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Sample records for depressive episodes results

  1. Illness episodes, physician visits, and depressive symptoms.

    PubMed

    Berkanovic, E; Hurwicz, M L

    1992-08-01

    Although there is a large literature examining the effects of distress on the demand for medical care, the data on which this literature is based are equivocal. Nonetheless, this literature is cited frequently by those who advocate a national mental health policy designed to produce a cost-effective "medical offset effect." In this study, longitudinal data on illness episodes, physician visits, and depressive symptoms were collected from 940 Medicare recipients enrolled in a health maintenance organization (HMO) under a Tax Equity and Fiscal Responsibility Act (TEFRA) contract. Seven waves of interviews were conducted over a period of 1 year. This article presents two sets of analyses. In the first, controlling for chronic conditions and demographics reported at baseline, the relationships between depressive symptoms reported at baseline, and all illness episodes and physician visits that occurred over the subsequent year are examined. In the second, controlling for depressive symptoms and demographics reported at baseline, the relationships between illness episodes and physician visits over the study year, and depressive symptoms recorded at the final interview are examined. The data indicate that, whereas depressive symptoms at baseline are virtually unrelated to subsequent illness episodes and physician visits, illness episodes and physician visits are related to subsequent depressive symptoms. These data indicate, therefore, that policies aimed at diverting the distressed from seeking medical care may result in further inequities in the receipt of needed care. PMID:10120227

  2. Emotional Maltreatment and Depression: Prospective Prediction of Depressive Episodes

    PubMed Central

    Liu, Richard T.; Alloy, Lauren B.; Abramson, Lyn Y.; Iacoviello, Brian M.; Whitehouse, Wayne G.

    2010-01-01

    Background Most research to date on the role of maltreatment experiences in depression has focused on physical and sexual maltreatment. However, several researchers have theorized that emotional maltreatment may be more strongly linked to depression. Furthermore, prospective studies in this area are lacking. The present study addressed these issues by examining whether experiences of current emotional maltreatment predicted the development of new prospective episodes of major (MD) or minor depression (MiD), and the subtype of hopelessness depression (HD) in young adults. It also assessed whether current emotional maltreatment from peers and from authority figures separately predicted the occurrence of depressive episodes. Method One hundred and sixty-five participants from the Cognitive Vulnerability to Depression Project were followed prospectively for 2.5 years. Current emotional maltreatment and new depressive episodes were assessed with life event and diagnostic interviews administered every six weeks. Results Greater overall emotional maltreatment predicted shorter time to onset of new MD, MiD, and HD episodes. Peer- and authority-perpetrated emotional maltreatment separately predicted shorter time to development of new HD episodes. Conclusions Greater emotional maltreatment in young adults prospectively predicts onset of depression, particularly HD. These findings highlight the importance of adult emotional maltreatment experiences in determining targets for prevention and treatment. PMID:19152341

  3. [Acupuncture in patients with minor depressive episodes and generalized anxiety. Results of an experimental study].

    PubMed

    Eich, H; Agelink, M W; Lehmann, E; Lemmer, W; Klieser, E

    2000-03-01

    In a placebo-controlled, randomized, modified double-blind study we investigated the effects of body needle acupuncture (n = 10) in 43 patients with minor depression (ICD 10 F32.0, F32.1) and 13 patients with generalized anxiety disorders (ICD10 F41.1). The severity of the disease was assessed by the Clinical Global Impression Scale (CGI). Treatment response was defined as a significant improvement in CGI. An intent-to-treat analysis was performed to compare treatment responses between verum- and placebo acupuncture. After completing an total of 10 acupuncture sessions the verum acupuncture group (n = 28) showed a significantly larger clinical improvement compared to the placebo group (Mann-Whitney test, p < 0.05). There were significantly more responders in the verum-compared to the placebo group (60.7% vs. 21.4%; chi-square test, p < 0.01). In contrast, no differences in the response rates were evident just after 5 acupuncture sessions. A multivariate analysis with the independent factor acupuncture (verum vs. placebo) and the results of the results of the additional rating scales (total score of HAMA, HAMD, Bf-S, BL) as dependent variables (ANOVA, 1:54 D.F.) revealed a clear trend towards lower HAMA scores in the verum group after completing 10 acupunctures (F3.29, p = 0.075). This corresponds well to the high response rate of 85.7% in patients with generalized anxiety disorders, in whom verum acupuncture was applied. Our results indicate that needle acupuncture (Du.20, Ex.6, He.7, Pe.6, Bl.62) leads to a significant clinical improvement as well as to a remarkable reduction in anxiety symptoms in patients with minor depression or with generalized anxiety disorders. The total sum of acupuncture sessions and the specific location of acupuncture needle insertions might be important factors for bringing about therapeutic success. PMID:10758845

  4. Serotonin transporter gene moderates childhood maltreatment’s effects on persistent but not single-episode depression: Replications and implications for resolving inconsistent results

    PubMed Central

    Uher, Rudolf; Caspi, Avshalom; Houts, Renate; Sugden, Karen; Williams, Benjamin; Poulton, Richie; Moffitt, Terrie E.

    2013-01-01

    Background Genetic and environmental factors shape life-long vulnerability to depression, but most gene–environment interaction (G×E) research has focused on cross-sectional assessments rather than life-course phenotypes. This study tests the hypothesis that the G×E involving the length polymorphism in the serotonin-transporter-gene-linked-promoter-region (5-HTTLPR) and childhood maltreatment is specific to depression that runs a persistent course in adulthood. Methods The hypothesis is tested in two cohorts. Men and women in the Dunedin Study (N=847), New Zealand, followed to age 32 years with 96% retention and women in the E-Risk Study (N=930), England, followed to age 40 years with 96% retention. Diagnoses of past-year major depressive episode were established at four separate assessments. Depression diagnosed on two or more occasions was considered persistent. Results In both cohorts, statistical tests of gene–environment interactions showed positive results for persistent depression but not single-episode depression. Individuals with two short 5-HTTLPR alleles and childhood maltreatment had elevated risk of persistent but not single-episode depression. Limitations Some cases of recurrent depression may have been misclassified as single-episode due to non-contiguous assessment windows, but this would have a conservative effect on the findings. Chronic and recurrent depression could not be reliably distinguished due to non-contiguous periods of assessment. Therefore, the term persistent depression is used to describe either chronic or recurrent course. Conclusions The specific effect on persistent depression increases the significance of this G×E for public health. Research that does not distinguish persistent course may underestimate G×E effects and account for some replication failures in G×E research. PMID:21439648

  5. Epidemiology of Major Depressive Episode in a Southern European Country: Results from the ESEMeD-Spain Project

    PubMed Central

    Gabilondo, Andrea; Rojas-Farreras, Sonia; Vilagut, Gemma; Haro, Josep M.; Fernández, Ana; Pinto-Meza, Alejandra; Alonso, Jordi

    2013-01-01

    Background Information of the epidemiology of Major Depressive Episode (MDE) in Spain, one of the biggest southern European countries, is scarce and heterogeneous. The objective of this study was to assess the epidemiology of the disorder in the Spanish sample of the ESEMeD project. Methods The ESEMED-Spain project is a cross-sectional, general population, household survey conducted with a representative sample of Spanish non-institutionalized adult population. The survey instrument was the CIDI 3.0, a structured diagnostic interview to assess disorders and treatment. Results Lifetime prevalence was 10.6% while 12-month prevalence was 4.0%. A monotonic increase in lifetime overall prevalence was found from the youngest to the 50–64 cohort, declining then in the oldest group. Median age of onset was 30.0. Being a woman (OR= 2.7), previously married (OR= 1.8), unemployed or disabled to work (OR= 2.9) was associated to higher risk of 12-month-MDE. The highest comorbid associations were with dysthymia (OR= 73.1) and panic disorder (OR= 41.8). Limitations 1. Psychiatric diagnoses were made by trained lay interviewers and this could have an imperfect sensitivity/specificity; 2. Individuals with mental illness could have more frequently rejected to participate in the survey; 3. Age-related recall bias could have affected the accuracy of age of onset estimates. Conclusions The study shows that prevalence MDE in Spain is lower than in other Western countries. Important findings are the early age of onset, the high proportion of chronicity, and the high female/male ratio. Taken together, results offer a complex picture of the epidemiology of MDE in Spain, when compared to other countries in Europe. The role of cultural factors is discussed. PMID:19428121

  6. The Prevalence and Diagnostic Validity of Short-Duration Hypomanic Episodes and Major Depressive Episodes.

    PubMed

    Miller, Shefali; Dennehy, Ellen B; Suppes, Trisha

    2016-03-01

    Current diagnostic criteria for a hypomanic episode, as outlined in both the fourth and fifth editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV and DSM-5), require a minimum duration of four consecutive days of symptoms of mood elevation. The 4-day criterion for duration of hypomania has been challenged as arbitrary and lacking empirical support, with many arguing that shorter-duration hypomanic episodes are highly prevalent and that those experiencing these episodes are clinically more similar to patients with bipolar disorder than to those with unipolar major depressive disorder. We review the current evidence regarding the prevalence, diagnostic validity, and longitudinal illness correlates of shorter-duration hypomanic episodes and summarize the arguments for and against broadening the diagnostic criteria for hypomania to include shorter-duration variants. Accumulating findings suggest that patients with major depressive episodes and shorter-duration hypomanic episodes represent a complex clinical phenotype, perhaps best conceptualized as being on the continuum between those with unipolar depressive episodes alone and those with DSM-5-defined bipolar II disorder. Further investigation is warranted, ideally involving large prospective, controlled studies, to elucidate the diagnostic and treatment implications of depression with shorter-duration hypomanic episodes. PMID:26830885

  7. Cumulative Depression Episodes Predicts Later C-Reactive Protein Levels: A Prospective Analysis

    PubMed Central

    Copeland, William E.; Shanahan, Lilly; Worthman, Carol; Angold, Adrian; Costello, E. Jane

    2013-01-01

    Background Depression is associated with elevated levels of the inflammation marker C -reactive protein (CRP), yet the direction of this association remains unclear. This study tested bi-directional longitudinal associations between CRP and depression in a sample of adolescent and young adults. The study compared the effects of current depression to the cumulative episodes of depression over time. Methods Nine waves of data from the prospective population-based Great Smoky Mountains Study (N = 1,420) were used, covering children in the community aged 9–16, 19, and 21 years old. Structured interviews were used to assess depressive symptoms, depression diagnosis, and cumulative depressive episodes. Bloodspots were collected at each observation and assayed for CRP levels. Results CRP levels were not associated with later depression status. In contrast, all depression-related variables displayed evidence of association with later CRP levels. The associations with depressive symptoms and diagnostic status were attenuated after controlling for covariates particularly body mass index, smoking, and medication use. The effect of cumulative depressive episodes, however, continued to be significant after accounting for a range of covariates. Body mass index, smoking behavior and recent infections may mediate a portion of the effect of cumulative episodes on later CRP, but cumulative depressive episodes continued to predict CRP levels independently. Conclusions The occurrence of multiple depressive episodes exerted the greatest effect on later CRP levels. This suggests that risk for the diseases of middle age - cardiovascular and metabolic disease – may begin in childhood and depend, in part, upon long-term emotional functioning. PMID:22047718

  8. The association of major depressive episode and personality traits in patients with fibromyalgia

    PubMed Central

    de Melo Santos, Danyella; Lage, Laís Verderame; Jabur, Eleonora Kehl; Kaziyama, Helena Hideko Seguchi; Iosifescu, Dan V; de Lucia, Mara Cristina Souza; Fráguas, Renério

    2011-01-01

    INTRODUCTION: Personality traits have been associated with primary depression. However, it is not known whether this association takes place in the case of depression comorbid with fibromyalgia. OBJECTIVE: The authors investigated the association between a current major depressive episode and temperament traits (e.g., harm avoidance). METHOD: A sample of 69 adult female patients with fibromyalgia was assessed with the Temperament and Character Inventory. Psychiatric diagnoses were assessed with the Mini-International Neuropsychiatric Interview severity of depressive symptomatology with the Beck Depression Inventory, and anxiety symptomatology with the IDATE-state and pain intensity with a visual analog scale. RESULTS: A current major depressive episode was diagnosed in 28 (40.5%) of the patients. They presented higher levels of harm avoidance and lower levels of cooperativeness and self-directedness compared with non-depressed patients, which is consistent with the Temperament and Character Inventory profile of subjects with primary depression. However, in contrast to previous results in primary depression, no association between a major depressive episode and self-transcendence was found. CONCLUSIONS: The results highlight specific features of depression in fibromyalgia subjects and may prove important for enhancing the diagnosis and prognosis of depression in fibromyalgia patients. PMID:21808861

  9. Hair thyroid hormones concentration in patients with depression changes with disease episodes in female Chinese.

    PubMed

    Wei, Jinxue; Sun, Guizhi; Zhao, Liansheng; Liu, Xiang; Lin, Dongtao; Li, Tao; Ma, Xiaohong

    2014-12-15

    Abnormal function of thyroid and deregulation of level of blood thyroid hormones, including triiodothyronine (T3) and thyroxine (T4), have been observed in patients with major depression. Nevertheless, no consistent conclusion can be drawn from previous reports. Hair hormones reflect average hormones levels in a certain period and have been involved in the studies of psychiatric diseases. However, no research has elucidated the relation between hair thyroid hormones level and depression. In the present study, we explored the correlation between thyroid hormones and major depression by analyzing and comparing the levels of hair thyroid hormones in patients with depression (n=30) and healthy controls (n=30). Our results showed that the levels of hair T3 and T4 were significantly lower in patients with depression in disease episode than that in pre-disease episode or in healthy controls. Moreover, patients with depression in pre-disease episode had a higher hair T4 level than healthy controls. No significant correlation was observed between hair T3 or T4 levels and the Hamilton depression rating scale and Hamilton anxiety rating scale scores. Our results indicate that hair thyroid hormones levels change with the episodes of depressions, which may be helpful for pathological studies of depression.

  10. Difference in the binocular rivalry rate between depressive episodes and remission.

    PubMed

    Jia, Ting; Ye, Xing; Wei, Qiang; Xie, Wen; Cai, Chunlan; Mu, Jingjing; Dong, Yi; Hu, Panpan; Hu, Xinglong; Tian, Yanghua; Wang, Kai

    2015-11-01

    Binocular rivalry refers to a phenomenon in which, when different images are presented to each eye simultaneously, perception alternates spontaneously between monocular views rather than being a superposition of the two images. Recently, the involvement of serotonin systems has been reported to be related to the phenomenon. There is abundant evidence for abnormalities of the serotonin systems in depression and the antidepressants that enhance 5-HT transmission, which in turn improves mood and behavior. However, the available data with respect to rivalry rates in depression are less clear. Therefore, we aimed to explore whether perceptual rivalry was affected by a dysfunctional serotonin system in patients with depression and whether there was a rivalry rate difference between episode and remission states in depression patients. Twenty-eight patients with depression and 30 healthy controls were recruited in the study. We assessed the rivalry rate and the 17-item Hamilton Depression Rating Scale (HAMD) in patients with depression during clinical episode and remission states. The results suggested that alternation rates for patients during episodes were significantly slower than during remission and than in healthy controls. Also, alternation rates for patients during remission were slower than in healthy controls. These results may provide further clues to serotonergic neural systems contributing to the dynamics of perception rivalry and may foster enlightenment regarding the field of binocular rivalry in psychiatric disorders other than bipolar disorder. PMID:26247392

  11. [Vortioxetine: a new antidepressant to treat depressive episodes].

    PubMed

    Colle, R; Corruble, E

    2016-02-01

    Vortioxetine is a new antidepressant, which mechanism of action is multimodal, targeting the 5-HT1A, 5-HT1B, 5-HT1D, 5-HT3, 5-HT7 receptors and the serotonin transporter (5-HTT). Its efficacy and safety were assessed in fourteen studies including more than 3700 patients with a major depressive episode and treated with vortioxetine. In short-term studies (8 weeks), vortioxetine is more efficacious than placebo in decreasing depressive symptoms as measured by the MADRS total score, response rate (vortioxetine: 53.2% vs placebo: 35.2%) and remission rate (vortioxetine: 29.2% vs placebo: 19.3%). In a long-term study (52 weeks), vortioxetine is also superior to placebo in preventing relapses and recurrences. Moreover, in second line treatment, after failure of a first line selective serotonin reuptake inhibitor (SSRI) or serotonin norepinephrin reuptake inhibitor (SNRI), vortioxetine is superior to agomelatine in improving depressive symptoms and achieving response and remission. Furthermore, the positive effects of vortioxetine on improvement of cognitive symptoms of major depressive episodes are particularly well established in several clinical trials. The tolerability profile of vortioxetine is favourable. The recommended daily posology of vortioxetine is 10mg/d. Vortioxetine is a new antidepressant drug with a multimodal mechanism of action, well-documented efficacy and safety profiles. PMID:26358483

  12. Serum biomarkers predictive of depressive episodes in panic disorder.

    PubMed

    Gottschalk, M G; Cooper, J D; Chan, M K; Bot, M; Penninx, B W J H; Bahn, S

    2016-02-01

    Panic disorder with or without comorbid agoraphobia (PD/PDA) has been linked to an increased risk to develop subsequent depressive episodes, yet the underlying pathophysiology of these disorders remains poorly understood. We aimed to identify a biomarker panel predictive for the development of a depressive disorder (major depressive disorder and/or dysthymia) within a 2-year-follow-up period. Blood serum concentrations of 165 analytes were evaluated in 120 PD/PDA patients without depressive disorder baseline diagnosis (6-month-recency) in the Netherlands Study of Depression and Anxiety (NESDA). We assessed the predictive performance of serum biomarkers, clinical, and self-report variables using receiver operating characteristics curves (ROC) and the area under the ROC curve (AUC). False-discovery-rate corrected logistic regression model selection of serum analytes and covariates identified an optimal predictive panel comprised of tetranectin and creatine kinase MB along with patient gender and scores from the Inventory of Depressive Symptomatology (IDS) rating scale. Combined, an AUC of 0.87 was reached for identifying the PD/PDA patients who developed a depressive disorder within 2 years (n = 44). The addition of biomarkers represented a significant (p = 0.010) improvement over using gender and IDS alone as predictors (AUC = 0.78). For the first time, we report on a combination of biological serum markers, clinical variables and self-report inventories that can detect PD/PDA patients at increased risk of developing subsequent depressive disorders with good predictive performance in a naturalistic cohort design. After an independent validation our proposed biomarkers could prove useful in the detection of at-risk PD/PDA patients, allowing for early therapeutic interventions and improving clinical outcome.

  13. Serum biomarkers predictive of depressive episodes in panic disorder.

    PubMed

    Gottschalk, M G; Cooper, J D; Chan, M K; Bot, M; Penninx, B W J H; Bahn, S

    2016-02-01

    Panic disorder with or without comorbid agoraphobia (PD/PDA) has been linked to an increased risk to develop subsequent depressive episodes, yet the underlying pathophysiology of these disorders remains poorly understood. We aimed to identify a biomarker panel predictive for the development of a depressive disorder (major depressive disorder and/or dysthymia) within a 2-year-follow-up period. Blood serum concentrations of 165 analytes were evaluated in 120 PD/PDA patients without depressive disorder baseline diagnosis (6-month-recency) in the Netherlands Study of Depression and Anxiety (NESDA). We assessed the predictive performance of serum biomarkers, clinical, and self-report variables using receiver operating characteristics curves (ROC) and the area under the ROC curve (AUC). False-discovery-rate corrected logistic regression model selection of serum analytes and covariates identified an optimal predictive panel comprised of tetranectin and creatine kinase MB along with patient gender and scores from the Inventory of Depressive Symptomatology (IDS) rating scale. Combined, an AUC of 0.87 was reached for identifying the PD/PDA patients who developed a depressive disorder within 2 years (n = 44). The addition of biomarkers represented a significant (p = 0.010) improvement over using gender and IDS alone as predictors (AUC = 0.78). For the first time, we report on a combination of biological serum markers, clinical variables and self-report inventories that can detect PD/PDA patients at increased risk of developing subsequent depressive disorders with good predictive performance in a naturalistic cohort design. After an independent validation our proposed biomarkers could prove useful in the detection of at-risk PD/PDA patients, allowing for early therapeutic interventions and improving clinical outcome. PMID:26687614

  14. Prevalence of metabolic syndrome among patients with major depressive disorder--differences between newly diagnosed first episode and recurrent disease.

    PubMed

    Ljubicic, Rudolf; Jakovac, Hrvoje; Bistrović, Ivana Ljubicić; Franceski, Tanja; Mufić, Ana Kovak; Karlović, Dalibor

    2013-12-01

    The objective of the present study was to assess differences in prevalence of the metabolic syndrome among depressed patients in regard to the duration of the illness (first episode versus recurrent episodes). A total of 190 patients suffering from major depressive disorder were included in the study, diagnosed according to International classification of disorders, 10th revision. The same criteria were used to divide participants into two groups: first episode major depressive disorder and major depressive disorder with recurrent episodes. The metabolic syndrome was defined according to the criteria of the American National Cholesterol Education Program-Treatment Panel III. Results showed that metabolic syndrome is significantly more prevalent in patients with recurrent major depressive disorder (45.2%) compared to patients with first episode of major depressive disorder (27.3%), mainly due to differences in plasma glucose, triglycerides and HDL-cholesterol levels. These findings indicate the importance of the duration of depression and the number of recurring episodes as factors involved in etiopathogenesis of the associated metabolic syndrome.

  15. Overgeneral autobiographical memory at baseline predicts depressive symptoms at follow-up in patients with first-episode depression.

    PubMed

    Liu, Yansong; Zhang, Fuquan; Wang, Zhiqiang; Cao, Leiming; Wang, Jun; Na, Aiguo; Sun, Yujun; Zhao, Xudong

    2016-09-30

    Previous studies have shown that overgeneral autobiographical memory (OGM) is a characteristic of depression. However, there are no studies to explore the association between baseline OGM and depressive symptoms at follow-up in patients with first-episode depression (FE). This study investigated whether baseline OGM predicts depressive symptoms at follow-up in patients with FE. We recruited 125 patients with FE. The participants were divided into remitted group and non-remitted group according to the severity of their depression at 12 months follow-up. The measures consisted of the 17-item Hamilton Depression Rating Scale, Ruminative Response Scale, and Autobiographical Memory Test. Hierarchical linear regression analyses and bootstrap mediation analyses were conducted. The results showed that non-remitted patients had more OGM at baseline. Baseline OGM predicted depressive symptoms at follow-up in patients with FE. Rumination mediated the relationship between baseline OGM and depressive symptoms at follow-up. Our findings highlight OGM as a vulnerability factor involved in the maintenance of depression in patients with FE. PMID:27392229

  16. Overgeneral autobiographical memory at baseline predicts depressive symptoms at follow-up in patients with first-episode depression.

    PubMed

    Liu, Yansong; Zhang, Fuquan; Wang, Zhiqiang; Cao, Leiming; Wang, Jun; Na, Aiguo; Sun, Yujun; Zhao, Xudong

    2016-09-30

    Previous studies have shown that overgeneral autobiographical memory (OGM) is a characteristic of depression. However, there are no studies to explore the association between baseline OGM and depressive symptoms at follow-up in patients with first-episode depression (FE). This study investigated whether baseline OGM predicts depressive symptoms at follow-up in patients with FE. We recruited 125 patients with FE. The participants were divided into remitted group and non-remitted group according to the severity of their depression at 12 months follow-up. The measures consisted of the 17-item Hamilton Depression Rating Scale, Ruminative Response Scale, and Autobiographical Memory Test. Hierarchical linear regression analyses and bootstrap mediation analyses were conducted. The results showed that non-remitted patients had more OGM at baseline. Baseline OGM predicted depressive symptoms at follow-up in patients with FE. Rumination mediated the relationship between baseline OGM and depressive symptoms at follow-up. Our findings highlight OGM as a vulnerability factor involved in the maintenance of depression in patients with FE.

  17. Association of folate intake with the occurrence of depressive episodes in middle-aged French men and women.

    PubMed

    Astorg, Pierre; Couthouis, Aline; de Courcy, Geneviève Potier; Bertrais, Sandrine; Arnault, Nathalie; Meneton, Pierre; Galan, Pilar; Hercberg, Serge

    2008-07-01

    A low folate intake or a low folate status have been found to be associated with a higher frequency of depression in populations, but the existence and the direction of a causal link between folate intake or status and depression is still uncertain. The aim of this study was to seek the relation between the habitual folate intake in middle-aged men and women and the occurrence of depressive episodes. In a subsample of 1864 subjects (809 men and 1055 women) from the French SU.VI.MAX cohort, dietary habits have been measured at the beginning of the follow-up (six 24 h records) and declarations of antidepressant prescription, taken as markers of depressive episodes, have been recorded during the 8-year follow-up. No significant association was observed between folate intake and the risk of any depressive episode or of a single depressive episode during the follow-up, in both men and women. In contrast, the risk of experiencing recurrent depressive episodes (two or more) during the follow-up was strongly reduced in men with high folate intake (OR 0.25 (95 % CI 0.06, 0.98) for the highest tertile v. the lowest, P for trend 0.046). This association was not observed in women. These results suggest that a low folate intake may increase the risk of recurrent depression in men.

  18. The relevance of oxidative stress status in first episode and recurrent depression.

    PubMed

    Stefanescu, Cristinel; Ciobica, Alin

    2012-12-20

    Oxidative and nitrosative stress (O&NS) could play an important role in the pathophysiology of major depression (MDD). The aim of the present work was to evaluate the specific activity of the main peripheral antioxidant defences (superoxide dismutase--SOD and glutathione peroxidase--GPX) and the level of malondialdehyde--MDA (a lipid peroxidation maker), in depressed patients, as compared to an age-matched control group. Also, we were interested to see if there are any differences between first episode vs. recurrent depression groups, in terms of oxidative stress markers. Additionally, we want it to investigate the effects of different antidepressant medication (mirtazapine, venlafaxine, tianeptine and escitalopram) on oxidative status of depressed patients. Our results showed an increased oxidative stress status in the serum of patients with MDD, expressed by a significant decrease of both SOD and GPX specific activities and a significant increase of the lipid peroxidation marker MDA, as compared to the control group. When we analyzed the oxidative stress status in depressed patients based on chronicity we observed significant decrease of SOD and GPX specific activities in recurrent depression group, as compared to the first episode group. Moreover, a very significant increase in MDA concentration was observed in recurrent depression patients, as compared to the first episode group. Our work provides additional evidences of increased oxidative stress in MDD, expressed by altered antioxidant enzyme activity and increased levels of lipid peroxidation. Also, it seems that sub-classifying depression into different subtypes, based on chronicity, can predict differences in the levels of some various oxidative stress markers. PMID:22840610

  19. Subclinical Depressive Symptoms and Continued Cannabis Use: Predictors of Negative Outcomes in First Episode Psychosis

    PubMed Central

    González-Ortega, Itxaso; Alberich, Susana; Echeburúa, Enrique; Aizpuru, Felipe; Millán, Eduardo; Vieta, Eduard; Matute, Carlos; González-Pinto, Ana

    2015-01-01

    Background Although depressive symptoms in first episode psychosis have been associated with cannabis abuse, their influence on the long-term functional course of FEP patients who abuse cannabis is unknown. The aims of the study were to examine the influence of subclinical depressive symptoms on the long-term outcome in first episode-psychosis patients who were cannabis users and to assess the influence of these subclinical depressive symptoms on the ability to quit cannabis use. Methods 64 FEP patients who were cannabis users at baseline were followed-up for 5 years. Two groups were defined: (a) patients with subclinical depressive symptoms at least once during follow-up (DPG), and (b) patients without subclinical depressive symptoms during follow-up (NDPG). Psychotic symptoms were measured using the Positive and Negative Syndrome Scale (PANSS), depressive symptoms using the Hamilton Depression Rating Scale (HDRS)-17, and psychosocial functioning was assessed using the Global Assessment of Functioning (GAF). A linear mixed-effects model was used to analyze the combined influence of cannabis use and subclinical depressive symptomatology on the clinical outcome. Results Subclinical depressive symptoms were associated with continued abuse of cannabis during follow-up (β= 4.45; 95% confidence interval [CI]: 1.78 to 11.17; P = .001) and with worse functioning (β = -5.50; 95% CI: -9.02 to -0.33; P = .009). Conclusions Subclinical depressive symptoms and continued cannabis abuse during follow-up could be predictors of negative outcomes in FEP patients. PMID:25875862

  20. Discovery of serum biomarkers predicting development of a subsequent depressive episode in social anxiety disorder.

    PubMed

    Gottschalk, M G; Cooper, J D; Chan, M K; Bot, M; Penninx, B W J H; Bahn, S

    2015-08-01

    Although social anxiety disorder (SAD) is strongly associated with the subsequent development of a depressive disorder (major depressive disorder or dysthymia), no underlying biological risk factors are known. We aimed to identify biomarkers which predict depressive episodes in SAD patients over a 2-year follow-up period. One hundred sixty-five multiplexed immunoassay analytes were investigated in blood serum of 143 SAD patients without co-morbid depressive disorders, recruited within the Netherlands Study of Depression and Anxiety (NESDA). Predictive performance of identified biomarkers, clinical variables and self-report inventories was assessed using receiver operating characteristics curves (ROC) and represented by the area under the ROC curve (AUC). Stepwise logistic regression resulted in the selection of four serum analytes (AXL receptor tyrosine kinase, vascular cell adhesion molecule 1, vitronectin, collagen IV) and four additional variables (Inventory of Depressive Symptomatology, Beck Anxiety Inventory somatic subscale, depressive disorder lifetime diagnosis, BMI) as optimal set of patient parameters. When combined, an AUC of 0.86 was achieved for the identification of SAD individuals who later developed a depressive disorder. Throughout our analyses, biomarkers yielded superior discriminative performance compared to clinical variables and self-report inventories alone. We report the discovery of a serum marker panel with good predictive performance to identify SAD individuals prone to develop subsequent depressive episodes in a naturalistic cohort design. Furthermore, we emphasise the importance to combine biological markers, clinical variables and self-report inventories for disease course predictions in psychiatry. Following replication in independent cohorts, validated biomarkers could help to identify SAD patients at risk of developing a depressive disorder, thus facilitating early intervention.

  1. Personality traits in the differentiation of major depressive disorder and bipolar disorder during a depressive episode.

    PubMed

    Araujo, Jaciana Marlova Gonçalves; dos Passos, Miguel Bezerra; Molina, Mariane Lopez; da Silva, Ricardo Azevedo; Souza, Luciano Dias de Mattos

    2016-02-28

    The aim of this study was to determine the differences in personality traits between individuals with Major Depressive Disorder (MDD) and Bipolar Disorder (BD) during a depressive episode, when it can be hard to differentiate them. Data on personality traits (NEO-FFI), mental disorders (Mini International Neuropsychiatric Interview Plus) and socioeconomic variables were collected from 245 respondents who were in a depressive episode. Individuals with MDD (183) and BD (62) diagnosis were compared concerning personality traits, clinical aspects and socioeconomic variables through bivariate analyses (chi-square and ANOVA) and multivariate analysis (logistic regression). There were no differences in the prevalence of the disorders between socioeconomic and clinical variables. As for the personality traits, only the difference in Agreeableness was statistically significant. Considering the control of suicide risk, gender and anxiety comorbidity in the multivariate analysis, the only variable that remained associated was Agreeableness, with an increase in MDD cases. The brief version of the NEO inventories (NEO-FFI) does not allow for the analysis of personality facets. During a depressive episode, high levels of Agreeableness can indicate that MDD is a more likely diagnosis than BD.

  2. Selected Executive Skills in Adolescents with Recent First Episode Major Depression

    ERIC Educational Resources Information Center

    Kyte, Zoe A.; Goodyer, Ian M.; Sahakian, Barbara J.

    2005-01-01

    Background: To investigate whether recent first episode major depression in adolescence is characterised by selected executive difficulties in attentional flexibility, behavioural inhibition and decision-making. Methods: Selected executive functions were compared in adolescents with recent (past year) first episode major depression (n = 30) and…

  3. Treatment response for acute depression is not associated with number of previous episodes: lack of evidence for a clinical staging model for major depressive disorder.

    PubMed

    Dodd, Seetal; Berk, Michael; Kelin, Katarina; Mancini, Michele; Schacht, Alexander

    2013-09-01

    Mental illness has been observed to follow a neuroprogressive course, commencing with prodrome, then onset, recurrence and finally chronic illness. In bipolar disorder and schizophrenia responsiveness to treatment mirrors these stages of illness progression, with greater response to treatment in the earlier stages of illness and greater treatment resistance in chronic late stage illness. Using data from 5627 participants in 15 controlled trials of duloxetine, comparator arm (paroxetine, venlafaxine, escitalopram) or placebo for the treatment of an acute depressive episode, the relationship between treatment response and number of previous depressive episodes was determined. Data was dichotomised for comparisons between participants who had >3 previous episodes (n=1697) or ≤3 previous episodes (n=3930), and additionally for no previous episodes (n=1381) or at least one previous episode (n=4246). Analyses were conducted by study arm for each clinical trial, and results were then pooled. There was no significant difference between treatment response and number of previous depressive episodes. This unexpected finding suggests that treatments to reduce symptoms of depression during acute illness do not lose efficacy for patients with a longer history of illness.

  4. Herbal medicine for hospitalized patients with severe depressive episode: a retrospective controlled study.

    PubMed

    Liu, Lan-Ying; Feng, Bin; Chen, Jiong; Tan, Qing-Rong; Chen, Zheng-Xin; Chen, Wen-Song; Wang, Pei-Rong; Zhang, Zhang-Jin

    2015-01-01

    Herbal medicine is increasingly used in depressed patients. The purpose of this retrospective controlled study was to evaluate the efficacy and safety of herbal medicine treatment of severe depressive episode. A total of 146 severely depressed subjects were selected from patients who were admitted to the Department of Psychosomatics of Tongde Hospital at Hangzhou, China between 1st September 2009 and 30th November 2013. While all were medicated with psychotropic drugs, 78 received additional individualized herbal medicine. The severity of depressive symptoms was measured using 24-item Hamilton Rating Scale for Depression (HAMD-24) at admission and thereafter once weekly during hospital stay. The proportion of patients achieving clinical response and remission and incidence of adverse events were compared. The two groups had similar average length of hospital stay for approximately 28 days and were not different in the use of psychotropic medications. Survival analysis revealed that patients with herbal medicine had significantly higher chance of achieving clinical response [relative risk (RR)=2.179, P<0.001] and remission (RR=5.866, P<0.001) compared to those without herbal medicine. Patients with herbal medicine experienced remarkably fewer incidences of physical tiredness, headache, palpitation, dry mouth and constipation, but had a significantly higher incidence of digestive discomfort compared to patients without herbal medicine. These results indicate that additional treatment with individualized herbal medicine enhances antidepressant response and reduces certain side effects associated with psychotropic medications. Herbal medicine is an effective and relatively safe therapy for severe depressive episode (Trial Registration: ChiCTR-OCH-13003864).

  5. Maternal Depressive Symptoms as a Predictor of Alcohol Use Onset and Heavy Episodic Drinking in Youths

    ERIC Educational Resources Information Center

    Lamis, Dorian A.; Malone, Patrick S.; Lansford, Jennifer E.; Lochman, John E.

    2012-01-01

    Objective: The current study addressed a gap in the literature by investigating the association between maternal depressive symptoms and subsequent timing of their children's alcohol use onset and heavy episodic drinking (HED). Childhood depression/dysthymia symptoms, harsh discipline, and parental positive regard were examined as potential…

  6. Volumetric MRI study of the habenula in first episode, recurrent and chronic major depression.

    PubMed

    Carceller-Sindreu, M; de Diego-Adeliño, J; Serra-Blasco, M; Vives-Gilabert, Y; Martín-Blanco, A; Puigdemont, D; Álvarez, E; Pérez, V; Portella, M J

    2015-11-01

    The habenula (Hb) can play an important role in major depressive disorder (MDD) as it is a key node between fronto-limbic areas and midbrain monoaminergic structures. In vivo neuroimaging studies have shown reductions in Hb volume in a post-mortem sample of patients with affective disorders but findings in unipolar MDD are not consistent. The current study aimed to investigate whether the Hb volume differed between patients with different stages of unipolar MDD and healthy subjects. We also explored differences in grey (GM) and white matter (WM) volumes and potential age and gender effects. High-resolution images were acquired using a 3T-scanner from 95 participants (21 with first-episode MDD; 20 with remitted-recurrent MDD; 20 with treatment-resistant/chronic MDD; and 34 healthy controls).Two researchers blinded to clinical data manually delineated habenular nuclei, with excellent inter-rater agreement. Multivariate analysis of covariance revealed a significant group-by-gender interaction (F9,258=2.22; p=0.02). Univariate effects emerged for Hb-WM volumes (F3,86=3.12; p=0.03) but not for total Hb volumes (F3,86=0.59; p=0.62) or Hb-GM volumes (F3,86=2.01; p=0.12). Women with a first-episode MDD had greater Hb-WM volumes than healthy controls and patients with treatment-resistant/chronic MDD (p<0.01). These findings remained unaltered when controlled for total intracranial volume or medication load. Our results do not support decreased total Hb volumes in unipolar MDD, in patients with first-episode or in patients with long-lasting recurrent or chronic depression. However, the increased Hb-WM volume we observed in women with a first-episode suggests involvement of Hb and its projections in early stages of the recovery process and in the course of MDD. PMID:26404405

  7. Incident Major Depressive Episodes increase the severity and risk of apathy in HIV infection

    PubMed Central

    Kamat, Rujvi; Cattie, Jordan E.; Marcotte, Thomas D.; Woods, Steven Paul; Franklin, Donald R.; Corkran, Stephanie H.; Ellis, Ronald J.; Grant, Igor; Heaton, Robert K.

    2015-01-01

    Apathy and depression are inter-related yet separable and prevalent neuropsychiatric disturbances in persons infected with HIV. In the present study of 225 HIV+ persons, we investigated the role of an incident depressive episode in changes in apathy. Participants completed the apathy subscale of the Frontal Systems Behavior Scale during a detailed neuropsychiatric and neuromedical evaluation at visit 1 and again at approximately a 14 month follow-up. The Composite International Diagnostic Interview was used to obtain diagnoses of a new major depressive disorder. At their follow-up visit, participants were classified into four groups depending on their visit 1 elevation in apathy and new major depressive episode (MDE) status. Apathetic participants at baseline with a new MDE (n=23) were at risk for continued, clinically elevated apathy at follow-up, although severity of symptoms did not increase. Of the 144 participants without clinically elevated apathy at visit 1, those who developed a new MDE (n=16) had greater apathy symptomatology at follow-up than those without MDE. These findings suggest that HIV+ individuals, who do not as yet present with elevated apathy, may be at greater risk of elevated psychiatric distress should they experience a new/recurrent depressive episode. Thus, in the context of previous findings, it appears that although apathy and depression are separable constructs, they interact such that a new depressive episode is a risk factor for incident apathy. PMID:25679203

  8. Anxiety, depression and school absenteeism in youth with chronic or episodic headache

    PubMed Central

    Rousseau-Salvador, Céline; Amouroux, Rémy; Annequin, Daniel; Salvador, Alexandre; Tourniaire, Barbara; Rusinek, Stéphane

    2014-01-01

    BACKGROUND: Chronic daily headache (CDH) in children has been documented in general and clinical populations. Comorbid psychological conditions, risk factors and functional outcomes of CDH in children are not well understood. OBJECTIVES: To examine anxiety and depression, associated risk factors and school outcomes in a clinical population of youth with CDH compared with youth with episodic headache (EH). METHODS: Data regarding headache characteristics, anxiety, depression and missed school days were collected from 368 consecutive patients eight to 17 years of age, who presented with primary headache at a specialized pediatric headache centre. RESULTS: A total of 297 patients (81%) were diagnosed with EH and 71 were diagnosed with CDH. Among those with CDH, 78.9% presented with chronic tension-type headache and 21.1% with chronic migraine (CM). Children with CDH had a higher depression score than the standardized reference population. No difference was observed for anxiety or depression scores between children with CDH and those with EH. However, children with CM were more anxious and more depressed than those with chronic tension-type headache. Youth experiencing migraine with aura were three times as likely to have clinically significant anxiety scores. Headache frequency and history were not associated with psychopathological symptoms. Children with CDH missed school more often and for longer periods of time. CONCLUSIONS: These findings document the prevalence of anxiety, depression and school absenteeism in youth with CDH or EH. The present research also extends recent studies examining the impact of aura on psychiatric comorbidity and the debate on CM criteria. PMID:24911174

  9. Cortisol response to psychosocial stress during a depressive episode and remission.

    PubMed

    Morris, Matthew C; Rao, Uma

    2014-01-01

    This study compared cortisol responses to a standardized psychosocial stressor during a major depressive episode (MDE) and again during remission in adolescents and young adults. Twenty-six individuals with no personal or family history of a major psychiatric disorder (NC) and 24 individuals with a diagnosis of major depressive disorder (MDD) at Time 1 participated in the study. The MDD group showed robust cortisol responses during their index episode and after recovery. In contrast, the NC group showed habituation to the repeated psychosocial stressor, as evident in a flatter cortisol response profile at Time 2. Within the MDD group, net peak cortisol during the first stress test was positively associated with the duration of the index MDE and negatively associated with the total duration of all MDEs. Whereas summary indices of cortisol responses were relatively stable across repeated stress tasks within the MDD group, this was not the case for NC. Results demonstrate that cortisol responses fail to habituate to repeated psychosocial stress during recovery from an MDE and could reflect a trait-like marker of risk for recurrence.

  10. Increased activities of both superoxide dismutase and catalase were indicators of acute depressive episodes in patients with major depressive disorder.

    PubMed

    Tsai, Meng-Chang; Huang, Tiao-Lai

    2016-01-30

    Oxidative stress may play an important role in the pathophysiology of major depressive disorder (MDD). The aim of this study was to investigate the serum levels of oxidative stress biomarkers and S100B in patients with MDD in an acute phase, and evaluate the changes in superoxide dismutase (SOD), protein carbonyl content (PCC), glutathione peroxidase (GPX), 8-hydroxy 2'-deoxyguanosine after treatment (8-OHdG), catalase (CAT), thiobarbituric acid reactive substances (TBARS) and S100B. We consecutively enrolled 21 MDD inpatients in an acute phase and 40 healthy subjects. Serum oxidative stress markers were measured with assay kits. Serum SOD and CAT activities in MDD patients in an acute phase were significantly higher than those of healthy subjects, and serum PCC levels were significantly lower. The HAM-D scores had a significantly positive association with S100B levels. Eighteen depressed patients were followed up, and there was no significant difference among all of the markers after treatment. In conclusion, our results suggest that increased activities of both SOD and CAT might be indicators of acute depressive episodes in MDD patients.

  11. Two prospective studies of changes in stress generation across depressive episodes in adolescents and emerging adults.

    PubMed

    Morris, Matthew C; Kouros, Chrystyna D; Hellman, Natalie; Rao, Uma; Garber, Judy

    2014-11-01

    The stress generation hypothesis was tested in two different longitudinal studies examining relations between weekly depression symptom ratings and stress levels in adolescents and emerging adults at varied risk for depression. The participants in Study 1 included 240 adolescents who differed with regard to their mothers' history of depressive disorders. Youth were assessed annually across 6 years (Grades 6-12). Consistent with the depression autonomy model, higher numbers of prior major depressive episodes (MDEs) were associated with weaker stress generation effects, such that higher levels of depressive symptoms predicted increases in levels of dependent stressors for adolescents with two or more prior MDEs, but depressive symptoms were not significantly related to dependent stress levels for youth with three or more prior MDEs. In Study 2, the participants were 32 remitted-depressed and 36 never-depressed young adults who completed a psychosocial stress task to determine cortisol reactivity and were reassessed for depression and stress approximately 8 months later. Stress generation effects were moderated by cortisol responses to a laboratory psychosocial stressor, such that individuals with higher cortisol responses exhibited a pattern consistent with the depression autonomy model, whereas individuals with lower cortisol responses showed a pattern more consistent with the depression sensitization model. Finally, comparing across the two samples, stress generation effects were weaker for older participants and for those with more prior MDEs. The complex, multifactorial relation between stress and depression is discussed.

  12. Temperament and Character in Euthymic Major Depressive Disorder Patients: The Effect of Previous Suicide Attempts and Psychotic Mood Episodes

    PubMed Central

    Albayrak, Yakup; Ekinci, Aslı Erkan

    2012-01-01

    Objective The purpose of this study was to examine personality traits of patients with major depressive disorder and explore the possible connections between personality and clinical and sociodemographic variables. Methods The sociodemographic and clinical properties of 80 patients with major depression, who were euthymic according to Hamilton Depression Scale scores, were recorded. Their personality was evaluated by using Temperament and Character Inventory and results were compared with 80 age- and sex-matched healthy controls. We used general linear model analysis to evaluate the manner in which the variables contributed to TCI scores. Results Remitted depressive patients scored significantly lower on on self-directedness and higher on harm avoidance than HC. Previous suicide attempts had a main effect only on harm avoidance while previous psychotic mood episodes were significantly associated with novelty seeking, self-directedness and cooperativeness. With respect to numeric clinical variables, only duration of illness was significantly and negatively correlated with NS and RD scores. Conclusion Patients with euthymic major depressive disorder may have significantly different personality traits than the normal population, and patients with different clinical and sociodemographic characteristics may show different personality patterns. In addition, assessment of major depressed patients by means of the Temperament and Character Inventory may be helpful to get a deeper insight into those personality traits underlying suicidality and the emergence of psychotic mood episode. PMID:22707961

  13. A comparison of capacities for social cognition and metacognition in first episode and prolonged depression.

    PubMed

    Ladegaard, Nicolai; Lysaker, Paul H; Larsen, Erik R; Videbech, Poul

    2014-12-30

    There is a growing awareness that social cognition is a valuable construct for understanding the psycho-social disabilities in depressive illness. Numerous studies have linked affective disorders to impairments in social cognition and specifically the processing of discrete emotional stimuli. Only few studies have investigated the relation between the burden of depressive illness and social cognitive ability. To study these issues, we compared a group of first-episode depressed patients with a group of chronically depressed patients (duration >2 years) on a broad array of higher-order social cognitive measures including the metacognition assessment scale abbreviated. Contrary to prediction, deficits in social cognition were roughly equivalent between the two groups and there was no significant link between symptom severity and social cognitive ability. Having moderate to severe major depressive disorder (MDD) could be sufficient to predict the presence of deficits in social cognitive ability.

  14. Depression

    MedlinePlus

    ... The depression generally lifts during spring and summer. Bipolar disorder is different from depression but is included in this list is because someone with bipolar disorder experiences episodes of extreme low moods (depression). But ...

  15. Prevalence and clinical significance of subsyndromal manic symptoms, including irritability and psychomotor agitation, during bipolar major depressive episodes

    PubMed Central

    Judd, Lewis L.; Schettler, Pamela J.; Akiskal, Hagop; Coryell, William; Fawcett, Jan; Fiedorowicz, Jess G.; Solomon, David A.; Keller, Martin B.

    2013-01-01

    Background There is increasing evidence that subsyndromal manic symptoms occur frequently during bipolar major depressive episodes (MDEs) and may be a subtle form of ‘depressive mixed state.’ This paper examines the prevalence and clinical characteristics of MDEs with subsyndromal manic symptoms. The specific effects of overt irritability and psychomotor agitation are examined. Methods Bipolar (type I or II) patients with an MDE at intake (N=142) were compared based on the presence or absence of concurrent subsyndromal manic symptoms. The groups were further subdivided by the presence of symptoms of overt irritability and/or psychomotor agitation. Results Subsyndromal manic symptoms during bipolar MDEs were highly prevalent (76.1%), and were associated with significantly increased severity of depression/dysphoria in the intake episode, longer episode duration, and more suicidal ideation and behavior (past, current, and during long-term follow-up). Overt irritability and psychomotor agitation were the most prevalent subsyndromal manic symptoms (co-occurring in 57% and 39% of MDEs, respectively), and accounted for most of the negative effects associated with subsyndromal manic symptoms. Limitations The findings need to be confirmed in larger samples, which also examine the relationship to adequate antidepressant and/or mood stabilizing treatment. Conclusions The presence of one or more subsyndromal manic symptoms appears to be the modal presentation of bipolar MDEs and a marker for a subtle form of bipolar mixed depressive state. In particular, patients with symptoms of overt irritability and/or psychomotor agitation should be monitored closely to avoid serious clinical outcomes such as longer affective episodes, exacerbation of manic symptoms syndromal mania, and heightened suicidality. PMID:22314261

  16. Pretreatment anterior cingulate activity predicts antidepressant treatment response in major depressive episodes.

    PubMed

    Rentzsch, Johannes; Adli, Mazda; Wiethoff, Katja; Gómez-Carrillo de Castro, Ana; Gallinat, Jürgen

    2014-04-01

    Major depressive disorder leads to substantial individual and socioeconomic costs. Despite the ongoing efforts to improve the treatment for this condition, a trial-and-error approach until an individually effective treatment is established still dominates clinical practice. Searching for clinically useful treatment response predictors is one of the most promising strategies to change this quandary therapeutic situation. This study evaluated the predictive value of a biological and a clinical predictor, as well as a combination of both. Pretreatment EEGs of 31 patients with a major depressive episode were analyzed with neuroelectric brain imaging technique to assess cerebral oscillations related to treatment response. Early improvement of symptoms served as a clinical predictor. Treatment response was assessed after 4 weeks of antidepressant treatment. Responders showed more slow-frequency power in the right anterior cingulate cortex compared to non-responders. Slow-frequency power in this region was found to predict response with good sensitivity (82 %) and specificity (100 %), while early improvement showed lower accuracy (73 % sensitivity and 65 % specificity). Combining both parameters did not further improve predictive accuracy. Pretreatment activity within the anterior cingulate cortex is related to antidepressive treatment response. Our results support the search for biological treatment response predictors using electric brain activity. This technique is advantageous due to its low individual and socioeconomic burden. The benefits of combining both, a clinically and a biologically based predictor, should be further evaluated using larger sample sizes.

  17. Cross-national epidemiology of DSM-IV major depressive episode

    PubMed Central

    2011-01-01

    Background Major depression is one of the leading causes of disability worldwide, yet epidemiologic data are not available for many countries, particularly low- to middle-income countries. In this paper, we present data on the prevalence, impairment and demographic correlates of depression from 18 high and low- to middle-income countries in the World Mental Health Survey Initiative. Methods Major depressive episodes (MDE) as defined by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DMS-IV) were evaluated in face-to-face interviews using the World Health Organization Composite International Diagnostic Interview (CIDI). Data from 18 countries were analyzed in this report (n = 89,037). All countries surveyed representative, population-based samples of adults. Results The average lifetime and 12-month prevalence estimates of DSM-IV MDE were 14.6% and 5.5% in the ten high-income and 11.1% and 5.9% in the eight low- to middle-income countries. The average age of onset ascertained retrospectively was 25.7 in the high-income and 24.0 in low- to middle-income countries. Functional impairment was associated with recency of MDE. The female: male ratio was about 2:1. In high-income countries, younger age was associated with higher 12-month prevalence; by contrast, in several low- to middle-income countries, older age was associated with greater likelihood of MDE. The strongest demographic correlate in high-income countries was being separated from a partner, and in low- to middle-income countries, was being divorced or widowed. Conclusions MDE is a significant public-health concern across all regions of the world and is strongly linked to social conditions. Future research is needed to investigate the combination of demographic risk factors that are most strongly associated with MDE in the specific countries included in the WMH. PMID:21791035

  18. Transnational Ties and Past-Year Major Depressive Episodes among Latino Immigrants

    PubMed Central

    Alcántara, Carmela; Chen, Chih-Nan; Alegría, Margarita

    2014-01-01

    Objective Latino immigrants live in an increasingly global world where maintaining contact with kin in the home country is easier than ever. We examined: (a) the annual distribution of remittances burden (percentage of remittances/household income) and visits to the home country; (b) the association of these transnational ties with odds of a past-year major depressive episode (MDE); and (c) moderation by Latino sub-ethnicity or gender. Methods We conducted weighted logistic regression analyses with the Latino immigrant subsample (N=1614) of the National Latino and Asian American Study. Results Mexican and Other Latino immigrants had greater remittances burden than Puerto Rican migrants. Cuban immigrants made fewer visits back home than Puerto Rican migrants. After adjustment for socio-demographics and pre-migration psychiatric history, a percentage increase in remittances burden decreased odds of MDE (OR=0.80 [95%CI:0.67–.0.98]), whereas visits back home increased odds of MDE (OR=1.04 [95%CI:1.01–1.06]). Latino sub-ethnicity was not a significant moderator. Visits back home were more strongly linked to depression among women than men. Conclusions The distribution of transnational ties differs by Latino subgroup, although its association with depression is similar across groups. Monetary giving in the form of remittances might promote a greater sense of self-efficacy, social integration, and caregiving for relatives back home that positively affect mental health. Visits back home, especially for women, might signal social stress from strained relationships with kin/spouses/children left behind, or increased caregiving demands that negatively affect mental health. Clinical practice with immigrants should routinely assess the social resources and strains that fall outside national borders. PMID:25090146

  19. Residential Transience, Major Depressive Episodes, and the Risk of Suicidal Thoughts, Plans, and Attempts.

    PubMed

    Glasheen, Cristie; Forman-Hoffman, Valerie L

    2015-12-01

    The association between past-year residential transience (frequent moving) and suicidal ideation among a nationally representative sample of over 190,000 U.S. adults was evaluated. Suicidal thoughts, plans, and attempts were more prevalent among transient adults. Among adults without major depressive episodes (MDE), transience was associated with 70% to 90% greater odds of suicidal ideation compared to nontransient adults. Among adults with MDE, transience was associated with a 60% to 80% increased odds of suicidal ideation compared to nontransient adults. Residential transience may be an indicator for increased suicide risk even in the absence of depression. PMID:25823805

  20. Major Depressive Episode among Full-Time College Students and Other Young Adults, Aged 18 to 22

    MedlinePlus

    ... Past Year Major Depressive Episode (MDE), by Full-Time College Status: Percentages, 2008 to 2010 Severity of Impairment Home Management: No Interference Home Management: Mild Home Management: Moderate ...

  1. The association of major depressive episodes with income inequality and the human development index.

    PubMed

    Cifuentes, Manuel; Sembajwe, Grace; Tak, SangWoo; Gore, Rebecca; Kriebel, David; Punnett, Laura

    2008-08-01

    The aim of this study was to estimate the association between country income distribution and human development with the 12-month occurrence of major depressive episodes across countries. A total of 251,158 people surveyed by the World Health Organization from 2002 to 2003 from 65 countries were included in the study. The survey contained items for identifying major depressive episodes (MDE) in the previous 12 months, attained education (used as an indicator of individual socioeconomic status) and other demographic information. Income inequality was measured with the Gini index, a national-level indicator; the United Nations human development index (HDI) measured overall country development. Country-level and multilevel linear regression models were utilized to study the associations. We found that moderately developed countries had the lowest adjusted prevalence of MDE followed by high and low developed countries. The Gini index was positively associated with major depressive episodes, but only among high HDI countries. After adjusting for age, gender, marital status, education and HDI, the multilevel prevalence ratio indicated a 4% increase in risk of MDE for a person living in a country associated with a 1% increment in income equality. This finding means, for example, that comparing two highly developed countries, one with low income inequality (Gini=0.25) with another with high income inequality (Gini=0.39), one would expect to see an increase in the prevalence of MDE from 4.0% to 6.2%. These findings raise important questions about the role of income inequality on social forces that can lead to depression.

  2. Dissociated large-scale functional connectivity networks of the precuneus in medication-naïve first-episode depression.

    PubMed

    Peng, Daihui; Liddle, Elizabeth B; Iwabuchi, Sarina J; Zhang, Chen; Wu, Zhiguo; Liu, Jun; Jiang, Kaida; Xu, Lin; Liddle, Peter F; Palaniyappan, Lena; Fang, Yiru

    2015-06-30

    An imbalance in neural activity within large-scale networks appears to be an important pathophysiological aspect of depression. Yet, there is little consensus regarding the abnormality within the default mode network (DMN) in major depressive disorder (MDD). In the present study, 16 first-episode, medication-naïve patients with MDD and 16 matched healthy controls underwent functional magnetic resonance imaging (fMRI) at rest. With the precuneus (a central node of the DMN) as a seed region, functional connectivity (FC) was measured across the entire brain. The association between the FC of the precuneus and overall symptom severity was assessed using the Hamilton Depression Rating Scale. Patients with MDD exhibited a more negative relationship between the precuneus and the non-DMN regions, including the sensory processing regions (fusiform gyrus, postcentral gyrus) and the secondary motor cortex (supplementary motor area and precentral gyrus). Moreover, greater severity of depression was associated with greater anti-correlation between the precuneus and the temporo-parietal junction as well as stronger positive connectivity between the precuneus and the dorsomedial prefrontal cortex. These results indicate that dissociated large-scale networks of the precuneus may contribute to the clinical expression of depression in MDD. PMID:25957017

  3. The effect of negative mood and major depressive episode on working memory and implicit learning.

    PubMed

    Borbély-Ipkovich, Emőke; Janacsek, Karolina; Németh, Dezső; Gonda, Xenia

    2014-03-01

    Major depressive episode (MDE) is one of the most common psychiatric diagnoses and it has long-term mental and physiological consequences. The status of cognitive functions is of specific importance in case of affective disorders, due to their influence not only on patients' behaviour, but to a certain extent also on the success of psychotherapy. In addition, examining the impact of mood and affective disorders on cognitive functions also helps us understand the relationship between brain plasticity and neurocognitive networks. While the relationship between explicit, conscious memory and mood are relatively well-explored, the effect of mood and affective disorders on working memory and implicit sequence learning received less attention. The present review aims to overview available results in these less-explored areas. Research suggests that while working memory performance shows impairments in MDE and in some specific mood conditions, effects of affective disorders and mood on implicit sequence learning are more contradictory, highlighting the need for further studies in this field.

  4. Hippocampus, glucocorticoids and neurocognitive functions in patients with first-episode major depressive disorders.

    PubMed

    Kaymak, Semra Ulusoy; Demir, Başaran; Sentürk, Senem; Tatar, Ilkan; Aldur, M Mustafa; Uluğ, Berna

    2010-04-01

    The aim of this study was to determine whether there was any relationship between hippocampal volume, and glucocorticoid regulation, and cognitive dysfunctions in drug-naïve major depressive disorder (MDD) patients during their first episode. Twenty drug-free female MDD patients in their first episode and 15 healthy females as control subjects were included in the study. All subjects underwent 3.0 Tesla (T) magnetic resonance imaging (MRI), comprehensive neuropsychological testing and dexamethasone suppression tests (DST). The volumes of the right and left hippocampus of the patients were found to be significantly smaller than those of the controls. Patients were found to have significantly lower scores on measures of attention, working memory, psychomotor speed, executive functions, and visual and verbal memory fields. The performance of the patients only in the recollection memory and memory of reward-associated rules were positively correlated with hippocampal volumes. The volumes of the left and right hippocampus did not correlate with basal or post-dexamethasone cortisol levels. Our findings indicate that depressed patients have smaller hippocampi even in the earlier phase of their illness. Further research efforts are needed to explain the mechanisms that are responsible for the small hippocampus in depressed patients.

  5. Regional increases of cortical thickness in untreated, first-episode major depressive disorder

    PubMed Central

    Qiu, L; Lui, S; Kuang, W; Huang, X; Li, J; Li, J; Zhang, J; Chen, H; Sweeney, J A; Gong, Q

    2014-01-01

    The large majority of structural MRI studies of major depressive disorder (MDD) investigated volumetric changes in chronic medicated patients in whom course of illness and treatment effects may impact anatomic measurements. Further, in few studies, separate measurements of cortical thickness and surface area have been performed that reflect different neurobiological processes regulated by different genetic mechanisms. In the present study, we investigated both cortical thickness and surface area in first-episode, treatment-naïve, mid-life MDD to elucidate the core pathophysiology of this disease and its early impact on the brain. We observed increased cortical thickness in the right hemisphere, including medial orbitofrontal gyrus, pars opercularis, rostral middle frontal gyrus and supramarginal gyrus. Increased thickness of rostral middle frontal gyrus was negatively related with depression severity on the Hamilton Depression Rating Scale. Furthermore, MDD patients showed significantly increased associations in cortical thickness measurements among areas where increased cortical thickness was observed. Analysis of pial area revealed a trend toward increased surface area in the left parahippocampal gyrus in MDD. To permit comparison of our data with those of previous gray matter volume studies, voxel-based morphometry was performed. That analysis revealed significantly increased gray matter volume in left paracentral lobule, left superior frontal gyrus, bilateral cuneus and thalamus which form limbic-cortico–striato–pallido–thalamic loops. These changes in first-episode, treatment-naïve, mid-life MDD patients may reflect an active illness-related cortical change close to illness onset, and thus potentially provide important new insight into the early neurobiology of the disorder. PMID:24713859

  6. Regional increases of cortical thickness in untreated, first-episode major depressive disorder.

    PubMed

    Qiu, L; Lui, S; Kuang, W; Huang, X; Li, J; Li, J; Zhang, J; Chen, H; Sweeney, J A; Gong, Q

    2014-01-01

    The large majority of structural MRI studies of major depressive disorder (MDD) investigated volumetric changes in chronic medicated patients in whom course of illness and treatment effects may impact anatomic measurements. Further, in few studies, separate measurements of cortical thickness and surface area have been performed that reflect different neurobiological processes regulated by different genetic mechanisms. In the present study, we investigated both cortical thickness and surface area in first-episode, treatment-naïve, mid-life MDD to elucidate the core pathophysiology of this disease and its early impact on the brain. We observed increased cortical thickness in the right hemisphere, including medial orbitofrontal gyrus, pars opercularis, rostral middle frontal gyrus and supramarginal gyrus. Increased thickness of rostral middle frontal gyrus was negatively related with depression severity on the Hamilton Depression Rating Scale. Furthermore, MDD patients showed significantly increased associations in cortical thickness measurements among areas where increased cortical thickness was observed. Analysis of pial area revealed a trend toward increased surface area in the left parahippocampal gyrus in MDD. To permit comparison of our data with those of previous gray matter volume studies, voxel-based morphometry was performed. That analysis revealed significantly increased gray matter volume in left paracentral lobule, left superior frontal gyrus, bilateral cuneus and thalamus which form limbic-cortico-striato-pallido-thalamic loops. These changes in first-episode, treatment-naïve, mid-life MDD patients may reflect an active illness-related cortical change close to illness onset, and thus potentially provide important new insight into the early neurobiology of the disorder. PMID:24713859

  7. Suicidality and symptoms of anxiety, irritability, and agitation in patients experiencing manic episodes with depressive symptoms: a naturalistic study

    PubMed Central

    Eberhard, Jonas; Weiller, Emmanuelle

    2016-01-01

    Purpose Patients with a bipolar I disorder (BD-I) manic episode meeting the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), criteria for “with mixed features” have a high incidence of suicide attempts and of anxiety, irritability, and agitation (AIA) symptoms. The aim of this analysis was to explore the relationship between suicidality and AIA symptoms in patients with BD-I experiencing mania with depressive symptoms, using data from a previous naturalistic study. Patients and methods Psychiatrists completed an online questionnaire about their adult patients who had a current BD-I manic episode. Questions covered the DSM-5 “with mixed features” specifier, the severity of AIA symptoms, the frequency and controllability of suicidal ideation, and the number of suicide attempts. Results Of 1,035 patients with BD-I mania who were included in the analyses, 348 (33.6%) met the criteria for the DSM-5 “with mixed features” specifier (three or more depressive symptoms). These patients were further stratified according to the severity of their AIA symptoms: “mild AIA” (zero or one AIA symptom above a severity threshold; 105 patients) or “severe AIA” (all three AIA symptoms above a severity threshold; 167 patients). A greater incidence of suicidal ideation was observed in the severe AIA group (71.9%) than in the mild AIA group (47.6%). Twice as many patients had easily controlled suicidal ideation than difficult-to-control suicidal ideation in both subgroups. The mean number of suicide attempts was higher in the severe AIA group than in the mild AIA group, during the current episode (0.84 vs 0.34 attempts, respectively; P<0.05) and over the patient’s lifetime (1.56 vs 1.04 attempts, respectively). Conclusion The high risk of suicide among BD-I mania patients with depressive symptoms is further increased when they experience severe AIA symptoms. Recognizing AIA symptoms in BD-I mania could provide a means of identifying

  8. Suicidality and symptoms of anxiety, irritability, and agitation in patients experiencing manic episodes with depressive symptoms: a naturalistic study

    PubMed Central

    Eberhard, Jonas; Weiller, Emmanuelle

    2016-01-01

    Purpose Patients with a bipolar I disorder (BD-I) manic episode meeting the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), criteria for “with mixed features” have a high incidence of suicide attempts and of anxiety, irritability, and agitation (AIA) symptoms. The aim of this analysis was to explore the relationship between suicidality and AIA symptoms in patients with BD-I experiencing mania with depressive symptoms, using data from a previous naturalistic study. Patients and methods Psychiatrists completed an online questionnaire about their adult patients who had a current BD-I manic episode. Questions covered the DSM-5 “with mixed features” specifier, the severity of AIA symptoms, the frequency and controllability of suicidal ideation, and the number of suicide attempts. Results Of 1,035 patients with BD-I mania who were included in the analyses, 348 (33.6%) met the criteria for the DSM-5 “with mixed features” specifier (three or more depressive symptoms). These patients were further stratified according to the severity of their AIA symptoms: “mild AIA” (zero or one AIA symptom above a severity threshold; 105 patients) or “severe AIA” (all three AIA symptoms above a severity threshold; 167 patients). A greater incidence of suicidal ideation was observed in the severe AIA group (71.9%) than in the mild AIA group (47.6%). Twice as many patients had easily controlled suicidal ideation than difficult-to-control suicidal ideation in both subgroups. The mean number of suicide attempts was higher in the severe AIA group than in the mild AIA group, during the current episode (0.84 vs 0.34 attempts, respectively; P<0.05) and over the patient’s lifetime (1.56 vs 1.04 attempts, respectively). Conclusion The high risk of suicide among BD-I mania patients with depressive symptoms is further increased when they experience severe AIA symptoms. Recognizing AIA symptoms in BD-I mania could provide a means of identifying

  9. Validity of the bereavement exclusion criterion for the diagnosis of major depressive episode.

    PubMed

    Zisook, Sidney; Shear, Katherine; Kendler, Kenneth S

    2007-06-01

    Since the publication of DSM-III in 1980, the official position of American psychiatry has been that the presence of bereavement is an exclusion criterion for the diagnosis of a major depressive episode (MDE). However, the empirical validity of this exclusion has not been well established. As DSM-V is now being planned, it is timely to reexamine the bereavement exclusion, particularly in the light of new evidence since the last reviews of this subject. This paper evaluates the relative validity of two competing hypotheses: 1) the bereavement exclusion for the diagnosis of MDE is not valid because, using validating criteria, bereavement related depression (BRD) within the first two months after the death of a loved one resembles non-bereavement related depression (SMD); 2) the bereavement exclusion for the diagnosis of MDD is valid because, using validating criteria, BRD within the first two months after the death of a loved one does not resemble SMD. The prevailing evidence more strongly supports Hypothesis 1 than Hypothesis 2. Thus, the bereavement exclusion for the diagnosis of MDE may no longer be justified. PMID:18235867

  10. Mild cognitive impairment, poor episodic memory, and late-life depression are associated with cerebral cortical thinning and increased white matter hyperintensities

    PubMed Central

    Fujishima, Motonobu; Maikusa, Norihide; Nakamura, Kei; Nakatsuka, Masahiro; Matsuda, Hiroshi; Meguro, Kenichi

    2014-01-01

    In various independent studies to date, cerebral cortical thickness and white matter hyperintensity (WMH) volume have been associated with episodic memory, depression, and mild cognitive impairment (MCI). The aim of this study was to uncover variations in cortical thickness and WMH volume in association with episodic memory, depressive state, and the presence of MCI simultaneously in a single study population. The participants were 186 individuals with MCI (clinical dementia rating [CDR] of 0.5) and 136 healthy elderly controls (HCs; CDR of 0) drawn from two community-based cohort studies in northern Japan. We computed cerebral cortical thickness and WMH volume by using MR scans and statistically analyzed differences in these indices between HCs and MCI participants. We also assessed the associations of these indices with memory performance and depressive state in participants with MCI. Compared with HCs, MCI participants exhibited thinner cortices in the temporal and inferior parietal lobes and greater WMH volumes in the corona radiata and semioval center. In MCI participants, poor episodic memory was associated with thinner cortices in the left entorhinal region and increased WMH volume in the posterior periventricular regions. Compared with non-depressed MCI participants, depressed MCI participants showed reduced cortical thickness in the anterior medial temporal lobe and gyrus adjacent to the amygdala bilaterally, as well as greater WMH volume as a percentage of the total intracranial volume (WMHr). A higher WMHr was associated with cortical thinning in the frontal, temporal, and parietal regions in MCI participants. These results demonstrate that episodic memory and depression are associated with both cortical thickness and WMH volume in MCI participants. Additional longitudinal studies are needed to clarify the dynamic associations and interactions among these indices. PMID:25426066

  11. Residual symptoms in patients with partial versus complete remission of a major depressive disorder episode: patterns of painful physical symptoms in depression

    PubMed Central

    Harada, Eiji; Satoi, Yoichi; Kikuchi, Toshiaki; Watanabe, Koichiro; Alev, Levent; Mimura, Masaru

    2016-01-01

    Objective The patterns of residual painful physical symptoms (PPS) and emotional symptoms among patients with partial remission (PR) or complete remission (CR) of a major depressive disorder (MDD) episode were compared. Methods This is a multicenter, cross-sectional, observational study. Patients who had originally been diagnosed with MDD, were treated with an antidepressant for 12 weeks for that episode, and achieved either PR or CR at study entry were enrolled in the study. Using the 17-item Hamilton Rating Scale for Depression (HAM-D17), PR was defined as a score of ≥8 and ≤18 and CR as a score of ≤7. Residual symptoms were assessed using the Brief Pain Inventory-Short Form (BPI-SF) and the HAM-D17. Results A total of 323 patients (CR =158, PR =165) were included in the study. Patients in the PR group had a higher mean (standard deviation) score in the HAM-D17 than those in the CR group (11.8 [3.1] and 4.4 [2.0], respectively). BPI-SF results showed that “at least moderate PPS” (score ≥3 on BPI-SF question 5) was significantly more prevalent among patients with PR than those with CR (37.0% vs 16.5%, respectively; odds ratio =3.04; P<0.001). Presence of pain (any severity) was also more prevalent among patients with PR than those with CR (54.5% vs 35.4%, respectively). The HAM-D17 results for individual items indicated that impaired work and activities, depressed mood, psychological and somatic anxiety, and general somatic symptoms were observed in at least 75% of patients with PR. Conclusion PR was associated with a higher prevalence of at least moderate PPS. Other residual symptoms commonly observed in patients with PR included typical core emotional symptoms (eg, loss of interest, depressed mood, and psychological anxiety). These results underline the importance of PPS, because PPS is clinically relevant for the patients but difficult to assess with the commonly used depression evaluation scale. PMID:27418827

  12. The Epidemiology of Major Depressive Episode in the Iraqi General Population

    PubMed Central

    Al-Hamzawi, Ali Obaid; Bruffaerts, Ronny; Bromet, Evelyn J.; AlKhafaji, Abdulzahra Mohammed; Kessler, Ronald C.

    2015-01-01

    Objective To assess the prevalence, symptom severity, functional impairment, and treatment of major depressive episode (MDE) in the Iraqi general population. Methods The Iraq Mental Health Survey is a nationally representative face-to-face survey of 4,332 non-institutionalized adults aged 18+ interviewed in 2006–2007 as part of the WHO World Mental Health Surveys. Prevalence and correlates of DSM-IV MDE were determined with the WHO Composite International Diagnostic Interview (CIDI). Findings Lifetime and 12-month prevalence of MDE were 7.4% and 4.0%, respectively. Close to half (46%) of the 12-month MDE cases were severe/very severe. MDE was more common among women and those previously married. Median age of onset was 25.2. Only one-seventh of 12-month MDE cases received treatment despite being associated with very substantial role impairment (on average 70 days out of role in the past year). Conclusions MDE is a commonly occurring disorder in the Iraqi general population and is associated with considerable disability and low treatment. Efforts are needed to decrease the barriers to treatment and to educate general medical providers in Iraq about the recognition and treatment of depression. PMID:26230265

  13. Association between genetic polymorphisms in the serotonergic system and comorbid personality disorders among patients with first-episode depression.

    PubMed

    Bukh, Jens D; Bock, Camilla; Kessing, Lars V

    2014-06-01

    Studies on the association between genetic polymorphisms and personality disorders have provided inconsistent results. Using the "enriched sample method," the authors of the present study aimed to assess the association between polymorphisms in the serotonergic transmitter system and comorbid personality disorders in patients recently diagnosed with first-episode depression. A total of 290 participants were systematically recruited via the Danish Psychiatric Central Research Register. Diagnoses of personality disorders were assessed by a SCID-II interview, and polymorphisms in the genes encoding the serotonin transporter, serotonin receptors 1A, 2A, 2C, and tryptophan hydroxylase 1 were genotyped. The authors found a significant effect of the length polymorphism in the serotonin transporter gene (5-HTTLPR) on cluster B personality disorder (mainly borderline disorder), but no influence on cluster C personality disorder, and no associations between other polymorphisms and personality disorders. The study adds evidence to the effect of the serotonin transporter gene specifically on cluster B personality disorders.

