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Behaviour Research and Therapy Dec 2015We investigated factors hypothesized to moderate the effects of cognitive behavioral group-based (CB group) and bibliotherapy depression prevention programs. Using data... (Randomized Controlled Trial)
Randomized Controlled Trial
Moderators of the effects of indicated group and bibliotherapy cognitive behavioral depression prevention programs on adolescents' depressive symptoms and depressive disorder onset.
We investigated factors hypothesized to moderate the effects of cognitive behavioral group-based (CB group) and bibliotherapy depression prevention programs. Using data from two trials (N = 631) wherein adolescents (M age = 15.5, 62% female, 61% Caucasian) with depressive symptoms were randomized into CB group, CB bibliotherapy, or an educational brochure control condition, we evaluated the moderating effects of individual, demographic, and environmental factors on depressive symptom reductions and major depressive disorder (MDD) onset over 2-year follow-up. CB group and bibliotherapy participants had lower depressive symptoms than controls at posttest but these effects did not persist. No MDD prevention effects were present in the merged data. Relative to controls, elevated depressive symptoms and motivation to reduce depression amplified posttest depressive symptom reduction for CB group, and elevated baseline symptoms amplified posttest symptom reduction effects of CB bibliotherapy. Conversely, elevated substance use mitigated the effectiveness of CB group relative to controls on MDD onset over follow-up. Findings suggest that both CB prevention programs are more beneficial for youth with at least moderate depressive symptoms, and that CB group is more effective for youth motivated to reduce their symptoms. Results also imply that substance use reduces the effectiveness of CB group-based depression prevention.
Topics: Adolescent; Bibliotherapy; Cognition; Cognitive Behavioral Therapy; Depression; Depressive Disorder; Depressive Disorder, Major; Female; Humans; Male; Psychotherapy, Group; Risk Factors; Social Support; Substance-Related Disorders; Young Adult
PubMed: 26480199
DOI: 10.1016/j.brat.2015.10.002 -
Behaviour Research and Therapy Jan 1995Beck's cognitive theory of depression has provided a successful description of depressive thinking, with one major exception. The hypothesis that depressed people show... (Review)
Review
Beck's cognitive theory of depression has provided a successful description of depressive thinking, with one major exception. The hypothesis that depressed people show biased negative thinking seems contradicted by research indicating that Ss scoring 9 or above on the Beck Depression Inventory were more accurate than their nondepressed counterparts in judging contingencies between their responses and outcomes, seemingly showing "depressive realism". Depressive realism research has attracted attention in numerous areas of psychology, along with critical commentary focused on such issues as whether realism is limited to mild depressive states, whether laboratory tasks are sufficient to document realism, and whether realism is a general characteristic of either depressed or nondepressed people. We analyze the main critiques and show how debates about depressive realism can be heuristic for refinement of cognitive theory of depression.
Topics: Attention; Depressive Disorder; Humans; Personality Assessment; Reality Testing; Thinking
PubMed: 7872935
DOI: 10.1016/0005-7967(94)e0016-c -
European Neurology 2001
Topics: Depressive Disorder; Humans; Stroke; Time Factors
PubMed: 11205620
DOI: 10.1159/000052081 -
The Psychiatric Clinics of North America Mar 1996The psychotherapy of dysthymic disorder has received too little serious attention and funding. Impressive advances in the pharmacotherapy of dysthymic disorder should... (Review)
Review
The psychotherapy of dysthymic disorder has received too little serious attention and funding. Impressive advances in the pharmacotherapy of dysthymic disorder should not obscure the need for psychosocial treatment for the high proportion of patients who do not respond to medication. Despite the dearth of psychotherapy outcome studies in this area, such data that do exist suggest that relatively brief, focal, antidepressant psychotherapies may successfully treat many patients with lifelong mood disorders. Maintenance therapy probably is indicated to ensure the persistence of treatment gains.
