Basic and Clinical Aspects of Depression
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Abstracts of Poster Presentations 259 31.01.01 PHARMACOTHERAPY, PSYCHOTHERAPY, AND PSYCHOEDUCATIONAL INTERVENTIONS: EFFICACY IN RECURRENT DEPRESSION POSTER E. Frank, and D. J. Kupfer We are currently engaged in a study of maintenance treatments for PRESENTATION recurrent unipolar depression which compares the efficacy of psychotherapy, pharmacotherapy and their combination. Rather 31.01 than focusing exclusively on the number of recurrences in each of the experimental conditions, we have also been concerned with the quality of patients' lives between episodes and with the !ength of the symptom-free interval. The three-year maintenance phase of our study is still in progress; therefore, final results will not be available for another 18 months to 2 years. We can, however, discuss the information available on Basic and Clinical Aspects those 62 patients who have already experienced a recurrence of illness and for whom the blind has been broken. While the majority of Depression of recurrences have been experienced by patients in the non- medication conditions, it would appear that, with or without medication, psychotherapy has had a significant effect in delaying the onset of a new episode. At this point in time, however, we have little evidence that continued psychotherapy adds to the generally good quality of patients' social functioning in symptom-free interval. A full understanding of the additive and interactive effects of pharmacotherapy and psychotherapy in the treatment of recurrent depression must await the completion of this study ",,,'here analyses which indicate both the recurrences and the survivors will be possible, University of Pittsburgh, School of Medicine, Department of Psychiatry and Psychology, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213 31.01.02 31.01.03 CHARACTERISATIOt; OF DEPRESSIVE SUSGROUPS ON THE THE THERAPY 3F ORGANIC DEPRESSION BASIS OF PSYCHOPATHOLOGICAL,PSYCHOPHYSIOLOGICAL, Marko Munjlza NEUROENDOCRINOLOGICAL AND CLI!;IC~L PARAMETERS IN THE COURSE OF ~EPRESSION According to the recent reports ]ssued by WHO the prevalence rate of E.M.STEINHEYER,A.CZERNIK depression is from 3 to 5 per cent for the whole population. The greater comparat~an-aqysls Is presented of symptoma- incidence of ~3r~ous psychogeriatric disorders with depressive symptoma- tological,phychophysiological,neuroendocrinolo- tology, as well as numerous somatic and neurologic disorders: appears to gical,diagnosisspecific,and course-specific pa- be the sign o'~ an inCreasingly large number of somatogenic depression and rameters of 38 =emale impatients durina the de- depressive syndrome on the whole. pressive phase of and after relief from depres- Since the aet~olugy of somatogenic depression has within itself somatic, sion.We studied the state or trait dependence of neurologic, b;olugic, social and other factors, the author explores the specific reaction patterns of operationalized application of combined therapy with vasoactive substances and antide- depressive subgroups.The extent to which the pa- pressants. Data were collected prospectively on 190 patients, both genders tients can be subdividet into distinguishable (86 males and 1C4 females), in age from 45 tO 75 years, over a six weeks groups during the depressive phase and after re- period. Throughout the study, the patients received Pentoxyfilin (Trental) covery from depression,and the specific diffe- and antidepres.~nts according to the form of depressive reaction --inhibited rences between the possible subgroups are shown. or agitated picture. The results of the cluster-,discriminant-,and In addition to tee statistical analysis, particular attention is paid to the factor-analyses demonstrate a very high dominan- clinical evalu~ior of applied therapy inthe most frequent symptoms of ce of biochemical and neuroendocrinoloqical na- somatogenic depression. During the clinical evaluation different scales rameters for the determination of depression- were used in accordance with symptomatology. The combination of specific reaction patterns durin 9 depression.A PentoxyfiIin ar=:l antidepressants at all these scales appears to offer more greater coherence,i.e.,a lower indeeence of the advantages tl-en any other method improving the existing state~ of individual psychoautonomic,co9nitive,and psycho- depressive mood, depressive inhibition, symptoms of fear and SOmatic physiological systems was confirmed,which sug- manifestations. This satisfactory outcome of combined therapy also gests a narrowina and a reduction of the "de- provides improvement in the sphere of concentration and memory, grees of freedom~(HEIMANN) in the depressive producing willir~jress for social contacts and interest in work and