Clinical effectiveness of the electrodermal orienting reactivity test for evaluating relapse and recurrence risk in patients hospitalized for depression

BackgroundRecurrence is a problem for many patients who have episodes of depression. In experimental settings, hyporeactivity in the Electrodermal Orienting Reactivity (EDOR) test has been observed to be more frequent in these patients. The aim of this study was to investigate the clinical value of this test with regard to a prognosis of episode recurrence in patients hospitalized for depression.MethodsThe study was performed using a cohort design at a specialized psychiatric clinic in Warsaw, Poland. The primary endpoint measure was relapse or recurrence of depression. Data on electrodermal reactivity measured by the EDOR test, clinical status, and psychiatric history were collected at the clinic. Relapse and recurrence data were collected by clinical interviews 1year after the EDOR test. The predictive (adjusting for confounders) and comparative (relative to other predictors) performance of electrodermal hyporeactivity was assessed using simple and multiple binary logistic regression.ResultsThe patient sample included 97 patients aged between 20 and 81years (mean, 51.2years). Twenty patients (20.6%) were hyporeactive in the EDOR test. The group of hyporeactive patients did not differ significantly from the reactive group with regard to background factors or clinical status on admission. Forty-seven patients (51.6%) had at least one depressive episode during the follow-up period. In the analysis including potential confounders, the likelihood of relapse or recurrence of depression was nearly five times higher among the hyporeactive patients than the reactive patients (odds ratio [OR], 4.7; 95% confidence interval (CI), 1.3-16.2; p=0.015). In the comparative analysis, only hyporeactivity was found to be associated with recurring episodes (OR, 3.3; 95% CI, 1.1-10.2; p=0.036).ConclusionsElectrodermal hyporeactivity was associated with a higher risk of relapse or recurrence after discharge among patients hospitalized for depression. This finding warrants further clinical investigations that cover different types of depression and account for causal mechanisms.Trial registrationThe study design was registered in the German Clinical Trials Register (DRKS00010082).Funding Agencies|Linkoping University</p

Recommendations for the prevention and treatment of postpartum depression

Epidemiological data clearly indicate that depression is becoming an increasingly important health and social problemtoday. According to the World Health Organization (WHO), depression currently affects 350 million people worldwide andis considered the second most common cause of disability in Europe after ischemic heart disease. It is estimated that thishealth problem may affect as many as five million people in Poland. The gap between the reported number of patientstreated and the prevalence of depression, highlights the scale of unmet needs. With the limited availability of specialistsin psychiatric care, the most appropriate measures seem to be those aimed at increasing the competence of doctors ofother specialties in the diagnosis and treatment of depression. Early detection and treatment results in faster remission,reduces relapses and mortality.The recommendations concerning prevention of depression were commissioned by the Polish Ministry of Health as a part ofthe Depression Prevention Program for 2016–2020. The Program has developed recommendations addressed to specialistsin various fields of medicine, other than psychiatry, focusing on three risk groups: children and adolescents, women in theperinatal period and the elderly. These recommendations focus on the management of suspected postpartum depressionand provide specific guidelines for medical staff having contact with pregnant and postpartum women (gynecologists,midwives, pediatricians)

ATTITUDES TOWARDS ECT: A SURVEY OF POLISH MENTAL HEALTH PROFESSIONALS

Background: Although the efficacy of electroconvulsive therapy (ECT) has been well established, the utilization rate of ECT has decreased in Poland in recent years. One of the main reasons could be the negative attitude towards ECT in the community and by mental health professionals. The aim of this study was to assess the knowledge about and attitudes toward ECT in Polish mental health professionals including psychiatrists and non-physicians: nurses, psychologists, social workers. Subject and methods: Psychiatrists and other mental health professionals in two large Polish hospitals were approached to participate in the survey by completing a 28-item questionnaire. The specific hospitals have been selected due to the fact that they were located in the same province of Poland (Mazowsze), had similar catchment area and profile, provided similar mental health services with only one exception; one offered ECT while the other did not. Of the 185 questionnaires that had been distributed, 165 were completed yielding a response rate of 89.19%. The study population consists of 85 psychiatrists and trainees and 80 nonphysicians. Results: Psychiatrists did not differ from other mental health professionals with respect to the knowledge and attitudes toward ECT. However, there were significant differences in the attitude (9.1±3.8 vs 7.1±3.3; p<0.001) and knowledge (5.9±3.8 vs 2.8±4.1; p<0.001) scores between those professionals, who have ever worked in a psychiatric ward where they could observe ECT sessions and those who have not had such an opportunity. Conclusions: Frequent witnessing of ECT sessions seems to be the most effective educational intervention to change negative attitudes towards ECT

Evidence for the Efficacy of Bright Light Therapy for Bipolar Depression

No abstract availabl