Asberg Depression Rating Scale Research Articles

A Cross-sectional Study to Assess Psychiatric Co-morbidity among Patients of Migraine and Other Headaches

Introduction: Migraine is the most common cause of vascular headache with a one-year prevalence as high as 6-14.3%. Having various pathophysiological theories, it occurs in much co-morbidity with several medical as well as psychiatric disorders like mood disorders, phobia, anxiety spectrum, etc. Migraine, especially when co-morbid with psychiatric illness stands markedly burdensome economically, diagnostically, therapeutically and prognostically. Hence, needs even further research. Aim: To study patients with migraine versus other types of headache and to study psychiatric co-morbidity among patients with migraine. Materials and Methods: This cross-sectional study was conducted on total 100 patients presenting with headache, meeting the criteria were taken up for the study and divided into two groups. Patients meeting International Headache Society (IHS) criteria for migraine were enrolled under group A and patients suffering from headache other than migraine under group B. Having subjected to detailed history and evaluation, patients were subjected to Symptom checklist-80, Hamilton’s Anxiety Rating Scale (HARS) and Montgomery Asberg Depression Rating Scale (MADRS), International Classification of Diseases (ICD)-10 criteria. The data so collected was subjected to statistical analysis and association of psychiatric morbidity with migraine patients was assessed. Results: Patients with migraine (group A) and among those too, patients having psychiatric morbidity had significantly (p<0.01) longer duration of illness (≥8 years), more frequent attacks ≥5 attacks per month and had longer duration of each attack >24 hours compared to the other groups. Patients having migraine had significantly (p<0.01) higher psychiatric morbidity, more SCL-80 symptoms (mean score 83.05); more depressive symptoms (mean MADRS score was 31.9±9.2) and more anxiety with the mean Hamilton Anxiety score was 23.3 than in patients without psychiatric morbidity. Conclusion: A thorough evaluation of psychiatric disorders in migraine is important so as to propose a non segregated model of care to direct the burden and deterioration associated with psychiatric co-morbidity in migraine.

Современные методы диагностики и лечения тревожных и депрессивных расстройств

Depressive disorder, or depression, is one of the most common psychiatric diseases affecting millions worldwide. Anxiety disorders are also common. Most patients with anxiety refer to general practitioners with the signs of vegetative dysfunction. Anxiety per se occurs in 40% and is associated with depression (mixed anxiety-depressive disorder) IN 26%. Comorbidity of anxiety and depression is relatively high, and the extent of this comorbidity changes with aging. This paper reviews diagnostic and treatment modalities for anxiety and depression. Their diagnosis includes clinical examination and questionnaire. This paper describes Neuro Scanner, an application that includes four scales to diagnose anxiety and depression, i.e., the Veyn Scale, Spielberg Trait Anxiety scale, Hospital Anxiety and Depression Scale (HADS), and Montgomery–Asberg Depression Rating Scale (MADRS). To date, a large amount of data illustrating a significant genetic, neurobiological, and symptomatic similarity of depression and anxiety has been accumulated. This phenomenon accounts for the efficacy of the same drugs (e.g., antidepressants, anxiolytics, neuroleptics, etc.). KEYWORDS: anxiety, depression, comorbidity, anhedonia, diagnosis, Neuro Scanner, anti-depressants, anxiolytics, cognitive behavioral therapy. FOR CITATION: Kotova O.V., Belyaev A.A., Akarachkova E.S. State-of-the-art diagnostic and treatment modalities for anxiety and depression. Russian Medical Inquiry. 2021;5(10):648–653 (in Russ.). DOI: 10.32364/2587-6821-2021-5-10-648-653.

Copper Concentrations in Ketamine Therapy for Treatment-Resistant Depression.