  14. Identifying Risk for Onset of Major Depressive Episodes in Low-Income Latinas during Pregnancy and Postpartum

    ERIC Educational Resources Information Center

    Le, Huynh-Nhu; Munoz, Ricardo F.; Soto, Jose A.; Delucchi, Kevin L.; Ippen, Chandra Ghosh

    2004-01-01

    This study aimed to identify subgroups of pregnant women at imminent (1 year) risk for major depressive episodes. Participants were 84 low-income, predominantly Mexican women using public sector obstetrics services who participated in monthly interviews during pregnancy and up to 6 months postpartum. Participants were designated a priori as "more…

  15. Transnational ties and past-year major depressive episodes among Latino immigrants.

    PubMed

    Alcántara, Carmela; Chen, Chih-Nan; Alegría, Margarita

    2015-07-01

    Latino immigrants live in an increasingly global world in which maintaining contact with kin in the home country is easier than ever. We examined (a) the annual distribution of remittances burden (percentage of remittances/household income) and visits to the home country, (b) the association of these transnational ties with a past-year major depressive episode (MDE), and (c) moderation by Latino subethnicity or gender. We conducted weighted logistic regression analyses with the Latino immigrant subsample (N = 1,614) of the National Latino and Asian American Study. Mexican and Other Latino immigrants had greater remittances burden than Puerto Rican migrants. Cuban immigrants made the fewest visits back home. After adjustment for sociodemographics and premigration psychiatric history, remittances burden decreased odds of MDE (odds ratio [OR] = 0.80, 95% confidence interval [CI] [0.67, .0.98]), whereas visits back home increased odds of MDE (OR = 1.04, 95% CI [1.01, 1.06]). Latino subethnicity was not a significant moderator. Visits back home were more strongly linked to depression among women than men. The distribution of transnational ties differs by Latino subgroup, although its association with depression is similar across groups. Monetary giving through remittances might promote a greater sense of self-efficacy, and caregiving for relatives back home that positively affect mental health. Visits back home, especially for women, might signal social stress from strained relationships with kin, spouses, or children left behind, or increased caregiving demands that negatively affect mental health. Clinical practice with immigrants should routinely assess the social resources and strains that fall outside national borders. PMID:25090146

  16. Predicting the onset and persistence of episodes of depression in primary health care. The predictD-Spain study: Methodology

    PubMed Central

    Bellón, Juan Ángel; Moreno-Küstner, Berta; Torres-González, Francisco; Montón-Franco, Carmen; GildeGómez-Barragán, María Josefa; Sánchez-Celaya, Marta; Díaz-Barreiros, Miguel Ángel; Vicens, Catalina; de Dios Luna, Juan; Cervilla, Jorge A; Gutierrez, Blanca; Martínez-Cañavate, María Teresa; Oliván-Blázquez, Bárbara; Vázquez-Medrano, Ana; Sánchez-Artiaga, María Soledad; March, Sebastia; Motrico, Emma; Ruiz-García, Victor Manuel; Brangier-Wainberg, Paulette Renée; del Mar Muñoz-García, María; Nazareth, Irwin; King, Michael

    2008-01-01

    Background The effects of putative risk factors on the onset and/or persistence of depression remain unclear. We aim to develop comprehensive models to predict the onset and persistence of episodes of depression in primary care. Here we explain the general methodology of the predictD-Spain study and evaluate the reliability of the questionnaires used. Methods This is a prospective cohort study. A systematic random sample of general practice attendees aged 18 to 75 has been recruited in seven Spanish provinces. Depression is being measured with the CIDI at baseline, and at 6, 12, 24 and 36 months. A set of individual, environmental, genetic, professional and organizational risk factors are to be assessed at each follow-up point. In a separate reliability study, a proportional random sample of 401 participants completed the test-retest (251 researcher-administered and 150 self-administered) between October 2005 and February 2006. We have also checked 118,398 items for data entry from a random sample of 480 patients stratified by province. Results All items and questionnaires had good test-retest reliability for both methods of administration, except for the use of recreational drugs over the previous six months. Cronbach's alphas were good and their factorial analyses coherent for the three scales evaluated (social support from family and friends, dissatisfaction with paid work, and dissatisfaction with unpaid work). There were 191 (0.16%) data entry errors. Conclusion The items and questionnaires were reliable and data quality control was excellent. When we eventually obtain our risk index for the onset and persistence of depression, we will be able to determine the individual risk of each patient evaluated in primary health care. PMID:18657275

  17. The Daily Functionality in a Major Depressive Episode Cohort of Romanian Patients - a Non-Interventional Study

    PubMed Central

    PRELIPCEANU, Dan; PURNICHI, Traian; MARINESCU, Victor; MATEI, Valentin

    2015-01-01

    Objectives: The aim of this non-interventional, investigator driven study was to assess the functionality of patients with major depression under treatment with agomelatine in real life clinical practice. Material and methods: The study was multicenter, non-interventional and evaluated the functionality of the adult patients with a DSM-IV diagnosis of MDD (single or recurrent episode and no treatment in the previous 6 months). It took place in Romania and it was a 10-weeks study. After the clinicians took the medical decision of treatment with agomelatine and if the patient agreed to be evaluated more accurate in this study, in order to assess functionality, patients completed at each visit the Sheehan Disability Scale (SDS). Patients were assessed also with QIDS-C (Quick Inventory of Depressive Symptomatology), a measure of depression symptoms severity and CGI scale severity (CGI-S), CGI scale improvement (CGI-I) and therapeutic index. Also, data about demographics and disease were collected during clinical interviews and from medical records. Results: The functionality as assessed with SDS showed a significant functional impairment at baseline with scores >6 for each of the 3 inter-related domains of work/school, social and family life. At the end of the study, all functional aspects were improved although a mild impairment still persist requiring further treatment. A total of 1191 patients were analyzed (mean age: 47 years, 68% female). Mean QIDS-16 total score at baseline was 14.3 and decreased over the 10-week prospective period to 2.3. Most patients were treated with agomelatine. Conclusion: This study outcome confirms the fast on set of functionality improvement of agomelatine and further treatment need for the total remission of clinical depressive symptomatology after 10 weeks of treatment. PMID:26225148

  18. Noradrenaline plays a critical role in the switch to a manic episode and treatment of a depressive episode

    PubMed Central

    Kurita, Masatake

    2016-01-01

    Although antidepressants may increase the risk of switching to mania in bipolar disorder (BD), clinicians have been using antidepressants to treat patients with bipolar depression. Appropriate treatments for bipolar depression remain controversial. In BD, antidepressants comprise a double-edged sword in terms of their efficacy in treating depression and the increased risk of switching. This review presents an important table outlining the benefit in terms of depression improvement and the risk of switching in the clinical setting. It also proposes strategies based on the characteristics of antidepressants such as their pharmacology, specifically the equilibrium dissociation constant (KD) of the noradrenaline transporter. This table will be useful for clinicians while considering benefit and risk. Antidepressants augmenting noradrenaline may be effective in bipolar depression. However, it is easily presumed that such antidepressants may also have a risk of switching to mania. Therefore, antidepressants augmenting noradrenaline will be the recommended treatment in combination with an antimanic agent, or they may be used for short-term treatment and early discontinuation. The corresponding medical treatment guidelines probably need to be reevaluated and updated based on biological backgrounds. From previous studies, we understand that the stability of noradrenaline levels is important for BD amelioration, based on the pathophysiology of the disorder. It is hoped that researchers will reevaluate BD by conducting studies involving noradrenaline. PMID:27703355

  19. Efficacy of Hypericum extract WS® 5570 compared with paroxetine in patients with a moderate major depressive episode – a subgroup analysis

    PubMed Central

    Seifritz, Erich; Hatzinger, Martin; Holsboer-Trachsler, Edith

    2016-01-01

    Abstract Objectives: efficacy and tolerability of WS® 5570 for the treatment of acute mild-to-moderate depression, has been demonstrated in various studies. Here, we present a subgroup analysis of a double blind, randomised trial to compare the therapeutic efficacy of WS® 5570 with paroxetine in patients suffering from a major depressive episode with moderate symptom intensity. Methods: moderate depression was defined by a baseline Hamilton Depression Rating Scale (HAM-D) total score between 22 and 25. Patients received, after a single blind placebo run-in phase of 3–7 d, either 3 × 300 mg/d WS® 5570 or 20 mg/d paroxetine for six weeks. The change of the HAM-D total score was used to describe the efficacy of WS® 5570 compared with paroxetine in the subgroup of patients with moderate depression. Results: the reductions of the HAM-D total score were significantly more pronounced in patients treated with 3 × 300 mg/d WS® 5570 compared to 20 mg/d paroxetine. Conclusions: patients treated with WS® 5570 not only showed a reduction in depression severity score but also yielded greater response and remission rates compared with patients treated with paroxetine. KeypointsVarious studies showed the efficacy and tolerability of WS® 5570 for the treatment of acute mild-to-moderate depression.Beneficial effects of WS® 5570 have been also shown in patients with moderate-to-severe depression.In this study reductions of the HAM-D total score were significantly more pronounced in patients with moderate depression treated with WS® 5570 compared with paroxetine.Patients treated with WS® 5570 not only showed a reduction in depression severity score but also yielded greater response and remission rates compared with patients treated with paroxetine. PMID:27161105

  20. Chronological and subjective age differences in flourishing mental health and major depressive episode.

    PubMed

    Keyes, Corey L M; Westerhof, Gerben J

    2012-01-01

    Mental health is more than the absence of psychopathology, but few studies use positive mental health along with a measure of past year major depressive episode (MDE). This study addresses this gap by investigating the association of MDE and flourishing mental health (FMH) with chronological age and subjective (felt and ideal) age. Data are from the Midlife in the United States random digit dialing sample of adults ages 25 to 74, collected in 1995 (n = 3032). Rates of MDE were lowest, and FMH highest, among the three oldest age cohorts (45-54, 55-64, 65-74 years). Subjective age was linked with chronological age; with age, adults tend to feel younger, and want to be an age that is younger, than their actual age. As predicted by the model of subjective age as an adaptive strategy, feeling younger was related to a lower risk of MDE and a higher risk of FMH. However, wanting to be younger was related to a lower risk of FMH and unrelated to MDE. PMID:21780972

  1. Migraine generator network and spreading depression dynamics as neuromodulation targets in episodic migraine

    NASA Astrophysics Data System (ADS)

    Dahlem, Markus A.

    2013-12-01

    Migraine is a common disabling headache disorder characterized by recurrent episodes sometimes preceded or accompanied by focal neurological symptoms called aura. The relation between two subtypes, migraine without aura (MWoA) and migraine with aura (MWA), is explored with the aim to identify targets for neuromodulation techniques. To this end, a dynamically regulated control system is schematically reduced to a network of the trigeminal nerve, which innervates the cranial circulation, an associated descending modulatory network of brainstem nuclei, and parasympathetic vasomotor efferents. This extends the idea of a migraine generator region in the brainstem to a larger network and is still simple and explicit enough to open up possibilities for mathematical modeling in the future. In this study, it is suggested that the migraine generator network (MGN) is driven and may therefore respond differently to different spatio-temporal noxious input in the migraine subtypes MWA and MWoA. The noxious input is caused by a cortical perturbation of homeostasis, known as spreading depression (SD). The MGN might even trigger SD in the first place by a failure in vasomotor control. As a consequence, migraine is considered as an inherently dynamical disease to which a linear course from upstream to downstream events would not do justice. Minimally invasive and noninvasive neuromodulation techniques are briefly reviewed and their rational is discussed in the context of the proposed mechanism.

  2. The role of adiposity in the relationship between serum leptin and severe major depressive episode.

    PubMed

    Ubani, Chinedu C; Zhang, Jian

    2015-08-30

    To assess the role that adiposity plays in the association between leptin and major depressive episode (MDE), we analyzed the data of 1046 men and 1359 women aged 20-39 years, who completed an interview and had blood collected as a part of the National Health and Nutrition Examination Survey (NHANES) between 1991 and 1994. Waist-hip ratio (WHR) was used as an indicator of adiposity. MDE was assessed with the Diagnostic Interview Schedule. For normal-WHR women, the prevalence of MDE was reversely associated with leptin levels, 13.7(4.4)%, 12.2(4.0)% and 2.3(1.8)% respectively for lower, interquartile, and upper quartile. For abnormal-WHR women, the prevalence of MDE was positively associated with leptin, 6.1(2.3)%, 9.1(2.4)% and 20.0 (3.8) respectively for the three leptin levels. Compared to women with lower quartile of leptin, the odds ratio of MDE for women with upper quartile was 0.09 (0.01-0.98) for normal-WHR women but 4.35 (1.55-12.2) for abnormal-WHR women. No moderating effects were observed among men. Using BMI in place of WHR revealed similar findings. The association between MDE and leptin is moderated by adiposity. High leptin levels are associated with low odds of MDE among women with normal adiposity but high odds among women with abnormal adiposity.

  3. No change in N-acetyl aspartate in first episode of moderate depression after antidepressant treatment: 1H magnetic spectroscopy study of left amygdala and left dorsolateral prefrontal cortex

    PubMed Central

    Bajs Janović, Maja; Kalember, Petra; Janović, Špiro; Hrabač, Pero; Folnegović Grošić, Petra; Grošić, Vladimir; Radoš, Marko; Henigsberg, Neven

    2014-01-01

    Background The role of brain metabolites as biological correlates of the intensity, symptoms, and course of major depression has not been determined. It has also been inconclusive whether the change in brain metabolites, measured with proton magnetic spectroscopy, could be correlated with the treatment outcome. Methods Proton magnetic spectroscopy was performed in 29 participants with a first episode of moderate depression occurring in the left dorsolateral prefrontal cortex and left amygdala at baseline and after 8 weeks of antidepressant treatment with escitalopram. The Montgomery-Asberg Depression Rating Scale, the Hamilton Rating Scale for Depression, and the Beck Depression Inventory were used to assess the intensity of depression at baseline and at the endpoint of the study. At endpoint, the participants were identified as responders (n=17) or nonresponders (n=12) to the antidepressant therapy. Results There was no significant change in the N-acetyl aspartate/creatine ratio (NAA/Cr) after treatment with antidepressant medication. The baseline and endpoint NAA/Cr ratios were not significantly different between the responder and nonresponder groups. The correlation between NAA/Cr and changes in the scores of clinical scales were not significant in either group. Conclusion This study could not confirm any significant changes in NAA after antidepressant treatment in the first episode of moderate depression, or in regard to therapy response in the left dorsolateral prefrontal cortex or left amygdala. Further research is necessary to conclude whether NAA alterations in the first episode of depression could possibly be different from chronic or late-onset depression, and whether NAA alterations in stress-induced (reactive) depression are different from endogenous depression. The potential role of NAA as a biomarker of a treatment effect has yet to be established. PMID:25278754

  4. Episodic acidification of streams in the northeastern United States: Chemical and biological results of the episodic response project. Final report

    SciTech Connect

    Wigington, P.J.; Baker, J.P.; DeWalle, D.R.; Kretser, W.A.; Murdoch, P.S.

    1993-10-01

    The document is the result of a cooperative research effort involving scientists from several agencies as part of the Aquatic Effects Research Program (AERP) of the U.S. Environmental Protection Agency (EPA). The Episodic Response Project (ERP) is an intensive study conducted at a limited number of sites, rather than an extensive regional study. The three areas targeted by the ERP are the Northern Appalachian Plateau of Pennsylvania, and the Adirondack and Catskill Mountains of New York. Each stream was monitored from fall 1988 through spring 1990, with continuous measurement of discharge and automated water sampling at fixed time intervals or at specified stage level changes. The water samples underwent chemical analysis for acid neutralizing capacity (ANC), pH, total dissolved aluminum, dissolved organic carbon (DOC), sulfate, nitrate, chloride, calcium, magnesium, potassium, and sodium. Furthermore, a subset of samples were analyzed for inorganic aluminum. Specific streams, participating institutions and cooperators, methods, and results are presented in the report.

  5. A double-blind comparison of tianeptine, imipramine and placebo in the treatment of major depressive episodes.

    PubMed

    Cassano, G B; Heinze, G; Lôo, H; Mendlewicz, J; Sousa, M P

    1996-01-01

    In the course of the international development of tianeptine (T), depressed patients were recruited by 18 centres from Belgium, Italy, Mexico, Portugal, Spain and Switzerland in a double-blind parallel group study versus placebo (P) and imipramine (I). Efficacy and safety of tianeptine were evaluated in 187 depressed inpatients (56% female, 44% male), who fulfilled criteria for either major depression, single episode (24.6%) or recurrent (66.8%), or depressed bipolar disorder (8.6%). After a seven-day run-in placebo pre-inclusion period, patients were treated in double-blind conditions with tianeptine (37.5 mg/d) or imipramine (150 mg/d) or placebo for 14 days, including an increasing daily dose period of three days. After the fourteenth day and until the end of the sixth week of treatment, a flexible dosage was introduced in accordance with the therapeutic efficacy and/or the potential adverse events (T: 25-50 mg/d; I: 100-200 mg/d; P; 2-4 capsules). Discontinuation of treatment occurred in 57 patients (30.5%) with more inefficacy on placebo and tianeptine (P: 16/23; T: 11/17; I: 7/17), and more side-effects on imipramine (P: 1/23; T: 1/17; I: 7/17). Final MADRS scores in intention-to-treat analysis were 22.3 +/- 1.5, 17.3 +/- 1.6 and 18.4 +/- 1.5 for placebo, tianeptine and imipramine, respectively. Statistical analysis demonstrated the antidepressive efficacy of tianeptine and imipramine versus placebo (P = 0.012 and P = 0.034, respectively), and no difference between tianeptine and imipramine. In patients treated for 42 days (n = 129) the MADRS scores dropped from 62.3% on tianeptine, 54.2% on imipramine and 48.5% on placebo. These results confirmed the efficacy of tianeptine (37.5 mg/d) in the treatment of major depression and depressed bipolar disorder when compared to placebo. No difference was found between tianeptine and imipramine (150 mg/d) for the efficacy and between tianeptine and placebo for all safety criteria. The following adverse events were

  6. Associations Between Compulsive Buying and Substance Dependence/Abuse, Major Depressive Episode, and Generalized Anxiety Disorder Among Men and Women

    PubMed Central

    Zhang, Chenshu; Brook, Judith S.; Leukefeld, Carl G.; Brook, David W.

    2016-01-01

    Aims The objective of this study was to examine the associations between compulsive buying (CB) and substance dependence/abuse, major depressive episode (MDE), and generalized anxiety disorder (GAD) at mean age 43. Methods Participants came from a community-based random sample of residents in two New York counties (N=548). The participants were followed from adolescence to early midlife. The mean age of participants at the most recent interview was 43.0 (SD=2.8). Fifty five percent of the participants were females. Over 90% of the participants were white. The prevalence of substance dependence/abuse, MDE, and GAD (during the past 5 years before the interviews) was 6.6%, 13.7, and 11.5%, respectively. Results Logistic regression analyses showed that CB was significantly associated with substance dependence/abuse [Adjusted Odds Ratio (A.O.R.) = 1.60], MDE (A.O.R. = 1.70), and GAD (A.O.R. = 1.63), despite controlling for substance dependence/abuse, MDE, and GAD, respectively, at mean age 37, and demographic factors. Discussion Since the study sample is limited to predominantly white participants (over 90%) with a close association to a small geographic area, the findings may not be generalizable to racial/ethnic minority groups or individuals living in other parts of the country. Nevertheless, it is important that clinicians treating substance dependence/abuse, MDE, and GAD consider the role of CB. PMID:27215919

  7. Modeling neural immune signaling of episodic and chronic migraine using spreading depression in vitro.

    PubMed

    Pusic, Aya D; Grinberg, Yelena Y; Mitchell, Heidi M; Kraig, Richard P

    2011-06-13

    Migraine and its transformation to chronic migraine are healthcare burdens in need of improved treatment options. We seek to define how neural immune signaling modulates the susceptibility to migraine, modeled in vitro using spreading depression (SD), as a means to develop novel therapeutic targets for episodic and chronic migraine. SD is the likely cause of migraine aura and migraine pain. It is a paroxysmal loss of neuronal function triggered by initially increased neuronal activity, which slowly propagates within susceptible brain regions. Normal brain function is exquisitely sensitive to, and relies on, coincident low-level immune signaling. Thus, neural immune signaling likely affects electrical activity of SD, and therefore migraine. Pain perception studies of SD in whole animals are fraught with difficulties, but whole animals are well suited to examine systems biology aspects of migraine since SD activates trigeminal nociceptive pathways. However, whole animal studies alone cannot be used to decipher the cellular and neural circuit mechanisms of SD. Instead, in vitro preparations where environmental conditions can be controlled are necessary. Here, it is important to recognize limitations of acute slices and distinct advantages of hippocampal slice cultures. Acute brain slices cannot reveal subtle changes in immune signaling since preparing the slices alone triggers: pro-inflammatory changes that last days, epileptiform behavior due to high levels of oxygen tension needed to vitalize the slices, and irreversible cell injury at anoxic slice centers. In contrast, we examine immune signaling in mature hippocampal slice cultures since the cultures closely parallel their in vivo counterpart with mature trisynaptic function; show quiescent astrocytes, microglia, and cytokine levels; and SD is easily induced in an unanesthetized preparation. Furthermore, the slices are long-lived and SD can be induced on consecutive days without injury, making this preparation the

  8. Modeling Neural Immune Signaling of Episodic and Chronic Migraine Using Spreading Depression In Vitro

    PubMed Central

    Mitchell, Heidi M.; Kraig, Richard P.

    2011-01-01

    Migraine and its transformation to chronic migraine are healthcare burdens in need of improved treatment options. We seek to define how neural immune signaling modulates the susceptibility to migraine, modeled in vitro using spreading depression (SD), as a means to develop novel therapeutic targets for episodic and chronic migraine. SD is the likely cause of migraine aura and migraine pain. It is a paroxysmal loss of neuronal function triggered by initially increased neuronal activity, which slowly propagates within susceptible brain regions. Normal brain function is exquisitely sensitive to, and relies on, coincident low-level immune signaling. Thus, neural immune signaling likely affects electrical activity of SD, and therefore migraine. Pain perception studies of SD in whole animals are fraught with difficulties, but whole animals are well suited to examine systems biology aspects of migraine since SD activates trigeminal nociceptive pathways. However, whole animal studies alone cannot be used to decipher the cellular and neural circuit mechanisms of SD. Instead, in vitro preparations where environmental conditions can be controlled are necessary. Here, it is important to recognize limitations of acute slices and distinct advantages of hippocampal slice cultures. Acute brain slices cannot reveal subtle changes in immune signaling since preparing the slices alone triggers: pro-inflammatory changes that last days, epileptiform behavior due to high levels of oxygen tension needed to vitalize the slices, and irreversible cell injury at anoxic slice centers. In contrast, we examine immune signaling in mature hippocampal slice cultures since the cultures closely parallel their in vivo counterpart with mature trisynaptic function; show quiescent astrocytes, microglia, and cytokine levels; and SD is easily induced in an unanesthetized preparation. Furthermore, the slices are long-lived and SD can be induced on consecutive days without injury, making this preparation the

  9. Episode-Based Evolution Pattern Analysis of Haze Pollution: Method Development and Results from Beijing, China.

    PubMed

    Zheng, Guangjie; Duan, Fengkui; Ma, Yongliang; Zhang, Qiang; Huang, Tao; Kimoto, Takashi; Cheng, Yafang; Su, Hang; He, Kebin

    2016-05-01

    Haze episodes occurred in Beijing repeatedly in 2013, resulting in 189 polluted days. These episodes differed in terms of sources, formation processes, and chemical composition and thus required different control policies. Therefore, an overview of the similarities and differences among these episodes is needed. For this purpose, we conducted one-year online observations and developed a program that can simultaneously divide haze episodes and identify their shapes. A total of 73 episodes were identified, and their shapes were linked with synoptic conditions. Pure-haze events dominated in wintertime, whereas mixed haze-dust (PM2.5/PM10 < 60%) and mixed haze-fog (Aerosol Water/PM2.5 ∼ 0.3) events dominated in spring and summer-autumn, respectively. For all types, increase of ratio of PM2.5 in PM10 was typically achieved before PM2.5 reached ∼150 μg/m(3). In all PM2.5 species observed, organic matter (OM) was always the most abundant component (18-60%), but it was rarely the driving factor: its relative contribution usually decreased as the pollution level increased. The only OM-driven episode observed was associated with intensive biomass-burning activities. In comparison, haze evolution generally coincided with increasing sulfur and nitrogen oxidation ratios (SOR and NOR), indicating the enhanced production of secondary inorganic species. Applicability of these conclusions required further tests with simultaneously multisite observations.

  10. Mindfulness-Based Interventions for People Diagnosed with a Current Episode of an Anxiety or Depressive Disorder: A Meta-Analysis of Randomised Controlled Trials

    PubMed Central

    Strauss, Clara; Cavanagh, Kate; Oliver, Annie; Pettman, Danelle

    2014-01-01

    Objective Mindfulness-based interventions (MBIs) can reduce risk of depressive relapse for people with a history of recurrent depression who are currently well. However, the cognitive, affective and motivational features of depression and anxiety might render MBIs ineffective for people experiencing current symptoms. This paper presents a meta-analysis of randomised controlled trials (RCTs) of MBIs where participants met diagnostic criteria for a current episode of an anxiety or depressive disorder. Method Post-intervention between-group Hedges g effect sizes were calculated using a random effects model. Moderator analyses of primary diagnosis, intervention type and control condition were conducted and publication bias was assessed. Results Twelve studies met inclusion criteria (n = 578). There were significant post-intervention between-group benefits of MBIs relative to control conditions on primary symptom severity (Hedges g = −0.59, 95% CI = −0.12 to −1.06). Effects were demonstrated for depressive symptom severity (Hedges g = −0.73, 95% CI = −0.09 to −1.36), but not for anxiety symptom severity (Hedges g = −0.55, 95% CI = 0.09 to −1.18), for RCTs with an inactive control (Hedges g = −1.03, 95% CI = −0.40 to −1.66), but not where there was an active control (Hedges g = 0.03, 95% CI = 0.54 to −0.48) and effects were found for MBCT (Hedges g = −0.39, 95% CI = −0.15 to −0.63) but not for MBSR (Hedges g = −0.75, 95% CI = 0.31 to −1.81). Conclusions This is the first meta-analysis of RCTs of MBIs where all studies included only participants who were diagnosed with a current episode of a depressive or anxiety disorder. Effects of MBIs on primary symptom severity were found for people with a current depressive disorder and it is recommended that MBIs might be considered as an intervention for this population. PMID:24763812

  11. Chronic and episodic interpersonal stress as statistically unique predictors of depression in two samples of emerging adults.

    PubMed

    Vrshek-Schallhorn, Suzanne; Stroud, Catherine B; Mineka, Susan; Hammen, Constance; Zinbarg, Richard E; Wolitzky-Taylor, Kate; Craske, Michelle G

    2015-11-01

    Few studies comprehensively evaluate which types of life stress are most strongly associated with depressive episode onsets, over and above other forms of stress, and comparisons between acute and chronic stress are particularly lacking. Past research implicates major (moderate to severe) stressful life events (SLEs), and to a lesser extent, interpersonal forms of stress; research conflicts on whether dependent or independent SLEs are more potent, but theory favors dependent SLEs. The present study used 5 years of annual diagnostic and life stress interviews of chronic stress and SLEs from 2 separate samples (Sample 1 N = 432; Sample 2 N = 146) transitioning into emerging adulthood; 1 sample also collected early adversity interviews. Multivariate analyses simultaneously examined multiple forms of life stress to test hypotheses that all major SLEs, then particularly interpersonal forms of stress, and then dependent SLEs would contribute unique variance to major depressive episode (MDE) onsets. Person-month survival analysis consistently implicated chronic interpersonal stress and major interpersonal SLEs as statistically unique predictors of risk for MDE onset. In addition, follow-up analyses demonstrated temporal precedence for chronic stress; tested differences by gender; showed that recent chronic stress mediates the relationship between adolescent adversity and later MDE onsets; and revealed interactions of several forms of stress with socioeconomic status (SES). Specifically, as SES declined, there was an increasing role for noninterpersonal chronic stress and noninterpersonal major SLEs, coupled with a decreasing role for interpersonal chronic stress. Implications for future etiological research were discussed.

  12. Chronic and Episodic Interpersonal Stress as Statistically Unique Predictors of Depression in Two Samples of Emerging Adults

    PubMed Central

    Vrshek-Schallhorn, Suzanne; Stroud, Catherine B.; Mineka, Susan; Hammen, Constance; Zinbarg, Richard; Wolitzky-Taylor, Kate; Craske, Michelle G.

    2016-01-01

    Few studies comprehensively evaluate which types of life stress are most strongly associated with depressive episode onsets, over and above other forms of stress, and comparisons between acute and chronic stress are particularly lacking. Past research implicates major (moderate to severe) stressful life events (SLEs), and to a lesser extent, interpersonal forms of stress; research conflicts on whether dependent or independent SLEs are more potent, but theory favors dependent SLEs. The present study used five years of annual diagnostic and life stress interviews of chronic stress and SLEs from two separate samples (Sample 1 N = 432; Sample 2 N = 146) transitioning into emerging adulthood; one sample also collected early adversity interviews. Multivariate analyses simultaneously examined multiple forms of life stress to test hypotheses that all major SLEs, then particularly interpersonal forms of stress, and then dependent SLEs would contribute unique variance to major depressive episode (MDE) onsets. Person-month survival analysis consistently implicated chronic interpersonal stress and major interpersonal SLEs as statistically unique predictors of risk for MDE onset. In addition, follow-up analyses demonstrated temporal precedence for chronic stress; tested differences by gender; showed that recent chronic stress mediates the relationship between adolescent adversity and later MDE onsets; and revealed interactions of several forms of stress with socioeconomic status (SES). Specifically, as SES declined, there was an increasing role for non-interpersonal chronic stress and non-interpersonal major SLEs, coupled with a decreasing role for interpersonal chronic stress. Implications for future etiological research were discussed. PMID:26301973

  13. Neural state and trait bases of mood-incongruent memory formation and retrieval in first-episode major depression.

    PubMed

    van Wingen, Guido A; van Eijndhoven, Philip; Cremers, Henk R; Tendolkar, Indira; Verkes, Robbert Jan; Buitelaar, Jan K; Fernández, Guillén

    2010-06-01

    Mood-congruent cognitive biases constitute critical factors for the vulnerability to depression and its maintenance. One important aspect is impaired memory for positive information during depression and after recovery. To elucidate its state (during depression only) and trait (during depression and recovery) related neural bases, we investigated medication free depressed, recovered, and healthy individuals with functional MRI while they memorized and recognized happy and neutral face stimuli. The imaging results revealed group differences in mood-incongruent successful memory encoding and retrieval activity already in the absence of significant memory performance differences. State effects were observed in the amygdala and posterior cingulate cortex. Whereas the amygdala was generally involved in memory formation, its activity predicted subsequent forgetting of neutral faces in depressed patients. Furthermore, the amygdala and posterior cingulate cortex were involved in memory retrieval of happy faces in depressed patients only. Trait effects were observed in the fusiform gyrus and prefrontal cortex. The fusiform gyrus was involved in memory formation and retrieval of happy faces in both patient groups, whereas it was involved in memory formation and retrieval of neutral faces in healthy individuals. Similar trait effects were observed during memory retrieval in the orbitofrontal cortex and left inferior frontal gyrus. Thus, while memory processing of positive information in the amygdala and posterior cingulate cortex is biased during depression only, memory processing in the fusiform gyrus and prefrontal cortex is biased also after recovery. These distinct neural mechanisms may respectively constitute symptom maintenance and cognitive vulnerability factors for depression.

  14. Comparison of plasma MicroRNA levels in drug naive, first episode depressed patients and healthy controls.

    PubMed

    Camkurt, Mehmet Akif; Acar, Şenel; Coşkun, Salih; Güneş, Mehmet; Güneş, Serkan; Yılmaz, Mehmet Fatih; Görür, Ayşegül; Tamer, Lülüfer

    2015-10-01

    Major depression is the most common psychiatric disorder. The diagnosis of depression depends on a patient's subjective complaints, and the nature of the heterogeneous disorder. Thus, there is no known biomarker for depression to date. Previous research has indicated that microRNAs are dysregulated in bipolar disorder and schizophrenia. We aimed to investigate microRNA dysregulation in plasma samples of patients with major depression. Venous blood samples of 50 depressed patients and 41 healthy controls were collected and the quantification of microRNAs was established using qRT-PCR. We found miR-320a significantly downregulated and miR-451a significantly upregulated in depressed patients. We also found miR-17-5p and miR-223-3p upregulated, but not as significantly as miR-451a. Merging our results with previous published data shows that the blood miR-320 family may be a potential microRNA family dysregulated in major depression. Research should be performed on miR-320-related pathways and their relationship to depression. Additionally, miR-451a could serve as a candidate biomarker for depression based on the acting mechanism of ketamine. Studies targeting miR-451a levels before and after treatment could be helpful. PMID:26343596

  15. Vulnerability for new episodes in recurrent major depressive disorder: protocol for the longitudinal DELTA-neuroimaging cohort study

    PubMed Central

    Mocking, Roel J T; Figueroa, Caroline A; Rive, Maria M; Geugies, Hanneke; Servaas, Michelle N; Assies, Johanna; Koeter, Maarten W J; Vaz, Frédéric M; Wichers, Marieke; van Straalen, Jan P; de Raedt, Rudi; Bockting, Claudi L H; Harmer, Catherine J; Schene, Aart H; Ruhé, Henricus G

    2016-01-01

    Introduction Major depressive disorder (MDD) is widely prevalent and severely disabling, mainly due to its recurrent nature. A better understanding of the mechanisms underlying MDD-recurrence may help to identify high-risk patients and to improve the preventive treatment they need. MDD-recurrence has been considered from various levels of perspective including symptomatology, affective neuropsychology, brain circuitry and endocrinology/metabolism. However, MDD-recurrence understanding is limited, because these perspectives have been studied mainly in isolation, cross-sectionally in depressed patients. Therefore, we aim at improving MDD-recurrence understanding by studying these four selected perspectives in combination and prospectively during remission. Methods and analysis In a cohort design, we will include 60 remitted, unipolar, unmedicated, recurrent MDD-participants (35–65 years) with ≥2 MDD-episodes. At baseline, we will compare the MDD-participants with 40 matched controls. Subsequently, we will follow-up the MDD-participants for 2.5 years while monitoring recurrences. We will invite participants with a recurrence to repeat baseline measurements, together with matched remitted MDD-participants. Measurements include questionnaires, sad mood-induction, lifestyle/diet, 3 T structural (T1-weighted and diffusion tensor imaging) and blood-oxygen-level-dependent functional MRI (fMRI) and MR-spectroscopy. fMRI focusses on resting state, reward/aversive-related learning and emotion regulation. With affective neuropsychological tasks we will test emotional processing. Moreover, we will assess endocrinology (salivary hypothalamic-pituitary-adrenal-axis cortisol and dehydroepiandrosterone-sulfate) and metabolism (metabolomics including polyunsaturated fatty acids), and store blood for, for example, inflammation analyses, genomics and proteomics. Finally, we will perform repeated momentary daily assessments using experience sampling methods at baseline. We

  16. Rumination as a Vulnerability Factor to Depression in Adolescents in Mainland China: Lifetime History of Clinically Significant Depressive Episodes

    ERIC Educational Resources Information Center

    Hong, Wei; Abela, John R. Z.; Cohen, Joseph R.; Sheshko, Dana M.; Shi, Xiao Ting; Hamel, Anton Van; Starrs, Claire

    2010-01-01

    The current study tested the vulnerability and sex differences hypotheses of the response styles theory of depression (Nolen-Hoeksema, 1991). Participants included 494 tenth-grade students (M = 15.25 years, SD = 0.47) recruited from two secondary schools in Beijing, China. Participants completed self-report measures assessing rumination and…

  17. The effects of mindfulness-based cognitive therapy on recurrence of depressive episodes, mental health and quality of life: A randomized controlled study.

    PubMed

    Godfrin, K A; van Heeringen, C

    2010-08-01

    Depression is characterized by a large risk of relapse/recurrence. Mindfulness-based cognitive therapy (MBCT) is a recent non-drug psychotherapeutic intervention to prevent future depressive relapse/recurrence in remitted/recovered depressed patients. In this randomized controlled trial, the authors investigated the effects of MBCT on the relapse in depression and the time to first relapse since study participation, as well as on several mood states and the quality of life of the patients. 106 recovered depressed patients with a history of at least 3 depressive episodes continued either with their treatment as usual (TAU) or received MBCT in addition to TAU. The efficacy of MBCT was assessed over a study period of 56 weeks. At the end of the study period relapse/recurrence was significantly reduced and the time until first relapse increased in the MBCT plus TAU condition in comparison with TAU alone. The MBCT plus TAU group also showed a significant reduction in both short and longer-term depressive mood and better mood states and quality of the life. For patients with a history of at least three depressive episodes who are not acutely depressed, MBCT, added to TAU, may play an important role in the domain of relapse prevention in depression.

  18. Criticism and Depression among the Caregivers of At-Risk Mental State and First-Episode Psychosis Patients.

    PubMed

    Hamaie, Yumiko; Ohmuro, Noriyuki; Katsura, Masahiro; Obara, Chika; Kikuchi, Tatsuo; Ito, Fumiaki; Miyakoshi, Tetsuo; Matsuoka, Hiroo; Matsumoto, Kazunori

    2016-01-01

    Expressed emotion (EE), especially criticism, is an important predictor of outcomes for the patient for a wide range of mental health problems. To understand complex links between EE and various relevant variables in early phase psychosis, this study examined criticism, distress of caregivers, other patients', and caregivers' variables, and links between criticism and these variables in those with at-risk mental state (ARMS) for psychosis and first-episode psychosis (FEP). The participants were 56 patients (mean age 18.8 ± 4.2 years) with ARMS and their caregivers (49.4 ± 5.8 years) and 43 patients (21.7 ± 5.2 years) with FEP and their caregivers (49.3 ± 7.4 years). We investigated criticisms made by caregivers using the Japanese version of the Family Attitude Scale and caregiver depressive symptoms via the self-report Beck Depression Inventory. We also assessed psychiatric symptoms and functioning of the patients. Approximately one-third of caregivers of patients with ARMS or FEP had depressive symptoms, predominately with mild-to-moderate symptom levels, whereas only a small portion exhibited high criticism. The level of criticism and depression were comparable between ARMS and FEP caregivers. The link between criticism, caregivers' depression, and patients' symptoms were observed in FEP but not in ARMS caregivers. These findings imply that the interaction between criticism and caregivers' and patients' mental states may develop during or after the onset of established psychosis and interventions for the caregivers should be tailored to the patient's specific stage of illness. Interventions for FEP caregivers should target their emotional distress and include education about patient's general symptoms. PMID:26918629

  19. Compensatory cognitive training for people with first-episode schizophrenia: results from a pilot randomized controlled trial.

    PubMed

    Mendella, Paul D; Burton, Cynthia Z; Tasca, Giorgio A; Roy, Paul; St Louis, Lea; Twamley, Elizabeth W

    2015-03-01

    Cognitive training or remediation now has multiple studies and meta-analyses supporting its efficacy in improving cognition and functioning in people with schizophrenia. However, relatively little is known about cognitive training outcomes in early psychosis. We conducted a pilot randomized controlled trial of Compensatory Cognitive Training (CCT) compared to Treatment as Usual (TAU) in 27 participants with first-episode psychosis who had received treatment for psychosis for less than six months. Assessments of cognition (MATRICS Consensus Cognitive Battery; MCCB) and functional capacity (UCSD Performance-Based Skills Assessment-Brief; UPSA-B) were administered at baseline and following the 12-week treatment. The CCT condition, compared to TAU, was associated with significant improvements on the MCCB composite score, as well as MCCB subtests measuring processing speed (Trail Making) and social cognition (Mayer-Salovey-Caruso Emotional Intelligence Test), with large effects on these three outcome measures. There were no significant CCT-associated effects on the UPSA-B or on positive, negative, or depressive symptoms. CCT treatment of cognitive impairments in first-episode schizophrenia is feasible and can result in large effect size improvements in global cognition, processing speed, and social cognition. PMID:25631454

  20. Authoritarian parenting and youth depression: Results from a national study.

    PubMed

    King, Keith A; Vidourek, Rebecca A; Merianos, Ashley L

    2016-01-01

    Depression is a prevalent illness affecting youth across the nation. The study purpose was to examine depression and authoritarian parenting among youth from 12 to 17 years of age. A secondary data analysis of the National Survey on Drug Use and Health was performed in the present study. All participants in the present study were youth (N = 17,399) nationwide. The results revealed that 80.6% of youth participants reported having five or more depressive symptoms. Parenting styles based on depression significantly differed among males, females, 12-13-year-olds, 14-15-year-olds, and 16-17-year-olds. Specifically, those who reported experiencing authoritarian parenting practices were more likely to report depressive symptoms compared to their counterparts who experienced authoritative parenting practices. Emphasizing the role of the parents and teaching positive parenting practices and authoritative parenting styles may increase success of prevention programs.

  1. Authoritarian parenting and youth depression: Results from a national study.

    PubMed

    King, Keith A; Vidourek, Rebecca A; Merianos, Ashley L

    2016-01-01

    Depression is a prevalent illness affecting youth across the nation. The study purpose was to examine depression and authoritarian parenting among youth from 12 to 17 years of age. A secondary data analysis of the National Survey on Drug Use and Health was performed in the present study. All participants in the present study were youth (N = 17,399) nationwide. The results revealed that 80.6% of youth participants reported having five or more depressive symptoms. Parenting styles based on depression significantly differed among males, females, 12-13-year-olds, 14-15-year-olds, and 16-17-year-olds. Specifically, those who reported experiencing authoritarian parenting practices were more likely to report depressive symptoms compared to their counterparts who experienced authoritative parenting practices. Emphasizing the role of the parents and teaching positive parenting practices and authoritative parenting styles may increase success of prevention programs. PMID:26939843

  2. Early maladaptive schema-related impairment and co-occurring current major depressive episode-related enhancement of mental state decoding ability in borderline personality disorder.

    PubMed

    Unoka, Zsolt Szabolcs; Fogd, Dóra; Seres, Imola; Kéri, Szabolcs; Csukly, Gábor

    2015-04-01

    Disturbed interpersonal relationships specific to borderline personality disorder (BPD) suggest biased processing of social information. The goal of this study was to examine alterations in mental state decoding (MSD) and their associations with early maladaptive schemas (EMS) that may lead to the misinterpretation of incoming information. In addition, the authors' aim was to evaluate the effects of a co-occurring current major depressive episode (MDE) on the MSD performance of BPD patients. Seventy-eight BPD patients (34 with MDE) and 76 matched healthy controls (HC) were assessed for Reading the Mind in the Eyes Test (RMET) and the level of EMS. The authors found that impairment in the total RMET performance, as well as specific impairment regarding the recognition of positive and neutral items, was associated with EMS, and enhanced vigilance to negative mental states was characteristic to BPD with MDE. Results suggest that MSD ability is altered in two independent ways in BPD. PMID:24932871

  3. Early maladaptive schema-related impairment and co-occurring current major depressive episode-related enhancement of mental state decoding ability in borderline personality disorder.

    PubMed

    Unoka, Zsolt Szabolcs; Fogd, Dóra; Seres, Imola; Kéri, Szabolcs; Csukly, Gábor

    2015-04-01

    Disturbed interpersonal relationships specific to borderline personality disorder (BPD) suggest biased processing of social information. The goal of this study was to examine alterations in mental state decoding (MSD) and their associations with early maladaptive schemas (EMS) that may lead to the misinterpretation of incoming information. In addition, the authors' aim was to evaluate the effects of a co-occurring current major depressive episode (MDE) on the MSD performance of BPD patients. Seventy-eight BPD patients (34 with MDE) and 76 matched healthy controls (HC) were assessed for Reading the Mind in the Eyes Test (RMET) and the level of EMS. The authors found that impairment in the total RMET performance, as well as specific impairment regarding the recognition of positive and neutral items, was associated with EMS, and enhanced vigilance to negative mental states was characteristic to BPD with MDE. Results suggest that MSD ability is altered in two independent ways in BPD.

  4. Insomnia brings soldiers into mental health treatment, predicts treatment engagement, and outperforms other suicide-related symptoms as a predictor of major depressive episodes.

    PubMed

    Hom, Melanie A; Lim, Ingrid C; Stanley, Ian H; Chiurliza, Bruno; Podlogar, Matthew C; Michaels, Matthew S; Buchman-Schmitt, Jennifer M; Silva, Caroline; Ribeiro, Jessica D; Joiner, Thomas E

    2016-08-01

    Given the high rates of suicide among military personnel and the need to characterize suicide risk factors associated with mental health service use, this study aimed to identify suicide-relevant factors that predict: (1) treatment engagement and treatment adherence, and (2) suicide attempts, suicidal ideation, and major depressive episodes in a military sample. Army recruiters (N = 2596) completed a battery of self-report measures upon study enrollment. Eighteen months later, information regarding suicide attempts, suicidal ideation, major depressive episodes, and mental health visits were obtained from participants' military medical records. Suicide attempts and suicidal ideation were very rare in this sample; negative binomial regression analyses with robust estimation were used to assess correlates and predictors of mental health treatment visits and major depressive episodes. More severe insomnia and agitation were significantly associated with mental health visits at baseline and over the 18-month study period. In contrast, suicide-specific hopelessness was significantly associated with fewer mental health visits. Insomnia severity was the only significant predictor of major depressive episodes. Findings suggest that assessment of sleep problems might be useful in identifying at-risk military service members who may engage in mental health treatment. Additional research is warranted to examine the predictive validity of these suicide-related symptom measures in a more representative, higher suicide risk military sample. PMID:27218816

  5. Disrupted Structural and Functional Connectivity in Prefrontal-Hippocampus Circuitry in First-Episode Medication-Naïve Adolescent Depression

    PubMed Central

    Geng, Haiyang; Wu, Feng; Kong, Lingtao; Tang, Yanqing; Zhou, Qian; Chang, Miao; Zhou, Yifang; Jiang, Xiaowei; Li, Songbai; Wang, Fei

    2016-01-01

    Background Evidence implicates abnormalities in prefrontal-hippocampus neural circuitry in major depressive disorder (MDD). This study investigates the potential disruptions in prefrontal-hippocampus structural and functional connectivity, as well as their relationship in first-episode medication-naïve adolescents with MDD in order to investigate the early stage of the illness without confounds of illness course and medication exposure. Methods Diffusion tensor imaging and resting-state functional magnetic resonance imaging (rs-fMRI) data were acquired from 26 first-episode medication-naïve MDD adolescents and 31 healthy controls (HC). Fractional anisotropy (FA) values of the fornix and the prefrontal-hippocampus functional connectivity was compared between MDD and HC groups. The correlation between the FA value of fornix and the strength of the functional connectivity in the prefrontal cortex (PFC) region showing significant differences between the two groups was identified. Results Compared with the HC group, adolescent MDD group had significant lower FA values in the fornix, as well as decreased functional connectivity in four PFC regions. Significant negative correlations were observed between fornix FA values and functional connectivity from hippocampus to PFC within the HC group. There was no significant correlation between the fornix FA and the strength of functional connectivity within the adolescent MDD group. Conclusions First-episode medication-naïve adolescent MDD showed decreased structural and functional connectivity as well as deficits of the association between structural and functional connectivity shown in HC in the PFC-hippocampus neural circuitry. These findings suggest that abnormal PFC-hippocampus neural circuitry may present in the early onset of MDD and play an important role in the neuropathophysiology of MDD. PMID:26863301

  6. Misdiagnosed Hypomanic Symptoms in Patients with Treatment-Resistant Major Depressive Disorder in Italy: Results from the Improve Study

    PubMed Central

    Francesca, Moro Maria; Efisia, Lecca Maria; Alessandra, Ghillani M.; Marianna, Alacqua; Giovanni, Carta Mauro

    2014-01-01

    Background:Undiagnosed and therefore inadequately treated hypomanic symptoms may be a leading cause of drug resistance in depression diagnosed as unipolar (major depressive disorder, MDD). The purpose of the IMPROVE study was to identify the rate of misdiagnoses in patients with treatment-resistant MDD by screening for the presence of previous hypomanic episodes, and to study the characteristics of those patients with a positive history of hypomania. Methods:Patients attending 29 psychiatric units throughout Italy with a diagnosis of MDD who were resistant to anti-depressant treatment were included in this multicentre, observational single visit study. The Hypomania Checklist 32 (HCL-32) was administered to detect underlying bipolarity. Results: Among the 466 enrolled patients, 256 (57.40%) were positive at screening for a previous hypomanic episode (HCL-32 ≥12), therefore suggesting a misdiagnosis. These patients scored higher than those with a negative history in both the “active/elated hypomania” (11.27±3.11 vs 3.57±3.05; P<0.0001) and “irritable/risk-taking hypomania” (2.87±2.03 vs 2.06±1.73; P<0.001) HCL-32 sub-scales. Patients with a positive history of hypomania were younger, had a higher number of previous depressive episodes and a higher frequency of comorbid conditions compared to those with a negative history. Conclusions:This study suggests that screening for hypomania in MDD-resistant patients facilitates identification of a notable proportion of undiagnosed cases of bipolar spectrum disorder. Patients with a positive history of hypomania at screening had a demographic/clinical bipolar-like profile that included young age, higher number of previous depressive episodes and higher frequency of comorbid conditions. They also had both higher active and irritable hypomania symptom scores. PMID:24761153

  7. Ten-year outcomes in first episode psychotic major depression patients compared with schizophrenia and bipolar patients.

    PubMed

    Heslin, M; Lappin, J M; Donoghue, K; Lomas, B; Reininghaus, U; Onyejiaka, A; Croudace, T; Jones, P B; Murray, R M; Fearon, P; Doody, G A; Dazzan, P; Craig, T J; Morgan, C

    2016-10-01

    We aimed to investigate long-term outcomes in psychotic major depression patients compared to schizophrenia and bipolar/manic psychosis patients, in an incidence sample, while accounting for diagnostic change. Based on Aetiology and Ethnicity in Schizophrenia and Other Psychoses (ÆSOP and ÆSOP-10), a first episode psychosis cohort was followed-up 10years after first presentation. The Schedules for Clinical Assessment in Neuropsychiatry, WHO Life Chart and Global Assessment of Functioning were used to assess clinical, social and service use outcomes. Seventy-two PMD patients, 218 schizophrenia patients and 70 psychotic bipolar disorder/mania patients were identified at baseline. Differences in outcome between PMD and bipolar patients based on baseline and lifetime diagnosis were minimal. Differences in clinical, social and service use outcomes between PMD and schizophrenia were more substantial with PMD patients showing better outcomes on most variables. However, there was some weak evidence (albeit not quite statistically significant at p<0.05) based on lifetime diagnoses that PMD patients were more likely to attempt suicide (OR 2.31, CI 0.98-5.42, p0.055) and self-harm (OR 2.34, CI 0.97-5.68, p0.060). PMD patients have better social and service use outcomes compared to people with schizophrenia, but may be more likely to attempt suicide or self-harm. This unique profile is important for clinicians to consider in any risk assessment.

  8. Disrupted causal connectivity anchored on the anterior cingulate cortex in first-episode medication-naive major depressive disorder.

    PubMed

    Feng, Zhan; Xu, Shunliang; Huang, Manli; Shi, Yushu; Xiong, Bing; Yang, Hong

    2016-01-01

    In recent years, major depressive disorder (MDD) has been demonstrated to be associated with abnormalities in neural networks, particularly the prefrontal-limbic network (PLN). However, there are few current studies that have examined information flow in the PLN. In this study, Granger causality analysis (GCA), based on signed regression coefficient, was used to explore changes in causal connectivity in resting-state PLNs of MDD patients. A total of 23 first-episode medication-naïve MDD patients and 20 normal control participants were subjected to resting-state functional magnetic resonance imaging (RS-fMRI) scans. Increased causal effects of the right insular cortex, right putamen and right caudate on the rostral anterior cingulate cortex (rACC) and reduced causal effects of bilateral dorsolateral prefrontal cortex (DLPFC) and left orbitofrontal cortex (OFC) on the rACC were found in MDD patients compared to normal controls. The extensive reduction in the causal effect of the prefrontal cortex (PFC) demonstrates impaired top-down cognitive control in MDD patients. Changes in the causal relationship between the right insula and rACC suggest problems in coordination of the default mode network by the right anterior insular cortex (rAI). These findings provide valuable insight into MDD-related neural network disorders reported in previous RS-fMRI studies and may potentially guide clinical treatment of MDD in the future. PMID:26234517

  9. Gender Differences in Depressive Symptom Profile: Results from Nationwide General Population Surveys in Korea.

    PubMed

    Kim, Ji-Hyun; Cho, Maeng Je; Hong, Jin Pyo; Bae, Jae Nam; Cho, Seong-Jin; Hahm, Bong-Jin; Lee, Dong-Woo; Park, Jong-Ik; Lee, Jun-Young; Jeon, Hong Jin; Chang, Sung Man

    2015-11-01

    This study investigated gender differences in symptom profiles of major depressive disorder (MDD) in the Korean general population. Data were pooled from the series of nationwide Korean Epidemiologic Catchment Area surveys conducted in 2001, 2006 and 2011, respectively. Of the 18,807 participants, 507 (397 women and 110 men) were diagnosed with MDD within the prior 12 months. In agreement with previous studies, women with MDD appeared to be more vulnerable to experiencing atypical depressive episodes defined as depression with two or more symptoms of fatigue, increased appetite and hypersomnia (P < 0.001). In terms of individual symptoms, female gender was significantly related with higher prevalence of fatigue (P = 0.008), hypersomnia (P = 0.001), noticeable psychomotor retardation (P = 0.029) and suicidal attempts (P = 0.016) with adjustment for birth cohort effect, partner status, and employment status. In the same analysis, men with MDD appeared more vulnerable to decreased libido than women (P = 0.009). This is the first report to demonstrate gender differences in symptomatology of MDD in the general Korean population, and the results are comparable to previous investigations from western societies. Assumingly, the intercultural similarity in female preponderance to atypical depression might reflect the common biological construct underlying the gender difference in mechanism of MDD. In clinical settings, gender differences of MDD should be carefully considered, because these features could be related with treatment response and drug side effects. PMID:26539012

  10. Gender Differences in Depressive Symptom Profile: Results from Nationwide General Population Surveys in Korea.

    PubMed

    Kim, Ji-Hyun; Cho, Maeng Je; Hong, Jin Pyo; Bae, Jae Nam; Cho, Seong-Jin; Hahm, Bong-Jin; Lee, Dong-Woo; Park, Jong-Ik; Lee, Jun-Young; Jeon, Hong Jin; Chang, Sung Man

    2015-11-01

    This study investigated gender differences in symptom profiles of major depressive disorder (MDD) in the Korean general population. Data were pooled from the series of nationwide Korean Epidemiologic Catchment Area surveys conducted in 2001, 2006 and 2011, respectively. Of the 18,807 participants, 507 (397 women and 110 men) were diagnosed with MDD within the prior 12 months. In agreement with previous studies, women with MDD appeared to be more vulnerable to experiencing atypical depressive episodes defined as depression with two or more symptoms of fatigue, increased appetite and hypersomnia (P < 0.001). In terms of individual symptoms, female gender was significantly related with higher prevalence of fatigue (P = 0.008), hypersomnia (P = 0.001), noticeable psychomotor retardation (P = 0.029) and suicidal attempts (P = 0.016) with adjustment for birth cohort effect, partner status, and employment status. In the same analysis, men with MDD appeared more vulnerable to decreased libido than women (P = 0.009). This is the first report to demonstrate gender differences in symptomatology of MDD in the general Korean population, and the results are comparable to previous investigations from western societies. Assumingly, the intercultural similarity in female preponderance to atypical depression might reflect the common biological construct underlying the gender difference in mechanism of MDD. In clinical settings, gender differences of MDD should be carefully considered, because these features could be related with treatment response and drug side effects.

  11. Episodic acidification of small streams in the northeastern united states: ionic controls of episodes

    USGS Publications Warehouse

    Wigington, P.J.; DeWalle, David R.; Murdoch, Peter S.; Kretser, W.A.; Simonin, H.A.; Van Sickle, J.; Baker, J.P.

    1996-01-01

    As part of the Episodic Response Project (ERP), we intensively monitored discharge and stream chemistry of 13 streams located in the Northern Appalachian region of Pennsylvania and in the Catskill and Adirondack Mountains of New York from fall 1988 to spring 1990. The ERP clearly documented the occurrence of acidic episodes with minimum episodic pH ??? 5 and inorganic monomeric Al (Alim) concentrations >150 ??g/L in at least two study streams in each region. Several streams consistently experienced episodes with maximum Alim concentrations >350 ??g/L. Acid neutralizing capacity (ANC) depressions resulted from complex interactions of multiple ions. Base cation decreases often made the most important contributions to ANC depressions during episodes. Organic acid pulses were also important contributors to ANC depressions in the Adirondack streams, and to a lesser extent, in the Catskill and Pennsylvania streams. Nitrate concentrations were low in the Pennsylvania streams, whereas the Catskill and Adirondack study streams had high NO3- concentrations and large episodic pulses (???54 ??eq/L). Most of the Pennsylvania study streams also frequently experienced episodic pulses of SO42- (???78 ??eq/L), whereas the Adirondack and Catskill streams did not. High baseline concentrations of SO42- (all three study areas) and NO3- (Adirondacks and Catskills) reduced episodic minimum ANC, even when these ions did not change during episodes. The ion changes that controlled the most severe episodes (lowest minimum episodic ANC) differed from the ion changes most important to smaller, more frequent episodes. Pulses of NO3- (Catskills and Adirondacks), SO42- (Pennsylvania), or organic acids became more important during major episodes. Overall, the behavior of streamwater SO42- and NO4- is an indicator that acidic deposition has contributed to the severity of episodes in the study streams.

  12. The results of the Swiss observational study of the new, fast-dissolving mirtazapine formulation in depressed patients.

    PubMed

    Delini-Stula, Alexandra; Bischof, Roland

    2006-01-01

    Objective. The purpose of the present study was to document the experience with the use of a new, fast-dissolving oral tablet (FDT, RemeronSolTab®) of mirtazapine, a NaSSA antidepressant, in the treatment of depressed patients in daily practice in Switzerland. Methods. It was an open, prospective collection of observations in a total of 1121 depressive patients (>18 years old, both sexes). The treatment duration was 8 weeks with assessments after the second and eighth week. Efficacy measures were CGI (seven points) and specific check-lists for the ratings of severity of anxiety and sleep disturbances. At the end of the trial the acceptance (eight-item questionnaire) of the new formulation was recorded too. Results. The results showed that there was highly significant (P<0.001) and rapid improvement of severity of depression, anxiety and sleep disturbances in the whole population. Subgroup analyses showed that the antidepressant efficacy was independent of gender, initial severity of depression or of the type of depression (first episode, recurrent, chronic depression). The majority of patients (80%) liked at least one of the properties of FDT and, out of 75% of patients having experience with conventional tablet, 50% stated to be better compliant with this new formulation. Conclusion. This report documents the antidepressant efficacy of mirtazapine FDT. The new formulation found good acceptance by the patients. The results also suggest a likelihood of improved compliance with the mirtazapine FDT. PMID:24940962

  13. Epidemiological and clinical characterization following a first psychotic episode in major depressive disorder: comparisons with schizophrenia and bipolar I disorder in the Cavan-Monaghan First Episode Psychosis Study (CAMFEPS).

    PubMed

    Owoeye, Olabisi; Kingston, Tara; Scully, Paul J; Baldwin, Patrizia; Browne, David; Kinsella, Anthony; Russell, Vincent; O'Callaghan, Eadbhard; Waddington, John L

    2013-07-01

    While recent research on psychotic illness has focussed on the nosological, clinical, and biological relationships between schizophrenia and bipolar disorder, little attention has been directed to the most common other psychotic diagnosis, major depressive disorder with psychotic features (MDDP). As this diagnostic category captures the confluence between dimensions of psychotic and affective psychopathology, it is of unappreciated heuristic potential to inform on the nature of psychotic illness. Therefore, the epidemiology and clinical characteristics of MDDP were compared with those of schizophrenia and bipolar disorder within the Cavan-Monaghan First Episode Psychosis Study (n = 370). Epidemiologically, the first psychotic episode of MDDP (n = 77) was uniformly distributed across the adult life span, while schizophrenia (n = 73) and bipolar disorder (n = 73) were primarily disorders of young adulthood; the incidence of MDDP, like bipolar disorder, did not differ between the sexes, while the incidence of schizophrenia was more common in males than in females. Clinically, MDDP was characterized by negative symptoms, executive dysfunction, neurological soft signs (NSS), premorbid intellectual function, premorbid adjustment, and quality of life similar to those for schizophrenia, while bipolar disorder was characterized by less prominent negative symptoms, executive dysfunction and NSS, and better quality of life. These findings suggest that what we currently categorize as MDDP may be more closely aligned with other psychotic diagnoses than has been considered previously. They indicate that differences in how psychosis is manifested vis-à-vis depression and mania may be quantitative rather than qualitative and occur within a dimensional space, rather than validating categorical distinctions.

  14. The Papez Circuit in First-Episode, Treatment-Naive Adults with Major Depressive Disorder: Combined Atlas-Based Tract-Specific Quantification Analysis and Voxel-Based Analysis

    PubMed Central

    Jiang, Wenyan; Gong, Gaolang; Wu, Feng; Kong, Lingtao; Chen, Kaiyuan; Cui, Wenhui; Ren, Ling; Fan, Guoguang; Sun, Wenge; Ma, Huan; Xu, Ke; Tang, Yanqing; Wang, Fei

    2015-01-01

    Previous findings suggest that the Papez Circuit may have a role in major depressive disorders. We used atlas-based tract-specific quantification analysis and voxel-based analysis to examine the integrity of white matter tracts involved in mood regulation (including tracts in the Papez Circuit). Diffusion tensor imaging acquired from 35 first-episode, treatment-naive adults with major depressive disorders and 34 healthy adult controls were compared. Our statistical approach compared structural integrity of 11 major white matter tracts between the major depressive disorder and adult controls, as well as illness duration influence in patients. Fractional anisotropy was decreased in the hippocampal cingulum and in the anterior thalamic radiation according to both analytical approaches, all of which were important tracts included in the Papez Circuit. Our results support the role of the Papez Circuit in major depressive disorders with the minimal probability of false positive due to similar findings in both analyses that have complementary advantages. Dysfunction of the Papez Circuit may be a potential marker for studying the pathogenesis of major depressive disorders. PMID:25996480

  15. The papez circuit in first-episode, treatment-naive adults with major depressive disorder: combined atlas-based tract-specific quantification analysis and voxel-based analysis.

    PubMed

    Jiang, Wenyan; Gong, Gaolang; Wu, Feng; Kong, Lingtao; Chen, Kaiyuan; Cui, Wenhui; Ren, Ling; Fan, Guoguang; Sun, Wenge; Ma, Huan; Xu, Ke; Tang, Yanqing; Wang, Fei

    2015-01-01

    Previous findings suggest that the Papez Circuit may have a role in major depressive disorders. We used atlas-based tract-specific quantification analysis and voxel-based analysis to examine the integrity of white matter tracts involved in mood regulation (including tracts in the Papez Circuit). Diffusion tensor imaging acquired from 35 first-episode, treatment-naive adults with major depressive disorders and 34 healthy adult controls were compared. Our statistical approach compared structural integrity of 11 major white matter tracts between the major depressive disorder and adult controls, as well as illness duration influence in patients. Fractional anisotropy was decreased in the hippocampal cingulum and in the anterior thalamic radiation according to both analytical approaches, all of which were important tracts included in the Papez Circuit. Our results support the role of the Papez Circuit in major depressive disorders with the minimal probability of false positive due to similar findings in both analyses that have complementary advantages. Dysfunction of the Papez Circuit may be a potential marker for studying the pathogenesis of major depressive disorders.

  16. IRRITABLE MOOD IN ADULT MAJOR DEPRESSIVE DISORDER: RESULTS FROM THE WORLD MENTAL HEALTH SURVEYS

    PubMed Central

    Kovess-Masfety, Viviane; Alonso, Jordi; Angermeyer, Matthias; Bromet, Evelyn; de Girolamo, Giovanni; de Jonge, Peter; Demyttenaere, Koen; Florescu, Silvia E.; Gruber, Michael J.; Gureje, Oye; Hu, Chiyi; Huang, Yueqin; Karam, Elie G.; Jin, Robert; Lépine, Jean-Pierre; Levinson, Daphna; McLaughlin, Katie A.; Medina-Mora, María E.; O’Neill, Siobhan; Ono, Yutaka; Posada-Villa, José A.; Sampson, Nancy A.; Scott, Kate M.; Shahly, Victoria; Stein, Dan J.; Viana, Maria C.; Zarkov, Zahari; Kessler, Ronald C.

    2014-01-01

    Background Although irritability is a core symptom of DSM-IV major depressive disorder (MDD) for youth but not adults, clinical studies find comparable rates of irritability between nonbipolar depressed adults and youth. Including irritability as a core symptom of adult MDD would allow detection of depression-equivalent syndromes with primary irritability hypothesized to be more common among males than females. We carried out a preliminary examination of this issue using cross-national community-based survey data from 21 countries in the World Mental Health (WMH) Surveys (n = 110,729). Methods The assessment of MDD in the WHO Composite International Diagnostic Interview includes one question about persistent irritability. We examined two expansions of the definition of MDD involving this question: (1) cases with dysphoria and/or anhedonia and exactly four of nine Criterion A symptoms plus irritability; and (2) cases with two or more weeks of irritability plus four or more other Criterion A MDD symptoms in the absence of dysphoria or anhedonia. Results Adding irritability as a tenth Criterion A symptom increased lifetime prevalence by 0.4% (from 11.2 to 11.6%). Adding episodes of persistent irritability increased prevalence by an additional 0.2%. Proportional prevalence increases were significantly higher, but nonetheless small, among males compared to females. Rates of severe role impairment were significantly lower among respondents with this irritable depression who did not meet conventional DSM-IV criteria than those with DSM-IV MDD. Conclusion Although limited by the superficial assessment in this single question on irritability, results do not support expanding adult MDD criteria to include irritable mood. PMID:23364997

  17. Treatment for Adolescents With Depression Study (TADS): Safety Results

    PubMed Central

    Emslie, Graham; Kratochvil, Christopher; Vitiello, Benedetto; Silva, Susan; Mayes, Taryn; McNulty, Steven; Weller, Elizabeth; Waslick, Bruce; Casat, Charles; Walkup, John; Pathak, Sanjeev; Rohde, Paul; Posner, Kelly; March, John

    2012-01-01

    Objective To compare the rates of physical, psychiatric, and suicide-related events in adolescents with MDD treated with fluoxetine alone (FLX), cognitive-behavioral therapy (CBT), combination treatment (COMB), or placebo (PBO). Method Safety assessments included adverse events (AEs) collected by spontaneous report, as well as systematic measures for specific physical and psychiatric symptoms. Suicidal ideation and suicidal behavior were systematically assessed by self- and clinician reports. Suicidal events were also reanalyzed by the Columbia Group and expert raters using the Columbia-Classification Algorithm for Suicidal Assessment used in the U.S. Food and Drug Administration reclassification effort. Results Depressed adolescents reported high rates of physical symptoms at baseline, which improved as depression improved. Sedation, insomnia, vomiting, and upper abdominal pain occurred in at least 2% of those treated with FLX and/or COMB and at twice the rate of placebo. The rate of psychiatric AEs was 11% in FLX, 5.6% in COMB, 4.5% in PBO, and 0.9% in CBT. Suicidal ideation improved overall, with greatest improvement in COMB. Twenty-four suicide-related events occurred during the 12-week period: 5 patients (4.7%) in COMB, 10 (9.2%) in FLX, 5 (4.5%) in CBT, and 3 (2.7%) in placebo. Statistically, only FLX had more suicide-related events than PBO (p = .0402, odds ratio [OR] = 3.7, 95% CI 1.00–13.7). Only five actual attempts occurred (2 COMB, 2 FLX, 1 CBT, 0 PBO). There were no suicide completions. Conclusions Different methods for eliciting AEs produce different results. In general, as depression improves, physical complaints and suicidal ideation decrease in proportion to treatment benefit. In this study, psychiatric AEs and suicide-related events are more common in FLX-treated patients. COMB treatment may offer a more favorable safety profile than medication alone in adolescent depression. PMID:17135989

  18. Improvements in Depression and Changes in Fatigue: Results from the SLAM DUNC Depression Treatment Trial

    PubMed Central

    Bengtson, Angela M.; Gaynes, Bradley N.; McGuinness, Teena; Quinlivan, Evelyn B.; Ogle, Michelle; Heine, Amy; Thielman, Nathan M.; Pence, Brian W.

    2016-01-01

    Fatigue and depression are common co-morbid conditions among people with HIV infection. We analyzed a population of HIV-infected adults with depression, who were enrolled in a depression treatment trial, to examine the extent to which improvements in depression over time were associated with improvements in HIV-related fatigue. Data for this analysis come from a randomized controlled trial to evaluate the effectiveness of improved depression treatment on antiretroviral adherence. Fatigue was measured using the HIV-Related Fatigue Scale, and depressive symptoms were measured with the Hamilton Depression Rating Scale. Participants (n = 234) were on average nearly 44 years of age and predominantly male, black or African American, and unemployed. Individuals who experienced stronger depression response (i.e., greater improvement in depression score) had larger decreases in fatigue. However, even among those who demonstrated a full depression response, nearly three-quarters continued to have either moderate or severe fatigue at 6 and 12 months. PMID:26525221

  19. The Clinical and Cost Effectiveness of Vortioxetine for the Treatment of a Major Depressive Episode in Patients With Failed Prior Antidepressant Therapy: A Critique of the Evidence.

    PubMed

    Lomas, James; Llewellyn, Alexis; Soares, Marta; Simmonds, Mark; Wright, Kath; Eastwood, Alison; Palmer, Stephen

    2016-09-01

    The National Institute for Health and Care Excellence (NICE) invited the manufacturer of vortioxetine (Lundbeck) to submit clinical and cost-effectiveness evidence for vortioxetine for the treatment of major depressive episodes (MDEs), as part of the Institute's Single Technology Appraisal (STA) process. The Centre for Reviews and Dissemination and Centre for Health Economics at the University of York were commissioned to act as the independent Evidence Review Group (ERG). This article provides a description of the company submission, the ERG review and the resulting NICE guidance TA367 issued in November 2015. The ERG critically reviewed the evidence presented in the manufacturer's submission and identified areas requiring clarification, for which the manufacturer provided additional evidence. Two phase III randomised controlled trials for a second-line population involving vortioxetine were identified-REVIVE and TAK318. These two trials represent only 972 of over 7000 patients included in trials of vortioxetine. In REVIVE, there was a statistically significant difference in depression scores favouring vortioxetine compared with agomelatine [mean Montgomery-Åsberg Depression Rating Scale (MADRS) score difference of 2.16 points; 95 % confidence interval 0.81-3.51]. The ERG concluded that, based on all the evidence, rather than the substantially restricted subset of evidence originally considered by the manufacturer, vortioxetine is likely to be similar in efficacy to other analysed antidepressants [citalopram, sertraline, escitalopram and venlafaxine extended release (XR)], and may be more efficacious than agomelatine and inferior to duloxetine. The ERG concluded that vortioxetine may be more tolerable than other analysed antidepressants (sertraline, venlafaxine XR and bupropion), although the limited data prevent firm conclusions. The base-case incremental cost-effectiveness ratio (ICER) of vortioxetine reported by the manufacturer was £378 per quality

  20. Do Different Tests of Episodic Memory Produce Consistent Results in Human Adults?

    ERIC Educational Resources Information Center

    Cheke, Lucy G.; Clayton, Nicola S.

    2013-01-01

    A number of different philosophical, theoretical, and empirical perspectives on episodic memory have led to the development of very different tests with which to assess it. Although these tests putatively assess the same psychological capacity, they have rarely been directly compared. Here, a sample of undergraduates was tested on three different…

  1. Interaction of FKBP5 Gene Variants and Adverse Life Events in Predicting Depression Onset: Results From a 10-Year Prospective Community Study

    PubMed Central

    Zimmermann, Petra; Brückl, Tanja; Nocon, Agnes; Pfister, Hildegard; Binder, Elisabeth B.; Uhr, Manfred; Lieb, Roselind; Moffitt, Terrie E.; Caspi, Avshalom; Holsboer, Florian; Ising, Marcus

    2013-01-01

    Objective The binding protein FKBP5 is an important modulator of the function of the glucocorticoid receptor, the main receptor of the stress horm one system. This turns the FKBP5 gene into a key candidate for gene-environment interactions, which are considered critical for pathogenesis of stress-related disorders. The authors explored gene-environment interactions between FKBP5 gene variants and adverse life events in predicting the first occurrence of a major depressive episode. Method The analyses were based on 884 Caucasians in a 10-year prospective community study. At baseline, they were 14–24 years old and did not fulfill criteria for a major depressive episode. The DSM-IV-based Munich Composite International Diagnostic Interview was used to assess adverse life events preceding baseline and major depressive episodes during follow-up. On the basis of previous findings, five single-nucleotide polymorphisms (SNPs) within the FKBP5 gene were selected for genotyping. Results While the authors did not observe genetic main effects, they found interactions between the five SNPs and traumatic (but not separation) events, with the strongest effect for severe trauma. The effect of trauma on incident major depressive episodes was evident among subjects homozygous for the minor alleles but not subjects with other genotypes. The findings were replicated in the U.K. Environmental Risk Longitudinal Twin Study. Conclusions These hypothesis-driven results suggest that an interaction between FKBP5 genotype and trauma is involved in the onset of depression. Subjects homozygous for the minor alleles of the investigated FKBP5 SNPs seem to be particularly sensitive to effects of trauma exposure in terms of triggering depression onset. PMID:21865530

  2. An Open-Label Feasibility Trial of Repetitive Transcranial Magnetic Stimulation for Treatment-Resistant Major Depressive Episodes.

    PubMed

    Fujiwara, Masaki; Inagaki, Masatoshi; Higuchi, Yuji; Uchitomi, Yosuke; Terada, Seishi; Kodama, Masafumi; Kishi, Yoshiki; Yamada, Norihito

    2016-08-01

    Repetitive transcranial magnetic stimulation (rTMS) has been reported to be a new treatment option for treatment-resistant depression. In Japan, there has been limited research into its feasibility, efficacy, and tolerability. We have launched a trial of rTMS for treating medication-resistant major depressive disorder and bipolar depression. We are investigating low-frequency rTMS to the right dorsolateral prefrontal cortex and traditional high-frequency rTMS to the left dorsolateral prefrontal cortex, in 20 patients. The primary outcome of the study is the treatment completion rate. This study will provide new data on the usefulness of rTMS for treatment-resistant depression in Japan. PMID:27549679

  3. Episodic memory and organizational strategy in free recall in unipolar depression: the role of cognitive support and executive functions.

    PubMed

    Taconnat, Laurence; Baudouin, Alexia; Fay, Severine; Raz, Naftali; Bouazzaoui, Badiaa; El-Hage, Wissam; Isingrini, Michel; Ergis, Anne-Marie

    2010-08-01

    Executive functioning and memory impairment have been demonstrated in adults with depression. Executive functions and memory are related, mainly when the memory tasks require controlled processes (attentional resource demanding processes)--that is, when a low cognitive support (external aid) is provided. A cross-sectional study was carried out on 45 participants: 21 with depression, and 24 healthy controls matched for age, verbal ability, education level, and anxiety score. Cognitive support was manipulated by providing a categorized word list at encoding, presented either clustered (high cognitive support) or randomized (low cognitive support) to both depressed and healthy adults. The number of words recalled was calculated, and an index of clustering was computed to assess organizational strategies. Participants were also administered cognitive tests (executive functions, cognitive speed, and categorical fluency) to explore the mediators of organizational strategies. Depressed participants had greater difficulty recalling and organizing the words, but the differences between the two groups were reduced for both measures when high cognitive support was provided at encoding. Healthy adults performed better on all cognitive tests. Statistical analyses revealed that in the depressed group, executive functions were the only variable associated with clustering and only when low cognitive support was provided. These findings support the view that the decrement in executive function due to depression may lead to impairment in organization when this mnemonic strategy has to be self-initiated.

  4. Treatment of malaria fever episodes among children in Malawi: results of a KAP survey.

    PubMed

    Slutsker, L; Chitsulo, L; Macheso, A; Steketee, R W

    1994-03-01

    Caretakers of children (< 10 years of age) were questioned about management of pediatric malarial fever episodes in a nation-wide knowledge, attitudes, and practices survey conducted in Malawi. A total of 1,531 households in 30 randomly selected clusters of 51 households each were sampled and interviewed. Overall 557 caretakers reported a fever in their child in the previous 2 weeks; 43%-judged the illness as severe. Fifty-two percent of caretakers brought their febrile children to clinic. Clinic attendance was positively correlated with young age of the child (< 4 years), severe illness, and higher socioeconomic status. Seventy-four percent of clinic attenders gave their child an antimalarial; in contrast, only 42% of those not attending clinic gave an antimalarial. Optimal therapy (administration of an antimalarial promptly and at the proper dosage) was received by only 7% of febrile children. Children taken to clinic were twice as likely to receive optimal therapy as were non-attenders. Identification of critical points in the optimal therapy algorithm and characteristics of caretakers linked with sub-optimal therapy may help malaria control programs target specific groups and health education messages to improve treatment of malaria fever episodes.

