The Association Between Physical Morbidity and Subtypes of Severe Depression.

The Association between Physical Morbidity and Subtypes of Severe Depression.

Filed under: Depression Treatment

Psychother Psychosom. 2013; 82(1): 45-52
Ostergaard SD, Petrides G, Dinesen PT, Skadhede S, Bech P, Munk-Jørgensen P, Nielsen J

Background: Physical illness and depression are related, but the association between specific physical diseases and diagnostic subtypes of depression remains poorly understood. This study aimed to clarify the relationship between a number of physical diseases and the nonpsychotic and psychotic subtype of severe depression. Methods: This is a historical prospective cohort study. The study population consisted of all patients diagnosed with ICD-10 severe depression, either nonpsychotic or psychotic subtype, in Danish psychiatric hospitals between 1994 and 2008. The patients’ history of physical disease was assessed using the Danish National Patient Register. Using logistic regression it was investigated whether specific physical diseases were associated with relative increased risk for subsequent development of either the nonpsychotic or psychotic depressive subtype. Results: A total of 24,173 patients with severe depression were included in the study. Of those, 8,260 (34%) were of the psychotic subtype. A history of the following physical diseases, as opposed to their absence, increased the relative risk for subsequent development of the nonpsychotic compared to the psychotic depressive subtype [adjusted incidence odds ratio (AIOR) nonpsychotic vs. psychotic]: ischemic heart disease (AIOR = 1.3, p < 0.001), hypertension (AIOR = 1.2, p = 0.008), stroke (AIOR = 1.2, p = 0.042) and chronic lower pulmonary disease (AIOR = 1.2, p = 0.005). The total load of physical disease also increased the relative risk of nonpsychotic depression [AIOR = 1.05 (per disease), p = 0.001]. Conclusions: This study revealed that, in severe depression, a history of physical disease increased the relative risk of the nonpsychotic rather than the psychotic subtype. HubMed – depression


Nutrient-Based Therapies for Bipolar Disorder: A Systematic Review.

Filed under: Depression Treatment

Psychother Psychosom. 2012 Nov 6; 82(1): 10-19
Sylvia LG, Peters AT, Deckersbach T, Nierenberg AA

Background: Pharmacotherapy is the first line of treatment for bipolar disorder, but many patients continue to experience persistent subthreshold symptoms. Alternative adjunct treatments, including nutritional therapies, may have the potential to alleviate residual symptoms and improve the outcomes of standard pharmacotherapy. The aim of this paper is to critically review the current clinical evidence and mechanisms of action of nutrient-based therapies alone or in combination with commonly used pharmacotherapies for mania and bipolar depression. Methods: We conducted a Medline search for clinical trials conducted with humans, published in English from 1960 to 2012 using nutritional supplements such as n-3, chromium, inositol, choline, magnesium, folate and tryptophan alone or in combination with pharmacotherapies for the treatment of bipolar disorder. Results: Preliminary data yields conflicting but mainly positive evidence for the use of n-3 fatty acids and chromium in the treatment of bipolar depression. Limited evidence found that inositol may be helpful for bipolar depression, but larger sample sizes are needed. Preliminary randomized, controlled trials suggest that choline, magnesium, folate and tryptophan may be beneficial for reducing symptoms of mania. Conclusions: Given the potential public health impact of identifying adjunct treatments that improve psychiatric as well as physical health outcomes, nutritional treatments appear promising for the management of bipolar disorder but require further study.
HubMed – depression


Citalopram versus psychological training for depression and anxiety symptoms in hemodialysis patients.

Filed under: Depression Treatment

Iran J Kidney Dis. 2012 Nov; 6(6): 446-51
Hosseini SH, Espahbodi F, Mirzadeh Goudarzi SM

Introduction. This study was designed to compare an antidepressant medication, citalopram, with psychological training in hemodialysis patients with symptoms of anxiety and depression. Materials and Methods. A total number of 44 hemodialysis patients scored 8 and more on the Hospital Anxiety and Depression Scale (HADS) were randomly allocated to two groups to receive citalopram, 20 mg/d, for 3 months or to attend 6 sessions of 1-hour psychological training. A nephrologist and a senior psychiatry resident were responsible for training of the patients, which contained explaining the anatomy of the kidneys, causes of kidney failure, treatment modalities, the mechanism involved in hemodialysis, the required care in hemodialysis patients, stages of adaptive reaction in human, and techniques of problem solving, stress management, and muscle relaxation. Both groups completed the HADS once before and once after the treatment. The final results of the two groups were compared. Results. Citalopram administration led to a significant decrease in the patients’ depression score (P = .001), anxiety score (P = .048), and total HADS score (P = .002). Psychological training sessions also decreased significantly depression (P = .04), anxiety (P = .03), and total HADS scores (P = .045). There was no significant difference in the amount of decrease in the scores of depression (P = .65), anxiety (P = .19), and the total HADS (P = .66) between the two groups. Conclusions. Psychological training and citalopram have similar effects on improving the symptoms of anxiety and depression in hemodialysis patients.
HubMed – depression


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