The clinical relevance of qualitatively distinct subtypes of depression

Kessing, Lars Vedel; Bukh, Jens Drachmann

doi:10.1002/wps.20461

Cited by 11 publications

(7 citation statements)

References 10 publications

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“…The ICD-10 ( 18 ) diagnosis of MD requires four symptoms, whereas the DSM-V ( 19 ) criteria are based on seven main symptoms, and the Hamilton Depression Rating Scale (HDRS) gives an MD diagnosis threshold for scores ranging from 7 to 17 as widely accepted by clinicians or cutoff scores from 8 to 16 as suggested by the recent severity classification of HDRS ( 20 – 23 ). However, depression is heterogeneous and presents with highly variable clinical symptoms, so its diagnosis cannot be made merely by the number of symptoms, but should include their detailed analysis and causal relations ( 24 – 26 ). Diagnosis of MD was reported to be less stable compared with diagnosis of severe depression using ICD-10 criteria and was characterized by a fair level of agreement (kappa = 0.25) between clinicians compared with the moderate reliability in severe depression cases (kappa = 0.53) ( 8 , 27 ).…”

Section: Introductionmentioning

confidence: 99%

Language Patterns Discriminate Mild Depression From Normal Sadness and Euthymic State

et al. 2018

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ObjectivesDeviations from typical word use have been previously reported in clinical depression, but language patterns of mild depression (MD), as distinct from normal sadness (NS) and euthymic state, are unknown. In this study, we aimed to apply the linguistic approach as an additional diagnostic key for understanding clinical variability along the continuum of affective states.MethodsWe studied 402 written reports from 124 Russian-speaking patients and 77 healthy controls (HC), including 35 cases of NS, using hand-coding procedures. The focus of our psycholinguistic methods was on lexico-semantic [e.g., rhetorical figures (metaphors, similes)], syntactic [e.g., predominant sentence type (single-clause and multi-clause)], and lexico-grammatical [e.g., pronouns (indefinite, personal)] variables. Statistical evaluations included Cohen’s kappa for inter-rater reliability measures, a non-parametric approach (Mann–Whitney U-test and Pearson chi-square test), one-way ANOVA for between-group differences, Spearman’s and point-biserial correlations to analyze relationships between linguistic and gender variables, discriminant analysis (Wilks’ λ) of linguistic variables in relation to the affective diagnostic types, all using SPSS-22 (significant, p < 0.05).ResultsIn MD, as compared with healthy individuals, written responses were longer, demonstrated descriptive rather than analytic style, showed signs of spoken and figurative language, single-clause sentences domination over multi-clause, atypical word order, increased use of personal and indefinite pronouns, and verb use in continuous/imperfective and past tenses. In NS, as compared with HC, we found greater use of lexical repetitions, omission of words, and verbs in continuous and present tenses. MD was significantly differentiated from NS and euthymic state by linguistic variables [98.6%; Wilks’ λ(40) = 0.009; p < 0.001; r = 0.992]. The highest predictors in discrimination between MD, NS, and euthymic state groups were the variables of word order (typical/atypical) (r = −0.405), ellipses (omission of words) (r = 0.583), colloquialisms (informal words/phrases) (r = 0.534), verb tense (past/present/future) (r = −0.460), verbs form (continuous/perfect) (r = 0.345), amount of reflexive (e.g., myself)/personal (r = 0.344), and negative (e.g., nobody)/indefinite (r = 0.451) pronouns. The most significant between-group differences were observed in MD as compared with both NS and euthymic state.ConclusionMD is characterized by patterns of atypical language use distinguishing depression from NS and euthymic state, which points to a potential role of linguistic indicators in diagnosing affective states.

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Section: Introductionmentioning

confidence: 99%

Language Patterns Discriminate Mild Depression From Normal Sadness and Euthymic State

et al. 2018

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“…It was found that 17% of patients had a psychiatric condition; of these 10% had depression. Similarly, in 2018, Jørgensen et al (3) found, in a cohort of 877 patients with PN, 8.5% had depression, thus PN seems more often to be associated with having a psychiatric condition compared with the background population (10,11).…”

Section: Main Findings and Interpretationmentioning

confidence: 93%

Treatment and Burden of Disease in a Cohort of Patients with Prurigo Nodularis: A Survey-based Study

Todberg

Zachariae²,

Skov³

2020

Acta Derm Venerol

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Prurigo nodularis is a rare skin disease characterized by intense pruritus, leading to lack of sleep and reduced quality of life. For dermatologists worldwide, treatment of prurigo nodularis remains a challenge, as there are no approved treatments for the disease and patients are often insufficiently treated with the existing therapies. This patientbased survey examined treatment tendencies and treatment effectiveness, comorbidities, pruritus and quality of life in a cohort of patients with prurigo nodularis. Overall, topical corticosteroids and ultraviolet B are the most commonly used treatments; however, topical corticosteroids under occlusion, zinc-dressing treatment and steroid injection were reported as the most effective treatments. Prurigo nodularis is a pruritic dermatosis with poor treatment options. To describe treatment patterns, comorbidities, pruritus, and quality of life a survey was administered to 92 patients with prurigo nodularis. A total of 52 patients completed the survey. The most frequently used treatments were topical corticosteroids, which were prescribed to 49/52 patients, with positive effect in 13/49. A total of 46/52 patients were treated with ultraviolet B, and 9/46 reported a positive effect. A positive effect was reported for topical corticosteroids under occlusion in 21/40, for zinc dressing treatment in 17/37, for steroid injection in 9/14, for methotrexate in 5/16, and for thalidomide in 4/12 of treated patients. Thirty-six patients reported a Pittsburgh Sleep Quality Index >5, indicating poor sleep. Patients with prurigo nodularis are severely bothered by pruritus negatively affecting quality of life. Various treatments are prescribed; most frequently topical corticosteroids and ultraviolet B. Surprisingly, patients reported topical corticosteroids under occlusion, zincdressing treatment and steroid injection as the most effective.

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“…A reflection of the ongoing debate about these and other controversial diagnostic topics can be found in recent issues of this journal [2][3][4][5][6][7][8][9][10][11][12][13][14][15] .…”

Section: Icd-11 Sessions In the 17th World Congress Of Psychiatrymentioning

confidence: 99%

ICD‐11 sessions in the 17th World Congress of Psychiatry

Rosa

2018

World Psychiatry

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The clinical relevance of qualitatively distinct subtypes of depression

Cited by 11 publications

References 10 publications

Language Patterns Discriminate Mild Depression From Normal Sadness and Euthymic State

Language Patterns Discriminate Mild Depression From Normal Sadness and Euthymic State

Treatment and Burden of Disease in a Cohort of Patients with Prurigo Nodularis: A Survey-based Study

ICD‐11 sessions in the 17th World Congress of Psychiatry

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