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Patel E, Ramaiah P, Mamaril-Davis JC, Bauer IL, Koujah D, Seideman T, Kelbert J, Nosova K, Bina RW. Outcome differences between males and females undergoing deep brain stimulation for treatment-resistant depression: systematic review and individual patient data meta-analysis. J Affect Disord 2024; 351:481-488. [PMID: 38296058 DOI: 10.1016/j.jad.2024.01.251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 01/22/2024] [Accepted: 01/26/2024] [Indexed: 02/06/2024]
Abstract
BACKGROUND Treatment-resistant depression (TRD) occurs more commonly in women. Deep brain stimulation (DBS) is an emerging treatment for TRD, and its efficacy continues to be explored. However, differences in treatment outcomes between males and females have yet to be explored in formal analysis. METHODS A PRISMA-compliant systematic review of DBS for TRD studies was conducted. Patient-level data were independently extracted by two authors. Treatment response was defined as a 50 % or greater reduction in depression score. Percent change in depression scores by gender were evaluated using random-effects analyses. RESULTS Of 737 records, 19 studies (129 patients) met inclusion criteria. The mean reduction in depression score for females was 57.7 % (95 % CI, 64.33 %-51.13 %), whereas for males it was 35.2 % (95 % CI, 45.12 %-25.23 %) (p < 0.0001). Females were more likely to respond to DBS for TRD when compared to males (OR = 2.44, 95 % CI 1.06, 1.95). These differences varied in significance when stratified by DBS anatomical target, age, and timeframe for responder classification. LIMITATIONS Studies included were open-label trials with small sample sizes. CONCLUSIONS Our findings suggest that females with TRD respond at higher rates to DBS treatment than males. Further research is needed to elucidate the implications of these results, which may include connectomic sexual dimorphism, depression phenotype variations, or unrecognized symptom reporting differences. Methodological standardization of outcome scales, granular demographic data, and individual subject outcomes would allow for more robust comparisons between trials.
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Affiliation(s)
- Ekta Patel
- University of Arizona College of Medicine - Phoenix, Phoenix, AZ, USA
| | - Priya Ramaiah
- University of Arizona College of Medicine - Phoenix, Phoenix, AZ, USA
| | | | - Isabel L Bauer
- University of Arizona College of Medicine - Phoenix, Phoenix, AZ, USA
| | - Dalia Koujah
- University of Arizona College of Medicine - Phoenix, Phoenix, AZ, USA
| | - Travis Seideman
- University of Arizona College of Medicine - Phoenix, Phoenix, AZ, USA
| | - James Kelbert
- University of Arizona College of Medicine - Phoenix, Phoenix, AZ, USA
| | - Kristin Nosova
- Department of Neurosurgery, Banner University Medical Center/University of Arizona College of Medicine - Phoenix, Phoenix, AZ, USA
| | - Robert W Bina
- Department of Neurosurgery, Banner University Medical Center/University of Arizona College of Medicine - Phoenix, Phoenix, AZ, USA.
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Mayes TL, Deane AE, Aramburu H, Yagnik K, Trivedi MH. Improving Identification and Treatment Outcomes of Treatment-Resistant Depression Through Measurement-Based Care. Psychiatr Clin North Am 2023; 46:227-245. [PMID: 37149342 DOI: 10.1016/j.psc.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Measurement-based care (MBC) is the systematic screening and ongoing assessment of symptoms, side effects, and adherence to adjust treatments as needed based on these factors. Studies show MBC leads to improved outcomes for depression and treatment-resistant depression (TRD). In fact, MBC may reduce the chances of developing TRD, as it leads to optimized treatment strategies based on symptom changes and compliance. There are many rating scales available for monitoring depressive symptoms, side effects, and adherence. These rating scales can be used in a variety of clinical settings to help guide treatment decisions, including depression treatment decisions.
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Affiliation(s)
- Taryn L Mayes
- Center for Depression Research and Clinical, Peter O'Donnell Jr. Brain Institute and the Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas, 75390-9119, USA
| | - Amber E Deane
- Center for Depression Research and Clinical, Peter O'Donnell Jr. Brain Institute and the Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas, 75390-9119, USA
| | - Hayley Aramburu
- Center for Depression Research and Clinical, Peter O'Donnell Jr. Brain Institute and the Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas, 75390-9119, USA
| | - Kush Yagnik
- Center for Depression Research and Clinical, Peter O'Donnell Jr. Brain Institute and the Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas, 75390-9119, USA
| | - Madhukar H Trivedi
- Center for Depression Research and Clinical, Peter O'Donnell Jr. Brain Institute and the Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas, 75390-9119, USA.
