212 research outputs found
The koukopoulos mixed depression rating scale (KMDRS): an international mood network (IMN) validation study of a new mixed mood rating scale
No full textBACKGROUND:
It has been proposed that the broad major depressive disorder (MDD) construct is heterogenous. Koukopoulos has provided diagnostic criteria for an important subtype within that construct, "mixed depression" (MxD), which encompasses clinical pictures characterized by marked psychomotor or inner excitation and rage/anger, along with severe depression. This study provides psychometric validation for the first rating scale specifically designed to assess MxD symptoms cross-sectionally, the Koukopoulos Mixed Depression Rating Scale (KMDRS).
METHODS:
350 patients from the international mood network (IMN) completed three rating scales: the KMDRS, Montgomery-Asberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS). KMDRS' psychometric properties assessed included Cronbach's alpha, inter-rater reliability, factor analysis, predictive validity, and Receiver Operator Curve analysis.
RESULTS:
Internal consistency (Cronbach's alpha = 0.76; 95% CI 0.57, 0.94) and interrater reliability (kappa = 0.73) were adequate. Confirmatory factor analysis identified 2 components: anger and psychomotor excitation (80% of total variance). Good predictive validity was seen (C-statistic = 0.82 95% CI 0.68, 0.93). Severity cut-off scores identified were as follows: none (0-4), possible (5-9), mild (10-15), moderate (16-20) and severe (> 21) MxD.
LIMITATIONS:
Non DSM-based diagnosis of MxD may pose some difficulties in the initial use and interpretation of the scoring of the scale. Moreover, the cross-sectional nature of the evaluation does not verify the long-term stability of the scale.
CONCLUSIONS:
KMDRS was a reliable and valid instrument to assess MxD symptoms
Transitions: Athanasios Koukopoulos [AθανάσιΟς κΟυκόπΟυλΟς], M.D. (1931–2013)
No full textAthanasios Koukopoulos was born in Chaeronea, a village in the district of Boeotia in central Greece, on 23 November 1931 as the son of Konstantinos and Maria Koukopoulos. His father hoped that he would remain at home to manage the land they owned, but Athanasios preferred to study. His energetic and supportive mother fought for his education. At the end of World War II, following years of exposure to violence and privation, his family moved to Athens just before the Greek civil war of 1946 to 1949. In Athens, Koukopoulos continued his education while playing professional basketball with the prestigious Panatinaikos Sports Club of Athens, which later on presented him with the Golden Clover award. In 1951, he moved to Italy despite remaining hard feelings in Greece following the recent Greco-Italian war of 1940 to 1941 and the subsequent Balkan campaign of the Axis powers in World War II
Validation of the Italian version of the Koukopoulos Mixed Depression Rating Scale (KMDRS) in an Italian sample of subjects with mood disorders
No full textIntroduzione. Il costrutto della depressione mista (MxD), ovvero la presenza di sintomi eccitativi nel contesto di un episodio depressivo, è stato oggetto di crescente interesse negli ultimi anni. Recentemente la Koukopoulos Mixed Depression Rating Scale (KMDRS) è stata validata per la valutazione della gravità di tale costrutto. L’obiettivo dello studio è quello di validare la versione italiana della KMDRS. Materiali e metodi. 396 pazienti con episodio depressivo maggiore (EDM) sono stati reclutati presso il Centro Lucio Bini di Roma (età media=44,73 anni, DS=15,93). A tutti i partecipanti sono state somministrate le seguenti scale psicometriche: la KMDRS, la Montgomery-Åsberg Depression Rating Scale (MADRS), la Young Mania Rating Scale (YMRS), la Clinical Global Impressions (CGI) e la Valutazione Globale del Funzionamento (VGF). Sono state calcolate la validità predittiva, l’analisi Receiver Operator Curve (ROC), il valore alfa di Chronbach e l’affidabilità dell’accordo tra i ricercatori. Risultati. La validità predittiva (C-statistico= 0,80; IC 95%: 0,75, 0,85) e la capacità predittiva [OR=1,25±,03 (SE); 95% CI: 1,18, 1,32; p<,001] sono risultate buone e in linea con quelle relative alla versione originale della scala, mentre la consistenza interna (alfa di Cronbach=,70, IC 95%: 0,65, 0,75) e l’affidabilità dell’accordo tra i ricercatori sono risultate adeguate. Conclusioni. I risultati ottenuti sono in linea con quelli relativi alla scala originale. Pertanto la versione italiana della KMDRS rappresenta uno strumento valido per la valutazione della MxD.Background: The construct of mixed depression (MxD), namely the simultaneous presence of excitatory symptoms during a depressive episode, has gained increased interest in the recent years. The Koukopoulos Mixed Depression Rating Scale (KMDRS) has been recently validated for the diagnosis and assessment of MxD. The aim of this study was to validate the Italian version of the KMDRS.
