Preview

Neurology, Neuropsychiatry, Psychosomatics

Advanced search

Depressions with eating disorders: clinical manifestations and therapy

https://doi.org/10.14412/2074-2711-2020-4-49-56

Full Text:

Abstract

Depression is a common comorbid diagnosis in patients with eating disorders (EDs). The development of pathogenetic therapy for depression with EDs is far from being completed.

The objective of the psychopharmacotherapeutic study was to evaluate the efficacy and tolerability of melatonergic monotherapy with the antidepressant agomelatine (25–50 mg/day at night) for depressions with two ED variants: hyperphagic (n=32) and hypo- and aphagic (n=31) EDs.

Patients and methods. The investigation enrolled patients of both sexes, aged 18 to 65 years. The investigators performed clinical psychopathological and experimental psychological studies, as well as psychometric examination using the 21-item Hamilton Depression Rating Scale (HDRS-21), the Clinical Global Impression (CGI), the Supplemental Hospital Offset Payment Program (SHOPP), the Dutch Eating Behavior Questionnaire (DEBQ), and statistical data processing.

Results and discussion. There was a significant pronounced antidepressant effect of 6-week agomelatine therapy for depressions occurring with different ED variants both in the pattern of the depressive symptom complex and in that of concurrent with and preceding the latter. At the same time, the efficacy of the drug did not depend on the clinical presentations of the leading hypothymic syndrome, the variants of EDs, and the duration of actual depression. However, by the end of the study period, a larger effect was achieved in the therapy for depressions with the hyperphagic variant of EDs, as well as in patients with EDs manifesting in the pattern of depressive symptom complex. Agomelatine has a favorable tolerance profile. BMI tends to become normal in patients with different variants of EDs during the therapy. The adverse events are transient and/or unclear; they do not require therapy discontinuation.

Conclusion. Agomelatine is an effective and relatively safe drug that can be recommended to treat depressions concurrent with EDs in therapeutic dosages for at least 6 weeks.

About the Authors

V. E. Medvedev
Department of Psychiatry, Psychotherapy, and Psychosomatic Pathology, Faculty of Continuing Medical Education, Medical Institute, Peoples’ Friendship University of Russia (RUDN University); Psychiatric Clinical Hospital Thirteen, Moscow Healthcare Department; 3Clinical Hospital One, Presidential Administration of the Russian Federation; International Institute of Psychosomatic Health
Russian Federation

Vladimir Ernstovich Medvedev

6, Miklukho-Maklai St., Moscow 117198
27, Stavropolskaya St., Moscow 109559
10, Starovolynskaya St., Moscow 121352
14, Neglinnaya St., Build. 1, Moscow 107031 



V. I. Frolova
Peoples’ Friendship University of Russia (RUDN University)
Russian Federation

Department of Psychiatry, Psychotherapy, and Psychosomatic Pathology, Faculty of Continuing Medical Education, Medical Institute

6, Miklukho-Maklai St., Moscow 117198

 



E. V. Gushanskaya
Department of Psychiatry, Psychotherapy, and Psychosomatic Pathology, Faculty of Continuing Medical Education, Medical Institute, Peoples’ Friendship University of Russia (RUDN University); Psychiatric Clinical Hospital Thirteen, Moscow Healthcare Department
Russian Federation
6, Miklukho-Maklai St., Moscow 117198
27, Stavropolskaya St., Moscow 109559


Yu. S. Fofanova
Clinical Hospital One, Presidential Administration of the Russian Federation
Russian Federation
10, Starovolynskaya St., Moscow 121352


S. E. Martynov
International Institute of Psychosomatic Health
Russian Federation
14, Neglinnaya St., Build. 1, Moscow 107031


N. L. Zuikova
Peoples’ Friendship University of Russia (RUDN University)
Russian Federation

Department of Psychiatry, Psychotherapy, and Psychosomatic Pathology, Faculty of Continuing Medical Education, Medical Institute

6, Miklukho-Maklai St., Moscow 117198


A. M. Burno
Peoples’ Friendship University of Russia (RUDN University)
Russian Federation

Department of Psychiatry, Psychotherapy, and Psychosomatic Pathology, Faculty of Continuing Medical Education, Medical Institute

6, Miklukho-Maklai St., Moscow 117198


S. V. Nekrasova
Peoples’ Friendship University of Russia (RUDN University)
Russian Federation

Department of Psychiatry, Psychotherapy, and Psychosomatic Pathology, Faculty of Continuing Medical Education, Medical Institute

6, Miklukho-Maklai St., Moscow 117198


I. V. Salyntsev
Peoples’ Friendship University of Russia (RUDN University)
Russian Federation

Department of Psychiatry, Psychotherapy, and Psychosomatic Pathology, Faculty of Continuing Medical Education, Medical Institute

6, Miklukho-Maklai St., Moscow 117198


References

1. Mazaeva NA. Anorexia nervosa: review of the foreign publications. Part 1. Diagnostic criteria, epidemiology, pathogenesis. Psychiatry and Psychopharmacotherapy. 2019;21(3):9-16 (In Russ.).

