A Cross-Sectional Study of the Prevalence of Cognitive and Physical Symptoms During Long-Term Antidepressant Treatment

Fava, Maurizio; Graves, Lesley; Benazzi, Franco; Scalia, Margaret; Iosifescu, Dan V.; Alpert, Jonathan E.; Papakostas, George I.

doi:10.4088/jcp.v67n1113

Cited by 194 publications

(159 citation statements)

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“…Several arousal-reducing interventions lead to improvement in depression, such as sleep deprivation which leads to a rapid and pronounced reduction of depressive symptomatology in more than half of the patients [82] , whereas recovery sleep and short naps can result in prompt return of depressive symptomatology. Drowsiness is a highly frequent side effect of antidepressants [83][84][85][86] , and all standard antidepressants, and also electroconvulsive therapy, reduce the firing rate of neurons in the noradrenergic locus coeruleus [87] , which plays an essential role in arousal regulation [88][89][90] . In this context it is of interest that also other arousal-reducing drugs, such as scopolamine and ketamine, have demonstrated antidepressant effects [91,92] .…”

Section: The Vigilance Regulation Model Of Affective Disorders and Adhdmentioning

confidence: 99%

Assessment of Wakefulness and Brain Arousal Regulation in Psychiatric Research

Sander¹,

Hensch²,

Wittekind³

et al. 2015

Neuropsychobiology

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tion of wakefulness to the environmental and situational needs so that the optimal balance between energy conservation and responsiveness can be obtained. Since one approach to the assessment of brain arousal regulation is the classification of EEG vigilance stages, a computer-based algorithm (Vigilance Algorithm Leipzig) has been introduced, allowing classification of EEG vigilance stages in EEG recordings under resting conditions. The time course of EEG vigilance stages in EEGs of 15-20 min duration allows estimation of the individual arousal regulation (hyperstable, adaptive, or unstable vigilance pattern). The vigilance model of affective disorders and attention-deficit/hyperactivity disorder links a disturbed arousal regulation to the pathogenesis of psychiatric disorders and accordingly helps to explain and possibly also predict treatment effects of pharmacological and nonpharmacological interventions for these conditions. AbstractDuring the last few decades, much knowledge has been gained about sleep being a heterogeneous condition with several distinct sleep stages that represent fundamentally different physiological states. The same applies for the wake state which also comprises distinct global functional states (called vigilance stages). However, various terms and concepts have been introduced describing different aspects of wakefulness, and accordingly several methods of assessment exist, e.g. sleep laboratory assessments (Multiple Sleep Latency Test, Maintenance of Wakefulness Test), questionnaires (Epworth Sleepiness Scale, Karolinska Sleepiness Scale), behavioural tasks (Psychomotor Vigilance Test) or electroencephalography (EEG)-based assessments (Alpha Attenuation Test, Karolinska Drowsiness Test). Furthermore, several theoretical concepts about the regulation of sleep and wakefulness have been put forward, and physiological correlates have been identified. Most relevant for healthy functioning is the regulation of brain arousal and the adap-

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Section: The Vigilance Regulation Model Of Affective Disorders and Adhdmentioning

confidence: 99%

Assessment of Wakefulness and Brain Arousal Regulation in Psychiatric Research

Sander¹,

Hensch²,

Wittekind³

et al. 2015

Neuropsychobiology

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“…The Massachusetts General Hospital Cognitive and Physical Functioning Questionnaire (CPFQ) 23 was used to assess cognitive symptoms of depression.…”

