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Hamilton Rating Scale (hamilton + rating_scale)

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Medical Sciences95%

Kinds of Hamilton Rating Scale

  • item hamilton rating scale
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    Selected Abstracts

    The effect of depression on quality of life of patients with type II diabetes mellitus

    DEPRESSION AND ANXIETY, Issue 2 2008
    brahim Eren M.D.
    Abstract Diabetes mellitus (DM) is a frequently encountered metabolic disease with chronic features and involves numerous complications throughout its course, which causes severe restriction and disability in an individual's life. It has been reported that the incidence of depression is higher in diabetic patients and that diabetes is one of the risk factors in the development of depression. It has also been reported that co-morbid psychiatric disorders cause further deterioration in the quality of life in diabetic patients. The aim of this study was to investigate the effects of depression on the quality of life in type II DM patients. Sixty patients (30 females and 30 males) with current major depressive episode diagnosed according to DSM-IV criteria, and 48 type II DM patients (30 females and 18 males) without a major depressive episode (non-depressed group) were included in the study. All patients were evaluated with a semi-structured interview form to assess the clinical features of DM, Hamilton Rating Scale for Anxiety (HRSA), Hamilton Rating Scale for Depression (HRSD), and the Turkish version of The World Health Organization Quality of Life Assessment-Brief (WHOQOL-BREF). The HRSD and HRSA scores in the depressed group were 24.87±4.83 and 21.07±5.44, respectively, whereas those in the non-depressed group were 7.83±3.92 and 6.88±3.43, respectively. The physical health, psychological health, social relationship, environmental and social pressure domain, general health-related quality of life, overall quality of life, and WHOQOL-BREF total scores were found significantly lower in the depressed group than the non-depressed group. There were significant negative correlations between HRSD and HRSA scores and physical health, psychological health, social relationship, environmental and social pressure domain, general health-related quality of life, overall quality of life, and WHOQOL-BREF total scores. Furthermore, there were significant negative correlations between the HbA1c level and physical health, social relationship, environmental domain, social pressure domain, general health-related quality of life, overall quality of life, and WHOQOL-BREF total scores. However, there was a significant positive correlation between the level of education and physical health, psychological health, social relationship, environmental social pressure domain, overall quality of life, and WHOQOL-BREF total scores. There were significant negative correlations between social relationship domain score, and age and duration of illness. Our study demonstrates that the presence of depression in type II DM further deteriorates the quality of life of the patients. Since treating depression would have a beneficial effect on the quality of life, clinicians should carefully assess for depression associated with type II DM. Depression and Anxiety 0:1,9, 2007. © 2007 Wiley-Liss, Inc. [source]

    An open-label trial of enhanced brief interpersonal psychotherapy in depressed mothers whose children are receiving psychiatric treatment,,

    DEPRESSION AND ANXIETY, Issue 7 2006
    Holly A. Swartz M.D.
    Abstract Major depression affects one out of five women during her lifetime. Depressed mothers with psychiatrically ill children represent an especially vulnerable population. Challenged by the demands of caring for ill children, these mothers often put their own needs last; consequently, their depressions remain untreated. This population is especially difficult to engage in treatment. We have developed a nine-session intervention, an engagement session followed by eight sessions of brief interpersonal psychotherapy designed to increase maternal participation in their own psychotherapy, resolve symptoms of maternal depression, and enhance relationships (IPT-MOMS). This open-label trial assesses the feasibility and acceptability of providing this treatment to depressed mothers. Thirteen mothers meeting DSM-IV criteria for major depression were recruited from a pediatric mental health clinic where their school-age children were receiving psychiatric treatment. Subjects (mothers) were treated openly with IPT-MOMS. Eighty-five percent (11/13) completed the study. Subjects were evaluated with the Hamilton Rating Scale for Depression, and completed self-report measures of quality of life and functioning at three time points: baseline, after treatment completion, and 6-months posttreatment. A signed rank test was used to compare measurement changes between assessment time points. Subjects showed significant improvement from baseline to posttreatment on measures of maternal symptoms and functioning. These gains were maintained at 6-month follow-up. Therapy was well tolerated and accepted by depressed mothers, who are typically difficult to engage in treatment. A high proportion of subjects completed treatment and experienced improvements in functioning. Future randomized clinical trials are needed to establish the efficacy of this approach. Depression and Anxiety 23:398,404, 2006. Published 2006 Wiley-Liss, Inc. [source]

    The efficacy of reboxetine in the treatment-refractory patients with panic disorder: an open label study

    HUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 7 2002
    P. N. Dannon
    Abstract Background and Objective Selective serotonin reuptake inhibitors (SSRIs) are currently the first-line treatment for panic disorder, although up to 30% of patients either do not respond to SSRIs or withdraw due to adverse events. Reboxetine, a selective norepinephrine reuptake inhibitor (selective NRI), is effective in treating depression and may alleviate depression-related anxiety. This study aimed to investigate the efficacy of reboxetine in the treatment of patients with panic disorder who did not respond to SSRIs. Method In this 6-week, open-label study, 29 adult outpatients with panic disorder who had previously failed to respond to SSRI treatment received reboxetine 2,mg/day, titrated to a maximum of 8,mg/day over the first 10 days. Efficacy was assessed using the Panic Self-Questionnaire (PSQ), the Hamilton Rating Scale for Anxiety (HAM-A), the 17-item Hamilton Rating Scale for Depression (HRSD) and the Global Assessment of Functioning (GAF) Scale. Results The 24 patients who completed the study responded well to reboxetine treatment. Significant improvement (p,<,0.001) was observed in the number of daily panic attacks, and on the scales measuring anxiety, depression and functioning. Reboxetine was generally well tolerated. Five patients withdrew due to adverse events. Conclusions Reboxetine appears to be effective in the treatment of SSRI-refractory panic disorder patients and warrants further clinical investigation. Copyright © 2002 John Wiley & Sons, Ltd. [source]

    Continuation and long-term maintenance treatment with Hypericum extract WS® 5570 after successful acute treatment of mild to moderate depression , rationale and study design

    INTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 3 2004
    Chairman, S. Kasper Professor
    Abstract Unipolar major depression is often a chronic disease that may require lifelong prophylaxis. Recovery from an acute episode is followed by 4-6 months of relapse prevention. After that, long-term maintenance treatment is administered to avoid recurrence. We present the rationale and design of an ongoing double-blind, randomized, placebo-controlled trial investigating the efficacy of Hypericum extract WS® 5570 in relapse prevention in recurrent unipolar depression. An estimated sample of 425 adults with recurrent, mild to moderate major depression (ICD-10 and DSM-IV criteria), ,3 previous episodes (last 5 years) and a total score ,20 points on the 17-item Hamilton Rating Scale for Depression (HAMD) will be included. After a one-week wash out patients receive 3 × 300 mg/day WS® 5570 single-blind for 6 weeks. Responders are randomized to 26 weeks of double-blind continuation treatment with 3 × 300 mg/day WS® 5570 or placebo. Patients completing continuation treatment without relapse enter 52 weeks of double-blind maintenance treatment, where those treated with WS® 5570 are re-randomized to 3 × 300 mg/day WS® 5570 or placebo. The primary outcome measure is the time to relapse during continuation treatment (HAMD ,16, clinical diagnosis of depression, or premature treatment termination for inefficacy). Hypericum extract, with its favourable tolerability profile, could be an interesting option for long-term prophylaxis. The trial was designed according to current consensus and guidance. Notably, it includes long-term prophylactic treatment with the same drug and the same therapeutic dose applied during acute treatment, uses well-defined outcome measures and provides a clear distinction between relapse and recurrence. Copyright © 2004 Whurr Publishers Ltd. [source]

    Onset of Depression in Elderly Persons After Hip Fracture: Implications for Prevention and Early Intervention of Late-Life Depression

    JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2007
    Eric J. Lenze MD
    OBJECTIVES: To identify predictors of onset of major depressive disorder (MDD) and of depressive symptoms in subjects who suffered a hip fracture. DESIGN: Prospective naturalistic study. SETTING: University of Pittsburgh Medical Center,Shadyside, a large urban hospital in Pittsburgh, Pennsylvannia. PARTICIPANTS: One hundred twenty-six elderly patients who received surgical fixation for hip fracture and who were not experiencing a major depressive episode at the time of the fracture; severely cognitively impaired persons were excluded. MEASUREMENTS: Subjects were evaluated at the time of hospital discharge using a battery of clinical measures (including apathy measured using the Apathy Evaluation Scale (AES), delirium, cognitive measures, social support, and disability level). Depression was assessed at the end of the surgical stay, 2 weeks later, and then monthly for 6 months, using the Hamilton Rating Scale for Depression (Ham-D) to evaluate symptomatology and the Primary Care Evaluation of Mental Disorders to evaluate diagnosis of MDD. RESULTS: Eighteen of 126 subjects (14.3%) developed MDD after hip fracture. Of these, 11 developed MDD by the end of the hospitalization, and seven developed MDD between 2 and 10 weeks later. Logistic regression showed that baseline apathy score, as measured using the AES, was the only clinical measure associated with the development of MDD (odds ratio=1.09, 95% confidence interval=1.03,1.16, P=.003); 46.2% of those with high AES scores developed MDD, versus 10.9% of those with lower scores. In contrast, cognitive variables, delirium, disability after hip fracture, and other factors related to the fracture (e.g., fracture type) were not associated with MDD. A repeated-measures analysis with Ham-D over time as a dependent variable generally confirmed these findings; depressive symptoms were highest immediately after the fracture, and apathy and delirium scores were associated with higher depressive symptom levels. CONCLUSION: The onset of MDD is common after hip fracture, and the greatest period of risk is immediately after the fracture. Individuals with clinical evidence of apathy are at high risk for developing MDD, and evaluation and close follow-up of such individuals is warranted. However, further research is needed to examine other candidate variables (e.g., clinical measures or biomarkers) to model adequately the risk for MDD after hip fracture and other disabling medical events. [source]