Methods: Patients with a major depressive episode (MDE) (N=396, age, mean=44.73 years, SD=15.93) were recruited at Lucio Bini Center, Rome, Italy. All participants were administered the Italian version of the KMDRS, the Montgomery-Åsberg Depression Rating Scale (MADRS), the Young Mania Rating Scale (YMRS), the Clinical Global Impressions (CGI), and the Global Assessment of Functioning (GAF). We calculated predictive validity, and performed Receiver Operator Curve (ROC) analysis, Cronbach's alpha, and inter-rater reliability.
Results: Predictive validity (C-statistic= 0.80; IC 95%: 0.75, 0.85) and capacity [OR=1.25±.03 (SE); 95% CI: 1.18, 1.32; p<.001] were good, matching those of the original version, whereas internal consistency (Cronbach's alpha = .70, IC 95%: 0.65, 0.75) and interrater reliability (Cohen's kappa= 0.74) were adequate.
Conclusions: The agreement of results with those of the original version point to the validity of the Italian version of KMDRS in assessing MxD
Memantine in the treatment and prophylaxis of bipolar II disorder and comorbid fibromyalgia. A case report
No full textWe have recently reported that memantine has a clinically relevant antimanic and long-lasting mood-stabilizing effect in treatment-resistant bipolar disorders, both as augmenting agent and as monotherapy. We have also observed an acute antimanic and sustained mood-stabilizing effect in a small number of patients with bipolar I disorder who had had minimal previous pharmacotherapy. In this article, we report the case of a young woman suffering from bipolar II disorder with associated fibromyalgia, in whom memantine showed an acute antimanic and a long-term prophylactic effect on both bipolar disorder as well as the associated fibromyalgia syndrome
Fallimenti terapeutici nei pazienti bipolari: nuove strategie. Atti del Convegno del 21-22 gennaio 2005, Roma, realizzato in collaborazione con AstraZeneca.
No full textThe Koukopoulos mixed depression rating scale (KMDRS) and the assessment of mixed symptoms during the perinatal period
No full textBackground: Mixed symptoms in depression may underlie bipolar diathesis rather than unipolarity. Uncovering mixed depression (MxD) is crucial for appropriate management, especially in the perinatal period, as it may affect treatment planning and impact future child development. We used a scale specific for identifying MxD and tested its validity in pregnant and postpartum women with depression. Methods: Women developing a major depressive episode (MDE) during their perinatal period extending from pregnancy to one year postpartum from November-2012 through June-2019 were assessed with BPRS-18, EPDS, CGI-S, GAF, HAM-A, HAM-D, Koukopoulos' Mixed Depression Rating Scale (KMDRS), TEMPS, and YMRS. They were classified, based on KMDRS criteria, as with mixed (MxD) or without (nonMxD) mixed symptoms. We conducted ROC analysis and performed factor analysis of the KMDRS. Results: Of 45 included, MxD (N = 19) were biased towards diagnosis of bipolar disorder and nonMxD (N = 26) towards major depressive disorder. Other sociodemographic variables did not differ significantly between MxD and nonMxD. MxD scored higher on total YMRS, BPRS, and KMDRS, and on KMDRS-6 Subjective Feelings of Irritability and KMDRS-12 Suicidal Impulsiveness items. The KMDRS correlated in the entire sample, in MxD and nonMxD, with the YMRS and the BPRS, while correlating with the HAM-D in nonMxD only. The KMDRS showed acceptable AUC distribution, with a 68% sensitivity and 58% specificity. Best-fit was three-factor-structure, explaining 54.66% of cumulative variance. Limitations: Small sample and cross-sectional design. Conclusions: The KMDRS is fit for investigating MxD along with the YMRS and the BPRS in perinatal women with a MDE
Athanasios koukopoulos’ psychiatry: The primacy of mania and the limits of antidepressants
No full text© 2017 Bentham Science Publishers. Background: Athanasios Koukopoulos provided a radical model for understanding depressive and manic conditions. Objective: To review, explain, and analyze Koukopoulos’ concept of the primacy of mania, with special attention to the role of antidepressants. Method: A conceptual review of Koukopoulos’ writings and lectures on this topic is given._ Results: Koukopoulos held that depressive states are caused by manic states; the former do not occur without the latter. The most common scenario of the inseparability of depressive and manic symptoms occurs in mixed states, which we estimate to represent about one-half of all depressive episodes in all patients (not just bipolar illness). In a review of the empirical evidence for this topic, we conclude that empirical evidence exists to support the primary of mania thesis in almost 80% of depressed patients. Since antidepressants worsen mania, they would be expected to worsen depression as well in this model.
