Seasonality in atypical depression

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/30092/1/0000464.pd

Electroconvulsive therapy in delusional and non-delusional depressive disorder

Major depressive disorder (MDD) patients (n=66) treated with electroconvulsive therapy were stratified by the presence (n=30) or absence (n=36) of delusional symptoms (by Research Diagnostic Criteria) to compare their response to treatment. At discharge from hospital 83% of the MDD with psychosis group and 58% of the MDD without psychosis group were good responders (P=0.03). The implications of this are discussed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/28498/1/0000295.pd

Effect of hyperventilation on seizure length during electroconvulsive therapy

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/28660/1/0000477.pd

Seasonal symptom variation in patients with chronic fatigue: Comparison with major mood disorders

The psychobiology of idiopathic fatigue has received renewed interest in the medical literature in recent years. In order to examine the relation between chronic, idiopathic fatigue and specific subtypes of depressive illness, we characterized the pattern and severity of seasonal symptom variation in 73 patients with chronic, idiopathic fatigue, compared to patients with major depression (n = 55), a typical depression (n = 35), and seasonal affective disorder (n = 16). Fifty of the fatigued subjects also met the specific Centers for Disease Control and Prevention case criteria for chronic fatigue syndrome, though this definition was unable to discriminate a distinct subgroup of patients, based on their seasonality scores alone. As a group, the fatigued subjects reported the lowest levels of symptom seasonality of any of the study groups. Further, even in those fatigued subjects with scores in the range of those seen in patients with seasonal affective disorder, seasonality was not reported to be a subjectively distressing problem. These findings lend support to the idea that although chronic fatigue shares some clinical features with certain mood disorders, they are not the same illnesses. These data are also consistent with the emerging view that chronic fatigue represents a heterogeneously determined clinical condition.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/31850/1/0000799.pd

Shortened REM latency PostECT is associated with rapid recurrence of depressive symptomatology

Electroconvulsive therapy (ECT) is highly effective in the treatment of major depressive disorder (MDD). The 1-year relapse rates are reported to be high and in the 30%-60% range, however. To test whether polysomnography (PS) can identify patients with a propensity for relapse we studied 20 patients, responders to a course of ECT, with PS studies. All patients met baseline diagnostic criteria for MDD, were treated with ECT following standardized protocols, had PS studies performed after the course of ECT in a medication-free state, received maintenance antidepressants postECT, and were followed periodically with phone interviews. The recurrence of depressive symptoms was determined at 3 months and 6 months after discharge. Fifty-five percent of the patients were symptomatic when evaluated 6 months after the ECT. Sleep Onset rapid eye movement (REM) periods were identified in 55% of the patients. As a group, patients who had experienced a recurrence of depressive symptoms by 6 months after discharge, had significantly shorter REM latencies after the course of ECT. A shorter REM latency after ECT identified patients who at six months demonstrated significant depressive symptomatology. Shortened REM latency after ECT in patients with MDD appears to be a correlate of vulnerability for relapse.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/31388/1/0000302.pd

Monitoring of antidepressant response to ECT with polysomnographic recordings and the dexamethasone suppression test

Ten patients treated with electroconvulsive therapy (ECT) only were followed with serial sleep polysomnographic recordings and dexamethasone suppression tests (DSTs). Both biological correlates of depression showed improvement with ECT. The use of serial sleep measures and serial DSTs in monitoring the clinical response to ECT is discussed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/27310/1/0000331.pd

Noradrenergic response to intravenous yohimbine in patients with depression and comorbidity of depression and panic

Adrenergic response following infusions of yohimbine or normal saline was evaluated in 9 control subjects, 8 patients suffering from a major depressive episode (MDE), and 12 patients suffering from concurrent MDE and panic disorder (MDE+P). Blood was drawn at -20, 0, 5, 10, 20, 45, and 90 min following the infusions, and assayed for norepinephrine (NE) and 3-methoxy-4-hydroxy-phenyl glycol (MHPG). Although the patient groups exhibited higher baseline NF concentrations, and a greater NE area under the plasma concentration versus time curve (AUC0-90) during the yohimbine infusion, the differences were not statistically significant. Baseline NE was significantly correlated with the NE AUC0-90 in all three groups, suggesting that, although the NE system may be dysregulated in the MDE and MDE+P patients, the NE system still appears to respond somewhat predictably following a challenge, even though the actual magnitude of response may vary.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/30516/1/0000146.pd

Predictors of response to electroconvulsive therapy in major depressive disorder,

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/27302/1/0000323.pd