Skip to content

This Week in Psychiatry – 2/7/11

February 4, 2011

Antidepressants, But No Lifetime Mental Disorder

A study from The Journal of Clinical Psychiatry used a large mental health epidemiology survey (N=20,013) to examine the use of antidepressants in the absence of a lifetime psychiatric disorder. Respondents with or without a 1-year or lifetime mental disorder who were taking an antidepressant were asked to indicate why they needed the medication. Of the respondents who had taken an antidepressant in the past year (n=1,441), 26.3% did not meet lifetime criteria, of whom 89% cited at least one indicator of need. The most common 3 indicators were depressive symptoms, anxiety symptoms, and poor sleep. Respondents receiving antidepressants without lifetime criteria were more likely to be older, white, and female, and to receive their prescriptions from family physicians.

Trajectory of MDD with Subthreshold Hypomania

Does subthreshold hypomania in MDD patients predict onset of new mania? Participants in the NIMH Collaborative Depression Study with an MDD diagnosis at intake (n=550) were followed prospectively for a mean of 17.5 years. Monitoring intervals tracked their course of illness and identified any hypomania or mania. Hypomania or mania was identified in 19.6% of the sample, of which 12.2% and 7.5% received a revised diagnosis for bipolar II and bipolar I disorder, respectively. Age at onset, psychotic symptoms, and number of subthreshold hypomania symptoms predicted development of bipolar disorder. This study appeared in The American Journal of Psychiatry.

Bright Light Therapy: Effects on Older Adults with MDD

Bright light therapy may improve circadian rhythm disturbances in older people with nonseasonal MDD. Published in the Archives of General Psychiatry, a double-blind, randomized, placebo-controlled trial tested 3 weeks of 1-hour early morning bright light therapy in 89 patients (aged >60 years) with MDD. Outcome measures included Hamilton Scale Depression scores, and levels of sleep, cortisol, and melatonin. Depression scores improved after bright light therapy, sleep efficiency increased, and evening levels of melatonin rose more steeply, and 24-hour cortisol levels decreased, compared to placebo.



“This Week in Psychiatry” is written by Lonnie Stoltzfoos

Leave a Comment

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s

%d bloggers like this: