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Biomedical subjects

Y Meesters

Publications and source records attributed to Y Meesters.

At least 19 recordsLinked to original sources
PubMed2006

Clinical efficacy of agomelatine in depression: the evidence.

Despite the advances of recent decades, there is still an urgent need for antidepressants with improved efficacy, safety and tolerability. Agomelatine is a new antidepressant with an innovative pharmacological profile. It is the first melatonergic antidepressant, and is a potent agonist of melatonin receptors (MT1 and MT2) with 5-HT2C antagonist properties. The efficacy of 25 mg/day agomelatine in treating major depressive disorder (MDD) has been demonstrated in a number of placebo-controlled studies. Evidence of improvement in depressive symptoms was observed in a dose-ranging study in which 25 mg/day agomelatine was significantly better than placebo, whatever the rating scale used (Hamilton Rating Scale for Depression, Clinical Global Impression, and Montgomery-Asberg Depression Rating Scale). These results have been confirmed in two similarly designed placebo-controlled studies. Agomelatine also produces a significant improvement in anxiety compared to placebo, according to Hamilton Rating Scale for Anxiety scores. The efficacy of agomelatine has been studied in subpopulations with more severe depression, demonstrating its efficacy in these difficult-to-treat patients. In view of the available data on agomelatine, this antidepressant can be regarded as an innovative treatment for MDD patients, offering a new approach in the management of depressed patients.

Acetamides↗
PubMed2006

[A comparative study of two methods of personality assessment, the TCI and the NVM (Dutch shortened version of the MMPI)].

BACKGROUND: Various types of reliable instruments are available for measuring personality dimensions. One of these instruments is the NVM, which is a Dutch shortened version of the Minnesota Multiphasic Personality Inventory, but its use is no longer permitted. AIM: To find out whether the Temperament and Character Inventory (TCI) can serve as an alternative to the NVM. METHOD: A study has compared the NVM questionnaire to the TCI, which is a personality questionnaire designed from a more psychiatric perspective. The two types of questionnaire were completed by 91 psychiatric (out)patients. Correlation analyses were performed. RESULTS: Statistically significant correlations were found between the various scales of the NVM and the TCI. Unique combinations of the TCI scales were found to predict the various NVM scales. CONCLUSION: It is worth considering the TCI as an alternative to the NVM.

Adolescent↗
PubMed2001

Extraocular light therapy in winter depression: a double-blind placebo-controlled study.

BACKGROUND: It has been hypothesized that the circadian pacemaker is phase delayed in seasonal affective disorder, (SAD) winter type, and that the phase advance resulting from morning ocular light accounts for the efficacy of light therapy. Extraocular light has been reported to produce phase-shifts of the human circadian pacemaker. This allows a double-blind, placebo-controlled study of light therapy in SAD. METHODS: Twenty-nine SAD patients participated. Clinical state was measured on days 1, 8, and 15 of the protocol. From days 4 through 8, 15 patients (4 M, 11 F) received extraocular light by fiberoptic illumination, and 14 (4 M, 10 F) placebo (no light) in the popliteal fossae, from 8 AM to 11 AM. In the evenings of days 3 and 8, the salivary dim light melatonin onset (DLMO) was assessed. Patients completed daily self-ratings on mood, alertness, and sleep. RESULTS: Both conditions showed a progressive improvement of clinical state over time. Between conditions, no significant differences were observed in clinical scores, the self-ratings on mood and alertness, and in timing of the DLMO before and directly after treatment. CONCLUSIONS: The response to extraocular light therapy in SAD patients did not exceed its placebo effect. Extraocular light did not induce a phase shift of the circadian pacemaker.

Adult↗
PubMed2000

Nonverbal interpersonal attunement and extravert personality predict outcome of light treatment in seasonal affective disorder.

