Respecting the 'stages' of depression: Considering depression severity and readiness to seek help.

Science.gov (United States)

Lueck, Jennifer A

2018-07-01

Despite knowing the value of message customization, empirical results have failed to provide clear indicators of what make a depression help-seeking message effective. The present research examines stages of depression in response to a prominent communication strategy, gain versus loss framing, to inform possibilities for effective message customization. Two experimental studies were conducted with a student (N = 126) and U.S. adult (N = 738) sample that tested the effects of gain versus loss framing at different stages of depression. A persuasive gain-frame advantage was found for those with mild and severe depression, whereas a boomerang effect was found for both gain and loss framing among those with moderately severe depression. With regards to intention to seek help, neither gain nor loss framing was found to influence intentions. Stages of depression was a strong predictor, with strongest intentions to seek help observed among those with either minor or severe symptoms of depression. Effective health messaging must be matched with unique characteristics and needs of individuals at each 'stage' of depression in order to produce favorable outcomes. 'Stages' of depression should be known and carefully assessed before the creation and launch of communication interventions. Copyright © 2018 Elsevier B.V. All rights reserved.

Personal and Perceived Depression Stigma among Arab Adolescents: Associations with Depression Severity and Personal Characteristics.

Science.gov (United States)

Dardas, Latefa Ali; Silva, Susan G; Smoski, Moria J; Noonan, Devon; Simmons, Leigh Ann

2017-10-01

In Arab communities, the selection, utilization, and attitudes towards mental health services are substantially affected by existing mental illness stigma. However, little is known about how the stigma of depression manifests among Arab adolescents, which makes it difficult to design, implement, and disseminate effective anti-stigma interventions for this vulnerable population. Therefore, the purpose of this study was to determine levels of depression stigma among Arab adolescents. The specific aims were to (1) describe the severity of personal and perceived depression stigma among Arab adolescents and its relationship to severity of depression, and (2) determine characteristics associated with severity of depression stigma among Arab adolescents. This study was conducted in Jordan, a Middle Eastern Arab country. A nationally representative, school-based survey was utilized. A total of 2349 Jordanian adolescents aged 12-17 completed and returned the survey packets, which included measures on individual characteristics, depression severity, and depression stigma. The majority of the adolescents (88%) reported scores indicating moderate to high depression stigma. Adolescents reported higher rates of perceived stigma than personal stigma. Depression stigma was not significantly associated with severity of depression, but with adolescent's sex, age, region of residence, parents' education, and history of mental health problem. This is the first Arab study to isolate the influence of adolescent depression and personal characteristics on personal and perceived depression stigmas, and highlight the presence of these distinctions early in adolescence. Such distinction can inform the design and implementation of policies and interventions to reduce both personal and perceived stigma. The study provides important recommendations on when, how, and why to utilize school settings for anti-depression stigma interventions. Copyright © 2017 Elsevier Inc. All rights reserved.

Relationship of severity of depression, anxiety and stress with severity of fibromyalgia.

Science.gov (United States)

Alok, R; Das, S K; Agarwal, G G; Salwahan, L; Srivastava, R

2011-01-01

Negative affects like depression, anxiety and stress are frequently observed in patients with fibromyalgia (FMS). Understanding the association between FMS and negative affects is likely to help in deciding the choice of treatment. The aim of this study was to determine the correlation between the severity of FMS with the severity of depression, anxiety and stress. Sixty patients with fibromyalgia and 60 healthy controls were included in the study. Fibromyalgia Impact Questionnaire Revised (FIQR), and Depression, Anxiety and Stress Scale (DASS21) were administered to both the groups. The mean age of study population was 40.4±9.9 and 36±8.7 for FMS and control groups respectively. Most of the patients were females (93.3%). In subjects without FMS, depression was seen in 5% and was significantly associated with all three components of FIQR (pdepression, anxiety and stress were found significantly associated with the severity of all three components of FIQR, namely pain, function and symptoms (pdepression, anxiety and stress and in FMS magnitude of negative affects is significantly correlated with FIQR. However, depression alone in absence of FMS can also give rise to all three components of FIQR.

Is one's usual dinner companion associated with greater odds of depression? Using data from the 2014 Korean National Health and Nutrition Examination Survey.

Science.gov (United States)

Lee, Sang Ah; Park, Eun-Cheol; Ju, Yeong Jun; Nam, Jin Young; Kim, Tae Hyun

2016-09-01

Support from one's family has been reported to have a positive effect on depression severity. Hence, family dinnertimes, when whole family can gather together, can be effective to depression by providing support from family. We investigate the association between the dinner companion and depression, and the differences in this association by gender, living arrangement and household composition. We used the Korea National Health and Nutrition Examination Survey 2014 data. A total of 4,181 individuals were included. We classified participants by their dinner companions as follows: dinner with family, dinner with others and eating alone. Depression was measured by using the 9-item Patient Health Questionnaire. Logistic regression analysis was used to investigate the association. Those who ate dinner alone (odds ratio (OR): 1.53, 95% confidence interval (CI): 1.04-2.25) had higher depression rate compared to those who had dinner with family. The subgroup analysis indicated that men, those who live with others and those living in a second-generation household who ate dinner alone had greater odds of having depressive symptoms. Those who usually eat dinner alone have greater odds of developing depression compared to those who have dinner with their family. As such, family dinnertimes may help to alleviate depressive moods. © The Author(s) 2016.

Postpartum Depression After Mild and Severe Preeclampsia

NARCIS (Netherlands)

Hoedjes, Meeke; Berks, Durk; Vogel, Ineke; Franx, Arie; Bangma, Meike; Darlington, Anne-Sophie E.; Visser, Willy; Duvekot, Johannes J.; Habbema, J. Dik F.; Steegers, Eric A. P.; Raat, Hein

2011-01-01

Objective: To describe the prevalence of postpartum depressive symptoms after preeclampsia, to assess the extent to which the prevalence of postpartum depressive symptoms differs after mild and severe preeclampsia, and to investigate which factors contribute to such differences. Methods: Women

Psychosocial factors predicting severity of depression among ...

African Journals Online (AJOL)

Background and Objectives: Depression as major psychological sequelea of the HIV/AIDS infection has continued to attract investigation. With few studies in Nigeria, it is unclear whether levels of perceived stigma, sexual risk behaviors, and anticipated discrimination are differentially associated with severity of depression.

Effects of three types of potentially biasing information on symptom severity judgments for major depressive episode.

Science.gov (United States)

Mumma, Gregory H

2002-10-01

Two experiments examined the effects of potentially biasing information on judgments of symptom severity pertaining to the diagnosis of major depressive episode (MDE). In both experiments, clinicians viewed videotapes of two actor-simulated patients responding to questions from a standardized diagnostic interview. In Study 1, an expectancy effect was found for both patients such that prior information about a clear-cut history of depression resulted in lower rated severity of current symptoms. In addition, a halo effect was observed for one patient in Study 1 and both patients in Study 2: Clear-cut depressive nonverbal behavior (DNVB) resulted in greater rated severity for symptoms that should not have been affected (e.g., appetite/weight change, suicidal ideation). Clear-cut versus near-threshold information for the two essential criteria for MDE did not affect subsequent judgments in either study. Implications for diagnostic interviewing are discussed. Copyright 2002 Wiley Periodicals, Inc. J Clin Psychol 58: 1327-1345, 2002.

Disrupted reward circuits is associated with cognitive deficits and depression severity in major depressive disorder.

Science.gov (United States)

Gong, Liang; Yin, Yingying; He, Cancan; Ye, Qing; Bai, Feng; Yuan, Yonggui; Zhang, Haisan; Lv, Luxian; Zhang, Hongxing; Xie, Chunming; Zhang, Zhijun

2017-01-01

Neuroimaging studies have demonstrated that major depressive disorder (MDD) patients show blunted activity responses to reward-related tasks. However, whether abnormal reward circuits affect cognition and depression in MDD patients remains unclear. Seventy-five drug-naive MDD patients and 42 cognitively normal (CN) subjects underwent a resting-state functional magnetic resonance imaging scan. The bilateral nucleus accumbens (NAc) were selected as seeds to construct reward circuits across all subjects. A multivariate linear regression analysis was employed to investigate the neural substrates of cognitive function and depression severity on the reward circuits in MDD patients. The common pathway underlying cognitive deficits and depression was identified with conjunction analysis. Compared with CN subjects, MDD patients showed decreased reward network connectivity that was primarily located in the prefrontal-striatal regions. Importantly, distinct and common neural pathways underlying cognition and depression were identified, implying the independent and synergistic effects of cognitive deficits and depression severity on reward circuits. This study demonstrated that disrupted topological organization within reward circuits was significantly associated with cognitive deficits and depression severity in MDD patients. These findings suggest that in addition to antidepressant treatment, normalized reward circuits should be a focus and a target for improving depression and cognitive deficits in MDD patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

Assessing depression related severity and functional impairment: the Overall Depression Severity and Impairment Scale (ODSIS.

Directory of Open Access Journals (Sweden)

Masaya Ito

Full Text Available The Overall Depression Severity and Impairment Scale (ODSIS is a brief, five-item measure for assessing the frequency and intensity of depressive symptoms, as well as functional impairments in pleasurable activities, work or school, and interpersonal relationships due to depression. Although this scale is expected to be useful in various psychiatric and mental health settings, the reliability, validity, and interpretability have not yet been fully examined. This study was designed to examine the reliability, factorial, convergent, and discriminant validity of a Japanese version of the ODSIS, as well as its ability to distinguish between individuals with and without a major depressive disorder diagnosis.From a pool of registrants at an internet survey company, 2830 non-clinical and clinical participants were selected randomly (619 with major depressive disorder, 619 with panic disorder, 576 with social anxiety disorder, 645 with obsessive-compulsive disorder, and 371 non-clinical panelists. Participants were asked to respond to the ODSIS and conventional measures of depression, functional impairment, anxiety, neuroticism, satisfaction with life, and emotion regulation.Exploratory and confirmatory factor analysis of three split subsamples indicated the unidimensional factor structure of ODSIS. Multi-group confirmatory factor analysis showed invariance of factor loadings between non-clinical and clinical subsamples. The ODSIS also showed excellent internal consistency and test-retest intraclass correlation coefficients. Convergence and discriminance of the ODSIS with various measures were in line with our expectations. Receiver operating characteristic curve analyses showed that the ODSIS was able to detect a major depressive syndrome accurately.This study supports the reliability and validity of ODSIS in a non-western population, which can be interpreted as demonstrating cross-cultural validity.

Impact of severity of personality disorder on the outcome of depression.

Science.gov (United States)

Kelly, Brendan D; Nur, Ula A; Tyrer, Peter; Casey, Patricia

2009-06-01

The influence of severity of personality disorder on outcome of depression is unclear. Four hundred and ten patients with depression in 9 urban and rural communities in Finland, Ireland, Norway, Spain and the United Kingdom, were randomised to individual problem-solving treatment (n=121), group sessions on depression prevention (n=106) or treatment as usual (n=183). Depressive symptoms were recorded at baseline, 6 and 12 months. Personality assessment was performed using the Personality Assessment Schedule and analysed by severity (no personality disorder, personality difficulty, simple personality disorder, complex personality disorder). Complete personality assessments were performed on 301 individuals of whom 49.8% had no personality disorder; 19.3% had personality difficulties; 13.0% had simple personality disorder; and 17.9% had complex personality disorder. Severity of personality disorder was correlated with Beck Depression Inventory (BDI) scores at baseline (Spearman's r=0.21; ppersonality disorder and treatment type for depression. While multi-variable analyses indicate that depressive symptoms at baseline are the strongest predictor of depressive symptoms at 6 and 12 months, the strong correlations between severity of personality disorder and depressive symptoms make it difficult to establish the independent effect of personality disorder on outcome of depression.

Predictability of depression severity based on posterior alpha oscillations.

Science.gov (United States)

Jiang, H; Popov, T; Jylänki, P; Bi, K; Yao, Z; Lu, Q; Jensen, O; van Gerven, M A J

2016-04-01

We aimed to integrate neural data and an advanced machine learning technique to predict individual major depressive disorder (MDD) patient severity. MEG data was acquired from 22 MDD patients and 22 healthy controls (HC) resting awake with eyes closed. Individual power spectra were calculated by a Fourier transform. Sources were reconstructed via beamforming technique. Bayesian linear regression was applied to predict depression severity based on the spatial distribution of oscillatory power. In MDD patients, decreased theta (4-8 Hz) and alpha (8-14 Hz) power was observed in fronto-central and posterior areas respectively, whereas increased beta (14-30 Hz) power was observed in fronto-central regions. In particular, posterior alpha power was negatively related to depression severity. The Bayesian linear regression model showed significant depression severity prediction performance based on the spatial distribution of both alpha (r=0.68, p=0.0005) and beta power (r=0.56, p=0.007) respectively. Our findings point to a specific alteration of oscillatory brain activity in MDD patients during rest as characterized from MEG data in terms of spectral and spatial distribution. The proposed model yielded a quantitative and objective estimation for the depression severity, which in turn has a potential for diagnosis and monitoring of the recovery process. Copyright © 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Plasma galanin is a biomarker for severity of major depressive disorder.

Science.gov (United States)

Wang, Yong-Jun; Yang, Yu-Tao; Li, Hui; Liu, Po-Zi; Wang, Chuan-Yue; Xu, Zhi-Qing David

2014-01-01

This study investigated the association between plasma galanin level and depression severity. The severity of depression symptoms of 79 patients with major depressive disorder (MDD; 52 women and 27 men, 71 patients in onset, 8 in remission) was assessed using the 17-item Hamilton Depression Rating Scale. Venous fasting blood samples (5 mL) were taken from the 79 MDD patients, 35 healthy siblings, and 19 healthy controls, and plasma samples were prepared. Galanin levels in the plasma were measured by radioimmunoassay. Plasma galanin in MDD patients was significantly higher than that of remission patients, healthy siblings, or healthy controls (P 0.05). There was a significant positive correlation between plasma galanin levels and depression severity in women MDD patients (r = 0.329, df = 42, P = 0.020), but not in men patients. Plasma galanin levels may be an important biomarker for depression severity, especially in female patients.

Efficacy of Desvenlafaxine Compared With Placebo in Major Depressive Disorder Patients by Age Group and Severity of Depression at Baseline.

Science.gov (United States)

Mosca, Daniel; Zhang, Min; Prieto, Rita; Boucher, Matthieu

2017-04-01

This post hoc meta-analysis evaluated the efficacy and safety of desvenlafaxine 50 and 100 mg versus placebo across age groups and severity of depression at baseline in patients with major depressive disorder. Data from placebo and desvenlafaxine 50-mg and 100-mg dose arms were pooled from 9 short-term, placebo-controlled, major depressive disorder studies (N = 4279). Effects of age (18-40 years, >40 to depression severity (mild, 17-item Hamilton Rating Scale for Depression total score [HAM-D17] ≤18; moderate, HAM-D17 >18 to depression and function compared with placebo for patients 18 to 40 years, older than 40 to younger than 55 years, and 55 to younger than 65 years, with no significant evidence of an effect of age. Desvenlafaxine significantly improved most measures of depression and function in moderately and severely depressed patients. There was a significant baseline severity by treatment interaction for HAM-D17 total score only (P = 0.027), with a larger treatment effect for the severely depressed group. Desvenlafaxine significantly improved depressive symptoms in patients younger than 65 years and in patients with moderate or severe baseline depression. Sample sizes were not adequate to assess desvenlafaxine efficacy in patients 65 years or older or with mild baseline depression.

Tinnitus severity, depression, and the big five personality traits.

Science.gov (United States)

Langguth, B; Kleinjung, T; Fischer, B; Hajak, G; Eichhammer, P; Sand, P G

2007-01-01

A growing number of self-report measures for the evaluation of tinnitus severity has become available to research and clinical practice. This has led to an increased awareness of depression and personality as predictors of tinnitus severity in addition to loudness and other psychoacoustic measures. However, the net impact of personality dimensions on tinnitus ratings has not been investigated when the effect of depressed mood is controlled. In the present study, we demonstrate the role of the big five personality traits, 'Neuroticism', 'Extraversion', 'Openness', 'Agreeableness', and 'Conscientiousness', in affecting scores on two standard instruments for grading tinnitus-related complaints, the tinnitus handicap inventory (THI), and the tinnitus questionnaire (TQ). When 72 individuals with chronic tinnitus were examined, 'Agreeableness' negatively correlated with THI scores (p=.003), whereas the anxiety trait 'Neuroticism' correlated both with depressive symptomatology (ptrait anxiety and depression, low 'Agreeableness' was thus identified as a novel predictor of tinnitus severity on the THI.

WIC mothers' depressive symptoms are associated with greater use of feeding to soothe, regardless of perceived child negativity.

Science.gov (United States)

Savage, Jennifer S; Birch, Leann L

2017-04-01

Maternal symptoms of depression are related to suboptimal parenting practices and child well-being; women with elevated symptoms tend to be less responsive to their children. The objective is to explore how maternal depressive symptomatology is related to childhood obesity-promoting parenting behaviours, and whether depressive symptomatology moderates the association between perceived child negativity and the use of food to soothe among low-income mothers. There is a cross-sectional sample of 60 mothers and their formula fed infants/toddlers participating in the Special Supplemental Woman, Infants and Children Program. Measures included the Infant Behaviors Questionnaire, Baby's Basic Needs Questionnaire, the feeding problem assessment form and Center for Epidemiological Studies Depression Scale. Depressive symptoms exceeded the clinical screening cut-off for 38% of women. Mothers with depressive symptoms perceived their child to be more negative and were more likely to use food to soothe, add cereal to the bottle and put baby to bed with bottle than mothers without depressive symptoms. Generalized linear models revealed that child negativity was associated with greater use of food to soothe but that this effect was moderated by maternal depression: negativity was positively associated with food to soothe among non-depressed but not depressed mothers. A high proportion of low-income mothers reported elevated depressive symptoms; depressive symptomatology was positively associated with perceived child negativity and greater reported use of controlling feeding practices. Screening for maternal depressive symptoms may help in providing more individually tailored counselling on responsive feeding. © 2016 World Obesity Federation.

Gender differences in severity, symptomatology and distribution of melancholia in major depression

DEFF Research Database (Denmark)

Hildebrandt, Malene Grubbe; Stage, Kurt Bjerregaard; Kragh-Soerensen, Per

2003-01-01

BACKGROUND: Studies of gender differences in the clinical presentation of depression have provided divergent results. This study aimed at analyzing gender differences in severity, symptomatology and distribution of melancholia in major depression. SAMPLING AND METHODS: The study comprised 930 in...... Scale from 1965 for melancholia (N1) in a subsample of patients (n = 439). A factor analysis on the HDS was performed. Non-parametric statistical tests were used and only gender differences greater than 20% were considered clinically relevant. RESULTS: The median on the HDS total score was 22...... and the median number of symptoms was 13 for both men and women. Presentation of specific symptoms was similar for men and women. The factor analysis revealed no gender differences, and neither did analyses on symptoms of Axes II and IV. According to the N1, 80% of the men and 66% of the women suffered from...

The Association between Physical Morbidity and Subtypes of Severe Depression

DEFF Research Database (Denmark)

Østergaard, Søren Dinesen; Petrides, Georgio; Dinesen, Peter Thisted

2013-01-01

Physical illness and depression are related, but the association between specific physical diseases and diagnostic subtypes of depression remains poorly understood. This study aimed to clarify the relationship between a number of physical diseases and the nonpsychotic and psychotic subtype...... of severe depression....

The prevalence and correlates of severe depression in a cohort of Mexican teachers.

Science.gov (United States)

Soria-Saucedo, Rene; Lopez-Ridaura, Ruy; Lajous, Martin; Wirtz, Veronika J

2018-07-01

Depression is among the 10 major causes of disability in Mexico. Yet, local contextual factors associated to the disorder remain poorly understood. We measured the impact of several factors on severe depression such as demographics, pharmacotherapy, multimorbidity, and unhealthy behaviors in Mexican teachers. A total of 43,845 Mexican female teachers from 12 Mexican states answered the Patient Health Questionnaire (PHQ9). Data were part the Mexican Teacher's Cohort prospective study, the largest ongoing cohort study in Latin America. Unadjusted and adjusted estimates assessed the impact of several contextual factors between severe versus mild-no depression cases. In total 7026 teachers (16%) had a PHQ9 score compatible with severe depression. From them, only 17% received psychotropics, compared to 60% for those with a formal diagnosis. Less than 5% of teachers with PHQ9 scores compatible with severe depression had a formal diagnosis. Adjusted analysis reported higher odds of pharmacotherapy, having ≥ 3 comorbidities, higher levels of couple, family and work stress, fewer hours of vigorous physical activity, higher alcohol consumption, and smoking as risk factors for severe depression. Also, rural residents of northern and center states appeared more severely depressed compared to their urban counterparts. On average, the PHQ9 scores differed by ~ 10 points between severe and mild-no depressed teachers. A cross-sectional design. Also, the study focused on female teachers between ages 25 and 74 years old, reducing the generalizability of the estimates. Under-diagnosis of clinical depression in Mexican teachers is concerning. Unhealthy behavior is associated with severe depression. The information collected in this study represents an opportunity to build prevention mechanisms of depression in high-risk subgroups of female educators and warrants improving access to mental care in Mexico. Copyright © 2018 Elsevier B.V. All rights reserved.

Role of depression severity and impulsivity in the relationship between hopelessness and suicidal ideation in patients with major depressive disorder.

Science.gov (United States)

Wang, Yan-yu; Jiang, Neng-zhi; Cheung, Eric F C; Sun, Hong-wei; Chan, Raymond C K

2015-09-01

Hopelessness, depression and impulsivity all contribute to the development of suicidal ideation in patients with major depressive disorder, but the pathway of these factors to suicidal ideation is not clear. This study examined the meditating effect of depression severity on the relationship between hopelessness and suicidal ideation and explored how this mediating effect was moderated by impulsivity. A total of 162 patients with major depressive disorder (MDD) completed a structured clinical diagnostic interview and a battery of scales assessing depression severity, hopelessness, suicidal ideation, and impulsivity. Regression analyses with bootstrapping methods were used to examine the mediating and moderating effects of various risk factors. Mediation analysis revealed a significant indirect effect of hopelessness on suicidal ideation, and the effect was fully mediated through depression severity. On moderation analysis, the moderating effects of the relationship between depression severity and suicidal ideation were significant in both the medium and high impulsivity groups. The present study was limited by the assessment of trait impulsivity and observer-rated depression severity, which might not fully reflect momentary impulsivity and feeling of depression when suicidal ideation occurs. Depression severity plays a mediator role in the relationship between hopelessness and suicidal ideation and this mechanism is contingent on the levels of impulsivity. MDD patients with higher impulsivity appear to be more likely to have suicidal ideations even when they are less depressed. These findings highlight the importance of impulsivity assessment and alleviation of depressive symptoms to prevent suicidality in patients with MDD. Copyright © 2015 Elsevier B.V. All rights reserved.

Identifying depression severity risk factors in persons with traumatic spinal cord injury.

Science.gov (United States)

Williams, Ryan T; Wilson, Catherine S; Heinemann, Allen W; Lazowski, Linda E; Fann, Jesse R; Bombardier, Charles H

2014-02-01

Examine the relationship between demographic characteristics, health-, and injury-related characteristics, and substance misuse across multiple levels of depression severity. 204 persons with traumatic spinal cord injury (SCI) volunteered as part of screening efforts for a randomized controlled trial of venlafaxine extended release for major depressive disorder (MDD). Instruments included the Patient Health Questionnaire-9 (PHQ-9) depression scale, the Alcohol Use Disorders Identification Test (AUDIT), and the Substance Abuse in Vocational Rehabilitation-Screener (SAVR-S), which contains 3 subscales: drug misuse, alcohol misuse, and a subtle items scale. Each of the SAVR-S subscales contributes to an overall substance use disorder (SUD) outcome. Three proportional odds models were specified, varying the substance misuse measure included in each model. 44% individuals had no depression symptoms, 31% had mild symptoms, 16% had moderate symptoms, 6% had moderately severe symptoms, and 3% had severe depression symptoms. Alcohol misuse, as indicated by the AUDIT and the SAVR-S drug misuse subscale scores were significant predictors of depression symptom severity. The SAVR-S substance use disorder (SUD) screening outcome was the most predictive variable. Level of education was only significantly predictive of depression severity in the model using the AUDIT alcohol misuse indicator. Likely SUD as measured by the SAVR-S was most predictive of depression symptom severity in this sample of persons with traumatic SCI. Drug and alcohol screening are important for identifying individuals at risk for depression, but screening for both may be optimal. Further research is needed on risk and protective factors for depression, including psychosocial characteristics. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Individuals with more severe depression fail to sustain nucleus accumbens activity to preferred music over time.

Science.gov (United States)

Jenkins, Lisanne M; Skerrett, Kristy A; DelDonno, Sophie R; Patrón, Víctor G; Meyers, Kortni K; Peltier, Scott; Zubieta, Jon-Kar; Langenecker, Scott A; Starkman, Monica N

2018-05-30

We investigated the ability of preferred classical music to activate the nucleus accumbens in patients with Major depressive disorder (MDD). Twelve males with MDD and 10 never mentally ill male healthy controls (HC) completed measures of anhedonia and depression severity, and listened to 90-second segments of preferred classical music during fMRI. Compared to HCs, individuals with MDD showed less activation of the left nucleus accumbens (NAcc). Individuals with MDD showed attenuation of the left NAcc response in later compared to earlier parts of the experiment, supporting theories that MDD involves an inability to sustain reward network activation. Counter intuitively, we found that NAcc activity during early music listening was associated with greater depression severity. In whole-brain analyses, anhedonia scores predicted activity in regions within the default mode network, supporting previous findings. Our results support theories that MDD involves an inability to sustain reward network activation. It also highlights that pleasant classical music can engage critical neural reward circuitry in MDD. Copyright © 2018 Elsevier B.V. All rights reserved.

Severity of depression in hepatitis B and hepatitis C patients

International Nuclear Information System (INIS)

Qureshi, M.O.; Khokhar, N.; Shafqat, F.

2012-01-01

Objective: To assess and compare the severity of depression in chronic hepatitis B (CHB), chronic hepatitis C (CHC) and healthy subjects. Study Design: Comparative study. Place and Duration of Study: Shifa International Hospital, Islamabad from July 2011 to February 2012. Methodology:A total of 206 subjects were divided in three groups. Group-I (chronic hepatitis C, n = 95), group-II (chronic hepatitis B, n = 29) and group-III (healthy subjects, n = 82). They were matched for age, gender and socioeconomic status and were compared for frequency and severity of depression as measured by Hospital Anxiety and Depression Scale (HADS). Results: Some degree of depression was noted in all groups. Frequency of depression was 72.6% in group-I, 58.6% in group-II and 37.8% in group-III (p value < 0.001). Conclusion: Both CHC and CHB had high frequency of some degree of depression. Hepatitis C patients had more depressive features than CHB. It is worthwhile to do more close mental health observation in them. A multidisciplinary team including a psychiatric specialist can help in this approach. (author)

Parsing trait and state effects of depression severity on neurocognition: Evidence from a 26-year longitudinal study.

Science.gov (United States)

Sarapas, Casey; Shankman, Stewart A; Harrow, Martin; Goldberg, Joseph F

2012-11-01

Cognitive dysfunction in mood disorders falls along a continuum, such that more severe current depression is associated with greater cognitive impairment. It is not clear whether this association reflects transient state effects of current symptoms on cognitive performance, or persistent, trait-like differences in cognition that are related to overall disorder severity. We addressed this question in 42 unipolar and 47 bipolar participants drawn from a 26-year longitudinal study of psychopathology, using measures of attention/psychomotor processing speed, cognitive flexibility, verbal fluency, and verbal memory. We assessed (a) the extent to which current symptom severity and past average disorder severity predicted unique variance in cognitive performance; (b) whether cognitive performance covaried with within-individual changes in symptom severity; and (c) the stability of neurocognitive measures over six years. We also tested for differences among unipolar and bipolar groups and published norms. Past average depression severity predicted performance on attention/psychomotor processing speed in both groups, and in cognitive flexibility among unipolar participants, even after controlling for current symptom severity, which did not independently predict cognition. Within-participant state changes in depressive symptoms did not predict change in any cognitive domain. All domains were stable over the course of six years. Both groups showed generalized impairment relative to published norms, and bipolar participants performed more poorly than unipolar participants on attention/psychomotor processing speed. The results suggest a stable relationship between mood disorder severity and cognitive deficits. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Gender Differences in Rating Stressful Events, Depression, and Depressive Cognition.

Science.gov (United States)

Sowa, Claudia J.; Lustman, Patrick J.

1984-01-01

Administered the Life Stress Questionnaire, the Beck Depression Inventory, and the Automatic Thought Questionnaire to 140 students. Results showed significant sex differences. Men reported more stressful life change, but women rated the impact of stressors more severely and had higher depression. Men exhibited greater distortions in cognitive…

Accuracy of automated classification of major depressive disorder as a function of symptom severity.

Science.gov (United States)

Ramasubbu, Rajamannar; Brown, Matthew R G; Cortese, Filmeno; Gaxiola, Ismael; Goodyear, Bradley; Greenshaw, Andrew J; Dursun, Serdar M; Greiner, Russell

2016-01-01

Growing evidence documents the potential of machine learning for developing brain based diagnostic methods for major depressive disorder (MDD). As symptom severity may influence brain activity, we investigated whether the severity of MDD affected the accuracies of machine learned MDD-vs-Control diagnostic classifiers. Forty-five medication-free patients with DSM-IV defined MDD and 19 healthy controls participated in the study. Based on depression severity as determined by the Hamilton Rating Scale for Depression (HRSD), MDD patients were sorted into three groups: mild to moderate depression (HRSD 14-19), severe depression (HRSD 20-23), and very severe depression (HRSD ≥ 24). We collected functional magnetic resonance imaging (fMRI) data during both resting-state and an emotional-face matching task. Patients in each of the three severity groups were compared against controls in separate analyses, using either the resting-state or task-based fMRI data. We use each of these six datasets with linear support vector machine (SVM) binary classifiers for identifying individuals as patients or controls. The resting-state fMRI data showed statistically significant classification accuracy only for the very severe depression group (accuracy 66%, p = 0.012 corrected), while mild to moderate (accuracy 58%, p = 1.0 corrected) and severe depression (accuracy 52%, p = 1.0 corrected) were only at chance. With task-based fMRI data, the automated classifier performed at chance in all three severity groups. Binary linear SVM classifiers achieved significant classification of very severe depression with resting-state fMRI, but the contribution of brain measurements may have limited potential in differentiating patients with less severe depression from healthy controls.

