Biomedical subjects

Anthony J Levitt

Publications and source records attributed to Anthony J Levitt.

22 records · Page 2Linked to original sources

PubMed2003

Impact of antidepressant side effects on adolescent quality of life.

OBJECTIVE: This study examines the relative impact of antidepressant side effects on adolescents with a history of major depression. METHODS: We used Q-sort methodology to capture the opinions of adolescents with a history of depression (n = 22), adults with a history of depression (n = 20), healthy adolescents (n = 20), and clinicians (n = 18) on the impact of 40 common antidepressant side effects. We asked subjects to force rank the side effects, judging each side effect on its relative impact on their daily lives. We also examined the impact of these side effects on health status and medication compliance. Primary analyses compared adolescents with depression with the other groups on their mean rankings for each of the 40 side effects. Secondary analyses included paired comparisons for ratings on health status and compliance. RESULTS: Although all groups ranked syncope and vomiting among the worst 5 side effects, significant differences were found between the groups on other side effects, such as anxiety, sleepiness, and hair loss. Based on the side effect with the most negative impact, adolescents with depression judged their own compliance (mean = 22%) to be higher than predicted by clinicians (mean = 11%). There were no significant differences between the groups on the mean rating of health status. CONCLUSIONS: Adolescents with depression, adults with depression, healthy adolescents, and clinicians agreed on the negative impact of 2 side effects: vomiting and syncope. Q-sort methodology provides valuable insight into the similarities and differences in opinion regarding the potential impact of side effects in patient groups.

Adolescent↗

PubMed2002

Utility scores of symptom profiles in major depression.

Utility is a measure of undesirability for a specific health state. This study determines the utility scores for the individual symptoms of depression, and examines the impact that personal experience with depression has on these scores. Seventy-five subjects (19 with current depression, 21 with past depression, and 35 healthy controls) assigned utility scores to each of 10 individual symptoms of depression, and three depression severity profiles. Utility scores were measured using the standard gamble technique. Mean utility scores were used to list the symptoms of depression from most to least undesirable. The three diagnostic groups were compared with respect to the magnitude of undesirability of the depressive symptoms. The results of this study found that individuals assigned different utility scores to different symptoms of depression. The psychological symptoms of depression such as suicidal ideation, guilt and depressed mood were ranked as more undesirable than the somatic symptoms of depression. Each diagnostic group ranked the symptoms of depression in a similar manner. Patients with a current depression were willing to accept a greater risk of death to avoid suffering from lifelong depressive symptoms as compared to patients with a past depression or healthy controls.

Adult↗

PubMed2002

A comparison of open treatment of seasonal major and minor depression with light therapy.

BACKGROUND: Although several investigators have described a milder form of seasonal affective disorder (SAD), called subsyndromal SAD, little is known about the effect of light therapy in this group. The current study evaluates 3 weeks of open treatment with light therapy in SAD and subsyndromal SAD patients. METHODS: Subjects with major or minor depression according to DSM-IV with a seasonal pattern were recruited during the winter of 1998-1999 from clinic patients and media advertising. Subjects were commenced on open treatment of morning light therapy, for 30 min daily using a new fluorescent light therapy unit that produced approximately 5,000 lux at a distance of 12 inches. The treatment lasted 3 weeks and at the end of the first and second week of treatment the duration of exposure could be increased to a maximum of 60 min at the discretion of the clinician. The Structured Interview Guide for the Hamilton Depression Rating Scale-SAD version (SIGH-SAD) was administered weekly to evaluate outcome. Response was defined in a variety of ways to reflect the fact that subsyndromal SAD subjects had milder symptoms. RESULTS: Forty-six subjects entered treatment and 44 (SAD, n = 29, subsyndromal SAD, n = 15) completed at least 2 weeks. Response rates were generally similar in SAD subjects (64-69%) and subsyndromal SAD (40-67%) patients. There was a trend for longer exposure to be associated with better outcome. CONCLUSIONS: Light therapy may be an effective treatment for subjects with both major and minor depression with a seasonal pattern. Optimal duration, for the light therapy unit used in this study, is likely 45-60 min daily.

Adult↗

PubMed2002

The impact of latitude on the prevalence of seasonal depression.

BACKGROUND: This study sought to determine whether the prevalence of the seasonal subtype of major depression (SAD) in the community varied as a function of latitude. METHODS: Random telephone numbers were generated across 8 degrees of latitude (41.5 degrees N to 49.5 degrees N) for the province of Ontario. Eight strata of 1 degree each were sampled equally throughout a 12-month period. Using a validated and structured diagnostic interview, we interviewed by telephone respondents over 20 years of age who had lived in the region for 3 years or more. We evaluated patterns of symptom change across seasons to establish a diagnosis of SAD according to DSM-IV criteria. RESULTS: Of the 2078 households that were assessed for eligibility, 1605 (77%) completed the interview. The crude prevalence of lifetime SAD was 2.6% (95% CI, 1.9 to 3.5). There was no impact of latitude on prevalence of either major depression or the seasonal subtype across the 8 strata, although the global measure of the severity of seasonal change in mood was significantly negatively correlated with latitude. CONCLUSIONS: SAD is a common subtype of major depression in Ontario, but there is no evidence to support an increase in prevalence with increasing latitude.

Adult↗