  5. Depressive symptoms among Jordanian youth: results of a national survey.

    PubMed

    Ismayilova, Leyla; Hmoud, Olimat; Alkhasawneh, Esra; Shaw, Stacey; El-Bassel, Nabila

    2013-02-01

    This study examines level of depression and factors associated with depression among female and male youth in Jordan. The study uses data from a cross-sectional survey conducted among a national sample of 14-25 year old youth attending educational institutions in Jordan (N = 8,129). On average, respondents reported frequently experiencing feelings of sadness (66 %), loss of joy (49 %) and loss of hope in living (43 %). Regression models demonstrated that higher levels of depressive symptoms were observed among females and among youth exposed to violence. Better parent-child relationships were associated with lower depression score. Among males depressive symptoms were associated with poor economic status, low assertiveness and a higher likelihood of alcohol use and smoking. There is a need for mental health prevention programs for youth in Jordan that enhance youth's social and emotional skills, strengthen parent-child relationships, and reduce violence in school, home and in the community.

  6. Depression

    MedlinePlus

    ... make negative thinking worse. previous continue Depression Can Go Unrecognized People with depression may not realize they ... themselves or who have eating disorders or who go through extreme mood changes may have unrecognized depression. ...

  7. Increased prefrontal and parietal cortical thickness does not correlate with anhedonia in patients with untreated first-episode major depressive disorders.

    PubMed

    Yang, Xin-hua; Wang, Yi; Huang, Jia; Zhu, Cui-ying; Liu, Xiao-qun; Cheung, Eric F C; Xie, Guang-rong; Chan, Raymond C K

    2015-10-30

    Cerebral morphological abnormalities in major depressive disorder (MDD) may be modulated by antidepressant treatment and course of illness in chronic medicated patients. The present study examined cortical thickness in patients with untreated first-episode MDD to elucidate the early pathophysiology of this illness. Here, we examined cortical thickness in patients with first-episode MDD (N=27) and healthy controls (N=27) using an automated surface-based method (in FreeSurfer). By assessing the correlation between caudate volume and cortical thickness at each vertex on the cortical surface, a caudate-cortical network was obtained for each group. Subsequent analysis was performed to assess the effect of anhedonia by the Temporal Experience of Pleasure Scale. We observed increased cortical thickness at the right orbital frontal cortex and the left inferior parietal gyrus in MDD patients compared with healthy controls. Furthermore, morphometric correlational analysis using cortical thickness measurement revealed increased caudate-cortical connectivity in the bilateral superior parietal gyrus in MDD patients. All changes were not related to anhedonia. These preliminary findings may reflect disorder manifestation close to illness onset and may provide insight into the early neurobiology of MDD.

  8. [Fatigue and depression].

    PubMed

    Hell, Daniel

    2015-04-22

    Fatigue is characterised in an overview of the literature as a specific phenomenon of depression. Its differential diagnosis is discussed. Distinctions and correspondences to burnout are elaborated. Fatigue is not an obligatory symptom of depressive episodes, although it can contribute to depressive developments. The importance of fatigue in depressive episodes and its therapy is shown with the help of a circular model of depression.

  9. Effects of an internet-based cognitive behavioural therapy intervention on preventing major depressive episodes among workers: a protocol for a randomised controlled trial

    PubMed Central

    Imamura, Kotaro; Kawakami, Norito; Furukawa, Toshi A; Matsuyama, Yutaka; Shimazu, Akihito; Kasai, Kiyoto

    2015-01-01

    Introduction The aim of this study is to examine the effects of an internet-based cognitive behavioural therapy (iCBT) program on decreasing the risk of major depressive episodes (MDEs) among workers employed in a private corporate group in Japan, using a randomised controlled trial design. Methods and analysis All of the workers in a corporate group (n=20 000) will be recruited through an invitation email. Participants who fulfil the inclusion criteria will be randomly allocated to intervention or control groups (planned N=4050 for each group). They will be allowed to complete the six lessons of the iCBT program within 10 weeks after the baseline survey. Those in the control group will receive the same iCBT after 12 months. The program includes several CBT skills: self-monitoring, cognitive restructuring, assertiveness, problem-solving and relaxation. The primary outcome measure is no new onset of MDE (using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR)/DSM-5 criteria) during the 12-month follow-up. Assessment will use the web version of the WHO Composite International Diagnostic Interview V.3.0 depression section. Ethics and dissemination The Research Ethics Review Board of Graduate School of Medicine, the University of Tokyo (No. 3083-(2)), approved the study procedures. Trial registration number The study protocol is registered at the UMIN Clinical Trials Registry (UMIN-CTR; ID=UMIN000014146). PMID:25968004

  10. Inflammation and metabolic changes in first episode psychosis: preliminary results from a longitudinal study.

    PubMed

    Russell, Alice; Ciufolini, Simone; Gardner-Sood, Poonam; Bonaccorso, Stefania; Gaughran, Fiona; Dazzan, Paola; Pariante, Carmine M; Mondelli, Valeria

    2015-10-01

    Metabolic abnormalities are commonly observed in patients with psychosis, and may confer greater risk of developing cardiovascular disease later in life. Such abnormalities are associated with inflammation in the general population, and there is increasing evidence for elevated inflammation in patients with first episode psychosis (FEP). The aim of this preliminary study is to examine the effect of changes in inflammation, as measured by high-sensitivity C-reactive protein (hsCRP), on metabolic changes in a three-month longitudinal study in a FEP sample. Fifty-three FEP patients from in- and out-patient services in South London, England, were included in this longitudinal study. Social and clinical data were collected, and fasting blood samples and anthropometric measurements (weight, Body Mass Index (BMI), lipid profile and gluco-metabolic parameters) were obtained at baseline and at three-month follow-up. Correlation analyses showed that those with increases in hsCRP over the three-month period also had increases in triglyceride levels (r=0.49, p=0.02). No association was observed with other lipid profile, or gluco-metabolic parameters, across the whole sample. Increases in weight and BMI were also associated with increases in triglyceride levels (r=0.33, p=0.02; and r=0.31, p=0.03, respectively); however, a multiple linear regression analysis found that the effects of inflammation on triglycerides were independent from the effect of changes in weight, and from the baseline inflammatory state. Our preliminary findings suggest that those patients experiencing greater increases in inflammation early on in the course of their illness may be at greater risk of developing short-term metabolic abnormalities, in particular dyslipidaemia, independent of weight-gain. Future work should investigate the use of inflammatory markers to identify patients in greater need of physical health interventions. PMID:26100489

  11. Electroconvulsive therapy: results in depressive illness from the Leicestershire trial.

    PubMed Central

    Brandon, S; Cowley, P; McDonald, C; Neville, P; Palmer, R; Wellstood-Eason, S

    1984-01-01

    Electroconvulsive therapy was investigated in a double blind trial. Altogether 186 clinically selected patients were referred to the trial, but 48 of these did not participate. According to the present state examination, 95 of the remaining 138 patients fell into one of the classes of major depression. Patients were randomly allocated to a course of real or simulated electroconvulsive therapy. Treatment was given twice a week with a maximum of eight treatments. On the Hamilton depressive rating scale the improvement in the group given real treatment was significantly greater than that in the group given simulated treatment both at two weeks (p = 0.014) and at four weeks (p = 0.0001). At follow up at 12 and 28 weeks there was no difference between the treatment groups. At the end of the four week trial consultants, who were blind to the allocation of treatment, rated the patients who had received real treatment as having made a significantly greater improvement than the patients who had received simulated treatment (p less than 0.00005). Further analysis showed that electroconvulsive therapy was effective in depression associated with delusions and in depression associated with retardation. PMID:6418300

  12. Depression prevalence and primary care among vulnerable patients at a free outpatient clinic in Paris, France, in 2010: results of a cross-sectional survey

    PubMed Central

    2013-01-01

    Background Data on the prevalence of depression and on how a depressive episode prompts the sufferer to seek primary care are not scarce, but the available evidence on the prevalence of depression among immigrants and poor people who frequent general practice facilities is scarce. The Baudelaire Outpatient Clinic at the Saint-Antoine Hospital in Paris provides free medical and social assistance to the poor and/or uninsured. The goal of our study was to estimate the prevalence of depression among these outpatients, to characterize this depressed population, and to analyze its demand for primary care for depressive episodes. Methods From September to December 2010, we conducted a cross-sectional, observational survey among users of the Baudelaire Outpatient Clinic. French-speaking patients attending the clinic between September 15 and December 30, 2010 who agreed to answer a questionnaire administered face-to-face before their consultation were included in the study. The chi-squared test (or Fisher’s exact test for small samples) was used for the comparisons of proportions. Logistic regression models were estimated, along with the odds ratios (OR) and their 95% confidence intervals (95% CIs), for the multivariate analysis of factors associated with depression and healthcare-seeking. Models were estimated separately for men and women, since sex was an interaction factor. The statistical analyses were performed using Stata v. 10 software (StataCorp LP, College Station, Texas, USA). Results Of the 250 patients included (mean age: 45 years), 52.0% were men and 52.4% were immigrants. Close to 40% of them reported having no supplemental health insurance. The estimated prevalence of depression in this population was 56.7%. Depression was more prevalent among the women, immigrants, and people from the poorer socioeconomic groups. Only half of these depressed patients, mostly women, reported having discussed their depression with a physician. French nationality and complete

  13. REM sleep-like episodes of motoneuronal depression and respiratory rate increase are triggered by pontine carbachol microinjections in in situ perfused rat brainstem preparation.

    PubMed

    Brandes, Ivo F; Stettner, Georg M; Mörschel, Michael; Kubin, Leszek; Dutschmann, Mathias

    2011-05-01

    Hypoglossal nerve activity (HNA) controls the position and movements of the tongue. In persons with compromised upper airway anatomy, sleep-related hypotonia of the tongue and other pharyngeal muscles causes increased upper airway resistance, or total upper airway obstructions, thus disrupting both sleep and breathing. Hypoglossal nerve activity reaches its nadir, and obstructive episodes are longest and most severe, during rapid eye movement stage of sleep (REMS). Microinjections of a cholinergic agonist, carbachol, into the pons have been used in vivo to investigate the mechanisms of respiratory control during REMS. Here, we recorded inspiratory-modulated phrenic nerve activity and HNA and microinjected carbachol (25-50 nl, 10 mm) into the pons in an in situ perfused working heart-brainstem rat preparation (WHBP), an ex vivo model previously validated for studies of the chemical and reflex control of breathing. Carbachol microinjections were made into 40 sites in 33 juvenile rat preparations and, at 24 sites, they triggered depression of HNA with increased respiratory rate and little change of phrenic nerve activity, a pattern akin to that during natural REMS in vivo. The REMS-like episodes started 151 ± 73 s (SD) following microinjections, lasted 20.3 ± 4.5 min, were elicited most effectively from the dorsal part of the rostral nucleus pontis oralis, and were prevented by perfusion of the preparation with atropine. The WHBP offers a novel model with which to investigate cellular and neurochemical mechanisms of REMS-related upper airway hypotonia in situ without anaesthesia and with full control over the cellular environment.

  14. Depression.

    PubMed

    Stewart, Donna E; Gucciardi, Enza; Grace, Sherry L

    2004-08-25

    HEALTH ISSUE: Depression causes significant distress or impairment in physical, social, occupational and other key areas of functioning. Women are approximately twice as likely as men to experience depression. Psychosocial factors likely mediate the risks for depression incurred by biological influences. KEY FINDINGS: Data from the 1999 National Population Health Survey show that depression is more common among Canadian women, with an annual self-reported incidence of 5.7% compared with 2.9% in men. The highest rates of depression are seen among women of reproductive age. Predictive factors for depression include previous depression, feeling out of control or overwhelmed, chronic health problems, traumatic events in childhood or young adulthood, lack of emotional support, lone parenthood, and low sense of mastery. Although depression is treatable, only 43% of depressed women had consulted a health professional in 1998/99 and only 32.4% were taking antidepressant medication. People with lower education, inadequate income, and fewer contacts with a health professional were less likely to receive depression treatment. DATA GAPS AND RECOMMENDATIONS: A better understanding of factors that increase vulnerability and resilience to depression is needed. There is also a need for the collection and analysis of data pertaining to: prevalence of clinical anxiety; the prevalence of depression band 12 months after childbirth factors contributing to suicide contemplation and attempts among adolescent girls, current treatments for depression and their efficacy in depressed women at different life stages; interprovincial variation in depression rates and hospitalizations and the impact and costs of depression on work, family, individuals, and society.

  15. Depression, desperation, and suicidal ideation in college students: results from the American Foundation for Suicide Prevention College Screening Project at Emory University.

    PubMed

    Garlow, Steven J; Rosenberg, Jill; Moore, J David; Haas, Ann P; Koestner, Bethany; Hendin, Herbert; Nemeroff, Charles B

    2008-01-01

    The objective of this investigation was to examine suicidal ideation and depression in undergraduate college students who participated in the American Foundation for Suicide Prevention-sponsored College Screening Project at Emory University. The principal measure of depressive symptoms was the nine-item depression module from the Patient Health Questionnaire (PHQ-9). Additional questions were focused on current suicidal ideation, past suicide attempts, and episodes of deliberate self-harm and on symptoms of anxiety and distress. Seven hundred and twenty-nine students participated over a 3-school-year interval (2002-2005). Most notably, 11.1% of the students endorsed current (past 4 weeks) suicidal ideation and 16.5% had a lifetime suicide attempt or self-injurious episode. Students with current suicidal ideation had significantly higher depression symptom severity than those without suicidal ideation (t = -9.34, df = 706, P<.0001, d = 1.9), and 28.5% of the students with PHQ-9 scores of 15 or higher reported suicidal ideation compared to 5.7% of those with lower scores (chi(2) = 56.29, df = 1, P<.0001, two-tailed). Suicidal ideation was prominently associated with symptoms of desperation (odds ratio 2.6, 95% CI 1.5-4.6, P<.001). The vast majority of students with moderately severe to severe depression (85%) or current suicidal ideation (84%) were not receiving any psychiatric treatment at the time of assessment. These results suggest that there is a strong relationship between severity of depressive symptoms and suicidal ideation in college students, and that suicidal feelings and actions are relatively common in this group. This underscores the need to provide effective mental health outreach and treatment services to this vulnerable population. As this analysis was based on data collected at a single institution, the results may not be representative of all college students or young adults.

  16. Episodic Memories

    ERIC Educational Resources Information Center

    Conway, Martin A.

    2009-01-01

    An account of episodic memories is developed that focuses on the types of knowledge they represent, their properties, and the functions they might serve. It is proposed that episodic memories consist of "episodic elements," summary records of experience often in the form of visual images, associated to a "conceptual frame" that provides a…

  17. Predicting episodic memory performance using different biomarkers: results from Argentina-Alzheimer’s Disease Neuroimaging Initiative

    PubMed Central

    Russo, María Julieta; Cohen, Gabriela; Chrem Mendez, Patricio; Campos, Jorge; Nahas, Federico E; Surace, Ezequiel I; Vazquez, Silvia; Gustafson, Deborah; Guinjoan, Salvador; Allegri, Ricardo F; Sevlever, Gustavo

    2016-01-01

    Purpose Argentina-Alzheimer’s Disease Neuroimaging Initiative (Arg-ADNI) is the first ADNI study to be performed in Latin America at a medical center with the appropriate infrastructure. Our objective was to describe baseline characteristics and to examine whether biomarkers related to Alzheimer’s disease (AD) physiopathology were associated with worse memory performance. Patients and methods Fifteen controls and 28 mild cognitive impairment and 13 AD dementia subjects were included. For Arg-ADNI, all biomarker parameters and neuropsychological tests of ADNI-II were adopted. Results of positron emission tomography (PET) with fluorodeoxyglucose and 11C-Pittsburgh compound-B (PIB-PET) were available from all participants. Cerebrospinal fluid biomarker results were available from 39 subjects. Results A total of 56 participants were included and underwent baseline evaluation. The three groups were similar with respect to years of education and sex, and they differed in age (F=5.10, P=0.01). Mean scores for the baseline measurements of the neuropsychological evaluation differed significantly among the three groups at P<0.001, showing a continuum in their neuropsychological performance. No significant correlations were found between the principal measures (long-delay recall, C-Pittsburgh compound-B scan, left hippocampal volume, and APOEε4) and either age, sex, or education (P>0.1). Baseline amyloid deposition and left hippocampal volume separated the three diagnostic groups and correlated with the memory performance (P<0.001). Conclusion Cross-sectional analysis of baseline data revealed links between cognition, structural changes, and biomarkers. Follow-up of a larger and more representative cohort, particularly analyzing cerebrospinal fluid and brain biomarkers, will allow better characterization of AD in our country.

  18. Predicting episodic memory performance using different biomarkers: results from Argentina-Alzheimer’s Disease Neuroimaging Initiative

    PubMed Central

    Russo, María Julieta; Cohen, Gabriela; Chrem Mendez, Patricio; Campos, Jorge; Nahas, Federico E; Surace, Ezequiel I; Vazquez, Silvia; Gustafson, Deborah; Guinjoan, Salvador; Allegri, Ricardo F; Sevlever, Gustavo

    2016-01-01

    Purpose Argentina-Alzheimer’s Disease Neuroimaging Initiative (Arg-ADNI) is the first ADNI study to be performed in Latin America at a medical center with the appropriate infrastructure. Our objective was to describe baseline characteristics and to examine whether biomarkers related to Alzheimer’s disease (AD) physiopathology were associated with worse memory performance. Patients and methods Fifteen controls and 28 mild cognitive impairment and 13 AD dementia subjects were included. For Arg-ADNI, all biomarker parameters and neuropsychological tests of ADNI-II were adopted. Results of positron emission tomography (PET) with fluorodeoxyglucose and 11C-Pittsburgh compound-B (PIB-PET) were available from all participants. Cerebrospinal fluid biomarker results were available from 39 subjects. Results A total of 56 participants were included and underwent baseline evaluation. The three groups were similar with respect to years of education and sex, and they differed in age (F=5.10, P=0.01). Mean scores for the baseline measurements of the neuropsychological evaluation differed significantly among the three groups at P<0.001, showing a continuum in their neuropsychological performance. No significant correlations were found between the principal measures (long-delay recall, C-Pittsburgh compound-B scan, left hippocampal volume, and APOEε4) and either age, sex, or education (P>0.1). Baseline amyloid deposition and left hippocampal volume separated the three diagnostic groups and correlated with the memory performance (P<0.001). Conclusion Cross-sectional analysis of baseline data revealed links between cognition, structural changes, and biomarkers. Follow-up of a larger and more representative cohort, particularly analyzing cerebrospinal fluid and brain biomarkers, will allow better characterization of AD in our country. PMID:27695331

  19. Relative effects on a low-volume road system of landslides resulting from episodic storms in northern Idaho

    USGS Publications Warehouse

    McClelland, D.E.; Foltz, R.B.; Falter, C.M.; Wilson, W.D.; Cundy, T.; Schuster, R.L.; Saurbier, J.; Rabe, C.; Heinemann, R.

    1999-01-01

    In late November to early December 1995 and February 1996, northern Idaho was hit by heavy rains on a deep snowpack, resulting in two flood and landslide events of historic magnitude. Each of these storms was larger than the previous significant storm, which occurred in January 1974. A study was initiated by the U.S. Department of Agriculture Forest Service to survey and study the effects of the resultant landslides on the Clearwater National Forest, including the effects on the aquatic ecosystem. The results of this study were compared with the estimated average natural sediment resulting from landslides to evaluate the incremental impacts of these recent episodic landslides. They were also compared with the results of a study conducted on the landslides resulting from the January 1974 storm to determine if the landscape was responding more severely to large storms as a result of Forest Service management activities over the past 21 years. The general results of this study indicate that, of the Forest Service management activities, roads are the major contributor; however, they contribute less sediment than natural landslides. The total resultant sediment appears to be within the transport capacity of the aquatic system, and the landslide response in 1974 was similar to the 1995-1996 response. The results of the aquatic ecosystem study were generally mixed, with some habitat parameters indicating degradation, some unchanged, and some improved as a result of the flooding or flooding with landslide sediment.

  20. Female sexual dysfunction: A comparative study in drug naive 1st episode of depression in a general hospital of South Asia

    PubMed Central

    Roy, Payel; Manohar, Shivananda; Raman, Rajesh; Sathyanarayana Rao, T. S.; Darshan, M. S.

    2015-01-01

    Background: Women's sexual dysfunction is found to be highly prevalent in western and Indian literature. Limited studies are available on drug naive depression in western literature and in Indian population. Aim: To determine the prevalence rate and symptom profile of female sexual dysfunctions in patients with untreated depression. Design: A cross-sectional study in the psychiatry out-patient department of general hospital in South India. Materials and Methods: Following written informed consent female sexual functioning index (FSFI) and Arizona Sexual Experience Scale (ASEX) – female version and Hamilton Depression Rating Scale (HAMD - 17 item) on 30 cases and 30 controls was administered. Sociodemographic data, pattern and type of sexual dysfunctions were enquired. Data were analyzed using descriptive statistics, contingency co-efficient analysis and stepwise multiple regression. Results: The mean score of HAMD 17 item in study group was 19.13. The study showed that female sexual dysfunction was 70.3% in study group compared to 43.3% in control FSFI scores above 16 in HAMD had dysfunction of 76% with FSFI in study group. With ASEX-F sexual dysfunction was 73.3% in study compared to 20% in control. Scores above 16 in HAMD had 80% of sexual dysfunction with ASEX-F in study group. Conclusion: The study found that ASEX-F co-related better with HAMD 17 item. Following the onset of depression, the incidence of sexual dysfunction started at an early age in women. PMID:26600576

  1. Self-other representations mediate the relationship between Five-Factor Model depression and depressive states.

    PubMed

    Huprich, Steven K; Pouliot, Gregory S; Bruner, Reino

    2012-01-01

    While it is well established that trait depression is a risk factor for experiencing increased rates of episodes of depression, it is also the case that the ways in which the self and others are perceived, and nature of the relationship between self and other, predispose individuals to frequent depressive episodes. In this study, 182 psychiatric outpatients at three treatment facilities were evaluated for Five-Factor Model depressive traits, depressive states, and self-other representations (object relations). It was hypothesized that object relations would mediate the relationship between trait and state depression. Results partially confirmed this hypothesis. While trait depression significantly predicted variance in the Beck Depression Inventory-II (BDI-II; Beck et al., 1988), two dimensions of the Bell Object Relations and Reality Testing Inventory (BORRTI; Bell, 1995)--Alienation and Insecure Attachment--partially mediated the relationship between trait and state depression. Similarly, trait depression predicted tendencies to experience frequent shifts toward depressive episodes, although the Insecure Attachment and Egocentricity scales of the BORRTI fully mediated the relationship between trait depression and depressive lability. Knowledge of self-other representations, which is being considered for inclusion in the DSM-5, allows for a more refined understanding of those factors that contribute shifts in depressive mood. PMID:22642436

  2. Facial recognition of happiness among older adults with active and remitted major depression.

    PubMed

    Shiroma, Paulo R; Thuras, Paul; Johns, Brian; Lim, Kelvin O

    2016-09-30

    Biased emotion processing in depression might be a trait characteristic independent of mood improvement and a vulnerable factor to develop further depressive episodes. This phenomenon of among older adults with depression has not been adequately examined. In a 2-year cross-sectional study, 59 older patients with either active or remitted major depression, or never-depressed, completed a facial emotion recognition task (FERT) to probe perceptual bias of happiness. The results showed that depressed patients, compared with never depressed subjects, had a significant lower sensitivity to identify happiness particularly at moderate intensity of facial stimuli. Patients in remission from a previous major depressive episode but with none or minimal symptoms had similar sensitivity rate to identify happy facial expressions as compared to patients with an active depressive episode. Further studies would be necessary to confirm whether recognition of happy expression reflects a persistent perceptual bias of major depression in older adults. PMID:27428081

  3. Remission in Major Depression: Results from a Geriatric Primary Care Population

    PubMed Central

    Azar, Armin R.; Chopra, Mohit P.; Cho, Lydia Y.; Coakley, Eugenie; Rudolph, James L.

    2010-01-01

    OBJECTIVES While a recent task force report recommended that remission from major depression be defined according to DSM criteria, most previous work has used depressive symptom rating scales. The current study sought to identify baseline factors associated with treatment outcome in major depression, diagnosed according to DSM-IV criteria. METHODS Data from the Primary Care Research in Substance Abuse and Mental Health for the Elderly (PRISM-E) study were utilized. This analysis focused on 792 geriatric primary care patients with major depression at baseline, who were randomized to services by a mental health professional in primary care or specialty settings. Major depression was diagnosed according to DSM-IV criteria based on a structured interview at baseline and six months. The primary outcome was the absence of any DSM-IV depressive disorder at six-month follow-up. Association with baseline demographic characteristics, comorbid anxiety disorder, “at risk” drinking, number of co-occurring medical conditions, and depressive symptom severity was examined using multiple logistic regression modeling. RESULTS Remission occurred in 228 (29%) patients with completed follow-up assessments, while 564 (71%) did not remit. Factors which increased the odds of non-remission included comorbid anxiety (OR=1.60, 95%CI 1.11–2.31), female sex (OR=1.49, 95%CI 1.04–2.15), general medical comorbidity (OR=1.15, 95%CI 1.07–1.24), and increased baseline depressive symptom severity (OR=1.04, 95%CI 1.03–1.06). CONCLUSIONS The findings underscore the importance of using DSM criteria to define remission from major depression, and suggest that concurrent measurement of depression severity, comorbid anxiety and medical comorbidity are important in identifying patients requiring targeted interventions to optimize remission from major depression. PMID:21157850

  4. Depression.

    ERIC Educational Resources Information Center

    Strock, Margaret

    Approximately ten percent of the population suffers from a depressive illness each year. Although the economic cost is high, the cost in human suffering is immeasurable. To help educate the population about this disorder, this paper presents a definition of depression and its common manifestations. The symptoms that people often experience are…

  5. Depression.

    PubMed

    Weissman, Myrna

    2009-04-01

    This is an invited article on how my career as an epidemiologist studying depression unfolded. The role of the Civil Rights movement in opening the PhD doors to women at Yale began my career. The unfolding of depression studies are described. These studies included a clinical trial of medication and what later was known as interpersonal psychotherapy (IPT), the first community survey of psychiatric disorder, family genetic and brain imaging studies or depression and anxiety disorders. I hope the new generation will have the wonderful opportunities I have had.

  6. Depression.

    PubMed

    Weissman, Myrna

    2009-04-01

    This is an invited article on how my career as an epidemiologist studying depression unfolded. The role of the Civil Rights movement in opening the PhD doors to women at Yale began my career. The unfolding of depression studies are described. These studies included a clinical trial of medication and what later was known as interpersonal psychotherapy (IPT), the first community survey of psychiatric disorder, family genetic and brain imaging studies or depression and anxiety disorders. I hope the new generation will have the wonderful opportunities I have had. PMID:19344866

  7. Depression

    MedlinePlus

    ... newborns, as well as jitteriness, difficulty feeding, and low blood sugar after delivery. However, moms who stop medications can ... a kind of antidepressant for treating depression and anxiety disorders. However, a number of research studies show ...

  8. Efficacy of depression treatments for immigrant patients: results from a systematic review

    PubMed Central

    2014-01-01

    Background The unprecedented rates of global migration present unique challenges to mental health services in migrant receiving countries to provide efficacious and culturally salient treatment for mental health conditions including depression. This review aimed to identify and evaluate the effectiveness of depression interventions specifically directed towards first-generation immigrant populations. Methods We conducted a systematic review of original research published between 2000 and 2013 that investigated depression interventions in first generation immigrants. Results Fifteen studies were included; the majority focused on Latino immigrants living in the United States (US). Twelve studies investigated the use of psychotherapies; the remainder examined collaborative care models and physical exercise-based interventions. Cognitive Behavioral Therapy and Behavioral Activation tended to improve depressive symptoms, especially when culturally adapted to suit clients while Problem Solving Therapy improved depressive symptomology with and without adaptations. Collaborative care and exercise did not significantly improve depressive symptoms. Conclusion Depression may be effectively treated by means of psychotherapies, especially when treatments are culturally adapted. However the reviewed studies were limited due to methodological weaknesses and were predominantly undertaken in the US with Latino patients. To improve generalizability, future research should be undertaken in non-US settings, amongst diverse ethnic groups and utilize larger sample sizes in either randomized clinical trials or observational cohort studies. PMID:24930429

  9. Stress sensitivity interacts with depression history to predict depressive symptoms among youth: prospective changes following first depression onset.

    PubMed

    Technow, Jessica R; Hazel, Nicholas A; Abela, John R Z; Hankin, Benjamin L

    2015-04-01

    Predictors of depressive symptoms may differ before and after the first onset of major depression due to stress sensitization. Dependent stressors, or those to which characteristics of individuals contribute, have been shown to predict depressive symptoms in youth. The current study sought to clarify how stressors' roles may differ before and after the first depressive episode. Adolescents (N = 382, aged 11 to 15 at baseline) were assessed at baseline and every 3 months over the course of 2 years with measures of stressors and depressive symptoms. Semi-structured interviews were conducted every 6 months to assess for clinically significant depressive episodes. Hierarchical linear modeling showed a significant interaction between history of depression and idiographic fluctuations in dependent stressors to predict prospective elevations of symptoms, such that dependent stressors were more predictive of depressive symptoms after onset of disorder. Independent stressors predicted symptoms, but the strength of the association did not vary by depression history. These results suggest a synthesis of dependent stress and stress sensitization processes that might maintain inter-episode depressive symptoms among youth with a history of clinical depression.

  10. [Concept and results of an awareness campaign: the "Nuremberg Alliance against Depression"].

    PubMed

    Althaus, D; Hegerl, U

    2003-03-10

    Currently, only a small percentage of patients with depressive disorders receive adequate pharmacological or psychotherapeutic treatment. Apart from deficits in diagnosis and treatment, misconceptions and prejudice with regard to depression on the part of the public at large are major reasons for this situation. Fear of medical treatment, in particular, is common. Within the framework of a multilevel depression and suicide prevention program conducted in Nuremberg ("Nuremberg Alliance against Depression") in the years 2001 and 2002, an intensive public awareness campaign was undertaken; two telephone surveys were carried out to evaluate the outcome in comparison with a control region. The results revealed that awareness and knowledge of the condition among the public was considerably improved,while negative attitudes towards antidepressant medication remained unchanged.

  11. The effects of anti-depressants on depression symptom scores at 12 months follow-up in patients with cardiometabolic disease: Results from a large primary care cohort

    PubMed Central

    Jani, Bhautesh Dinesh; Purves, David; Barry, Sarah J. E.; McCowan, Colin; Cavanagh, Jonathan; Mair, Frances S.

    2015-01-01

    Background: Evidence on the long-term usefulness of anti-depressants in managing depression in cardiometabolic disease is limited. Aim: We examined the effects of anti-depressant prescribing on depressive symptoms at 12 months follow-up in patients with cardiometabolic disease and a positive depression screening result at baseline. Design and Setting: We retrospectively reviewed routine UK primary care data for patients with coronary heart disease, diabetes and previous stroke for the year 2008–2009. 35,537 patients with one of the three above diseases underwent depression screening using the Hospital Anxiety and Depression Scale (HADS-D). Of 7080 patients with a positive screening result (HADS-D ≥ 8), 3933 (55.5%) patients had a repeat HADS-D recorded at 12 months follow-up. Methods: We compared the change in HADS-D at follow-up and remission rate in those who were prescribed anti-depressants (n = 223) against those who were not (n = 3710). Results: The mean change in HADS-D from baseline, for the nonprescribed group was similar to the reduction observed in patients who were continuously prescribed (n = 93) with anti-depressants during follow-up. Patients who were prescribed intermittently (n = 72) or only one (n = 58) prescription during follow-up had a lower reduction in HADS-D compared to the nonprescribed group. There was no difference in remission rates between continuously prescribed and the nonprescribed group, but remission was lower in patients prescribed intermittently and single prescription. Conclusion: Improvement in depressive symptoms in patients with cardiometabolic disease at 12 months was not any better in patients prescribed with anti-depressants compared to the nonprescribed group. The role of anti-depressants in the management of depression in cardiometabolic disease merits further investigation. PMID:26286616

  12. Depression.

    PubMed

    Tallo, Donato

    2014-04-15

    Reading the CPD article was beneficial to my professional nursing practice and development. I gained a greater understanding of how depression is likely to exacerbate the effects of a physical illness or complicate the treatment of other health conditions. PMID:24712633

  13. Correlates and Predictors of Depression in College Students: Results from the Spring 2000 National College Health Assessment

    ERIC Educational Resources Information Center

    Leino, E. Victor; Kisch, Jeremy

    2005-01-01

    The present analyses used depression-related items and co-factors from the National College Health Assessment (NCHA), Spring 2000. The results indicate 10.3 % of college students (6.2% male and 12.6% female) reported ever having been diagnosed with depression. Of those ever diagnosed with depression, 39% were diagnosed in the last year, 27% were…

  14. Hydrologic and Geomorphic Changes Resulting from the Onset of Episodic Glacial Lake Outburst Floods: Colonia River, Chile

    NASA Astrophysics Data System (ADS)

    Jacquet, J.; McCoy, S. W.; McGrath, D.; Nimick, D.; Friesen, B.; Fahey, M. J.; Leidich, J.; Okuinghttons, J.

    2015-12-01

    The Colonia river system, draining the eastern edge of the Northern Patagonia Icefield, Chile, has experienced a dramatic shift in flow regime from one characterized by seasonal discharge variability to one dominated by episodic glacial lake outburst floods (GLOFs). We use multi-temporal visible satellite images, high-resolution digital elevation models (DEMs) derived from stereo image pairs, and in situ observations to quantify sediment and water fluxes out of the dammed glacial lake, Lago Cachet Dos (LC2), as well as the concomitant downstream environmental change. GLOFs initiated in April 2008 and have since occurred, on average, two to three times a year. Differencing concurrent gage measurements made on the Baker River upstream and downstream of the confluence with the Colonia river finds peak GLOF discharges of ~ 3,000 m3s-1, which is ~ 4 times the median discharge of the Baker River and over 20 times the median discharge of the Colonia river. During each GLOF, ~ 200,000,000 m3 of water evacuates from the LC2, resulting in erosion of valley-fill sediments and the delta on the upstream end of LC2. Differencing DEMs between April 2008 and February 2014 revealed that ~ 2.5 x 107 m3 of sediment was eroded. Multi-temporal DEM differencing shows that erosion rates were highest initially, with > 20 vertical m of sediment removed between 2008 and 2012, and generally less than 5 m between 2012 and 2014. The downstream Colonia River Sandur also experienced geomorphic changes due to GLOFs. Using Landsat imagery to calculate the normalized difference water index (NDWI), we demonstrate that the Colonia River was in a stable configuration between 1984 and 2008. At the onset of GLOFs in April 2008, a change in channel location began and continued with each subsequent GLOF. Quantification of sediment and water fluxes due to GLOFs in the Colonia river valley provides insight on the geomorphic and environmental changes in river systems experiencing dramatic shifts in flow

  15. Hospice Services for Complicated Grief and Depression: Results from a National Survey

    PubMed Central

    Ghesquiere, Angela R.; Aldridge, Melissa D.; Johnson-Hürzeler, Rosemary; Kaplan, Daniel; Bruce, Martha L.; Bradley, Elizabeth

    2016-01-01

    OBJECTIVES To describe the prevalence of screening for complicated grief (CG) and depression in hospice and access to bereavement therapy and to examine whether screening and access to therapy varied according to hospice organizational characteristics or staff training and involvement. DESIGN Cross-sectional national survey conducted from 2008 to 2009. SETTING United States. PARTICIPANTS Hospices (N = 591). MEASUREMENTS Whether hospices screened for depression or CG at the time of death or provided access to bereavement therapy (individual or group). Organizational characteristics included region, chain status, ownership, and patient volume. Staffing-related variables included training length and meeting attendance requirements. RESULTS Fifty-five percent of hospices provided screening for CG and depression and access to bereavement therapy, 13% provided screening but not access to bereavement therapy, 24% provided access to bereavement therapy but not screening, and 8% neither screened nor provided access to bereavement therapy. Hospices with 100 patients per day or more were significantly more likely to provide screening and access to bereavement therapy. CONCLUSION Hospices appear to have high capacity to provide screening for CG and depression and to deliver group and individual therapy, but data are needed on whether screeners are evidence based and whether therapy addresses CG or depression specifically. Future work could build upon existing infrastructure to ensure use of well-validated screeners and evidence-based therapies. PMID:26456597

  16. Importance of Depression in Diabetes.

    ERIC Educational Resources Information Center

    Lustman, Patrick J.; Clouse, Ray E.; Anderson, Ryan J.

    Depression doubles the likelihood of comorbid depression, which presents as major depression in 11% and subsyndromal depression in 31% of patients with the medical illness. The course of depression is chronic, and afflicted patients suffer an average of one episode annually. Depression has unique importance in diabetes because of its association…

  17. Effect of adjuvant sleep hygiene psychoeducation and lorazepam on depression and sleep quality in patients with major depressive disorders: results from a randomized three-arm intervention

    PubMed Central

    Rahimi, Alireza; Ahmadpanah, Mohammad; Shamsaei, Farshid; Cheraghi, Fatemeh; Sadeghi Bahmani, Dena; Holsboer-Trachsler, Edith; Brand, Serge

    2016-01-01

    Background Sleep disturbances are a common co-occurring disturbance in patients with major depressive disorders (MDDs) and accordingly deserve particular attention. Using a randomized design, we investigated the effects of three different adjuvant interventions on sleep and depression among patients with MDD: a sleep hygiene program (SHP), lorazepam (LOR), and their combination (SHP–LOR). Methods A total of 120 outpatients with diagnosed MDD (mean age: 48.25 years; 56.7% females) and treated with a standard SSRI (citalopram at 20–40 mg at therapeutic level) were randomly assigned to one of the following three conditions: SHP (n=40), LOR (1 mg/d; n=40), SHP–LOR (1 mg/d; n=40). At the beginning and at the end of the study 8 weeks later, patients completed two questionnaires, the Pittsburgh Sleep Quality Index to assess sleep and the Beck Depression Inventory to assess symptoms of depression. Results Sleep disturbances decreased over time and in all groups. No group differences or interactions were observed. Symptoms of depression decreased over time and in all three groups. Reduction in symptoms of depression was greatest in the SHP–LOR group and lowest in the LOR group. Conclusion The pattern of results suggests that all three adjuvant treatments improved symptoms of sleep disturbances and depression, with greater benefits for the SHP–LOR for symptoms of depression, but not for sleep. Nevertheless, risks and benefits of benzodiazepine prescriptions should be taken into account. PMID:27382293

  18. Adaptive learning can result in a failure to profit from good conditions: implications for understanding depression

    PubMed Central

    Trimmer, Pete C.; Higginson, Andrew D.; Fawcett, Tim W.; McNamara, John M.; Houston, Alasdair I.

    2015-01-01

    Background and objectives: Depression is a major medical problem diagnosed in an increasing proportion of people and for which commonly prescribed psychoactive drugs are frequently ineffective. Development of treatment options may be facilitated by an evolutionary perspective; several adaptive reasons for proneness to depression have been proposed. A common feature of many explanations is that depressive behaviour is a way to avoid costly effort where benefits are small and/or unlikely. However, this viewpoint fails to explain why low mood persists when the situation improves. We investigate whether a behavioural rule that is adapted to a stochastically changing world can cause inactivity which appears similar to the effect of depression, in that it persists after the situation has improved. Methodology: We develop an adaptive learning model in which an individual has repeated choices of whether to invest costly effort that may result in a net benefit. Investing effort also provides information about the current conditions and rates of change of the conditions. Results: An individual following the optimal behavioural strategy may sometimes remain inactive when conditions are favourable (i.e. when it would be better to invest effort) when it is poorly informed about the current environmental state. Initially benign conditions can predispose an individual to inactivity after a relatively brief period of negative experiences. Conclusions and implications: Our approach suggests that the antecedent factors causing depressed behaviour could go much further back in an individual s history than is currently appreciated. The insights from our approach have implications for the ongoing debate about best treatment options for patients with depressive symptoms. PMID:25916884

  19. Three year outcomes of an early intervention for psychosis service as compared with treatment as usual for first psychotic episodes in a standard community mental health team - final results.

    PubMed

    Agius, Mark; Shah, Samir; Ramkisson, Roshelle; Murphy, Suzanne; Zaman, Rashid

    2007-09-01

    Sixty-two patients who had been treated for three years in an ad-hoc, assertive treatment team for patients who had suffered a first psychotic episode were compared to sixty-two patients who had been followed up after a first psychotic episode in a community mental health team. All patients had suffered a first or early psychotic episode. The main differences between the two teams was that the ad-hoc team was assertive in its approach, offered more structured psycho-education, relapse prevention and psycho-social interventions, and had a policy of using atypical anti-psychotics at the lowest effective dose. There were many differences in outcome measures at the end of three years between the two groups. The EI patients are more likely to be taking medication at the end of three years. They are more compliant with medication. They are more likely to be prescribed Atypical Medication. The EI patients are more likely to have returned to Work or Education. The EI patients are more likely to remain living with their families. They are less likely to suffer depression to the extent of requiring anti-depressants. They appear to commit less suicide attempts. The patients in the EI service also appear to be less likely to suffer relapse and re-hospitalisation, and are less likely to have involuntary admission to hospital. They have systematic relapse prevention plans based on Early Warning Signs. They and their families receive more psycho-education. These indications suggest that the EI patients are at the end of three years better able to manage their illness/vulnerability on their own than the CMHT patients. More patients in the EI group stopped using illicit drugs than in the CMHT group. All the above changes were statistically significant except for the total improvement in employment status and education status, which however approached significance. These results suggest that an ad-hoc Early Intervention Team is more effective than standard Community Mental Health

  20. Depressive rumination alters cortisol decline in Major Depressive Disorder.

    PubMed

    LeMoult, Joelle; Joormann, Jutta

    2014-07-01

    Depressive rumination - a central characteristic of Major Depressive Disorder (MDD) - is a maladaptive emotion regulation strategy that prolongs sad mood and depressive episodes. Considerable research demonstrates the emotional and behavioral consequences of depressive rumination, yet few studies investigate its effect on neuroendocrine functioning. The current study examined the effect of an emotion regulation manipulation on the trajectory of cortisol concentrations among individuals with MDD and healthy controls (CTL). Sadness was induced via forced failure. Participants then were randomly assigned to a depressive rumination or distraction emotion regulation induction. MDDs in the rumination condition exhibited less cortisol decline compared to MDDs in the distraction condition and compared to CTLs in either condition. Findings suggest that depressive rumination alters the trajectory of cortisol secretion in MDD and may prolong cortisol production. Results thereby provide important insights into the interaction of biological and psychological factors through which distress contributes to MDD.

  1. Clinical Significance of the Number of Depressive Symptoms in Major Depressive Disorder: Results from the CRESCEND Study.

    PubMed

    Park, Seon-Cheol; Sakong, Jeongkyu; Koo, Bon Hoon; Kim, Jae-Min; Jun, Tae-Youn; Lee, Min-Soo; Kim, Jung-Bum; Yim, Hyeon-Woo; Park, Yong Chon

    2016-04-01

    Our study aimed to establish the relationship between the number of depressive symptoms and the clinical characteristics of major depressive disorder (MDD). This would enable us to predict the clinical significance of the number of depressive symptoms in MDD patients. Using data from the Clinical Research Center for Depression (CRESCEND) study in Korea, 853 patients with DSM-IV MDD were recruited. The baseline and clinical characteristics of groups with different numbers of depressive symptoms were compared using the χ(2) test for discrete variables and covariance (ANCOVA) for continuous variables. In addition, the scores of these groups on the measurement tools were compared by ANCOVA after adjusting the potential effects of confounding variables. After adjusting the effects of monthly income and history of depression, a larger number of depressive symptoms indicated higher overall severity of depression (F [4, 756] = 21.458, P < 0.001) and higher levels of depressive symptoms (F [4, 767] = 19.145, P < 0.001), anxiety symptoms (F [4, 765] = 12.890, P < 0.001) and suicidal ideation (F [4, 653] = 6.970, P < 0.001). It also indicated lower levels of social function (F [4, 760] = 13.343, P < 0.001), and quality of life (F [4, 656] = 11.975, P < 0.001). However, there were no significant differences in alcohol consumption (F [4, 656] = 11.975, P < 0.001). The number of depressive symptoms can be used as an index of greater illness burden in clinical psychiatry. PMID:27051248

  2. Clinical Significance of the Number of Depressive Symptoms in Major Depressive Disorder: Results from the CRESCEND Study

    PubMed Central

    2016-01-01

    Our study aimed to establish the relationship between the number of depressive symptoms and the clinical characteristics of major depressive disorder (MDD). This would enable us to predict the clinical significance of the number of depressive symptoms in MDD patients. Using data from the Clinical Research Center for Depression (CRESCEND) study in Korea, 853 patients with DSM-IV MDD were recruited. The baseline and clinical characteristics of groups with different numbers of depressive symptoms were compared using the χ2 test for discrete variables and covariance (ANCOVA) for continuous variables. In addition, the scores of these groups on the measurement tools were compared by ANCOVA after adjusting the potential effects of confounding variables. After adjusting the effects of monthly income and history of depression, a larger number of depressive symptoms indicated higher overall severity of depression (F [4, 756] = 21.458, P < 0.001) and higher levels of depressive symptoms (F [4, 767] = 19.145, P < 0.001), anxiety symptoms (F [4, 765] = 12.890, P < 0.001) and suicidal ideation (F [4, 653] = 6.970, P < 0.001). It also indicated lower levels of social function (F [4, 760] = 13.343, P < 0.001), and quality of life (F [4, 656] = 11.975, P < 0.001). However, there were no significant differences in alcohol consumption (F [4, 656] = 11.975, P < 0.001). The number of depressive symptoms can be used as an index of greater illness burden in clinical psychiatry. PMID:27051248

  3. Rejection episodes.

    PubMed

    Koyama, H; Cecka, J M

    1992-01-01

    Based upon analyses of 40,671 kidney transplants reported to the UNOS Scientific Renal Transplant Registry between October 1987 and August 1992: 1. Twenty-four percent of the 21,923 recipients of first cadaver grafts experienced one or more rejection episodes during their transplant hospitalization, 52% during the first 6 months. At 12 months, only 40% of patients remained rejection-free. Patients who experienced any rejection during the first 6 months had a 72% 1-year graft survival rate compared with 95% for those who remained rejection-free (p < 0.001). 2. Recipients of transplants from living donors had a significantly lower incidence of rejection episodes. There was a clear effect of histocompatibility in comparing the incidence of rejection in HLA-identical sibling transplants (8% at discharge and 32% at 1 year) with that in 1-haplotype disparate transplants (22% at discharge and 52% at 1 year, p < 0.01 at each time point). Rejections were reported for 25% of transplants from other living donors at discharge and for 56% at 1 year, similar to the figures for cadaver transplants. 3. Histocompatibility also influenced the incidence of rejection in first cadaver-donor transplants. Only 15% of recipients of 0-HLA-A,B mismatched kidneys had rejection episodes reported at discharge, compared with 26% of those who received kidneys completely mismatched for HLA-A,B antigens (p < 0.01). At 1 year, 56% of HLA-A,B matched patients remained rejection-free, whereas only 35% of those mismatched for 4 antigens had no reported rejection through the first year (p < 0.01). Considering HLA-DR antigen mismatches, 19% of the 0-antigen mismatched group had rejection episodes at discharge, versus 28% for those with 2 HLA-DR mismatches (p < 0.01), and at 1 year, the percentage who were rejection-free decreased from 48% to 40% and 34% with 0, 1, and 2 HLA-DR mismatches, respectively. 4. The incidence of rejection episodes decreased as the recipient's age increased. Patients under age

  4. Petrologic constraints on rift-zone processes - Results from episode 1 of the Puu Oo eruption of Kilauea volcano, Hawaii

    USGS Publications Warehouse

    Garcia, M.O.; Ho, R.A.; Rhodes, J.M.; Wolfe, E.W.

    1989-01-01

    The Puu Oo eruption in the middle of Kilauea volcano's east rift zone provides an excellent opportunity to utilize petrologic constraints to interpret rift-zone processes. Emplacement of a dike began 24 hours before the start of the eruption on 3 January 1983. Seismic and geodetic evidence indicates that the dike collided with a magma body in the rift zone. Most of the lava produced during the initial episode of the Puu Oo eruption is of hybrid composition, with petrographic and geochemical evidence of mixing magmas of highly evllved and more mafic compositions. Some olivine and plagioclase grains in the hybrid lavas show reverse zoning. Whole-rock compositional variations are linear even for normally compatible elements like Ni and Cr. Leastsquares mixing calculations yield good residuals for major and trace element analyses for magma mixing. Crystal fractionation calculations yield unsatisfactory residuals. The highly evolved magma is similar in composition to the lava from the 1977 eruption and, at one point, vents for these two eruptions are only 200 m apart. Possibly both the 1977 lava and the highly evolved component of the episode 1 Puu Oo lava were derived from a common body of rift-zone-stored magma. The more mafic mixing component may be represented by the most mafic lava from the January 1983 eruption; it shows no evidence of magma mixing. The dike that was intruded just prior to the start of the Puu Oo eruption may have acted as a hydraulic plunger causing mixing of the two rift-zone-stored magmas. ?? 1989 Springer-Verlag.

  5. Internet use, Facebook intrusion, and depression: Results of a cross-sectional study.

    PubMed

    Błachnio, A; Przepiórka, A; Pantic, I

    2015-09-01

    Facebook has become a very popular social networking platform today, particularly among adolescents and young adults, profoundly changing the way they communicate and interact. However, some reports have indicated that excessive Facebook use might have detrimental effects on mental health and be associated with certain psychological problems. Because previous findings on the relationship between Facebook addiction and depression were not unambiguous, further investigation was required. The main objective of our study was to examine the potential associations between Internet use, depression, and Facebook intrusion. A total of 672 Facebook users took part in the cross-sectional study. The Facebook Intrusion Questionnaire and the Center for Epidemiologic Studies Depression Scale were used. For collecting the data, the snowball sampling procedure was used. We showed that depression can be a predictor of Facebook intrusion. Our results provides additional evidence that daily Internet use time in minutes, gender, and age are also predictors of Facebook intrusion: that Facebook intrusion can be predicted by being male, young age, and an extensive number of minutes spent online. On the basis of this study, it is possible to conclude that there are certain demographic - variables, such as age, gender, or time spent online - that may help in outlining the profile of a user who may be in danger of becoming addicted to Facebook. This piece of knowledge may serve for prevention purposes. PMID:25963476

  6. Internet use, Facebook intrusion, and depression: Results of a cross-sectional study.

    PubMed

    Błachnio, A; Przepiórka, A; Pantic, I

    2015-09-01

    Facebook has become a very popular social networking platform today, particularly among adolescents and young adults, profoundly changing the way they communicate and interact. However, some reports have indicated that excessive Facebook use might have detrimental effects on mental health and be associated with certain psychological problems. Because previous findings on the relationship between Facebook addiction and depression were not unambiguous, further investigation was required. The main objective of our study was to examine the potential associations between Internet use, depression, and Facebook intrusion. A total of 672 Facebook users took part in the cross-sectional study. The Facebook Intrusion Questionnaire and the Center for Epidemiologic Studies Depression Scale were used. For collecting the data, the snowball sampling procedure was used. We showed that depression can be a predictor of Facebook intrusion. Our results provides additional evidence that daily Internet use time in minutes, gender, and age are also predictors of Facebook intrusion: that Facebook intrusion can be predicted by being male, young age, and an extensive number of minutes spent online. On the basis of this study, it is possible to conclude that there are certain demographic - variables, such as age, gender, or time spent online - that may help in outlining the profile of a user who may be in danger of becoming addicted to Facebook. This piece of knowledge may serve for prevention purposes.

  7. Ambient Air Pollution and Depressive Symptoms in Older Adults: Results from the MOBILIZE Boston Study

    PubMed Central

    Wang, Yi; Eliot, Melissa N.; Koutrakis, Petros; Gryparis, Alexandros; Schwartz, Joel D.; Coull, Brent A.; Mittleman, Murray A.; Milberg, William P.; Lipsitz, Lewis A.

    2014-01-01

    Background: Exposure to ambient air pollution, particularly from traffic, has been associated with adverse cognitive outcomes, but the association with depressive symptoms remains unclear. Objectives: We investigated the association between exposure to ambient air and traffic pollution and the presence of depressive symptoms among 732 Boston-area adults ≥ 65 years of age (78.1 ± 5.5 years, mean ± SD). Methods: We assessed depressive symptoms during home interviews using the Revised Center for Epidemiological Studies Depression Scale (CESD-R). We estimated residential distance to the nearest major roadway as a marker of long-term exposure to traffic pollution and assessed short-term exposure to ambient fine particulate matter (PM2.5), sulfates, black carbon (BC), ultrafine particles, and gaseous pollutants, averaged over the 2 weeks preceding each assessment. We used generalized estimating equations to estimate the odds ratio (OR) of a CESD-R score ≥ 16 associated with exposure, adjusting for potential confounders. In sensitivity analyses, we considered CESD-R score as a continuous outcome and mean annual residential BC as an alternate marker of long-term exposure to traffic pollution. Results: We found no evidence of a positive association between depressive symptoms and long-term exposure to traffic pollution or short-term changes in pollutant levels. For example, we found an OR of CESD-R score ≥ 16 of 0.67 (95% CI: 0.46, 0.98) per interquartile range (3.4 μg/m3) increase in PM2.5 over the 2 weeks preceding assessment. Conclusions: We found no evidence suggesting that ambient air pollution is associated with depressive symptoms among older adults living in a metropolitan area in attainment of current U.S. regulatory standards. Citation: Wang Y, Eliot MN, Koutrakis P, Gryparis A, Schwartz JD, Coull BA, Mittleman MA, Milberg WP, Lipsitz LA, Wellenius GA. 2014. Ambient air pollution and depressive symptoms in older adults: results from the MOBILIZE Boston

  8. Pain Coping Strategies and Depression in Rheumatoid Arthritis.

    ERIC Educational Resources Information Center

    Brown, Gregory K.; And Others

    1989-01-01

    Examined role of pain episodes and active and passive pain coping strategies in predicting depression in 287 patients with rheumatoid arthritis (RA). Findings revealed pain, passive coping, and interaction between the 2 accounted for higher depression. Results also indicated that frequent use of passive pain coping strategies in face of high pain…

  9. [Acoustic and optical perceptual disorders in depressive diseases--an overview of results from experimental studies].

    PubMed

    Kallert, T W

    1996-01-01

    This literature review concentrates on a disregarded part of depressive disorders' symptomatology (especially concerning present-day classifications of mental disorders) that can be approached with a great number of experimental procedures. From the acoustical field the following findings are demonstrated and discussed: elevated click thresholds in auditory signal detection, changed ear asymmetry in dichotic click detection and differences in dichotic listening asymmetries according to symptomatology. The most important results from the so far investigated optical perceptual disturbances in depressive disorders are: breakdown of perceptual defence in the form of greater access to emotionally unpleasant stimuli referring to the tachistoscopic recognition of neutral/unpleasant words, impairments at near-distance assessments, disturbances in recognition and discrimination of facial emotions-especially concerning the perception of emotional chimeric faces. Interpretational attempts for these acoustical and optical disturbances of perception reach from developmental psychology to biological psychiatry. Changes in hemisphere functions hold the dominating position in this discussion. Up to now it remains open to what extent the reported results correlate with the clinical phenomenology of depressive disorders, of what diagnostic specifity they are and if the can be viewed with sufficient reliability as state marker and indicators for theraopeutical effects.

  10. Estimating net drawdown resulting from episodic withdrawals at six well fields in the coastal plain physiographic province of Virginia

    USGS Publications Warehouse

    Focazio, M.J.; Speiran, G.K.

    1993-01-01

    The groundwater-flow system of the Virginia Coastal Plain consists of areally extensive and interconnected aquifers. Large, regionally coalescing cones of depression that are caused by large withdrawals of water are found in these aquifers. Local groundwater systems are affected by regional pumping, because of the interactions within the system of aquifers. Accordingly, these local systems are affected by regional groundwater flow and by spatial and temporal differences in withdrawals by various users. A geographic- information system was used to refine a regional groundwater-flow model around selected withdrawal centers. A method was developed in which drawdown maps that were simulated by the regional groundwater-flow model and the principle of superposition could be used to estimate drawdown at local sites. The method was applied to create drawdown maps in the Brightseat/Upper Potomac Aquifer for periods of 3, 6, 9, and 12 months for Chesapeake, Newport News, Norfolk, Portsmouth, Suffolk, and Virginia Beach, Virginia. Withdrawal rates were supplied by the individual localities and remained constant for each simulation period. This provides an efficient method by which the individual local groundwater users can determine the amount of drawdown produced by their wells in a groundwater system that is a water source for multiple users and that is affected by regional-flow systems.

  11. Plasminogen Activator Inhibitor-1 in depression: Results from Animal and Clinical Studies.

    PubMed

    Jiang, Haitang; Li, Xiaoli; Chen, Suzhen; Lu, Na; Yue, Yingying; Liang, Jinfeng; Zhang, Zhijun; Yuan, Yonggui

    2016-01-01

    Evidence suggests that plasminogen activator inhibitor-1 (PAI-1) is a stress-related factor, and serum PAI-1 levels are increased in patients with major depressive disorders (MDD). Herein, we analysed PAI-1 protein levels in the brain, cerebrospinal fluid (CSF) and serum of rodents exposed to chronic unpredictable mild stress or treated with escitalopram. In addition, we examined PAI-1 concentrations in serum obtained from 17 drug-free depressed patients before and after escitalopram treatment. We found that PAI-1 expression was increased in area 1 of the cingulate cortex and prelimbic cortex of the medial prefrontal cortex as well as in the hippocampal cornu ammonis 3 and dentate gyrus in stressed rats. A downregulation of PAI-1 following chronic escitalopram treatment was also found. PAI-1 levels were higher in the CSF and serum in stressed rats than in controls, although the difference did not reach statistical significance in the serum. Escitalopram treatment significantly decreased PAI-1 levels in the serum, but not in the CSF. MDD patients had significantly greater serum PAI-1 concentrations than controls. Our results suggest that PAI-1 is implicated in the pathophysiology of depression. PMID:27456456

  12. Plasminogen Activator Inhibitor-1 in depression: Results from Animal and Clinical Studies

    PubMed Central

    Jiang, Haitang; Li, Xiaoli; Chen, Suzhen; Lu, Na; Yue, Yingying; Liang, Jinfeng; Zhang, Zhijun; Yuan, Yonggui

    2016-01-01

    Evidence suggests that plasminogen activator inhibitor-1 (PAI-1) is a stress-related factor, and serum PAI-1 levels are increased in patients with major depressive disorders (MDD). Herein, we analysed PAI-1 protein levels in the brain, cerebrospinal fluid (CSF) and serum of rodents exposed to chronic unpredictable mild stress or treated with escitalopram. In addition, we examined PAI-1 concentrations in serum obtained from 17 drug-free depressed patients before and after escitalopram treatment. We found that PAI-1 expression was increased in area 1 of the cingulate cortex and prelimbic cortex of the medial prefrontal cortex as well as in the hippocampal cornu ammonis 3 and dentate gyrus in stressed rats. A downregulation of PAI-1 following chronic escitalopram treatment was also found. PAI-1 levels were higher in the CSF and serum in stressed rats than in controls, although the difference did not reach statistical significance in the serum. Escitalopram treatment significantly decreased PAI-1 levels in the serum, but not in the CSF. MDD patients had significantly greater serum PAI-1 concentrations than controls. Our results suggest that PAI-1 is implicated in the pathophysiology of depression. PMID:27456456

  13. Continuum beliefs in the stigma process regarding persons with schizophrenia and depression: results of path analyses

    PubMed Central

    Mnich, Eva E.; Angermeyer, Matthias C.; von dem Knesebeck, Olaf

    2016-01-01

    Background Individuals with mental illness often experience stigmatization and encounter stereotypes such as being dangerous or unpredictable. To further improve measures against psychiatric stigma, it is of importance to understand its components. In this study, we attend to the step of separation between “us” and “them” in the stigma process as conceptualized by Link and Phelan. In using the belief in continuity of mental illness symptoms as a proxy for separation, we explore its associations with stereotypes, emotional responses and desire for social distance in the stigma process. Methods Analyses are based on a representative survey in Germany. Vignettes with symptoms suggestive of schizophrenia (n = 1,338) or depression (n = 1,316) were presented to the respondents, followed by questions on continuum belief, stereotypes, emotional reactions and desire for social distance. To examine the relationship between these items, path models were computed. Results Respondents who endorsed the continuum belief tended to show greater prosocial reactions (schizophrenia: 0.07; p < 0.001, depression: 0.09; p < 0.001) and less desire for social distance (schizophrenia: −0.13; p < 0.001, depression: −0.14; p < 0.001) toward a person with mental illness. In both cases, agreement with the stereotypes of unpredictability and dangerousness was positively associated with feelings of anger and fear as well as desire for social distance. There were no statistically significant relations between stereotypes and continuum beliefs. Discussion Assumptions regarding continuum beliefs in the stigma process were only partially confirmed. However, there were associations of continuum beliefs with less stigmatizing attitudes toward persons affected by either schizophrenia or depression. Including information on continuity of symptoms, and thus oppose perceived separation, could prove helpful in future anti-stigma campaigns. PMID:27703840

  14. Norbin ablation results in defective adult hippocampal neurogenesis and depressive-like behavior in mice.

    PubMed

    Wang, Hong; Warner-Schmidt, Jennifer; Varela, Santiago; Enikolopov, Grigori; Greengard, Paul; Flajolet, Marc

    2015-08-01

    Adult neurogenesis in the hippocampus subgranular zone is associated with the etiology and treatment efficiency of depression. Factors that affect adult hippocampal neurogenesis have been shown to contribute to the neuropathology of depression. Glutamate, the major excitatory neurotransmitter, plays a critical role in different aspects of neurogenesis. Of the eight metabotropic glutamate receptors (mGluRs), mGluR5 is the most highly expressed in neural stem cells. We previously identified Norbin as a positive regulator of mGluR5 and showed that its expression promotes neurite outgrowth. In this study, we investigated the role of Norbin in adult neurogenesis and depressive-like behaviors using Norbin-deficient mice. We found that Norbin deletion significantly reduced hippocampal neurogenesis; specifically, the loss of Norbin impaired the proliferation and maturation of newborn neurons without affecting cell-fate specification of neural stem cells/neural progenitor cells (NSCs/NPCs). Norbin is highly expressed in the granular neurons in the dentate gyrus of the hippocampus, but it is undetectable in NSCs/NPCs or immature neurons, suggesting that the effect of Norbin on neurogenesis is likely caused by a nonautonomous niche effect. In support of this hypothesis, we found that the expression of a cell-cell contact gene, Desmoplakin, is greatly reduced in Norbin-deletion mice. Moreover, Norbin-KO mice show an increased immobility in the forced-swim test and the tail-suspension test and reduced sucrose preference compared with wild-type controls. Taken together, these results show that Norbin is a regulator of adult hippocampal neurogenesis and that its deletion causes depressive-like behaviors.

  15. Norbin ablation results in defective adult hippocampal neurogenesis and depressive-like behavior in mice

    PubMed Central

    Wang, Hong; Warner-Schmidt, Jennifer; Varela, Santiago; Enikolopov, Grigori; Greengard, Paul; Flajolet, Marc

    2015-01-01

    Adult neurogenesis in the hippocampus subgranular zone is associated with the etiology and treatment efficiency of depression. Factors that affect adult hippocampal neurogenesis have been shown to contribute to the neuropathology of depression. Glutamate, the major excitatory neurotransmitter, plays a critical role in different aspects of neurogenesis. Of the eight metabotropic glutamate receptors (mGluRs), mGluR5 is the most highly expressed in neural stem cells. We previously identified Norbin as a positive regulator of mGluR5 and showed that its expression promotes neurite outgrowth. In this study, we investigated the role of Norbin in adult neurogenesis and depressive-like behaviors using Norbin-deficient mice. We found that Norbin deletion significantly reduced hippocampal neurogenesis; specifically, the loss of Norbin impaired the proliferation and maturation of newborn neurons without affecting cell-fate specification of neural stem cells/neural progenitor cells (NSCs/NPCs). Norbin is highly expressed in the granular neurons in the dentate gyrus of the hippocampus, but it is undetectable in NSCs/NPCs or immature neurons, suggesting that the effect of Norbin on neurogenesis is likely caused by a nonautonomous niche effect. In support of this hypothesis, we found that the expression of a cell–cell contact gene, Desmoplakin, is greatly reduced in Norbin-deletion mice. Moreover, Norbin-KO mice show an increased immobility in the forced-swim test and the tail-suspension test and reduced sucrose preference compared with wild-type controls. Taken together, these results show that Norbin is a regulator of adult hippocampal neurogenesis and that its deletion causes depressive-like behaviors. PMID:26195764

  16. Mild traumatic brain injury results in depressed cerebral glucose uptake: An (18)FDG PET study.

    PubMed

    Selwyn, Reed; Hockenbury, Nicole; Jaiswal, Shalini; Mathur, Sanjeev; Armstrong, Regina C; Byrnes, Kimberly R

    2013-12-01

    Moderate to severe traumatic brain injury (TBI) in humans and rats induces measurable metabolic changes, including a sustained depression in cerebral glucose uptake. However, the effect of a mild TBI on brain glucose uptake is unclear, particularly in rodent models. This study aimed to determine the glucose uptake pattern in the brain after a mild lateral fluid percussion (LFP) TBI. Briefly, adult male rats were subjected to a mild LFP and positron emission tomography (PET) imaging with (18)F-fluorodeoxyglucose ((18)FDG), which was performed prior to injury and at 3 and 24 h and 5, 9, and 16 days post-injury. Locomotor function was assessed prior to injury and at 1, 3, 7, 14, and 21 days after injury using modified beam walk tasks to confirm injury severity. Histology was performed at either 10 or 21 days post-injury. Analysis of function revealed a transient impairment in locomotor ability, which corresponds to a mild TBI. Using reference region normalization, PET imaging revealed that mild LFP-induced TBI depresses glucose uptake in both the ipsilateral and contralateral hemispheres in comparison with sham-injured and naïve controls from 3 h to 5 days post-injury. Further, areas of depressed glucose uptake were associated with regions of glial activation and axonal damage, but no measurable change in neuronal loss or gross tissue damage was observed. In conclusion, we show that mild TBI, which is characterized by transient impairments in function, axonal damage, and glial activation, results in an observable depression in overall brain glucose uptake using (18)FDG-PET. PMID:23829400

  17. Maternal depression from pregnancy to 4 years postpartum and emotional/behavioural difficulties in children: results from a prospective pregnancy cohort study.

    PubMed

    Woolhouse, Hannah; Gartland, Deirdre; Mensah, Fiona; Giallo, Rebecca; Brown, Stephanie

    2016-02-01

    Considerable attention has been focused on women's mental health in the perinatal period and the subsequent impacts on children. Comparatively, we know much less about maternal depression at later time points and the potential implications for child mental health. The objective of this paper was to explore the association between maternal depression and child emotional/behavioural difficulties at 4 years postpartum, taking into account earlier episodes of perinatal depression. The Maternal Health Study is a prospective cohort study of 1,507 nulliparous women. Maternal depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS) in early pregnancy and at 3, 6 and 12 months postpartum and again at 4 years postpartum. Maternal depressive symptoms at 4 years postpartum were associated with significantly increased odds of child emotional/behavioural difficulties (odds ratio (OR) = 3.46, 95 % confidence interval (CI) = 2.21-5.43). This remained significant after adjusting for earlier episodes of perinatal depression and socio-demographic characteristics (OR = 2.07, 95 % CI = 1.18-3.63). We also observed a robust association between child difficulties at age 4 and measures of socio-economic disadvantage. Our findings suggest a pressing need to rethink current paradigms of maternal health surveillance and extend mental health surveillance and support to at least 4 years postpartum. PMID:26271281

  18. The Importance of Irritability as a Symptom of Major Depressive Disorder: Results from the National Comorbidity Survey Replication

    PubMed Central

    Fava, Maurizio; Hwang, Irving; Rush, A. John; Sampson, Nancy; Walters, Ellen E.; Kessler, Ronald C.

    2010-01-01

    Irritability is a diagnostic symptom of child-adolescent but not adult major depressive disorder (MDD) in both the DSM-IV and ICD-10 systems. We explore the importance of irritability for sub-typing adult DSM-IV MDD in the National Comorbidity Survey Replication (NCS-R), a national US adult household survey. The WHO Composite International Diagnostic Interview (CIDI) was used to assess prevalence of many DSM-IV disorders in the lifetime and in the year before interview (12-month prevalence). MDD was assessed conventionally (i.e., requiring either persistent sadness or loss of interest), but with irritability included as one of the Criterion A symptoms. We also considered the possibility that irritability might be a diagnostic symptom of adult MDD (i.e., detect cases who had neither sad mood nor loss of interest). Twelve-month MDD symptom severity was assessed with the Quick Inventory of Depressive Symptomatology and role impairment with the Sheehan Disability Scale. After excluding bipolar spectrum disorders, irritability during depressive episodes was reported by roughly half of respondents with lifetime DSM-IV MDD. Irritability in the absence of either sad mood or loss of interest, in comparison, was rare. Irritability in MDD was associated with early age-of-onset, lifetime persistence, comorbidity with anxiety and impulse-control disorders, fatigue and self-reproach during episodes, and disability. Irritability was especially common in MDD among respondents in the age range 18–44 and students. Further investigation is warranted of distinct family aggregation, risk factors, and treatment response. Consideration should also be given to including irritability as a non-diagnostic symptom of adult MDD in DSM-V and ICD-11. PMID:19274052

  19. Potential Relationship between Season of Birth and Clinical Characteristics in Major Depressive Disorder in Koreans: Results from the CRESCEND Study

    PubMed Central

    Park, Seon-Cheol; Sakong, Jeong-Kyu; Koo, Bon Hoon; Kim, Jae-Min; Jun, Tae-Youn; Lee, Min-Soo; Kim, Jung-Bum; Yim, Hyeon-Woo

    2016-01-01

    We aimed to examine the potential relationship between season of birth (SOB) and clinical characteristics in Korean patients with unipolar non-psychotic major depressive disorder (MDD). Using data from the Clinical Research Center for Depression (CRESCEND) study in South Korea, 891 MDD patients were divided into two groups, those born in spring/summer (n=457) and those born in autumn/winter (n=434). Measurement tools comprising the Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Brief Psychiatric Rating Scale, Scale for Suicidal Ideation, Clinical Global Impression of severity, Social and Occupation Functional Assessment Scale, WHO Quality of Life assessment instrument-abbreviated version, Alcohol Use Disorder Identification Test, and Temperament and Character Inventory were used to evaluate depression, anxiety, overall symptoms, suicidal ideation, global severity, social function, quality of life, drinking, and temperament and character, respectively. Using independent t-tests for continuous variables and χ2 tests for discrete variables, the clinical characteristics of the two groups were compared. MDD patients born in spring/summer were on average younger at onset of first depressive episode (t=2.084, p=0.038), had greater loss of concentration (χ2=4.589, p=0.032), and were more self-directed (t=2.256, p=0.025) than those born in autumn/winter. Clinically, there was a trend for the MDD patients born in spring/summer to display the contradictory characteristics of more severe clinical course and less illness burden; this may have been partly due to a paradoxical effect of the 5-HT system. PMID:26996582

  20. Seasonal Variation of Depressive Symptoms in Unipolar Major Depressive Disorder

    PubMed Central

    Cobb, Bryan S.; Coryell, William H.; Cavanaugh, Joseph; Keller, Martin; Solomon, David A.; Endicott, Jean; Potash, James B.; Fiedorowicz, Jess G.

    2014-01-01

    Objectives Retrospective and cross-sectional studies of seasonal variation of depressive symptoms in unipolar major depression have yielded conflicting results. We examined seasonal variation of mood symptoms in a long-term prospective cohort – the Collaborative Depression Study (CDS). Methods The sample included 298 CDS participants from five academic centers with a prospectively derived diagnosis of unipolar major depression who were followed for at least ten years of annual or semi-annual assessments. Generalized linear mixed models were utilized to investigate the presence of seasonal patterns. In a subset of 271 participants followed for at least 20 years, the stability of a winter depressive pattern was assessed across the first two decades of follow-up. Results A small increase in proportion of time depressed was found in the months surrounding the winter solstice, although the greatest symptom burden was seen in December through April with a peak in March. The relative burden of winter depressive symptoms in the first decade demonstrated no relationship to that of the second decade. The onset of new episodes was highest October through January, peaking in January. Conclusions There exists a small but statistically significant peak in depressive symptoms from the month of the winter solstice to the month of the spring equinox. However, the predominance of winter depressive symptoms did not appear stable over the long-term course of illness. PMID:25176622

  1. Depressive Symptoms, Psychiatric Medication Use, and Risk of Type 2 Diabetes: Results from the Health and Retirement Study

    PubMed Central

    Ratliff, Scott; Mezuk, Briana

    2015-01-01

    Objective This prospective study investigates the relationships between depressive symptoms, psychiatric medication use, and their interaction on risk of developing type 2 diabetes. Method Data come from the 1998 – 2010 waves of the Health and Retirement Study, a U.S. nationally-representative cohort of adults aged 51 and older. Analysis is restricted to participants <65 who did not have diabetes in 1998 (N=8,704). Depressive symptoms were assessed using the 8-item Center for Epidemiologic Studies–Depression scale. Risk of diabetes over the 12-year follow-up period was assessed using Cox proportional hazard models with time-varying covariates. Results After adjusting for covariates, both depressive symptoms (hazard ratio [HR]: 1.06, 95% Confidence Interval [CI]: 1.02 – 1.09) and psychiatric medication use (HR: 1.57, 95% CI: 1.25 – 1.96) were associated with development of diabetes. The interaction between depressive symptoms and medication use was significant (beta = −0.240, p = .049), indicating that the association between elevated depressive symptoms and diabetes was higher among respondents not taking medications. The associations between depressive symptoms and medication use were also attenuated by increasing BMI. Conclusion Findings highlight the complex relationship between depressive symptoms and psychiatric medications on diabetes risk, and the need for a nuanced understanding of these factors. PMID:26094130

  2. Episodic coronal heating

    NASA Technical Reports Server (NTRS)

    Sturrock, P. A.; Dixon, W. W.; Klimchuk, J. A.; Antiochos, S. K.

    1990-01-01

    A study is made of the observational consequences of the hypothesis that there is no steady coronal heating, the solar corona instead being heated episodically, such that each short burst of heating is followed by a long period of radiative cooling. The form of the resulting contribution to the differential emission measure (DEM), and to a convenient related function (the differential energy flux, DEF) is calculated. Observational data for the quiet solar atmosphere indicate that the upper branch of the DEM, corresponding to temperatures above 100,000 K, can be interpreted in terms of episodic energy injection at coronal temperatures.

  3. Impact of increasing heat waves on U.S. ozone episodes in the 2050s: Results from a multimodel analysis using extreme value theory

    NASA Astrophysics Data System (ADS)

    Shen, L.; Mickley, L. J.; Gilleland, E.

