Annabelle M. Mournet , Alexander J. Millner , Evan M. Kleiman
{"title":"Characteristics of self-harm on an adolescent psychiatric inpatient unit based on neurodevelopmental diagnoses","authors":"Annabelle M. Mournet , Alexander J. Millner , Evan M. Kleiman","doi":"10.1016/j.jadr.2024.100796","DOIUrl":"https://doi.org/10.1016/j.jadr.2024.100796","url":null,"abstract":"<div><h3>Introduction</h3><p>Engagement in self-harm is common among youth in psychiatric inpatient units, however the nature of self-harm may be different in psychiatric care due to the increased supervision and theoretically decreased access to typical means of self-harm. This study aims to describe daily reports of self-harm experienced during psychiatric inpatient stays among adolescents and compare these inpatient self-harm experiences based on neurodevelopmental diagnoses (NDDs, including autism) given that self-harm methods differ across NDD diagnostic groups outside of the inpatient unit.</p></div><div><h3>Methods</h3><p>Data were derived from a larger study of risk factors among a sample of 119 suicidal adolescent inpatients, recruited from a large, urban adolescent inpatient psychiatric unit. Participants answered a daily series of self-report questions, including items about self-harm engagement, frequency, and methods used since the last survey.</p></div><div><h3>Results</h3><p>There was no difference in the number of participants who reported any engagement in self-harm based on diagnostic group (χ<sup>2</sup> = 0.08, <em>p</em> = .96). There were also no differences in the frequency of self-harm across diagnostic groups (<em>F</em> = 2.40, <em>p</em> = .12). There were no differences in the use of any method across diagnostic groups (<em>p</em>s > 0.05).</p></div><div><h3>Conclusions</h3><p>Findings revealed that in an inpatient unit where patients are presenting for self-harm risk, there are no significant differences in engagement, frequency, or methods used for self-harm based on autism and NDD status. These analyses provide valuable clinical information regarding a lack of differences in self-harm by these diagnostic subgroups. Future research should seek to further explore functional purposes of self-harm on inpatient unit and how this differs by diagnoses.</p></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"17 ","pages":"Article 100796"},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666915324000829/pdfft?md5=07b1cf5b61d02ea05445cdbfb5709bd6&pid=1-s2.0-S2666915324000829-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140650295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kyu-Hyoung Jeong , Seoyoon Lee , Chungyun Kim , Jung-Hu Im , Hyeju Jung
{"title":"Patterns of depression among women post-divorce and the influential factors: Latent growth modeling","authors":"Kyu-Hyoung Jeong , Seoyoon Lee , Chungyun Kim , Jung-Hu Im , Hyeju Jung","doi":"10.1016/j.jadr.2024.100789","DOIUrl":"https://doi.org/10.1016/j.jadr.2024.100789","url":null,"abstract":"<div><h3>Objectives</h3><p>The purpose of this study is to longitudinally examine the change in depressive symptoms immediately following divorce among Korean women during the COVID-19 outbreak, as well as to verify the factors affecting the change in depressive symptoms.</p></div><div><h3>Methods</h3><p>A total of 401 women from the Korean Longitudinal Survey of Women & Families(KLoWF) were analyzed between 2012(4th wave) and 2020(8th wave). Latent Growth Modeling is utilized to assess the overall trajectory of depressive symptoms in women following divorce.</p></div><div><h3>Results</h3><p>In the immediate aftermath of divorce, the level of depressive symptoms in divorced women was high, but gradually decreased over time, only to reappear later on. The factors impacting the initial depressive symptom levels among women post-divorce revealed that lower educational attainment, lower subjective economic status, and poorer subjective health status were associated with higher depressive symptom levels. Among the factors influencing the rate of change in depressive symptoms, living alone emerged as the only statistically significant factor. The depressive symptom levels of women living alone declined gradually, whereas the depressive symptom levels of women living with someone decreased more rapidly.</p></div><div><h3>Conclusion</h3><p>As a result of this study, valuable data can be used to develop practical interventions aimed at enhancing the mental well-being of women post-divorce, particularly during challenging circumstances such as the COVID-19 outbreak.