Section: Mental Health Outcomesmentioning

confidence: 99%

Impact of a Depression Care Management Program for Hospitalized Cardiac Patients

Huffman

Mastromauro²,

Sowden³

et al. 2011

Circ: Cardiovascular Quality and Outcomes

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Background— Depression is independently associated with poor outcomes among patients with acute cardiac disease. Collaborative care depression management programs have been used in outpatients to improve depression outcomes, but such a program had never been initiated in the hospital or used for patients with a wide range of cardiac illnesses. Methods and Results— This was a prospective, randomized trial of a low-intensity, 12-week collaborative care program versus usual care for 175 depressed patients hospitalized for acute coronary syndrome, arrhythmia, or heart failure. Study outcomes, assessed using mixed regression models to compare groups at 6 weeks, 12 weeks, and 6 months, included mental health (depression, cognitive symptoms of depression, anxiety, and mental health-related quality of life) and medical (physical health-related quality of life, adherence to medical recommendations, and cardiac symptoms) outcomes. Collaborative care subjects (n=90) had significantly greater improvements on all mental health outcomes at 6 and 12 weeks, including rates of depression response (collaborative care, 59.7% versus usual care 33.7%; odds ratio, 2.91; P =0.003 at 6 weeks; 51.5% versus 34.4%; odds ratio, 2.02; P =0.04 at 12 weeks), though these effects decreased after intervention. At 6 months, intervention subjects had significantly greater self-reported adherence and significantly reduced number and intensity of cardiac symptoms. Conclusions— Among patients with a broad range of cardiac diagnoses, a collaborative care depression management program initiated during hospitalization led to significant improvements in multiple clinically important mental health outcomes and had promising effects on relevant medical outcomes after intervention. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT00847132.

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“…For example, lower blood pressure (Moonen et al 2015) or cardiovascular disease and cardiovascular risk factors (Ligthart et al 2012) have also been shown to be involved in increased apathy in normal aging, even if cardiovascular risk factors per se are more indirectly correlated with apathy than silent cerebrovascular disease (Yao et al 2015). Similarly, pharmacological treatments were not assessed despite the evidence that some agents such as antidepressants (Barnhart et al 2004;Fava et al 2006) can induce apathy syndrome. Despite the fact that all patients with a major depressive disorder were excluded, we could not totally exclude that some patients received antidepressant treatments.…”

Section: Limitationsmentioning

confidence: 99%

Multidimensional model of apathy in older adults using partial least squares—path modeling

Raffard¹,

Bortolon²,

Burca³

et al. 2016

AGE

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Apathy defined as a mental state characterized by a lack of goal-directed behavior is prevalent and associated with poor functioning in older adults. The main objective of this study was to identify factors contributing to the distinct dimensions of apathy (cognitive, emotional, and behavioral) in older adults without dementia. One hundred and fifty participants (mean age, 80.42) completed self-rated questionnaires assessing apathy, emotional distress, anticipatory pleasure, motivational systems, physical functioning, quality of life, and cognitive functioning. Data were analyzed using partial least squares variance-based structural equation modeling in order to examine factors contributing to the three different dimensions of apathy in our sample. Overall, the different facets of apathy were associated with cognitive functioning, anticipatory pleasure, sensitivity to reward, and physical functioning, but the contribution of these different factors to the three dimensions of apathy differed significantly. More specifically, the impact of anticipatory pleasure and physical functioning was stronger for the cognitive than for emotional apathy. Conversely, the impact of sensibility to reward, although small, was slightly stronger on emotional apathy. Regarding behavioral apathy, again we found similar latent variables except for the cognitive functioning whose impact was not statistically significant. Our results highlight the need to take into account various mechanisms involved in the different facets of apathy in older adults without dementia, including not only cognitive factors but also motivational variables and aspects related to physical disability. Clinical implications are discussed.

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A Cross-Sectional Study of the Prevalence of Cognitive and Physical Symptoms During Long-Term Antidepressant Treatment

Cited by 194 publications

References 0 publications

Assessment of Wakefulness and Brain Arousal Regulation in Psychiatric Research

Assessment of Wakefulness and Brain Arousal Regulation in Psychiatric Research

Impact of a Depression Care Management Program for Hospitalized Cardiac Patients

Multidimensional model of apathy in older adults using partial least squares—path modeling

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