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The Journal of Nervous and Mental... Jun 2021The specific relationships between impulsiveness, inattention, sad, low mood, and irritability have not been systematically examined in young people with major...
The specific relationships between impulsiveness, inattention, sad, low mood, and irritability have not been systematically examined in young people with major depressive disorder with and without persistent depressive disorder. The relationships are important to clarify because these symptom dimensions may increase suicidal risk in children and adolescents with these depressive disorders. A total of 313 medication-naive young people (aged 6-16 years) with active major depressive disorder (MDD) alone, persistent depressive disorder (DD) alone, and comorbid MDD and DD were identified. "Inattention," "sad/unhappy," and "irritable" mood were identified by parent standardized questionnaire. Standard multiple regression was used to investigate how well inattention, sad/unhappy, and irritable mood predict impulsiveness. Inattention (32% of the variance, increased) and irritable mood (5% of the variance, increased) both made independent significant contributions to impulsiveness, whereas sad/unhappy mood did not. Decreasing irritability via more targeted and comprehensive management approaches may ameliorate impulsiveness in young people with these depressive disorders.
Topics: Adolescent; Adolescent Behavior; Attention; Child; Child Behavior; Comorbidity; Depressive Disorder, Major; Dysthymic Disorder; Female; Humans; Impulsive Behavior; Irritable Mood; Male; Sadness
PubMed: 34037553
DOI: 10.1097/NMD.0000000000001293 -
Frontiers in Psychology 2021Emotional disorder symptoms are highly prevalent and a common cause of disability among children and adolescents. Screening and early detection are needed to identify...
Emotional disorder symptoms are highly prevalent and a common cause of disability among children and adolescents. Screening and early detection are needed to identify those who need help and to improve treatment outcomes. Nowadays, especially with the arrival of the COVID-19 outbreak, assessment is increasingly conducted online, resulting in the need for brief online screening measures. The aim of the current study was to examine the reliability and different sources of validity evidence of a new web-based screening questionnaire for emotional disorder symptoms, the DetectaWeb-Distress Scale, which assesses mood (major depression and dysthymic disorder), anxiety (separation anxiety, generalized anxiety, social phobia, panic disorder/agoraphobia, and specific phobia), obsessive-compulsive disorder, post-traumatic stress disorder, suicidality (suicidal ideation, plans, and attempts), and global distress. A total of 1,499 participants (aged 8-18) completed the DetectaWeb-Distress Scale and specific questionnaires for emotional disorder symptoms, suicidal behaviors, and well-being through a web-based survey. Results indicated that a structural model of 10 correlated factors fits reasonably better in comparison to the remaining models; measurement invariance for age and gender; good internal consistency (McDonald's ω ranging from 0.65 to 0.94); and significant positive correlation with other measures of anxiety, depression, PTSD, or distress, and negative correlation with well-being measures, displaying support for convergent-discriminant validity. We also found that girls scored higher than boys on most of the subscales, and children had higher scores for social anxiety, specific phobia, panic disorder, and obsessive-compulsive symptoms, whereas adolescents scored higher on depressive symptoms, suicidality, and generalized anxiety, but the effect sizes were small to medium for all comparisons. The DetectaWeb-Distress Scale is a valid, innovative, and useful online tool for the screening and evaluation of preventive programs for mental health in children and adolescents.
PubMed: 33658965
DOI: 10.3389/fpsyg.2021.627604 -
BMJ Open Feb 2021To assess the global prevalence estimates of depressive symptoms, dysthymia and major depressive disorders (MDDs) among homeless people. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To assess the global prevalence estimates of depressive symptoms, dysthymia and major depressive disorders (MDDs) among homeless people.
DESIGN
Systematic review and meta-analysis.
DATA SOURCES
Databases including PubMed, Scopus and Web of Science were systematically searched up to February 2020 to identify relevant studies that have reported data on the prevalence of depressive symptoms, dysthymia and MDDs among homeless people.
ELIGIBILITY CRITERIA
Original epidemiological studies written in English that addressed the prevalence of depressive problems among homeless people.
DATA EXTRACTION AND SYNTHESIS
A random-effect meta-analysis was performed to pool the prevalence estimated from individual studies. Subgroup and sensitivity analyses were employed to compare the prevalence across the groups as well as to identify the source of heterogeneities. The Joanna Briggs Institute's quality assessment checklist was used to measure the study quality. Cochran's Q and the I test were used to assess heterogeneity between the studies.