Changes in serum copper concentration are observed in patients with depressive symptoms. Unmet needs in contemporary antidepressant treatment have increased interest in non-monoaminergic antidepressants, such as ketamine, an anaesthetic drug that has demonstrated a rapid antidepressant effect in patients with treatment-resistant depression (TRD). The purpose of this study was to examine whether serum copper concentrations change during ketamine treatment and whether there is an association between the copper concentrations and treatment response measured using psychometric scale scores. Moreover, the interlink between somatic comorbidities and copper concentration was studied. Patients with major depressive disorder or bipolar disorder were rated weekly by a clinician using the Montgomery–Asberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS). Copper level assessments were carried out weekly before the start of ketamine treatment and then after every second infusion and one week after the last ketamine infusion. The serum concentration of copper before ketamine treatment was significantly higher than that after the fifth infusion (p = 0.016), and the serum concentration after the treatment was significantly higher than that after the fifth infusion (p = 0.048). No significant correlations between changes in the copper serum concentrations and MADRS or YMRS were found. The serum copper level was not associated with somatic comorbidities during the course of treatment. This study provides data on the role of copper in short-term intravenous ketamine treatment in TRD, although no clear evidence of a connection between the copper level and treatment response was found.

Long-Term Assessment of Lurasidone in Schizophrenia: Post Hoc Analysis of a 12-Month, Double Blind, Active-Controlled Trial and 6-Month Open-Label Extension Study.

IntroductionA post hoc analysis of a double-blind (DB) active control trial and an open-label extension (OLE) study was conducted to evaluate the long-term effects of lurasidone in patients with schizophrenia.MethodsIn the DB trial, patients were randomised to receive lurasidone or risperidone for 12 months. In OLE, all patients received lurasidone for an additional 6 months. Treatment-emergent adverse events (TEAEs) were evaluated. Efficacy assessments included relapse rate (DB trial only), and Positive and Negative Syndrome Scale, Clinical Global Impression–Severity scale, and Montgomery–Åsberg Depression Rating Scale.ResultsIn the DB trial, patients with schizophrenia were randomised to lurasidone (n = 399) and risperidone (n = 190), of whom 129 and 84 continued into OLE, respectively. During the DB trial, incidence of TEAEs was similar for lurasidone (84.1%) and risperidone (84.2%). Lurasidone was associated with minimal changes in metabolic variables and prolactin levels, whereas risperidone was associated with clinically significant increases in prolactin and fasting glucose levels. The proportion of patients with metabolic syndrome was significantly lower in patients treated with lurasidone versus risperidone at the end of the DB trial (25.5% vs 40.4%; p = 0.0177). During OLE, patients switching from risperidone to lurasidone experienced a reduction in weight and prolactin levels; those continuing treatment with lurasidone experienced minimal changes in metabolic variables and prolactin. At the end of OLE, the proportion of patients with metabolic syndrome was no longer significantly different between groups (23.5% vs 31.5%; p = not significant). Efficacy outcomes were generally similar between groups during the DB trial, and were maintained during OLE.ConclusionLurasidone was generally well tolerated and effective in clinically stable schizophrenia patients over the long term. Lurasidone was also generally well tolerated and maintained effectiveness over 6 months in patients switching from risperidone. Patients switching from risperidone experienced improvements in metabolic parameters and prolactin levels. These findings confirm lurasidone’s long-term effectiveness and favourable metabolic profile in patients with schizophrenia.Trial RegistrationClinicalTrials.gov identifier NCT00641745.

Minocycline as adjunctive treatment for major depressive disorder: Pooled data from two randomized controlled trials.