    2016-04-01

    We develop a statistical model using extreme value theory to estimate the 2000-2050 changes in ozone episodes across the United States. We model the relationships between daily maximum temperature (Tmax) and maximum daily 8 h average (MDA8) ozone in May-September over 2003-2012 using a Point Process (PP) model. At ~20% of the sites, a marked decrease in the ozone-temperature slope occurs at high temperatures, defined as ozone suppression. The PP model sometimes fails to capture ozone-Tmax relationships, so we refit the ozone-Tmax slope using logistic regression and a generalized Pareto distribution model. We then apply the resulting hybrid-extreme value theory model to projections of Tmax from an ensemble of downscaled climate models. Assuming constant anthropogenic emissions at the present level, we find an average increase of 2.3 d a-1 in ozone episodes (>75 ppbv) across the United States by the 2050s, with a change of +3-9 d a-1 at many sites.

  4. The controversial link between antidepressants and suicidality risks in adults: data from a naturalistic study on a large sample of in-patients with a major depressive episode.

    PubMed

    Seemüller, Florian; Riedel, Michael; Obermeier, Michael; Bauer, Michael; Adli, Mazda; Mundt, Christoph; Holsboer, Florian; Brieger, Peter; Laux, Gerd; Bender, Wolfram; Heuser, Isabella; Zeiler, Joachim; Gaebel, Wolfgang; Jäger, Markus; Henkel, Verena; Möller, Hans-Jürgen

    2009-03-01

    Some meta-analyses of randomized placebo-controlled trials on antidepressants conclude that there might be an increased risk for suicidal behaviour, especially in children and adolescents but also in adults. Placebo-controlled trials exclude patients with serious suicidality and might therefore underestimate the risk of respective adverse events. The change of suicidal ideation and the prevalence of suicides and non-fatal suicide attempts were therefore analysed in a large naturalistic prospective multicentre study of depressed in-patients. Additionally, specific risk factors for new emergence of suicidal ideation were investigated. The naturalistic prospective study was performed in 12 psychiatric hospitals of the German research network on depression and suicidality (seven psychiatric university hospitals and five district hospitals) in Germany. All patients (n=1014) were hospitalized and had to meet DSM-IV criteria for major depressive disorder. Six events were defined for the purposes of statistical analysis: 'emergence', 'extended emergence', 'improvement' and 'worsening of suicidal ideation', 'suicide attempts' and 'suicides'. Logistic regression analysis and classification and regression trees (CART) analyses were conducted to determine specific risk factors for new emergence of suicidal ideation. The mean HAMD total score decreased from 24.8 at baseline to 10 after 10 wk. An effect on suicidality was evident by week 2 in the sense of a decrease of the mean HAMD item-3 score. Emergence, worsening and improvement of suicidal ideation occurred in 3.2%, 14.74% and 90.79% of patients, respectively. A total of 10 suicide attempts and two suicides were reported. The rate of suicides (13.44/1000 patient-years) was rather low and comparable to the rate observed in randomized controlled antidepressant trials. Five risk factors for emergence of suicidal ideation were determined with two independent statistical methods: age (with higher risk at age <45 yr), treatment

  5. Type 2 Deiodinase Disruption in Astrocytes Results in Anxiety-Depressive-Like Behavior in Male Mice.

    PubMed

    Bocco, Barbara M L C; Werneck-de-Castro, João Pedro; Oliveira, Kelen C; Fernandes, Gustavo W; Fonseca, Tatiana L; Nascimento, Bruna P P; McAninch, Elizabeth A; Ricci, Esther; Kvárta-Papp, Zsuzsanna; Fekete, Csaba; Bernardi, Maria Martha; Gereben, Balázs; Bianco, Antonio C; Ribeiro, Miriam O

    2016-09-01

    Millions of levothyroxine-treated hypothyroid patients complain of impaired cognition despite normal TSH serum levels. This could reflect abnormalities in the type 2 deiodinase (D2)-mediated T4-to-T3 conversion, given their much greater dependence on the D2 pathway for T3 production. T3 normally reaches the brain directly from the circulation or is produced locally by D2 in astrocytes. Here we report that mice with astrocyte-specific Dio2 inactivation (Astro-D2KO) have normal serum T3 but exhibit anxiety-depression-like behavior as found in open field and elevated plus maze studies and when tested for depression using the tail-suspension and the forced-swimming tests. Remarkably, 4 weeks of daily treadmill exercise sessions eliminated this phenotype. Microarray gene expression profiling of the Astro-D2KO hippocampi identified an enrichment of three gene sets related to inflammation and impoverishment of three gene sets related to mitochondrial function and response to oxidative stress. Despite normal neurogenesis, the Astro-D2KO hippocampi exhibited decreased expression of four of six known to be positively regulated genes by T3, ie, Mbp (∼43%), Mag (∼34%), Hr (∼49%), and Aldh1a1 (∼61%) and increased expression of 3 of 12 genes negatively regulated by T3, ie, Dgkg (∼17%), Syce2 (∼26%), and Col6a1 (∼3-fold) by quantitative real-time PCR. Notably, in Astro-D2KO animals, there was also a reduction in mRNA levels of genes known to be affected in classical animal models of depression, ie, Bdnf (∼18%), Ntf3 (∼43%), Nmdar (∼26%), and GR (∼20%), which were also normalized by daily exercise sessions. These findings suggest that defects in Dio2 expression in the brain could result in mood and behavioral disorders. PMID:27501182

  6. Impact of childhood trauma on postpartum depression: a prospective study.

    PubMed

    De Venter, Maud; Smets, Jorien; Raes, Filip; Wouters, Kristien; Franck, Erik; Hanssens, Myriam; Jacquemyn, Yves; Sabbe, Bernard G C; Van Den Eede, Filip

    2016-04-01

    Studies on the impact of childhood trauma on postpartum depression show inconsistencies and methodological limitations. The present study examines the effect of childhood trauma on depression 12 and 24 weeks after childbirth, while controlling for history of depression, depression symptoms during pregnancy and type D personality. During the third trimester of pregnancy, 210 women completed self-report questionnaires assessing depression (current and/or past episodes), childhood trauma and type D personality, of whom 187 participated in the postpartum follow-up, with depression symptoms being reassessed at 12 and 24 weeks after delivery with three depression outcome measures. Eventually, 183 participants were retained for analysis. Results indicated no predictive value of childhood trauma on postpartum depression in the univariate analyses, nor after controlling for previous depression, depression symptoms during pregnancy and type D personality. However, past depression and depression symptoms during pregnancy did independently and convincingly predict postpartum depression, especially at 12 weeks and to a lesser extent at 24 weeks following childbirth. Overall, we found no significant association between childhood trauma and postpartum depression. Past depression and depression symptoms during pregnancy are more relevant factors to assess before childbirth.

  7. Impact of childhood trauma on postpartum depression: a prospective study.

    PubMed

    De Venter, Maud; Smets, Jorien; Raes, Filip; Wouters, Kristien; Franck, Erik; Hanssens, Myriam; Jacquemyn, Yves; Sabbe, Bernard G C; Van Den Eede, Filip

    2016-04-01

    Studies on the impact of childhood trauma on postpartum depression show inconsistencies and methodological limitations. The present study examines the effect of childhood trauma on depression 12 and 24 weeks after childbirth, while controlling for history of depression, depression symptoms during pregnancy and type D personality. During the third trimester of pregnancy, 210 women completed self-report questionnaires assessing depression (current and/or past episodes), childhood trauma and type D personality, of whom 187 participated in the postpartum follow-up, with depression symptoms being reassessed at 12 and 24 weeks after delivery with three depression outcome measures. Eventually, 183 participants were retained for analysis. Results indicated no predictive value of childhood trauma on postpartum depression in the univariate analyses, nor after controlling for previous depression, depression symptoms during pregnancy and type D personality. However, past depression and depression symptoms during pregnancy did independently and convincingly predict postpartum depression, especially at 12 weeks and to a lesser extent at 24 weeks following childbirth. Overall, we found no significant association between childhood trauma and postpartum depression. Past depression and depression symptoms during pregnancy are more relevant factors to assess before childbirth. PMID:26189446

  8. The evolution of episodic memory

    PubMed Central

    Allen, Timothy A.; Fortin, Norbert J.

    2013-01-01

    One prominent view holds that episodic memory emerged recently in humans and lacks a “(neo)Darwinian evolution” [Tulving E (2002) Annu Rev Psychol 53:1–25]. Here, we review evidence supporting the alternative perspective that episodic memory has a long evolutionary history. We show that fundamental features of episodic memory capacity are present in mammals and birds and that the major brain regions responsible for episodic memory in humans have anatomical and functional homologs in other species. We propose that episodic memory capacity depends on a fundamental neural circuit that is similar across mammalian and avian species, suggesting that protoepisodic memory systems exist across amniotes and, possibly, all vertebrates. The implication is that episodic memory in diverse species may primarily be due to a shared underlying neural ancestry, rather than the result of evolutionary convergence. We also discuss potential advantages that episodic memory may offer, as well as species-specific divergences that have developed on top of the fundamental episodic memory architecture. We conclude by identifying possible time points for the emergence of episodic memory in evolution, to help guide further research in this area. PMID:23754432

  9. Psychotherapy for subclinical depression: meta-analysis

    PubMed Central

    Cuijpers, Pim; Koole, Sander L.; van Dijke, Annemiek; Roca, Miquel; Li, Juan; Reynolds, Charles F.

    2014-01-01

    Background There is controversy about whether psychotherapies are effective in the treatment of subclinical depression, defined by clinically relevant depressive symptoms in the absence of a major depressive disorder. Aims To examine whether psychotherapies are effective in reducing depressive symptoms, reduce the risk of developing major depressive disorder and have comparable effects to psychological treatment of major depression. Method We conducted a meta-analysis of 18 studies comparing a psychological treatment of subclinical depression with a control group. Results The target groups, therapies and characteristics of the included studies differed considerably from each other, and the quality of many studies was not optimal. Psychotherapies did have a small to moderate effect on depressive symptoms against care as usual at the post-test assessment (g = 0.35, 95% CI 0.23-0.47; NNT = 5, 95% CI 4-8) and significantly reduced the incidence of major depressive episodes at 6 months (RR = 0.61) and possibly at 12 months (RR = 0.74). The effects were significantly smaller than those of psychotherapy for major depressive disorder and could be accounted for by non-specific effects of treatment. Conclusions Psychotherapy may be effective in the treatment of subclinical depression and reduce the incidence of major depression, but more high-quality research is needed. PMID:25274315

  10. Depressive symptoms and carotid intima-media thickness in South American Hispanics: results from the PREVENCION study.

    PubMed

    Chirinos, Diana A; Medina-Lezama, Josefina; Salinas-Najarro, Belissa; Arguelles, William; Llabre, Maria M; Schneiderman, Neil; Paz-Manrique, Roberto; Bolanos, Juan F; Khan, Zubair; Chirinos, Julio A

    2015-04-01

    This study aimed to: (1) examine the relationship between depressive symptoms and subclinical atherosclerosis, measured by carotid intima-media thickness (IMT); and, (2) Determine the moderating effect of gender in this relationship among South American Hispanics. We studied 496 adults enrolled in the population-based PREVENCION study. Carotid IMT was measured with high-resolution ultrasonography. Depressive symptoms were assessed using the Hospital Anxiety and Depression Scale. Mean carotid IMT was 0.66 mm. (SD = 0.17) and mean depression score was 5.6 (SD = 3.5). Depressive symptoms were not associated with carotid IMT (β = 0.04, p = 0.222) in multivariate analyses. A significant moderating effect of gender was found (β for interaction = 0.10, p = 0.030), resulting from a significant association between depressive symptoms and carotid IMT in men but not women. Depressive symptoms were associated with subclinical atherosclerosis in South American Hispanic men but not women after controlling for demographic characteristics and traditional cardiovascular risk factors.

  11. The Bipolar II Depression Questionnaire: A Self-Report Tool for Detecting Bipolar II Depression

    PubMed Central

    Leung, Chi Ming; Yim, Chi Lap; Yan, Connie T. Y.; Chan, Cheuk Chi; Xiang, Yu-Tao; Mak, Arthur D. P.; Fok, Marcella Lei-Yee; Ungvari, Gabor S.

    2016-01-01

    Bipolar II (BP-II) depression is often misdiagnosed as unipolar (UP) depression, resulting in suboptimal treatment. Tools for differentiating between these two types of depression are lacking. This study aimed to develop a simple, self-report screening instrument to help distinguish BP-II depression from UP depressive disorder. A prototype BP-II depression questionnaire (BPIIDQ-P) was constructed following a literature review, panel discussions and a field trial. Consecutively assessed patients with a diagnosis of depressive disorder or BP with depressive episodes completed the BPIIDQ-P at a psychiatric outpatient clinic in Hong Kong between October and December 2013. Data were analyzed using discriminant analysis and logistic regression. Of the 298 subjects recruited, 65 (21.8%) were males and 233 (78.2%) females. There were 112 (37.6%) subjects with BP depression [BP-I = 42 (14.1%), BP-II = 70 (23.5%)] and 182 (62.4%) with UP depression. Based on family history, age at onset, postpartum depression, episodic course, attacks of anxiety, hypersomnia, social phobia and agoraphobia, the 8-item BPIIDQ-8 was constructed. The BPIIDQ-8 differentiated subjects with BP-II from those with UP depression with a sensitivity/specificity of 0.75/0.63 for the whole sample and 0.77/0.72 for a female subgroup with a history of childbirth. The BPIIDQ-8 can differentiate BP-II from UP depression at the secondary care level with satisfactory to good reliability and validity. It has good potential as a screening tool for BP-II depression in primary care settings. Recall bias, the relatively small sample size, and the high proportion of females in the BP-II sample limit the generalization of the results. PMID:26963908

  12. The Bipolar II Depression Questionnaire: A Self-Report Tool for Detecting Bipolar II Depression.

    PubMed

    Leung, Chi Ming; Yim, Chi Lap; Yan, Connie T Y; Chan, Cheuk Chi; Xiang, Yu-Tao; Mak, Arthur D P; Fok, Marcella Lei-Yee; Ungvari, Gabor S

    2016-01-01

    Bipolar II (BP-II) depression is often misdiagnosed as unipolar (UP) depression, resulting in suboptimal treatment. Tools for differentiating between these two types of depression are lacking. This study aimed to develop a simple, self-report screening instrument to help distinguish BP-II depression from UP depressive disorder. A prototype BP-II depression questionnaire (BPIIDQ-P) was constructed following a literature review, panel discussions and a field trial. Consecutively assessed patients with a diagnosis of depressive disorder or BP with depressive episodes completed the BPIIDQ-P at a psychiatric outpatient clinic in Hong Kong between October and December 2013. Data were analyzed using discriminant analysis and logistic regression. Of the 298 subjects recruited, 65 (21.8%) were males and 233 (78.2%) females. There were 112 (37.6%) subjects with BP depression [BP-I = 42 (14.1%), BP-II = 70 (23.5%)] and 182 (62.4%) with UP depression. Based on family history, age at onset, postpartum depression, episodic course, attacks of anxiety, hypersomnia, social phobia and agoraphobia, the 8-item BPIIDQ-8 was constructed. The BPIIDQ-8 differentiated subjects with BP-II from those with UP depression with a sensitivity/specificity of 0.75/0.63 for the whole sample and 0.77/0.72 for a female subgroup with a history of childbirth. The BPIIDQ-8 can differentiate BP-II from UP depression at the secondary care level with satisfactory to good reliability and validity. It has good potential as a screening tool for BP-II depression in primary care settings. Recall bias, the relatively small sample size, and the high proportion of females in the BP-II sample limit the generalization of the results. PMID:26963908

  13. LONGITUDINAL COURSE OF ADOLESCENT DEPRESSION: NEUROENDOCRINE AND PSYCHOSOCIAL PREDICTORS

    PubMed Central

    Rao, Uma; Hammen, Constance L.; Poland, Russell E.

    2009-01-01

    Objective The study examined whether cortisol measures are associated with the clinical course of depression in adolescents. Further, the study evaluated whether the relationship between cortisol and clinical course is moderated by environmental stress and/or social support. Method Fifty-five adolescents with depression (age range 13–18) were recruited. In addition to a systematic diagnostic assessment, information was obtained on environmental stress and social support. Urinary free cortisol measures were collected on three consecutive nights during the index episode. Clinical follow-up evaluations were conducted at regular intervals over a 5-year period, documenting recovery from the index depressive episode and recurrent episodes. Information on environmental stress and social support also was gathered during each follow-up assessment. Results Consistent with prior reports, the majority of adolescents (92.2%) recovered from the initial depressive episode. A substantial proportion of the recovered youth (42.6%) experienced a subsequent episode during the follow-up period. Higher cortisol levels were associated with a longer time to recovery from the index depressive episode. The effect of cortisol on recovery was moderated by social support. The combination of elevated cortisol and recent stressful experiences predicted recurrence, whereas a higher level of social support was protective against recurrence. Conclusions These data, in conjunction with prior literature, suggest that depression reflects an underlying neurobiological vulnerability that may predispose individuals with high vulnerability to chronic, recurrent episodes. Psychosocial factors, independently or in combination with an underlying neurobiological vulnerability, also play an important role in determining the clinical course of depression. PMID:20215936

  14. Diabetes, Depressive Symptoms, and Inflammation in Older Adults: Results from the Health, Aging, and Body Composition Study

    PubMed Central

    Doyle, Todd A.; de Groot, Mary; Harris, Tamara; Schwartz, Frank; Strotmeyer, Elsa S.; Johnson, Karen C.; Kanaya, Alka

    2013-01-01

    Objective Up-regulated levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP) are common to both type 2 diabetes mellitus (T2DM) and elevated depressive symptoms, yet little attention has been given to the biological mechanisms associated with these co-morbidities. This study examined the association between inflammation and both T2DM and elevated depressive symptoms. Methods Baseline data were analyzed from 3,009 adults, aged 70–79, participating in the Health, Aging, and Body Composition Study. Diabetes was assessed per self-report, medication use, fasting glucose and/or glucose tolerance tests. Elevated depressive symptoms were categorized using the Center for Epidemiologic Studies Depression scale (cut-score≥20). Log-transformed IL-6, TNF-α, and CRP were analyzed using ANCOVA. Results Participants with T2DM and elevated depressive symptoms (T2DM+DEP n=14) demonstrated significantly (p<.05) higher IL-6 compared to (T2DM Only n=628), (DEP Only n=49), and (No T2DM or DEP n=2,067) groups following covariate adjustment. Similarly, participants with T2DM+DEP (n=14) had significantly (p<.05) higher CRP, after covariate adjustment, compared to DEP Only (n=50) and No T2DM or DEP groups (n=2,153). No association was observed for TNF-α. Conclusions These findings provide evidence that inflammation is associated with T2DM and elevated depressive symptoms. Participants with T2DM+DEP demonstrated the highest IL-6 levels compared to all other groups. Greater CRP levels were also observed in T2DM, but not elevated depressive symptoms, which may suggest that differential associations between T2DM and depressive symptoms exist for various inflammatory markers. Further investigation into these associations could aid in understanding the biological pathways underlying both T2DM and depressive symptoms. PMID:24182629

  15. [Citalopram in depression (results of an open multicenter study in phase IV of the clinical trial)].

    PubMed

    Vinar, O; Svestka, J; Koníková, M

    1993-12-01

    249 depressed patients were treated by 35 psychiatrists in an open multicenter trial during 6 weeks with citalopram. The protocol enabled that naturalistic treatment conditions could be kept. The results were rated with the help of the Clinical Global Impression (CGI) scale. The treatment was successful in 77% of the patients. 5 patients dropped out because of adverse effects, 8 patients did not finish the trial due to insufficient efficacy. In 160 patients (64.2%) no adverse effects were registered. Transient mild headaches in 8.4% and nausea in 4% were the most frequent adverse events. The best effects were observed in patients who were rated as moderately ill (82.8% ameliorated) at pretreatment. Nevertheless, also 66.7% of those rated as severely ill before the treatment improved substantially. In patients treated with higher doses than 20 mg/day, the improvement rate was not higher than in those treated with 20 mg daily. PMID:8124734

  16. Basal insulin regime change from Lantus to Toujeo resulted in fewer hypoglycaemic episodes in a 28-year-old man with diabetes mellitus.

    PubMed

    Shields, Alexandra; Sankaranarayanan, Sailesh

    2016-01-01

    An active 28-year-old man with type 1 diabetes mellitus reported a reduced number of hypoglycaemic episodes following change in basal regime insulin glargine from U100 Lantus to U300 Toujeo. Consequently, an improved quality of life was also reported. Flash-based glucose monitoring was utilised to record 24-hour continuous glucose levels throughout two comparable 60-day periods before and after the change in regimen. Low blood glucose was most likely between 03:00 and 08:00. Nocturnal hypoglycaemic episodes (≤3.9 mmol/L) reduced by an average of 2.5 episodes per week. Severe hypoglycaemic episodes (≤2.9 mmol/L) reduced to an average of 0.4 per week, down from 1.5 per week. Nocturnal hypoglycaemic episodes reduced in frequency and severity. Furthermore, nocturnal hypoglycaemia episodes occurred in a more predictable time window. This was especially important in the reported reduction of impact on the patient's quality of life, as the episodes tended to be associated with anxiety and low mood. Patient education needed to facilitate this change was minimal, and benefits to the patient were great, including decreased sleep disturbances and reduced risk of associated anxiety symptoms. PMID:27307429

  17. Postpartum Depression Prevention for Reservation-Based American Indians: Results from a Pilot Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Ginsburg, Golda S.; Barlow, Allison; Goklish, Novalene; Hastings, Ranelda; Baker, Elena Varipatis; Mullany, Britta; Tein, Jenn-Yun; Walkup, John

    2012-01-01

    Background: Postpartum depression is a devastating condition that affects a significant number of women and their offspring. Few preventive interventions have targeted high risk youth, such as American Indians (AIs). Objective: To evaluate the feasibility of a depression prevention program for AI adolescents and young adults. Methods: Expectant AI…

  18. Diabetes mellitus and comorbid depression: improvement of both diseases with milnacipran. A replication study (results of the Austrian Major Depression Diabetes Mellitus study group).

    PubMed

    Abrahamian, Heidemarie; Hofmann, Peter; Kinzl, Johann; Toplak, Hermann

    2012-01-01

    Comorbid depression is common in patients with type 2 diabetes mellitus and is associated with greater mortality risk and a higher incidence of diabetic complications and decreased quality of life. In an earlier pilot study, we found that treatment with the serotonin norepinephrine reuptake inhibitor antidepressant, milnacipran, significantly improved metabolic parameters in diabetic patients with comorbid depression who had an antidepressant response. We sought to replicate these results in a larger cohort (n = 135). Patients received milnacipran and metformin for 6 months and metabolic parameters and depressive symptoms were measured at baseline and after 3 and 6 months. At the end of the study, 72.6% of patients had an antidepressant response (≥50% reduction of baseline Beck Depression Inventory score). Overall, there was significant improvement in the metabolic and anthropometric parameters measured. The number of patients with glycated hemoglobin > 8% (>63.9 mmol/mol), an indicator of poor metabolic control requiring intensive therapeutic intervention, decreased from 31.9% at baseline to 11.9% during the study. As found in the pilot study, levels of total cholesterol and triglycerides were only significantly decreased in antidepressant responders. Body weight was significantly reduced in both responders and nonresponders but the effect size was significantly greater in the responder group. In contrast to the pilot study, fasting blood glucose and glycated hemoglobin were significantly decreased to a similar extent in both antidepressant-responders and nonresponders. The present study thus replicates some of the original findings. The main difference between the present and the pilot study is that in the larger cohort significant reductions in fasting blood glucose and glycated hemoglobin were found in all patients irrespective of whether or not they responded to antidepressant treatment. The present data underline the importance of diagnosis and treatment of

  19. Faster onset of antidepressant effects of citalopram compared with sertraline in drug-naïve first-episode major depressive disorder in a Chinese population: a 6-week double-blind, randomized comparative study.

    PubMed

    Hsu, Ju-Wei; Su, Tung-Ping; Huang, Chen-Ying; Chen, Ying-Sheue; Chou, Yuan-Hwa

    2011-10-01

    Several previous studies, including a meta-analysis, reported no significant differences between various selective serotonin reuptake inhibitors (SSRIs) in the treatment of major depressive disorder. However, because of the different chemical structure of SSRIs and the difference in the frequency of serotonin transporter polymorphisms between ethnic groups, a head-to-head comparative study between SSRIs in different populations may be enlightening. We compared the efficacy and adverse effect profiles of citalopram and sertraline in a double-blinded randomized clinical trial in a Chinese population of drug-naïve patients with first-episode major depressive disorder. Fifty-one patients were randomly assigned to citalopram or sertraline treatment. The Montgomery-Åsberg Depression Rating Scale (MADRS) was used as the primary outcome. Efficacy and adverse effects were analyzed in an intent-to-treat population. Efficacy was analyzed using a last-observation-carried-forward method for early terminators. There were no significant differences in demographic characteristics at baseline. No significant differences were found in MADRS scores between citalopram and sertraline at baseline (36.6 ± 5.5 vs 38.2 ± 4.9; P = 0.322) or at the end of treatment (week 6; 10.8 ± 10.0 vs 16.7 ± 11.3; P = 0.082). However, MADRS scores in the citalopram group were significantly lower at week 1 (25.2 ± 8.5 vs 30.4 ± 6.1; P = 0.029) and week 3 (15.9 ± 10.0 vs 22.1 ± 8.7; P = 0.037). Overall, treatment-emergent adverse effects were reported by 14.3% and 28.6% of patients in the citalopram and sertraline groups, respectively. In conclusion, citalopram and sertraline were both efficacious and well tolerated. However, citalopram exhibited a significantly faster onset than sertraline during the early weeks of treatment and tended to have a better efficacy in overall treatment, although the statistic was not significant.

  20. The Association between Hypertension and Depression and Anxiety Disorders: Results from a Nationally-Representative Sample of South African Adults

    PubMed Central

    Grimsrud, Anna; Stein, Dan J.; Seedat, Soraya; Williams, David; Myer, Landon

    2009-01-01

    Objective Growing evidence suggests high levels of comorbidity between hypertension and mental illness but there are few data from low- and middle-income countries. We examined the association between hypertension and depression and anxiety in South Africa. Methods Data come from a nationally-representative survey of adults (n = 4351). The Composite International Diagnostic Interview was used to measure DSM-IV mental disorders during the previous 12-months. The relationships between self-reported hypertension and anxiety disorders, depressive disorders and comorbid anxiety-depression were assessed after adjustment for participant characteristics including experience of trauma and other chronic physical conditions. Results Overall 16.7% reported a previous medical diagnosis of hypertension, and 8.1% and 4.9% were found to have a 12-month anxiety or depressive disorder, respectively. In adjusted analyses, hypertension diagnosis was associated with 12-month anxiety disorders [Odds ratio (OR) = 1.55, 95% Confidence interval (CI) = 1.10–2.18] but not 12-month depressive disorders or 12-month comorbid anxiety-depression. Hypertension in the absence of other chronic physical conditions was not associated with any of the 12-month mental health outcomes (p-values all <0.05), while being diagnosed with both hypertension and another chronic physical condition were associated with 12-month anxiety disorders (OR = 2.25, 95% CI = 1.46–3.45), but not 12-month depressive disorders or comorbid anxiety-depression. Conclusions These are the first population-based estimates to demonstrate an association between hypertension and mental disorders in sub-Saharan Africa. Further investigation is needed into role of traumatic life events in the aetiology of hypertension as well as the temporality of the association between hypertension and mental disorders. PMID:19440241

  1. Differential associations of depressive symptom dimensions with cardio-vascular disease in the community: results from the Gutenberg health study.

    PubMed

    Michal, Matthias; Wiltink, Jörg; Kirschner, Yvonne; Wild, Philipp S; Münzel, Thomas; Ojeda, Francisco M; Zeller, Tanja; Schnabel, Renate B; Lackner, Karl; Blettner, Maria; Zwiener, Isabella; Beutel, Manfred E

    2013-01-01

    A current model suggested that the somatic symptom dimension accounts for the adverse effect of depression in patients with coronary heart disease (CHD). In order to test this model we sought to determine in a large population-based sample how symptom dimensions of depression are associated with CHD, biomarkers and traditional risk factors. The associations of cognitive and somatic symptom dimensions of depression with CHD, risk factors, endothelial function, and biomarkers of inflammation and myocardial stress were analyzed cross-sectionally in a sample of n = 5000 Mid-Europeans aged 35-74 years from the Gutenberg Health Study (GHS). Only the somatic symptom dimension of depression was associated with CHD, biomarkers (inflammation, vascular function) and cardio-vascular risk factors. When multivariable adjustment was applied by demographic and cardiovascular risk factors, the weak associations of the somatic symptom dimension with the biomarkers disappeared. However, the associations of the somatic symptom dimension with CHD, myocardial infarction, obesity, dyslipidemia and family history of myocardial infarction remained. Both dimensions of depression were independently associated with a previous diagnosis of depression and distressed personality (type D). Thus, our results partly confirm current models: Somatic, but not cognitive-affective symptom dimensions are responsible for the association between depression and CHD, inflammation, vascular function and cardiovascular risk factors in the general population. However, our findings challenge the assumptions that somatic depression might be due to inflammation or vascular dysfunction as consequence of progressed atherosclerotic disease. They rather emphasize a close interplay with life-style factors and with a family history of MI. PMID:23967272

  2. Examining the relationship between anxiety and depression and exacerbations of COPD which result in hospital admission: a systematic review

    PubMed Central

    Pooler, Alison; Beech, Roger

    2014-01-01

    Objectives Exacerbations of chronic obstructive pulmonary disease (COPD) are the third largest cause of emergency hospital admissions in the UK. This systematic literature review explored the relationship between the hospitalization rates and the COPD comorbidities, anxiety, and depression. Methods The Centre for Research Dissemination’s framework for systematic reviews was followed using search terms relating to COPD, anxiety, depression, and hospital admission. Papers identified were assessed for relevance and quality, using a suitable Critical Appraisal Skills Programme tool and Mixed Methods Assessment Tool. Results Twenty quantitative studies indicated that anxiety and depression led to a statistically significant increase in the likelihood of COPD patients being hospitalized. These comorbidities also led to an increased length of stay and a greater risk of mortality postdischarge. Other significant factors included lower Body-Mass Index, Airflow Obstruction, Dyspnea, and Exercise scores, female gender, lower socioeconomic status, poorer patient perceived quality of life, increased severity of lung function, and less improvement in dyspnea from admission to discharge. It was also highlighted that only 27%–33% of those with depression were being treated for it. Four qualitative studies revealed that patients saw anxiety and depression as a major factor that affected their ability to cope with and self-manage their condition. Implications Findings from the systematic review have highlighted a need for better recognition and treatment of anxiety and depression amongst individuals with COPD. Ongoing research will develop and test strategies for promoting better management and self-management as a means of reducing hospital admissions. PMID:24729698

  3. Antidepressants in type II versus type I bipolar depression: A randomized discontinuation trial

    PubMed Central

    Vöhringer, Paul A.; Ostacher, Michael J.; El-Mallakh, Rif S.; Holtzman, Niki S.; Thommi, Sairah B.; Whitham, Elizabeth A.; Sullivan, Matthew C.; Baldassano, Claudia F.; Goodwin, Fredrick K.; Baldessarini, Ross J.; Ghaemi, S. Nassir

    2015-01-01

    Background We sought to test the hypothesis that antidepressants (ADs) may show preferential efficacy and safety among type-II over type-I bipolar disorder (BD) patients. Methods DSM-IV BD-I (n=21) and -II patients (n=49) in acute major depressive episodes were treated with ADs plus mood-stabilizers to euthymia sustained for two months, and then randomized openly to continue or discontinue ADs for up to three years. Outcomes were episode-recurrences and changes in standardized symptom-ratings. Results In follow-up averaging 1.64±0.98 years, both subgroups showed improvement in depressive episode frequency with AD continuation, but contrary to the hypothesis, more improvement was seen in type I than in type II bipolar depression (for type II, mean decrease in depressive episodes per year 0.21 ± 0.26 [CI:0.05, 0.37]; for type I: mean decrease 0.35 ± 0.15 [CI:0.30, 0.41]). Type II subjects continued on ADs had slightly more depressive, but fewer manic/hypomanic, episodes than BD-I subjects. No notable differences were seen in either group in time to a recurrence of mood episodes or total time-in-remission. Conclusions The findings do not confirm the hypothesis that long-term AD treatment in BP-II has better outcomes than in BD-I patients, except somewhat lower risk of manic/hypomanic episodes. PMID:26267418

  4. Blunted neural response to rewards as a vulnerability factor for depression: Results from a family study.

    PubMed

    Weinberg, Anna; Liu, Huiting; Hajcak, Greg; Shankman, Stewart A

    2015-11-01

    Depressive disorders are associated with significant economic and public health burdens as well as increased morbidity. Yet, perhaps due to the heterogeneous nature of the disease, prevention and intervention efforts are only moderately efficacious. A better understanding of core mechanisms of depressive disorders might aid in the development of more targeted intervention, and perhaps help identify individuals at risk. One mechanism that may be particularly important to depressive phenotypes is reward insensitivity. Examination of neurobiological correlates of reward-processing, which should relate more directly to the neuropathology of depression, may be helpful in identifying liability for the disorder. To that end, we used a family study design to examine whether a neural response to rewards is a familial risk factor for depression in a sample of probands with a wide range of internalizing psychopathology, as well as their biological siblings. Event-related potentials were recorded during a simple forced-choice gambling paradigm, in which participants could either win or lose small amounts of money. Lower levels of positive affect in probands predicted a reduced neural response to rewards in siblings, even over and above the sibling's own level of positive and negative affect. Additionally, the neural response to rewards was familial (i.e., correlated among siblings). Combined, these analyses suggest that a blunted neural response to rewards may be useful in identifying individuals vulnerable to depressive illnesses. PMID:26214708

  5. Job Strain, Depressive Symptoms, and Drinking Behavior Among Older Adults: Results From the Health and Retirement Study

    PubMed Central

    Bohnert, Amy S. B.; Ratliff, Scott; Zivin, Kara

    2011-01-01

    Objective. To examine the relationship between job strain and two indicators of mental health, depression and alcohol misuse, among currently employed older adults. Method. Data come from the 2004 and 2006 waves of the Health and Retirement Study (N = 2,902). Multivariable logistic regression modeling was used to determine the association between job strain, indicated by the imbalance of job stress and job satisfaction, with depression and alcohol misuse. Results. High job strain (indicated by high job stress combined with low job satisfaction) was associated with elevated depressive symptoms (odds ratio [OR] = 2.98, 95% confidence interval [CI]: 1.99–4.45) relative to low job strain after adjusting for sociodemographic characteristics, labor force status, and occupation. High job stress combined with high job satisfaction (OR = 1.93) and low job stress combined with low job satisfaction (OR = 1.94) were also associated with depressive symptoms to a lesser degree. Job strain was unrelated to either moderate or heavy drinking. These associations did not vary by gender or age. Discussion. Job strain is associated with elevated depressive symptoms among older workers. In contrast to results from investigations of younger workers, job strain was unrelated to alcohol misuse. These findings can inform the development and implementation of workplace health promotion programs that reflect the mental health needs of the aging workforce. PMID:21427175

  6. Delusions in first-episode psychosis: Principal component analysis of twelve types of delusions and demographic and clinical correlates of resulting domains.

    PubMed

    Paolini, Enrico; Moretti, Patrizia; Compton, Michael T

    2016-09-30

    Although delusions represent one of the core symptoms of psychotic disorders, it is remarkable that few studies have investigated distinct delusional themes. We analyzed data from a large sample of first-episode psychosis patients (n=245) to understand relations between delusion types and demographic and clinical correlates. First, we conducted a principal component analysis (PCA) of the 12 delusion items within the Scale for the Assessment of Positive Symptoms (SAPS). Then, using the domains derived via PCA, we tested a priori hypotheses and answered exploratory research questions related to delusional content. PCA revealed five distinct components: Delusions of Influence, Grandiose/Religious Delusions, Paranoid Delusions, Negative Affect Delusions (jealousy, and sin or guilt), and Somatic Delusions. The most prevalent type of delusion was Paranoid Delusions, and such delusions were more common at older ages at onset of psychosis. The level of Delusions of Influence was correlated with the severity of hallucinations and negative symptoms. We ascertained a general relationship between different childhood adversities and delusional themes, and a specific relationship between Somatic Delusions and childhood neglect. Moreover, we found higher scores on Delusions of Influence and Negative Affect Delusions among cannabis and stimulant users. Our results support considering delusions as varied experiences with varying prevalences and correlates. PMID:27344587

  7. Delusions in first-episode psychosis: Principal component analysis of twelve types of delusions and demographic and clinical correlates of resulting domains.

    PubMed

    Paolini, Enrico; Moretti, Patrizia; Compton, Michael T

    2016-09-30

    Although delusions represent one of the core symptoms of psychotic disorders, it is remarkable that few studies have investigated distinct delusional themes. We analyzed data from a large sample of first-episode psychosis patients (n=245) to understand relations between delusion types and demographic and clinical correlates. First, we conducted a principal component analysis (PCA) of the 12 delusion items within the Scale for the Assessment of Positive Symptoms (SAPS). Then, using the domains derived via PCA, we tested a priori hypotheses and answered exploratory research questions related to delusional content. PCA revealed five distinct components: Delusions of Influence, Grandiose/Religious Delusions, Paranoid Delusions, Negative Affect Delusions (jealousy, and sin or guilt), and Somatic Delusions. The most prevalent type of delusion was Paranoid Delusions, and such delusions were more common at older ages at onset of psychosis. The level of Delusions of Influence was correlated with the severity of hallucinations and negative symptoms. We ascertained a general relationship between different childhood adversities and delusional themes, and a specific relationship between Somatic Delusions and childhood neglect. Moreover, we found higher scores on Delusions of Influence and Negative Affect Delusions among cannabis and stimulant users. Our results support considering delusions as varied experiences with varying prevalences and correlates.

  8. [Obstructive sleep apnoea syndrome as the cause of atypical depression].

    PubMed

    Lang, F U; Hösch, H; Seibert, H; Klug, R; Köppler, D; Jäger, M

    2011-09-01

    Sleep apnoea is a common disorder presenting with somatic comorbidities and psychiatric symptoms. This case report describes a 43-year-old man with an organic depressive disorder due to obstructive sleep apnoea. Initially, an atypical depressive episode or schizophrenic residual syndrome had been considered likely diagnoses; subsequent polysomnography results, however, suggested obstructive sleep apnoea instead. Upon nasal continuous positive airway pressure (nCPAP), the respiratory distress symptoms improved. The case report highlights the association between sleep disturbances and depressive symptoms. In patients presenting with symptoms of atypical depression and excess body weight sleep apnoea should be considered.

  9. Surface displacements resulting from magma-chamber roof subsidence, with application to the 2014-2015 Bardarbunga-Holuhraun volcanotectonic episode in Iceland

    NASA Astrophysics Data System (ADS)

    Browning, John; Gudmundsson, Agust

    2015-12-01

    The conditions which lead to caldera collapse are still poorly constrained. As there have only been four, possibly five, well-documented caldera forming events in the past century, the geodetic signals produced during chamber roof subsidence, or chamber volume reduction (shrinkage) in general, are not well documented or understood. In particular, when two or more geodetic sources are operating and providing signals at the same time, it is important to be able to estimate the likely contribution of each. Simultaneous activities of different geodetic sources are common and include pressure changes in magma chambers/reservoirs occurring at the same time as dyke emplacement. Here we present results from numerical models designed to simulate the subsidence of a magma-chamber roof, either directly (chamber shrinkage) or through ring-fault displacement, and the induced surface deformation and crustal stresses. We consider chamber depths at 3 km, 5 km, and 7 km below the crustal surface, using both non-layered (isotropic) and layered (anisotropic) crustal models. We also model the effects of a caldera lake and of a thick ice cover (ice sheet) on top of the caldera. The results suggest that magma-chamber roof subsidences between 20 m and 100 m generate large (tens of centimetres) vertical and, in particular, horizontal displacements at the surfaces of the ice and the crust out to distances of up to tens of kilometres from the caldera/chamber centre. Crustal layering tends to reduce, but increasing chamber depth to enlarge, the horizontal and vertical surface displacements. Applying the results to the ice subsidence in the Bardarbunga Caldera during the 2014-2015 Bardarbunga-Holuhraun volcanotectonic episode indicates that the modelled ice displacements are less than those geodetically measured. Also, the geodetically measured crustal displacements are less than expected for a 60 m chamber-roof subsidence. The modelling results thus suggest that only part of the ice

  10. Two-year predictors of runaway and homeless episodes following shelter services among substance abusing adolescents.

    PubMed

    Slesnick, Natasha; Guo, Xiamei; Brakenhoff, Brittany; Feng, Xin

    2013-10-01

    Given high levels of health and psychological costs associated with the family disruption of homelessness, identifying predictors of runaway and homeless episodes is an important goal. The current study followed 179 substance abusing, shelter-recruited adolescents who participated in a randomized clinical trial. Predictors of runaway and homeless episodes were examined over a two year period. Results from the hierarchical linear modeling analysis showed that family cohesion and substance use, but not family conflict or depressive symptoms, delinquency, or school enrollment predicted future runaway and homeless episodes. Findings suggest that increasing family support, care and connection and reducing substance use are important targets of intervention efforts in preventing future runaway and homeless episodes amongst a high risk sample of adolescents. PMID:24011094

  11. Risk factors for depressive symptomatology in a drug using population.

    PubMed Central

    Buckner, J C; Mandell, W

    1990-01-01

    This study employs a prospective design to examine possible personality, drug use, stressful life event, and social support-related variables associated with the onset of a depressive episode in a cohort of psychoactive drug using young adults. Two waves of data, collected one year apart, were available on 942 individuals. Cases (n = 62) were free of depressive symptoms at time 1 but reported significant symptomatology at time 2 as measured by the depression subscale of the Brief Symptom Inventory. Controls (n = 490) were those free of depressive symptoms at both time points. In multivariate analyses, users of the central nervous system depressant methaqualone had a nearly four-fold elevated risk for depressed mood as compared to nonusers. Additional risk factors significant after multivariate adjustment included lower self-esteem at time 1 and negative life events. These results highlight the multifactorial nature of depressive symptomatology. PMID:2327536

  12. Sarcopenia Is Not Associated with Depression in Korean Adults: Results from the 2010–2011 Korean National Health and Nutrition Examination Survey

    PubMed Central

    Byeon, Chae-Hwa; Kang, Kee-Young; Kang, Se-Hun; Kim, Han-Kyul

    2016-01-01

    Background Sarcopenia is associated with metabolic disorders, cardiovascular disease, and mortality; however, its association with depression in the general population remains unknown. Therefore, we investigated this association in Korea. Methods This study included 8,958 and 8,518 subjects from the 2010–2011 Korean National Health and Nutrition Examination Survey V-1, 2. The study was restricted to participants ≥20 years of age who had completed the survey, including whole-body dual-energy X-ray absorptiometry scans. After exclusion, 7,364 subjects were included in our final analysis. Age was categorized into three groups (20–39, 40–59, and ≥60 years), and subjects were categorized according to their sarcopenic and obesity status. Depression was categorized into three groups (not depressed, depressed, and depression). Results The sarcopenia group did not have a higher prevalence of depression or depressive symptoms compared to the nonsarcopenia group; the same was true even when obesity was considered. All age groups showed non-significant associations between sarcopenia and depression. In multivariate logistic regression models, no significant associations were observed between sarcopenia and prevalence of depression or depressed symptoms in men and women. Conclusion We found no associations between sarcopenia and the prevalence of depression or depressed symptoms in Korean adults. Future large prospective studies and randomized controlled trials are needed to further assess this relationship. PMID:26885321

  13. Hippocampal atrophy in recurrent major depression.

    PubMed Central

    Sheline, Y I; Wang, P W; Gado, M H; Csernansky, J G; Vannier, M W

    1996-01-01

    Hippocampal volumes of subjects with a history of major depressive episodes but currently in remission and with no known medical comorbidity were compared to matched normal controls by using volumetric magnetic resonance images. Subjects with a history of major depression had significantly smaller left and right hippocampal volumes with no differences in total cerebral volumes. The degree of hippocampal volume reduction correlated with total duration of major depression. In addition, large (diameter > or = 4.5 mm)-hippocampal low signal foci (LSF) were found within the hippocampus, and their number also correlated with the total number of days depressed. These results suggest that depression is associated with hippocampal atrophy, perhaps due to a progressive process mediated by glucocorticoid neurotoxicity. Images Fig. 1 Fig. 4 PMID:8632988

  14. Depressive symptoms in youth with type 1 or type 2 diabetes: Results of the Pediatric Diabetes Consortium screening assessment of depression in diabetes study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    To evaluate the frequency of depressive symptoms and the diagnosis and management of depression in youth with type 1 diabetes (T1D) and type 2 diabetes (T2D) enrolled in the Pediatric Diabetes Consortium T1D and T2D registries. The Children's Depression Inventory (CDI) 2 Self-Report (Short) version ...

  15. Physical Activity Related to Depression and Predicted Mortality Risk: Results from the Americans' Changing Lives Study

    ERIC Educational Resources Information Center

    Lee, Pai-Lin; Lan, William; Lee, Charles C.-L.

    2012-01-01

    This study examined the association between three types of physical activities (PA) and depression, and the relationship between PA and later mortality. Previous studies rarely assessed these associations in one single study in randomly selected population samples. Few studies have assessed these relations by adjusting the covariate of…

  16. Neighborhood Social Resources and Depressive Symptoms: Longitudinal Results from the Multi-Ethnic Study of Atherosclerosis.

    PubMed

    Moore, Kari A; Hirsch, Jana A; August, Carmella; Mair, Christina; Sanchez, Brisa N; Diez Roux, Ana V

    2016-06-01

    The ways in which a neighborhood environment may affect depression and depressive symptoms have not been thoroughly explored. This study used longitudinal data from 5475 adults in the Multi-Ethnic Study of Atherosclerosis to investigate associations of time-varying depressive symptoms between 2000 and 2012 (measured using the 20-item Center for Epidemiologic Studies Depression Scale (CES-D)) with survey-based measures of neighborhood safety and social cohesion (both individual-level perceptions and neighborhood-level aggregates) and densities of social engagement destinations. Linear mixed models were used to examine associations of baseline cross-sectional associations and cumulative exposures with changes over time in CES-D. Econometric fixed effects models were utilized to investigate associations of within-person changes in neighborhood exposures with within-person changes in CES-D. Adjusting for relevant covariates, higher safety and social cohesion and greater density of social engagement destinations were associated with lower CES-D at baseline. Greater cumulative exposure to these features was not associated with progression of CES-D over 10 years. Within-person increases in safety and in social cohesion were associated with decreases in CES-D, although associations with cohesion were not statistically significant. Social elements of neighborhoods should be considered by community planners and public health practitioners to achieve optimal mental health.

  17. Ethiopathogenesis of Depressive Disorders

    PubMed Central

    Pasquini, M; Berardelli, I; Biondi, M

    2014-01-01

    Etiology of depressive disorders is still unknown. Several factors are involved in its pathophysiology such as neurotransmitters and neuroendocrine alterations, genetics, life events and their appraisal. Some of these components are strictly linked. Subjects with a family member affected by mood disorders are more prone to suffer from depressive disorders. It is also true that receiving feedbacks of indifference or neglect during childhood from one parent who suffer from depression may represent a factor of vulnerability. Indeed, reaction to a specific negative event may determine an increased allostasis which lead to a depressive episode. Thus, a psychological cause does not exclude a neurobiological cascade. Whereas in other cases recurrent depressive episodes appear in absence of any negative life event. This review provides a set of data regarding the current etiopathogenesis models of depression, with a particular attention to the neurobiological correlates and vulnerability factors. PMID:25614753

  18. Adolescent Depression.

    ERIC Educational Resources Information Center

    Evans, Dina M.

    Affective disorder is characterized by maladaptive changes in mood, attitudes, energy level, and physical status. These changes constitute the basic dimensions of depression. Depression results from a combination of genetic and experiential factors. There are sex differences and age differences with regard to depression, and there is a high…

  19. Impact of Depression on Health Care Utilization and Costs among Multimorbid Patients – Results from the MultiCare Cohort Study

    PubMed Central

    Bock, Jens-Oliver; Luppa, Melanie; Brettschneider, Christian; Riedel-Heller, Steffi; Bickel, Horst; Fuchs, Angela; Gensichen, Jochen; Maier, Wolfgang; Mergenthal, Karola; Schäfer, Ingmar; Schön, Gerhard; Weyerer, Siegfried; Wiese, Birgitt; König, Hans-Helmut

    2014-01-01

    Objective The objective of this study was to describe and analyze the effects of depression on health care utilization and costs in a sample of multimorbid elderly patients. Method This cross-sectional analysis used data of a prospective cohort study, consisting of 1,050 randomly selected multimorbid primary care patients aged 65 to 85 years. Depression was defined as a score of six points or more on the Geriatric Depression Scale (GDS-15). Subjects passed a geriatric assessment, including a questionnaire for health care utilization. The impact of depression on health care costs was analyzed using multiple linear regression models. A societal perspective was adopted. Results Prevalence of depression was 10.7%. Mean total costs per six-month period were €8,144 (95% CI: €6,199-€10,090) in patients with depression as compared to €3,137 (95% CI: €2,735-€3,538; p<0.001) in patients without depression. The positive association between depression and total costs persisted after controlling for socio-economic variables, functional status and level of multimorbidity. In particular, multiple regression analyses showed a significant positive association between depression and pharmaceutical costs. Conclusion Among multimorbid elderly patients, depression was associated with significantly higher health care utilization and costs. The effect of depression on costs was even greater than reported by previous studies conducted in less morbid patients. PMID:24638040

  20. Reevaluation of patients with bipolar disorder on manic episode: improving the diagnosing of mixed episode.

    PubMed

    Kim, Kyung Ran; Cho, Hyun-Sang; Kim, Se Joo; Seok, Jeong-Ho; Lee, Eun; Jon, Duk-In

    2013-08-01

    Mixed manic/depressive episodes in patients with bipolar disorder are underdiagnosed because of restrictive diagnostic criteria. Using the broader definition of a mixed episode represented by the Cincinnati criteria, we reevaluated the medical records of patients with bipolar disorder hospitalized for a manic episode. We also examined the predictive power of previously unrecognized depressive symptoms. Of 520 inpatients with mania, we retrospectively diagnosed 59 (11.3%) as having a probable mixed episode. Compared with the patients with pure mania, the patients with mixed episodes were more likely to have a family history of psychiatric illness, comorbid personality disorder, and a history of suicide attempts. Binary logistic regression revealed that loss of interest, loss of energy, feelings of worthlessness, and feelings of helplessness had good positive predictive value (>0.7) for mixed episodes. Accurate diagnosis of mixed episodes may require a broadening of diagnostic criteria and emphasis on symptoms such as loss of interest, loss of energy, and feelings of worthlessness and helplessness.

  1. Episodic memory in nonhuman animals

    PubMed Central

    Templer, Victoria L.

    2013-01-01

    Summary Episodic memories differ from other types of memory because they represent aspects of the past not present in other memories, such as the time, place, or social context in which the memories were formed. Focus on phenomenal experience in human memory, such as the sense of “having been there” has resulted in conceptualizations of episodic memory that are difficult or impossible to apply to nonhumans. It is therefore a significant challenge for investigators to agree on objective behavioral criteria that can be applied in nonhumans and still capture features of memory thought to be critical in humans. Some investigators have attempted to use neurobiological parallels to bridge this gap. However, defining memory types on the basis of the brain structures involved rather than on identified cognitive mechanisms risks missing the most crucial functional aspects of episodic memory, which are ultimately behavioral. The most productive way forward is likely a combination of neurobiology and sophisticated cognitive testing that identifies the mental representations present in episodic memory. Investigators that have refined their approach from asking the naïve question “do nonhuman animals have episodic memory” to instead asking “what aspects of episodic memory are shared by humans and nonhumans” are making progress. PMID:24028963

  2. The prevalence and clinical characteristics associated with Diagnostic and Statistical Manual Version-5-defined anxious distress specifier in adults with major depressive disorder: results from the International Mood Disorders Collaborative Project

    PubMed Central

    McIntyre, Roger S.; Woldeyohannes, Hanna O.; Soczynska, Joanna K.; Vinberg, Maj; Cha, Danielle S.; Lee, Yena; Gallaugher, Laura A.; Dale, Roman S.; Alsuwaidan, Mohammad T.; Mansur, Rodrigo B.; Muzina, David J.; Carvalho, Andre; Kennedy, Sidney

    2016-01-01

    Objectives: The aim of the study was to evaluate the prevalence of and illness characteristics in adults with major depressive disorder (MDD) with anxious distress specifier (ADS) enrolled in the International Mood Disorders Collaborative Project, which is a collaborative research platform at the Mood Disorders Psychopharmacology Unit, University of Toronto, Canada and the Cleveland Clinic, Cleveland, Ohio, USA. Methods: Data from participants who met criteria for a current major depressive episode as part of MDD (n = 830) were included in this post hoc analysis. Diagnostic and Statistical Manual Version-5-defined ADS was operationalized as the presence of at least two out of three proxy items instead of two out of five specifiers. Results: A total of 464 individuals (i.e. 56%) met criteria for ADS. There were no between-group differences in sociodemographic variables (e.g. gender, employment, marital status). Greater severity of illness was observed in adults with ADS as evidenced by a higher number of hospitalizations, higher rates of suicidal ideation, greater depressive symptom severity, greater workplace impairment, decreased quality of life, and greater self-reported cognitive impairment. Conclusions: Our findings underscore the importance of evaluating ADS in adults with MDD as its presence identifies a subpopulation with greater illness-associated burden and hazards. PMID:27347362

  3. The bacterial lysate Lantigen B reduces the number of acute episodes in patients with recurrent infections of the respiratory tract: the results of a double blind, placebo controlled, multicenter clinical trial.

    PubMed

    Braido, Fulvio; Melioli, Giovanni; Candoli, Piero; Cavalot, Andrea; Di Gioacchino, Mario; Ferrero, Vittorio; Incorvaia, Cristoforo; Mereu, Carlo; Ridolo, Erminia; Rolla, Giovanni; Rossi, Oliviero; Savi, Eleonora; Tubino, Libero; Reggiardo, Giorgio; Baiardini, Ilaria; di Marco, Eddi; Rinaldi, Gilberto; Canonica, Giorgio Walter; Accorsi, Carlo; Bossilino, Claudia; Bonzano, Laura; DiLizia, Michela; Fedrighini, Barbara; Garelli, Valentina; Gerace, Vincenzo; Maniscalco, Sara; Massaro, Ilaria; Messi, Alessandro; Milanese, Manlio; Peveri, Silvia; Penno, Arminio; Pizzimenti, Stefano; Pozzo, Tiziana; Raie, Alberto; Regina, Sergio; Sclifò, Francesca

    2014-12-01

    Studies in the 1970s and 1980s reported that bacterial lysates (BL) had a prophylactic effect on recurrent respiratory tract infections (RRTI). However, controlled clinical study procedures have evolved substantially since then. We performed a trial using updated methods to evaluate the efficacy of Lantigen B®, a chemical BL. This double blind, placebo controlled, multi-center clinical trial had the primary objective of assessing the capacity of Lantigen B to significantly reduce the total number of infectious episodes in patients with RRTI. Secondary aims were the RRTI duration, the frequency and the severity of the acute episodes, the use of drugs and the number of missed workdays. In the subgroup of allergic patients with RRTI, the number of allergic episodes (AE) and the use of anti-allergic drugs were also evaluated. One hundred and sixty patients, 79 allocated to the treated group (TG) and 81 to the placebo group (PG), were enrolled; 30 were lost during the study and 120 (79 females and 38 males) were evaluated. The PG had 1.43 episodes in the 8-months of follow-up while the TG had 0.86 episodes (p=0.036). A similar result was observed in the allergic patients (1.80 and 0.86 episodes for the PG and the TG, respectively, p=0.047). The use of antibiotics was reduced (mean 1.24 and 2.83 days of treatment for the TG and the PG). Logistic regression analysis indicated that the estimated risk of needing antibiotics and NSAIDs was reduced by 52.1 and 30.6%, respectively. With regard to the number of AE, no significant difference was observed between the two groups, but bronchodilators, antihistamines and local corticosteroids were reduced by 25.7%, 56.2% and 41.6%, respectively, in the TG. Lantigen B significantly reduced the number of infectious episodes in patients with RRTI. This finding suggests a first line use of this drug for the prophylaxis of infectious episodes in these patients. PMID:25445613

  4. Preferred Features of E-Mental Health Programs for Prevention of Major Depression in Male Workers: Results From a Canadian National Survey

    PubMed Central

    Lam, Raymond W; Ho, Kendall; Attridge, Mark; Lashewicz, Bonnie M; Patten, Scott B; Marchand, Alain; Aiken, Alice; Schmitz, Norbert; Gundu, Sarika; Rewari, Nitika; Hodgins, David; Bulloch, Andrew; Merali, Zul

    2016-01-01

    Background Major depression is a prevalent mental disorder and imposes considerable burden on health and productivity. Men are not immune to major depression, yet they often delay seeking help because of perceived stigma and gender norms. E-mental health programs hold potential for early prevention of major depression. However, we have little knowledge about men’s preferences for design features of e-mental health programs. Objectives The objective of this study was to (1) estimate and compare the proportions of Internet use for medical information, preferred design features, and likely use of e-mental health programs; (2) examine factors associated with the likely use of e-mental health programs; and (3) understand potential barriers to the use of e-mental health programs among Canadian working men, who were at high risk of a major depressive episode (MDE). Methods A cross-sectional survey in 10 Canadian provinces was conducted between March and December 2015. Random digit dialing method was used through household landlines and cell phones to collect data from 511 working men who were at high risk of having an MDE and 330 working men who were at low risk of having an MDE. Results High-risk men were more likely to endorse the importance of accessing health resources on the Internet than low-risk men (83.4% vs 75.0%, respectively; P=.01). Of the 17 different features assessed, the top three features most likely to be used by high-risk men were: “information about improving sleep hygiene” (61.3%), “practice and exercise to help reduce symptoms of stress and depression” (59.5%), and “having access to quality information and resources about work stress issues” (57.8%). Compared with men at low risk for MDE, men at high risk for MDE were much more likely to consider using almost every one of the different design features. Differences in preferences for the design features by age among men at high risk of MDE were found only for 3 of 17 features

  5. [Sleep electroencephalography in depression and mental disorders with depressive comorbidity].

    PubMed

    Eiber, R; Escande, M

    1999-01-01

    Traditional scoring of sleep EEG in depressed patients shows abnormalities in sleep maintenance, sleep architecture, REM sleep, the distribution of slow wave and REM sleep during the night. Computerized analysis that comprises the period-amplitude analysis procedure and spectral analysis discloses changes in delta activity and distribution of delta activity. However, these methods of analysing EEG sleep are not able to distinguish the various concepts of depression: endogenous and non-endogenous depression, unipolar and bipolar depression, psychotic and non-psychotic depression. Polysomnographical data in patients with recurrent depression show alteration during remission suggesting trait-like abnormalities of sleep in depression illness. Shortened REM latency is not specific in depression. This sleep parameter is defined in many different ways explaining the heterogeneousness of study results and the failure of constituting a biological marker. Many sleep parameters are affected by several factors such as age, gender and severity. Several physiopathological hypotheses have been proposed to explain EEG sleep alterations. They refer either to circadian rhythms such as the two process model of Borbély, the phase advance hypothesis and the circadian amplitude hypothesis, or to neurotransmitter abnormalities such as the cholinergic hypothesis. None of them takes sufficient account of all the sleep abnormalities. Sleep abnormalities have also been described in other psychiatric disorders such as mania, panic and obsessional-compulsive disorders, generalized anxiety, phobias, post-traumatic stress disorder, eating disorders, borderline personality, schizophrenia and dementia. None of them have a particular sleep EEG profile which allows to differentiate between them. A concomitant episode of major depression cannot be uncovered by sleep recordings.

  6. Attitudes and beliefs of the French public about schizophrenia and major depression: results from a vignette-based population survey

    PubMed Central

    2013-01-01

    Background In their study ‘Mental Health in the General Population: Images and Realities’ Jean-Luc Roelandt et al. found a huge divide between the French public’s conceptualizations of insanity and depression. The study aims to examine whether such differences can be replicated using modern operationalized diagnostic criteria for schizophrenia and major depressive disorder. Methods In 2012, an online survey was conducted using a representative sample drawn from the adult French population (N = 1600). After presentation of a case-vignette depicting a person with either schizophrenia or major depressive disorder a fully structured interview was carried out. Results Despite some similarities marked differences between both disorders emerge regarding beliefs and attitudes. While respondents presented with the schizophrenia vignette more frequently defined symptoms as the expression of an illness with a stronger biological component and a less favorable prognosis, demanding psychiatric treatment, respondents presented with the depression vignette considered the occurrence of symptoms more frequently as the consequence of current psychosocial stress, benefitting not only from established but also from alternative treatments. People with schizophrenia were more frequently perceived as unpredictable and dangerous, there was a stronger need to separate one-self from them, they were more frequently met with fear and less frequently reacted to with pro-social feelings, and they also faced more rejection. Conclusions The French public draws a clear line between schizophrenia and major depressive disorder. This applies equally to beliefs about both disorders and to attitudes towards the persons afflicted. There is a need for interventions trying to reduce existing misconceptions in order to improve the care of patients. PMID:24252540

  7. Changes in symptoms of depression with weight loss: results of a randomized trial.

    PubMed

    Faulconbridge, Lucy F; Wadden, Thomas A; Berkowitz, Robert I; Sarwer, David B; Womble, Leslie G; Hesson, Louise A; Stunkard, Albert J; Fabricatore, Anthony N

    2009-05-01

    Recent studies of rimonabant have re-awakened interest in the possible adverse psychiatric effects of weight loss, as well as of weight loss medications. This study examined changes in symptoms of depression in 194 obese participants (age = 43.7 +/- 10.2 years; BMI = 37.6 +/- 4.1 kg/m(2)) in a 1-year randomized trial of lifestyle modification and medication. Participants were assigned to (i) sibutramine alone; (ii) lifestyle modification alone; (iii) sibutramine plus lifestyle modification (i.e., combined therapy); or (iv) sibutramine plus brief therapy. Participants completed the Beck Depression Inventory-II (BDI-II) at baseline and weeks 6, 10, 18, 26, 40, and 52. At 1 year, participants in combined therapy lost the most weight and those in sibutramine alone the least (12.1 +/- 8.8% vs. 5.5 +/- 6.5%; P < 0.01). Mean BDI-II scores across all participants declined from 8.1 +/- 6.9 to 6.2 +/- 7.7 at 1 year (P < 0.001), with no significant differences among groups. Despite this favorable change, 13.9% of participants (across the four groups) reported potentially discernible increases (>or= 5 points on the BDI-II) in symptoms of depression at week 52. They lost significantly less weight than participants in the rest of the sample (5.4 +/- 7.8% vs. 9.0 +/- 7.8%, respectively; P < 0.03). The baseline prevalence of suicidal ideation was 3.6%. Seven new cases of suicidal ideation were observed during the year, with three in lifestyle modification alone. Further research is needed to identify characteristics of obese patients at risk of negative mood changes (and suicidal ideation) in response to behavioral and pharmacologic therapies. PMID:19197266

  8. Depression and All-Cause Mortality Among Persons With Diabetes: Are Older Adults at Higher Risk? - Results from the Translating Research Into Action for Diabetes (TRIAD) Study

    PubMed Central

    Kimbro, Lindsay B.; Mangione, Carol M.; Steers, W. Neil; Duru, O. Kenrik; McEwen, Laura; Karter, Andrew; Ettner, Susan L.

    2014-01-01

    Background/Objectives Several studies have found that depression leads to an increased risk of mortality among patients with diabetes. Our goal is to compare the strength of the association between depression and mortality between the elderly and non-elderly population. Design A survival analysis conducted in a longitudinal cohort study of persons with diabetes to test the association of depression and mortality among Medicare-aged and non-Medicare aged persons. Setting Managed care. Participants 3341 persons aged 18 and over with diabetes who participated in the wave 2 survey of the Translating Research Into Action for Diabetes (TRIAD) study. Measurements The primary outcome was mortality risk, which was measured as days until death using linked data from the National Death Index. Depression was measured using the Patient Health Questionnaire (PHQ8). Results After controlling for age, gender, race/ethnicity, income, and other comorbidities, mortality risk among depressed persons with diabetes was 49% higher than among non-depressed persons with diabetes. However, our results varied by age. After controlling for the same variables, mortality risk among persons over the age 65 years and older with depression was 78% greater than among elderly persons without depression. For the less than 65-year-old cohort, the effect of depression on mortality was smaller and not statistically significant. Conclusion This analysis suggests that the effect of depression on mortality among persons with diabetes is most significant for older adults. Because there is evidence in the literature that treatment of depression in the elderly can lead to lower mortality, our results may suggest that older adults with diabetes should be considered a high priority population for depression screening and treatment. PMID:24823259

  9. Episodic future thinking.

    PubMed

    Atance, Cristina M.; O'Neill, Daniela K.

    2001-12-01

    Thinking about the future is an integral component of human cognition - one that has been claimed to distinguish us from other species. Building on the construct of episodic memory, we introduce the concept of 'episodic future thinking': a projection of the self into the future to pre-experience an event. We argue that episodic future thinking has explanatory value when considering recent work in many areas of psychology: cognitive, social and personality, developmental, clinical and neuropsychology. Episodic future thinking can serve as a unifying concept, connecting aspects of diverse research findings and identifying key questions requiring further reflection and study.

  10. Neighborhood disadvantage and self-assessed health, disability, and depressive symptoms: longitudinal results from the Health and Retirement Study

    PubMed Central

    Glymour, M. Maria; Mujahid, Mahasin; Wu, Qiong; White, Kellee; Tchetgen Tchetgen, Eric J.

    2010-01-01

    Purpose Using a longitudinal cohort, we assessed the association between neighborhood disadvantage and incidence of poor health and function in three domains. Methods Over 4,000 enrollees aged 55–65 in the national Health and Retirement Study were assessed biennially from 1998 through 2006 for incidence of: fair/poor self-rated health (SRH), elevated depressive symptoms, and limitations in five basic Activities of Daily Living (disability). Each analysis was restricted to subjects without that condition in 1994 or 1996. Neighborhoods (census tracts, time-updated for moves), were considered disadvantaged if they fell below the 25th percentile in an index comprising 6 socioeconomic status indicators. Repeated measures logistic regressions, inverse probability weighted to account for individual confounders, selective survival, and loss to follow-up, were used to estimate odds ratios (ORs) for incidence of each outcome in the wave following exposure to disadvantaged neighborhood. Results After covariate adjustment, neighborhood disadvantage predicted onset of fair/poor SRH (OR=1.32; 95% confidence interval 1.11, 1.57), but not disability (OR=0.98; 0.82, 1.16) or elevated depressive symptoms (OR=0.98; 0.83, 1.16). Conclusions Results confirmed prior findings that neighborhood disadvantage predicts SRH in a longitudinal context, but did not support an association between neighborhood disadvantage and onset of disability or elevated depressive symptoms. PMID:20933193

  11. Cognitive deficits in bipolar disorder: from acute episode to remission.

    PubMed

    Volkert, J; Schiele, M A; Kazmaier, Julia; Glaser, Friederike; Zierhut, K C; Kopf, J; Kittel-Schneider, S; Reif, A

    2016-04-01

    Considerable evidence demonstrates that neuropsychological deficits are prevalent in bipolar disorder during both acute episodes and euthymia. However, it is less clear whether these cognitive disturbances are state- or trait-related. We here present the first longitudinal study employing a within-subject pre- and post-testing examining acutely admitted bipolar patients (BP) in depression or mania and during euthymia, aiming to identify cognitive performance from acute illness to remission. Cognitive performance was measured during acute episodes and repeated after at least 3 months of remission. To do so, 55 BP (35 depressed, 20 hypo-/manic) and 55 healthy controls (HC) were tested with a neuropsychological test battery (attention, working memory, verbal memory, executive functioning). The results showed global impairments in acutely ill BP compared to HC: depressed patients showed a characteristic psychomotor slowing, while manic patients had severe deficits in executive functioning. Twenty-nine remitted BP could be measured in the follow-up (dropout rate 48 %), whose cognitive functions partially recovered, whereas working memory and verbal memory were still impaired. However, we found that subthreshold depressive symptoms and persisting sleep disturbances in euthymic BP were associated with reduced speed, deficits in attention and verbal memory, while working memory was correlated with psychotic symptoms (lifetime). This result indicates working memory as trait related for a subgroup of BP with psychotic symptoms. In contrast, attention and verbal memory are negatively influenced by state factors like residual symptoms, which should be more considered as possible confounders in the search of cognitive endophenotypes in remitted BP. PMID:26611783

  12. Ziprasidone Augmentation of Escitalopram for Major Depressive Disorder: Efficacy Results from a Randomized, Double-Blind, Placebo-Controlled Study

    PubMed Central

    Papakostas, George I.; Fava, Maurizio; Baer, Lee; Swee, Michaela B.; Jaeger, Adrienne; Bobo, William V.; Shelton, Richard C.

    2016-01-01

    Objective To test the efficacy of adjunctive ziprasidone in adults with non-psychotic unipolar major depression experiencing persistent symptoms following 8 weeks of open-label escitalopram. Method This was a multi-center, parallel randomized, double-blind, placebo-controlled trial conducted at three academic medical centers in the United States. The participant pool consisted of 139 outpatients with persistent symptoms of major depressive disorder following an 8-week open label trial of escitalopram (phase 1). Subjects were randomized (1:1, n=139) to adjunctive ziprasidone (escitalopram+ziprasidone, n=71) or adjunctive placebo (escitalopram+placebo, n=68), with 8 weekly follow-up assessments. Primary outcome was defined by clinical response according to the 17-item Hamilton Depression Rating Scale (HAMD-17) and determined by a 50% or greater reduction in scale scores. The Hamilton Anxiety Rating scale (HAM-A) and Visual Analogue Scale for Pain were defined a priori as key secondary outcome measures. Results Rates of clinical response (35.2% vs. 20.5%, p=0.04) and mean improvement in HAMD-17 total scores (−6.4 ± 6.4 vs. −3.3 ± 6.2, p=0.04) were significantly greater for the escitalopram+ziprasidone group. Several secondary measures of antidepressant efficacy were also in favor of adjunctive ziprasidone. Escitalopram+ziprasidone also resulted in significantly greater improvement in HAM-A, but not Visual Analogue Scale for Pain scores. Ten (14%) patients discontinued escitalopram+ziprasidone due to intolerance versus none for escitalopram+placebo (p<0.01 versus placebo). Conclusions Adjunctive ziprasidone, when added to escitalopram, demonstrated antidepressant efficacy in adult patients with major depressive disorder experiencing persistent symptoms following 8 weeks of open-label escitalopram. PMID:26085041

  13. Assessing Effects of l-Methylfolate in Depression Management: Results of a Real-World Patient Experience Trial

    PubMed Central

    Shelton, Richard C.; Sloan Manning, J.; Tipa, Eleanor V.

    2013-01-01

    Objective: l-Methylfolate has been shown in retrospective and prospective studies to enhance antidepressant response. The aim of this study was to prospectively assess change in depression severity and medication satisfaction in patients prescribed l-methylfolate within a naturalistic setting. Method: Between November 2010 and April 2012, patients who reported being treated for major depressive disorder rated their experiences before and after 3 months on the prescription medical food l-methylfolate (Deplin) 7.5 mg or 15 mg, through an automated telephone system. Survey questions included the 9-item Patient Health Questionnaire (PHQ-9), as well as quality of life and medication satisfaction questions. The primary outcome was change in depression severity from baseline to endpoint. Results: Of 554 patients, 502 reported that l-methylfolate was added to their existing antidepressant and 52 were treated with l-methylfolate alone, without an antidepressant. Enrolled participants reported a mean reduction of 8.5 points (58.2% decrease) in their PHQ-9 score (mean baseline PHQ-9 score = 14.6, mean follow-up PHQ-9 score = 6.1; P = .000); 376 (67.9%) responded to treatment (50% reduction in baseline PHQ-9 score) and 253 (45.7%) achieved remission (follow-up PHQ-9 score < 5) after an average of 95 days of therapy. In addition, patients achieved significant reductions in self-reported impairment in their work/home/social life (P = .000). Medication satisfaction with l-methylfolate (mean satisfaction score = 7.0) was significantly higher than with prior medication (mean satisfaction score = 5.2; P = .000). Conclusions: Results show that in a naturalistic setting, patients managed with l-methylfolate achieved statistically significant improvements in self-reported depression symptoms and functioning and greater satisfaction with their medication treatment. PMID:24392264

  14. Personality in recovered depressed elderly.

    PubMed

    Schneider, L S; Zemansky, M F; Bender, M; Sloane, R B

    1992-01-01

    Personality traits in euthymic elderly subjects with and without past histories of major depressive episodes were assessed using the Structured Clinical Interview for DSM-III-R and the Social Adjustment Scale-SR. Recovered depressed subjects were characterized by significantly more personality traits from DSM-III-R Clusters B and C than controls, and they exhibited differences in social adjustment, as well. Subjects who have recovered from depressive episodes may show significant differences in personality and social adjustment that might represent residua of past depression, a trait characteristic, or a risk factor for recurrence.

  15. Yawning in depression: worth looking into.

    PubMed

    Hensch, T; Blume, A; Böttger, D; Sander, C; Niedermeier, N; Hegerl, U

    2015-05-01

    Yawning often occurs during states of increased sleep propensity. Depression is associated with sleep problems and tiredness. The aim of this paper is to review the present knowledge about possible changes of yawning during an episode of major depression (MD) and to report data on yawning from an online depression forum comprising of 450,000 postings. A literature search did not reveal any study about yawning in people with MD when compared to controls. However, there is evidence for an increased frequency of yawning under the influence of antidepressants. Analysis of the depression forum postings revealed 63 people writing about increased yawning in the context of depression. However, all but one of them were treated with antidepressants; and yawning was not reported as a symptom of depression, but in most cases (N=56) as occurring as a result of treatment with antidepressants. These findings are in agreement with a tonic hyperarousal in typical depression which is reduced by all standard antidepressants. For clinicians, it would be of interest to know whether yawning is reduced in untreated depression and whether it predicts treatment outcome.

  16. Partner violence and major depression in women: a community study of Chinese Americans.

    PubMed

    Hicks, Madelyn Hsiao-Rei; Li, Zhonghe

    2003-11-01

    This cross-sectional, retrospective study used epidemiological and anthropological methods toward two aims: 1) to examine associations between partner violence and major depression in a community probability sample of women and 2) to provide new data on partner violence in Chinese Americans. In this study, 181 Chinese American women were interviewed, with 178 completing structured sections on CIDI 2.1 major depression and on partner violence history. Results indicate that a history of partner violence is associated with significantly higher rates of lifetime, 12-month, and current major depression in this community population. This effect is specific and independent of other factors. Partner violence also has a dose-response relationship with the severity of major depression episodes, increasing risk for severe and moderate episodes. The strength and specificity of this association, its dose-response effect, and its commonality across different populations suggest a possible causal role for partner violence needing further investigation in research on major depression in women.

