Depression Factor Scores Research Articles

Depressive symptoms at baseline predict fewer negative symptoms at follow-up in patients with first-episode schizophrenia

There is uncertainty regarding the prognostic value of depressive symptoms in schizophrenia, having previously been associated with both favourable and poor outcome. This study investigated the relationship between baseline depressive symptoms and treatment outcome at 6, 12 and 24 weeks in 80 subjects with first-episode schizophrenia or schizophreniform disorder in terms of PANSS total and subscale score changes. No significant association was found between baseline PANSS depression factor scores and PANSS total and subscore changes. However, a significant inverse correlation between baseline depression scores and negative scores at 6, 12 and 24 weeks was found ( p=0.044, 0.023 and 0.012, respectively). Multiple regression analysis indicated that this finding could not be explained on the basis of age, gender or duration of untreated psychosis. These findings support previous work suggesting that high baseline depressive scores predict favourable outcome.

Studies on the psychosomatic functioning of ill-health according to eastern and western medicine 7. Psychoimmuno-endocrinological changes induced by Kampo medication and relaxation training.

Using the anxiety-affinitive constitution index (AACI) that we created, we measured the degree of the anxiety-affinitive constitution as an equivalent of ill-health for the study of psychoimmuno-endrocrinological changes induced by Kampo medication and relaxation training (RT). With 20 sixth-year Saga Medical School students (average age: 24.8 +/- 1.4) as the subjects, we obtained three results: (1) relaxation training produced lowered STAI trait and state anxiety scores and tended to transform the respiratory pattern from thoracic to abdominal; (2) Kampo medication generated lowered GHQ-30 total scores and lowered the depression factor scores for its symptom components; and (3) Kampo medication for overcoming blood stagnation induced lowered NK cell activity, whereas Kampo medication for providing a tonic effect on vital energy and enriching blood brought about elevated NK cell activity and blood cortisol concentration. These results strongly suggest that while Kampo medication alleviated psychological distress as demonstrated by lowered GHQ-30 scores, RT improved the respiratory pattern, as demonstrated by increased abdominal dominance. The utmost attention must be paid to the prolonged administration of drugs for overcoming blood stagnation because of their possible immunosuppressive action.

The low prevalence of high levels of expressed emotion in Bali

The present study contrasts the expressed emotion (EE) status in family members of schizophrenic patients between Bali (Indonesia) and Tokyo (Japan), the former being a non-industrialized society and the latter an industrialized society in Asia. The EE ratings of each key relative for 62 consecutively hospitalized schizophrenic patients at the Bangli State Mental Hospital (Bali) and 33 consecutively admitted schizophrenics at Komagino Hospital (Tokyo) were obtained using the Five Minute Speech Sample (FMSS) method. A significantly lower prevalence of high EE (12.9%) was observed in Bali compared with Tokyo (36.4%) ( P<0.01). This result may explain the better social adjustment of schizophrenics in Bali. In addition, in Bali, to clarify the EE effect in this non-industrialized society, we examined the relationship between each key relative’s EE and the patient’s psychotic symptoms at admission, as assessed by the Brief Psychiatric Rating Scale (BPRS) and the Scales for the Assessment of Negative Symptoms (SANS). Moreover, the association between each family member’s EE and a patient’s rate of re-admission over the 1-year period following discharge was evaluated. The EE value was significantly related to the anxious–depression factor score in the BPRS, but not to either of the other factor scores in the BPRS or SANS subscales. Furthermore, EE status was not a reliable predictor of patient re-admission over the 1-year period following discharge in Bali.

Prevalence and Expression of Depressive Symptomatology in Students with and without Learning Disabilities

The present study compared girls and boys with and without learning disabilities (LD) on mean reports of depressive symptoms, prevalence of depression and type of depressive symptoms reported. One hundred children with LD (46 girls, 54 boys) ana 104 children without LD (50 girls, 54 boys) were compared on the Children's Depression Inventory's (Kovacs, 1992) overall score, percent meeting the cutoff for depression (19) and subscale factor scores indicating symptom patterns. Results revealed that (a) mean level of depressive symptoms between students with and without LD did not differ but prevalence of depression was marginally different; (b) girls with LD reported higher mean levels of depressive symptoms and higher prevalence of depression than girls without LD, whereas there was no difference in mean levels of depressive symptoms or prevalence of depression for boys with or without LD; (c) students with LD reported more symptoms of ineffectiveness; (d) girls reported more negative mood and less interpersonal problems than boys; and (e) girls with LD reported more symptoms indicative of a loss of pleasure, negative self-esteem and interpersonal problems relative to their peers without LD, while boys with or without LD did not differ in their symptom type reports. Implications and limitations of the results are discussed with reference to previous research and directions for future investigation.