Severity of anxiety- but not depression- is associated with oxidative stress in Major Depressive Disorder.

Science.gov (United States)

Steenkamp, Lisa R; Hough, Christina M; Reus, Victor I; Jain, Felipe A; Epel, Elissa S; James, S Jill; Morford, Alexandra E; Mellon, Synthia H; Wolkowitz, Owen M; Lindqvist, Daniel

2017-09-01

Oxidative stress is implicated in both depression and anxiety, but it is currently unclear whether this relates to syndromal diagnoses or trans-diagnostic dimensional symptoms. We examined the relationship between oxidative stress and severity of depression and anxiety symptoms in individuals with Major Depressive Disorder (MDD). Plasma oxidative stress markers F2-isoprostanes and oxidized glutathione (GSSG), and the antioxidant reduced glutathione (GSH), were assessed in 69 physically healthy, medication-free MDD subjects. Symptoms of anxiety and depression were assessed using the Hamilton Anxiety (HAM-A) and Hamilton Depression (HAM-D) Rating Scales. Total HAM-A and HAM-D scores, along with "core" anxiety and depression subscales, and individual HAM-D items "psychic anxiety" and "depressed mood," were related to oxidative stress markers. Analyses controlled for age, sex, BMI, and smoking. Total HAM-A ratings were positively associated with F2-isoprostanes (β=.26, p=.042) and GSSG (β=.25, p=.049), but not GSH (β=.05, p=.711). Core anxiety severity was positively associated with F2-isoprostanes (β=.34, p=.012) and GSSG, although this did not reach significance (β=.24, p=.074). None of the biological markers were significantly associated with total HAM-D or core depression ratings (all p>.13). Subjects scoring high on "psychic anxiety" had elevated F2-isoprostanes (p=.030) and GSSG (p=.020). This was not seen with "depressed mood" scores (all p>.12). We assessed peripheral oxidative markers, but their relationship to the brain is unclear. Oxidative stress is more closely related to anxiety than depression symptoms in MDD. This highlights the importance of relating oxidative stress to specific symptoms and could provide new insights into the biological correlates of affective disorders. Copyright © 2017 Elsevier B.V. All rights reserved.

Impact of facial burns: relationship between depressive symptoms, self-esteem and scar severity.

Science.gov (United States)

Hoogewerf, Cornelis Johannes; van Baar, Margriet Elisabeth; Middelkoop, Esther; van Loey, Nancy Elisa

2014-01-01

This study assessed the role of self-reported facial scar severity as a possible influencing factor on self-esteem and depressive symptoms in patients with facial burns. A prospective multicentre cohort study with a 6 months follow-up was conducted including 132 patients with facial burns. Patients completed the Patient and Observer Scar Assessment Scale, the Rosenberg Self-esteem Scale and the Hospital Anxiety and Depression Scale. Structural Equation Modeling was used to assess the relations between depressive symptoms, self-esteem and scar severity. The model showed that patient-rated facial scar severity was not predictive for self-esteem and depressive symptoms six months post-burn. There was, however, a significant relationship between early depressive symptoms and both patient-rated facial scar severity and subsequent self-esteem. The variables in the model accounted for 37% of the variance in depressive symptoms six months post-burn and the model provided a moderately well-fitting representation of the data. The study suggests that self-esteem and depressive symptoms were not affected by self-reported facial scar severity but that earlier depressive symptoms were indicative for a more severe self-reported facial scar rating. Therefore, routine psychological screening during hospitalisation is recommended in order to identify patients at risk and to optimise their treatment. Copyright © 2014 Elsevier Inc. All rights reserved.

Fiber tract-specific white matter lesion severity Findings in late-life depression and by AGTR1 A1166C genotype.

Science.gov (United States)

Taylor, Warren D; Zhao, Zheen; Ashley-Koch, Allison; Payne, Martha E; Steffens, David C; Krishnan, Ranga R; Hauser, Elizabeth; MacFall, James R

2013-02-01

Past work demonstrated that late-life depression is associated with greater severity of ischemic cerebral hyperintense white matter lesions, particularly frontal lesions. However, these lesions are also associated with other neuropsychiatric deficits, so these clinical relationships may depend on which fiber tracts are damaged. We examined the ratio of lesion to nonlesioned white matter tissue within multiple fiber tracts between depressed and nondepressed elders. We also sought to determine if the AGTR1 A1166C and BDNF Val66Met polymorphisms contributed to vulnerability to lesion development in discrete tracts. The 3T structural MR images and blood samples for genetic analyses were acquired on 54 depressed and 37 nondepressed elders. Lesion maps were created through an automated tissue segmentation process and applied to a probabilistic white matter fiber tract atlas allowing for identification of the fraction of the tract occupied by lesion. The depressed cohort exhibited a significantly greater lesion ratio only in the left upper cingulum near the cingulate gyrus (F((1,86)) = 4.62, P = 0.0344), supporting past work implicating cingulate dysfunction in the pathogenesis of depression. In the 62 Caucasian subjects with genetic data, AGTR1 C1166 carriers exhibited greater lesion ratios across multiple tracts including the anterior thalamic radiation and inferior fronto-occipital fasciculus. In contrast, BDNF Met allele carriers exhibited greater lesion ratios only in the frontal corpus callosum. Although these findings did not survive correction for multiple comparisons, this study supports our hypothesis and provides preliminary evidence that genetic differences related to vascular disease may increase lesion vulnerability differentially across fiber tracts. Copyright © 2011 Wiley Periodicals, Inc.

Whiplash-associated disorders: who gets depressed? Who stays depressed?

Science.gov (United States)

Carroll, Linda J.; Cassidy, J. David; Côté, Pierre

2010-01-01

Depression is common in whiplash-associated disorders (WAD). Our objectives were to identify factors associated with depressive symptomatology occurring in the initial stages of WAD, and to identify factors predicting the course of depressive symptoms. A population-based cohort of adults sustaining traffic-related WAD was followed at 6 weeks, 3, 6, 9, and 12 months. Baseline measures (assessed a median of 11 days post-crash) included demographic and collision-related factors, prior health, and initial post-crash pain and symptoms. Depressive symptomatology was assessed at baseline and at each follow-up using the Centre for Epidemiological Studies Depression Scale (CES-D). We included only those who participated at all follow-ups (n = 3,452; 59% of eligible participants). Using logistic regression, we identified factors associated with initial (post-crash) depression. Using multinomial regression, we identified baseline factors predicting course of depression. Courses of depression were no depression; initial depression that resolves, recurs or persists, and later onset depression. Factors associated with initial depression included greater neck and low back pain severity, greater percentage of body in pain, numbness/tingling in arms/hand, dizziness, vision problems, post-crash anxiety, fracture, prior mental health problems, and poorer general health. Predictors of persistent depression included older age, greater initial neck and low back pain, post-crash dizziness, vision and hearing problems, numbness/tingling in arms/hands, anxiety, prior mental health problems, and poorer general health. Recognition of these underlying risk factors may assist health care providers to predict the course of psychological reactions and to provide effective interventions. PMID:20127261

Is postpartum depression a homogenous disorder: time of onset, severity, symptoms and hopelessness in relation to the course of depression.

Science.gov (United States)

Kettunen, Pirjo; Koistinen, Eeva; Hintikka, Jukka

2014-12-10

Postpartum depression (PPD) is a common illness, but due to the underlying processes and the diversity of symptoms, some variability is exhibited. The risk of postpartum depression is great if the mother has previously suffered from depression, but there is some evidence that a certain subgroup of women only experience depression during the postpartum period. The study group consisted of 104 mothers with postpartum major depression and a control group of 104 postpartum mothers without depression. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) was used for data collection. The severity of depression and other mental symptoms were assessed using several validated rating scales. A history of past depression (82%), including depression during pregnancy (42%) and during the postpartum period (53%), was very common in those with current PPD. Eighteen per cent of mothers with current PPD had previously not had any depressive episodes and four per cent had experienced depression only during the postpartum period. Therefore, pure PPD was rare. The onset of PPD was usually (84%) within six weeks of childbirth. Obsessive-compulsive symptoms, phobic anxiety, paranoid ideation, depressed mood, diminished pleasure/interest, decreased energy, and psychomotor agitation/retardation were common with all kinds of depression histories. Pure PPD was the most similar to the first depressive episode. Nevertheless, the severity of depression, the level of hopelessness, somatisation, interpersonal sensitivity, anxiety, hostility, psychoticism, sleep disturbance, and suicidal ideation were lower, appetite changed less, and concentration was better than in other recurrent depressions. According to this study, PPD is not a homogenous disorder. The time of onset, severity, symptoms, level of hopelessness, and the course of depression vary. Recurrent depression is common. All mothers must be screened during the sixth week postpartum at the latest. Screening alone is not

Dimensional depression severity in women with major depression and post-traumatic stress disorder correlates with fronto-amygdalar hypoconnectivty.

Science.gov (United States)

Satterthwaite, T D; Cook, P A; Bruce, S E; Conway, C; Mikkelsen, E; Satchell, E; Vandekar, S N; Durbin, T; Shinohara, R T; Sheline, Y I

2016-07-01

Depressive symptoms are common in multiple psychiatric disorders and are frequent sequelae of trauma. A dimensional conceptualization of depression suggests that symptoms should be associated with a continuum of deficits in specific neural circuits. However, most prior investigations of abnormalities in functional connectivity have typically focused on a single diagnostic category using hypothesis-driven seed-based analyses. Here, using a sample of 105 adult female participants from three diagnostic groups (healthy controls, n=17; major depression, n=38; and post-traumatic stress disorder, n=50), we examine the dimensional relationship between resting-state functional dysconnectivity and severity of depressive symptoms across diagnostic categories using a data-driven analysis (multivariate distance-based matrix regression). This connectome-wide analysis identified foci of dysconnectivity associated with depression severity in the bilateral amygdala. Follow-up seed analyses using subject-specific amygdala segmentations revealed that depression severity was associated with amygdalo-frontal hypo-connectivity in a network of regions including bilateral dorsolateral prefrontal cortex, anterior cingulate and anterior insula. In contrast, anxiety was associated with elevated connectivity between the amygdala and the ventromedial prefrontal cortex. Taken together, these results emphasize the centrality of the amygdala in the pathophysiology of depressive symptoms, and suggest that dissociable patterns of amygdalo-frontal dysconnectivity are a critical neurobiological feature across clinical diagnostic categories.

Differential relationship between depression severity and patients' perceived family functioning in women versus in men.

Science.gov (United States)

Febres, Jeniimarie; Rossi, Rita; Gaudiano, Brandon A; Miller, Ivan W

2011-07-01

Previous research suggests that depression and family functioning are related and that women and men may differ in how they respond to and cope with depression. Significantly less attention has been paid to whether sex moderates the relationship between family functioning and depression. In the current study, the relationship between depression severity and perceived family functioning, both generally and in specific areas, was examined in women and men (N = 117) hospitalized with major depression. The level of depression severity was not significantly different in men and in women. Correlations between depression severity and most domains of family functioning were significant and positive for men only. Furthermore, sex statistically moderated the associations between depression severity and family functioning in the areas of problem solving, communication, affective responsiveness, and behavior control. The implications for the assessment and treatment of family dysfunction in severely depressed patients are discussed.

Are severe depressive symptoms associated with infertility-related distress in individuals and their partners?

DEFF Research Database (Denmark)

Peterson, Brennan D.; Sejbæk, Camilla Sandal; Prritano, Matthew

2014-01-01

the individual and partner level. What is known already?: An infertility diagnosis, the stress of medical treatments and a prior history of depression are risk factors for future depression in those undergoing fertility treatments. Studies examining the impact of severe depressive symptoms on infertility-related......Study question: Are severe depressive symptoms in women and men associated with individual and dyadic infertility-related stress in couples undergoing infertility treatment? Summary answer: Severe depressive symptoms were significantly associated with increased infertility-related distress at both....../materials, setting, methods: Participants were consecutively referred patients undergoing a cycle of medically assisted reproduction treatment at five Danish public and private clinics specializing in treating fertility patients. Severe depressive symptoms were measured by the Mental Health Inventory 5 from...

Maternal effects alter the severity of inbreeding depression in the offspring.

Science.gov (United States)

Pilakouta, Natalie; Smiseth, Per T

2016-09-14

A maternal effect is a causal influence of the maternal phenotype on the offspring phenotype over and above any direct effects of genes. There is abundant evidence that maternal effects can have a major impact on offspring fitness. Yet, no previous study has investigated the potential role of maternal effects in influencing the severity of inbreeding depression in the offspring. Inbreeding depression is a reduction in the fitness of inbred offspring relative to outbred offspring. Here, we tested whether maternal effects due to body size alter the magnitude of inbreeding depression in the burying beetle Nicrophorus vespilloides We found that inbreeding depression in larval survival was more severe for offspring of large females than offspring of small females. This might be due to differences in how small and large females invest in an inbred brood because of their different prospects for future breeding opportunities. To our knowledge, this is the first evidence for a causal effect of the maternal phenotype on the severity of inbreeding depression in the offspring. In natural populations that are subject to inbreeding, maternal effects may drive variation in inbreeding depression and therefore contribute to variation in the strength and direction of selection for inbreeding avoidance. © 2016 The Author(s).

Anaerobic muscle strengthening physical activity and depression severity among USA adults.

Science.gov (United States)

Cangin, Causenge; Harris, Randall; Binkley, Philip; Schwartzbaum, Judith; Focht, Brian

2018-06-01

We investigated the association between depression and anaerobic physical activity (while controlling aerobic physical activity), using a nationally representative sample of USA adults ( n  = 7354) who participated in the cross sectional National Health and Nutrition Examination Survey (NHANES, 1999-2006). We defined depression using the validated "Patient Health Questionnaire" (PHQ 9 ) scale of 0-27 as PHQ 9   ≥  10. Severity of depression was classified by clinically established PHQ 9 levels: mild (5-9), dysthymic (10-14), moderate (15-19), and major depression ( ≥ 20). We used logistic regression to estimate adjusted odds ratios of depression associated with distinct types of activity (only aerobic, only anaerobic, combined regime). We used multinomial logistic regression to examine associations of anaerobic activity with various severity levels of depression (mild, dysthymic, moderate, and major depression) with adjustment for aerobic activity. Women had higher prevalence of depression than men (8.4% versus 5.7%), whereas anaerobic muscle strengthening activity was more common in men than women (35% versus 24%). Adjusting for aerobic activity , anaerobic activity was inversely associated with depression (PHQ 9   ≥  10) in women under 50 (OR = 0.57; 95%CI = 0.41-0.81), all women (OR = 0.59; 0.43-0.80), men under 50 (OR = 0.85; 0.58-1.2), and all men (OR = 0.72; 0.51-1.01). Anaerobic activity was inversely associated with severity level of depressive symptoms in women and men. The combined regimen of anaerobic muscle strengthening activity and meeting the Physical Activity Guideline for America (PAGA) was related to the lowest odds ratio of depression in women (OR = 0.50; 95%CI = 0.33-0.75) and men (OR = 0.39; 95%CI = 0.23-0.62). Independent of aerobic physical activity, anaerobic muscle strengthening activity is significantly and inversely associated with depression among USA adults.

Big Five personality and depression diagnosis, severity and age of onset in older adults.

Science.gov (United States)

Koorevaar, A M L; Comijs, H C; Dhondt, A D F; van Marwijk, H W J; van der Mast, R C; Naarding, P; Oude Voshaar, R C; Stek, M L

2013-10-01

Personality may play an important role in late-life depression. The aim of this study is to examine the association between the Big Five personality domains and the diagnosis, severity and age of onset of late-life depression. The NEO-Five Factor Inventory (NEO-FFI) was cross-sectionally used in 352 depressed and 125 non-depressed older adults participating in the Netherlands Study of Depression in Older Persons (NESDO). Depression diagnosis was determined by the Composite International Diagnostic Interview (CIDI). Severity of depression was assessed by the Inventory of Depressive Symptomatology (IDS). Logistic and linear regression analyses were applied. Adjustments were made for sociodemographic, cognitive, health and psychosocial variables. Both the presence of a depression diagnosis and severity of depression were significantly associated with higher Neuroticism (OR=1.35, 95% CI=1.28-1.43 and B=1.06, ppersonality measures. This study confirms an association between personality and late-life depression. Remarkable is the association found between high Openness and earlier age of depression onset. © 2013 Elsevier B.V. All rights reserved.

Mindfulness, Quality of Life, and Severity of Depressive Symptoms Among Patients With Schizophrenia and Patients With Major Depressive Disorder.

Science.gov (United States)

Rayan, Ahmad Hussien Rateb

2017-05-01

The current study used a descriptive correlational design to examine the relationship between mindfulness and quality of life (QOL) among patients with schizophrenia (n = 160) and patients with major depressive disorder (MDD) (n = 161), controlling for demographic and clinical variables. Participants completed self-reported questionnaires regarding demographic variables, severity of depression, QOL, and mindfulness. Patients diagnosed with MDD had higher mindfulness scores than patients diagnosed with schizophrenia. Mindfulness scores were significantly associated with the severity of depression among participants. After controlling for the demographic variables and severity of depressive symptoms, mindfulness had a unique variance in QOL among patients with schizophrenia, but not among patients with MDD. The current study provides preliminary evidence regarding the role of mindfulness in improving depressive symptoms and the overall QOL among patients diagnosed with mental illness. [Journal of Psychosocial Nursing and Mental Health Services, 55(5), 40-50.]. Copyright 2017, SLACK Incorporated.

Plasma sterols and depressive symptom severity in a population-based cohort.

Directory of Open Access Journals (Sweden)

Basar Cenik

Full Text Available Convergent evidence strongly suggests major depressive disorder is heterogeneous in its etiology and clinical characteristics. Depression biomarkers hold potential for identifying etiological subtypes, improving diagnostic accuracy, predicting treatment response, and personalization of treatment. Human plasma contains numerous sterols that have not been systematically studied. Changes in cholesterol concentrations have been implicated in suicide and depression, suggesting plasma sterols may be depression biomarkers. Here, we investigated associations between plasma levels of 34 sterols (measured by mass spectrometry and scores on the Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR16 scale in 3117 adult participants in the Dallas Heart Study, an ethnically diverse, population-based cohort. We built a random forest model using feature selection from a pool of 43 variables including demographics, general health indicators, and sterol concentrations. This model comprised 19 variables, 13 of which were sterol concentrations, and explained 15.5% of the variation in depressive symptoms. Desmosterol concentrations below the fifth percentile (1.9 ng/mL, OR 1.9, 95% CI 1.2-2.9 were significantly associated with depressive symptoms of at least moderate severity (QIDS-SR16 score ≥10.5. This is the first study reporting a novel association between plasma concentrations cholesterol precursors and depressive symptom severity.

The role of early adversity and recent life stress in depression severity in an outpatient sample.

Science.gov (United States)

Vogt, Dominic; Waeldin, Sandra; Hellhammer, Dirk; Meinlschmidt, Gunther

2016-12-01

Pre-, peri-, and postnatal stress have frequently been reported to be associated with negative health outcomes during adult life. However, it is unclear, if these factors independently predict mental health in adulthood. We estimated potential associations between reports of pre-, peri-, and postnatal stress and depression severity in outpatients (N = 473) diagnosed with depression, anxiety or somatoform disorders by their family physician. We retrospectively assessed pre-, peri-, and postnatal stress and measured depression severity as well as recent life stress using questionnaires. First, we estimated if depression severity was predicted by pre-, peri- and/or postnatal stress using multiple regression models. Second, we compared pre- and postnatal stress levels between patient subgroups of different degrees of depression severity, performing multilevel linear modeling. Third, we analyzed if an association between postnatal stress and current depression severity was mediated by recent life stress. We found no associations of pre-, or perinatal stress with depression severity (all p > 0.05). Higher postnatal stress was associated with higher depression severity (p stress as compared to patients with none to minimal, or mild depression (all p life stress of the association between postnatal stress and depression severity (p stress predicted depression severity in adult life. This association was mediated by recent life stress. Copyright © 2016 Elsevier Ltd. All rights reserved.

Mothers’ Depression and Stress, Severity of Autism among Children and Family Income

OpenAIRE

Athari, Pegah; Department of educational psychology, Faculty of Education Universiti Teknologi Malaysia; Ghaedi, Leila; Department of educational psychology, Faculty of Education Universiti Teknologi Malaysia

2013-01-01

This study was conducted to investigate the relationship between mothers’ depression and stress compared with severity of autism in children and the effect of family income on the relationship between these two latter variables. Levels of depression and stress among mothers (n=250) were measured based on Depression Anxiety and Stress Scale of 42 items (DASS¬-42). The severity of autism among children was assessed by Autism Behavior Checklist (ABC) according to children’s teachers reports (n=2...

Psychometric evaluation of the Major Depression Inventory (MDI) as depression severity scale using the LEAD (Longitudinal Expert Assessment of All Data) as index of validity

DEFF Research Database (Denmark)

Bech, Per; Timmerby, N; Martiny, K

2015-01-01

BACKGROUND: The Major Depression Inventory (MDI) was developed to cover the universe of depressive symptoms in DSM-IV major depression as well as in ICD-10 mild, moderate, and severe depression. The objective of this study was to evaluate the standardization of the MDI as a depression severity......-IV major depression. The conventional VAS scores for no, mild, moderate, and severe depression were used for the standardization of the MDI. RESULTS: The inter-correlation for the MDI with the clinician ratings (VAS, MES, HAM-D17 and HAM-D6) increased over the rating weeks in terms of Pearson coefficients....... After nine weeks of therapy the coefficient ranged from 0.74 to 0.83. Using the clinician-rated VAS depression severity scale, the conventional MDI cut-off scores for no or doubtful depression, and for mild, moderate and severe depression were confirmed. CONCLUSIONS: Using the VAS as index of external...

Exercise and severe major depression: effect on symptom severity and quality of life at discharge in an inpatient cohort.

Science.gov (United States)

Schuch, F B; Vasconcelos-Moreno, M P; Borowsky, C; Zimmermann, A B; Rocha, N S; Fleck, M P

2015-02-01

Exercise is a potential treatment for depression. However, few studies have evaluated the role of adjunct exercise in the treatment of severely major depressed inpatients. The goal of this study was to evaluate the effects of add-on exercise on the usual treatment of severely depressed inpatients. Fifty participants were randomized to an exercise (exercise + usual treatment) or a control (usual treatment) group. Twenty-five patients were randomly allocated to each group. The participants in the exercise group performed three sessions per week throughout the hospitalization period, with a goal dose of 16.5 kcal/kg/week plus the usual pharmacological treatment. Depressive symptoms and the Quality of Life (QoL) of the participants were assessed at the baseline, the second week, and discharge. A significant group × time interaction was found for depressive symptoms and the physical and psychological domains of QoL. Differences between groups occurred at the second week and discharge with respect to depressive symptoms and the physical and psychological domains of QoL. There was no difference in the remission rate at discharge (48% and 32% for the exercise and control group, respectively). An NNT of 6.25 was found. No significant baseline characteristics predict remission at discharge. Add-on exercise is an efficacious treatment for severely depressed inpatients, improving their depressive symptoms and QoL. Initial acceptance of exercise remains a challenge. Copyright © 2014 Elsevier Ltd. All rights reserved.

The association of antidepressant and statin use with death and incident cardiovascular disease varies by depression severity.

Science.gov (United States)

May, Heidi T; Bair, Tami L; Reiss-Brennan, Brenda; Knight, Stacey; Anderson, Jeffrey L; Horne, Benjamin D; Brunisholz, Kimberly D; Muhlestein, Joseph B

2017-09-01

Depression has been reported to be associated with a greater risk of death and cardiovascular disease (CVD); however, the impact of antidepressants (ADM) on CVD risk remains controversial. Statin use is known to decrease CVD risk. Whether the use of these medications together affects CVD risk has not been studied. Patients (N = 26,828) completing the patient health questionnaire (PHQ-9), ≥40 years of age, without prior CVD, and no prior ADM use were studied. Depressive severity was categorized as none-mild (PHQ-9 score ≤14, n = 21,517) and moderate-severe (PHQ-9 score ≥15, n = 5311). Cox hazard regression was used to evaluate the association of no ADM/no statin use (n = 23,104 [86.1%]), ADM/no statin use (n = 877 [3.3%]), no ADM/statin use (n = 2627 [9.8%]), and ADM/statin use (n = 220 [.8%]) with major adverse cardiovascular events (MACE: death, CAD, stroke). Patients averaged 56 ± 12 years; 61% female. There were 1182 (4.4%) 3 year MACE events. The association of ADM and statin use with MACE varied by depressive symptom severity, with statin therapy associated with a decreased risk in the none-mild group (HR = .78, p = .007) and ADM in the moderate-high group (HR = 0.58, p = 0.02). Concomitant use of ADMs and statins did not appear to provide additive benefit.

Relationship between severity of depression symptoms and iron deficiency anemia in women with major depressive disorder

Directory of Open Access Journals (Sweden)

Seyed gholamreza Noorazar

2015-11-01

Full Text Available Introduction: Iron deficiency (ID is a common nutritional problem lead to many unintended consequences such as decrease energy, immune system problems, and neurological dysfunction. The most common psychological disorder is depression. A patient with ID anemia (IDA show signs and symptoms of behavioral and mood disorders like depression. Methods: In this study, 100 female patients with diagnosed major depression in years 2010 and 2011 were studied. In all patients standard Hamilton depression rating scale (HDRS was used to evaluate depression severity. Blood samples were taken for complete blood count difference analysis and evaluating anemia and in those with hemoglobin (Hb < 12 mg/dl, ferritin, and total iron binding capacity were checked to evaluate IDA. Results: Patients mean age was 36.34 ± 10.43 years old. Mean HDRS score was 32.20 ± 4.07. 19 had anemia, and among them 8% had IDA. Mean HDRS score in patients with IDA (33.37 ± 1.90 was higher than those without (32.09 ± 4.19, but the difference was not significant (P = 0.39. There was no difference between patients with and without anemia in HDRS score. The negative relation was observed between Hb levels, and HDRS score (Pearson correlation = -0.21, P = 0.03. Conclusion: We observed that the negative correlation between Hb levels and HDRS score. It demonstrates the effect of Hb decrease and anemia occurrence on depression severity; however, it needs more studies.

Symptoms of depression in survivors of severe sepsis: a prospective cohort study of older Americans.

Science.gov (United States)

Davydow, Dimitry S; Hough, Catherine L; Langa, Kenneth M; Iwashyna, Theodore J

2013-09-01

To examine if incident severe sepsis is associated with increased risk of subsequent depressive symptoms and to assess which patient characteristics are associated with increased risk of depressive symptoms. Prospective longitudinal cohort study. Population-based cohort of older U.S. adults interviewed as part of the Health and Retirement Study (1998-2006). A total of 439 patients who survived 471 hospitalizations for severe sepsis and completed at least one follow-up interview. Depressive symptoms were assessed with a modified version of the Center for Epidemiologic Studies Depression Scale. Severe sepsis was identified using a validated algorithm in Medicare claims. The point prevalence of substantial depressive symptoms was 28% at a median of 1.2 years before sepsis, and remained 28% at a median of 0.9 years after sepsis. Neither incident severe sepsis (relative risk [RR]: 1.00; 95% confidence interval [CI]: 0.73, 1.34) nor severe sepsis-related clinical characteristics were significantly associated with subsequent depressive symptoms. These results were robust to potential threats from missing data or alternative outcome definitions. After adjustment, presepsis substantial depressive symptoms (RR: 2.20; 95% CI: 1.66, 2.90) and worse postsepsis functional impairment (RR: 1.08 per new limitation; 95% CI: 1.03, 1.13) were independently associated with substantial depressive symptoms after sepsis. The prevalence of substantial depressive symptoms in severe sepsis survivors is high but is not increased relative to their presepsis levels. Identifying this large subset of severe sepsis survivors at increased risk for major depression, and beginning interventions before hospital discharge, may improve outcomes. Copyright © 2013 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Likelihood of Suicidality at Varying Levels of Depression Severity: A Re-Analysis of NESARC Data

Science.gov (United States)

Uebelacker, Lisa A.; Strong, David; Weinstock, Lauren M.; Miller, Ivan W.

2010-01-01

Although it is clear that increasing depression severity is associated with more risk for suicidality, less is known about at what levels of depression severity the risk for different suicide symptoms increases. We used item response theory to estimate the likelihood of endorsing suicide symptoms across levels of depression severity in an…

The prevalence and predictors of severe depression among the elderly in Malaysia.

Science.gov (United States)

Rashid, Abdul; Tahir, Ibrahim

2015-03-01

The population of Malaysia is relatively young, due to this there is a dearth in research conducted among the elderly especially relating to depression. The aim of this study is to determine the prevalence and the predictors of severe depression among the elderly in Malaysia. A sample of 2005 older adults randomly selected from the Penang State government's list of elderly receiving aid participated in the study. The Geriatric Depression Scale was used to screen for depression. Socio-demographic, social support, disease, functional and other factors were looked at as possible predictor variables. The prevalence of severe depression was 19.2 %. Indians (aOR = 2.0), being married (aOR = 10.5), widowed & divorced (aOR = 5.2), having poor (aOR = 2.7) or moderate social support (aOR = 2.7), having no one (aOR = 2.9), relatives (aOR = 2.3) or religious figures & others (aOR = 1.9) as compared to a spouse as a source of emotional support, feeling extremely lonely (aOR = 3.4), not socially active (aOR = 2.3), cognitively impaired (aOR 2.5), activities limited due to illness or disability (aOR = 1.6) and poor sleep quality (aOR = 3.6) were significant predictor variables. The prevalence of severe depression was high. It is pertinent that older adults, especially those with risk factors identified in this study be screened for depression at every opportunity.

What predicts depression in cardiac patients: sociodemographic factors, disease severity or theoretical vulnerabilities?

