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  1. Fulltext Psychiatric disorders among young male adult prisoners: a cross sectional study in a Malaysian prison
    Azlin, B., Salina Akhtar, M. Y., Nik Ruzyanei, N. J., Hazli, Z., Normala, I.
    Malaysian Journal of Medicine and Health Sciences, 2010;6(2):65-70.
    MyJurnal
    Introduction: In recent years there has been an increase in the number of young people in prison. This
    study is the first to look at the proportion of psychiatric disorders among young adult prisoners. Objective: The main objective is to determine the percentage of psychiatric disorders among young adult male prisoners Method: A cross sectional study of young adult male prisoners, with ages ranged between 18 and 21 years old, was conducted between September and December, 2008 at the Kajang Prison. A total of 225 inmates participated in the study which used the Mini International Neuropsychiatric Interview (M.I.N.I) as its instrument. Results: The percentage of psychiatric disorders was 60.0%. Alcohol and substance related disorders had the highest prevalence at 50.2%, followed by Major Depressive Disorders and Dysthymia at 16.9%. About 39.6% were observed to have antisocial personality disorder. Psychiatric disorders were found to have significant differences (p
    Matched MeSH terms: Depressive Disorder, Major
  2. Fulltext Relationship among depression, self-efficacy, and quality of life among students in medical and allied health sciences
    Firdaus Mukhtar, Hairul Anuar Hashim
    Malaysian Journal of Medicine and Health Sciences, 2010;6(2):51-58.
    MyJurnal
    Introduction: This study examined a cognitive model of depression among undergraduate students of
    medical and allied health sciences. Methods: Participants (N = 279) completed a series of questionnaires related to depression (Beck Depression Inventory-Malay), negative cognitions (Automatic Thoughts Questionnaire-Malay), dysfunctional attitude (Dysfunctional Attitude Scale-Malay), stressful life events (Life Events Survey), self-efficacy (General Self-Efficacy) and quality of life (WHO Quality of Life- BREF). Results: Results of descriptive analysis revealed a higher percentage of severe depression among males when compared to female students. Results of structural equation modeling indicated an adequate fit of the model ( 2= 21.29, df = 15, p > .13; GFI = 0.97; CFI = 0.97; RMSEA = .04).
    Conclusion: The findings also indicated the potential roles of self-efficacy in mediating depression.
    The results are discussed in terms of self-regulating strategies of managing depression and the roles that university authorities may play in helping students to regulate depression.
    Matched MeSH terms: Depressive Disorder, Major
  3. Fulltext Depression and coping strategies used by postnatal mothers during the postpartum period
    Norliza, J., Siti Khuzaimah, A.S., Emad A.S., Norimah, S.
    Malaysian Journal of Psychiatry, 2014;23(2):63-72.
    MyJurnal
    The objective of this study is to evaluate the depression and coping strategies used by postnatal mothers during the postpartum period.This study used cross-sectional design and was conducted at the University Malaya Medical Centre from November 2013 to January 2014. This study involved 150 respondents (postnatal mothers) and used instrumentation adopted from the Malay version of Edinburgh Postnatal Depression Scale (EPDS) and the Malay version of Brief COPE. The results showed 32 (21.3%) postnatal mothers have had severe depression. Emotional coping strategies were reported to be the most used by postnatal mothers (mean = 4.77 ± 0.70). There was a significant association between problem-focused coping strategies and race (p=0.045) where it was mostly used by Malay participants (mean = 3.39±0.46). There was a mild negative relation between EPDS and problem focus (r=-0.168, p=0.04). On the other hand, there was a mild positive relation between depression level and avoidant emotion (r= 0.162, p= 0.047). The psychological support from nurses and family was needed to improve depression and coping strategies used so that it can improve health outcome among postnatal mothers.
    Matched MeSH terms: Depressive Disorder, Major
  4. Fulltext Depression symptoms level among thyroid disorders patients at Central region of Peninsular Malaysia
    Siti Nur Illiani, J., Azlina, D., Sanisah, S., Ramli, M., Nik Noor Fatnoon, N.A.
    Malaysian Journal of Psychiatry, 2017;26(1):0-0.
    MyJurnal
    Background of Study: Patients with thyroid disorders were found to have
    continued to experience symptoms of depression despite the great of treatment has
    been given to the patient to balance the thyroid hormones. Objective: The aim of
    this study is to determine the level of depression symptoms among various types
    of thyroid disorders patients.

