Biomedical subjects

Susan G Kornstein

Publications and source records attributed to Susan G Kornstein.

23 records · Page 2Linked to original sources

PubMed2002

Chronic depression in women.

Chronic depression represents an important public health concern for women. It is underrecognized and undertreated and is associated with significant functional impairment and high rates of comorbidity. Moreover, recent research suggests that chronic depression may affect women more seriously than men; for example, women may experience illness onset at an earlier age and experience more severe psychosocial impairment compared with men. Recent studies have demonstrated the efficacy of both antidepressant medications and psychotherapy in treating chronic depression, with differential responsiveness to some treatments between women and men. Young women should be screened carefully and treated vigorously to prevent the serious consequences of this condition.

Adult↗

PubMed2002

Sexual function and satisfaction in the treatment of chronic major depression with nefazodone, psychotherapy, and their combination.

BACKGROUND: Changes in sexual interest/satisfaction and function are frequently associated with major depression and the use of some antidepressant treatments. This study compares the effects of antidepressant medication, psychotherapy, and combined treatment on sexual interest/satisfaction and function in patients with chronic major depression. METHOD: Outpatients with chronic forms of DSM-IV major depressive disorder (N = 681) were randomly assigned to 12 weeks of nefazodone, Cognitive Behavioral Analysis System of Psychotherapy (CBASP), or combined nefazodone/CBASP. The Modified Rush Sexual Inventory was used to assess sexual functioning, and the 24-item Hamilton Rating Scale for Depression was used to assess depressive symptoms. RESULTS: At baseline, 65% of men and 48% of women reported some sexual dysfunction. Statistically significant linear improvement in sexual interest/satisfaction was noted across all 3 treatment groups (p < .001). Additionally, significant improvement in sexual function was observed across all 3 treatment groups on a composite measure of female sexual function (p < .001). Controlling for depressive symptoms and gender, combined treatment produced greater improvement in total sexual interest/satisfaction than CBASP alone (p = .007), but was not significantly different from nefazodone alone. Improvement in depressive symptoms was associated with improved sexual interest/satisfaction for men and women and, for men, improved sexual functioning. CONCLUSION: Chronic depression is associated with high rates of sexual dysfunction. Treatment with nefazodone, CBASP, and combined treatment improved sexual interest/satisfaction, with greatest improvement observed with combined treatment.

Adult↗

PubMed2002

Remission as the critical outcome of depression treatment.

Major depressive disorder is currently the fourth largest contributor to the worldwide burden of disease. Direct and indirect costs associated with depression place a significant burden on the health care system and society. Despite the development of new antidepressant medications, the management of patients with depression remains a therapeutic challenge. Obtaining a response in antidepressant therapy-commonly defined in clinical trials as an improvement of >erotonergic and noradrenergic neurotransmission, will increase the likelihood of remission.

Antidepressive Agents↗

PubMed2002

Gender-specific differences in depression and treatment response.

Epidemiologic studies have shown that the prevalence of depression is about twice as high in women than in men. Both neurobiologic and psychosocial factors may contribute to this difference. Gender differences in depression have also been noted with regard to symptom presentation, comorbid disorders, course of illness, and response to treatment. This article provides an overview of gender differences in the phenomenology and treatment of depression, particularly the effect of gender on antidepressant treatment response. Clinicians should consider gender as a factor in both the assessment and treatment of depression.

Antidepressive Agents↗

PubMedDate not supplied

Expert guidelines for the treatment of severe PMS, PMDD, and comorbidities: the role of SSRIs.

The hallmark feature of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) is the predictable, cyclic nature of symptoms or distinct on/offness that begins in the late luteal phase of the menstrual cycle and remits shortly after the onset of menstruation. PMDD is distinguished from PMS by the severity of symptoms, predominance of mood symptoms, and role dysfunction, particularly in personal relationships and marital/family domains. Several treatment modalities are beneficial in PMDD and severe PMS, but the selective serotonin reuptake inhibitors (SSRIs) have emerged as first-line therapy. The SSRIs can be administered continuously throughout the entire month, intermittently from ovulation to the onset of menstruation, or semi-intermittently with dosage increases during the late luteal phase. These guidelines present practical treatment algorithms for the use of SSRIs in women with pure PMDD or severe PMS, PMDD and underlying subsyndromal clinical features of mood or anxiety, or premenstrual exacerbation of a mood/anxiety disorder.

Anxiety↗