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Biomedical subjects

G Malhi

Publications and source records attributed to G Malhi.

7 recordsLinked to original sources
PubMed2006

Actions taken to cope with depression in patients seeking specialist care.

OBJECTIVE: To assess the rates and perceived effectiveness of actions used to cope with depression and the factors influencing these in an outpatient sample seeking help for depression. METHOD: One hundred and seventy-six patients (74 male, 102 female) aged 16-82 years (M = 42, SD = 14.4 years) with a major depressive episode (DSM-IV criteria) were assessed using a number of measures that covered sociodemographics, history of psychiatric illness, actions taken to alleviate depression and their perceived effectiveness. Logistic regression analyses assessed age, gender and illness characteristics associated with the use and perceived effectiveness of strategies adopted to manage depression. RESULTS: Medical interventions were used and perceived to be effective in alleviating depressive symptoms by most of the sample, as were self-help and complementary therapies. Sociodemographic and illness-related characteristics had a significant influence, with younger age and having experienced an episode of anxiety disorder found to be the strongest predictors for the use of coping strategies. Being female was the strongest predictor for their effectiveness. CONCLUSION: A range of actions for depression, including medical and complementary interventions, were used and found to be helpful in a sample that had sought professional help for depression. Gender, age, depression and anxiety factors were all found to predict the use and perceived effectiveness of these strategies.

Adaptation, Psychological↗
PubMed2005

Sleeping in? The impact of age and depressive sub-type on hypersomnia.

BACKGROUND: While early morning wakening is held to be a classic feature of melancholia, we investigate the clinical observation that young patients with melancholia and bipolar depression tend to be more likely to report hypersomnia. METHODS: We examine age-related rates of those two sleep disturbance patterns in a consecutive set of out-patients with differing depressive sub-types assessed over a 20-year period. RESULTS: Hypersomnia was more likely to be reported than early morning wakening across all age bands by those with non-melancholic depression. Hypersomnia was also more likely than early morning wakening in younger patients with melancholia and bipolar disorder but, with age, early morning wakening became the dominant pattern. LIMITATIONS: The study was retrospective, undertaken in a sample attending a tertiary referral unit and artefactual determinants of the associations were not pursued. CONCLUSIONS: We speculate that hypersomnia may be a non-specific homeostatic coping response to stress and thus to the non-melancholic depressive disorders, but that this pattern is overruled by an early morning wakening pattern in the more biological depressive sub-types as the individual ages, perhaps reflecting a noradrenergic contribution.

Adult↗
PubMed2005

Progressing a spectrum model for defining non-melancholic depression.

OBJECTIVE: To further develop a 'spectrum model' for non-melancholic disorders that encompasses underlying personality styles and clinical patterning. METHOD: In a sample of patients with non-melancholic depression, we studied four personality constructs influencing risk to depression, assessing associational strength and specificity between personality scores and symptom and coping response patterns. RESULTS: Analyses refined four personality dimensions (anxious worrying, irritability, social inhibition, and self-centredness) for testing the model. For all dimensions, personality style was specifically linked with a mirroring 'coping' response. Quantification of specific links allowed development of a spectrum model for the non-melancholic depressive disorders in which underpinning personality style showed some specific links with the clinical 'pattern' of symptoms and coping repertoires. CONCLUSION: The model has the capacity to assist clinical assessment, identify aetiological personality influences and allow specific treatment effects for the heterogeneous non-melancholic depressive disorders to be determined.

Adaptation, Psychological↗
PubMed2004

Studying personality characteristics in bipolar depressed subjects: how comparator group selection can dictate results.

OBJECTIVE: To examine the extent to which identification of any distinct personality characteristics in bipolar subjects are influenced by selection of the comparison diagnostic group. METHOD: Scores were compared on several general measures of personality style and, additionally, the prevalence of disordered personality functioning was examined in a sample of 198 non-psychotic depressed subjects, 39 with bipolar depression and 159 with unipolar depression. RESULTS: When the bipolar subjects were separately compared with unipolar subjects, and to sub-sets of those with clinically and DSM-IV defined melancholic and non-melancholic depression, quite differing results were suggested. In essence, clinically-defined melancholic subjects had the least personality psychopathology in comparison with the non-melancholic and bipolar subjects. CONCLUSION: Whether subjects with bipolar disorder have any distinct personality characteristics or over-represented co-morbid personality disorders remains quite unclear when reference is made to the literature. We suggest that inconsistencies across studies may reflect choice and representation of depressive sub-types within the unipolar comparator group.

Adult↗
PubMed2003

An Australian validation study of the temperament and character inventory.

OBJECTIVE: To assess the validity of the temperament and character inventory (TCI) measure in an Australian sample. METHOD: A sample of depressed subjects completed the TCI and a measure assessing personality disorder constructs (PDCs), while family members and psychiatrists also returned PDC ratings. RESULTS: Factor analyses generally supported the TCI constructs, when the temperament and character scales were analysed separately. Self-reported PDC scores were validated against corroborative witness ratings and used to assess the TCIs concurrent validity. Validation analyses supported all TCI temperament scales, but the Self-transcendence Character scale was unassociated with PDC scores. The remaining two character scales (i.e. cooperativeness and self-directedness) were non-specifically associated with all PDC scores. CONCLUSION: Study results support the validity of the TCI scales, but question the best model for conceptualizing the TCI. It is suggested that two character scales quantify disordered functioning, while temperament scales quantify style, constructs that may be inter-related or independent in individual subjects.

Adult↗
PubMed2001

Are atypical antipsychotic drugs also atypical antidepressants?

OBJECTIVE: To report a case series and review the psychopharmacology of the neuroleptic drugs to suggest that the atypical antipsychotic drugs may have an antidepressant action, at least for those patients with the melancholic subtype. METHOD: We note the literature suggesting that the older (or typical) antipsychotic drugs were established as having antidepressant activity, describe an open study of some two dozen patients with a treatment-resistant melancholic depression, describe rapid resolution of depression and augmentation benefits associated with commencing an atypical antipsychotic drug in a percentage of subjects, and then review relevant psychopharmacological studies to consider whether there is a rationale for use of antipsychotic drugs to treat depression. RESULTS: Of some two dozen patients treated with an atypical antipsychotic drug, almost immediate improvement was noted in four patients, and evidence of augmentation benefit obtained in another three patients. CONCLUSIONS: Impressions from this case series are encouraging. However, as open clinical observational studies are problematic, controlled studies are required to establish whether the atypical antipsychotic drugs have a role in the management of certain expressions of depression, and, in particular, treatment-resistant melancholic depression.

Adult↗