The Koukopoulos mixed depression rating scale (KMDRS) and the assessment of mixed symptoms during the perinatal period
No full textBackground: Mixed symptoms in depression may underlie bipolar diathesis rather than unipolarity. Uncovering mixed depression (MxD) is crucial for appropriate management, especially in the perinatal period, as it may affect treatment planning and impact future child development. We used a scale specific for identifying MxD and tested its validity in pregnant and postpartum women with depression. Methods: Women developing a major depressive episode (MDE) during their perinatal period extending from pregnancy to one year postpartum from November-2012 through June-2019 were assessed with BPRS-18, EPDS, CGI-S, GAF, HAM-A, HAM-D, Koukopoulos’ Mixed Depression Rating Scale (KMDRS), TEMPS, and YMRS. They were classified, based on KMDRS criteria, as with mixed (MxD) or without (nonMxD) mixed symptoms. We conducted ROC analysis and performed factor analysis of the KMDRS. Results: Of 45 included, MxD (N = 19) were biased towards diagnosis of bipolar disorder and nonMxD (N = 26) towards major depressive disorder. Other sociodemographic variables did not differ significantly between MxD and nonMxD. MxD scored higher on total YMRS, BPRS, and KMDRS, and on KMDRS-6 Subjective Feelings of Irritability and KMDRS-12 Suicidal Impulsiveness items. The KMDRS correlated in the entire sample, in MxD and nonMxD, with the YMRS and the BPRS, while correlating with the HAM-D in nonMxD only. The KMDRS showed acceptable AUC distribution, with a 68% sensitivity and 58% specificity. Best-fit was three-factor-structure, explaining 54.66% of cumulative variance. Limitations: Small sample and cross-sectional design. Conclusions: The KMDRS is fit for investigating MxD along with the YMRS and the BPRS in perinatal women with a MDE
Memantine in the treatment and prophylaxis of bipolar type II mood disorder and co-morbid eating disorder. a case report [Memantina nel trattamento e nella profilassi del disturbo dell’umore bipolare di tipo II in comorbilità con disturbo del comportamento alimentare. un caso clinico]
No full textRIASSUNTO. Abbiamo recentemente riportato che la memantina ha un effetto antimaniacale clinicamente rilevante e un prolungato effetto profilattico nel disturbo bipolare resistente ai trattamenti convenzionali,sia come “augmenting” terapia sia in monoterapia.Abbiamo, inoltre, osservato un effetto antimaniacale acuto e profilattico a lungo termine in pazienti bipolari di tipo I “naïve”. Qui descriviamo la storia clinica di una giovane paziente con disturbo bipolare di tipo II associato a un grave disturbo del comportamento alimentare, che conferma che
la memantina ha un effetto antimaniacale acuto e previene le ricadute del disturbo bipolare in comorbilità con disturbi del comportamento
alimentare.We have recently reported that memantine has a clinically relevant antimanic and long-lasting mood-stabilizing effect in treatment-resistant bipolar disorders, both as augmenting agent and as a monotherapy. Moreover, we observed an acute antimanic and sustained mood-stabilizing effect also in "naive" bipolar type I disorder. Here we report a case history of a young woman suffering from bipolar type II mood disorder, associated with a very severe eating disorder, showing an acute antimanic and a long-term prophylactic effect of memantine on bipolar disorder and comorbid eating disorder
- …