    Methods: A cross sectional study was carried out at
    one of the government hospital at central region of Peninsular Malaysia from
    August to October 2016. Patients were diagnosed as thyroid disorders, Malaysian
    citizen, above 18 years old and did not have any psychiatric disorders were
    included in this study.Depression Anxiety Stress Scale-42 (DASS-42) was
    selected to determine the severity of depression symptoms and interpreted as
    follow: less than 9-no depression, between 10 and 13-mild depression, between
    14-20-moderate depression, between 21 and 27- severe depression and more than
    28-extreme severe depression. Descriptive statistic was analysed by IBM
    Statistical Package for the Social Sciences (SPSS) version 21.0.

    Results: About
    15% (23) out of 153 thyroid patients had varies degree of depression symptoms
    from mild to severe extremely depression. Patients who had hyperthyroid were
    found to have more depressed, followed by hypothyroid and thyroid cancer group.

    Conclusion: These findings would suggest that the depression score was higher in
    the patients who have hyperthyroid. A more detail and thorough study is
    recommended to be done, in order to confirm these findings.
    Matched MeSH terms: Depressive Disorder, Major
  5. Caregiver depression: The contributing role of depression in patients, stigma, social support and religiosity
    Chai YC, Mahadevan R, Ng CG, Chan LF, Md Dai F
    Int J Soc Psychiatry, 2018 09;64(6):578-588.
    PMID: 30074421 DOI: 10.1177/0020764018792585
    BACKGROUND: Depression has been well studied as part of caregiver burden among patients with severe mental illnesses. Curiously, though, there has been little data in terms of caregiver burden with specific focus on depression among caregivers of patients with major depressive disorder (MDD).

    AIM: This study aims to determine the rate of depression among caregivers of person with depression and its psychosocial correlates, which include stigma, perceived social support, religious commitment and the severity of the patient's symptoms.

    METHODS: A cross-sectional study was conducted among 165 patients diagnosed with MDD using the Mini-International Neuropsychiatric Interview (M.I.N.I.) together with their caregivers. Apart from gathering social demographic data, patients were administered the 16-item Quick Inventory of Depressive Symptomatology-Self-Rated Version (QIDS-SR 16), whereas the caregivers were required to answer Patient Health Questionnaire-9 (PHQ-9), Multidimensional Scale of Perceived Social Support (MSPSS), Duke University Religion Index (DUREL) and Depression Stigma Scale (DSS). Those who scored ⩾5 on PHQ-9 were further assessed with interviewer-rated M.I.N.I. to diagnose the presence of depression.

    RESULTS: A total of 47 (28.5%) caregivers were found to have depressive symptoms. Out of that total, 13 (7.9%) were diagnosed to have MDD using M.I.N.I. From univariate analysis, factors associated with depression in caregivers were the severity of symptoms in patients ( p 

