Patología dual en Depresión: recomendaciones en el tratamiento

Muñoz, Judit Tirado; Farré, Adriana; Mestre-Pintó, Joan Ignasi; Szerman, Néstor; Torrens, Marta

doi:10.20882/adicciones.868

Cited by 35 publications

(34 citation statements)

References 31 publications

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“…Depression, a serious debilitating mental disease, is among the leading causes of disability leading to a high rate of suicide and economic burden and affecting up to 120 million people worldwide. 1 The current diagnosis of depression is mainly based on patient interviews and symptoms, with uncertainties as high as 30% as a consequence. 2 Thus, it is important to find an objective examination method to improve the diagnostic accuracy of depression.…”

Section: Introductionmentioning

confidence: 99%

Nesfatin-1 and cortisol: potential novel diagnostic biomarkers in moderate and severe depressive disorder

Xu¹,

Liang³

et al. 2018

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BackgroundThis study aimed to determine whether plasma nesfatin-1, cortisol, and inflammatory cytokines could be used as novel noninvasive biomarkers for the diagnosis of moderate and severe depressive disorder (MSDD).Materials and methodsA total of 70 patients with MSDD and 70 healthy subjects were assessed. Patients with MSDD were selected from Hefei Fourth People’s Hospital, Anhui Mental Health Center, and subjects in the control group were selected from healthy volunteers. Hamilton Depression Rating Scale-17 (HAMD-17) was used to evaluate the two groups. ELISA was used for the measurement of plasma nesfatin-1, cortisol, IL-6, C-reactive protein (CRP), and tumor necrosis factor-α (TNF-α) levels. The diagnostic value of plasma nesfatin-1, cortisol, IL-6, CRP, and TNF-α for MSDD was assessed.ResultsCompared to healthy controls, the HAMD-17 scores and average nesfatin-1, cortisol, IL-6, and CRP levels in patients with MSDD were significantly increased. Moreover, multivariate linear regression analysis showed that HAMD-17 score was positively associated with plasma nesfatin-1 and cortisol. Furthermore, the results of the receiver operating characteristic (ROC) curve analysis revealed an area under curve (AUC) of 0.985 with 94.3% sensitivity and 97.1% specificity of nesfatin-1, and an AUC of 0.957 with 91.4% sensitivity and 85.7% specificity of cortisol in discriminating patients with MSDD from healthy volunteers. A combined ROC analysis using nesfatin-1 and cortisol revealed an AUC of 0.993 with a sensitivity of 97.1% and a specificity of 98.6% in separating patients with MSDD from healthy volunteers.ConclusionThese results suggest that plasma nesfatin-1 and cortisol might be potential novel biomarkers for the diagnosis of MSDD.

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Section: Introductionmentioning

confidence: 99%

Nesfatin-1 and cortisol: potential novel diagnostic biomarkers in moderate and severe depressive disorder

Xu¹,

Liang³

et al. 2018

PRBM

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“…In particular, a robust prevalence (27–34%) has been reported in previous studies ( 3 , 4 ) for the co-morbidity of MDD and cocaine use disorder (CUD), in which MDD can be independent (primary MDD) or cocaine-induced (CUD-induced MDD). In this context, the distinction between independent and CUD-induced MDD might be crucial to improve treatment strategy and outcomes ( 5 ). To date, the diagnosis is based on clinical criteria [using DSM-5 ( 6 ) or ICD-10 ( 7 )] and there is a need for specific biomarkers to facilitate the differentiation between primary MDD and CUD-induced MDD to improve diagnosis and clinical management.…”

Section: Introductionmentioning

confidence: 99%

A Biomarker to Differentiate between Primary and Cocaine-Induced Major Depression in Cocaine Use Disorder: The Role of Platelet IRAS/Nischarin (I1-Imidazoline Receptor)

et al. 2017

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The association of cocaine use disorder (CUD) and comorbid major depressive disorder (MDD; CUD/MDD) is characterized by high prevalence and poor treatment outcomes. CUD/MDD may be primary (primary MDD) or cocaine-induced (CUD-induced MDD). Specific biomarkers are needed to improve diagnoses and therapeutic approaches in this dual pathology. Platelet biomarkers [5-HT2A receptor and imidazoline receptor antisera selected (IRAS)/nischarin] were assessed by Western blot in subjects with CUD and primary MDD (n = 16) or CUD-induced MDD (n = 9; antidepressant free, AD−; antidepressant treated, AD+) and controls (n = 10) at basal level and/or after acute tryptophan depletion (ATD). Basal platelet 5-HT2A receptor (monomer) was reduced in comorbid CUD/MDD subjects (all patients: 43%) compared to healthy controls, and this down-regulation was independent of AD medication (decreases in AD−: 47%, and in AD+: 40%). No basal differences were found for IRAS/nischarin contents in AD+ and AD− comorbid CUD/MDD subjects. The comparison of IRAS/nischarin in the different subject groups during/after ATD showed opposite modulations (i.e., increases and decreases) in response to low plasma tryptophan levels with significant differences discriminating between the subgroups of CUD with primary MDD and CUD-induced MDD. These specific alterations suggested that platelet IRAS/nischarin might be useful as a biomarker to discriminate between primary and CUD-induced MDD in this dual pathology.

