- Email: [email protected]
P.2.056 Prevalence of depressive symptoms and cognitive deterioration in elderly people and correlation between them
$416
•
P2 Affective disorders and antidepressants Levetiracetam add-on treatment for bipolar patients suffering from subsyndromal symptoms: preliminary data of an open 6-months longitudinal study
B. Bernhard*, C. Born, F. Seemuller, H. Grunze. Ludwig Maximilians University Hospital, Psychiatty and Psychotherapy, Munich, Germany I n t r o d u c t i o n : Several antiepileptic drugs (AEDs) have shown
efficacy in stabilising mood in bipolar disorders during recent decades. Levetiracetam (LEV) is a novel AED with broad spectrum efficacy in epilepsy. Single case reports indicate mood stabilising efficacy in acute phases of bipolar disorder. Our study evaluated LEV efficacy given for 6 months in bipolar patients suffering subsyndromal symptoms. M e t h o d s : Patients were included with Young Mania Rating Scale (YMRS) scores ~<12 points and Inventory of Depressive Symptoms-Clinician Version (IDS-C) scores ~<16 points. LEV doses were titrated between 2000 nag/day and 4000 nag/day depending on tolerability. During the 6-month study period, ratings were carried out at monthly visits using YMRS, IDS-C, Clinical Global Impression Scale-Bipolar Version (CGI-BP), Global Assessment of Functioning Scale (GAF), and prospective National Institute of Mental Health Lifechart methodology (NIMHLCM) for the assessment of psychopathology. Side effects were assessed using the scale developed by Udvalg for Kliniske Undersoegelser (UKU-scale) and the Sexual Functioning Questionnaire (CSFQ). We also looked for anxiety using Boerner's Anxiety Scale (BOEAS). Results: 16 patients, aged 25 70 (median 50) years, suffering subsyndromal symptoms were included. Medication at study entry comprised one or a combination of lithium (n 6), antipsychotic (n 10), other AED (n 9). LEV was added at a mean dose of 1875 mg/day and patients followed up for a mean of 88 (range 14 200) days. We observed a significant decrease in the YMRS score (p < 0.01) and a slight increase of the IDS-C score however not statistically significant (p > 0.05). 11 (69%) patients discontinued LEV therapy due to depressive symptom increase (n 8, 73%) or lack of compliance (n 3, 27%). No manic exacerbations nor other adverse events were recorded. Mean LEV dose of patients who did not discontinue was 2600 mg/kg/day. C o n c l u s i o n : The preliminary results of this study are in accordance with former observations of the antimanic efficiency of LEV. LEV may be a suitable alternative for stabilising patients with mild manic symptoms. This study was supported by UCB Pharma, Germany.
•
Prevalence of depressive symptoms and cognitive deterioration in elderly people and correlation between them
M.C. Garcia Mahia, C. Cimadevila Alvarez, M. Vidal Millares *, J. Brenlla Gonzalez, J. Fraiz Calvo. Hospital Gil Casares,
Psychiatty, Santiago de Compostela (La Coru~a), Spain I n t r o d u c t i o n : Depression is a prevalent illness in elderly people.
Cognitive deterioration associated to depressive symptoms is frequently considered as Dementia, specially in Primary Care. The study of the relation between both pathologies is necessary for the treatment of mental illness in elderly people.
Objective: The aim of this study is to investigate whether depressive syptoms are related to certain areas of cognitive decline in elderly people. M e t h o d s : Sample was composed of community people older than 65 years (n 927), mean age 72.9; 55.1% were women and 44.9% men. Depressive symptoms were measured by Beck Depression Inventory (BDI). Instruments used to study cognitive function were Blessed Dementia Scale (BDS), Mini Mental State Examination (MMSE), Verbal fluency test, Clock Drawing Task, Wechsler digit substitution test and Wechsler similarity test. Results were analyzed with SPSS v 12.0 for windows. Results: 15.2% of the sample present cognitive deterioration in Blessed Dementia Scale, with statistical significance in relation between growing age, female sex and cognitive deterioration (p < 0.005). Using MMSE 28% of the sample present cognitive decline, finding the same relation between sex, age and cognitive condition. 33.5% of the sample present mild depression, 9.1% moderate depression and 1.4% present severe depression using BDI. Correlations between depression and cognitive tests were analyzed. In demographic factors low income and social support was significantly correlated with depression but marital status, occupation and education were not correlated. The scores of BDI were correlated with the MMSE and BDS. C o n c l u s i o n s : There is a high prevalence of depressive symptoms and cognitive deterioration in elderly people. High levels of depressive symptoms are associated with cognitive deterioration, especially in comprehension and judgment, delayed recall, verbal memory and visuospacial coordination in elderly people.
