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Psychiatry and Clinical Neurosciences Feb 2016Autobiographical memory (AM) is a ubiquitous human experience that belongs to long-term declarative memory. It plays interpersonal and intrapsychic functions. The main... (Review)
Review
Autobiographical memory (AM) is a ubiquitous human experience that belongs to long-term declarative memory. It plays interpersonal and intrapsychic functions. The main aim of this study is to present results of contemporary research on AM in recurrent depressive disorders. The available research literature suggests that AM dysfunctions are a precursor and risk factor for recurrent depressive disorders and that they also appear to be a consequence of depressive symptoms in a bidirectional and interacting manner. These data suggest that AM might be a viable therapeutic target for cognitive remediation strategies, given the impact of cognition on diverse clinical outcomes.
Topics: Cognition; Depressive Disorder; Humans; Memory Disorders; Memory, Episodic
PubMed: 26522618
DOI: 10.1111/pcn.12370 -
Canadian Journal of Psychiatry. Revue... Feb 2018Obsessive-compulsive symptoms (OCS) co-occur frequently with anxiety and depressive disorders, but the nature of their relationship and their impact on severity of...
OBJECTIVE
Obsessive-compulsive symptoms (OCS) co-occur frequently with anxiety and depressive disorders, but the nature of their relationship and their impact on severity of anxiety and depressive disorders is poorly understood. In a large sample of patients with anxiety and depressive disorders, we assessed the frequency of OCS, defined as a Young Adult Self-Report Scale-obsessive-compulsive symptoms score >7. The associations between OCS and severity of anxiety and/or depressive disorders were examined, and it was investigated whether OCS predict onset, relapse, and persistence of anxiety and depressive disorders.
METHODS
Data were obtained from the third (at 2-year follow-up) and fourth wave (at 4-year follow-up) of data collection in the Netherlands Study of Anxiety and Depression cohort, including 469 healthy controls, 909 participants with a remitted disorder, and 747 participants with a current anxiety and/or depressive disorder.
RESULTS
OCS were present in 23.6% of the total sample, most notably in those with current combined anxiety and depressive disorders. In patients with a current disorder, OCS were associated with severity of this disorder. Moreover, OCS predicted (1) first onset of anxiety and/or depressive disorders in healthy controls (odds ratio [OR], 5.79; 95% confidence interval [CI], 1.15 to 29.14), (2) relapse in those with remitted anxiety and/or depressive disorders (OR, 2.31; 95% CI, 1.55 to 3.46), and (3) persistence in patients with the combination of current anxiety and depressive disorders (OR, 4.42; 95% CI, 2.54 to 7.70) within the 2-year follow-up period Conclusions: OCS are closely related to both the presence and severity of anxiety and depressive disorders and affect their course trajectories. Hence, OCS might be regarded as a course specifier signaling unfavorable outcomes. This specifier may be useful in clinical care to adapt and intensify treatment in individual patients.
Topics: Adult; Anxiety Disorders; Comorbidity; Depressive Disorder; Female; Follow-Up Studies; Humans; Male; Middle Aged; Netherlands; Obsessive-Compulsive Disorder; Prevalence; Prognosis; Severity of Illness Index
PubMed: 28511595
DOI: 10.1177/0706743717711170 -
Harvard Review of Psychiatry 2018Major depressive disorder (MDD) is one of the most prevalent conditions in psychiatry. Patients who do not respond to traditional monoaminergic antidepressant treatments... (Review)
Review
Major depressive disorder (MDD) is one of the most prevalent conditions in psychiatry. Patients who do not respond to traditional monoaminergic antidepressant treatments have an especially difficult-to-treat type of MDD termed treatment-resistant depression. Subanesthetic doses of ketamine-a glutamatergic modulator-have shown great promise for rapidly treating patients with the most severe forms of depression. As such, ketamine represents a promising probe for understanding the pathophysiology of depression and treatment response. Through neuroimaging, ketamine's mechanism may be elucidated in humans. Here, we review 47 articles of ketamine's effects as revealed by neuroimaging studies. Some important brain areas emerge, especially the subgenual anterior cingulate cortex. Furthermore, ketamine may decrease the ability to self-monitor, may increase emotional blunting, and may increase activity in reward processing. Further studies are needed, however, to elucidate ketamine's mechanism of antidepressant action.
