Does the Revised Child Anxiety and Depression Scale (RCADS) Measure Anxiety Symptoms Consistently Across Adolescence? the TRAILS Study.

Does the Revised Child Anxiety and Depression Scale (RCADS) measure anxiety symptoms consistently across adolescence? The TRAILS study.

Int J Methods Psychiatr Res. 2013 Mar 11;
Mathyssek CM, Olino TM, Hartman CA, Ormel J, Verhulst FC, Van Oort FV

We assessed if the Revised Child Anxiety and Depression Scale (RCADS) measures anxiety symptoms similarly across age groups within adolescence. This is crucial for valid comparison of anxiety levels between different age groups. Anxiety symptoms were assessed biennially in a representative population sample (n?=?2226) at three time points (age range 10-17?years) using the RCADS anxiety subscales (generalized anxiety disorder [GAD], obsessive-compulsive disorder [OCD], panic disorder [PD], separation anxiety [SA], social phobia [SP]). We examined longitudinal measurement invariance of the RCADS, using longitudinal confirmatory factor analysis, by examining the factor structure (configural invariance), factor loadings (metric invariance) and thresholds (strong invariance). We found that all anxiety subtypes were configural invariant. Metric invariance held for items on the GAD, OCD, PD and SA subscales; yet, for the SP subscale three items showed modest longitudinal variation at age 10-12. Model fit decreased modestly when enforcing additional constraints across time; however, model fit for these models was still adequate to excellent. We conclude that the RCADS measures anxiety symptoms similarly across time in a general population sample of adolescents; hence, measured changes in anxiety symptoms very likely reflect true changes in anxiety levels. We consider the instrument suitable to assess anxiety levels across adolescence. Copyright © 2013 John Wiley & Sons, Ltd. HubMed – depression


Physical Activity and Health Outcomes Among HIV-Infected Men Who Have Sex with Men: A Longitudinal Mediational Analysis.

Ann Behav Med. 2013 Mar 13;
Blashill AJ, Mayer KH, Crane H, Magidson JF, Grasso C, Mathews WC, Saag MS, Safren SA

BACKGROUND: Low physical activity is associated with depression, which may, in turn, negatively impact antiretroviral therapy (ART) adherence among HIV-infected individuals; however, prior studies have not investigated the relationships between physical inactivity and ART non-adherence. PURPOSE: The purpose of this study was to examine the association of physical inactivity, depression, ART non-adherence, and viral load in HIV-infected men who have sex with men. METHODS: The sample (N?=?860) was from a large, multicenter cohort of HIV-infected patients engaged in clinical care. RESULTS: Across time, depression mediated the relationship between physical inactivity and ART non-adherence (??=?0.075) and the relationship between physical inactivity and viral load (??=?0.05). ART non-adherence mediated the relationship between depression and viral load (??=?0.002) and the relationship between physical inactivity and viral load (??=?0.009). CONCLUSIONS: Low levels of physical activity predicted increased depression and poor ART adherence over time, which subsequently predicted higher viral load. HubMed – depression


[Mini-Mental State Examination in geriatrics : An evaluation of diagnostic quality.]

Z Gerontol Geriatr. 2013 Mar 14;
Beyermann S, Trippe RH, Bähr AA, Püllen R

BACKGROUND: Several studies have identified moderate reliability and validity for the Mini-Mental State Examination (MMSE). Some researchers showed the superiority of other dementia screening tests over the MMSE considering the test quality criteria. The aim of this study was the evaluation of MMSE, especially in the area of geriatrics. PATIENTS AND METHODS: MMSE and DemTect were carried out with 154 geriatric patients: 71 persons without cognitive impairment and 83 persons without delirium showed cognitive impairments as revealed by the DemTect. In addition, we also applied the Clock-Drawing-Test (CDT), Reisberg-Scale, Geriatric Depression-Scale (GDS, 15-item version) and the Confusion-Assessment-Method (CAM). RESULTS: According to the multitrait-multimethod approach, MMSE’s convergent and divergent validity is similar to that of the DemTect. Both tests correlate only moderately with Spearman (r?=?0.609) and revealed similar results for dementia in 57.1?% of the patients. MMSE showed low reliability and moderate reliability (Cronbach’s ??=?0.82) when ten items with low discriminatory power were excluded from the total test score. Difficulty of all items is only moderate (p?=?0.86) and only eight items of the MMSE showed good test difficulty. CONCLUSION: All in all, DemTect and MMSE are not interchangeable. The MMSE estimates the average cognitive impairment of patients as considerably less pronounced than the DemTect. MMSE is, thus, not an instrument that would be recommended for the identification of mild cognitive impairment. In this case, tests with higher reliability and validity should be used. HubMed – depression


Effects of pramipexole on the processing of rewarding and aversive taste stimuli.

Psychopharmacology (Berl). 2013 Mar 14;
McCabe C, Harwood J, Brouwer S, Harmer CJ, Cowen PJ

RATIONALE: Pramipexole, a D2/D3 dopamine receptor agonist, has been implicated in the development of impulse control disorders in patients with Parkinson’s disease. Investigation of single doses of pramipexole in healthy participants in reward-based learning tasks has shown inhibition of the neural processing of reward, presumptively through stimulation of dopamine autoreceptors. OBJECTIVES: This study aims to examine the effects of pramipexole on the neural response to the passive receipt of rewarding and aversive sight and taste stimuli. METHODS: We used functional magnetic resonance imaging to examine the neural responses to the sight and taste of pleasant (chocolate) and aversive (mouldy strawberry) stimuli in 16 healthy volunteers who received a single dose of pramipexole (0.25 mg) and placebo in a double-blind, within-subject, design. RESULTS: Relative to placebo, pramipexole treatment reduced blood oxygen level-dependent activation to the chocolate stimuli in the areas known to play a key role in reward, including the ventromedial prefrontal cortex, the orbitofrontal cortex, striatum, thalamus and dorsal anterior cingulate cortex. Pramipexole also reduced activation to the aversive condition in the dorsal anterior cingulate cortex. There were no effects of pramipexole on the subjective ratings of the stimuli. CONCLUSIONS: Our results are consistent with an ability of acute, low-dose pramipexole to diminish dopamine-mediated responses to both rewarding and aversive taste stimuli, perhaps through an inhibitory action of D2/3 autoreceptors on phasic burst activity of midbrain dopamine neurones. The ability of pramipexole to inhibit aversive processing might potentiate its adverse behavioural effects and could also play a role in its proposed efficacy in treatment-resistant depression. HubMed – depression



Ketamine for Depression – Doctor Fruitman, MD – Psychiatrist in NYC Dr. Edward Fruitman, MD explains how to treat depression with Ketamine. Current research shows that Ketamine, an old anesthetic, works very quickly in relieving the symptoms of severe depression in patients who had no response to medications and/or ECT. Ketamine has been widely used as an anesthetic for minor procedures since the 1960’s. In many countries, it is used by the first aid response workers when dealing with minor trauma. The safety of Ketamine is such that it is used as outpatient anesthetic by non-physicians. The exact mechanism of how Ketamine works for depression is not fully known. Ketamine works on a neurotransmitter system called Glutamate (NMDA receptors), which is the most widespread neurotransmitter in the brain. Many major research institutions are conducting trials and studies on this subject. The public clinical results are excellent, but the mechanism of action still remains a mystery. We individualize treatment to the particular patient. At Trifecta, we try to make the patient a full partner in the treatment process. Trifecta Health Medical Center 115 Broadway, New York, NY, 10006 (212) 233-2830