activity. phase.After recovery from depression,psycholoni- The satifying effect of combined therapy with regard to the therapy with cal and cognitive parameters have more relevan- antidepressants only, especially in depressive, somatic and neurasthenic ce and show a high discriminant validity between difficulties, is iliu~rated most obviously by statistical analysis Where the neurotic and endogenous depressive subgroups. significant difference was obtained already at level below 0.05 for the Abtl. Psychiatrie der Medizinischen Einrichtun- benefit of Pentoxyfilin in combination with antidepressants. gender Rheinisch-Westf~lischen Technischen Hochschule Aachen,Pauwelsstr.,51&~cnen INSTITUTE FOR MENTAL HEALTH, Palmoticeva 37, 11000 Belgrade YUGOSLAVIA Belgrade University Medical ghool 260 31.01.04 31.01.05 RELATIONAL DEPRESSION RATING SCALE AND CLINICAL PATTERNS OF COGN I T I VE AND PSYCHOMOTOR ASSESSMENT OF MAPROTILINE D I STURBANCES I N DEPRESSED PAT I ENTS UNDER Y, Poinso, M. Ohayon SEDATIVE AND ACTIVATING ANTIDEPRESSIVE THERAPY Reliable rating scales are needed in multicentric trials of psychoactive drugs. The C.R. Vieira, M. Paes de Sousa~ M.L. Figueira, L.C. author presents a new depression rating scale (RDRS) stressing the Psychiatrist- Pestana, M. Feio Patient relationship during a non*directive clinical interview, our basic hypothe- Since previous studies showed that activating sis being that the clinician evaluates the severity of the depression more upon ant idepressive therapy improves cognitive and this relation than upon the seeking of the classical depressive symptoms. There- psychomotor performances of depressive patients, the fore, RDRS scans the relational elements of the interindividual communication question remained if the same effect was achieved (ie. 1) non-verbal communication tokens: features' and body's mobility, look, clo- with sedative antideoressive drugs. thes, 2) verbal communication: voice, topics, adaptability, 3) emotional display: In matched samples of depressive patients submitted effective need, anguish during the interview, aggressivity and irritability, self- to activating (Amineptine) and sedative (Dothiepine aggressivity). The 12m item is a global estimation of the quality of the and Trazodone) antidepressive treatments, , tests of psychiatrist-patient interaction. central nervous arousal (CFF), attention, Short-term RDRS performs a reliable estimation of depression, with a perfect correlation with other classical rating scales such as MADRS, as demonstrated by the statis- and iconic visual and verbal memory and choice tical assessment reaction time (CRT), were performed before and Its main interests are: 1) easy rating, even by generalists. 2) Monofactorial struc- after four weeks of treatment. The data obtained ture, all the items being closely correlated or:ly with the intensity of depression. were statistically (means, standard deviations and 3) steady logarithmic decrement of RDRS sco;es under trealmenL ANOVA) compared among themselves and also with 4) good inter-observer reliability. the data obtained with the same battery of test_-- in As an instance, the author presents the results of a mult~=ntric trial of Maprotiline a sample of normal subjects. The results were using RDRS together with other rating scales. The scale was welcomed by the analysed and discussed. clinicians, owing to the fact t~at it needs no change in their own way of interview, Dept. of Psychiatry. Faculty of Medicine of Lisbon. Its results are quite similar to those of the other rating scales used, showing no Hospital St a Maria. Av. Prof. Egas Moniz. P-1600 gross discrepancy. This study confirms the value of RDRS as a rating tool for de- Lisbon. Portugal. pression. Laboratoire de Traltemant des Connaissances, CHU Sainte-Marguerite, 270, Boulevard de Ste-Marguerite, 13009-Marseille (FRANCE) 31.01.06 31.01.07 THE INFLUENCE OF SOME PSYCHO-SOC IAL AND TAIL SUSPENSION TEST : STRAIN DIFFt~RENCES AND THE'EFFECTS PATHOLOGICAL CHARACTERISTICS OF DEPRESSIVE OF THREE ANTIDEPRESSANTS PATIENTS ON THE SYNDROMATIC EVOLUTION UNDER ANTIDEPRESSIVE THERAPY A. Len~m'c. I. AvriL L Stdru and R.D. Porsolt M. Paes de Sousa, M. L. Figueir a 424 depressive patients treated with several Mice when suspended by the tail will alternate between periods of vigorous antidepressant drugs (Clomipramine, Doxepine, activity (searching) and immobility (waiting). Immobility, like that measured in the Dibenzepine, Tandamine, Nomifensine, Amineptine, "behavioural despair" test, is reduced by a wide variety of antidepressants. The Amitrityline, Nortriptilyne and Minaprine) were procedure has been automated (ITEMATIC-TST) and permits the objective described and assessed before and after 1-2 months measurement of two parameters, immobility and the power of movements. The of treatment