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Costa T, Rushton SP, Watson S, Ng WF. Depression in Sjögren's syndrome mediates the relationship between pain, fatigue, sleepiness, and overall quality of life. RHEUMATOLOGY AND IMMUNOLOGY RESEARCH 2023; 4:78-89. [PMID: 37818348 PMCID: PMC10561071 DOI: 10.2478/rir-2023-0012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 05/28/2023] [Indexed: 10/12/2023]
Abstract
Objectives Sjögren's syndrome (SS) includes many extra-glandular symptoms such as fatigue, pain, sleepiness and depression, which impact on quality of life (QoL). These symptoms also influence each other and could be linked by autonomic nervous system (ANS) dysregulation. Our aim was to model the role of putative predictive variables, including depression in the relationships between ANS function, fatigue, and QoL in SS. Methods Cross-sectional analysis of self-reported data from the multicentre UK primary SS registry. The Composite Autonomic Symptom Scale (COMPASS) was used to assess autonomic function, the Hospital Anxiety and Depression Scale (HADS) to assess anxiety and depression and the EuroQol-5 Dimension (EQ-5D) to assess QoL. Validated scales were used for other clinical variables. Using multiple regression analysis and structural equation modelling (SEM), we investigated how the QoL of people with SS is impacted by the direct and indirect effects of fatigue, sleepiness, depression, symptom burden and ANS function, and their interactions. Results Data was obtained for 1046 people with SS, 56% COMPASS completers. Symptoms of ANS dysregulation were common. Participants with ANS dysregulation had more severe depression, anxiety, dryness, fatigue, pain, sleepiness and QoL (P < 0.01 for all). Depression, anxiety, dryness, and pain were independent predictors of ANS function in the multiple regression model (P < 0.05 for all). ANS function could not be included in the SEM. The SEM model had good fit to the data (comparative fit index = 0.998) and showed that, in people with SS, depression mediates the effects of pain, fatigue and sleepiness on QoL. Conclusion Our results show that diagnosing and treating depression in people with SS could have direct positive impact on QoL, and significantly ameliorate the impact of fatigue and pain.
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Affiliation(s)
- Tiago Costa
- Translational and Clinical Research Institute, Faculty of Medical Sciences, The Medical School, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
- Northern Centre for Mood Disorders, Wolfson Research Centre, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, St. Nicholas Hospital, Jubilee Road, Gosforth, Newcastle upon Tyne, NE3 3XT, UK
| | - Stephen P Rushton
- School of Natural and Environmental Science, Agriculture Building, Newcastle University, King’s Road, Newcastle upon Tyne, NE1 7RU, UK
| | - Stuart Watson
- Translational and Clinical Research Institute, Faculty of Medical Sciences, The Medical School, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
- Northern Centre for Mood Disorders, Wolfson Research Centre, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, St. Nicholas Hospital, Jubilee Road, Gosforth, Newcastle upon Tyne, NE3 3XT, UK
| | - Wan-Fai Ng
- Translational and Clinical Research Institute, Faculty of Medical Sciences, The Medical School, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
- National Institute for Health and Care Research (NIHR) Newcastle Biomedical Research Centre, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK
- NIHR Newcastle Clinical Research Facility, Level 6, Leazes Wing, Royal Victoria Infirmary, Newcastle upon Tyne Hospitals NHS Foundation Trust, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP, UK
| | - On behalf of the UK primary Sjögren's Syndrome Registry
- Translational and Clinical Research Institute, Faculty of Medical Sciences, The Medical School, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
- Northern Centre for Mood Disorders, Wolfson Research Centre, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, St. Nicholas Hospital, Jubilee Road, Gosforth, Newcastle upon Tyne, NE3 3XT, UK
- School of Natural and Environmental Science, Agriculture Building, Newcastle University, King’s Road, Newcastle upon Tyne, NE1 7RU, UK
- National Institute for Health and Care Research (NIHR) Newcastle Biomedical Research Centre, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK
- NIHR Newcastle Clinical Research Facility, Level 6, Leazes Wing, Royal Victoria Infirmary, Newcastle upon Tyne Hospitals NHS Foundation Trust, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP, UK
