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Biomedical subjects

Poul Videbech

Publications and source records attributed to Poul Videbech.

16 recordsLinked to original sources
PubMed2006

Bodily symptoms in moderate and severe depression.

The aim of this study was to describe bodily symptoms in severe depression, testing the hypotheses that patients with depression compared with healthy controls have several specific bodily symptoms and complaints, and furthermore that changes in severity of depression correlate to changes in bodily symptoms. Inpatients (n=29) with a diagnosis of moderate to severe depression (ICD-10) and 29 matched healthy controls were included in the study. Bodily symptoms were assessed with the Body Awareness Scale (BAS) and the severity of depression with the Hamilton Depression Scale (HDS). Patients were assessed twice, i.e. when admitted to hospital and again when discharged. The patients with severe depression had more muscular tension, pain-complaints, restricted breathing, negative attitudes towards own body and lesser centring in movements compared with the healthy controls (p<0.001). Improvement in bodily symptoms was statistically significant (p<0.01), and an improvement in depression score was observed. The findings of the study may underline the importance of investigating bodily symptoms in depression and indicates a need for a specific physiotherapeutic treatment of patients with moderate to severe depression.

Adult↗
PubMed2006

Electroconvulsive therapy: predictors and trends in utilization from 1976 to 2000.

BACKGROUND: Use of electroconvulsive therapy (ECT) may have changed during the last decades due to advances in psychopharmacology and organizational changes of psychiatric care. OBJECTIVES: To identify predictors for receiving ECT for the first time and to describe temporal trends in ECT utilization. METHODS: A register-based case-control study. The sample included 2010 cases treated with ECT between 1976 and 2000 and 148,284 controls. RESULTS: Predictors for receiving first ECT were unipolar affective disorders, long admissions, and no previous admissions. Significantly fewer patients with bipolar and schizoaffective disorders received the treatment in 2000 compared with 1976. CONCLUSIONS: Unipolar affective disorders, long duration of admissions, and no history of previous admissions are strong predictors of receiving first ECT. Despite a decrease in available inpatient beds, the treatment is used in 5.5% of admissions, and during the last 15 years of the study period, ECT utilization has been remarkably stable.

Adolescent↗
PubMed2005

[Treatment of postictal (emergence) delirium after electroconvulsive therapy].

Most patients treated with electroconvulsive therapy (ECT) develop cognitive and motor aspects of delirium afterwards. These symptoms are often self-limiting, lasting 10 to 20 minutes. However, about 10% of these patients develop a state characterised by confusion, restlesness, repetitive movements, lack of response to commands and amnesia regarding the period. This state, called emergence delirium, usually has a short duration but may persist for hours. In the present case a 50-year-old woman had 18 ECT treatments for severe depression. She experienced excellent effects as regards the depressive symptoms, but postictally she developed all the above-mentioned symptoms of delirium, which lasted for several hours. The ECT continued, and the patient was successfully treated for the condition with administration of i.v. diazepam (5 mg) shortly after the end of each seizure.

Anti-Anxiety Agents↗
PubMed2004

The Danish PET/depression project: performance on Stroop's test linked to white matter lesions in the brain.

The Stroop test (ST) assesses the integrity of prefrontal and cingulate functioning. Patients with major depression perform poorly on the ST, pointing to disturbed function in these areas. We therefore used positron emission tomography to study 41 in-patients with major depression and 46 age- and gender-matched controls during neuropsychological activation with the ST. Magnetic resonance imaging was used for coregistration and for description of the localization of white matter lesions (WML). The cerebral blood flow (CBF) changes during ST were mapped for each of the two study groups, and inter-group differences were calculated on a voxel-by-voxel basis. The patients were followed for 3 to 5 years to ensure diagnostic stability. The control group activated anterior cingulate regions, prefrontal cortices, insula, thalamus and cerebellum. Despite the patients' slower performance with more errors, no significant differences were found comparing the activations in the two groups. The performance was, however, correlated to the number of WML in frontal lobes, insula and adjacent to the basal ganglia, whereas WML in other locations was not related to performance. We thus partly explain the poorer performance by increased frequency of WML in frontostriatal pathways in the depressed patients, impairing neurotransmission.

Adult↗
PubMed2004

Pain thresholds during and after treatment of severe depression with electroconvulsive therapy.

