Clinical Correlates and Outcome of Major Depressive Disorder and Comorbid Migraine: A Report of the European Group for the Study of Resistant Depression

Background: The present multicenter study aimed at defining the clinical profile of patients with major depressive disorder (MDD) and comorbid migraine. Methods: Demographic and clinical information for 1410 MDD patients with vs without concurrent migraine were compared by descriptive statistics, analyses of covariance, and binary logistic regression analyses. Results: The point prevalence rate for comorbid migraine was 13.5% for female and 6.2% for male patients. MDD + migraine patients were significantly younger, heavier, more likely female, of non-Caucasian origin, outpatient, and suffering from asthma. The presence of MDD + migraine resulted in a significantly higher functional disability. First-line antidepressant treatment strategy revealed a trend towards agomelatine. Second-generation antipsychotics were significantly less often administered for augmentation treatment in migraineurs. Overall, MDD + migraine patients tended to respond worse to their pharmacotherapy. Conclusion: Treatment guidelines for comorbid depression and migraine are warranted to ensure optimal efficacy and avoid possible pitfalls in psychopharmacotherapy, including serotonin syndrome

Sex-related effects in major depressive disorder: Results of the European Group for the Study of Resistant Depression

Background: Sex-related effects on the evolution and phenotype of major depressive disorder (MDD) were reported previously. Methods: This European multicenter cross-sectional study compared sociodemographic, clinical, and treatment patterns between males and females in a real-world sample of 1410 in- and outpatients with current MDD. Results: Male MDD patients (33.1%) were rather inpatients, suffered from moderate to high suicidality levels, received noradrenergic and specific serotonergic antidepressants (ADs) as first-line AD treatment, generally higher mean AD daily doses, and showed a trend towards a more frequent administration of add-on treatments. Female MDD patients (66.9%) were rather outpatients, experienced lower suicidality levels, comorbid thyroid dysfunction, migraine, asthma, and a trend towards earlier disease onset. Conclusions: The identified divergencies may contribute to the concept of male and female depressive syndromes and serve as predictors of disease severity and course, as they reflect phenomena that were repeatedly related to treatment-resistant depression (TRD). Especially the greater necessity of inpatient treatment and more complex psychopharmacotherapy in men may reflect increased therapeutic efforts undertaken to treat suicidality and to avoid TRD. Hence, considering sex may guide the diagnostic and treatment processes towards targeting challenging clinical manifestations including comorbidities and suicidality, and prevention of TRD and chronicity

Kwentong Pambata: Interactive Storybook for Filipino Fables, Legends, Parables and Short Stories

This paper focused on the development and evaluation of a mobile application in which children could interact, be entertained, and especially be educated at the same time. It was mainly designed for children, parents/guardians, and teachers as well. The interactive storybook which was created was different from those available in the market.  Kwentong Pambata is a children’s storybook application designed for Android devices that features Filipino legends, fables, parables and short stories designed for Filipino children and children all over the world. It portrays Filipino values, traditions and character which contains moral lesson at the end of each story that would educate children’s view in life, their characters, moral uprightness, and values. It is a storybook which contains fun pictures, texts, and sounds that kids will truly enjoy. The goal of the study is to develop an Android application that children could interact, learn, read, be entertained, improve and develop children’s imagination and comprehension skills at an early age, and to promote Filipino stories and moral values. Kwentong Pambata application was developed using ActionScript 3.0. and Adobe Flash CS5.5. The application has 3 different language translations such as Filipino, English, and Mandarin. The proponents used ADDIE model for the development of the application. After the development, the application was evaluated. The total number of 40 respondents which were selected through probability sampling is used for the evaluation process. The application was evaluated according to its Usability, Reliability, Efficiency and Graphical User Interface (GUI).  The evaluation questionnaire showed that the application was rated as very satisfactory with the help of the respondents and was improved throughout its revisions

Add-on benzodiazepine treatment in patients with major depressive disorder \u2013 results from a European cross-sectional multicenter study

Since many patients with major depressive disorder (MDD) do not satisfactorily respond to initial antidepressant monotherapy, add-on treatment strategies with other psychiatric compounds are often established. The present European multicenter cross-sectional study comprising 1410 MDD in- and outpatients investigated the prescription pattern of benzodiazepines as add-on treatment in the psychopharmacotherapy of MDD. Analyses of variance, chi-squared tests, and logistic regression analyses were conducted to examine differences in socio-demographic, clinical, and treatment characteristics between benzodiazepine users and non-users. The prescription rate for adjunctive benzodiazepine treatment amounted to 31.35%. The most often administered benzodiazepines were lorazepam (11.13%), clonazepam (6.74%), and alprazolam (6.60%). Benzodiazepine users exhibited more severe depressive symptoms expressed by a higher mean Montgomery and \uc5sberg Depression Rating Scale total score at study entry (26.92 \ub1 11.07 vs 23.55 \ub1 11.23, p<.0001) and at the beginning of the current major depressive episode (35.74 \ub1 8.08 vs 33.31 \ub1 7.40, p<.0001). Furthermore, they were characterized by a higher proportion of patients receiving additional augmentation/combination medications with antidepressants (40.95% vs 24.28%, p<.0001), antipsychotics (41.63% vs 18.39%, p<.0001), and low-potency antipsychotics (10.18% vs 4.75%, p<.0001). Moreover, benzodiazepine prescription was associated with older age, unemployment, inpatient treatment, suicide risk, psychotic and melancholic features, comorbid panic disorder, agoraphobia, social phobia, and obsessive-compulsive disorder. Taken together, our findings indicate that benzodiazepine augmentation in MDD is first of all established in severe/difficult-to-treat conditions and serves as predictor for the use of additional augmentation/combination treatment strategies