RESULTS
Forty publications, including 17 215 participants, were included in the final analysis. This meta-analysis demonstrated considerably higher prevalence rates of depressive symptoms 46.72% (95% CI 37.77% to 55.90%), dysthymia 8.25% (95% CI 4.79% to 11.86%), as well as MDDs 26.24% (95% CI 21.02% to 32.22%) among homeless people. Our subgroup analysis showed that the prevalence of depressive symptoms was high among younger homeless people (<25 years of age), whereas the prevalence of MDD was high among older homeless people (>50 years of age) when compared with adults (25-50 years).
CONCLUSION
This review showed that nearly half, one-fourth and one-tenth of homeless people are suffering from depressive symptoms, dysthymia and MDDs, respectively, which are notably higher than the reported prevalence rates in the general population. The findings suggest the need for appropriate mental health prevention and treatment strategies for this population group.
Topics: Adult; Depression; Depressive Disorder, Major; Dysthymic Disorder; Ill-Housed Persons; Humans; Middle Aged; Prevalence
PubMed: 33622940
DOI: 10.1136/bmjopen-2020-040061 -
Journal of Clinical Psychology Feb 2021Intensive short-term dynamic psychotherapy (ISTDP) was developed to manage treatment impasses preventing the experiencing of feelings related to childhood attachment...
Intensive short-term dynamic psychotherapy (ISTDP) was developed to manage treatment impasses preventing the experiencing of feelings related to childhood attachment interruptions, such as parental loss. According to ISTDP theory, certain categories of patients will exhibit habitual patterns of responding within the treatment relationship (called defenses) to certain anxiety-provoking thoughts and feelings. Such defensive behaviors interrupt awareness of one's own feelings, self-directed compassion and engagement in close human attachments, including the bond with the therapist. Rupture-repair sequences in ISTDP are primarily considered in the context of a patient's defenses and the responses a therapist has to these defenses. By understanding and clarifying these defenses, this risk of subsequent misalliance, that is negative shifts or ruptures in the alliance, are minimized. In this paper we summarize ISTDP theory and technique through the use of clinical vignettes to illustrate defense management as a rupture-repair equivalent in ISTDP.
Topics: Anxiety; Dysthymic Disorder; Emotions; Humans; Male; Middle Aged; Object Attachment; Psychotherapy, Brief; Psychotherapy, Psychodynamic; Therapeutic Alliance
PubMed: 33476417
DOI: 10.1002/jclp.23115 -
Psychotherapy Research : Journal of the... Nov 2021This study explored whether treatment outcomes in a trial on the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) vs. Supportive Psychotherapy (SP) for... (Randomized Controlled Trial)
Randomized Controlled Trial
This study explored whether treatment outcomes in a trial on the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) vs. Supportive Psychotherapy (SP) for patients with early-onset chronic depression differ between alliance patterns. Session-to-session ratings of the therapeutic alliance (Helping Alliance Questionnaire (HAQ)) from 254 outpatients with chronic depression (CBASP: 134; SP: 120) who took part in a multicenter randomized controlled trial of CBASP vs. SP were used to categorize patients into three alliance pattern categories for the patients' and therapists' rating separately. Based on the reliable change in the HAQ from one session to the next categories were: no rupture, unrepaired rupture, rupture-repair. Depression severity (24-item Hamilton Rating Scale for Depression) at post-treatment, at 12- and 24- months follow-up was the outcome. The alliance pattern categories for therapists and patients did not differ between CBASP and SP. Only the alliance patterns calculated for patients were associated with outcome: in the unrepaired rupture category, patients had higher HRSD-ratings across time points ( = 0.047). CBASP was not associated with more or fewer ruptures or repairs as compared to SP in the treatment of chronic depression. The study highlights the need to resolve ruptures to avoid poor outcomes. ClinicalTrials.gov identifier: NCT00970437.
Topics: Cognitive Behavioral Therapy; Depression; Dysthymic Disorder; Humans; Psychotherapy; Therapeutic Alliance; Treatment Outcome
PubMed: 33455531
DOI: 10.1080/10503307.2021.1874070 -
Psychophysiology Apr 2021Neurocognitive impairments commonly observed in depressive disorders are thought to be reflected in reduced P300 amplitudes. To date, depression-related P300 amplitude...