    Latest news and product developments

    PRESCRIBER, Issue 5 2008
    Article first published online: 3 APR 200
    Newer antidepressants no better than placebo? A new meta-analysis suggests that newer antidepressants are no superior to placebo in most patients with depression , the exception being those with very severe depression, who can expect a small benefit. Writing in the online-only open access journal PLoS Medicine (5:e45.doi:10.1371/ journal.pmed.0050045), researchers from Hull and the US analysed published and unpublished trials submitted to the Food and Drug Administration in marketing applications for fluoxetine, paroxetine, venlafaxine (Efexor) and nefazodone (no longer available). Using the Hamilton Rating Scale for Depression (HRSD) score as an endpoint, meta-analysis of 35 trials involving 5133 patients and lasting six to eight weeks showed that mean HRSD score improved by 9.6 points with drug treatment and 7.8 with placebo. The authors say the difference of 1.8 was statistically significant but below the criterion for clinical significance (3.0) set by NICE in its clinical guideline on depression. A review of the study by the NHS Knowledge Service (www.nhs.uk) points out that it omits trials published after the drugs were licensed (1999) and those not sponsored by the pharmaceutical industry. It did not include any patients with severe depression and only one trial in patients with moderate depression. An earlier US study of data submitted to the FDA (N Eng J Med 2008;358:25260) showed that published trials of antidepressants were more likely to be positive (37/38) than unpublished ones (3/25). Further, FDA analysts concluded that 51 per cent of trials (published and unpublished) demonstrated positive findings compared with 94 per cent of those that were published. Audit reveals variations in hospital psoriasis care There are unacceptably large variations in the quality of care for patients with psoriasis in UK hospitals, a report by the British Association of Dermatologists and the Royal College of Physicians reveals. The audit of 100 hospital units found that 39 per cent restricted access to biological therapies because of cost, and over one-third of pharmacies could not supply ,specials' such as topical coal tar preparations. More positively, the units are adequately resourced to provide timely communication with GPs. RCGP responds to Public Accounts Committee The Royal College of General Practitioners has agreed with the Commons Public Accounts Committee that drug package labelling should include the cost of the medication. The suggestion was made by the Committee in its report Prescribing Costs in Primary Care. While recognising the importance of generic prescribing, the RCGP cautions against frequent medication switches because it may unsettle patients. ,Any changes must be carried out for sound clinical reasons with good communication between GPs and their patients,' it adds. Statins for patients with kidney disease? Statins reduce cardiovascular risk in people with chronic kidney disease, a new study suggests, but their effects on renal function remain unclear (BMJ 2008; published online doi: 10.1136/bmj. 39472.580984.AE). The meta-analysis of 50 trials involving a total of 30 144 patients found that statins reduced lipids and cardiovascular events regardless of the severity of kidney disease. However, all-cause mortality was unaffected and, although proteinuria improved slightly, there was no change in the rate of decline of glomerular filtration rate. An accompanying editorial (BMJ 2008; published online doi:10.1136/ bmj.39483.665139.80) suggests that the indications for statin therapy to reduce cardiovascular risk in patients with chronic kidney disease should be the same as for those with normal renal function. New NICE guidance New clinical guidelines from NICE (see New from NICE, pages 14,15) include the diagnosis and management of irritable bowel syndrome in adults in primary care, the care and management of osteoarthritis in adults, and the diagnosis and treatment of prostate cancer. In a public health guideline on smoking cessation services, NICE endorses the use of nicotine replacement patches for 12,17 year olds. Suspect additives in children's medicines The Food Commission (www.foodcomm.org.uk) has drawn attention to the presence in children's medicines of food additives it says are linked with hyperactivity. The Commission, a national nonprofit organisation campaigning for ,the right to safe, wholesome food', says that seven common additives (including tartrazine, sodium benzoate and Ponceau 4R) are associated with hyperactivity in susceptible children. Checking the SPCs, it found that 28 of 70 children's medicines , including formulations of paracetamol, ibuprofen, amoxicillin, erythromycin and codeine phosphate throat linctus , contain at least one suspect additive. Digoxin may increase mortality in AF patients An observational study has suggested that digoxin may increase deaths in patients with atrial fibrillation (Heart 2008;94:191,6). The study was a planned subgroup analysis of a trial evaluating anticoagulant therapy in 7329 patients with atrial fibrillation. Of these, 53 per cent were treated with digoxin. Mortality was significantly higher among digoxin users than nonusers (4.22 vs 2.66 per cent per year); myocardial infarction and other vascular deaths (but not stroke, systemic embolic episodes and major bleeding events) were significantly more frequent with digoxin. Poor communications cause readmission Elderly hospital patients are often discharged with inadequate information or arrangements for care, causing almost three-quarters to be readmitted within a week, say investigators from Nottingham (Qual Safety Health Care 2008;17:71,5). Retrospective review of records for 108 consecutive patients aged over 75 found that readmission was related to medication in 38 per cent and, of these, 61 per cent were considered avoidable. Almost two-thirds had no discharge letter or were readmitted before the letter was typed; two-thirds of discharge letters had incomplete documentation of medication changes. Copyright © 2008 Wiley Interface Ltd [source]

