Quick Inventory Of Depressive Symptomatology-Self-Report Score Research Articles

A genome-wide association study of escitalopram treatment outcomes in patients with major depressive disorder

Major depressive disorder (MDD) is a common psychological condition, the consequences of which, such as suicide, can be severe. Escitalopram, a selective serotonin reuptake inhibitor, is a commonly used antidepressant in clinics. However, more than one-third of patients with MDD do not respond to this drug. Gene polymorphism may affect the efficacy of escitalopram, but the genetic architecture of the antidepressant response in patients with MDD remains unclear. We perform a genome-wide association study (GWAS) of the genetic effect on the outcome of escitalopram in patients with MDD. A total of 203 patients with MDD and 176 healthy control (HC) adults were recruited from Beijing Anding Hospital. Patients received 12 weeks of antidepressant treatment with escitalopram. The Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR) or Hamilton depression scale (HAMD) were used to evaluate the severity of depression symptoms at the baseline and the end of 2 and 12 weeks of treatment. A total of 140 variants in MDD patients were identified by GWAS to have genome-wide significance (p < 5e − 8) compared with HCs. Similarly, 189 and 18 variants were identified to be associated with QIDS-SR and HAMD score changes in patients after antidepressant treatment (p < 1e − 5), including rs12602361, rs72799048, rs16842235, and rs2518256. In the two weeks QIDS-SR score study, the gene-level association for these variants and gene set enrichment analyses implicate the enrichment of genes involved in the synaptic plasticity process and nervous system development. Our results implicate the predictive capacity of the effect of escitalopram treatment, supporting a link between genetic basis and remission of depression.

Treatment-resistant depression patients with baseline suicidal ideation required more treatments to achieve therapeutic response with ketamine/esketamine

BackgroundThere is an urgent need to identify interventions to reduce suicidality. We investigated the antisuicidal effects of intravenous (IV) ketamine and intranasal (IN) esketamine among patients with treatment-resistant depression (TRD) in a historical cohort study. MethodsThe Quick Inventory of Depressive Symptomatology self-report (QIDS-SR) question 12 was used to measure suicidal ideation (SI). Cox proportional hazards models were used to evaluate associations between the number of treatments to response and baseline SI (yes, Q12 > 0 versus no, Q12 = 0), adjusting for covariates and modified baseline QIDS-SR score. We evaluated associations between the number of treatments to a 50 % reduction in SI score between IV and IN treatment. ResultsFifty-two adults (62.5 % female, median age 49.1 years) received IV ketamine (71 %, n = 37) or IN esketamine (29 %, n = 15). Eighty-one percent of patients reported SI at baseline. Among those with baseline SI, 60 % had improved SI scores while 38 % did not change, and among those with no SI, 80 % did not change. After adjusting for covariates, the hazard ratios (HR) of response were significantly lower among those with baseline SI (HR = 0.36, 95 % CI, 0.14–0.92, p = 0.03). The number of treatments to achieve a 50 % reduction in SI score did not depend on group (IN esketamine vs. IV ketamine HR = 0.74 [95 % CI, 0.27–2.05]; p = 0.57). LimitationsSmall sample size and lack of a placebo group. ConclusionsThis study suggests that patients with baseline suicidal ideation require more treatments to achieve a response with ketamine or esketamine. The antisuicidal response seemed similar between IV ketamine and IN esketamine.

Acute Suicidal Ideation in the Context of Esketamine Maintenance Therapy

Acute Suicidal Ideation in the Context of Esketamine Maintenance Therapy

The effect of the time to remission on residual symptoms and functioning among depressive patients

ObjectivesTo explore the effect of time to remission on residual symptoms, functioning and quality of life (QOL) of the patients with major depressive disorder (MDD). MethodA total of 434 patients were enrolled from 16 sites of China. The Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR) and self-rating scales were assessed at baseline, and months 1, 3 and 6. Baseline remitters were defined as those subjects with a QIDS-SR score ≤ 5 at baseline. Later remitters was defined as those reaching remission one month (Month 1 remitters) or three month (Month 3 remitters) after baseline. Persistent non-remitters were defined as those with QIDS-SR score > 5 at all 3 assessments. A follow-up assessment was done at month 6 to examine outcomes. Cross-lagged models indicated QIDS-SR predicted social functioning and QOL. ResultsTotally, 179 patients at baseline achieved remission. An additional 141 participants remitted at month 1 (n = 94) or month 3 (n = 47), and 63 patients were persistent non-remitters. There were significant differences between all groups on depression severity at baseline. QOL was similar for both late remitter groups, which was better than non-remitters, but lower than early-remitters. Late remitters and non-remitters showed significant differences on change of functioning and QOL (P < 0.001) at each visit. By 6 months, all remitting groups showed lower depression severity and better social functioning and QOL than persistent non-remitters. Cross-lagged models indicated QIDS-SR predicted social functioning and QOL. ConclusionWe confirmed the association of earlier remission with a better quality of remission at early stage; but the time to remission does not affect future functioning and QOL.