Topics: Adult; Antidepressive Agents; Combined Modality Therapy; Depressive Disorder; Female; Humans; Male; Middle Aged; Personality Assessment; Psychotherapy; Treatment Outcome
PubMed: 8677216
DOI: 10.1016/s0193-953x(05)70278-1 -
Current Psychiatry Reports Sep 2013Depression and cognitive disorders, including dementia and mild cognitive impairment, are common in the elderly. Depression is also a common feature of cognitive... (Review)
Review
Depression and cognitive disorders, including dementia and mild cognitive impairment, are common in the elderly. Depression is also a common feature of cognitive impairment although the symptoms of depression in cognitive impairment differ from depression without cognitive impairment. Pre-morbid depression approximately doubles the risk of subsequent dementia. There are two predominant, though not mutually exclusive, constructs linking pre-morbid depression to subsequent cognitive impairment: Alzheimer's pathology and the vascular depression hypothesis. When evaluating a patient with depression and cognitive impairment, it is important to obtain caregiver input and to evaluate for alternative etiologies for depressive symptoms such as delirium. We recommend a sequential approach to the treatment of depression in dementia patients: (1) a period of watchful waiting for milder symptoms, (2) psychosocial treatment program, (3) a medication trial for more severe symptoms or failure of psychosocial interventions, and (4) possible ECT for refractory symptoms.
Topics: Antidepressive Agents; Cognition Disorders; Depressive Disorder; Electroconvulsive Therapy; Humans; Risk Factors
PubMed: 23933974
DOI: 10.1007/s11920-013-0384-1 -
Journal of Psychiatry & Neuroscience :... Mar 2019
Topics: Animals; Depressive Disorder, Major; Humans; Neuronal Plasticity
PubMed: 31038297
DOI: 10.1503/jpn.190072 -
Journal of Affective Disorders Sep 2013Few studies have examined differences in disability and comorbity among major depressive disorder (MDD), dysthymia, and double depression in African-Americans (AA). (Comparative Study)
Comparative Study
BACKGROUND
Few studies have examined differences in disability and comorbity among major depressive disorder (MDD), dysthymia, and double depression in African-Americans (AA).
METHODS
A secondary analysis was performed on AA in the National Survey of American Life. Interviews occurred 2001-2003. A four stage national area probability sampling was performed. DSM-IV-TR diagnoses were obtained with a modified version of the World Health Organization's expanded version of the Composite International Diagnostic Interview. Disability was measured by interview with the World Health Organization's Disability Assessment Schedule II.
RESULTS
Compared to non-depressed AA, AA endorsing MDD (t=19.0, p=0.0001) and double depression (t=18.7, p=0.0001) reported more global disability; AA endorsing MDD (t=8.5, p=0.0063) reported more disability in the getting around domain; AA endorsing MDD (t=19.1, p=0.0001) and double depression (t=12.1, p=0.0014) reported more disability in the life activities domain. AA who endorsed double depression reported similar disability and comorbidities with AA who endorsed MDD. Few AA endorsed dysthymia.
LIMITATIONS
This was a cross-sectional study subject to recall bias. The NSAL did not measure minor depression.
CONCLUSIONS
The current study supports the idea of deleting distinct chronic subtypes of depression and consolidating them into a single category termed chronic depression.
Topics: Adolescent; Adult; Black or African American; Comorbidity; Cross-Sectional Studies; Depressive Disorder; Depressive Disorder, Major; Diagnostic and Statistical Manual of Mental Disorders; Disability Evaluation; Dysthymic Disorder; Female; Humans; Male; Middle Aged; United States; Young Adult
PubMed: 23809403
DOI: 10.1016/j.jad.2013.05.089 -
Tijdschrift Voor Psychiatrie 2007Comorbidity of depressive and personality disorder occurs frequently, in literature percentages of around 50 to nearly 80 percent are found. Also in the Mentrum... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Comorbidity of depressive and personality disorder occurs frequently, in literature percentages of around 50 to nearly 80 percent are found. Also in the Mentrum depression study on which this article is grounded, high percentages of around 66% were found. There is no equivocal treatment method of choice in literature, and opinions differ as to whether personality pathology has an adverse influence on the efficacy of the treatment for depression.