Pain and depression are often associated suggesting that both conditions share a common neurobiological mechanism, which modulate emotional function and processing of noxious information. Pain thresholds are hypothesized to be altered in depressed patients and normalized with the amelioration of depression. The purpose of this study was therefore to determine pain thresholds in patients during and after treatment with electroconvulsive therapy (ECT) of severe depression and in healthy controls. Seventeen depressed patients (Hamilton depression score > 18) and an age and gender matched control group of same size participated in the study. Pain detection and tolerance thresholds to pressure and pain tolerance thresholds to the Cold Pressor Test by exposure to ice-water was measured twice in depressed patients during and after ECT and twice in controls with a similar time interval. While ECT significantly improved Hamilton depression score (from mean 23.9 (SD:5) to mean 12.5 (SD:5.7)) there was no significant change in pain thresholds during and after ECT in the patient group. However, depressed patients had significantly lower pain tolerance in the Cold Pressor Test on both examinations and on pressure pain tolerance on the second examination day than their corresponding control subjects. The differential effect of ECT on depression score and pain processing indicate that mood and noxious processing are not medicated directly by the same systems but that a complex relationship between pain and depression exists.

Adolescent↗
PubMed2004

Repetitive transcranial magnetic stimulation as add-on antidepressant treatment. The applicability of the method in a clinical setting.

Recent research indicates that repetitive transcranial magnetic stimulation (rTMS) over the frontal cortex has an antidepressant effect. The aim of the present pilot study was to assess the antidepressant effect, side-effects and the applicability in daily clinical practice of left prefrontal high-frequency rTMS. Fifteen inpatients with major depression (ICD-10 and DSM-IV) were randomized to receive 15 days of real left prefrontal high-frequency rTMS (20 trains of 10 s, 60-s interval, 10 Hz, 90% of motor threshold) or sham rTMS as add on to conventional antidepressant treatment. Depressive symptoms and side-effects were evaluated blindly during the treatment period. Five out of eight patients receiving real rTMS suffered from local discomfort during treatment. Three of them dropped out and the project was closed for that reason. Real rTMS did not add efficacy to standard antidepressant medication. This pilot study did not confirm the antidepressant effect of left frontal high-frequency rTMS. Unwanted effects led to considerable patient drop-out and premature termination of the study. The result suggests that alternative treatment delivery technology should be considered.

Adult↗
PubMed2004

Hippocampal volume and depression: a meta-analysis of MRI studies.

OBJECTIVE: Several studies have found reduced hippocampal volume in patients with unipolar depression, but discrepancies exist. The authors performed a systematic review and meta-analysis of volumetric studies of the hippocampus in patients with mood disorders. METHOD: Studies of hippocampal volume in unipolar and bipolar patients were identified. A meta-analysis of the 12 studies of unipolar depression fulfilling specific criteria was performed. The sample comprised 351 patients and 279 healthy subjects. RESULTS: The studies were highly heterogeneous regarding age and gender distribution, age at onset of the disorder, average number of episodes, and responsiveness to treatment, but the pooled effect size of depression was significant in both hemispheres for the unipolar patients. The weighted average showed a reduction of hippocampal volume of 8% on the left side and 10% on the right side. The causes of the heterogeneity were analyzed, and a meta-regression showed that the total number of depressive episodes was significantly correlated to right but not left hippocampal volume reduction. CONCLUSIONS: Hippocampal volume is reduced in patients with unipolar depression, maybe as a consequence of repeated periods of major depressive disorder. Bipolar patients did not seem to show a reduction in hippocampal volume, but this has been much less investigated.

Adult↗
PubMed2003

The Danish PET/depression project: poor verbal fluency performance despite normal prefrontal activation in patients with major depression.

The verbal fluency (VF) test is associated with prefrontal and cingulate functioning. We used positron emission tomography (PET) to test the hypothesis that inactivity in these regions can explain why patients with depression often perform poorly on this test. Forty-one patients with major depression and 46 controls were scanned during rest and during activation with the VF test. The differences between the two conditions were mapped for each of the two groups, and between-group differences in the activation pattern were calculated on a voxel-by-voxel basis. As predicted, the patients performed significantly more poorly on the test. In both groups activations were seen in the left anterior cingulate region, the left dorsolateral prefrontal cortex, the left medial prefrontal cortex, and the right cerebellum. Performance was correlated to the cerebral perfusion in to the left occipitotemporal gyrus and the left cerebellum. However, no difference in activation between the two groups was significant. The present study had sufficient power to detect potential differences between the two groups, and the subtraction tasks were appropriate. Therefore, the result supports the notion that abnormalities in the prefrontal cortex in depression are qualitative in nature rather than quantitative; this suggests depression involves dys-coordination of neural activity in the frontal lobes rather than a simple reduction in activity.

