Nondysphoric Depression Following Stroke

Paradiso, Sergio; Vaidya, Jatin G.; Tranel, Daniel; Kosier, Todd; Robinson, Robert G.

doi:10.1176/jnp.2008.20.1.52

Cited by 28 publications

(27 citation statements)

References 48 publications

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“…Consistent with expectations, the non-depressed group was less functionally impaired than both depression groups (NDD and DD)[1][2][4][8][25]. Similar results have been reported among older nursing home dwellers [27], but no previous study reported social functional adaptation in older nursing home patients with NDD.…”

Section: Discussionsupporting

confidence: 80%

“…Earlier studies have described NDD as subthreshold or subsyndromal depression (by definition not meeting DSM-V criteria)[1][4][7][8]. As expected (based on inclusion criteria) lower HAM-D scores were found among participants with NDD compared to DD [2][46][48][58].…”

Section: Discussionmentioning

confidence: 56%

“…Psychopathological features distinguishing between NDD and DD relative to non-depressed participants included hopelessness, worthlessness and helplessness. Paradiso et al [8] reported significant rates of self-depreciation/worthlessness among stroke victims with NDD. Lower likelihood of anxiety in NDD the present study is similar to an earlier study by Paradiso et al [2], and consistent with lower rates of psychological symptoms including anxiety among elderly with depression [59].…”

Section: Discussionmentioning

confidence: 99%

“…Subjects were categorized as dysphoric depression (DD), NDD, and non-depressed comparison participants following criteria of prior research [4][8] and symptoms assessed using the Ham-D [35]. Subjects were categorized as NDD if they admitted to one the following ideational symptoms of depression: guilt, self-depreciation, worthlessness, pessimism, or sense of failure, and 2 or more vegetative symptoms including change in appetite and sleep, fatigue, agitation or trouble concentrating, but did not endorse sadness or anhedonia.…”

Section: Methodsmentioning

confidence: 99%

“…The DSM-V also contemplates depressive symptoms causing clinically significant distress or impairment in social or occupational functioning, not meeting criteria for major depression or any other mood disorder class (e.g., unspecified depressive disorder in DSM-V) [3]. Recently attention has been drawn to the fact that syndromic clusters of ideational (e.g., guilt) and vegetative (e.g., poor sleep or fatigue) depressive symptoms but at best inconsistent reporting of affective symptoms (nondysphoric depression or NDD) may have psychiatric significance and be present in excess among older adults [4][5][6][7][8]. The exact nature of this clinical condition is currently not fully known.…”

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confidence: 99%

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Social Adaptive Functioning, Apathy, and Nondysphoric Depression among Nursing Home-Dwelling Very Old Adults

Onwuameze

Paradiso²

2014

Psychopathology

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Background: Apathetic and subsyndromal depressive conditions are common in the oldest old. This study examined whether nondysphoric depression (NDD), a clinical condition characterized by ideational and vegetative but no emotional symptoms of depression, belongs to the apathetic presentations of late-life depression. Rates of NDD, dysphoric depression (DD), apathy, and social functional impairment were examined in a sample of nondemented very old (mean age 87.5 years, SD = 7.7) nursing home residents. It was hypothesized that individuals with NDD show greater apathy and greater social functional impairment relative to DD and nondepressed individuals. Methods: Social functioning was measured using the Social-Adaptive Functioning Evaluation (SAFE) and apathy was measured using the global apathy rating on the Scale for the Assessment of Negative Symptoms (SANS). Results: The rates of DD (50.0%) and NDD (27.4%) were quite high. Participants with DD reported greater apathy than those with NDD (and nondepressed individuals). NDD and DD subjects showed greater social functional impairment relative to the comparison group. There was no difference in social functioning between DD and NDD individuals. Conclusions: The present data are inconsistent with the view that NDD among the oldest old is an apathetic form of depression. NDD involves social functional impairment. Limitations include rather selected population of nursing home residents that may have included individuals with early dementia, lack of data on prior depressive episodes, and apathy assessment not validated on the specific population.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Social Adaptive Functioning, Apathy, and Nondysphoric Depression among Nursing Home-Dwelling Very Old Adults

Onwuameze

Paradiso²

2014

Psychopathology

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Cognitive and daily functioning in older adults with vegetative symptoms of depression

Paradiso

Duff

Vaidya

et al. 2009

Int J Geriat Psychiatry

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Objectives In primary care 50–95% of patients with depression present with vegetative symptoms (VS). Based on the extant literature, older adults showing VS (but no dysphoria) may show functional impairment but this hypothesis has not been empirically tested. The goal of this study was to examine neurocognitive and daily functioning of elderly patients showing exclusively VS in comparison with patients presenting with VS and dysphoria. Methods Seven hundred and eighty-seven primary care patients received measures of neurocognition and daily functioning. Neurocognition was measured with the repeatable battery for the assessment of neuropsychological status (RBANS). Three groups were compared: (1) patients with two or more VS of depression without dysphoria (VS − D), (2) patients with at least one VS and dysphoria (VS + D), and (3) comparison patients without multiple VS or dysphoria. Results Nearly one third of the sample (31%) fell into the VS − D group, whereas 15% fell into the VS + D group. Both VS groups showed poorer neurocognition and activities of daily living than comparisons. Only one subtest of the RBANS (i.e., picture naming) showed a significant difference between VS + D and VS − D, and there was no significant difference on daily functioning. VS − D patients reported less frequent past history of depression and endorsed less anxiety compared to VS + D. Conclusions Elderly patients presenting with clusters of VS with or without dysphoria show poorer neurocognitive and functional performance. Relative poorer cognition and daily functioning in VS − D are potential harbingers of further decline and consistent with under-reporting of sadness in older age.

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Occurrence of Depressive Symptoms Among Older Adults after a Stroke in the Nursing Home Facility

Kowalska

Bojko

Szczepańska-Gieracha

et al. 2016

Rehabilitation Nursing

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Purpose The aim of the study was to analyze the prevalence of depressive symptoms among older adults after stroke in a nursing home (NH). Design The study was conducted in a NH and included 50 patients after stroke with a mean age of 74.62 (±8.2). Method The Mini Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Acceptance Illness Scale (AIS) and Barthel Index (BI) were used. Findings Mean GDS was 7.60 (±2.75); 74% of patients had depressive symptoms. The study showed a significant relationship between GDS and marital status (p = .043). A negative correlations between GDS and MMSE (p = .029), GDS and BI (p = .049), and GDS and AIS (p < .0001) were found. Conclusion The occurrence of depressive symptoms in older adults after stroke depends on their mental and functional status, degree of acceptance of illness, and marital status. Clinical Relevance Early detection of depressive symptoms in stroke patients allows rehabilitation nurses to optimize the therapeutic effects.

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Nondysphoric Depression Following Stroke

Cited by 28 publications

References 48 publications

Social Adaptive Functioning, Apathy, and Nondysphoric Depression among Nursing Home-Dwelling Very Old Adults

Social Adaptive Functioning, Apathy, and Nondysphoric Depression among Nursing Home-Dwelling Very Old Adults

Cognitive and daily functioning in older adults with vegetative symptoms of depression

Occurrence of Depressive Symptoms Among Older Adults after a Stroke in the Nursing Home Facility

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