AIM
To compare the results of pharmacotherapy and combined therapy in the treatment of depressive disorders in patients with and without comorbid personality disorder.
METHOD
A 6 month randomised clinical trial of antidepressants and combined therapy in ambulatory patients with major depressive disorder and a baseline score of at least 14 points on the 17-item Hamilton Rating Scale for Depression. Pharmacotherapy follows three subsequent steps in case of intolerance/inefficacy: fluoxetine, amitriptyline and moclobemide. In addition combination therapy includes 16 short-term sessions of psychodynamic supportive psychotherapy. Possible personality pathology is assessed by means of the 'Vragenlijst Kenmerken Persoonlijkheid' (a self report version of the International Personality Disorder Examination). Analyses of (co) variance and chi-squared tests were applied to assess the differences in both treatment conditions in the group with and without personality pathology.
RESULTS
Combined therapy was significantly more effective than pharmacotherapy for depressed patients with personality disorders. For depressed patients without personality disorders, combined therapy was not more effective than pharmacotherapy alone.
CONCLUSION
The combination of psychotherapy and pharmacotherapy seems to be the treatment of choice for depressed patients with comorbid personality pathology.
Topics: Adolescent; Adult; Antidepressive Agents; Combined Modality Therapy; Comorbidity; Depressive Disorder; Female; Humans; Male; Middle Aged; Personality Disorders; Psychotherapy; Treatment Outcome
PubMed: 17611937
DOI: No ID Found -
Clinical Psychology Review Mar 2000Depression and substance use disorders are highly prevalent in the general population and often co-occur within the same individual. This association is most commonly... (Review)
Review
Depression and substance use disorders are highly prevalent in the general population and often co-occur within the same individual. This association is most commonly explained either by a causal relationship or a shared etiologic factor underlying both disorders. In light of these mechanisms of association, this article summarizes evidence from clinical, epidemiologic, and genetic epidemiologic studies. Details of a large family study designed to addresses key methodological and conceptual issues identified in the review are also presented. The association of alcoholism with depression is likely to be attributable to causal factors rather than a shared etiology, but the scarcity of information for other classes of substance use disorders precludes similar conclusions regarding their association with depression. The lack of unidirectional and consistent patterns of association for depression and substance use disorders indicates that multiple mechanisms of comorbidity are likely to be simultaneously active in this population.
Topics: Comorbidity; Depressive Disorder; Epidemiologic Studies; Family Health; Female; Humans; Male; Substance-Related Disorders
PubMed: 10721496
DOI: 10.1016/s0272-7358(99)00026-4 -
Biological Psychiatry Jan 1997The structural neuroimaging findings in mood disorders were reviewed, to evaluate evidence for a neuroanatomic model of pathophysiology, involving the prefrontal cortex,... (Review)
Review
The structural neuroimaging findings in mood disorders were reviewed, to evaluate evidence for a neuroanatomic model of pathophysiology, involving the prefrontal cortex, the basal ganglia, the amygdala-hippocampus complex, thalamus, and connections among these structures. Global atrophy is not consistently found. The best replicated finding is an increased rate of white matter and periventricular hyperintensities. A smaller frontal lobe, cerebellum, caudate, and putamen appear present in unipolar depression. A larger third ventricle, and smaller cerebellum and perhaps temporal lobe appear present in bipolar disorder. These localized structural changes involve regions that may be critical in the pathogenesis of mood disorders. Generalized and localized anatomic alterations may be related to age or vascular disease. The clinical and biological correlates of these changes need to be investigated to allow development of a more complete model of pathophysiology of mood disorders.
Topics: Atrophy; Bipolar Disorder; Brain; Brain Mapping; Depressive Disorder; Diagnostic Imaging; Humans; Magnetic Resonance Imaging; Tomography, X-Ray Computed
PubMed: 8988799
DOI: 10.1016/s0006-3223(96)00006-6