Clinical predictors of response and remission in inpatients with depressive syndromes

Riedel, Michael; Möller, Hans‐Jürgen; Obermeier, Michael; Adli, Mazda; Bauer, Michael; Kronmüller, Klaus; Brieger, Peter; Laux, Gerd; Bender, Wolfram; Heuser, Isabella; Zeiler, Joachim; Gäebel, Wolfgang; Schennach-Wolff, Rebecca; Henkel, Verena; Seemüller, Florian

doi:10.1016/j.jad.2011.04.007

Cited by 69 publications

(61 citation statements)

References 39 publications

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“…without the assistance of a therapist) when negative inputs are removed. For example, the model would predict better response to medication in patients with shorter episodes and fewer dysfunctional attitudes, which is consistent with clinical data (Kohler et al 2015;Riedel et al 2011). By contrast, psychotherapy, for example CBT, is proposed to target "top-down" biases directly and should be effective when "bottom-up" biases are weaker, since the absence of negatively biased inputs should enable schemata to resolve more easily.…”

Section: A Cognitive Neuropsychological Model Of Depression and Its Tsupporting

confidence: 68%

Affective Biases in Humans and Animals

Robinson

Roiser

2015

Translational Neuropsychopharmacology

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Depression is one of the most common but poorly understood psychiatric conditions. Although drug treatments and psychological therapies are effective in some patients, many do not achieve full remission and some patients receive no apparent benefit. Developing new improved treatments requires a better understanding of the aetiology of symptoms and evaluation of novel therapeutic targets in pre-clinical studies. Recent developments in our understanding of the basic cognitive processes that may contribute to the development of depression and its treatment offer new opportunities for both clinical and pre-clinical research. This chapter discusses the clinical evidence supporting a cognitive neuropsychological model of depression and antidepressant efficacy, and how this information may be usefully translated to pre-clinical investigation. Studies using neuropsychological tests in depressed patients and at risk populations have revealed basic negative emotional biases and disrupted reward and punishment processing, which may also impact on non-affective cognition. These affective biases are sensitive to antidepressant treatments with early onset effects observed, suggesting an important role in recovery. This clinical work into affective biases has also facilitated back-translation to animals and the development of assays to study affective biases in rodents. These animal studies suggest that, similar to humans, rodents in putative negative affective states exhibit negative affective biases on decision-making and memory tasks. Antidepressant treatments also induce positive biases in these rodent tasks, supporting the translational validity of this approach. Although still in the early stages of development and validation, affective biases in depression have the potential to offer new insights into the clinical condition, as well as facilitating the development of more translational approaches for pre-clinical studies.

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Section: A Cognitive Neuropsychological Model Of Depression and Its Tsupporting

confidence: 68%

Affective Biases in Humans and Animals

Robinson

Roiser

2015

Translational Neuropsychopharmacology

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“…The most important baseline predictors of suicide attempts (SAs) are baseline severity, the number of previous hospitalizations and the length of the current episode of depression 1 . The probability of having two or more SAs over the past year increased with the severity of substance use and violent behavior across attempter subtypes.…”

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confidence: 99%

Suicide attempts in a emergency hospital

Alves

Silva

Magalhães

et al. 2014

Arq. Neuro-Psiquiatr.

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The most important baseline predictors of suicide attempts (SAs) are baseline severity, the number of previous hospitalizations and the length of the current episode of depression 1 . The probability of having two or more SAs over the past year increased with the severity of substance use and violent behavior across attempter subtypes. A previous study indicates that the treatment of depressive symptoms in teen attempters remains an important goal 2 . Suicidal and nonsuicidal self-harm are both significant risks for depressed adolescents treated in the clinic. The presence of family dysfunction, high levels of suicidality and recent self-harm (suicidal or nonsuicidal) should alert us to a high risk for future SA. The presence of recent nonsuicidal self-injury is by far the strongest predictor of future nonsuicidal self-injury .A previous study has shown that, regardless of gender, the risk factors that are significantly associated with increased odds of SA include suicidal ideation, depressive symptoms, having a friend with a past history of attempted or completed suicide, and having a family member with a history of AbstrACtThis study aimed to characterize the profiles of suicide attempts that were attended to in the Hospital of Alagoas in the year 2010. Four hundred sixty-one charts and service bulletins were analyzed. Patients attempting suicide were predominately female. There were significant difference for suicide attempts (SAs) among men and women in the age of 10 to 19 years and 60 to 69 years. Women have tried more suicide aged between 10 and 19 years and men between 60 and 69 years. The ingestion of drugs was the most frequent method for women; and poisoning, use of sharp objects and hanging for men. The results of this study may contribute to elaboration, planning and implementation of preventive measures to reduce cases of SAs.Keywords: suicide, attempted, suicide, emergency service, hospital, epidemiology.resumo Este estudo teve como objetivo caracterizar o perfil das tentativas de suicídio (TS) que foram atendidos num Hospital de Alagoas, no ano de 2010. Quatrocentos e sessenta e um boletins foram analisados. Houve diferença significativa para as tentativas de suicídio entre homens e mulheres nas faixas etárias de 10 a 19 anos e de 60 a 69 anos. As mulheres cometem mais suicídio na faixa etária entre 10 e 19 anos e os homens entre 60 e 69 anos. A ingestão de drogas foi o método mais frequente para as mulheres; o envenenamento, uso de objetos pontiagudos e enforcamento para homens. Os resultados deste estudo podem contribuir para a elaboração, planejamento e implementação de medidas preventivas em casos de TS.Palavras-chave: tentativa de suicídio, suicídio, serviço hospitalar de emergência, epidemiologia.

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“…Some other researchers reported that severity and duration of the disorder at the start of treatment [43,44,45,46] were negative predictors of success at the end of inpatient therapy [46] and in the 2- to 3-year follow-up [42]. …”

Section: Discussionmentioning

confidence: 99%

Dimensions of the Operationalized Psychodynamic Diagnosis System that Predict Long-Term Outcome after Inpatient Psychotherapy

Schneider¹,

Tiemann²,

Stumpf³

et al. 2014

Psychopathology

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Background/Aims: To determine whether the Operationalized Psychodynamic Diagnosis (OPD) system can be useful in predicting patient outcome in the long term. Methods: OPD was assessed by the therapists prior to and after inpatient treatment. Patients completed psychometric scales at the start and completion of psychosomatic-psychotherapeutic inpatient treatment and at the follow-up. Outcome was defined by the general factor emerging from a principal component analysis of the Brief Symptom Inventory, Hospital Anxiety and Depression Scale and Inventory of Interpersonal Problems at katamnesis, representing individual differences in general distress. Results: Several dimensions of the OPD system proved to be predictors of general distress at the follow-up in 253 former inpatients. Negative predictors of long-term outcome were the high internal impediments to change, namely high secondary gains from illness and also less integrated structural abilities. Positive OPD predictors of long-term outcome were the treatment success achieved at the end of inpatient psychotherapy in changing the illness concept towards a psychological understanding of symptoms, lower levels of complaints and a higher functional level. Also the achieved level of awareness for the individual maladaptive behavioral pattern is predictive of a favorable long-term outcome. Conclusions: The results provide evidence for the clinical relevance and the predictive value of OPD.

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Clinical predictors of response and remission in inpatients with depressive syndromes

Cited by 69 publications

References 39 publications

Affective Biases in Humans and Animals

Affective Biases in Humans and Animals

Suicide attempts in a emergency hospital

Dimensions of the Operationalized Psychodynamic Diagnosis System that Predict Long-Term Outcome after Inpatient Psychotherapy

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