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Comorbid Depression (comorbid + depression)
Selected AbstractsThe Influence of Comorbid Depression on Seizure SeverityEPILEPSIA, Issue 12 2003Joyce A. Cramer Summary:,Purpose: To determine the relation between depressive symptoms and seizure severity among people with epilepsy. Methods: A postal questionnaire was used to survey a nationwide community sample about seizures and depression. The Seizure Severity Questionnaire (SSQ) assessed the severity and bothersomeness of seizure components. The Centers for Epidemiological Studies-Depression scale categorized levels of depression. Results: Respondents categorized as having current severe (SEV, n = 166), mild,moderate (MOD, n = 74), or no depression (NO, n = 443) differed significantly in SSQ scores (all p < 0.0001). People with SEV or MOD reported significantly worse problems than did those with NO depression for overall seizure recovery (mean, 5.3, 4.9, 4.5, respectively); overall severity (5.0, 4.5, 4.2); and overall seizure bother (5.3, 4.8, 4.4) (all p < 0.005). Cognitive, emotional, and physical aspects of seizure recovery also were rated worse among people with SEV than with NO depression (all p < 0.05). Symptoms of depression were significantly correlated with higher levels of all components of generalized tonic,clonic seizure severity (r = 0.33,0.48; all p < 0.0001), and partial seizures (r = 0.31,0.38; all p < 0.01). Conclusions: Clinically depressed people with epilepsy reported higher levels of perceived severity and bother from seizures, as well as greater problems with overall seizure recovery than did nondepressed people experiencing similar types of seizures. The pervasive influence of depressive symptoms on reports of seizure activity suggests that people with epilepsy should be screened for depression. These data highlight the importance of detecting and treating depression among people with epilepsy. [source] No Influence of 5-HTTLPR Gene Polymorphism on Migraine Symptomatology, Comorbid Depression, and ChronificationHEADACHE, Issue 3 2010Thomas Wieser MD (Headache 2010;50:420-430) Background., The serotonergic system is thought to play an important role for mediating susceptibility to migraine and depression, which is frequently found comorbid in migraine. The functional polymorphism in the serotonin transporter gene linked polymorphic region (5-HTTLPR/SLC6A4) was previously associated with attack frequency and, thus, possibly with chronification. Objective., We hypothesized that patients with the "s" allele have higher attack frequency and, paralleling results in depression research, higher scores of depression. Methods., Genetic analysis of the SLC6A4 44 bp insertion/deletion polymorphism (5-HTTLPR) was performed in 293 patients with migraine with and without aura. Self-rating questionnaires were used for assessment of depression. Results., Multinomial logistic regression analysis found no evidence for association of the 5-HTTLPR polymorphism with either depression or migraine attack frequency. Conclusion., We were not able to demonstrate any influence of the serotonin transporter 5-HTTLPR polymorphism on migraine phenomenology (attack frequency or comorbid depression), thereby excluding this variant to be a common genetic denominator for chronic migraine and depression. [source] Eating disorders in older women: Does late onset anorexia nervosa exist?INTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 5 2010Samantha Scholtz MRCPsych Abstract Objective: The objective of this study is to determine whether eating disorders can present for the first time in older people. Method: This is a descriptive study of patients above the age of 50 years who have presented to a national eating disorder center within the last 10 years. Results: Thirty-two patients were identified; data were available for 26 of these patients and 11 agreed for further interview and questionnaire completion. There were no cases where the eating disorder had its onset late in life. Of the 11 interviewed, six participants retained a diagnosis of anorexia nervosa, four had Eating Disorder Not Otherwise Specified and only one was recovered. Comorbid depression was universal in those still suffering with an eating disorder diagnosis, and their level of social functioning was impaired. Discussion: Anorexia nervosa is a chronic and enduring mental illness that, although rare, can be found in older people. In our sample, we found no evidence of late-onset disorders; all described cases were lifelong. © 2009 by Wiley Periodicals, Inc. Int J Eat Disord 2010 [source] The association between antidepressant use and hypoglycaemia in diabetic patients: a nested case,control