Supplemental Material, Sociodemographic_apathy_scores_sites_2sep2019 for Are Apathy and Depressiv... more Supplemental Material, Sociodemographic_apathy_scores_sites_2sep2019 for Are Apathy and Depressive Symptoms Related to Vascular White Matter Hyperintensities in Severe Late Life Depression? by Mardien Leoniek Oudega, Amna Siddiqui, Mike P. Wattjes, Frederik Barkhof, Mara ten Kate, Majon Muller, Filip Bouckaert, Mathieu Vandenbulcke, François-Laurent De Winter, Pascal Sienaert, Max L. Stek, Hannie C. Comijs, Nicole C. M. Korten, Louise Emsell, Piet Eikelenboom, Didi Rhebergen, Eric van Exel and Annemieke Dols in Journal of Geriatric Psychiatry and Neurology
Supplemental material, AUT872373_Supplemental_material for Autism and depression are connected: A... more Supplemental material, AUT872373_Supplemental_material for Autism and depression are connected: A report of two complimentary network studies by Barbara FC van Heijst, Marie K Deserno, Didi Rhebergen and Hilde M Geurts in Autism
BACKGROUND Loneliness and social isolation have both been found to be associated with increased m... more BACKGROUND Loneliness and social isolation have both been found to be associated with increased mortality in previous studies. One potential underlying mechanism is via the hypothalamic-pituitary-adrenal axis. OBJECTIVE This study aimed to examine the association between social network size and cortisol, to analyze the associations between both loneliness and social network size and mortality, and to examine to what extent the association between network size and/or loneliness and mortality is mediated by cortisol. DESIGN The study group consisted of 443 depressed and non-depressed participants of the Netherlands Study of Depression in the Elderly (NESDO). Cross-sectional analysis of the association between social network size and cortisol measures was followed by a survival analysis of the associations between both social network size and loneliness and mortality. RESULTS There were no significant associations between social network size and cortisol measures. Loneliness and small ...
Introduction Aging is characterized by a deterioration of health, which often manifests in multip... more Introduction Aging is characterized by a deterioration of health, which often manifests in multiple health domains. Depressive symptoms, cardiovascular morbidity and loneliness are indicators of mental, physical and social health, respectively, and are highly prevalent at old age. The aim of this study was to investigate how these indicators mutually, and longitudinally, influence one another at old age. We hypothesized that depressive symptoms, cardiovascular morbidity and loneliness have risk increasing effects on one another, which would pose opportunities to prevent a downward spiral of health decline and to improve health at old age. Methods Data from 2979 respondents from the Longitudinal Aging Study Amsterdam, aged 55 years and over, including five measurements with approximately three-year intervals (maximum follow-up of 13 years), were analyzed. A score ≥16 points on the Center for Epidemiologic Studies Depression Scale indicated depressive symptoms. A score of ≥3 points on...
Eeuwenlang werden psychomotore verschijnselen beschouwd als een kernsymptoom van de melancholie. ... more Eeuwenlang werden psychomotore verschijnselen beschouwd als een kernsymptoom van de melancholie. Dit symptoom werd dermate belangrijk geacht dat sommigen de melancholie als een bewegingsstoornis beschouwden, eerder dan als een stemmingsstoornis (Berrios 1988). Kraepelin benadrukte dat ‘de remming het opvallendste klinische verschijnsel’ was, en dat ‘hiermee vergeleken, de sombere stemming weinig prominent was’ (Sobin & Sackeim 1997). Ook hedendaagse academici beschrijven de melancholie als een hersenziekte die niet alleen de stemming en de cognitie beïnvloedt, maar ook de motorische functies (Taylor & Fink 2006). Psychomotore symptomen (ps) bij depressieve stoornissen Voorspellen psychomotore symptomen de behandelrespons bij depressieve stoornissen?
artikel Het feit dat mensen met een ernstige psychiatrische aandoening zo’n 20 jaar korter leven ... more artikel Het feit dat mensen met een ernstige psychiatrische aandoening zo’n 20 jaar korter leven dan mensen uit de algemene bevolking, wijst onomstotelijk op een grote ongelijkheid in gezondheid en toegang tot gezondheidszorg tussen beide groepen. Zestig procent van de doodsoorzaken betreft behandelbare ziektes, zoals cardiovasculaire aandoeningen, diabetes en hypertensie (Cook 2011). Verschillende oorzaken zijn hier debet aan. Te denken valt aan een grotere prevalentie van risicofactoren zoals roken en gebrek aan lichamelijke activiteit onder mensen met een psychiatrische aandoening, iatrogene effecten van psychofarmaca – zoals het metabool syndroom – en een hogere prevalentie van suïcides (Thornicroft 2011). Echter, de laatste jaren is bewezen dat mensen met een psychiatrische aandoening tevens een mindere kwaliteit van somatische zorg en slechtere toegang tot somatische zorgfaciliteiten krijgen.
