Journal of affective disorders
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Posttraumatic stress disorder (PTSD) is a complex psychiatric illness that can be difficult to diagnose, due in part to its comorbidity with major depressive disorder (MDD). Given that researchers have found no difference in prevalence rates of PTSD and MDD after accounting for overlapping symptoms, the latent structures of PTSD and MDD may account for the high comorbidity. In particular, the PTSD Negative Alterations in Cognition and Mood (NACM) and Hyperarousal factors have been characterized as non-specific to PTSD. Therefore, we compared the factor structures of the Diagnostic and Statistical Manual of Mental Disorders, 5thedition (DSM-5) PTSD and MDD and examined the mediating role of the PTSD NACM and Hyperarousal factors on the relationship between MDD and PTSD symptom severity. ⋯ Implications concerning the shared somatic complaints and psychological distress in the comorbidity of PTSD and MDD are discussed.
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Social anxiety disorder (SAD) and depressive symptoms often covary. Yet, uncertainty still abounds vis-à-vis the individual symptom-to-symptom associations between these two disorders. Inspired by the network approach to psychopathology that conceptualizes comorbidity as a natural consequence arising from bridge symptoms that can transmit activation from one disorder to the other, we applied network analytic methods to characterize the associations among core symptoms of SAD-i.e. fear and avoidance of social situations-and comorbid depressive symptoms among 174 individuals with DSM-IV-TR criteria for SAD. ⋯ This study adds to a small but growing empirical literature revealing that the co-occurrence between two disorders is best portrayed as sets of symptom-to-symptom connections. As some individual symptoms show differential association in the co-occurrence between SAD and depression, those symptoms may be valuable targets for future research and treatment.
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Alexithymia, not fibromyalgia, predicts the attribution of pain to anger-related facial expressions.
Fibromyalgia (FM) is a syndrome characterized by chronic, widespread musculoskeletal pain, occurring predominantly in women. Previous studies have shown that patients with FM display a pattern of selective processing or cognitive bias which fosters the encoding of pain-related information. The present study tested the hypothesis of an increased attribution of pain to facial expressions of emotions (FEE), in patients with FM. As previous studies have shown that alexithymia influences the processing of facial expressions, independent of specific clinical conditions, we also investigated whether alexithymia, rather than FM per se, influenced attribution of pain to FEE. ⋯ Alexithymia, rather than FM per se, plays a key role in explaining the observed differences in pain attribution to anger-related facial expressions.
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Randomized Controlled Trial
A randomized clinical trial of adjunctive ketamine anesthesia in electro-convulsive therapy for depression.
Electroconvulsive therapy (ECT) is a rapid acting and effective treatment for both major depressive disorder (MDD) and bipolar disorder (BP). Both propofol and ketamine are commonly used anesthetic agents but recent clinical studies suggest that ketamine has rapid-acting antidepressant properties, itself, at sub-anesthetic doses. ⋯ Ketamine plus propofol anesthesia in the ECT treatment of MDD and BP was not superior on any measure to propofol alone.
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Bipolar Disorder (BD) cannot be reliably distinguished from Major Depressive Disorder (MDD) until the first manic or hypomanic episode. Consequently, many patients with BD are treated with antidepressants without mood stabilizers, a strategy that is often ineffective and carries a risk of inducing a manic episode. We previously reported reduced cortical thickness in right precuneus, right caudal middle-frontal cortex and left inferior parietal cortex in BD compared with MDD. ⋯ Our results add to previously published data which suggest that regional gray matter volume should be investigated further as a clinical diagnostic tool to predict BD before the appearance of a manic or hypomanic episode.