Phenomenology of mania: evidence for distinct depressed, dysphoric, and euphoric presentations.

A substantial number of manic episodes include conspicuous depressive symptoms. Manic episodes have been clinically classified a posteriori using preset criteria. The aim of this study was to investigate the possibility that there might be a natural division of manic episodes into clinical types. One hundred and five inpatients met Research Diagnostic Criteria and DSM-III-R criteria for manic episodes and were rated before institution of pharmacological treatment. The authors conducted a factor analysis of 37 behavior rating items from the Schedule for Affective Disorders and Schizophrenia. The resulting factors were used as independent variables in a cluster analysis of the patients. This analysis revealed four factors corresponding to manic activation, depressed state, sleep disturbance, and irritability/paranoia. Cluster analysis separated the patients into two groups. One included patients with major depressive disorder and mania. Blind, a priori clinical classification into classic and mixed mania (mania plus depression) showed that all of the patients in the depressed cluster, and about 40% of those in the nondepressed cluster, were in a mixed state according to clinical criteria. Comparison of the clinically mixed and nonmixed patients in the nondepressed cluster revealed that the mixed patients in that cluster had higher scores for items related to anger, worry, dysphoria, and irritability. These data suggest that manic episodes can be naturalistically classified as classic (predominately euphoric), dysphoric, or depressed.

Psychological adjustment of infertile women entering IVF treatment: Differentiating aspects and influencing factors

To evaluate the psychological adjustment of infertile women compared with a control group of mothers and to determine which personal or marital factors influence the amount of emotional disorders in the infertile group. Cross-sectional questionnaire study with a group of infertile women and a group of mothers attending a routine gynecological examination. Infertile women and mothers received the questionnaires after a psychological or medical examination respectively, at a Sterility Center in a Department of Obstetrics and Gynaecology. One hundred and twenty-two infertile women, entering an IVF program, and 57 mothers attending a routine care visit. Stressful events, self-esteem, job and marital satisfaction, care and control measures of intimate bond, state-trait anxiety, depression, psychophysiological symptoms and global emotional factor scores. The organic infertile group was higher than mothers on satisfaction with their relationship with their husbands, perception of care and state-anxiety. The emotional factor scores of infertile women, controlled for stressful events, were influenced by a) number of IVF-cycles and availability for adoption, b) job position, job satisfaction and self-esteem, c) personality dimensions. State and trait anxiety scores were influenced by the level of global marital satisfaction. Infertile women, entering an IVF treatment program, do not necessarily show signs of psychological maladjustment. Their level of state-anxiety can be considered a situational response to the treatment stress. The infertility condition and its treatment can be effectively dealt with by women having a good personality disposition, a high level of self-esteem, who are satisfied with their job and relationship with their husband, and who are willing to adopt a child as a last solution for their maternal need.

Use of the Hamilton and Montgomery-Asberg Depression Scales in Institutionalized Elderly Patients

In screening for a study of drug treatment of major depression, the authors obtained data on depressive symptoms in elderly residential care patients (N = 116; average age 84 years; 81% women). Principal-components analysis (with varimax rotation) of the Hamilton Rating Scale for Depression yielded a four-factor solution (accounting for 47.2% of variance): core depression, anxiety, insomnia-hypochondriasis, and cognitive-ideational symptoms. The Montgomery-Asberg Depression Scale yielded two factors (54% of variance)-core depression and anxiety. Core depression factor scores from both scales (but not other factor scores) predicted mortality. The association of core depression with mortality (in subsets of patients for which data on these covariates were available) remained significant after measures of illness burden and disability were controlled.

Cognition and coping in agoraphobia and depression: A multivariate approach

A multivariate strategy for the cognitive study of overlapping symptom disorders is presented and exemplified by an empirical investigation. Inpatients who met DSM-III-R criteria for anxiety and/or unipolar depressive disorders were assessed on 13 agoraphobic and depressive symptom subscales. Factor analyses of these scales were performed and yielded an agoraphobic and a depressive factor. The patients (N = 117) completed the Multidimensional Health Locus of Control scales, the Attributional Style Questionnaire, and the Ways of Coping Check List. Stepwise regression analyses were performed with the cognitive and coping variables as independent variables. The externalizing of mental health locus of control to chance was the only significant predictor of agoraphobia factor score. Attributional variables were the only consistent predictors of depression factor score.