    Matched MeSH terms: Depressive Disorder, Major
  6. Fulltext Psychiatric comorbidity among community-based, treatment seeking opioid dependents in Klang Valley
    Azlin Baharudin, Lotfi Anuar, Suriati Saini, Osman Che Bakar, Rosdinom Razali, Nik Ruzyanei Nik Jaafar
    Sains Malaysiana, 2013;42(3):417-421.
    The main objectives in this study were to determine the percentage of psychiatric comorbidity among treatment seeking opioid dependents in Klang Valley. A cross sectional study of opioid dependence patients was conducted between December 2007 and May 2008 at ten community-based drug substitution therapy clinics in Klang Valley. A total of 204 opioid dependence patients participated in the study using the structured clinical interview for DSM-IV Axis I disorders
    (SCID-I) as its instruments. The percentage of psychiatric comorbidity among opioid dependents was 43.6%. Major depressive disorder had the highest prevalence at 32.6%, followed by dysthymia at 23.6% and Panic disorder at 14.6%. Psychiatric comorbidity were found to have significant differences (p<0.05) in connection with history of polysubstance abuse, previous history of court sentences (legal status) and family history of psychiatric illnesses. This study showed that the percentage of psychiatric comorbidity is high among the opioid dependents. It highlights the urgent need for the psychiatric comorbidity to be assessed and early intervention is important for this group of patients.
    Matched MeSH terms: Depressive Disorder, Major
  7. Fulltext Peranan sokongan sosial terhadap kemurungan dalam kalangan remaja penagih dadah
    Faizah Mat I, Norizan H, Rozmi I
    Jurnal Psikologi Malaysia, 2018;32:109-118.
    The number of adolescents involved in drug addiction increases every year. Statistic shows that in 2015 there were 6,406 addicts from age 13 to 24 years old compared to 4,954 detected in 2014. The majority of those addicts had major depression. It is predicted that by 2020, depression will be the second leading causes of global burden of diseases after heart disease. This study aims to identify the relationship between social support and depression among adolescent drug addicts. The study used quantitative method by distributing the questionnaires to respondents. A total of 367 adolescent drug adddicts were involved in this study. The results showed a significant negative relationship between social support and depression. The results of the study also showed that there were relationships between social support from guardian, friends and closed friends and depression. The implication of the study suggested that the role of social support such as family members and close friends are crucial to help adolecents cope with depression and addiction.
    Matched MeSH terms: Depressive Disorder, Major
  8. Fulltext Clinical and sociodemographic correlates of suicidality in patients with major depressive disorder from six Asian countries
    Lim AY, Lee AR, Hatim A, Tian-Mei S, Liu CY, Jeon HJ, et al.
    BMC Psychiatry, 2014;14:37.
    PMID: 24524225 DOI: 10.1186/1471-244X-14-37
    BACKGROUND: East Asian countries have high suicide rates. However, little is known about clinical and sociodemographic factors associated with suicidality in Asian populations. The aim of this study was to evaluate the factors associated with suicidality in patients with major depressive disorder (MDD) from six Asian countries.
    METHODS: The study cohort consisted of 547 outpatients with MDD. Patients presented to study sites in China (n = 114), South Korea (n = 101), Malaysia (n = 90), Singapore (n = 40), Thailand (n = 103), and Taiwan (n = 99). All patients completed the Mini-International Neuropsychiatric Interview (MINI), the Montgomery-Asberg Depression Rating Scale (MADRS), the Global Severity Index(SCL-90R), the Fatigue Severity Scale, the 36-item short-form health survey, the Sheehan Disability Scale, and the Multidimensional Scale of Perceived Social Support (MSPSS). Patients were classified as showing high suicidality if they scored ≥ 6 on the MINI suicidality module. Multivariate logistic regression analysis was used to examine sociodemographic and clinical factors related to high suicidality.
    RESULTS: One hundred and twenty-five patients were classed as high suicidality. Unemployed status (adjusted odds ratio [OR] 2.43, p < 0.01), MADRS score (adjusted OR 1.08), p < 0.001, and GSI (SCL-90R) score (adjusted OR 1.06, p < 0.01) were positively related to high suicidality. Hindu (adjusted OR 0.09, p < 0.05) or Muslim (adjusted OR 0.21, p < 0.001) religion and MSPSS score (adjusted OR 0.82, p < 0.05) were protective against high suicidality.