Randomized controlled clinical trials that have investigated minocycline as an adjunctive treatment for major depressive disorder have proved promising. Data from two studies were pooled to evaluate more definitively whether the addition of minocycline to standard treatment for major depressive disorder leads to an improvement of depressive symptoms when compared with placebo. Both studies were multi-site, double-blinded, placebo-controlled trials of minocycline 200 mg/day added to treatment as usual during a 12-week period. The primary outcome measure was change in depressive symptoms (Montgomery-Asberg Depression Rating Scale in Dean et al. and Hamilton Depression Rating Scale in Husain et al.). Secondary outcomes were change in depression severity (Montgomery-Asberg Depression Rating Scale for Dean et al. and 9-item Patient Health Questionnaire in Husain et al.), anxiety severity (Hamilton Anxiety Rating Scale in Dean et al. and Generalized Anxiety Disorder 7-item scale in Husain et al.) and functional status, which were also evaluated as potential mediators on the primary outcome. A total of 112 participants were included in the pooled data (Dean et al., n = 71; Husain et al., n = 41). A significant change from baseline to week 12 was noted in depressive symptoms - differential change (Placebo vs Minocycline): 9.0, 95% confidence interval = [4.2, 13.9], Cohen's D (95% confidence interval): 0.71 [0.29, 1.14], p < 0.001 - anxiety severity - differential change (Placebo vs Minocycline): 0.38, confidence interval = [0.00, 0.75], Cohen's D (95% confidence interval): 0.41 [0.00, 0.82], p = 0.050) and functional status - differential change (Placebo vs Minocycline): 1.0, 95% confidence interval = [0.4, 1.5], Cohen's D (95% confidence interval): 0.76 [0.34, 1.19], p = 0.001). Duration of illness, current use of benzodiazepine and pain medication were identified as moderators, whereas functional status as a mediator/predictor. The improvement of depressive symptoms, anxiety severity and functional status is promising and suggests that minocycline has potential as an adjunctive treatment for major depressive disorder. However, further studies are warranted to confirm therapeutic effects of minocycline in major depressive disorder. NCT02263872, registered October 2014, and ACTRN12612000283875, registered March 2012.

Study of neuropsychological deficits in late onset depression.

Older adults with depression often have cognitive deficits contributing to higher morbidity and increased risk for conversion to dementia. Research on this area is limited from India. The objective of the current study is to examine the neuropsychological measures in older adults with Late-onset depression (LOD) compared to healthy controls (HC). Sample included older adults with depression as per DSM-IV TR criteria seeking treatment from Geriatric Clinic and Services, National Institute of Mental Health and Neurosciences (NIMHANS). Geriatric depression scale, Montgomery Asberg depression rating scale and Hamilton anxiety rating scale were applied to screen and measure the severity of depression. Comprehensive assessment of neurocognitive function was done using NIMAHNS Neuropsychological Battery for Elderly (NNBE, 2013). Sample included 76 LOD patients and 76 healthy controls (HC) who were matched for age, gender and education. The mean age of onset of illness was 63.17(SD-6.54) years and median duration of total illness was 29.5 months. In the standard assessments, the mean score on GDS was 9.28 (SD-3.32) and MADRS was 18.88 (SD-6.07). The LOD group had lower Hindi Mental Status Examination (HMSE) score compared to HC (28.64 ± 2.09 vs 30.05 ± 1.26, p < 0.001). Compared to HC, LOD group performed poorly on tasks of attention, executive function, verbal and visual memory, verbal fluency and visuo-spatial skills. Recognition memory and logical memory were relatively preserved in LOD compared to HC. Cognitive deficits were seen predominantly in attention and executive function, visuo-spatial skills and memory similar to previous studies. It is advisable to routinely assess cognitive symptoms in older adults presenting with depression.

Thérapie cognitivo-comportementale et psychanalyse : une efficacité comparable au cours de la crise dépressive ?

Our study compares the efficacy of two therapeutic treatments, cognitive behavioral and psychoanalytic, on a depressed population hospitalized in the same institution. We recorded the degree of intensity and improvement of fifteen subjects in a depressive state followed by a psychologist trained in CBT, and recorded the same for fifteen subjects followed by a psychoanalytical psychologist, using the Montgomery–Asberg Depression Rating Scale (MADRS). Both the first and final follow-up scores were compared, and the difference between the two depression scores was calculated. At the same time, the degree of therapeutic alliance was measured using the therapeutic alliance scale, therapist version (WAI-T). The comparison of the MADRS averages and the point spread demonstrate a significant and equivalent reduction in the depressive crisis for both groups. The WAI-T scores and the comparison of the average to the overall score indicate a similar quality of alliance. These results suggest that the frame of reference is not the cornerstone of a psychotherapy's efficacy, but is rather based on the foundation of a good therapeutic alliance with benevolent neutrality, the maintenance of a good distance, the ability to maintain the frame, a sufficient management of anxiety in the face of suicidal thoughts, with a structuring implication towards the subject. This, associated with a more active relational dynamic on the part of the therapist, compared to the investment he would develop in other types of follow-ups. These results demonstrate that the collaboration between professionals using a different theoretical framework can contribute to obtaining attractive benefits for the subjects.

