Materiały źródłowe

• #1 Prediction of Remission of Pharmacologically Treated Psychotic Depression: A Machine Learning Approach | Population Health Sciences

  https://phs.weill.cornell.edu/news/prediction-remission-pharmacologically-treated-psychotic-depression-machine-learning-approach

  Major depressive disorder (MDD) with psychotic features, also known as psychotic depression, accounts for approximately 17 percent of MDD cases in the community. […] Compared with non-psychotic depression, psychotic depression is associated with a longer recovery time and increased rates of relapse and recurrence, hospitalization, suicide attempts, completed suicide, and all-cause mortality. […] The multivariate models had 65 to 67 percent accuracy in predicting remission of psychotic depression. […] Researchers found that longer duration of depressive episodes, somatic or tactile hallucinations, higher cumulative burden of physical comorbidity, and single or divorced marital status were independent predictors of longer time to remission of psychotic depression treated with combination pharmacotherapy.

• #2 A genetic risk score to predict treatment nonresponse in psychotic depression | Translational Psychiatry

  https://www.nature.com/articles/s41398-024-02842-x

  Psychotic depression is a severe and difficult-to-treat subtype of major depressive disorder for which higher rates of treatment-resistant depression were found. […] We created a genetic risk score (GRS) based on a large treatment-resistant depression genome-wide association study. […] Our results suggest that a treatment-resistant depression GRS is predictive of treatment nonresponse and nonremission in psychotic depression. […] We found that patients with a high treatment-resistant depression GRS were less likely to show response and remission. […] We show that the risk of nonresponse and nonremission is the highest (PPV=100%) in patients within the top 10% of the treatment-resistant depression GRS and that patients with a GRS in the top 40% are more likely to show nonresponse and nonremission compared to patients with lower GRSs.

• #3 Ten-year outcomes in first episode psychotic major depression patients compared with schizophrenia and bipolar patients

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5147459/

  We aimed to investigate long-term outcomes in psychotic major depression patients compared to schizophrenia and bipolar/manic psychosis patients, in an incidence sample, while accounting for diagnostic change. […] PMD patients have better social and service use outcomes compared to people with schizophrenia, but may be more likely to attempt suicide or self-harm. This unique profile is important for clinicians to consider in any risk assessment. […] Findings in this paper highlight that people with PMD have better social and service use outcomes compared with people with schizophrenia, but appear more likely to attempt suicide or self-harm. Outcomes for people with PMD are similar to those for people with bipolar/mania. Further, important differences between diagnostic groups were detected when accounting for diagnostic change. […] Based on lifetime diagnoses, PMD patients are around twice as likely as schizophrenia patients to attempt suicide, with around a third (31%) of patients attempting suicide at some point within the first ten years following first episode of psychosis.

• #4 Ten-year outcomes in first episode psychotic major depression patients compared with schizophrenia and bipolar patients

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5147459/

  We aimed to investigate long-term outcomes in psychotic major depression patients compared to schizophrenia and bipolar/manic psychosis patients, in an incidence sample, while accounting for diagnostic change. […] PMD patients have better social and service use outcomes compared to people with schizophrenia, but may be more likely to attempt suicide or self-harm. This unique profile is important for clinicians to consider in any risk assessment. […] Findings in this paper highlight that people with PMD have better social and service use outcomes compared with people with schizophrenia, but appear more likely to attempt suicide or self-harm. Outcomes for people with PMD are similar to those for people with bipolar/mania. Further, important differences between diagnostic groups were detected when accounting for diagnostic change. […] Based on lifetime diagnoses, PMD patients are around twice as likely as schizophrenia patients to attempt suicide, with around a third (31%) of patients attempting suicide at some point within the first ten years following first episode of psychosis.