    CONCLUSIONS: A variety of sociodemographic and clinical factors were associated with high suicidality in Asian patients with MDD. These factors may facilitate the identification of MDD patients at risk of suicide.
    Matched MeSH terms: Depressive Disorder, Major/psychology*
  9. Lack of association between TPH2 gene polymorphisms with major depressive disorder in multiethnic Malaysian population
    Nazree NE, Loke AC, Zainal NZ, Mohamed Z
    Asia Pac Psychiatry, 2015 Mar;7(1):72-7.
    PMID: 24376086 DOI: 10.1111/appy.12118
    Numerous association studies of candidate genes studies with major depressive disorder (MDD) have been conducted for many years; however, the evidence of association between genes and the risk of developing MDD still remains inconclusive. In this study, we aimed to investigate the association between the tryptophan hydroxylase 2 (TPH2) gene and MDD in three ethnic groups (Malay, Chinese and Indian) within the Malaysian population.
    Matched MeSH terms: Depressive Disorder, Major/genetics*
  10. Employment program for patients with severe mental illness in Malaysia: a 3-month outcome
    Wan Kasim SH, Midin M, Abu Bakar AK, Sidi H, Nik Jaafar NR, Das S
    Compr Psychiatry, 2014 Jan;55 Suppl 1:S38-45.
    PMID: 23602390 DOI: 10.1016/j.comppsych.2013.03.011
    OBJECTIVE: This study aimed to examine the rate and predictive factors of successful employment at 3 months upon enrolment into an employment program among patients with severe mental illness (SMI).
    METHODS: A cross-sectional study using universal sampling technique was conducted on patients with SMI who completed a 3-month period of being employed at Hospital Permai, Malaysia. A total of 147 patients were approached and 126 were finally included in the statistical analyses. Successful employment was defined as the ability to work 40 or more hours per month. Factors significantly associated with successful employment from bivariate analyses were entered into a multiple logistic regression analysis to identify predictors of successful employment.
    RESULTS: The rate of successful employment at 3 months was 68.3% (n=81). Significant factors associated with successful employment from bivariate analyses were having past history of working, good family support, less number of psychiatric admissions, good compliance to medicine, good interest in work, living in hostel, being motivated to work, satisfied with the job or salary, getting a preferred job, being in competitive or supported employment and having higher than median scores of PANNS on the positive, negative and general psychopathology. Significant predictors of employment, from a logistic regression model were having good past history of working (p<0.021; OR 6.12; [95% CI 2.1-11.9]) and getting a preferred job (p<0.032; [OR 4.021; 95% CI 1.83-12.1]).
    CONCLUSION: Results showed a high employment rate among patients with SMI. Good past history of working and getting a preferred job were significant predictors of successful employment.
    Matched MeSH terms: Depressive Disorder, Major/rehabilitation
  11. Fulltext Impact of pharmacist intervention on adherence and measurable patient outcomes among depressed patients: a randomised controlled study
    Aljumah K, Hassali MA
    BMC Psychiatry, 2015;15:219.
    PMID: 26376830 DOI: 10.1186/s12888-015-0605-8
    Adherence to antidepressant treatment is essential for the effective management of patients with major depressive disorder. Adherence to medication is a dynamic decision-making process, and pharmacists play an important role in improving adherence to antidepressant treatment in different settings within the healthcare system. The aim of this study was to assess whether pharmacist interventions based on shared decision making improved adherence and patient-related outcomes.
    Matched MeSH terms: Depressive Disorder, Major/drug therapy*
  12. Association between functional polymorphisms in serotonin transporter gene (SLC6A4) and escitalopram treatment response in depressive patients in a South Indian population
    Mandal T, Bairy LK, Sharma PSVN
    Eur J Clin Pharmacol, 2020 Jun;76(6):807-814.
    PMID: 32253447 DOI: 10.1007/s00228-020-02866-4
    PURPOSE: Ethnicity plays a key role in deciding the direction of the association between serotonin transporter gene polymorphisms and treatment response of selective serotonin reuptake inhibitors (SSRIs). The present study explored the association of 5HTTLPR and 5HTTLPR-rs25531 polymorphisms with the treatment response of escitalopram in South Indian patients with major depressive disorder.

