(s):  
Lars Vedel Kessing
Keyword(s):  
Depressive Disorder ◽  
Depressive Episode ◽  
Prophylactic Treatment ◽  
First Episode ◽  
Case Register ◽  
Course Of Illness ◽  
Icd 10 ◽  
Single Depressive Episode ◽  
First Contact ◽  
Depressive Episodes

BackgroundIt is not clear whether the severity of depressive episodes changes during the course of depressive disorder.AimsTo investigate whether the severity of depressive episodes increases during the course of illness.MethodUsing a Danish nationwide case register, all psychiatric inpatients and out-patients with a main ICD-10 diagnosis of a single mild, moderate or severe depressive episode at the end of first contact were identified. Patients included in the study were from the period 1994–2003.ResultsA total of 19 392 patients received a diagnosis of a single depressive episode at first contact. The prevalence of severe depressive episodes increased from 25.5% at the first episode to 50.0% at the 15th episode and the prevalence of psychotic episodes increased from 8.7% at the first episode to 25.0% at the 15th episode. The same pattern was found regardless of gender, age at first contact and calendar year.ConclusionsThe increasing severity of depressive episodes emphasises the importance of early and sustained prophylactic treatment.

Psychological treatments

Depression ◽  
2018 ◽  
pp. 53-62 ◽  
Author(s):  
Raymond W. Lam
Keyword(s):  
Combined Treatment ◽  
Behavioural Therapy ◽  
Problem Solving Therapy ◽  
Psychological Treatments ◽  
Cognitive Behavioural ◽  
Alternate Forms ◽  
Severity Of Depression ◽  
Analysis System ◽  
Evidenced Based ◽  
Depressive Episodes

Evidenced-based psychological treatments for acute depression include problem solving therapy, behavioural activation, cognitive behavioural therapy, interpersonal psychotherapy, and, for chronic depression, cognitive behavioural-analysis system of psychotherapy. Mindfulness-based cognitive therapy, originally developed as a maintenance treatment, also has benefit in acute depressive episodes. Technologies that can deliver therapy via computer, internet or mobile devices, with or without therapist guidance, have increasing evidence to support their use as alternate forms of therapy. For mild to moderate severity of depression, evidence-based psychological treatments are first-line treatments and are as effective as pharmacotherapy. Combined treatment with psychotherapy and pharmacotherapy is more effective than either monotherapy and is clinically indicated for more severe, chronic or comorbid depressions.

Use of the Hypomania Checklist-32 and the Mood Disorder Questionnaire for detecting bipolarity in 1,051 patients with major depressive disorder

2011 ◽  
Vol 27 (8) ◽  
pp. 577-581 ◽  
Author(s):  
J.K. Rybakowski ◽  
D. Dudek ◽  
T. Pawlowski ◽  
D. Lojko ◽  
M. Siwek ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Mood Disorder ◽  
Antidepressant Drugs ◽  
Severe Form ◽  
Major Depressive ◽  
Psychiatric Hospitalizations ◽  
Mood Disorder Questionnaire ◽  
Icd 10 ◽  
Depressive Episodes

AbstractPurposeTo use the Hypomania Checklist (HCL-32) and the Mood Disorder Questionnaire (MDQ), for detecting bipolarity in depressed patients.PatientsOne thousand and fifty-one patients fulfilling ICD-10 criteria for unipolar major depressive episode, single or recurrent, were studied. Patients were assessed using a structured demographic and clinical data interview, and by the Polish versions of the HCL-32 and MDQ questionnaires.ResultsHypomanic symptoms exceeding cut-off criteria for bipolarity by HCL-32 were found in 37.5% of patients and, by MDQ, in 20% of patients. Patients with HCL-32 (+) or MDQ (+) differed significantly from patients with HCl-32 (−) and MDQ (−) respectively, by being less frequently married, having more family history of depression, bipolar disorder, alcoholism and suicide, earlier onset of illness, and more depressive episodes and psychiatric hospitalizations. The percentage of patients resistant to treatment with antidepressant drugs was significantly higher in HCL-32 (+) vs HCL-32 (−) and in MDQ (+) vs MDQ (−): 43.9% vs 30.0%, and 26.4% vs 12.4%, respectively.ConclusionsThe results confirm a substantial percentage of bipolarity in major depressive disorder. Such patients have a number of clinical characteristics pointing on a more severe form of the illness and their depression is more resistant to treatment with antidepressants.

scholarly journals Maintenance Pharmacotherapy for Recurrent Major Depressive Disorder in Primary Care: A 5-year Follow-up Study

2017 ◽  
Vol 41 (1) ◽  
pp. 111-114 ◽  
Author(s):  
K. Riihimäki ◽  
M. Vuorilehto ◽  
E. Isometsä
Keyword(s):  
Primary Care ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Maintenance Treatment ◽  
Antidepressant Treatment ◽  
Major Depressive ◽  
Recurrent Major Depressive Disorder ◽  
Major Depressive Episodes ◽  
Depressive Episodes