</p></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"17 ","pages":"Article 100789"},"PeriodicalIF":0.0,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666915324000751/pdfft?md5=c4ecca2bc1d5145f66df9e6cff531510&pid=1-s2.0-S2666915324000751-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140647230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Problem orientation as a moderator of the relation between discrimination and passive suicidal ideation","authors":"Roberto López Jr. , Christianne Esposito-Smythers","doi":"10.1016/j.jadr.2024.100792","DOIUrl":"https://doi.org/10.1016/j.jadr.2024.100792","url":null,"abstract":"<div><h3>Background</h3><p>Passive suicidal ideation (i.e., the desire to be dead) may be an important, yet understudied, risk factor for suicidal behavior. Experiences of discrimination have been linked to greater severity of suicidal ideation though less work has examined factors that influence this relation. Though not explicitly tested, prior work suggests that problem orientation, defined as an individual's general beliefs about problems in daily life, may be an important moderator of this relation. In the present study, positive and negative problem orientation were hypothesized to moderate the relation between everyday discrimination and past month frequency of passive suicidal ideation.</p></div><div><h3>Method</h3><p>The study consisted of a diverse (62.4 % non-White; 21.4 % Latino/a/x; 27 % sexual minority) adult sample (<em>N</em> = 392; <em>M</em><sub>age</sub> = 20.24, <em>SD</em> = 2.49, 67.3 % female) recruited from a U.S. Mid-Atlantic college campus. Discrimination, problem orientation, past-month depressive symptoms, and past-month frequency of passive suicidal ideation were assessed using self-report measures. A single path model with Bayesian estimation was used to evaluate concurrent relations among study variables.</p></div><div><h3>Results</h3><p>After controlling for depressive symptoms, sex, sexual identity, and age, positive problem orientation buffered the impact of lifetime discrimination on past month passive suicidal ideation (<em>b</em> = -0.01, 95 % credibility interval [CI]: [-0.008, -0.001]). Negative problem orientation did not moderate this relation (<em>b</em> = 0.00, 95 % CI: [-0.002, 0.003]).</p></div><div><h3>Limitations</h3><p>Study design was cross-sectional in nature.</p></div><div><h3>Conclusions</h3><p>Results suggest that bolstering positive problem orientation in treatment with young adults who have experienced discrimination may help reduce suicide risk.</p></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"17 ","pages":"Article 100792"},"PeriodicalIF":0.0,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666915324000787/pdfft?md5=01cd3ca7b7d59ed87fdb6b591d9d9ea7&pid=1-s2.0-S2666915324000787-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140646149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kyu-Hyoung Jeong , Sunghee Kim , Seoyoon Lee , Eun Jee Chang
{"title":"A study of depression dynamics and contributing factors among individuals with disabilities pre and post-COVID-19","authors":"Kyu-Hyoung Jeong , Sunghee Kim , Seoyoon Lee , Eun Jee Chang","doi":"10.1016/j.jadr.2024.100793","DOIUrl":"10.1016/j.jadr.2024.100793","url":null,"abstract":"<div><p>The purpose of this study is to investigate the trajectory of depression over time among all registered individuals with disability, including the period since the onset of COVID-19. In this study, we analyzed the results of the 12th-16th Korea Welfare Panel Study(KoWePS) which was conducted from 2017 to 2021. 793 individuals who were able to estimate the change in depression all period were selected for the final analysis. There was a significant increase in depression among people with disabilities occurs over time, and the level of depression rose gradually. Individuals being women, the lower the household income, the more severe the disability, and not having a physical disability was associated with the likelihood of higher depression. The health care system needs to be improved to be more disability-friendly to promote the health of people with disability, who are relatively more vulnerable during an infectious disease pandemic, such as COVID-19.</p></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"17 ","pages":"Article 100793"},"PeriodicalIF":0.0,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666915324000799/pdfft?md5=81ca5146b073249eca33f8ec3a212a8d&pid=1-s2.0-S2666915324000799-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140796849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Non-prescribed Ritalin use among medical students and its association with depression: A study in Iran","authors":"Roya Vaziri-harami , Saharnaz Vaziri-harami , Yasin Firouzi Laktarashani","doi":"10.1016/j.jadr.2024.100790","DOIUrl":"https://doi.org/10.1016/j.jadr.2024.100790","url":null,"abstract":"<div><h3>Background</h3><p>Methylphenidate, a nervous system stimulant, is the active ingredient in the brand-name medication Ritalin. The non-medical consumption of this drug is on the rise worldwide, particularly among medical students who belong to an at-risk group. However, misusing this drug can have adverse effects such as depression. In this study, we sought to evaluate the relationship between arbitrary use of Ritalin and the incidence of depression and explore associated factors.