Neurocognitive impairments commonly observed in depressive disorders are thought to be reflected in reduced P300 amplitudes. To date, depression-related P300 amplitude reduction has mostly been demonstrated cross-sectionally, while its clinical implication for the course of depression remains largely unclear. Moreover, the relationship between P300 and specific clinical characteristics of depression is uncertain. To shed light on the functional significance of the P300 in depression, we examined whether initial P300 amplitude prospectively predicted changes in depressive symptoms among a community sample of 58 adults (mean age = 38.86 years old, 81% female) with a current depressive disorder. This sample was assessed at two-time points, separated by approximately nine months (range = 6.6-15.9). At the initial visit, participants completed clinical interviews, self-report measures, and a flanker task, while EEG was recorded to derive P300 amplitude. At the follow-up visit, participants again completed the same clinical interviews and self-report measures. Results indicated that a reduced P300 amplitude at the initial visit was associated with higher total depressive symptoms at follow-up, even after controlling for initial depressive symptoms. These data indicate the potential clinical utility for the P300 as a neural marker of disease course among adults with a current depressive disorder. Future research may target P300 in interventions to determine whether depression-related outcomes can be improved.
Topics: Adolescent; Adult; Biomarkers; Depressive Disorder, Major; Dysthymic Disorder; Electroencephalography; Event-Related Potentials, P300; Female; Follow-Up Studies; Humans; Male; Middle Aged; Young Adult
PubMed: 33433019
DOI: 10.1111/psyp.13767 -
Acta Neuropsychiatrica Jun 2021To evaluate the use of biofeedback intervention in the levels of depression. The main hypothesis tested if the use of biofeedback improves depression levels compared to... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To evaluate the use of biofeedback intervention in the levels of depression. The main hypothesis tested if the use of biofeedback improves depression levels compared to the control group.
METHODS
A randomised clinical trial. The final sample was composed of 36 participants (18 in the experimental group, receiving 6 training, once a week, with biofeedback; and 18 in the control group, who received conventional treatment in the service).Outcome measures were assessed in two stages: pre-test and post-test. The research used the following instruments: demographic survey data, Mini International Neuropsychiatric Interview 5.0.0 and Beck Depression Inventory (BDI). The factors and variables were presented in terms of descriptive and inferential statistics. Fisher's exact test (p < 0.05) was used to verify the existence of an association between the counting variables. The multinomial logistic regression model was adopted, and the Logit link function was used, as the software RStudio version 3.6.2.
RESULTS
The factors that remained in the final model were group, sex, partner, atypical antidepressant, benzodiazepines, mood stabiliser, antiepileptic and antihistamine, according to the levels of depression based on the BDI. The group that did not receive biofeedback intervention had 16 times more chances of increasing the depression levels compared to participants in the experimental group.
CONCLUSION
The use of biofeedback reduces depression, thus, representing a complementary alternative for the treatment of moderate and severe depression, and dysthymia.
Topics: Adult; Antidepressive Agents; Biofeedback, Psychology; Case-Control Studies; Depression; Dysthymic Disorder; Female; Humans; Logistic Models; Male; Middle Aged; Outcome Assessment, Health Care; Prevalence; Psychiatric Status Rating Scales; Risk Factors; Severity of Illness Index; Surveys and Questionnaires
PubMed: 33427129
DOI: 10.1017/neu.2020.46 -
Vnitrni Lekarstvi 2020Long lasting, low intensity depressive episodes have been diversely integrated according to the classifications types or the psychodynamic points of view. The concept of...
Long lasting, low intensity depressive episodes have been diversely integrated according to the classifications types or the psychodynamic points of view. The concept of anxious persistent lasting depression, neurotic depressive states, neurotic depression have been unified into the dysthymic disorder category of the DSM classification. This concept unification have been a topic of dispute considering that dysthymic disorder was a restrictive, heterogeneous an extensively comorbid diagnosis. Nevertheless the definition of this category offers the opportunity to place the notions of temperament, personality, adjustment disorder. Including dysthymic disorders as a category inside of the mood disorders classification suggests the interest of using an antidepressive medication in presence of chronic depressive states not included in the major depressive disorder category. But the most important treatment is psychotherapy, because dysthymie is connected with pathologic cognition and interpretation of reality. This paper describes that dysthymia induced similar problems in the family members of dysthymic persons, and even induced somatic disorders in sensitive persons, as described in this paper.
Topics: Depression; Depressive Disorder, Major; Dysthymic Disorder; Humans; Male; Personality Disorders; Spouses
PubMed: 33380135
DOI: No ID Found -
Epilepsia Jan 2021To utilize traumatic brain injury (TBI) as a model for investigating functioning during acute stress experiences in psychogenic nonepileptic seizures (PNES) and to...