• #5 Prediction of Remission of Pharmacologically Treated Psychotic Depression: A Machine Learning Approach | Population Health Sciences

  https://phs.weill.cornell.edu/news/prediction-remission-pharmacologically-treated-psychotic-depression-machine-learning-approach

  Major depressive disorder (MDD) with psychotic features, also known as psychotic depression, accounts for approximately 17 percent of MDD cases in the community. […] Compared with non-psychotic depression, psychotic depression is associated with a longer recovery time and increased rates of relapse and recurrence, hospitalization, suicide attempts, completed suicide, and all-cause mortality. […] The multivariate models had 65 to 67 percent accuracy in predicting remission of psychotic depression. […] Researchers found that longer duration of depressive episodes, somatic or tactile hallucinations, higher cumulative burden of physical comorbidity, and single or divorced marital status were independent predictors of longer time to remission of psychotic depression treated with combination pharmacotherapy.

• #6 Prediction of Remission of Pharmacologically Treated Psychotic Depression: A Machine Learning Approach | Population Health Sciences

  https://phs.weill.cornell.edu/news/prediction-remission-pharmacologically-treated-psychotic-depression-machine-learning-approach

  A higher number of lifetime depressive episodes and peripheral vascular or cardiovascular disease were predictors of a shorter time to remission. […] Many of these factors are consistent predictors of worse treatment outcomes of MDD. […] These findings now extend to psychotic depression. […] Results support a novel finding regarding somatic or tactile hallucinations as a marker of poorer treatment response in psychotic depression.

• #7 Prediction of Remission of Pharmacologically Treated Psychotic Depression: A Machine Learning Approach | Population Health Sciences

  https://phs.weill.cornell.edu/news/prediction-remission-pharmacologically-treated-psychotic-depression-machine-learning-approach

  Major depressive disorder (MDD) with psychotic features, also known as psychotic depression, accounts for approximately 17 percent of MDD cases in the community. […] Compared with non-psychotic depression, psychotic depression is associated with a longer recovery time and increased rates of relapse and recurrence, hospitalization, suicide attempts, completed suicide, and all-cause mortality. […] The multivariate models had 65 to 67 percent accuracy in predicting remission of psychotic depression. […] Researchers found that longer duration of depressive episodes, somatic or tactile hallucinations, higher cumulative burden of physical comorbidity, and single or divorced marital status were independent predictors of longer time to remission of psychotic depression treated with combination pharmacotherapy.

• #8 Prediction of Remission of Pharmacologically Treated Psychotic Depression: A Machine Learning Approach | Population Health Sciences

  https://phs.weill.cornell.edu/news/prediction-remission-pharmacologically-treated-psychotic-depression-machine-learning-approach

  Major depressive disorder (MDD) with psychotic features, also known as psychotic depression, accounts for approximately 17 percent of MDD cases in the community. […] Compared with non-psychotic depression, psychotic depression is associated with a longer recovery time and increased rates of relapse and recurrence, hospitalization, suicide attempts, completed suicide, and all-cause mortality. […] The multivariate models had 65 to 67 percent accuracy in predicting remission of psychotic depression. […] Researchers found that longer duration of depressive episodes, somatic or tactile hallucinations, higher cumulative burden of physical comorbidity, and single or divorced marital status were independent predictors of longer time to remission of psychotic depression treated with combination pharmacotherapy.

• #9 Prediction of Remission of Pharmacologically Treated Psychotic Depression: A Machine Learning Approach | Population Health Sciences

  https://phs.weill.cornell.edu/news/prediction-remission-pharmacologically-treated-psychotic-depression-machine-learning-approach

  A higher number of lifetime depressive episodes and peripheral vascular or cardiovascular disease were predictors of a shorter time to remission. […] Many of these factors are consistent predictors of worse treatment outcomes of MDD. […] These findings now extend to psychotic depression. […] Results support a novel finding regarding somatic or tactile hallucinations as a marker of poorer treatment response in psychotic depression.

• #10 A genetic risk score to predict treatment nonresponse in psychotic depression | Translational Psychiatry

  https://www.nature.com/articles/s41398-024-02842-x

  Psychotic depression is a severe and difficult-to-treat subtype of major depressive disorder for which higher rates of treatment-resistant depression were found. […] We created a genetic risk score (GRS) based on a large treatment-resistant depression genome-wide association study. […] Our results suggest that a treatment-resistant depression GRS is predictive of treatment nonresponse and nonremission in psychotic depression. […] We found that patients with a high treatment-resistant depression GRS were less likely to show response and remission. […] We show that the risk of nonresponse and nonremission is the highest (PPV=100%) in patients within the top 10% of the treatment-resistant depression GRS and that patients with a GRS in the top 40% are more likely to show nonresponse and nonremission compared to patients with lower GRSs.