</p></div><div><h3>Methods</h3><p>In this descriptive cross-sectional study, we examined 100 medical students enrolled at (XXX) Medical School (XXX) who reported taking at least one dose of Ritalin in the past month. We gathered participant data, including demographics such as age, education, residence status, history of psychiatric illness, and history of psychiatric medication use. Additionally, we collected information related to depression and anxiety using a questionnaire design based on the Hamilton scoring system in which a score range of 10–13 indicates mild depression, a score range of 14–17 signifies mild to moderate depression, and a score exceeding 17 indicates moderate to severe depression.</p></div><div><h3>Results</h3><p>Several noteworthy findings emerged from our study. We observed that the average age of female (26.45 ± 4.55, <em>n</em> = 39) participants was significantly higher than that of their male (24.26 ± 3.71, <em>n</em> = 61) counterparts (<em>p</em> = 0.01). Moreover, the average final depression score for students was determined to be 18.19, with a median score of 16. The data analysis revealed that 45% of students exhibited moderate to severe depression, whereas 55% experienced either no depression or only mild symptoms.</p></div><div><h3>Conclusions</h3><p>Our study indicates that depression is indeed a significant side effect of Ritalin use among medical students.</p></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"17 ","pages":"Article 100790"},"PeriodicalIF":0.0,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666915324000763/pdfft?md5=b07098a5efed3d5d50172f61d9736b76&pid=1-s2.0-S2666915324000763-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140650296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J.M. Bessa , G. Cotovio , O. Doellinger , J. Freitas , E. Lara , A. Matos Pires , M. Serra , G. Martins de Amorim , A. Filipa Pereira , A.J. Oliveira-Maia
{"title":"Real-world evidence from a European cohort study of patients with treatment resistant depression: Country-specific data for Portugal","authors":"J.M. Bessa , G. Cotovio , O. Doellinger , J. Freitas , E. Lara , A. Matos Pires , M. Serra , G. Martins de Amorim , A. Filipa Pereira , A.J. Oliveira-Maia","doi":"10.1016/j.jadr.2024.100791","DOIUrl":"https://doi.org/10.1016/j.jadr.2024.100791","url":null,"abstract":"<div><h3>Background</h3><p>Treatment resistant depression (TRD; failure to respond to ≥2 treatments in the same major depressive episode) affects 10–30 % of patients with major depressive disorder. In Portugal, the disease burden is estimated to exceed that of heart failure, highlighting the critical unmet needs of these patients.</p></div><div><h3>Methods</h3><p>A non-interventional cohort study of patients with TRD collected real-world data from several European countries. All patients started a new antidepressant treatment at baseline. We present a sub-analysis of baseline characteristics and Month 6 treatment outcomes in Portuguese patients.</p></div><div><h3>Results</h3><p>Among 411 patients enrolled, 37 were Portuguese. At baseline, 45.9 % of Portuguese patients had severe depression versus 32.6 % of the total study population. Portuguese patients had numerically greater impairments in work and productivity, measured by the Work Productivity and Activity Impairment questionnaire and the Sheehan Disability Scale. There was considerable heterogeneity in treatments used in the Portuguese subgroup, with 31 different treatment strategies reported. At Month 6, a greater proportion of Portuguese patients (<em>n</em> = 27) achieved either response or remission (40.7 %) compared with the total study population (<em>n</em> = 306; 26.5 %).</p></div><div><h3>Limitation</h3><p>Small patient numbers in the Portuguese subgroup.</p></div><div><h3>Conclusions</h3><p>The higher baseline disease severity and productivity impairment in the Portuguese subgroup relative to the total study population suggests notable societal disease burden, whilst the heterogeneity of treatments used indicates a lack of clinical consensus. Despite Portuguese patients reporting higher rates of response and remission than the overall study population, most patients failed to respond to treatment, highlighting an unmet need for TRD in Portugal.