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The contribution of depressive ‘disorder characteristics’ to determinations of prognosis for adults with depression: an individual patient data meta-analysis
- Joshua E. J. Buckman, Rob Saunders, Zachary D. Cohen, Phoebe Barnett, Katherine Clarke, Gareth Ambler, Robert J. DeRubeis, Simon Gilbody, Steven D. Hollon, Tony Kendrick, Edward Watkins, Nicola Wiles, David Kessler, David Richards, Deborah Sharp, Sally Brabyn, Elizabeth Littlewood, Chris Salisbury, Ian R. White, Glyn Lewis, Stephen Pilling
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- Journal:
- Psychological Medicine / Volume 51 / Issue 7 / May 2021
- Published online by Cambridge University Press:
- 14 April 2021, pp. 1068-1081
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- Article
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Background
This study aimed to investigate general factors associated with prognosis regardless of the type of treatment received, for adults with depression in primary care.
MethodsWe searched Medline, Embase, PsycINFO and Cochrane Central (inception to 12/01/2020) for RCTs that included the most commonly used comprehensive measure of depressive and anxiety disorder symptoms and diagnoses, in primary care depression RCTs (the Revised Clinical Interview Schedule: CIS-R). Two-stage random-effects meta-analyses were conducted.
ResultsTwelve (n = 6024) of thirteen eligible studies (n = 6175) provided individual patient data. There was a 31% (95%CI: 25 to 37) difference in depressive symptoms at 3–4 months per standard deviation increase in baseline depressive symptoms. Four additional factors: the duration of anxiety; duration of depression; comorbid panic disorder; and a history of antidepressant treatment were also independently associated with poorer prognosis. There was evidence that the difference in prognosis when these factors were combined could be of clinical importance. Adding these variables improved the amount of variance explained in 3–4 month depressive symptoms from 16% using depressive symptom severity alone to 27%. Risk of bias (assessed with QUIPS) was low in all studies and quality (assessed with GRADE) was high. Sensitivity analyses did not alter our conclusions.
ConclusionsWhen adults seek treatment for depression clinicians should routinely assess for the duration of anxiety, duration of depression, comorbid panic disorder, and a history of antidepressant treatment alongside depressive symptom severity. This could provide clinicians and patients with useful and desired information to elucidate prognosis and aid the clinical management of depression.
List of contributors
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- By Jimmy N. Avari, Joshua Berman, David A. Brent, Benjamin D. Brody, Carolyn Broudy, Gerard E. Bruder, Deborah L. Cabaniss, Megan S. Chesin, Melissa P. DelBello, Davangere P. Devanand, Jordan W. Eipper, Jean Endicott, Eric A. Fertuck, Michael B. First, Benicio N. Frey, Emily Gastelum, Lucas Giner, Barbara L. Gracious, David J. Hellerstein, Aerin M. Hyun, David A. Kahn, Jürgen Kayser, S. Aiden Kelly, James H. Kocsis, Robert A. Kowatch, Gonzalo Laje, Martin J. Lan, Kyle A. B. Lapidus, Frances R. Levin, Sarah H. Lisanby, J. John Mann, Sanjay J. Mathew, Patrick J. McGrath, Francis J. McMahon, Barnett S. Meyers, Luciano Minuzzi, Diana E. Moga, Philip R. Muskin, Edward V. Nunes, Maria A. Oquendo, Ramin V. Parsey, Joan Prudic, Annie E. Rabinovitch, Drew Ramsey, Steven P. Roose, Moacyr A. Rosa, Bret R. Rutherford, Roberto Sassi, Peter A. Shapiro, Margaret G. Spinelli, Barbara H. Stanley, Meir Steiner, Jonathan W. Stewart, M. Elizabeth Sublette, Craig E. Tenke, Jiuan Su Terman, Michael Terman, Michael E. Thase, Helen Verdeli, Myrna M. Weissman
