Behavioural measurement and drug response characteristics of unipolar and bipolar depression

Katz, Martin Μ.; Robins, Eli; Croughan, Jack; Secunda, Steven K.; Swann, Alan C.

doi:10.1017/s0033291700043257

Cited by 65 publications

(32 citation statements)

References 12 publications

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“…The MV battery, used to evaluate drug actions, combines scores from doctor ratings with scores from patient self-reports to derive measures of 11 components of the depressive disorder such as depressed mood, anxiety, hostility and distressed expression, as described previously (Katz et al, 1982. In addition, three independent severity dimensions, comprised by combining constructs found by principal components analysis to be associated, i.e.…”

Section: Methodsmentioning

confidence: 99%

A multivantaged behavioural method for measuring onset and sequence of the clinical actions of antidepressants

Katz

Houston

Brannan³

et al. 2004

Int. J. Neuropsychopharm.

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An aim in development of new antidepressants (ADs) now includes increasing speed of action. New drugs are tested primarily in outpatients who are less severely depressed than the patients treated in earlier trials of the tricyclic drugs. To determine early efficacy requires measures sensitive to initial changes in components of the illness as well as in the severity of the entire syndrome of depression. This paper describes the development of a brief 'multivantaged' (MV) method for assessing the major behavioural and affective components of depression. The revised Brief MV was significantly reduced from the original to make it more feasible to apply in outpatient studies. In this study we determined the Brief MV's (1) reliability and comparability to the original and (2) its ability to detect the onset of specific behavioural effects in outpatients treated with paroxetine for 6 wk. The latter is compared to the ability of the Hamilton Depression Scale (HAMD) to detect changes in global severity. The constructs derived from the Brief MV were found to be highly similar to those of the original version and as reliable. In depressed patients who responded to paroxetine, the HAMD and MV detected onset of improvement after 7 d of treatment. The Brief MV revealed that the improvement in global severity was due to the drug's action at this time on behaviours such as anxiety and distressed expression, as well as on a severity dimension of anxiety-agitation-somatization. Thus, the Brief MV, in uncovering underlying behavioural actions, represents an important addition to the current unidimensional HAMD approach in drug research.

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Section: Methodsmentioning

confidence: 99%

A multivantaged behavioural method for measuring onset and sequence of the clinical actions of antidepressants

Katz

Houston

Brannan³

et al. 2004

Int. J. Neuropsychopharm.

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“…Other measures of the components of depression, for example, psychomotor performance, derived from our earlier work, are described below. These have been described previously (Katz et al, 1982(Katz et al, , 1984(Katz et al, , 1989.…”

Section: Measurement Of Behavioral Components and Severity Of The Depmentioning

confidence: 99%

“…In a principal components analysis of the intercorrelations of the 11 state constructs, three orthogonal dimensions were identified, accounting for approximately 75% of the variance (Katz et al, 1982(Katz et al, , 1984. The dimensions, which consist of combined constructs, represent three independent components of severity of the disorder and help to explain the major areas of functioning measured: (I) Depressed mood-retardation of movement and speech (DM-MR dimension).…”

Section: Measurement Of Behavioral Components and Severity Of The Depmentioning

confidence: 99%

Onset and Early Behavioral Effects of Pharmacologically Different Antidepressants and Placebo in Depression

