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P.2.a Affictive disorders and antidepressants - Affective disorders (clinical) Conclusions: Most depressed patients who are prescribed a hypnotic continue such treatment for much longer than is recommended. Duration of use varies considerably by age, with elderly patients being most likely to be treated for longer periods. This is of particular concern due to the increased likelihood of adverse drug reactions, such as falling and cognitive deficits, associated with the use of benzodiazepines in elderly patients. This study was funded by Servier Laboratories Limited, UK. GPRD is owned by the UK Department of Health and operates within the Medicines and Healthcare products Regulatory Agency (MHRA). GPRD is funded by the MHRA, Medical Research Council, various universities, contract research organisations and pharmaceutical companies. The views expressed in this abstract are those of the authors and do not reflect the official policy or position of the Medicines and Healthcare products Regulatory Agency, UK.
Ip.2.a.0361 Depression and anxiety among couples presenting for In-Vitro-Fertilization and Embryo Transfer (IVF/ET)
S381
However, men had a depressive or anxiety disorder only in the presence of a male factor as the etiology for infertility. Suicidal ideation was present in 30% of the study group, and was reported by significantly more women (50%) than men (10%). Across all scales, the factors of anxiety, depression and somatization were significantly higher than other factors. Seventy percent of couples had at least one partner with a DSM-IV diagnosable psychiatric disorder. Conclusions: Depressive and anxiety disorders are prevalent among couples presenting for IVF-ET. Women are affected significantly more often than men, regardless ofthe etiology ofinfertility. Our study highlights the importance of screening for depression and anxiety with early, appropriate intervention in this population. References [1] Demyttenaere K, Bonte L, Gheldof M, Vervaeke M, Meuleman C, Vanderschuerem D, D'Hooghe T. Coping style and depression level influence outcome in in-vitro fertilization. Fertility and Sterility. 1998: 60: 1026-33. [2] Beutel M, Kupfer J, Kirchmeyer P, Kehde S, Kohn FM, SchroederPrintzen I, Gips H, Herrero HJ, Weidner W. Treatment-related stresses and depression in couples undergoing assisted reproductive treatment by IVF or ICSI. Andrologia 1999; 31: 27-35.
S. Sonawalla1 ., R. Parikh1 , F. Parikh1 . 1Jaslok Hospital and Research Center, Psychiatry, Mumbai, India Purpose: Infertility affects an estimated 10-15% of couples of the reproductive age. In addition to being a medical and a social crisis, infertility can be a psychological crisis, which can threaten marital stability, adversely affect inter-personal relationships and even physical health, and leave the couple with a sense of total loss of control. Technology for assisted reproduction has advanced at a rapid pace in recent years. Infertility treatment, especially with techniques such as In-Vitro Fertilization and Embryo Transfer (IVF-ET), can be an arduous and expensive process for the couple, fraught with uncertainty, physical discomfort, and ethical and financial concerns, contributing to stress in these couples. Studies have suggested that patients undergoing in-vitro fertilization-embryo transfer (IVF-ET) experience high levels of stress, depression and anxiety. The purpose of this study was to examine the prevalence of depression and anxiety in 30 consecutive couples presenting for IVF-ET at an assisted reproduction center in Bombay. Methods: We evaluated 60 outpatients (30 consecutive couples) (mean age: 32.3 + 5.2 years; 30 men, 30 women) presenting for IVF/ET at our center for assisted reproduction in Bombay, India. All couples were interviewed individually first, then together, using a semi-structured interview technique which was devised for them. A clinical diagnosis was made using the DSM-IV (Diagnostic and Statistical Manual-IV (American Psychiatric Association, 1994). We administered six rating scales to each patient: three self-rated and three clinician-rated. These were: The Hamilton Depression Rating Scale (HDRS), The Hamilton Anxiety Rating Scale (HARS), The Brief Psychiatric Rating Scale (BPRS), and The Self-Rating Symptom Scale (SRSS). All couples were briefly counseled at the end of the interview and referred when indicated to a hospital psychiatrist for further management. The data was analyzed using the Statistical Package for Social Sciences (SPSS). Summary of results: We found that 40% of the study population met DSM-IV criteria for an axis I mood or anxiety disorder: 15% had major depressive disorder (MDD), 18.3% had dysthymic disorder, and 6.7% had an anxiety disorder. Women had a significantly higher prevalence of depressive and anxiety disorders compared to men, regardless ofthe etiology of infertility.