A double‐blind study of alprazolam and oxazepam in the treatment of anxiety

In a randomized double-blind study with parallel group design involving 60 anxious psychoneurotic outpatients, the anxiolytic activity of alprazolam was compared with that of oxazepam. Following a 4 to 7-day placebo washout period, both groups showed a similar and significant response to treatment during the 4-week active treatment phase. An important intergroup difference emerged in the fear/anxiety component of the Lipman SRSS with the alprazolam groups showing a significantly greater mean reduction from the baseline score. During alprazolam treatment there was also a significant reduction in the depression factor score of the Lipman SRSS by the termination of the study and for all 4 weeks combined. Furthermore, the global impression of treatment was judged by patients as more favourable towards alprazolam than towards oxazepam. Only one person in each group reported a serious side effect. The results indicate that the anxiolytic activity of alprazolam is at least as good as that of oxazepam.

Assessment of depression in an elderly medical population

Two self-rating depression scales, the Depression Factor Score derived from the SCL-90 and the Geriatric Depression Scale were administered to 220 medical geriatric in-patients, and two psychiatrists, after a clinical interview, made a diagnosis according to the DSM-III criteria for affective disorders. Eighteen patients were found to be affected by major depression, 49 by dysthymic disorder, 14 by atypical depression and 13 by an adjustment disorder with depressive mood. Women and single persons proved to be significantly more affected by depressive disturbances. The performance of both scales was good, so that they seem to be useful instruments aiding the non-specialist physician in a rapid screening procedure for the identification of depression in elderly patients with medical problems.

Depression in geriatric and adult medical inpatients.

The authors administered two scales for the evaluation of depression, the Zung SDS and the DFS (Depression Factor Score), derived from the SCL-90, to two groups of medical inpatients: One composed of adult subjects (N = 201) and the other of geriatric subjects (N = 178). The results confirm a high presence of depressive symptoms among patients with medical problems, particularly among geriatric subjects; the prevalence of depression was 20.39% for the adults and 42.13% for the elderly patients. High indices of correlation between the two scales were found for both populations. A multiple regression analysis indicated that the factors most predictive of depressive symptoms are female sex and the presence of somatic symptoms likely to lead to disability for elderly subjects and low social class and female sex for adults.

Anxiety and depression in geriatric and adult medical inpatients: a comparison.

Anxiety and depression were evaluated for two groups of medical inpatients, one of 178 geriatric subjects, the other of 201 adults, using the Anxiety Factor Score and the Depression Factor Score derived from the SCL-90. The geriatric subjects scored higher than the adults for depression. The adults scored higher for anxiety, but also had high depression scores. Women of both groups scored significantly higher than men on the depression scale. Moreover, adult women reported a higher mean score than adult men on the anxiety scale. No significant difference emerged in relation to the type of organic disease among the adult patients, while among the geriatric patients, subjects with disorders of the CNS, muscular-skeletal apparatus and blood scored significantly higher on the depression scale than those with other diseases.

Trazodone in Treatment-Resistant Depression: An Open Study

Trazodone was well tolerated and reasonably effective in a group of 25 treatment-resistant depressed patients. Three patients dropped out of the study during the first week because of side effects. Of the 22 patients who completed 2 or more weeks on trazodone, 63% showed at least a 50% reduction in Hamilton Rating Scale for Depression (HAM-D) score for at least two consecutive weekly rating periods. The group had significant decreases in HAM-D, Brief Psychiatric Rating Scale, and Profile of Mood States Depression Factor scores by the end of the first week of treatment. A few patients who did not respond during the initial 4 weeks of the study did so after 2 or 3 months (after 4 weeks, ratings were done monthly). Side effects were not generally a problem. Sedation occurred in 46% of the patients but was easily managed. Anticholinergic side effects were absent, and hypotension was present only if patients took large doses on an empty stomach. Perhaps because the trazodone dosage was generally not raised rapidly, three more severely depressed patients did not respond. The three patients on stable maintenance lithium prior to starting trazodone also failed to improve. On the other hand, no exacerbation of psychosis or precipitation of mania or hypomania occurred on trazodone.

A Hope scale applicable to verbal samples.

A Hope scale is described, applicable to the content analysis of verbal samples. Percentile Hope scores are provided from a normative sample of children (109), adults (91), and a group of psychiatric outpatients (68). Construct validation studies indicated significant negative correlations between Hope scores and psychiatric ratings from the BPRS Depression and Anergia factor scores, the Hamilton Depression Rating Scale factors of Anxiety-Depression and Sleep Disturbance and, also, with scores from the Jacobs Ego Weakness Scale. Significant positive correlations occurred with scores from the Anant Belongingness Scale. Hope scores were found capable of predicting favorable outcome among patients in a Mental Health Crisis Clinic, survival time in patients with terminal cancer, patients likely to follow treatment recommendations, and improvement in the BPRS Depression factor in acute schizophrenic patients after a single dose of thioridazine.