Katz

Tekell

Bowden

et al. 2003

Neuropsychopharmacol

233

153

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This study was aimed at resolving the time course of clinical action of antidepressants (ADs) and the type of early behavioral changes that precede recovery in treatment-responsive depressed patients. The first goal was to identify, during the first 2 weeks of treatment, the onset of clinical actions of the selective serotonin reuptake inhibitor (SSRI), paroxetine, and the selective noradrenergic reuptake inhibitor, desipramine (DMI). The second aim was to test the hypothesis that the two pharmacologic subtypes would induce different early behavioral changes in treatment-responsive patients. The design was a randomized, parallel group, placebo-controlled, double-blind study for 6 weeks of treatment following a 1-week washout period. The study utilized measures of the major behavioral components of the depressive disorder as well as overall severity. The results indicated that the onset of clinical actions of DMI ranged from 3 to 13 days, averaged 13 days for paroxetine, and was 16-42 days for placebo. Furthermore, as hypothesized, the different types of ADs initially impacted different behavioral aspects of the disorder. After 1 week of treatment, DMI produced greater reductions in motor retardation and depressed mood than did paroxetine and placebo, and this difference persisted at the second week of treatment. Early improvement in depressed mood-motor retardation differentiated patients who responded to DMI after 6 weeks of treatment from those that did not. Paroxetine initially reduced anxiety more in responders than in nonresponders, and by the second week, significantly improved depressed mood and distressed expression in responders to a greater extent. Depressed patients who responded to placebo showed no consistent early pattern of behavior improvement. Early drug-specific behavioral changes were highly predictive of ultimate clinical response to the different ADs, results that could eventually be applied directly to clinical practice.

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“…This study was not aimed directly at determining onset of AD activity but included comprehensive behavioral analysis of the baseline depressive state, relatively rapid administration of amitriptyline or imipramine during the first week to achieve a high steady dosage, and early and frequent measurement of the impact of drugs on the major affective and behavioral components. Further, the behavioral and affective structure of the severe depressive disorder was analyzed in a large sample of hospitalized unipolar and bipolar patients through application of a range of clinical methods, e.g., Hamilton Depression Scale (1960), SCL-90 (Derogatis et al, 1974), video measures of expressive and affective state (Katz et al, 1982). It was determined that the variance across behavioral, cognitive, affective and psychomotor aspects of the state could be explained in large part (75% of the variance) by three dimensions: (1) anxiety-physical agitation-somatization; (2) depressed mood-motor retardation; and (3) hostility-interpersonal sensitivity (Katz et al, 1984; see Table 1).…”

Section: On the Structure And "Core" Of Depressionmentioning

confidence: 99%

Onset of antidepressant activity: Reexamining the structure of depression and multiple actions of drugs

1996

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The question of when antidepressant drugs (AD) initiate significant clinical actions in depressed patients is still unsettled. Findings from early studies on whether there is a lag in the onset of therapeutic actions were in disagreement. More recent results with the selective serotonin reuptake inhibitors (SSRIs) and other new Ads indicate that clinical actions occur within the first 2 weeks. In this paper, evidence from efficacy studies with the Ads is reviewed and the methodologic and conceptual obstacles to achieving definitive results about the onset issue are analyzed. Depression, formerly viewed as a homogenous disorder, is now seen as heterogenous and multifaceted in structure. Such major structural components as anxiety and disturbed psychomotor functioning can be as significant to the core of the disorder as depressed mood itself. Further, the Ads have been shown to act initially on different facets of the clinical disorder which then result in multiple clinical actions, e.g., an initial reduction in anxiety followed by stimulation of motor activity. Data from the NIMH Collaborative Study of the Psychobiology of Depression are used to illustrate: (1) the componential structure of severe depressive disorder; (2) the sequence of change in the major behavioral components of the disorder associated with the tricyclic drugs; (3) the consequent ‘multiple’ onsets of clinical actions; and (4) measurement of the clinical significance and visibility of the early behavioral changes. Recent results describing new behavioral and methodological approaches, the use of early clinical changes to predict outcome, and strategies for designing sound studies of onset are discussed. Depression and Anxiety 4:257–267, 1996/1997.© 1997 Wiley‐Liss, Inc.

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Behavioural measurement and drug response characteristics of unipolar and bipolar depression

Cited by 65 publications

References 12 publications

A multivantaged behavioural method for measuring onset and sequence of the clinical actions of antidepressants

A multivantaged behavioural method for measuring onset and sequence of the clinical actions of antidepressants

Onset and Early Behavioral Effects of Pharmacologically Different Antidepressants and Placebo in Depression

Onset of antidepressant activity: Reexamining the structure of depression and multiple actions of drugs

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