1p.2.a.0371 The efficacy and safety of milnacipran 50 mg bid in patients with major depression: the results of a clinical trial A. Gogus 1 , T. Oral2 ., O. Berksun3 , O. Karamustafalioglu4 , S. Vahip 5, Z. Tunca6 , O. Yazice. 1Hacettepe University Medical Faculty, Psychiatry Dept., Ankara, Turkey; 2Bakirkoy Mental Hospital, Psychiatry Dept., Istanbul, Turkey; 3Ankara University Medical Faculty, Psychiatry Dept., Ankara, Turkey; 4 Sisli Etfal Training and Research Hospital, Psychiatry Dept., Istanbul, Turkey; 5 Ege University Medical Faculty, Psychiatry Dept., Izmir, Turkey; 6 Dokuz Eylul University Medical Faculty, Psychiatry Dept., Izmir, Turkey; 7Istanbul University Istanbul Medical Faculty, Psychiatry Dept., Istanbul, Turkey Objective: Milnacipran has been proved to be effective and safe in the treatment of major depression. In this study, the efficacy and safety ofmilnacipran administered 100mg daily for 8 weeks, in outpatients with moderate to severe depression, are evaluated. Methods: Seventy patients, of whom 57 are female, in age range of 19-62 years, with Montgomery-Asberg Depression Rating Scale (MADRS) total score >=20 are enrolled at six sites. After a one-week run-in period, all were put on milnacipran treatment starting with 25 mg in the evening on the first day and up titrating to 50 mg bid within one week. MADRS, Hamilton Depression Rating Scale with 17 items (Hamilton-17) and Clinical Global Impression (CGI) scales were administered at baseline and also at weeks 1, 2, 4, 6 and 8. Systematic questioning of adverse events was performed also at all post-baseline visits. Classification of adverse events was performed according to MedORA dictionary. All analysis presented here are performed in intent-to-treat (ITT) population with Last-Observation-Carried-Forward (LOCF) approach applied for missing data. Comparisons of mean scale scores between visits were done by Student's t test with Bonferroni correction for multiple pairwise comparisons. Results: Fifty-nine (84%) patients attended to week 4 and 51 (73%) patients attended to week 8. MADRS scores decreased from 32.1±6.0 at baseline to 25.0±8.2 at week 1, to 19.6±8.2 at week 2, to 16.4±8.6 at week 4, to 13.4±9.5 at week 6 and to
Ip.2.a.0361 Depression and anxiety among couples presenting for In-Vitro-Fertilization and Embryo Transfer (IVF/ET)
S381
However, men had a depressive or anxiety disorder only in the presence of a male factor as the etiology for infertility. Suicidal ideation was present in 30% of the study group, and was reported by significantly more women (50%) than men (10%). Across all scales, the factors of anxiety, depression and somatization were significantly higher than other factors. Seventy percent of couples had at least one partner with a DSM-IV diagnosable psychiatric disorder. Conclusions: Depressive and anxiety disorders are prevalent among couples presenting for IVF-ET. Women are affected significantly more often than men, regardless ofthe etiology ofinfertility. Our study highlights the importance of screening for depression and anxiety with early, appropriate intervention in this population. References [1] Demyttenaere K, Bonte L, Gheldof M, Vervaeke M, Meuleman C, Vanderschuerem D, D'Hooghe T. Coping style and depression level influence outcome in in-vitro fertilization. Fertility and Sterility. 1998: 60: 1026-33. [2] Beutel M, Kupfer J, Kirchmeyer P, Kehde S, Kohn FM, SchroederPrintzen I, Gips H, Herrero HJ, Weidner W. Treatment-related stresses and depression in couples undergoing assisted reproductive treatment by IVF or ICSI. Andrologia 1999; 31: 27-35.