Effectiveness and Tolerability of Lurasidone for Bipolar Types I and II and Other Specified Bipolar Depression: A 12-Week Observational Study.

There are few guidelines on the management of depressive episodes in patients with bipolar type II (BDII) and related disorders (other specified bipolar and related disorders [OSBD]). Lurasidone is a potential option for treating depressive episodes in BDII/OSBD. This retrospective chart review study aimed to examine the effectiveness and tolerability of lurasidone for use in patients with bipolar depression. We reviewed 66 consecutive outpatients with bipolar depression who were prescribed lurasidone between June 2020 and January 2021 and examined 12-week outcomes. Fourteen patients were diagnosed with BDI, and 52 patients were diagnosed with BDII/OSBD (42 BDII and 10 OSBD). Depressive symptoms were evaluated by the Quick Inventory of Depressive Symptomatology, Self-Report (QIDS-SR) at baseline and 2, 4, and 12 weeks. Tolerability was assessed throughout the study period by the incidence of adverse events, such as akathisia, nausea, and manic/hypomanic switch, as well as the lurasidone dropout rate due to adverse events. The total QIDS-SR score at 2 ( P < 0.001), 4 ( P < 0.001), and 12 weeks ( P < 0.001) was significantly lower than that measured at baseline. Remission rate during study period was 29.1%. Of the 66 participants, 47 (71.2%) continued taking lurasidone and 27 (40.9%) and 16 (24.2%) reported adverse events and akathisia, respectively. No significant difference in total QIDS-SR score, dropout rate due to adverse events, rate of adverse events, or rate of akathisia was found between the BDII/OSBD and BDI groups. Lurasidone is tolerated and could be effective for managing depressive episodes in patients with BDII/OSBD and BDI.

Treatment Outcomes of Electroconvulsive Therapy for Depressed Patients With and Without Borderline Personality Disorder: A Retrospective Cohort Study.

Electroconvulsive therapy (ECT) is the gold-standard treatment for refractory depression. Borderline personality disorder (BPD) is generally considered a poor predictor of treatment response. We sought to assess symptom-severity outcomes among depressed patients with (BPD+) and without (BPD-) comorbid BPD undergoing acute phase ECT. The study sample consisted of at least moderately depressed patients who received an acute course of ECT from January 2011 to December 2016 at an academic, freestanding psychiatric hospital. Participants completed a DSM-IV-validated BPD screening instrument at baseline. Measures of DSM-IV depressive symptom severity from the Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR) were taken serially on 4 occasions. Outcomes of interest comprised total QIDS-SR score trajectory, QIDS-SR suicidality subscore, and symptom cluster subscores posited to differentiate response among antidepressant treatments. Of the 693 individuals who met study inclusion criteria, 145 (20.9%) screened positive for BPD. Overall, ECT was associated with significant improvement of depressive symptoms (χ²₁ = 504.8, P < .0001). Despite differing from BPD- individuals on key baseline features, BPD+ individuals responded to ECT with similar improvement in overall depression severity (χ²₁ = 0.22, P = .64), suicidality (χ²₁ = 1.63, P = .20), and core emotional (χ²₁ = 0.63, P = .43), sleep (χ²₁ = 0.20, P = .65), and atypical (χ²₁ = 1.30, P = .25) symptoms after 15 treatments. Post hoc analysis indicated a slightly less robust overall response among the BPD+ group by the 15th treatment. Acute course ECT benefits depressed patients with or without comorbid BPD, although patients with BPD may exhibit less pronounced improvement over time.

An Association Between the Inflammatory Biomarker GlycA and Depressive Symptom Severity.

