Abstract:
BACKGROUND:We report on the assessment and outcome of the first 1000 patients referred to a tertiary referral depression clinic established to assess the utility of diagnostic sub-typing on clinical course of illness. METHODS:Diagnostic, treatment recommendations, prognostic judgments and 12-week outcome data were examined. RESULTS:Nearly 40% of those with a primary mood disorder were diagnosed with bipolar disorder, of whom three-quarters received such a diagnosis for the first time. Alternative diagnoses or formulations were provided for 68% of the total sample, with the therapeutic paradigm altered for the majority (86%) of patients. Improvement rates were indicative of a higher level of improvement in those diagnosed with bipolar disorder (some 70%) compared to those with unipolar disorders (some 60%). Overall, however, rates of 'full remission' were low, being 2% and up to 12% for bipolar and unipolar patients respectively and perhaps reflecting the tertiary nature of the assessing clinical facility. Baseline clinician predictions were in the order of 60% accuracy in predicting outcome, irrespective of diagnostic grouping. LIMITATIONS:Anticipation factors (e.g. attending a specialist tertiary referral service) may have contributed non-specifically to outcome. Use of clinician-derived diagnoses rather than strict DSM-IV criteria limits comparisons to other studies. CONCLUSIONS:The high rates of a first-time bipolar diagnosis suggest that detection and diagnosis of this condition continues to be problematic. Low remission rates underline the chronic nature of many mood disorders, and the need for ongoing management given the high risk of relapse. Our findings offer support for the importance of identifying bipolar disorder and distinguishing depressive sub-types in order to shape more targeted treatments, a task that might be advanced by the establishment of more tertiary referral services.
journal_name
J Affect Disordjournal_title
Journal of affective disordersauthors
Parker G,Fletcher K,Barrett M,Breakspear M,Rees AMdoi
10.1016/j.jad.2010.11.004subject
Has Abstractpub_date
2011-06-01 00:00:00pages
52-8issue
1-3eissn
0165-0327issn
1573-2517pii
S0165-0327(10)00686-5journal_volume
131pub_type
杂志文章abstract::In an attempt to improve the classification of Bipolar II disorders, we have examined a consecutive series of 687 primary major depressives: 5.1% gave a past history of mania (Bipolar I), 13.7% met our operational criteria for hypomania (Bipolar II), and the remaining 81.2% were provisionally categorized as 'unipolar....
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/0165-0327(92)90044-7
更新日期:1992-10-01 00:00:00
abstract:BACKGROUND:Depression is associated with an increased risk of cardiovascular diseases (CVD) and cardiovascular mortality. We investigated to what extent subjective health status explained the apparent association between depressive symptoms and cardiovascular mortality in older European men. METHODS:Data were used fro...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/j.jad.2008.07.005
更新日期:2009-04-01 00:00:00
abstract::Current formal psychiatric approaches to nosology are plagued by an unwieldy degree of heterogeneity with insufficient appreciation of the commonalities of emotional, personality, behavioral, and addictive disorders. We address this challenge by building a spectrum model that integrates the advantages of Cloninger's a...
journal_title:Journal of affective disorders
pub_type: 杂志文章,评审
doi:10.1016/j.jad.2006.02.025
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:Crying, a complex neurobiological behavior with psychosocial and communication features, has been little studied in relationship to the menstrual cycle. METHODS:In the Mood and Daily Life study (MiDL), a community sample of Canadian women aged 18-43 years, n=76, recorded crying proneness and crying frequenc...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/j.jad.2016.08.044
更新日期:2017-01-15 00:00:00
abstract:BACKGROUND:Peripartum depression [PPD] is a public health problem which has been widely studied. Nonetheless, study findings and clinical guidelines for PPD treatment differ among countries and the condition is still underdiagnosed and undertreated, suggesting the importance of a global understanding of PPD. The Riseup...