Motor activity patterns can distinguish between interepisode bipolar disorder patients and healthy controls

Bipolar disorder (BD) is linked to circadian rhythm disruptions resulting in aberrant motor activity patterns. We aimed to explore whether motor activity alone, as assessed by longitudinal actigraphy, can be used to classify accurately BD patients and healthy controls (HCs) into their respective groups. Ninety-day actigraphy records from 25 interepisode BD patients (ie, Montgomery-Asberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS)<15) and 25 sex- and age-matched HCs were used in order to identify latent actigraphic biomarkers capable of discriminating between BD patients and HCs. Mean values and time variations of a set of standard actigraphy features were analyzed and further validated using the random forest classifier. Using all actigraphy features, this method correctly assigned 88% (sensitivity=85%, specificity=91%) of BD patients and HCs to their respective group. The classification success may be confounded by differences in employment between BD patients and HCs. When motor activity features resistant to the employment status were used (the strongest feature being time variation of intradaily variability, Cohen's d=1.33), 79% of the subjects (sensitivity=76%, specificity=81%) were correctly classified. A machine-learning actigraphy-based model was capable of distinguishing between interepisode BD patients and HCs solely on the basis of motor activity. The classification remained valid even when features influenced by employment status were omitted. The findings suggest that temporal variability of actigraphic parameters may provide discriminative power for differentiating between BD patients and HCs while being less affected by employment status.

Perinatal suicidality: Risk factors in South African women with mental illness.

Maternal Mortality is a global health concern. The lack of suicide data, particularly in low and middle income countries, is concerning and needs to be addressed. This study assessed suicidality and associated factors during pregnancy and the postpartum period amongst women with known psychiatric diagnoses. The study sample included pregnant South African women over the age of 18 years with a psychiatric disorder who presented at two maternal mental health clinics. Suicidality was assessed by means of psychiatric interviews - the Mini International Neuropsychiatric Interview and the Montgomery Asberg Depression Rating Scale. The results revealed that women were at a higher risk of experiencing suicidality if they had attempted suicide before, presented at a later gestation for psychiatric care or were employed. It was also clear that multiple assessments, carried out by means of clinical interviews and various scales, were necessary to screen suicidality successfully in pregnant women diagnosed with psychiatric illness. The results confirmed the view of the World Health Organization that in order to promote mental health and well-being, women's health should be viewed contextually, not in isolation. Screening for and treatment of perinatal mental illness, including suicidality, are essential if we hope to meet the maternal morbidity and mortality targets of the United Nations by 2030.

Associations between resilience and quality of life in patients experiencing a depressive episode

Despite the obvious assumption that resilience affects the course of affective disorders, studies investigating resilience in people experiencing a depressive episode are scarce. The current study explored whether resilience might differently impact quality of life (QoL) in these patients as compared to healthy control subjects. To this end, 60 patients and 75 control subjects were included into a cross-sectional study. In patients, psychopathology was assessed by means of the Montgomery Asberg Depression Rating Scale (MADRS). The Resilience Scale (RS-25) and the WHOQOL-BREF were used in both patients and control subjects to assess resilience and QoL. Depressive patients indicated significantly lower degrees of resilience and QoL compared to healthy subjects. However, there was evidence that patients experiencing a depressive episode do not inevitably have low RS-25 scores. In healthy subjects, a moderate correlation was found between resilience and all WHOQOL-BREF domains, whereas in patients, resilience correlated moderately with global and psychological QoL and with environment. The mediation analysis revealed that the difference in QoL between patients and healthy subjects was partially mediated by resilience. The present study confirms the assumption that resilience is not merely characterized by the absence of psychopathology but is important for the QoL of patients experiencing a depressive episode.