    METHODS: A total of 148 depressive patients receiving escitalopram 10-20 mg/day were genotyped for 5HTTLPR and rs25531 polymorphisms. Clinical assessment was done at baseline and after 4, 8, and 12 weeks using the 17-item Hamilton Depression Rating Scale (HDRS-17), Montgomery-Asberg Depression Rating Scale (MADRS), and Clinical Global Impression Scale (CGI). At the end of week 12, patients were defined as responders and non-responders based on HDRS17 and MADRS scores. Chi-square test and logistic regression analysis were performed to investigate the genotypic influence on treatment response. Comparison of continuous variables among different groups was done using Student's t test or one-way ANOVA.

    RESULTS: Out of 148 study subjects, 65 (43.9%) were responders and 83 (56.08%) were non-responders. We observed a significant (p value

    Matched MeSH terms: Depressive Disorder, Major/drug therapy*
  13. Fulltext Joint analysis of psychiatric disorders increases accuracy of risk prediction for schizophrenia, bipolar disorder, and major depressive disorder
    Maier R, Moser G, Chen GB, Ripke S, Cross-Disorder Working Group of the Psychiatric Genomics Consortium, Coryell W, et al.
    Am J Hum Genet, 2015 Feb 05;96(2):283-94.
    PMID: 25640677 DOI: 10.1016/j.ajhg.2014.12.006
    Genetic risk prediction has several potential applications in medical research and clinical practice and could be used, for example, to stratify a heterogeneous population of patients by their predicted genetic risk. However, for polygenic traits, such as psychiatric disorders, the accuracy of risk prediction is low. Here we use a multivariate linear mixed model and apply multi-trait genomic best linear unbiased prediction for genetic risk prediction. This method exploits correlations between disorders and simultaneously evaluates individual risk for each disorder. We show that the multivariate approach significantly increases the prediction accuracy for schizophrenia, bipolar disorder, and major depressive disorder in the discovery as well as in independent validation datasets. By grouping SNPs based on genome annotation and fitting multiple random effects, we show that the prediction accuracy could be further improved. The gain in prediction accuracy of the multivariate approach is equivalent to an increase in sample size of 34% for schizophrenia, 68% for bipolar disorder, and 76% for major depressive disorders using single trait models. Because our approach can be readily applied to any number of GWAS datasets of correlated traits, it is a flexible and powerful tool to maximize prediction accuracy. With current sample size, risk predictors are not useful in a clinical setting but already are a valuable research tool, for example in experimental designs comparing cases with high and low polygenic risk.
    Matched MeSH terms: Depressive Disorder, Major/genetics
  14. Factors Associated With Antidepressant Dosing in Asia: Findings From the Research on Asian Psychotropic Prescription Study
    Rajaratnam K, Xiang YT, Tripathi A, Chiu HF, Si TM, Chee KY, et al.
    J Clin Psychopharmacol, 2016 Dec;36(6):716-719.
    PMID: 27753726
    In this study, we sought to examine factors associated with dosing of antidepressants (ADs) in Asia. Based on reported data and clinical experience, we hypothesized that doses of ADs would be associated with demographic and clinical factors and would increase over time. This cross-sectional, pharmacoepidemiological study analyzed data collected within the Research Study on Asian Psychotropic Prescription Pattern for Antidepressants from 4164 participants in 10 Asian countries, using univariate and multivariate methods. The AD doses varied by twofold among countries (highest in PR China and RO Korea, lowest in Singapore and Indonesia), and averaged 124 (120-129) mg/d imipramine-equivalents. Average daily doses increased by 12% between 2004 and 2013. Doses were significantly higher among hospitalized patients and ranked by diagnosis: major depression > anxiety disorders > bipolar disorder, but were not associated with private/public or psychiatric/general-medical settings, nor with age, sex, or cotreatment with a mood stabilizer. In multivariate modeling, AD-dose remained significantly associated with major depressive disorder and being hospitalized. Doses of ADs have increased somewhat in Asia and were higher when used for major depression or anxiety disorders than for bipolar depression and for hospitalized psychiatric patients.
    Matched MeSH terms: Depressive Disorder, Major/drug therapy*
  15. Comparison of psychotropic prescriptions between oncology and cardiology inpatients: result from a pharmacy database in a teaching hospital in Malaysia
    Ng CG, Mohamed S, Wern TY, Haris A, Zainal NZ, Sulaiman AH
    Asian Pac J Cancer Prev, 2014;15(10):4261-4.
    PMID: 24935381
    OBJECTIVE: To examine the prescription rates in cancer patients of three common psychotropic drugs: anxiolytic/ hypnotic, antidepressant and antipsychotic.

    MATERIALS AND METHODS: In this retrospective cohort study, data were extracted from the pharmacy database of University Malaya Medical Center (UMMC) responsible for dispensing records of patients stored in the pharmacy's Medication Management and Use System (Ascribe). We analyzed the use of psychotropics in patients from the oncology ward and cardiology from 2008 to 2012. Odds ratios (ORs) were adjusted for age, gender and ethnicity.

    RESULTS: A total of 3,345 oncology patients and 8,980 cardiology patients were included. Oncology patients were significantly more often prescribed psychotropic drugs (adjusted OR: anxiolytic/hypnotic=5.55 (CI: 4.64-6.63); antidepressants=6.08 (CI: 4.83-7.64) and antipsychotics=5.41 (CI: 4.17-7.02). Non-Malay female cancer patients were at significantly higher risk of anxiolytic/hypnotic use.

