-
Annals of Clinical Psychiatry :... Nov 2022The newly developed app TellUs is a digital offering for psychiatric outpatient treatment that includes diagnostic and therapeutic tools. The aim of this study was to...
BACKGROUND
The newly developed app TellUs is a digital offering for psychiatric outpatient treatment that includes diagnostic and therapeutic tools. The aim of this study was to test the clinical efficiency and patient satisfaction of TellUs.
METHODS
Sixty-four patients with depressive disorder took part in the study for 3 months. The intervention group was treated digitally with TellUs and the control group received visiting treatment (treatment as usual) during that time.
RESULTS
In both groups, a significant decrease of depressive symptoms and general strain through psychological symptoms, along with an increase of quality of life in the psychological domain, was shown. Furthermore, both groups were highly satisfied with the treatment.
CONCLUSIONS
TellUs was shown to be equivalent to treatment as usual in terms of clinical efficiency and patient satisfaction.
Topics: Humans; Quality of Life; Outpatients; Telemedicine; Psychotherapy; Depressive Disorder
PubMed: 36282605
DOI: 10.12788/acp.0091 -
The International Journal of... Feb 2019Treatment-resistant depression refers to major depressive disorder, treatment of the disorder, and failure to obtain an "acceptable" outcome. Regarding the disorder, the... (Review)
Review
Treatment-resistant depression refers to major depressive disorder, treatment of the disorder, and failure to obtain an "acceptable" outcome. Regarding the disorder, the heterogeneous concept of major depressive disorder and the multiple definitions of treatment-resistant depression, hesitating between a categorical and a more dimensional approach, as well as the divergence between diagnostic criteria and the items in the assessment scales are a source of confusion. Classifications do not take into account the dramatic influence of patient characteristics strongly impacting outcome, although these can be the cause of so-called pseudo-resistance. Outcome is the result of spontaneous evolution, nonspecific factors (including placebo), and active treatment factors. These should be differentiated to have a reliable estimation of the impact of different treatment modalities before we can asses treatment-resistant depression or before we can ascertain the (non)efficacy of treatments for treatment-resistant depression.The impact and burden of major depressive disorder and treatment-resistant depression are immense and go far beyond their economic cost. It is often forgotten that both are not only associated with increased suicidality but also with nonsuicidal mortality and that both can even result in requests for assisted dying. The caregiver burden and associated stigma are also too often overlooked despite that it has been suggested that they do influence (treatment) outcome.
Topics: Cost of Illness; Depressive Disorder, Major; Depressive Disorder, Treatment-Resistant; Humans
PubMed: 29961822
DOI: 10.1093/ijnp/pyy052 -
Behavioural Brain Research Feb 2019Deep brain stimulation (DBS) is a new therapeutic approach for treatment-resistant depression (TRD). There is a preliminary evidence of the efficacy and safety of DBS... (Review)
Review
Deep brain stimulation (DBS) is a new therapeutic approach for treatment-resistant depression (TRD). There is a preliminary evidence of the efficacy and safety of DBS for TRD in the subgenual anterior cingulate cortex, the ventral capsule/ventral striatum, the nucleus accumbens, the lateral habenula, the inferior thalamic peduncle, the medial forebrain bundle, and the bed nucleus of the stria terminalis. Optimal stimulation targets, however, have not yet been determined. Here we provide updated knowledge substantiating the suitability of each of the current and potential future DBS targets for treating depression. In this review, we discuss the future outlook for DBS treatment of depression in light of the fact that antidepressant effects of DBS can be achieved using different targets.
Topics: Animals; Brain; Deep Brain Stimulation; Depressive Disorder; Humans
PubMed: 30414974
DOI: 10.1016/j.bbr.2018.11.004 -
Practical Neurology Oct 2017Depression is a frequent non-motor symptom of Parkinson's disease. Its prevalence varies widely across studies (between 2.7% and 90%); around 35% have clinically... (Review)
Review
Depression is a frequent non-motor symptom of Parkinson's disease. Its prevalence varies widely across studies (between 2.7% and 90%); around 35% have clinically significant depressive symptoms. Although depression can have an immense impact on the quality of life of affected patients and their caregivers, depressive symptoms in Parkinson's disease frequently remain unrecognised and, as a result, remain untreated. Here we overview the diagnostic challenges and pitfalls, including the factors contributing to the underdiagnosis of depression. We also discuss current ideas on the underlying pathophysiology. Finally, we offer a treatment approach based on currently available evidence.