journal_title:Journal of affective disorders
pub_type: 杂志文章,评审
doi:10.1016/j.jad.2020.05.112
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Antenatal depression is common and associated with adverse consequences for mothers, babies, and future generations. Limitations with conventional approaches has resulted in additional therapies being considered. This study examined the feasibility and effectiveness of acupuncture for improving mental health...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/j.jad.2020.05.089
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:This study examines comorbidity of posttraumatic stress disorder (PTSD) and depression following myocardial infarction (MI). It has two aims: (a) to examine whether this comorbidity is predicted by the objective severity of the MI and the patients' initial appraisal and stress responses; and (b) to determine...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/j.jad.2006.03.016
更新日期:2006-08-01 00:00:00
abstract::Despite advances in the pharmacologic treatment of bipolar disorder, it is clear that additional strategies are needed to provide patients with longer-term mood stability. Recent years have witnessed the development of a number of psychosocial strategies for bipolar disorder that are design as adjuncts to ongoing phar...
journal_title:Journal of affective disorders
pub_type: 杂志文章,评审
doi:10.1016/s0165-0327(01)00460-8
更新日期:2003-01-01 00:00:00
abstract::472 bipolar patients were followed up retrospectively over 17 years. The patients that died were compared with the general population and a control group. The former comparison showed greater mortality from suicide, cardiovascular and respiratory causes in the index population and the latter, that the deceased were mo...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/0165-0327(94)90112-0
更新日期:1994-06-01 00:00:00
abstract:BACKGROUND:In a previous study examining the association of hyperthymic temperament and daily light exposure (illuminance), we compared hyperthymic scores of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-auto questionnaire version (TEMPS-A) acquired from residents in Sapporo and Oita in Japan, which ...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/j.jad.2014.03.029
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Evidence suggests a bidirectional association between migraine and depression in individuals and in twins. However, whether a bidirectional association between migraine and depression also occurs among siblings (probands and unaffected nontwin siblings) remains unknown. METHODS:Using the Taiwan National Hea...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/j.jad.2020.10.056
更新日期:2021-01-15 00:00:00
abstract:BACKGROUND:Previous work indicates that emotive processing, such as of facial expressions, may be altered in major depressive disorder (MDD). Individuals with MDD tend to exhibit a mood-congruent processing bias, though MDD may also be characterized by blunted emotive processing in general. Females tend to exhibit enha...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/j.jad.2011.10.047
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Bipolar disorders are frequently diagnosed and treated as unipolar depression initially and accurate diagnosis is often delayed by 8 to 10years. It has been demonstrated that the bipolar spectrum disorders are associated with notable disability and that the current diagnostic gold standard, the Structured Cl...
journal_title:Journal of affective disorders
pub_type: 杂志文章,评审
doi:10.1016/j.jad.2011.12.033
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to compare the rate of symptom relief to functional improvement and examine the relationships between symptom relief and functional improvement during the acute phase of treatment. METHODS:A total of 131 acutely ill inpatients with major depressive disorder were enrolled to rec...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/j.jad.2015.04.022
更新日期:2015-08-15 00:00:00
abstract:BACKGROUND:Symptoms of depression and anxiety are common in children with obsessive-compulsive disorder (OCD) and associated with more severe OCD, greater impairment, and worse treatment outcome. Beyond twin studies showing that genetic factors contribute to the high co-occurrence, few studies have examined how OCD, de...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/j.jad.2020.03.090
更新日期:2020-06-15 00:00:00
abstract:BACKGROUND:Major depressive disorder may be a heterogeneous disorder, yet melancholic depression is the most consistently described subtype, regarded as qualitatively different to non-melancholic depression in terms of cognitive and motor impairments. Eye movement studies in depression are infrequent and findings are i...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/j.jad.2006.03.018
更新日期:2006-07-01 00:00:00
abstract:BACKGROUND:We used resting-state functional magnetic resonance imaging to examine possible amygdala-prefrontal cortex functional connectivity abnormalities and to clarify the correlation of the abnormal connectivity with response to antidepressant medications. METHODS:We recruited 40 drug-naïve patients with first-epi...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/j.jad.2020.05.053
更新日期:2020-09-01 00:00:00
abstract::The plasma prolactin response to thyrotropin-releasing hormone, which is thought to be mediated by central 5-HT mechanisms, has been studied in patients with affective disorders. There was no difference between depressive patients (taken as a whole), bipolar patients undergoing a manic phase and controls in the prolac...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/0165-0327(80)90032-4