    CONCLUSIONS: Psychotropic drugs prescription is common in cancer patients. Anxiolytic/hypnotic prescription rates are significantly higher in non-Malay female patients in Malaysia.

    Matched MeSH terms: Depressive Disorder, Major/complications; Depressive Disorder, Major/drug therapy
  16. High prevalence of hypokalemia after acute acetaminophen overdose: impact of psychiatric illness
    Zyoud SH, Awang R, Syed Sulaiman SA, Al-jabi SW
    Hum Exp Toxicol, 2010 Sep;29(9):773-8.
    PMID: 20144962 DOI: 10.1177/0960327110361759
    Hypokalemia is not an isolated disease but an associated finding in a number of different diseases. It is also a commonly neglected condition among patients with acute acetaminophen overdose.
    Matched MeSH terms: Depressive Disorder, Major/blood; Depressive Disorder, Major/complications
  17. The association of suicide risk with negative life events and social support according to gender in Asian patients with major depressive disorder
    Park S, Hatim Sulaiman A, Srisurapanont M, Chang SM, Liu CY, Bautista D, et al.
    Psychiatry Res, 2015 Aug 30;228(3):277-82.
    PMID: 26160206 DOI: 10.1016/j.psychres.2015.06.032
    We investigated the associations between negative life events, social support, depressive and hostile symptoms, and suicide risk according to gender in multinational Asian patients with major depressive disorder (MDD). A total of 547 outpatients with MDD (352 women and 195 men, mean age of 39.58±13.21 years) were recruited in China, South Korea, Malaysia, Singapore, Thailand, and Taiwan. All patients were assessed with the Mini-International Neuropsychiatric Interview, the Montgomery-Asberg Depression Rating Scale, the Symptoms Checklist 90-Revised, the Multidimensional Scale of Perceived Social Support, and the List of Threatening Experiences. Negative life events, social support, depressive symptoms, and hostility were all significantly associated with suicidality in female MDD patients. However, only depressive symptoms and hostility were significantly associated with suicidality in male patients. Depression severity and hostility only partially mediated the association of negative life events and poor social support with suicidality in female patients. In contrast, hostility fully mediated the association of negative life events and poor social support with suicidality in male patients. Our results highlight the need of in-depth assessment of suicide risk for depressed female patients who report a number of negative life events and poor social supports, even if they do not show severe psychopathology.
    Matched MeSH terms: Depressive Disorder, Major/ethnology; Depressive Disorder, Major/psychology*
  18. Clinical and sociodemographic correlates of severe insomnia in psychotropic drug-free, Asian outpatients with major depressive disorder
    Srisurapanont M, Likhitsathian S, Chua HC, Udomratn P, Chang S, Maneeton N, et al.
    J Affect Disord, 2015 Nov 1;186:26-31.
    PMID: 26226430 DOI: 10.1016/j.jad.2015.06.032
    BACKGROUND: Little has been known regarding the correlates of severe insomnia in major depressive disorder (MDD). This post-hoc analysis aimed to examine the sociodemographic and clinical correlates of severe insomnia in psychotropic drug-free, Asian adult outpatients with MDD.
    METHODS: Participants were psychotropic drug-free patients with MDD, aged 18-65 years. By using the Symptom Checklist-90 Items, Revised (SCL-90-R), a score of 4 (severe distress) on any one of three insomnia items was defined as severe insomnia. Other measures included the Montgomery-Asberg Depression Rating Scale (MADRS), the Fatigue Severity Scale (FSS), the nine psychopathology subscales of SCL-90-R, the Physical and Mental Component Summaries of Short Form Health Survey (SF-36 PCS and SF-36 MCS), and the Sheehan Disability Scale (SDS).
    RESULTS: Of 528 participants, their mean age being 39.5 (SD=13.26) years, 64.2% were females, and 239 (45.3%) had severe insomnia. The logistic regression model revealed that low educational qualifications (less than secondary school completion), high SCL-90-R Depression scores, high SCL-90-R Anxiety scores, and low SF-36 PCS scores were independently correlated with severe insomnia (p's
    Matched MeSH terms: Depressive Disorder, Major/complications*; Depressive Disorder, Major/psychology
  19. Fulltext Double-blind, placebo-controlled study of lurasidone monotherapy for the treatment of bipolar I depression
    Kato T, Ishigooka J, Miyajima M, Watabe K, Fujimori T, Masuda T, et al.
    Psychiatry Clin Neurosci, 2020 Dec;74(12):635-644.
    PMID: 32827348 DOI: 10.1111/pcn.13137
    AIM: Previous studies conducted primarily in the USA and Europe have demonstrated the efficacy and safety of lurasidone 20-120 mg/day for the treatment of bipolar I depression. The aim of the current study was to evaluate the efficacy and safety of lurasidone monotherapy for the treatment of bipolar I depression among patients from diverse ethnic backgrounds, including those from Japan.