  17. Kraepelin and manic-depressive insanity: an historical perspective.

    PubMed

    Mondimore, Francis M

    2005-02-01

    Since the time of the ancient Greeks, physicians have recognized a certain relatedness between the mental states of depression and mania. In the mid-Nineteenth century, French alienists proposed a 'double' or 'circular' illness consisting of alternating depressed and manic episodes and at the beginning of the twentieth century, Emil Kraepelin introduced the term 'manic-depressive insanity.' Kraepelin's broad clinical experience resulted in compelling descriptions of the symptoms of mood disorders that have arguably never been surpassed. The Kraepelinian nosology continues to provide a touchstone for modern classification systems of the mood disorders.

  18. The relationship between HIV/Sexually Transmitted Infection risk and alcohol use during commercial sex episodes: results from the study of female commercial sex workers in the Philippines.

    PubMed

    Chiao, Chi; Morisky, Donald E; Rosenberg, Rhonda; Ksobiech, Kate; Malow, Robert

    2006-01-01

    The HIV/Sexually Transmitted Infection (STI) risk associated with alcohol use between female commercial sex workers (FCSWs) and their customers has been understudied. We examined this relationship for 1,114 FCSWs aged 15-54 with data collected during the baseline study period (1994 to 1998) in four southern provinces of the Philippines. Two alcohol-related risk situations during commercial sex episodes were examined: prior alcohol use by an FCSW and perceived intoxication in a customer. The influence of sociodemographic variables on sexual risk behaviors was also studied. Multiple sexual risk behaviors were observed with more frequency for FCSWs if alcohol was used before commercial sex or if the episode involved a customer perceived to be intoxicated. Forty-two percent of FCSWs who had sex with an intoxicated customer were STI positive, significantly more than FCSWs who did not have sex with an intoxicated customer (28%, p < .01). Similar significant differences were found for FCSWs who did not consume alcohol before having sex and were STI positive (29%) versus FCSW who did consume alcohol before sex and were STI positive (33%, p < .01). Our analyses reinforce accumulating evidence in the field that sexual risk reduction interventions need to go beyond the behaviors of individual FCSWs to meet the layering of risks such as observed in this study. Multilevel strategies targeting customer substance use and other situational and structural factors have proven to be pivotal mediators in our other research with this population. These experiences and the limitations of this study are discussed. PMID:17002991

  19. The Relationship Between HIV/Sexually Transmitted Infection Risk and Alcohol Use During Commercial Sex Episodes: Results From the Study of Female Commercial Sex Workers in the Philippines

    PubMed Central

    CHIAO, CHI; MORISKY, DONALD E.; ROSENBERG, RHONDA; KSOBIECH, KATE; MALOW, ROBERT

    2011-01-01

    The HIV/Sexually Transmitted Infection (STI) risk associated with alcohol use between female commercial sex workers (FCSWs) and their customers has been understudied. We examined this relationship for 1,114 FCSWs aged 15–54 with data collected during the baseline study period (1994 to 1998) in four southern provinces of the Philippines. Two alcohol-related risk situations during commercial sex episodes were examined: prior alcohol use by an FCSW and perceived intoxication in a customer. The influence of sociodemographic variables on sexual risk behaviors was also studied. Multiple sexual risk behaviors were observed with more frequency for FCSWs if alcohol was used before commercial sex or if the episode involved a customer perceived to be intoxicated. Forty-two percent of FCSWs who had sex with an intoxicated customer were STI positive, significantly more than FCSWs who did not have sex with an intoxicated customer (28%, p < .01). Similar significant differences were found for FCSWs who did not consume alcohol before having sex and were STI positive (29%) versus FCSW who did consume alcohol before sex and were STI positive (33%, p < .01). Our analyses reinforce accumulating evidence in the field that sexual risk reduction interventions need to go beyond the behaviors of individual FCSWs to meet the layering of risks such as observed in this study. Multilevel strategies targeting customer substance use and other situational and structural factors have proven to be pivotal mediators in our other research with this population. These experiences and the limitations of this study are discussed. PMID:17002991

  20. Associations of various perceived-stress situations with depressive symptoms in ≥50-year old Taiwanese men and women: Results from the Taiwan Longitudinal Study on Aging.

    PubMed

    Tsai, Hsin-Jen; Chang, Fu-Kuei

    2016-01-01

    This study was aimed to evaluate the cross-sectional and longitudinal associations between various perceived-stress and depressive symptoms in old Taiwanese men and women aged 50 years and over. Data were derived from the Taiwan Longitudinal Study on Aging. Stress for health, finance, and family members' related issues were all cross-sectionally associated with concurrent depressive symptoms for men and women (all P<0.05). Increased/constant-high health stress was positively associated with subsequent depressive symptoms in both genders (all P<0.05). Constantly high job stress and increased stress over family members' problems were associated with higher likelihood of subsequent depressive symptoms in men (P<0.05). Constantly high/increased financial stress and relationship strain with family members were positively associated with subsequent depressive symptoms in women (all P<0.05). The results suggest that stress for health, job, finance, and family members-related issues are unequally associated with depressive symptoms among Taiwanese men and women aged 50 years and over. Changes of health stress even reduced are significantly associated with subsequent depressive symptoms. Long-term job stress and increased stress over family members' problems increase occurrences of men's depressive symptoms, while increased/long-term financial stress and relationship-strain with family members increase occurrences of women's depressive symptoms. Long-term high health stress has more impacts on men's depressive symptoms than women's, while long-term high relationship strain with family members has more impacts on women's depressive symptoms than men's. PMID:27490720

  1. Symptoms at Onset in First Episode Schizophrenia: Caregivers Perspectives

    PubMed Central

    Tharoor, Hema; Ganesh, Aarthi

    2015-01-01

    Background: Early recognition of symptoms is important in the management of psychosis. Caregivers understanding and attribution of symptoms plays a major role in treatment selection. Aim: The aim was to identify the various symptoms cluster recognized by caregivers at illness onset in first episode schizophrenia. Subjects and Methods: In a cross-sectional study 40 key caregivers of patients with first episode of Schizophrenia (International Classification of Diseases-10) attending the outpatient services of Schizophrenia Research Foundation were recruited. Caregivers were assessed using a questionnaire adapted from the Psychiatric and Personal History Schedule. Statistical Analysis: Principal component (PCP) analysis. Results: Caregivers were predominantly women. Parents (58%), siblings (18%), spouse (12%), and children (12%) formed the sample. The caregiver easily recognized depressive symptoms. An analysis was done to analyze symptom data rated on the caregiver questionnaire indicated a four-factor solution. PCP analysis produced a clear depressive, anxious, irritable, and vegetative factor (Eigenvalue >0.05). Caregivers (40%) attributed present lifestyle as causality. The first contact of help in almost half of the sample (45%) was to a psychiatric facility. Conclusion: Caregiver's perception about mental illness and ability to identify the four factors has important treatment implications. Studying patterns of help seeking may be a useful strategy in early intervention programs. PMID:26702170

  2. Social support in depression: structural and functional factors, perceived control and help-seeking.

    PubMed

    Kleinberg, A; Aluoja, A; Vasar, V

    2013-12-01

    Aims. This study examined the associations of social support, loneliness and locus of control with depression and help-seeking in persons with major depression. Methods. Twelve-month help-seeking for emotional problems was assessed in a cross-sectional 2006 Estonian Health Survey. Non-institutionalized individuals aged 18-84 years (n = 6105) were interviewed. A major depressive episode was assessed using the Mini-International Neuropsychiatric Interview. Factors describing social support, social and emotional loneliness and locus of control were assessed, and their associations with depression were analysed. The associations with reported help-seeking behaviour among people identified as having a major depressive episode (n = 343) were explored. Results. Low frequency of contacts with one's friends and parents, emotional loneliness, external locus of control and emotional dissatisfaction with couple relations were significant factors predicting depression in the multivariate model. External locus of control was associated with help-seeking in the depressed sample. Interactions of emotional loneliness, locus of control and frequency of contacts with parents significantly predicted help-seeking in the depressed sample. Conclusions. Depression is associated with structural and functional factors of social support and locus of control. Help-seeking of depressed persons depends on locus of control, interactions of emotional loneliness, locus of control and contacts with the parental family.

  3. [Role of personality in depression of the elderly: difference between early and late life depression].

    PubMed

    Nubukpo, Philippe; Hartmann, Joël; Clément, Jean-Pierre

    2005-03-01

    Personality disorders have been implicated in the occurrence of depression in the elderly. The main purpose of this study was to assess the role of personality disorders in depression of the elderly and to distinguish between early and late onset depression. The study included 48 subjects over 65 years of age from a department of psychiatry, who suffered from a major depressive episode according to the criteria of the DSM-III-R, without bipolar characteristics. The patients were examined at two different times. At the first interview, depression was assessed by the mini-GDS and the CES-D scales, and a cognitive disorder was ruled out by the Mini-Mental State Examination. The patients were then classified in two groups according to the time of the first occurrence of depression, before (early onset depression) or after (late onset depression) 65 years of age. A second evaluation was performed after the cure of the depression. The patients' personality was then assessed using the International Personality Disorder Examination, in its VKP French-translated version, which evaluates personality disorders as defined by the criteria of the DSM-III-R and the ICD-10. The frequency of personality disorders was higher in patients with early-onset depression rather than in those with late onset depression. The most frequent personality disorder was avoiding personality (Cluster C) according to categorical as well as dimensional assessment. "Dependant personality" (Cluster C) was also quite often associated with early-onset depression. However this results should be confirmed by a larger study.

  4. Emotions, self-esteem, and paranoid episodes: an experience sampling study.

    PubMed

    Thewissen, Viviane; Bentall, Richard P; Oorschot, Margreet; A Campo, Joost; van Lierop, Thom; van Os, Jim; Myin-Germeys, Inez

    2011-06-01

    OBJECTIVES. The evidence to date for a causal role of emotions in the generation of paranoid symptoms is scarce, mainly because of a lack of studies investigating the longitudinal association between emotional processes and paranoia. The primary aim of this study was to investigate whether momentary emotional experiences (anxiety, depression, anger/irritability) and self-esteem predicted the onset and duration of a paranoid episode. We also studied whether levels of emotional experiences and self-esteem were respectively higher and lower during a paranoid episode. DESIGN. A 1-week, prospective momentary assessment study. METHODS. Data were collected using the experience sampling method, a structured self-assessment diary technique. The sample consisted of 158 individuals who ranged across the paranoia continuum. Participants with a psychotic disorder were recruited from in-patient and out-patient mental health services. Participants without psychotic disorder were sampled from the general population. RESULTS. Specific aspects of emotional experience were implicated in the onset and persistence of paranoid episodes. Both an increase in anxiety and a decrease in self-esteem predicted the onset of paranoid episodes. Cross-sectionally, paranoid episodes were associated with high levels of all negative emotions and low level of self-esteem. Initial intensity of paranoia and depression was associated with longer, and anger/irritability with shorter duration of paranoid episodes. CONCLUSIONS. Paranoid delusionality is driven by negative emotions and reductions in self-esteem, rather than serving an immediate defensive function against these emotions and low self-esteem. Clinicians need to be aware of the central role of emotion-related processes and especially self-esteem in paranoid thinking.

  5. Melancholic versus non-melancholic depression: differences on cognitive function. A longitudinal study protocol

    PubMed Central

    2010-01-01

    Background Cognitive dysfunction is common among depressed patients. However, the pattern and magnitude of impairment during episodes of major depressive disorder (MDD) through to clinical remission remains unclear. Heterogeneity of depressive patients and the lack of longitudinal studies may account for contradictory results in previous research. Methods/Design This longitudinal study will analyze cognitive differences between CORE-defined melancholic depressed patients (n = 60) and non-melancholic depressed patients (n = 60). A comprehensive clinical and cognitive assessment will be performed at admission and after 6 months. Cognitive dysfunction in both groups will be longitudinally compared, and the persistence of cognitive impairment after clinical remission will be determined. Discussion The study of neuropsychological dysfunction and the cognitive changes through the different phases of depression arise a wide variety of difficulties. Several confounding variables must be controlled to determine if the presence of depression could be considered the only factor accounting for group differences. PMID:20565743

  6. Maternal Antenatal Depression and Infant Disorganized Attachment at 12 months

    PubMed Central

    Hayes, Lisa J.; Goodman, Sherryl H.; Carlson, Elizabeth

    2012-01-01

    Although high rates of attachment disorganization have been observed in infants of depressed mothers, little is known about the role of antenatal depression as a precursor to infant attachment disorganization. The primary aim of this study was to examine associations between maternal antenatal depression and infant disorganization at 12 months in a sample of women (N = 79) at risk for perinatal depression. A secondary aim was to test the roles of maternal postpartum depression and maternal parenting quality as potential moderators of this predicted association. Among women with histories of major depressive episodes, maternal depressive symptoms were assessed at multiple times during pregnancy and the first year postpartum, maternal parenting quality was measured at 3 months postpartum, and attachment disorganization was assessed at 12 months postpartum. Results revealed that infants classified as disorganized had mothers with higher levels of depressive symptoms during pregnancy compared to infants classified as organized. Maternal parenting quality moderated this association, as exposure to higher levels of maternal depressive symptoms during pregnancy was only associated with higher rates of infant disorganized attachment when maternal parenting at 3 months was less optimal. These findings suggest that enhancing maternal parenting behaviors during this early period in development has the potential to alter pathways to disorganized attachment among infants exposed to antenatal maternal depressive symptoms, which could have enduring consequences for child wellbeing. PMID:23216358

  7. The Impact of Exposure to Interpersonal Violence on Gender Differences in Adolescent-Onset Major Depression: Results from the National Comorbidity Survey Replication (NCS-R)

    PubMed Central

    Dunn, Erin C.; Gilman, Stephen E.; Willett, John B.; Slopen, Natalie B.; Molnar, Beth E.

    2014-01-01

    Background Beginning in adolescence, females are at significantly higher risk for depression than males. Despite substantial efforts, gaps remain in our understanding of this disparity. This study tested whether gender differences in adolescent-onset depression arise because of female’s greater exposure or sensitivity to violence. Methods Data came from 5692 participants in the National Comorbidity Survey Replication. Trained interviewers collected data about major depression and participants’ exposure to four types of interpersonal violence (physical abuse, sexual assault, rape, and witnessing violence) using a modified version of the Composite International Diagnostic Interview. We used discrete time survival analysis to investigate gender differences in the risk of adolescent onset depression. Results 5.7% of the sample met DSM-IV criteria for depression by age 18; 5.8% of the sample reported being physically abused, 11.7% sexually assaulted, 8.5% raped, and 13.2% witnessed violence by age 18. Females had 1.51 times higher odds of depression by age 18 than males. Exposure to all types of violence was associated with an increased odds of depression in both the past year and the years following exposure. Adjusting for exposure to violence partially attenuated the association between gender and depression, especially for sexual assault (OR attenuated=1.28; 15.23%) and rape (OR attenuated=1.32; 12.59%). There was no evidence that females were more vulnerable to the effects of violence than males. Discussion Gender differences in depression are partly explained by females’ higher likelihood of experiencing interpersonal violence. Reducing exposure to sexual assault and rape could therefore mitigate gender differences in depression. PMID:22447513

  8. Differences Between Early and Late Onset Adult Depression

    PubMed Central

    Bukh, Jens Drachmann; Bock, Camilla; Vinberg, Maj; Gether, Ulrik; Kessing, Lars Vedel

    2011-01-01

    Background: It is unclear, whether age-of-onset identifies subgroups of depression. Aim: To assess the clinical presentation of depression with onset in the early adult age (18-30 years) as compared to depression with later onset (31-70 years). Method: A total number of 301 patients with first episode depression were systematically recruited. Characteristics including psychiatric co-morbidity, personality disorders and traits, stressful life events prior to onset, family history, and treatment outcome were assessed by structured interviews and compared by chi-square tests for categorical data, t-tests for continuous parametric data and Mann-Whitney U-test for continuous nonparametric data. Logistic and multiple regression analyses were used to adjust the analyses for potentially confounding variables. Results: Patients with early onset of depression were characterised by a higher prevalence of co-morbid personality disorders, higher levels of neuroticism, and a lower prevalence of stressful life events preceding onset compared to patients with later age-of-onset. There were no differences in severity of the depressive episode, treatment outcome or family loading of psychiatric illness. Conclusion: Early adult onset of depression is associated with co-morbid personality deviances, whereas late onset is associated with environmental risk factors. PMID:21866230

  9. Are the obese at greater risk for depression?

    PubMed

    Roberts, R E; Kaplan, G A; Shema, S J; Strawbridge, W J

    2000-07-15

    Two waves of data from a community-based study (Alameda County Study, 1994-1995) were used to investigate the association between obesity and depression. Depression was measured with 12 items covering Diagnostic and Statistical Manual of Mental Disorders: DSM-IV diagnostic criteria for major depressive episode. Following US Public Health Service criteria, obese subjects were defined as those with body mass index scores at the 85th percentile or higher. Covariates were age, sex, education, marital status, social isolation and social support, chronic medical conditions, functional impairment, life events, and financial strain. Results were mixed. In cross-sectional analyses, greater odds for depression in 1994 were observed for the obese, with and without adjustment for covariates. When obesity and depression were examined prospectively, controlling for other variables, obesity in 1994 predicted depression in 1995 (odds ratio (OR) = 1.73, 95% confidence interval (CI): 1.04, 2.87). When the data were analyzed with obesity defined as a body mass index of > or = 30, cross-sectional results were the same. However, the prospective multivariate analyses were not significant (OR = 1.43, 95% CI: 0.85, 2.43). Although these data do not resolve the role of obesity as a risk factor for depression, overall the results suggest an association between obesity and depression. The authors found no support for the "jolly fat" hypothesis (obesity reduces risk of depression). However, there has been sufficient disparity of results thus far to justify continued research.

  10. Evaluating depressive symptoms in mania: a naturalistic study of patients with bipolar disorder

    PubMed Central

    Young, Allan H; Eberhard, Jonas

    2015-01-01

    Objective This study aimed to evaluate patients with bipolar I disorder (BD-I) who have mania with depressive symptoms and who meet the new “with mixed features” specifier of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). Method This prospective, multinational, naturalistic study surveyed psychiatrists and their patients with BD-I from October 2013 to March 2014. Eligible patients had BD-I, had a (current) manic episode, and had experienced onset of a manic episode within the previous 3 months. Psychiatrists provided patient information on depressive symptoms (DSM-5 criteria); symptoms of anxiety, irritability, and agitation; suicide attempts; and physician satisfaction with treatment response. Data were stratified according to whether patients met the criteria for the BD-I “with mixed features” specifier of DSM-5 (≥3 depressive symptoms) or not, and characteristics were compared between the two subgroups. Patients also self-reported on depressive symptoms using the Mini-International Neuropsychiatric Interview module questionnaire. Results Overall, 34% of 1,035 patients met the criteria for BD-I “with mixed features,” exhibiting ≥3 depressive symptoms during their current manic episode. This correlated with the matched patient self-reports of depressive symptoms. During their current manic episode, BD-I patients “with mixed features” had more severe symptoms of anxiety, irritability, and agitation (average composite severity score of 4.1 vs 3.4), a higher incidence of suicide attempts (38% vs 9%), and more physician dissatisfaction with treatment response (22% vs 14%), compared to patients with 0–2 depressive symptoms (all P<0.05). Conclusion This study found that patients with BD-I “with mixed features” (ie, ≥3 depressive symptoms during a manic episode), suffered, on average, from a greater burden of disease than patients with pure mania. Improved identification of these patients may help to optimize

  11. Association of Baseline Depressive Symptoms with Prevalent and Incident Pre-Hypertension and Hypertension in Postmenopausal Hispanic Women: Results from the Women’s Health Initiative

    PubMed Central

    Zambrana, Ruth E.; López, Lenny; Dinwiddie, Gniesha Y.; Ray, Roberta M.; Eaton, Charles B.; Phillips, Lawrence S.; Wassertheil-Smoller, Sylvia

    2016-01-01

    Background Depression and depressive symptoms are risk factors for hypertension (HTN) and cardiovascular disease (CVD). Hispanic women have higher rates of depressive symptoms compared to other racial/ethnic groups yet few studies have investigated its association with incident prehypertension and hypertension among postmenopausal Hispanic women. This study aims to assess if an association exists between baseline depression and incident hypertension at 3 years follow-up among postmenopausal Hispanic women. Methods Prospective cohort study, Women’s Health Initiative (WHI), included 4,680 Hispanic women who participated in the observational and clinical trial studies at baseline and at third-year follow-up. Baseline current depressive symptoms and past depression history were measured as well as important correlates of depression—social support, optimism, life events and caregiving. Multinomial logistic regression was used to estimate prevalent and incident prehypertension and hypertension in relation to depressive symptoms. Results Prevalence of current baseline depression ranged from 26% to 28% by hypertension category and education moderated these rates. In age-adjusted models, women with depression were more likely to be hypertensive (OR = 1.25; 95% CI 1.04–1.51), although results were attenuated when adjusting for covariates. Depression at baseline in normotensive Hispanic women was associated with incident hypertension at year 3 follow-up (OR = 1.74; 95% CI 1.10–2.74) after adjustment for insurance and behavioral factors. However, further adjustment for clinical covariates attenuated the association. Analyses of psychosocial variables correlated with depression but did not alter findings. Low rates of antidepressant medication usage were also reported. Conclusions In the largest longitudinal study to date of older Hispanic women which included physiologic, behavioral and psychosocial moderators of depression, there was no association between baseline

  12. Inflammation markers and Major Depressive Disorder in Patients with Chronic Heart Failure: Results from the Sertraline Against Depression and Heart Disease in Chronic Heart Failure (SADHART-CHF) study

    PubMed Central

    Xiong, Glen L.; Prybol, Kevin; Boyle, Stephen H.; Hall, Russell; Streilein, Robert D; Steffens, David C.; Krishnan, Ranga; Rogers, Joseph G.; O’Connor, Christopher M.; Jiang, Wei

    2015-01-01

    Background Major Depressive Disorder (MDD) and Chronic Heart Failure (CHF) have in common heightening states of inflammation, manifested by elevated inflammation markers such as C-reactive protein (CRP). This study compared inflammatory biomarker profiles in CHF patients with MDD to those without MDD. Methods The study recruited patients admitted to inpatient care for acute heart failure exacerbations, after psychiatric diagnostic interview. Patients with Beck Depression Inventory (BDI) scores < 10 and with no prior history of depression served as the non-depressed reference group (n = 25). MDD severity was defined as: Mild (BDI 10–15; n = 48); Moderate (BDI 16–23; n = 51); and Severe (BDI ≥ 24; n = 33). A Bio-Plex assay measured 18 inflammation markers. Ordinal logistic models were used to examine the association of MDD severity and biomarker levels. Results Adjusting for age, sex, statin use, BMI, LVEF, tobacco use, and NHYA class the MDD overall group variable was significantly associated with elevated interleukin (IL) −2 (p = .019), IL-4 (p = .020), IL-6 (p = .026),, interferon (INF)-γ (p = .010), monocyte chemoattractant protein (MCP-1) (p = .002), macrophage inflammatory protein (MIP-1β) (p = .003) and tumor necrosis factor (TNF)-α (p = .004). MDD severity subgroups had a greater probability of elevated IL-6, IL-8, IFN-γ, MCP-1, MIP-1β, and TNF-α compared to none-depressed group. The non-depressed group had greater probability of elevated IL-17 (p < 0.001) and IL-1β (p < 0.01). Conclusions MDD in CHF patients was associated with altered inflammation marker levels compared to CHF patients who had no depression. Whether effective depression treatment will normalize the altered inflammation marker levels requires further study. PMID:26186432

  13. COMT Val158Met, but not BDNF Val66Met, is associated with white matter abnormalities of the temporal lobe in patients with first-episode, treatment-naïve major depressive disorder: a diffusion tensor imaging study

    PubMed Central

    Hayashi, Kenji; Yoshimura, Reiji; Kakeda, Shingo; Kishi, Taro; Abe, Osamu; Umene-Nakano, Wakako; Katsuki, Asuka; Hori, Hikaru; Ikenouchi-Sugita, Atsuko; Watanabe, Keita; Ide, Satoru; Ueda, Issei; Moriya, Junji; Iwata, Nakao; Korogi, Yukunori; Kubicki, Marek; Nakamura, Jun

    2014-01-01

    We investigated the association between the Val158Met polymorphism of the catechol-O-methyltransferase (COMT) gene, the Val66Met polymorphism of the brain-derived neurotrophic factor (BDNF) gene, and white matter changes in patients with major depressive disorder (MDD) and healthy subjects using diffusion tensor imaging (DTI). We studied 30 patients with MDD (17 males and 13 females, with mean age ± standard deviation [SD] =44±12 years) and 30 sex- and age-matched healthy controls (17 males and 13 females, aged 44±13 years). Using DTI analysis with a tract-based spatial statistics (TBSS) approach, we investigated the differences in fractional anisotropy, radial diffusivity, and axial diffusivity distribution among the three groups (patients with the COMT gene Val158Met, those with the BDNF gene Val66Met, and the healthy subjects). In a voxel-wise-based group comparison, we found significant decreases in fractional anisotropy and axial diffusivity within the temporal lobe white matter in the Met-carriers with MDD compared with the controls (P<0.05). No correlations in fractional anisotropy, axial diffusivity, or radial diffusivity were observed between the MDD patients and the controls, either among those with the BDNF Val/Val genotype or among the BDNF Met-carriers. These results suggest an association between the COMT gene Val158Met and the white matter abnormalities found in the temporal lobe of patients with MDD. PMID:25061303

  14. Sexual victimization history, depression, and task physiology as predictors of sexual revictimization: results from a 6-month prospective pilot study.

    PubMed

    Waldron, Jonathan C; Wilson, Laura C; Patriquin, Michelle A; Scarpa, Angela

    2015-02-01

    The current study examined depression and physiological reactivity to a sexual threat task as longitudinal predictors of sexual revictimization in women with sexual victimization histories. The sample included 14 young adult women (M(age) = 19.15) who reported child sexual abuse. Heart rate and root mean square of the successive differences were measured at baseline and during the presentation of sexual victimization-related words during an Emotional Stroop task. Results indicated that women who reported a greater history of childhood sexual abuse and adult sexual victimization were at increased risk for sexual revictimization 6 months after initial data collection. Furthermore, even after accounting for their childhood and adult sexual victimization histories and depression symptoms, women who exhibited reduced, or blunted, physiological activity during the sexual victimization stimuli of the Stroop task were more likely to report sexual revictimization during the 6-month follow-up. The findings suggest that sexual victimization survivors may benefit from interventions that address physiological blunting and the recognition of sexual threat cues in their environment. PMID:24923892

  15. Depression and cognitive impairment following recovery from thrombotic thrombocytopenic purpura.

    PubMed

    Han, Bowie; Page, Evaren E; Stewart, Lauren M; Deford, Cassandra C; Scott, James G; Schwartz, Lauren H; Perdue, Jedidiah J; Terrell, Deirdra R; Vesely, Sara K; George, James N

    2015-08-01

    After recovery from an acute episode of acquired thrombotic thrombocytopenic purpura (TTP), patients often describe problems with memory, concentration, and endurance. We have previously reported the occurrence of depression and cognitive impairment in these patients. In this study, we describe the frequency, severity, and clinical course of depression and cognitive impairment. Fifty-two (85%) out of 61 eligible Oklahoma Registry patients who had recovered from TTP, documented by ADAMTS13 activity <10%, have had at least one (median, four) evaluation for depression over 11 years using the Beck Depression Inventory-II; 31 (59%) patients screened positive for depression at least once; in 15 (29%), the results suggested severe depression at least once. Nine of these 15 patients had a psychiatric interview, the definitive diagnostic evaluation; the diagnosis of major depressive disorder was established in eight (89%) patients. In 2014, cognitive ability was evaluated in 33 patients by the Montreal Cognitive Assessment and the Repeatable Battery for Assessment of Neuropsychological Status (RBANS). Both tests detected significant cognitive impairment in the patients as a group. Fifteen out of the 33 patients had been evaluated by extensive cognitive tests in 2006. The 2014 RBANS results were significantly worse than the 2006 results for the overall score and two out of the five RBANS domains (immediate and delayed memory). Neither depression nor cognitive impairment was significantly associated with the occurrence of relapses or ADAMTS13 activity <10% during remission. These observations emphasize the importance of screening evaluations for depression and cognitive impairment after recovery from acquired TTP.

  16. A Pilot for Improving Depression Care on College Campuses: Results of the College Breakthrough Series-Depression (CBS-D) Project

    ERIC Educational Resources Information Center

    Chung, Henry; Klein, Michael C.; Silverman, Daniel; Corson-Rikert, Janet; Davidson, Eleanor; Ellis, Patricia; Kasnakian, Caroline

    2011-01-01

    Objective: To implement a pilot quality improvement project for depression identification and treatment in college health. Participants: Eight college health center teams composed primarily of primary care and counseling service directors and clinicians. Methods: Chronic (Collaborative) Care Model (CCM) used with standardized screening to…

  17. Sleep Disturbances and Risk of Depression in Older Men

    PubMed Central

    Paudel, Misti; Taylor, Brent C.; Ancoli-Israel, Sonia; Blackwell, Terri; Maglione, Jeanne E.; Stone, Katie; Redline, Susan; Ensrud, Kristine E.

    2013-01-01

    Introduction: Self-reported sleep disturbances are associated with an increased risk of depression in younger and older adults, but associations between objective assessments of sleep/wake disturbances via wrist actigraphy and risk of depression are unknown. Methods: Depressive symptoms (Geriatric Depression Scale [GDS]), self-reported (questionnaires), and objective (actigraphy) sleep parameters were measured at baseline in 2,510 nondepressed men 67 y or older. Depressive symptoms were reassessed an average of 3.4 ± 0.5 y later. Results: Of the 2,510 men without evidence of depression at baseline, 116 (4.6%) were depressed (GDS ≥ 6) at the follow-up examination. After adjusting for multiple potential confounders, including baseline depressive symptoms (GDS 0-5), there was evidence of an association between poor self-reported sleep quality and higher odds of being depressed at follow-up (multivariable odds ratio [MOR] = 1.53, 95% confidence interval (CI) 1.00-2.33). In age- and site-adjusted models, objectively measured reduced sleep efficiency (odds ratio [OR] = 1.88, 95% CI 1.13-3.13), prolonged sleep latency (OR = 1.77, 95% CI 1.04-3.00), greater nighttime wakefulness (OR = 1.48, 95% CI 1.01-2.18) and multiple long-wake episodes (OR = 1.69, 95% CI 1.15-2.47) were associated with increased odds of depression at follow-up, but these associations were attenuated and no longer significant after further adjustment for number of depressive symptoms at baseline. Self-reported excessive daytime sleepiness and objectively measured total sleep time were not associated with depression status at follow-up. Excluding baseline antidepressant users from the analyses did not alter the results. Conclusions: Among nondepressed older men, poor self-reported sleep quality was associated with increased odds of depression several years later. Associations between objectively measured sleep disturbances (e.g., reduced sleep efficiency, prolonged sleep latency, greater nighttime

  18. Interactions between spontaneous and provoked cortisol secretory episodes in man.

    PubMed

    Brandenberger, G; Follénius, M; Muzet, A

    1984-09-01

    This study describes the interactions between cortisol peaks due to spontaneous episodic release and peaks provoked by external stimuli. Successive and equidistant transitory rises of similar amplitude and duration were produced either by muscular exercise (30 min, 75% VO2max) or by injecting ACTH1-24 (Synacthen: 250 ng) before and after the midday meal-related peak. ACTH1-24 was also injected during sleep before the nocturnal sequence of the major secretory episodes. In all instances, cortisol levels had reverted to basal levels when the second stimulus was applied. ACTH-induced cortisol peaks depressed the subsequent meal-related peaks, the exercise-induced peaks, and the spontaneous secretory episodes at the end of the night, and thus had a strong depressor capacity. When exercise was the prior stimulus, the subsequent meal-related peaks were depressed, but the response to later exercise was not affected. Meal-related peaks and the spontaneous diurnal or nocturnal peaks did not depress the subsequent secretory episodes. These quantitatively comparable cortisol episodes were preceded by ACTH rises whose amplitude and duration were not identical: spontaneous and meal-related ACTH peaks were smaller than the provoked one; exercise-induced ACTH peaks were of longer duration than those after ACTH1-24 injection. The different depressor capacities of similar sized cortisol episodes and the lack of proportionality between spontaneous and provoked ACTH and cortisol peaks suggest that there are separate adrenocortical activation channels, which depend on the origin of the stimulation.

  19. Depression Management Training: A Structured Group Approach.

    ERIC Educational Resources Information Center

    Lerman, Charles A.; Baron, Augustine, Jr.

    1981-01-01

    Describes a structured group program called Depression Management Training (DMT). The purpose of DMT is to provide an intensive, interactive experience to participants who have problems handling recurrent, episodic depression. Suggests DMT increases participants' awareness of multidimensional sources of depression and enhances their coping…

  20. A comparison of placebo responders and nonresponders in subgroups of depressive disorder.

    PubMed Central

    Bialik, R J; Ravindran, A V; Bakish, D; Lapierre, Y D

    1995-01-01

    The objective of this study was to determine if the placebo treatment response varied in subgroups of depressed patients (single episode, recurrent, and double depression). Data from placebo-treated patients from seven placebo-controlled clinical trials were pooled and analyzed retrospectively. The placebo response rate was highest for females with a single episode of depression (66.7%) and lowest for females with recurrent depressive episodes (13.3%). Among patients experiencing their first episode, placebo responders had lower Hamilton Rating Scale for Depression (HAMD) total scores at baseline and lower ratings of pschomotor retardation than nonresponders. For patients having a recurrence of an episode, placebo responders had lower baseline ratings of somatic anxiety. The major finding was that patients suffering from their first depressive episode differed from patients with recurrent depressive episodes in the rate of placebo response, effect of gender, and the clinical symptoms that were associated with a positive placebo response. PMID:7647079

  1. Path analysis of the chronicity of depression using the comprehensive developmental model framework.

    PubMed

    Fandiño-Losada, Andrés; Bangdiwala, Shrikant I; Lavebratt, Catharina; Forsell, Yvonne

    2016-07-01

    Background Depressive disorder is recognized as recurrent or chronic in the majority of affected individuals; but literature is not consistent about determinants of the disorder course. Aims To analyse the relationships between familial, personal and environmental characteristics in different life phases and their effects on the chronicity of depression in a population-based sample. Methods It was a longitudinal panel study with three waves (W1-W3) for 651 adult men and women with diagnosis of minor/major depression or dysthymia at W1 of the Swedish PART (mental health, work and relations) study. Risk factors and co-morbidities were assessed with questionnaires. The main outcome was an episode of minor/major depression or dysthymia at 10-12 years of follow-up (W3). Liability for depressive episodes was determined using exploratory structural equation modelling (SEM), following a path approach with step-wise specification searches. Results Most of the risk factors determined, directly or indirectly, depression severity at W3. Somatic trait anxiety, partner loss and other negative life events at W1, depressive symptoms at W2, and life difficulties and other dependent life events at W3 had direct effects on the outcome. Conclusions SEM model revealed complex and intertwined psychopathological pathways leading to chronicity of depression, given previous episodes, which could be assembled in two main mechanisms: a depressive-internalizing path and an adversity path comprised of life events. Pathways are simpler than those of depression occurrence, emphasizing the relevance of personality factors as depression determinants, and excluding disability levels, co-morbidities and social support. These novel findings need to be replicated in future studies.

  2. Preventing Depression in Later Life: Translation From Concept to Experimental Design and Implementation

    PubMed Central

    Sriwattanakomen, Roy; Ford, Angela F.; Thomas, Stephen B.; Miller, Mark D.; Stack, Jacqueline A.; Morse, Jennifer Q.; Kasckow, John; Brown, Charlotte; Reynolds, Charles F.

    2009-01-01

    Objective The authors detail the public health need for depression prevention research and the decisions made in designing an experiment testing problem solving therapy as “indicated” preventive intervention for high-risk older adults with subsyndromal depression. Special attention is given to the recruitment of African Americans because of well-documented inequalities in mental health services and depression treatment outcomes between races. Methods A total of 306 subjects (half white, half African American) with scores of 16 or higher on the Center for Epidemiological Studies of Depression Scale, but with no history of major depressive disorder in the past 12 months, are being recruited and randomly assigned to either problem solving therapy-primary care or to a dietary education control condition. Time to, and rate of, incident episodes of major depressive disorder are to be modeled using survival analysis. Level of depressive symptoms will be analyzed via a mixed models approach. Results Twenty-two subjects have been recruited into the study, and to date eight have completed the randomly assigned intervention and postintervention assessment. Four of 22 have exited after developing major depressive episodes. None have complained about study procedures or demands. Implementation in a variety of community settings is going well. Conclusion The data collected to date support the feasibility of translating from epidemiology to RCT design and implementation of empirical depression prevention research in later life. PMID:18515690

  3. Relationships between changes in sustained fronto-striatal connectivity and positive affect in major depression resulting from antidepressant treatment.

    PubMed

    Heller, Aaron S; Johnstone, Tom; Light, Sharee N; Peterson, Michael J; Kolden, Gregory G; Kalin, Ned H; Davidson, Richard J

    2013-02-01

    OBJECTIVE Deficits in positive affect and their neural bases have been associated with major depression. However, whether reductions in positive affect result solely from an overall reduction in nucleus accumbens activity and fronto-striatal connectivity or the additional inability to sustain engagement of this network over time is unknown. The authors sought to determine whether treatment-induced changes in the ability to sustain nucleus accumbens activity and fronto-striatal connectivity during the regulation of positive affect are associated with gains in positive affect. METHOD Using fMRI, the authors assessed the ability to sustain activity in reward-related networks when attempting to increase positive emotion during performance of an emotion regulation paradigm in 21 depressed patients before and after 2 months of antidepressant treatment. Over the same interval, 14 healthy comparison subjects underwent scanning as well. RESULTS After 2 months of treatment, self-reported positive affect increased. The patients who demonstrated the largest increases in sustained nucleus accumbens activity over the 2 months were those who demonstrated the largest increases in positive affect. In addition, the patients who demonstrated the largest increases in sustained fronto-striatal connectivity were also those who demonstrated the largest increases in positive affect when controlling for negative affect. None of these associations were observed in healthy comparison subjects. CONCLUSIONS Treatment-induced change in the sustained engagement of fronto-striatal circuitry tracks the experience of positive emotion in daily life. Studies examining reduced positive affect in a variety of psychiatric disorders might benefit from examining the temporal dynamics of brain activity when attempting to understand changes in daily positive affect.

  4. Depression storage and infiltration effects on overland flow depth-velocity-friction at desert conditions: field plot results and model

    NASA Astrophysics Data System (ADS)

    Rossi, M. J.; Ares, J. O.

    2012-09-01

    Water infiltration and overland flow are relevant in considering water partition among plant life forms, the sustainability of vegetation and the design of sustainable hydrological models and management. In arid and semi-arid regions, these processes present characteristic trends imposed by the prevailing physical conditions of the upper soil as evolved under water-limited climate. A set of plot-scale field experiments at the semi-arid Patagonian Monte (Argentina) were performed in order to estimate the effect of depression storage areas and infiltration rates on depths, velocities and friction of overland flows. The micro-relief of undisturbed field plots was characterized at z-scale 1 mm through close-range stereo-photogrammetry and geo-statistical tools. The overland flow areas produced by controlled water inflows were video-recorded and the flow velocities were measured with image processing software. Antecedent and post-inflow moisture were measured, and texture, bulk density and physical properties of the upper soil were estimated based on soil core analyses. Field data were used to calibrate a physically-based, mass balanced, time explicit model of infiltration and overland flows. Modelling results reproduced the time series of observed flow areas, velocities and infiltration depths. Estimates of hydrodynamic parameters of overland flow (Reynolds-Froude numbers) are informed. To our knowledge, the study here presented is novel in combining several aspects that previous studies do not address simultaneously: (1) overland flow and infiltration parameters were obtained in undisturbed field conditions; (2) field measurements of overland flow movement were coupled to a detailed analysis of soil microtopography at 1 mm depth scale; (3) the effect of depression storage areas in infiltration rates and depth-velocity friction of overland flows is addressed. Relevance of the results to other similar desert areas is justified by the accompanying biogeography analysis

  5. Antepartum Depression and Anxiety Associated with Disability in African Women: Cross-Sectional Results from the CDS Study in Ghana and Côte d'Ivoire

    PubMed Central

    Bindt, Carola; Appiah-Poku, John; Te Bonle, Marguerite; Schoppen, Stefanie; Feldt, Torsten; Barkmann, Claus; Koffi, Mathurin; Baum, Jana; Nguah, Samuel Blay; Tagbor, Harry; Guo, Nan; N'Goran, Eliezer; Ehrhardt, Stephan

    2012-01-01

    Background Common mental disorders, particularly unipolar depressive disorders, rank among the top 5 with respect to the global burden of disease. As a major public health concern, antepartum depression and anxiety not only affects the individual woman, but also her offspring. Data on the prevalence of common mental disorders in pregnant women in sub-Saharan Africa are scarce. We provide results from Ghana and Côte d'Ivoire. Methods We subsequently recruited and screened n = 1030 women in the third trimester of their pregnancy for depressed mood, general anxiety, and perceived disability using the Patient Health Questionnaire depression module (PHQ-9), the 7-item Anxiety Scale (GAD-7), and the World Health Organisation Disability Assessment Schedule II (WHO-DAS 2.0, 12-item version). In addition to estimates of means and prevalence, a hierarchical linear regression model was calculated to determine the influence of antepartum depression and anxiety on disability. Results In Ghana, 26.6% of women showed substantially depressed mood. In Côte d'Ivoire, this figure was even higher (32.9%). Clear indications for a generalized anxiety disorder were observed in 11.4% and 17.4% of pregnant women, respectively. Comorbidity of both conditions was common, affecting about 7.7% of Ghanaian and 12.6% of Ivorian participants. Pregnant women in both countries reported a high degree of disability regarding everyday activity limitations and participation restrictions. Controlled for country and age, depression and anxiety accounted for 33% of variance in the disability score. Conclusions Antepartum depression and anxiety were highly prevalent in our sample and contributed substantially to perceived disability. These serious threats to health must be further investigated and more data are needed to comprehensively quantify the problem in sub-Saharan Africa. PMID:23110236

  6. Duloxetine and care management treatment of older adults with comorbid major depressive disorder and chronic low back pain: results of an open-label pilot study

    PubMed Central

    Karp, Jordan F.; Weiner, Debra K.; Dew, Mary A.; Begley, Amy; Miller, Mark D.; Reynolds, Charles F.

    2010-01-01

    Objective: In older adults, major depressive disorder (MDD) and chronic low back pain (CLBP) are common and mutually exacerbating. We predicted that duloxetine pharmacotherapy and Depression and Pain Care Management (DPCM) would result in (1) significant improvement in MDD and CLBP and (2) significant improvements in health-related quality of life, anxiety, disability, self-efficacy, and sleep quality. Design and Intervention: Twelve week open-label study using duloxetine up to 120 mg/day + DPCM. Setting: Outpatient late-life depression research clinic. Patients: Thirty community-dwelling adults >60 years old. Outcome Measures: Montgomery Asberg Depression Rating Scale (MADRS) and McGill Pain Questionnaire-Short Form (MPQ-SF). Results: 46.7% (n = 14) of the sample had a depression remission. All subjects who met criteria for the depression remission also had a pain response. 93.3% (n = 28) had a significant pain response. Of the subjects who met criteria for a low back pain response, 50% (n = 14) also met criteria for the depression remission. The mean time to depression remission was 7.6 (SE = 0.6) weeks. The mean time to pain response was 2.8 (SE = 0.5) weeks. There were significant improvements in mental health-related quality of life, anxiety, sleep quality, somatic complaints, and both self-efficacy for pain management and for coping with symptoms. Physical health-related quality of life, back pain-related disability, and self-efficacy for physical functioning did not improve. Conclusions: Serotonin and norepinephrine reuptake inhibitors like duloxetine delivered with DPCM may be a good choice to treat these linked conditions in older adults. Treatments that target low self-efficacy for physical function and improving disability may further increase response rates. PMID:19750557

  7. Computerized adaptive measurement of depression: A simulation study

    PubMed Central

    Gardner, William; Shear, Katherine; Kelleher, Kelly J; Pajer, Kathleen A; Mammen, Oommen; Buysse, Daniel; Frank, Ellen

    2004-01-01

    Background Efficient, accurate instruments for measuring depression are increasingly important in clinical practice. We developed a computerized adaptive version of the Beck Depression Inventory (BDI). We examined its efficiency and its usefulness in identifying Major Depressive Episodes (MDE) and in measuring depression severity. Methods Subjects were 744 participants in research studies in which each subject completed both the BDI and the SCID. In addition, 285 patients completed the Hamilton Depression Rating Scale. Results The adaptive BDI had an AUC as an indicator of a SCID diagnosis of MDE of 88%, equivalent to the full BDI. The adaptive BDI asked fewer questions than the full BDI (5.6 versus 21 items). The adaptive latent depression score correlated r = .92 with the BDI total score and the latent depression score correlated more highly with the Hamilton (r = .74) than the BDI total score did (r = .70). Conclusions Adaptive testing for depression may provide greatly increased efficiency without loss of accuracy in identifying MDE or in measuring depression severity. PMID:15132755

  8. Depression risk in patients with coronary heart disease in Germany

    PubMed Central

    Konrad, Marcel; Jacob, Louis; Rapp, Michael A; Kostev, Karel

    2016-01-01

    AIM To determine the prevalence of depression and its risk factors among patients with coronary heart disease (CHD) treated in German primary care practices. METHODS Longitudinal data from nationwide general practices in Germany (n = 1072) were analyzed. Individuals initially diagnosed with CHD (2009-2013) were identified, and 59992 patients were included and matched (1:1) to 59992 controls. The primary outcome measure was an initial diagnosis of depression within five years after the index date among patients with and without CHD. Cox proportional hazards models were used to adjust for confounders. RESULTS Mean age was equal to 68.0 years (SD = 11.3). A total of 55.9% of patients were men. After a five-year follow-up, 21.8% of the CHD group and 14.2% of the control group were diagnosed with depression (P < 0.001). In the multivariate regression model, CHD was a strong risk factor for developing depression (HR = 1.54, 95%CI: 1.49-1.59, P < 0.001). Prior depressive episodes, dementia, and eight other chronic conditions were associated with a higher risk of developing depression. Interestingly, older patients and women were also more likely to be diagnosed with depression compared with younger patients and men, respectively. CONCLUSION The risk of depression is significantly increased among patients with CHD compared with patients without CHD treated in primary care practices in Germany. CHD patients should be routinely screened for depression to ensure improved treatment and management. PMID:27721937

  9. Atypical patterns of respiratory sinus arrhythmia index an endophenotype for depression

    PubMed Central

    Yaroslavsky, Ilya; Rottenberg, Jonathan; Kovacs, Maria

    2015-01-01

    Can atypical patterns of parasympathetic nervous system activity serve as endophenotypes for depression? Using respiratory sinus arrhythmia (RSA) as an index of parasympathetic nervous system function, we examined this question in two studies: one involving mothers with and without depression histories and their offspring (at high and low risk for depression, respectively), and a further study of adolescent sibling pairs concordant and discordant for major depression. In both studies, subjects were exposed to sad mood induction; subjects’ RSA was monitored during rest periods and in response to the mood induction. We used Gottesman and Gould’s (2003) criteria for an endophenotype and a priori defined “atypical” and “normative” RSA patterns (combinations of resting RSA and RSA reactivity). We found that atypical RSA patterns (a) predicted current depressive episodes and remission status among women with histories of juvenile onset depression and healthy controls, (b) predicted longitudinal trajectories of depressive symptoms among high- and low-risk young offspring, (c) were concordant across mothers and their juvenile offspring, (d) were more prevalent among never-depressed youth at high risk for depression than their low-risk peers, and (e) were more concordant across adolescent sibling pairs in which both versus only one had a history of major depression. Thus, the results support atypical RSA patterns as an endophenotype for depression. Possible mechanisms by which RSA patterns increase depression risk and their genetic contributors are discussed. PMID:25422965

  10. Selective Hyper-responsiveness of the Interferon System in Major Depressive Disorders and Depression Induced by Interferon Therapy

    PubMed Central

    Hoyo-Becerra, Carolina; Erim, Yesim; Kis, Bernhard; Wang, Bo; Scherbaum, Norbert; Gerken, Guido

    2012-01-01

    Background Though an important percentage of patients with chronic hepatitis C virus (HCV) undergoing interferon (IFN) therapy develop depressive symptoms, the role of the IFN system in the pathogenesis of depressive disorders is not well understood. Methods 50 patients with HCV infection were treated with standard combination therapy (pegylated IFN-α2a/ribavirin). IFN-induced gene expression was analyzed to identify genes which are differentially regulated in patients with or without IFN-induced depression. For validation, PBMC from 22 psychiatric patients with a severe depressive episode (SDE) and 11 controls were cultivated in vitro with pegylated IFN-α2a and gene expression was analyzed. Results IFN-induced depression in HCV patients was associated with selective upregulation of 15 genes, including 6 genes that were previously described to be relevant for major depressive disorders or neuronal development. In addition, increased endogenous IFN-production and selective hyper-responsiveness of these genes to IFN stimulation were observed in SDE patients. Conclusions Our data suggest that selective hyper-responsiveness to exogenous (IFN therapy) or endogenous (depressive disorders) type I IFNs may lead to the development of depressive symptoms. These data could lead to the discovery of novel therapeutic approaches to treat IFN-induced and major depressive disorders. PMID:22701688

  11. The role of financial hardship, mastery and social support in the association between employment status and depression: results from an Australian longitudinal cohort study

    PubMed Central

    Crowe, Laura; Butterworth, Peter

    2016-01-01

    Objective There is robust epidemiological and clinical evidence of the harmful effects of unemployment on psychological well-being, but the mechanisms through which this occurs is still strongly debated. In addition, there is even less evidence on the impact of underemployment on mental health. Using longitudinal data collected from a cohort of 20–24 years old, the present study examines a range of employed states and investigates the role of mastery, financial hardship and social support in the relationship between labour status and depression. Method Responses were from the Personality and Total Health (PATH) Through Life Project: A representative, community-based survey conducted in Canberra and Queanbeyan (NSW) in Australia, where respondents (n=2404) in their early twenties were followed for 8 years. Depression was measured using the self-report Goldberg Depression Scale, with the likely presence of depression being indicated by scores 7 or greater. Results The analyses identified unemployment and underemployment as significant predictors of depression, compared to their employed counterparts. Both unemployment and underemployment remained significantly correlated with depression even after accounting for sociodemographic, economic and psychological variables. Social support, financial hardship and a sense of personal control (mastery) all emerged as important mediators between unemployment and depression. Conclusions Both unemployment and underemployment were associated with increased risk of depression. The strength of this relationship was attenuated but remained significant after accounting for key variables (mastery, financial hardship and social support), and extensive sociodemographic and health covariates, indicating that no or inade­quate employment contributes to poorer mental health over and above these factors. PMID:27235296

  12. Cerebral White Matter Lesions and Affective Episodes Correlate in Male Individuals with Bipolar Disorder

    PubMed Central

    Birner, Armin; Seiler, Stephan; Lackner, Nina; Bengesser, Susanne A.; Queissner, Robert; Fellendorf, Frederike T.; Platzer, Martina; Ropele, Stefan; Enzinger, Christian; Schwingenschuh, Petra; Mangge, Harald; Pirpamer, Lukas; Deutschmann, Hannes; McIntyre, Roger S.; Kapfhammer, Hans-Peter; Reininghaus, Bernd; Reininghaus, Eva Z.

    2015-01-01

    Background Cerebral white matter lesions (WML) have been found in normal aging, vascular disease and several neuropsychiatric conditions. Correlations of WML with clinical parameters in BD have been described, but not with the number of affective episodes, illness duration, age of onset and Body Mass Index in a well characterized group of euthymic bipolar adults. Herein, we aimed to evaluate the associations between bipolar course of illness parameters and WML measured with volumetric analysis. Methods In a cross-sectional study 100 euthymic individuals with BD as well as 54 healthy controls (HC) were enrolled to undergo brain magnetic resonance imaging using 3T including a FLAIR sequence for volumetric assessment of WML-load using FSL-software. Additionally, clinical characteristics and psychometric measures including Structured Clinical Interview according to DSM-IV, Hamilton-Depression, Young Mania Rating Scale and Beck’s Depression Inventory were evaluated. Results Individuals with BD had significantly more (F = 3.968, p < .05) WML (Mdn = 3710mm3; IQR = 2961mm3) than HC (Mdn = 2185mm3; IQR = 1665mm3). BD men (Mdn = 4095mm3; IQR = 3295mm3) and BD women (Mdn = 3032mm3; IQR = 2816mm3) did not significantly differ as to the WML-load or the number and type of risk factors for WML. However, in men only, the number of manic/hypomanic episodes (r = 0.72; p < .001) as well as depressive episodes (r = 0.51; p < .001) correlated positively with WML-load. Conclusions WML-load strongly correlated with the number of manic episodes in male BD patients, suggesting that men might be more vulnerable to mania in the context of cerebral white matter changes. PMID:26252714

  13. Theory of mind is independent of episodic memory.

    PubMed

    Rosenbaum, R Shayna; Stuss, Donald T; Levine, Brian; Tulving, Endel

    2007-11-23

    Theory of mind (ToM) to infer other people's current mental states and episodic memory of personal happenings have been assumed to be closely related. We report two participants with severely impaired episodic memory who perform indistinguishably from healthy controls on objective ToM tests. These results suggest that ToM can function independently of episodic memory.

  14. Stresses and Disability in Depression across Gender

    PubMed Central

    Deshpande, Sharmishtha S.; Kalmegh, Bhalchandra; Patil, Poonam N.; Ghate, Madhav R.; Sarmukaddam, Sanjeev; Paralikar, Vasudeo P.

    2014-01-01

    Depression, though generally episodic, results in lasting disability, distress, and burden. Rising prevalence of depression and suicide in the context of epidemiological transition demands more attention to social dimensions like gender related stresses, dysfunction, and their role in outcome of depression. Cross-sectional and follow-up assessment of men and women with depression at a psychiatric tertiary centre was undertaken to compare their illness characteristics including suicidal ideation, stresses, and functioning on GAF, SOFAS, and GARF scales (N = 107). We reassessed the patients on HDRS-17 after 6 weeks of treatment. Paired t-test and chi-square test of significance were used to compare the two groups, both before and after treatment. Interpersonal and marital stresses were reported more commonly by women (P < 0.001) and financial stresses by men (P < 0.001) though relational functioning was equally impaired in both. Women had suffered stresses for significantly longer duration (P = 0.0038). Men had more impairment in social and occupational functioning compared to females (P = 0.0062). History of suicide attempts was significantly associated with more severe depression and lower levels of functioning in case of females with untreated depression. Significant cross-gender differences in stresses, their duration, and types of dysfunction mandate focusing on these aspects over and above the criterion-based diagnosis. PMID:24579042

  15. The development of lurasidone for bipolar depression.

    PubMed

    Loebel, Antony; Xu, Jane; Hsu, Jay; Cucchiaro, Josephine; Pikalov, Andrei

    2015-11-01

    Bipolar disorder is a chronic, recurrent illness that ranks among the top 10 causes of disability in the developed world. As the illness progresses, major depressive episodes increasingly predominate. However, few treatment options are available that have demonstrated efficacy in the treatment of bipolar depression, either as monotherapy or adjunctive therapy in combination with mood stabilizers. Lurasidone is an atypical antipsychotic drug that was initially developed for the treatment of schizophrenia. Since no previous atypical antipsychotic development program had proceeded directly from work on schizophrenia to bipolar depression, the decision to focus on this indication represented an innovation in central nervous system drug development and was designed to address a clinically significant unmet need. The current review summarizes key results of a clinical development program undertaken to characterize the efficacy and safety of lurasidone in patients diagnosed with bipolar depression. Lurasidone is currently the only treatment for bipolar depression approved in the United States as both a monotherapy and an adjunctive therapy with lithium or valproate. The approval of lurasidone expands available treatment options for patients with bipolar depression and provides a therapy with an overall favorable risk-benefit profile. PMID:26771990

  16. The administration of a polyvalent mechanical bacterial lysate in elderly patients with COPD results in serological signs of an efficient immune response associated with a reduced number of acute episodes.

    PubMed

    Ricci, Rossella; Palmero, Candida; Bazurro, Gyada; Riccio, Anna Maria; Garelli, Valentina; Di Marco, Eddi; Cirillo, Carmelina; Braido, Fulvio; Canonica, Giorgio Walter; Melioli, Giovanni

    2014-02-01

    The administration of a polyvalent mechanical bacterial lysate (PMBL) in elderly patients with COPD has been shown to reduce the number of exacerbation. This is largely related to the involvement of cells belonging to the innate and the adaptive immune system (including dendritic cells, granulocytes, T and B lymphocytes and NK cells) that actively cooperate inducing the production of specific opsonizing antibodies directed to the antigens of PMBL. We have evaluated the production of antibodies directed to respiratory and systemic pathogens in a group of elderly COPD patients, recruited in a clinical trial, ancillary to a larger multicenter double blind, placebo-controlled, parallel-designed clinical trial in which patients were randomized to daily receive either PMBL or placebo. The treated group not only experienced a reduced number of seroconversion, but also, better controlled the number of infectious episodes and COPD exacerbations. It was thus evident that the administration of PMBL resulted not only effective in inducing the secretion of specific antibodies, but also effective in reducing the infectious episodes trough the potentiation of the antibody-mediated arm of the immune response. PMID:23792312

  17. Depression - resources

    MedlinePlus

    Resources - depression ... Depression is a medical condition. If you think you may be depressed, see a health care provider. ... following organizations are good sources of information on depression : American Psychological Association -- www.apa.org/topics/depress/ ...

  18. Air Pollution and Emergency Department Visits for Depression: A Multicity Case-Crossover Study

    PubMed Central

    Szyszkowicz, Mieczysław; Kousha, Termeh; Kingsbury, Mila; Colman, Ian

    2016-01-01

    BACKGROUND The aim of this study was to investigate the associations between ambient air pollution and emergency department (ED) visits for depression. METHODS Health data were retrieved from the National Ambulatory Care Reporting System. ED visits for depression were retrieved from the National Ambulatory Care Reporting System using the International Classification of Diseases (ICD-10), Tenth revision codes; ICD-10: F32 (mild depressive episode) and ICD-10: F33 (recurrent depressive disorder). A case-crossover design was employed for this study. Conditional logistic regression models were used to estimate odds ratios. RESULTS For females, exposure to ozone was associated with increased risk of an ED visit for depression between 1 and 7 days after exposure, for males, between 1 and 5, and 8 days after exposure, with odds ratios ranging between 1.02 and 1.03. CONCLUSIONS These findings suggest that, as hypothesized, there is a positive association between exposure to air pollution and ED visits for depression.

  19. Episodic transdermal delivery of testosterone.

    PubMed

    Malik, Ritu; Venkatesh, K S; Dwivedi, Anil Kumar; Misra, Amit

    2012-06-01

    Film-forming lotions, precast films and adhesive patches containing testosterone (T) were prepared by compounding vinylic, acrylic and cellulosic polymers with a variety of excipients in order to achieve distribution of T in domains of heterogeneity within multicomponent matrices. The feasibility of this approach in achieving episodic transdermal delivery of testosterone (T) was investigated. Composition-dependent differences in extent of in vitro drug release and periodicity were observed. Representative formulations showing the most pronounced episodic T release in vitro were tested in female rats. Whereas intravenously administered T decayed exponentially, three maxima of T in serum were observed upon application of selected formulations. Thus, peak serum concentrations of 240, 36, and 29 ng/dL were observed at 0.2, 5, and 16.8 h after application of the preferred lotion formulation, and 89, 65, and 64 ng/dL at 1, 16.4, and 48.8 h after patches. Deconvolution, noncompartment pharmacokinetic analysis and multiple peak fitting also indicated episodicity. These results suggest the feasibility of using transdermal systems for pulsatile T delivery in a variety of clinical applications, including hormone supplementation and male contraception.

  20. Acceptance-based Behavior Therapy for Depression with Psychosis: Results from a Pilot Feasibility Randomized Controlled Trial

    PubMed Central

    Gaudiano, Brandon A.; Busch, Andrew M.; Wenze, Susan J.; Nowlan, Kathryn; Epstein-Lubow, Gary; Miller, Ivan W.

    2015-01-01

    Acceptance-based depression and psychosis therapy (ADAPT), a mindfulness/acceptance-based behavioral activation treatment, showed clinically significant effects in the treatment of depression with psychosis in a previous open trial. The goal of the current study was to further test the feasibility of ADAPT to determine the utility of testing it in a future clinical trial, following a stage model of treatment development. Feasibility was determined by randomizing a small number of patients (N = 13) with comorbid depression and psychosis to medication treatment as usual plus enhanced assessment and monitoring (EAM) versus ADAPT for 4 months of outpatient treatment. Both conditions were deemed acceptable by patients. Differences in between-subjects effect sizes favored ADAPT post-treatment and were in the medium to large range for depression, psychosocial functioning, and experiential avoidance (ie, the target mechanism). Thus ADAPT shows promise for improving outcomes compared to medications alone and requires testing in a fully powered randomized trial. PMID:26352221

  1. Serum 25-Hydroxyvitamin D in Patients with Major Depressive Disorder

    PubMed Central

    DANA-ALAMDARI, Leila; KHEIROURI, Sorayya; NOORAZAR, Seyed Gholamreza

    2015-01-01

    Background: We investigated the association between serum 25(OH) D levels and depressive symptoms in patients with major depressive disorder (MDD). Methods: Eighty-five adults, 44 drug free patients with MDD and 41 apparently healthy controls, participated in the study. The Hamilton Depression Rating Scale was used to assess severity of major depression. Mental health of the controls was assessed according to DSM-IV criteria. Stress level of the participants was assessed by the Holmes and Rahe stress scale. Serum 25(OH) D levels was measured by immunochemiluminescence assay. Vitamin D deficiency was defined as a serum 25(OH) D concentration of lower than 20 ng/ml. Results: Depressed patients had the higher levels of stress. There was a positive correlation between stress level and disease severity (r= 0.32, P= 0.03). In total participants, mean percentage of vitamin D deficiency was 77.6% with 75% in patients and 80.5% in the healthy subjects. There were no differences between the two groups in serum 25(OH) D levels and percentage of subjects with the vitamin deficiency. A negative correlation was observed between disease severity and serum 25(OH) D level of patients with depression episodes < 2 y (r= −0.38, P = 0.08) and winter samples (samples collected and measured from December to march, r= −0.62, P = 0.004). Conclusion: Serum 25(OH) D levels were not associated with depression. However, the inverse relationship between levels of vitamin D and depressive symptoms in current depression episodes and in sun-deprived season warrants further investigation. PMID:26284211

  2. Integrative deficits in depression and in negative mood states as a result of fronto-parietal network dysfunctions.

    PubMed

    Brzezicka, Aneta

    2013-01-01

    Depression is a disorder characterized not only by persistent negative mood, lack of motivation and a "ruminative" style of thinking, but also by specific deficits in cognitive functioning. These deficits are especially pronounced when integration of information is required. Previous research on linear syllogisms points to a clear pattern of cognitive disturbances present in people suffering from depressive disorders, as well as in people with elevated negative mood. Such disturbances are characterized by deficits in the integration of piecemeal information into coherent mental representations. In this review, I present evidence which suggests that the dysfunction of specific brain areas plays a crucial role in creating reasoning and information integration problems among people with depression and with heightened negative mood. As the increasingly prevalent systems neuroscience approach is spreading into the study of mental disorders, it is important to understand how and which brain networks are involved in creating certain symptoms of depression. Two large brain networks are of particular interest when considering depression: the default mode network (DMN) and the fronto-parietal (executive) network (FNP). The DMN network shows abnormally high activity in the depressed population, whereas FNP circuit activity is diminished. Disturbances within the FNP network seem to be strongly associated with cognitive problems in depression, especially those concerning executive functions. The dysfunctions within the fronto-parietal network are most probably connected to ineffective transmission of information between prefrontal and parietal regions, and also to an imbalance between FNP and DMN circuits. Inefficiency of this crucial circuits functioning may be a more general mechanism leading to problems with flexible cognition and executive functions, and could be the cause of more typical symptoms of depression like persistent rumination.

  3. Cognitive function, functional performance and severity of depression in Chinese older persons with late-onset depression.

    PubMed

    Tam, C W C; Lam, L C W

    2012-03-01

    OBJECTIVES. The relationship between cognitive status and depressive symptoms and their liability to cause functional decline are of clinical and public health importance as it appears to be common, frequently coexists, and may be treatable. This study examined the relationship of depression severity and cognitive performance and the impact of such an interaction on functional ability in Chinese elderly subjects with late-onset depression. METHODS. A total of 105 non-demented elderly patients with late-onset depression were recruited. Impairment in instrumental activities of daily living and severity of depression were respectively assessed with the Disability Assessment for Dementia scale and the 24-item Hamilton Depression Rating Scale. Various cognitive domains were assessed including global cognitive function, delayed episodic memory, and executive functions. The relationship between specific cognitive impairment and mood symptom severity was assessed. The clinical correlates of functional performance were also examined. RESULTS. Increasingly severe depression was associated with lower scores in the Mini-Mental State Examination, delayed recall, and poorer performance in the Trail Making Test-Part A (after adjusting for the effect of age and education). The severity of apathy correlated negatively with the Mini-Mental State Examination scores only. Among the depressed subjects, greater levels of depression and apathy, poorer performance in Trail Making Test-Part B, and mild parkinsonian signs were associated with lower functional scores. CONCLUSIONS. Lack of interest and motivation, depressive mood, compounded by behavioural abnormalities resulting from executive dysfunction, accounted for functional disability in elderly subjects with late-onset depression. These relationships may provide the background for developing interventions targeting functional deficits associated with specific cognitive dysfunctions and depression.

  4. Changes in HIV Outcomes Following Depression Care in a Resource-Limited Setting: Results from a Pilot Study in Bamenda, Cameroon

    PubMed Central

    Gaynes, Bradley N.; Pence, Brian W.; Atashili, Julius; O’Donnell, Julie K.; Njamnshi, Alfred K.; Tabenyang, Mbu Eyongetah; Arrey, Charles Kefie; Whetten, Rachel; Whetten, Kathryn; Ndumbe, Peter

    2015-01-01

    Background Little is known about how improved depression care affects HIV-related outcomes in Africa. In a sample of depressed HIV patients in a low income, sub-Saharan country, we explored how implementing measurement-based antidepressant care (MBC) affected HIV outcomes over 4 months of antidepressant treatment. Methods As part of a project adapting MBC for use in Cameroon, we enrolled 41 depressed HIV patients on antiretroviral therapy in a pilot study in which a depression care manager (DCM) provided an outpatient HIV clinician with evidence-based decision support for antidepressant treatment. Acute depression management was provided for the first 12 weeks, with DCM contact every 2 weeks and HIV clinician appointments every 4 weeks. We measured HIV clinical and psychiatric outcomes at 4 months. Results Participants were moderately depressed at baseline (mean Patient Health Questionnaire [PHQ] score = 14.4, range 13.1, 15.6). All HIV clinical outcomes improved by four month follow-up: mean (range) CD4 count improved from 436 (2, 860) to 452 (132, 876), mean (range) log-viral load decreased from 4.02 (3.86, 4.17) to 3.15 (2.81, 3.49), the proportion with virologic suppression improved from 0% to 18%, mean (range) HIV symptoms decreased from 6.4 (5.5, 7.3) to 3.1 (2.5, 3.7), the proportion reporting good or excellent health improved from 18% to 70%, and the proportion reporting any missed ARV doses in the past month decreased from 73% to 55%. Concurrently, psychiatric measures improved. The mean (range) PHQ score decreased from 14.4 (13.1, 15.6) to 1.6 (0.8, 2.4) and 90% achieved depression remission, while mean maladaptive coping style scores decreased and mean adaptive coping scores and self-efficacy scores improved. Conclusion In this pilot study of an evidence-based depression treatment intervention for HIV-infected patients in Cameroon, a number of HIV behavioral and non-behavioral health outcomes improved over 4 months of effective depression treatment

  5. Physical activity as a protective factor against depressive symptoms in older Chinese veterans in the community: result from a national cross-sectional study

    PubMed Central

    Du, Wen-Jin; Tan, Ji-Ping; Yi, Fang; Zou, Yong-Ming; Gao, Ya; Zhao, Yi-Ming; Wang, Lu-Ning

    2015-01-01

    Background Physical activity is generally considered to be effective in reducing the prevalence of depression and promoting remission of its symptoms. However, large-scale epidemiological research on this issue is lacking in older Chinese adults. We performed a nationwide epidemiological survey to determine the relationship between physical activity and depressive symptoms in older Chinese veterans in the community, with adjustment for potential confounders. Methods A cross-sectional study was conducted in a representative sample of 9,676 community-dwelling older Chinese veterans. Depressive symptoms were identified using the Center for Epidemiological Studies Depression Scale. Physical activity was self-reported using a one-year physical activity questionnaire. Information about covariates was obtained by questionnaire-based interview. Relationships between study variables and symptoms of depression were estimated using unadjusted and adjusted analyses. Results The median age was 82.29 (interquartile range 80.25–84.60) years. In total, 81.84% of the study participants engaged in physical activity that was predominantly light in intensity. In unadjusted analyses, physical activity was associated with a significantly decreased likelihood of depressive symptoms (5.43% versus 18.83%, P<0.0001). Multivariate logistic regression with adjustment and controlling for confounders, physical activity was still inversely associated with depressive symptoms and was the only independent protective factor (odds ratio 0.57, 95% confidence interval 0.44–0.72, P<0.0001) among the associated factors in this study. In a univariate general linear model, there was a significant difference in Center for Epidemiological Studies Depression Scale score between subjects participating in active physical activity and those who did not (F=59.07, P<0.0001). Conclusion This study found an inverse relationship between physical activity and symptoms of depression in older Chinese veterans in

  6. Differences in demographic composition and in work, social, and functional limitations among the populations with unipolar depression and bipolar disorder: results from a nationally representative sample

    PubMed Central

    2011-01-01

    Background Existing literature on mood disorders suggests that the demographic distribution of bipolar disorder may differ from that of unipolar depression, and also that bipolar disorder may be especially disruptive to personal functioning. Yet, few studies have directly compared the populations with unipolar depressive and bipolar disorders, whether in terms of demographic characteristics or personal limitations. Furthermore, studies have generally examined work-related costs, without fully investigating the extensive personal limitations associated with diagnoses of specific mood disorders. The purpose of the present study is to compare, at a national level, the demographic characteristics, work productivity, and personal limitations among individuals diagnosed with bipolar disorder versus those diagnosed with unipolar depressive disorders and no mood disorder. Methods The Medical Expenditure Panel Survey 2004-2006, a nationally representative survey of the civilian, non-institutionalized U.S. population, was used to identify individuals diagnosed with bipolar disorder and unipolar depressive disorders based on ICD-9 classifications. Outcomes of interest were indirect costs, including work productivity and personal limitations. Results Compared to those with depression and no mood disorder, higher proportions of the population with bipolar disorder were poor, living alone, and not married. Also, the bipolar disorder population had higher rates of unemployment and social, cognitive, work, and household limitations than the depressed population. In multivariate models, patients with bipolar disorder or depression were more likely to be unemployed, miss work, and have social, cognitive, physical, and household limitations than those with no mood disorder. Notably, findings indicated particularly high costs for bipolar disorder, even beyond depression, with especially large differences in odds ratios for non-employment (4.6 for bipolar disorder versus 1.9 for

  7. Depression, Alcohol Dependence and Abuse, and Drinking and Driving Behavior

    PubMed Central

    Zhang, Ye; Sloan, Frank A.

    2015-01-01

    Background Alcohol dependence/abuse and depression are positively related. Prior studies focused on relationships between drinking and driving and alcohol dependence/abuse, drinking and driving and problem drinking, or drinking and driving and depression separately. No study has addressed how depression is linked to drinking and driving through various underlying channels in the same study. Methods This study investigated relationships between depression, alcohol dependence/abuse, and the number of self-reported drinking and driving episodes. We also explored underlying behavioral channels between depression and alcohol dependence/abuse and binge drinking, reducing drinking amounts when planning to drive, and use of designated drivers. Data on 1,634 drinkers came from a survey fielded in eight U.S. cities. We employed ordinary least squares regression (OLS) and path analysis to assess drinking and driving and underlying channels. Results With OLS, being depressed increased the number of drinking and driving episodes during the past year by 0.572. This increase decreased to 0.411 episodes/year increase after adding socio-demographic characteristics and household income and lost statistical significance after controlling for alcohol dependence/abuse. The path analysis showed that depression is positively associated with drinking and driving, indirectly operating through not using a designated driver, but is not directly associated with drinking and driving. Alcohol dependence/abuse is directly associated with drinking and driving, and indirectly with drinking and driving through binge drinking. Conclusion Our results suggest that treatment should focus on helping individuals with depression to obtain assistance from others, such as obtaining a designated driver. Since self-control of drinking in anticipation of driving did not significantly reduce drinking and driving episodes, this study finds no empirical support for emphasizing improved self-control when the

  8. The Role of Episodic and Semantic Memory in Episodic Foresight

    ERIC Educational Resources Information Center

    Martin-Ordas, Gema; Atance, Cristina M.; Louw, Alyssa

    2012-01-01

    In this paper we describe a special form of future thinking, termed "episodic foresight" and its relation with episodic and semantic memory. We outline the methodologies that have largely been developed in the last five years to assess this capacity in young children and non-human animals. Drawing on Tulving's definition of episodic and semantic…

  9. Dopamine, depression and antidepressants.

    PubMed

    Dailly, Eric; Chenu, Franck; Renard, Caroline E; Bourin, Michel

    2004-12-01

    Abstract The relationship between depression and dopamine deficiency in the mesolimbic pathway has been hypothesized for many years. The experimental studies with animal models of depression and the human studies implicate the role of the dopamine system in depression. Not only do dopaminergic receptor agonists, but also antagonists such as olanzapine exhibit antidepressant effects associated with standard antidepressants in patients with treatment-resistant depression. This paradoxical result suggests that further investigations are necessary to understand the role played by dopamine in depression.

  10. Episodes, events, and models

    PubMed Central

    Khemlani, Sangeet S.; Harrison, Anthony M.; Trafton, J. Gregory

    2015-01-01

    We describe a novel computational theory of how individuals segment perceptual information into representations of events. The theory is inspired by recent findings in the cognitive science and cognitive neuroscience of event segmentation. In line with recent theories, it holds that online event segmentation is automatic, and that event segmentation yields mental simulations of events. But it posits two novel principles as well: first, discrete episodic markers track perceptual and conceptual changes, and can be retrieved to construct event models. Second, the process of retrieving and reconstructing those episodic markers is constrained and prioritized. We describe a computational implementation of the theory, as well as a robotic extension of the theory that demonstrates the processes of online event segmentation and event model construction. The theory is the first unified computational account of event segmentation and temporal inference. We conclude by demonstrating now neuroimaging data can constrain and inspire the construction of process-level theories of human reasoning. PMID:26578934

  11. [Psychotic episode due to Hashimoto's thyroiditis].

