Klinische Depression

Sometimes suicide is committed suddenly and other times suicide is planned long time ago. This study aims to know about the background of the time effect for psychic life how the idea of suicide is growing up. Is suicide unpredictable or is there another factor like latency coming up for being acted out? Incarceration and prison environment has a very high risk for suicide in France. This study confronted observations of psychiatrists and psychologists having prisoners as patients. Their observations are compared too with psychiatrists and psychologists having a double professional experience in town and in prison. Interpretations of statistics about suicide risk complete information. This interpretation is helped by the phenomenological notion of the threshold effect (Zutt, Kuhlenkampf) coming from early experimental psychology (Th. Fechner). All results agree about the importance of being in contact with the prisoner from the very beginning of his incarceration. The incarcerated person has to get started when entering in prison by verbalizing about himself. Later he may have lost all motivation and may be tired by all interpersonal effort. The risk of hetero and auto-aggression will be high.

Background: Cognitive symptoms are some of the most distressing for patients who are depressed. The goal was to investigate whether depressed patients’ cognition changed depending on treatment with SSRIs (No-NOR) vs. Norepinephrine-enhancing medications (NOR) during an inpatient stay.
Methods: This was an observational, naturalistic, pilot study that used a repeated measures design. 119 depressed inpatients, average age 39 years, 61% females, 77% Caucasian, 74% with mood disorders, 50% Cluster B traits/disorders and 32% psychoactive substance abuse disorders participated. The Trail Making Test (TMT), Hamilton Depression Rating Scale (HDRS), and Outcome Questionnaire-45(OQ-45) were used.
Results: Revealed significant differences between admission and discharge in HDRS (MA=24, MD=9, t (98)=25.30, p<0.001), and OQ-45 (MA=105, MD=72, t (97)=12.91, p<0.001) scores. Mean time to complete the TMT-A at discharge for all NOR patients was 32.92 ± 22.47 seconds, and was significantly shorter than the comparable mean for the No-NOR group (39.10 ± 18.88 seconds, t=-2.33, p=0.022).
Conclusion: Patients taking SNRIs, alone or in combination with benzodiazepines, Seroquel or TCAs (NOR), had significantly shorter completion times for the TMT-A test at discharge than did patients taking SSRIs, with or without benzodiazepines (No-NOR). This cognitive improvement developed independently of significant reductions in depressive symptomatology and interpersonal/social functioning impairment.