We investigated whether personality and nonverbal interpersonal processes can predict the subsequent response to light treatment in seasonal affective disorder (SAD) patients. In 60 SAD patients, Neuroticism and Extraversion were assessed prior to light treatment (4 days with 30 min of 10.000 lux). From videotaped clinical interviews, the nonverbal interpersonal attunement (i.e. equalizing durations and frequencies of elements of behaviour between conversation partners) was registered for the patients' support seeking and the interviewers' support giving behaviour. The higher Extraversion and the more the patients and the interviewers got attuned over the interview, the more favourable the outcome of light treatment was. Hence, personality and nonverbal interpersonal processes may be involved in the response to light treatment in SAD.

Adolescent↗
PubMed1999

Prophylactic treatment of seasonal affective disorder (SAD) by using light visors: bright white or infrared light?

BACKGROUND: Thirty-eight patients with SAD participated in a light visor study addressing two questions. 1. Can the development of a depressive episode be prevented by daily exposure to bright light started before symptom onset in early fall and continued throughout the winter? 2. Does the light have to be visible in order to have beneficial effects? METHODS: Three groups participated in the study: I (n = 14) received bright white light (2500 lux); II, (n = 15) received infrared light (0.18 lux); III (n = 9, control group) did not receive any light treatment at all. RESULTS: Infrared light is just as effective as bright white light. Both are more effective than the control condition. CONCLUSIONS: Light visors can be effectively used to prevent the development of SAD. The fact that exposure to infrared light was as effective as exposure to bright white light questions the specific role of visible light in the treatment of SAD.

Adult↗
PubMed1998

Case study: dawn simulation as maintenance treatment in a nine-year-old patient with seasonal affective disorder.

After four winter seasons of successful treatment with light boxes, a 9-year-old patient with seasonal affective disorder refused to make further use of the light box. Instead he was treated with dawn simulation (a dim light administered just before waking up and gradually increased in intensity). The patient used dawn simulation therapy from October until mid-May, with an occasional variation of the maximum light intensity (100, 200, or 300 iux). The patient, his parents, and his teacher were all happy with this type of treatment.

Child↗
PubMed1997

Prediction of acute and late responses to light therapy from vocal (pitch) and self-rated activation in seasonal affective disorder.

It was hypothesized that pre-treatment activation plays a role in the response to light therapy in Seasonal Affective Disorder (SAD). In 55 SAD patients (DSMIII-R) energetic and tense activation was assessed before light therapy via self-rating (AD-ACL) and voice sound characteristics (mean pitch and variation in pitch). These variables were studied in relation to the "acute" response to 4 days of light therapy (30 min, 10000 lux) and to a "late" response (11 (10) days after light therapy had stopped). Acute response was defined as the percent change in 3 times daily self-rated depressed mood (AMS) with respect to the average of 4 baseline days. "Late" response was defined as the percent change in HRSD or AMS scores between baseline and 11 (10) days after light therapy. It was found that patients having high pitched voices with small variation in this pitch benefitted more from light therapy than the patients with low pitch and large variation in pitch levels. This effect was only significant after the first day of light exposure. No other significant relations were found between baseline activation and acute or late responses to light therapy. Hence, light therapy seems to give extra comfort in "tense" patients, who become rapid responders to light therapy.

Adult↗
PubMed1995

[Light therapy in 3 children with winter depression].

In three children, boys of 5 and 13 years old and a girl aged 10, seasonal affective disorder was diagnosed based on mood changes (listlessness, fears) and increased sleepiness in the winter season. They were treated successfully with light therapy (5 consecutive days 30 min 10,000 lux of full spectrum light without ultraviolet). In two patients the disorder recurred in the fall/winter the year(s) thereafter, and they were again treated successfully.

Adolescent↗
PubMed1995

Observed behavior of patients with seasonal affective disorder and an interviewer predicts response to light treatment.

We investigated whether observable behavior of seasonal affective disorder (SAD) patients and an interviewer during an interview before light treatment is related to the response to the light treatment. Different observed behavioral elements of 24 SAD patients and of 2 interviewers, assessed before light treatment, were reduced to "behavioral factors." Forward multiple regression analyses were applied to investigate whether these factors might predict the response to light therapy (3 h of bright light between 09:00 and 12:00 h or between 18:00 and 21:00 h on 5 consecutive days). In addition, it was investigated whether the interviewers' factors could be predicted from the patients' factors. Both patients' and interviewers' factors predicted the response to light treatment. Response-related factors of patients and interviewers were interrelated. The results suggest that behavioral processes may play a role in the mechanisms underlying the response to light treatment in SAD. They support the relevance of interpersonal theories in seasonal depression.