Topics: Depressive Disorder; Humans; Neurologists; Parkinson Disease
PubMed: 28739866
DOI: 10.1136/practneurol-2017-001650 -
Physiological Research 2015Reduced levels of vitamin or its metabolites have been reported in various psychiatric disorders. Insufficient levels of vitamin D in depressive patients have been... (Review)
Review
Reduced levels of vitamin or its metabolites have been reported in various psychiatric disorders. Insufficient levels of vitamin D in depressive patients have been confirmed by many authors, but there have been conflicting results in subjects with anxiety disorders. In the present cross-sectional study, levels of calcidiol were determined in groups of depressive men and women and in men and women with anxiety disorders and compared with age matched controls. Significantly lower levels of calcidiol were found in men and women with depression as well as in age matched patients with anxiety disorders.
Topics: Animals; Anxiety; Cross-Sectional Studies; Depressive Disorder; Humans; Mood Disorders; Vitamin D
PubMed: 26680471
DOI: 10.33549/physiolres.933082 -
American Journal of Psychotherapy Mar 2020Family-based interpersonal psychotherapy (FB-IPT) is an evidence-based psychosocial intervention for depression in preadolescents (ages 8-12 years). Adapted from... (Review)
Review
Family-based interpersonal psychotherapy (FB-IPT) is an evidence-based psychosocial intervention for depression in preadolescents (ages 8-12 years). Adapted from interpersonal psychotherapy for adolescents with depression and modified for younger children, this therapy includes structured dyadic sessions with preadolescents and their parents, guidance for parents in supporting their children and decreasing negative parent-child interactions, and a focus on preadolescents' comorbid anxiety and peer relationships. This article reviews the conceptual foundations and risk factors related to preadolescent depression and the rationale for focusing on improving preadolescents' interpersonal relationships to decrease depressive symptoms and risk for depression during adolescence. The structure and goals for the initial, middle, and termination phases of FB-IPT are described, as well as the specific communication and problem-solving strategies presented to preadolescents and parents. Last, research on the efficacy of FB-IPT is summarized, as are future directions for implementing this promising psychosocial intervention for preadolescent depression in community settings.
Topics: Anxiety; Child; Depression; Depressive Disorder; Family Therapy; Humans; Interpersonal Psychotherapy; Interpersonal Relations; Peer Group
PubMed: 32050785
DOI: 10.1176/appi.psychotherapy.20190028 -
Neuroscience and Biobehavioral Reviews Dec 2018Depressive disorder accounts for a substantial proportion of psychiatric problems across the globe and has a devastating impact on quality of life and occupational... (Review)
Review
Depressive disorder accounts for a substantial proportion of psychiatric problems across the globe and has a devastating impact on quality of life and occupational function. Psychological models of depression emphasize the causal role of cognitive distortions in this disease, and cognitive problems have been included in the diagnostic criteria for depressive episodes. Here, we focus on recent progress in preclinical modelling of aberrations in one of the most important neurocognitive mechanisms involved in the manifestation of depression - abnormal sensitivity to positive and negative feedback. First, we summarize the recent advances in understanding neurocognitive mechanisms of aberrant feedback sensitivity in depression and underlying neurobiological substrates. Second, by combining behavioural, neurochemical, neuroanatomical and pharmacological approaches, we evaluate the translational value of the probabilistic reversal-learning (PRL) task, a behavioural paradigm that enables investigation of correlates of feedback sensitivity in humans and animals. Finally, we identify and discuss directions for future investigation, including cognitive biomarkers of depression and resilience to stress based on feedback sensitivity and personalized treatment targets.
