Mood spectrum symptoms during a major depressive episode: Differences between 145 patients with bipolar disorder and 155 patients with major depressive disorder. Arguments for a dimensional approach

2019 ◽  
Vol 22 (4) ◽  
pp. 385-391 ◽  
Author(s):  
Alessandro Cuomo ◽  
Andrea Aguglia ◽  
Eugenio Aguglia ◽  
Simone Bolognesi ◽  
Arianna Goracci ◽  
...  
2015 ◽  
Vol 21 (2) ◽  
pp. 4 ◽  
Author(s):  
Robyn Anne Van Schoor ◽  
Pierre M Joubert

<p><strong>Background.</strong> Adverse life events (ALEs) as precipitants of a major depressive episode (MDE) have been the subject of many studies. These studies indicate an increase in ALEs in the 6 months preceding an MDE.</p><p><strong>Objectives. </strong>The study examined what participants, suffering from major depressive disorder (MDD) or bipolar disorder (BD), perceived as the precipitating ALE of a current MDE. The severity and categories of ALEs were compared between these two patient groups.</p><p><span><strong>Methods. </strong>Consenting, adult inpatients were sourced from Weskoppies Hospital, Steve Biko Academic Hospital, Tshwane District Hospital, Denmar Psychiatric Hospital and Vista Clinic in the Pretoria area. A semi-structured questionnaire was used to obtain demographic data and the diagnosis. Information regarding the course of the disorder, including the number of previous MDEs and the age at which the first MDE occurred, was also obtained. The perceived precipitating ALE was detailed for each participant. A severity value referred to as a Life Change Unit Score (LCU score), based on the Recent Life Changes Questionnaire (RLCQ) by Miller and Rahe, was then assigned to each participant’s perceived precipitant.</span></p><p><span><strong>Results.</strong> Of the 64 participants, 12.7 % were experiencing a first MDE. In those participants who had experienced prior episodes the average number (standard deviation (SD)) of previous episodes was 3.86 (2.46). The mean approximate age (SD) at first onset of an MDE was 24.81 (10.9) years. The BD group had significantly more previous MDEs than the MDD group. Although the average LCU scores were higher in the BD group than the MDD group this did not reach statistical significance. Therefore, this study could not find a difference in the severity of the perceived precipitants between the BD group and MDD group. However, when the LCU scores were analysed within subcategories of the RLCQ, it was found that participants with BD perceived significantly more problems associated with the workplace as precipitants of a current MDE than individuals with MDD.</span></p><p><strong>Conclusion.</strong> Most participants could link an ALE to the onset of a current MDE. The study did not find a differential response to ALEs between patients with BD and MDD. The severity of the social precipitants did not differ significantly between the two groups. The notion of a ‘kindling effect’ could not be supported by the outcome of this study. Because some study participants experienced ALEs not accounted for by the RLCQ, a more comprehensive assessment instrument may be more appropriate for similar studies.</p>


2017 ◽  
Vol 92 ◽  
pp. 119-123 ◽  
Author(s):  
Fernanda Pedrotti Moreira ◽  
Karen Jansen ◽  
Taiane de Azevedo Cardoso ◽  
Thaíse Campos Mondin ◽  
Pedro Vieira da Silva Magalhães ◽  
...  

2011 ◽  
Vol 89 (9) ◽  
pp. 647-653 ◽  
Author(s):  
Chuanjun Zhuo ◽  
Ying Wang ◽  
Hongjun Tian ◽  
Xiaohui Wang ◽  
Yuhui Chen ◽  
...  

This study used a model of ischemia–reperfusion injury to the brachial artery endothelium to investigate whether the protective role of ischemic postconditioning (IPostC) is impaired in patients with major depressive episode. Flow-mediated dilation (FMD) was measured before and after ischemia–reperfusion in the absence or presence of IPostC in 24 patients with major depressive disorder and 20 healthy controls. In addition, the severity of the depression, as assessed by the Hamilton Depression Rating Scale (HDRS) and Beck Depression Inventory (BDI) scores, and plasma nitrogen dioxide (NOx) levels were also determined. Ischemia–reperfusion resulted in a significant decrease in FMD in both patients with a major depressive episode and healthy controls. IPostC effectively prevented this decrease in FMD in healthy controls, but not in patients with a major depressive episode. HDRS and BDI scores were markedly increased, but plasma NOx levels decreased, in patients with a major depressive episode compared with those in healthy controls. Correlation analysis showed that HDRS and BDI scores and plasma NOx levels were significantly associated with post-ischemia–reperfusion FMD. These results suggest that endothelial protection by IPostC is impaired in patients with major depressive disorder, which may be related to the decrease in endothelial nitric oxide production and the severity of the depression.


2012 ◽  
Vol 44 (7) ◽  
pp. 1361-1367 ◽  
Author(s):  
R. H. Perlis ◽  
C. Cusin ◽  
M. Fava

BackgroundDraft DSM-5 criteria for a mixed major depressive episode have been proposed, but their predictive validity has not yet been established. We hypothesized that such symptoms would be associated with poorer antidepressant treatment outcomes.MethodWe examined outcomes among individuals with major depressive disorder participating in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study, an effectiveness study conducted at primary and specialty care centers in the USA. Mixed features were derived from the six self-report items of the mania subscale of the Psychiatric Diagnosis Screening Questionnaire. Primary analyses examined the association between the presence of at least two of these in the 6 months before study entry, and remission across up to four sequential treatment trials, as well as adverse outcomes.ResultsOf the 2397 subjects with a major depressive episode of at least 6 months' duration, 449 (18.7%) reported at least two mixed symptoms. The presence of such symptoms was associated with a greater likelihood of remission across up to four sequential treatments, which persisted after adjustment for potential confounding clinical and demographic variables (adjusted hazard ratio 1.16, 95% confidence interval 1.03–1.28). Two individual items, expansive mood and cheerfulness, were strongly associated with a greater likelihood of remission.ConclusionsProposed DSM-5 mixed state features were associated with a greater rather than a lesser likelihood of remission. While unexpected, this result suggests the potential utility of further investigation of depressive mixed states in major depression.


1997 ◽  
Vol 14 (1) ◽  
pp. 35-37 ◽  
Author(s):  
Dinesh K Arya

AbstractA 48 year old housewife, admitted with a diagnosis of major depressive episode suddenly developed Ganser syndrome during the course of her illness. This resulted in spontaneous resolution of symptoms of depression. The resolution of intrapsychic conflict as a result of development of Ganser syndrome which led to sudden remission of major depressive episode is discussed.


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