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Giampetruzzi E, Tan AC, LoPilato A, Kitay B, Posse PR, McDonald WM, Hermida AP, Crowell A, Hershenberg R. The impact of adverse childhood experiences on adult depression severity and treatment outcomes. J Affect Disord 2023; 333:233-239. [PMID: 37086798 DOI: 10.1016/j.jad.2023.04.071] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/06/2023] [Accepted: 04/16/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND Past research has established that adverse childhood experiences (ACE) are correlated with depression severity. The purpose of the present study was to examine how the number and nature of ACE exposure is associated with symptomatology and treatment outcomes in adult patients with treatment resistant depression (TRD). METHODS Participants include 454 patients with a diagnosis of major depression or persistent depressive disorder. A one-way analysis of variance (ANOVA) was used to assess whether number of ACEs was associated with certain outcomes. Linear regression analyses were performed to model the associations between the five ACE subtypes (e.g., sexual abuse, physical violence, injury/illness, childhood grief, and parental upheaval) and symptom severity. Logistic regression analyses were then used to model the association between ACE subtypes and history of lifetime suicide attempt(s) and inpatient admission(s). RESULTS Greater ACE exposure was associated with more severe symptomatology and treatment outcomes, but these differences were only seen between patients reporting no ACEs versus 3+ ACEs. Only the subtypes of violence and illness/injury were significant predictors of more severe symptomatology. The ACE subtypes of sexual trauma and violence uniquely predicted a lifetime suicide attempt(s), and only the subtype of sexual trauma predicted lifetime inpatient admission(s). LIMITATIONS Limitations of the present study include retrospective adult assessments of childhood trauma, lack of data on ACE severity and timing, and the cross-sectional reporting of multiple study measures. CONCLUSIONS Exposure to multiple ACE subtypes, particularly sexual and physical trauma, is associated with depression symptom severity, and history of suicidality, and inpatient admission(s).
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Affiliation(s)
- Eugenia Giampetruzzi
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, United States of America.
| | - Amanda C Tan
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, United States of America
| | - Allison LoPilato
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, United States of America
| | - Brandon Kitay
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, United States of America
| | - Patricio Riva Posse
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, United States of America
| | - William M McDonald
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, United States of America
| | - Adriana P Hermida
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, United States of America
| | - Andrea Crowell
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, United States of America
| | - Rachel Hershenberg
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, United States of America
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Cummergen K, Hannah L, Jopling L, Cameron R, Walsh C, Perez J. What outcomes matter to service users who experience persistent depression: A mixed-method narrative review and synthesis. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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6
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Kennedy JC, Dunlop BW, Craighead LW, Nemeroff CB, Mayberg HS, Craighead WE. Assessing in-session rumination and its effects on CBT for depression. Behav Res Ther 2022; 159:104209. [PMID: 36283238 DOI: 10.1016/j.brat.2022.104209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 08/29/2022] [Accepted: 10/05/2022] [Indexed: 12/14/2022]
Abstract
The study evaluated if rumination of patients during therapy (i.e., in-session rumination) relates to whether or not they do less well in CBT treatment. We developed a reliably assessed in-session rumination observational measure and evaluated its relationship to depression over the course of CBT. Rated sessions came from 63 treatment-naïve patients with major depressive disorder who participated in CBT in the PReDICT study (Dunlop et al., 2017). In-session rumination was operationalized as repetitive, negative, and passive talking about depressive topics. Trained undergraduates rated the intensity and duration of in-session rumination occurring during 57 initial therapy sessions (i.e., session one) and 45 sessions in the middle of treatment (i.e., session eight). The observational ratings were sufficiently reliable (all ICCs > 0.69). Mixed model results indicated that greater intensity of in-session rumination during the initial treatment session predicted higher levels of subsequent clinician-rated depressive symptoms (p < .023). Regression results indicated that greater intensity and duration of in-session rumination at session 8 significantly predicted higher clinician-rated symptoms at end of treatment (p's < 0.02). In-session rumination intensity and duration were not, however, related to subsequent self-reported depressive symptoms. The results support efforts to identify which patients might benefit from rumination-specific interventions.