更新日期:1980-12-01 00:00:00
abstract:BACKGROUND:Increasing gender equality remains an imperative for countries and organisations worldwide, and is associated with the improved life outcomes of men and women. Unlike many health and wellbeing indicators, death by suicide is more common among men, but suicidal behaviours are more common among women. Understa...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/j.jad.2020.07.105
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:This study assesses depression among primary care patients, the relationship between depression and functioning, and how frequently depressed individuals receive mental health treatment. METHODS:Two hundred and thirteen participants completed a diagnostic interview and measures of functional impairment and ...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/s0165-0327(98)00191-8
更新日期:1999-09-01 00:00:00
abstract:BACKGROUND:Although recent neuroimaging studies have suggested that functional deficits in facial perception are associated with panic disorder (PD), the possibility of cortical thickness and perfusion abnormalities have not been studied in patients with PD. We aimed to investigate alterations in cortical thickness and...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/j.jad.2020.07.139
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Family history studies in adults reveal strong familiality for the anxiety disorders with some specificity. The aim of the current study was to establish whether there was an elevated rate of anxiety disorders in the parents of children with anxiety disorders, and whether there was intergenerational specific...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/j.jad.2006.03.017
更新日期:2006-07-01 00:00:00
abstract:BACKGROUND:Psychological distress symptoms are associated with an increased risk of psychiatric disorders and medical illness. Although psychological distress is influenced by environmental factors, such as socioeconomic status, lifetime events, or interpersonal relationships, substantial interindividual variation also...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/j.jad.2019.04.011
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:Whether there is a difference in perceived social support (PSS) and related factors among college students from one- and multiple-child families was unclear. METHODS:We conducted a population-based, cross-sectional study between October 2017 and February 2018, randomly selected college students with sibling...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/j.jad.2020.07.027
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Given the poor prognosis of late-life depression, it is crucial to identify those at risk. Our objective was to construct and validate a prediction rule for an unfavourable course of late-life depression. METHODS:For development and internal validation of the model, we used The Netherlands Study of Depressi...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/j.jad.2018.04.026
更新日期:2018-08-01 00:00:00
abstract::Transient DST non-suppression during disulfiram-treatment was fortuitously observed in a depressed patient. A disulfiram-potentiated DST (DSTd) was constructed by giving 800 mg disulfiram on the dexamethasone and postdexamethasone days. DST and DSTd were compared intraindividually in 21 patients and 14 controls. Disul...
journal_title:Journal of affective disorders
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0165-0327(93)90059-s
更新日期:1993-08-01 00:00:00
abstract:BACKGROUND:Anxiety is a common mental health problem in youth. The current study aimed to test the effectiveness of an online self-directed anxiety prevention program in a school-based sample and to compare two methods of implementing an anxiety program in schools. METHODS:A three-arm cluster stratified randomised con...
journal_title:Journal of affective disorders
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jad.2016.02.049
更新日期:2016-05-15 00:00:00
abstract::In a double-blind study the selective monoamine oxidase-A inhibitor brofaromine was compared with the classical MAOI tranylcypromine in 39 patients with major depression resistant to treatment with tricyclic antidepressants. Concerning efficacy no significant differences were found. Ten out of 22 patients responded to...
journal_title:Journal of affective disorders
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0165-0327(93)90104-r
更新日期:1993-07-01 00:00:00
abstract:BACKGROUND:The aim of this study was to investigate whether uric acid levels are different between patients with remission period of bipolar disorder type I (BD) and patients with remission period of major depressive disorder (MDD). METHODS:For this aim 41 patients diagnosed with BD and 30 patients diagnosed with recu...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/j.jad.2014.04.053
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:Bipolar disorder (BD) patients show morphological abnormalities in gray matter (GM) and white matter (WM), which can be revealed by structure MRI (sMRI) and diffusion tensor imaging (DTI) respectively. However, previous studies on BD mainly relied on separated analysis of single neuroimaging modality, and it...
journal_title:Journal of affective disorders
pub_type: 杂志文章
doi:10.1016/j.jad.2019.11.119
更新日期:2020-02-15 00:00:00