S. Sonawalla1 ., R. Parikh1 , F. Parikh1 . 1Jaslok Hospital and Research Center, Psychiatry, Mumbai, India Purpose: Infertility affects an estimated 10-15% of couples of the reproductive age. In addition to being a medical and a social crisis, infertility can be a psychological crisis, which can threaten marital stability, adversely affect inter-personal relationships and even physical health, and leave the couple with a sense of total loss of control. Technology for assisted reproduction has advanced at a rapid pace in recent years. Infertility treatment, especially with techniques such as In-Vitro Fertilization and Embryo Transfer (IVF-ET), can be an arduous and expensive process for the couple, fraught with uncertainty, physical discomfort, and ethical and financial concerns, contributing to stress in these couples. Studies have suggested that patients undergoing in-vitro fertilization-embryo transfer (IVF-ET) experience high levels of stress, depression and anxiety. The purpose of this study was to examine the prevalence of depression and anxiety in 30 consecutive couples presenting for IVF-ET at an assisted reproduction center in Bombay. Methods: We evaluated 60 outpatients (30 consecutive couples) (mean age: 32.3 + 5.2 years; 30 men, 30 women) presenting for IVF/ET at our center for assisted reproduction in Bombay, India. All couples were interviewed individually first, then together, using a semi-structured interview technique which was devised for them. A clinical diagnosis was made using the DSM-IV (Diagnostic and Statistical Manual-IV (American Psychiatric Association, 1994). We administered six rating scales to each patient: three self-rated and three clinician-rated. These were: The Hamilton Depression Rating Scale (HDRS), The Hamilton Anxiety Rating Scale (HARS), The Brief Psychiatric Rating Scale (BPRS), and The Self-Rating Symptom Scale (SRSS). All couples were briefly counseled at the end of the interview and referred when indicated to a hospital psychiatrist for further management. The data was analyzed using the Statistical Package for Social Sciences (SPSS). Summary of results: We found that 40% of the study population met DSM-IV criteria for an axis I mood or anxiety disorder: 15% had major depressive disorder (MDD), 18.3% had dysthymic disorder, and 6.7% had an anxiety disorder. Women had a significantly higher prevalence of depressive and anxiety disorders compared to men, regardless ofthe etiology of infertility.
1p.2.a.0371 The efficacy and safety of milnacipran 50 mg bid in patients with major depression: the results of a clinical trial A. Gogus 1 , T. Oral2 ., O. Berksun3 , O. Karamustafalioglu4 , S. Vahip 5, Z. Tunca6 , O. Yazice. 1Hacettepe University Medical Faculty, Psychiatry Dept., Ankara, Turkey; 2Bakirkoy Mental Hospital, Psychiatry Dept., Istanbul, Turkey; 3Ankara University Medical Faculty, Psychiatry Dept., Ankara, Turkey; 4 Sisli Etfal Training and Research Hospital, Psychiatry Dept., Istanbul, Turkey; 5 Ege University Medical Faculty, Psychiatry Dept., Izmir, Turkey; 6 Dokuz Eylul University Medical Faculty, Psychiatry Dept., Izmir, Turkey; 7Istanbul University Istanbul Medical Faculty, Psychiatry Dept., Istanbul, Turkey Objective: Milnacipran has been proved to be effective and safe in the treatment of major depression. In this study, the efficacy and safety ofmilnacipran administered 100mg daily for 8 weeks, in outpatients with moderate to severe depression, are evaluated. Methods: Seventy patients, of whom 57 are female, in age range of 19-62 years, with Montgomery-Asberg Depression Rating Scale (MADRS) total score >=20 are enrolled at six sites. After a one-week run-in period, all were put on milnacipran treatment starting with 25 mg in the evening on the first day and up titrating to 50 mg bid within one week. MADRS, Hamilton Depression Rating Scale with 17 items (Hamilton-17) and Clinical Global Impression (CGI) scales were administered at baseline and also at weeks 1, 2, 4, 6 and 8. Systematic questioning of adverse events was performed also at all post-baseline visits. Classification of adverse events was performed according to MedORA dictionary. All analysis presented here are performed in intent-to-treat (ITT) population with Last-Observation-Carried-Forward (LOCF) approach applied for missing data. Comparisons of mean scale scores between visits were done by Student's t test with Bonferroni correction for multiple pairwise comparisons. Results: Fifty-nine (84%) patients attended to week 4 and 51 (73%) patients attended to week 8. MADRS scores decreased from 32.1±6.0 at baseline to 25.0±8.2 at week 1, to 19.6±8.2 at week 2, to 16.4±8.6 at week 4, to 13.4±9.5 at week 6 and to