    METHODS: Patients were randomly assigned to double-blind treatment for 6 weeks with lurasidone, 20-60 mg/day (n = 184) or 80-120 mg/day (n = 169), or placebo (n = 172). The primary end-point was change from baseline to Week 6 on the Montgomery-Åsberg Depression Rating Scale (MADRS).

    RESULTS: Lurasidone treatment significantly reduced mean MADRS total scores from baseline to Week 6 for the 20-60-mg/day group (-13.6; adjusted P = 0.007; effect size = 0.33), but not for the 80-120-mg/day group (-12.6; adjusted P = 0.057; effect size = 0.22) compared with placebo (-10.6). Treatment with lurasidone 20-60 mg/day also improved MADRS response rates, functional impairment, and anxiety symptoms. The most common adverse events associated with lurasidone were akathisia and nausea. Lurasidone treatments were associated with minimal changes in weight, lipids, and measures of glycemic control.

    CONCLUSION: Monotherapy with once daily doses of lurasidone 20-60 mg, but not 80-120 mg, significantly reduced depressive symptoms and improved functioning in patients with bipolar I depression. Results overall were consistent with previous studies, suggesting that lurasidone 20-60 mg/day is effective and safe in diverse ethnic populations, including Japanese.

    Matched MeSH terms: Depressive Disorder, Major/drug therapy*; Depressive Disorder, Major/ethnology
  20. Comparable efficacy and safety of 8 weeks treatment with agomelatine 25-50mg or fluoxetine 20-40mg in Asian out-patients with major depressive disorder
    Shu L, Sulaiman AH, Huang YS, Fones Soon Leng C, Crutel VS, Kim YS
    Asian J Psychiatr, 2014 Apr;8:26-32.
    PMID: 24655622 DOI: 10.1016/j.ajp.2013.09.009
    OBJECTIVE: This randomized, double-blind study evaluates the efficacy and tolerability of agomelatine, using fluoxetine as an active comparator, in Asian patients suffering from moderate to severe major depressive disorder (MDD).
    METHOD: Patients were randomly assigned to receive either agomelatine (25-50mg/day, n=314) or fluoxetine (20-40mg/day, n=314) during an 8-week treatment period. The main outcome measure was the change in Hamilton Depression Rating Scale 17 items (HAM-D17) scores. Secondary efficacy criteria included scores on Clinical Global Impression Severity of illness (CGI-S) and Improvement of illness (CGI-I), patient sleeping improvement using the self-rating Leeds Sleep Evaluation Questionnaire (LSEQ) and anxiety using the Hamilton Anxiety Rating Scale (HAM-A) scores. Tolerability and safety evaluations were based on emergent adverse events.
    RESULTS: Agomelatine and fluoxetine exert a comparable antidepressant efficacy in the Asian population. Mean changes over 8 weeks were clinically relevant and similar in both groups (-14.8±7.3 and -15.0±8.1 on HAM-D17 scale in agomelatine and fluoxetine groups, respectively). The between-group difference reached statistical significance on non-inferiority test (p=0.015). Clinically relevant decreases in CGI-S and CGI-I scores were observed over the treatment period in both groups. The two treatments were equally effective on the symptoms of both anxiety and sleep. The good tolerability profile and safety of both doses of agomelatine was confirmed in the Asian population.
    CONCLUSIONS: Agomelatine and fluoxetine are equally effective in the treatment of MDD-associated symptoms in Asian depressed patients.
    KEYWORDS: Agomelatine; Antidepressant; Asian population; Fluoxetine
    Study site in Malaysia: Psychiatric clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Depressive Disorder, Major/drug therapy*
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