Topics: Antidepressive Agents; Cerebral Cortex; Depressive Disorder, Major; Depressive Disorder, Treatment-Resistant; Humans; Ketamine
PubMed: 29465479
DOI: 10.1097/HRP.0000000000000179 -
European Archives of Psychiatry and... Apr 2021
Topics: Antidepressive Agents; Depressive Disorder, Major; Humans; Ketamine; Precision Medicine
PubMed: 33666694
DOI: 10.1007/s00406-021-01249-9 -
BMC Psychiatry Aug 2022Major depressive disorder (MDD) is one of the most common mental disorders worldwide, estimated to affect 10-15% of the population per year. Treatment resistant...
INTRODUCTION
Major depressive disorder (MDD) is one of the most common mental disorders worldwide, estimated to affect 10-15% of the population per year. Treatment resistant depression (TRD) is estimated to affect a third of these patients who show difficulties in social and occupational function, decline of physical health, suicidal thoughts and increased health care utilization. We describe the prevalence of MDD, TRD and associated healthcare resource utilization in Maccabi Healthcare Services (MHS), a 2.5 million-member state-mandated health service in Israel.
METHODS
All MHS members with an MDD diagnosis were identified within the years 2017-2018 and prevalence assessed by age, sex and TRD. To assess the incidence of MDD, members aged 18-65 years at the start of any MDD episode were identified between 1 January 2016 and 31 May 2018 with at least one systemic first-line antidepressant treatment within three months before or after the initial episode. Treatment patterns, time on first-line treatment, and healthcare resource utilization were compared by TRD.
RESULTS
A total of 4960 eligible MDD patients were identified (median age = 51 years, 65% female), representing a period prevalence of 0.218%, and of those, a high proportion of patients received drug treatment (92%). Among incident MDD cases (n = 2553), 24.4% had TRD. Factors associated with TRD included increasing age and personality disorder. Median time on treatment was 3.7 months (longer for those without TRD than those with) and 81.9% of patients purchased more than one month's supply of therapy. In the year after index, patients with TRD had a significant increased number of visits to primary care physicians, psychiatrists, emergency room visits, general hospitalizations, and psychiatric hospitalizations.
CONCLUSION
Our study shows that prevalence of MDD in Israel is low compared to other countries, however once diagnosed, patients' are likely to receive drug treatment. Among patients diagnosed with MDD, the proportion of TRD is similar to other countries, increases with age and is associated with increased healthcare utilization, therefore should be a focus of continued research for finding effective long term treatment options.
Topics: Antidepressive Agents; Depressive Disorder, Major; Depressive Disorder, Treatment-Resistant; Female; Humans; Israel; Male; Middle Aged; Retrospective Studies
PubMed: 35948895
DOI: 10.1186/s12888-022-04184-8 -
International Journal of Molecular... Jan 2016Accumulating evidence regarding clinical, neurobiological, genetic, and environmental factors suggests a bidirectional link between obesity and depressive disorders.... (Review)
Review
Accumulating evidence regarding clinical, neurobiological, genetic, and environmental factors suggests a bidirectional link between obesity and depressive disorders. Although a few studies have investigated the link between obesity/excess body weight and the response to antidepressants in depressive disorders, the effect of weight on treatment response remains poorly understood. In this review, we summarized recent data regarding the relationship between the response to antidepressants and obesity/excess body weight in clinical studies of patients with depressive disorders. Although several studies indicated an association between obesity/excess body weight and poor antidepressant responses, it is difficult to draw definitive conclusions due to the variability of subject composition and methodological differences among studies. Especially, differences in sex, age and menopausal status, depressive symptom subtypes, and antidepressants administered may have caused inconsistencies in the results among studies. The relationship between obesity/excess body weight and antidepressant responses should be investigated further in high-powered studies addressing the differential effects on subject characteristics and treatment. Moreover, future research should focus on the roles of mediating factors, such as inflammatory markers and neurocognitive performance, which may alter the antidepressant treatment outcome in patients with comorbid obesity and depressive disorder.
Topics: Adult; Age Factors; Antidepressive Agents; Body Mass Index; Clinical Trials as Topic; Depressive Disorder; Female; Humans; Male; Middle Aged; Obesity; Prognosis; Sex Factors; Treatment Outcome
PubMed: 26771598
DOI: 10.3390/ijms17010080 -
Journal of Affective Disorders Apr 2020This study investigated the eight-year course and outcomes of depressive mood disorders and the key outcome predictors among adolescent outpatients.
OBJECTIVES
This study investigated the eight-year course and outcomes of depressive mood disorders and the key outcome predictors among adolescent outpatients.
METHODS
Depressive adolescent outpatients (N = 148) in a naturalistic clinical setting were assessed at baseline, six months, 12 months and eight years using diagnostic and self-report instruments. Baseline predictors covered selected sociodemographic, clinical and treatment-related characteristics. The outcomes were time to recovery, recurrence, time spent being ill and longitudinal latent profiles of depressive symptoms.
