Relapse in Major Depressive Disorder

Keller, Martin B.; Shapiro, Robert; Lavori, Philip W.; Wolfe, Nicola

doi:10.1001/archpsyc.1982.04290080031005

Cited by 254 publications

(95 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…For example, it has been shown that the chronicity of stressors is associated with the chronicity of depressive episodes. 58,59 Finally, another possible explanation for the associations between the HPAaxis function and the bowel symptoms could be factors emanating from the bowel (eg, microbiotica and subtle inflammation) which potentially could influence both the HPA-axis function as well as the mood. Recent studies suggest an associaton between the gut microbiotica and symptoms of anxiety/depression, indicating the complexity pertaining the issue of the brain-gut axis.…”

Section: Discussionmentioning

confidence: 99%

Hypothalamus-Pituitary-Adrenal Axis Hypersuppression Is Associated with Gastrointestinal Symptoms in Major Depression

Karling

Wikgren

Adolfsson

et al. 2016

J Neurogastroenterol Motil

View full text Add to dashboard Cite

Background/AimsGastrointestinal symptoms and hypothalamus-pituitary-adrenal (HPA) axis dysfunction are frequently observed in patients with major depression. The primary aim of the study was to investigate the relationship between HPA-axis function and self-perceived functional gastrointestinal symptoms in major depression. MethodsPatients with major depression (n = 73) and controls representative of the general population (n = 146) underwent a weightadjusted very low dose dexamethasone suppression test (DST). Patients and controls completed the gastrointestinal symptom rating scale-iritable bowel syndrome (GSRS-IBS) and the hospital anxiety depression scale. Medical records of the patients were screened over a ten year period for functional gastrointestinal disorder and pain conditions. ResultsPatients with high GSRS-IBS scores (above median) exhibited HPA-axis hypersuppression more often than controls (defined by the lowest 10% cutoff of the post-DST cortisol values among controls, adjusted OR 7.25, CI 1.97-26.7) whereas patients with low GSRS-IBS scores did not differ from controls concerning their post-DST cortisol values. Patients who had consulted primary care for functional gastrointestinal disorder (P = 0.039), lumbago (P = 0.006) and chronic multifocal pain (P = 0.057) also exhibited an increased frequency of hypersuppression. Conclusions

show abstract

Section: Discussionmentioning

confidence: 99%

Hypothalamus-Pituitary-Adrenal Axis Hypersuppression Is Associated with Gastrointestinal Symptoms in Major Depression

Karling

Wikgren

Adolfsson

et al. 2016

J Neurogastroenterol Motil

View full text Add to dashboard Cite

show abstract

“…PREVALENCE AND CLINICAL COURSE OF DEPRESSION: A REVIEW 13 whether comorbid dysthymia is present (Keller, Shapiro, Lavori, & Wolfe, 1982;Mueller et al, 1996), whether one is unemployed, or for example if a person has experienced a recent bereavement (Ohayon et al, 1999).…”

Section: Accepted M Manuscriptmentioning

confidence: 99%

“…Reporting that almost 8% of participants did not recover after 5 years. They note that the majority (70%) of participants recovered from their index episode of depression within 1-year (Keller et al, 1982). By 2-years 20% had still not recovered, by 5-years 12% were still depressed (Keller et al, 1992), by 10-years 7% had not experienced remission (Mueller et al, 1996) and by 15-years the percentage of participants not recovered was 6% (Keller & Boland, 1998).…”

Section: Accepted M Manuscriptmentioning

confidence: 99%

“…Relapsed individuals meet the full syndrome criteria and it occurs during a period of remission. One early report on relapse from major depressive disorder (Keller et al, 1982) documents a high rate of relapse (25%) after 12-weeks and notably the majority of those (25%) relapsed after 4-weeks. In the CDS study, 22% of those who achieved full remission from their primary episode of depression had relapsed within the year (Keller, Lavori, Endicott et al, 1983).…”

