Browsing by Subject "Major depressive disorder"
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Item Open Access Care utilization in eating disorders: for whom are multiple episodes of care more likely?(Eating and weight disorders : EWD, 2022-10) Gorrell, Sasha; Le Grange, Daniel; Blalock, Dan V; Hutchinson, Valerie; Johnson, Madelyn; Duffy, Alan; Mehler, Philip S; Johnson, Craig; Manwaring, Jamie; McClanahan, Susan; Rienecke, Renee DPurpose
The current study aimed to determine baseline clinical features among adults receiving varied levels of care for transdiagnostic eating disorders (N = 5206, 89.9% female, mean age 29 years old) that may be associated with increased care utilization.Methods
We used negative binomial regression models to evaluate associations among eating disorder diagnoses, other psychiatric features (e.g., lifetime history of comorbid disorders), and the number of episodes of care for treatment of the eating disorder.Results
Having a diagnosis of binge eating disorder (p < .001) or avoidant restrictive food intake disorder (p = .04) were associated with lower odds of readmissions. A lifetime diagnosis of major depressive disorder (p < .001) or self-injury (p < .001) was each associated with significantly higher odds of readmissions.Conclusions
Care utilization may differ according to eating disorder diagnosis, with a likelihood of increased readmission for those with a history of mood disorder or self-injury. Identification of individuals with greater vulnerability for eating disorder care utilization holds potential in aiding treatment and discharge planning, and development.Level of evidence
Level III: evidence obtained from well-designed cohort or case-control analytic studies.Item Open Access Effect of Repetitive Transcranial Magnetic Stimulation on the Structural and Functional Connectome in Patients with Major Depressive Disorder(2017-05-08) Asturias, GabrielaThrough this whole-brain exploratory analysis, our aim is to study the effect of repetitive transcranial magnetic stimulation (rTMS) on the structural and functional connectivity of patients with major depressive disorder. Twenty-five currently depressed patients (age 21–68) participated in the study. Patients received daily 10-Hz rTMS over the left dlPFC five days/week for five weeks. Treatment response was assessed using the 24-item Hamilton Rating Scale for Depression (HAMD-24) at baseline and after the course of TMS. MRIs were acquired within seven days prior to starting rTMS and within three days after the end of treatment. Using diffusion tensor images and resting-state fMRI data we computed the whole-brain functional and structural connectomes. We used graph theory techniques to characterize brain architecture to identify potential biomarkers for depression severity and response to treatment. The frontal pole, part of the midline core in the default mode network (DMN) and the exteroception compartment of the depression network (DN), was identified as a potential biomarker for depression severity. The intracalcarine cortex and lateral occipital cortex, neither part of the default mode network and depression network, were defined as potential biomarkers for treatment response. The subcallosal cortex, orbitofrontal cortex, and supramarginal gyrus were identified as potential biomarkers for treatment response and their change across the treatment protocol could explain the simultaneous effect of rTMS on structural and functional connectivity. Ultimately, the goal is to articulate specific hypotheses that will inform treatment strategies for patients with major depressive disorder.Item Open Access Impact of Early Life Stress on Neural Network Dysregulation and Major Depressive Disorder in Adulthood(2016-04-11) Crain, MatthewEarly life stress (ELS) during childhood has been found to be directly associated with serious psychopathology in adults, which is often resistant to conventional treatment. There is growing evidence that ELS is linked to dysregulation of functional neural networks in adults. Specifically, previous studies of adults with ELS have demonstrated altered activation among the default mode network (DMN), executive control network (ECN), salience network (SN), and dorsal attention network (DAN), though findings have been inconsistent. The aim of the current study was to examine the relationship between retrospective self-reported ELS, including sexual, physical, and emotional abuse and neglect, and the extent and nature of impaired connectivity among functional neural networks using a resting-state fMRI paradigm with 35 adult outpatients diagnosed with major depressive disorder (MDD) and 20 non-depressed control participants. The degree of self-reported ELS was significantly higher in the MDD group than in controls. Furthermore, MDD was significantly associated with widespread hypo-connectivity between the DMN and DAN and the ECN and SN as well as hyper-connectivity within the DMN and DAN. Finally, ELS severity was associated with even greater hyper-connectivity within the DMN for MDD patients. This functional neural network dysregulation, potentiated by ELS, may play a critical role in producing the more pervasive and serious emotional lability, rumination, impaired self-reference, dysfunctional stress response, and obsessions and compulsions seen in MDD and related psychopathology. These findings suggest the importance of developing treatment methods that directly restore healthy balance to these critical functional neural networks impacted by childhood trauma.