The underlying mechanisms of depression remain unclear; however, current literature suggests a relationship between inflammation and depression. The association between the inflammatory biomarker high-sensitivity C-reactive protein (hs-CRP) and depression has been previously investigated, but the relationship between GlycA, a novel spectroscopic inflammatory biomarker, and depression does not appear to have been examined. Data were obtained from The Dallas Heart Study (DHS, conducted between 2000 and 2002), which consisted of a large community-based sample of Dallas County residents (N = 3,033). Depressive symptom severity was assessed with the Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR). It was hypothesized that the serum GlycA level would be a statistically significant predictor of QIDS-SR scores after control for demographic covariates. Multiple linear regression was used to assess the relationship between GlycA level and QIDS-SR scores. The role of hs-CRP in predicting QIDS-SR scores was also explored. GlycA level was a statistically significant positive predictor of QIDS-SR score (β = .053, P = .038) with control for sex, age, antidepressant use, ethnicity, smoking status, drinking status, body mass index, and years of education. In a subset of adults with moderate-to-severe depression, GlycA level was not associated with QIDS-SR scores. Additionally, hs-CRP level was not a statistically significant predictor of QIDS-SR scores. This study found a positive association between the inflammatory biomarker GlycA, but not hs-CRP, and depressive symptom severity in a large multiethnic and multiracial community-based sample. Thus, these results provide the first indication that GlycA may be a potentially useful novel biomarker of depression.

Association of menopause symptoms with depressive symptom severity in a diverse community-based sample

The Dallas Heart Study dataset was used to examine relationships between menopausal symptoms and depressive symptom severity in 384 women (37–73 years old) self-reporting as menopausal. Self-reported menopausal symptoms were grouped based on the Menopause-specific Quality of Life Questionnaire (MENQOL). Depressive symptom severity was assessed using the Quick Inventory of Depressive Symptomatology – Self-Report (QIDS-SR). The relationship between menopause symptom groups, ethnicity and QIDS-SR was evaluated using multiple linear regression. Endorsement of sexual symptoms was positively associated with QIDS-SR score (β = .12, p = .031), suggesting that sexual dysfunction during menopause may be a predictor of underlying depressive symptoms.

Coexistence of lower urinary tract symptoms (LUTS) with depressive symptoms in patients suffering from depressive disorders.

The aim of the present study was to investigate the correlation between lower urinary tract symptoms (LUTS) and severity of depressive symptoms in patients treated for depression. 102 patients (43 males, 59 females) aged 20-67 (M = 46.1) treated for depression were included in this cross-sectional analysis. Depressive symptoms were assessed with the 17-item Hamilton Depression Rating Scale (HDRS) and Quick Inventory of Depressive Symptomatology - Self Report (QIDS-SR). LUTS were examined with the International Prostate Symptom Score (IPSS). In order to analyze the impact of presented symptoms, both urological and psychiatric, on quality of life of analyzed individuals the 30-item General Health Questionnaire (GHQ-30) was used. The average IPSS score in women was significantly higher than in men (9.59 vs. 6; p = 0.04). Patients suffering from at least moderate depression assessed with QIDS-SR had significantly higher scores in IPSS (9.76 vs. 4.1; p = 0.002). Severity of all LUTS assessed with IPSS correlated with QIDS-SR score in examined men (p < 0.05). In women, the total IPSS score correlated with the QIDS-SR score (p < 0.05) and with the total GHQ-30 score (p < 0.05). Anumber of other significant (p < 0.05) correlations were observed between the total IPSS score and certain items' scores in the GHQ-30 both in men and women. LUTS are common among patients with depression. There is a correlation between severity of depressive symptoms and LUTS. LUTS affect quality of life and well-being as well as cause marked distress in depressed patients. Comorbidity of LUTS and depression should draw attention of both psychiatrists and urologists and enhance interdisciplinary treatment approach. Further prospective and cohort studies are essential to reveal more details of the correlation between LUTS and depression.

Identification of Baseline Characteristics Associated With Development of Depression Among Patients With Head and Neck Cancer