Hashimoto encephalitis (he) is an auto-immune disease, with 40-50% of patients developing psychop... more Hashimoto encephalitis (he) is an auto-immune disease, with 40-50% of patients developing psychopathology. This could require targeted treatment. HE and prednison could both cloud the identification of a concurrent depressive disorder. We saw a 78-year-old woman with he and a severe depression, and treated her succesfully with ect.
BACKGROUND Assessment of psychomotor symptoms may lead to better classification of depressive dis... more BACKGROUND Assessment of psychomotor symptoms may lead to better classification of depressive disorders. AIM To test the inter-rater reliability of the Dutch version of CORE, an observational instrument for psychomotor symptoms. METHOD The CORE was used with 37 depressed in-patients and was scored by 5 psychiatrists. Intra-class correlation (ICCagreement) was tested. RESULTS ICCagreement of the total score (0.80), and the subscales non-interaction (0.74), retardation (0.70) and agitation (0.79) were sufficient. CONCLUSION The Dutch version of the CORE is a reliable instrument.
BACKGROUND Unidirectional studies suggest that the effects between cardiovascular disease, depres... more BACKGROUND Unidirectional studies suggest that the effects between cardiovascular disease, depressive symptoms and loneliness are reciprocal, but this has not been tested empirically. The aim was to study how cardiovascular morbidity, depressive symptoms and loneliness influence each other longitudinally. METHODS Data from 2979 older adults from the Longitudinal Aging Study Amsterdam were analysed. Depressive symptoms (≥16 points on the Center for Epidemiologic Studies Depression Scale), loneliness (≥3 points on the De Jong Gierveld Loneliness Scale) and cardiovascular morbidity were measured five times during 13-year follow-up. With structural equation modelling, a full cross-lagged panel model was compared to nine nested models reflecting different sets of temporal effects. RESULTS The best-fitting cross-lagged panel model showed reciprocal risk increasing effects between depressive symptoms and loneliness and a risk increasing effect of cardiovascular morbidity on depressive symptoms. LIMITATIONS A cross-lagged panel model has technical limitations, such as that the chosen time lag may not be appropriate for each effect. In addition, differential loss to follow-up and collider bias may have led to an underestimation of the effects. CONCLUSIONS Reciprocal effects tend to occur only between depressive symptoms and loneliness. Their interplay with cardiovascular morbidity seems more complex and mostly indirect, highlighting the potential of interventions to reduce depressive symptoms, loneliness and cardiovascular morbidity in concert to improve health at old age.
Psychotic major depression (PMD) is hypothesized to be a distinct clinical entity from nonpsychot... more Psychotic major depression (PMD) is hypothesized to be a distinct clinical entity from nonpsychotic major depression (NPMD). However, neurobiological evidence supporting this notion is scarce. The aim of this study is to identify gray matter volume (GMV) differences between PMD and NPMD and their longitudinal change following electroconvulsive therapy (ECT). Structural magnetic resonance imaging (MRI) data from 8 independent sites in the Global ECT-MRI Research Collaboration (GEMRIC) database (n = 108; 56 PMD and 52 NPMD; mean age 71.7 in PMD and 70.2 in NPMD) were analyzed. All participants underwent MRI before and after ECT. First, cross-sectional whole-brain voxel-wise GMV comparisons between PMD and NPMD were conducted at both time points. Second, in a flexible factorial model, a main effect of time and a group-by-time interaction were examined to identify longitudinal effects of ECT on GMV and longitudinal differential effects of ECT between PMD and NPMD, respectively. Compared...