• #11 A genetic risk score to predict treatment nonresponse in psychotic depression | Translational Psychiatry

  https://www.nature.com/articles/s41398-024-02842-x

  We studied associations by comparing the unadjusted odds ratios(OR) and the predictive values (i.e. PPV, NPV and accuracy) for treatment nonresponse and nonremission between the GRS group and the reference group. […] The prediction of nonresponse and nonremission by the GRS was evaluated through the AUC of a ROC curve. […] In conclusion, our study suggests that the treatment-resistant depression GRS might be valuable in predicting treatment nonresponse and nonremission in psychotic depression.

• #12 Prediction of Remission of Pharmacologically Treated Psychotic Depression: A Machine Learning Approach | Population Health Sciences

  https://phs.weill.cornell.edu/news/prediction-remission-pharmacologically-treated-psychotic-depression-machine-learning-approach

  Major depressive disorder (MDD) with psychotic features, also known as psychotic depression, accounts for approximately 17 percent of MDD cases in the community. […] Compared with non-psychotic depression, psychotic depression is associated with a longer recovery time and increased rates of relapse and recurrence, hospitalization, suicide attempts, completed suicide, and all-cause mortality. […] The multivariate models had 65 to 67 percent accuracy in predicting remission of psychotic depression. […] Researchers found that longer duration of depressive episodes, somatic or tactile hallucinations, higher cumulative burden of physical comorbidity, and single or divorced marital status were independent predictors of longer time to remission of psychotic depression treated with combination pharmacotherapy.

• #13 A Machine-Learning-Algorithm-Based Prediction Model for Psychotic Symptoms in Patients with Depressive Disorder

  https://www.mdpi.com/2075-4426/12/8/1218

  Psychotic symptoms are rarely concurrent with the clinical manifestations of depression. […] The area under the curve was 0.823. The overall accuracy was 0.931 (95% confidence interval: 0.897–0.956). Severe depression (degree of depression) was the most important variable in the prediction model, followed by diminished appetite, subthreshold (degree of depression), ideas or acts of self-harm or suicide, outpatient status, age, psychomotor retardation or agitation, and others. […] In conclusion, the machine-learning-based model predicted concurrent psychotic symptoms in patients with major depression in connection with the “severity psychosis” hypothesis. […] Psychotic major depression is clinically characterized by a longer duration of each subsequent episode; increased vulnerability of conversion to bipolar disorder; greater familial prevalence of bipolar disorder and major depressive disorder; and greater rates of recurrence, suicide, and mortality compared to non-psychotic major depression.

• #14 A Machine-Learning-Algorithm-Based Prediction Model for Psychotic Symptoms in Patients with Depressive Disorder

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9394314/

  Thus, psychotic depression may be a clinical syndrome distinct from non-psychotic depression. […] Concurrent psychotic symptoms were present only among the Chinese, Japanese, Indian, and Thai patients with depressive disorders. […] The prediction model was clinically applicable for identifying concurrent psychotic symptoms among patients with major depression, whereas we rarely observed concurrent psychotic symptoms.

• #15 A Machine-Learning-Algorithm-Based Prediction Model for Psychotic Symptoms in Patients with Depressive Disorder

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9394314/

  Psychotic symptoms are rarely concurrent with the clinical manifestations of depression. […] The area under the curve was 0.823. The overall accuracy was 0.931 (95% confidence interval: 0.8970.956). Severe depression (degree of depression) was the most important variable in the prediction model, followed by diminished appetite, subthreshold (degree of depression), ideas or acts of self-harm or suicide, outpatient status, age, psychomotor retardation or agitation, and others. […] In conclusion, the machine-learning-based model predicted concurrent psychotic symptoms in patients with major depression in connection with the severity psychosis hypothesis. […] In this study, severe depression (degree of depression) was the most important variable in the prediction model, showing the highest statistical coefficient (2 = 21.104) among the prediction model variables.