</p></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"17 ","pages":"Article 100791"},"PeriodicalIF":0.0,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666915324000775/pdfft?md5=f3041adff91d566232674e036dd9702b&pid=1-s2.0-S2666915324000775-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140650294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Problematic sexual behaviours, dissociation, and adult attachment: A path analysis model","authors":"Alessio Gori , Eleonora Topino","doi":"10.1016/j.jadr.2024.100786","DOIUrl":"https://doi.org/10.1016/j.jadr.2024.100786","url":null,"abstract":"<div><h3>Background</h3><p>Problematic sexual behaviours are controversial phenomena, lacking diagnostic consensus, yet they are significant and warrant in-depth scientific research due to their clinically significant consequences. Therefore, this study aimed to explore the association between potential risk factors of sex addiction and problematic online pornography use, with a specific focus on the role of attachment and dissociation.</p></div><div><h3>Method</h3><p>A sample of 375 participants (<em>M<sub>age</sub></em> = 30 years; <em>SD</em> = 12.441) was involved in the research. The collected data were analysed by implementing a path analysis model.</p></div><div><h3>Results</h3><p>Significant and positive total effects in the relationships between fearful/preoccupied attachment patterns and both sex addiction and problematic online pornography use were shown. Furthermore, these associations were significantly mediated by dissociation. Finally, sex addiction and problematic online pornography use were significantly associated with daily thoughts about sex and weekly online pornography use, respectively.</p></div><div><h3>Limitations</h3><p>The cross-sectional design and the use of only self-report measures in an online survey should be kept in mind while interpreting the results.</p></div><div><h3>Conclusions</h3><p>Such data provide useful insight into the complex interplay of attachment, dissociation, and problematic sexual behaviours, providing information that may inform and guide targeted clinical interventions.</p></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"17 ","pages":"Article 100786"},"PeriodicalIF":0.0,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666915324000726/pdfft?md5=0c373f34f7fdf147882e97a1882acef5&pid=1-s2.0-S2666915324000726-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140641102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Trait dimensions of anticipatory and consummatory reward relate differently to self-injurious thoughts and behaviors in a community adult sample","authors":"Wendy Huerta , Nadia Bounoua , Naomi Sadeh","doi":"10.1016/j.jadr.2024.100788","DOIUrl":"https://doi.org/10.1016/j.jadr.2024.100788","url":null,"abstract":"<div><h3>Background</h3><p>Self-injurious thoughts and behaviors (SITBs) are a major problem worldwide and continue to be a serious public health concern. Research investigating risk factors for suicide has shown that reward processes, such as the inability to feel pleasure, may confer risk for SITBs. However, less work has examined how different dimensions of trait reward relate to SITBs. Accordingly, the present study investigated the unique and interactive effects of trait anticipatory and consummatory reward for explaining SITBs.</p></div><div><h3>Methods</h3><p>260 community adults ages 18–55 (<em>M/SD</em> = 32.79/10.54, females = 49.6 %, males = 50.4 %) completed an interview, neuropsychological tests, and questionnaires. We used hierarchical multivariate multiple regression analysis to assess cross-sectional associations between trait anticipatory and consummatory reward and different types of SITBs [self-injurious thoughts, nonsuicidal self-injury (NSSI), and suicide attempts] from the <em>Risky, Impulsive, and Self-destructive Behavior Questionnaire</em>.</p></div><div><h3>Results</h3><p>The unique variance associated with anticipatory and consummatory reward were differentially related to self-injurious thoughts but unrelated to self-injurious behaviors (NSSI/suicide attempts). The interaction of anticipatory and consummatory reward was associated with self-injurious behavior, such that the inability to experience both anticipatory and consummatory reward was associated with higher frequency of NSSI.</p></div><div><h3>Limitations</h3><p>Limitations of the study include its cross-sectional nature and reliance on self-reported measures.</p></div><div><h3>Conclusions</h3><p>Low anticipatory reward and high consummatory reward may confer risk for self-injurious thoughts. Low levels of both trait anticipatory and consummatory reward may confer risk for NSSI. Findings suggest reward sensitivity may be an understudied risk factor for a range of SITBs.</p></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"17 ","pages":"Article 100788"},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266691532400074X/pdfft?md5=6d78dd807e64558d77d4f764636b5840&pid=1-s2.0-S266691532400074X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140650293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pietro Carmellini, Alessandro Cuomo, Andrea Fagiolini