study,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 4 2008Hieronymus J. Derijks PharmD Abstract Purpose Hypoglycaemia is a limiting factor for glycaemic management of diabetes with intensive insulin and/or oral antidiabetic drug (OAD) regimen. Case reports suggest that antidepressants may interfere with blood glucose metabolism in patients with diabetes mellitus potentially increasing the risk of clinically relevant hypoglycaemia. Comorbid depression treated with antidepressants could therefore further complicate glycaemic control. We have carried out a nested case,control study among diabetic patients to assess the risk of hypoglycaemia requiring hospitalisation associated with the use of antidepressants. Methods Diabetic patients treated with insulin and/or OADs were selected from the Dutch Pharmo system. Exposure to antidepressants was the primary determinant investigated. Use of antidepressants was further subclassified based on the receptor binding profile to investigate whether specific pharmacological properties could explain a potential influence on glucose homeostasis. Conditional logistic regression was used to estimate odds ratios and to adjust for confounding factors. Results From the base cohort (40 600 patients), 549 (1.35%) cases were identified and 1897 controls were selected. Current use of any antidepressant was not associated with a significantly higher risk of hypoglycaemia requiring hospitalisation (OR: 1.36 (95%CI: 0.84,2.20)). A trend for a higher risk on hypoglycaemia was identified for antidepressants with high affinity for the serotonin reuptake transporter. The risk on severe hypoglycaemia was increased after 3 years of use (OR: 2.75 (95%CI: 1.31,5.77)). Conclusions It is important for diabetic patients using antidepressants for more than 3 years to pay attention for symptoms of hypoglycaemia and strict blood glucose self-monitoring. Copyright © 2008 John Wiley & Sons, Ltd. [source] Citalopram treatment of social anxiety disorder with comorbid major depressionDEPRESSION AND ANXIETY, Issue 4 2003Franklin R. Schneier M.D. Abstract Treatment of patients with both social anxiety disorder and major depression has been little studied although social anxiety disorder and depression frequently co-occur. Each disorder has been shown to respond to serotonin reuptake inhibitor treatment. Objectives of this study were to characterize a sample of these comorbid patients and to assess response to treatment with citalopram. Patients with primary DSM-IV generalized subtype of social anxiety disorder and comorbid major depression (N = 21) were assessed for symptoms of each disorder, including atypical depressive features, and functional impairment. Patients were treated with a flexible dose of open label citalopram for 12 weeks. Response rates for the intention-to-treat sample at week 12 were 14/21 (66.7%) for social anxiety disorder and 16/21 (76.2%) for depression. All continuous measures of social anxiety, depression, and functional impairment improved significantly with treatment, but depression symptoms responded more rapidly and more completely than social anxiety symptoms. Mean dose of citalopram at study endpoint was 37.6 mg/day. Only three patients (14.3%) fulfilled DSM-IV criteria for atypical features of depression, although 18 (85.7%) fulfilled the criterion for interpersonal rejection sensitivity. Citalopram treatment may benefit patients with primary social anxiety disorder and comorbid major depression, and it should be further studied in controlled trials. Improvement in social anxiety disorder symptoms lagged behind improvement in depression, and greater than 12 weeks of treatment may be required to assess full social anxiety response in patients with comorbid depression. The overlap of social anxiety disorder with atypical features of depression may primarily be due to the shared feature of rejection sensitivity. Depression and Anxiety 17:191,196, 2003. © 2003 Wiley-Liss, Inc. [source] Platelet activation and secretion in patients with major depression, thoracic aortic atherosclerosis, or renal dialysis treatmentDEPRESSION AND ANXIETY, Issue 3 2002Dominique L. Musselman M.D., M.S. Abstract Relatively little is known concerning the magnitude of alterations of platelet activation and secretion markers of patients with major depression when compared to patients at increased risk for, or with current, clinically significant atherosclerosis. Markers of in vivo platelet stimulation and secretion were measured under basal conditions in normal comparison subjects (n = 12) and three patient groups: patients diagnosed with DSM-IV major depression (n = 15), dialysis-dependent patients (n = 12), and patients with severe thoracic aortic atherosclerosis (n = 10). In comparison to normal