Journal of affective disorders
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Research into the role of migraine in somatic symptoms of major depressive disorder (MDD) has long been neglected; hence, the aim of this study was to compare the impact of migraine and anxiety comorbidities on the somatic symptoms of patients with MDD. ⋯ Comorbidity with migraine was found to be associated with more somatic symptoms in patients with MDD, and migraine was a strong and independent predictor for the somatic symptoms of MDD. Future studies on the somatic symptoms of MDD should therefore take migraine into consideration.
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Untreated major depressive disorder (MDD) is a major risk factor for suicide, but some data suggest antidepressants may be associated with increased suicidal ideation (SI) in some depressed patients. The purpose of this study was to determine whether, and in whom, treatment of MDD is associated with increased or emergent SI. ⋯ SI and behaviors, core features of MDD, wax and wane in intensity before, during, and perhaps after treatment. It is clinically important to understand risk factors, maintain careful surveillance and treat as vigorously as necessary to attain remission.
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Bilateral electroconvulsive therapy (BLECT) is useful in affective disorders and schizophrenia. Studies on electrical dose during BLECT are sparse. The Royal College of Psychiatrists recommends the use of electrical dose at 50-100% above seizure threshold. We studied the impact of change of BLECT practice from using threshold-level to 1.5 times threshold-level electrical dose in patients with depression, mania and schizophrenia. ⋯ Patients with schizophrenia and depression treated with BLECT at 1.5 times threshold-level electrical stimulus require similar number of ECT sessions as with threshold-level. However, patients with mania show clinical improvement with significantly fewer ECT sessions if treated at suprathreshold stimulus.
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It has been suggested that antidepressants may have neuroprotective abilities but it has newer been investigated lately whether treatment with antidepressants reduces the risk of dementia. ⋯ Continued long-term antidepressant treatment was associated with a reduced rate of dementia, however, not to the same level as the rate for the general population.