    Randomized, single-blind, trial of sertraline and buspirone for treatment of elderly patients with generalized anxiety disorder

    PSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 2 2010
    Naghmeh Mokhber MD
    Aim:, Generalized anxiety disorder (GAD) in elderly people is common, but few systematic studies regarding the best treatments have been performed. The aim of the present study was to evaluate the efficacy and safety of sertraline and buspirone in the treatment of elderly patients with GAD. Methods:, Based on selection criteria, 46 patients were recruited who met DSM-IV criteria for GAD. Patients were randomly assigned to sertraline (50,100 mg/day) or buspirone (10,15 mg/day) for 8 weeks in a single-blind trial. The primary outcome measure used in the present study was the Hamilton Rating Scale for Anxiety (HRSA). Results:, Both sertraline and buspirone had significant anxiolytic efficacy. A steady decrease in the total HRSA scores for both groups was observed throughout the study period. After 2 and 4 weeks, buspirone was found to be significantly superior to sertraline (P < 0.001), but at the end of study period this difference did not reach statistical significance (P = 0.16). The mean HRSA score after 8 weeks significantly decreased in subjects treated with sertraline (P < 0.001), and buspirone (P < 0.001). No clinically adverse events or changes in laboratory test results were observed during the study period. Conclusion:, Both sertraline and buspirone appear to be efficacious and well tolerated in the treatment of GAD in elderly patients. Further studies with larger sample size, evaluating the effect of medical illness, cognitive impairment, depression, and combined therapy with support and psychotherapy are needed. [source]

    Reliability and validity of the Thai version of the WHO-Five Well-Being Index in primary care patients

    PSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 2 2009
    Ratana Saipanish md
    Aims:, Because of the high patient load in Thailand, we need a practical measurement to help primary physicians detect depression. This study aimed to examine the reliability and validity of the Thai version of the World Health Organization-Five Well-Being Index (WHO-5-T), which is short and easy to use as a screening tool for major depression in primary care patients. Methods:, The English version of the WHO-Five Well-Being Index was translated into Thai. Back-translations, cross-cultural adaptation and field testing of the pre-final version with final adjustments were performed accordingly. The WHO-5-T was administered randomly to 300 patients in our primary care clinic. Then the patients were further assessed using the Mini International Neuropsychiatric Interview and the Hamilton Rating Scale for Depression as the gold standard of diagnosis and symptom severity, respectively. Results:, Completed data were obtained from 274 respondents. Their mean age was 44.6 years [standard deviation (SD) = 14.7] and 73.7% of them were female. The mean WHO-5-T score was 14.32 (SD = 5.26). The WHO-5-T had a satisfactory internal consistency (Cronbach's alpha = 0.87) and showed moderate convergent validity with the Hamilton Rating Scale for Depression (r = ,0.54; P < 0.001). The optimal cut-off score of the WHO-5-T <12 revealed a sensitivity of 0.89 and a specificity of 0.71 in detecting depression. The area under the curve in this study was 0.86 (SD = 0.03, 95% confidence interval 0.81 to 0.89). Conclusions:, The Thai version of the WHO-Five Well-Being Index was found to be a reliable and valid self-assessment to screen for major depression in primary care setting at a cut-off point of <12. [source]

    Improvement of cognitive functioning in mood disorder patients with depressive symptomatic recovery during treatment: An exploratory analysis

    PSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 5 2006
    LAURA MANDELLI Psy.
    Abstract, Depressive symptoms have a large impact on cognitive test performance of mood disorder patients. After remission, some improvement of cognitive functioning has been observed, but also stable deficits have been reported both during depression and remission. In the present study, the authors aimed to investigate the cognitive functioning of mood disorder patients in relation to early symptomatic recovery, by comparing performances at the Wechsler Adult Intelligence Scale-Revised (WAIS-R) of responders and non-responders to the antidepressant treatment. The sample was composed of 51 hospitalized patients for a major depressive episode (major depressives/bipolars = 37/14). All patients were treated with fluvoxamine and evaluated at baseline and after 4 weeks using the 21-item Hamilton Rating Scale for Depression. All subjects were once assessed for their cognitive functioning with the WAIS-R, at the end of the fourth week of treatment. In the current sample, patients who showed a significant symptomatic remission after 4 weeks of treatment showed higher total WAIS-R scores and a lower incidence of cognitive impairment, compared to non-responders to treatment. No major differences could be observed on any particular subtest, but rather a global improving of scores in responders compared to non-responders to pharmacotherapy. Pre-treatment illness severity, that was significantly higher among non-responders, was significantly associated with patients' intelligence quotient scores. Despite a number of limitations, present data support a strong effect of depressive symptoms on patients WAIS-R performances and an early global improvement of cognitive functioning concurrent with symptomathology recovery during pharmacological treatment. [source]

    Vagal tone as an indicator of treatment response in major depression

    PSYCHOPHYSIOLOGY, Issue 6 2002
    Andrea S. Chambers
    Increased vagal tone has been associated with treatment success using pharmacological agents and cognitive-behavioral treatment in major depression, but not using electroconvulsive therapy. The present study investigated whether increases in vagal tone would be associated with favorable treatment response with nonpharmacological treatment. At baseline and following treatment, 16 subjects were administered the Hamilton Rating Scale for Depression (HRSD) followed by electrocardiographic recording. Those with little change in vagal tone from before to after treatment showed minimal reduction in HRSD score (,4.8); those with larger vagal tone change showed a large decrease in HRSD score (,14.8). Changes in vagal tone are thus related to favorable treatment response in depression, and do not represent anticholinergic pharmacological effects. Future work manipulating vagal tone might prove informative in teasing apart the causal role of vagal tone and depression. [source]

    Effects of lamotrigine in patients with bipolar disorder and alcohol dependence

    BIPOLAR DISORDERS, Issue 3 2006
    Gabriel Rubio
    Background:, Bipolar disorder is significantly associated with alcohol use disorders. Anticonvulsant drugs are used in the treatment of bipolar disorder and they have also been used to treat alcohol dependence. The purpose of the present study was to evaluate tolerance and safety of lamotrigine in a dual-diagnosis population presenting bipolar disorder and alcohol dependence. Open-label lamotrigine was examined in 28 outpatients with DSM-IV bipolar disorder and alcohol dependence. Lamotrigine was added to existing medication regimens. Method:, Lamotrigine was started at a dose of 25 mg/day and titrated to a maximum dose of 300 mg/day. Subjects received a baseline evaluation which included a Structured Clinical Interview for DSM-IV (SCID) and weekly assessments for 12 weeks with the Hamilton Rating Scale for Depression (HAM-D), Young Mania Rating Scale (YMRS), Brief Psychiatric Rating Scale (BPRS), Severity of Alcohol Dependence Scale (SADS), a Visual Analogue Scale for Craving severity (VASC), and alcohol consumption. The concentration of carbohydrate-deficient transferrin (CDT) was used as an indirect measure of alcohol consumption. The sample consisted of 18 men and 10 women diagnosed with alcohol dependence and bipolar disorder I (n = 21) or bipolar disorder II (n = 7), with a mean age of 36.5 ± 7.7 years. Results:, Significant improvement was observed in HAM-D, YMRS, and BPRS scores (p < 0.01). Craving and CDT also significantly decreased (p < 0.001). Lamotrigine was well tolerated with no dropout subjects due to adverse events. Conclusion:, Lamotrigine is safe and well tolerated in this sample and associated with improvement in mood, alcohol craving and alcohol consumption. A placebo-controlled study would be of interest. [source]

    Acute treatment outcomes in patients with bipolar I disorder and co-morbid borderline personality disorder receiving medication and psychotherapy