Effect of oral isotretinoin on anxiety and depression in patients with acne

Objective: To study the side effect profile of systemic isotretinoin (ITT) and its association with anxiety and depression in the Indian population. Materials and Methods: In this prospective observational study, 300 patients of either gender, aged >12 years, taking oral ITT were evaluated for severity of acne by the visual analog scale (VAS) and psychiatric side effects with the Hamilton anxiety rating scale (HAM-A) and Montgomery Asberg Depression Rating scale (MADRS) at baseline up till the fourth visit. Software R version 3.6.0. was employed to analyze the data. Results: A significant improvement in VAS score was observed at baseline to final visit (P = 0.001). Significant increase in MADRS score was observed at baseline to final visit (P

A systematic review of ketamine for the treatment of depression among older adults.

To review the currently available data on the use of ketamine in the treatment of depression among older adults from randomized controlled studies. Randomized controlled trials. Variable. 60 years and older with depression. Ketamine. Change in Montgomery-Asberg Depression Rating Scale (MADRS) scores. Two studies met the inclusion criteria. The first study showed a significant reduction in depression symptoms with use of repeated subcutaneous ketamine administration among older adults with depression. The second study failed to achieve significance on its primary outcome measure but did show a decrease in MADRS scores with intranasal ketamine along with a higher response and remission rates in esketamine group compared with the placebo group. The adverse effects from ketamine generally lasted only a few hours and abated spontaneously. No cognitive adverse effects were noted in either trial from the use of ketamine. The current evidence for use of ketamine among older adults with depression indicates some benefits with one positive and one negative trial. Although one of the trials did not achieve significance on the primary outcome measure, it still showed benefit of ketamine in reducing depressive symptoms. Ketamine was well tolerated in both studies with adverse effects being mild and transient.

Mindfulness-Based Interventions for In-Patients With Schizophrenia Spectrum Disorders-A Qualitative Approach.

In recent years, mindfulness-based interventions (MBI) have gained clinical relevance in the treatment of patients with schizophrenia spectrum disorders (SSDs). High symptom burden, long durations of hospitalization and high rehospitalization rates demonstrate the severity and cost-intensity of these disorders. MBIs have shown promising treatment outcomes in a small number of trials, primarily taking place in English-speaking countries. The current study aims to explore mechanisms and processes as well as adverse effects of MBIs on in-patients with SSDs in a German university hospital setting. A qualitative design based on inductive thematic analysis accompanied by quantitative assessments was chosen. A semi-structured interview guide was developed by psychiatrists and psychologists to assess patient experiences, perceptions, thoughts, and feelings during and after taking part in a MBI. Twenty-seven interviews were conducted between September 2017 and October 2018 with in-patients who are diagnosed with schizophrenia or schizoaffective disorder. Rater-based questionnaires, such as the Positive and Negative Syndrome Scale (PANSS), Montgomery Asberg Depression Rating Scale (MADRS), and Psychotic Symptom Rating Scales-Auditory Hallucination (PSYRATS-AH) were administered at baseline to collect clinical outcomes. Qualitative analysis revealed two domains: content and function. In the first domain related to content with the core elements “detachment and rumination”, “presence and getting lost”, “non-judgment and judgment”, and effects with “emotions”, “cognition”, and “symptom changes”. A second domain related to function was extracted, including the relevance of perception of context and transfer to everyday life. Overall, improvements concerning cognition, distress, and psychopathology were detected, while no adverse effects, such as increased psychotic symptoms, were revealed. As the first study of its kind, mechanisms, processes, and the safety of MBIs were explored and confirmed in a sample of German in-patients with SSDs. The results of this qualitative study are in line with recent findings on MBIs amongst patients with psychotic disorders from other countries. Results lay the ground for future research to focus on the systematic study of MBIs in large samples, its treatment processes, outcomes, and effectiveness for in-patients with SSDs.