    PubMed

    Nazou, M; Parlapani, E; Nazlidou, E-I; Athanasis, P; Bozikas, V P

    2016-01-01

    Thyroid hormones are crucial in adult brain metabolic activity. As a result, abnormal thyroid gland function and in particular hypofunction, might cause principally depression and neurocognitive dysfunction. Psychosis, presented mainly with thought disorders and perceptual disturbances, is a much rarer manifestation of hypothyreoidism. A correlation between hypothyreoidism and psychosis has been described since 1888, especially in cases of advanced hypothyreoidism. A few years later (1949), Asher first added the terminology "myxedema madness" to the literature. Psychotic symptoms typically appear after the onset of physical symptoms, usually with a delay of months or years. The case of a female patient who presented a psychotic episode as a first manifestation of hypothyroidism will be described. NE, a 48 yearold female patient, was admitted for the first time to an inpatient mental health care unit due to delusions of persecution and reference, as well as auditory hallucinations that appeared a few weeks ago. After the patient admission, routine laboratory examination was conducted. In order to relieve the patient from her sense of discomfort and while awaiting laboratory results, olanzapine, 5 mg/day, was administered. Neurological examination and cranial computed tomography scan were unremarkable. Hormonal laboratory tests though revealed severe low thyroid hormone levels. Thyroid antibody testing certified Hashimoto's thyroiditis. Olanzapine was discontinued and the patient received thyroid hormone substitution, levothyroxine 75 μg/day, instead. The patient was discharged showing a significant improvement of psychotic symptoms after a 12-day hospitalization. A month later the patient was reevaluated. She had fully recovered from the psychotic episode. A year later, the patient continues to remain free from psychiatric symptoms, while thyroid hormone levels have been restored within normal range. The patient continues receiving only thyroid hormone substitution

  12. Mobile Phone and Web-based Cognitive Behavior Therapy for Depressive Symptoms and Mental Health Comorbidities in People Living With Diabetes: Results of a Feasibility Study

    PubMed Central

    Ma, Howard

    2016-01-01

    Background Depression is often comorbid with diabetes; however, undertreatment of depressive symptoms in people affected is common. Objective We studied preliminary acceptability and effectiveness of a fully automated, mobile phone, and web-based public health intervention, myCompass, for reducing depressive symptoms and improving mental health comorbidities in people with diabetes. Methods In this single-group feasibility study, 89 volunteers with type 1 (n=34) or type 2 (n=55) diabetes and at least mild depressive symptoms used myCompass for 7 weeks. Web-based measures of depressive and anxious symptoms, functional impairment, diabetes-specific variables, and user satisfaction were completed at baseline, postintervention, and 3-month follow-up. Results Retention rates were 54% (n=48) at postintervention and 36% (n=32) at follow-up. Depressive symptoms were significantly improved at postintervention (P<.001; within-group effect size d=1.05), with gains persisting at follow-up. Mental health comorbidities, including anxiety (P<.001), functioning (P<.001), and diabetes-specific distress (P<.001), also showed significant and sustained improvement. Satisfaction with myCompass was high, with convenience and ease of program use, and relevance of program content rated positively by participants. Conclusions The myCompass program shows promise as an acceptable and effective treatment for depression and comorbid mental health problems in people with diabetes. The program is broadly available, free to use, and may benefit patients with diabetes who do not access services and/or wish to manage their mental health themselves. Replication of these findings in a controlled study is warranted. PMID:27245948

  13. The relationship of body image with symptoms of depression and anxiety in patients with anorexia nervosa during outpatient psychotherapy: Results of the ANTOP study.

    PubMed

    Junne, Florian; Zipfel, Stephan; Wild, Beate; Martus, Peter; Giel, Katrin; Resmark, Gaby; Friederich, Hans-Christoph; Teufel, Martin; de Zwaan, Martina; Dinkel, Andreas; Herpertz, Stephan; Burgmer, Markus; Tagay, Sefik; Rothermund, Eva; Zeeck, Almut; Ziser, Katrin; Herzog, Wolfgang; Löwe, Bernd

    2016-06-01

    Body image disturbance represents a central characteristic of anorexia nervosa (AN). Depression and anxiety are the most common mental comorbidities in patients with AN. This study aims to investigate the relationship of body image with symptoms of depression and anxiety during outpatient psychotherapy in AN. Analyses were conducted using the data set of the Anorexia Nervosa Treatment Outpatient Study (ANTOP) randomized controlled trial. The ANTOP study included N = 242 females with AN between 18 and 56 years of age. The trial was designed to compare enhanced cognitive behavioral therapy (CBT-E) and focal psychodynamic therapy (FPT) with optimized treatment as usual (TAU-O) for patients with AN. The analyses on body image dimensions were conducted using measures of correlations and multiple linear regression analyses to assess the relationship and longitudinal prediction of symptoms of depression and anxiety by body image dimensions. Results showed that body image perceptions were significantly associated with symptoms of depression and anxiety in patients with AN at all treatment stages. In addition, body image dimensions at early treatment stages predict depression and anxiety in follow-up measurements. The correlation of symptoms of depression and anxiety by body image perceptions increased along treatment course. The persistence of body image disturbance, while body mass index increases under treatment (persistency effect), may constitute a relevant factor contributing to the course of the most common affective comorbidities of depression and anxiety in patients with AN. Body image disturbances in patients with AN should therefore be explicitly targeted within the specialized psychotherapy of affected patients. (PsycINFO Database Record PMID:27267500

  14. Developmental Trajectories of Irritability and Bidirectional Associations With Maternal Depression

    PubMed Central

    Wiggins, Jillian Lee; Mitchell, Colter; Stringaris, Argyris; Leibenluft, Ellen

    2014-01-01

    Objective Irritability is a dimensional trait in typical development and a common presenting symptom in many psychiatric disorders, including depression. However, little is known about the developmental trajectory of irritability or how child irritability interacts with maternal depression. The present study (1) identifies classes of irritability trajectories from toddlerhood to middle childhood; (2) characterizes maternal depression and other family, social environment, and child variables within each irritability trajectory class; and (3) as a more exploratory analysis, examines bidirectional associations between maternal depression and child irritability. Method 4,898 families from the Fragile Families and Child Wellbeing Study reported on irritability symptoms at ages 3, 5, and 9, assessed with items from the Child Behavior Checklist. Parental major depressive episode was assessed using the Composite International Diagnostic Interview – Short Form at child ages 1, 3, 5, 9. Results A latent class growth analysis identified five irritability classes: low decreasing; moderate decreasing; high steady; initially very high, then decreasing; and high increasing. Children with more severe irritability trajectories are more likely to have mothers with recurrent depression, and, with the exception of the most severe (high increasing irritability) class, were more likely to have mothers who were exposed to violence. Moreover, paternal depression and alcohol use, as well as maternal drug and alcohol use, were also risk factors for membership in the more severe irritability classes. A latent auto-regressive cross-lag model showed that child irritability at ages 3 and 5 is associated with increased mother depression at 5 and 9, respectively. Conversely, mother depression at child ages 1 and 3 is associated with increased child irritability at 3 and 5. Conclusion Irritability development across toddlerhood and middle childhood has five main trajectory types, which differ on

  15. [Association of obesity and depression].

    PubMed

    Rihmer, Zoltán; Purebl, György; Faludi, Gábor; Halmy, László

    2008-10-01

    It has been long known that the frequency of overweight and obese people is higher among depressed and bipolar patients than in the general population. The marked alteration of body weight (and appetite) is one of the most frequent of the 9 symptoms of major depressive episode, and these symptoms occur during recurrent episodes of depression with a remarkably high consequence. According to studies with representative adult population samples, in case of obesity (BMI over 30) unipolar or bipolar depression is significantly more frequently (20-45%) observable. Since in case of depressed patients appetite and body weight reduction is observable during the acute phase, the more frequent obesity in case of depressed patients is related (primarily) not only to depressive episodes, but rather to lifestyle factors, to diabetes mellitus also more frequently occurring in depressed patients, to comorbid bulimia, and probably to genetic-biological factors (as well as to pharmacotherapy in case of medicated patients). At the same time, according to certain studies, circadian symptoms of depression give rise to such metabolic processes in the body which eventually lead to obesity and insulin resistance. According to studies in unipolar and bipolar patients, 57-68% of patients is overweight or obese, and the rate of metabolic syndrome was found to be between 25-49% in bipolar patients. The rate of metabolic syndrome is further increased by pharmacotherapy. Low total and HDL cholesterol level increases the risk for depression and suicide and recent studies suggest that omega-3-fatty acids possess antidepressive efficacy. Certain lifestyle factors relevant to healthy metabolism (calorie reduction in food intake, regular exercise) may be protective factors related to depression as well. The depression- and possibly suicide-provoking effect of sibutramine and rimonabant used in the pharmacotherapy of obesity is one of the greatest recent challenges for professionals and patients

  16. Plasma peptidases as prognostic biomarkers in patients with first-episode psychosis.

    PubMed

    Fernández-Atucha, Ainhoa; Echevarría, Enrique; Larrinaga, Gorka; Gil, Javier; Martínez-Cengotitabengoa, Mónica; González-Pinto, Ana M; Irazusta, Jon; Seco, Jesús

    2015-08-15

    The plasma activity of nine aminopeptidases was monitored over a year in first-episode psychotic patients. We observed significant differences in aminopeptidase B (APB), aminopeptidase N (APN) and dipeptidyl peptidase IV (DPPIV), but not in puromycin-sensitive aminopeptidase (PSA), prolyl endopeptidase (PEP), cysteine aminopeptidase (Cys-AP), aspartate aminopeptidase (Asp-AP), glutamate aminopeptidase (Glu) or piroglutamate aminopeptidase (PGI) in these patients compared to controls, and also a progressive increase in plasma activity, correlated to changes in scores on clinical scales, Global Assessment of Functioning scale (GAF) and Hamilton Depression Rating Scale (HDRS), at 1 month of follow-up. At 1 month after diagnosis, the median score obtained by patients on the GAF was negatively associated with the plasma activity of APB and PEP measured at the beginning of the psychotic episode, indicating a role as a negative prognostic factor that can predict psychiatric symptomatology. In the case of HDRS, scores at 1 month after diagnosis were found to be positively associated with the initial plasma activity of DPPIV, APN and PSA, indicating that their initial elevation is a negative prognostic factor that can predict subsequent depressive symptomatology. Taken together, these results suggest a pathophysiological involvement of plasma peptidases and indicate that aminopeptidase activity can predict the course of first-episode psychosis patients, acting as a prognostic indicator.

  17. Life Stress, the "Kindling" Hypothesis, and the Recurrence of Depression: Considerations From a Life Stress Perspective

    ERIC Educational Resources Information Center

    Monroe, Scott M.; Harkness, Kate L.

    2005-01-01

    Major depression is frequently characterized by recurrent episodes over the life course. First lifetime episodes of depression, however, are typically more strongly associated with major life stress than are successive recurrences. A key theoretical issue involves how the role of major life stress changes from an initial episode over subsequent…

  18. Genetics Home Reference: episodic ataxia

    MedlinePlus

    ... Ebers GC. A genome-wide screen and linkage mapping for a large pedigree with episodic ataxia. Neurology. ... investigators. Primary episodic ataxias: diagnosis, pathogenesis and treatment. Brain. 2007 Oct;130(Pt 10):2484-93. Epub ...

  19. Concurrent Trajectories of Change in Adolescent and Maternal Depressive Symptoms in the TORDIA Study

    PubMed Central

    Esposito-Smythers, Christianne; Curby, Timothy W.; Renshaw, Keith D.

    2013-01-01

    Depression has a heightened prevalence in adolescence, with approximately 15 % of adolescents experiencing a major depressive episode by age 18. Depression in adolescence also poses a risk for future distress and impairment. Despite treatment advances, many adolescents relapse after initial remission. Family context may be an important factor in the developmental trajectory of adolescent depression, and thus in enhancing treatment. This study examined concurrent change over time in adolescent and maternal depressive symptoms in the context of the Treatment of Resistant Depression in Adolescents study. Participants were 334 adolescents (mean age: 16; SD: 1.6; 70 % female, 84 % Caucasian), and their mothers (n = 241). All adolescents were clinically depressed when they entered the study and had received previous selective serotonin reuptake inhibitor (SSRI) treatment. Adolescents received acute treatment for 12 weeks and additional treatment for 12 more weeks. Adolescent depression and suicidal ideation were assessed at 0, 6, 12, 24, 48 and 72 weeks, while maternal depressive symptoms were assessed at 0, 12, 24, 48 and 72 weeks. Latent basis growth curve analyses showed a significant correlation over 72 weeks between trajectories of maternal and adolescent depressive symptoms, supporting the hypothesis of concurrent patterns of change in these variables. The trajectories were correlated more strongly in a subsample that included only dyads in which mothers reported at least one depressive symptom at baseline. Results did not show a correlation between trajectories of maternal depressive symptoms and adolescent suicidal ideation. These findings suggest that adolescent and maternal depressive symptoms change in tandem, and that treatment for adolescent depression can benefit the wider family system. Notably, most mothers in this sample had subclinical depressive symptoms. Future research might explore these trajectories in dyads with more severely depressed mothers

  20. Risk Factors Associated with Unsafe Injection Practices at the First Injection Episode among Intravenous Drug Users in France: Results from PrimInject, an Internet Survey

    PubMed Central

    Guichard, Anne; Guignard, Romain; Lert, France; Roy, Elise

    2015-01-01

    Background. New drug use patterns may increase the risk of human immunodeficiency virus and hepatitis infections. In France, new injection patterns among youths with diverse social backgrounds have emerged, which may explain the persistently high rates of hepatitis C virus infection. This study explores factors associated with injection risk behaviours at first injection among users who began injecting in the post-2000 era. Methods. A cross-sectional study was conducted on the Internet from October 2010 to March 2011, through an online questionnaire. Multivariate logistic regression identified the independent correlates of needle sharing and equipment (cooker/cotton filter) sharing. Results. Among the 262 respondents (mean age 25 years), 65% were male. Both risk behaviours were positively associated with initiation before 18 years of age (aOR 3.7 CI 95% 1.3–10.6 and aOR 3.0 CI 95% 1.3–7.0) and being injected by another person (aOR 3.1 CI 95% 1.0–9.9 and aOR 3.0 CI 95% 1.3–7.1). Initiation at a party was an independent correlate of equipment sharing (aOR 2.6 95% CI 1.0–6.8). Conclusions. Results suggest a need for innovative harm reduction programmes targeting a variety of settings and populations, including youths and diverse party scenes. Education of current injectors to protect both themselves and those they might initiate into injection is critically important. PMID:26504609

  1. Predicting Response to Depression Treatment: The Role of Negative Cognition

    ERIC Educational Resources Information Center

    Beevers, Christopher G.; Wells, Tony T.; Miller, Ivan W.

    2007-01-01

    Repeated experiences with major depressive disorder (MDD) may strengthen associations between negative thinking and dysphoria, rendering negative cognition more accessible and pronounced with each episode. According to cognitive theory, greater negative cognition should lead to a more protracted episode of depression. In this study of 121 adults…

  2. Attentional Episodes in Visual Perception

    ERIC Educational Resources Information Center

    Wyble, Brad; Potter, Mary C.; Bowman, Howard; Nieuwenstein, Mark

    2011-01-01

    Is one's temporal perception of the world truly as seamless as it appears? This article presents a computationally motivated theory suggesting that visual attention samples information from temporal episodes (episodic simultaneous type/serial token model; Wyble, Bowman, & Nieuwenstein, 2009). Breaks between these episodes are punctuated by periods…

  3. DEPRESSION and SEROTONIN REUPTAKE INHIBITOR TREATMENT AS RISK FACTORS FOR PRETERM BIRTH

    PubMed Central

    Yonkers, Kimberly A.; Norwitz, Errol R.; Smith, Megan V.; Lockwood, Charles J.; Gotman, Nathan; Luchansky, Edward; Lin, Haiqun; Belanger, Kathleen

    2012-01-01

    Background Major depressive disorder as well as the use of serotonin reuptake inhibitors in pregnancy have been associated with preterm birth. Studies that have attempted to separate effects of illness from treatment have been inconclusive. We sought to explore the separate effects of serotonin reuptake inhibitor use and major depressive episodes in pregnancy on risk of preterm birth. Methods We conducted a prospective cohort study of 2793 pregnant women, oversampled for a recent episode of major depression or use of a serotonin reuptake inhibitor. We extracted data on birth outcomes from hospital charts and used binary logistic regression to model preterm birth (<37 weeks’ gestation). We used ordered logistic regression to model early (<34 weeks’ gestation) or late (34-36 weeks) preterm birth, and we used nominal logistic regression to model preterm birth antecedents (spontaneous preterm labor/preterm premature rupture of membranes/preterm for medical indications/term). Results Use of a serotonin reuptake inhibitor, both with (odds ratio=2.1 [95% confidence interval=1.0—4.6]) and without (1.6=[1.0—2.5]) a major depressive episode, was associated with preterm birth. A major depressive episode without serotonin reuptake inhibitor use (1.2; [0.68—2.1]) had no clear effect on preterm risk. None of these exposures was associated with early preterm birth. Use of serotonin reuptake inhibitors in pregnancy was associated with increases in spontaneous but not medically indicated preterm birth. Conclusions Serotonin reuptake inhibitor use increased risk of preterm birth. Although the effect of a major depressive episode alone was unclear, symptomatic women undergoing antidepressant treatment had elevated risk. PMID:22627901

  4. Residential Road Traffic Noise and High Depressive Symptoms after Five Years of Follow-up: Results from the Heinz Nixdorf Recall Study

    PubMed Central

    Orban, Ester; McDonald, Kelsey; Sutcliffe, Robynne; Hoffmann, Barbara; Fuks, Kateryna B.; Dragano, Nico; Viehmann, Anja; Erbel, Raimund; Jöckel, Karl-Heinz; Pundt, Noreen; Moebus, Susanne

    2015-01-01

    Background: Traffic noise affects a large number of people, particularly in urbanized areas. Noise causes stress and annoyance, but less is known about the relationship between noise and depression. Objective: We investigated the association of residential road traffic noise with depressive symptoms using 5-year follow-up data from a German population-based study. Methods: We analyzed data from 3,300 participants in the Heinz Nixdorf Recall study who were between 45 and 75 years old and were without depressive symptoms at baseline (2000–2003). Depressive symptoms were defined based on the Center for Epidemiologic Studies Depression scale (CES-D) 15-item questionnaire (total score ≥ 17) and antidepressant medication intake. Road traffic noise was modeled according to European Parliament/Council Directive 2002/49/EC. High noise exposure was defined as annual mean 24-hr noise levels > 55 A-weighted decibels [dB(A)]. Poisson regression with robust variance was used to estimate relative risks (RRs) a) adjusting for the potential confounders age, sex, socioeconomic status (SES), neighborhood-level SES, and traffic proximity; b) additionally adjusting for body mass index and smoking; and c) additionally adjusting for the potential confounders/intermediates comorbidities and insomnia. Results: Overall, 35.7% of the participants were exposed to high residential road traffic noise levels. At follow-up (mean = 5.1 years after baseline), 302 participants were classified as having high depressive symptoms, corresponding to an adjusted RR of 1.29 (95% CI: 1.03, 1.62; Model 1) for exposure to > 55 versus ≤ 55 dB(A). Adjustment for potential confounders/intermediates did not substantially alter the results. Associations were stronger among those who reported insomnia at baseline (RR = 1.62; 95% CI: 1.10, 2.59 vs. RR = 1.21; 95% CI: 0.94, 1.57) and appeared to be limited to those with ≤ 13 years of education (RR = 1.43; 95% CI: 1.10, 1.85 vs. 0.92; 95% CI: 0.56, 1.53 for

  5. Cushing's Syndrome Masquerading as Treatment Resistant Depression

    PubMed Central

    Anil Kumar, B. N.; Grover, Sandeep

    2016-01-01

    Treatment resistant depression (TRD) is a common clinical occurrence among patients treated for major depressive disorder. A significant proportion of patients remain significantly depressed in spite of aggressive pharmacological and psychotherapeutic approaches. Management of patient with treatment resistant depression requires thorough evaluation for physical causes. We report a case of recurrent depressive disorder, who presented with severe depressive episode without psychotic symptoms, not responding to multiple adequate trials of antidepressants, who on investigation was found to have Cushing's syndrome and responded well to Ketoconazole. PMID:27335521

  6. Cushing's Syndrome Masquerading as Treatment Resistant Depression.

    PubMed

    Anil Kumar, B N; Grover, Sandeep

    2016-01-01

    Treatment resistant depression (TRD) is a common clinical occurrence among patients treated for major depressive disorder. A significant proportion of patients remain significantly depressed in spite of aggressive pharmacological and psychotherapeutic approaches. Management of patient with treatment resistant depression requires thorough evaluation for physical causes. We report a case of recurrent depressive disorder, who presented with severe depressive episode without psychotic symptoms, not responding to multiple adequate trials of antidepressants, who on investigation was found to have Cushing's syndrome and responded well to Ketoconazole. PMID:27335521

  7. Emerging antidepressants to treat major depressive disorder.

    PubMed

    Block, Samantha G; Nemeroff, Charles B

    2014-12-01

    Depression is a common disorder with an annual risk of a depressive episode in the United States of 6.6%. Only 30-40% of patients remit with antidepressant monotherapy, leaving 60-70% of patients who do not optimally respond to therapy. Unremitted depressive patients are at increased risk for suicide. Considering the prevalence of treatment resistant depression and its consequences, treatment optimization is imperative. This review summarizes the latest treatment modalities for major depressive disorder including pharmacotherapy, electroconvulsive therapy, repetitive transcranial magnetic stimulation and psychotherapy. Through advancements in research to better understand the pathophysiology of depression, advances in treatment will be realized.

  8. Cushing's Syndrome Masquerading as Treatment Resistant Depression.

    PubMed

    Anil Kumar, B N; Grover, Sandeep

    2016-01-01

    Treatment resistant depression (TRD) is a common clinical occurrence among patients treated for major depressive disorder. A significant proportion of patients remain significantly depressed in spite of aggressive pharmacological and psychotherapeutic approaches. Management of patient with treatment resistant depression requires thorough evaluation for physical causes. We report a case of recurrent depressive disorder, who presented with severe depressive episode without psychotic symptoms, not responding to multiple adequate trials of antidepressants, who on investigation was found to have Cushing's syndrome and responded well to Ketoconazole.

  9. Does psychodynamic short-term psychotherapy for depressed breast cancer patients also improve fatigue? Results from a randomized controlled trial.

    PubMed

    Weißflog, Gregor; Brähler, Elmar; Leuteritz, Katja; Barthel, Yvette; Kuhnt, Susanne; Wiltink, Jörg; Zwerenz, Rüdiger; Beutel, Manfred E

    2015-08-01

    The purpose of this study was to determine (a) the course of fatigue in depressed breast cancer patients, (b) the effect of a depression-focused individual psychodynamic psychotherapy on fatigue, and (c) the associations of fatigue with depression, quality of life and treatment-related variables. In a German multicentre randomized controlled trial in Leipzig and Mainz, depressed early breast cancer patients (UICC stage 0-III, age 18-70 years) were randomly assigned to a short-term psychodynamic psychotherapy (STPP, an adaptation of the Supportive-Expressive psychotherapy by Luborsky for cancer patients) or treatment as usual (TAU) and completed data assessment pre- and post-treatment. Fatigue was assessed with the Multidimensional Fatigue Inventory (MFI-20). All analyses were conducted as complete case analyses including 52 STPP and 54 TAU completers (n = 106). The trial is registered at http://www.controlled-trials.com , number ISRCTN96793588. Fatigue declined significantly from a high level pre-treatment to post-treatment, but remained significantly higher than among population-based controls and a mixed sample of cancer patients. Significant time by group interactions favoured STPP for the subscales reduced activity and physical fatigue and the total scale. The strength of the associations between total fatigue and depression increased from 0.49 pre-treatment to 0.63 (Quality of life -0.52 to -0.63) at follow-up. STPP is beneficial for reducing dimensions of fatigue (particularly reduced activity and physical fatigue) in depressed breast cancer patients. Chronic fatigue needs more clinical attention in this vulnerable group.

  10. A study of the interrupted REM episode.

    PubMed

    Merica, H; Gaillard, J M

    1991-12-01

    Brief interruptions of REM sleep are considered to be part of the REM episode. The maximum allowable duration of such an interruption, which is used to define the end of the REM episode, is currently a matter of debate. Making measurements on individual REM cycles, inter-REM interval analysis was carried out to determine whether the generally adopted 15 minute empirical rule for this maximum needs to be extended to 25 minutes as suggested by several including Kobayashi et al. Our results show that there is no reason to alter the 15 minute rule and that measurements which do not take into account the time-of-night effect may be misleading. The proportion of interrupted REM episodes observed in our population of healthy adults is high. We have therefore also examined in some detail the phenomenology of the temporal evolution of the structure and content of the interrupted REM episodes. Both showed a definite change over the night: the interruptions in the earlier episodes tend to return the system to slow wave sleep while those in the later episodes tend to return it to wake. It is hypothesized that these interruptions reflect a measure of REM sleep pressure and its interaction with both slow wave sleep and wake pressures. PMID:1798770

  11. [Bipolarity correlated factors in major depression: about 155 Tunisian inpatients].

    PubMed

    Gassab, L; Mechri, A; Gaha, L; Khiari, G; Zaafrane, F; Zougaghi, L

    2002-01-01

    .0001) catatonic characteristics (37.3% versus 20.3%; p=0.03), hypersomnia (51% versus 20.3%; p=0.03) and psychomotor inhibition (83.3% versus 42.4%; p=0.00007). Negatively correlated factors of bipolar depression were: somatic comorbidity such as diabetes, hypertension and rhumatismal diseases (12.5% versus 28.8%; p=0.012) and association with dysthymic disorders (2.2% versus 12.1%; p=0.029). No correlation was found between bipolarity and life events in childhood, seasonal character, alcoholic dependence and suicide attempt. Concerning the validity of predictive factors of bipolarity proposed by Akiskal, we found: history of bipolar disorders (Sensibility: 29.2%, specificity: 96.6%, Positive Predictive Value (PPV): 93%), hypersomnia (Sensibility: 51%, specificity: 80%, PPV: 80%), onset before the age of 25 years (Sensibility: 62.5%, specificity: 70%, PPV: 77%), psychomotor inhibition (Sensibility: 83.3%, specificity 58%, PPV: 76%), and psychotic characteristics (Sensibility: 69.8%, specificity: 62.7%, PPV: 75%). In spite of methodological differences, our results tallied with the other studies. We focus on the importance of the bipolar family history criterion, which has the highest PPV, and the limits of psychotic characteristics criterion which has the lowest PPV. This may be explained by the frequency of these characteristics of affective disorders in our cultural context. The association of the hypersomnia and psychomotor inhibition in one criterion in order to increase their diagnostic power. Our study helps us to identify the factors that would predict the bipolar evolution of a depressive episode allowing the use of specific treatment and ensuring the improvement of prognostic. PMID:12232537

  12. Effects of short-term inpatient treatment on sensitivity to a size contrast illusion in first-episode psychosis and multiple-episode schizophrenia

    PubMed Central

    Silverstein, Steven M.; Keane, Brian P.; Wang, Yushi; Mikkilineni, Deepthi; Paterno, Danielle; Papathomas, Thomas V.; Feigenson, Keith

    2013-01-01

    Introduction: In the Ebbinghaus illusion, a shape appears larger than its actual size when surrounded by small shapes and smaller than its actual size when surrounded by large shapes. Resistance to this visual illusion has been previously reported in schizophrenia, and linked to disorganized symptoms and poorer prognosis in cross-sectional studies. It is unclear, however, when in the course of illness this resistance first emerges or how it varies longitudinally with illness phase. Method: We addressed these issues by having first-episode psychosis patients, multiple-episode schizophrenia patients and healthy controls complete a psychophysical task at two different time points, corresponding to hospital admission and discharge for patients. The task required judging the relative size of two circular targets centered on either side of the screen. Targets were presented without context (baseline), or were surrounded by shapes that made the size judgment harder or easier (misleading and helpful contexts, respectively). Context sensitivity was operationalized as the amount of improvement relative to baseline in the helpful condition minus the amount of decrement relative to baseline in the misleading condition. Results: At hospital admission, context sensitivity was lower in the multiple-episode group than in the other groups, and was marginally less in the first episode than in the control group. In addition, schizophrenia patients were significantly more and less accurate than the other groups in the misleading and helpful conditions, respectively. At discharge, all groups exhibited similar context sensitivity. In general, poorer context sensitivity was related to higher levels of disorganized symptoms, and lower level of depression, excitement, and positive symptoms. Discussion: Resistance to the Ebbinghaus illusion, as a characteristic of the acute phase of illness in schizophrenia, increases in magnitude after the first episode of psychosis. This suggests that

  13. Recurrent Episodes of Dissociative Fugue

    PubMed Central

    Angothu, Hareesh; Pabbathi, Lokeswar Reddy

    2016-01-01

    Dissociative fugue is rare entity to encounter with possible differentials of epilepsy and malingering. It is one of the dissociative disorders rarely seen in clinical practice more often because of the short lasting nature of this condition. This might also be because of organized travel of the individuals during the episodes and return to their families after the recovery from episodes. This is a case description of a patient who has experienced total three episodes of dissociative fugue. The patient has presented during the third episode and two prior episodes were diagnosed as fugue episodes retrospectively based on the history. Planned travel in this case by the patient to a distant location was prevented because of early diagnosis and constant vigilance till the recovery. As in this case, it may be more likely that persons with Dissociative fugue may develop similar episodes if they encounter exceptional perceived stress. However, such conclusions may require follow-up studies. PMID:27114633

  14. Cost-effectiveness of a Primary Care Depression Intervention

    PubMed Central

    Pyne, Jeffrey M; Rost, Kathryn M; Zhang, Mingliang; Williams, D Keith; Smith, Jeffrey; Fortney, John

    2003-01-01

    OBJECTIVE To determine the incremental cost-effectiveness of a quality improvement depression intervention (enhanced care) in primary care settings relative to usual care. DESIGN Following stratification, we randomized 12 primary care practices to enhanced or usual care conditions and followed patients for 12 months. SETTING Primary care practices located in 10 states across the United States. PATIENTS/PARTICIPANTS Two hundred eleven patients beginning a new treatment episode for major depression. INTERVENTIONS Training the primary care team to assess, educate, and monitor depressed patients during the acute and continuation stages of their depression treatment episode over 1 year. MEASUREMENTS AND MAIN RESULTS Cost-effectiveness was measured by calculating incremental (enhanced minus usual care) costs and quality-adjusted life years (QALYs) derived from SF-36 data. The mean incremental cost-effectiveness ratio in the main analysis was $15,463 per QALY. The mean incremental cost-effectiveness ratios for the sensitivity analyses ranged from $11,341 (using geographic block variables to control for pre-intervention service utilization) to $19,976 (increasing the cost estimates by 50%) per QALY. CONCLUSIONS This quality improvement depression intervention was cost-effective relative to usual care compared to cost-effectiveness ratios for common primary care interventions and commonly cited cost-effectiveness ratio thresholds for intervention implementation. PMID:12823650

  15. Effect of Health Comparisons on Functional Health and Depressive Symptoms - Results of a Population-Based Longitudinal Study of Older Adults in Germany

    PubMed Central

    Hajek, André; König, Hans-Helmut

    2016-01-01

    Objective To investigate the effect of health comparisons on functional health and depressive symptoms in a longitudinal approach. Gender differences were examined. Methods The German Ageing Survey (DEAS) is a nationwide, representative longitudinal study of community dwelling individuals living in Germany aged 40 and older. The surveys in 2008 and 2011 were used, with n = 3,983 respondents taking part in both waves. Health comparisons were quantified by the question “How would you rate your health compared with other people your age” (Much better; somewhat better; the same; somewhat worse, much worse). Functional health was assessed by the subscale “physical functioning” of the 36-Item Short Form Health Survey (SF-36) and depressive symptoms were measured by the Center for Epidemiologic Studies Depression Scale (CES-D). Results Adjusting for sociodemographic factors, self-assessed health, social network, self-efficacy and optimism, and morbidity, fixed effects regressions revealed that functional health decreased significantly and considerably with negative health comparisons in the total sample (transitions from ‘the same’ to ‘much worse’: β = -11.8), predominantly in men. The effects of negative health comparisons (transitions from ‘the same’ to ‘much worse’: β = 4.8) on depressive symptoms were comparable (in terms of significance) to the effects on functional health, with stronger effects in women. Positive comparisons did not affect functional health and depressive symptoms. Conclusion Our findings underline the relevance of negative health comparisons on functional health (men) and depressive symptoms (women). Comparison effects are asymmetric and mostly upwards. PMID:27213731

  16. Impairment in episodic and chronic cluster headache.

    PubMed

    Jürgens, Tim P; Gaul, Charly; Lindwurm, Andrea; Dresler, Thomas; Paelecke-Habermann, Yvonne; Schmidt-Wilcke, Tobias; Lürding, Ralf; Henkel, Karsten; Leinisch, Elke

    2011-04-01

    Despite being an excruciating headache, little is known about the burden of cluster headache (CH) regarding its various subtypes. In a multicentre, prospective study, patients with chronic CH (n = 27), with episodic CH in the active (n = 26) and outside the active period (n = 22), migraine patients (n = 24) and healthy controls (n = 31) were included. Epidemiological data, the German version of the Headache Disability Inventory (HDI) and a screening for psychiatric complaints were applied. About 25% of chronic CH patients in our study received invalidity allowance due to CH. HDI scores (total and subscales emotion and function) indicated a severe headache-specific disability (one-way ANOVA: P < 0.01). Patients with chronic and active episodic CH were significantly more affected than patients with inactive CH and migraine. Healthy volunteers were significantly less affected than all headache patients. Symptoms suggestive of psychiatric co-morbidity were found predominantly in chronic CH: depressive symptoms (56%), signs of agoraphobia (33%) and suicidal tendencies (25%) were frequently reported. Patients with chronic and active episodic CH were severely impaired in non-economic and economic domains such as disability, working life and psychiatric complaints. Remarkably, psychiatric co-morbidity was highest in chronic CH. Thus, especially chronic CH warrants special medical and further supportive care. PMID:21123629

  17. Effectiveness of Problem-Solving Therapy for Older, Primary Care Patients with Depression: Results from the IMPACT Project

    ERIC Educational Resources Information Center

    Arean, Patricia; Hegel, Mark; Vannoy, Steven; Fan, Ming-Yu; Unuzter, Jurgen

    2008-01-01

    Purpose: We compared a primary-care-based psychotherapy, that is, problem-solving therapy for primary care (PST-PC), to community-based psychotherapy in treating late-life major depression and dysthymia. Design and Methods: The data here are from the IMPACT study, which compared collaborative care within a primary care clinic to care as usual in…

  18. Relative Cost-Effectiveness of Treatments for Adolescent Depression: 36-Week Results from the TADS Randomized Trial

    ERIC Educational Resources Information Center

    Domino, Marisa Elena; Foster, E. Michael; Vitiello, Benedetto; Kratochvil, Christopher J.; Burns, Barbara J.; Silva, Susan G.; Reinecke, Mark A.; March, John S.

    2009-01-01

    Randomized controlled trials that involve 327 participants aged 12 to 18 who were diagnosed with major depression were given either fluoxetine alone, cognitive-behavioral therapy, or a combination of both. Cost-effectiveness acceptability curves suggest that combination treatment is highly likely to be the most cost-effective treatment than…

  19. Venlafaxine ER for the Treatment of Pediatric Subjects with Depression: Results of Two Placebo-Controlled Trials

    ERIC Educational Resources Information Center

    Emslie, Graham J.; Findling, Robert L.; Yeung, Paul P.; Kunz, Nadia R.; Li, Yunfeng

    2007-01-01

    Objective: The safety, efficacy, and tolerability of venlafaxine extended release (ER) in subjects ages 7 to 17 years with major depressive disorder were evaluated in two multicenter, randomized, double-blind, placebo-controlled trials conducted between October 1997 and August 2001. Method: Participants received venlafaxine ER (flexible dose,…

  20. Changes in Neighborhood Characteristics and Depression Among Sexual Minority Young Adults

    PubMed Central

    Everett, Bethany G.

    2014-01-01

    Using the National Longitudinal Study of Adolescent Health, this study examined the relationship between changes in neighborhood characteristics during the transition from adolescence to young adulthood and depression among sexual minority young adults. Previous research has found that neighborhood characteristics influence sexual minority mental health and that sexual minorities are more likely to move to more urban and politically liberal locations. No study to date, however, has examined the impact of changes in neighborhood characteristics on sexual minority depression. The results from this study show that decreases in the percent urban was associated with increased risk of depression and decreases in the percent Republican voters in sexual minority’s neighborhood was associated with decreases in risk of depression. The results suggest that clinicians may want to screen sexual minority youth for recent changes in their neighborhoods to assess if these changes may be related to the onset or exacerbation of depressive episodes. PMID:24217448

  1. Subthreshold depression in adolescence: a systematic review.

    PubMed

    Bertha, Eszter A; Balázs, Judit

    2013-10-01

    In adolescence, the number of depressive symptoms is rising notably. Individuals may have relevant depressive symptoms without meeting the full criteria of a major depressive episode (MDE), a condition referred to as subthreshold depression (sD). This article presents a review on adolescent sD examining the prevalence, the quality of life (QoL), the risk of developing MDE, and preventive programs available for adolescents living with sD. A systematic literature search from the year of the introduction of Diagnostic and Statistic Manual for Mental Disorders Fourth Edition (DSM-IV) until 2012 (18 years) was conducted with a special focus on adolescent sD. Data from 27 studies were included into this review. The results show high prevalence of sD among adolescents, with a negative impact on QoL, and provide evidence that sD is a significant risk indicator of later MDE; therefore, individuals with sD represent good targets for preventive interventions. Our review highlights the fact that sD is a significant health problem among adolescents indeed, and adolescents with sD could be a subgroup of youth, who need further help to reduce their clinically significant depressive symptoms for the successful prevention of a later MDE.

  2. Maintenance Deep Transcranial Magnetic Stimulation Sessions are Associated with Reduced Depressive Relapses in Patients with Unipolar or Bipolar Depression

    PubMed Central

    Rapinesi, Chiara; Bersani, Francesco Saverio; Kotzalidis, Georgios D.; Imperatori, Claudio; Del Casale, Antonio; Di Pietro, Simone; Ferri, Vittoria R.; Serata, Daniele; Raccah, Ruggero N.; Zangen, Abraham; Angeletti, Gloria; Girardi, Paolo

    2015-01-01

    Introduction: Deep transcranial magnetic stimulation (dTMS) is a new form of TMS allowing safe stimulation of deep brain regions. The objective of this preliminary study was to assess the role of dTMS maintenance sessions in protecting patients with bipolar disorder (BD) or recurrent major depressive disorder (MDD) from developing depressive or manic relapses in a 12-month follow-up period. Methods: Twenty-four drug-resistant patients with a current depressive episode and a diagnosis of MDD or BD have been enrolled in the study. All the participants underwent daily dTMS sessions for 4 weeks. One group (maintenance – M group) received additional maintenance dTMS sessions weekly or twice a week. Results: After the first dTMS cycle, a significant reduction of Hamilton Depression Rating Scale (HDRS) scores was observed in all participants. Subsequently, the HDRS mean scores did not significantly change over time in the M group, while it significantly increased in the non-M-group after 6 and 12 months. Discussion: This study confirms previous evidence of a positive therapeutic effect of dTMS on depressive symptoms and suggests that, after recovery from acute episodes, maintenance dTMS sessions may be helpful in maintaining euthymia in a 12-month follow-up period. PMID:25709596

  3. Depressive symptoms, life satisfaction and prevalence of sleep disturbances in the general population of Germany: results from the Heinz Nixdorf Recall study

    PubMed Central

    Lacruz, Maria Elena; Schmidt-Pokrzywniak, Andrea; Dragano, Nico; Moebus, Susanne; Deutrich, Susanne Eva; Möhlenkamp, Stefan; Schmermund, Axel; Kaelsch, Hagen; Erbel, Raimund; Stang, Andreas

    2016-01-01

    Objectives It appears that not only depression, but also low life satisfaction (LS), is related to sleep disorder in the general population. We evaluate whether the prevalence of sleep disorder attributable to depressed mood is greater among participants with low LS. Setting, participants and outcome measures Analysis of cross-sectional data from 3880 cohort members from the German Heinz Nixdorf Recall study (2006–2008) aged 51–81 years. Standard mood (Center for Epidemiological Studies Depression scale (CES-D) for Depressive symptoms and a single-item life satisfaction measure) and sleep quality (Pittsburgh Sleep Quality Index, PSQI) measures were conducted as part of the survey. Multiple imputation was used to deal with missing data in outcome, exposures or covariates. Relative excess risk for interaction (RERI) and its 95% CIs were estimated using adjusted prevalence ORs. Owing to the study size, the precision of the measures of additive interaction is relatively low. Results We observed an association between depressed mood (5-units increase in CES-D score) (POR=1.7 (95% CI 1.6 to 1.8)) and sleep disorder, and between low LS (not very satisfied vs very satisfied) (POR=1.5 (1.1 to 2.2)) and sleep disorder. Also, we observed a synergistic effect between lower level of LS (not very satisfied) and depressed mood (score ≥16) on prevalence of sleep disorders (RERI=3.7 (−0.2 to 7.1)). Furthermore, these findings were corroborated in sensitivity analysis carried out with the complete case data set and in sex-specific analyses (RERI=5.5 (−0.4 to 11.3), and RERI=2.4 (−2.5 to 7.4) for men and women, respectively). Conclusions Both depressed mood and LS are notably associated with sleep quality, and these relationships are best captured by considering their joint effects. Depression and LS need to be taken into consideration when analysing sleep quality. PMID:26729376

  4. Counseling in Primary Care Improves Depression and Quality of Life

    PubMed Central

    Carta, MG; Petretto, D; Adamo, S; Bhat, KM; Lecca, ME; Mura, G; Carta, V; Angermeyer, M; Moro, MF

    2012-01-01

    Introduction: To measure the effectiveness on Quality of Life of adjunctive cognitive behavioral counseling in the setting of General Practitioners (GPs) along with the treatment as usual (TAU;) for the treatment of depression. Methods: Six month-controlled trial of patients who were referred to randomly assigned GPs (four for experimental group of patients and ten for the control) was done. Experimental sample had 34 patients with DSM-IV diagnosis of Depression (Depressed Episode, Dysthymia, or Adjustment Disorder with Depressed Mood) receiving the TAU supplemented with counseling. Control group had 30 patients with diagnosis of Depression receiving only the TAU. Results: The Beck Depression Inventory (BDI) score improved in both groups. Patients in the experimental group showed greater improvement compared to the control group at T2. The World Health Organization Quality OF Life Questionnaire (WHOQOL) score also improved in the experimental group but not in the control group. The improvement in the experimental group was statistically significant in terms of both BDI and WHOQOL scores. Conclusions: Adding counseling to TAU in general medical practice settings is more effective in controlling the symptoms of depression and improving the quality of life as measured over a period of six months, than TAU alone. These results while encouraging, also calls for a larger study involving a largersample size and a longer period of time. PMID:23173011

  5. Sleep, Illness Course, and Concurrent Symptoms in Inter-episode Bipolar Disorder

    PubMed Central

    Eidelman, Polina; Talbot, Lisa S.; Gruber, June; Harvey, Allison G.

    2010-01-01

    We investigated associations between sleep, illness course, and concurrent symptoms in 21 participants with bipolar disorder who were inter-episode. Sleep was assessed using a week-long diary. Illness course and symptoms were assessed via validated semi-structured interviews. Lower and more variable sleep efficiency and more variable total wake time were associated with more lifetime depressive episodes. Variability in falling asleep time was positively correlated with concurrent depressive symptoms. Sleep efficiency was positively correlated with concurrent manic symptoms. These findings suggest that inter-episode sleep disturbance is associated with illness course and that sleep may be an important intervention target in bipolar disorder. PMID:20004888

  6. Role of genetic factors in depression based on studies of Tourette syndrome and ADHD probands and their relatives

    SciTech Connect

    Comings, D.E.

    1995-04-24

    Tourette syndrome (TS) is a common, neuropsychiatric disorder which has many similarities to attention deficit hyperactivity disorder (ADHD). TS probands have a high frequency of a variety of behavioral disorders including depression. The depression may be due to a pleiotropic effect of the Gts genes, proband ascertainment bias, or a result of coping with the chronic tics. To distinguish between these hypotheses we examined the responses to 17 Diagnostic Interview Schedule questions to evaluate the 9 DSM-III-R criteria for major depressive episode in 1,080 adults consisting of TS and ADHD probands, their relatives and controls. Using a Bonferonni corrected p there was a significant progressive increase in 16 of 17 depressive symptoms and for a life time history of a major depressive episode in groups with increased genetic loading for Gts genes. Similar trends were seen in the small number of ADHD probands and their relatives. There was also a significant increase for these variables in non-proband TS relatives versus non-TS relatives, indicating the association of depression with Gts genes was not due to ascertainment bias or the inappropriate choice of controls. Multiple linear regression analysis indicated that obsessive-compulsive behaviors, sex, ADHD, drug abuse, and age all showed a more significant effect on depressive symptoms than the number of tics. The presence or absence of TS in the relatives had a much greater effect on risk for depression than the presence or absence of an episode of major depression in the proband. These results are consistent with the hypothesis that Gts and ADHD genes play a major role in depression. 69 refs., 5 tabs.

  7. Lifetime episodes of dysphoria: gender, early childhood loss and personality.

    PubMed

    Roberts, J E; Gotlib, I H

    1997-05-01

    The roles of gender, early childhood loss and personality as risk factors for lifetime episodes of dysphoria were examined in a large sample of college students (N = 557). Dysphoria classifications were based on the Inventory to Diagnose Depression (IDD) and the IDD-Lifetime Version. Brief dysphoria was defined as meeting DSM-III-R symptom criteria for major depression without meeting the two-week duration criteria, whereas protracted dysphoria required that the duration criteria were also met. Although females reported higher levels of depressive symptoms and neuroticism than did males, and were more likely to have a lifetime history of episodes of dysphoria, males were more susceptible to the adverse effects of early childhood loss. Males with loss were more likely to have a history of protracted dysphoria and to report higher levels of neuroticism than were males who did not experience an early parental loss. Neuroticism, in turn, acted as a trait vulnerability characteristic to episodes of dysphoria in both males and females. Interestingly, the effects of gender on lifetime experience of dysphoria were mediated by neuroticism: females' increased vulnerability to episodes of dysphoria was due to their elevated levels of neuroticism.

  8. The potential impact of trauma on the ability to prevent depression among low-income mothers

    PubMed Central

    Silverstein, Michael; Feinberg, Emily; Cabral, Howard; Linhart, Yaminette Diaz; Sandler, Jenna; Hegel, Mark; Appugliese, Danielle Pierce; Beardslee, William

    2011-01-01

    Background Violent trauma is common in urban communities. We explored the hypothesis that past trauma could moderate the effect of a cognitive behavioral intervention designed to prevent depression among urban, low-income mothers. Methods Synthesis of two pilot randomized trials of problem solving education (PSE), among 93 mothers of children hospitalized in the neonatal intensive care unit or enrolled in community-based Early Intervention programs. Outcomes included depressive symptoms, perceived stress, social functioning. Results were adjusted for baseline depressive symptoms, then stratified according to subjects’ trauma history. Results Fifteen of 44 PSE subjects (34%) experienced a moderately severe depressive symptom episode during the four-month follow-up period, as opposed to 21 of 45 control subjects (47%) – for a nearly significant adjusted odds ratio (aOR) of 0.36 (95% CI 0.13, 1.02). Among mothers without trauma histories, far fewer PSE mothers (5 of 24; 21%) experienced an episode of moderately severe depressive symptoms than control mothers (12 of 26; 46%), for a significant aOR of 0.15 (95% CI 0.03, 0.79). Conversely, among mothers with trauma histories, a similar proportion of PSE mothers (10 of 19; 53%) experienced an episode of moderately severe depressive symptoms as control mothers (9 of 19; 47%). Similar trends held for perceived stress and social functioning. Conclusions PSE may be more effective at preventing depression among mothers without trauma histories. Our results are consistent with the depression treatment literature, but are novel because they support the principle of intervention moderation in a risk-prevention – as opposed to treatment – paradigm. PMID:21506207

  9. Preliminary results of a randomized controlled trial carried out with a fixed combination of S-adenosyl-L-methionine and betaine versus amitriptyline in patients with mild depression

    PubMed Central

    Di Pierro, Francesco; Settembre, Roberto

    2015-01-01

    Background S-adenosyl-L-methionine (SAMe), a safe, endogenous, pleiotropic methyl donor well known for its antidepressant role, has been assumed to have a possible role in increasing plasma levels of compounds known to be able to raise cardiovascular risk. Although the issue is still being debated, betaine (trimethylglycine), a specific methyl donor involved in the homocysteine circuit, may be able to reduce such a risk and/or, by determining a sparing effect on endogenous SAMe, may be able to improve the clinical efficiency of SAMe itself. Indeed, preliminary results have shown clinical improvement determined by an add-on therapy with betaine administered along with SAMe, versus SAMe alone, to patients affected by mild/moderate depression. Aim To evaluate the safety and antidepressant role played by the association of SAMe plus betaine versus amitriptyline administered in untreated individuals with a recent diagnosis of mild depression. Methods This small, open-label, randomized, observational study enrolled 64 individuals with a diagnosis of mild depression according to the Zung Self-Rating Depression Scale. After randomization, they were treated with either Laroxyl® (amitriptyline, 75 mg/day) or DDM Metile® (enteric-coated SAMe, 500 mg/day, plus betaine, 250 mg/day) for 12 months. Assessment of clinical scores and tolerability was performed at T=0 and after 3, 6, and 12 months. Results After 3 months, both treatments showed a small and not statistically significant improvement. After 6 and 12 months, both treated groups demonstrated a more noticeable improved response, although the group treated with SAMe plus betaine showed better results in terms of score, number of individuals in remission, and side effects. Compliance was overlapping in both treatments. Conclusion The association of SAMe plus betaine seems to be a safe and effective tool to counteract mild depression and also when used as monotherapy in subjects with a recent diagnosis. PMID:25678811

  10. Positive Imagery-Based Cognitive Bias Modification as a Web-Based Treatment Tool for Depressed Adults

    PubMed Central

    Blackwell, Simon E.; Browning, Michael; Mathews, Andrew; Pictet, Arnaud; Welch, James; Davies, Jim; Watson, Peter; Geddes, John R.

    2015-01-01

    Depression is a global health problem requiring treatment innovation. Targeting neglected cognitive aspects may provide a useful route. We tested a cognitive-training paradigm using positive mental imagery (imagery cognitive bias modification, imagery CBM), developed via experimental psychopathology studies, in a randomized controlled trial. Training was delivered via the Internet to 150 individuals with current major depression. Unexpectedly, there was no significant advantage for imagery CBM compared with a closely matched control for depression symptoms as a whole in the full sample. In exploratory analyses, compared with the control, imagery CBM significantly improved anhedonia over the intervention and improved depression symptoms as a whole for those participants with fewer than five episodes of depression and those who engaged to a threshold level of imagery. Results suggest avenues for improving imagery CBM to inform low-intensity treatment tools for depression. Anhedonia may be a useful treatment target for future work. PMID:25984421

  11. Neural changes associated with the generation of specific past and future events in depression.

    PubMed

    Hach, Sylvia; Tippett, Lynette J; Addis, Donna Rose

    2014-12-01

    It is well established that individuals affected by depression experience difficulty in remembering the past and imagining the future. This impairment is evident in increased rumination on non-specific, generic events and in the generation of fewer specific events during tasks tapping past and future thinking. The present fMRI study investigated whether neural changes during the construction of autobiographical events was evident in depression, even when key aspects of performance (event specificity, vividness) were matched. We employed a multivariate technique (Spatiotemporal Partial Least Squares) to examine whether task-related whole brain patterns of activation and functional connectivity of the hippocampus differed between depressed participants and non-depressed controls. Results indicate that although the depression group retained the ability to recruit the default network during the autobiographical tasks, there was reduced activity in regions associated with episodic richness and imagery (e.g., hippocampus, precuneus, cuneus). Moreover, patterns of hippocampal connectivity in the depression group were comparable to those of the control group, but the strength of this connectivity was reduced in depression. These depression-related reductions were accompanied by increased recruitment of lateral and medial frontal regions in the depression group, as well as distinct patterns of right hippocampal connectivity with regions in the default and dorsal attention networks. The recruitment of these additional neural resources may reflect compensatory increases in post-retrieval processing, greater effort and/or greater self-related referential processing in depression that support the generation of specific autobiographical events.

  12. Epilepsy coexisting with depression.

    PubMed

    Błaszczyk, Barbara; Czuczwar, Stanisław J

    2016-10-01

    Depression episodes in epilepsy is the most common commorbidity, affecting between 11% and 62% of patients with epilepsy. Although researchers have documented a strong association between epilepsy and psychiatric comorbidities, the nature of this relationship is poorly understood. The manifestation of depression in epilepsy is a complex issue having many interacting neurobiological and psychosocial determinants, including clinical features of epilepsy (seizure frequency, type, foci, or lateralization of foci) and neurochemical or iatrogenic mechanisms. Other risk factors are a family history of psychiatric illness, particularly depression, a lack of control over the seizures and iatrogenic causes (pharmacologic and surgical). In addition, treatment with antiepileptic drugs (AEDs) as well as social coping and adaptation skills have also been recognised as risk factors of depression associated with epilepsy. Epilepsy may foster the development of depression through being exposed to chronic stress. The uncertainty and unpredictability of seizures may instigate sadness, loneliness, despair, low self-esteem, and self-reproach in patients with epilepsy and lead to social isolation, stigmatization, or disability. Often, depression is viewed as a reaction to epilepsy's stigma and the associated poor quality of life. Moreover, patients with epilepsy display a 4-5 higher rate of depression and suicide compared with healthy population. PMID:27634589

  13. Why Is Past Depression the Best Predictor of Future Depression? Stress Generation as a Mechanism of Depression Continuity in Girls

    ERIC Educational Resources Information Center

    Rudolph, Karen D.; Flynn, Megan; Abaied, Jamie L.; Groot, Alison; Thompson, Renee

    2009-01-01

    This study examined whether a transactional interpersonal life stress model helps to explain the continuity in depression over time in girls. Youth (86 girls, 81 boys; M age = 12.41, SD = 1.19) and their caregivers participated in a three-wave longitudinal study. Depression and episodic life stress were assessed with semistructured interviews.…

  14. Contagious Depression: Negative Attachment Cognitions as a Moderator of the Temporal Association between Parental Depression and Child Depression

    ERIC Educational Resources Information Center

    Abela, John R. Z.; Zinck, Suzanne; Kryger, Shelley; Zilber, Irene; Hankin, Benjamin L.

    2009-01-01

    This study examined whether negative attachment cognitions moderate the association between the onset of depressive symptoms in children and their parents using a high-risk sample (parents with a history of major depressive episodes and their children) and a multiwave longitudinal design. During the initial assessment, 140 children (ages 6-14)…

  15. Relationship of Temperament and Character in Remitted Depressed Patients with Suicidal Ideation and Suicide Attempts—Results from the CRESCEND Study

    PubMed Central

    Woo, Young Sup; Jun, Tae-Youn; Jeon, Yang-Hwan; Song, Hoo Rim; Kim, Tae-Suk; Kim, Jung-Bum; Lee, Min-Soo; Kim, Jae-Min; Jo, Sun-Jin

    2014-01-01

    The aim of this study was to evaluate the Temperament and Character Inventory (TCI) scores of a sample of Korean patients with remitted depression who had attempted suicide and reported suicidal ideation and to compare their scores with those of remitted depressed patients without suicidal ideation. Adult depression patients who had completed 12 weeks of follow-up (N = 138) were divided into three groups: patients with a history of suicide attempts (N = 23); patients with current suicidal ideation (N = 59); and patients without current suicidal ideation (N = 56). After controlling for covariates, no significant differences were found among the three groups on any measure of temperament or character except self-directedness and self-transcendence. The self-transcendence scores of the lifetime suicide-attempt group were significantly higher compared with those of the suicidal-ideation group; post hoc analysis revealed that self-directedness was significantly lower in the suicide-attempt group compared with the non-suicidal group. The results from the present study suggest that remitted depression patients with a history of suicide attempts do not differ from non-attempters in temperament, but do differ in certain character traits. PMID:25279671

  16. Pairing-specific long-term depression of Purkinje cell excitatory postsynaptic potentials results from a classical conditioning procedure in the rabbit cerebellar slice.

    PubMed

    Schreurs, B G; Oh, M M; Alkon, D L

    1996-03-01

    1. Using a rabbit cerebellar slice preparation, we stimulated a classical conditioning procedure by stimulating parallel fiber inputs to Purkinje cells with the use of a brief, high-frequency train of eight constant-current pulses 80 ms before climbing fiber inputs to the same Purkinje cell were stimulated with the use of a brief, lower frequency train of three constant-current pulses. In all experiments, we assessed the effects of stimulation by measuring the peak amplitude of Purkinje cell excitatory postsynaptic potentials (EPSPs) to single parallel fiber test pulses. 2. Intradendritically recorded Purkinje cell EPSPs underwent a long-term (> 20 min) reduction in peak amplitude (30%) after paired stimulation of the parallel and climbing fibers but not after unpaired or parallel fiber alone stimulation. We call this phenomenon pairing-specific long-term depression (PSD). 3. Facilitation of the peak amplitude of a second EPSP elicited by a parallel fiber train occurred both before and after paired stimulation suggesting that the locus of depression was not presynaptic. Depression of the peak amplitude of a depolarizing response to focal application of glutamate following pairings of parallel and climbing fiber stimulation added support to a suggested postsynaptic locus of the PSD effect. 4. The application of aniracetam potentiated EPSP peak amplitude by 40%, but these values returned to baseline as a result of pairings. With the removal of aniracetam from the bath 20 min after pairings, normal levels of pairing-specific EPSP depression were observed, indicating that the effect did not result from direct desensitization of alpha-amino-3-hydroxy-5-methyl-4-isoxazole-proprionic acid (AMPA) receptors. 5. Incubation of slices in the protein kinase inhibitor H-7 potentiated EPSP peak amplitudes slightly (9%), but peak amplitudes returned to baseline levels after pairings. The net reduction in EPSP peak amplitude of < 10% after pairings suggested that H-7 partially

  17. Dose-dependent changes in cognitive function with exercise augmentation for major depression: results from the TREAD study.

    PubMed

    Greer, Tracy L; Grannemann, Bruce D; Chansard, Matthieu; Karim, Alyzae I; Trivedi, Madhukar H

    2015-02-01

    Cognitive dysfunction has been repeatedly observed in major depressive disorder (MDD), particularly in areas of attention, verbal and nonverbal learning and memory, and executive functioning. Exercise has been shown to improve cognitive outcomes in other populations, including age-associated cognitive decline, but has not to our knowledge been investigated as an augmentation strategy in depression. This study evaluated the effectiveness of exercise augmentation on cognitive performance in persons with MDD and residual symptoms that included cognitive complaints following initial treatment with a selective serotonin reuptake inhibitor (SSRI). Participants enrolled in the Treatment with Exercise Augmentation for Depression (TREAD) study were randomized to receive either a low or high dose exercise regimen. TREAD participants who provided informed consent for the current study completed Cambridge Neuropsychological Test Automated Battery measures assessing Attention, Visual Memory, Executive Function/Set-shifting and Working Memory, and Executive Function/Spatial Planning domains. Data were analyzed for 39 participants completing both baseline and Week 12 cognitive testing. Overall tests indicated a significant task × group × time interaction for the Executive Function/Set-shifting and Working Memory domain. Post-hoc tests indicated improvements in high dose exercisers' spatial working memory, but decreases in spatial working memory and set-shifting outcomes in low dose exercisers. Both groups improved on measures of psychomotor speed, attention, visual memory and spatial planning. This study suggests a dose-response effect of exercise in specific executive function and working memory tasks among depressed persons with a partial response to SSRI and cognitive complaints, with some cognitive functions improving regardless of exercise dose.

  18. Theory of mind ability predicts prognosis of outpatients with major depressive disorder.

    PubMed

    Yamada, Kazuo; Inoue, Yumiko; Kanba, Shigenobu

    2015-12-15

    A theory of mind (ToM) deficit in patients with major depressive episodes is associated with difficulty in social adjustment, and thus may indicate a poorer prognosis. We investigated the association between ToM deficits and the outcome in patients who had recovered from major depressive episodes. We evaluated ToM abilities of 100 patients with major depressive disorder during a period of remission. The patients were followed up for one year and their outcomes observed. After one year, patients who had a ToM deficit according to a second-order false belief question relapsed significantly more frequently than did patients who did not have a deficit (Fisher's exact test P<0.0001; relative risk (RR)=8.286; CI 2.608, 26.324). Significant differences between these two groups were shown in scores of the Global Assessment of Functioning Scale (P<0.0001). Our results suggest that a ToM deficit after symptom remission in patients with major depressive disorder predicts a higher relapse rate and lower social function one year after recovering from a major depressive episode.

  19. Association between the BDNF Val66Met Polymorphism and Chronicity of Depression

    PubMed Central

    Lee, Yujin; Lim, Shinn Won; Kim, Soo Yeon; Chung, Jae Won; Kim, Jinwoo; Myung, Woojae; Song, Jihae; Kim, Seonwoo; Carroll, Bernard J

    2013-01-01

    Objective Both clinical and biological factors influence the course of depressive disorders. This study tested for associations between the brain-derived neurotrophic factor (BDNF) gene at the Val66Met locus and the course of major depressive disorder (MDD). Methods Three hundred ten Korean subjects (209 patients, 101 controls) were genotyped for rs6265 at nucleotide 196 (G/A), which produces an amino acid substitution at codon 66 (Val66Met) of the gene for BDNF. Course of illness was evaluated both by chronicity of current episode (episode duration >24 months) and by the lifetime history of recurrences. Results Patients with the Met/Met BDNF genotype had a significantly higher rate of chronic depression than all others. There was a significant dose effect of the Met allele on chronicity. Compared with the Val/Val genotype, the relative risk of chronicity was 1.67 for the Val/Met genotype, and 2.58 for the Met/Met genotype. Lifetime history of recurrent episodes was not related to BDNF genotypes but was significantly associated with younger age of onset and with a history of depression in first degree relatives. Conclusion BDNF genotyping may be informative for anticipating chronicity in major depression. PMID:23482723

  20. Neural Reactivity to Rewards and Losses in Offspring of Mothers and Fathers with Histories of Depressive and Anxiety Disorders

    PubMed Central

    Kujawa, Autumn; Proudfit, Greg Hajcak; Klein, Daniel N.

    2016-01-01

    Depression appears to be characterized by reduced neural reactivity to receipt of reward. Despite evidence of shared etiologies and high rates of comorbidity between depression and anxiety, this abnormality may be relatively specific to depression. However, it is unclear whether children at risk for depression also exhibit abnormal reward responding, and if so, whether risk for anxiety moderates this association. The feedback negativity (FN) is an event-related potential component sensitive to receipt of rewards versus losses that is reduced in depression. Using a large community sample (N=407) of 9-year old children who had never experienced a depressive episode, we examined whether histories of depression and anxiety in their parents were associated with the FN following monetary rewards and losses. Results indicated that maternal history of depression was associated with a blunted FN in offspring, but only when there was no maternal history of anxiety. In addition, greater severity of maternal depression was associated with greater blunting of the FN in children. No effects of paternal psychopathology were observed. Results suggest that blunted reactivity to rewards versus losses may be a vulnerability marker that is specific to pure depression, but is not evident when there is also familial risk for anxiety. In addition, these findings suggest that abnormal reward responding is evident as early as middle childhood, several years prior to the sharp increase in the prevalence of depression and rapid changes in neural reward circuitry in adolescence. PMID:24886003

  1. Concealed semantic and episodic autobiographical memory electrified.

    PubMed

    Ganis, Giorgio; Schendan, Haline E

    2012-01-01

    Electrophysiology-based concealed information tests (CIT) try to determine whether somebody possesses concealed information about a crime-related item (probe) by comparing event-related potentials (ERPs) between this item and comparison items (irrelevants). Although the broader field is sometimes referred to as "memory detection," little attention has been paid to the precise type of underlying memory involved. This study begins addressing this issue by examining the key distinction between semantic and episodic memory in the autobiographical domain within a CIT paradigm. This study also addresses the issue of whether multiple repetitions of the items over the course of the session habituate the brain responses. Participants were tested in a 3-stimulus CIT with semantic autobiographical probes (their own date of birth) and episodic autobiographical probes (a secret date learned just before the study). Results dissociated these two memory conditions on several ERP components. Semantic probes elicited a smaller frontal N2 than episodic probes, consistent with the idea that the frontal N2 decreases with greater pre-existing knowledge about the item. Likewise, semantic probes elicited a smaller central N400 than episodic probes. Semantic probes also elicited a larger P3b than episodic probes because of their richer meaning. In contrast, episodic probes elicited a larger late positive complex (LPC) than semantic probes, because of the recent episodic memory associated with them. All these ERPs showed a difference between probes and irrelevants in both memory conditions, except for the N400, which showed a difference only in the semantic condition. Finally, although repetition affected the ERPs, it did not reduce the difference between probes and irrelevants. These findings show that the type of memory associated with a probe has both theoretical and practical importance for CIT research. PMID:23355816

  2. The neurobiology of depression and antidepressant action.

    PubMed

    Willner, Paul; Scheel-Krüger, Jørgen; Belzung, Catherine

    2013-12-01

    We present a comprehensive overview of the neurobiology of unipolar major depression and antidepressant drug action, integrating data from affective neuroscience, neuro- and psychopharmacology, neuroendocrinology, neuroanatomy, and molecular biology. We suggest that the problem of depression comprises three sub-problems: first episodes in people with low vulnerability ('simple' depressions), which are strongly stress-dependent; an increase in vulnerability and autonomy from stress that develops over episodes of depression (kindling); and factors that confer vulnerability to a first episode (a depressive diathesis). We describe key processes in the onset of a 'simple' depression and show that kindling and depressive diatheses reproduce many of the neurobiological features of depression. We also review the neurobiological mechanisms of antidepressant drug action, and show that resistance to antidepressant treatment is associated with genetic and other factors that are largely similar to those implicated in vulnerability to depression. We discuss the implications of these conclusions for the understanding and treatment of depression, and make some strategic recommendations for future research.

  3. What differentiates episodic future thinking from complex scene imagery?

    PubMed

    de Vito, Stefania; Gamboz, Nadia; Brandimonte, Maria A

    2012-06-01

    We investigated the contributions of familiarity of setting, self-relevance and self-projection in time to episodic future thinking. The role of familiarity of setting was assessed, in Experiment 1, by comparing episodic future thoughts to autobiographical future events supposed to occur in unfamiliar settings. The role of self-relevance was assessed, in Experiment 2, by comparing episodic future thoughts to future events involving familiar others. The role of self-projection in time was assessed, in both Experiments, by comparing episodic future thoughts to autobiographical events that were not temporal in nature. Results indicated that episodic future thoughts were more clearly represented than autobiographical future events occurring in unfamiliar setting and future events involving familiar others. Our results also revealed that episodic future thoughts were indistinguishable from autobiographical atemporal events with respect to both subjective and objective detail ratings. These results suggest that future and atemporal events are mentally represented in a similar way.

  4. Depression and Suicide in Schizophrenic Patients.

    ERIC Educational Resources Information Center

    Salama, Aziz A.

    1988-01-01

    Identified schizophrenic patients as distinctive subgroup of patients who can suffer from major depressive illness and can commit suicide. Found 22.4 percent of 620 schizophrenics in psychiatric facility showed symptoms of major depressive episode. Seven patients committed suicide during acute phase of illness, 9 attempted suicide while…

  5. Cognition in Late Life Depression: Treatment Considerations

    PubMed Central

    Koenig, Aaron M.

    2014-01-01

    Opinion statement Late life depression (LLD) frequently presents with cognitive impairment, and growing evidence suggests that these disease processes are “linked” in multiple ways. For some individuals, LLD may be a recurrence of a long-standing depressive illness, while for others it may be the leading symptom of a developing neuropathological disorder. Overall, studies investigating the relationship between treatment of LLD and improvement in cognitive functioning have yielded mixed results. Research suggests that a subset of individuals with LLD and cognitive dysfunction will experience an improvement in cognitive function after antidepressant treatment, though a significant proportion will continue to exhibit cognitive impairment following resolution of their depressive symptoms. From a treatment standpoint, it is critical to ensure that an individual's depressive symptoms have been treated to remission, measured by a standardized rating scale such as the Geriatric Depression Scale (GDS). SSRI or SNRI monotherapy is often effective, and may be enhanced by employing an evidence-based psychotherapy such as Problem Solving Therapy (PST) or Interpersonal Therapy (IPT), modified to accommodate cognitive impairments that may be present. With respect to specific treatment of cognitive dysfunction, cognitive augmentation or training strategies can be helpful for some patients, and may be explored in combination with treatment of the primary depressive episode. While the introduction of a cholinesterase inhibitor (e.g. donepezil) may be considered, the potential benefit (modest improvement in cognition and functioning) must be weighed against an increased risk for worsening or recurrent depression. Finally, lifestyle factors—such as aerobic exercise, follow-up with a primary care physician for management of co-morbid medical illnesses, and regular participation in stimulating activities (such as through a senior center)—are important and should be included as

  6. Relationship Between Depressive State and Treatment Characteristics of Acute Cervical Spinal Cord Injury in Japan

    PubMed Central

    Matsuda, Yasufumi; Kubo, Tatsuhiko; Fujino, Yoshihisa; Matsuda, Shinya; Wada, Futoshi; Sugita, Atsuko

    2016-01-01

    Background Few studies have assessed whether treatment of acute cervical spinal cord injury (SCI) patients contributes to depression. Methods Using an administrative database, we assessed patients for whom the diagnosis was unspecified injuries of cervical spinal cord (International Classification of Diseases and Injuries-10th (ICD-10) code; S14.1). We categorized patients with codes for depressive episode (ICD-10 code; F32) or recurrent depressive disorder (F33), or those prescribed antidepressants (tricyclic, tetracyclic, Selective Serotonin Reuptake Inhibitors, Serotonin Noradrenaline Reuptake Inhibitors, Trazodone, Sulpiride, or Mirtazapine) as having a depressive state. We compared the rate of each acute treatment between the depressive state group and the non-depressive state group using chi-square tests, and a multiple logistic regression model was used to identify the association between the acute treatment and depressive state. Results There were 151 patients who were judged to be in a depressive state, and the other 2115 patients were categorized into the non-depressive state group. Intervention of intravenous anesthesia, tracheostomy, artificial respiration, and gastrostomy had a significant positive correlation with depressive state. Multiple logistic regression analysis showed that tracheostomy (odds ratio [OR] 2.18; 95% confidence interval [CI], 1.09–4.38) and artificial respiration (OR 2.28; 95% CI, 1.32–3.93) were significantly associated with depressive state, and men had a 36% reduction in the risk of depressive state compared with women (OR 0.64; 95% CI, 0.44–0.94), whereas age, wound-treatment, all of the orthopedic procedures, intravenous anesthesia, and gastrostomy were not associated with depressive state. Conclusions These findings suggest that tracheostomy, artificial respiration and female gender in the acute phase after cervical SCI might be associated with the development of depression. PMID:26567604

  7. The Episodic Nature of Episodic-Like Memories

    ERIC Educational Resources Information Center

    Easton, Alexander; Webster, Lisa A. D.; Eacott, Madeline J.

    2012-01-01

    Studying episodic memory in nonhuman animals has proved difficult because definitions in humans require conscious recollection. Here, we assessed humans' experience of episodic-like recognition memory tasks that have been used with animals. It was found that tasks using contextual information to discriminate events could only be accurately…

  8. 6-Month Outcomes from a Randomized Controlled Trial to Prevent Perinatal Depression in Low-Income Home Visiting Clients

    PubMed Central

    Tandon, S. Darius; Leis, Julie A.; Mendelson, Tamar; Perry, Deborah F.; Kemp, Karen

    2013-01-01

    Objectives Perinatal depression (PD) has negative consequences for mothers and children and is more prevalent among women of low socioeconomic status. Home visitation programs serve low-income pregnant women at risk for PD. This study tested the efficacy of a group-based cognitive behavioral intervention (Mothers and Babies Course; MB) in reducing depressive symptoms and preventing the onset of perinatal depression among low-income women enrolled in home visitation. Methods A randomized controlled trial was conducted. Seventy-eight women who were pregnant or had a child less than 6 months of age and who were assessed as at risk for PD were randomized to the MB intervention or usual home visiting services. Depressive symptoms were assessed at baseline and 1-week, 3- and 6-months post-intervention; depressive episodes were assessed with a clinical interview at the 6-month follow-up. Results Depressive symptoms declined at a significantly greater rate for intervention participants than usual care participants between baseline and 1-week, 3 months, and 6 months post-intervention. At the six-month follow-up, 15% of women who received the MB intervention had experienced a major depressive episode as compared with 32% of women receiving usual care. Conclusions Integrating mental health interventions into home visitation appears to be a promising approach for preventing PD. Cognitive behavioral techniques can be effective in preventing depression in perinatal populations and treating it. PMID:23793487

  9. [Masked depression].

    PubMed

    Preradović, M; Griva, D; Eror, S

    1991-01-01

    The study comprised 25 patients with masked depression and 30 patients with endogenous depression. According to the general characteristics both groups were homogenous and accordingly, comparable. Together with clinical evaluation of depressive syndrome, psychological management was applied. Rorschach test, Thematic Apperception Test and Minnesota Multiphasic Personality Inventory were used in the study. In the clinical picture of masked depressions somatovegetative disorders dominated and depressive behavior in endogenous depression. The frequence of suicid does not differ between patients with masked and endogenous depression.

  10. Classification of ischaemic episodes with ST/HR diagrams.

    PubMed

    Faganeli Pucer, Jana; Demšar, Janez; Kukar, Matjaž

    2012-01-01

    Coronary artery disease is the developed world's premier cause of mortality and the most probable cause of myocardial ischaemia. More advanced diagnostic tests aside, in electrocardiogram (ECG) analysis it manifests itself as a ST segment deviation, targeted by both exercise ECG and ambulatory ECG. In ambulatory ECG, besides ischaemic ST segment deviation episodes there are also non-ischaemic heart rate related episodes which aggravate real ischaemia detection. We present methods to transform the features developed for the heart rate adjustment of ST segment depression in exercise ECG for use in ambulatory ECG. We use annotations provided by the Long-Term ST Database to plot the ST/HR diagrams and then estimate the overall and maximal slopes of the diagrams in the exercise and recovery phase for each ST segment deviation episode. We also estimate the angle at the extrema of the ST/HR diagrams. Statistical analysis shows that ischaemic ST segment deviation episodes have significantly steeper overall and maximal slopes than heart rate related episodes, which indicates the explored features' utility for distinguishing between the two types of episodes. This makes the proposed features very useful in automated ECG analysis. PMID:22874369

  11. Classification of ischaemic episodes with ST/HR diagrams.

    PubMed

    Faganeli Pucer, Jana; Demšar, Janez; Kukar, Matjaž

    2012-01-01

    Coronary artery disease is the developed world's premier cause of mortality and the most probable cause of myocardial ischaemia. More advanced diagnostic tests aside, in electrocardiogram (ECG) analysis it manifests itself as a ST segment deviation, targeted by both exercise ECG and ambulatory ECG. In ambulatory ECG, besides ischaemic ST segment deviation episodes there are also non-ischaemic heart rate related episodes which aggravate real ischaemia detection. We present methods to transform the features developed for the heart rate adjustment of ST segment depression in exercise ECG for use in ambulatory ECG. We use annotations provided by the Long-Term ST Database to plot the ST/HR diagrams and then estimate the overall and maximal slopes of the diagrams in the exercise and recovery phase for each ST segment deviation episode. We also estimate the angle at the extrema of the ST/HR diagrams. Statistical analysis shows that ischaemic ST segment deviation episodes have significantly steeper overall and maximal slopes than heart rate related episodes, which indicates the explored features' utility for distinguishing between the two types of episodes. This makes the proposed features very useful in automated ECG analysis.