Adult↗
PubMed1995

Light therapy for seasonal affective disorder. The effects of timing.

BACKGROUND: Sixty-eight patients with seasonal affective disorder participated in a 10,000-lux light treatment study in which two questions were addressed: do response rates differ when the light is applied at different times of the day and does short-term rank ordering of morning and evening light influence response rates? METHOD: Three groups of patients received a 4-day light treatment: (I) in the morning (8.00-8.30 a.m., n = 14), (II) in the afternoon (1.00-1.30 p.m., n = 15) or (III) in the evening (8.00-8.30 p.m., n = 12). Two additional groups of patients received two days of morning light treatment followed by two days of evening light (IV, n = 13) or vice versa (V, n = 14). RESULTS: Response rates for groups I, II and III were 69, 57 and 80% respectively, with no significant differences between them. Response rates for groups IV and V were 67 and 50% respectively; this difference was not significant and these percentages did not differ significantly from those of groups I and III. CONCLUSIONS: The results indicate that the timing of light treatment is not critical and that short-term rank ordering of morning and evening light does not influence therapeutic outcome.

Adult↗
PubMed1994

Relationship between cognitive sensitivity to (symbolic) light in remitted seasonal affective disorder patients and the onset time of a subsequent depressive episode.

The role of cognitive sensitivity to light in the development of seasonal affective disorder (SAD, winter type) was studied by comparing 29 SAD patients during remission with 29 non-depressed controls matched by sex and age, and by relating measures for cognitive sensitivity of remitted SAD patients to the onset of a depressive episode during the following autumn/winter. To ensure that only cognitive processes were involved, the subjects were exposed to symbolic light. Three schematic drawings of ambiguous faces expressing different emotions were embedded in light or dark backgrounds for this purpose. The subjects rated the various facial expressions with respect to the degree of elation-sadness, rejection-invitation, and activation-sleepiness. SAD patients saw larger differences in activation between faces embedded in light and dark backgrounds than controls, perceiving less activation in faces with dark backgrounds. Furthermore, the larger the difference that SAD patients saw in invitation between faces with light and dark backgrounds, the earlier they became depressed in the subsequent autumn/winter. Only the SAD patients who became depressed early (before December 21) differed from controls in the perception of invitation. Results are interpreted within the framework of psychological theories on the development of depression and suggest that altered cognitive sensitivity of SAD patients to light plays a role in the development of depressive episodes.

Adult↗
PubMed1993

Morning and evening light treatment of seasonal affective disorder: response, relapse and prediction.

Patients with seasonal affective disorder were randomly assigned to treatment with light in the morning (9.00-12.00 a.m.; n = 16; ML) or evening (6.00-9.00 p.m.; n = 11; EL). An intensive 24-day assessment procedure revealed the same response rates: 57% for ML, 50% for EL. During the rest of the winter season a relatively low relapse rate of 54% was found. No differences between ML and EL were found in the time course of depressed mood or fatigue. A significant negative correlation was found between diurnal variation during baseline and therapeutic response: the larger the diurnal variation the less the response, indicating a potential negative predictive value for this symptom. There were no significant correlations between baseline fatigue or hypersomnia and response.

Adult↗
PubMed1993

Assessing atypical seasonal affective disorder complaints by means of self-rating.

The atypical complaints of Seasonal Affective Disorder (SAD) are usually assessed clinically by means of 7 questions added to the Hamilton Rating Scale for Depression (HRSDadd). In this study, these complaints were assessed by means of relevant and modified items of the Beck Depression Inventory (BDIadd), a self-rating instrument. A highly significant correlation between the two assessment procedures was found. This suggests that the BDIadd is a very useful alternative to the HRSDadd.

Adult↗