149 - Enriching Cognitive-Behavioral Therapy with Emotion Regulation Training in Patients with Persistent Physical Symptoms: A 3- year follow-up

The objective was to compare a brief interdisciplinary psychotherapeutic intervention to standard care as treatments for patients recently diagnosed with severe motor conversion disorder or nonepileptic attacks.This randomized controlled trial of 23 consecutive patients compared (a) an interdisciplinary psychotherapeutic intervention group receiving four to six sessions by a consultation liaison psychiatrist, the first and last sessions adding a neurological consultation and a joint psychiatric and neurological consultation, and (b) a standard care group. After intervention, patients were assessed at 2, 6 and 12 months with the Somatoform Dissociation Questionnaire (SDQ-20), Clinical Global Impression scale, Rankin scale, use of medical care, global mental health [Montgomery and Asberg Depression Rating Scale, Beck Depression Inventory, mental health component of Short Form (SF)-36] and quality of life (SF-36). We calculated linear mixed models.Our intervention brought a statistically significant improvement of physical symptoms [as measured by the SDQ-20 (P< .02) and the Clinical Global Impression scale (P= .02)] and psychological symptoms [better scores on the mental health component of the SF-36 (P< .05) and on the Beck Depression Inventory (P< .05)] and a reduction in new hospital stays after intervention (P< .05).A brief psychotherapeutic intervention taking advantage of a close collaboration with neurology consultants in the setting of consultation liaison psychiatry appears effective.

Male Anabolic Androgenic Steroid Users with Personality Disorders Report More Aggressive Feelings, Suicidal Thoughts, and Criminality.

Background and objectives: Anabolic androgenic steroids (AAS) are mainly used for aesthetic and performance-enhancing reasons. Their use is a growing public health problem and concern for society because of their adverse effects. The primary aim of this study was to identify psychiatric and personality disorders and to measure anxiety and depression in AAS users. Materials and Methods: Fifty-six males who actively contacted the Anti-Doping Hot-Line and wished to stop using AAS were included. Structured Clinical Interviews Diagnosis-I and -II were used to diagnose psychiatric and personality disorders. The Brief Scale for Anxiety and Montgomery Asberg Depression Rating Scale (subscales from the Comprehensive Psychopathological Rating Scale) were used to measure changes in anxiety and depression. Structured Clinical Interviews Diagnosis-I and -II were performed at one time point. Anxiety and depression were measured at inclusion and after six months. Urine samples were collected for an analysis of AAS and drugs of abuse. Results: All participants reported some adverse effects that they associated with AAS use. In total, 56% and 52% of the cohort fulfilled the criteria for Structured Clinical Interviews Diagnosis-I and -II diagnoses, respectively. A significantly increased risk of reporting aggressive feelings/behaviors (Odds Ratio (OR) = 4.9; Confidence Interval (CI) 0.99–25, p = 0.04), suicidal thoughts/attempts (OR = 4.6, CI 95; 0.99–21, p = 0.04) and criminality (OR = 6.5, CI 1–39, p = 0.03) was found among individuals with AAS use fulfilling the criteria for personality disorders compared with those without such AAS use. The Brief Scale for Anxiety score decreased from the median of 15 at inclusion to 10 at the follow-up visit six months later (p = 0.01, n = 19). Conclusions: Our findings indicate that among individuals with AAS use, those with a personality disorder report more aggressive behaviors, suicidal thoughts/suicidal attempts, and criminality than those without a personality disorder.