• #16 A Machine-Learning-Algorithm-Based Prediction Model for Psychotic Symptoms in Patients with Depressive Disorder

  https://www.mdpi.com/2075-4426/12/8/1218

  Psychotic symptoms are rarely concurrent with the clinical manifestations of depression. […] The area under the curve was 0.823. The overall accuracy was 0.931 (95% confidence interval: 0.897–0.956). Severe depression (degree of depression) was the most important variable in the prediction model, followed by diminished appetite, subthreshold (degree of depression), ideas or acts of self-harm or suicide, outpatient status, age, psychomotor retardation or agitation, and others. […] In conclusion, the machine-learning-based model predicted concurrent psychotic symptoms in patients with major depression in connection with the “severity psychosis” hypothesis. […] Psychotic major depression is clinically characterized by a longer duration of each subsequent episode; increased vulnerability of conversion to bipolar disorder; greater familial prevalence of bipolar disorder and major depressive disorder; and greater rates of recurrence, suicide, and mortality compared to non-psychotic major depression.

• #17 A Machine-Learning-Algorithm-Based Prediction Model for Psychotic Symptoms in Patients with Depressive Disorder

  https://www.mdpi.com/2075-4426/12/8/1218

  The prediction model was clinically applicable for identifying concurrent psychotic symptoms among patients with major depression, whereas we rarely observed concurrent psychotic symptoms. Although the sensitivity requires improvement, the model can be used to detect concurrent psychotic symptoms in patients with major depression.

• #18 Prediction of electroconvulsive therapy response and remission in major depression: meta-analysis | The British Journal of Psychiatry | Cambridge Core

  https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/prediction-of-electroconvulsive-therapy-response-and-remission-in-major-depression-metaanalysis/259FD7600E652E9D272481FC6D87F4F9

  Presence of psychotic features is a predictor of ECT remission (odds ratio (OR) = 1.47, P = 0.001) and response (OR = 1.69, P 0.001), as is older age (standardised mean difference (SMD) = 0.26 for remission and 0.35 for response (P 0.001)). […] A weaker association was detected between the severity of depression and response to treatment (SMD 0.19, P = 0.001). […] This meta-analysis provides evidence for the superior efficacy of ECT in patients with depression with psychotic features, in older patients and in those with a more severe depression, whereas data on melancholic symptoms were inconclusive. […] The effect size of psychotic symptoms as predictor of response and remission was considerably higher than the effect found in a recent meta-analysis on ECT response prediction by Haq et al (OR = 1.34, P = 0.12).

• #19 Clinical Effectiveness of Electroconvulsive Therapy for Psychotic vs Nonpsychotic Depression: A Cohort Study

  https://www.psychiatrist.com/jcp/clinical-effectiveness-electroconvulsive-therapy-psychotic-vs-nonpsychotic-depression/

  Individuals experiencing major depression with psychotic features (MD-P) may respond better and have fewer cognitive effects with electroconvulsive therapy (ECT) than those without psychotic features (MD-NP). […] Individuals with MD-P had a higher rate of response and similar rates of adverse cognitive effects compared to patients with MD-NP with ECT treatment. However, after accounting for differences in patient characteristics, we no longer identified an association between psychotic symptoms and treatment response. […] In the largest cohort study to date comparing treatment outcomes between individuals with MD-P and MD-NP receiving ECT, our work identified several clinically important outcomes. We found that among those with MD-P compared to MD-NP, ECT is associated with higher rates of dramatic treatment responses with similar rates of adverse cognitive effects. However, once baseline group differences are accounted for, the presence of psychotic symptoms is no longer predictive of treatment response, and, instead, characteristics like age, antidepressant treatment, and potentially catatonic symptoms are more strongly associated with treatment response.

• #20 Clinical Effectiveness of Electroconvulsive Therapy for Psychotic vs Nonpsychotic Depression: A Cohort Study

  https://www.psychiatrist.com/jcp/clinical-effectiveness-electroconvulsive-therapy-psychotic-vs-nonpsychotic-depression/

  Our findings suggest that individuals with MD-P are more likely to display a significant treatment response, but that this effect may not necessarily be due to psychotic symptoms and may be related to associated patient and treatment factors such as age, concomitant medication treatment, and presence of catatonic symptoms.