    BIPOLAR DISORDERS, Issue 2 2005
    Holly A Swartz
    Objective:, Patients suffering from both bipolar I disorder and borderline personality disorder (BPD) pose unique treatment challenges. The purpose of this matched case,control study was to compare acute treatment outcomes of a sample of patients who met standardized diagnostic criteria for both bipolar I disorder and BPD (n = 12) to those who met criteria for bipolar I disorder only (n = 58). Method:, Subjects meeting criteria for an acute affective episode were treated with a combination of algorithm-driven pharmacotherapy and weekly psychotherapy until stabilization (defined as four consecutive weeks with a calculated average of the 17-item version of the Hamilton Rating Scale for Depression and Bech-Rafaelsen Mania scale totaling ,7). Results:, Only three of 12 (25%) bipolar-BPD patients achieved stabilization, compared with 43 of 58 (74%) bipolar-only patients. Two of the three bipolar-BPD patients who did stabilize took over 95 weeks to do so, compared with a median time-to-stabilization of 35 weeks in the bipolar-only group. The bipolar-BPD group received significantly more atypical mood-stabilizing medications per year than the bipolar-only group (Z = 4.3, p < 0.0001). Dropout rates in the comorbid group were high. Conclusions:, This quasi-experimental study suggests that treatment course may be longer in patients suffering from both bipolar I disorder and BPD. Some patients improved substantially with pharmacotherapy and psychotherapy, suggesting that this approach is worthy of further investigation. [source]

    Frequency of psychiatric disorders in blepharospasm does not differ from hemifacial spasm

    ACTA NEUROPSYCHIATRICA, Issue 5 2010
    Fernando Machado Dias
    Dias FM, Doyle F, Kummer A, Cardoso F, Fontenelle LF, Teixeira AL. Frequency of psychiatric disorders in blepharospasm does not differ from hemifacial spasm. Objective: To compare the frequency of psychiatric disorders and the severity of psychiatric symptoms between patients with blepharospasm (BS) and hemifacial spasm (HS). Methods: BS is a type of primary focal dystonia characterised by recurrent and involuntary eye blinking. HS is a condition with different pathophysiology but similar clinical phenotype. Twenty-two patients with BS and 29 patients with HS participated in this study. They underwent a comprehensive psychiatric evaluation that included a structured clinical interview for current psychiatric diagnosis according to Diagnostic Statistical Manual, fourth edition (DSM-IV) (MINI-Plus) and psychometric scales, including the Yale-Brown Obsessive-Compulsive Scale (YBOCS), the Beck Depression Inventory (BDI), the Hamilton Rating Scale for Depression (HRSD), the Hamilton Anxiety Scale (HAS) and the Liebowitz Social Anxiety Scale (LSAS). Results: BS and HS groups did not differ in most demographic and clinical parameters, such as gender, age and length of symptoms. The frequency of psychiatric disorders and the severity of psychiatric symptoms were similar in both groups. Conclusion: BS does not seem to have more psychiatric disorders than HS. [source]

    Melancholic symptoms as assessed by the Hamilton Depression Rating Scale and outcomes with and without electroconvulsive therapy on an in-patient mood disorders unit

    ACTA NEUROPSYCHIATRICA, Issue 1 2010
    Keith G. Rasmussen
    Rasmussen KG, Stevens SR, Kung S, Mohan A. Melancholic symptoms as assessed by the Hamilton Depression Rating Scale and outcomes with and without electroconvulsive therapy on an in-patient mood disorders unit. Background: We investigated whether 24-item Hamilton Rating Scale for Depression (HamD24)-based melancholia ratings correlated with treatment outcome, with special focus on whether electroconvulsive therapy (ECT) was used in depressed patients treated on an in-patient mood disorders unit. Methods: We analysed the data on ECT- versus non-ECT-treated patients' outcomes relative to melancholia subscale scores. Two HamD24 -based melancholia rating scale scores were computed for 201 depressed in-patients at admission and discharge. Baseline melancholia ratings were analysed to see if they correlated with improvement in total HamD24 scores. We also tested to see if the melancholia subscales followed unimodal or bimodal distributions. Results: Melancholic symptoms as assessed by one of the HamD24 -based subscales directly correlated with overall improvement. Although ECT treatment was associated with greater improvement than was noted in non-ECT-treated patients, severity of melancholia ratings did not affect this relationship. Finally, both melancholia subscale scores followed approximately unimodal distributions. Conclusions: HamD24 -based methods to assess severity of melancholic symptoms have limited clinical utility on an in-patient mood disorders unit in general, and for predicting ECT response in particular. Furthermore, these methods do not seem to identify bimodal populations of depressed patients (i.e. melancholic vs. non-melancholic). [source]

    Effect of risperidone on plasma catecholamine metabolites and brain-derived neurotrophic factor in patients with bipolar disorders

    HUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 7 2006
    Reiji Yoshimura
    Abstract A combination treatment with a mood stabilizer and an antipsychotic drug is often used in as many as 90% of subjects with acute mania. Recently, augmentation therapy with atypical antipsychotics has been investigated in both the acute and long-term treatment of bipolar disorder with or without psychosis. In the present study, the authors investigated the efficacy of risperidone treatment for both acute manic and depressive episodes in bipolar disorder. Eighteen patients (M/F: 8/10, age: 34,±,15,yr) who met the DSM-IV criteria for bipolar I disorder (12 cases of manic episodes, 6 cases of depressive episodes) with risperidone treatment were evaluated regarding their clinical improvement using the Young Mania rating Scale (YMRS) and the Hamilton rating Scale for Depression (Ham-D). Plasma concentrations of HVA and MHPG were analyzed by HPLC-ECD and plasma brain-derived neurotrophic factor (BDNF) levels were detected by sandwich ELISA. The mean scores of the YMRS were 22, 18, 12, 8, and 5 at time points before and 1, 2, 3, and 4 weeks after the risperidone administration, respectively. The mean scores of the Ham-D were 24, 25, 21, 21, and 19 at time points before and 1, 2, 3, and 4 weeks after the risperidone administration, respectively. The plasma levels of HVA and 3-methoxy-4-hydroxyphenylglycol (MHPG) were observed to have decreased 4 weeks after risperidone administration in manic patients. The levels did not change in depressive patients. The plasma levels of BDNF were decreased in depressive patients compared with manic patients or healthy controls. However, the administration of risperidone did not alter plasma BDNF levels. Copyright © 2006 John Wiley & Sons, Ltd. [source]

    Effects of warm-supplementing kidney yang (WSKY) capsule added on risperidone on cognition in chronic schizophrenic patients: a randomized, double-blind, placebo-controlled, multi-center clinical trial

    HUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 6 2008
    Zhen-hua Chen
    Abstract Objective To evaluate the effects of warm-supplementing kidney yang (WSKY) capsule added on risperidone on cognition in chronic schizophrenic patients. Methods A randomized, double-blind, placebo-controlled, multi-center clinical trial was conducted. All 200 patients who met the DSM-IV diagnostic criteria for schizophrenia were randomly assigned to double-blind treatment with WSKY capsule (n,=,100) or placebo (n,=,100) added on risperidone for 8 weeks. The primary outcome measure was the cognitive function assessment assessed by the classic form of the Wisconsin Card Sorting Test (WCST) at baseline and week 8. The secondary outcome measures were assessed including the positive and negative symptoms scale (PANSS), the social disability screening schedule (SDSS), and the Hamilton rating scale for depression (HAM-D-17) at baseline, week 2, week 4, and week 8. The extrapyramidal side effects were assessed each week using the abnormal involuntary movement scale (AIMS) and rating scale for extrapyramidal side effects (RSESE), while adverse events were assessed using treatment emergent symptoms scale (TESS) as additional indicators of tolerability throughout the trial. Results The response rates of the WSKY group for the number of completed categories (CC), errors responses number (ER), perseveringly errors responses number (PER), and conceptual level (CL) of WCST assessment were significantly higher than those of placebo. The reduction in the SDSS score from baseline to endpoint was significantly greater in the WSKY group than those in the placebo. There were no significant differences in the response rates for the correct responses number, perseveringly responses number (PR) of WCST between the treatment groups. The improvements in the WCST indexes, PANSS score, HAM-D-17 score were no significant differences from baseline to endpoint between the two groups at week 8.There were no significant differences in AIMS, RSESE, and TESS compared patients treated with WSKY capsule with those in placebo during treatment. Conclusion WSKY capsule added on risperidone may improve cognitive function, social function of the chronic schizophrenic patients, and the WSKY safely during treatment. Copyright © 2008 John Wiley & Sons, Ltd. [source]

    IL-6 levels decrease with SSRI treatment in patients with major depression

    HUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 7 2005
    Ayse Devrim Basterzi
    Abstract Objective Some evidence indicates that an immune response with an increased production of proinflammatory cytokines often accompanies major depression. The objective of this study was to examine the serum levels of IL-6 in patients with major depression and the changes occurring in IL-6 levels during treatment with selective serotonin reuptake inhibitors (SSRI). Method Twenty-three patients with a DSM-IV diagnosis of major depressive disorder and 23 healthy matched controls were included in the study. The severity of depression was measured with the Hamilton rating scale for depression. Blood samples for IL-6 levels were obtained at baseline and at week 6 of treatment and IL-6 concentrations were evaluated using a solid phase sandwich enzyme immunoassay. All patients were treated with an SSRI. Results The IL-6 levels showed no statistically significant difference between the patients and the controls at baseline. However, IL-6 levels after treatment with SSRIs were significantly lower compared with the baseline IL-6 levels of both the patients and the controls. Conclusion The results of this study suggest that proinflammatory cytokines show some changes during the course of treatment of major depression. These findings might also be considered as supporting the hypothesis of a modulatory role of antidepressants on the immune system. Copyright © 2005 John Wiley & Sons, Ltd. [source]