M95. DSM-5 CLINICIAN-RATED DIMENSIONS OF PSYCHOSIS SYMPTOM SEVERITY: PSYCHOMETRIC PROPERTIES

BackgroundIn DSM-5, a number of “emerging measures” are included for further research and clinical evaluation. These patient assessment measures were developed to be administered at the initial patient interview and to monitor treatment progress. One of these instruments is the Clinician-Rated Dimensions of Psychosis Symptom Severity (CRDPSS). Using this instrument, a clinician can rate the severity of eight symptom dimensions of psychotic disorders. The psychometric properties and the applicability of the instrument in clinical practice have not yet been investigated. The current study aims to investigate the internal consistency, factor structure and external validity with other assessment instruments.MethodsThe CRDPSS measures eight symptom dimensions, namely Hallucinations, Delusions, Disorganized speech, Abnormal psychomotor behavior, Negative Symptoms, Impaired Cognition, Depression and Mania. Items are scored on a five-point scale ranging from “Not present” to “Present and Severe”. This interview has been applied in the Psychosis Recent Onset GRoningen Survey (PROGR-S), a diagnostic protocol for patients with a suspected recent-onset psychotic disorder (n = 164 in the current analysis). Besides the CRDPSS, scores on the Positive and Negative Syndrome Scale (PANSS), Health of Nations Outcome Measure (HoNOS), the Mongomery Asberg Depression Rating Scale (MADRS), Cambridge Cambridge Neuropsychological Test Automated Battery (CANTAB) and mini-Structural Clinical Assessment in Neuropsychiatry (mini-SCAN) were used for current analyses. The Crohnbach Alpha was calculated to investigate internal consistency, exploratory factor analysis was applied, and the convergent validity was investigated by calculating non-parametric correlations of the CRDPSS with similar items or subscales of the other instruments.ResultsThe Cronbach’s alpha of the CRDPSS was 0.36, indicating low internal consistency. Factor analysis resulted in three Factors: 1. Delusions/Mania, 2. Abnormal psychomotor behavior/Negative Symptoms/Impaired cognition, 3. Hallucinations/Depression. For hallucinations, Delusions, and Depression a Kendall’s tau of 0.35 – 0.45 was observed with the other instrument scores and for Impaired cognition tau = 0.6, indicating a weak to moderate association. Negative symptoms resulted in tau < 0.2 and for the other instruments tau < 0.1, but in these cases the measure of the other instruments was of questionable quality.DiscussionThe internal consistency of the CRDPSS was poor and factor analysis resulted in factors that differed to some extent from previous findings. Moreover, the convergent validity with other instruments was poor to moderate. In conclusion, based on first analyses the reliability and clinical applicability of the CRDPSS appears limited. Future studies should investigate inter-rater reliability, test-retest reliability, use more optimal measures to investigate convergent validity and use larger samples.

Quality of life and depressive symptoms in patients with lumbar disc herniation undergoing open discectomy: A 6-month follow up study from a tertiary care hospital in Eastern India

Introduction : Aim of this 6-month follow-up study was to find the difference between the Quality of Life (QOL) and depressive symptoms of patients with Lumbar Disc Herniation undergoing open discectomy attending a tertiary care hospital in Eastern India Materials and Methods: Hundred patients fulfilling inclusion and exclusion criteria were included in the study. Twenty patients either dropped out of follow-up or were not able to complete the investigations. Eighty patients was the final patient population. Socio-demographic profile sheet, Clinical profile sheet, GHQ 12, SF-36 for Quality of Life and Montgomery Asberg Depression Rating Scale were used at Presurgery i.e. at baseline (S0), at 1 months (S1), at 3 months (S2), and at 6 months (S3) post-discectomy. Results: Sixty-three percent of patients were male and majority (75%) was from rural background. The most common site of disc herniation was at L4-L5 followed by L5-S1.Various subscales of SF-36 showed significant improvement at 3 months and 6-months post operation. GHQ-12 scores were significantly lower at the end of 6 months indicating an improvement in general physical and mental health. Depressive symptoms on MADRS showed that at the end of 6 months the scores were significantly lower compared to pre-surgery scores and at 6 months they could be categorized in the euthymic range. Conclusion: The discectomy procedure not only relieves the pain symptom but also improves depression resulting from pain symptoms, functionality, general health and overall quality of life of patients suffering from herniated lumbar disc. Initial lack of improvement in pain symptoms and functionality post surgery could be due to Depressive symptoms. Assessment of depressive symptoms and its treatment could improve both functionality as well as perceived pain. Keywords: Herniated disc, Low back pain, Quality of Life, Depressive Symptoms.

The problematic use of social networking sites associates with elevated symptoms in patients with major depressive disorder.