Science.gov (United States)

Doyle, F; McGee, H M; Conroy, R M; Delaney, M

2011-05-01

Depression is associated with increased cardiovascular risk in acute coronary syndrome (ACS) patients, but some argue that elevated depression is actually a marker of cardiovascular disease severity. Therefore, disease indices should better predict depression than established theoretical causes of depression (interpersonal life events, reinforcing events, cognitive distortions, type D personality). However, little theory-based research has been conducted in this area. In a cross-sectional design, ACS patients (n = 336) completed questionnaires assessing depression and psychosocial vulnerabilities. Nested logistic regression assessed the relative contribution of demographic or vulnerability factors, or disease indices or vulnerabilities to depression. In multivariate analysis, all vulnerabilities were independent significant predictors of depression (scoring above threshold on any scale, 48%). Demographic variables accounted for vulnerabilities accounting for significantly more (pseudo R² = 0.16, χ²(change) = 150.9, df = 4, p vulnerabilities increased the overall variance explained to 22% (pseudo R² = 0.22, χ² = 58.6, df = 4, p vulnerabilities predicted depression status better than did either demographic or disease indices. The presence of these proximal causes of depression suggests that depression in ACS patients is not simply a result of cardiovascular disease severity.

Complex partial seizure with severe depression and conduct ...

African Journals Online (AJOL)

Complex partial seizure complicated by psychiatric comorbidities like depression and conduct disorder presents management challenges for both the physician and parents. The etiology of such psychiatric comorbidities may be related to the seizure or to several other unrelated risk factors. The psychiatric comorbidities and ...

Depressive Symptom Severity and Community Collective Efficacy following the 2004 Florida Hurricanes.

Directory of Open Access Journals (Sweden)

Carol S Fullerton

Full Text Available There is a lack of research investigating community-level characteristics, such as community collective efficacy, mitigating the impact of disasters on psychological health, specifically depression. We examined the association of community collective efficacy with depressive symptom severity in Florida public health workers (n = 2249 exposed to the 2004 hurricane season using a multilevel approach. Cross-sectional anonymous questionnaires were distributed electronically to all Florida Department of Health (FDOH personnel that assessed depressive symptom severity and collective efficacy nine months after the 2004 hurricane season. Analyses were conducted at the individual level and community level using zip codes. The majority of participants were female (81.9%, and ages ranged from 20 to 78 years (median = 49 years. The majority of participants (73.4% were European American, 12.7% were African American, and 9.2% were Hispanic. Using multilevel analysis, our data indicate that higher community-level and individual-level collective efficacy were associated with significantly lower depressive symptom severity (b = -0.09 [95% CI: -0.13, -0.04] and b = -0.09 [95% CI: -0.12, -0.06], respectively even after adjusting for individual sociodemographic variables, community socioeconomic characteristics, individual injury/damage, and community storm damage. Lower levels of depressive symptom severity were associated with communities with high collective efficacy. Our study highlights the possible importance of programs that enrich community collective efficacy for disaster communities.

Disengagement from tasks as a function of cognitive load and depressive symptom severity.

Science.gov (United States)

Bowie, Christopher R; Milanovic, Melissa; Tran, Tanya; Cassidy, Sarah

2017-01-01

Depression is associated with impairment in cognition and everyday functioning. Mechanisms of cognitive dysfunction in depression and the factors that influence strategic deployment of cognitive abilities in complex environments remain elusive. In this study we investigated whether depression symptom severity is associated with disengagement from a working memory task (Paced Auditory Serial Addition Task; PASAT) with parametric adjustment of task difficulty. 235 participants completed the Beck Depression Inventory, low and high cognitive load conditions of the PASAT, and quality of life. Cognitive disengagement was the sum of consecutive items in which participants did not proffer a response to the trial. Individuals with higher depression severity showed more cognitive disengagement on the high but not low cognitive load trial of the PASAT; they did not differ in number of correct responses. Increased disengagement from the low to high cognitive load was associated with more impaired quality of life. Depression severity is associated with increased disengagement from tasks as difficulty increases. These findings suggest the importance of measuring how cognitive skills are avoided in complex environments in addition to considering performance accuracy. Individuals with depressive symptoms might preferentially avoid cognitive tasks that are perceived as more complex in spite of intact ability.

Intimate Partner Violence and Depression Symptom Severity among South African Women during Pregnancy and Postpartum: Population-Based Prospective Cohort Study.

Directory of Open Access Journals (Sweden)

Alexander C Tsai

2016-01-01

Full Text Available Violence against women by intimate partners remains unacceptably common worldwide. The evidence base for the assumed psychological impacts of intimate partner violence (IPV is derived primarily from studies conducted in high-income countries. A recently published systematic review identified 13 studies linking IPV to incident depression, none of which were conducted in sub-Saharan Africa. To address this gap in the literature, we analyzed longitudinal data collected during the course of a 3-y cluster-randomized trial with the aim of estimating the association between IPV and depression symptom severity.We conducted a secondary analysis of population-based, longitudinal data collected from 1,238 pregnant women during a 3-y cluster-randomized trial of a home visiting intervention in Cape Town, South Africa. Surveys were conducted at baseline, 6 mo, 18 mo, and 36 mo (85% retention. The primary explanatory variable of interest was exposure to four types of physical IPV in the past year. Depression symptom severity was measured using the Xhosa version of the ten-item Edinburgh Postnatal Depression Scale. In a pooled cross-sectional multivariable regression model adjusting for potentially confounding time-fixed and time-varying covariates, lagged IPV intensity had a statistically significant association with depression symptom severity (regression coefficient b = 1.04; 95% CI, 0.61-1.47, with estimates from a quantile regression model showing greater adverse impacts at the upper end of the conditional depression distribution. Fitting a fixed effects regression model accounting for all time-invariant confounding (e.g., history of childhood sexual abuse yielded similar findings (b = 1.54; 95% CI, 1.13-1.96. The magnitudes of the coefficients indicated that a one-standard-deviation increase in IPV intensity was associated with a 12.3% relative increase in depression symptom severity over the same time period. The most important limitations of our study

Cerebrospinal fluid D-serine concentrations in major depressive disorder negatively correlate with depression severity.

Science.gov (United States)

Ishiwata, Sayuri; Hattori, Kotaro; Sasayama, Daimei; Teraishi, Toshiya; Miyakawa, Tomoko; Yokota, Yuuki; Matsumura, Ryo; Nishikawa, Toru; Kunugi, Hiroshi

2018-01-15

D-serine is an endogenous co-agonist of N-methyl-D-aspartate receptor (NMDAR) and plays an important role in glutamate neurotransmission. Several studies suggested the possible involvement of D-serine related in the pathophysiology of psychiatric disorders including major depression disorders (MDD). We tried to examine whether cerebrospinal fluid (CSF) or plasma D-serine concentrations are altered in MDD and whether D-serine concentrations correlated with disease severity. 26 MDD patients and 27 healthy controls matched for age, sex and ethnicity were enrolled. We measured amino acids in these samples using by high-performance liquid chromatography with fluorometric detection. D-serine and L-serine, precursor of D-serine, levels in CSF or plasma were not significantly different in patients of MDD compared to controls. Furthermore, a significant correlation between D-serine levels in CSF and Hamilton Depression Rating Scale (HAMD)-17 score was observed (r = -0.65, p = 0.006). Furthermore, we found a positive correlation between CSF D-serine and HVA concentrations in MDD patients (r = 0.54, p = 0.007). CSF D-serine concentrations were correlated with those of plasma in MDD (r = 0.61, p = 0.01) but not in controls. In CSF, we also confirmed a significant correlation between D-serine and L-serine levels in MDD (r = 0.72, p depression severity and HVA concentrations and further investigation were required to reveal the effect of medication and disease heterogeneity. Copyright © 2017 Elsevier B.V. All rights reserved.

Accuracy of automated classification of major depressive disorder as a function of symptom severity

Directory of Open Access Journals (Sweden)

Rajamannar Ramasubbu, MD, FRCPC, MSc

2016-01-01

Conclusions: Binary linear SVM classifiers achieved significant classification of very severe depression with resting-state fMRI, but the contribution of brain measurements may have limited potential in differentiating patients with less severe depression from healthy controls.

Gender similarities in somatic depression and in DSM depression secondary symptom profiles within the context of severity and bereavement.

Science.gov (United States)

Thompson, Angus H; Bland, Roger C

2018-02-01

Most population studies report higher rates of depression among women than men, and some researchers have observed gender differences in depression symptoms overall, or in sub-groupings (e.g. somatic depression). However, gender symptom differences have been inconsistent, prompting this investigation of gender differences in secondary DSM symptom profiles in the context of bereavement status, age, and depression severity. Individuals with symptoms of core depression (flat affect or anhedonia) were selected from a large survey of adults in the Alberta, Canada workforce. Analyses involved the comparison of gender profiles across the seven DSM-IV secondary depressive symptoms plus a MANOVA of sex, bereavement, and age, with secondary symptoms comprising the dependent variable. Gender profiles were very similar, irrespective of depression severity or bereavement. Secondary symptoms were marginally more common among women and more frequent among bereaved young adults, but there was no evidence for a gender-related somatic factor. First, data were gathered only for persons in the workforce and thus may not be generalizable to, for example, stay-at-home parents or those with employment issues. Second, the focus here is restricted to DSM symptoms, leaving risk factors, social roles, and brain functioning for separate investigation. Third, inferences were drawn from associations between groups of persons, rather than between individuals, requiring caution when speculating about individual attributes. Gender differences in depression represent a difference in amount, not kind, suggesting that the range of depressive experiences is similar for men and women. There was no gender difference ascribable to somatic depression. Copyright © 2017 Elsevier B.V. All rights reserved.

Homeopathic Individualized Q-Potencies versus Fluoxetine for Moderate to Severe Depression: Double-Blind, Randomized Non-Inferiority Trial

Directory of Open Access Journals (Sweden)

U. C. Adler

2011-01-01

Full Text Available Homeopathy is a complementary and integrative medicine used in depression, The aim of this study is to investigate the non-inferiority and tolerability of individualized homeopathic medicines [Quinquagintamillesmial (Q-potencies] in acute depression, using fluoxetine as active control. Ninety-one outpatients with moderate to severe depression were assigned to receive an individualized homeopathic medicine or fluoxetine 20 mg day−1 (up to 40 mg day−1 in a prospective, randomized, double-blind double-dummy 8-week, single-center trial. Primary efficacy measure was the analysis of the mean change in the Montgomery & Åsberg Depression Rating Scale (MADRS depression scores, using a non-inferiority test with margin of 1.45. Secondary efficacy outcomes were response and remission rates. Tolerability was assessed with the side effect rating scale of the Scandinavian Society of Psychopharmacology. Mean MADRS scores differences were not significant at the 4th (P = .654 and 8th weeks (P = .965 of treatment. Non-inferiority of homeopathy was indicated because the upper limit of the confidence interval (CI for mean difference in MADRS change was less than the non-inferiority margin: mean differences (homeopathy-fluoxetine were −3.04 (95% CI −6.95, 0.86 and −2.4 (95% CI −6.05, 0.77 at 4th and 8th week, respectively. There were no significant differences between the percentages of response or remission rates in both groups. Tolerability: there were no significant differences between the side effects rates, although a higher percentage of patients treated with fluoxetine reported troublesome side effects and there was a trend toward greater treatment interruption for adverse effects in the fluoxetine group. This study illustrates the feasibility of randomized controlled double-blind trials of homeopathy in depression and indicates the non-inferiority of individualized homeopathic Q-potencies as compared to fluoxetine in acute treatment of

Homeopathic Individualized Q-Potencies versus Fluoxetine for Moderate to Severe Depression: Double-Blind, Randomized Non-Inferiority Trial

Science.gov (United States)

Adler, U. C.; Paiva, N. M. P.; Cesar, A. T.; Adler, M. S.; Molina, A.; Padula, A. E.; Calil, H. M.

2011-01-01

Homeopathy is a complementary and integrative medicine used in depression, The aim of this study is to investigate the non-inferiority and tolerability of individualized homeopathic medicines [Quinquagintamillesmial (Q-potencies)] in acute depression, using fluoxetine as active control. Ninety-one outpatients with moderate to severe depression were assigned to receive an individualized homeopathic medicine or fluoxetine 20 mg day−1 (up to 40 mg day−1) in a prospective, randomized, double-blind double-dummy 8-week, single-center trial. Primary efficacy measure was the analysis of the mean change in the Montgomery & Åsberg Depression Rating Scale (MADRS) depression scores, using a non-inferiority test with margin of 1.45. Secondary efficacy outcomes were response and remission rates. Tolerability was assessed with the side effect rating scale of the Scandinavian Society of Psychopharmacology. Mean MADRS scores differences were not significant at the 4th (P = .654) and 8th weeks (P = .965) of treatment. Non-inferiority of homeopathy was indicated because the upper limit of the confidence interval (CI) for mean difference in MADRS change was less than the non-inferiority margin: mean differences (homeopathy-fluoxetine) were −3.04 (95% CI −6.95, 0.86) and −2.4 (95% CI −6.05, 0.77) at 4th and 8th week, respectively. There were no significant differences between the percentages of response or remission rates in both groups. Tolerability: there were no significant differences between the side effects rates, although a higher percentage of patients treated with fluoxetine reported troublesome side effects and there was a trend toward greater treatment interruption for adverse effects in the fluoxetine group. This study illustrates the feasibility of randomized controlled double-blind trials of homeopathy in depression and indicates the non-inferiority of individualized homeopathic Q-potencies as compared to fluoxetine in acute treatment of outpatients

Quantitative Susceptibility Mapping Reveals an Association between Brain Iron Load and Depression Severity

Directory of Open Access Journals (Sweden)

Shun Yao

2017-08-01

Full Text Available Previous studies have detected abnormal serum ferritin levels in patients with depression; however, the results have been inconsistent. This study used quantitative susceptibility mapping (QSM for the first time to examine brain iron concentration in depressed patients and evaluated whether it is related to severity. We included three groups of age- and gender-matched participants: 30 patients with mild-moderate depression (MD, 14 patients with major depression disorder (MDD and 20 control subjects. All participants underwent MR scans with a 3D gradient-echo sequence reconstructing for QSM and performed the 17-item Hamilton Depression Rating Scale (HDRS test. In MDD, the susceptibility value in the bilateral putamen was significantly increased compared with MD or control subjects. In addition, a significant difference was also observed in the left thalamus in MDD patients compared with controls. However, the susceptibility values did not differ between MD patients and controls. The susceptibility values positively correlated with the severity of depression as indicated by the HDRS scores. Our results provide evidence that brain iron deposition may be associated with depression and may even be a biomarker for investigating the pathophysiological mechanism of depression.

Mirtazapine Treatment of a Severe Depressive Episode and Resolution of Elevated Inflammatory Markers

Directory of Open Access Journals (Sweden)

Shahzad M. Alikhan

2013-01-01

Full Text Available Depression has been shown to be associated with systemic inflammatory activity and the mode of action of several antidepressants appears to involve immunomodulation. Effects on immune system activity have also recently been observed in correlation with therapeutic response to mirtazapine in cardiac patients with depression, but no study has yet examined these effects in otherwise physically healthy depressed patients treated with mirtazapine. This report describes an association between a clinical antidepressant response and a decrease in markers of systemic inflammation observed during pharmacotherapy with mirtazapine in a severely depressed but physically well patient. This observation adds to the evidence that changes in inflammatory responses may be implicated in the mode of action of antidepressants. Further studies of antidepressant responses to mirtazapine and levels of inflammatory markers in depressed patients without medical comorbidity can help elucidate the role of the immune system in the pathophysiology of depression, and hence contribute to the development of novel antidepressant therapies.

Anxiety and depressive symptoms in primary caregivers of patients with severe depression. A snapshot from a military mental health care facility

International Nuclear Information System (INIS)

Javed, M.; Ayaz, S.B.; Ullah, A.; Matee, S.

2015-01-01

This study aimed at determining the frequency and severity of anxiety and depressive symptoms in primary caregivers of severely depressed patients and evaluate the impact of demographic factors. Methodology: It was a cross-sectional study conducted in the out-patient as well as the in-patient setting of Armed Forces institute of Mental Health, Rawalpindi, from September 2009 to May 2012. Through non-probability purposive sampling, primary caregivers of patients diagnosed with severe depression by consultant psychiatrists were included and scored by resident psychiatrists on Revised Beck Depression Inventory (BDI-II) and Beck Anxiety Inventory (BAI). Results: Of 316 caregivers (mean age: 37.75 ± 12.26 years), majority (52.8%) were females, married (70.6%), employed (58.5%), earned < Rs. 5,000 per month (40.5%) and literate from grade 1-5 (21.8%). Most of them were mothers (25.3%) of the patients and were the caregivers for less than one year (43.4%). The mean total BDI-II score was 17.29 ± 13.94.It was significantly high in subjects belonging to age group of < 44 years. The mean total BAI score was 14.44 ± 11.56 and it was not significantly related to any demographic factor. Conclusion: Caregivers of severely depressed patients suffered considerable levels of anxiety and depressive symptoms. Younger caregivers were at higher risk of developing depressive symptoms but the age did not significantly affect development of anxiety. Gender, marital status, employment status, monthly income, relationship with the patient, ethnicity based on provinces, educational level and duration of care giving did not appear to be significantly related to the development of anxiety or depressive symptoms in our sample. (author)

What predicts depression in cardiac patients: Sociodemographic factors, disease severity or theoretical vulnerabilities?

OpenAIRE

Doyle, Frank; McGee, Hannah; Conroy, Ronán; Delaney, Mary

2011-01-01

Depression is associated with increased cardiovascular risk in patients with acute coronary syndrome (ACS), but some argue that elevated depression is actually a marker of cardiovascular disease severity. Therefore, disease indices should be better predictors of depression than established theoretical causes of depression (interpersonal life events, reinforcing events, cognitive distortions, type D personality). However, little theory-based research has been conducted in this area. In a cross...

Secondary depression in severe anxiety disorders: a population-based cohort study in Denmark

Science.gov (United States)

Meier, Sandra M; Petersen, Liselotte; Mattheisen, Manuel; Mors, Ole; Mortensen, Preben B; Laursen, Thomas M

2016-01-01

Summary Background Depression and anxiety disorders are highly comorbid conditions and a worldwide disease burden; however, large-scale studies delineating their association are scarce. In this retrospective study, we aimed to assess the effect of severe anxiety disorders on the risk and course of depression. Methods We did a population-based cohort study with prospectively gathered data in Denmark using data from three Danish population registers: The Danish Civil Registration System, the Danish Psychiatric Central Register, and the Danish National Hospital Registry. We selected the cohort from people born in Denmark between Jan 1, 1955, and Dec 31, 2002, who we followed up from Jan 1, 1994, to Dec 31, 2012. The cohort was restricted to individuals with known parents. First, we investigated the effect of specific anxiety diagnoses on risk of single depressive episodes and recurrent depressive disorder. Second, we investigated the effect of comorbid anxiety on risk of readmission for depression, adjusting for sex, age, calendar year, parental age, place at residence at time of birth, and the interaction of age with sex. Findings We included 3 380 059 individuals in our study cohort. The adjusted incidence rate ratio (IRR) for single depressive episodes was 3·0 (95% CI 2·8–3·1, pdepressive disorder was 5·0 (4·8–5·2) in patients with severe anxiety disorders compared with the general population. Compared with control individuals, the offspring of parents with anxiety disorders were more likely to be diagnosed with single depressive episodes (1·9, 1·8–2·0) or recurrent depressive disorder (2·1, 1·9–2·2). Comorbid anxiety increased the readmission rates in both patients with single depressive episodes and patients with recurrent depressive disorder. Interpretation Severe anxiety constitutes a significant risk factor for depression. Focusing on specific anxiety disorders might help to identify individuals at risk of depression, thereby providing new

[Association between health related quality of life and severity of depression in patients with major depressive disorder].

Science.gov (United States)

Cao, Yuping; Li, Wen; Shen, Jingjin; Zhang, Yalin

2011-02-01

To investigate the association between health related quality of life (HRQoL) and severity of depression in patients with major depressive disorder (MDD). Short Form 36 Health Survey Questionnaire (SF-36) was administered to 103 MDD patients at the baseline and 6-week follow-up. Hamilton Depression Rating for Depression (HAMD) and Clinical Global Impression (CGI) were administered at the baseline, 2- and 6-week follow-up, respectively. All SF-36 component scores in the 6-week follow-up were significantly higher than those at the baseline (Pphysical, general health, vitality, social functioning, role-emotion and mental health were significantly higher in the remission group than those in the non-remission group (Phealth transition was significantly associated with higher scores of HAMD and sleep disturbance at the baseline (Phealth and role-emotion were strongly associated with higher score of anxiety/somatization at the baseline (both Phealth was positively associated with reduction rate of cognitive disturbance at the 2-week endpoint (Phealth transition were positively associated with the reduction rate of sleep disturbance at the 2-week endpoint (both Pdepression was significantly associated with a worse HRQoL in patients with MDD. A 6-week antidepressant treatment may result in comparable HRQoL improvements. The components of HRQoL vary with severity of various symptoms of depression at the baseline and their early improvement after the treatment.

The increasing burden of depression

Directory of Open Access Journals (Sweden)

Lépine J-P

2011-05-01

Full Text Available Jean-Pierre Lépine1, Mike Briley21Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris Unité INSERM 705 CNRS UMR 8206, Université Paris Diderot, Paris, France; 2NeuroBiz Consulting and Communication, Castres, FranceAbstract: Recent epidemiological surveys conducted in general populations have found that the lifetime prevalence of depression is in the range of 10% to 15%. Mood disorders, as defined by the World Mental Health and the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, have a 12-month prevalence which varies from 3% in Japan to over 9% in the US. A recent American survey found the prevalence of current depression to be 9% and the rate of current major depression to be 3.4%. All studies of depressive disorders have stressed the importance of the mortality and morbidity associated with depression. The mortality risk for suicide in depressed patients is more than 20-fold greater than in the general population. Recent studies have also shown the importance of depression as a risk factor for cardiovascular death. The risk of cardiac mortality after an initial myocardial infarction is greater in patients with depression and related to the severity of the depressive episode. Greater severity of depressive symptoms has been found to be associated with significantly higher risk of all-cause mortality including cardiovascular death and stroke. In addition to mortality, functional impairment and disability associated with depression have been consistently reported. Depression increases the risk of decreased workplace productivity and absenteeism resulting in lowered income or unemployment. Absenteeism and presenteeism (being physically present at work but functioning suboptimally have been estimated to result in a loss of $36.6 billion per year in the US. Worldwide projections by the World Health Organization for the year 2030 identify unipolar major depression as the leading cause of disease burden

Greater incidence of depression with hypnotic use than with placebo

Directory of Open Access Journals (Sweden)

Kripke Daniel F

2007-08-01

Full Text Available Abstract Background Although it has been claimed that insomnia causes an increased risk for depression, adequate controlled trials testing this hypothesis have not been available. This study contrasted the incidence of depression among subjects receiving hypnotics in randomized controlled trials versus those receiving placebo. Methods The incidence of depression among patients randomized to hypnotic drugs or placebo was compiled from prescribing information approved by the United States Food and Drug Administration (FDA and from FDA New Drug Application documents. Available data for zolpidem, zaleplon, eszopiclone, and ramelteon were accessed. Results Data for 5535 patients randomized to a hypnotic and for 2318 randomized to placebo were compiled. The incidence of depression was 2.0% among participants randomized to hypnotics as compared to 0.9% among those randomized in parallel to placebo (p Conclusion Modern hypnotics were associated with an increased incidence of depression in data released by the FDA. This suggests that when there is a risk of depression, hypnotics may be contra-indicated. Preventive treatments such as antidepressant drugs, cognitive-behavioral therapy, or bright light might be preferred. Limitations in the FDA data prevented a formal meta-analysis, and there was a lack of information about drop-out rates and definitions of depression. Trials specifically designed to detect incident depression when treating insomnia with hypnotic drugs and better summarization of adverse events in trials submitted to the FDA are both necessary.

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

Science.gov (United States)

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, Pherbal 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). Copyright © 2014 Elsevier B.V. All rights reserved.

Depressive Symptoms on the Geriatric Depression Scale and Suicide Deaths in Older Middle-aged Men: A Prospective Cohort Study.

Science.gov (United States)

Yi, Sang-Wook

2016-05-01

Prospective evaluations of the associations between depressive symptoms and suicide deaths have been mainly performed in high-risk populations, such as individuals with psychiatric disorders or histories of self-harm. The purpose of this study was to prospectively examine whether more severe depressive symptoms assessed using the Geriatric Depression Scale (GDS) were associated with a greater risk of death from suicide in a general-risk population. A total of 113 478 men from the Korean Veterans Health Study (mean age, 58.9 years) who participated in a postal survey in 2004 were followed up for suicide mortality until 2010. Over 6.4 years of follow-up, 400 men died by suicide (56.7 deaths per 100 000 person-years). More severe depressive symptoms were associated with greater risk of suicide death (p for trend depression were 2.18 for mild depression, 2.13 for moderate depression, 3.33 for severe depression, and 3.67 for extreme depression. After adjusting for potential confounders, men with a potential depressive disorder had an approximate 90% higher mortality from suicide (adjusted HR, 1.92; 95% confidence interval [CI], 1.38 to 2.68; pdepression. Each five-point increase in the GDS score was associated with a higher risk of death by suicide (adjusted HR, 1.22; psuicide deaths was 0.61 (95% CI, 0.58 to 0.64). Depressive symptoms assessed using the GDS were found to be a strong independent predictor of future suicide. However, the estimate of relative risk was weaker than would be expected based on retrospective psychological autopsy studies.

Predicting relapse in major depressive disorder using patient-reported outcomes of depressive symptom severity, functioning, and quality of life in the Individual Burden of Illness Index for Depression (IBI-D).

Science.gov (United States)

Ishak, Waguih William; Greenberg, Jared M; Cohen, Robert M

2013-10-01

Patients with Major Depressive Disorder (MDD) often experience unexpected relapses, despite achieving remission. This study examines the utility of a single multidimensional measure that captures variance in patient-reported Depressive Symptom Severity, Functioning, and Quality of Life (QOL), in predicting MDD relapse. Complete data from remitted patients at the completion of 12 weeks of citalopram in the STAR*D study were used to calculate the Individual Burden of Illness index for Depression (IBI-D), and predict subsequent relapse at six (n=956), nine (n=778), and twelve months (n=479) using generalized linear models. Depressive Symptom Severity, Functioning, and QOL were all predictors of subsequent relapse. Using Akaike information criteria (AIC), the IBI-D provided a good model for relapse even when Depressive Symptom Severity, Functioning, and QOL were combined in a single model. Specifically, an increase of one in the IBI-D increased the odds ratio of relapse by 2.5 at 6 months (β=0.921 ± 0.194, z=4.76, pDepressive Symptom Severity in the IBI-D is useful in assessing the full burden of illness and in adequately predicting relapse, in MDD. © 2013 Elsevier B.V. All rights reserved.

Predictability of depression severity based on posterior alpha oscillations

NARCIS (Netherlands)

Jiang, H.; Popov, T.; Jylänki, P.P.; Bi, K.; Yao, Z.; Lu, Q.; Jensen, O.; Gerven, M.A.J. van

2016-01-01

Objective: We aimed to integrate neural data and an advanced machine learning technique to predict individual major depressive disorder (MDD) patient severity. Methods: MEG data was acquired from 22 MDD patients and 22 healthy controls (HC) resting awake with eyes closed. Individual power spectra

Depressive symptomatology in severe dementia in a European sample: prevalence, associated factors and prescription rate of antidepressants.

Science.gov (United States)

Giebel, Clarissa M; Sutcliffe, Caroline; Renom-Guiteras, Anna; Arve, Seija; Hallberg, Ingalill Rahm; Soto, Maria; Zabalegui, Adelaida; Hamers, Jan; Saks, Kai; Challis, David

2015-04-01

Depression is a common comorbid disorder of dementia. This study explores the prevalence of and factors associated with depressive symptomatology, and antidepressant prescription rates in severe dementia across eight European countries. In total, 414 people with severe dementia completed measures of cognition and quality of life (QoL), whilst carers completed proxy measures of activities of daily living (ADLs), depression, neuropsychiatric symptoms, QoL and comorbidity. Findings indicated that 30% of the sample had depression, whilst the highest and lowest prevalence of depression was reported in Germany and Finland, respectively. Lower QoL, the presence of pain and more frequent neuropsychiatric symptoms were associated with depressive symptomatology, whilst no significant relationship between impairment of ADLs, comorbidity, and depression emerged. Spain and Estonia had the highest and lowest rates of antidepressant prescribing, respectively, whilst Germany had the highest discrepancy between depressive symptomatology and prescription. The study highlights variations across countries in the prevalence of depressive symptomatology in severe dementia and prescription of antidepressants. Information about factors associated with depressive symptomatology may help to better identify and manage depression.

Risk factors for suicide among 34,671 patients with psychotic and non-psychotic severe depression

DEFF Research Database (Denmark)

Leadholm, Anne Katrine K; Rothschild, Anthony J; Nielsen, Jimmi

2014-01-01

BACKGROUND: Severe unipolar depression is associated with increased risk of suicide, but it remains unknown whether the same risk factors are present in the non-psychotic (non-PD) and psychotic (PD) subtypes respectively. Therefore, this study aimed to identify risk factors for suicide in non......-PD and PD separately, and to investigate if the presence of psychotic symptoms is an independent risk factor for suicide in severe depression. METHODS: This register-based, nationwide, historical prospective cohort study used logistic regression analyses to ascertain risk factors for suicide among all...... adults diagnosed with severe depression at Danish psychiatric hospitals between January 1, 1994 and December 31, 2010. The risk for suicide was expressed as adjusted odds ratios (AOR). RESULTS: A total of 34,671 individuals with severe depression (non-PD: n=26,106 and PD: n=12,101) were included...

EEG alpha power as an intermediate measure between brain-derived neurotrophic factor Val66Met and depression severity in patients with major depressive disorder.

Science.gov (United States)

Zoon, Harriët F A; Veth, C P M; Arns, Martijn; Drinkenburg, W H I M; Talloen, Willem; Peeters, Pieter J; Kenemans, J L

2013-06-01

Major depressive disorder has a large impact on patients and society and is projected to be the second greatest global burden of disease by 2020. The brain-derived neurotrophic factor (BDNF) gene is considered to be one of the important factors in the etiology of major depressive disorder. In a recent study, alpha power was found to mediate between BDNF Met and subclinical depressed mood. The current study looked at a population of patients with major depressive disorder (N = 107) to examine the association between the BDNF Val66Met polymorphism, resting state EEG alpha power, and depression severity. For this purpose, repeated-measures analysis of variance, partial correlation, and multiple linear models were used. Results indicated a negative association between parietal-occipital alpha power in the eyes open resting state and depression severity. In addition, Met/Met patients showed lower global absolute alpha power in the eyes closed condition compared with Val-carriers. These findings are in accordance with the previously uncovered pathway between BDNF Val66Met, resting state EEG alpha power, and depression severity. Additional research is needed for the clarification of this tentative pathway and its implication in personalized treatment of major depressive disorder.