AbstractBackgroundMost practice guidelines recommend maintenance antidepressant treatment for recurrent major depressive disorder. However, the degree to which such guidance is actually followed in primary health care has remained obscure. We investigated the provision of maintenance antidepressant treatment within a representative primary care five-year cohort study.MethodsIn the Vantaa Primary Care Depression Study, a stratified random sample of 1119 adult patients was screened for depression using the Prime-MD. Depressive and comorbid psychiatric disorders were diagnosed using SCID-I/P and SCID-II interviews. Of the 137 patients with depressive disorders, 82% completed the prospective five-year follow-up. A graphic life chart enabling evaluation of the longitudinal course of episodes plus duration of pharmacotherapies was used. In accordance with national guidelines, an indication for maintenance treatment was defined to exist after three or more lifetime major depressive episodes (MDEs); maintenance treatment was to commence four months after onset of full remission.ResultsOf the cohort patients, 34% (46/137) had three or more lifetime MDEs, thus indicating the requirement for maintenance pharmacotherapy. Of these, half (54%, 25/46) received maintenance treatment, for only 29% (489/1670) of the months indicated.ConclusionsIn this cohort of depressed primary care patients, half of patients with indications for maintenance treatment actually received it, and only for a fraction of the time indicated. Antidepressant maintenance treatment for the prevention of recurrences is unlikely to be subject to large-scale actualization as recommended, which may significantly undermine the potential public health benefits of treatment.

BDNF and NT3 concentrations in post-mortem brain tissue of individuals with recurrent depressive disorder

2011 ◽  
Vol 26 (S2) ◽  
pp. 689-689
Author(s):  
A.J. Sheldrick ◽  
S. Camara ◽  
P. Riederer ◽  
T.M. Michel
Keyword(s):  
Depressive Disorder ◽  
Brain Tissue ◽  
Antidepressant Treatment ◽  
Brain Regions ◽  
Post Mortem ◽  
Post Mortem Brain ◽  
Neurotrophin 3 ◽  
Therapeutic Mechanism ◽  
Icd 10 ◽  
History Of

IntroductionNeurotrophines such as brain-derived neurotrophic factor (BDNF) and neurotrophin 3 (NT3) have been implicated in the pathogenesis of depression and the therapeutic mechanism of antidepressants. Several clinical studies on depressive disorder (DD) have shown that levels of blood BDNF are diminished in depression and increase during antidepressant treatment. So far, only few studies have examined concentrations of neurotrophic factors in post-mortem brain tissue of individuals who suffered from DD.Objectives/aimsThe objective of the study was to show whether BDNF and NT3 levels in post-mortem brain tissue of individuals who suffered from recurrent DD and who had been treated with antidepressants differed compared to controls.MethodsSpecimens from cortical and limbic areas of post-mortem brain tissue of 7 individuals with an ante-mortem diagnosis of recurrent depressive disorder based on ICD-10 criteria (F33.0–F33.8) who received no psychotropic medication other than selective serotonin re-uptake inhibitors 6 months preceding death were selected. We compared the concentrations of BDNF and NT3 with 14 matched controls without any history of psychiatric disorder or treatment with psychotropic drugs.ResultsWe detected no significant differences of either NT 3 or BDNF concentrations in any of the brain regions examined in patients who had suffered from DD and had been treated with antidepressants compared to controls.ConclusionsThese findings could be interpreted as a neurotrophic effect of antidepressant treatment in patients with recurrent DD, supporting the notion that depression improvement is associated with neuroplastic changes. However, more research using post-mortem brain tissue is needed.

scholarly journals Severity of depressive episodes according to ICD-10: prediction of risk of relapse and suicide

2004 ◽  
Vol 184 (2) ◽  
pp. 153-156 ◽  
Author(s):  
Lars Vedel Kessing
Keyword(s):  
Depressive Episode ◽  
Predictive Ability ◽  
Course Of Illness ◽  
Icd 10 ◽  
Single Depressive Episode ◽  
Severity Of Depression ◽  
Depressive Episodes ◽  
Risk Of Relapse

BackgroundThe ICD–10 categorisation of severity of depression into mild, moderate and severe depressive episodes has not been validated.AimsTo validate the ICD–10 categorisation of severity of depression by estimating its predictive ability on the course of illness and suicidal outcome.MethodAll psychiatric in-patients in Denmark who had received a diagnosis of a single depressive episode at their first discharge between 1994 and 1999 were identified. The risk of relapse and the risk of suicide were compared for patients discharged with an ICD–10 diagnosis of a single mild, moderate or severe depressive episode.ResultsAt their first discharge, 1103 patients had an ICD–10 diagnosis of mild depressive episode, 3182 had a diagnosis of moderate depressive episode and 2914 had a diagnosis of severe depressive episode. The risk of relapse and the risk of suicide were significantly different for the three types of depression – increasing from mild to moderate to severe depressive episode.ConclusionsThe ICD–10 way of grading severity is clinically useful and should be preserved in future versions.

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