References [1] Folstein MF, Folstein SE, McHugh PR. Mini-mental state: a practical method for grading cognitive state of patients for the clinical. J. Psychatr Res 1975: 12; 18~198. [2] Ballard CG, Bannister C, Oyebode E Depression in dementia sufferers. Int J Geriatr Psychiatry 1996b; 11:507 15.
•
Confirmed clinical efficacy of agomelatine (25-50 mg) in major depression: two randomized, double blind, placebo-controlled studies
J.R Oli61 *, R. Emsley 2. ]Sainte-Anne Hospital, University Department of Psychiatry, Paris cedex 14, France; 2Faculty of Medicine, Psychiatty, South Afi'ica A i m of the studies: Agomelatine, the first melatonin receptor agonist antidepressant, has proven its efficacy in major depressive disorder (MDD) in a pivotal 8-week study with 711 patients[l]. In this dose ranging study, agomelatine 25 nag/day demonstrated a significant antidepressant efficacy versus placebo with a good tolerability. The two presented 6-week studies were aimed to confirm the efficacy and safety of agomelatine in the treatment of MDD, starting at 25 nag/day with the possibility of increasing at 50rag/day after two weeks of treatment in case of insufficient improvement. M e t h o d s : Patients (212 in the first study and 238 in the second one) fulfilling DMS-IV criteria for MDD were randomised to agomelatine 25rag or placebo. In the first study, 107 patients received agomelatine and 105 placebo, with respective mean baseline scores of 26.5 and 26.7 on the Hamilton Depression scale (HAM-D). In the second study, 118 patients received agomelatine and 120 placebo, with respective baseline scores of 27.4 and 27.2. Insufficient improvement was based on the HAM-D and
•
P2 Affective disorders and antidepressants Levetiracetam add-on treatment for bipolar patients suffering from subsyndromal symptoms: preliminary data of an open 6-months longitudinal study
B. Bernhard*, C. Born, F. Seemuller, H. Grunze. Ludwig Maximilians University Hospital, Psychiatty and Psychotherapy, Munich, Germany I n t r o d u c t i o n : Several antiepileptic drugs (AEDs) have shown
efficacy in stabilising mood in bipolar disorders during recent decades. Levetiracetam (LEV) is a novel AED with broad spectrum efficacy in epilepsy. Single case reports indicate mood stabilising efficacy in acute phases of bipolar disorder. Our study evaluated LEV efficacy given for 6 months in bipolar patients suffering subsyndromal symptoms. M e t h o d s : Patients were included with Young Mania Rating Scale (YMRS) scores ~<12 points and Inventory of Depressive Symptoms-Clinician Version (IDS-C) scores ~<16 points. LEV doses were titrated between 2000 nag/day and 4000 nag/day depending on tolerability. During the 6-month study period, ratings were carried out at monthly visits using YMRS, IDS-C, Clinical Global Impression Scale-Bipolar Version (CGI-BP), Global Assessment of Functioning Scale (GAF), and prospective National Institute of Mental Health Lifechart methodology (NIMHLCM) for the assessment of psychopathology. Side effects were assessed using the scale developed by Udvalg for Kliniske Undersoegelser (UKU-scale) and the Sexual Functioning Questionnaire (CSFQ). We also looked for anxiety using Boerner's Anxiety Scale (BOEAS). Results: 16 patients, aged 25 70 (median 50) years, suffering subsyndromal symptoms were included. Medication at study entry comprised one or a combination of lithium (n 6), antipsychotic (n 10), other AED (n 9). LEV was added at a mean dose of 1875 mg/day and patients followed up for a mean of 88 (range 14 200) days. We observed a significant decrease in the YMRS score (p < 0.01) and a slight increase of the IDS-C score however not statistically significant (p > 0.05). 11 (69%) patients discontinued LEV therapy due to depressive symptom increase (n 8, 73%) or lack of compliance (n 3, 27%). No manic exacerbations nor other adverse events were recorded. Mean LEV dose of patients who did not discontinue was 2600 mg/kg/day. C o n c l u s i o n : The preliminary results of this study are in accordance with former observations of the antimanic efficiency of LEV. LEV may be a suitable alternative for stabilising patients with mild manic symptoms. This study was supported by UCB Pharma, Germany.
