Number of illness episodes as predictor of residual symptoms in major depressive disorder

Serafini, Gianluca; Nebbia, Jacopo; Cipriani, N; Conigliaro, Claudia; Erbuto, Denise; Pompili, Maurizio; Amore, Mario

doi:10.1016/j.psychres.2017.09.026

“…Although the burden and disability related to this condition, the STAR*D study clearly showed that about 50% of patients with major depressive disorder (MDD) will experience a response with the first treatment [3] but only 30% achieve a complete remission and the remaining percentage will need to undergo several additional treatment trials in order to improve response [4]. These remission rates are lower in treatment-resistant depression (TRD) [5] which is associated with a higher risk of recurrence, substance abuse, and suicidal behavior [6,7]. Furthermore, MDD frequently appears to exert neuro-progressive clinical characteristics, with recurring episodes of increasing severity, reduced therapeutic response [8], and persistence of residual symptoms which commonly predict a poorer outcome [9].…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, MDD frequently appears to exert neuro-progressive clinical characteristics, with recurring episodes of increasing severity, reduced therapeutic response [8], and persistence of residual symptoms which commonly predict a poorer outcome [9]. In this context, it is crucial to obtain a complete remission or—at least—manage and appropriately treat depressive residual symptoms in order to reduce the risk of relapses, associated psychosocial impairment, and suicidal attempts [6,10]. …”

Section: Introductionmentioning

confidence: 99%

The Efficacy of Buprenorphine in Major Depression, Treatment-Resistant Depression and Suicidal Behavior: A Systematic Review

Serafini

¹

,

Adavastro

²

,

Canepa

³

et al. 2018

IJMS

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Although several pharmacological options to treat depression are currently available, approximately one third of patients who receive antidepressant medications do not respond adequately or achieve a complete remission. Thus, novel strategies are needed to successfully address those who did not respond, or partially respond, to available antidepressant pharmacotherapy. Research findings revealed that the opioid system is significantly involved in the regulation of mood and incentives salience and may be an appropriate target for novel therapeutic agents. The present study aimed to systematically review the current literature about the use of buprenorphine (BUP) for major depression, treatment-resistant depression (TRD), non-suicidal self-injury (NSSI) behavior, and suicidal behavior. We investigated Pubmed and Scopus databases using the following keywords: “buprenorphine AND depression”, “buprenorphine AND treatment resistant depression”, “buprenorphine AND suicid*”, “buprenorphine AND refractory depression”. Several evidence demonstrate that, at low doses, BUP is an efficacious, well-tolerated, and safe option in reducing depressive symptoms, serious suicidal ideation, and NSSI, even in patients with TRD. However, more studies are needed to evaluate the long-term effects, and relative efficacy of specific combinations (e.g., BUP + samidorphan (BUP/SAM), BUP + naloxone (BUP/NAL), BUP + naltrexone) over BUP monotherapy or adjunctive BUP treatment with standard antidepressants, as well as to obtain more uniform guidance about the optimal BUP dosing interval.

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“…Number of episodes and illness duration are considered as risk factors of pharmaco-resistance and are involved in depression recurrence 11,12 . They also may signal risk of residual symptoms, such as sleep disturbances, executive impairments and anxiety 13 . They are considered by a group of experts as great indicators of prognosis and severity of TRD [14][15][16] .…”

Section: Discussionmentioning

confidence: 99%

Brain SPECT perfusion and PET metabolism as discordant biomarkers in major depressive disorder

Tastevin

¹

,

Boyer

²

,

Korchia

³

et al. 2020

Preprint

0

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Background: Brain SPECT perfusion and PET metabolism have been, most often interchangeably, proposed to study the underlying pathological process in major depressive disorder (MDD). The objective of this study was to specify similarities and inconsistencies between these two biomarkers according to global characteristics of the disease. We conducted a retrospective study in 16 patients suffering from treatment-resistant MDD who underwent, during the same current episode, a cerebral perfusion SPECT with 99mTc-HMPAO and a metabolic PET with 18F-FDG. Whole-brain voxel-based SPM(T) maps were generated in correlation with the number of depressive episodes and in correlation with the depression duration, separately for the two exams (p-voxel<0.001 uncorrected, k>20). Results: No significant correlations were found between brain metabolism and either the number of depressive episodes or the duration of the disease, even at an uncorrected p-voxel<0.005. On the other hand, the increased number of depressive episodes was correlated with decreased perfusion of the right middle frontal cortex, the right anterior cingulum cortex, the right insula, the right medial temporal cortex and the left precuneus. The increased depression duration was correlated with decreased perfusion of the right anterior cingulum cortex. Conclusions: This preliminary study demonstrates more significant results with brain perfusion compared with glucose metabolism in treatment-resistant MDD, highlighting the value of brain SPECT despite less favourable instrumentation detection compared to PET.

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“…involved in depression recurrence 11,12 . They also may signal risk of residual symptoms, such as sleep disturbances, executive impairments and anxiety 13 . They are considered by a group of experts as great indicators of prognosis and severity of TRD [14][15][16] .…”

Section: Number Of Episodes and Illness Duration Are Considered As Rimentioning

confidence: 99%

Brain SPECT perfusion and PET metabolism as discordant biomarkers in major depressive disorder

Tastevin

¹

,

Boyer

²

,

Korchia

³

et al. 2020

Preprint

0

View full text Add to dashboard Cite

Background: Brain SPECT perfusion and PET metabolism have been, most often interchangeably, proposed to study the underlying pathological process in major depressive disorder (MDD). The objective of this study was to specify similarities and inconsistencies between these two biomarkers according to global characteristics of the disease. We conducted a retrospective study in 16 patients suffering from treatment-resistant MDD who underwent, during the same current episode, a cerebral perfusion SPECT with 99mTc-HMPAO and a metabolic PET with 18F-FDG. Whole-brain voxel-based SPM(T) maps were generated in correlation with the number of depressive episodes and in correlation with the depression duration, separately for the two exams (p-voxel<0.001 uncorrected, k>20). Results: No significant correlations were found between brain metabolism and either the number of depressive episodes or the duration of the disease, even at an uncorrected p-voxel<0.005. On the other hand, the increased number of depressive episodes was correlated with decreased perfusion of the right middle frontal cortex, the right anterior cingulum cortex, the right insula, the right medial temporal cortex and the left precuneus. The increased depression duration was correlated with decreased perfusion of the right anterior cingulum cortex. Conclusions: This preliminary study demonstrates more significant results with brain perfusion compared with glucose metabolism in treatment-resistant MDD, highlighting the value of brain SPECT despite less favourable instrumentation detection compared to PET.

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Number of illness episodes as predictor of residual symptoms in major depressive disorder

Cited by 11 publications

References 37 publications

The Efficacy of Buprenorphine in Major Depression, Treatment-Resistant Depression and Suicidal Behavior: A Systematic Review

The Efficacy of Buprenorphine in Major Depression, Treatment-Resistant Depression and Suicidal Behavior: A Systematic Review

Brain SPECT perfusion and PET metabolism as discordant biomarkers in major depressive disorder

Brain SPECT perfusion and PET metabolism as discordant biomarkers in major depressive disorder

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