Melancholia agitata and mixed depression

OBJECTIVE: The diagnostic entity of major depressive episode includes both simple and agitated or mixed depression. Mixed depression is characterized by a full depressive episode with several symptoms of excitatory nature. Mixed depressions worsen if treated with antidepressants. METHOD: We have reviewed the clinical charts of the 2141 patients treated at the Centro Lucio Bini of Rome from January 1999 to June 2006. These patients were diagnosed according to DSM-IV criteria. Research diagnostic criteria were applied for agitated depression with motor agitation and Author's diagnostic criteria for agitated depression without motor agitation. RESULTS: One thousand and twenty-six patients had a depressive episode as index episode. Three hundred and forty six (33%) were mixed depressive states. One hundred and thirty eight (44%) of them were spontaneous; in 173 cases, the onset of the mixed depression was associated with antidepressants. CONCLUSION: Psychic and motor agitation are considered equally important for the definition of agitated depression. Treating agitated depression with antidepressants worsens the clinical picture. The use of Electroconvulsive Therapy (ECT), neuroleptics and anticonvulsants are recommended. The term Melancholia Agitata is proposed for agitated (mixed) depression

Validity of the Shahin Mixed Depression Scale: A Self-Rated Instrument Designed to Measure the Non-DSM Mixed Features in Depression

Background: The DSM5-defined mixed features in depression do not include psychomotor agitation, irritability or distractibility because they are considered overlapping symptoms. A growing number of modern psychiatrists have expressed dissatisfaction with this and proposed alternative sets of mixed symptoms that are much more common and clinically relevant. Among such alternative criteria were those proposed by Koukopoulos. He utilized the research diagnostic criteria of agitated depression (RDC-A) as a mixed depression subtype, and validated another form of mixed depression, the Koukopoulos criteria for mixed depression (K-DMX). Purpose: This study provides psychometric validation for the first self-rated scale designed to measure the most common mixed symptoms in depression as proposed by Koukopoulos. Patients and methods: We conducted a multicenter cross-sectional study of 170 patients with unipolar depression. They completed the Shahin Mixed Depression Scale (SMDS) and underwent expert interviews as a gold standard reference. SMDS' psychometric properties were assessed, including Cronbach's alpha, factor analysis, sensitivity, specificity, predictive value and accuracy. Results: We found significant association and agreement between mixity according to SMDS and the gold standard (K-DMX and RDC-A according to expert interview) with good internal consistency (Cronbach's alpha=0.87), high sensitivity (=91.4%), specificity (=98.0%), positive predictive value (=96.9%), negative predictive value (= 94.2%) and accuracy (=95.2%). Factor analysis identified one factor for psychomotor agitation and another for mixity without psychomotor agitation. Conclusion: SMDS was a reliable and valid instrument for assessing the frequently encountered and clinically relevant mixed features in depression

Consumer Confidence at an All-Time Low in New Hampshire 2/19/2009

Consumer confidence in New Hampshire is at record lows and residents have become increasingly pessimistic about both the state’s and the country’s economic outlook

NH Consumers Optimistic About NH Economy, Pessimistic About US Economy 8/26/13

New Hampshire residents continue to be upbeat about the future of the state’s economy but see bad times ahead for the U.S. The percentage of NH residents who think that they are personally better off since last year is at its highest point in six years

Granite Staters Still Optimistic About Business in NH, Pessimistic About Conditions in US 4/08/14

Perceptions about New Hampshire’s future business conditions continue to improve and have reached their highest level in nine years. However, New Hampshire residents’ perceptions about nationwide business conditions, while getting better, remain pessimistic. Granite Staters also think it is a good time to buy a major household item

Granite Staters Optimistic About Business Conditions In NH 2/11/14

Confidence in New Hampshire’s future business conditions is at its highest level in eight years. Confidence in nationwide business conditions has rebounded somewhat since October, but most remain pessimistic. A majority of Granite Staters think this is a good time to buy a major household item

NH: Economic Optimism 5/5/16

New Hampshire residents remain optimistic about business conditions in the state and are somewhat optimistic about the national economy. The majority of Granite Staters don’t expect their household financial condition to change over the next year and few expect things will get worse

Consumer Confidence Steady In NH 7/28/15

New Hampshire residents continue to feel optimistic about business conditions in the state. They are less optimistic about the U.S. economy. Granite Staters also feel it is a good time to buy a major household item

Granite Staters Better Off Than A Year Ago, But Not Optimistic About US Economy 6/2/15

New Hampshire residents feel they are financially better off than they were a year ago, and expect to be in a similar position next year. Granite Staters believe New Hampshire business conditions are improving but are not optimistic about national economic conditions