Association between severity of depression and clinico-biochemical markers of polycystic ovary syndrome.

Science.gov (United States)

Enjezab, Behnaz; Eftekhar, Maryam; Ghadiri-Anari, Akram

2017-11-01

Polycystic ovary syndrome (PCOS), as the most common endocrine disorder among reproductive-aged women may lead to psychological morbidity. The present study set out to evaluate the severity of depression in PCOS and non-PCOS women and to evaluate correlation between depression score with body mass index, HOMA-IR, and testosterone level in every group (PCOS and non-PCOS women) in Yazd province. In this cross-sectional study, 62 women with PCOS and 61 non- PCOS subjects (20 to 40 years) who were attending Imam-Ali Clinic in Yazd, Iran from September 2014 through March 2015 participated. These persons completed the Beck Depression Short Inventory (BDI-S) Questionnaire. Frequency of depression in PCOD and healthy persons and correlation between depression severity with body mass index, HOMA-IR, testosterone level in PCOS and non- PCOS women were evaluated by ANOVA test and independent-samples t-test and Pearson correlation. P-value of less than 0.05 was considered as statistically significant. Data analyses were performed using SPSS version 16. Of 62 PCOS subjects, 40 (64.5%) were verified positive for depression, determined by the BDI-S Questionnaire. In the control group, 60.7% had depression. Mean±SE score of depression for PCOS and non-PCOS women were 7.47±5.54 and 7.57±5.77 respectively. There was no statistically significant correlation between body mass index, HOMA-IR, testosterone level with depression score in either group separately or together. We found considerable amounts of depression in our population. There is no correlation between body mass index, HOMA-IR, and testosterone level with depression score in our study.

Relapse insomnia increases greater risk of anxiety and depression: evidence from a population-based 4-year cohort study.

Science.gov (United States)

Chen, Ping-Jen; Huang, Charles Lung-Cheng; Weng, Shih-Feng; Wu, Ming-Ping; Ho, Chung-Han; Wang, Jhi-Joung; Tsai, Wan-Chi; Hsu, Ya-Wen

2017-10-01

We investigated the longitudinal impacts of insomnia on the subsequent developments of anxiety and depression during a four-year follow-up. We further categorized individuals with insomnia into different insomnia subgroups to examine whether the risk of anxiety and depression varies by subtype. Participants were identified from National Health Insurance enrollees in Taiwan during 2002-2009. The study included 19,273 subjects with insomnia and 38,546 matched subjects without insomnia. All subjects did not have previous diagnosis of insomnia, sleep apnea, anxiety, or depression. Compared with non-insomniacs, insomniacs had a higher risk of developing anxiety only [adjusted hazard ratio (HR) = 8.83, 95% CI = 7.59-10.27], depression only (adjusted HR = 8.48, 95% CI = 6.92-10.39), and both anxiety and depression (adjusted HR = 17.98, 95% CI = 12.65-25.56). When breaking down the insomnia subgroups, individuals with a relapse of insomnia (adjusted HR = 10.42-26.80) had the highest risk of anxiety only, depression only, and both anxiety and depression, followed by persistent insomnia (adjusted HR = 9.82-18.98), then remitted insomnia (adjusted HR = 4.50-8.27). All three insomnia subgroups had a greater four-year cumulative incidence rate than the non-insomnia group for anxiety only, depression only, and both anxiety and depression (p anxiety or/and depression. Awareness of insomnia and treatment of insomnia should be recommended at clinics, and patterns of insomnia should be monitored to help treatment and control of subsequent psychiatric disorders. Future research with comprehensive data collection is needed to identify factors that contribute to different insomnia subtypes. Copyright © 2017 Elsevier B.V. All rights reserved.

[Anxiety and polymorphism Val66Met of BDNF gene--predictors of depression severity in ischemic heart disease].

Science.gov (United States)

Golimbet, V E; Volel', B A; Kopylov, F Iu; Dolzhikov, A V; Korovaitseva, G I; Kasparov, S V; Isaeva, M I

2015-01-01

In a framework of search for early predictors of depression in patients with ischemic heart disease (IHD) we studied effect of molecular-genetic factors (polymorphism of brain-derived neirotrophic factor--BDNF), personality traits (anxiety, neuroticism), IHD severity, and psychosocial stressors on manifestations of depression in men with verified diagnosis of IHD. Severity of depression was assessed by Hamilton Depression Rating Scale 21-item (HAMD 21), anxiety and neuroticism were evaluated by the Spielberger State-Trait Anxiety Inventory and "Big Five" questionnaire, respectively. It wa shown that personal anxiety and ValVal genotype of BDNF gene appeared to be predictors of moderate and severe depression.

Predictors of switching from mania to depression in a large observational study across Europe (EMBLEM).

Science.gov (United States)

Vieta, Eduard; Angst, Jules; Reed, Catherine; Bertsch, Jordan; Haro, Josep Maria

2009-11-01

The risk of switching from mania to depression in bipolar disorder has been poorly studied. Large observational studies may be useful in identifying variables that predict switch to depression after mania and provide data on medication use and outcomes in "real world" patients. EMBLEM (European Mania in Bipolar Longitudinal Evaluation of Medication) is a 2-year, prospective, observational study of patients with a manic/mixed episode. Symptom severity measures included Clinical Global Impression-Bipolar Disorder scale (CGI-BP), Young Mania Rating Scale (YMRS) and 5-item Hamilton Depression Rating Scale. Switching was defined using CGI-BP mania and depression such that patients changed from manic and not depressed to depressed but not manic over two consecutive observations within the first 12 weeks of follow-up. Cox proportional hazards models identified baseline variables independently associated with switch to depression. Of 2390 patients who participated in the maintenance phase (i.e. up to 24 months), 120 (5.0%) switched to depression within the first 12 weeks. Factors associated with greater switching to depression include previous depressive episodes, substance abuse, greater CGI-BP overall severity and benzodiazepine use. Factors associated with lower switching rates were greater CGI-BP depression, lower YMRS severity and atypical antipsychotic use. The definition of switching biased against patients with mixed episodes being likely to switch. Strictly defined, switch to depression from mania occurs in a small proportion of bipolar patients. Clinical history, illness severity, co-morbidities and treatment patterns are associated with switching to depression. Atypical antipsychotics may protect against switch to depression.

Depressive Symptoms on the Geriatric Depression Scale and Suicide Deaths in Older Middle-aged Men: A Prospective Cohort Study

Directory of Open Access Journals (Sweden)

Sang-Wook Yi

2016-05-01

Full Text Available Objectives: Prospective evaluations of the associations between depressive symptoms and suicide deaths have been mainly performed in high-risk populations, such as individuals with psychiatric disorders or histories of self-harm. The purpose of this study was to prospectively examine whether more severe depressive symptoms assessed using the Geriatric Depression Scale (GDS were associated with a greater risk of death from suicide in a general-risk population. Methods: A total of 113 478 men from the Korean Veterans Health Study (mean age, 58.9 years who participated in a postal survey in 2004 were followed up for suicide mortality until 2010. Results: Over 6.4 years of follow-up, 400 men died by suicide (56.7 deaths per 100 000 person-years. More severe depressive symptoms were associated with greater risk of suicide death (p for trend <0.001. The unadjusted hazard ratios (HRs in comparison to the absence of depression were 2.18 for mild depression, 2.13 for moderate depression, 3.33 for severe depression, and 3.67 for extreme depression. After adjusting for potential confounders, men with a potential depressive disorder had an approximate 90% higher mortality from suicide (adjusted HR, 1.92; 95% confidence interval [CI], 1.38 to 2.68; p<0.001 than men without depression. Each five-point increase in the GDS score was associated with a higher risk of death by suicide (adjusted HR, 1.22; p<0.001. The value of the area under the receiver operating characteristics curve of GDS scores for suicide deaths was 0.61 (95% CI, 0.58 to 0.64. Conclusions: Depressive symptoms assessed using the GDS were found to be a strong independent predictor of future suicide. However, the estimate of relative risk was weaker than would be expected based on retrospective psychological autopsy studies.

Severe Intellectual Disability: Systematic Review of the Prevalence and Nature of Presentation of Unipolar Depression

Science.gov (United States)

Walton, Catherine; Kerr, Mike

2016-01-01

Background: The diagnosis of depression in severe and profound intellectual disability is challenging. Without adequate skills in verbal self-expression, standardized diagnostic criteria cannot be used with confidence. The purpose of this systematic review was to investigate the assessment and diagnosis of unipolar depression in severe and…

Comparison study of memory status in war-PTSD veterans with depression and non- veterans depressed patients

Directory of Open Access Journals (Sweden)

Radfar Shokofeh

2012-03-01

Results: The mean age of the veterans and non-veterans was 43.9±4.7 and 42±9.4 years, respectively. Memory status did not differ between the two groups (P>0.05. There was no statistically significant correlation between duration and severity of PTSD with memory impairment (P>0.05. A negative correlation was found between personal and general information with re-experiencing in the veterans (P<0.05. Impaired memory was correlated with age greater than 45, educational level lower than high school diploma, severity of depression and longer participation in war. Conclusion: Although both PTSD and major depression affected memory, but memory status did not differ between patients with PTSD and depression and patients with chronic depression.

Gender, negative life events and coping on different stages of depression severity: A cross-sectional study among Chinese university students.

Science.gov (United States)

Sun, Xiao-Jun; Niu, Geng-Feng; You, Zhi-Qi; Zhou, Zong-Kui; Tang, Yun

2017-02-01

The effects of gender, negative life events, and coping on depression have been well-documented. But depression is a heterogeneous syndrome of which the severity ranged from mild depression to major depression. This study aimed to investigate the specific effects of gender, negative life events, and coping on different stages of depression severity. A total of 5989 students (aged 16-25 years, M=20.85, SD=0.58), recruited from six universities in the central region of China using the stratified cluster sampling method, completed Life Events Questionnaire, Coping Response Inventory, and Beck Depression Inventory-Ⅱ. Among the participants, 708 (11.8%) students presented different severity levels of depression. Gender, negative life events, positive coping, and negative coping all had significant effects on depression. That is, the possibility of being depressed was significantly higher in female university students, or students who had more negative life events, more negative coping, or positive coping. In terms of the different stages of depression severity, all these factors had significant effects on the stage from non- depression to mild depression; only gender, negative life events and positive coping had significant effects on the stage from mild depression to moderate depression; only gender had a significant effect on the stage from moderate depression to major depression. The causal role of these factors on different stages of depression severity could not be inferred. Moreover, the participants were from a non-clinical population. The effects of gender, negative life events and coping varied in different stages of depression severity. The effects of life events and coping styles became insignificant with the increasing severity of depression, whereas the effect of gender remained significant. The results could provide guidance for the prevention, intervention, and treatment of depression. Copyright © 2016. Published by Elsevier B.V.

Incidence of postpartum depression and couple relationship quality.

Science.gov (United States)

Małus, Aleksandra; Szyluk, Justyna; Galińska-Skok, Beata; Konarzewska, Beata

2016-12-23

The childbirth constitutes a significant event in a woman's life and in the marital/ couple dyad. The changes which follow childbirth require re-organization of previous coping styles and development of new methods of adaptation, which proves difficult. The current study evaluated to what extent the development of postpartum depression symptoms in new mothers was associated with their level of satisfaction in marital relationship. The study included 100 women in their first month after delivery. The women completed questionnaires regarding postpartum depression (Postpartum Depression Screening Scale) and marital relationship quality (Marital Compatibility Questionnaire). There was a significant correlation between the level of postpartum depression and relationship quality. A greater severity of postpartum depression symptoms (sleeping/ eating disturbances, anxiety/insecurity, emotional lability, mental confusion, loss of self, guilt/ shame, suicidal thoughts) occurred in women who were less satisfied with their relationship, i.e., those who experienced a decreased level of intimacy, self-fulfillment and partner similarity, as well as a deeper sense of disillusionment. Women who declared deeper satisfaction with their relationship displayed a greater sense of mental well-being. No correlation was found between the occurrence of postpartum depression and socio-demographic factors (age, education level, place of residence) and factors associated with the subjects' childbearing history (number of children, number of pregnancies, history of miscarriage, family planning, prior diagnosis of depression, type of delivery, newborn's condition following birth, infant feeding method). Patients dissatisfied with the quality of their marital relationship experienced an increased severity of postpartum depression symptoms. Greater satisfaction with relationship quality was expressed by women in formalized relationships.

[Marital status and the severity of perinatal depression among pregnant women].

Science.gov (United States)

Podolska, Magdalena; Sipak-Szmigiel, Olimpia

2010-01-01

Cohabitation existing for ages in all human cultures is becoming more common since the 1960s due to complex changes in postmodern societies. These societies have made the phenomenon of cohabitation the object of adequate theoretical reflection. The aim of this work was to determine whether the marital status of pregnant women affects the severity of perinatal depression. We enrolled 117 gravida hospitalized in 2006 and 2007 at the Department of Maternal-Fetal Medicine, Pomeranian Medical University. The gestational age ranged from week 32 to 40. The clinical condition of each gravida was assessed during routine obstetric history taking. The Edinburgh Postnatal Depression Scale by Cox, Holden, and Sagovski was used as the screening test for perinatal depression. 1. The marital status of the gravida with emphasis on cohabitation is a significant correlate of perinatal depression and its risk. 2. Clinical examination should concentrate not only on the physical and medical condition but also on the psychosocial status of the patient as the predictor of perinatal depression. 3. All pregnant women living in informal partnerships should be offered psychological support.

Veteran preferences for romantic partner involvement in depression treatment.

Science.gov (United States)

Hershenberg, Rachel; Mavandadi, Shahrzad; Klaus, Johanna R; Oslin, David W; Sayers, Steven L

2014-01-01

The objective was to examine Veterans' preferences for romantic partner involvement in depression treatment and patient characteristics that are associated with the likelihood of preferred involvement. One hundred seventy-nine Veterans who met criteria for major or minor depression reported if they wanted their partners to give them medication reminders, accompany them to appointments, and speak with their treatment provider. Greater depression severity and wanting a partner to be less critical and more encouraging were associated with greater preferences for involvement. Veterans may view their partners' involvement in depression treatment as one opportunity for partners to decrease blame or understand more about their problems. Published by Elsevier Inc.

Quality of Life, Functioning, and Depressive Symptom Severity in Older Adults With Major Depressive Disorder Treated With Citalopram in the STAR*D Study.

Science.gov (United States)

Steiner, Alexander J; Recacho, Jennifer; Vanle, Brigitte; Dang, Jonathan; Wright, Stephanie M; Miller, Justin S; Kauzor, Kaitlyn; Reid, Mark; Bashmi, Luma E; Mirocha, James; Danovitch, Itai; IsHak, Waguih William

2017-07-01

Major depressive disorder (MDD) can substantially worsen patient-reported quality of life (QOL) and functioning. Prior studies have examined the role of age in MDD by comparing depressive symptom severity or remission rates between younger and older adults. This study examines these outcomes before and after SSRI treatment. On the basis of prior research, we hypothesized that older adults would have worse treatment outcomes in QOL, functioning, and depressive symptom severity and that nonremitters would have worse outcomes. A retrospective secondary data analysis was conducted from the National Institute of Mental Health-funded Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study (July 2001-September 2006). We analyzed data for 2,280 nonpsychotic adults with DSM-IV-TR-defined MDD who received citalopram monotherapy. Older adults were classified as adults aged 65 years and above. All subjects completed patient-reported QOL, functioning, and depressive symptom severity measures at entry and exit. Subjects included 106 older adults and 2,174 adults older adults and adults Older adults had smaller treatment effect sizes for all outcomes, particularly functioning. Conversely, mean change scores from entry to exit were equivalent across all outcomes. Remitters at exit had significantly better responses to treatment than nonremitters for the majority of outcomes. Findings suggest that older adults and younger adults have comparable treatment responses to citalopram monotherapy, with significant improvements in patient-reported depressive symptom severity, functioning, and QOL. ClinicalTrials.gov identifier: NCT00021528. © Copyright 2017 Physicians Postgraduate Press, Inc.

Sleep disturbance relates to neuropsychological functioning in late-life depression.

Science.gov (United States)

Naismith, Sharon L; Rogers, Naomi L; Lewis, Simon J G; Terpening, Zoë; Ip, Tony; Diamond, Keri; Norrie, Louisa; Hickie, Ian B

2011-07-01

Sleep-wake disturbance in older people is a risk factor for depression onset and recurrence. The aim of this study was to determine if objective sleep-wake disturbance in late-life depression relates to neuropsychological functioning. Forty-four older patients with a lifetime history of major depression and 22 control participants underwent psychiatric, medical and neuropsychological assessments. Participants completed self-report sleep measures, sleep diaries and wore wrist actigraphy for two weeks. Outcome measures included sleep latency, the number and duration of nocturnal awakenings and the overall sleep efficiency. Patients with depression had a greater duration of nocturnal awakenings and poorer sleep efficiency, in comparison to control participants. Sleep disturbance in patients was associated with greater depression severity and later ages of depression onset. It also related to poorer psychomotor speed, poorer verbal and visual learning, poorer semantic fluency as well as poorer performance on tests of executive functioning. These relationships largely remained significant after controlling for depression and estimated apnoea severity. This sample had only mild levels of depression severity and results require replication in patients with moderate to severe depression. The inclusion of polysomnography and circadian markers would be useful to delineate the specific features of sleep-wake disturbance that are critical to cognitive performance. Sleep-wake disturbance in older patients with depression is related to neuropsychological functioning and to later ages of illness onset. This study suggests that common neurobiological changes may underpin these disease features, which may, in turn, warrant early identification and management. Copyright © 2011 Elsevier B.V. All rights reserved.

The impact of depressive and bipolar symptoms on socioeconomic status, core symptoms, function and severity of fibromyalgia.

Science.gov (United States)

Gota, Carmen E; Kaouk, Sahar; Wilke, William S

2017-03-01

To evaluate the prevalence of depressive and bipolar symptoms in a cohort of consecutive fibromyalgia (FM) patients seen in a tertiary care center and to determine the relationship between depressive and manic symptoms with FM symptoms, socioeconomic status, severity and function. Three hundred and five FM patients were enrolled; demographic, clinical and questionnaire data were collected. Depressive symptoms were measured by the Patient Health Questionnaire (PHQ-9), manic symptoms by the Mood Disorders Questionnaire (MDQ). The FM cohort had the following characteristics: age 43.53 (11.7) years; 86.5% white; 82.7% female; PHQ-9 ≥ 10, 59.7%, mean 11.9 (7.3); no depression 11.4%, mild 29.1%, moderate 27.5%, moderate severe 17.7%, severe 14%; anxiety 41.6%; 21.3% had either an MDQ score ≥ 7 and/or reported a past diagnosis of bipolar disorder (BD). Increasing levels of depression severity, as well as a positive screen for BD were significantly associated with increasing prevalence and severity of FM symptoms, longer duration of morning stiffness, and increased severity of FM. Increasing levels of depression were significantly associated with increase in prevalence of reported past sexual abuse, and a decline in socioeconomic status, including higher disability and unemployment rates. Patients with severe FM disease activity, high load of symptoms, prolonged morning stiffness, increased disability, lower socioeconomic status and those who take a lot of medications for FM should be evaluated for depressive and manic symptoms. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

A study on the prevalence of depression and the severity of depression in patients of chronic obstructive pulmonary disease in a semi-urban Indian population.

Science.gov (United States)

Agarwal, Abhishekl; Batra, Sakshi; Prasad, Rajendra; Verma, Anand; Jilani, Abdul Q; Kant, Surya

2018-03-19

Chronic obstructive pulmonary disease (COPD) is one of the few respiratory diseases which is associated with a number of comorbidities. Psychiatric disease like depression is a very important comorbidity of COPD because it decreases the feeling of wellbeing in the patient and also interferes with the compliance with medication thereby increasing the risk of hospitalization in the COPD patient. A cross-sectional study was done for two years in the department of pulmonary medicine at Era's Lucknow medical college and hospital, Lucknow. A total of 150 patients were enrolled for the study after a clinico-radiological screening for the diagnosis confirmed on spirometry. After the confirmation of the diagnosis of COPD in these patients, they were screened for depression using the PHQ-9 scale in our department of pulmonary medicine. The confirmation of the diagnosis of depression was done according to the ICD-10 guidelines for depression and the severity of depression was graded using HAM-D scale in the department of psychiatry at our institute. The most common age group enrolled in the study was 51-60 years of age (40.67%). One hundred and fifteen patients (76.7%) of the enrolled patients were smokers while the remaining 35 patients (23.3%) were non-smokers. Depression was found to be present in 46 out of the total 150 patients in the study. Thus, the prevalence of depression in our study was 30.67%. Depression was seen in COPD groups B,C and D. Out of the 46 patients of COPD with depression,18 had mild depression (39.13%), 26 had moderate depression (56.52%) and 2 had severe depression (4.35%). Hence, depression of all grades (i.e., mild, moderate and severe depression) is seen in COPD groups B, C and D.

Urinary free cortisol levels among depressed men and women: differential relationships to age and symptom severity?

Science.gov (United States)

Grant, M M; Friedman, E S; Haskett, R F; Riso, L P; Thase, M E

2007-01-01

Preclinical and clinical models of depression suggest sex differences may be mediated at least in part, by differences in hormonal modulation of hypothalamic-pituitary-adrenal (HPA) axis activity. Unraveling the consequences of moderating influences from the effect of sexual dimorphism will be vital to elaborating models of pathophysiology. The current study investigated urinary free cortisol (UFC) among younger adults with mild to moderate major depressive disorder to clarify the relationship with potential demographic and clinical moderators. Male patients had higher mean UFC levels than female patients. Moreover, significant interactions between age and severity were found among men, but not women. In contrast to prior findings, neither age nor severity effects on UFC levels were found among female patients. Conclusions from the current study are limited by the absence of cortisol data from matched controls. Thus it was not possible to disentangle sex differences in baseline physiology from that of pathophysiological differences tied specifically to depression. Despite several methodological limitations, the interactions between sex and both age and severity in this large sample of depressed patients are suggestive of differential pathophysiology for regulation of UFC excretion, and could reflect a neuroprotective effect for estrogen among younger depressed women.

Associations among depression severity, painful physical symptoms, and social and occupational functioning impairment in patients with major depressive disorder: a 3-month, prospective, observational study

Directory of Open Access Journals (Sweden)

Harada E

2017-09-01

Full Text Available Eiji Harada,1 Yoichi Satoi,2 Atsushi Kuga,1 Hirofumi Tokuoka,1 Toshiaki Kikuchi,3 Koichiro Watanabe,4 Levent Alev,1 Masaru Mimura3 1Biomedicine, Medicines Development Unit Japan, Eli Lilly Japan K.K, Kobe, Japan; 2Statistical Science, Eli Lilly Japan K.K., Kobe, Japan; 3Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; 4Department of Neuropsychiatry, Kyorin University School of Medicine, Tokyo, Japan Purpose: To investigate associations among depression severity, painful physical symptoms (PPS, and social and occupational functioning impairment in patients with major depressive disorder (MDD who had achieved complete remission (CR or partial remission (PR after acute treatment.Patients and methods: This was a 12-week, multicenter, prospective, observational study. Patients with MDD treated with an antidepressant medication for the previous 12 weeks (±3 weeks who had achieved CR (defined as a 17-item Hamilton Rating Scale for Depression [HAM-D17] score ≤7 or PR (HAM-D17 score ≥8 and ≤8 were enrolled. Depression severity, PPS, and impairment in social and occupational functioning were assessed using the HAM-D17, the Brief Pain Inventory (Short Form (BPI-SF, and the Social and Occupational Functioning Assessment Scale (SOFAS, respectively, at enrollment (Week 12 and after 12 weeks (Week 24.Results: Overall, 323 Japanese patients with MDD were enrolled (CR n=158, PR n=165 and 288 patients completed the study (CR n=139, PR n=149. HAM-D17 and SOFAS scores were strongly and negatively correlated at enrollment (Week 12; P<0.0001 and Week 24 (P<0.0001. A weak negative correlation between the BPI-SF and SOFAS was observed at Week 24 (P=0.0011, but not at enrollment (P=0.164. Remission status at enrollment (CR or PR was associated with achieving normal social and occupational functioning (SOFAS score ≥80 at Week 24 in patients who had not achieved normal social and occupational functioning (SOFAS score <80 at

The effect of self efficacy and meaning in life on posttraumatic stress disorder and depression severity among veterans.

Science.gov (United States)

Blackburn, Laura; Owens, Gina P

2015-03-01

The current study examined the relationships among combat exposure, presence of and search for meaning in life, general and social self-efficacy, and both posttraumatic stress disorder (PTSD) and depression symptom severity for a Veteran sample (N = 93). Participants completed an online survey comprising the Combat Exposure Scale, Meaning in Life Questionnaire, Self-Efficacy Scale, Depression subscale of the Depression, Anxiety, Stress Scales-21, and PTSD Checklist-Specific Stressor version. The majority of participants were male and Caucasian. Participants served in various service eras To determine factors that predicted PTSD and depression severity, separate hierarchical linear regressions were performed. In the final PTSD model, rank, combat exposure, and general self-efficacy were significant predictors, with officer rank, lower combat exposure, and higher general self-efficacy associated with lower PTSD severity. The interaction between combat exposure and general self-efficacy was also significant, with self-efficacy moderating the relationship between combat exposure and PTSD severity. For depression, rank, presence of meaning in life, and general self-efficacy were significant predictors in the model, with officer rank, higher presence of meaning in life, and general self-efficacy associated with lower depression severity. A focus on strengthening self-efficacy may assist with lower levels of PTSD and depression symptomatology after combat trauma. © 2014 Wiley Periodicals, Inc.

Severe insomnia is associated with hypertriglyceridemia in women with major depression treated in psychiatry settings.

Science.gov (United States)

Costemale-Lacoste, Jean-François; Trabado, Séverine; Verstuyft, Céline; El Asmar, Khalil; Butlen-Ducuing, Florence; Colle, Romain; Ferreri, Florian; Polosan, Mircea; Haffen, Emmanuel; Balkau, Beverley; Falissard, Bruno; Feve, Bruno; Becquemont, Laurent; Corruble, Emmanuelle

2017-08-01

Hypertriglyceridemia (HTG) is a cardiovascular risk factor. In the general population, elevated fasting triglyceridemia (TG) is associated with insomnia. Since insomnia is a core symptom of Major Depressive Episodes (MDE), we studied the association of severe insomnia with HTG in major depression. We used the baseline data of the METADAP cohort, comprising 624 patients with a current MDE in a context of Major Depressive Disorder treated in psychiatry settings, without current alcohol use disorders. Patients were screened for severe insomnia, defined by a score of four or more on the three Hamilton Depression Rating Scale (HDRS) sleep items, and for HTG characterised by TG≥200mg/dL. Severe insomnia was observed in 335(54%) patients with a current MDE, of whom 234(70%) were women; 49(8%) patients had HTG, of whom 25(51%) were women. 69(11%) patients were treated with lipid-lowering drugs. Severe insomnia was associated with a higher frequency of HTG in the whole sample (9.9% vs 5.6%, p=0.046) and in the subgroup of women (9.0% vs 2.0%, p=0.002). Multivariate logistic regression analyses adjusted for age, education levels, BMI and total HDRS scores confirmed the association between severe insomnia and HTG in the whole sample (OR=2.02, 95%CI [1.00-4.08], p=0.05) as well as in the subgroup of women (OR=4.82, 95%CI [1.5-15.5], p=0.008). No association was shown in men. HTG should be systematically investigated in depressed patients with severe insomnia and particularly in women. Further studies are needed to explain the association we observed between severe insomnia and HTG. Copyright © 2017 Elsevier B.V. All rights reserved.

Using thermographic cameras to investigate eye temperature and clinical severity in depression

Science.gov (United States)

Maller, Jerome J.; George, Shefin Sam; Viswanathan, Rekha Puzhavakkathumadom; Fitzgerald, Paul B.; Junor, Paul

2016-02-01

Previous studies suggest that altered corneal temperature may be a feature of schizophrenia, but the association between major depressive disorder (MDD) and corneal temperature has yet to be assessed. The aim of this study is to investigate whether eye temperature is different among MDD patients than among healthy individuals. We used a thermographic camera to measure and compare the temperature profile across the corneas of 16 patients with MDD and 16 age- and sex-matched healthy subjects. We found that the average corneal temperature between the two groups did not differ statistically, although clinical severity correlated positively with right corneal temperature. Corneal temperature may be an indicator of clinical severity in psychiatric disorders, including depression.

Cognitive-Behavioral Therapy for Depression Using Mind Over Mood: CBT Skill Use and Differential Symptom Alleviation.

Science.gov (United States)

Hawley, Lance L; Padesky, Christine A; Hollon, Steven D; Mancuso, Enza; Laposa, Judith M; Brozina, Karen; Segal, Zindel V

2017-01-01

Cognitive-behavioral therapy (CBT) for depression is highly effective. An essential element of this therapy involves acquiring and utilizing CBT skills; however, it is unclear whether the type of CBT skill used is associated with differential symptom alleviation. Outpatients (N = 356) diagnosed with a primary mood disorder received 14 two-hour group sessions of CBT for depression, using the Mind Over Mood protocol. In each session, patients completed the Beck Depression Inventory and throughout the week they reported on their use of CBT skills: behavioral activation (BA), cognitive restructuring (CR), and core belief (CB) strategies. Bivariate latent difference score (LDS) longitudinal analyses were used to examine patterns of differential skill use and subsequent symptom change, and multigroup LDS analyses were used to determine whether longitudinal associations differed as a function of initial depression severity. Higher levels of BA use were associated with a greater subsequent decrease in depressive symptoms for patients with mild to moderate initial depression symptoms relative to those with severe symptoms. Higher levels of CR use were associated with a greater subsequent decrease in depressive symptoms, whereas higher levels of CB use were followed by a subsequent increase in depressive symptoms, regardless of initial severity. Results indicated that the type of CBT skill used is associated with differential patterns of subsequent symptom change. BA use was associated with differential subsequent change as a function of initial severity (patients with less severe depression symptoms demonstrated greater symptom improvement), whereas CR use was associated with symptom alleviation and CB use with an increase in subsequent symptoms as related to initial severity. Copyright © 2016. Published by Elsevier Ltd.