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Affiliation(s)
- J C Kennedy
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University School of Medicine, Atlanta, GA, United States; Department of Psychology, Emory University, Atlanta, GA, United States
| | - B W Dunlop
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University School of Medicine, Atlanta, GA, United States
| | - L W Craighead
- Department of Psychology, Emory University, Atlanta, GA, United States
| | - C B Nemeroff
- Department of Psychiatry and Behavioral Sciences, Dell School of Medicine, University of Texas, Austin, TX, United States
| | - H S Mayberg
- The Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - W E Craighead
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University School of Medicine, Atlanta, GA, United States; Department of Psychology, Emory University, Atlanta, GA, United States.
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Martinez Agulleiro L, de Filippis R, Rosson S, Patil B, Prizgint L, Talasazan N, Meltzer HY, Kane JM, Gibbons RD, Guinart D. Awareness of illness moderates self-assessment of psychotic symptoms. Aust N Z J Psychiatry 2022; 56:1287-1294. [PMID: 34784772 DOI: 10.1177/00048674211057480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Self-reports or patient-reported outcome measures are seldom used in psychosis due to concerns about the ability of patients to accurately report their symptomatology, particularly in cases of low awareness of illness. The aim of this study was to assess the effect of insight on the accuracy of self-reported psychotic symptoms using a computerized adaptive testing tool (CAT-Psychosis). METHODS A secondary analysis of data drawn from the CAT-Psychosis development and validation study was performed. The Brief Psychiatric Rating Scale and the Scale of Unawareness of Mental Disorders were administered by clinicians. Patients completed the self-reported version of the CAT-Psychosis. Patients were median-split regarding their insight level to compare the correlation between the two psychosis severity measures. A subgroup sensitivity analysis was performed only on patients with schizophrenia spectrum disorders. RESULTS A total of 159 patients with a psychotic disorder who completed both CAT-Psychosis and Scale of Unawareness of Mental Disorders were included. For the whole sample, CAT-Psychosis scores showed convergent validity with Brief Psychiatric Rating Scale ratings (r = 0.517, 95% confidence interval = [0.392, 0.622], p < 0.001). Insight was found to moderate this correlation (β = -0.511, p = 0.005), yet agreement between both measures remained statistically significant for both high (r = 0.621, 95% confidence interval = [0.476, 0.733], p < 0.001) and low insight patients (r = 0.408, 95% confidence interval = [0.187, 0.589], p < 0.001), while psychosis severity was comparable between these groups (for Brief Psychiatric Rating Scale: U = 3057, z = -0.129, p = 0.897; disorganization: U = 2986.5, z = -0.274, p = 0.784 and for CAT-Psychosis: U = 2800.5, z = -1.022, p = 0.307). Subgroup of patients with schizophrenia spectrum disorders showed very similar results. CONCLUSIONS Insight moderates the correlation between self-reported and clinician-rated severity of psychosis, yet CAT-Psychosis remains valid in patients with both high and low awareness of illness.