comparison subjects, depressed patients and patients with thoracic aortic atherosclerosis exhibited the greatest platelet stimulation as detected by increased anti-LIBS platelet binding. Dialysis-dependent patients exhibited the highest plasma concentrations of the renally-excreted platelet-specific secretion protein, ,-thromboglobulin. This study extends previous observations of increased platelet activation in patients with major depression and documents similar alterations in patients with transesophageal echocardiography (TEE)-documented thoracic aortic atherosclerosis. Future studies will determine whether the magnitude of platelet stimulation and secretion in patients with comorbid depression and atherosclerotic aortic disease is greater than that observed in nondepressed patients with atherosclerotic aortic disease or major depression alone. These findings provide further evidence for either increased platelet activation and/or intrinsic heightened platelet reactivity as one of the biological substrates underlying the increased risk of depressed patients for cardiovascular disease. Depression and Anxiety 15:91,101, 2002. © 2002 Wiley-Liss, Inc. [source] Perceived parental rearing in subjects with obsessive,compulsive disorder and their siblingsACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2010L. Lennertz Lennertz L, Grabe HJ, Ruhrmann S, Rampacher F, Vogeley A, Schulze-Rauschenbach S, Ettelt S, Meyer K, Kraft S, Reck C, Pukrop R, John U, Freyberger HJ, Klosterkötter J, Maier W, Falkai P, Wagner M. Perceived parental rearing in subjects with obsessive,compulsive disorder and their siblings. Objective:, Perceived parenting in patients suffering from obsessive,compulsive disorder (OCD) is examined. We attempted to overcome some methodological limitations of prior studies by taking age of onset, parental OCD and comorbid depression into consideration. In addition, we included data from unaffected siblings to corroborate information on parental rearing. Method:, One hundred and twenty-two cases with OCD and 41 of their siblings as well as 59 healthy controls and 45 of their siblings completed the German short-version of the EMBU (FEE). Results:, Obsessive,compulsive disorder cases reported less parental warmth and more parental rejection and control. Further analyses indicated that parenting is also associated with OCD in cases with late onset and cases without parents affected by OCD. OCD cases with comorbid depression described their parents particularly negatively. Data from siblings indicated good validity of perceived parenting in OCD. Conclusion:, This study provides further evidence for dysfunctional child rearing being relevant to the development of OCD and depression. [source] Computer-based psychological treatment for comorbid depression and problematic alcohol and/or cannabis use: a randomized controlled trial of clinical efficacyADDICTION, Issue 3 2009Frances J. Kay-Lambkin ABSTRACT Aims To evaluate computer- versus therapist-delivered psychological treatment for people with comorbid depression and alcohol/cannabis use problems. Design Randomized controlled trial. Setting Community-based participants in the Hunter Region of New South Wales, Australia. Participants Ninety-seven people with comorbid major depression and alcohol/cannabis misuse. Intervention All participants received a brief intervention (BI) for depressive symptoms and substance misuse, followed by random assignment to: no further treatment (BI alone); or nine sessions of motivational interviewing and cognitive behaviour therapy (intensive MI/CBT). Participants allocated to the intensive MI/CBT condition were selected at random to receive their treatment ,live' (i.e. delivered by a psychologist) or via a computer-based program (with brief weekly input from a psychologist). Measurements Depression, alcohol/cannabis use and hazardous substance use index scores measured at baseline, and 3, 6 and 12 months post-baseline assessment. Findings (i) Depression responded better to intensive MI/CBT compared to BI alone, with ,live' treatment demonstrating a strong short-term beneficial effect which was matched by computer-based treatment at 12-month follow-up; (ii) problematic alcohol use responded well to BI alone and even better to the intensive MI/CBT intervention; (iii) intensive MI/CBT was significantly better than BI alone in reducing cannabis use and hazardous substance use, with computer-based therapy showing the largest treatment effect. Conclusions Computer-based treatment, targeting both depression and substance use simultaneously, results in at least equivalent 12-month outcomes relative to a ,live' intervention. For clinicians treating people with comorbid depression and alcohol problems, BIs