2. Mazaeva NA. Anorexia nervosa: review of the foreign publications. Part 2. Clinico-biological correlations, prognosis and management. Psychiatry and Psychopharmacotherapy. 2019;21(4):4-12 (In Russ.).

3. Beilharz F, Phillipou A, Castle D, et al. Dysmorphic concern in anorexia nervosa: implications for recovery. Psychiatry Res. 2019;273:657-61. doi: 10.1016/j.psychres.2019.01.102

4. Calugi S, El Ghoch M, Conti M, Grave RD. Depression and treatment outcome in anorexia nervosa. Psychiatry Res. 2014;218(1-2):195-200. doi: 10.1016/j.psychres.2014.04.024

5. Moskowitz L, Weiselberg E. Anorexia nervosa/Atypical anorexia nervosa. Curr Probl Pediatr Adolescent Health Care. 2017;47(4):70-84. doi: 10.1016/j.cppeds.2017.02.003

6. Zerwas S, Lund BC, Von Holle A, et al. Factors associated with recovery from anorexia nervosa. J Psychiatr Res. 2013;47:972-9. doi: 10.1016/j.jpsychires.2013.02.011

7. Lamerz A, Kuepper-Nybelen J, Bruning N, et al. Prevalence of obesity, binge eating, and night eating in a cross-sectional field survey of 6-year-old children and their parents in a German urban population. J Child Psychol Psychiat. 2005;46:385-93. doi: 10.1111/j.14697610.2004.00363.x

8. Lundgren JD, Allison KC, O’Reardon JP, et al. Prevalence of the Night Eating Syndrome in a Psychiatric Population. Am J Psychiat. 2006;163:156-8. doi: 10.1176/appi.ajp.163.1.156

9. Rand CS, Macgregor AM, Stunkard AJ. The night eating syndrome in the general population and among postoperative obesity surgery patients. Int J Eat Dis. 1997;22:65-9. doi: 10.1002/(sici)1098108x(199707)22:1<65::aid-eat8>3.3.co;2-e

10. Smulevich AB, Kolyutskaya EV, Gushanskaya EV, Medvedev VE. On the problem of subsyndromal seasonal affective disorder. Psikhiatriya. 2003;1(1):24-8 (In Russ.).

11. Hannanova AN, Bykov YuV, Bekker RA. Melatonin: perspectives in therapy of different psychiatric disorders (a literature review). V mire nauchnykh otkrytii. 2017;9(1):131-49. doi: 10.12731/wsd-2017-1-131-149 (In Russ.).

12. Medvedev VE, Retyunskii KYu, Ovchinnikov AA, et al. Differences in the assessment of the severity of depression by doctors and patients in the course of combined therapy with agomelatine (multicenter study «EMOTION»). Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2016;(11):26-34. doi: 10.17116/jnevro201611611126-34 (In Russ.).

13. Medvedev VE, Ter-Israelyan AYu, Frolova VI, et al. Experience of using Valdoxan in depression with cognitive impairment. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2018;(2):77-80. doi: 10.17116/jnevro20181182177-80 (In Russ.).

14. Medvedev VE, Frolova VI, Epifanov AV. New possibilities of pharmacotherapy of mental disorders in patients with cardiovascular diseases. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2014;114(9):30-7 (In Russ.).

15. Chernova EV, Kozhechkina OV, Ter-Israelyan AYu, Medvedev VE. Efficiency and tolerability of agomelatine (Valdoxan) in the treatment of endogenous depression in a day hospital. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2016;(10):43-6. doi: 10.17116/jnevro201611610143-46 (In Russ.).

16. Medvedev VE. Agomelatine in the treatment of mild-to-moderate depression in patients with cardiovascular disorders: results of the National Multicenter Observational Study PULSE. Neuropsychiatr Dis Treat. 2017;13:1141-51. doi: 10.2147/ndt.s129793

17. Medvedev VE. Use of valdoxan (Agomelatin) in the combined treatment of moderate and severe nonpsychotic depression. Neurosci Behav Physiol. 2013;43(7):878-82. doi: 10.1007/s11055-013-9822-0

18. Medvedev VE, Retyunskii KY, Ovchinnikov AA, et al. Differences in Assessment of the Severity of Depression by Doctors and Patients during Combined Therapy with Agomelatine (the EMOTION multicenter trial). Neurosci Behav Physiol. 2018;48(3):367-76. doi: 10.1007/s11055-018-0572-x

19. Garner DM, Olmstead MP, Polivy J. Development and validation of a mulidimensional eating disorder inventory for anorexia nervosa and bulimia. Intern J Eating Disord. 1983;2:15-34. doi: 10.1002/1098108x(198321)2:2<15::aideat2260020203>3.0.co;2-6

20. Il'chik OA, Sivukha SV, Skugarevskii OA, Suikhi S. Russian-language adaptation of the «Eating behavior assessment scale» methodolog. Psikhiatriya, psikhoterapiya i klinicheskaya psikhologiya. 2011;(1):39-50 (In Russ.).