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Affiliation(s)
- Luis Martinez Agulleiro
- Department of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY, USA.,Psychiatry Department, Complexo Hospitalario Universitario de Ferrol, Ferrol, Spain
| | - Renato de Filippis
- Department of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY, USA.,Psychiatric Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Stella Rosson
- Department of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY, USA.,Psychiatric Unit, Department of Mental Health, Azienda ULSS 3 Serenissima, Venice, Italy.,Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Biostatistics, Epidemiology and Public Health, University of Padova, Padua, Italy
| | - Bhagyashree Patil
- Department of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY, USA
| | - Lara Prizgint
- Department of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY, USA
| | - Nahal Talasazan
- Department of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY, USA
| | | | - John M Kane
- Department of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY, USA.,Institute for Behavioral Health, Feinstein Institutes for Medical Research, Manhasset, NY, USA.,Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, Manhasset, NY, USA
| | - Robert D Gibbons
- Center for Health Statistics and Departments of Medicine, Public Health Sciences (Biostatistics), Psychiatry, Comparative Human Development, and the Committee on Quantitative Methods, University of Chicago, Chicago, IL, USA
| | - Daniel Guinart
- Department of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY, USA.,Institute for Behavioral Health, Feinstein Institutes for Medical Research, Manhasset, NY, USA.,Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, Manhasset, NY, USA.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Institut de Neuropsiquiatria i Addiccions (INAD), Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Departament de Psiquiatria, Universitat Autònoma de Barcelona, Barcelona, Spain
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Watanabe Y, Nishimura A, Kikuchi T, Sawada N, Imazaki M, Inada I, Watanabe K. Central monitoring of depression and anxiety symptoms reduces placebo responses in depression clinical trials: A post hoc exploratory analysis of data from the phase III CCT-004 trial of vortioxetine. Neuropsychopharmacol Rep 2022; 42:468-477. [PMID: 36151855 PMCID: PMC9773757 DOI: 10.1002/npr2.12288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 08/02/2022] [Accepted: 08/04/2022] [Indexed: 01/03/2023] Open
Abstract
AIM Clinical trials of antidepressants often fail to demonstrate their efficacy versus placebo, suggesting that patient selection based on physician ratings of depression may contribute to a high placebo response. METHODS In the CCT-004 trial of vortioxetine, central monitoring was employed to compare physician and patient ratings of depression and anxiety at baseline and over time to identify factors contributing to a large placebo response, as well as to explore the potential of a unique patient-rated clinical measure combining QIDS-J and Himorogi Self-rating Anxiety Scale (HSAS), to contribute to optimal patient selection at baseline and patient monitoring over time. RESULTS The CCT-004 trial showed similar trends between the QIDS-J and MADRS (Montgomery-Åsberg Depression Rating Scale) ratings. It was suggested that central monitoring of the QIDS-J and MADRS ratings of depression and anxiety symptoms helped reduce the baseline score inflation by calling the study sites' attention to discrepancies between these ratings at baseline; it also allowed these ratings to be assessed for their concordance over time. Of note, MDD patients with baseline QIDS-J scores ≥11/HSAS ≤19 were associated with the smallest placebo response, with the effect size being larger than that for those with QIDS-J scores ≤10/HSAS ≥20. CONCLUSION The use of both physician and patient ratings of depression and anxiety symptoms at baseline and over time, as well as their central monitoring, helped minimize the baseline score inflation and optimize patient monitoring over time, and allowed the antidepressant to be evaluated for its full therapeutic potential.
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Affiliation(s)
| | - Akira Nishimura
- Pharmaceutical Development DivisionTowa Pharmaceutical Co., Ltd.OsakaJapan
| | - Toshiaki Kikuchi
- Department of NeuropsychiatryKeio University School of MedicineTokyoJapan
| | | | - Manami Imazaki
- Neuroscience Therapeutic Area Strategy Unit, Takeda Development Center JapanTakeda Pharmaceutical Company LimitedOsakaJapan
| | - Isao Inada
- Neuroscience Therapeutic Area Strategy Unit, Takeda Development Center JapanTakeda Pharmaceutical Company LimitedOsakaJapan
| | - Koichiro Watanabe
- Department of NeuropsychiatryKyorin University School of MedicineTokyoJapan
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Validation of the Malay Self-Report Quick Inventory of Depressive Symptomatology in a Malaysian Sample. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052801. [PMID: 35270494 PMCID: PMC8910357 DOI: 10.3390/ijerph19052801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/18/2022] [Accepted: 02/18/2022] [Indexed: 11/17/2022]
Abstract
Depression is ranked as the second-leading cause for years lived with disability worldwide. Objective monitoring with a standardized scale for depressive symptoms can improve treatment outcomes. This study evaluates the construct and concurrent validity of the Malay Self-Report Quick Inventory of Depressive Symptomatology (QIDS-SR16) among Malaysian clinical and community samples. This cross-sectional study was based on 277 participants, i.e., patients with current major depressive episode (MDE), n = 104, and participants without current MDE, n = 173. Participants answered the Malay QIDS-SR16 and were administered the validated Malay Mini-International Neuropsychiatric Interview (MINI) for DSM-IV-TR. Factor analysis was used to determine construct validity, alpha statistic for internal consistency, and receiver operating characteristic (ROC) analysis for concurrent validity with MINI to determine the optimal threshold to identify MDE. Data analysis provided evidence for the unidimensionality of the Malay QIDS-SR16 with good internal consistency (Cronbach’s α = 0.88). Based on ROC analysis, the questionnaire demonstrated good validity with a robust area under the curve of 0.916 (p < 0.000, 95% CI 0.884−0.948). A cut-off score of nine provided the best balance between sensitivity (88.5%) and specificity (83.2%). The Malay QIDS-SR16 is a reliable and valid instrument for identifying MDE in unipolar or bipolar depression.