Adult↗
PubMed2003

[Measuring of preoperative anxiety by three self-reporting scales: State Trait Anxiety Inventory, Symptoms CheckList 92 and visual analogue scale].

INTRODUCTION: Preoperative anxiety is a common phenomenon. It is therefore necessary to investigate whether quantitative self-reporting anxiety scales can be helpful in the anaesthetic clinic and research. The aim of this study was to compare the state trait anxiety inventory (STAI), symptoms checklist 92 (SCL 92), the subscales anxiety and phobic anxiety, and a visual analogue scale for anxiety (VAS). MATERIAL AND METHODS: Thirty-eight women consecutively referred for elective breast surgery filled in the rating scales the day before the operation. RESULTS: A statistically significant correlation was found between STAI, SCL 92, anxiety, and VAS. The patients' STAI and SCL 92 anxiety scores were markedly higher than that of the background population. DISCUSSION: In this study the STAI scale, SCL 92 anxiety, and VAS measure all essential features of the phenomenon. SCL 92 anxiety is nevertheless considered to be the most appropriate rating scale, because it has been validated in a Danish population.

Adolescent↗
PubMed2002

[Breast feeding and treatment with antidepressive agents. A literature review].

Depression after delivery occurs frequently and, apart from being very painful, it may cause disturbance in the child's development. A number of these depressions are so severe that medical antidepressant treatment is indicated. This raises the question whether this kind of treatment should call for interruption of breast-feeding. The problem is, however, that breast-feeding is of major importance to the child, as well as to the mother. A review of present knowledge about the excretion of antidepressants in breast milk and the reports on the possible effects on the child would be useful, in order to create a qualified basis for decision-making, together with the patient, on whether or not to interrupt the breast-feeding. Furthermore, examination of the references would result in concrete guidelines for the most appropriate way of dealing with the treatment, if it is decided to continue the breast-feeding.

Antidepressive Agents↗
PubMed2002

Putative tests of frontal lobe function: a PET-study of brain activation during Stroop's Test and verbal fluency.

Stroop's test and the Verbal Fluency test are commonly argued to be measures of the integrity of the prefrontal cortex. This assumption has only to some degree been confirmed by lesion studies. In the present study, Positron Emission Tomography (PET) with H(2)(15)O was used to further validate Stroop's test and the Verbal Fluency as measures of frontal lobe function; both tests were implemented as activation paradigms during scanning of normal middleaged individuals. Stroop interference was found to activate the left anterior cingulate cortex, the supplementary motor cortex, thalamus, and the cerebellum. Although the prominent anterior cingulate activation is in the frontal lobe, it is not prefrontal. Verbal Fluency activated the left inferior frontal cortex and the left dorsolateral prefrontal cortex, the supplementary motor cortex, the anterior cingulate cortex and the cerebellum. These results bring this latter test closer to being a specific test of prefrontal function.

Adult↗
PubMed2002

Cognitive deficits in major depression.

Major depression is a mood disorder that is often accompanied by the impairment of cognitive functions. Although suggestive, the large range of existing neuropsychological, neuropsychiatric, and, lately, neuroimaging investigations have not yet given a consistent picture of the psychological and biological disturbances involved in this psychiatric disorder. The present study of the cognitive functions in depression was part of an extensive investigation, including neuropsychological testing, psychiatric examination, and neuroimaging. A representative sample of 40 severely depressed hospitalized patients and a group of 49 closely matched control subjects were tested with an extensive neuropsychological test battery. Results, corrected for various confounding factors, confirmed the current notion that depressed patients suffer from wide-spread cognitive impairments. The group analysis did not allow any hypothesis on a possible pattern to the dysfunctions, but heterogeneity in the test performances calls for further analysis of the data in patient subgroups in relation to neuroimaging results.

Adolescent↗