ObjectiveThe aim of the present study was to investigate differences in discontinuation time among antidepressants and total antidepressant discontinuation rate of patients with depression over a 6 month period in a naturalistic treatment setting.MethodsWe reviewed the medical records of 900 patients with major depressive disorder who were initially prescribed only one kind of antidepressant. The prescribed antidepressants and the reasons for discontinuation were surveyed at baseline and every 4 weeks during the 24 week study. We investigated the discontinuation rate and the mean time to discontinuation among six antidepressants groups.ResultsMean and median overall discontinuation times were 13.8 and 12 weeks, respectively. Sertraline and escitalopram had longer discontinuation times than that of fluoxetine, and patients who used sertraline discontinued use significantly later than those taking mirtazapine. No differences in discontinuation rate were observed after 24 weeks among these antidepressants. About 73% of patients discontinued antidepressant treatment after 24 weeks.ConclusionSertraline and escitalopram tended to have longer mean times to discontinuation, although no difference in discontinuation rate was detected between antidepressants after 24 weeks. About three-quarters of patients discontinued antidepressant maintenance therapy after 24 weeks.
ObjectiveThis study analyzed the symptom frequencies of 17-item Hamilton Depression Rating Scale (HDRS-17) to understand the characteristics of each item and to propose the possible symptoms clusters.MethodsFrom psychiatric clinics of 18 Hospitals in Korea, 1,183 patients, diagnosed with major depressive disorder (psychotic or non-psychotic), dysthymia or depressive disorder not otherwise specified. according to DSM-IV criteria, participated in this study from January 2006 to August 2008. The frequencies of each item of HDRS-17 were analyzed according to sex and severity. In addition, we compared this study with a previous study performed in England by Hamilton and with two studies performed in Korea by Kim et al.ResultsThe frequencies of HDRS-17 items varied widely in this study, ranging from 95.8% in work and activities to 37.4% in loss of weight. But, depressed mood, psychic anxiety and work and activities items exhibited constant and higher frequency or rank regardless of study, the severity of depression or sex. Insomnia early, somatic gastrointestinal, genital symptoms and insight showed relatively constant but lower frequency or rank in disregard of studies or the clinical variables. Other symptoms had variable frequencies or ranks according to the variable clinical situations (culture, time, sex, severity of depression).ConclusionWe propose three clusters of symptoms in depressive disorders: core symptoms cluster, an associated symptoms, and a situation-specific symptoms. We can use these possible symptom clusters of depression in simplifying diagnosis of depression, increasing diagnostic specificity in special situation and indexing disease severity.
Background: This study aimed to investigate the relationship between exercise and depression based on responses to 2016 Korean National Health and Nutrition Examination Survey (KNHANES) and the Patient Health Questionairre-9 (PHQ-9). Specifically, this study examined which physical activities have the greatest effects in combating depression. Methods: This study was based on data from 2016 KNHANES and responses to the PHQ-9 questionnaire on physical activity. We selected 2,245 people of age >19 years, who completed the surveys. Physical activity variables included number of days of walking, duration of walking, days of strength training, and aerobic physical activity. These variables subdivided into aerobic and muscle strengthening activities and their effects on depression were examined. Results: All the variables, except duration of walking, were negatively correlated with the PHQ-9 scale scores. However, of the physical activity variables included in the hierarchical regression analysis, only the number of days of walking over 1 week had a statistically significant negative effect on the PHQ-9 scores. Conclusion: For adults, aerobic activity (walking) had a greater effect on reducing depression than muscle strengthening activity. The frequency and consistency of walking had a greater impact than the duration of walks. These results suggest that regular walking is a better form of physical activity than strength training for its effect on mood and it assists in overcoming depression.
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