Objective: Despite the effectiveness of electroconvulsive therapy (ECT), patients and practitione... more Objective: Despite the effectiveness of electroconvulsive therapy (ECT), patients and practitioners are often reluctant to start it due to the risk of transient cognitive side effects, particularly in older patients. Inflammatory processes may be associated with the occurrence of these effects. This study assessed whether inflammatory markers prior to ECT are associated with cognitive functioning in depressed patients treated with ECT. Methods: Between 2011 and 2013, 97 older patients (mean [SD] age = 73.1 [8.1] years) with severe unipolar depression (according to DSM-IV) referred for ECT were included. Mini-Mental State Examination (MMSE) scores were used to determine cognitive functioning prior to, weekly during, and in the first week after a course of ECT. Serum levels of C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-10 (IL-10), and tumor necrosis factor-α (TNF-α) were assessed prior to ECT. Results: In fully adjusted models, there was an association between TNF-α and cognitive functioning (β = -1.05; 95% CI, -2.04 to -0.06; f2 = 0.06). An association was also found between baseline levels of IL-10 and TNF-α and lower MMSE scores during ECT (IL-10: β = -2.08; 95% CI, -3.22 to -0.95; TNF-α: β = -0.65; 95% CI, -1.07 to -0.22). In addition, an association was found between baseline CRP and lower MMSE scores directly after a course of ECT (β = -0.51; 95% CI, -0.93 to -0.09; f2 = 0.10). Associations with IL-6 did not reach significance. Conclusions: This study suggests that inflammatory processes are associated with lower cognitive functioning prior to ECT and predispose for further cognitive dysfunction during and after a course of ECT. Trial registration: ClinicalTrials.gov identifier: NCT02667353.
In this commentary, we address current clinical practice of long-term antidepressant use in older... more In this commentary, we address current clinical practice of long-term antidepressant use in older adults with depression, and recommend improvements. Compared with younger adults, older adults more frequently use antidepressants in the long term, although they may not always benefit from them, and in spite of an increased risk for adverse events. Unfortunately, evaluations of long-term antidepressant use are sparse, especially in older age groups. To prevent and reduce inappropriate long-term use and adverse events, antidepressant use in older age groups should be regularly evaluated.
Background With increasing age, symptoms of depression may increasingly overlap with age-related ... more Background With increasing age, symptoms of depression may increasingly overlap with age-related physical frailty and cognitive decline. We aim to identify late-life-related subtypes of depression based on measures of depressive symptom dimensions, cognitive performance, and physical frailty. Methods A clinical cohort study of 375 depressed older patients with a DSM-IV depressive disorder (acronym NESDO). A latent profile analysis was applied on the three subscales of the Inventory of Depressive Symptomatology, as well as performance in five cognitive domains and two proxies for physical frailty. For each class, we investigated remission, dropout, and mortality at 2-year follow-up as well as change over time of depressive symptom severity, cognitive performance, and physical frailty. Results A latent profile analysis model with five classes best described the data, yielding two subgroups suffering from pure depression (“mild” and “severe” depression, 55% of all patients) and three s...
Supplemental Material, Sociodemographic_apathy_scores_sites_2sep2019 for Are Apathy and Depressiv... more Supplemental Material, Sociodemographic_apathy_scores_sites_2sep2019 for Are Apathy and Depressive Symptoms Related to Vascular White Matter Hyperintensities in Severe Late Life Depression? by Mardien Leoniek Oudega, Amna Siddiqui, Mike P. Wattjes, Frederik Barkhof, Mara ten Kate, Majon Muller, Filip Bouckaert, Mathieu Vandenbulcke, François-Laurent De Winter, Pascal Sienaert, Max L. Stek, Hannie C. Comijs, Nicole C. M. Korten, Louise Emsell, Piet Eikelenboom, Didi Rhebergen, Eric van Exel and Annemieke Dols in Journal of Geriatric Psychiatry and Neurology
Supplemental material, AUT872373_Supplemental_material for Autism and depression are connected: A... more Supplemental material, AUT872373_Supplemental_material for Autism and depression are connected: A report of two complimentary network studies by Barbara FC van Heijst, Marie K Deserno, Didi Rhebergen and Hilde M Geurts in Autism
BACKGROUND Loneliness and social isolation have both been found to be associated with increased m... more BACKGROUND Loneliness and social isolation have both been found to be associated with increased mortality in previous studies. One potential underlying mechanism is via the hypothalamic-pituitary-adrenal axis. OBJECTIVE This study aimed to examine the association between social network size and cortisol, to analyze the associations between both loneliness and social network size and mortality, and to examine to what extent the association between network size and/or loneliness and mortality is mediated by cortisol. DESIGN The study group consisted of 443 depressed and non-depressed participants of the Netherlands Study of Depression in the Elderly (NESDO). Cross-sectional analysis of the association between social network size and cortisol measures was followed by a survival analysis of the associations between both social network size and loneliness and mortality. RESULTS There were no significant associations between social network size and cortisol measures. Loneliness and small ...