Physical appearance concerns are uniquely associated with the severity of steroid dependence and depression in anabolic-androgenic steroid users.

Science.gov (United States)

Griffiths, Scott; Jacka, Brendan; Degenhardt, Louisa; Murray, Stuart B; Larance, Briony

2018-02-27

Emerging research suggests that the sub-population of anabolic-androgenic steroid (AAS) users who experience physical appearance concerns may suffer greater psychological dysfunction than other sub-populations, including users with athletic or occupational concerns. Thus, among current AAS users, we sought to determine whether, and to what extent, social physique anxiety-an established measure of appearance concern-was associated with psychological dysfunction. Interviews were conducted with a sample of 74 male AAS users living in Australia. Users completed self-report instruments of the severity of AAS dependence, depression, hazardous and risky drinking, use of non-AAS illicit drugs, psychological side-effects due to AAS use and abnormal test results due to AAS use. Multivariate analyses revealed that greater social physique anxiety was uniquely associated with more severe symptoms of both AAS dependence and depression. Moreover, the effect size of these relationships was large. Social physique anxiety was not associated with hazardous or risky drinking, non-AAS illicit drug use, psychological side-effects or abnormal test results. Limitations notwithstanding, the study is consistent with the notion that AAS users who experience appearance concerns are at heightened risk of co-morbid psychological dysfunction. Given trends indicating an increase in the prevalence of AAS use in Australia and elsewhere, the findings suggest that health-care systems may need to consider prioritising the sub-population of AAS users who experience appearance concerns. Further investigation of the clinical syndrome of AAS dependence is required, including its relation to body image and eating disorders. © 2018 Australasian Professional Society on Alcohol and other Drugs.

Wake and light therapy for moderate-to-severe depression - a randomized controlled trial

DEFF Research Database (Denmark)

Kragh, M; Martiny, K; Videbech, P

2017-01-01

Objective: To examine the efficacy of using wake and light therapy as a supplement to standard treatment of hospitalized patients with depression. Method: In this randomized, controlled study, 64 patients with moderate-to-severe depression were allocated to standard treatment or to the intervention......, which additionally consisted of three wake therapy sessions in one week, 30-min daily light treatment and sleep time stabilization over the entire nine-week study period. Results: Patients in the wake therapy group had a significant decrease in depressive symptoms in week one as measured by HAM-D17, 17...

The Direct and Interactive Effects of Neuroticism and Life Stress on the Severity and Longitudinal Course of Depressive Symptoms

Science.gov (United States)

Brown, Timothy A.; Rosellini, Anthony J.

2011-01-01

The direct and interactive effects of neuroticism and stressful life events (chronic and episodic stressors) on the severity and temporal course of depression symptoms were examined in 826 outpatients with mood and anxiety disorders, assessed on three occasions over a one-year period (intake, 6- and 12-month follow-ups). Neuroticism, chronic stress, and episodic stress were uniquely associated with intake depression symptom severity. A significant interaction effect indicated that the strength of the effect of neuroticism on initial depression severity increased as chronic stress increased. Although neuroticism did not have a significant direct effect on the temporal course of depression symptoms, chronic stress significantly moderated this relationship such that neuroticism had an increasingly deleterious effect on depression symptom improvement as the level of chronic stress over follow-up increased. In addition, chronic stress over follow-up (but not episodic stress) was uniquely predictive of less depression symptom improvement. Consistent with a stress generation framework, however, initial depression symptom severity was positively associated with chronic stress during follow-up. The results are discussed in regard to diathesis-stress conceptual models of emotional disorders and the various roles of stressful life events in the onset, severity, and maintenance of depressive psychopathology. PMID:21381799

How is a specialist depression service effective for persistent moderate to severe depressive disorder?: a qualitative study of service user experience.

Science.gov (United States)

Thomson, Louise; Barker, Marcus; Kaylor-Hughes, Catherine; Garland, Anne; Ramana, Rajini; Morriss, Richard; Hammond, Emily; Hopkins, Gail; Simpson, Sandra

2018-06-15

A specialist depression service (SDS) offering collaborative pharmacological and cognitive behaviour therapy treatment for persistent depressive disorder showed effectiveness against depression symptoms versus usual community based multidisciplinary care in a randomised controlled trial (RCT) in specialist mental health services in England. However, there is uncertainty concerning how specialist depression services effect such change. The current study aimed to evaluate the factors which may explain the greater effectiveness of SDS compared to Treatment as Usual (TAU) by exploring the experience of the RCT participants. Qualitative audiotaped and transcribed semi-structured interviews were conducted 12-18 months after baseline with 21 service users (12 SDS, 9 TAU arms) drawn from all three sites. Inductive thematic analysis using a grounded approach contrasted the experiences of SDS with TAU participants. Four themes emerged in relation to service user experience: 1. Specific treatment components of the SDS: which included sub-themes of the management of medication change, explaining and developing treatment strategies, setting realistic expectations, and person-centred and holistic approach; 2. Individual qualities of SDS clinicians; 3. Collaborative team context in SDS: which included sub-themes of communication between healthcare professionals, and continuity of team members; 4. Accessibility to SDS: which included sub-themes of flexibility of locations, frequent consultation as reinforcement, gradual pace of treatment, and challenges of returning to usual care. The study uncovered important mechanisms and contextual factors in the SDS that service users experience as different from TAU, and which may explain the greater effectiveness of the SDS: the technical expertise of the healthcare professionals, personal qualities of clinicians, teamwork, gradual pace of care, accessibility and managing service transitions. Usual care in other specialist mental health

Severe Intellectual Disability: Systematic Review of the Prevalence and Nature of Presentation of Unipolar Depression.

Science.gov (United States)

Walton, Catherine; Kerr, Mike

2016-09-01

The diagnosis of depression in severe and profound intellectual disability is challenging. Without adequate skills in verbal self-expression, standardized diagnostic criteria cannot be used with confidence. The purpose of this systematic review was to investigate the assessment and diagnosis of unipolar depression in severe and profound intellectual disability. The review aimed to examine the methods used to assess for depression. The secondary aim was to explore the frequency and symptoms of depression. The PRISMA (2009) Checklist for systematic review was followed, and a search of electronic databases was undertaken. Nine studies were included in the qualitative synthesis from over 2000 records identified. The quality of the studies was assessed and scored, with a wide range of results. Individual studies scored between 2 and 7 of a maximum possible score of 8. The diagnostic tools utilized by each of the studies were assessed and compared. In terms of the methods used to assess for depression, results were varied. This was due to the heterogeneous nature of the individual study designs. The Aberrant Behaviour Checklist consistently showed promise, in particular when combined with other instruments or clinical examination. Qualitative analysis of the selected studies has shown a wide variation in the quality of primary research in this field, with more required to make firm conclusions regarding the diagnosis, frequency and presentation of depression in severe and profound intellectual disability. © 2015 John Wiley & Sons Ltd.

Improvement of depressive symptoms in patients with moderate-to-severe psoriasis treated with ustekinumab: an open label trial validated using beck depression inventory, Hamilton depression rating scale measures and 18fluorodeoxyglucose (FDG) positron emission tomography (PET).

Science.gov (United States)

Kim, Seong-Jang; Park, Min-Young; Pak, Kyoungjune; Han, Junhee; Kim, Gun-Wook; Kim, Hoon-Soo; Ko, Hyun-Chang; Kim, Moon-Bum; Kim, Byung-Soo

2018-05-07

Psoriasis is a chronic skin disease associated with psychiatric co-morbidities, especially depression. Early detection of psychological vulnerability in patients with psoriasis seems to be of great clinical importance and significantly impacts the quality of life of the patients. We sought to clarify the association between psoriasis and depressive symptoms in patients with moderate-to-severe psoriasis, and to determine the risk factors for depressive symptoms and analyze the effect of ustekinumab on the symptoms. We also aimed to evaluate the changes in glucose metabolism using 18 fluorodeoxyglucose (FDG) positron emission tomography (FDG-PET). Fifteen patients with moderate-to-severe psoriasis scheduled to be treated with ustekinumab were enrolled. At baseline and after achieving a 75% reduction in the Psoriasis Area and Severity Index (PASI) score (PASI75), all patients underwent a psychiatric interview and FDG-PET. Fifteen healthy volunteers were enrolled for comparison. Patients with moderate-to-severe psoriasis were more depressed than those in the control group were (p Inventory and Hamilton Depression Rating Scale psychiatric interviews (p < .05). However, FDG-PET of the brain showed no significant difference before and after PASI75 achievement using ustekinumab injection. Patients with moderate-to-severe psoriasis are at an increased risk for depressive symptoms, and treatment with ustekinumab may be beneficial. FDG-PET does not reflect the changes in depressive symptoms in such patients.

Do concomitant pain symptoms in patients with major depression affect quality of life even when taking into account baseline depression severity?

Directory of Open Access Journals (Sweden)

Novick D

2013-05-01

Full Text Available Diego Novick,1 William Montgomery,2 Zbigniew Kadziola,3 Victoria Moneta,4 Xiaomei Peng,5 Roberto Brugnoli,6 Josep Maria Haro41Eli Lilly and Company, Windlesham, Surrey, UK; 2Eli Lilly Australia Pty Ltd, West Ryde, NSW, Australia; 3Eli Lilly Austria GmbH, Vienna, Austria; 4Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain; 5Eli Lilly and Company, Indianapolis, IN, USA; 6Università di Roma, “Sapienza,” Rome, ItalyBackground: Patients with major depressive disorder (MDD may suffer from concomitant pain symptoms. The aim of this study is to determine whether the presence of painful physical symptoms (PPS influences quality of life when taking into account baseline depression severity.Methods: Patients with a new or first episode of MDD (n = 909 were enrolled in a 3-month prospective observational study in East Asia. The Hamilton Depression Rating Scale, Clinical Global Impression-Severity score, Somatic Symptom Inventory, and EuroQoL questionnaire-5 Dimensions (EQ-5D and EQ-Visual Analogue Scale (EQ-VAS were assessed at baseline and 3 months’ follow-up. The presence of PPS was defined as a mean score of ≥2 on the Somatic Symptom Inventory pain-related items. Regression analyses determined predictors of quality of life at 3 months, adjusting for age, sex, depressive symptoms, overall severity, and quality of life at baseline.Results: PPS were present (PPS+ at baseline in 52% of patients. During the 3-month follow-up, EQ-VAS scores improved from 47.7 (standard deviation [SD] 20.6 to 72.5 (SD 20.4, and EQ-5D improved from 0.48 (SD 0.34 to 0.80 (SD 0.26. At 3 months, mean EQ-VAS was 66.4 (SD 21.2 for baseline PPS+ patients versus 78.5 (SD 17.6 for baseline PPS- patients, and mean EQ-5D was 0.71 (SD 0.29 versus 0.89 (SD 0.18. PPS+ at baseline was a significant predictor of quality of life at 3 months after adjusting for sociodemographic and baseline clinical variables

Sex Differences in Depression: Does Inflammation Play a Role?

Science.gov (United States)

Derry, Heather M; Padin, Avelina C; Kuo, Jennifer L; Hughes, Spenser; Kiecolt-Glaser, Janice K

2015-10-01

Women become depressed more frequently than men, a consistent pattern across cultures. Inflammation plays a key role in initiating depression among a subset of individuals, and depression also has inflammatory consequences. Notably, women experience higher levels of inflammation and greater autoimmune disease risk compared to men. In the current review, we explore the bidirectional relationship between inflammation and depression and describe how this link may be particularly relevant for women. Compared to men, women may be more vulnerable to inflammation-induced mood and behavior changes. For example, transient elevations in inflammation prompt greater feelings of loneliness and social disconnection for women than for men, which can contribute to the onset of depression. Women also appear to be disproportionately affected by several factors that elevate inflammation, including prior depression, somatic symptomatology, interpersonal stressors, childhood adversity, obesity, and physical inactivity. Relationship distress and obesity, both of which elevate depression risk, are also more strongly tied to inflammation for women than for men. Taken together, these findings suggest that women's susceptibility to inflammation and its mood effects may contribute to sex differences in depression. Depression continues to be a leading cause of disability worldwide, with women experiencing greater risk than men. Due to the depression-inflammation connection, these patterns may promote additional health risks for women. Considering the impact of inflammation on women's mental health may foster a better understanding of sex differences in depression, as well as the selection of effective depression treatments.

Relationship Between Depression and Perception of Pain Severity in Patients Admitted to General Surgery Ward

Directory of Open Access Journals (Sweden)

Mehdi Samadzadeh

2016-11-01

Full Text Available Background Depression is considered as the most common psychological problem in individuals. Patients with persistent pain usually suffer from depression, disturbance in interpersonal relations, fatigue, and reduced physical and psychological performance. Objectives The aim of this study was to survey the relationship between depression and perception of pain severity in patients admitted to general surgery ward. Methods This research was a cross-sectional descriptive study. The study population included patients admitted to general surgery ward at hospitals of Ardabil city during 2010 - 2011. The study sample consisted of 168 individuals (male and female who were selected by nonrandomized convenience sampling method. The data were collected using a questionnaire on demographic information, the Beck depression inventory (BDI, and Toren questionnaire on pain beliefs and perceptions. The SPSS software was used for statistical analysis. Results The highest frequency of participants had moderate depression (44.1% while the lowest frequency belonged to healthy individuals (4.2%. The score of depression was higher in men (23.21 ± 7.56 than women (19.19 ± 6.84 as the same as the score of pain perception (8.91 ± 2.34 vs. 7.95 ± 1.87, respectively. The results indicated that there was a positive significant relationship between depression and perception of pain severity (P ≤ 0.01. This means that patients who have a history of depression feel much more pain during hospitalization and after the surgery. Conclusions Depressed or anguished patients report more pain compared to healthy ones.

HAM-D17 and HAM-D6 sensitivity to change in relation to desvenlafaxine dose and baseline depression severity in major depressive disorder

DEFF Research Database (Denmark)

Bech, P; Boyer, P; Germain, J-M

2010-01-01

INTRODUCTION: This retrospective analysis compared sensitivity to change on the 17-item and 6-item Hamilton Rating Scales For Depression (HAM-D (17) and HAM-D (6), respectively) in relation to antidepressant dose and baseline depression severity. METHODS: Data were derived from 6 randomized, double...

Pharmacological treatment of severely depressed patients: a meta-analysis comparing efficacy of mirtazapine and amitriptyline

NARCIS (Netherlands)

Kasper, S.; Zivkov, M.; Roes, K.C.B.; Pols, A.G.

1997-01-01

Efficacy data were available from 405 severely depressed patients (baseline 17-item Hamilton Rating Scale for Depression-HAMD scores ≤25) participating in randomized, double blind, amitriptyline-controlled studies of mirtazapine. Main efficacy variables were changes from baseline in the group mean

Night-eating syndrome and the severity of self-reported depressive symptoms from the Korea Nurses' Health Study: analysis of propensity score matching and ordinal regression.

Science.gov (United States)

Kim, O-S; Kim, M S; Lee, J E; Jung, H

2016-12-01

The prevalence of night-eating syndrome (NES) and depression is increasing worldwide. Although nurses, in particular, are exposed to work in an environment of irregular eating, shift work, and stressful settings, limited research exist. In fact, the prevalence of NES among Korean nurses has never been reported. The aim of this study was to determine the prevalence of NES as well as the association between NES and severity of self-reported depressive symptoms among South Korean female nurses. The Korea Nurses' Health Study, following the protocols of the Nurses' Health Study led by the Harvard University, collected data on Korean female nurses. Survey responses from 3617 participants were included, and 404 responses were analyzed in this cross-sectional study using propensity score matching. Descriptive, Spearman's and Cramer's correlations, propensity score matching, and multivariable ordinal logistic regression were conducted as statistical analysis. The prevalence of both NES and self-reported depressive symptoms among Korean female nurses were higher compared with nurses in prior studies. Nurses with NES were 1.65 times more likely to have greater severity of depressive symptoms than those without NES (95% confidence interval [1.19-2.10], odds ratio = 1.65) after adjusting for covariates including sociodemographic characteristics, health behavioural factors, and shift work. This study suggests significant association between NES and the severity of self-reported depressive symptoms among Korean female nurses after adjusting for covariates. Policy makers and hospital managers need to develop strategies to reduce depression and NES among nurses for enhancement of nurses' mental and physical health as well as for improvement of care quality. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

DEPRESSION MEDIATES THE RELATION OF INSOMNIA SEVERITY WITH SUICIDE RISK IN THREE CLINICAL SAMPLES OF U.S. MILITARY PERSONNEL.

Science.gov (United States)

Bryan, Craig J; Gonzales, Jacqueline; Rudd, M David; Bryan, AnnaBelle O; Clemans, Tracy A; Ray-Sannerud, Bobbie; Wertenberger, Evelyn; Leeson, Bruce; Heron, Elizabeth A; Morrow, Chad E; Etienne, Neysa

2015-09-01

A growing body of empirical research suggests insomnia severity is directly related to suicide ideation, attempts, and death in nonmilitary samples, even when controlling for depression and other suicide risk factors. Few studies have explored this relationship in U.S. military personnel. The present study entailed secondary data analyses examining the associations of insomnia severity with suicide ideation and attempts in three clinical samples: Air Force psychiatric outpatients (n = 158), recently discharged Army psychiatric inpatients (n = 168), and Army psychiatric outpatients (n = 54). Participants completed the Beck Scale for Suicide Ideation, the Beck Depression Inventory-II or Patient Health Questionnaire-9, the Insomnia Severity Index, and the Posttraumatic Stress Disorder Checklist at baseline; two samples also completed these measures during follow-up. Sleep disturbance was associated with concurrent (β's > 0.21; P's 0.39; P's suicide ideation in all three samples. When adjusting for age, gender, depression, and posttraumatic stress, insomnia severity was no longer directly associated with suicide ideation either concurrently (β's 0.200) or prospectively (β's 0.063), but depression was (β's > 0.22; P's depression mediated the relation of insomnia severity with suicide ideation. Across three clinical samples of military personnel, depression explained the relationship between insomnia severity and suicide risk. © 2015 Wiley Periodicals, Inc.

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

Science.gov (United States)

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 depressive symptoms (F [4, 767] = 19.145, P depressive symptoms can be used as an index of greater illness burden in clinical psychiatry.

Dissociative, depressive, and PTSD symptom severity as correlates of nonsuicidal self-injury and suicidality in dissociative disorder patients.

Science.gov (United States)

Webermann, Aliya R; Myrick, Amie C; Taylor, Christina L; Chasson, Gregory S; Brand, Bethany L

2016-01-01

The present study investigates whether symptom severity can distinguish patients diagnosed with dissociative identity disorder and dissociative disorder not otherwise specified with a recent history of nonsuicidal self-injury (NSSI) and suicide attempts from those patients without recent self-harm. A total of 241 clinicians reported on recent history of patient NSSI and suicide attempts. Of these clinicians' patients, 221 completed dissociative, depressive, and posttraumatic stress disorder symptomatology measures. Baseline cross-sectional data from a naturalistic and prospective study of dissociative disorder patients receiving community treatment were utilized. Analyses evaluated dissociative, depressive, and posttraumatic stress disorder symptom severity as methods of classifying patients into NSSI and suicide attempt groupings. Results indicated that dissociation severity accurately classified patients into NSSI and suicidality groups, whereas depression severity accurately classified patients into NSSI groups. These findings point to dissociation and depression severity as important correlates of NSSI and suicidality in patients with dissociative disorders and have implications for self-harm prevention and treatment.

Mobile Phone Sensor Correlates of Depressive Symptom Severity in Daily-Life Behavior: An Exploratory Study

Science.gov (United States)

Saeb, Sohrab; Zhang, Mi; Karr, Christopher J; Schueller, Stephen M; Corden, Marya E; Kording, Konrad P

2015-01-01

Background Depression is a common, burdensome, often recurring mental health disorder that frequently goes undetected and untreated. Mobile phones are ubiquitous and have an increasingly large complement of sensors that can potentially be useful in monitoring behavioral patterns that might be indicative of depressive symptoms. Objective The objective of this study was to explore the detection of daily-life behavioral markers using mobile phone global positioning systems (GPS) and usage sensors, and their use in identifying depressive symptom severity. Methods A total of 40 adult participants were recruited from the general community to carry a mobile phone with a sensor data acquisition app (Purple Robot) for 2 weeks. Of these participants, 28 had sufficient sensor data received to conduct analysis. At the beginning of the 2-week period, participants completed a self-reported depression survey (PHQ-9). Behavioral features were developed and extracted from GPS location and phone usage data. Results A number of features from GPS data were related to depressive symptom severity, including circadian movement (regularity in 24-hour rhythm; r=-.63, P=.005), normalized entropy (mobility between favorite locations; r=-.58, P=.012), and location variance (GPS mobility independent of location; r=-.58, P=.012). Phone usage features, usage duration, and usage frequency were also correlated (r=.54, P=.011, and r=.52, P=.015, respectively). Using the normalized entropy feature and a classifier that distinguished participants with depressive symptoms (PHQ-9 score ≥5) from those without (PHQ-9 score mobile phone sensor data, including GPS and phone usage, provided behavioral markers that were strongly related to depressive symptom severity. While these findings must be replicated in a larger study among participants with confirmed clinical symptoms, they suggest that phone sensors offer numerous clinical opportunities, including continuous monitoring of at-risk populations with

The effects of exercise on oxidative stress (TBARS) and BDNF in severely depressed inpatients.

Science.gov (United States)

Schuch, Felipe Barreto; Vasconcelos-Moreno, Mirela Paiva; Borowsky, Carolina; Zimmermann, Ana Beatriz; Wollenhaupt-Aguiar, Bianca; Ferrari, Pamela; de Almeida Fleck, Marcelo Pio

2014-10-01

Exercise can be an effective treatment for depression. Although the efficacy of exercise is well established, little is known concerning the biological changes associated with the antidepressant effects of exercise. A randomized, controlled trial was conducted to evaluate the effects of adding exercise to the usual treatment on the thiobarbituric acid-reactive substances (TBARS) and brain-derived neurotrophic factor (BDNF) serum levels of severely depressed inpatients. Twenty-six participants were randomized to an exercise group (n=15, exercise+treatment as usual) or a control group (n=11, treatment as usual). The participants in the exercise group completed a targeted dose of 16.5 kcal/kg/week of aerobic exercise, three times per week, throughout their hospitalizations. The control group did not exercise during their hospitalizations. The mean hospitalization length was of 21.63 (4.5)×23.82 (5.7) days for exercise and control groups, respectively. The exercise group performed a median of nine sessions. After adjusting for previous tobacco use, a significant group×time interaction was found for TBARS serum levels (p=0.02). A post hoc Bonferroni test revealed differences between the exercise and control groups at discharge. A significant time effect (pexercise to the usual treatment of severely depressed inpatients decreases the TBARS serum levels of severely depressed inpatients after 3 weeks. Adding exercise had no additional effects on BDNF serum levels.

Prevalence and predictors of depressive symptoms among HIV-positive men who inject drugs in Vietnam.

Science.gov (United States)

Levintow, Sara N; Pence, Brian W; Ha, Tran Viet; Minh, Nguyen Le; Sripaipan, Teerada; Latkin, Carl A; Vu, Pham The; Quan, Vu Minh; Frangakis, Constantine; Go, Vivian F

2018-01-01

HIV infection is common among people who inject drugs (PWID), and HIV-positive PWID may be particularly vulnerable to depression. This study measured the prevalence of depressive symptoms and the factors associated with severe symptoms among 455 HIV-positive PWID in Thai Nguyen, Vietnam. We used cross-sectional data from PWID in a randomized controlled trial of an intervention to reduce high-risk injecting and sexual behaviors in Thai Nguyen from 2009-2013. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D). We used logistic regression to assess demographic, clinical, and psychosocial predictors of severe depressive symptoms (CES-D≥23) with prevalence odds ratios (POR) and 95% confidence intervals (CI). The prevalence of severe depressive symptoms (CES-D≥23) was 44%. 25% of participants had mild to moderate depressive symptoms (16≤CES-D<23), and 31% experienced no depressive symptoms (CES-D<16). Not being married, self-rated poor health, greater frequency of injection drug use, history of overdose, no alcohol use, and daily cigarette smoking were positively associated with severe depressive symptoms in unadjusted models and remained predictive in a multivariable model. The strongest predictors of depressive symptoms were self-reported poor health (POR = 2.94, 95% CI: 1.82, 4.76), no current alcohol use (POR = 2.35, 95% CI: 1.47, 3.77), and not currently married or cohabitating (POR = 2.21, 95% CI = 1.40, 3.47). Severe depressive symptoms were common among HIV-positive PWID in Thai Nguyen and were strongly associated with demographic, clinical, and psychosocial factors. Interventions that promote social support from family and reduce drug dependence may particularly benefit PWID experiencing severe depressive symptoms. Greater recognition and treatment of depressive symptoms has the potential to enhance quality of life and improve HIV clinical outcomes for PWID.

Traumatic severity and trait resilience as predictors of posttraumatic stress disorder and depressive symptoms among adolescent survivors of the Wenchuan earthquake.

Directory of Open Access Journals (Sweden)

Liuhua Ying

Full Text Available PURPOSE: To examine the associations between trauma severity, trait resilience, and posttraumatic stress disorder (PTSD and depressive symptoms among adolescent survivors of the Wenchuan earthquake, China. METHODS: 788 participants were randomly selected from secondary schools in the counties of Wenchuan and Maoxian, the two areas most severely affected by the earthquake. Participants completed four main questionnaires including the Child PTSD Symptom Scale, the Center for Epidemiologic Studies Depression Scale for Children, the Connor and Davidson's Resilience Scale, and the Severity of Exposure to Earthquake Scale. RESULTS: After adjusting for the effect of age and gender, four aspects of trauma severity (i.e., direct exposure, indirect exposure, worry about others, and house damage were positively associated with the severity of PTSD and depressive symptoms, whereas trait resilience was negatively associated with PTSD and depressive symptoms and moderated the relationship between subjective experience (i.e., worry about others and PTSD and depressive symptoms. CONCLUSIONS: Several aspects (i.e., direct exposure, indirect exposure, worry about others, and house damage of earthquake experiences may be important risk factors for the development and maintenance of PTSD and depression. Additionally, trait resilience exhibits the beneficial impact on PTSD and depressive symptoms and buffers the effect of subjective experience (i.e., worry about others on PTSD and depressive symptoms.

Association of different levels of depressive symptoms with symptomatology, overall disease severity, and quality of life in women with fibromyalgia.

Science.gov (United States)

Soriano-Maldonado, Alberto; Amris, Kirstine; Ortega, Francisco B; Segura-Jiménez, Víctor; Estévez-López, Fernando; Álvarez-Gallardo, Inmaculada C; Aparicio, Virginia A; Delgado-Fernández, Manuel; Henriksen, Marius; Ruiz, Jonatan R

2015-12-01

This study examined the associations of different levels of depression with pain, sleep quality, fatigue, functional exercise capacity, overall fibromyalgia (FM) severity, and health-related quality of life (HRQoL) in women with FM. A total of 451 women with FM participated in this cross-sectional study. Depressive symptoms (Beck Depression Inventory; BDI-II), pain intensity (numerical rating scale; NRS), pain sensitivity (algometry), sleep quality (Pittsburgh Sleep Quality Index), fatigue (Multidimensional Fatigue Inventory), functional exercise capacity (6-min walk test), FM severity (revised Fibromyalgia Impact Questionnaire), and HRQoL (SF-36) were assessed. Participants with severe depressive symptoms had significantly higher pain intensity (NRS = 1.1; 95 % CI 0.3-1.8), fatigue (12.6-units; 95 % CI 8.2-17.1) and overall FM severity (12.6-units; 95 % CI 11.4-23.7), as well as poorer sleep quality (3.2-units; 95 % CI 1.7-4.7) and mental component of HRQoL (-17.0-units; 95 % CI -21.0 to -12.9) than participants with minimal signs of depression. There was no association of signs of depression with pain sensitivity, exercise capacity, or the physical component of HRQoL (P > 0.05). These results extend current knowledge on the association of signs of depression with FM severity and quality of life in women with FM, and suggest that severity of depressive symptoms could potentially be a prognostic factor to be considered in future prospective intervention studies.

A pharmacoeconomic evaluation of escitalopram versus citalopram in the treatment of severe depression in the United Kingdom.

Science.gov (United States)

Wade, Alan G; Toumi, Idris; Hemels, Michiel E H

2005-04-01

Severe depression can increase the risk of psychiatric hospitalization, as well as inpatient and outpatient care; it may also lead to long-term absenteeism from work. However, the cost-effectiveness of antidepressant therapy for severe depression has been little studied. The aim of this work was to investigate the cost-effectiveness of escitalopram compared with citalopram in patients with severe depression (Montgomery-Asberg Depression Rating Scale [MADRS] total score > or = 30) in the United Kingdom. A probabilistic decision tree with a 6-month time horizon was adapted to the UK setting. The model incorporated clinical data, resource use directly related with care of severe depression, and lost productivity costs due to absenteeism. Primary results were remission (MADRS escitalopram instead of citalopram rendered a higher overall remission rate (relative difference, 10.3%) and first-line success rate (relative difference, 35.4%). The mean cost per successfully treated patient was 15.7% (146 British pounds) lower for escitalopram (786 British pounds [range, 702-876 British pounds]) compared with citalopram (932 British pounds [range, 843-1028 British pounds]) from the NHS perspective and 15.6% (238 British pounds) lower for escitalopram (1283 British pounds [range, 1157-1419 British pounds]) than for citalopram (1521 British pounds [range, 1383-1675 British pounds]) from the societal perspective. The mean cost per severely depressed patient treated (overall study group) was 32 British pounds lower for escitalopram (422 British pounds [range, 404-441 British pounds]) than citalopram (454 British pounds [range, 436-471 British pounds]) from an NHS perspective and 50 British pounds lower for escitalopram (690 British pounds [range, 665-714 British pounds]) than citalopram (740 British pounds [range, 715-767 British pounds]) from the societal perspective. Using multivariate sensitivity analyses, we found that, in 99.8% of the cases, escitalopram was dominant from both

Health-related quality of life and symptom severity in Chinese patients with major depressive disorder.