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“…Hasta la fecha, se ha resaltado la importancia de distinguir entre depresión primaria e inducida en pacientes con trastorno por uso de sustancias y, entre los fármacos antidepresivos, únicamente la desipramina ha mostrado eficacia en la mejora de los síntomas depresivos en consumidores de cocaína. (Tirado-Muñoz, Farré, Mestre-Pintó, Szerman y Torrens, 2018).…”

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“…Cada vez hay más investigaciones que describen las diferencias y la relevancia clínica entre la depresión primaria y la inducida en poblaciones con trastorno por uso de sustancias (TUS). En términos generales, las personas con TUS y depresión inducida consumen más (Cohn et al, 2011;Davis et al, 2008) y tienen peor pronóstico (Magidson et al, 2013;Tirado-Muñoz et al, 2018). Además, dichos pacientes presentan más trastornos y riesgo de suicidio (Conner et al, 2014), mayor número de ingresos hospitalarios, y una mayor cantidad de fármacos prescritos a lo largo de la vida (Schuckit et al, 1997).…”

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“…Leventhal, Mooney, De-Laune y Schmitz (2006) hallaron que los pacientes con TCC y TDM-P informan más frecuentemente de deterioro afectivo que los pacientes con TDM-IC. Por tanto, es esencial diferenciar entre ambos tipos de episodios debido a las implicaciones que tiene tanto en el pronóstico como en el tratamiento y las adaptaciones que se deben llevar a cabo en consecuencia (Foulds et al, 2015;Tirado-Muñoz et al, 2018). La prevalencia de cada tipo de episodio depresivo no está clara.…”

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Trastorno por uso de cocaína y depresión: Cuando el diagnóstico clínico no es suficiente

et al. 2020

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Antecedentes: El consumo de cocaína es un creciente problema de salud en todo el mundo. Además, los pacientes con trastorno por consumo de cocaína (TCC) presentan una alta comorbilidad con el trastorno depresivo mayor (TDM). Estos pacientes pueden presentar dos tipos de TDM: trastorno depresivo mayor primario (TDM-P) y trastorno depresivo mayor inducido por cocaína (TDM-IC). El objetivo de este estudio es evaluar las diferencias en la sintomatología depresiva (TDM-P vs. TDM-IC) en los pacientes con TCC para mejorar su tratamiento. Métodos: Se llevó a cabo un análisis secundario en una muestra transversal de 160 pacientes que presentaban TCC y algún TDM. La evaluación clínica, así como el diagnóstico diferencial entre TDM-P y TDM-IC, se realizó utilizando la entrevista PRISM. Resultados: Los hombres representaron el 80% de la muestra con una edad media de 38,61 años y el 64,5% sólo tenía estudios primarios. El diagnóstico de TDM-IC (61,3%) fue más frecuente que el de TDM-P (38,7%). Los pacientes con TDM-IC mostraron una edad de aparición más temprana para el TCC. El 79,4% de los pacientes cumplían criterios para otro trastorno por consumo de sustancias. Únicamente el criterio "Cambios en el peso o en el apetito" fue estadísticamente más prevalente (57,1%) en los pacientes con TDM-P.Conclusiones: Existen diferencias en el criterio "Cambios en el peso o en el apetito" entre TDM-P y TDM-IC. Se necesita más investigación a fin de obtener un diagnóstico diferencial entre los dos tipos de depresión y proporcionar un mejor tratamiento para los pacientes con TCC. Palabras clave: Patología dual; Trastorno por uso de cocaína; Trastornos relacionados con el uso de cocaína; Trastorno depresivo; Trastorno depresivo inducido. Background: Cocaine use is a growing global health problem and patients with cocaine use disorders (CUD) present several complications, including high rates of major depression. These subjects present two types of major depressive disorder (MDD): primary major depressive disorder (P-MDD) and cocaine-induced major depressive disorder (CI-MDD). To improve treatment, it is necessary to distinguish between both types. The aim of this study was to assess the differences in depressive symptomatology criteria (P-MDD vs CI-MDD) in CUD patients. Methods: Secondary data analysis was carried out with a cross-sectional sample of 160 patients presenting CUD and MDD. Clinical assessment was performed using the Psychiatric Research Interview for Substance and Mental Disorders (PRISM). A differential diagnosis was obtained between P-MDD and CI-MDD. Results: Menrepresented 80% of the sample, the mean age was 38.61 years, and 64.5% had elementary studies. CI-MDD diagnosis (61.3%) was more frequent than P-MDD (38.7%). There was a younger age of CUD onset in CI-MDD patients. In addition, 79.4% of the patients had another substance use disorder diagnosis. The criterion "Changes in weight or appetite" was more prevalent (57.1%) in P-MDD group. Conclusions:We found differences in the criterion "Changes in weight or appetite".Fur...

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Patología dual en Depresión: recomendaciones en el tratamiento

Cited by 35 publications

References 31 publications

Nesfatin-1 and cortisol: potential novel diagnostic biomarkers in moderate and severe depressive disorder

Nesfatin-1 and cortisol: potential novel diagnostic biomarkers in moderate and severe depressive disorder

A Biomarker to Differentiate between Primary and Cocaine-Induced Major Depression in Cocaine Use Disorder: The Role of Platelet IRAS/Nischarin (I1-Imidazoline Receptor)

Trastorno por uso de cocaína y depresión: Cuando el diagnóstico clínico no es suficiente

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