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Biomedical subjects

Brian M Iacoviello

Publications and source records attributed to Brian M Iacoviello.

2 recordsLinked to original sources
PubMed2006

The course of depression in individuals at high and low cognitive risk for depression: a prospective study.

BACKGROUND: Negative cognitive styles have been shown to prospectively predict depression onset and recurrence. Research has also begun to suggest that cognitive styles may be associated with the course of depression as well. This study examined whether cognitive risk for depression onset also predicts the course of depression in a prospective design. METHODS: One hundred fifty-nine initially nondepressed participants from the Temple-Wisconsin Cognitive Vulnerability to Depression Project who experienced a depressive episode while in the study were followed prospectively for 2.5 years. Four indicators of the course of depression were assessed from diagnostic interviews and questionnaires administered every 6 weeks: the number, severity and duration of episodes and the chronicity of the depression experienced. RESULTS: Cognitive high-risk participants experienced more episodes of depression, more severe episodes, and more chronic courses than low-risk participants. There were no risk group differences observed for the duration of episodes. LIMITATIONS: This study's sample was chosen to include individuals with high and low cognitive vulnerability to depression, potentially limiting the generalizability of the findings to other individuals. Also, the study included some participants with a past history of depression. CONCLUSIONS: Negative cognitive styles predict a worse course of depression as well as rendering an individual prone to depression onset. This highlights that the cognitive factors impacting depression's course overlap, at least partly, with those that initiate depression. Thus, knowledge of a depressed individual's cognitive styles could aid in prognosis and treatment planning.

Adolescent↗
PubMed2003

Nortriptyline for treatment-resistant depression.

BACKGROUND: Up to 30% of patients with major depression fail to respond to an antidepressant trial, with most taking a selective serotonin reuptake inhibitor (SSRI) as initial treatment. While the tricyclic antidepressants might be effective for SSRI nonresponders, they have been relegated to third- and fourth-line treatment. This study assesses the efficacy of nortriptyline for patients with treatment-resistant major depression. METHOD: 92 patients with treatment-resistant DSM-III-R major depression, with resistance defined by at least 1, but no more than 5, well-documented adequate trials of antidepressants during the current episode, were treated openly with nortriptyline for 6 weeks. Patients were titrated up to full target doses of nortriptyline within 1 week, with target blood levels of 100 ng/mL. Response was defined as a 50% or greater decrease of baseline 17-item Hamilton Rating Scale for Depression score. We performed an intent-to-treat analysis with the last observation carried forward. RESULTS: Approximately 40% of patients were responders (N = 39) and 12% were remitters (N = 11) after 6 weeks of nortriptyline. Over a third of patients were unable to complete the trial. CONCLUSION: Nortriptyline was effective for over a third of patients with treatment-resistant depression, and nortriptyline should be considered as potential treatment if patients fail to respond to other antidepressants.

Adolescent↗