• #21 Prevalence and risk factors for psychotic symptoms in young, first-episode and drug-naïve patients with major depressive disorder | BMC Psychiatry | Full Text

  https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-024-05517-5

  Major depressive disorder (MDD) is a common psychiatric disorder worldwide. Psychotic depression has been reported to be frequently under-diagnosed due to poor recognition of psychotic features. Therefore, the purpose of this study was to reveal the rate and risk factors of psychotic symptoms in young, drug-naïve patients with major depressive disorder at the time of their first episode. […] The rate of psychotic symptoms among young adult MDD patients was 9.1%. […] Our findings suggest that psychotic symptoms are common in young MDD patients. Several clinical variables and biochemical indicators are associated with the occurrence of psychotic symptoms in young MDD patients. […] The prevalence of psychotic symptoms among young MDD patients was 9.1%. […] The prevalence of suicide attempts was much higher in the psychotic subgroup than in the non-psychotic subgroup. […] HAMD, TSH, TC, and severe anxiety were independently associated with psychotic symptoms in young MDD patients.

• #22 Health-related quality of life in severe psychotic disorders during integrated care: 5-year course, prediction and treatment implications (ACCESS II) | Health and Quality of Life Outcomes | Full Text

  https://hqlo.biomedcentral.com/articles/10.1186/s12955-022-02039-0

  Studies on outcomes mapping Quality of Life (QoL) as patient-reported outcome over a longer period in severe psychotic disorders are scarce. […] Results indicate that the overall symptom burden at time of inclusion is not decisive for the perceived QoL in the long-term course while the reduction in the severity of depressive and positive symptoms is important. This means focusing even more on the treatment of depressive symptoms and include traumatherapeutic aspects in the long-term treatment of severe psychotic disorders if needed. […] Earlier results indicate the critical role of depression in determining QoL among early psychosis patients by demonstrating that greater baseline depressive symptom severity prospectively predicted poor QoL. […] The only sociodemographic variable that has a significant impact on the course of QoL over a 5-year treatment period was having or not having a traumatic event before age 18 (in QoL total score as well as in all domains).

• #23 Health-related quality of life in severe psychotic disorders during integrated care: 5-year course, prediction and treatment implications (ACCESS II) | Health and Quality of Life Outcomes | Full Text

  https://hqlo.biomedcentral.com/articles/10.1186/s12955-022-02039-0

  Focusing on the early course of treatment, results show that a decrease in the severity of depressive symptomatology is crucial for a perceived increase in one’s QoL (total QoL score, physical health and subjective feelings). To affirm depression as a critical determinant of prospective subjective QoL is also in line with earlier results.

• #24 Health-related quality of life in severe psychotic disorders during integrated care: 5-year course, prediction and treatment implications (ACCESS II) | Health and Quality of Life Outcomes | Full Text

  https://hqlo.biomedcentral.com/articles/10.1186/s12955-022-02039-0

  Studies on outcomes mapping Quality of Life (QoL) as patient-reported outcome over a longer period in severe psychotic disorders are scarce. […] Results indicate that the overall symptom burden at time of inclusion is not decisive for the perceived QoL in the long-term course while the reduction in the severity of depressive and positive symptoms is important. This means focusing even more on the treatment of depressive symptoms and include traumatherapeutic aspects in the long-term treatment of severe psychotic disorders if needed. […] Earlier results indicate the critical role of depression in determining QoL among early psychosis patients by demonstrating that greater baseline depressive symptom severity prospectively predicted poor QoL. […] The only sociodemographic variable that has a significant impact on the course of QoL over a 5-year treatment period was having or not having a traumatic event before age 18 (in QoL total score as well as in all domains).