Introduction Aging is characterized by a deterioration of health, which often manifests in multip... more Introduction Aging is characterized by a deterioration of health, which often manifests in multiple health domains. Depressive symptoms, cardiovascular morbidity and loneliness are indicators of mental, physical and social health, respectively, and are highly prevalent at old age. The aim of this study was to investigate how these indicators mutually, and longitudinally, influence one another at old age. We hypothesized that depressive symptoms, cardiovascular morbidity and loneliness have risk increasing effects on one another, which would pose opportunities to prevent a downward spiral of health decline and to improve health at old age. Methods Data from 2979 respondents from the Longitudinal Aging Study Amsterdam, aged 55 years and over, including five measurements with approximately three-year intervals (maximum follow-up of 13 years), were analyzed. A score ≥16 points on the Center for Epidemiologic Studies Depression Scale indicated depressive symptoms. A score of ≥3 points on...
Eeuwenlang werden psychomotore verschijnselen beschouwd als een kernsymptoom van de melancholie. ... more Eeuwenlang werden psychomotore verschijnselen beschouwd als een kernsymptoom van de melancholie. Dit symptoom werd dermate belangrijk geacht dat sommigen de melancholie als een bewegingsstoornis beschouwden, eerder dan als een stemmingsstoornis (Berrios 1988). Kraepelin benadrukte dat ‘de remming het opvallendste klinische verschijnsel’ was, en dat ‘hiermee vergeleken, de sombere stemming weinig prominent was’ (Sobin & Sackeim 1997). Ook hedendaagse academici beschrijven de melancholie als een hersenziekte die niet alleen de stemming en de cognitie beïnvloedt, maar ook de motorische functies (Taylor & Fink 2006). Psychomotore symptomen (ps) bij depressieve stoornissen Voorspellen psychomotore symptomen de behandelrespons bij depressieve stoornissen?
artikel Het feit dat mensen met een ernstige psychiatrische aandoening zo’n 20 jaar korter leven ... more artikel Het feit dat mensen met een ernstige psychiatrische aandoening zo’n 20 jaar korter leven dan mensen uit de algemene bevolking, wijst onomstotelijk op een grote ongelijkheid in gezondheid en toegang tot gezondheidszorg tussen beide groepen. Zestig procent van de doodsoorzaken betreft behandelbare ziektes, zoals cardiovasculaire aandoeningen, diabetes en hypertensie (Cook 2011). Verschillende oorzaken zijn hier debet aan. Te denken valt aan een grotere prevalentie van risicofactoren zoals roken en gebrek aan lichamelijke activiteit onder mensen met een psychiatrische aandoening, iatrogene effecten van psychofarmaca – zoals het metabool syndroom – en een hogere prevalentie van suïcides (Thornicroft 2011). Echter, de laatste jaren is bewezen dat mensen met een psychiatrische aandoening tevens een mindere kwaliteit van somatische zorg en slechtere toegang tot somatische zorgfaciliteiten krijgen.
Hashimoto encephalitis (he) is an auto-immune disease, with 40-50% of patients developing psychop... more Hashimoto encephalitis (he) is an auto-immune disease, with 40-50% of patients developing psychopathology. This could require targeted treatment. HE and prednison could both cloud the identification of a concurrent depressive disorder. We saw a 78-year-old woman with he and a severe depression, and treated her succesfully with ect.
BACKGROUND Assessment of psychomotor symptoms may lead to better classification of depressive dis... more BACKGROUND Assessment of psychomotor symptoms may lead to better classification of depressive disorders. AIM To test the inter-rater reliability of the Dutch version of CORE, an observational instrument for psychomotor symptoms. METHOD The CORE was used with 37 depressed in-patients and was scored by 5 psychiatrists. Intra-class correlation (ICCagreement) was tested. RESULTS ICCagreement of the total score (0.80), and the subscales non-interaction (0.74), retardation (0.70) and agitation (0.79) were sufficient. CONCLUSION The Dutch version of the CORE is a reliable instrument.
BACKGROUND Unidirectional studies suggest that the effects between cardiovascular disease, depres... more BACKGROUND Unidirectional studies suggest that the effects between cardiovascular disease, depressive symptoms and loneliness are reciprocal, but this has not been tested empirically. The aim was to study how cardiovascular morbidity, depressive symptoms and loneliness influence each other longitudinally. METHODS Data from 2979 older adults from the Longitudinal Aging Study Amsterdam were analysed. Depressive symptoms (≥16 points on the Center for Epidemiologic Studies Depression Scale), loneliness (≥3 points on the De Jong Gierveld Loneliness Scale) and cardiovascular morbidity were measured five times during 13-year follow-up. With structural equation modelling, a full cross-lagged panel model was compared to nine nested models reflecting different sets of temporal effects. RESULTS The best-fitting cross-lagged panel model showed reciprocal risk increasing effects between depressive symptoms and loneliness and a risk increasing effect of cardiovascular morbidity on depressive symptoms. LIMITATIONS A cross-lagged panel model has technical limitations, such as that the chosen time lag may not be appropriate for each effect. In addition, differential loss to follow-up and collider bias may have led to an underestimation of the effects. CONCLUSIONS Reciprocal effects tend to occur only between depressive symptoms and loneliness. Their interplay with cardiovascular morbidity seems more complex and mostly indirect, highlighting the potential of interventions to reduce depressive symptoms, loneliness and cardiovascular morbidity in concert to improve health at old age.