•
Prevalence of depressive symptoms and cognitive deterioration in elderly people and correlation between them
M.C. Garcia Mahia, C. Cimadevila Alvarez, M. Vidal Millares *, J. Brenlla Gonzalez, J. Fraiz Calvo. Hospital Gil Casares,
Psychiatty, Santiago de Compostela (La Coru~a), Spain I n t r o d u c t i o n : Depression is a prevalent illness in elderly people.
Cognitive deterioration associated to depressive symptoms is frequently considered as Dementia, specially in Primary Care. The study of the relation between both pathologies is necessary for the treatment of mental illness in elderly people.
Objective: The aim of this study is to investigate whether depressive syptoms are related to certain areas of cognitive decline in elderly people. M e t h o d s : Sample was composed of community people older than 65 years (n 927), mean age 72.9; 55.1% were women and 44.9% men. Depressive symptoms were measured by Beck Depression Inventory (BDI). Instruments used to study cognitive function were Blessed Dementia Scale (BDS), Mini Mental State Examination (MMSE), Verbal fluency test, Clock Drawing Task, Wechsler digit substitution test and Wechsler similarity test. Results were analyzed with SPSS v 12.0 for windows. Results: 15.2% of the sample present cognitive deterioration in Blessed Dementia Scale, with statistical significance in relation between growing age, female sex and cognitive deterioration (p < 0.005). Using MMSE 28% of the sample present cognitive decline, finding the same relation between sex, age and cognitive condition. 33.5% of the sample present mild depression, 9.1% moderate depression and 1.4% present severe depression using BDI. Correlations between depression and cognitive tests were analyzed. In demographic factors low income and social support was significantly correlated with depression but marital status, occupation and education were not correlated. The scores of BDI were correlated with the MMSE and BDS. C o n c l u s i o n s : There is a high prevalence of depressive symptoms and cognitive deterioration in elderly people. High levels of depressive symptoms are associated with cognitive deterioration, especially in comprehension and judgment, delayed recall, verbal memory and visuospacial coordination in elderly people.
References [1] Folstein MF, Folstein SE, McHugh PR. Mini-mental state: a practical method for grading cognitive state of patients for the clinical. J. Psychatr Res 1975: 12; 18~198. [2] Ballard CG, Bannister C, Oyebode E Depression in dementia sufferers. Int J Geriatr Psychiatry 1996b; 11:507 15.
•
Confirmed clinical efficacy of agomelatine (25-50 mg) in major depression: two randomized, double blind, placebo-controlled studies
J.R Oli61 *, R. Emsley 2. ]Sainte-Anne Hospital, University Department of Psychiatry, Paris cedex 14, France; 2Faculty of Medicine, Psychiatty, South Afi'ica A i m of the studies: Agomelatine, the first melatonin receptor agonist antidepressant, has proven its efficacy in major depressive disorder (MDD) in a pivotal 8-week study with 711 patients[l]. In this dose ranging study, agomelatine 25 nag/day demonstrated a significant antidepressant efficacy versus placebo with a good tolerability. The two presented 6-week studies were aimed to confirm the efficacy and safety of agomelatine in the treatment of MDD, starting at 25 nag/day with the possibility of increasing at 50rag/day after two weeks of treatment in case of insufficient improvement. M e t h o d s : Patients (212 in the first study and 238 in the second one) fulfilling DMS-IV criteria for MDD were randomised to agomelatine 25rag or placebo. In the first study, 107 patients received agomelatine and 105 placebo, with respective mean baseline scores of 26.5 and 26.7 on the Hamilton Depression scale (HAM-D). In the second study, 118 patients received agomelatine and 120 placebo, with respective baseline scores of 27.4 and 27.2. Insufficient improvement was based on the HAM-D and