{"title":"Efficacy of topiramate in treating obsessive compulsive disorder: A systematic review and meta-analysis","authors":"Pietro Carmellini, Alessandro Cuomo, Andrea Fagiolini","doi":"10.1016/j.jadr.2024.100787","DOIUrl":"https://doi.org/10.1016/j.jadr.2024.100787","url":null,"abstract":"<div><h3>Background</h3><p>This systematic review and meta-analysis aimed to synthesize the evidence of efficacy and tolerability of adjunctive topiramate treatment for patients with obsessive-compulsive disorder.</p></div><div><h3>Methods</h3><p>A systematic search was conducted on MEDLINE, Cochrane Central Register of Controlled Trials, and OpenGrey to identify randomized controlled trials assigning participants with OCD to pharmacological intervention with topiramate. Study inclusion and data extraction were undertaken by two reviewers independently. The primary outcome was the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scale score, as a continuous variable within-subject OCD illness severity before and after treatment. The weighted mean difference (WMD) with 95 % confidence interval was calculated between the topiramate group and the control group.</p></div><div><h3>Results</h3><p>Five studies were selected for inclusion in the systematic review, 4 of which were also included in the quantitative synthesis of data. The WMD in the Y-BOCS score between topiramate and placebo subjects was -0.49 (-2.28, 1.30) (<em>p</em> = 0.00); The results show a trend towards an effect of topiramate, but the estimate was not significant. Subgroup analysis revealed a significant effect at 12 weeks but not at 16 weeks (<em>p</em> = 0.00).</p></div><div><h3>Limitations</h3><p>Low quality of the studies included and small sample size.</p></div><div><h3>Conclusion</h3><p>There is a small positive signal for an anti-obsessive/compulsive effect in OCD patients which should encourage further research with larger, randomized, and placebo-controlled trials to assess topiramate's potential role in OCD treatment comprehensively.</p></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"17 ","pages":"Article 100787"},"PeriodicalIF":0.0,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666915324000738/pdfft?md5=e8de762d28263aaf508ffadb41977e90&pid=1-s2.0-S2666915324000738-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140647231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aubrey Bornhoff, Edward B. Davis, Jonathon Yousey, Cynthia Neal Kimball, Emily Stier, Emily Wang
{"title":"Patient and provider perspectives on the phenomenon and effective treatment of treatment-resistant depression: A grounded theory","authors":"Aubrey Bornhoff, Edward B. Davis, Jonathon Yousey, Cynthia Neal Kimball, Emily Stier, Emily Wang","doi":"10.1016/j.jadr.2024.100779","DOIUrl":"https://doi.org/10.1016/j.jadr.2024.100779","url":null,"abstract":"<div><h3>Background</h3><p>Treatment-Resistant Depression (TRD) is a poorly understood but prevalent clinical phenomenon that lacks a widely accepted definition, explanatory model, or set of practice recommendations. It involves a chronic form of unipolar Major Depressive Disorder (MDD) that fails to respond to at least two first-line clinical treatments. TRD affects as many as 70 % of patients who fail to respond to their first trial of antidepressant medication and 60 % of patients who fail to respond to their first phase of psychotherapy.</p></div><div><h3>Purpose</h3><p>This qualitative study aims to develop a model for understanding the phenomenon of unipolar TRD and the practices involved in its effective treatment.</p></div><div><h3>Methods</h3><p>This study involved a grounded theory analysis of interviews with four adult-American patients with unipolar TRD and five American providers who routinely treat such patients.</p></div><div><h3>Results</h3><p>A model of unipolar TRD was developed, explaining common etiological and maintaining factors of unipolar TRD and offering recommendations for guiding effective treatment.</p></div><div><h3>Limitations</h3><p>This study had a small sample size (<em>N</em> = 9) with limited sociodemographic diversity (all Americans; only two females; one racial/ethnic minority; no sexual minorities), which may limit its generalizability.</p></div><div><h3>Conclusions</h3><p>Nevertheless, its emergent theory underscores the importance of TRD patients cultivating positive views of medication and psychotherapy while collaborating with their providers to obtain psychoeducation, build mindfulness/coping skills, enhance social support, and re-engage with pleasurable activities. It recommends that mental health providers focus on processing TRD patients’ subjective experiences, validating patients’ frustrations, and monitoring and calibrating patients’ expectations.</p></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"16 ","pages":"Article 100779"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666915324000659/pdfft?md5=5a7030f4e77e54181cd5767bc21d7f11&pid=1-s2.0-S2666915324000659-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140344426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}