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Tonn P, Seule L, Degani Y, Herzinger S, Klein A, Schulze N. Evaluation of a Digital Content-free Speech Analysis Tool to Measure Affective Distress in Mental Health (Preprint). JMIR Form Res 2022; 6:e37061. [PMID: 36040767 PMCID: PMC9472064 DOI: 10.2196/37061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 05/08/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Peter Tonn
- Neuropsychiatric Center of Hamburg, Hamburg, Germany
| | - Lea Seule
- Neuropsychiatric Center of Hamburg, Hamburg, Germany
| | | | | | | | - Nina Schulze
- Neuropsychiatric Center of Hamburg, Hamburg, Germany
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11
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Kaur H, Scholl JC, Owens-Gary M. Depression and Diabetes in Workers Across the Life Span: Addressing the Health of America's Workforce-Behavioral Risk Factor Surveillance System, 2014-2018. Diabetes Spectr 2022; 35:198-206. [PMID: 35668882 PMCID: PMC9160556 DOI: 10.2337/ds21-0022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Diabetes affects nearly 12.2% of U.S. adults. Comorbid depressive symptoms among U.S. workers with diabetes are associated with increased unemployment and reduced work performance. This study examined the age-group-specific prevalence of depression among U.S. workers with self-reported diabetes and identified factors associated with depression. METHODS Data from the 2014-2018 Behavioral Risk Factor Surveillance System were used to examine the prevalence of depression among adult workers with diabetes in the United States. Relationships between depression prevalence and diabetes and demographic, physical, and behavioral risk factors were examined through bivariate and multivariable analyses. Age was categorized into four groups: 18-34, 35-54, 55-64, and ≥65 years. RESULTS The overall prevalence of self-reported depression among U.S. workers with diabetes was 17.4-30% higher than among those without diabetes. Workers with diabetes aged 18-34 years had the highest depression prevalence (28.7%) compared with other age-groups. Female workers with diabetes were significantly more likely than male workers to report depression in all age-groups. Young adult workers with diabetes who had another chronic disease were nearly three times more likely to report depression than those without another chronic condition. There were no overlapping patterns of prevalence of diabetes and depression by state. CONCLUSION Workers with diabetes are at an increased risk of depression, which can affect their overall health and productivity. These findings indicate that, among those with diabetes, young adult workers and women are most likely to have depression. Employee wellness programs may address the specific needs of individuals with diabetes and depression.
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Affiliation(s)
- Harpriya Kaur
- Division of Science Integration, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH
- Corresponding author: Harpriya Kaur,
| | - Juliann C. Scholl
- Division of Science Integration, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH
| | - Michelle Owens-Gary
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
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Reinhard MA, Zentz K, Nenov-Matt T, Barton BB, Rek SV, Goerigk S, Brakemeier EL, Musil R, Jobst A, Padberg F. Cognitive behavioral analysis system of psychotherapy reduces loneliness in patients with persistent depressive disorder. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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Validation of the McIntyre And Rosenblat Rapid Response Scale (MARRRS) in Adults with Treatment-Resistant Depression Receiving Intravenous Ketamine Treatment. J Affect Disord 2021; 288:210-216. [PMID: 33965843 DOI: 10.1016/j.jad.2021.03.053] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 03/03/2021] [Accepted: 03/19/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Depression severity and efficacy measurement scales employed for rapid-acting treatments (e.g., ketamine) were initially validated in adults receiving conventional monoamine-based antidepressants. The emergence of rapid-acting antidepressants in psychiatry provides the impetus for outcome measures that have been validated as sensitive to change with rapid-acting treatments. Herein, we provide results validating the McIntyre and Rosenblat Rapid Response Scale (MARRRS). METHODS Adults with treatment-resistant depression (TRD) receiving intravenous (IV) ketamine had depressive symptoms measured with the 16-Item Quick Inventory Depressive Symptoms Self-Report (QIDS-SR-16) and MARRRS at baseline and as a repeated measure across an acute course of four infusions. The MARRRS is a self-report measure assessing depressive symptoms during the past 72 hours. RESULTS Sixty-four patients (Mage = 45.4 ± 13.5) were included. The MARRRS had a high internal consistency across acute infusions as determined by Cronbach's alpha (0.84 to 0.94). There was significant convergent validity between the QIDS-SR-16 and MARRRS total scores across infusions (rs(292) = .87, p < .001); the MARRRS was also sensitive to change (rs(49) = .70, p < .001). Exploratory factor analysis revealed that MARRRS items loaded onto two factors (i.e., dysphoria and psychic anxiety) accounting for 63.4% of the total variance. LIMITATIONS Heterogenous sample of adults with TRD receiving open-label treatment without placebo comparison. CONCLUSION The MARRRS is a brief validated self-report metric of depression symptom severity that is sensitive to change with the rapid-acting antidepressant ketamine. Measuring outcomes with the MARRRS informs treatment progress and facilitates treatment decisions in persons receiving the rapid-acting antidepressant ketamine. Studies of other rapid-acting antidepressants should incorporate outcome measures that are validated as sensitive to change with rapid-acting antidepressants.
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Baandrup L, Rasmussen JØ, Mainz J, Videbech P, Kristensen S. Patient-Reported Outcome Measures in Mental Health Clinical Research: A Descriptive Review in Comparison with Clinician-Rated Outcome Measures. Int J Qual Health Care 2021; 34:ii70-ii97. [PMID: 33404610 DOI: 10.1093/intqhc/mzab001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 11/11/2020] [Accepted: 01/06/2021] [Indexed: 11/14/2022] Open
Abstract
PURPOSE To review how patient-reported outcomes measures in mental health clinical research complement traditional clinician-rated outcomes measures. DATA SOURCES Medline, Embase, PsycInfo and Scopus. STUDY SELECTION Latest update of the literature search was conducted in August 2019, using a specified set of search terms to identify controlled and uncontrolled studies (published since 1996) of pharmacological or non-pharmacological interventions in adults (≥18 years) in hospital-based mental health care. DATA EXTRACTION Two authors extracted data independently using a pre-designed extraction form. RESULTS OF DATA SYNTHESIS Among the 2962 publications identified, 257 were assessed by full text reading. A total of 24 studies reported in 26 publications were included in this descriptive review. We identified subjective and objective outcome measures, classified these according to the pharmacopsychometric triangle and compared them qualitatively in terms of incremental information added to the clinical study question. The data reviewed here from primarily depression and schizophrenia intervention studies show that results from patient-reported outcome measures and clinician-rated outcome measures generally point in the same direction. There was a relative lack of patient-reported outcome measures on functioning and medication side effects compared with patient-reported outcome measures on symptom burden and health-related quality of life. CONCLUSION Patient-reported outcomes and clinician-rate outcomes supplement each other and at most times support identical study conclusions. Future studies would benefit from a more systematic approach towards use of patient-reported outcomes and a clearer rationale of how to weigh and report the results in comparison with clinician-rated outcomes.
