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62 results

Page 1 of 4

  • Suicidal ideation and other persisting symptoms after CBT or antidepressant medication treatment for major depressive disorder
  • Boadie W. Dunlop, Philip E. Polychroniou, Jeffrey J. Rakofsky, Charles B. Nemeroff, W. Edward Craighead, Helen S. Mayberg
  • Journal: Psychological Medicine / Volume 49 / Issue 11 / August 2019
  • Published online by Cambridge University Press: 12 September 2018, pp. 1869-1878
  • Print publication: August 2019
  • View abstract
    Background

    Persisting symptoms after treatment for major depressive disorder (MDD) contribute to ongoing impairment and relapse risk. Whether cognitive behavior therapy (CBT) or antidepressant medications result in different profiles of residual symptoms after treatment is largely unknown.

    Methods

    Three hundred fifteen adults with MDD randomized to treatment with either CBT or antidepressant medication in the Predictors of Remission in Depression to Individual and Combined Treatments (PReDICT) study were analyzed for the frequency of residual symptoms using the Montgomery Asberg Depression Rating Scale (MADRS) item scores at the end of the 12-week treatment period. Separate comparisons were made for treatment responders and non-responders.

    Results

    Among treatment completers (n = 250) who responded to CBT or antidepressant medication, there were no significant differences in the persistence of residual MADRS symptoms. However, non-responders treated with medication were significantly less likely to endorse suicidal ideation (SI) at week 12 compared with those treated with CBT (non-responders to medication: 0/54, 0%, non-responders to CBT: 8/30, 26.7%; p = .001). Among patients who terminated the trial early (n = 65), residual MADRS item scores did not significantly differ between the CBT- and medication-treated groups.

    Conclusions

    Depressed adults who respond to CBT or antidepressant medication have similar residual symptom profiles. Antidepressant medications reduce SI, even among patients for whom the medication provides little overall benefit.

A Concise Guide to Understanding Suicide
  • A Concise Guide to Understanding Suicide
  • Epidemiology, Pathophysiology and Prevention
  • Edited by Stephen H. Koslow, Pedro Ruiz, Charles B. Nemeroff
  • Published online: 05 October 2014
  • Print publication: 18 September 2014
  • View description
    Suicide rates continue to increase globally. The volume of research in this field has also expanded rapidly. In A Concise Guide to Understanding Suicide, leading researchers and clinicians provide a concise review of recent literature, report solutions achieved and give practical guidance for patient care to aid understanding and help prevent suicide. Each chapter is highly focused to provide pertinent information covering all major aspects of the field, from epidemiology and theories of causation through to treatment and prevention. This text will educate practising clinicians (psychologists, psychiatrists, nurses, counsellors, and emergency room personnel) and other health care workers and researchers, as well as providing a pathway for undergraduate and graduate students interested in furthering their understanding of the complexities surrounding suicide. Further, mental health professionals and those in the social sciences will be extremely interested in this monograph, as will the University community, armed forces and interested lay public.
  • Chapter 15 - Theneuroendocrine effects of early life trauma
  • from Section 2 - Biological approaches to early life trauma
  • Edited by Ruth A. Lanius, University of Western Ontario, Eric Vermetten, Universiteit Utrecht, The Netherlands, Clare Pain, University of Toronto
  • Book: The Impact of Early Life Trauma on Health and Disease
  • Published online: 03 May 2011
  • Print publication: 05 August 2010, pp 157-165
  • View abstract

    Summary

    This chapter delineates the developmental trauma disorder (DTD) diagnosis proposed by the National Child Traumatic Stress DSM-V Taskforce. The numerous clinical expressions of the damage resulting from childhood interpersonal trauma are currently relegated to a whole variety of seemingly unrelated comorbidities, such as conduct disorder, attention-deficit hyperactivity disorder (ADHD) and separation anxiety. The chapter discusses the effects of childhood interpersonal trauma on brain activity, self-awareness and social functioning. Several large-sample studies have examined the causal relationship between childhood interpersonal trauma and DTD symptoms. These studies have documented the correlations of age of first trauma exposure, trauma severity and duration of exposure with DTD symptoms. Contemporary neuroscience research suggests that effective treatment needs to involve learning to modulate arousal, learning to tolerate feelings and sensations by increasing the capacity for interoception and learning that, after confrontation with physical helplessness, it is essential to engage in taking effective action.

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