Although excessive use of social networking site (SNS) is related to undesired effects on healthy individual's psychological well-being, there is a huge gap in studies performed with individuals who suffer from various mental disorders. The main goal of this study is to examine the association between problematic utilization of SNSs and depressive symptoms across patients diagnosed with major depressive disorder (MDD). 111 patients diagnosed with MDD (diagnoses confirmed via the Structured Clinical Interview for DSM-5-Clinician Version (SCID-5/CV)) and 108 healthy controls (HCs) were recruited for the study. Montgomery-Asberg Depression Rating Scale (MADRS) and Bergen Social Media Addiction Scale (BSMAS) were administered by both MDD and HC groups. Group comparisons were estimated with multivariate analysis of covariance (MANCOVA) analyses. To identify the relationship between SNS addiction and depressive symptoms, the Pearson correlations were performed, and finally, we computed the multiple linear regression analyses to determine whether SNS addiction predicts depressive symptoms. The results revealed that MDD group is more addicted to SNS relative to HC. In addition, depressive symptoms were significantly predicted by 'relapse' subdimension and the overall score of SNS addiction in the MDD group. Our study illustrated the detrimental effects of excessive SNSs usage on depressive symptoms in MDD particularly for the individuals in 'relapse' state of SNS addiction. The mental health workers should consider the usage patterns of SNSs in patients diagnosed with MDD during their clinical observation and management.

Hamilton scale and MADRS are interchangeable in meta-analyses but can disagree at trial level

Background and ObjectiveMajor depressive disorder is a multidimensional disease, in which demonstrating the efficacy of treatments is difficult. The Hamilton Rating Scale for Depression (HRSD) and the Montgomery–Asberg Depression Rating Scale (MADRS) cover different domains but are used interchangeably as primary measures of the outcome in trials and—with standardized measures—in meta-analyses. We aimed at understanding (i) whether the choice of the outcome measurement tool can influence the outcome of a trial, and if so, (ii) whether one systematically outperforms the other, and (iii) whether using standardized measures of the effect in meta-analysis is justified. MethodsShort-term randomized trials in patients with major depressive disorder that used both the scales were systematically searched and the results were collected. To quantify the differences in the results—both in terms of the standardized mean difference (SMD) and odds ratio (OR) for response—and their range, data were analyzed and plotted with the Bland–Altman method. Results161 comparisons from 80 studies were included, involving a total of 18,189 patients. Neither of the two scales appears systematically more sensitive to the treatment effect than the other in terms of SMDs (P-value = 0.06, 95% CI −0.044 to 0.001) or ORs (P-value = 0.15, 95% CI −0.25 to 0.04). However, the variability of differences between the HRSD and MADRS largely depends on the number of patients included in the comparison. ConclusionNo systematic differences between the two scales were found supporting the use of standardized measures in meta-analyses. However, the same trial may give very different results with either scale, especially in small trials. Further research is needed to understand the causes of this variability.

Depressive Symptom Trajectories Associated With Standard and Accelerated rTMS

Abstract Background To determine if an accelerated rTMS protocol results in distinct depressive symptom response trajectories, compared to a standard rTMS protocol. We also sought to validate previous analyses that identified distinct depressive symptom response trajectories with rTMS treatment using an external dataset. Method Data from two recent clinical trials comparing accelerated rTMS protocol delivered to the left dorsolateral prefrontal cortex (DLPFC) with standard once-daily rTMS protocol were used to identify depressive symptom response trajectories. The accelerated protocol in Trial 1 was conventional 10-Hz rTMS, while Trial 2 employed intermittent theta burst stimulation (iTBS). Participants were adult outpatients (18–70 years old) with bipolar or unipolar depression and moderate-severe depression (Montgomery Asberg Depression Rating Scale score >19) who had failed to respond to adequate courses of two different antidepressants. We used group-based trajectory modeling to identify MADRS response trajectories, and regression techniques adjusting for baseline depressive symptom severity to determine the association between treatment protocol and depressive symptom response trajectory. Results Treatment outcomes of 189 participants were analysed. We identified four distinct response trajectories: “nonresponse” (N = 59; 30.7%), “minimal response” (N = 65; 34.1%), “higher symptoms, response” (N = 26; 14.6%), “lower symptoms, response” (N = 39; 20.6%). We failed to find an association between rTMS protocol (accelerated vs standard) with depressive symptom response trajectory even after adjusting for baseline depressive symptom severity. Conclusion The accelerated rTMS protocol in this study did not impact depressive symptom response trajectories. This work provides further confirmatory evidence that there are distinct depressive symptom response trajectories with rTMS delivered to the left DLPFC. Australian new zealand clinical trials registry ACTRN12616000443493 and ACTRN12613000044729.