Section: Relapsementioning

confidence: 99%

See 1 more Smart Citation

Prevalence and clinical course of depression: A review

Richards

2011

Clinical Psychology Review

489

288

View full text Add to dashboard Cite

“…[2][3][4][5] When starting antidepressant therapy, the dose of antidepressant is low and is slowly increased, and careful attention is paid to the development of anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia, hypomania, and mania, the so-called "activation syndrome." The target dose is the lowest dose that adequately suppresses depressive symptoms with tolerable side effects.…”

mentioning

confidence: 99%

Influence of Genetic Polymorphisms and Concomitant Anxiolytic Doses on Antidepressant Maintenance Doses in Japanese Patients with Depression

Inoue

Murofushi

Nagaoka

et al. 2016

Biological & Pharmaceutical Bulletin

View full text Add to dashboard Cite

To prevent recurrent depression, patients should ideally continue treatment for >6 months with the antidepressant dose that effectively suppressed acute depressive symptoms. However, there are inter-individual differences in the antidepressant doses required to achieve response and maintenance. Therefore, this study was conducted to examine the role of clinical features, including genetic polymorphisms, on the antidepressant dose required for maintenance therapy in 82 Japanese patients with depression. We calculated the antidepressant dose using the imipramine equivalent scale and the dose of concomitant anxiolytics and hypnotics using the diazepam equivalent scale. The 82 participants were classified into two groups based on the median imipramine equivalent dose, and we examined the influence of patient characteristics and the presence of genetic polymorphisms of brain-derived neurotropic factor (BDNF; rs6265) and cyclic adenosine monophosphate responsive element-binding protein 1 (CREB1; rs2253306, rs4675690, rs769963) on the antidepressant maintenance dose. Using a multivariate logistic regression analysis, we found that the concomitant diazepam equivalent dose and presence of the CREB1 rs4675690 polymorphism were significantly associated with the antidepressant maintenance dose. We concluded that these factors influenced the antidepressant dose in maintenance therapy among Japanese patients with depression. However, further research is required in large cohorts.Key words antidepressant; maintenance dose; depressive disorder; polymorphism; brain-derived neurotrophic factor; cyclic AMP responsive element binding protein 1 Depressive disorder is a common psychiatric disorder, with approximately 350 million people being affected worldwide. 1)Moreover, it is associated with a high rate of recurrence and chronicity, with 12-35% of all cases becoming chronic and 13.2% experiencing recurrence within 5 years.2-5) When starting antidepressant therapy, the dose of antidepressant is low and is slowly increased, and careful attention is paid to the development of anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia, hypomania, and mania, the so-called "activation syndrome." The target dose is the lowest dose that adequately suppresses depressive symptoms with tolerable side effects. After achieving remission, the therapeutic dose acutely required is continued as maintenance therapy for >6 months to prevent recurrence. 6,7)Several reports suggest that when an antidepressant is ineffective in suppressing depressive symptoms, combination therapy with another antidepressant or anxiolytic or hypnotic drugs is more effective than increasing the dose of the preexisting antidepressant. [8][9][10] In studies on Japanese patients with depression, 23.4-35.9% of cases were treated with antidepressant combination therapy and 60.3-73.0% were treated with concomitant anxiolytic or hypnotic drugs. In addition, it is known that inter-individual differences exist in the daily dosing ...

show abstract

Relapse in Major Depressive Disorder

Cited by 254 publications

References 21 publications

Hypothalamus-Pituitary-Adrenal Axis Hypersuppression Is Associated with Gastrointestinal Symptoms in Major Depression

Hypothalamus-Pituitary-Adrenal Axis Hypersuppression Is Associated with Gastrointestinal Symptoms in Major Depression

Prevalence and clinical course of depression: A review

Influence of Genetic Polymorphisms and Concomitant Anxiolytic Doses on Antidepressant Maintenance Doses in Japanese Patients with Depression

Contact Info

Product

Resources

About