  12. [Endogenous anesthetic depressions (psychopathology and typology)].

    PubMed

    Baranov, P A

    2011-01-01

    The psychopathological structure of anesthetic depressions was studied in 80 patients with progredient schizophrenia. Three variants of anesthetic depression were distinguished, viz, anxiety anesthesia with agitation, sensorial psychic anesthesia, and multiple depersonalization symptoms; melancholic anesthesia with the depressive triad, self-reproach ideas and sensorial ideatory psychic anesthesia; anesthesia proper with ideatory psychic anesthesia as the main or sole manifestation of depression. The study revealed transitions of these variants in the structure of schizophrenic episodes from anxiety anesthetic to melancholic anesthetic and further on to purely anesthetic ones. The latter type of depression proved refractory to antidepressive therapy and tended to persist for a long time. PMID:21674918

  13. Late-life depression in Peru, Mexico and Venezuela: the 10/66 population-based study

    PubMed Central

    Guerra, Mariella; Ferri, Cleusa P.; Sosa, Ana Luisa; Salas, Aquiles; Gaona, Ciro; Gonzales, Victor; de la Torre, Gabriela Rojas; Prince, Martin

    2009-01-01

    Background The proportion of the global population aged 60 and over is increasing, more so in Latin America than any other region. Depression is common among elderly people and an important cause of disability worldwide. Aims To estimate the prevalence and correlates of late-life depression, associated disability and access to treatment in five locations in Latin America. Method A one-phase cross-sectional survey of 5886 people aged 65 and over from urban and rural locations in Peru and Mexico and an urban site in Venezuela. Depression was identified according to DSM–IV and ICD–10 criteria, Geriatric Mental State–Automated Geriatric Examination for Computer Assisted Taxonomy (GMS–AGECAT) algorithm and EURO–D cut-off point. Poisson regression was used to estimate the independent associations of sociodemographic characteristics, economic circumstances and health status with ICD–10 depression. Results For DSM–IV major depression overall prevalence varied between 1.3% and 2.8% by site, for ICD–10 depressive episode between 4.5% and 5.1%, for GMS–AGECAT depression between 30.0% and 35.9% and for EURO–D depression between 26.1% and 31.2%; therefore, there was a considerable prevalence of clinically significant depression beyond that identified by ICD–10 and DSM–IV diagnostic criteria. Most older people with depression had never received treatment. Limiting physical impairments and a past history of depression were the two most consistent correlates of the ICD–10 depressive episode. Conclusions The treatment gap poses a significant challenge for Latin American health systems, with their relatively weak primary care services and reliance on private specialists; local treatment trials could establish the cost-effectiveness of mental health investment in the government sector. PMID:19949200

  14. Using mixed methods to examine the role of Veterans’ illness perceptions on depression treatment utilization and HEDIS concordance

    PubMed Central

    Glickman, Mark E.; Bokhour, Barbara G.; Dell, Natalie S.; Mueller, Nora M.; Zhao, Shibei; Osei-Bonsu, Princess E.; Rodrigues, Stephanie; Coldwell, Craig M.; Ngo, Tu A.; Schlosser, James; Vielhauer, Melanie J.; Pirraglia, Paul A.; Eisen, Susan V.

    2014-01-01

    Background Although depression screening occurs annually in Department of Veterans Affairs (VA) primary care, many Veterans may not be receiving guideline-concordant depression treatment. Objectives To determine whether Veterans’ illness perceptions of depression may be serving as barriers to guideline-concordant treatment. Research Design We used a prospective, observational design involving a mailed questionnaire and chart review data collection to assess depression treatment utilization and concordance with Healthcare Effectiveness Data and Information Set guidelines adopted by the VA. The Self-Regulation Model of Illness Behavior guided the study. Subjects Veterans who screened positive for a new episode of depression at three VA primary care clinics in the U.S. Northeast. Measures The Illness Perceptions Questionnaire-Revised, measuring patients’ perceptions of their symptoms, cause, timeline, consequences, cure or controllability and coherence of depression and its symptoms, was our primary measure to calculate Veterans’ illness perceptions. Treatment utilization was assessed three months after the positive depression screen through chart review. HEDIS guideline-concordant treatment was determined according to a checklist created for the study. Results 839 Veterans screened positive for a new episode of depression from May 2009–June 2011; 275 (32.8%) completed the survey. 92 (33.9%) received HEDIS guideline-concordant depression treatment. Veterans’ illness perceptions of their symptoms, cause, timeline, and controllability of depression predicted receiving guideline-concordant treatment. Conclusions Many Veterans are not receiving guideline-concordant treatment for depression. HEDIS guideline measures may not be assessing all aspects of quality depression care. Conversations about Veterans’ illness perceptions and their specific needs are encouraged to ensure that appropriate treatment is achieved. PMID:24374425

  15. Late Life Recurrent Depression: Challenge to Mental Health Care.

    ERIC Educational Resources Information Center

    Hinrichsen, Gregory A.

    For the vast majority of persons of all ages who suffer from major depression, it is recurrent. A traditional wisdom has been that elderly persons respond more poorly to treatment for serious depression than younger persons. The psychiatric status of 127 elderly persons hospitalized for an episode of major depression was systematically assessed…

  16. Preventing postpartum depression: A meta-analytic review

    PubMed Central

    Sockol, Laura E.; Epperson, C. Neill; Barber, Jacques P.

    2014-01-01

    This meta-analysis assessed the efficacy of a wide range of preventive interventions designed to reduce the severity of postpartum depressive symptoms or decrease the prevalence of postpartum depressive episodes. A systematic review identified 37 randomized or quasi-randomized controlled trials in which an intervention was compared to a control condition. Differences between treatment and control conditions in the level of depressive symptoms and prevalence of depressive episodes by 6 months postpartum were assessed in separate analyses. Depressive symptoms were significantly lower at post-treatment in intervention conditions, with an overall effect size in the small range after exclusion of outliers (Hedges' g = 0.18). There was a 27% reduction in the prevalence of depressive episodes in intervention conditions by 6 months postpartum after removal of outliers and correction for publication bias. Later timing of the postpartum assessment was associated with smaller differences between intervention and control conditions in both analyses. Among studies that assessed depressive symptoms using the EPDS, higher levels of depressive symptoms at pre-treatment were associated with smaller differences in depressive symptoms by 6 months postpartum. These findings suggest that interventions designed to prevent postpartum depression effectively reduce levels of postpartum depressive symptoms and decrease risk for postpartum depressive episodes. PMID:24211712

  17. Pharmacological Management of Treatment-Resistant Pediatric Depression

    ERIC Educational Resources Information Center

    Kratochvil, Christopher J.; Wagner, Karen Dineen; Emslie, Graham; March, John

    2005-01-01

    A 13-year-old boy presents with treatment-resistant symptoms of major depression. This is his first episode of depression, initially treated with 200 mg sertraline for 12 weeks with no significant benefit. The severe depression has shown a partial response to weekly cognitive-behavioral therapy (CBT) and fluoxetine, which was titrated up to 60 mg…

  18. Risk Factors for Depressive Symptomatology in a Drug Using Population.

    ERIC Educational Resources Information Center

    Buckner, John C.; And Others

    1990-01-01

    Examines the effects of variables associated with the onset of a depressive episode on a group of 942 psychoactive drug-using young adults. Finds that controls were free of depressive symptoms but that methaqualone users were more prone to a depressed mood, lower self-esteem, and negative life events than nonusers. (FMW)

  19. Safety and effectiveness of controlled-release paroxetine in routine clinical practice: results of a postmarketing surveillance study of patients with depression

    PubMed Central

    Kato, Masaki; Kimura, Toshifumi; Kimura, Takeshi; Hara, Terufumi

    2015-01-01

    Objective Selective serotonin reuptake inhibitors are commonly used in the pharmacotherapy of depression. However, adverse events can lead to their early discontinuation. This study evaluated the safety and effectiveness of paroxetine controlled-release (CR) tablets in Japanese patients with depression/depressive state (hereafter referred to as depression) in routine clinical practice in Japan. Patients and methods This was an open-label, noninterventional, prospective, postmarketing surveillance study. A total of 3,213 patients aged 12–92 years with depression were prescribed paroxetine CR for 8 weeks at the physician’s discretion. Safety was evaluated on the basis of the reporting of adverse drug reactions. Effectiveness was evaluated on the basis of the physician’s assessment using the Clinical Global Impression-Global Improvement (CGI-GI) and the Clinical Global Impression-Severity of Illness (CGI-SI) scales, as well as on the basis of the patients’ self-reported satisfaction. The primary effectiveness outcome was the improvement rate based on the physician’s assessment using the CGI-GI. Results The incidence of adverse drug reactions was 11.2% (359/3,213; 95% confidence interval [CI]: 10.1%–12.3%). The common adverse drug reactions that accounted for 1.0% or more of the incidence were nausea (3.5%) and somnolence (2.7%). The proportion of patients who continued paroxetine CR at week 8 was 80.2% (2,577/3,213; 95% CI: 78.8%–81.6%). The improvement rate at week 8 (last observation carried forward) was 72.8% (2,132/2,927; 95% CI: 71.2%–74.4%). The proportion of patients with CGI-SI scores of moderately or severely ill decreased from 63.6% at baseline to 17.9% at week 8. The proportion of patients who were satisfied with paroxetine CR treatment was 69.8% (2,040/2,921; 95% CI: 68.1%–71.5%). Conclusion The results of this study suggest that paroxetine CR is a well-tolerated and efficacious treatment for depression in routine clinical practice. PMID

  20. The New Data on Dynamics of Permian - Triassic Magmatic Activity on Siberian Platform: Paleomagnetic Results from Tunguska Syncline and Angara - Taseeva Depression

    NASA Astrophysics Data System (ADS)

    Latyshev, A.; Veselovskiy, R. V.

    2015-12-01

    We perform the new paleomagnetic data from intrusive complexes of two regions of Siberian Trap province (Angara - Taseeva depression and Tunguska syncline). Results of paleomagnetic and geological investigation indicate that two different patterns of magmatic process took place in these regions. In Angara - Taseeva depression short intense peaks of magmatic activity alternate with more prolonged periods of relative quietness. These bursts of magmatic activity resulted in intruding of large dolerite sills. In the central part of Tunguska syncline local intrusive events took place on the background of effusive volcanic activity. Considering the new data together with previous paleomagnetic results from Norilsk and Maymecha - Kotuy regions (Pavlov et al., 2015), western part of Viluy basin (Konstantinov et al., 2014) and Angara-Taseeva depression (Latyshev et al., 2013), it can be concluded that pulsating character of magmatic activity is typical for the periphery of Tunguska syncline. However, the central part of Tunguska syncline is characterized by more prolonged and even style of volcanic process and less widescale intrusive events. This conclusion is important for understanding of LIPs formation and mantle plumes dynamics. This study was funded by grants RFBR # 14-05-31447 and 15-35-20599 and Ministry of Education and Science of the Russian Federation (grant 14.Z50.31.0017).

  1. Changes in beliefs and attitudes toward people with depression and schizophrenia - results of a public campaign in Germany.

    PubMed

    Makowski, Anna C; Mnich, Eva E; Ludwig, Julia; Daubmann, Anne; Bock, Thomas; Lambert, Martin; Härter, Martin; Dirmaier, Jörg; Tlach, Lisa; Liebherz, Sarah; von dem Knesebeck, Olaf

    2016-03-30

    We examined the impact of a mental health awareness campaign on public attitudes. The campaign was embedded in the project psychenet - Hamburg Network for Mental Health. Beliefs and attitudes were examined before and after specific awareness measures in Hamburg (intervention region) and Munich (control region). Analyses were based on representative surveys (2011: N=2014; 2014: N=2006). Vignettes with symptoms suggestive of depression respectively schizophrenia were presented, followed by questions on social distance, beliefs and emotional reactions. Analyses of variance tested variations between regions over time and differences between those aware of the campaign and those not aware. In 2014, 7.3% (n=74) of the Hamburg respondents were aware of the psychenet campaign. Regarding the total sample, there were minor changes in attitudes. Differentiated according to campaign awareness among Hamburg respondents, those who were aware showed less desire for social distance toward a person with depression. Moreover, respondents aware of the campaign stated less often that a person with schizophrenia is in need of help. The campaign had small impact on attitudes. A substantial change in ingrained attitudes toward persons with mental health problems is difficult to achieve with interventions targeting the general public.

  2. Delayed mood transitions in major depressive disorder.

    PubMed

    Korf, Jakob

    2014-05-01

    The hypothesis defended here is that the process of mood-normalizing transitions fails in a significant proportion of patients suffering from major depressive disorder. Such a failure is largely unrelated to the psychological content. Evidence for the hypothesis is provided by the highly variable and unpredictable time-courses of the depressive episodes. The main supporting observations are: (1) mood transitions within minutes or days have been reported during deep brain stimulation, naps after sleep deprivation and bipolar mood disorders; (2) sleep deprivation, electroconvulsive treatment and experimental drugs (e.g., ketamine) may facilitate mood transitions in major depressive disorder within hours or a few days; (3) epidemiological and clinical studies show that the time-to-recovery from major depressive disorder can be described with decay models implying very short depressive episodes; (4) lack of relationship between the length of depression and recovery episodes in recurrent depression; (5) mood fluctuations predict later therapeutic success in major depressive disorder. We discuss some recent models aimed to describe random mood transitions. The observations together suggest that the mood transitions have a wide variety of apparently unrelated causes. We suggest that the mechanism of mood transition is compromised in major depressive disorder, which has to be recognized in diagnostic systems.

  3. Sleep Quality in Women with and without Postpartum Depression

    PubMed Central

    Posmontier, Bobbie

    2008-01-01

    Objective To compare and measure the effects of sleep quality on women with and without postpartum depression (PPD). Design A case-control repeated measures matched pairs design. Setting Home and obstetric office. Participants Forty-six women who were 6 to 26 weeks postpartum. Two participants were dropped from the final analysis because they were outliers. Methods Participants underwent wrist actigraphy at home for 7 consecutive days to measure sleep quality (sleep latency, wake after sleep onset, sleep efficiency, wake episodes). The Postpartum Depression Screening Scale measured depression severity. Psychosocial variables were collected during a screening interview. A structured clinical interview was used to diagnose PPD. Correlations, t-tests, and hierarchical multiple regressions were run to analyze data. Results With the exception of wake episodes, sleep latency (B = 1.80, S.E. = 0.73, P<0.05), wake after sleep onset (B = 6.85, S.E. = 2.85, P<0.05), and thus sleep efficiency (B = −6.31, S.E. = 3.13, P<0.05) predicted PPD symptom severity. Conclusions Women with PPD experienced poorer sleep quality than women without PPD, and sleep quality worsened with increasing PPD symptom severity. Clinicians need to address measures to improve sleep quality in depressed mothers to decrease symptom severity, and researchers need to develop interventions to facilitate better sleep quality in women with PPD. PMID:19012723

  4. Caregiver Depression

    MedlinePlus

    ... will not sell or share your name. Caregiver Depression Tweet Bookmark this page | Email | Print Many caregivers ... depression See your doctor Treatment Coping Symptoms of depression Caregiving is hard — and can lead to feelings ...

  5. Postpartum depression

    MedlinePlus

    Depression - postpartum; Postnatal depression; Postpartum psychological reactions ... The exact causes of postpartum depression are unknown. Changes in hormone levels during and after pregnancy may affect a woman's mood. Many non-hormonal factors may also ...

  6. Feeling Bad on Facebook: Depression disclosures by college students on a Social Networking Site

    PubMed Central

    Moreno, Megan A; Jelenchick, Lauren A; Egan, Katie G; Cox, Elizabeth; Young, Henry; Gannon, Kerry E; Becker, Tara

    2011-01-01

    Background Depression is common and frequently undiagnosed among college students. Social networking sites are popular among college students and can include displayed depression references. The purpose of this study was to evaluate college students' Facebook disclosures that met DSM criteria for a depression symptom or a major depressive episode (MDE). Methods We selected public Facebook profiles from sophomore and junior undergraduates and evaluated personally written text: “status updates.” We applied DSM criteria to one year of status updates from each profile to determine prevalence of displayed depression symptoms and MDE criteria. Negative binomial regression analysis was used to model the association between depression disclosures and demographics or Facebook use characteristics. Results A total of 200 profiles were evaluated, profile owners were 43.5% female with a mean age of 20 years. Overall, 25% of profiles displayed depressive symptoms and 2.5% met criteria for MDE. Profile owners were more likely to reference depression if they averaged at least one online response from their friends to a status update disclosing depressive symptoms (exp(B)=2.1, p<0.001), or if they used Facebook more frequently (p<0.001). Conclusion College students commonly display symptoms consistent with depression on Facebook. Our findings suggest that those who receive online reinforcement from their friends are more likely to discuss their depressive symptoms publicly on Facebook. Given the frequency of depression symptom displays on public profiles, SNSs could be an innovative avenue for combating stigma surrounding mental health conditions, or for identifying students at risk for depression. PMID:21400639

  7. The association between lower educational attainment and depression owing to shared genetic effects? Results in ~25,000 subjects

    PubMed Central

    Peyrot, WJ; Lee, SH; Milaneschi, Y; Abdellaoui, A; Byrne, EM; Esko, T; de Geus, EJC; Hemani, G; Hottenga, JJ; Kloiber, S; Levinson, DF; Lucae, S; Martin, NG; Medland, SE; Metspalu, A; Milani, L; Noethen, MM; Potash, JB; Rietschel, M; Rietveld, CA; Ripke, S; Shi, J; Willemsen, G; Zhu, Z; Boomsma, DI; Wray, NR; Penninx, BWJH

    2015-01-01

    An association between lower educational attainment (EA) and an increased risk for depression has been confirmed in various western countries. This study examines whether pleiotropic genetic effects contribute to this association. Therefore, data were analyzed from a total of 9,662 Major Depressive Disorder (MDD) cases and 14,949 controls (with no lifetime MDD diagnosis) from the Psychiatric Genomics Consortium with additional Dutch and Estonian data. The association of EA and MDD was assessed with logistic regression in 15,138 individuals indicating a significantly negative association in our sample with an odds ratio for MDD 0.78 [0.75–0.82] per standard deviation increase in EA. With data of 884,105 autosomal common SNPs, three methods were applied to test for pleiotropy between MDD and EA: (i) genetic profile risk scores (GPRS) derived from training data for EA (independent meta-analysis on 120,000 subjects) and MDD (using a ten-fold leave-one-out procedure in the current sample) (ii) bivariate Genomic-Relationship-Matrix Restricted Maximum Likelihood (GREML), and (iii) SNP effect concordance analysis (SECA). With these methods we found (i) that the EA-GPRS did not predict MDD status, and MDD-GPRS did not predict EA, (ii) a weak negative genetic correlation with bivariate GREML analyses, but this correlation was not consistently significant, (iii) no evidence for concordance of MDD and EA SNP effects with SECA analysis. To conclude, our study confirms an association of lower EA and MDD risk, but this association was not due to measurable pleiotropic genetic effects, which suggests that environmental factors could be involved such as, for example, socioeconomic status. PMID:25917368

  8. Feasibility and Effectiveness of a Multi-Element Psychosocial Intervention for First-Episode Psychosis: Results From the Cluster-Randomized Controlled GET UP PIANO Trial in a Catchment Area of 10 Million Inhabitants.

    PubMed

    Ruggeri, Mirella; Bonetto, Chiara; Lasalvia, Antonio; Fioritti, Angelo; de Girolamo, Giovanni; Santonastaso, Paolo; Pileggi, Francesca; Neri, Giovanni; Ghigi, Daniela; Giubilini, Franco; Miceli, Maurizio; Scarone, Silvio; Cocchi, Angelo; Torresani, Stefano; Faravelli, Carlo; Cremonese, Carla; Scocco, Paolo; Leuci, Emanuela; Mazzi, Fausto; Pratelli, Michela; Bellini, Francesca; Tosato, Sarah; De Santi, Katia; Bissoli, Sarah; Poli, Sara; Ira, Elisa; Zoppei, Silvia; Rucci, Paola; Bislenghi, Laura; Patelli, Giovanni; Cristofalo, Doriana; Meneghelli, Anna

    2015-09-01

    Integrated multi-element psychosocial interventions have been suggested to improve the outcomes of first-episode psychosis (FEP) patients, but they have been studied primarily in experimental settings and in nonepidemiologically representative samples. Thus, we performed a cluster-randomized controlled trial, comparing an integrated multi-element psychosocial intervention, comprising cognitive behavioral therapy, family intervention, and case management, with treatment as usual (TAU) for FEP patients in 117 community mental health centers (CMHCs) in a large area of northern Italy (10 million inhabitants). The randomized units (clusters) were the CMHCs, and the units of observation the patients (and, when available, their family members). The primary hypotheses were that add-on multicomponent intervention: (1) results in greater improvements in symptoms, as assessed with positive and negative syndrome scale and (2) reduces in-hospital stay, based on days of hospitalization over the 9-month follow-up. Four hundred and forty-four FEP patients received the intervention or TAU and were assessed at baseline and 9 months. Based on the retention rates of patients (and families) in the experimental arm, multi-element psychosocial interventions can be implemented in routine mental health services. Regarding primary outcomes, patients in the experimental arm showed greater reductions in overall symptom severity, while no difference could be found for days of hospitalization. Among the secondary outcomes, greater improvements were detected in the experimental arm for global functioning, emotional well-being, and subjective burden of delusions. No difference could be found for service disengagement and subjective burden of auditory hallucinations. These findings support feasibility and effectiveness of early interventions for psychosis in generalist mental health services.

  9. Feasibility and Effectiveness of a Multi-Element Psychosocial Intervention for First-Episode Psychosis: Results From the Cluster-Randomized Controlled GET UP PIANO Trial in a Catchment Area of 10 Million Inhabitants

    PubMed Central

    Ruggeri, Mirella; Bonetto, Chiara; Lasalvia, Antonio; Fioritti, Angelo; de Girolamo, Giovanni; Santonastaso, Paolo; Pileggi, Francesca; Neri, Giovanni; Ghigi, Daniela; Giubilini, Franco; Miceli, Maurizio; Scarone, Silvio; Cocchi, Angelo; Torresani, Stefano; Faravelli, Carlo; Cremonese, Carla; Scocco, Paolo; Leuci, Emanuela; Mazzi, Fausto; Pratelli, Michela; Bellini, Francesca; Tosato, Sarah; De Santi, Katia; Bissoli, Sarah; Poli, Sara; Ira, Elisa; Zoppei, Silvia; Rucci, Paola; Bislenghi, Laura; Patelli, Giovanni; Cristofalo, Doriana; Meneghelli, Anna

    2015-01-01

    Integrated multi-element psychosocial interventions have been suggested to improve the outcomes of first-episode psychosis (FEP) patients, but they have been studied primarily in experimental settings and in nonepidemiologically representative samples. Thus, we performed a cluster-randomized controlled trial, comparing an integrated multi-element psychosocial intervention, comprising cognitive behavioral therapy, family intervention, and case management, with treatment as usual (TAU) for FEP patients in 117 community mental health centers (CMHCs) in a large area of northern Italy (10 million inhabitants). The randomized units (clusters) were the CMHCs, and the units of observation the patients (and, when available, their family members). The primary hypotheses were that add-on multicomponent intervention: (1) results in greater improvements in symptoms, as assessed with positive and negative syndrome scale and (2) reduces in-hospital stay, based on days of hospitalization over the 9-month follow-up. Four hundred and forty-four FEP patients received the intervention or TAU and were assessed at baseline and 9 months. Based on the retention rates of patients (and families) in the experimental arm, multi-element psychosocial interventions can be implemented in routine mental health services. Regarding primary outcomes, patients in the experimental arm showed greater reductions in overall symptom severity, while no difference could be found for days of hospitalization. Among the secondary outcomes, greater improvements were detected in the experimental arm for global functioning, emotional well-being, and subjective burden of delusions. No difference could be found for service disengagement and subjective burden of auditory hallucinations. These findings support feasibility and effectiveness of early interventions for psychosis in generalist mental health services. PMID:25995057

  10. Feasibility and Effectiveness of a Multi-Element Psychosocial Intervention for First-Episode Psychosis: Results From the Cluster-Randomized Controlled GET UP PIANO Trial in a Catchment Area of 10 Million Inhabitants.

    PubMed

    Ruggeri, Mirella; Bonetto, Chiara; Lasalvia, Antonio; Fioritti, Angelo; de Girolamo, Giovanni; Santonastaso, Paolo; Pileggi, Francesca; Neri, Giovanni; Ghigi, Daniela; Giubilini, Franco; Miceli, Maurizio; Scarone, Silvio; Cocchi, Angelo; Torresani, Stefano; Faravelli, Carlo; Cremonese, Carla; Scocco, Paolo; Leuci, Emanuela; Mazzi, Fausto; Pratelli, Michela; Bellini, Francesca; Tosato, Sarah; De Santi, Katia; Bissoli, Sarah; Poli, Sara; Ira, Elisa; Zoppei, Silvia; Rucci, Paola; Bislenghi, Laura; Patelli, Giovanni; Cristofalo, Doriana; Meneghelli, Anna

    2015-09-01

    Integrated multi-element psychosocial interventions have been suggested to improve the outcomes of first-episode psychosis (FEP) patients, but they have been studied primarily in experimental settings and in nonepidemiologically representative samples. Thus, we performed a cluster-randomized controlled trial, comparing an integrated multi-element psychosocial intervention, comprising cognitive behavioral therapy, family intervention, and case management, with treatment as usual (TAU) for FEP patients in 117 community mental health centers (CMHCs) in a large area of northern Italy (10 million inhabitants). The randomized units (clusters) were the CMHCs, and the units of observation the patients (and, when available, their family members). The primary hypotheses were that add-on multicomponent intervention: (1) results in greater improvements in symptoms, as assessed with positive and negative syndrome scale and (2) reduces in-hospital stay, based on days of hospitalization over the 9-month follow-up. Four hundred and forty-four FEP patients received the intervention or TAU and were assessed at baseline and 9 months. Based on the retention rates of patients (and families) in the experimental arm, multi-element psychosocial interventions can be implemented in routine mental health services. Regarding primary outcomes, patients in the experimental arm showed greater reductions in overall symptom severity, while no difference could be found for days of hospitalization. Among the secondary outcomes, greater improvements were detected in the experimental arm for global functioning, emotional well-being, and subjective burden of delusions. No difference could be found for service disengagement and subjective burden of auditory hallucinations. These findings support feasibility and effectiveness of early interventions for psychosis in generalist mental health services. PMID:25995057

  11. Psychiatric comorbidities of episodic and chronic migraine.

    PubMed

    Buse, Dawn C; Silberstein, Stephen D; Manack, Aubrey N; Papapetropoulos, Spyros; Lipton, Richard B

    2013-08-01

    Migraine is a prevalent disabling neurological disorder associated with a wide range of medical and psychiatric comorbidities. Population- and clinic-based studies suggest that psychiatric comorbidities, particularly mood and anxiety disorders, are more common among persons with chronic migraine than among those with episodic migraine. Additional studies suggest that psychiatric comorbidities may be a risk factor for migraine chronification (i.e., progression from episodic to chronic migraine). It is important to identify and appropriately treat comorbid psychiatric conditions in persons with migraine, as these conditions may contribute to increased migraine-related disability and impact, diminished health-related quality of life, and poor treatment outcomes. Here, we review the current literature on the rates of several psychiatric comorbidities, including depression, anxiety, and post-traumatic stress disorder, among persons with migraine in clinic- and population-based studies. We also review the link between physical, emotional, and substance abuse, psychiatric disorders, and migraine. Finally, we review the data on psychiatric risk factors for migraine chronification and explore theories and evidence underlying the comorbidity between migraine and these psychiatric disorders. PMID:23132299

  12. Pharmacotherapy of first-episode psychosis.

    PubMed

    Lambert, Martin; Conus, Philippe; Lambert, Tim; McGorry, Pat D

    2003-05-01

    Early intervention in psychosis has attracted more attention in the last few years. The treatment of this phase of the disorders requires a specific and adapted approach. The issue of engaging the patient is so critical that it influences not only the choice of medication, but also the context and the way in which it is administered. In the case of a first admission, patients should be observed for 24-48 h without any antipsychotic treatment, in order to clarify the diagnosis and exclude the possibility that symptoms are caused by acute intoxication with illicit substances, for example. The diagnosis is often difficult and unstable. A dimensional, rather than a categorical approach, is usually more likely to be adopted. In recent years, atypical antipsychotics have become the most frequently used first-line treatment. They are less likely to cause secondary negative symptoms, cognitive impairments and dysphoria. They also appear to influence the course of depression and hostility/aggression better than conventional neuroleptics, have possibly mood-stabilising properties and, subjectively, are often better accepted by patients. On the risk side, prevalence of acute extrapyramidal side effects and possibly tardive dyskinesia are lower, compared to the older neuroleptics. Although, the risk for short-term weight gain, cardiovascular, and especially hyperglycaemic complications are somewhat higher for some of these antipsychotics. Finally, the dose should be adapted as it has been shown that patients presenting a first psychotic episode respond to a lower dose of antipsychotic. This article focuses on the pharmacotherapy of first-episode psychosis, on the basis of a computerised and a manual search for articles dealing with antipsychotic treatment of these patients. Findings are discussed and combined in clinical guidelines for first-episode affective and non-affective psychosis, for patients with incomplete recovery or treatment resistance, for cases of emergency and

  13. Deconstructing major depression: a validation study of the DSM-IV symptomatic criteria

    PubMed Central

    Lux, V.; Kendler, K. S.

    2010-01-01

    Background The DSM-IV symptomatic criteria for major depression (MD) derive primarily from clinical experience with modest empirical support. Method The sample studied included 1015 (518 males, 497 females) Caucasian twins from a population-based registry who met criteria for MD in the year prior to the interview. Logistic regression analyses were conducted to compare the associations of: (1) single symptomatic criterion, (2) two groups of criteria reflecting cognitive and neurovegetative symptoms, with a wide range of potential validators including demographic factors, risk for future episodes, risk of MD in the co-twin, characteristics of the depressive episode, the pattern of co-morbidity and personality traits. Results The individual symptomatic criteria showed widely varying associations with the pattern of co-morbidity, personality traits, features of the depressive episode and demographic characteristics. When examined separately, these two criteria groups showed robust differences in their patterns of association, with the validators with the cognitive criteria generally producing stronger associations than the neurovegetative. Conclusions Among depressed individuals, individual DSM-IV symptomatic criteria differ substantially in their predictive relationship with a range of clinical validators. These results challenge the equivalence assumption for the symptomatic criteria for MD and suggest a more than expected degree of ‘ covert ’ heterogeneity among these criteria. Part of this heterogeneity is captured by the distinction between cognitive versus neurovegetative symptoms, with cognitive symptoms being more strongly associated with most clinically relevant characteristics. Detailed psychometric evaluation of DSM-IV criteria is overdue. PMID:20059797

  14. Bipolar I disorder and major depressive disorder show similar brain activation during depression

    PubMed Central

    Cerullo, Michael A; Eliassen, James C; Smith, Christopher T; Fleck, David E; Nelson, Erik B; Strawn, Jeffrey R; Lamy, Martine; DelBello, Melissa P; Adler, Caleb M; Strakowski, Stephen M

    2014-01-01

    Objectives Despite different treatments and course of illness, depressive symptoms appear similar in major depressive disorder (MDD) and bipolar I disorder (BP-I). This similarity of depressive symptoms suggests significant overlap in brain pathways underlying neurovegetative, mood, and cognitive symptoms of depression. These shared brain regions might be expected to exhibit similar activation in individuals with MDD and BP-I during functional magnetic resonance imaging (fMRI). Methods fMRI was used to compare regional brain activation in participants with BP-I (n = 25) and MDD (n = 25) during a depressive episode as well as 25 healthy comparison (HC) participants. During the scans, participants performed an attentional task that incorporated emotional pictures. Results During the viewing of emotional images, subjects with BP-I showed decreased activation in the middle occipital gyrus, lingual gyrus, and middle temporal gyrus compared to both subjects with MDD and HC participants. During attentional processing, participants with MDD had increased activation in the parahippocampus, parietal lobe, and postcentral gyrus. However, among these regions, only the postcentral gyrus also showed differences between MDD and HC participants. Conclusions No differences in cortico-limbic regions were found between participants with BP-I and MDD during depression. Instead, the major differences occurred in primary and secondary visual processing regions with decreased activation in these regions in BP-I compared to major depression. These differences were driven by abnormal decreases in activation seen in the participants with BP-I. Posterior activation changes are a common finding in studies across mood states in participants with BP-I. PMID:24990479

  15. Memory Specificity and Mindfulness Jointly Moderate the Effect of Reflective Pondering on Depressive Symptoms in Individuals With a History of Recurrent Depression

    PubMed Central

    2015-01-01

    In previously depressed individuals, reflective thinking may easily get derailed and lead to detrimental effects. This study investigated the conditions in which such thinking is, or is not, adaptive. Levels of mindfulness and autobiographical memory specificity were assessed as potential moderators of the relationship between reflective thinking and depressive symptoms. Two hundred seventy-four individuals with a history of three or more previous episodes of depression completed self-report measures of depressive symptoms, rumination—including subscales for reflection and brooding—and mindfulness, as well as an autobiographical memory task to assess memory specificity. In those low in both mindfulness and memory specificity, higher levels of reflection were related to more depressive symptoms, whereas in all other groups higher levels of reflection were related to fewer depressive symptoms. The results demonstrate that the relation between reflective pondering and depressive symptoms varies depending on individual state or trait factors. In previously depressed individuals, the cognitive problem-solving aspect of reflection may be easily hampered when tendencies toward unspecific processing are increased, and awareness of mental processes such as self-judgment and reactivity is decreased. PMID:25643201

  16. Depressive Symptoms and Subjective And Objective Sleep In Community-Dwelling Older Women

    PubMed Central

    Maglione, Jeanne E.; Ancoli-Israel, Sonia; Peters, Katherine W.; Paudel, Misti L.; Yaffe, Kristine; Ensrud, Kristine E.; Stone, Katie L.

    2012-01-01

    Objectives To examine the relationship between depressive symptoms and subjective and objective sleep in older women. Design Cross-sectional. Setting Four US clinical centers. Participants 3045 community-dwelling women ≥70 years. Measurements Depressive symptoms were assessed with the Geriatric Depression Scale categorizing participants as “normal” (0–2, referent), “some depressive symptoms” (3–5), or “depressed” (≥6). Subjective sleep quality and daytime sleepiness were assessed using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Objective sleep measures were assessed with wrist actigraphy. Results In multivariable-adjusted models, there were graded associations between increased level of depressive symptoms and both worse subjective sleep quality and more subjective daytime sleepiness (p-trends <0.001). Women with some depressive symptoms (OR 1.82, CI 1.48–2.24) and depressed (OR 2.84, CI 2.08–3.86) women had greater odds of reporting poor sleep (PSQI>5). Women with some depressive symptoms (OR 1.97, CI 1.47–2.64) and depressed women (OR 1.70, CI 1.12–2.58) had greater odds of reporting excessive daytime sleepiness (ESS>10). There were also graded associations between increased level of depressive symptoms and objectively measured wake after sleep onset (WASO) (p-trend = 0.030) and long wake episodes >5 minutes (p-trend 0.006). Depressed women had modestly increased odds of WASO ≥1 hour (OR 1.37, CI 1.03–1.83). Women with some depressive symptoms (OR 1.49, CI 1.19–1.86) and depressed women (OR 2.04, CI 1.52–2.74) had greater odds of being in the highest quartile for number of nap episodes >5 minutes. No associations between depressive symptom level and prolonged sleep latency, reduced sleep efficiency, or reduced or increased total sleep time were found. Conclusion Greater depressive symptom levels were associated with more subjective sleep disturbance and objective evidence of sleep

  17. Mechanisms Underlying Neurocognitive Dysfunctions in Recurrent Major Depression

    PubMed Central

    Gałecki, Piotr; Talarowska, Monika; Anderson, George; Berk, Michael; Maes, Michael

    2015-01-01

    Recent work shows that depression is intimately associated with changes in cognitive functioning, including memory, attention, verbal fluency, and other aspects of higher-order cognitive processing. Changes in cognitive functioning are more likely to occur when depressive episodes are recurrent and to abate to some degree during periods of remission. However, with accumulating frequency and duration of depressive episodes, cognitive deficits can become enduring, being evident even when mood improves. Such changes in cognitive functioning give depression links to mild cognitive impairment and thereby with neurodegenerative conditions, including Alzheimer’s disease, Parkinson’s disease, schizophrenia, and multiple sclerosis. Depression may then be conceptualized on a dimension of depression – mild cognitive impairment – dementia. The biological underpinnings of depression have substantial overlaps with those of neurodegenerative conditions, including reduced neurogenesis, increased apoptosis, reactive oxygen species, tryptophan catabolites, autoimmunity, and immune-inflammatory processes, as well as decreased antioxidant defenses. These evolving changes over the course of depressive episodes drive the association of depression with neurodegenerative conditions. As such, the changes in cognitive functioning in depression have important consequences for the treatment of depression and in reconceptualizing the role of depression in wider neuroprogressive conditions. Here we review the data on changes in cognitive functioning in recurrent major depression and their association with other central conditions. PMID:26017336

  18. The Netherlands study of depression in older persons (NESDO); a prospective cohort study

    PubMed Central

    2011-01-01

    Background To study late-life depression and its unfavourable course and co morbidities in The Netherlands. Methods We designed the Netherlands Study of Depression in Older Persons (NESDO), a multi-site naturalistic prospective cohort study which makes it possible to examine the determinants, the course and the consequences of depressive disorders in older persons over a period of six years, and to compare these with those of depression earlier in adulthood. Results From 2007 until 2010, the NESDO consortium has recruited 510 depressed and non depressed older persons (≥ 60 years) at 5 locations throughout the Netherlands. Depressed persons were recruited from both mental health care institutes and general practices in order to include persons with late-life depression in various developmental and severity stages. Non-depressed persons were recruited from general practices. The baseline assessment included written questionnaires, interviews, a medical examination, cognitive tests and collection of blood and saliva samples. Information was gathered about mental health outcomes and demographic, psychosocial, biological, cognitive and genetic determinants. The baseline NESDO sample consists of 378 depressed (according to DSM-IV criteria) and 132 non-depressed persons aged 60 through 93 years. 95% had a major depression and 26.5% had dysthymia. Mean age of onset of the depressive disorder was around 49 year. For 33.1% of the depressed persons it was their first episode. 41.0% of the depressed persons had a co morbid anxiety disorder. Follow up assessments are currently going on with 6 monthly written questionnaires and face-to-face interviews after 2 and 6 years. Conclusions The NESDO sample offers the opportunity to study the neurobiological, psychosocial and physical determinants of depression and its long-term course in older persons. Since largely similar measures were used as in the Netherlands Study of Depression and Anxiety (NESDA; age range 18-65 years), data

  19. Episodic tremor triggers small earthquakes

    NASA Astrophysics Data System (ADS)

    Balcerak, Ernie

    2011-08-01

    It has been suggested that episodic tremor and slip (ETS), the weak shaking not associated with measurable earthquakes, could trigger nearby earthquakes. However, this had not been confirmed until recently. Vidale et al. monitored seismicity in the 4-month period around a 16-day episode of episodic tremor and slip in March 2010 in the Cascadia region. They observed five small earthquakes within the subducting slab during the ETS episode. They found that the timing and locations of earthquakes near the tremor suggest that the tremor and earthquakes are related. Furthermore, they observed that the rate of earthquakes across the area was several times higher within 2 days of tremor activity than at other times, adding to evidence of a connection between tremor and earthquakes. (Geochemistry, Geophysics, Geosystems, doi:10.1029/2011GC003559, 2011)

  20. Behind the Webb Episode 27

    NASA Video Gallery

    This episode of "Behind the Webb" explores the multi-tasking capabilities of one of the cameras on the Webb Space Telescope, the Near-Infrared Spectrograph. Newly designed technology known as "micr...

  1. Episodic plate tectonics on Venus

    NASA Technical Reports Server (NTRS)

    Turcotte, Donald

    1992-01-01

    Studies of impact craters on Venus from the Magellan images have placed important constraints on surface volcanism. Some 840 impact craters have been identified with diameters ranging from 2 to 280 km. Correlations of this impact flux with craters on the Moon, Earth, and Mars indicate a mean surface age of 0.5 +/- 0.3 Ga. Another important observation is that 52 percent of the craters are slightly fractured and only 4.5 percent are embayed by lava flows. These observations led researchers to hypothesize that a pervasive resurfacing event occurred about 500 m.y. ago and that relatively little surface volcanism has occurred since. Other researchers have pointed out that a global resurfacing event that ceased about 500 MYBP is consistent with the results given by a recent study. These authors carried out a series of numerical calculations of mantle convection in Venus yielding thermal evolution results. Their model considered crustal recycling and gave rapid planetary cooling. They, in fact, suggested that prior to 500 MYBP plate tectonics was active in Venus and since 500 MYBP the lithosphere has stabilized and only hot-spot volcanism has reached the surface. We propose an alternative hypothesis for the inferred cessation of surface volcanism on Venus. We hypothesize that plate tectonics on Venus is episodic. Periods of rapid plate tectonics result in high rates of subduction that cool the interior resulting in more sluggish mantle convection.

  2. Effectiveness of a Web-Based Guided Self-help Intervention for Outpatients With a Depressive Disorder: Short-term Results From a Randomized Controlled Trial

    PubMed Central

    Cuijpers, Pim; Beekman, Aartjan; van Straten, Annemieke

    2016-01-01

    Background Research has convincingly demonstrated that symptoms of depression can be reduced through guided Internet-based interventions. However, most of those studies recruited people form the general population. There is insufficient evidence for the effectiveness when delivered in routine clinical practice in outpatient clinics. Objective The objective of this randomized controlled trial was to study patients with a depressive disorder (as defined by the Diagnostic and Statistical Manual of Disorders, fourth edition), as assessed by trained interviewers with the Composite International Diagnostic Interview, who registered for treatment at an outpatient mental health clinic. We aimed to examine the effectiveness of guided Internet-based self-help before starting face-to-face treatment. Methods We recruited 269 outpatients, aged between 18 and 79 years, from outpatient clinics and randomly allocated them to Internet-based problem solving therapy (n=136), with weekly student support, or to a control condition, who remained on the waitlist with a self-help booklet (control group; n=133). Participants in both conditions were allowed to take up face-to-face treatment at the outpatient clinics afterward. We measured the primary outcome, depressive symptoms, by Center for Epidemiological Studies Depression scale (CES-D). Secondary outcome measures were the Hospital Anxiety and Depression Scale Anxiety subscale (HADS-A), Insomnia Severity Index questionnaire (ISI), and EuroQol visual analog scale (EQ-5D VAS). All outcomes were assessed by telephone at posttest (8 weeks after baseline). Results Posttest measures were completed by 184 (68.4%) participants. We found a moderate to large within-group effect size for both the intervention (d=0.75) and the control (d=0.69) group. However, the between-group effect size was very small (d=0.07), and regression analysis on posttreatment CES-D scores revealed no significant differences between the groups (b=1.134, 95% CI –2

  3. Antidepressants worsen rapid-cycling course in bipolar depression: A STEP-BD randomized clinical trial

    PubMed Central

    El-Mallakh, Rif S.; Vöhringer, Paul A.; Ostacher, Michael M.; Baldassano, Claudia F.; Holtzman, Niki S.; Whitham, Elizabeth A.; Thommi, Sairah B.; Goodwin, Frederick K.; Ghaemi, S. Nassir

    2015-01-01

    Background The use of antidepressants in rapid-cycling bipolar disorder has been controversial. We report the first randomized clinical trial with modern antidepressants on this topic. Methods As part of the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study, we analyzed, as an a priori secondary outcome, rapid cycling as a predictor of response in 68 patients randomized to continue versus discontinue antidepressant treatment, after initial response for an acute major depressive episode. Outcomes assessed were percent time well and total number of episodes. All patients received standard mood stabilizers. Results In those continued on antidepressants (AD), rapid cycling (RC) subjects experienced 268% (3.14/1.17) more total mood episodes/year, and 293% (1.29/0.44) more depressive episodes/year, compared with non-rapid cycling (NRC) subjects (mean difference in depressive episodes per year RC vs NRC was 0.85 ± 0.37 (SE), df=28, p =0.03). In the AD continuation group, RC patients also had 28.8% less time in remission than NRC patients (95% confidence intervals [9.9%, 46.5%], p = 0.004). No such differences between RC and NRC subjects were seen in the AD discontinuation group (Table 1). Analyses within the rapid-cycling subgroup alone were consistent with the above comparisons between RC and NRC subjects, stratified by maintenance antidepressant treatment, though limited by sample size. Conclusions In an a priori analysis, despite preselection for good antidepressant response and concurrent mood stabilizer treatment, antidepressant continuation in rapid-cycling was associated with worsened maintenance outcomes, especially for depressive morbidity, versus antidepressant discontinuation. PMID:26142612

  4. Treatment of major depression in later life: a life cycle perspective.

    PubMed

    Reynolds, C F

    1997-01-01

    The goal of this article is to provide a life-cycle perspective on the treatment of major depressive episodes in later life. Our studies have suggested that older patients appear to benefit as much, though perhaps more slowly, than mid-life patients from acute combined treatment (nortriptyline+interpersonal psychotherapy) of major depression. Given also the apparently higher relapse rate among the elderly, however, continuation treatment needs to be vigorous and closely monitored. The occurrence of severe life events prior to the index episode and the co-existence of an anxiety disorder both appear to prolong treatment response times, while chronic medical burden per se neither compromises response rates nor prolongs time to response. Self-rated perception of health improves with remission of depression in the elderly. As in mid-life patients, both antidepressant medication (nortriptyline) and interpersonal psychotherapy appear to possess chronic efficacy with respect to the prevention of recurrent episodes and prolongation of wellness. Finally, treatment of depression in the elderly results in improved quality of life, especially in domains of well being and coping. Particular challenges in the treatment of elderly patients are noncompliance and the prevention of suicide. The latter is closely linked to feelings of hopelessness, and these may be persistent in some patients. PMID:9237318

  5. Efficacy of tianeptine in major depressive disorders with or without melancholia.

    PubMed

    Ginestet, D

    1997-10-01

    The efficacy of tianeptine in the treatment of major depressive episodes was assessed in three double-blind placebo-controlled studies. In a first double-blind study comparing tianeptine (37.5 mg/day) with placebo, 126 patients with Major Depression or a Depressed Bipolar Disorder were treated for 42 days; 60% of these patients fulfilled DSM-III-R criteria for melancholia. Final MADRS scores showed the efficacy of tianeptine in comparison with placebo (P = 0.007). This result was confirmed by the time course of the Severity of Illness (CGI item 1) (P = 0.015). 58% of the patients responded to tianeptine versus 41% to placebo. In another study comparing tianeptine (37.5 mg/day), imipramine (150 mg/day), and placebo, 186 depressed patients were treated for 42 days. The patients had either Major Depression or Depressed Bipolar Disorder, without melancholia (DSM III-R). In the intention-to-treat analysis, final MADRS scores showed a better efficacy of tianeptine and imipramine than placebo (P = 0.012 and P = 0.034, respectively). There were 56% responders on tianeptine vs 48% on imipramine, and 32% on placebo. A third study involved 244 patients with Major Depression with or without melancholia (DSM-III-R). They were treated in a parallel group design with tianeptine (37.5 mg/day) or tianeptine (75 mg/day) or placebo for 42 days. The high rate of placebo-responders (> 65%) did not allow any conclusion about the efficacy of tianeptine. Altogether, tianeptine was shown to be an effective and safe medication for the treatment of major depressive episodes. However, a controlled study in endogenous depression would be useful to determine the position of tianeptine among the other antidepressants in this indication.

  6. Cortical thickness differences between bipolar depression and major depressive disorder

    PubMed Central

    Lan, Martin J; Chhetry, Binod Thapa; Oquendo, Maria A; Sublette, M Elizabeth; Sullivan, Gregory; Mann, J John; Parsey, Ramin V

    2014-01-01

    Objectives Bipolar disorder (BD) is a psychiatric disorder with high morbidity and mortality that cannot be distinguished from major depressive disorder (MDD) until the first manic episode. A biomarker able to differentiate BD and MDD could help clinicians avoid risks of treating BD with antidepressants without mood stabilizers. Methods Cortical thickness differences were assessed using magnetic resonance imaging in BD depressed patients (n = 18), MDD depressed patients (n = 56), and healthy volunteers (HVs) (n = 54). A general linear model identified clusters of cortical thickness difference between diagnostic groups. Results Compared to the HV group, the BD group had decreased cortical thickness in six regions, after controlling for age and sex, located within frontal and parietal lobes, and posterior cingulate cortex. Mean cortical thickness changes in clusters ranged from 7.6–9.6% (cluster wise p-values from 1.0 e−4 to 0.037). When compared to MDD, three clusters of lower cortical thickness in BD were identified that overlapped with clusters that differentiated the BD and HV groups. Mean cortical thickness changes in the clusters ranged from 7.5–8.2% (cluster wise p-values from 1.0 e−4 to 0.023). The difference in cortical thickness was more pronounced when the subgroup of subjects with bipolar I disorder (BD-I) was compared to the MDD group. Conclusions Cortical thickness patterns were distinct between BD and MDD. These results are a step toward developing an imaging test to differentiate the two disorders. PMID:24428430

  7. Attentional capture by emotional scenes across episodes in bipolar disorder: Evidence from a free-viewing task.

    PubMed

    García-Blanco, Ana; Salmerón, Ladislao; Perea, Manuel

    2015-05-01

    We examined whether the initial orienting, subsequent engagement, and overall allocation of attention are determined exogenously (i.e. by the affective valence of the stimulus) or endogenously (i.e. by the participant's mood) in the manic, depressive and euthymic episodes of bipolar disorder (BD). Participants were asked to compare the affective valence of two pictures (happy/threatening/neutral [emotional] vs. neutral [control]) while their eye movements were recorded in a free-viewing task. Results revealed that the initial orienting was exogenously captured by emotional images relative to control images. Importantly, engagement and overall allocation were endogenously captured by threatening images relative to neutral images in BD patients, regardless of their episode--this effect did not occur in a group of healthy controls. The threat-related bias in BD, which occurs even at the early stages of information processing (i.e. attentional engagement), may reflect a vulnerability marker.

  8. Attentional capture by emotional scenes across episodes in bipolar disorder: Evidence from a free-viewing task.

    PubMed

    García-Blanco, Ana; Salmerón, Ladislao; Perea, Manuel

    2015-05-01

    We examined whether the initial orienting, subsequent engagement, and overall allocation of attention are determined exogenously (i.e. by the affective valence of the stimulus) or endogenously (i.e. by the participant's mood) in the manic, depressive and euthymic episodes of bipolar disorder (BD). Participants were asked to compare the affective valence of two pictures (happy/threatening/neutral [emotional] vs. neutral [control]) while their eye movements were recorded in a free-viewing task. Results revealed that the initial orienting was exogenously captured by emotional images relative to control images. Importantly, engagement and overall allocation were endogenously captured by threatening images relative to neutral images in BD patients, regardless of their episode--this effect did not occur in a group of healthy controls. The threat-related bias in BD, which occurs even at the early stages of information processing (i.e. attentional engagement), may reflect a vulnerability marker. PMID:25796341

  9. [Spontaneous course of depression].

    PubMed

    Azorin, J M

    1995-03-01

    The study of the spontaneous course of depressions nowadays comes up against a number of obstacles. The most important of these is the necessity of using untreated cases, which virtually forces the contemporary researcher to refer to studies performed in the pretherapeutic era, if conclusions are not be drawn only from classical descriptions. Unfortunately, these studies are marked by the absence of strict diagnostic criteria, the heterogeneity of patients included in them, the lack of preciseness of evaluations and the primitive statistical methods used. They are concerned essentially with the duration of depressive phases and the factors which influence it. Among these latter are regularly found age, sex, the number of episodes, the duration of the preceding symptom-free interval, the severity and semiology of the attack, heredity, mode of onset, level of intelligence, the presence or absence of associated pathology and the presence or absence of hospitalisation. Chronicization of depression and the factors concerned with it have also been the object of several studies. A small number of investigations compare the course of the illness in untreated populations. The study of the spontaneous course of depression evidences the necessity of having consensus definitions, and may serve as a basis for a better comprehension of the process of cure and of the real impact of therapies designed to treat depression.

  10. Episodic Accretion among the Orion Protostars

    NASA Astrophysics Data System (ADS)

    Fischer, William J.; Safron, Emily; Megeath, S. Thomas

    2016-06-01

    Episodic accretion, where a young stellar object undergoes stochastic spikes in its disk-to-star accretion rate one or more times over its formation period, may be a crucial process in the formation of low-mass stars. These spikes result in a factor of 10 to 100 increase in the source luminosity over the course of several months that may persist for years. Six years after the Spitzer survey of the Orion molecular clouds, the WISE telescope mapped Orion with similar wavelength coverage. Thus, the two surveys can be used to explore the mid-infrared variability of young stars on this timescale, which is suitable for discovering episodic accretion events. Out of 319 Orion protostars that were targets of the Herschel Orion Protostar Survey, we identified two examples of episodic accretion with this method. One of them, HOPS 223, was previously known. The other, HOPS 383, is the first known example of episodic accretion in a Class 0 protostar (age < 0.2 Myr). With these and one other outburst that began early in the Spitzer mission, we estimate that the most likely interval between protostellar outbursts is 740 years, with a 90% confidence interval of 470 to 6200 years. These outbursts are weaker than the optically revealed FU Ori events. We will update the mid-infrared light curves of HOPS 223 and HOPS 383 with recent data from FORCAST aboard SOFIA; HOPS 223 shows signs of fading.

  11. Context Prediction Analysis and Episodic Memory

    PubMed Central

    Mizumori, Sheri J. Y.

    2013-01-01

    Events that happen at a particular place and time come to define our episodic memories. Extensive experimental and clinical research illustrate that the hippocampus is central to the processing of episodic memories, and this is in large part due to its analysis of context information according to spatial and temporal references. In this way, hippocampus defines ones expectations for a given context as well as detects errors in predicted contextual features. The detection of context prediction errors is hypothesized to distinguished events into meaningful epochs that come to be recalled as separate episodic memories. The nature of the spatial and temporal context information processed by hippocampus is described, as is a hypothesis that the apparently self-regulatory nature of hippocampal context processing may ultimately be mediated by natural homeostatic operations and plasticity. Context prediction errors by hippocampus are suggested to be valued by the midbrain dopamine system, the output of which is ultimately fed back to hippocampus to update memory-driven context expectations for future events. Thus, multiple network functions (both within and outside hippocampus) combine to result in adaptive episodic memories. PMID:24109442

  12. Cost effectiveness of olanzapine in prevention of affective episodes in bipolar disorder in the United Kingdom.

    PubMed

    McKendrick, J; Cerri, K H; Lloyd, A; D'Ausilio, A; Dando, S; Chinn, C

    2007-08-01

    This study evaluated the cost effectiveness of olanzapine compared with lithium as maintenance therapy for patients with bipolar I disorder (BP1) in the UK. A Markov model was developed to assess costs and outcomes from the perspective of the UK National Health Service over a 1-year period. Patients enter the model after stabilization of a manic episode and are then treated with olanzapine or lithium. Using the findings of a recent randomized clinical trial, the model considers the monthly risk of manic or depressive episodes and of dropping out from allocated therapy. health care resources associated with acute episodes were derived primarily from a recent UK chart review. Costs of maintenance therapy and monitoring were also considered. Key factors influencing cost effectiveness were identified and included in a stochastic sensitivity analysis. The model estimated that, compared to lithium, olanzapine significantly reduced the annual number of acute mood episodes per patient from 0.81 to 0.58 (difference -0.23; 95% CI: -0.34, -0.12). Per patient average annual care costs fell by 799 UK pounds (95% CI: - 1,824 UK pounds, 59 UK pounds) driven by reduced inpatient days--but the cost difference was not statistically significant. Sensitivity analysis found the results to be robust to plausible variation in the model's parameters. The model estimated that using olanzapine instead of lithium as maintenance therapy for BP1 would significantly reduce the rate of acute mood events resulting in reduced hospital costs. Based on available evidence, there is a high likelihood that olanzapine would reduce costs of care compared to lithium.

  13. Episodic phrenic-inhibitory vagus nerve stimulation paradoxically induces phrenic long-term facilitation in rats

    PubMed Central

    Zhang, Yi; McGuire, Michelle; White, David P; Ling, Liming

    2003-01-01

    All respiratory long-term facilitation (LTF) is induced by inspiratory-excitatory stimulation, suggesting that LTF needs inspiratory augmentation and is the result of a Hebbian mechanism (coincident pre- and post-synaptic activity strengthens synapses). The present study examined the long-term effects of episodic inspiratory-inhibitory vagus nerve stimulation (VNS) on phrenic nerve activity. We hypothesized that episodic VNS would induce phrenic long-term depression. The results are compared with those obtained following serotonin receptor antagonism or episodic carotid sinus nerve stimulation (CSNS). Integrated phrenic neurograms were measured before, during and after three episodes of 5 min VNS (50 Hz, 0.1 ms), each separated by a 5 min interval, at a low (˜50 μA), medium (˜200 μA) or high (˜500 μA) stimulus intensity in anaesthetized, vagotomized, neuromuscularly blocked and artificially ventilated rats. Medium- and high-intensity VNS eliminated rhythmic phrenic activity during VNS, while low-intensity VNS only reduced phrenic burst frequency. At 60 min post-VNS, phrenic amplitude was higher than baseline (35 ± 5 % above baseline, mean ± S.E.M., P < 0.05) in the high-intensity group but not in the low- (−4 ± 4 %) or medium-intensity groups (−10 ± 15 %), or in the high-intensity with methysergide group (4 mg kg−1, I.P.) (−11 ± 5 %). These data, which are inconsistent with our hypothesis, indicate that phrenic-inhibitory VNS induces a serotonin-dependent phrenic LTF similar to that induced by phrenic-excitatory CSNS (33 ± 7 %) and may require activation of high-threshold afferent fibres. These data also suggest that the synapses on phrenic motoneurons do not use the Hebbian mechanism in this LTF, as these motoneurons were suppressed during VNS. PMID:12872010

  14. Emotional stress-reactivity and positive affect among college students: the role of depression history.

    PubMed

    O'Hara, Ross E; Armeli, Stephen; Boynton, Marcella H; Tennen, Howard

    2014-02-01

    Multiple theories posit that people with a history of depression are at higher risk for a depressive episode than people who have never experienced depression, which may be partly due to differences in stress-reactivity. In addition, both the dynamic model of affect and the broaden-and-build theory suggest that stress and positive affect interact to predict negative affect, but this moderation has never been tested in the context of depression history. The current study used multilevel modeling to examine these issues among 1,549 college students with or without a history of depression. Students completed a 30-day online diary study in which they reported daily their perceived stress, positive affect, and negative affect (including depression, anxiety, and hostility). On days characterized by higher than usual stress, students with a history of depression reported greater decreases in positive affect and greater increases in depressed affect than students with no history. Furthermore, the relations between daily stress and both depressed and anxious affect were moderated by daily positive affect among students with remitted depression. These results indicate that students with a history of depression show greater stress-reactivity even when in remission, which may place them at greater risk for recurrence. These individuals may also benefit more from positive affect on higher stress days despite being less likely to experience positive affect on such days. The current findings have various implications both clinically and for research on stress, mood, and depression. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

  15. Clinical Impact of the Temporal Relationship between Depression and Type 2 Diabetes: The Fremantle Diabetes Study Phase II

    PubMed Central

    Bruce, David G.; Davis, Wendy A.; Cetrullo, Violetta; Starkstein, Sergio E.; Davis, Timothy M. E.

    2013-01-01

    Background The clinical features of type 2 diabetes may differ depending on whether first depression episode precedes or follows the diagnosis of diabetes. Methods Type 2 patients from the observational community-based Fremantle Diabetes Study Phase II underwent assessment of lifetime depression using the Brief Lifetime Depression Scale (developed and validated for this study) supplemented by information on current depression symptoms (Patient Health Questionnaire, 9-item version) and use of antidepressants. Patients were categorized as never depressed (Group 1), having had depression before diabetes diagnosis (Group 2), diagnosed with depression and diabetes within 2 years of each other (Group 3) and having depression after diabetes diagnosis (Group 4). Results Of 1391 patients, 20.8% were assigned to Group 2, 6.0% to Group 3 and 14.5% to Group 4. In Group 2, depression occurred a median 15.6 years before diabetes onset at age 37.2±14.7 years. These patients had similar clinical characteristics to never depressed patients except for reduced self-care behaviours and having more symptomatic peripheral arterial disease. In Group 4, depression occurred a median 9.9 years after diabetes onset at age 59.8±13.0 years. These patients had long duration diabetes, poor glycaemic control, more intensive management and more diabetic complications. Group 4 patients had more current depression than Group 2 but were less likely to be receiving antidepressants. Conclusions/Interpretation The clinical features of depression and type 2 diabetes are heterogeneous depending on their temporal relationship. There may be corresponding differences in the pathogenesis of depression in diabetes that have implications for diagnosis and management. PMID:24324682

  16. The Efficacy of Two Adolescent Substance Abuse Treatments and the Impact of Comorbid Depression: Results of a Small Randomized Controlled Trial

    PubMed Central

    Santisteban, Daniel A.; Mena, Maite P.; Muir, Joan; McCabe, Brian E.; Abalo, Clara; Cummings, Amanda M.

    2016-01-01

    Objective The purpose of this randomized trial was to investigate the efficacy of two behavioral treatments focusing on different change mechanisms in ameliorating a borderline personality disorder constellation of behaviors and substance use in adolescents referred by juvenile diversion programs. Methods Forty adolescents 14 to 17 years of age and meeting DSM IV criteria for borderline personality disorder and substance use disorders were randomized to Integrative Borderline Personality Disorder-Oriented Adolescent Family Therapy (I-BAFT) or Individual Drug Counseling (IDC). This design allowed a comparison of two manualized interventions, one family-based and one individually-oriented. Profiles of clinical change were used to detect impact and to estimate treatment effect sizes. Results Primary analyses showed that both interventions had a clinically significant impact on borderline personality disorder behaviors 12 months after baseline but with no differential treatment effects. The impact on substance use was more complex. Subgroup analyses revealed that adolescents with depression had significantly more severe profiles of borderline personality disorder and substance use. These youth were the only group to show reductions in substance use, but only if they received the I-BAFT intervention. Study data also documented the high dosage of intensive residential treatment needed by this population. Conclusions and Implications for Practice Results highlight the intensive treatment needs of juvenile justice involved youth with co-occurring substance use and borderline personality disorder including depression, the hybrid outpatient and residential treatment often required by this population, and the promise of a family oriented approach particularly for youth with severe symptoms and co-occurring depression. PMID:25799306

  17. Mindfulness predicts relapse/recurrence in major depressive disorder after mindfulness-based cognitive therapy.

    PubMed

    Michalak, Johannes; Heidenreich, Thomas; Meibert, Petra; Schulte, Dietmar

    2008-08-01

    Empirical evidence for the effectiveness of mindfulness-based cognitive therapy (MBCT) is encouraging. However, data concerning the role of mindfulness in its relapse preventive effect are lacking. In our study, 25 formerly depressed patients received MBCT. Mindfulness was assessed before and immediately after MBCT using the Mindful Attention and Awareness Scale. Mindfulness significantly increased during MBCT, and posttreatment levels of mindfulness predicted the risk of relapse/recurrence to major depressive disorder in the 12-month follow-up period. Mindfulness predicted the risk of relapse/recurrence after controlling for numbers of previous episodes and residual depressive symptoms. The results provide preliminary evidence for the notion that mindfulness is an important factor in relapse prevention in major depression.

  18. Clinical safety and efficacy of tianeptine in 1,858 depressed patients treated in general practice.

    PubMed

    Guelfi, J D; Dulcire, C; Le Moine, P; Tafani, A

    1992-01-01

    1,927 outpatients were included by 392 general practitioners in an open study in order to evaluate the safety of tianeptine in the ambulatory treatment of depression. The results of 1,858 depressed patients without melancholia and psychotic features, fulfilling DSM III criteria of Major Depressive Episode or Dysthymic Disorder, could be analysed. 1,458 patients completed the 3-month treatment period. The group treated with 37.5 mg/day of tianeptine showed improvement on the Montgomery-Asberg Depression Rating Scale. With regard to the clinical tolerance of tianeptine, somatic complaints were rarely reported and adverse events necessitating premature termination of treatment (4.8% of included patients) were without clinical severity. Cardiovascular, haematologic, hepatic and biochemical safety were verified. No signs of dependence and no specific withdrawal symptoms were found after discontinuation of treatment.

  19. Perceived family functioning in depressed Chinese couples: a cross-sectional study.

    PubMed

    Wang, Jikun; Zhao, Xudong

    2013-03-01

    This study investigated family functioning in Chinese couples with a first episode of major depression, and in normal controls, and examined the association between depression severity and family impairment. Seventy-four patients with a first episode of major depression and 73 normal controls, together with their respective spouses, were assessed using the Family Assessment Device and Beck Depression Inventory. Patients with a first episode of major depression reported significantly higher Family Assessment Device scores for all dimensions compared with normal controls. Beck Depression Inventory scores were positively associated with Family Assessment Device scores for patients with a first episode of major depression for five dimensions, but not for affective responsiveness and affective involvement. A first episode of major depression was thus associated with impaired family functioning in Chinese families, and depression severity was positively associated with family impairment for the depressed patients. These findings indicate the importance of including family interventions in the treatment of Chinese patients with a first episode of major depression. PMID:23078006

  20. Emotion recognition from dynamic emotional displays following anterior cingulotomy and anterior capsulotomy for chronic depression.

    PubMed

    Ridout, Nathan; O'Carroll, Ronan E; Dritschel, Barbara; Christmas, David; Eljamel, Muftah; Matthews, Keith

    2007-04-01

    Four patients that had received an anterior cingulotomy (ACING) and five patients that had received both an ACING and an anterior capsulotomy (ACAPS) as an intervention for chronic, treatment refractory depression were presented with a series of dynamic emotional stimuli and invited to identify the emotion portrayed. Their performance was compared with that of a group of non-surgically treated patients with major depression (n=17) and with a group of matched, never-depressed controls (n=22). At the time of testing, four of the nine neurosurgery patients had recovered from their depressive episode, whereas five remained depressed. Analysis of emotion recognition accuracy revealed no significant differences between depressed and non-depressed neurosurgically treated patients. Similarly, no significant differences were observed between the patients treated with ACING alone and those treated with both ACING and ACAPS. Comparison of the emotion recognition accuracy of the neurosurgically treated patients and the depressed and healthy control groups revealed that the surgically treated patients exhibited a general impairment in their recognition accuracy compared to healthy controls. Regression analysis revealed that participants' emotion recognition accuracy was predicted by the number of errors they made on the Stroop colour-naming task. It is plausible that the observed deficit in emotion recognition accuracy was a consequence of impaired attentional control, which may have been a result of the surgical lesions to the anterior cingulate cortex.

  1. Course and Severity of Maternal Depression: Associations with Family Functioning and Child Adjustment

    ERIC Educational Resources Information Center

    Foster, Cynthia Ewell; Webster, Melissa C.; Weissman, Myrna M.; Pilowsky, Daniel J.; Wickramaratne, Priya J.; Rush, A. John; Hughes, Carroll W.; Garber, Judy; Malloy, Erin; Cerda, Gabrielle; Kornstein, Susan G.; Alpert, Jonathan E.; Wisniewski, Stephen R.; Trivedi, Madhukar H.; Fava, Maurizio; King, Cheryl A.

    2008-01-01

    Number of lifetime episodes, duration of current episode, and severity of maternal depression were investigated in relation to family functioning and child adjustment. Participants were the 151 mother-child pairs in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) child multi-site study. Mothers were diagnosed with Major…

  2. Cognition - Childhood Maltreatment Interactions in the Prediction of Antidepressant Outcomes in Major Depressive Disorder Patients: Results from the iSPOT-D Trial

    PubMed Central

    Miller, Shefali; McTeague, Lisa M.; Gyurak, Anett; Patenaude, Brian; Williams, Leanne M.; Grieve, Stuart M.; Korgaonkar, Mayuresh S.; Etkin, Amit

    2016-01-01

    Background Childhood maltreatment history has been associated with poor treatment response in major depressive disorder (MDD), but the mechanisms underlying this relationship remain opaque. Dysfunction in the neural circuits for executive cognition is a putative neurobiological consequence of childhood maltreatment that may contribute importantly to adverse clinical outcomes. We used behavioral and neuroimaging measures of executive functioning to assess their contribution to the relationship between childhood maltreatment and antidepressant response in MDD patients. Methods 98 medication-free MDD outpatients participating in the International Study to Predict Optimized Treatment in Depression were assessed at baseline on behavioral neurocognitive measures and functional magnetic resonance imaging during tasks probing working memory (continuous performance task, CPT) and inhibition (Go/No-go). 77 patients completed 8 weeks of antidepressant treatment. Baseline behavioral and neuroimaging measures were assessed in relation to childhood maltreatment (history of childhood physical, sexual, and/or emotional abuse) and post-treatment depression outcomes. Results Patients with maltreatment exhibited decreased modulation of right dorsolateral prefrontal cortex (DLPFC) activity during working memory updating on the CPT, and a corresponding impairment in CPT behavioral performance outside the scanner. No between-group differences were found for imaging or behavior on the Go/No-go test of inhibition. Greater DLPFC activity during CPT significantly predicted post-treatment symptom improvement in patients without maltreatment, whereas the relationship between DLPFC activity and symptom change was non-significant, and in the opposite direction, in patients with maltreatment. Conclusions The effect of childhood maltreatment on prefrontal circuitry involved in executive function is a potential predictor of antidepressant outcomes. PMID:25917683

  3. Factitious psychogenic nonepileptic paroxysmal episodes

    PubMed Central

    Romano, Alissa; Alqahtani, Saeed; Griffith, James; Koubeissi, Mohamad Z.

    2014-01-01

    Mistaking psychogenic nonepileptic paroxysmal episodes (PNEPEs) for epileptic seizures (ES) is potentially dangerous, and certain features should alert physicians to a possible PNEPE diagnosis. Psychogenic nonepileptic paroxysmal episodes due to factitious seizures carry particularly high risks of morbidity or mortality from nonindicated emergency treatment and, often, high costs in wasted medical treatment expenditures. We report a case of a 28-year-old man with PNEPEs that were misdiagnosed as ES. The patient had been on four antiseizure medications (ASMs) with therapeutic serum levels and had had multiple intubations in the past for uncontrolled episodes. He had no episodes for two days of continuous video-EEG monitoring. He then disconnected his EEG cables and had an episode of generalized stiffening and cyanosis, followed by jerking and profuse bleeding from the mouth. The manifestations were unusually similar to those of ES, except that he was clearly startled by spraying water on his face, while he was stiff in all extremities and unresponsive. There were indications that he had sucked blood from his central venous catheter to expel through his mouth during his PNEPEs while consciously holding his breath. Normal video-EEG monitoring; the patient's volitional and deceptive acts to fabricate the appearance of illness, despite pain and personal endangerment; and the absence of reward other than remaining in a sick role were all consistent with a diagnosis of factitious disorder. PMID:25667902

  4. Factitious psychogenic nonepileptic paroxysmal episodes.

    PubMed

    Romano, Alissa; Alqahtani, Saeed; Griffith, James; Koubeissi, Mohamad Z

    2014-01-01

    Mistaking psychogenic nonepileptic paroxysmal episodes (PNEPEs) for epileptic seizures (ES) is potentially dangerous, and certain features should alert physicians to a possible PNEPE diagnosis. Psychogenic nonepileptic paroxysmal episodes due to factitious seizures carry particularly high risks of morbidity or mortality from nonindicated emergency treatment and, often, high costs in wasted medical treatment expenditures. We report a case of a 28-year-old man with PNEPEs that were misdiagnosed as ES. The patient had been on four antiseizure medications (ASMs) with therapeutic serum levels and had had multiple intubations in the past for uncontrolled episodes. He had no episodes for two days of continuous video-EEG monitoring. He then disconnected his EEG cables and had an episode of generalized stiffening and cyanosis, followed by jerking and profuse bleeding from the mouth. The manifestations were unusually similar to those of ES, except that he was clearly startled by spraying water on his face, while he was stiff in all extremities and unresponsive. There were indications that he had sucked blood from his central venous catheter to expel through his mouth during his PNEPEs while consciously holding his breath. Normal video-EEG monitoring; the patient's volitional and deceptive acts to fabricate the appearance of illness, despite pain and personal endangerment; and the absence of reward other than remaining in a sick role were all consistent with a diagnosis of factitious disorder. PMID:25667902

  5. Family Group Cognitive-Behavioral Preventive Intervention for Families of Depressed Parents: 18- and 24-month Outcomes

    PubMed Central

    Compas, Bruce E.; Forehand, Rex; Thigpen, Jennifer C.; Keller, Gary; Hardcastle, Emily J.; Cole, David A.; Potts, Jennifer; Haker, Kelly; Rakow, Aaron; Colletti, Christina; Reeslund, Kristen; Fear, Jessica; Garai, Emily; McKee, Laura; Merchant, M.J.; Roberts, Lorinda

    2014-01-01

    Objective In a long-term follow-up of a randomized controlled trial (Compas et al., 2009), to examine the effects at 18- and 24-month follow-ups of a Family Group Cognitive Behavioral (FGCB) preventive intervention for mental health outcomes for children and parents from families (N = 111) of parents with a history of major depressive disorder (MDD). Method Parents with a history of MDD and their 9 to 15-year-old children were randomly assigned to a FGCB intervention or a Written Information (WI) comparison condition. Children’s internalizing, externalizing, anxiety/depression, and depressive symptoms, episodes of MDD and other psychiatric diagnoses, and parents’ depressive symptoms and episodes of MDD were assessed at 18- and 24-months after randomization. Results Children in the FGCB condition were significantly lower in self-reports of anxiety/depression and internalizing symptoms at 18-months and significantly lower in externalizing symptoms at 18- and 24-months. Rates of MDD were significantly lower for children in the FGCB intervention over the 24-month follow-up (odds ratio = 2.91). No significant effects were found for parents’ symptoms of depression or episodes of MDD. Conclusions Support was found for a FGCB preventive intervention for children of parents with a history of MDD significantly reducing children’s episodes of MDD over a period of 2 years. Significant effects for the FGCB intervention were also found on internalizing and externalizing symptoms, with stronger effects at 18- than at 24-month follow-up. PMID:21707137

  6. Episodic Memory: A Comparative Approach

    PubMed Central

    Martin-Ordas, Gema; Call, Josep

    2013-01-01

    Historically, episodic memory has been described as autonoetic, personally relevant, complex, context-rich, and allowing mental time travel. In contrast, semantic memory, which is theorized to be free of context and personal relevance, is noetic and consists of general knowledge of facts about the world. The field of comparative psychology has adopted this distinction in order to study episodic memory in non-human animals. Our aim in this article is not only to reflect on the concept of episodic memory and the experimental approaches used in comparative psychology to study this phenomenon, but also to provide a critical analysis of these paradigms. We conclude the article by providing new avenues for future research. PMID:23781179

  7. The role of Toronto urban emissions in regional ozone episodes

    NASA Astrophysics Data System (ADS)

    Lin, Xiude; Roussel, Pascal B.; Meld, Octavio T.; Selorio, Percy M.