Science.gov (United States)

Cao, Yuping; Li, Wen; Shen, Jingjin; Malison, Robert T; Zhang, Yalin; Luo, Xingguang

2013-12-01

Patients suffering from major depressive disorder (MDD) have been reported to have substantial long-lasting limitations in multiple domains of health-related quality of life (HRQoL). The thoughtful assessment of HRQoL and the impact of treatment response on HRQoL are emerging as important issues in the care of patients with major depressive disorder. One hundred and three patients meeting Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for MDD took fluoxetine (20 mg/d) for 6 weeks and were assessed by the Short Form 36 Health Survey (SF-36), the 17-item Hamilton Depression Rating (HAMD-17) and the Clinical Global Impression (CGI) scales. Relationships between SF-36 scores and depressive symptom severity and early change of these symptoms were tested. SF-36 component scores at week 6 were higher than those at baseline (all P ≤ 0.0058). Scores for general health were significantly higher in responders than non-responders (P = 0.0009). The overall HAMD-17 and CGI scores at 2- and 6-week follow-up were significantly lower than those at baseline (P ≤ 0.0001). Higher scores for anxiety/somatization were significantly associated with poorer SF-36 scores at baseline (P = 0.0001); role-physical scores at week 6 were positively correlated with reduction rate of anxiety/somatization in 2-week follow-up (P = 0.0002). Depressive symptom severity was associated with HRQoL in patients with MDD. HRQoL may vary with severity of depression and/or anxiety-somatization at baseline. Copyright © 2013 Wiley Publishing Asia Pty Ltd.

Severity of complicated versus uncomplicated subthreshold depression: New evidence on the "Monotonicity Thesis" from the national comorbidity survey.

Science.gov (United States)

Wakefield, Jerome C; Schmitz, Mark F

2017-04-01

"Complicated" subthreshold depression (CsD) includes at least one of six pathosuggestive "complicated" symptoms: >6 months duration, marked role impairment, sense of worthlessness, suicidal ideation, psychotic ideation, and psychomotor retardation. "Uncomplicated" subthreshold depression (UsD) has no complicated features. Whereas studies show that complicated (CMDD) versus uncomplicated (UMDD) major depression differ substantially in severity and prognosis, UsD and CsD severity has not been previously compared. This study evaluates UsD and CsD pathology validator levels and examines whether the complicated/uncomplicated distinction offers incremental concurrent validity over the standard number-of-symptoms dimension as a depression severity measure. Using nationally representative community data from the National Comorbidity Survey, seven depression lifetime history subgroups were identified: one MDD screener symptom (n=1432); UsD (n=430); CsD (n=611); UMDD (n=182); and CMDD with 5-6 symptoms (n=518), 7 symptoms (n=217), and 8-9 symptoms (n=291). Severity was evaluated using five concurrent pathology validators: suicide attempt, interference with life, help seeking, hospitalization, and generalized anxiety disorder. CsD validator levels are substantially higher than both UsD and UMDD levels, and similar to mild CMDD, disconfirming the "monotonicity thesis" that severity increase with symptom number. Complicated/uncomplicated status predicts severity, and when complicatedness is controlled, number of symptoms no longer predicts validator levels. Diagnoses were based on respondents' fallible retrospective symptom reports during a lay-administered structured interview, which may not yield diagnoses comparable to clinicians' assessments. CsD is more severe than UsD and comparable to mild MDD. Complicated status more validly indicates depression severity than the standard number-of-symptoms measure. Copyright © 2017 Elsevier B.V. All rights reserved.

Depression, Help-Seeking and Self-Recognition of Depression among Dominican, Ecuadorian and Colombian Immigrant Primary Care Patients in the Northeastern United States

Directory of Open Access Journals (Sweden)

Susan Caplan

2015-08-01

Full Text Available Latinos, the largest minority group in the United States, experience mental health disparities, which include decreased access to care, lower quality of care and diminished treatment engagement. The purpose of this cross-sectional study of 177 Latino immigrants in primary care is to identify demographic factors, attitudes and beliefs, such as stigma, perceived stress, and ethnic identity that are associated with depression, help-seeking and self-recognition of depression. Results indicated that 45 participants (25% had depression by Patient Health Questionnaire (PHQ-9 criteria. Factors most likely to be associated with depression were: poverty; difficulty in functioning; greater somatic symptoms, perceived stress and stigma; number of chronic illnesses; and poor or fair self-rated mental health. Fifty-four people endorsed help-seeking. Factors associated with help-seeking were: female gender, difficulty in functioning, greater somatic symptoms, severity of depression, having someone else tell you that you have an emotional problem, and poor or fair self-rated mental health. Factors most likely to be associated with self-recognition were the same, but also included greater perceived stress. This manuscript contributes to the literature by examining attitudinal factors that may be associated with depression, help-seeking and self-recognition among subethnic groups of Latinos that are underrepresented in research studies.

Depression following traumatic brain injury: Impact on post-hospital residential rehabilitation outcomes.

Science.gov (United States)

Lewis, Frank D; Horn, Gordon J

2017-01-01

A need exists to better understand the impact of depression on functional outcomes following TBI. To evaluate the prevalence and severity of depression among a large group of chronic TBI adults; to determine the impact of depression on outcomes of post-hospital residential rehabilitation programs; and to assess effectiveness of post-hospital residential rehabilitation programs in treating depression. 820 adults with moderate to severe traumatic brain injury (TBI) were assigned to one of four groups based on MPAI- 4 depression ratings: (1) Not Depressed, (2) Mildly Depressed, (3) Moderately Depressed, and (4) Severely Depressed. Functional status was assessed at admission and discharge with the MPAI-4 Participation Index. Differences among groups were evaluated using conventional parametric tests. Rasch analysis established reliability and validity of MPAI-4 data. Rasch analysis demonstrated satisfactory construct validity and internal consistency (Person reliability = 0.89-0.92, Item reliability = 0.99). Of the 820 subjects, 39% presented with moderate to severe depressive symptoms at admission, These subjects demonstrated significantly higher MPAI-4 Participation scores than the mild and not depressed groups. Depressed groups realized significant improvement in symptoms, but, those remaining depressed at discharge had significantly greater disability than those who improved. Depressive symptoms had a deleterious impact on outcome. Remediation of symptoms during rehabilitation significantly improved outcomes.

Self-perceived personality characteristics in seasonal affective disorder and their implications for severity of depression.

Science.gov (United States)

Hjordt, Liv Vadskjær; Dam, Vibeke H; Ozenne, Brice; Hageman, Ida; Mc Mahon, Brenda; Mortensen, Erik Lykke; Knudsen, Gitte M; Stenbæk, Dea Siggaard

2018-04-01

The personality traits Neuroticism and Extraversion may be involved in the development of seasonal affective disorder (SAD). However, the impact of personality traits on SAD severity and whether such self-reported traits fluctuate with season is unknown. We investigated the association between Neuroticism, as acquired in a symptom-free phase and depression severity in individuals with SAD and seasonal changes in personality traits in individuals with SAD compared to healthy controls. Twenty-nine individuals diagnosed with SAD and thirty demographically matched controls completed the NEO Personality Inventory-Revised and the Major Depression Inventory twice: in summer when individuals with SAD were symptom-free, and in winter when they experienced SAD symptoms. In summer, the groups scored similarly on their personality traits, and the controls did not score any different in winter compared to summer. High scores on Neuroticism in summer was associated with more severe depressive symptoms in winter in SAD individuals. In winter, individuals with SAD scored higher on Neuroticism and lower on Extraversion, both compared to controls and to their own summer scores. Our results support that Neuroticism may represent a vulnerability marker related to SAD, and during a depressive episode Neuroticism and Extraversion may be sensitive markers of SAD pathology. Copyright © 2018 Elsevier B.V. All rights reserved.

Posttraumatic Stress Disorder and Depression Symptom Severities Are Differentially Associated With Hippocampal Subfield Volume Loss in Combat Veterans.

Science.gov (United States)

Averill, Christopher L; Satodiya, Ritvij M; Scott, J Cobb; Wrocklage, Kristen M; Schweinsburg, Brian; Averill, Lynnette A; Akiki, Teddy J; Amoroso, Timothy; Southwick, Steven M; Krystal, John H; Abdallah, Chadi G

2017-01-01

Two decades of human neuroimaging research have associated volume reductions in the hippocampus with posttraumatic stress disorder. However, little is known about the distribution of volume loss across hippocampal subfields. Recent advances in neuroimaging methods have made it possible to accurately delineate 10 gray matter hippocampal subfields. Here, we apply a volumetric analysis of hippocampal subfields to data from a group of combat-exposed Veterans. Veterans (total, n = 68, posttraumatic stress disorder, n = 36; combat control, n = 32) completed high-resolution structural magnetic resonance imaging. Based on previously validated methods, hippocampal subfield volume measurements were conducted using FreeSurfer 6.0. The Clinician-Administered PTSD Scale assessed posttraumatic stress disorder symptom severity; Beck Depression Inventory assessed depressive symptom severity. Controlling for age and intracranial volume, partial correlation analysis examined the relationship between hippocampal subfields and symptom severity. Correction for multiple comparisons was performed using false discovery rate. Gender, intelligence, combat severity, comorbid anxiety, alcohol/substance use disorder, and medication status were investigated as potential confounds. In the whole sample, total hippocampal volume negatively correlated with Clinician-Administered PTSD Scale and Beck Depression Inventory scores. Of the 10 hippocampal subfields, Clinician-Administered PTSD Scale symptom severity negatively correlated with the hippocampus-amygdala transition area (HATA). Beck Depression Inventory scores negatively correlated with dentate gyrus, cornu ammonis 4 (CA4), HATA, CA2/3, molecular layer, and CA1. Follow-up analysis limited to the posttraumatic stress disorder group showed a negative correlation between Clinician-Administered PTSD Scale symptom severity and each of HATA, CA2/3, molecular layer, and CA4. This study provides the first evidence relating posttraumatic stress

The role of depressive symptoms in treatment of adolescent cannabis use disorder with N-Acetylcysteine.

Science.gov (United States)

Tomko, Rachel L; Gilmore, Amanda K; Gray, Kevin M

2018-05-21

Relative to adults, adolescents are at greater risk of developing a cannabis use disorder (CUD) and risk may be exacerbated by co-occurring depressive symptoms. N-Acetylcysteine (NAC), an over-the-counter antioxidant, is thought to normalize glutamate transmission. Oxidative stress and glutamate transmission are disrupted in both depression and CUD. Thus, NAC may be particularly effective at promoting cannabis abstinence among adolescents with elevated depressive symptoms. Secondary analyses were conducted using a sub-sample of adolescents with CUD (N = 74) who participated in an 8-week randomized placebo-controlled clinical trial examining the efficacy of NAC for cannabis cessation. It was hypothesized that NAC would reduce severity of depressive symptoms, and that decreases depressive symptom severity would mediate decreases in positive weekly urine cannabinoid tests (11-nor-9-carboxy-Δ9-tetrahydrocannabinol). Additionally, it was expected that adolescents with greater severity of baseline depressive symptoms would be more likely to become abstinent when assigned NAC relative to placebo. Results from linear mixed models and generalized estimating equations did not suggest that NAC reduced severity of depressive symptoms, and the hypothesis that NAC's effect on cannabis cessation would be mediated by reduced depressive symptoms was not supported. However, an interaction between treatment condition and baseline severity of depressive symptoms as a predictor of weekly urine cannabinoid tests was significant, suggesting that NAC was more effective at promoting abstinence among adolescents with heightened baseline depressive symptoms. These secondary findings, though preliminary, suggest a need for further examination of the role of depressive symptoms in treatment of adolescent CUD with NAC. Copyright © 2018. Published by Elsevier Ltd.

[The degree of asthma severity in children and the level of maternal anxiety and depression].

Science.gov (United States)

Witkowska-Płusa, Urszula

2015-02-01

Care for sick children most often falls to mothers, which may affect their mental state, causing the states of depression and anxiety. The aim of this study was to determine the relationship between the severity of asthma in children and the level of anxiety and depression in mothers, taking into account the importance of the material status of the family, the educational level of the mothers, the presence of critical events, as well as the coexistence of allergic diseases in other family members. The study included 60 mothers of children with bronchial asthma. Age of mothers in the investigated families was on average 37.28 +/- 6.24 years, and most had a high school education (55.0%) or higher (28.3%). 16.7% of mothers and 8.3% fathers suffered from asthma. 13.3% of mothers of children with asthma were brought child alone. To assess the level of anxiety the inventory for measuring state and trait anxiety (STAI - State Trait Anxiety Inventory) developed by Spielberger, Gorsuch'a and Lushene'a was applied. To determine the changes in depressive the Beck Depression Inventory (BDI - Beck Depression Inventory questionnaire) was used. The Student's t test was included for two independent populations and a comparison of the results obtained in the questionnaire for diagnosing the level of anxiety and depression. For other parameters the correlation coefficient r-Pearson rank and Kendall's tau were performed. Mothers of children with moderate asthma compared to mothers of children with mild asthma had higher levels of anxiety (both state and properties), and also a slightly higher level of depression. Maternal age was connected positively and moderately strongly with the number held by children (r = 0.380; p = 0.003) and age of a child with asthma (r = 0.613, p = 0.0005). The duration of the child's disease was associated positively and moderately strongly with the level of state anxiety mother (X-1) (r = 0.345; p = 0.007) and a bit less and also positively with the

The role of empowerment and quality of life in depression severity among unemployed people with affective disorders receiving mental healthcare.

Science.gov (United States)

Johanson, Suzanne; Bejerholm, Ulrika

2017-09-01

Sick leave and unemployment are highly prevalent among people with affective disorders. Their depression severity is disabling and inversely related to having employment. No evidence-based vocational rehabilitation exists for this target group. Knowledge is therefore needed to understand the psychosocial factors that affect depression severity in order to develop new rehabilitation interventions. This study examined relationships between depression severity and empowerment, working life aspirations, occupational engagement, and quality of life in unemployed people with affective disorders receiving mental healthcare. In this cross-sectional study of 61 participants, instruments on psychosocial factors and questions on descriptive sociodemographic and clinical characteristics were administered. Descriptive, correlation, and regression statistics were applied. Correlation and regression analyses showed significant inverse relations between depression severity and empowerment and quality of life. The odds for more severe depression decreased with higher empowerment and quality of life. However, neither extent of engagement in daily life nor working life aspiration was related to depression severity. An empowerment approach and strategies, which support the quality of life, are needed in development of vocational rehabilitation interventions, and bridging of mental healthcare and vocational services. Implications for Rehabilitation Enhancing empowerment and quality life in the return to work process can decrease depression severity in unemployed people with affective disorder. There is a need to address work issues in addition to symptom reduction in primary and mental healthcare. Bridging the service and time gap between vocational rehabilitation and healthcare is recommended for mitigating long-term unemployment for people with affective disorders who want to work.

Negative mood-induced alcohol-seeking is greater in young adults who report depression symptoms, drinking to cope, and subjective reactivity.

Science.gov (United States)

Hogarth, Lee; Hardy, Lorna; Mathew, Amanda R; Hitsman, Brian

2018-04-01

Acute negative mood powerfully motivates alcohol-seeking behavior, but it remains unclear whether sensitivity to this effect is greater in drinkers who report depression symptoms, drinking to cope, and subjective reactivity. To examine these questions, 128 young adult alcohol drinkers (ages 18-25) completed questionnaires of alcohol use disorder symptoms, depression symptoms, and drinking to cope with negative affect. Baseline alcohol choice was measured by preference to enlarge alcohol versus food thumbnail images in two-alternative forced-choice trials. Negative mood was then induced by depressive statements and music, before alcohol choice was tested. Subjective reactivity was indexed by increased sadness pre- to post-mood induction. Baseline alcohol choice correlated with alcohol dependence symptoms (p = .001), and drinking coping motives (ps ≤ .01). Mood induction increased alcohol choice and subjective sadness overall (ps choice was associated with depression symptoms (p = .007), drinking to cope (ps ≤ .03), and subjective reactivity (p = .007). The relationship between mood-induced alcohol choice and drinking to cope remained significant after covarying for other drinking motives. Furthermore, the three predictors (depression, drinking to cope, and subjective reactivity) accounted for unique variance in mood-induced alcohol choice (ps ≥ .03), and collectively accounted for 18% of the variance (p choice task as sensitive to the relative value of alcohol and acute negative mood. The findings also accord with the core prediction of negative reinforcement theory that sensitivity to the motivational impact of negative mood on alcohol-seeking behavior may be an important mechanism that links depression and alcohol dependence. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Preoperative depression symptom severity and its impact on adherence to preoperative beta-blocker therapy.

Science.gov (United States)

Schonberger, Robert B; Feinleib, Jessica; Holt, Natalie; Dai, Feng; Brandt, Cynthia; Burg, Matthew M

2014-12-01

To test the association among depression symptoms, distressed personality type, and preoperative beta-blocker nonadherence and to estimate the prevalence of untreated major depression in this population. Prospective observational study. A veterans hospital. One hundred twenty patients on outpatient beta-blocker therapy presenting for surgery. The Patient Health Questionnaire (PHQ)-9, the D-Scale-14 (DS14), and Modified Morisky Scale (MMS) questionnaires. Of 99 participants who presented for surgery, the incidence of preoperative nonadherence was 14.1% (95% confidence interval 7%-21%), consistent with prior research. Nonadherence was 9.5% among those with no depression, 27.8% among those with mild depression, and 28.6% among those with moderate-to-severe depression (Cochran-Armitage test for trend p = 0.03). Distressed personality type was found in 35% of the cohort (95% confidence interval 26-45%) and was not associated with beta-blocker nonadherence (Fisher's exact test, p = 0.24). Among participants with symptoms of major depressive disorder (n = 25, 25.3%), more than half (n = 14, 56%) had no indication of depression listed at their most recent primary care visit. Patients with symptoms of depression on chronic beta-blocker therapy are susceptible to medication nonadherence on the day of surgery. Most surgical patients with symptoms of major depression lack a diagnosis of depression. Preoperative depression screening may thus (1) identify a population at increased risk of beta-blocker withdrawal, and (2) identify patients who may benefit from anesthesiologist-initiated referral for this treatable condition. Copyright © 2014 Elsevier Inc. All rights reserved.

Disagreement between self-reported and clinician-ascertained suicidal ideation and its correlation with depression and anxiety severity in patients with major depressive disorder or bipolar disorder.

Science.gov (United States)

Gao, Keming; Wu, Renrong; Wang, Zuowei; Ren, Ming; Kemp, David E; Chan, Philip K; Conroy, Carla M; Serrano, Mary Beth; Ganocy, Stephen J; Calabrese, Joseph R

2015-01-01

To study the disagreement between self-reported suicidal ideation (SR-SI) and clinician-ascertained suicidal ideation (CA-SI) and its correlation with depression and anxiety severity in patients with major depressive disorder (MDD) or bipolar disorder (BPD). Routine clinical outpatients were diagnosed with the MINI-STEP-BD version. SR-SI was extracted from the 16 Item Quick Inventory of Depression Symptomatology Self-Report (QIDS-SR-16) item 12. CA-SI was extracted from a modified Suicide Assessment module of the MINI. Depression and anxiety severity were measured with the QIDS-SR-16 and Zung Self-Rating Anxiety Scale. Chi-square, Fisher exact, and bivariate linear logistic regression were used for analyses. Of 103 patients with MDD, 5.8% endorsed any CA-SI and 22.4% endorsed any SR-SI. Of the 147 patients with BPD, 18.4% endorsed any CA-SI and 35.9% endorsed any SR-SI. The agreement between any SR-SI and any CA-SI was 83.5% for MDD and 83.1% for BPD, with weighted Kappa of 0.30 and 0.43, respectively. QIDS-SR-16 score, female gender, and ≥4 year college education were associated with increased risk for disagreement, 15.44 ± 4.52 versus 18.39 ± 3.49 points (p = 0.0026), 67% versus 46% (p = 0.0783), and 61% versus 29% (p = 0.0096). The disagreement was positively correlated to depression severity in both MDD and BPD with a correlation coefficient R(2) = 0.40 and 0.79, respectively, but was only positively correlated to anxiety severity in BPD with a R(2) = 0.46. Self-reported questionnaire was more likely to reveal higher frequency and severity of SI than clinician-ascertained, suggesting that a combination of self-reported and clinical-ascertained suicidal risk assessment with measuring depression and anxiety severity may be necessary for suicide prevention. Copyright © 2014 Elsevier Ltd. All rights reserved.

Depression

DEFF Research Database (Denmark)

Kessing, Lars Veddel; Bukh, Jens Drachmann

2014-01-01

The prevalence of depression is not clearly established, but estimated to 3-4% in a Danish questionnaire study. Lifetime's prevalences of 12-17% are reported in other community samples. In the current diagnostic system depression is defined categorically and operationally. It has been argued......, that these diagnostic criteria represent an oversimplification, which has blurred the concept of depression. We suggest a greater emphasis on the depressed mood as the core symptom of depression, which may increase the specificity of the diagnosis. Furthermore, basic principles for the treatment of depression...

Role of stress areas, stress severity, and stressful life events on the onset of depressive disorder: a case-control study.

Science.gov (United States)

Lueboonthavatchai, Peeraphon

2009-09-01

Although the stress and stressful life events are known as the precipitation of depressive disorder, the areas of stress and types of stressful life events found in depression are varied by different socio-cultural context. Identify the stress areas, stress severity, and types of stressful life events associated with the onset of depressive disorder in Thai depressed patients. Ninety depressed and ninety non-depressed subjects, aged above 18 years old, from the Department of Psychiatry, King Chulalongkorn Memorial Hospital, were recruited into the present study between July 2007 and January 2008. All subjects completed a demographic data form, and a 1-Year Life Stress Event Questionnaire. The association between the number of stressful life events, stress areas, stress severity, types of stressful life events, and the onset of depressive disorder were analyzed by independent t-test and chi-square test. Logistic regression was performed to identify the predictors of depressive disorder. Most of the subjects were young and middle-aged women, living in Bangkok and the central region. The depressed subjects experienced more stressful life events than the non-depressed subjects (5.81 +/- 3.19 vs. 3.24 +/- 2.80 events in one year) (p stress areas (health-related, family-related, financial, occupational, and social stress), and overall stress were associated with the onset of depressive disorder (p stress in all areas were at the higher risk of depressive disorder than those with the mild stress (p stress was the stress area highest associated with the depressive disorder (OR = 5.93, 95% CI = 2.33-16.92, p stressful life events associated with the onset of depressive disorder were the medical hospitalization, medical illness leading to missing work or disturbed daily routine, change in sleeping habits, absence of recreation, arguments with spouse, sexual difficulties with spouse, family financial problems, job loss, and trouble with boss (p stress was the significant

Depression increases in patients with Parkinson?s disease according to the increasing severity of the cognitive impairment

Directory of Open Access Journals (Sweden)

Marcos Hortes N. Chagas

2014-06-01

Full Text Available Objective : To test the hypothesis that severity of cognitive impairment modifies the association between depression and Parkinson’s disease (PD. Method : One-phase population-based door-to-door surveys. This is a secondary analysis of 1,451 people aged 65 years and older with cognitive impairment living in defined catchment areas. Depression was estimated according to ICD-10, self-reported PD, disability according to WHODAS-II and cognitive status according to the CSI-D. Results : The mean age of the sample was 79.3 years old and most (69% were women. Of the total sample, 16.1% had depression and it was significantly higher among participants with PD. There was an increase on the ORs of the association between depression and PD with decreased scores in the cognitive test (Adjusted OR from 0.98 to 8.04. Conclusion : The association between depression and PD increases with the severity of the cognitive impairment.

The severity of Internet addiction risk and its relationship with the severity of borderline personality features, childhood traumas, dissociative experiences, depression and anxiety symptoms among Turkish university students.

Science.gov (United States)

Dalbudak, Ercan; Evren, Cuneyt; Aldemir, Secil; Evren, Bilge

2014-11-30

The aim of this study was to investigate the relationship of Internet addiction (IA) risk with the severity of borderline personality features, childhood traumas, dissociative experiences, depression and anxiety symptoms among Turkish university students. A total of 271 Turkish university students participated in this study. The students were assessed through the Internet Addiction Scale (IAS), the Borderline Personality Inventory (BPI), the Dissociative Experiences Scale (DES), the Childhood Trauma Questionnaire (CTQ-28), the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). The rates of students were 19.9% (n=54) in the high IA risk group, 38.7% (n=105) in the mild IA risk group and 41.3% (n=112) in the group without IA risk. Correlation analyses revealed that the severity of IA risk was related with BPI, DES, emotional abuse, CTQ-28, depression and anxiety scores. Univariate covariance analysis (ANCOVA) indicated that the severity of borderline personality features, emotional abuse, depression and anxiety symptoms were the predictors of IAS score, while gender had no effect on IAS score. Among childhood trauma types, emotional abuse seems to be the main predictor of IA risk severity. Borderline personality features predicted the severity of IA risk together with emotional abuse, depression and anxiety symptoms among Turkish university students. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

[Poor self-esteem is correlated with suicide intent, independently from the severity of depression].

Science.gov (United States)

Perrot, C; Vera, L; Gorwood, P

2018-04-01

Suicide is a major Public Health concern, and low self-esteem might represent a major risk factor. Our main objective was to assess the correlation between self-esteem and suicide intent. More specifically, we aimed to examine the relationship between the different dimensions of self-esteem (total, general, familial, professional and social) and suicide intent. We also sought the role of depression in the relationship of self-esteem to suicide intent. This retrospective cross-sectional study was conducted at a suicide prevention department at the CMME (Sainte-Anne Hospital, Paris, France). We included patients aged 15 and older and admitted for suicide attempt over a 3-year period from January 2008 to December 2010. Self-esteem was assessed with the Coopersmith's Self-Esteem Inventory (SEI) scale that takes into account several domains of self-esteem. Subjects scoring over 5 points on the lie scale were excluded. Our primary endpoint was the correlation between self-esteem and suicide intent. Our secondary endpoint was the same correlation adjusted for depression severity (using the Hamilton scale). Suicide intent was estimated using Beck's Suicide Intentionality Scale (SIS). We examined the Pearson's correlation coefficients between self-esteem and suicide intent. These analyses were adjusted for the severity of depressive symptoms assessed with the Hamilton Depression Rating Scale (17 items). Overall, 132 patients were included. Suicide intent was correlated with total self-esteem (r=-0.227, P=0.009), social self-esteem (r=-0.331, Pself-esteem (r=-0.260, P=0.003). These results remained significant after adjusting for the level of depression for total score (r=-0.181, P=0.038), and the social (r=-0.282, P=0.001) and familial (r=-0.237, P=0.006) dimensions. Self-esteem (and especially social and familial dimensions) is likely to be associated with suicide intent, at least in part independently of the severity of depression, in a population of subjects

A LONGITUDINAL-STUDY OF INTERACTION PATTERNS OF A PSYCHIATRIST AND SEVERELY DEPRESSED-PATIENTS BASED ON OBSERVED BEHAVIOR - AN ETHOLOGICAL APPROACH OF INTERPERSONAL THEORIES OF DEPRESSION

NARCIS (Netherlands)

BOUHUYS, AL; VANDENHOOFDAKKER, RH

Observed behaviour of a psychiatrist interacting with severely depressed patients during an interview was related to the course of depression during hospitalization. The behavioural structure of such interaction could be described by 6 factors for the patients and 7 factors for the psychiatrist. The

Depression screening with patient-targeted feedback in cardiology: DEPSCREEN-INFO randomised clinical trial.

Science.gov (United States)

Löwe, Bernd; Blankenberg, Stefan; Wegscheider, Karl; König, Hans-Helmut; Walter, Dirk; Murray, Alexandra M; Gierk, Benjamin; Kohlmann, Sebastian

2017-02-01

International guidelines advocate depression screening in patients with coronary heart disease (CHD) and other chronic illnesses, but evidence is lacking. To test the differential efficacy of written patient-targeted feedback v. no written patient feedback after depression screening. Patients with CHD or hypertension from three cardiology settings were randomised and screened for depression (ClinicalTrials.gov Identifier: NCT01879111). Compared with the control group, where only cardiologists received written feedback, in the intervention group both cardiologists and patients received written feedback regarding depression status. Depression severity was measured 1 month (primary outcome) and 6 months after screening. The control group (n = 220) and the patient-feedback group (n = 155) did not differ in depression severity 1 month after screening. Six months after screening, the patient-feedback group showed significantly greater improvements in depression severity and was twice as likely to seek information about depression compared with the control group. Patient-targeted feedback in addition to screening has a significant but small effect on depression severity after 6 months and may encourage patients to take an active role in the self-management of depression. © The Royal College of Psychiatrists 2017.

Initial Severity and Differential Treatment Outcome in the National Institute of Mental Health Treatment of Depression Collaborative Research Program.

Science.gov (United States)

Elkin, Irene; And Others

1995-01-01

Random regression models were used to investigate the role of initial severity in the outcome of four treatments for major depression: cognitive behavioral therapy, interpersonal psychotherapy, imipramine plus clinical management, and placebo plus clinical management. Initial severity of depression and impairment of functioning significantly…

Depression and the Onset of Dementia in Adults with Mental Retardation.

Science.gov (United States)

Burt, Diana Byrd; And Others

1992-01-01

Comparison of 61 adults with Down's syndrome and 43 adults with mental retardation resulting from other causes found that 8 Down's syndrome adults had both depression and declines in functioning, whereas no adults in the other group showed functional declines. Greater severity of depression was related to poor functioning in adults with Down's…

HPA-axis hyperactivity and mortality in psychotic depressive disorder: preliminary findings.

Science.gov (United States)

Coryell, William; Fiedorowicz, Jess; Zimmerman, Mark; Young, Elizabeth

2008-06-01

The excess mortality associated with depressive disorders has been most often attributed to risks for suicide but diverse findings indicate that depressive disorders also increase risks for cardiovascular (CV) mortality. Among the possible mediators is the hypothalamic-pituitary-adrenal (HPA)-axis hyperactivity that characterizes many cases of relatively severe depressive disorder and severity is characteristic of psychotic depressive disorder. The following describes a 17-year mortality follow-up of 54 patients with Research Diagnostic Criteria (RDC) psychotic major depression or schizoaffective, mainly affective, depression. All had baseline assessments that included a 1mg dexamethasone suppression test with post-dexamethasone samples at 8 a.m., 4 p.m. and 11 p.m. Regression analyses showed that both greater age and higher maximum post-dexamethasone cortisol concentrations predicted deaths due to CV causes (t=4.01, pdepressive disorder to CV mortality.