Psychotic major depression (PMD) is hypothesized to be a distinct clinical entity from nonpsychot... more Psychotic major depression (PMD) is hypothesized to be a distinct clinical entity from nonpsychotic major depression (NPMD). However, neurobiological evidence supporting this notion is scarce. The aim of this study is to identify gray matter volume (GMV) differences between PMD and NPMD and their longitudinal change following electroconvulsive therapy (ECT). Structural magnetic resonance imaging (MRI) data from 8 independent sites in the Global ECT-MRI Research Collaboration (GEMRIC) database (n = 108; 56 PMD and 52 NPMD; mean age 71.7 in PMD and 70.2 in NPMD) were analyzed. All participants underwent MRI before and after ECT. First, cross-sectional whole-brain voxel-wise GMV comparisons between PMD and NPMD were conducted at both time points. Second, in a flexible factorial model, a main effect of time and a group-by-time interaction were examined to identify longitudinal effects of ECT on GMV and longitudinal differential effects of ECT between PMD and NPMD, respectively. Compared...
Objective: Despite the effectiveness of electroconvulsive therapy (ECT), patients and practitione... more Objective: Despite the effectiveness of electroconvulsive therapy (ECT), patients and practitioners are often reluctant to start it due to the risk of transient cognitive side effects, particularly in older patients. Inflammatory processes may be associated with the occurrence of these effects. This study assessed whether inflammatory markers prior to ECT are associated with cognitive functioning in depressed patients treated with ECT. Methods: Between 2011 and 2013, 97 older patients (mean [SD] age = 73.1 [8.1] years) with severe unipolar depression (according to DSM-IV) referred for ECT were included. Mini-Mental State Examination (MMSE) scores were used to determine cognitive functioning prior to, weekly during, and in the first week after a course of ECT. Serum levels of C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-10 (IL-10), and tumor necrosis factor-α (TNF-α) were assessed prior to ECT. Results: In fully adjusted models, there was an association between TNF-α and cognitive functioning (β = -1.05; 95% CI, -2.04 to -0.06; f2 = 0.06). An association was also found between baseline levels of IL-10 and TNF-α and lower MMSE scores during ECT (IL-10: β = -2.08; 95% CI, -3.22 to -0.95; TNF-α: β = -0.65; 95% CI, -1.07 to -0.22). In addition, an association was found between baseline CRP and lower MMSE scores directly after a course of ECT (β = -0.51; 95% CI, -0.93 to -0.09; f2 = 0.10). Associations with IL-6 did not reach significance. Conclusions: This study suggests that inflammatory processes are associated with lower cognitive functioning prior to ECT and predispose for further cognitive dysfunction during and after a course of ECT. Trial registration: ClinicalTrials.gov identifier: NCT02667353.
In this commentary, we address current clinical practice of long-term antidepressant use in older... more In this commentary, we address current clinical practice of long-term antidepressant use in older adults with depression, and recommend improvements. Compared with younger adults, older adults more frequently use antidepressants in the long term, although they may not always benefit from them, and in spite of an increased risk for adverse events. Unfortunately, evaluations of long-term antidepressant use are sparse, especially in older age groups. To prevent and reduce inappropriate long-term use and adverse events, antidepressant use in older age groups should be regularly evaluated.
Background With increasing age, symptoms of depression may increasingly overlap with age-related ... more Background With increasing age, symptoms of depression may increasingly overlap with age-related physical frailty and cognitive decline. We aim to identify late-life-related subtypes of depression based on measures of depressive symptom dimensions, cognitive performance, and physical frailty. Methods A clinical cohort study of 375 depressed older patients with a DSM-IV depressive disorder (acronym NESDO). A latent profile analysis was applied on the three subscales of the Inventory of Depressive Symptomatology, as well as performance in five cognitive domains and two proxies for physical frailty. For each class, we investigated remission, dropout, and mortality at 2-year follow-up as well as change over time of depressive symptom severity, cognitive performance, and physical frailty. Results A latent profile analysis model with five classes best described the data, yielding two subgroups suffering from pure depression (“mild” and “severe” depression, 55% of all patients) and three s...
Uploads
Papers by Didi Rhebergen