addressing both issues appear to be an appropriate and efficacious treatment option. Primary care of those with comorbid depression and cannabis use problems could involve computer-based integrated interventions for depression and cannabis use, with brief regular contact with the clinician to check on progress. [source] Association of tryptophan hydroxylase gene polymorphism with depression, anxiety and comorbid depression and anxiety in a population-based sample of postpartum Taiwanese womenGENES, BRAIN AND BEHAVIOR, Issue 6 2004H. S. Sun Depression and anxiety disorders often coexist clinically and both are known to have a genetic basis, but the mode of inheritance is too complicated to be determined so far. Serotonin is the biogenic amine neurotransmitter most commonly associated with depression and anxiety. Since tryptophan hydroxylase (TPH1) is the rate-limiting enzyme in serotonin biosynthesis, its role in the pathophysiology of these psychiatric diseases has been intensively studied. In this study, we examined whether polymorphism of the TPH1 gene is related to the etiology of major depression, anxiety and comorbid depression and anxiety. Five single nucleoside polymorphisms of the TPH1 gene were studied in a population-based sample of postpartum Taiwanese women consisting of 120 subjects with depression or/and anxiety and 86 matched normal controls. A significant difference (P = 0.0107) in genotype frequency for the T27224C polymorphism was found between the comorbid and normal groups, and risk analysis showed that the C allele conferred a strong protective effect (odds ratio = 0.27; 95% confident interval = 0.11,0.7). Three-allele haplotypes involving T27224C polymorphism were constructed and haplotype associations between particular haplotype combinations and various diseases identified. However, the associations were weak and the overall haplotype frequency profiles in all groups were similar. The results suggest that depression, anxiety, and comorbid depression and anxiety disorders may have related etiologies. In addition, this study suggests that the TPH1 gene might play a role in the pathogenesis of these closely related disorders. [source] No Influence of 5-HTTLPR Gene Polymorphism on Migraine Symptomatology, Comorbid Depression, and ChronificationHEADACHE, Issue 3 2010Thomas Wieser MD (Headache 2010;50:420-430) Background., The serotonergic system is thought to play an important role for mediating susceptibility to migraine and depression, which is frequently found comorbid in migraine. The functional polymorphism in the serotonin transporter gene linked polymorphic region (5-HTTLPR/SLC6A4) was previously associated with attack frequency and, thus, possibly with chronification. Objective., We hypothesized that patients with the "s" allele have higher attack frequency and, paralleling results in depression research, higher scores of depression. Methods., Genetic analysis of the SLC6A4 44 bp insertion/deletion polymorphism (5-HTTLPR) was performed in 293 patients with migraine with and without aura. Self-rating questionnaires were used for assessment of depression. Results., Multinomial logistic regression analysis found no evidence for association of the 5-HTTLPR polymorphism with either depression or migraine attack frequency. Conclusion., We were not able to demonstrate any influence of the serotonin transporter 5-HTTLPR polymorphism on migraine phenomenology (attack frequency or comorbid depression), thereby excluding this variant to be a common genetic denominator for chronic migraine and depression. [source] Gender Differences in Treatment-Seeking Chronic Headache SufferersHEADACHE, Issue 7 2001Dawn A. Marcus MD Objective.,To identify gender differences within a group of patients seeking treatment for chronic headache. Previous studies of the general population have reported differences in headache symptoms, frequency, disability, and psychological distress, with women affected with more severe and disabling symptoms than men. This study evaluated these features in a population seeking treatment. Methods.,Two hundred fifty-eight consecutive patients with headache attending a university headache clinic were evaluated with questionnaires about headache symptoms and psychological distress. Comparisons between men and women were made for headache symptoms, severity, frequency, trigger factors, comorbid depression and anxiety, and response to treatment. Results.,There were no gender differences in headache symptoms, frequency, severity, and duration. Headache triggers were gender-specific, with men more likely to endorse exercise and women more likely to endorse stress and exposure to odors. Psychological comorbidity was similar among men and women seeking