- Edited by J. John Mann, Columbia University, New York
- Edited in association with Patrick J. McGrath, Columbia University, New York, Steven P. Roose, Columbia University, New York
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- Book:
- Clinical Handbook for the Management of Mood Disorders
- Published online:
- 05 May 2013
- Print publication:
- 09 May 2013, pp vii-x
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Contributors
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- By Aakash Agarwala, Linda S. Aglio, Rae M. Allain, Paul D. Allen, Houman Amirfarzan, Yasodananda Kumar Areti, Amit Asopa, Edwin G. Avery, Patricia R. Bachiller, Angela M. Bader, Rana Badr, Sibinka Bajic, David J. Baker, Sheila R. Barnett, Rena Beckerly, Lorenzo Berra, Walter Bethune, Sascha S. Beutler, Tarun Bhalla, Edward A. Bittner, Jonathan D. Bloom, Alina V. Bodas, Lina M. Bolanos-Diaz, Ruma R. Bose, Jan Boublik, John P. Broadnax, Jason C. Brookman, Meredith R. Brooks, Roland Brusseau, Ethan O. Bryson, Linda A. Bulich, Kenji Butterfield, William R. Camann, Denise M. Chan, Theresa S. Chang, Jonathan E. Charnin, Mark Chrostowski, Fred Cobey, Adam B. Collins, Mercedes A. Concepcion, Christopher W. Connor, Bronwyn Cooper, Jeffrey B. Cooper, Martha Cordoba-Amorocho, Stephen B. Corn, Darin J. Correll, Gregory J. Crosby, Lisa J. Crossley, Deborah J. Culley, Tomas Cvrk, Michael N. D'Ambra, Michael Decker, Daniel F. Dedrick, Mark Dershwitz, Francis X. Dillon, Pradeep Dinakar, Alimorad G. Djalali, D. John Doyle, Lambertus Drop, Ian F. Dunn, Theodore E. Dushane, Sunil Eappen, Thomas Edrich, Jesse M. Ehrenfeld, Jason M. Erlich, Lucinda L. Everett, Elliott S. Farber, Khaldoun Faris, Eddy M. Feliz, Massimo Ferrigno, Richard S. Field, Michael G. Fitzsimons, Hugh L. Flanagan Jr., Vladimir Formanek, Amanda A. Fox, John A. Fox, Gyorgy Frendl, Tanja S. Frey, Samuel M. Galvagno Jr., Edward R. Garcia, Jonathan D. Gates, Cosmin Gauran, Brian J. Gelfand, Simon Gelman, Alexander C. Gerhart, Peter Gerner, Omid Ghalambor, Christopher J. Gilligan, Christian D. Gonzalez, Noah E. Gordon, William B. Gormley, Thomas J. Graetz, Wendy L. Gross, Amit Gupta, James P. Hardy, Seetharaman Hariharan, Miriam Harnett, Philip M. Hartigan, Joaquim M. Havens, Bishr Haydar, Stephen O. Heard, James L. Helstrom, David L. Hepner, McCallum R. Hoyt, Robert N. Jamison, Karinne Jervis, Stephanie B. Jones, Swaminathan Karthik, Richard M. Kaufman, Shubjeet Kaur, Lee A. Kearse Jr., John C. Keel, Scott D. Kelley, Albert H. Kim, Amy L. Kim, Grace Y. Kim, Robert J. Klickovich, Robert M. Knapp, Bhavani S. Kodali, Rahul Koka, Alina Lazar, Laura H. Leduc, Stanley Leeson, Lisa R. Leffert, Scott A. LeGrand, Patricio Leyton, J. Lance Lichtor, John Lin, Alvaro A. Macias, Karan Madan, Sohail K. Mahboobi, Devi Mahendran, Christine Mai, Sayeed Malek, S. Rao Mallampati, Thomas J. Mancuso, Ramon Martin, Matthew C. Martinez, J. A. Jeevendra Martyn, Kai Matthes, Tommaso Mauri, Mary Ellen McCann, Shannon S. McKenna, Dennis J. McNicholl, Abdel-Kader Mehio, Thor C. Milland, Tonya L. K. Miller, John D. Mitchell, K. Annette Mizuguchi, Naila Moghul, David R. Moss, Ross J. Musumeci, Naveen Nathan, Ju-Mei Ng, Liem C. Nguyen, Ervant Nishanian, Martina Nowak, Ala Nozari, Michael Nurok, Arti Ori, Rafael A. Ortega, Amy J. Ortman, David Oxman, Arvind Palanisamy, Carlo Pancaro, Lisbeth Lopez Pappas, Benjamin Parish, Samuel Park, Deborah S. Pederson, Beverly K. Philip, James H. Philip, Silvia Pivi, Stephen D. Pratt, Douglas E. Raines, Stephen L. Ratcliff, James P. Rathmell, J. Taylor Reed, Elizabeth M. Rickerson, Selwyn O. Rogers Jr., Thomas M. Romanelli, William H. Rosenblatt, Carl E. Rosow, Edgar L. Ross, J. Victor Ryckman, Mônica M. Sá Rêgo, Nicholas Sadovnikoff, Warren S. Sandberg, Annette