Patients with head and neck cancer (HNC) experience increased risk of depression and compromised quality of life. Identifying patients with HNC at risk of depression can help establish targeted interventions. To identify factors that may be associated with the development of moderate or severe depression during treatment of HNC. This is a retrospective, ad hoc, secondary analysis of prospectively collected data from a randomized, double-blind, placebo-controlled clinical trial. Patients were screened at academic- and community-based tertiary care HNC centers from January 2008 to December 2011. Of the 125 evaluable patients with stages II through IV HNC but without baseline depression, 60 were randomized to prophylactic antidepressant escitalopram oxalate and 65 to placebo at the time of the initial diagnosis. Data analyses were conducted from May 2016 to April 2017. Depression outcomes were measured using Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR) scores (range, 0-27 with a score of 11 or higher indicative of moderate or greater depression). Factors that may be associated with development of moderate or severe depression were assessed, including patient demographics; cancer site and stage; primary treatment modality (surgery or radiotherapy); history of depression or other psychiatric diagnosis; previous treatment of depression or suicide attempt, family history of depression, suicide, or suicide attempt; and baseline score on the QIDS-SR and clinician-rated QIDS instruments. Participants were stratified by study site, sex, cancer stage (early [stage II] vs advanced [stage III or IV]), primary modality of treatment (radiotherapy with or without chemotherapy vs surgery with or without radiotherapy), and randomization to placebo or escitalopram and balanced within these strata. The mean (SD) age of the 148 patients in the study population was 63.0 (11.9) years; 118 (79.7%) were men, and 143 (96.6%) were white. In the evaluable population of 125 patients, receiver operating characteristic analyses assessing the area under the curve for baseline QIDS-SR score (0.816; 95% CI, 0.696-0.935) and for initial radiotherapy-based treatment (0.681, 95% CI, 0.552-0.811) suggested that these 2 variables were associated with the likelihood of developing moderate or greater depression during the study period among patients who did not receive prophylactic antidepressants. The diagnostic sensitivity for identifying patients at risk of depression using the baseline QIDS-SR score improved to 100% at a threshold of 2 from 94% at a threshold of 4. Baseline symptoms and initial radiotherapy-based treatment may be associated with development of moderate or greater depression in patients with HNC. Patients with QIDS-SR baseline scores of 2 or higher may benefit the most from pharmacologic prophylaxis of depression.

Practical application of the neuroregenerative properties of ketamine: real world treatment experience

While controversial, ketamine has emerged as an effective treatment for refractory depression. Serial infusions have been performed 3 times per week, but our practical experience has challenged this precept concerning infusion frequency. Depression is associated with neuron loss, reduced synapse numbers, and dearborization of dendrites. Ketamine appears to potently induce mechanisms which reverse these neurodegenerative processes. Ketamine not only blocks the glutamate receptor, it activates eukaroyotic elongation factor 2 (eEF2). This, in turn, activates brain-derived neurotrophic factor (BDNF) protein synthesis. This is thought to underlie ketamine's enduring benefits. In addition, ketamine alters glycogen synthase kinase-3 (GSK-3) phosphorylation, probably responsible for its rapid antidepressant effect. Notably, inhibition of the BDNF receptor does not block the immediate benefits of ketamine, but does prevent the enduring effects. Neuro-Luminance Ketamine Infusion Centers have been treating patients with serial ketamine infusions for over three years. Our methods differ from what is often reported, as we perform infusions only once per week and generally do not perform more than five infusions. Data from 100 patients showed that 80% of the patients responded. The baseline Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR) score was 17.8 ± 2.8. Responders to ketamine showed a drop in QIDS-SR score of 10.8 ± 3.5, while non-responders showed a 0.8 ± 1.8 change. Moreover, they often had persistent benefits over several months. Recently, it was proposed that psychotomimetic effects are necessary during a ketamine infusion to yield effective antidepressant benefits. Yet, only one patient in our clinic has experienced hallucinations in three years. Nevertheless, 80% of our patients show clinical improvement. Further studies of clinical methods for ketamine infusion therapy are encouraged.

Could the Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR) be used in depressed schizophrenia patients?

BackgroundDeveloping accurate and time-efficient tools to measure depressive symptoms in schizophrenia is important for research and clinical practice. This study tested the psychometric properties of the Chinese version of the 16-item Quick Inventory of Depressive Symptomatology (QIDS-SR) in depressed schizophrenia patients. MethodsThis study included 337 clinically stable patients with schizophrenia. The severity of depressive symptoms was assessed using the Montgomery–Asberg Depression Rating Scale (MADRS), QIDS-SR at baseline and 2 weeks later. Negative symptoms and extrapyramidal symptoms were measured with the negative symptom score of Brief Psychiatric Rating Scale (BPRS) and the Simpson–Angus Scale of Extrapyramidal Symptoms (SAS), respectively. ResultsInternal consistency (Cronbach׳s alpha) was 0.73 and 0.67 for QIDS-SR at the baseline and endpoint, respectively. The intra-class correlation coefficient (ICC) for test–retest reliability over the two weeks was 0.77. Two domains (involvement and energy) at baseline and one domain (energy) at endpoint had the highest item-total correlations. The QIDS-SR total score was significantly correlated with the MADRS total score at baseline (r=0.44, p<0.01). Weak correlations of the QIDS-SR score with the scores of the BPRS negative (r=0.18) and the SAS (r=0.05) indicate good discriminant validity. The QIDS-SR showed unidimensional measurement properties in exploratory factor analysis at both baseline. The main limitation of the study is that only clinically stable schizophrenia patients were included. ConclusionsThe QIDS-SR has acceptable psychometric properties in stable schizophrenia patients and may be useful in both research and clinical practice.