    Gender differences in clinical presentation and response to sertraline treatment of generalized anxiety disorder,

    HUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 1 2005
    Meir Steiner
    Abstract Objective To evaluate gender differences in the clinical presentation of generalized anxiety disorder (GAD) and response to sertraline treatment. Methods Adult outpatients who met DSM-IV criteria for GAD with a minimum Hamilton rating scale for anxiety (HAM-A) total score,,,18 were randomized to 12 weeks of double-blind treatment with flexible doses (50,150,mg) of sertraline (n,=,182; female, 59%) or placebo (n,=,188; female, 51%). Results Clinical presentation of GAD was very similar in men and women in terms of the severity of the HAM-A psychic factor, severity of concomitant depression symptoms, duration of GAD, quality of life and impairment in physical health. Women had an earlier age of onset and higher HAM-A somatic factor scores compared with men. For both men and women, treatment with sertraline resulted in greater change from baseline to endpoint on the HAM-A compared with placebo (adjusted change,±,SE: men: ,12.1,±,0.9 vs ,8.8,±,0.9; women: ,11.4,±,0.8 vs ,7.1,±,0.9, p,<,0.001); the interaction between gender and treatment group was not significant, nor was there a significant difference between the average change from baseline for men compared with women. Similarly, responder rates based upon clinical global impression,improvement (CGI-I) scores at endpoint showed no significant interaction between gender and treatment, nor was there a significant difference in the response rates by gender; however, the response rate of sertraline compared with placebo was significantly different (p,<,0.0001) (men: 64% vs 40%; women: 62% vs 34%). Similar findings were evident at week 4 assessment and for completers (week 12). Overall, sertraline was well tolerated by both men and women. Discussion Women and men with GAD showed similar clinical presentations, with the exception that women had an earlier age of onset and reported more somatic anxiety symptoms. Sertraline was an effective and well tolerated treatment for GAD in both men and women. Copyright © 2004 John Wiley & Sons, Ltd. [source]

    Safety and efficacy of high dose of venlafaxine XL in treatment resistant major depression

    HUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 7 2002
    P. MbayaArticle first published online: 24 SEP 200
    Abstract Aim The aim of the study was to look at efficacy and the safety profile of high dose (450,600,mg) venlafaxine XL in five patients with treatment resistant major depressive illness. Methods Five patients with treatment resistant depression were treated with high dose venlafaxine XL. Efficacy was evaluated using the Montgomery,Asberg depression rating scale (MADRS), the 21-item Hamilton rating scale for depression (HAM-D-21) and the clinical global impressions (CGI) scale. Level of functioning was evaluated by social adaptation self-evaluation scale (SASS). Body weight, supine pulse and blood pressure were recorded. Results The response rate was based on a 50% decrease in MADRS and HAM-D scores between weeks 1 and 24. There was a more than 50% decrease in MADRS scores in 3 of 5 patients and 4 of 5 patients in HAM-D scores. There was a trend to improvement of SASS scores in three of the study patients and in two of them the mean scores were within the normal range. Supine pulse and blood pressure remained stable in four patients, except in one patient where there was a slight increase although the final reading at week 24 was normal. Weight was relatively stable in all three patients where it was recorded, but in one patient there was a slight increase which may have been due to an atypical neuroleptic the patient was taking at the time. Conclusion High dose venlafaxine was safe, well tolerated and effective in this small number of severe treatment resistant patients with major depression and it also improved social functioning. Copyright © 2002 John Wiley & Sons, Ltd. [source]

    Psychological effects of aromatherapy on chronic hemodialysis patients

    PSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 4 2000
    Takahiro Itai MD
    Abstract Effects of aromatherapy (odorless condition, lavender, and hiba oil) on mood and anxiety were investigated in 14 female patients who were being treated with chronic hemodialysis. A control period consisting of natural hospital smells was established before each test session, and then aromatic test conditions were systematically evaluated for odorless conditions as well as aromatic conditions containing lavender and hiba oil aromas. The effects of aromatherapy were measured using the Hamilton rating scale for depression (HAMD) and the Hamilton rating scale for anxiety (HAMA). Hiba oil aroma significantly decreased the mean scores of HAMD and HAMA, and lavender aroma significantly decreased the mean scores of HAMA. The mean scores of HAMD and HAMA in an odorless condition were not significantly different from those of the control conditions. These results indicate that in chronic hemodialysis patients hiba oil is an effective, non-invasive means for the treatment of depression and anxiety, and that lavender alleviates anxiety. [source]