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Affiliation(s)
- Lone Baandrup
- Mental Health Center Copenhagen, Gentofte Hospitalsvej 15, 4., 2900 Hellerup, Denmark.,Department of Clinical Medicine, University of Copenhagen, Denmark
| | | | - Jan Mainz
- Aalborg University Hospital, Psychiatry Aalborg, Denmark, DACS, Danish Center for Health Services Research, Aalborg University.,Clinical Institute, Aalborg University, Aalborg, Denmark.,Department for Community Mental Health, University of Haifa, Haifa, Israel
| | - Poul Videbech
- Center for Neuropsychiatric Depression Research, Mental Health Centre Glostrup, Copenhagen, Denmark
| | - Solvejg Kristensen
- Aalborg University Hospital, Psychiatry Aalborg, Denmark, DACS, Danish Center for Health Services Research, Aalborg University
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Etchecopar-Etchart D, Korchia T, Loundou A, Llorca PM, Auquier P, Lançon C, Boyer L, Fond G. Comorbid Major Depressive Disorder in Schizophrenia: A Systematic Review and Meta-Analysis. Schizophr Bull 2020; 47:298-308. [PMID: 33252130 PMCID: PMC8451068 DOI: 10.1093/schbul/sbaa153] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Comorbid major depressive disorder (MDD) in schizophrenia (SZ; SZ-MDD) has been identified as a major prognostic factor. However, the prevalence and associated factors of SZ-MDD have never been explored in a meta-analysis. All studies assessing the prevalence of SZ-MDD in stabilized outpatients with a standardized scale or with structured interviews were included. The Medline, Web of Science, PsycINFO, and Google Scholar databases were searched. Using random effects models, we calculated the pooled estimate of the prevalence of SZ-MDD. We used meta-regression and subgroup analyses to evaluate the potential moderators of the prevalence estimates, and we used the leave-one-out method for sensitivity analyses. Of the 5633 potentially eligible studies identified, 18 studies (n = 6140 SZ stabilized outpatients) were retrieved in the systematic review and included in the meta-analysis. The pooled estimate of the prevalence of SZ-MDD was 32.6% (95% CI: 27.9-37.6); there was high heterogeneity (I2 = 92.6%), and Egger's test did not reveal publication bias (P = .122). The following factors were found to be sources of heterogeneity: publication in or after 2015, the inclusion of patients from larger studies, the assessment tools, the inclusion of patients with substance use disorder or somatic chronic diseases, age, education level, the lifetime number of hospitalizations, and antidepressant use. Two-thirds of the extracted variables could not be explored due to an insufficient amount of published data. The prevalence of MDD is high among SZ individuals. Healthcare providers and public health officials should have an increased awareness of the burden of SZ-MDD.
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Affiliation(s)
- Damien Etchecopar-Etchart
- Hôpitaux Universitaires de Marseille, Department de Psychiatrie Universitaire, EA 3279: Aix-Marseille Université, CEReSS—Health Service Research and Quality of Life Center, Marseille, France
| | - Theo Korchia
- Hôpitaux Universitaires de Marseille, Department de Psychiatrie Universitaire, EA 3279: Aix-Marseille Université, CEReSS—Health Service Research and Quality of Life Center, Marseille, France
| | - Anderson Loundou
- Hôpitaux Universitaires de Marseille, Department de Psychiatrie Universitaire, EA 3279: Aix-Marseille Université, CEReSS—Health Service Research and Quality of Life Center, Marseille, France
| | | | - Pascal Auquier
- Hôpitaux Universitaires de Marseille, Department de Psychiatrie Universitaire, EA 3279: Aix-Marseille Université, CEReSS—Health Service Research and Quality of Life Center, Marseille, France
| | - Christophe Lançon
- Hôpitaux Universitaires de Marseille, Department de Psychiatrie Universitaire, EA 3279: Aix-Marseille Université, CEReSS—Health Service Research and Quality of Life Center, Marseille, France
| | - Laurent Boyer
- Hôpitaux Universitaires de Marseille, Department de Psychiatrie Universitaire, EA 3279: Aix-Marseille Université, CEReSS—Health Service Research and Quality of Life Center, Marseille, France
| | - Guillaume Fond
- Hôpitaux Universitaires de Marseille, Department de Psychiatrie Universitaire, EA 3279: Aix-Marseille Université, CEReSS—Health Service Research and Quality of Life Center, Marseille, France,To whom correspondence should be addressed; tel: +33668102258, e-mail:
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Sousa S, Robinson L, Franklin M, Watson S. Patient-reported and clinician-rated outcome measures: Complementary evidence from two different perspectives. J Affect Disord 2020; 276:848-849. [PMID: 32738670 DOI: 10.1016/j.jad.2020.07.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/01/2020] [Accepted: 07/03/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Soraia Sousa
- Cumbria Northumberland Tyne and Wear NHS Foundation Trust, Newcastle, UK.
| | - Lucy Robinson
- School of Psychology, Newcastle University, Newcastle, UK
| | - Mathew Franklin
- Health Economics and Decision Science (HEDS), School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Stuart Watson
- Newcastle University, Newcastle, UK, Cumbria Northumberland Tyne and Wear NHS Foundation Trust, Newcastle, UK
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