    To study the impact of the Greater Toronto urban emissions on O 3 levels in southern Ontario, the ambient ozone measurements made in Ontario during the time period of 1979-1988 were analysed. Statistics indicate an O 3 depression associated with the Greater Toronto urban plume under the conditions of regional O 3 episodes. An analysis of the 03 data at Dorset and Stouffville, two rural monitoring sites on the NE to NNE side of Toronto, with screening based on wind measurements, shows a possible negative impact of the Greater Toronto urban plume on the O 3 levels at 40 km downwind under regional episodic conditions. On average, the impact led to an O 3 depression of ˜ 22-27 ppbv within the Greater Toronto urban plume in comparison with the background air. A photochemical transport model was used further to investigate the impact of the Greater Toronto's anthropogenic emissions on O 3 levels downwind. The model includes a photochemical module, a vertical transport module and a horizontal mixing algorithm. Two sets of initial conditions were derived by running the model in the Eulerian mode, and by adjusting emissions to fit the ambient measurements of O 3, NO x and NMHCs under regional episodic conditions. The adjusted anthropogenic emission rates for the Greater Toronto urban area were 72.4 and 83.3 % of their original 1985 inventory values for NO x and NMHCs, respectively. The adjustment may reflect the uncertainties in the emissions inventory. Diurnal variations of the species at virtual receptors located at different downwind distances from Toronto were calculated by running the model following 25 plume puffs consecutively released at 60-minute intervals. The calculated O 3 depression at 40 km downwind is in good agreement with the historical ambient data. Calculated spatial distributions of the daily maximum O 3 levels indicate that, under the regional episodic conditions, there is an 03 depression of about 20 ppbv extending from the Greater Toronto urban core

  8. Episodic future thinking in generalized anxiety disorder.

    PubMed

    Wu, Jade Q; Szpunar, Karl K; Godovich, Sheina A; Schacter, Daniel L; Hofmann, Stefan G

    2015-12-01

    Research on future-oriented cognition in generalized anxiety disorder (GAD) has primarily focused on worry, while less is known about the role of episodic future thinking (EFT), an imagery-based cognitive process. To characterize EFT in this disorder, we used the experimental recombination procedure, in which 21 GAD and 19 healthy participants simulated positive, neutral and negative novel future events either once or repeatedly, and rated their phenomenological experience of EFT. Results showed that healthy controls spontaneously generated more detailed EFT over repeated simulations. Both groups found EFT easier to generate after repeated simulations, except when GAD participants simulated positive events. They also perceived higher plausibility of negative-not positive or neutral-future events than did controls. These results demonstrate a negativity bias in GAD individuals' episodic future cognition, and suggest their relative deficit in generating vivid EFT. We discuss implications for the theory and treatment of GAD. PMID:26398003

  9. Episodic future thinking in generalized anxiety disorder.

    PubMed

    Wu, Jade Q; Szpunar, Karl K; Godovich, Sheina A; Schacter, Daniel L; Hofmann, Stefan G

    2015-12-01

    Research on future-oriented cognition in generalized anxiety disorder (GAD) has primarily focused on worry, while less is known about the role of episodic future thinking (EFT), an imagery-based cognitive process. To characterize EFT in this disorder, we used the experimental recombination procedure, in which 21 GAD and 19 healthy participants simulated positive, neutral and negative novel future events either once or repeatedly, and rated their phenomenological experience of EFT. Results showed that healthy controls spontaneously generated more detailed EFT over repeated simulations. Both groups found EFT easier to generate after repeated simulations, except when GAD participants simulated positive events. They also perceived higher plausibility of negative-not positive or neutral-future events than did controls. These results demonstrate a negativity bias in GAD individuals' episodic future cognition, and suggest their relative deficit in generating vivid EFT. We discuss implications for the theory and treatment of GAD.

  10. The impact of comorbid depression on recovery from personality disorders and improvements in psychosocial functioning: results from a randomized controlled trial.

    PubMed

    Renner, Fritz; Bamelis, Lotte L M; Huibers, Marcus J H; Speckens, Anne; Arntz, Arnoud

    2014-12-01

    Depressive disorders often co-occur with personality disorders. The extent to which depressive disorders influence treatment outcome in personality disorders remains unclear. The aim of this study was to determine the impact of co-morbid depression on recovery from personality disorders and improvements in psychosocial functioning. This study drew data from a randomized-controlled trial in which patients (N = 320) with cluster-c (92%), paranoid, histrionic and/or narcissistic personality disorders received schema-therapy, treatment-as-usual, or clarification-oriented psychotherapy. Recovery from personality disorders at three-year follow-up and improvements in psychosocial functioning over a course of three years was predicted by the diagnostic status of depressive disorders at baseline using mixed model regression analyses. Based on the number of axis-I and axis-II disorders, personality disorder severity and global symptomatic distress and functioning a baseline severity index was computed and included in subsequent analyses to test the specificity of baseline depression in predicting outcomes. Patients with co-occurring depression reported higher baseline severity compared to patients without co-occurring depression. Depression at baseline was associated with lower recovery rates at three-year follow-up (p = 0.01) but this effect disappeared after controlling for baseline severity. Patients with depression at baseline reported higher psychosocial impairments throughout treatment (p < 0.001). Depression at baseline did not moderate treatment effects except for one psychosocial outcome measure. In conclusion, depression is associated with lower recovery rates from personality disorders but this effect disappears when general severity is taken into account. Patients with primarily cluster-c personality disorders and co-occurring depression might benefit from additional depression treatment in terms of improved psychosocial functioning.

  11. Psychiatric disorders and muscle tenderness in episodic and chronic migraine.

    PubMed

    Mongini, Franco; Deregibus, Andrea; Rota, Eugenia

    2005-09-01

    This review first reports on the data concerning the relationship between migraine and personality traits and psychiatric disorders. The relationship between migraine and tenderness of the pericranial and cervical muscles is then discussed. In one study, a psychologic assessment was performed in 56 women with migraine, and the Minnesota Multiphase Personality Inventory (MMPI) and State Trait Anxiety Inventory were administered at baseline (T0) and after 6-7 years (T2). Frequency, severity and duration of migraine were recorded at T0, after treatment (T1) and at T2, and their relationship to the prevalence of depression, MMPI and State Trait Anxiety Inventory data were examined. Pain parameters improved in all patients in T0-1, but were higher at T2 in patients with depression at T0. The patients whose migraine improved at T2 had significantly lower MMPI and State Trait Anxiety Inventory scores at T0 and T2. Moreover, the prevalence of depression of the patients whose migraine improved at T2 was 37.5% at T0 and decreased to 12.5% at T2. The authors subsequently studied the function of the frontal lobe in 23 female patients previously treated for chronic migraine and 23 controls by applying three neuropsychologic tests (gambling task, tower of hanoi-3 and object alternation test). The patient group performed significantly worse on the tower of hanoi-3 and the object alternation test. In order to assess the extent to which muscle tenderness may relate to psychiatric disorders in patients with migraine and tension-type headache, diagnosed according International Headache Society criteria [2004], a psychologic assessment was performed and palpation tenderness scores calculated for the pericranial and cervical muscles in 459 patients. In total, 125 patients had frequent episodic migraine, 97 had chronic migraine, 82 had frequent episodic tension-type headache and chronic tension-type headache was present in 83. In a further 72 patients, both episodic migraine and

  12. Temporal trends of neuro-autonomic complexity during severe episodes of bipolar disorders.

    PubMed

    Nardelli, Mimma; Valenza, Gaetano; Gentili, Claudio; Lanata, Antonio; Scilingo, Enzo Pasquale

    2014-01-01

    Bipolar disorder is a chronic psychiatric condition during which patients experience mood swings among depression, hypomania or mania, mixed state (depression-hypomania) and euthymia, i.e., good affective balance. Nowadays, an objective characterization of the temporal trends of the disease as a response to the pharmacological treatment through physiological signatures, especially during severe episodes, is still missing. In this study we show interesting findings relating neuro-autonomic complexity to severe pathological mood states. More specifically, we studied Sample Entropy (SampEn) measures on Heart Rate Variability series gathered from four bipolar patients recruited within the frame of the European project PSYCHE. Patients were monitored through long term ECG recordings from the first hospital admission until clinical remission, i.e., the euthymic state. We observed that a mood transition from mixed-state to euthymia passing through depression can be characterized by increased SampEn values, i.e. as the patient is going to recover, SampEn increases. These results are in agreement with the current literature reporting on the complexity dynamics of the cardiovascular system and can provide a promising and viable clinical decision support to objectify the diagnosis and improve the management of psychiatric disorders. PMID:25570609

  13. Migration of objects and inferences across episodes.

    PubMed

    Hannigan, Sharon L; Reinitz, Mark Tippens

    2003-04-01

    Participants viewed episodes in the form of a series of photographs portraying ordinary routines (e.g., eating at a restaurant) and later received a recognition test. In Experiment 1, it was shown that objects (e.g., a vase of flowers, a pewter lantern) that appeared in a single episode during the study phase migrated between memories of episodes described by the same abstract schema (e.g., from Restaurant Episode A at study to Restaurant Episode B at test), and not between episodes anchored by different schemas. In Experiment 2, it was demonstrated that backward causal inferences from one study episode influenced memories of other episodes described by the same schema, and that high-schema-relevant items viewed in one episode were sometimes remembered as having occurred in another episode of the same schematic type.

  14. Migration of objects and inferences across episodes.

    PubMed

    Hannigan, Sharon L; Reinitz, Mark Tippens

    2003-04-01

    Participants viewed episodes in the form of a series of photographs portraying ordinary routines (e.g., eating at a restaurant) and later received a recognition test. In Experiment 1, it was shown that objects (e.g., a vase of flowers, a pewter lantern) that appeared in a single episode during the study phase migrated between memories of episodes described by the same abstract schema (e.g., from Restaurant Episode A at study to Restaurant Episode B at test), and not between episodes anchored by different schemas. In Experiment 2, it was demonstrated that backward causal inferences from one study episode influenced memories of other episodes described by the same schema, and that high-schema-relevant items viewed in one episode were sometimes remembered as having occurred in another episode of the same schematic type. PMID:12795485

  15. Cross-sectional study of depression and help-seeking in Uttarakhand, North India

    PubMed Central

    Mathias, Kaaren; Goicolea, Isabel; Kermode, Michelle; Singh, Lawrence; Shidhaye, Rahul; Sebastian, Miguel San

    2015-01-01

    Objectives This study sought to use a population-based cross-sectional survey to describe depression prevalence, healthcare seeking and associations with socioeconomic determinants in a district in North India. Setting This study was conducted in Sahaspur and Raipur, administrative blocks of Dehradun district, Uttarakhand, in July 2014. Participants A population-based sample of 960 people over the age of 18 years was selected in 30 randomised clusters after being stratified by rural:urban census ratios. Primary outcome measures The survey used a validated screening tool, Patient Health Questionnaire, to identify people with depression, and collected information regarding socioeconomic variables and help-seeking behaviours. Depression prevalence and health seeking behaviours were calculated, and multivariable logistic regression was used to assess associations between risk factors and depression. Results Prevalence of depression was 6% (58/960), with a further 3.9% (37/960) describing a depressive episode of over 2 weeks in the past 12 months. Statistically significant adjusted OR for depression of more than 2 were found for people who were illiterate, classified as Scheduled Caste/Tribe or Other Backward Castes, living in temporary material housing and who had recently taken a loan. While over three quarters of people with depression (79%) had attended a private or government general medical practitioner in the past 3 months, none had received talking therapy (100% treatment gap) and two people (3.3%) had been prescribed antidepressants. Conclusions There are clear associations between social, educational and economic disadvantage and depression in this population. Strategies that address the social determinants of depression, such as education, social exclusion, financial protection and affordable housing for all are indicated. To address the large treatment gap in Uttarakhand, we must ensure access to primary and secondary mental health providers who can

  16. The Relationship Between Borderline Personality Disorder and Major Depression in Later Life: Acute Versus Temperamental Symptoms

    PubMed Central

    Galione, Janine N.; Oltmanns, Thomas F.

    2012-01-01

    Objective A recent issue in the personality disorder field is the prevalence and course of Axis II symptoms in later life. Focusing on the presentation of personality disorder criteria over time may have some utility in exploring the relationship between borderline personality disorder (BPD) and major depression in older adults. Temperamental personality symptoms are relatively resistant to change but tend to be nonspecific to disorders, while acute symptoms remit relatively quickly. We predicted that temperamental BPD symptoms would be positively correlated with a history of depression and did not expect to find a relationship between major depression and acute BPD symptoms. Method One thousand six hundred and thirty participants between the ages of 55 and 64 were recruited to participate in a community-based longitudinal study representative of the St. Louis area. Participants completed a battery of assessments at baseline, including diagnostic interviews for all ten personality disorders and major depressive disorder. Results Temperamental and acute BPD symptoms were significantly correlated with a history of major depression. After adjustments were made for the effects of temperamental symptoms on depression, acute symptoms were no longer correlated with a history of depression. As predicted, temperamental symptoms remained significantly related to depression, even after controlling for the effects of acute symptoms. BPD acute symptoms showed a unique negative correlation with the amount of time following remission from a depressive episode. Conclusions Overall, this study supports associations between major depression and borderline personality in older adults. The findings indicate that a history of major depression is primarily related to stable BPD symptoms related to emotional distress, which are more prevalent in older adults compared to acute features. PMID:23567384

  17. Major depression during interferon-α treatment: vulnerability and prevention

    PubMed Central

    Lotrich, Francis E.

    2009-01-01

    Major Depressive Disorder (MDD) during interferons (IFN-α) treatment can occur within a few months of therapy, and shares many homologies with other forms of MDD, Most patients are resilient to the side effect ofinterferon-induced depression (IFN-MDD), but 15% to 40% are vulnerable. Several studies have employed antidepressants to prevent the incidence of an IFN-MDD episode, and the results suggest that prophylactic antidepressants may be specifically useful in those with pre-existing subthreshold depressive symptoms andlor a history of prior MDD episodes. Several other potential markers of vulnerability for IFN-MDD have been implicated in assessments of nondepressed patients before they start IFN-α These include poor sleep quality, premorbid elevations in inflammatory cytokines, genetic polymorphisms in the serotonin system, personality, and social support. The interplay of these factors strongly predicts who is at risk for IFN-MDD, and indicates several potentially modifiable targets for the personalized prevention of IFN-MDD, PMID:20135899

  18. Teen Depression

    MedlinePlus

    ... shown that certain types of talk therapy or psychotherapy can help teens deal with depression. These include ... behaviors, and feelings related to depression, and interpersonal psychotherapy, which focuses on working on relationships. Read more ...

  19. Postpartum Depression

    MedlinePlus

    ... do not need treatment. The symptoms of postpartum depression last longer and are more severe. You may ... treatment right away, often in the hospital. Postpartum depression can begin anytime within the first year after ...

  20. Agomelatine for Depression in Schizophrenia: A Case-Series

    PubMed Central

    Mutschler, Jochen; Rüsch, Nicolas; Schönfelder, Herdis; Herwig, Uwe; Brühl, Annette B.; Grosshans, Martin; Rössler, Wulf; Russmann, Heike

    2012-01-01

    Objectives Agomelatine, a melatonin (MT1/MT2) receptor agonist and 5-HT2C receptor antagonist, is a new antidepressant and a potential therapeutic option for major depressive episodes and negative symptoms in persons with schizophrenia. We investigated such treatment outcomes with respect to antidepressant efficacy, safety, and tolerability. Methods We report a consecutive case series of seven patients with schizophrenia and comorbid major depressive symptoms who received agomelatine for a period of at least six weeks in addition to stable doses of antipsychotic agents. General psychopathology, positive, negative and depressive symptoms were assessed with standardized interviews. Relevant blood parameters were assessed. Results Depressive symptoms improved significantly. Positive symptoms remained stable, while negative symptoms and global psychopathology improved significantly. Agomelatine was well tolerated in most patients. Conclusions Our findings provide initial evidence that agomelatine is safe and efficacious in treating depressive symptoms in patients with schizophrenia. Furthermore, agomelatine seems to be effective for the treatment of negative symptoms. Randomized controlled trials are necessary to confirm these first observations.

  1. Multilevel Context of Depression in Two American Indian Tribes

    PubMed Central

    Kaufman, Carol E.; Beals, Janette; Croy, Calvin; Jiang, Luohua; Novins, Douglas K.

    2015-01-01

    Objective Depression is a major debilitating disease. For American Indians living in tribal reservations, who endure disproportionately high levels of stress and poverty often associated with depression, determining the patterns and correlates is key to appropriate clinical assessment and intervention development. Yet, little attention has been given to the cultural context of correlates for depression, including the influence of family, cultural traditions or practices, or community conditions. Method We used data from a large representative psychiatric epidemiological study among American Indians in two reservation communities to estimate nested individual and multilevel models of past-year Major Depressive Episode (MDE) accounting for family, cultural, and community conditions. Results We found that models including culturally informed individual-level measures significantly improved the model fit over demographics alone. We found significant community-level variation in the probability of past-year MDE diagnosis in one tribe even after accounting for individual-level characteristics. Conclusions Accounting for culture, family, and community context will facilitate research, clinician assessment, and treatment of depression in diverse settings. PMID:24016293

  2. Changes in self-schema structure in cognitive therapy for major depressive disorder: a randomized clinical trial.

    PubMed

    Dozois, David J A; Bieling, Peter J; Patelis-Siotis, Irene; Hoar, Lori; Chudzik, Susan; McCabe, Katie; Westra, Henny A

    2009-12-01

    Negative cognitive structure (particularly for interpersonal content) has been shown in some research to persist past a current episode of depression and potentially to be a stable marker of vulnerability for depression (D. J. A. Dozois, 2007; D. J. A. Dozois & K. S. Dobson, 2001a). Given that cognitive therapy (CT) is highly effective for treating the acute phase of a depressive episode and that this treatment also reduces the risk of relapse and recurrence, it is possible that CT may alter these stable cognitive structures. In the current study, patients were randomly assigned to CT+ pharmacotherapy (n = 21) or to pharmacotherapy alone (n = 21). Both groups evidenced significant and similar reductions in level of depression (as measured with the Beck Depression Inventory-II and the Hamilton Rating Scale for Depression), as well as automatic thoughts and dysfunctional attitudes. However, group differences were found on cognitive organization in favor of individuals who received the combination of CT+ pharmacotherapy. The implications of these results for understanding mechanisms of change in therapy and the prophylactic nature of CT are discussed.

  3. Increased cortical-limbic anatomical network connectivity in major depression revealed by diffusion tensor imaging.

    PubMed

    Fang, Peng; Zeng, Ling-Li; Shen, Hui; Wang, Lubin; Li, Baojuan; Liu, Li; Hu, Dewen

    2012-01-01

    Magnetic resonance imaging studies have reported significant functional and structural differences between depressed patients and controls. Little attention has been given, however, to the abnormalities in anatomical connectivity in depressed patients. In the present study, we aim to investigate the alterations in connectivity of whole-brain anatomical networks in those suffering from major depression by using machine learning approaches. Brain anatomical networks were extracted from diffusion magnetic resonance images obtained from both 22 first-episode, treatment-naive adults with major depressive disorder and 26 matched healthy controls. Using machine learning approaches, we differentiated depressed patients from healthy controls based on their whole-brain anatomical connectivity patterns and identified the most discriminating features that represent between-group differences. Classification results showed that 91.7% (patients=86.4%, controls=96.2%; permutation test, p<0.0001) of subjects were correctly classified via leave-one-out cross-validation. Moreover, the strengths of all the most discriminating connections were increased in depressed patients relative to the controls, and these connections were primarily located within the cortical-limbic network, especially the frontal-limbic network. These results not only provide initial steps toward the development of neurobiological diagnostic markers for major depressive disorder, but also suggest that abnormal cortical-limbic anatomical networks may contribute to the anatomical basis of emotional dysregulation and cognitive impairments associated with this disease. PMID:23049910

  4. Treatment of depression in general practice.

    PubMed

    Johnson, D A

    1973-04-01

    With the co-operation of the family doctors in five selected urban general practices the general-practitioner treatment of 73 patients suffering from a new episode of depressive illness was evaluated over a period of four months. The purpose was to test the belief that general practitioners are best fitted to manage most psychological ailments, and depression was chosen as the psychiatric illness most commonly seen in general practice. Medication was the principal treatment offered, and this was often inadequate in dosage or the patient defaulted. Drug defaulting was thought to be due partly to failure of supervision and follow-up and to too low a consultation rate. The low consultation rate was also thought to explain why few patients thought there was a therapeutic value in the doctor-patient relationship. The results of the study indicate that patients with depressive illness do not receive the best treatment in general practice. The reasons are several and responsibility must be shared by the medical practitioners, the current system of the general practice, and the patients themselves.

  5. RAGG - R EPISODIC AGGREGATION PACKAGE

    EPA Science Inventory

    The RAGG package is an R implementation of the CMAQ episodic model aggregation method developed by Constella Group and the Environmental Protection Agency. RAGG is a tool to provide climatological seasonal and annual deposition of sulphur and nitrogen for multimedia management. ...

  6. Perinatal depression

    PubMed Central

    Alhusen, Jeanne L.; Alvarez, Carmen

    2016-01-01

    Abstract: Perinatal depression is a common condition with significant adverse maternal, fetal, neonatal, and early childhood outcomes. The perinatal period is an opportune time to screen, diagnose, and treat depression. Improved recognition of perinatal depression, particularly among low-income women, can lead to improved perinatal health outcomes. PMID:26934457

  7. Reduction of kynurenic acid to quinolinic acid ratio in both the depressed and remitted phases of major depressive disorder.

    PubMed

    Savitz, Jonathan; Drevets, Wayne C; Wurfel, Brent E; Ford, Bart N; Bellgowan, Patrick S F; Victor, Teresa A; Bodurka, Jerzy; Teague, T Kent; Dantzer, Robert

    2015-05-01

    Low-grade inflammation is characteristic of a subgroup of currently depressed patients with major depressive disorder (dMDD). It may lead to the activation of the kynurenine-metabolic pathway and the increased synthesis of potentially neurotoxic metabolites such as 3-hydroxykynurenine (3HK) and quinolinic acid (QA), relative to kynurenic acid (KynA). Nevertheless, few studies have examined whether abnormalities in this pathway are present in remitted patients with MDD (rMDD). Here we compared the serum concentrations of kynurenine metabolites, measured using high performance liquid chromatography with tandem mass spectrometry, across 49 unmedicated subjects meeting DSM-IV-TR criteria for MDD, 21 unmedicated subjects meeting DSM-IV-TR criteria for rMDD, and 58 healthy controls (HCs). There was no significant group difference in the concentrations of the individual kynurenine metabolites, however both the dMDD group and the rMDD group showed a reduction in KynA/QA, compared with the HCs. Further, there was an inverse correlation between KynA/QA and anhedonia in the dMDD group, while in the rMDD group, there was a negative correlation between lifetime number of depressive episodes and KynA/QA as well as a positive correlation between the number of months in remission and KynA/QA. Our results raise the possibility that a persistent abnormality exists within the kynurenine metabolic pathway in MDD that conceivably may worsen with additional depressive episodes. The question of whether persistent abnormalities in kynurenine metabolism predispose to depression and/or relapse in remitted individuals remains unresolved.

  8. Health-related quality of life, depression, and self-esteem in adolescents with leprosy-affected parents: results of a cross-sectional study in Nepal

    PubMed Central

    2013-01-01

    Background Leprosy is a chronic infectious disease that has an impact on the Health-Related Quality of Life (HRQOL) of sufferers as well as their children. To date, no study has investigated the effects of parental leprosy on the well-being of adolescent children. Methods A cross-sectional study was conducted in the Lalitpur and Kathmandu districts of Nepal. Adolescents with leprosy-affected parents (n = 102; aged 11–17 years) and those with parents unaffected by leprosy (n = 115; 11–17 years) were investigated. Self-reported data from adolescents were collected using the Kinder Lebensqualität Fragebogen (KINDLR) questionnaire to assess HRQOL, the Center for Epidemiological Studies-Depression Scale (CES-D), and the Rosenberg Self-esteem Scale (RSES). Analysis of covariance (ANCOVA) was used to compare scores between the two groups. Multiple regression analysis was conducted to explore the determinants of HRQOL for adolescents with leprosy-affected parents. Results ANCOVA revealed that the KINDLR and RSES scores were significantly lower among adolescents with leprosy-affected parents compared with unaffected parents. However, the scores of “Friends” and “School” subscales of KINDLR were similar between the two groups. The CES-D score was significantly higher among adolescents with leprosy-affected parents than for adolescents with unaffected parents. The KINDLR scores for adolescents with both parents affected (n = 41) were significantly lower than the scores for those with one parent affected (n = 61). Multiple regression analysis revealed that adolescents with leprosy-affected parents who had higher levels of depressive symptoms were more likely to have lower KINDLR scores. A similar result was seen for adolescents where both parents had leprosy. Conclusions Adolescents with leprosy-affected parents had higher levels of depressive symptoms, lower levels of self-esteem, and lower HRQOL compared with adolescents whose parents were

  9. Prevalence and Characteristics of Probable Major Depression and Bipolar Disorder within UK Biobank: Cross-Sectional Study of 172,751 Participants

    PubMed Central

    Smith, Daniel J.; Nicholl, Barbara I.; Cullen, Breda; Martin, Daniel; Ul-Haq, Zia; Evans, Jonathan; Gill, Jason M. R.; Roberts, Beverly; Gallacher, John; Mackay, Daniel; Hotopf, Matthew; Deary, Ian; Craddock, Nick; Pell, Jill P.

    2013-01-01

    Objectives UK Biobank is a landmark cohort of over 500,000 participants which will be used to investigate genetic and non-genetic risk factors for a wide range of adverse health outcomes. This is the first study to systematically assess the prevalence and validity of proposed criteria for probable mood disorders within the cohort (major depression and bipolar disorder). Methods This was a descriptive epidemiological study of 172,751 individuals assessed for a lifetime history of mood disorder in relation to a range of demographic, social, lifestyle, personality and health-related factors. The main outcomes were prevalence of a probable lifetime (single) episode of major depression, probable recurrent major depressive disorder (moderate), probable recurrent major depressive disorder (severe), probable bipolar disorder and no history of mood disorder (comparison group). Outcomes were compared on age, gender, ethnicity, socioeconomic status, educational attainment, functioning, self-reported health status, current depressive symptoms, neuroticism score, smoking status and alcohol use. Results Prevalence rates for probable single lifetime episode of major depression (6.4%), probable recurrent major depression (moderate) (12.2%), probable recurrent major depression (severe) (7.2%) and probable bipolar disorder (1.3%) were comparable to those found in other population studies. The proposed diagnostic criteria have promising validity, with a gradient in evidence from no mood disorder through major depression and probable bipolar disorder in terms of gender distribution, socioeconomic status, self-reported health rating, current depressive symptoms and smoking. Significance The validity of our proposed criteria for probable major depression and probable bipolar disorder within this cohort are supported by these cross-sectional analyses. Our findings are likely to prove useful as a framework for a wide range of future genetic and non-genetic studies. PMID:24282498

  10. A Meta-Analysis of Oxidative Stress Markers in Depression

    PubMed Central

    Liu, Tao; Zhong, Shuming; Liao, Xiaoxiao; Chen, Jian; He, Tingting; Lai, Shunkai; Jia, Yanbin

    2015-01-01

    Object Studies have suggested that depression was accompanied by oxidative stress dysregulation, including abnormal total antioxidant capacity (TAC), antioxidants, free radicals, oxidative damage and autoimmune response products. This meta-analysis aims to analyse the clinical data quantitatively by comparing the oxidative stress markers between depressed patients and healthy controls. Methods A search was conducted to collect the studies that measured the oxidative stress markers in depressed patients. Studies were searched in Embase, Medline, PsychINFO, Science direct, CBMDisc, CNKI and VIP from 1990 to May 2015. Data were subjected to meta-analysis by using a random effects model for examining the effect sizes of the results. Bias assessments, heterogeneity assessments and sensitivity analyses were also conducted. Results 115 articles met the inclusion criteria. Lower TAC was noted in acute episodes (AEs) of depressed patients (p<0.05). Antioxidants, including serum paraoxonase, uric acid, albumin, high-density lipoprotein cholesterol and zinc levels were lower than controls (p<0.05); the serum uric acid, albumin and vitamin C levels were increased after antidepressant therapy (p<0.05). Oxidative damage products, including red blood cell (RBC) malondialdehyde (MDA), serum MDA and 8-F2-isoprostanes levels were higher than controls (p<0.05). After antidepressant medication, RBC and serum MDA levels were decreased (p<0.05). Moreover, serum peroxide in free radicals levels were higher than controls (p<0.05). There were no differences between the depressed patients and controls for other oxidative stress markers. Conclusion This meta-analysis supports the facts that the serum TAC, paraoxonase and antioxidant levels are lower, and the serum free radical and oxidative damage product levels are higher than controls in depressed patients. Meanwhile, the antioxidant levels are increased and the oxidative damage product levels are decreased after antidepressant medication

  11. Antipsychotic medication for early episode schizophrenia

    PubMed Central

    Bola, John; Kao, Dennis; Soydan, Haluk; Adams, Clive E

    2014-01-01

    Background Long-term treatment with antipsychotic medications in early episode schizophrenia spectrum disorders is common, but both short and long-term effects on the illness are unclear. There have been numerous suggestions that people with early episodes of schizophrenia appear to respond differently than those with multiple prior episodes. The number of episodes may moderate response to drug treatment. Objectives To assess the effects of antipsychotic medication treatment on people with early episode schizophrenia spectrum disorders. Search methods We searched the Cochrane Schizophrenia Group register (July 2007) as well as references of included studies. We contacted authors of studies for further data. Selection criteria Studies with a majority of first and second episode schizophrenia spectrum disorders comparing initial antipsychotic medication treatment with placebo, milieu, or psychosocial treatment. Data collection and analysis Working independently, we critically appraised records from 681 studies, of which five studies met inclusion criteria. We calculated risk ratios (RR) and their 95% confidence intervals (CI) where possible. For continuous data, we calculated mean difference (MD). We calculated numbers needed to treat/harm (NNT/NNH) where appropriate. Main results Five studies (combined total n=998) met inclusion criteria. Four studies (n=724) provided leaving the study early data and results suggested that individuals treated with a typical antipsychotic medication are less likely to leave the study early than those treated with placebo (Chlorpromazine: 3 RCTs n=353, RR 0.4 CI 0.3 to 0.5, NNT 3.2, Fluphenaxine: 1 RCT n=240, RR 0.5 CI 0.3 to 0.8, NNT 5; Thioridazine: 1 RCT n=236, RR 0.44 CI 0.3 to 0.7, NNT 4.3, Trifulperazine: 1 RCT n=94, RR 0.96 CI 0.3 to 3.6). Two studies contributed data to assessment of adverse effects and present a general pattern of more frequent side effects among individuals treated with typical antipsychotic medications

  12. The Hamilton Rating Scale for Depression: The making of a “gold standard” and the unmaking of a chronic illness, 1960–1980

    PubMed Central

    Worboys, Michael

    2013-01-01

    Objectives: To show why and how the Hamilton Rating Scale for Depression became the ‘Gold Standard’ for assessing therapies from the mid-1960s and how it was used to frame depression as a short-term and curable illness rather than a chronic one. Methods: My approach is that of the social construction of knowledge, identifying the interests, institutional contexts and practices that produce knowledge claims and then mapping the social processes of their circulation, validation and acceptance. Results: The circulation and validation of Hamilton Rating Scale for Depression was relatively slow and it became a ‘Gold Standard’ ‘from below’, from an emerging consensus amongst psychiatrists undertaking clinical trials for depression, which from the 1960s were principally with psychopharmaceuticals for short-term illness. Hamilton Rating Scale for Depression, drug trials and the construction of depression as non-chronic were mutually constituted. Discussion: Hamilton Rating Scale for Depression framed depression and its sufferers in new ways, leading psychiatrists to understand illness as a treatable episode, rather than a life course condition. As such, Hamilton Rating Scale for Depression served the interests of psychiatrists and psychiatry in its new era of drug therapy outside the mental hospital. However, Hamilton Rating Scale for Depression was a strange kind of ‘standard’, being quite non-standard in the widely varying ways it was used and the meanings given to its findings. PMID:23172888

  13. Kilauea east rift zone magmatism: An episode 54 perspective

    USGS Publications Warehouse

    Thornber, C.R.; Heliker, C.; Sherrod, D.R.; Kauahikaua, J.P.; Miklius, Asta; Okubo, P.G.; Trusdell, F.A.; Budahn, J.R.; Ridley, W.I.; Meeker, G.P.

    2003-01-01

    On January 29 30, 1997, prolonged steady-state effusion of lava from Pu'u'O'o was briefly disrupted by shallow extension beneath Napau Crater, 1 4 km uprift of the active Kilauea vent. A 23-h-long eruption (episode 54) ensued from fissures that were overlapping or en echelon with eruptive fissures formed during episode 1 in 1983 and those of earlier rift zone eruptions in 1963 and 1968. Combined geophysical and petrologic data for the 1994 1999 eruptive interval, including episode 54, reveal a variety of shallow magmatic conditions that persist in association with prolonged rift zone eruption. Near-vent lava samples document a significant range in composition, temperature and crystallinity of pre-eruptive magma. As supported by phenocryst liquid relations and Kilauea mineral thermometers established herein, the rift zone extension that led to episode 54 resulted in mixture of near-cotectic magma with discrete magma bodies cooled to ???1100??C. Mixing models indicate that magmas isolated beneath Napau Crater since 1963 and 1968 constituted 32 65% of the hybrid mixtures erupted during episode 54. Geophysical measurements support passive displacement of open-system magma along the active east rift conduit into closed-system rift-reservoirs along a shallow zone of extension. Geophysical and petrologic data for early episode 55 document the gradual flushing of episode 54 related magma during magmatic recharge of the edifice.

  14. Physical Activity Is Positively Associated with Episodic Memory in Aging.

    PubMed

    Hayes, Scott M; Alosco, Michael L; Hayes, Jasmeet P; Cadden, Margaret; Peterson, Kristina M; Allsup, Kelly; Forman, Daniel E; Sperling, Reisa A; Verfaellie, Mieke

    2015-11-01

    Aging is associated with performance reductions in executive function and episodic memory, although there is substantial individual variability in cognition among older adults. One factor that may be positively associated with cognition in aging is physical activity. To date, few studies have objectively assessed physical activity in young and older adults, and examined whether physical activity is differentially associated with cognition in aging. Young (n=29, age 18-31 years) and older adults (n=31, ages 55-82 years) completed standardized neuropsychological testing to assess executive function and episodic memory capacities. An experimental face-name relational memory task was administered to augment assessment of episodic memory. Physical activity (total step count and step rate) was objectively assessed using an accelerometer, and hierarchical regressions were used to evaluate relationships between cognition and physical activity. Older adults performed more poorly on tasks of executive function and episodic memory. Physical activity was positively associated with a composite measure of visual episodic memory and face-name memory accuracy in older adults. Physical activity associations with cognition were independent of sedentary behavior, which was negatively correlated with memory performance. Physical activity was not associated with cognitive performance in younger adults. Physical activity is positively associated with episodic memory performance in aging. The relationship appears to be strongest for face-name relational memory and visual episodic memory, likely attributable to the fact that these tasks make strong demands on the hippocampus. The results suggest that physical activity relates to cognition in older, but not younger adults.

  15. Aging-related episodic memory decline: are emotions the key?

    PubMed

    Kinugawa, Kiyoka; Schumm, Sophie; Pollina, Monica; Depre, Marion; Jungbluth, Carolin; Doulazmi, Mohamed; Sebban, Claude; Zlomuzica, Armin; Pietrowsky, Reinhard; Pause, Bettina; Mariani, Jean; Dere, Ekrem

    2013-01-01

    Episodic memory refers to the recollection of personal experiences that contain information on what has happened and also where and when these events took place. Episodic memory function is extremely sensitive to cerebral aging and neurodegerative diseases. We examined episodic memory performance with a novel test in young (N = 17, age: 21-45), middle-aged (N = 16, age: 48-62) and aged but otherwise healthy participants (N = 8, age: 71-83) along with measurements of trait and state anxiety. As expected we found significantly impaired episodic memory performance in the aged group as compared to the young group. The aged group also showed impaired working memory performance as well as significantly decreased levels of trait anxiety. No significant correlation between the total episodic memory and trait or state anxiety scores was found. The present results show an age-dependent episodic memory decline along with lower trait anxiety in the aged group. Yet, it still remains to be determined whether this difference in anxiety is related to the impaired episodic memory performance in the aged group.

  16. Aging-related episodic memory decline: are emotions the key?

    PubMed Central

    Kinugawa, Kiyoka; Schumm, Sophie; Pollina, Monica; Depre, Marion; Jungbluth, Carolin; Doulazmi, Mohamed; Sebban, Claude; Zlomuzica, Armin; Pietrowsky, Reinhard; Pause, Bettina; Mariani, Jean; Dere, Ekrem

    2013-01-01

    Episodic memory refers to the recollection of personal experiences that contain information on what has happened and also where and when these events took place. Episodic memory function is extremely sensitive to cerebral aging and neurodegerative diseases. We examined episodic memory performance with a novel test in young (N = 17, age: 21–45), middle-aged (N = 16, age: 48–62) and aged but otherwise healthy participants (N = 8, age: 71–83) along with measurements of trait and state anxiety. As expected we found significantly impaired episodic memory performance in the aged group as compared to the young group. The aged group also showed impaired working memory performance as well as significantly decreased levels of trait anxiety. No significant correlation between the total episodic memory and trait or state anxiety scores was found. The present results show an age-dependent episodic memory decline along with lower trait anxiety in the aged group. Yet, it still remains to be determined whether this difference in anxiety is related to the impaired episodic memory performance in the aged group. PMID:23378831

  17. Associations between Caregiver Support, Bullying, and Depressive Symptomatology among Sexual Minority and Heterosexual Girls: Results from the 2008 Boston Youth Survey

    ERIC Educational Resources Information Center

    Johnson, Renee M.; Kidd, Jeremy D.; Dunn, Erin C.; Green, Jennifer Greif; Corliss, Heather L.; Bowen, Deborah

    2011-01-01

    Although sexual minority (SM) youth are at an increased risk for being bullied and experiencing depression, it is unclear how caregiver support is interrelated with those variables. Therefore, we sought to assess (a) the prevalence of nonphysical bullying, depressive symptomatology, and caregiver support among heterosexual and SM girls, (b) the…

  18. Don’t be Too Strict with Yourself! Rigid Negative Self-Representation in Healthy Subjects Mimics the Neurocognitive Profile of Depression for Autobiographical Memory

    PubMed Central

    Sperduti, Marco; Martinelli, Pénélope; Kalenzaga, Sandrine; Devauchelle, Anne-Dominique; Lion, Stéphanie; Malherbe, Caroline; Gallarda, Thierry; Amado, Isabelle; Krebs, Marie-Odile; Oppenheim, Catherine; Piolino, Pascale

    2013-01-01

    Autobiographical memory (AM) comprises representation of both specific (episodic) and generic (semantic) personal information. Depression is characterized by a shift from episodic to semantic AM retrieval. According to theoretical models, this process (“overgeneralization”), would be linked to reduced executive resources. Moreover, “overgeneral” memories, accompanied by a negativity bias in depression, lead to a pervasive negative self-representation. As executive functions and AM specificity are also closely intricate among “non-clinical” populations, “overgeneral” memories could result in depressive emotional responses. Consequently, our hypothesis was that the neurocognitive profile of healthy subjects showing a rigid negative self-image would mimic that of patients. Executive functions and self-image were measured and brain activity was recorded, by means of fMRI, during episodic AMs retrieval in young healthy subjects. The results show an inverse correlation, that is, a more rigid and negative self-image produces lower performances in both executive and specific memories. Moreover, higher negative self-image is associated with decreased activity in the left ventro-lateral prefrontal and in the anterior cingulate cortex, repeatedly shown to exhibit altered functioning in depression. Activity in these regions, on the contrary, positively correlates with executive and memory performances, in line with their role in executive functions and AM retrieval. These findings suggest that rigid negative self-image could represent a marker or a vulnerability trait of depression by being linked to reduced executive function efficiency and episodic AM decline. These results are encouraging for psychotherapeutic approaches aimed at cognitive flexibility in depression and other psychiatric disorders. PMID:23734107

  19. Lifetime History of Major Depression Predicts the Development of the Metabolic Syndrome in Middle-Aged Women

    PubMed Central

    Goldbacher, Edie M.; Bromberger, Joyce; Matthews, Karen A.

    2010-01-01

    Objective To prospectively examine the association of major depression with incidence of the metabolic syndrome in women. Methods Data were drawn from one of seven sites of the Study of Women’s Health Across the Nation (SWAN), a prospective cohort study of the menopausal transition. Participants were 429 (34.5% African-American) women. Major depression and comorbid diagnoses were assessed via the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition Axis I Disorders at baseline and seven annual follow-up evaluations. The metabolic syndrome was measured at baseline and each follow-up evaluation (except the second) based on National Cholesterol Education Program (NCEP) criteria. Results Longitudinal generalized estimating equations (GEE) models indicated that, in women who were free of the metabolic syndrome at baseline, a lifetime major depression history or current major depressive episode at baseline was significantly associated with the onset and presence of the metabolic syndrome during the follow-up (odds ratio = 1.82; 95% Confidence Interval (CI) = 1.06–3.14). Survival analyses showed that, in women who were free of the metabolic syndrome at baseline, a lifetime major depression history or current major depressive episode at baseline predicted increased risk of developing the metabolic syndrome during the follow-up (hazard ratio = 1.66; 95% CI = 0.99–3.75). Lifetime history of alcohol abuse or dependence predicted incident metabolic syndrome and attenuated the association between depression and the metabolic syndrome in both models. Conclusions This study documents that major depression is a significant predictor of the onset of the metabolic syndrome. Intervention studies targeting depression may prevent the development of the metabolic syndrome in women. PMID:19188528

  20. A Qualitative Exploration of Depression in Emerging Adulthood: Disorder, Development, and Social Context

    PubMed Central

    Kuwabara, Sachiko A; Van Voorhees, Benjamin W; Gollan, Jackie K; Alexander, G Caleb

    2009-01-01

    Objective One in four emerging adults will experience a depressive episode between the ages of 18-25. We examined the lived experience of emerging adults with a focus on their treatment seeking, development, and the social context of their illness. Method In-depth interviews were conducted with 15 participants with major or minor depression. Interviews were recorded, transcribed verbatim, and analyzed using established qualitative methods. Results Emerging adults reported dynamic and complex interactions within and between thematic areas including identification as an individual with depression, interactions with the healthcare system, relationships with friends and family, and role transitions from childhood to adulthood. Depressed mood, concerns about self-identifying ones self as being depressed, the complexity of seeking care often without insurance or financial support, alienation from peers and family and a sense failure to achieve expected developmental milestones appeared to interact and exacerbate functional impairment. Conclusions Further research is needed to better understand and intervene upon pathways that lead to poor outcomes such as delayed milestones among emerging adults with depression. Health care providers should be conscious of the unique vulnerabilities posed by depressive disorders in this age group. PMID:17591508

  1. Validation of the Whooley questions and the Beck Depression Inventory in older adults

    PubMed Central

    Suija, Kadri; Rajala, Ulla; Jokelainen, Jari; Liukkonen, Timo; Härkönen, Pirjo; Keinänen-Kiukaanniemi, Sirkka; Timonen, Markku

    2012-01-01

    Objective To analyse the psychometric properties of the Whooley questions and the 21-item Beck Depression Inventory (BDI-21) in older adults with depression and chronic health problems. Design A population-based study. Setting Community. Subjects 474 adults, aged 72–73 years, living in the city of Oulu, Finland. Main outcome measures The screening parameters of the Whooley questions and the BDI-21 for detecting major depression. Results The prevalence of major depression according to the DSM-IV was 5.3% (single or recurrent episode) obtained by the Mini Neuropsychiatric Interview (MINI). The BDI-21 was best able to identify a current episode of major depression with a cut-off point of 11. The sensitivity and specificity of this cut-off point were 88.0% (95% confidence interval (95% CI) 68.8–97.5) and 81.7% (95% CI 77.8–85.2), respectively. The area under the receiver operating characteristics (ROC) curve was 0.89 (95% CI 0.83–0.96). The two Whooley screening questions had a sensitivity of 62.5% (95% CI 40.6–81.2) and either screening question plus the help question had a sensitivity of 66.7% (44.7–84.4). Conclusions The Beck Depression Inventory is a valid instrument for the diagnosis of depression in older adults. As a screening measure, the optimal cut-off score should be 11 or higher. Our results indicate that the sensitivity of the Whooley questions is not high enough to be used as a screening scale among the elderly. PMID:23113732

  2. The role of the mother-child relationship for anxiety disorders and depression: results from a prospective-longitudinal study in adolescents and their mothers.

    PubMed

    Asselmann, Eva; Wittchen, Hans-Ulrich; Lieb, Roselind; Beesdo-Baum, Katja

    2015-04-01

    This study aims to examine whether (a) low child valence (emotional connectedness) within the mother-child relationship increases the risk for offspring depression, (b) low child potency (individual autonomy) increases the risk for offspring anxiety, and (c) maternal psychopathology pronounces these associations. We used data from a prospective-longitudinal study of adolescents (aged 14-17 at baseline) and their mothers (N = 1,015 mother-child dyads). Anxiety disorders and depression were assessed repeatedly over 10 years in adolescents (T0, T1, T2, T3) and their mothers (T1, T3) using the DSM-IV/M-CIDI. Valence and potency were assessed in mothers (T1) with the Subjective Family Image Questionnaire. Odds ratios (OR) from logistic regression were used to estimate associations between low child valence/potency and offspring psychopathology (cumulated lifetime incidences; adjusted for sex and age). In separate models (low valence or low potency as predictor), low child valence predicted offspring depression only (OR = 1.26 per SD), while low child potency predicted offspring anxiety (OR = 1.24) and depression (OR = 1.24). In multiple models (low valence and low potency as predictors), low child valence predicted offspring depression only (OR = 1.19), while low child potency predicted offspring anxiety only (OR = 1.22). Low child potency interacted with maternal anxiety on predicting offspring depression (OR = 1.49), i.e. low child potency predicted offspring depression only in the presence of maternal anxiety (OR = 1.33). These findings suggest that low child valence increases the risk for offspring depression, while low child potency increases the risk for offspring anxiety and depression and interacts with maternal psychopathology on predicting offspring depression.

  3. Prevalence and associated factors for episodic and chronic daily headache in the Colombian population.

    PubMed

    Rueda-Sánchez, M; Díaz-Martínez, L A

    2008-03-01

    There are multiple risk factors for chronic daily headache (CDH), but they are usually assessed in an isolated form without an adequate control for confounders. CDH is considered a variant of episodic headache, but studies have not gathered enough evidence to evaluate simultaneously CDH and episodic in the same population. We set out to establish simultaneously the factors associated with chronic daily or episodic headache in a population setting, using a cross-sectional survey in a random sample of 1505 adult urban inhabitants (Bucaramanga, Colombia). The survey asked questions about headache, family and personal history of disease, and consumption or abuse of caffeine, alcohol, hypnotics and analgesics. The association among independent variables and CDH or episodic headache was made with multinomial logistic regression. Female gender, arterial hypertension or cranial trauma history, and a high score in the depression scale are associated with episodic headache and CDH. Parents with CDH, the complaint of multiple arousals during sleep and use of hypnotics are associated with CDH, but not with episodic headache. Age <36 years, alcoholism and snoring are factors associated only with episodic headache. Chronic daily headache and episodic headache have several common risk factors, but there are other factors not shared by both conditions. PMID:18254892

  4. Correlates of Suicidality among Patients with Psychotic Depression

    ERIC Educational Resources Information Center

    Schaffer, Ayal; Flint, Alastair J.; Smith, Eric; Rothschild, Anthony J.; Mulsant, Benoit H.; Szanto, Katalin; Peasley-Miklus, Catherine; Heo, Moonseong; Papademetriou, Eros; Meyers, Barnett S.

    2008-01-01

    The independent association of age and other factors with suicidality in patients with major depression with psychotic features was examined. Of the 183 study participants, 21% had a suicide attempt during the current episode. Male gender, Hispanic background, past suicide attempt, higher depression scores, and higher cognitive scores were each…

  5. African American College Students: Literacy of Depression and Help Seeking

    ERIC Educational Resources Information Center

    Stansbury, Kim L.; Wimsatt, Maureen; Simpson, Gaynell Marie; Martin, Fayetta; Nelson, Nancy

    2011-01-01

    Depression is a serious public health concern in the United States affecting almost 18.8 million adults. It is a common mental disorder in college students, with estimates of 1 in 4 "experiencing an episode by age 24." African American college students are at an elevated risk for depression due to racism, stress, sleep deprivation, and lack of…

  6. Postnatal Depression. A Review. EUR/HFA Target 8.

    ERIC Educational Resources Information Center

    World Health Organization, Copenhagen (Denmark). Regional Office for Europe.

    This document contains three reports on postnatal depression. The first, "The Maternity Blues," by Flemming Warborg Larsen, presents a literature review on the topic. It concludes that most women look back at the "blues" as an episode that was brief, unpleasant, and difficult to explain. The second report, "Postnatal Depressions," by Lene Lier,…

  7. Bipolar depression: Managing patients with second generation antipsychotics.

    PubMed

    Avery, Lindsay M; Drayton, Shannon J

    2016-01-01

    Bipolar affective disorder is a debilitating illness that manifests as cyclical episodes of mood elevation and depression, but the treatment of the depressive episodes (i.e., bipolar depression) differs considerably from the treatment of major depressive disorder. In bipolar affective disorder, it is well known that patients spend a significantly greater amount of time in depressive episodes than manic or hypomanic episodes, yet there are currently just three Food and Drug Administration-approved agents for the treatment of bipolar depression: (1) olanzapine/fluoxetine combination (2) quetiapine, both immediate- and extended-release, and (3) lurasidone. The literature review presented here focuses on the clinical trials that led to the Food and Drug Administration-approval of these second generation antipsychotics in the treatment of bipolar depression. The discussion highlights key considerations regarding overall treatment strategies to aid clinicians in the selection of pharmacologic agents. Recommended monitoring parameters, potential adverse effects, and pertinent counseling points for second generation antipsychotics used in bipolar depression are included. PMID:27079776

  8. Specific cognitive functions and depressive symptoms as predictors of activities of daily living in older adults with heterogeneous cognitive backgrounds

    PubMed Central

    de Paula, Jonas J.; Diniz, Breno S.; Bicalho, Maria A.; Albuquerque, Maicon Rodrigues; Nicolato, Rodrigo; de Moraes, Edgar N.; Romano-Silva, Marco A.; Malloy-Diniz, Leandro F.

    2015-01-01

    Cognitive functioning influences activities of daily living (ADL). However, studies reporting the association between ADL and neuropsychological performance show inconsistent results regarding what specific cognitive domains are related to each specific functional domains. Additionally, whether depressive symptoms are associated with a worse functional performance in older adults is still under explored. We investigated if specific cognitive domains and depressive symptoms would affect different aspects of ADL. Participants were 274 older adults (96 normal aging participants, 85 patients with mild cognitive impairment, and 93 patients probable with mild Alzheimer’s disease dementia) with low formal education (∼4 years). Measures of ADL included three complexity levels: Self-care, Instrumental-Domestic, and Instrumental-Complex. The specific cognitive functions were evaluated through a factorial strategy resulting in four cognitive domains: Executive Functions, Language/Semantic Memory, Episodic Memory, and Visuospatial Abilities. The Geriatric Depression Scale measured depressive symptoms. Multiple linear regression analysis showed executive functions and episodic memory as significant predictors of Instrumental-Domestic ADL, and executive functions, episodic memory and language/semantic memory as predictors of Instrumental-Complex ADL (22 and 28% of explained variance, respectively). Ordinal regression analysis showed the influence of specific cognitive functions and depressive symptoms on each one of the instrumental ADL. We observed a heterogeneous pattern of association with explained variance ranging from 22 to 38%. Different instrumental ADL had specific cognitive predictors and depressive symptoms were predictive of ADL involving social contact. Our results suggest a specific pattern of influence depending on the specific instrumental daily living activity. PMID:26257644

  9. Depression, anxiety, antidepressant use, and cardiovascular disease among Hispanic men and women of different national backgrounds: results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

    PubMed Central

    Wassertheil-Smoller, Sylvia; Arredondo, EM; Cai, JianWen; Castenada, Sheila; Choca, James P; Gallo, Linda; Jung, Molly; LaVange, Lisa M; Lee-Rey, Elizabeth T; Mosley, Thomas; Penedo, Frank J; Santistaban, DA; Zee, PC

    2014-01-01

    Purpose Describe prevalence and relationships to cardiovascular morbidity of depression, anxiety and medication use among Hispanic/Latinos of different ethnic backgrounds. Methods Cross-sectional analysis of 15,864 men and women ages 18–74 in the population-based Hispanic Community Health Study/Study of Latinos. Depressive and anxiety symptoms were assessed with shortened Center for Epidemiological Studies Depression scale and Spielberger Trait Anxiety Scale. Results Prevalence of high depressive symptoms ranged from low of 22.3% (95%CI: 20.4–24.3) to high of 38.0% (95%CI: 35.2–41.0) among those of Mexican or Puerto Rican background respectively. Adjusted odds ratios for depression rose monotonically with number of CVD risk factors from 1.46 (95%CI: 1.18, 1.75) for those with no risk factors to 4.36 (95%CI: 2.47, 7.70) for those with 5 risk factors. Antidepressant medication was used by 5% with striking differences between those with and without history of CVD (15.4% and 4.6% respectively) and between insured (8.2%) and uninsured (1.8%). Conclusions Among US Hispanics/Latinos, high depression and anxiety symptoms varied nearly twofold by Hispanic background and sex, history of CVD and increasing number of CVD risk factors. Antidepressant medication use was lower than in the general population, suggesting under treatment especially among those who had no health insurance. PMID:25439033

  10. Plant senescence cues entry into diapause in the gall fly Eurosta solidaginis: resulting metabolic depression is critical for water conservation.

    PubMed

    Williams, Jason B; Lee, Richard E

    2005-12-01

    Mechanisms and possible cues for seasonal increases in desiccation resistance in larvae of the goldenrod gall fly Eurosta solidaginis, were examined before and after natural and premature plant senescence, or after being removed from their gall and placed in either 100, 95 or 75% relative humidity (RH). Rates of water loss were 8.6-fold lower, averaging 0.7+/-0.2 microg mm(-2) h(-1), in larvae from senescent gall tissue and after all RH treatments than in control larvae from pre-senescent plants. Enhanced desiccation resistance occurred quickly, within 3 days of removal from their gall. Contrary to most previous reports, a large majority of the increased desiccation resistance (approximately 85%) was due to reduced respiratory transpiration with the remainder being the result of a lowered cuticular permeability. Rates of cuticular water loss were reduced by the presence of a vapor pressure gradient between the larval hemolymph and environmental water vapor and were probably due to increases in cuticular lipids and/or production of the cryoprotectant glycerol. Metabolic rate was reduced by over fourfold, averaging 0.07+/-0.01 microl CO2 g(-1) h(-1), in larvae from senescent gall tissue and all RH treatments compared to larvae from pre-senescent plants. The magnitude of the reduction in metabolic rates indicated that these larvae had entered diapause. In addition, larvae entered diapause in response to removal from, or degeneration of, the gall tissue they feed, on rather than seasonal changes in temperature or photoperiod. The low metabolic rates of the diapausing larvae probably allowed them to dramatically reduce their respiratory transpiration and total rate of water loss compared with non-diapausing controls. Thus, diapause, with its associated lowered metabolic rate, may be essential for conserving water in overwintering temperate insects, which may be dormant for six or more months of the year.

  11. PET quantification of serotonin transporter in suicide attempters with major depressive disorder

    PubMed Central

    Miller, Jeffrey M.; Hesselgrave, Natalie; Ogden, R. Todd; Sullivan, Gregory M.; Oquendo, Maria A.; Mann, J. John; Parsey, Ramin V.

    2013-01-01

    Background Several lines of evidence implicate abnormal serotonergic function in suicidal behavior and completed suicide, including low serotonin transporter binding in postmortem studies of completed suicide. We have also reported low in vivo serotonin transporter binding in major depressive disorder (MDD) during a major depressive episode using positron emission tomography with [11C]McN5652. We quantified regional brain serotonin transporter binding in vivo in depressed suicide attempters, depressed non-attempters, and healthy controls using positron emission tomography and a superior radiotracer, [11C]DASB. Methods 51 subjects with DSM-IV current MDD, 15 of whom were past suicide attempters, and 32 healthy controls underwent PET scanning with [11C]DASB to quantify in vivo regional brain serotonin transporter binding. Metabolite-corrected arterial input functions and plasma free-fraction were acquired to improve quantification. Results Depressed suicide attempters had lower serotonin transporter binding in midbrain compared with depressed non-attempters (p=0.031) and controls (p=0.0093). There was no difference in serotonin transporter binding comparing all depressed subjects to healthy controls considering six a priori regions of interest simultaneously (p=0.41). Conclusions Low midbrain serotonin transporter binding appears to be related to the pathophysiology of suicidal behavior rather than of major depressive disorder. This is consistent with postmortem work showing low midbrain serotonin transporter binding capacity in depressed suicides, and may partially explain discrepant in vivo findings quantifying serotonin transporter in depression. Future studies should investigate midbrain serotonin transporter binding as a predictor of suicidal behavior in MDD, and determine the cause of low binding. PMID:23453288

  12. Depression and Old Age Identification.

    ERIC Educational Resources Information Center

    Baum, Steven K.; Boxley, Russell L.

    1983-01-01

    Tested the relationship between psychological depression and feeling old in 308 older adults. Results indicated that regardless of age, people who felt older were more depressed and less healthy than people who felt younger. Depression was predicted by health and purpose in life, rather than where respondents lived. (JAC)

  13. Neediness and depression in women.

    PubMed

    Campos, Rui C; Mesquita, Isabel; Besser, Avi; Blatt, Sidney J

    2014-01-01

    In a 6-month longitudinal design, the authors examined the links between neediness and increases in depressive symptoms in women. Neediness was assessed with the self-report Depressive Experiences Questionnaire (DEQ), supplemented by a projective measure that assessed an important component of dependency, oral dependency, on the Rorschach. Results indicate that neediness correlated significantly with increases in depressive symptoms over the 6 months. Orality interacted with neediness to substantially increase the prediction of increases in depressive symptoms. PMID:24552427

  14. Oxidative stress, anti-oxidants and the cross-sectional and longitudinal association with depressive symptoms: results from the CARDIA study.

    PubMed

    Black, C N; Penninx, B W J H; Bot, M; Odegaard, A O; Gross, M D; Matthews, K A; Jacobs, D R

    2016-02-23

    Depression may be accompanied by increased oxidative stress and decreased circulating anti-oxidants. This study examines the association between depressive symptoms, F2-isoprostanes and carotenoids in a US community sample. The study includes 3009 participants (mean age 40.3, 54.2% female) from CARDIA (Coronary Artery Risk Development in Young Adults). Cross-sectional analyses were performed on data from the year 15 examination (2000-2001) including subjects whose depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale (CES-D) and had measurements of plasma F2-isoprostanes (gas chromatography/mass spectrometry) or serum carotenoids (high-performance liquid chromatography). Carotenoids zeaxanthin/lutein, β-cryptoxanthin, lycopene, α-carotene, β-carotene were standardized and summed. Longitudinal analyses were conducted using the data from other examinations at 5-year intervals. Cross-lagged analyses investigated whether CES-D predicted F2-isoprostanes or carotenoids at the following exam, and vice versa. Regression analyses were controlled for sociodemographics, health and lifestyle factors. F2-isoprostanes were higher in subjects with depressive symptoms (CES-D ⩾ 16) after adjustment for sociodemographics (55.7 vs 52.0 pg ml(-1); Cohen's d = 0.14, P < 0.001). There was no difference in F2-isoprostanes after further adjustment for health and lifestyle factors. Carotenoids were lower in those with CES-D scores ⩾ 16, even after adjustment for health and lifestyle factors (standardized sum 238.7 vs 244.0, Cohen's d = -0.16, P < 0.001). Longitudinal analyses confirmed that depression predicts subsequent F2-isoprostane and carotenoid levels. Neither F2-isoprostanes nor carotenoids predicted subsequent depression. In conclusion, depressive symptoms were cross-sectionally and longitudinally associated with increased F2-isoprostanes and decreased carotenoids. The association with F2-isoprostanes can largely be explained by

  15. Oxidative stress, anti-oxidants and the cross-sectional and longitudinal association with depressive symptoms: results from the CARDIA study

    PubMed Central

    Black, C N; Penninx, B W J H; Bot, M; Odegaard, A O; Gross, M D; Matthews, K A; Jacobs, D R

    2016-01-01

    Depression may be accompanied by increased oxidative stress and decreased circulating anti-oxidants. This study examines the association between depressive symptoms, F2-isoprostanes and carotenoids in a US community sample. The study includes 3009 participants (mean age 40.3, 54.2% female) from CARDIA (Coronary Artery Risk Development in Young Adults). Cross-sectional analyses were performed on data from the year 15 examination (2000–2001) including subjects whose depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale (CES-D) and had measurements of plasma F2-isoprostanes (gas chromatography/mass spectrometry) or serum carotenoids (high-performance liquid chromatography). Carotenoids zeaxanthin/lutein, β-cryptoxanthin, lycopene, α-carotene, β-carotene were standardized and summed. Longitudinal analyses were conducted using the data from other examinations at 5-year intervals. Cross-lagged analyses investigated whether CES-D predicted F2-isoprostanes or carotenoids at the following exam, and vice versa. Regression analyses were controlled for sociodemographics, health and lifestyle factors. F2-isoprostanes were higher in subjects with depressive symptoms (CES-D⩾16) after adjustment for sociodemographics (55.7 vs 52.0 pg ml−1; Cohen's d=0.14, P<0.001). There was no difference in F2-isoprostanes after further adjustment for health and lifestyle factors. Carotenoids were lower in those with CES-D scores ⩾16, even after adjustment for health and lifestyle factors (standardized sum 238.7 vs 244.0, Cohen's d=−0.16, P<0.001). Longitudinal analyses confirmed that depression predicts subsequent F2-isoprostane and carotenoid levels. Neither F2-isoprostanes nor carotenoids predicted subsequent depression. In conclusion, depressive symptoms were cross-sectionally and longitudinally associated with increased F2-isoprostanes and decreased carotenoids. The association with F2-isoprostanes can largely be explained by lifestyle

  16. Eye movement desensitization and reprocessing (EMDR) therapy in the treatment of depression: a matched pairs study in an inpatient setting

    PubMed Central

    Hase, Michael; Balmaceda, Ute Mirian; Hase, Adrian; Lehnung, Maria; Tumani, Visal; Huchzermeier, Christian; Hofmann, Arne

    2015-01-01

    Background Depression is a severe mental disorder that challenges mental health systems worldwide as the success rates of all established treatments are limited. Eye Movement Desensitization and Reprocessing (EMDR) therapy is a scientifically acknowledged psychotherapeutic treatment for PTSD. Given the recent research indicating that trauma and other adverse life experiences can be the basis of depression, the aim of this study was to determine the effectiveness of EMDR therapy with this disorder. Method In this study, we recruited a group of 16 patients with depressive episodes in an inpatient setting. These 16 patients were treated with EMDR therapy by reprocessing of memories related to stressful life events in addition to treatment as usual (TAU). They were compared to a group of 16 controls matched regarding diagnosis, degree of depression, sex, age and time of admission to hospital, which were receiving TAU only. Results Sixty-eight percent of the patients in the EMDR group showed full remission at end of treatment. The EMDR group showed a greater reduction in depressive symptoms as measured by the SCL-90-R depression subscale. This difference was significant even when adjusted for duration of treatment. In a follow-up period of more than 1 year the EMDR group reported less problems related to depression and less relapses than the control group. Conclusions EMDR therapy shows promise as an effective treatment for depressive disorders. Larger controlled studies are necessary to replicate our findings. PMID:26085967

  17. Effect of Taurine on Febrile Episodes in Acute Lymphoblastic Leukemia

    PubMed Central

    Islambulchilar, Mina; Asvadi, Iraj; Sanaat, Zohreh; Esfahani, Ali; Sattari, Mohammadreza

    2015-01-01

    Purpose: The purpose of our study was to evaluate the effect of oral taurine on the incidence of febrile episodes during chemotherapy in young adults with acute lymphoblastic leukemia. Methods: Forty young adults with acute lymphoblastic leukemia, at the beginning of maintenance course of their chemotherapy, were eligible for this study. The study population was randomized in a double blind manner to receive either taurine or placebo (2 gram per day orally). Life quality and side effects including febrile episodes were assessed using questionnaire. Data were analyzed using Pearson’s Chi square test. Results: Of total forty participants, 43.8% were female and 56.3 % were male. The mean age was 19.16±1.95 years (ranges: 16-23 years). The results indicated that the levels of white blood cells are significantly (P<0.05) increased in taurine treated group. There was no elevation in blasts count. A total of 70 febrile episodes were observed during study, febrile episodes were significantly (P<0.05) lower in taurine patients in comparison to the control ones. Conclusion: The overall incidence of febrile episodes and infectious complications in acute lymphoblastic leukemia patients receiving taurine was lower than placebo group. Taurine’s ability to increase leukocyte count may result in lower febrile episodes. PMID:25789226

  18. Recovery of streams from episodic acidification in northern Sweden.

    PubMed

    Laudon, Hjalmar; Hemond, Harry F

    2002-03-01

    Between 1990 and 1999, SO4(2-) deposition in northern Sweden decreased by over 50%. To determine if a corresponding amelioration of stream acidity has occurred, we analyzed trends in anthropogenically driven episodic acidification in five streams during the same time period, using the Boreal Dilution Model (BDM) (Bishop, K. H.; Laudon, H.; Kohler, S. Water Resour. Res. 2000, 36, 1873-1884). Although there was no significant change in the annual average streamwater chemistry, the anthropogenically driven episodic acidification associated with spring flood runoff decreased by between 40% and 80%. A strong correlation between winter SO4(2-) deposition and the anthropogenic component of episodic acidification in these five streams suggests that future reductions of acid deposition will further improve the spring flood acidification situation in northern Sweden. These results argue that reduced emissions of acid precursors have generated significant improvements in the surface water chemistry during episodes associated with spring runoff in northern Sweden.

  19. Evaluating cost-effectiveness using episodes of care.

    PubMed

    Lasdon, G S; Sigmann, P

    1977-03-01

    To test the feasibility of defining episodes of care as a cost-effectiveness measure, a pilot study was carried out in conjunction with an ongoing quality assessment program which involved abstracting prospective data from charts of patients treated for hypertension in the Primary Care Clinic of Hahnemann Medical College and Hospital. For comparison, data were abstracted retrospectively on hypertensive patients treated by faculty general internists in a fee-for-service private practice. The 12-month course of each patient was divided into controlled and uncontrolled episodes for which visit frequency rate and mean laboratory test utilization was calculated. Patient cost for each type of episode in each setting was calculated using standard charges. Results indicate that the episode definition is feasible and provides a measure for comparing the cost-effectiveness of different delivery systems treating the same health care problem. Factors omitted from the study that could affect cost-effectiveness are also discussed.

  20. Risk factors for antenatal depression, postnatal depression and parenting stress

    PubMed Central

    Leigh, Bronwyn; Milgrom, Jeannette

    2008-01-01

    Background Given that the prevalence of antenatal and postnatal depression is high, with estimates around 13%, and the consequences serious, efforts have been made to identify risk factors to assist in prevention, identification and treatment. Most risk factors associated with postnatal depression have been well researched, whereas predictors of antenatal depression have been less researched. Risk factors associated with early parenting stress have not been widely researched, despite the strong link with depression. The aim of this study was to further elucidate which of some previously identified risk factors are most predictive of three outcome measures: antenatal depression, postnatal depression and parenting stress and to examine the relationship between them. Methods Primipara and multiparae women were recruited antenatally from two major hoitals as part of the beyondblue National Postnatal Depression Program [1]. In this subsidiary study, 367 women completed an additional large battery of validated questionnaires to identify risk factors in the antenatal period at 26–32 weeks gestation. A subsample of these women (N = 161) also completed questionnaires at 10–12 weeks postnatally. Depression level was measured by the Beck Depression Inventory (BDI). Results Regression analyses identified significant risk factors for the three outcome measures. (1). Significant predictors for antenatal depression: low self-esteem, antenatal anxiety, low social support, negative cognitive style, major life events, low income and history of abuse. (2). Significant predictors for postnatal depression: antenatal depression and a history of depression while also controlling for concurrent parenting stress, which was a significant variable. Antenatal depression was identified as a mediator between seven of the risk factors and postnatal depression. (3). Postnatal depression was the only significant predictor for parenting stress and also acted as a mediator for other risk factors

  1. Efficacy of an Internet-Based Intervention Targeted to Adolescents with Subthreshold Depression

    ERIC Educational Resources Information Center

    Makarushka, Marta Maria

    2011-01-01

    Depression during adolescence is highly prevalent with as many as 20% experiencing a major depressive episode by the age of 18. Adolescent depression causes significant impairment across life areas including school functioning, such as poor academic performance and decreased academic achievement. Despite the existence of many evidence-based…

  2. Interpersonal Psychotherapy for Depressed Adolescents (IPT-A): A Case Illustration

    ERIC Educational Resources Information Center

    Hall, Elisabeth Baerg; Mufson, Laura

    2009-01-01

    This article describes the treatment of a depressed adolescent (15 years of age) boy using Interpersonal Psychotherapy for depressed adolescents (IPT-A). IPT-A is an empirically supported psychosocial intervention for adolescents suffering from a depressive episode. It is delivered as an individual psychotherapy with a minimum of parental…

  3. Maternal Depressive Symptoms in Pediatric Major Depressive Disorder: Relationship to Acute Treatment Outcome

    ERIC Educational Resources Information Center

    Kennard, Betsy D.; Hughes, Jennifer L.; Stewart, Sunita M.; Mayes, Taryn; Nightingale-Teresi, Jeanne; Tao, Rongrong; Carmody, Thomas; Emslie, Graham J.

    2008-01-01

    A study examined maternal depressive symptoms at the beginning and end of acute pediatric treatment of children with major depressive disorder (MDD). Results suggested a direct and possible reciprocal association between maternal and child depression severity.

  4. Assessing Interpersonal Subtypes in Depression.

    PubMed

    Simon, Sarah; Cain, Nicole M; Wallner Samstag, Lisa; Meehan, Kevin B; Muran, J Christopher

    2015-01-01

    The context-free diagnoses outlined by the Diagnostic and Statistical Manual of Mental Disorders might not provide enough information to represent the heterogeneity observed in depressed patients. Interpersonal factors have been linked to depression in a mutually influencing pathoplastic relationship where certain problems, like submissiveness, are related to symptom chronicity. This study evaluated interpersonal pathoplasticity in a range of depressive presentations. We examined archival data collected from 407 participants who met criteria for major depressive disorder (MDD), dysthymic disorder (DD), or subthreshold depression (sD). Latent profile analysis (LPA) identified 5 interpersonal subtypes (vindictive, intrusive, socially avoidant, exploitable, and cold). Apart from gender, the subtypes did not differ significantly on demographic characteristics, psychiatric comorbidity, or self-report depression severity. Socially avoidant participants were more likely to meet criteria for a clinical depression diagnosis (MDD or DD), whereas vindictive participants were more likely to have sD. Our results indicate that interpersonal problems could account for heterogeneity observed in depression.

  5. Planning Physical Education Lessons as Teaching "Episodes"

    ERIC Educational Resources Information Center

    Chatoupis, Constantine

    2016-01-01

    An "episode" is a unit of time within which teachers and students are working on the same objective and are engaged in the same teaching/learning style. The duration of each episode, as well as the number of them in a single lesson, may vary. Additionally, the multiple episodes of a lesson may have similar objectives, offer similar…

  6. [Atypical depression].

    PubMed

    Escande, M; Boucard, J

    1999-04-01

    The principal atypical aspects of depressive disease are: minor and attenued aspects, monosymptomatic and atypical aspects (food disorders and sleep disorders), masqued aspects (somatoform, anxious, characterial and addict disorders), atypical aspects of child (anxious nevrotical disorder), pseudo-demented and characterial aspects of aged subjects. Facing to these aspects, the diagnosis of depression is evoqued on: the recent and fast advent of these disorders, their morning predominance, their recurrent character, the state of attenued depressive symptoms (anhedonia), the positive responsiveness to treatment.

  7. [Depression and personality disorders: mutual influences].

    PubMed

    Rimlinger, B

    2010-12-01

    The first disposition described as having an influence on mood date back to ancient Greece. The current modeling of personality disorders is organized essentially in a category-specific logic (DSMIV, CIM-10) and dimensional logic ("big five", Eysenck model, Cloninger model, etc.). The heterogeneity of these evaluation tools affects the readability of the studies concerning the effects of comorbidity on depressive disorders. The frequency of the coexistence of personality disorders/depression (≥50%) which is associated with the severity of the depressive episodes, with pejorative evolutionary prognosis and resistance in treatments, appears to justify a reorganization of classifications in the future DSM-V.

  8. Depression in medically ill patients.

    PubMed

    Rackley, Sandra; Bostwick, J Michael

    2012-03-01

    In medically ill patients, given the many entities the phenotype of depression may represent, clinicians must be prepared to cast their diagnostic nets widely, not settling for the obvious but frequently incorrect choice of major depressive episode and throwing antidepressants at it willy nilly. Having chosen the correct diagnosis from among a broad differential of depression “look-alikes,” clinicians can draw upon a broad swath of treatment modalities including medications, psychotherapy, social supports, and spiritual interventions. Working as a psychiatrist in the medical arena requires the curiosity and analytic skills of a detective and the breadth of knowledge of a polymath adapting therapeutic tools from across the biopsychosociospiritual spectrum to the specific needs of the patient. PMID:22370500

  9. Association between depressive symptoms and reproductive variables in a group of perimenopausal women attending a menopause clinic in México City.

    PubMed

    Flores-Ramos, Mónica; Heinze, Gerhard; Silvestri-Tomassoni, Roberto

    2010-02-01

    The aim of this study was to explore the association between depressive symptoms and some variables related to the reproductive life, such as history of premenstrual dysphoric disorder, antecedent of postpartum depression, previous use of hormonal contraceptives, and current hot flushes, in a group of perimenopausal women attending a menopause clinic. Perimenopausal women, 45 to 55 years old, who had not received hormonal replacement therapy and/or psychotropic medication, were invited to participate in this study. 141 perimenopausal women were included; we obtained their psychiatric and gynecological data, and we evaluated their depressive symptomatology using the CES-D scale. There were a significantly higher number of cases of previous depressive episodes, PMDD and PPD history in depressed patients compared with non-depressed women; current hot flushes prevalence was similar between depressed and non-depressed women. Patients with a PMDD history were more likely to have experienced previous depressive episodes, a PPD history and high levels of depression. Variables associated with the level of depression were a previous history of PMDD, current hot flushes, and previous depressive episodes. The occurrence of perimenopausal depression is related to a previous history of PMDD, PPD, and depressive episodes; hot flushes only increase the severity of the depressive episode. PMID:19730981

  10. Self-compassion in depression: associations with depressive symptoms, rumination, and avoidance in depressed outpatients.