OBJECTIVE
To utilize traumatic brain injury (TBI) as a model for investigating functioning during acute stress experiences in psychogenic nonepileptic seizures (PNES) and to identify neural mechanisms underlying the link between changes in processing of stressful experiences and mental health symptoms in PNES.
METHODS
We recruited 94 participants: 50 with TBI only (TBI-only) and 44 with TBI and PNES (TBI + PNES). Participants completed mood (Beck Depression Inventory-II), anxiety (Beck Anxiety Inventory), and posttraumatic stress disorder (PTSD) symptom (PTSD Checklist-Specific Event) assessments before undergoing functional magnetic resonance imaging during an acute psychosocial stress task. Linear mixed-effects analyses identified clusters of significant interactions between group and neural responses to stressful math performance and stressful auditory feedback conditions within limbic brain regions (volume-corrected α = .05). Spearman rank correlation tests compared mean cluster signals to symptom assessments (false discovery rate-corrected α = .05).
RESULTS
Demographic and TBI-related measures were similar between groups; TBI + PNES demonstrated worse clinical symptom severity compared to TBI-only. Stressful math performance induced relatively greater reactivity within dorsomedial prefrontal cortex (PFC) and right hippocampal regions and relatively reduced reactivity within left hippocampal and dorsolateral PFC regions for TBI + PNES compared to TBI-only. Stressful auditory feedback induced relatively reduced reactivity within ventral PFC, cingulate, hippocampal, and amygdala regions for TBI + PNES compared to TBI-only. Changes in responses to stressful math within hippocampal and dorsal PFC regions were correlated with increased mood, anxiety, and PTSD symptom severity.
SIGNIFICANCE
Corticolimbic functions underlying processing of stressful experiences differ between patients with TBI + PNES and those with TBI-only. Relationships between these neural responses and symptom assessments suggest potential pathophysiologic mechanisms in PNES.
Topics: Adult; Anxiety; Anxiety Disorders; Brain; Brain Injuries, Traumatic; Conversion Disorder; Depression; Depressive Disorder, Major; Dysthymic Disorder; Female; Functional Neuroimaging; Hippocampus; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Neural Pathways; Prefrontal Cortex; Seizures; Stress Disorders, Post-Traumatic; Stress, Psychological
PubMed: 33238045
DOI: 10.1111/epi.16758 -
BMJ Open Nov 2020Composite diagnostic criteria alone are likely to create and introduce biases into diagnoses that subsequently have poor relationships with input symptoms. This study...
OBJECTIVES
Composite diagnostic criteria alone are likely to create and introduce biases into diagnoses that subsequently have poor relationships with input symptoms. This study aims to understand the relationships between the diagnoses and the input symptoms, as well as the magnitudes of biases created by diagnostic criteria and introduced into the diagnoses of mental illnesses with large disease burdens (major depressive episodes, dysthymic disorder, and manic episodes).
SETTINGS
General psychiatric care.
PARTICIPANTS
Without real-world data available to the public, 100 000 subjects were simulated and the input symptoms were assigned based on the assumed prevalence rates (0.05, 0.1, 0.3, 0.5 and 0.7) and correlations between symptoms (0, 0.1, 0.4, 0.7 and 0.9). The input symptoms were extracted from the diagnostic criteria. The diagnostic criteria were transformed into mathematical equations to demonstrate the sources of biases and convert the input symptoms into diagnoses.
PRIMARY AND SECONDARY OUTCOMES
The relationships between the input symptoms and diagnoses were interpreted using forward stepwise linear regressions. Biases due to data censoring or categorisation introduced into the intermediate variables, and the three diagnoses were measured.
RESULTS
The prevalence rates of the diagnoses were lower than those of the input symptoms and proportional to the assumed prevalence rates and the correlations between the input symptoms. Certain input or bias variables consistently explained the diagnoses better than the others. Except for 0 correlations and 0.7 prevalence rates of the input symptoms for the diagnosis of dysthymic disorder, the input symptoms could not fully explain the diagnoses.
CONCLUSIONS
There are biases created due to composite diagnostic criteria and introduced into the diagnoses. The design of the diagnostic criteria determines the prevalence of the diagnoses and the relationships between the input symptoms, the diagnoses, and the biases. The importance of the input symptoms has been distorted largely by the diagnostic criteria.
Topics: Bias; Depressive Disorder, Major; Dysthymic Disorder; Humans; Mania; Prevalence
PubMed: 33172939
DOI: 10.1136/bmjopen-2020-037022