Y. Schure, B. Scott Segal, Navil F. Sethna, Swapneel K. Shah, Shaheen F. Shaikh, Fred E. Shapiro, Torin D. Shear, Prem S. Shekar, Stanton K. Shernan, Naomi Shimizu, Douglas C. Shook, Kamal K. Sikka, Pankaj K. Sikka, David A. Silver, Jeffrey H. Silverstein, Emily A. Singer, Ken Solt, Spiro G. Spanakis, Wolfgang Steudel, Matthias Stopfkuchen-Evans, Michael P. Storey, Gary R. Strichartz, Balachundhar Subramaniam, Wariya Sukhupragarn, John Summers, Shine Sun, Eswar Sundar, Sugantha Sundar, Neelakantan Sunder, Faraz Syed, Usha B. Tedrow, Nelson L. Thaemert, George P. Topulos, Lawrence C. Tsen, Richard D. Urman, Charles A. Vacanti, Francis X. Vacanti, Joshua C. Vacanti, Assia Valovska, Ivan T. Valovski, Mary Ann Vann, Susan Vassallo, Anasuya Vasudevan, Kamen V. Vlassakov, Gian Paolo Volpato, Essi M. Vulli, J. Matthias Walz, Jingping Wang, James F. Watkins, Maxwell Weinmann, Sharon L. Wetherall, Mallory Williams, Sarah H. Wiser, Zhiling Xiong, Warren M. Zapol, Jie Zhou
- Edited by Charles Vacanti, Scott Segal, Pankaj Sikka, Richard Urman
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- Book:
- Essential Clinical Anesthesia
- Published online:
- 05 January 2012
- Print publication:
- 11 July 2011, pp xv-xxviii
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16 - Fetal programming of polycystic ovary syndrome
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- By David H. Abbott, University of Wisconsin, Cristin M. Bruns, Dean Clinic, USA, Deborah K. Barnett, University of Alaska Southeast, Daniel A. Dumesic, University of Wisconsin
- Edited by Gabor T. Kovacs, Monash University, Victoria, Robert Norman, University of Adelaide
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- Book:
- Polycystic Ovary Syndrome
- Published online:
- 29 September 2009
- Print publication:
- 22 February 2007, pp 262-287
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Summary
Introduction
Readily available, highly calorific foods (Briefel and Johnson 2004), together with an increasingly sedentary lifestyle (Winkleby and Cubbin 2004), are causing progressive detriments in human health (Mokdad et al. 1999, Katzmarzyk and Ardern 2004, Rigby et al. 2004). In the USA alone, overweight or obesity afflicts approximately one in three adult women and contributes to a rapidly increasing incidence of type 2 diabetes (NHANES 2006). The current epidemiological evidence suggests that such an escalating prevalence of obesity and diabetes will continue for the foreseeable future (Zimmet 1999, Zimmet et al. 2003). Such a prediction is of particular concern for women's reproductive health because obesity and diabetes contribute markedly to anovulatory infertility (Norman and Clark 1998, Norman et al. 2004), the most frequent cause of infertility in women (Abbott et al. 2004).
Metabolic dysfunction has considerable consequences for polycystic ovary syndrome (PCOS), a highly prevalent metabolic and infertility disorder of reproductive-aged women that is exacerbated by obesity (Ehrmann et al. 1995, Franks 1995, Dunaif 1997, Escobar-Morreale et al. 2004, Carmina et al. 2005). The syndrome has a highly heterogeneous presentation that can include androgen excess, amenorrhea, insulin resistance, and obesity, among other general health disorders (Abbott et al. 2002a, Dumesic et al. 2005). The most recent PCOS consensus diagnosis (The Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group 2004), however, requires the presence of only two out of three specific androgenic and reproductive criteria: (1) hyperandrogenism, as determined biochemically from circulating total or unbound testosterone levels or clinical signs of hyperandrogenism, (2) intermittent or absent menstrual cycles, and (3) polycystic ovaries, as visualized by ultrasound.
