Prevalence and Predictors of Depression in Patients With Systemic Lupus Erythematosus: A Cross-Sectional Study.

Prevalence and predictors of depression in patients with systemic lupus erythematosus: a cross-sectional study.

Neuropsychiatr Dis Treat. 2013; 9: 799-804
Maneeton B, Maneeton N, Louthrenoo W

The purpose of this study was to estimate the prevalence and examine the predictors of depression in patients with systemic lupus erythematosus (SLE).This cross-sectional study was conducted in the rheumatology clinic of a university hospital. All SLE patients that met the revised American College of Rheumatology (ACR) classification were included in the study. Sociodemographic data and medications were recorded. Disease activity for SLE was assessed with the Mexican-SLE Disease Activity Index (Mex-SLEDAI). All subjects were screened for anxiety and depression by using the Hamilton Anxiety Rating Scale (HAM-A) and the 17-item version of the Hamilton Depression Rating Scale (HAM-D17). Multiple linear regression analyses were used to determine predictors of depressive disorder.A total of 62 SLE (61 females and 1 male) patients participated in the study. Based on HAM-D17 and HAM-A, rates of depression and anxiety in SLE patients were 45.2% and 37.1%, respectively. The multiple linear regression analysis revealed that HAM-A score and younger age were significant predictors of depression in SLE patients.The findings suggest that depression and anxiety are common in SLE patients. In addition, higher levels of anxiety and a younger age may increase the risk of depression. Because of the small sample size, further studies should be conducted to confirm these results. HubMed – depression


Comparative clinical profile of mirtazapine and duloxetine in practical clinical settings in Japan: a 4-week open-label, parallel-group study of major depressive disorder.

Neuropsychiatr Dis Treat. 2013; 9: 781-6
Nagao K, Kishi T, Moriwaki M, Fujita K, Hirano S, Yamanouchi Y, Funahashi T, Iwata N

No studies have compared mirtazapine with duloxetine in patients with major depressive disorder (MDD). Fifty-six patients were nonrandomly assigned to a 4-week treatment with either 15 to 45 mg/day of mirtazapine (n = 22) or 20 to 60 mg/day of duloxetine (n = 34). The primary efficacy measurements were the Hamilton Rating Scale for Depression (HRSD) and the Montgomery-Åsberg Depression 6-point Rating Scale (MADRS) scores. The second efficacy measurements were the response and remission rates of treatment. Tolerability assessments were also performed. Fifty-six patients (43 male; age, 43.6 years) were recruited. There was no significant difference in the discontinuation rate between the mirtazapine and duloxetine treatment groups (P = 0.867). Both mirtazapine and duloxetine significantly improved the HRSD and MADRS scores from baseline (P < 0.0001-0.0004). While mirtazapine was superior to duloxetine in the reduction of HRSD scores (P = 0.0421), there was no significant change in MADRS scores in terms of between-group differences (P = 0.171). While more somnolence was observed with mirtazapine (P = 0.0399), more nausea was associated with duloxetine (P = 0.0089). No serious adverse events were observed for either antidepressant. Mirtazapine and duloxetine were safe and well-tolerated treatments for Japanese patients with MDD. Double-blind controlled studies are needed to further explore the efficacy and safety of mirtazapine and duloxetine in Japanese patients with MDD. HubMed – depression


Discrepancies in Cornell Scale for Depression in Dementia (CSDD) items between residents and caregivers, and the CSDD’s factor structure.

Clin Interv Aging. 2013; 8: 641-8
Wongpakaran N, Wongpakaran T, van Reekum R

This validation study aims to examine Cornell Scale for Depression in Dementia (CSDD) items in terms of the agreement found between residents and caregivers, and also to compare alternative models of the Thai version of the CSDD.A cross-sectional study was conducted of 84 elderly residents (46 women, 38 men, age range 60-94 years) in a long-term residential home setting in Thailand between March and June 2011. The selected residents went through a comprehensive geriatric assessment that included use of the Mini-Mental State Examination, Mini-International Neuropsychiatric Interview, and CSDD instruments. Intraclass correlation (ICC) was calculated in order to establish the level of agreement between the residents and caregivers, in light of the residents’ cognitive status. Confirmatory factor analysis (CFA) was adopted to evaluate the alternative CSDD models.The CSDD yielded a high internal consistency (Cronbach’s alpha = 0.87) and moderate agreement between residents and caregivers (ICC = 0.55); however, it was stronger in cognitively impaired subjects (ICC = 0.71). CFA revealed that there was no difference between the four-factor model, in which factors A (mood-related signs) and E (ideational disturbance) were collapsed into a single factor, and the five-factor model as per the original theoretical construct. Both models were found to be similar, and displayed a poor fit.The CSDD demonstrated a moderate level of interrater agreement between residents and caregivers, and was more reliable when used with cognitively impaired residents. CFA indicated a poorly fitting model in this sample. HubMed – depression