treatment, with a mean Beck Depression Inventory score of 10 and a mean Spielberger trait anxiety score of 39 for both men and women. Disability was greater in men, with 46% reporting restrictions in activities more than 3 days per week because of headache compared with 29% of women. In addition, men were more likely to contribute headache control to external figures than women. Conclusions.,Patients seeking treatment for chronic headache do not have the same gender-specific differences that have been reported in general population surveys. Men who seek treatment for headache are more likely to have significant disability, and are equally likely to have symptoms of depression and anxiety as women who seek treatment. Clinical and research investigations of headache triggers need to be gender-specific. [source] Civilian-based posttraumatic stress disorder and physical complaints: Evaluation of depression as a mediatorJOURNAL OF TRAUMATIC STRESS, Issue 4 2002Robert Miranda Jr. Abstract This study examined the role of comorbid depression in the somatic complaints of 32 individuals with civilian-based posttraumatic stress disorder (PTSD) while restricting the influence of detectable pathophysiology and additional psychiatric conditions. It was hypothesized that depressive symptomatology would mediate the relationship between PTSD and somatic symptom reporting. Participants were administered structured clinical interviews, a physical examination, and an electrocardiogram. Results of this study supported the hypothesis that depressive symptoms mediate the relationship between PTSD and physical complaints. These results add to a growing body of literature that suggests psychological factors play an influential role in the physical symptom reports of individuals with PTSD. [source] Polysomnography in patients with post-traumatic stress disorderPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 3 2010Sinan Yetkin MD Aims:, The purpose of the present study was to investigate sleep structure in post-traumatic stress disorder (PTSD) patients with and without any psychiatric comorbidities. The relationship between sleep variables and measurements of clinical symptom severity were also investigated. Methods:, Sleep patterns of 24 non-medicated male PTSD patients and 16 age- and sex-matched normal controls were investigated on polysomnography on two consecutive nights. Six PTSD-only patients and 15 PTSD patients with major depressive disorder (MDD) were also compared to normal controls. Sleep variables were correlated with PTSD symptoms. Results:, Compared to the normal controls, the PTSD patients with MDD had difficulty initiating sleep, poor sleep efficiency, decreased total sleep time, decreased slow wave sleep (SWS), and a reduced rapid eye movement (REM) sleep latency. The PTSD patients without any comorbid psychiatric disorders had moderately significant disturbances of sleep continuity, and decreased SWS, but no abnormalities of REM sleep. REM sleep latency was inversely proportional to the severity of startle response. SWS was found to be inversely correlated with the severity of psychogenic amnesia. Conclusions:, PTSD patients have disturbance of sleep continuity, and SWS deficit, without the impact of comorbid depression on sleep. The relationship between SWS and the inability to recall an important aspect of trauma may indicate the role of sleep in the consolidation of traumatic memories. The relationship between the severity of the startle response and REM latency may suggest that REM sleep physiology shares common substrates with the symptoms of PTSD. [source] Startle reflex modulation and autonomic responding during anxious apprehension in panic disorder patientsPSYCHOPHYSIOLOGY, Issue 6 2007Christiane A. Melzig Abstract The present study explored anxious apprehension in panic disorder patients and controls in two threat conditions, darkness and threat of shock. Autonomic arousal and startle eyeblink reflexes were recorded in 26 panic disorder patients and 22 controls during adaptation, a safe condition, threat of shock, and darkness. Exposure to darkness resulted in a clear potentiation of the startle reflex. Panic patients but not controls responded with an increase in heart rate that was positively related to severity of agoraphobic avoidance. Threat of shock resulted in a startle potentiation that tended to be stronger in panic patients without comorbid depression than controls and attenuated in those patients who suffered from severe depression. These data suggest that only panic patients without depression belong to the fear disorders spectrum whereas panic patients with comorbid depression might rather belong to the distress disorders profile. [source] | ||||||||||||||||||||||