Challenges in Integrating the High-K Gate Dielectric Film to the Conventional Cmos Process Flow
- Avinash Agarwal, Michael Freiler, Pat Lysaght, Loyd Perrymore, Renate Bergmann, Chris Sparks, Bill Bowers, Joel Barnett, Deborah Riley, Yudong Kim, Billy Nguyen, Gennadi Bersuker, Eric Shero, Jae E. Lim, Steven Lin, Jerry Chen, Robert W. Murto, Howard R. Huff
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- Journal:
- MRS Online Proceedings Library Archive / Volume 670 / 2001
- Published online by Cambridge University Press:
- 21 March 2011, K2.1
- Print publication:
- 2001
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ZrO2 and HfO2 and their alloys with SiO2 are currently among the leading high-k materials for replacing SiOxNy as the gate dielectric for the sub-100 nm technology nodes. International SEMATECH (ISMT) is currently investigating integration issues associated with this required change in materials. Our work has focused on the integration of ALCVD deposited ZrO2 and HfO2 with an industry standard conventional MOSFET process flow with poly-Si electrode. Since the impact of contamination by these new high-k materials introduced in a production fab has not yet been established, it becomes very critical to prevent cross- contamination through the process tools in the fab. A baseline study was completed within ISMT's fab and appropriate protocols for handling high-k materials have been established. The integrated high-k gate stack in a conventional transistor flow should not only meet all the performance requirements of scaled transistors, but the gate dielectric film should be able withstand high-temperature anneal steps. Reactions between ZrO2 and Si have been observed at temperatures as low as 560°C (during the amorphous Si deposition process). Various wet chemistries were also evaluated for removing the high-k film inadvertently deposited on wafer backside, and it was found that ZrO2 etches at extremely slow rates in the majority of the common wet etch chemistries available in a fab. A new hot HF based process was found to be successful in lowering Zr contamination on the wafer backside to as low as 1.8 E10 atoms/cm2. The patterning of a high-k gate stack with poly-Si electrode is another area that required considerable focus. Various dry (plasma) etch and wet etch chemistries were evaluated for etching ZrO2 using both blanket films as well as wafers with patterned poly-Si gate over the high-k films. On the full CMOS flow device wafers, most of these wet chemistries resulted in severe pitting in the ZrO2 film remaining over the source/drain (S/D) areas, as well as in the Si substrate and the field oxide. A poly-Si gate over ZrO2 gate dielectric film was successfully patterned using the standard poly-Si gate etch (Cl2/HBr) for the main etch, followed by a combination of HF and H2SO4 clean for removing all of the ZrO2 remaining over the S/D area. This allowed the fabrication of low-resistance contacts to transistor S/D areas, which ultimately resulted in demonstration of functional transistors with high-k gate dielectric films.
The Aspergillus nidulans hfa mutations affect genomic stability and cause diverse defects in cell cycle progression and cellular morphogenesis
- Michelle A. HUGHES, Deborah A. BARNETT, Zainon MOHD-NOOR, Susan L. WHITTAKER, John H. DOONAN, Susan J. ASSINDER
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- Journal:
- Mycological Research / Volume 104 / Issue 12 / December 2000
- Published online by Cambridge University Press:
- 17 January 2001, pp. 1439-1448
- Print publication:
- December 2000
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The hfa (high frequency of aneuploidy) mutants of Aspergillus nidulans carry conditional lethal (temperature-sensitive) defects which cause an increased frequency of aneuploids to be produced amongst their asexual progeny. When examined microscopically, most of the mutants grew and divided their nuclei at restrictive temperature, albeit more slowly than the wild-type, and aneuploidy was not attributable to an obvious cell cycle lesion. Exceptions were hfaB3 and hfaL1 which exhibited defects in nuclear division, although neither mutant arrested at a specific point in the cell cycle. Cells carrying hfaB3 contained only a single enlarged nucleus which was often transected (‘cut’) by the first septum and temperature-shift experiments showed that the mutation triggers aneuploidy by causing failure to properly exit mitosis. Although the hfaD1 mutant underwent nuclear division, it differed morphologically from wild-type by exhibiting a hyper-branching phenotype. The original hfaD1 isolate was shown also to carry a second unlinked mutation (designated hurA1) which confers resistance to hydroxyurea and partly alleviates the growth defects imposed by hfaD1.