RESULTS
The recovery rate from any depressive mood disorder was 73% at two years, 91% at five years and 94% by the end of the eight-year follow-up. Two thirds (67%) of the subjects presented at least one recurrence and 57% of them were depressed for 25% or more of the follow-up period. At the eight-year follow-up, 36% had a mood disorder, 48% suffered from anxiety and 26% had a personality disorder. Less severe depression at baseline predicted a shorter time to recovery, whereas recurrence was predicted by a younger age. A latent profile with initially moderate-level depressive symptoms but a poor distal outcome was associated with being female and borderline personality disorder.
LIMITATIONS
The female preponderance in the sample warrants caution when interpreting sex differences in the findings.
CONCLUSIONS
Although the depression outcome for some adolescents making the transition to young adulthood is promising, many of them experience long, even chronic episodes, and recurrences are common. Personality-disorder characteristics appeared to be significant outcome predictors in this adolescent population.
Topics: Adolescent; Adult; Depression; Depressive Disorder; Female; Follow-Up Studies; Humans; Male; Mood Disorders; Outpatients; Recurrence; Young Adult
PubMed: 32056921
DOI: 10.1016/j.jad.2020.01.174 -
European Review For Medical and... Jul 2020Major depression disorder (MDD) is an extremely prevalent disorder and is expected to be the second leading cause of disease burden by 2020 according to the World Health... (Review)
Review
Major depression disorder (MDD) is an extremely prevalent disorder and is expected to be the second leading cause of disease burden by 2020 according to the World Health Organisation (WHO). Moreover, this disease burden is predicted to rise in the next 20 years. Antidepressant medications are vital in the therapy of major depression. However, approximately 30-60% of patients treated with current antidepressant drugs fail to attain remission of depressive symptoms leading to drug resistance. Such patients account for a disproportionately great burden of disease, as supported by cost, augmented disability, and suicidal incidents. Antidepressants resistance remains to challenge mental health care professionals, and more relevant research relating newer medications is necessitated to enhance the quality of life of patients with depression. Enhancement in response rates continues the major challenge in antidepressant research, thus a wealth of potentials still exists concerning the antidepressant resistance for the management of major depression. However, the mechanisms causing resistance to antidepressant treatment remain unknown. Hence, clinical and basic research in understanding the fundamental mechanism of antidepressant resistance should remain a key priority. One potential source accounting for these differences in treatment outcome is genetic variations. The pharmacological mechanisms behind antidepressant response are only partly known but genetic factors play a significant role. Future research of risk factors should assist to advance the understanding of the mechanisms underlying drug resistance in mood disorders and contribute to progress their therapeutic management. Thus, psychiatrists could rely on more effective approaches to treat depressive episodes, reducing the incidence of further drug resistance. This review critically summarises the author's view on many aspects of treatment resistance, specific genetic biomarkers, potential strategies and clinical relevance from both clinical and preclinical studies in drug resistance to antidepressant therapies. Finally, this will allow us to suggest possible recommendations and innovative treatment strategies to improve therapeutic outcomes in managing antidepressant resistance.
Topics: Affect; Antidepressive Agents; Depressive Disorder, Major; Depressive Disorder, Treatment-Resistant; Drug Resistance; Humans; Mental Health; Pharmacogenomic Variants; Polymorphism, Single Nucleotide
PubMed: 32744705
DOI: 10.26355/eurrev_202007_22281 -
The Indian Journal of Medical Research Apr 2017
Topics: Depressive Disorder; History, Ancient; Humans; India
PubMed: 28862171
DOI: 10.4103/ijmr.IJMR_295_17 -
Child and Adolescent Psychiatric... Jul 2017This article reviews recent empirical literature on the prevalence, correlates, assessment, and treatment of preschool-onset internalizing disorders. Major advances in... (Review)
Review
This article reviews recent empirical literature on the prevalence, correlates, assessment, and treatment of preschool-onset internalizing disorders. Major advances in the acceptance and recognition of both preschool-onset depression and anxiety have occurred over the past decade. This work has been greatly enhanced by the discovery of genetic, neural, and physiologic indicators, which further validate these constellations of symptoms in young children. Despite this growth in research, much work still needs to be done to further elucidate the cause, risk, treatment, and protective factors for preschool-onset internalizing disorders.
Topics: Anxiety Disorders; Child, Preschool; Depressive Disorder; Humans
PubMed: 28577606
DOI: 10.1016/j.chc.2017.02.006