Topics: Animals; Depressive Disorder; Disease Models, Animal; Feedback, Psychological; Humans; Models, Psychological; Rodentia
PubMed: 30347197
DOI: 10.1016/j.neubiorev.2018.10.008 -
Behaviour Research and Therapy Nov 2014Major Depressive Disorder (MDD) is among the most prevalent of all psychiatric disorders and is the single most burdensome disease worldwide. In attempting to understand... (Review)
Review
Major Depressive Disorder (MDD) is among the most prevalent of all psychiatric disorders and is the single most burdensome disease worldwide. In attempting to understand the profound deficits that characterize MDD across multiple domains of functioning, researchers have identified aberrations in brain structure and function in individuals diagnosed with this disorder. In this review we synthesize recent data from human neuroimaging studies in presenting an integrated neural network framework for understanding the impairments experienced by individuals with MDD. We discuss the implications of these findings for assessment of and intervention for MDD. We conclude by offering directions for future research that we believe will advance our understanding of neural factors that contribute to the etiology and course of depression, and to recovery from this debilitating disorder.
Topics: Brain; Depressive Disorder; Humans; Nerve Net; Neuroimaging; Neurosciences; Psychiatric Status Rating Scales
PubMed: 25239242
DOI: 10.1016/j.brat.2014.08.008 -
Progress in Brain Research 2023Treatment-resistant depression (TRD) refers to depression that persists even after the patient has undergone adequate trials of two or more antidepressants at...
Treatment-resistant depression (TRD) refers to depression that persists even after the patient has undergone adequate trials of two or more antidepressants at appropriate doses and duration. While there may be controversy around this definition, it reflects the real-world clinical situation where drug therapy is often the primary treatment strategy for major depressive disorder. It's important to note that when a patient is diagnosed with TRD, a comprehensive evaluation of their psychosocial aspects should be carried out. Appropriate psychosocial interventions should also be provided to address the patient's needs. Various psychotherapy models have been proven effective in treating TRD, but not all of them have undergone empirical testing. As a result, some psychotherapy models may be underestimated in treating TRD. Clinicians should consult reference materials and assess the patient's psychosocial aspects to select the most appropriate psychotherapy model for TRD patients. Collaboration with psychologists, social workers, and occupational therapists can also provide valuable input in the decision-making process. This ensures that TRD patients receive comprehensive and effective care.
Topics: Humans; Depressive Disorder, Major; Psychotherapy; Antidepressive Agents; Depressive Disorder, Treatment-Resistant
PubMed: 37414492
DOI: 10.1016/bs.pbr.2023.03.001 -
European Archives of Psychiatry and... Dec 2016According to ICD-10 criteria, mixed anxiety and depressive disorder (MADD) is characterized by co-occurring, subsyndromal symptoms of anxiety and depression, severe... (Review)
Review
According to ICD-10 criteria, mixed anxiety and depressive disorder (MADD) is characterized by co-occurring, subsyndromal symptoms of anxiety and depression, severe enough to justify a psychiatric diagnosis, but neither of which are clearly predominant. MADD appears to be very common, particularly in primary care, although prevalence estimates vary, often depending on the diagnostic criteria applied. It has been associated with similarly pronounced distress, impairment of daily living skills, and reduced health-related quality of life as fully syndromal depression and anxiety. Although about half of the patients affected remit within a year, non-remitting patients are at a high risk of transition to a fully syndromal psychiatric disorder. The validity and clinical usefulness of MADD as a diagnostic category are under debate. It has not been included in the recently released DSM-5 since the proposed diagnostic criteria turned out to be not sufficiently reliable. Moreover, reviewers have disputed the justification of MADD based on divergent results regarding its prevalence and course, diagnostic stability over time, and nosological inconsistencies between subthreshold and threshold presentations of anxiety and depressive disorders. We review the evidence in favor and against MADD and argue that it should be included into classification systems as a diagnostic category because it may enable patients to gain access to appropriate treatment early. This may help to reduce patients' distress, prevent exacerbation to a more serious psychiatric disorder, and ultimately reduce the societal costs of this very common condition.
Topics: Anxiety Disorders; Depressive Disorder; Humans; International Classification of Diseases; Psychiatric Status Rating Scales
PubMed: 27002521
DOI: 10.1007/s00406-016-0684-7