21. Skugarevskii OA, Kopytov AV, Skugarevskaya MM, et al. Metod do-nozologicheskoi diagnostiki dezadaptivnogo pishchevogo povedeniya (in-struktsiya po primeneniyu) [Method of pre-nosological diagnosis of maladaptive eating behavior (instructions for use)]. Minsk; 2014. 9 p. (In Russ.).

22. Van Strien T, Frijters JER, Bergers GPA, Defares PB. The Dutch Eating Behavior Questionnaire (DEBQ) for assessment of restrained, emotinaland external eating behavior. Int J Eat Disord. 1986;5:295-315. doi: 10.1002/1098-108x(198602)5:2<295::aideat2260050209>3.0.co;2-t

23. Medvedev VE. Dysmorphic disorders: clinical and nosological heterogeneity. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2016;(8)1:49-55. doi: 10.14412/2074-2711-2016-1-49-55 (In Russ.).

24. Medvedev VE, Frolova VI, Martynov SE, Vissarionov VA. Dysmorphic disorder in the structure of mental disorders in patients of a plastic surgeon and cosmetologist. Psikhicheskoe zdorov'e. 2017;(2):48-55 (In Russ.).

25. Sidorenko VN, Arinchina NG, Dunai VI. Features of nutritional behavior and reproductive attitudes in modern youth. Reproduktivnoe zdorov'e. Vostochnaya Evropa. 2014;(5):47-53 (In Russ.).

26. Striegel-Moore RH, Franko DL, Garcia J. The validity and clinical utility of night eating syndrome. Int J Eat Disord. 2009;42:720-38. doi: 10.1002/eat.20721

27. Cleator J, Abbott J, Judd P, et al. Night eating syndrome: implications for severe obesity. Nutr Diabet. 2012;2:44. doi: 10.1038/nutd.2012.16

28. Goel N, Stunkard AJ, Rogers NL, et al. Circadian rhythm profiles in women with night eating syndrome. J Biol Rhythms. 2009;24:85-94. doi: 10.1177/0748730408328914

29. Rogers NL, Dinges DF, Allison KC, et al. Assessment of sleep in women with night eating syndrome. Sleep. 2006;29:814-9. doi: 10.1093/sleep/29.6.814

30. Zwaan M, Burgard MA, Schenk CH, Mitchell JE. Night time eating: a review of the literature. Eur Eat Dis Rev. 2003;11:7-24. doi: 10.1002/erv.501

31. Makhortova IS, Tsygankov BD, Shiryaev OYu. Correction of night meal syndrome in patients with anxiety-depressive disorders. Psikhicheskie rasstroistva v obshchei meditsine. 2013;(3):36-9 (In Russ.).

32. Makhortova IS, Shiryaev OYu, Tsygankov BD. Comparative analysis of the dynamics of cognitive indicators and body mass index in patients with depression and eating disorders. Psikhiatriya i psikhofarmakoterapiya. 2016;(4):28-31 (In Russ.).

33. Medvedev VE. Effectiveness and tolerance of modern antidepressants: results of network meta-analyzes and Russian experience. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2018;118(11):109-17. doi: 10.17116/jnevro2018118111109 (In Russ.).

34. Medvedev VE. Therapy of non-psychotic depressions within the framework of involutional hysteria (experience with Valdoxan). Psikhiatriya i psikhofarmakoterapiya. 2011;13(4):14-8 (In Russ.).

35. Medvedev VE. The use of Valdoxan (agomelatine) in the combined therapy of moderate and severe depressions of a non-psychotic level. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2012;(5, Pt. 1):37-40 (In Russ.).


For citation:


Medvedev V.E., Frolova V.I., Gushanskaya E.V., Fofanova Yu.S., Martynov S.E., Zuikova N.L., Burno A.M., Nekrasova S.V., Salyntsev I.V. Depressions with eating disorders: clinical manifestations and therapy. Neurology, Neuropsychiatry, Psychosomatics. 2020;12(4):49-56. (In Russ.) https://doi.org/10.14412/2074-2711-2020-4-49-56

Views: 56


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)