• #25 Long-term outcome of postpartum psychosis: a prospective clinical cohort study in 106 women | International Journal of Bipolar Disorders | Full Text

  https://journalbipolardisorders.springeropen.com/articles/10.1186/s40345-021-00236-2

  We did not find significant predictors of recurrence outside the postpartum period. […] Understanding who is at risk of a mood or psychotic disorder during follow-up, and whose vulnerability is limited to the postpartum period, is particularly important in guiding treatment decisions including long-term pharmacotherapy. […] Unfortunately, no biomarkers are currently available to help guide these decisions. […] In clinical practice, this means that long-term monitoring is warranted for everyone with postpartum psychosis. […] Another reason for long-term monitoring are the high suicide rates during follow-up, reported by other studies.

• #26 Ten-year outcomes in first episode psychotic major depression patients compared with schizophrenia and bipolar patients

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5147459/

  We aimed to investigate long-term outcomes in psychotic major depression patients compared to schizophrenia and bipolar/manic psychosis patients, in an incidence sample, while accounting for diagnostic change. […] PMD patients have better social and service use outcomes compared to people with schizophrenia, but may be more likely to attempt suicide or self-harm. This unique profile is important for clinicians to consider in any risk assessment. […] Findings in this paper highlight that people with PMD have better social and service use outcomes compared with people with schizophrenia, but appear more likely to attempt suicide or self-harm. Outcomes for people with PMD are similar to those for people with bipolar/mania. Further, important differences between diagnostic groups were detected when accounting for diagnostic change. […] Based on lifetime diagnoses, PMD patients are around twice as likely as schizophrenia patients to attempt suicide, with around a third (31%) of patients attempting suicide at some point within the first ten years following first episode of psychosis.

• #27 Long-term outcome of postpartum psychosis: a prospective clinical cohort study in 106 women | International Journal of Bipolar Disorders | Full Text

  https://journalbipolardisorders.springeropen.com/articles/10.1186/s40345-021-00236-2

  For the majority of women with first-onset postpartum psychosis, the risk of illness was limited to the period after childbirth. […] For the remaining women, postpartum psychosis was part of a mood/psychotic disorder with severe non-postpartum recurrence, mainly in the bipolar spectrum. […] No clinical predictors for risk of severe episodes outside the postpartum period emerged. […] Our findings add to previous evidence suggesting a fundamental link between postpartum psychosis and bipolar disorder, which may represent two distinct diagnoses within the same spectrum. […] Despite the widespread use of the term postpartum psychosis, this diagnosis is not recognized in current classification systems, including the International Classification of Diseases, Tenth Revision (ICD-10) and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

• #28 Clinical Effectiveness of Electroconvulsive Therapy for Psychotic vs Nonpsychotic Depression: A Cohort Study

  https://www.psychiatrist.com/jcp/clinical-effectiveness-electroconvulsive-therapy-psychotic-vs-nonpsychotic-depression/

  Individuals experiencing major depression with psychotic features (MD-P) may respond better and have fewer cognitive effects with electroconvulsive therapy (ECT) than those without psychotic features (MD-NP). […] Individuals with MD-P had a higher rate of response and similar rates of adverse cognitive effects compared to patients with MD-NP with ECT treatment. However, after accounting for differences in patient characteristics, we no longer identified an association between psychotic symptoms and treatment response. […] In the largest cohort study to date comparing treatment outcomes between individuals with MD-P and MD-NP receiving ECT, our work identified several clinically important outcomes. We found that among those with MD-P compared to MD-NP, ECT is associated with higher rates of dramatic treatment responses with similar rates of adverse cognitive effects. However, once baseline group differences are accounted for, the presence of psychotic symptoms is no longer predictive of treatment response, and, instead, characteristics like age, antidepressant treatment, and potentially catatonic symptoms are more strongly associated with treatment response.

• #29 Clinical Effectiveness of Electroconvulsive Therapy for Psychotic vs Nonpsychotic Depression: A Cohort Study

  https://www.psychiatrist.com/jcp/clinical-effectiveness-electroconvulsive-therapy-psychotic-vs-nonpsychotic-depression/

  Our findings suggest that individuals with MD-P are more likely to display a significant treatment response, but that this effect may not necessarily be due to psychotic symptoms and may be related to associated patient and treatment factors such as age, concomitant medication treatment, and presence of catatonic symptoms.

Zobacz więcej