Effects of an Internet intervention (Deprexis on severe depression symptoms: Randomized controlled trial

Directory of Open Access Journals (Sweden)

Björn Meyer

2015-03-01

Conclusions: These results replicate and extend previous findings by showing that Deprexis can facilitate symptomatic improvement over 3 months and, perhaps to a lesser degree, up until 6 months among adults with initially severe depression.

Interpersonal problems, dependency, and self-criticism in major depressive disorder.

Science.gov (United States)

Dinger, Ulrike; Barrett, Marna S; Zimmermann, Johannes; Schauenburg, Henning; Wright, Aidan G C; Renner, Fritz; Zilcha-Mano, Sigal; Barber, Jacques P

2015-01-01

The goal of the present research was the examination of overlap between 2 research traditions on interpersonal personality traits in major depression. We hypothesized that Blatt's (2004) dimensions of depressive experiences around the dimensions of relatedness (i.e., dependency) and self-definition (i.e., self-criticism) are associated with specific interpersonal problems according to the interpersonal circumplex model (Leary, 1957). In addition, we examined correlations of interpersonal characteristics with depression severity. Analyses were conducted on 283 patients with major depressive disorder combined from 2 samples. Of the patients, 151 participated in a randomized controlled trial in the United States, and 132 patients were recruited in an inpatient unit in Germany. Patients completed measures of symptomatic distress, interpersonal problems, and depressive experiences. Dependency was associated with more interpersonal problems related to low dominance and high affiliation, while self-criticism was associated with more interpersonal problems related to low affiliation. These associations were independent of depression severity. Self-criticism showed high overlap with cognitive symptoms of depression. The findings support the interpersonal nature of Blatt's dimensions of depressive experiences. Self-criticism is associated with being too distant or cold toward others as well as greater depression severity, but is not related to the dimension of dominance. © 2014 Wiley Periodicals, Inc.

Escitalopram is Associated with Reductions in Pain Severity and Pain Interference in Opioid Dependent Patients with Depressive Symptoms

Science.gov (United States)

Tsui, Judith I.; Herman, Debra S.; Kettavong, Malyna; Anderson, Bradley J.; Stein, Michael D.

2011-01-01

Pain is common among opioid dependent patients, yet pharmacologic strategies are limited. The aim of this study was to explore whether escitalopram, a selective serotonin reuptake inhibitor, was associated with reductions in pain. The study used longitudinal data from a randomized, controlled trial that evaluated the effects of escitalopram on treatment retention in patients with depressive symptoms who were initiating buprenorphine/naloxone for treatment of opioid dependence. Participants were randomized to take escitalopram 10mg or placebo daily. Changes in pain severity, pain interference and depression were assessed at 1, 2 and 3 months visits using the Visual Analog Scale, Brief Pain Inventory and the Beck Depression Inventory II, respectively. Fixed-effects estimator for panel regression models were used to assess the effects of intervention on changes in outcomes over time. Additional models were estimated to explore whether the intervention effect was mediated by within-person changes in depression. In this sample of 147 adults, we found that participants randomized to escitalopram had significantly larger reductions on both pain severity (b = −14.34, t = −2.66, p < .01) and pain interference (b = −1.20, t = −2.23, p < .05) between baseline and follow-up. After adjusting for within-subject changes in depression, the estimated effects of escitalopram on pain severity and pain interference were virtually identical to the unadjusted effects. In summary, this study of opioid-dependent patients with depressive symptoms found that treatment with escitalopram was associated with clinically meaningful reductions in pain severity and pain interference during the first three months of therapy. PMID:21924552

Dextroamphetamine sulfate provided quick relief of severe post-partum depression that was recalcitrant to standard antidepressants and psychotherapy.

Science.gov (United States)

Check, J H; Jaffe, A

2017-01-01

To determine if dextroamphetamine sulfate could improve symptoms of post-partum depression. A woman with severe post-partum depression that was resistant to standard antidepressant therapy and psychotherapy was treated with dextroamphetamine sulfate extended release capsules 15 mg/day. A quick and complete abrogation of the depression ensued along with improvement of migraine headaches, insomnia, and chronic fatigue. Dextr6amphetamine sulfate should be considered as a treatment modality for post-partum depression.

Antidepressant utilization after hospitalization with depression

DEFF Research Database (Denmark)

Wallach-Kildemoes, Helle; Thomsen, Louise Thirstrup; Kriegbaum, Margit

2014-01-01

Background: Antidepressant (AD) therapy is recommended for patients 4-12months after remission from depression. The aim was to examine whether immigrants (refugees or family reunited immigrants) from non-Western countries are at greater risk than Danish-born residents of 1) not initiating AD...... therapy after discharge and 2) early AD discontinuation. Methods: A cohort of immigrants from non-Western countries (n=132) and matched Danish-born residents (n=396) discharged after first admission with moderate to severe depression between 1 January 1996 and 31 May 2008 was followed in the Danish...... treatment after hospitalization with depression. This may indicate a need for a better understanding of the circumstances of this vulnerable group....

Clinical and sociodemographic correlates of severe insomnia in psychotropic drug-free, Asian outpatients with major depressive disorder.

Science.gov (United States)

Srisurapanont, Manit; Likhitsathian, Surinporn; Chua, Hong Choon; Udomratn, Pichet; Chang, Sungman; Maneeton, Narong; Maneeton, Benchaluk; Chen, Chia-Hui; Shih-Yen Chan, Edwin; Bautista, Dianne; Bin Sulaiman, Ahmad Hatim

2015-11-01

Little has been known regarding the correlates of severe insomnia in major depressive disorder (MDD). This post-hoc analysis aimed to examine the sociodemographic and clinical correlates of severe insomnia in psychotropic drug-free, Asian adult outpatients with MDD. Participants were psychotropic drug-free patients with MDD, aged 18-65 years. By using the Symptom Checklist-90 Items, Revised (SCL-90-R), a score of 4 (severe distress) on any one of three insomnia items was defined as severe insomnia. Other measures included the Montgomery-Asberg Depression Rating Scale (MADRS), the Fatigue Severity Scale (FSS), the nine psychopathology subscales of SCL-90-R, the Physical and Mental Component Summaries of Short Form Health Survey (SF-36 PCS and SF-36 MCS), and the Sheehan Disability Scale (SDS). Of 528 participants, their mean age being 39.5 (SD=13.26) years, 64.2% were females, and 239 (45.3%) had severe insomnia. The logistic regression model revealed that low educational qualifications (less than secondary school completion), high SCL-90-R Depression scores, high SCL-90-R Anxiety scores, and low SF-36 PCS scores were independently correlated with severe insomnia (p'sdepression and anxiety severity, and poor physical health. These findings may implicate the treatment of comorbid MDD and severe insomnia, for example, sleep hygiene education, pharmacological treatment. Copyright © 2015 Elsevier B.V. All rights reserved.

Anxiety and depressive symptoms and medical illness among adults with anxiety disorders.

Science.gov (United States)

Niles, Andrea N; Dour, Halina J; Stanton, Annette L; Roy-Byrne, Peter P; Stein, Murray B; Sullivan, Greer; Sherbourne, Cathy D; Rose, Raphael D; Craske, Michelle G

2015-02-01

Anxiety is linked to a number of medical conditions, yet few studies have examined how symptom severity relates to medical comorbidity. The current study assessed associations between severity of anxiety and depression and the presence of medical conditions in adults diagnosed with anxiety disorders. Nine-hundred eighty-nine patients diagnosed with panic, generalized anxiety, social anxiety, and posttraumatic stress disorders reported on the severity of anxiety and depressive symptoms and on diagnoses of 11 medical conditions. Severity of anxiety and depressive symptoms was strongly associated with having more medical conditions over and above control variables, and the association was as strong as that between BMI and disease. Odds of having asthma, heart disease, back problems, ulcer, migraine headache and eyesight difficulties also increased as anxiety and depressive symptom severity increased. Anxiety symptoms were independently associated with ulcer, whereas depressive symptoms were independently associated with heart disease, migraine, and eyesight difficulties. These findings add to a growing body of research linking anxiety disorders with physical health problems and indicate that anxiety and depressive symptoms deserve greater attention in their association with disease. Copyright © 2014 Elsevier Inc. All rights reserved.

Striatal dopamine D2/3 receptor-mediated neurotransmission in major depression: Implications for anhedonia, anxiety and treatment response.

Science.gov (United States)

Peciña, Marta; Sikora, Magdalena; Avery, Erich T; Heffernan, Joseph; Peciña, Susana; Mickey, Brian J; Zubieta, Jon-Kar

2017-10-01

Dopamine (DA) neurotransmission within the brain's reward circuit has been implicated in the pathophysiology of depression and in both, cognitive and pharmacological mechanisms of treatment response. Still, a direct relationship between measures of DA neurotransmission and reward-related deficits in patients with depression has not been demonstrated. To gain insight into the symptom-specific alterations in the DA system in patients with depression, we used positron emission tomography (PET) and the D 2/3 receptor-selective radiotracer [ 11 C]raclopride in twenty-three non-smoking un-medicated Major Depressive Disorder (MDD) patients and sixteen healthy controls (HC). We investigated the relationship between D 2/3 receptor availability and baseline measures of depression severity, anxiety, anhedonia, and cognitive and pharmacological mechanisms of treatment response. We found that, compared to controls, patients with depression showed greater D 2/3 receptor availability in several striatal regions, including the bilateral ventral pallidum/nucleus accumbens (vPAL/NAc), and the right ventral caudate and putamen. In the depressed sample, D 2/3 receptor availability in the caudal portion of the ventral striatum (NAc/vPAL) correlated with higher anxiety symptoms, whereas D 2/3 receptor availability in the rostral area of the ventral striatum correlated negatively with the severity of motivational anhedonia. Finally, MDD non-remitters showed greater baseline anxiety, greater D 2/3 availability in the NAc/vPAL, and greater placebo-induced DA release in the bilateral NAc. Our results demonstrate abnormally high D 2/3 receptor availability in the ventral striatum of patients with MDD, which seem to be associated with comorbid anxiety symptoms and lack of response to antidepressants. Copyright © 2017 Elsevier B.V. and ECNP. All rights reserved.

Increased autoimmune activity against 5-HT: a key component of depression that is associated with inflammation and activation of cell-mediated immunity, and with severity and staging of depression.

Science.gov (United States)

Maes, Michael; Ringel, Karl; Kubera, Marta; Berk, Michael; Rybakowski, Janusz

2012-02-01

Depression is characterized by inflammation and cell-mediated immune (CMI) activation and autoimmune reactions directed against a multitude of self-epitopes. There is evidence that the inflammatory response in depression causes dysfunctions in the metabolism of 5-HT, e.g. lowering the 5-HT precursor tryptophan, and upregulating 5-HT receptor mRNA. This study has been undertaken to examine autoimmune activity directed against 5-HT in relation to CMI activation and inflammation. 5-HT antibodies were examined in major depressed patients (n=109) versus normal controls (n=35) in relation to serum neopterin and lysozyme, and plasma pro-inflammatory cytokines (PIC), i.e. interleukin-1 (IL-1) and tumor necrosis factor-α (TNFα). Severity of depression was assessed with the Hamilton Depression Rating Scale (HDRS) and severity of fatigue and somatic symptoms with the Fibromyalgia and Chronic Fatigue Syndrome (FF) Rating Scale. The incidence of anti-5-HT antibody activity was significantly higher in depressed patients (54.1%), and in particular in those with melancholia (82.9%), than in controls (5.7%). Patients with positive 5-HT antibodies showed increased serum neopterin and lysozyme, and plasma TNFα and IL-1; higher scores on the HDRS and FF scales, and more somatic symptoms, including malaise and neurocognitive dysfunctions. There was a significant association between autoimmune activity to 5-HT and the number of previous depressive episodes. The autoimmune reactions directed against 5-HT might play a role in the pathophysiology of depression and the onset of severe depression. The strong association between autoimmune activity against 5-HT and inflammation/CMI activation is explained by multiple, reciprocal pathways between these factors. Exposure to previous depressive episodes increases the incidence of autoimmune activity directed against 5-HT, which in turn may increase the likelihood to develop new depressive episodes. These findings suggest that sensitization

Cognitive therapy for depressed adults with comorbid social phobia.

Science.gov (United States)

Smits, Jasper A J; Minhajuddin, Abu; Jarrett, Robin B

2009-04-01

Evidence suggests that comorbid depression influences the outcome of cognitive-behavioral treatment for patients presenting with social phobia. Little is known, however, about the influence of comorbid social phobia on the response to cognitive therapy (CT) for depression among adults presenting with recurrent major depressive disorder (MDD). These analyses seek to clarify this relationship. Patients (N=156) with recurrent DSM-IV MDD entered CT (20% also met DSM-IV criteria for social phobia). Every week during the course of CT, clinicians assessed depressive symptoms and patients completed self-report instruments measuring severity of depression and anxiety. At presentation, outpatients with comorbid social phobia reported greater levels of depressive symptoms and clinicians rated their impairment as more severe, compared to their counterparts without social phobia. Patients with or without comorbid social phobia did not differ significantly in (1) attrition rates; (2) response or sustained remission rates; (3) time to response or sustained remission; or (4) rate of improvement in symptoms of depression or anxiety. The lack of domain-specific measures limits inference with respect to the improvements in social anxiety that occur with CT of depression. These findings introduce the hypothesis that CT for depression may be flexible enough to treat the depressive symptoms of patients presenting with MDD who also suffer from social phobia.

Predicting depression from illness severity in cardiovascular disease patients: self-efficacy beliefs, illness perception, and perceived social support as mediators.

Science.gov (United States)

Greco, A; Steca, P; Pozzi, R; Monzani, D; D'Addario, M; Villani, A; Rella, V; Giglio, A; Malfatto, G; Parati, G

2014-04-01

Many studies have investigated the relationships between cardiovascular diseases and patients' depression; nevertheless, few is still known as regard the impact of illness severity on depression and whether psychosocial variables mediate this association. The aim of this study is to investigate the putative mediating role of illness representations, self-efficacy beliefs, and perceived social support on the relationship between illness severity and depression. A total of 75 consecutive patients with cardiovascular disease (80 % men; mean age = 65.44, SD = 10.20) were enrolled in an Italian hospital. Illness severity was measured in terms of left ventricular ejection fraction, whereas psychological factors were assessed using self-report questionnaires. The relationship between left ventricular ejection fraction and depression was mediated by identity illness perception, self-efficacy beliefs in managing cardiac risk factors, and perceived social support. The treatment of depression in cardiovascular disease patients may therefore benefit from a psychological intervention focused on patients' illness representations, self-efficacy beliefs, and their perceived social support.

The association between second-hand smoke exposure and depressive symptoms among pregnant women.

Science.gov (United States)

Huang, Jingya; Wen, Guoming; Yang, Weikang; Yao, Zhenjiang; Wu, Chuan'an; Ye, Xiaohua

2017-10-01

Tobacco smoking and depression are strongly associated, but the possible association between second-hand smoke (SHS) exposure and depression is unclear. This study aimed to examine the possible relation between SHS exposure and depressive symptoms among pregnant women. A cross-sectional survey was conducted in Shenzhen, China, using a multistage sampling method. The univariable and multivariable logistic regression models were used to explore the associations between SHS exposure and depressive symptoms. Among 2176 pregnant women, 10.5% and 2.0% were classified as having probable and severe depressive symptoms. Both binary and multinomial logistic regression revealed that there were significantly increased risks of severe depressive symptoms corresponding to SHS exposure in homes or regular SHS exposure in workplaces using no exposure as reference. In addition, greater frequency of SHS exposure was significantly associated with the increased risk of severe depressive symptoms. Our findings suggest that SHS exposure is positively associated with depressive symptoms in a dose-response manner among the pregnant women. Copyright © 2017 Elsevier B.V. All rights reserved.

Relationship of attention-deficit/hyperactivity disorder symptom severity with severity of alcohol-related problems in a sample of inpatients with alcohol use disorder

Directory of Open Access Journals (Sweden)

Bozkurt M

2016-07-01

Full Text Available Muge Bozkurt,1 Cuneyt Evren,1 Gokhan Umut,1 Bilge Evren2 1Research, Treatment and Training Center for Alcohol and Substance Dependence, Bakirkoy Prof Dr Mazhar Osman Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, 2Department of Psychiatry, Baltalimani State Hospital for Muskuloskeletal Disorders, Istanbul, Turkey Purpose: Attention-deficit/hyperactivity disorder (ADHD has been shown to be related to a higher risk of developing psychiatric problems such as depressive disorders, substance use disorder, and impulsivity. Adults who have comorbid ADHD and alcohol use disorder (AUD are at greater risk of negative outcomes. Thus, it is important to evaluate the relationship of ADHD symptoms and the severity of alcohol-related problems among patients with AUD. The aim of the present study was to evaluate the effect of ADHD symptoms on severity of alcohol-related problems, while controlling the effects of depression and impulsivity in a sample of inpatients with AUD. Patients and methods: Participants (n=190 were evaluated with the Beck Depression Inventory, the Short Form Barratt Impulsiveness Scale, the Michigan Alcohol Screening Test, and the Adult ADHD Self-Report Scale. Results: Severity of the scale scores was positively correlated with each other. Although severity of depression and impulsivity (particularly non-planning impulsivity predicted the severity of alcohol-related problems in a linear regression model, when severity of ADHD symptoms was included in the analysis, the inattentive subscale score, in particular, predicted the severity of alcohol-related problems together with non-planning impulsivity, whereas depression was no longer a predictor. Conclusion: These findings suggest that, together with non-planning impulsivity, symptoms of ADHD (particularly inattentive factor are an important factor that predict alcohol-related problems, while controlling the severity of depressive symptoms among inpatients

The joint association of depression and cognitive function with severe disability among community-dwelling older adults in Finland, Poland and Spain.

Science.gov (United States)

Olaya, Beatriz; Moneta, Maria Victoria; Koyanagi, Ai; Lara, Elvira; Miret, Marta; Ayuso-Mateos, José Luis; Chatterji, Somnath; Leonardi, Matilde; Koskinen, Seppo; Tobiasz-Adamczyk, Beata; Lobo, Antonio; Haro, Josep Maria

2016-04-01

To explore the joint association of depression and cognitive function with severe disability in nationally-representative samples of community-dwelling adults aged 50 years and older from Finland, Poland and Spain. Cross-sectional. Community-based. Population-based sample of 7987 non-institutionalized adults aged 50 and older. The outcome was severe disability, defined as ≥ 90th percentile of the 12-item version of the World Health Organization Disability Assessment Schedule (WHODAS 2.0). Past 12-month DSM-IV major depressive disorder was assessed with the depression module of the WHO Composite International Diagnostic Interview (CIDI). A global cognitive function score was obtained through neuropsychological tests. Product terms between depression and cognition were introduced in multivariable logistic regression models to test for interaction. Lower cognitive function and depression were both significantly associated with severe disability in all countries. A significant interaction was only found in Finland where the ORs (95% CIs) of depression for severe disability at the 25th (worse), 50th, and 75th (better) percentiles of cognitive function were 7.26 (4.28-12.32), 11.1 (6.7-18.38), and 17.56 (9.29-33.2), respectively. People with depression and cognitive decline are likely to benefit from the usual evidence-based treatments to reduce the burden of disability. However, in Finland, those with better cognitive function may benefit from more aggressive depression treatment. Future research is warranted to assess whether our results may be replicated.

Perceived Fatigue Interference and Depressed Mood: Comparison of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis Patients with Fatigued Breast Cancer Survivors.

Science.gov (United States)

Hall, Daniel L; Antoni, Michael H; Lattie, Emily G; Jutagir, Devika R; Czaja, Sara J; Perdomo, Dolores; Lechner, Suzanne C; Stagl, Jamie M; Bouchard, Laura C; Gudenkauf, Lisa M; Traeger, Lara; Fletcher, MaryAnn; Klimas, Nancy G

Persistent fatigue and depressive symptoms are both highly prevalent among patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) as well as breast cancer survivors. This study aimed to assess and directly compare perceptions of fatigue as highly interfering in one's daily functioning in both patient populations to better understand their relationships with depressed mood. Participants were 95 female CFS/ME patients and 67 females who were approximately 5 years post-treatment for stage 0-III breast cancer presenting with clinically elevated fatigue severity. Self-report measures were obtained on participants' fatigue-related interference in daily functioning and fatigue severity as well as depressed mood. Hierarchical regression was used to test effects controlling for relevant demographic, psychosocial, and medical covariates. CFS/ME patients endorsed greater depressed mood and fatigue interference than did fatigued breast cancer survivors, p's fatigued breast cancer survivors (β=.18, p =.19). CFS/ME patients reported elevated fatigue symptoms and depression relative to fatigued breast cancer survivors. In the former group, greater depressed mood was highly and significantly associated with greater fatigue-related inference in daily activities. Potential targets for cognitive behavioral interventions are discussed.

Perceived Fatigue Interference and Depressed Mood: Comparison of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis Patients with Fatigued Breast Cancer Survivors

Science.gov (United States)

Hall, Daniel L.; Antoni, Michael H.; Lattie, Emily G.; Jutagir, Devika R.; Czaja, Sara J.; Perdomo, Dolores; Lechner, Suzanne C.; Stagl, Jamie M.; Bouchard, Laura C.; Gudenkauf, Lisa M.; Traeger, Lara; Fletcher, MaryAnn; Klimas, Nancy G.

2015-01-01

Objective Persistent fatigue and depressive symptoms are both highly prevalent among patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) as well as breast cancer survivors. This study aimed to assess and directly compare perceptions of fatigue as highly interfering in one’s daily functioning in both patient populations to better understand their relationships with depressed mood. Methods Participants were 95 female CFS/ME patients and 67 females who were approximately 5 years post-treatment for stage 0-III breast cancer presenting with clinically elevated fatigue severity. Self-report measures were obtained on participants’ fatigue-related interference in daily functioning and fatigue severity as well as depressed mood. Hierarchical regression was used to test effects controlling for relevant demographic, psychosocial, and medical covariates. Results CFS/ME patients endorsed greater depressed mood and fatigue interference than did fatigued breast cancer survivors, p’sfatigued breast cancer survivors (β=.18, p=.19). Conclusions CFS/ME patients reported elevated fatigue symptoms and depression relative to fatigued breast cancer survivors. In the former group, greater depressed mood was highly and significantly associated with greater fatigue-related inference in daily activities. Potential targets for cognitive behavioral interventions are discussed. PMID:26180660

Relationship of smartphone use severity with sleep quality, depression, and anxiety in university students.

Science.gov (United States)

Demirci, Kadir; Akgönül, Mehmet; Akpinar, Abdullah

2015-06-01

The usage of smartphones has increased rapidly in recent years, and this has brought about addiction. The aim of the current study was to investigate the relationship between smartphone use severity and sleep quality, depression, and anxiety in university students. In total, 319 university students (203 females and 116 males; mean age = 20.5 ± 2.45) were included in the study. Participants were divided into the following three groups: a smartphone non-user group (n = 71, 22.3%), a low smartphone use group (n = 121, 37.9%), and a high smartphone use group (n = 127, 39.8%). All participants were evaluated using the Pittsburgh Sleep Quality Index, Beck Depression Inventory, Beck Anxiety Inventory; moreover, participants other than those in the smartphone non-user group were also assessed with the Smartphone Addiction Scale. The findings revealed that the Smartphone Addiction Scale scores of females were significantly higher than those of males. Depression, anxiety, and daytime dysfunction scores were higher in the high smartphone use group than in the low smartphone use group. Positive correlations were found between the Smartphone Addiction Scale scores and depression levels, anxiety levels, and some sleep quality scores. The results indicate that depression, anxiety, and sleep quality may be associated with smartphone overuse. Such overuse may lead to depression and/or anxiety, which can in turn result in sleep problems. University students with high depression and anxiety scores should be carefully monitored for smartphone addiction.

Relationship of Smartphone Use Severity with Sleep Quality, Depression, and Anxiety in University Students

Science.gov (United States)

Demi̇rci̇, Kadi̇r; Akgönül, Mehmet; Akpinar, Abdullah

2015-01-01

Background and Aims The usage of smartphones has increased rapidly in recent years, and this has brought about addiction. The aim of the current study was to investigate the relationship between smartphone use severity and sleep quality, depression, and anxiety in university students. Methods In total, 319 university students (203 females and 116 males; mean age = 20.5 ± 2.45) were included in the study. Participants were divided into the following three groups: a smartphone non-user group (n = 71, 22.3%), a low smartphone use group (n = 121, 37.9%), and a high smartphone use group (n = 127, 39.8%). All participants were evaluated using the Pittsburgh Sleep Quality Index, Beck Depression Inventory, Beck Anxiety Inventory; moreover, participants other than those in the smartphone non-user group were also assessed with the Smartphone Addiction Scale. Results The findings revealed that the Smartphone Addiction Scale scores of females were significantly higher than those of males. Depression, anxiety, and daytime dysfunction scores were higher in the high smartphone use group than in the low smartphone use group. Positive correlations were found between the Smartphone Addiction Scale scores and depression levels, anxiety levels, and some sleep quality scores. Conclusion The results indicate that depression, anxiety, and sleep quality may be associated with smartphone overuse. Such overuse may lead to depression and/or anxiety, which can in turn result in sleep problems. University students with high depression and anxiety scores should be carefully monitored for smartphone addiction. PMID:26132913

Major depressive disorder is characterized by greater reward network activation to monetary than pleasant image rewards.

Science.gov (United States)

Smoski, Moria J; Rittenberg, Alison; Dichter, Gabriel S

2011-12-30

Anhedonia, the loss of interest or pleasure in normally rewarding activities, is a hallmark feature of unipolar Major Depressive Disorder (MDD). A growing body of literature has identified frontostriatal dysfunction during reward anticipation and outcomes in MDD. However, no study to date has directly compared responses to different types of rewards such as pleasant images and monetary rewards in MDD. To investigate the neural responses to monetary and pleasant image rewards in MDD, a modified Monetary Incentive Delay task was used during functional magnetic resonance imaging to assess neural responses during anticipation and receipt of monetary and pleasant image rewards. Participants included nine adults with MDD and 13 affectively healthy controls. The MDD group showed lower activation than controls when anticipating monetary rewards in right orbitofrontal cortex and subcallosal cortex, and when anticipating pleasant image rewards in paracingulate and supplementary motor cortex. The MDD group had relatively greater activation in right putamen when anticipating monetary versus pleasant image rewards, relative to the control group. Results suggest reduced reward network activation in MDD when anticipating rewards, as well as relatively greater hypoactivation to pleasant image than monetary rewards. 2011 Elsevier Ireland Ltd. All rights reserved.

Mental State Decoding in Adolescent Boys with Major Depressive Disorder versus Sex-Matched Healthy Controls.

Science.gov (United States)

Mellick, William; Sharp, Carla

2016-01-01

Several adult depression studies have investigated mental state decoding, the basis for theory of mind, using the Reading the Mind in the Eyes Test. Findings have been mixed, but a comprehensive study found a greater severity of depression to be associated with poorer mental state decoding. Importantly, there has yet to be a similar study of adolescent depression. Converging evidence suggests that atypical mental state decoding may have particularly profound effects for psychosocial functioning among depressed adolescent boys. Adolescent boys with major depressive disorder (MDD, n = 33) and sex-matched healthy controls (HCs, n = 84) completed structured clinical interviews, self-report measures of psychopathology and the Child Eyes Test (CET). The MDD group performed significantly better than HCs on the CET overall (p = 0.002), underscored by greater accuracy for negatively valenced items (p = 0.003). Group differences on items depicting positive (p = 0.129) and neutral mental states (p = 0.081) were nonsignificant. Enhanced mental state decoding among depressed adolescent boys may play a role in the maintenance of and vulnerability to adolescent depression. Findings and implications are discussed. Limitations of this study include a reliance on self-report data for HC boys, as well as a lack of 'pure' depression among the boys with MDD. © 2016 S. Karger AG, Basel.

Frequency, trends, and antecedents of severe maternal depression after three million U.S. births.

Directory of Open Access Journals (Sweden)

Urbano L França

Full Text Available Postpartum depression carries adverse consequences for mothers and children, so widespread screening during primary care visits is recommended. However, the rates, timing, and factors associated with significant depressive episodes are incompletely understood.We examined the Healthcare Cost and Utilization Project (HCUP State Inpatient, Emergency Department, and Ambulatory Surgery and Services Databases from California (2005-2011 and Florida (2005-2012. Within 203 million records, we identified 3,213,111 births and all mothers who had hospital encounters for severe depression within 40 weeks following delivery. We identified 15,806 episodes of postpartum depression after 11,103 deliveries among 10,883 unique women, and calculated an overall rate of 36.7 depression- associated hospital visits per 10,000 deliveries. Upward trends were observed in both states, with combined five-year increases of 34%. First depressive events were most common within 30 days of delivery, but continued for the entire observation period. About half (1,661/3,325 of PPD first episodes occurred within 34 days of delivery, 70% (2,329/3,325 by the end of the second month, and 87% (2,893/3,325 before four-months of the delivery. Women with private insurance were less likely to have hospital encounters for depression than women with public insurance and women with depression were much more likely to have had some kind of hospital encounter at some time during their pregnancies. Rates of depression increased with the number of prenatal hospital encounters in a "dose-dependent" fashion: the rate of depression was 17.2/10,000 for women with no prenatal hospital visits, doubling for women with at least one encounter (34.9/10,000, and increasing 7-fold to 126/10,000 for women with three or more encounters during their pregnancies.Our findings suggest that (1 hospital encounters for post-partum depression are increasing, (2 screening should begin very early and continue for the

Frequency, trends, and antecedents of severe maternal depression after three million U.S. births.

Science.gov (United States)

França, Urbano L; McManus, Michael L

2018-01-01

Postpartum depression carries adverse consequences for mothers and children, so widespread screening during primary care visits is recommended. However, the rates, timing, and factors associated with significant depressive episodes are incompletely understood. We examined the Healthcare Cost and Utilization Project (HCUP) State Inpatient, Emergency Department, and Ambulatory Surgery and Services Databases from California (2005-2011) and Florida (2005-2012). Within 203 million records, we identified 3,213,111 births and all mothers who had hospital encounters for severe depression within 40 weeks following delivery. We identified 15,806 episodes of postpartum depression after 11,103 deliveries among 10,883 unique women, and calculated an overall rate of 36.7 depression- associated hospital visits per 10,000 deliveries. Upward trends were observed in both states, with combined five-year increases of 34%. First depressive events were most common within 30 days of delivery, but continued for the entire observation period. About half (1,661/3,325) of PPD first episodes occurred within 34 days of delivery, 70% (2,329/3,325) by the end of the second month, and 87% (2,893/3,325) before four-months of the delivery. Women with private insurance were less likely to have hospital encounters for depression than women with public insurance and women with depression were much more likely to have had some kind of hospital encounter at some time during their pregnancies. Rates of depression increased with the number of prenatal hospital encounters in a "dose-dependent" fashion: the rate of depression was 17.2/10,000 for women with no prenatal hospital visits, doubling for women with at least one encounter (34.9/10,000), and increasing 7-fold to 126/10,000 for women with three or more encounters during their pregnancies. Our findings suggest that (1) hospital encounters for post-partum depression are increasing, (2) screening should begin very early and continue for the first year

Impact of facial burns: relationship between depressive symptoms, self-esteem and scar severity

NARCIS (Netherlands)

Hoogewerf, C.J.; van Baar, M.E.; Middelkoop, E.; van Loey, N.E.

2014-01-01

Objective: This study assessed the role of self-reported facial scar severity as a possible influencing factor on self-esteem and depressive symptoms in patients with facial burns. Method: A prospective multicentre cohort study with a 6 months follow-up was conducted including 132 patients with

Impact of facial burns : relationship between depressive symptoms, self-esteem and scar severity

NARCIS (Netherlands)

Hoogewerf, Cornelis Johannes; van Baar, Margriet Elisabeth; Middelkoop, Esther; Van Loey, N.E.E.

2014-01-01

OBJECTIVE: This study assessed the role of self-reported facial scar severity as a possible influencing factor on self-esteem and depressive symptoms in patients with facial burns. METHOD: A prospective multicentre cohort study with a 6 months follow-up was conducted including 132 patients with

Relationships among pain, anxiety, and depression in primary care.

Science.gov (United States)

Means-Christensen, Adrienne J; Roy-Byrne, Peter P; Sherbourne, Cathy D; Craske, Michelle G; Stein, Murray B

2008-01-01

Pain, anxiety, and depression are commonly seen in primary care patients and there is considerable evidence that these experiences are related. This study examined associations between symptoms of pain and symptoms and diagnoses of anxiety and depression in primary care patients. Results indicate that primary care patients who endorse symptoms of muscle pain, headache, or stomach pain are approximately 2.5-10 times more likely to screen positively for panic disorder, generalized anxiety disorder, or major depressive disorder. Endorsement of pain symptoms was also significantly associated with confirmed diagnoses of several of the anxiety disorders and/or major depression, with odds ratios ranging from approximately 3 to 9 for the diagnoses. Patients with an anxiety or depressive disorder also reported greater interference from pain. Similarly, patients endorsing pain symptoms reported lower mental health functioning and higher scores on severity measures of depression, social anxiety, and posttraumatic stress disorder. Mediation analyses indicated that depression mediated some, but not all of the relationships between anxiety and pain. Overall, these results reveal an association between reports of pain symptoms and not only depression, but also anxiety. An awareness of these relationships may be particularly important in primary care settings where a patient who presents with reports of pain may have an undiagnosed anxiety or depressive disorder.

Impact of Behavioral Symptoms in Dementia Patients on Depression in Daughter and Daughter-in-Law Caregivers.

Science.gov (United States)

Lee, Juwon; Sohn, Bo Kyung; Lee, Hyunjoo; Seong, Sujeong; Park, Soowon; Lee, Jun-Young

2017-01-01

One caregiver relationship that has been neglected in caregiver depression research is the daughter-in-law. Compared with Western countries, in which those who are closer in familial relationships such as the spouse or child usually take care of the patient, in many Asian countries, the daughter-in-law often assumes the caretaker role. However, not much research has been done on how this relationship may result in different caregiver outcomes. We sought to identify whether the association between patient characteristics and caregiver depressive symptoms differs according to the familial relationship between caregiver and patient. Ninety-five daughter (n = 47) and daughter-in-law (n = 48) caregivers of dementia patients were asked to report their own depressive symptoms and patient behavioral symptoms. Patients' cognitive abilities, daily activities, and global dementia ratings were obtained. Hierarchical linear regression was employed to determine predictors of depressive symptoms. Daughters-in-law had marginally higher depressive scores. After adjusting for caregiver and patient characteristics, in both groups, greater dependency in activities of daily living and more severe and frequent behavioral symptoms predicted higher caregiver depressive scores. However, greater severity and frequency of behavioral symptoms predicted depression to a greater degree in daughters compared with daughters-in-law. Although behavioral symptoms predicted depression in both caregiver groups, the association was much stronger for daughters. This suggests that the emotional relationship between the daughter and patient exacerbates the negative effect of behavioral symptoms on caregiver depression. The familial relationship between the caregiver and dementia patient should be considered in managing caregiver stress.

The relationship between the severity of depression and cognitive coping strategies in patients with depressive episode

Directory of Open Access Journals (Sweden)

Chun-feng HU

2013-12-01

Full Text Available Objective: To explore the relationship between the depressive mood and cognitive emotion regulation strategies.  Methods: A total of 143 major depression patients were assessed with a self-designed questionnaire, Beck Depression Inventory (BDI, the Chinese version of Cognitive Emotion Regulation Questionnaire (CERQ-C and the twenty-item Toronto Scale (TAS-20, and 95 healthy people were involved as controls. Regression analysis was carried out for the influcing factors to depressive mood. Results: Compared with controls, Patients with Depressive Episode showed significantly higher total scores of inadaptability strategy，TAS and BDI(P<0.01. There were lots of factors, such as domestic stress and maladaptive strategy showed significant correlation with total score of BDI in major depression (P<0.05 or P<0.01. The factors of domestic stress and maladaptive strategy et al entered the regression equation for BDI by turns. Conclusions: Patients with depression suffered from maladaptive strategy. Cognitive coping strategies and stressl were the important influence factors of depression emotion in patients with depression.

The prevalence and clinical characteristics associated with Diagnostic and Statistical Manual Version-5-defined anxious distress specifier in adults with major depressive disorder

DEFF Research Database (Denmark)

McIntyre, Roger S.; Woldeyohannes, Hanna O; Soczynska, Joanna K

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......, 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...

Predictors of Positive Outcomes in Offspring of Depressed Parents and Non-depressed Parents Across 20 Years

Science.gov (United States)

Verdeli, Helen; Wickramaratne, Priya; Warner, Virginia; Mancini, Anthony; Weissman, Myrna

2014-01-01

Understanding differences in factors leading to positive outcomes in high-risk and low-risk offspring has important implications for preventive interventions. We identified variables predicting positive outcomes in a cohort of 235 offspring from 76 families in which one, both, or neither parent had major depressive disorder. Positive outcomes were termed resilient in offspring of depressed parents, and competent in offspring of non-depressed parents, and defined by two separate criteria: absence of psychiatric diagnosis and consistently high functioning at 2, 10, and 20 years follow-up. In offspring of depressed parents, easier temperament and higher self-esteem were associated with greater odds of resilient outcome defined by absence of diagnosis. Lower maternal overprotection, greater offspring self-esteem, and higher IQ were associated with greater odds of resilient outcome defined by consistently high functioning. Multivariate analysis indicated that resilient outcome defined by absence of diagnosis was best predicted by offspring self-esteem; resilient outcome defined by functioning was best predicted by maternal overprotection and self-esteem. Among offspring of non-depressed parents, greater family cohesion, easier temperament and higher self-esteem were associated with greater odds of offspring competent outcome defined by absence of diagnosis. Higher maternal affection and greater offspring self-esteem were associated with greater odds of competent outcome, defined by consistently high functioning. Multivariate analysis for each criterion indicated that competent outcome was best predicted by offspring self-esteem. As the most robust predictor of positive outcomes in offspring of depressed and non-depressed parents, self-esteem is an important target for youth preventive interventions. PMID:25374449

The effect of individual enabling and support on empowerment and depression severity in persons with affective disorders: outcome of a randomized control trial.

Science.gov (United States)

Porter, Susann; Bejerholm, Ulrika

2018-01-30

To evaluate the effect of Individual Enabling and Support (IES) on empowerment and depression severity as compared to Traditional Vocational Rehabilitation (TVR) in people with affective disorders at 12 months follow-up. Additionally, longitudinal changes within the intervention groups and the correlation over time between empowerment and depression severity were evaluated. A single-blind randomized controlled trial of two intervention groups, IES (n = 33) and TVR (n = 28), was performed with measurement points at baseline, 6, and 12 months. Individuals with affective disorders, including depression and bipolar disorder diagnoses were included. The Empowerment Scale and Montgomery-Åsberg Depression Self-Rating Scale were administered, and Intention-To-Treat analysis was applied. The study was registered with the trial number ISRCTN93470551. There was a statistically significant difference between the intervention groups on empowerment and depression severity at 12 months. Within-group analysis showed that IES-participants increased their perceived empowerment and decreased their depression severity between measurement points, this was not seen among TVR-participants. A moderate, inverse relationship was detected between empowerment and depression. IES is more effective in increasing empowerment and decreasing depression severity after a 12-month intervention than is TVR. This study was limited by a small sample size and larger trials in different contexts are needed.

Psychosocial functioning and depressive symptoms among HIV-positive persons receiving care and treatment in Kenya, Namibia, and Tanzania.

Science.gov (United States)

Seth, Puja; Kidder, Daniel; Pals, Sherri; Parent, Julie; Mbatia, Redempta; Chesang, Kipruto; Mbilinyi, Deogratius; Koech, Emily; Nkingwa, Mathias; Katuta, Frieda; Ng'ang'a, Anne; Bachanas, Pamela

2014-06-01

In sub-Saharan Africa, the prevalence of depressive symptoms among people living with HIV (PLHIV) is considerably greater than that among members of the general population. It is particularly important to treat depressive symptoms among PLHIV because they have been associated with poorer HIV care-related outcomes. This study describes overall psychosocial functioning and factors associated with depressive symptoms among PLHIV attending HIV care and treatment clinics in Kenya, Namibia, and Tanzania. Eighteen HIV care and treatment clinics (six per country) enrolled approximately 200 HIV-positive patients (for a total of 3,538 participants) and collected data on patients' physical and mental well-being, medical/health status, and psychosocial functioning. Although the majority of participants did not report clinically significant depressive symptoms (72 %), 28 % reported mild to severe depressive symptoms, with 12 % reporting severe depressive symptoms. Regression models indicated that greater levels of depressive symptoms were associated with: (1) being female, (2) younger age, (3) not being completely adherent to HIV medications, (4) likely dependence on alcohol, (5) disclosure to three or more people (versus one person), (6) experiences of recent violence, (7) less social support, and (8) poorer physical functioning. Participants from Kenya and Namibia reported greater depressive symptoms than those from Tanzania. Approximately 28 % of PLHIV reported clinically significant depressive symptoms. The scale-up of care and treatment services in sub-Saharan Africa provides an opportunity to address psychosocial and mental health needs for PLHIV as part of comprehensive care.

Predicting Depression From Language-Based Emotion Dynamics: Longitudinal Analysis of Facebook and Twitter Status Updates

Science.gov (United States)

Kern, Margaret L; Fulcher, Ben D; Rickard, Nikki S

2018-01-01

Background Frequent expression of negative emotion words on social media has been linked to depression. However, metrics have relied on average values, not dynamic measures of emotional volatility. Objective The aim of this study was to report on the associations between depression severity and the variability (time-unstructured) and instability (time-structured) in emotion word expression on Facebook and Twitter across status updates. Methods Status updates and depression severity ratings of 29 Facebook users and 49 Twitter users were collected through the app MoodPrism. The average proportion of positive and negative emotion words used, within-person variability, and instability were computed. Results Negative emotion word instability was a significant predictor of greater depression severity on Facebook (rs(29)=.44, P=.02, 95% CI 0.09-0.69), even after controlling for the average proportion of negative emotion words used (partial rs(26)=.51, P=.006) and within-person variability (partial rs(26)=.49, P=.009). A different pattern emerged on Twitter where greater negative emotion word variability indicated lower depression severity (rs(49)=−.34, P=.01, 95% CI −0.58 to 0.09). Differences between Facebook and Twitter users in their emotion word patterns and psychological characteristics were also explored. Conclusions The findings suggest that negative emotion word instability may be a simple yet sensitive measure of time-structured variability, useful when screening for depression through social media, though its usefulness may depend on the social media platform. PMID:29739736

Alcohol use severity and depressive symptoms among late adolescent Hispanics: Testing associations of acculturation and enculturation in a bicultural transaction model.

Science.gov (United States)

Cano, Miguel Ángel; de Dios, Marcel A; Castro, Yessenia; Vaughan, Ellen L; Castillo, Linda G; Lorenzo-Blanco, Elma I; Piña-Watson, Brandy; Berger Cardoso, Jodi; Ojeda, Lizette; Cruz, Rick A; Correa-Fernandez, Virmarie; Ibañez, Gladys; Auf, Rehab; Molleda, Lourdes M

2015-10-01

Research has indicated that Hispanics have high rates of heavy drinking and depressive symptoms during late adolescence. The purpose of this study was to test a bicultural transaction model composed of two enthnocultural orientations (acculturation and enculturation); and stressful cultural transactions with both the U.S. culture (perceived ethnic discrimination) and Hispanic culture (perceived intragroup marginalization) to predict alcohol use severity and depressive symptoms among a sample of 129 (men=39, women=90) late adolescent Hispanics (ages 18-21) enrolled in college. Results from a path analysis indicated that the model accounted for 18.2% of the variance in alcohol use severity and 24.3% of the variance in depressive symptoms. None of the acculturation or enculturation domains had statistically significant direct effects with alcohol use severity or depressive symptoms. However, higher reports of ethnic discrimination were associated with higher reports of alcohol use severity and depressive symptoms. Similarly, higher reports of intragroup marginalization were associated with higher depressive symptoms. Further, both ethnic discrimination and intragroup marginalization functioned as mediators of multiple domains of acculturation and enculturation. These findings highlight the need to consider the indirect effects of enthnocultural orientations in relation to health-related outcomes. Copyright © 2015 Elsevier Ltd. All rights reserved.

Aspects of Additional Psychiatric Disorders in Severe Depression/Melancholia: A Comparison between Suicides and Controls and General Pattern

Directory of Open Access Journals (Sweden)

Ulrika Heu

2018-06-01

Full Text Available Objective: Additional and comorbid diagnoses are common among suicide victims with major depressive disorder (MDD and have been shown to increase the suicide risk. The aim of the present study was first, to investigate whether patients with severe depression/melancholia who had died by suicide showed more additional psychiatric disorders than a matched control group. Second, general rates of comorbid and additional diagnoses in the total group of patients were estimated and compared with literature on MDD. Method: A blind record evaluation was performed on 100 suicide victims with severe depression/melancholia (MDD with melancholic and/or psychotic features: MDD-M/P and matched controls admitted to the Department of Psychiatry, Lund, Sweden between 1956 and 1969 and monitored to 2010. Diagnoses in addition to severe depression were noted. Results: Less than half of both the suicides and controls had just one psychiatric disorder (47% in the suicide and 46% in the control group. The average number of diagnoses was 1.80 and 1.82, respectively. Additional diagnoses were not related to an increased suicide risk. Anxiety was the most common diagnosis. Occurrence of suspected schizophrenia/schizotypal or additional obsessive-compulsive symptoms were more common than expected, but alcohol use disorders did not appear very frequent. Conclusions: The known increased risk of suicide in MDD with comorbid/additional diagnoses does not seem to apply to persons with MDD-M/P (major depressive disorder-depression/Melancholia. Some diagnoses, such as schizophrenia/schizotypal disorders, were more frequent than expected, which is discussed, and a genetic overlap with MDD-M/P is proposed.

Establishing the cut-off score for remission and severity-ranges on the Psychotic Depression Assessment Scale (PDAS)

DEFF Research Database (Denmark)

Østergaard, Søren D; Rothschild, Anthony J; Flint, Alastair J

2016-01-01

BACKGROUND: The Psychotic Depression Assessment Scale (PDAS) is a rating scale dedicated to the measurement of severity in psychotic depression (PD). The aim of this study was to establish the PDAS cut-off for remission of PD as well as PDAS score-ranges for mild, moderate, and severe PD...... on the PDAS and the severity-ranges for mild, moderate, and severe PD were defined using the Clinical Global Impression - Severity scale (CGI-S) as reference by means of pair-wise receiver operating characteristic (ROC) analyses. Subsequently, it was tested whether remission on the PDAS could separate...... the effects of Olanzapine+Sertraline vs. Olanzapine+Placebo through an intention-to-treat, mixed-effects logistic regression of the data from STOP-PD. RESULTS: According to the ROC analyses, the ideal cut-off for remission of PD was a PDAS total score moderate...

Depression and Chronic Health Conditions Among Latinos: The Role of Social Networks.

Science.gov (United States)

Soto, Sandra; Arredondo, Elva M; Villodas, Miguel T; Elder, John P; Quintanar, Elena; Madanat, Hala

2016-12-01

The purpose of this study was to examine the "buffering hypothesis" of social network characteristics in the association between chronic conditions and depression among Latinos. Cross-sectional self-report data from the San Diego Prevention Research Center's community survey of Latinos were used (n = 393). Separate multiple logistic regression models tested the role of chronic conditions and social network characteristics in the likelihood of moderate-to-severe depressive symptoms. Having a greater proportion of the network comprised of friends increased the likelihood of depression among those with high cholesterol. Having a greater proportion of women in the social network was directly related to the increased likelihood of depression, regardless of the presence of chronic health conditions. Findings suggest that network characteristics may play a role in the link between chronic conditions and depression among Latinos. Future research should explore strategies targeting the social networks of Latinos to improve health outcomes.

Religious and Spiritual Factors in Depression: Review and Integration of the Research

Science.gov (United States)

Bonelli, Raphael; Dew, Rachel E.; Koenig, Harold G.; Rosmarin, David H.; Vasegh, Sasan

2012-01-01

Depressive symptoms and religious/spiritual (R/S) practices are widespread around the world, but their intersection has received relatively little attention from mainstream mental health professionals. This paper reviews and synthesizes quantitative research examining relationships between R/S involvement and depressive symptoms or disorders during the last 50 years (1962 to 2011). At least 444 studies have now quantitatively examined these relationships. Of those, over 60% report less depression and faster remission from depression in those more R/S or a reduction in depression severity in response to an R/S intervention. In contrast, only 6% report greater depression. Of the 178 most methodologically rigorous studies, 119 (67%) find inverse relationships between R/S and depression. Religious beliefs and practices may help people to cope better with stressful life circumstances, give meaning and hope, and surround depressed persons with a supportive community. In some populations or individuals, however, religious beliefs may increase guilt and lead to discouragement as people fail to live up to the high standards of their religious tradition. Understanding the role that R/S factors play in preventing depression, facilitating its resolution, or leading to greater depression will help clinicians determine whether this is a resource or a liability for individual patients. PMID:22928096

Religious and Spiritual Factors in Depression: Review and Integration of the Research

Directory of Open Access Journals (Sweden)

Raphael Bonelli

2012-01-01

Full Text Available Depressive symptoms and religious/spiritual (R/S practices are widespread around the world, but their intersection has received relatively little attention from mainstream mental health professionals. This paper reviews and synthesizes quantitative research examining relationships between R/S involvement and depressive symptoms or disorders during the last 50 years (1962 to 2011. At least 444 studies have now quantitatively examined these relationships. Of those, over 60% report less depression and faster remission from depression in those more R/S or a reduction in depression severity in response to an R/S intervention. In contrast, only 6% report greater depression. Of the 178 most methodologically rigorous studies, 119 (67% find inverse relationships between R/S and depression. Religious beliefs and practices may help people to cope better with stressful life circumstances, give meaning and hope, and surround depressed persons with a supportive community. In some populations or individuals, however, religious beliefs may increase guilt and lead to discouragement as people fail to live up to the high standards of their religious tradition. Understanding the role that R/S factors play in preventing depression, facilitating its resolution, or leading to greater depression will help clinicians determine whether this is a resource or a liability for individual patients.

Effect of prenatal mindfulness training on depressive symptom severity through 18-months postpartum: A latent profile analysis.

Science.gov (United States)

Felder, Jennifer N; Roubinov, Danielle; Bush, Nicole R; Coleman-Phox, Kimberly; Vieten, Cassandra; Laraia, Barbara; Adler, Nancy E; Epel, Elissa

2018-02-28

We examined whether prenatal mindfulness training was associated with lower depressive symptoms through 18-months postpartum compared to treatment as usual (TAU). A controlled, quasi-experimental trial compared prenatal mindfulness training (MMT) to TAU. We collected depressive symptom data at post-intervention, 6-, and 18-months postpartum. Latent profile analysis identified depressive symptom profiles, and multinomial logistic regression examined whether treatment condition predicted profile. Three depressive symptom severity profiles emerged: none/minimal, mild, and moderate. Adjusting for relevant covariates, MMT participants were less likely than TAU participants to be in the moderate profile than the none/minimal profile (OR = 0.13, 95% CI = 0.03-0.54, p = .005). Prenatal mindfulness training may have benefits for depressive symptoms during the transition to parenthood. © 2018 Wiley Periodicals, Inc.

Peripartum depression and anxiety as an integrative cross domain target for psychiatric preventative measures.

Science.gov (United States)

Babb, Jessica A; Deligiannidis, Kristina M; Murgatroyd, Christopher A; Nephew, Benjamin C

2015-01-01

Exposure to high levels of early life stress has been identified as a potent risk factor for neurodevelopmental delays in infants, behavioral problems and autism in children, but also for several psychiatric illnesses in adulthood, such as depression, anxiety, autism, and posttraumatic stress disorder. Despite having robust adverse effects on both mother and infant, the pathophysiology of peripartum depression and anxiety are poorly understood. The objective of this review is to highlight the advantages of using an integrated approach addressing several behavioral domains in both animal and clinical studies of peripartum depression and anxiety. It is postulated that a greater focus on integrated cross domain studies will lead to advances in treatments and preventative measures for several disorders associated with peripartum depression and anxiety. Copyright © 2014 Elsevier B.V. All rights reserved.

Dual diagnosis in Depression: treatment recommendations.

Science.gov (United States)

Tirado Muñoz, Judit; Farré, Adriana; Mestre-Pintó, Joan; Szerman, Nestor; Torrens, Marta

2018-01-01

Comorbidity between substance use disorders (SUD) and major depression (MD) is the most common dual pathology in the field of addiction to substances and has prevalence rates ranging between 12% and 80%, which complicates the response to treatment and worsens the prognosis of patients. Differentiating between diagnoses of induced depressive episodes and primary depressive episodes concurrent to substance use is especially relevant for therapeutic management. This article presents the state of the art of the currently available pharmacologic treatments of comorbid depression in patients with SUD, taking into account the safety and risk of abuse of antidepressant drugs. Due to the fact that comorbidity of MD and SUD is frequent and presents greater psychopathological and medical severity, as well as worse social functioning, it is crucial to treat MD and SUD simultaneously using the integrated treatment model and not to treat both conditions separately.

Comparison of effects of bright light therapy alone or combined with fluoxetine on severity of depression, circadian rhythms, mood disturbance, and sleep quality, in patients with non-seasonal depression

Directory of Open Access Journals (Sweden)

Ağargün MY

2013-06-01

Full Text Available Mehmet Yücel Agargün,1 Gokben Hizli Sayar,2 Hüseyin Bulut,3 Oguz Tan21Medipol University, Department of Psychiatry, Istanbul, Turkey; 2Uskudar University, Neuropsychiatry Istanbul Hospital, Istanbul, Turkey; 3Büyükçekmece Government Hospital, Department of Psychiatry, Istanbul, TurkeyPurpose: To compare effects of bright light therapy (BLT alone or combined with the selective serotonin reuptake inhibitor (SSRI fluoxetine, on severity of depression, circadian rhythms, mood disturbance, and sleep quality, in patients with non-seasonal depression.Patients and methods: Drug-free patients who were administered 10,000 lux of BLT for 30 minutes for 7 days comprised the BLT group (n = 7, while patients who started fluoxetine as an add-on treatment day comprised the SSRI + BLT group (n = 8. The primary outcomes were severity of depression, measured using the Hamilton Depression Rating Scale (HAM-D and the Beck Depression Inventory (BDI; chronotype, measured using the Morningness Eveningness Questionnaire (MEQ; mood disturbance, measured using the Profile of Mood States (POMS survey; and sleep quality, measured using the Pittsburgh Sleep Quality Index (PSQI, before and after treatment in both groups.Results: All patients completed the study, and none reported obvious side effects. The mean onset age of depression was 26.1 years ± 5.3 years in the BLT group and 27 years ± 9.5 years in the SSRI + BLT group (P = 0.425. The number of past depressive episodes was 1.29 ± 0.76 in the BLT group, and 1.5 ± 0.8 in the SSRI + BLT group (P = 0.427. The difference between pre- and posttreatment scores revealed no significant difference between groups for the HAM-D scale, BDI, MEQ, POMS survey, and the PSQI.Conclusion: This study suggests that BLT is effective with respect to the severity of depression, circadian rhythms, mood disturbance, and sleep quality, in non-seasonal depression. However, there was no evidence in favor of adjunctive fluoxetine with BLT

Depression severity and quality of life of qualified and unqualified patients with a mood disorder for a research study targeting anhedonia in a clinical sample.

Science.gov (United States)

Gao, Keming; Sweet, Jennifer; Su, Meilei; Calabrese, Joseph R

2017-06-01

To investigate the depression severity and quality of life of qualified and unqualified patients with a mood disorder for a research study based on anhedonia severity. Diagnosis of major depressive disorder (MDD) or bipolar disorder (BPD) was ascertained with the MINI International Neuropsychiatric Interview. The severity of depression was measured with the 16-item Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-16-SR), and Item 5, "feeling sad (sadness)," QIDS-16-SR Item 13, "change in general interest," was used to measure the severity of anhedonia. The quality of life was measured with the Quality of Life, Enjoyment and Satisfaction Questionnaire (Q-LES-Q). Of 96 patients with MDD and 147 with bipolar I or II disorder, the severity rating on sadness and anhedonia was similar. The severities of anhedonia and sadness were highly correlated with R 2 of ≥0.91. Without considering depressive severity, 55% of patients would be eligible for a study if≥mild anhedonia was used as a severity criterion, but only 26% of patients eligible for a study if≥moderate anhedonia was used without considering substance use and medical comorbidities. If patients with ≥ moderate overall depressive symptoms were considered, 88.1% of patients would be eligible if≥mild anhedonia was required for a study, and 45.2% of patients would be eligible for a study if≥moderate anhedonia was required. For those who were unqualified for the study based on≥moderate anhedonia, about 1/3 had≥moderate overall depressive symptoms and less than 40% of maximum possible scores of Q-LES-Q. If only patients in remission based on overall depressive symptom severity were considered for a study of anhedonia, no patient would be eligible for the study. Depressive mood and anhedonia are highly correlated. Screening patients with a mood disorder and an overall moderate depressive severity is a cost-effective approach for a study targeting anhedonia, especially for a study requiring�

Severe water intoxication and secondary depressive syndrome in relation to delusional infestation

Directory of Open Access Journals (Sweden)

Lai J

2016-02-01

Full Text Available Jianbo Lai,1 Qiaoqiao Lu,1 Yi Xu,1,2 Shaohua Hu1,2 1Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 2The Key Laboratory of Mental Disorder’s Management in Zhejiang Province, Hangzhou, People’s Republic of China Abstract: This study presents a case of severe water intoxication in a female patient with delusional infestation. Self-induced excessive water ingestion is a rare medical condition, which has not been reported in patients with delusional infestation yet. The patient in this case study was a 60-year-old Chinese woman, who was admitted to our hospital because of a feeling of skin infestation. She suffered from loss of consciousness and generalized tonic–clonic seizure after drinking 12 L of water during bowel cleansing before colonoscopy. Sufficient laboratory and imaging examinations were performed to exclude other possible causes of severe hyponatremia, such as hypothyroidism, diabetes insipidus, and syndrome of inappropriate antidiuretic hormone. Besides, the cystic lesion in the posterior pituitary revealed by cranial magnetic resonance imaging was not accountable for her delusional symptoms as well as excessive drinking behavior. Her delusional symptoms were in complete remission with a combination of risperidone and aripiprazole. However, nearly 3 months after discharge, this patient suffered from depressed mood and was diagnosed with depressive syndrome, and even attempted suicide. This case highlights the possibility of self-induced water intoxication in patients with delusional infestation, inevitably adding to the complexity of the disease, and indicates the necessity of precautions for secondary psychotic or mood problems after symptomatological remission. Keywords: delusional infestation, depressive syndrome, suicide, water intoxication

Antidepressant utilization after hospitalization with depression

DEFF Research Database (Denmark)

Wallach-Kildemoes, Helle; Thomsen, Louise Thirstrup; Kriegbaum, Margit

2014-01-01

BACKGROUND: Antidepressant (AD) therapy is recommended for patients 4-12 months after remission from depression. The aim was to examine whether immigrants (refugees or family reunited immigrants) from non-Western countries are at greater risk than Danish-born residents of 1) not initiating AD...... therapy after discharge and 2) early AD discontinuation. METHODS: A cohort of immigrants from non-Western countries (n = 132) and matched Danish-born residents (n = 396) discharged after first admission with moderate to severe depression between 1 January 1996 and 31 May 2008 was followed in the Danish...... only minor impact on these associations. CONCLUSION: Immigrants seem less likely to receive the recommended AD treatment after hospitalization with depression. This may indicate a need for a better understanding of the circumstances of this vulnerable group....

Mediated and Moderated Effects of Neurocognitive Impairment on Outcomes of Treatment for Substance Dependence and Major Depression

Science.gov (United States)

Worley, Matthew J.; Tate, Susan R.; Granholm, Eric; Brown, Sandra A.

2015-01-01

Objective Neurocognitive impairment has not consistently predicted substance use treatment outcomes but has been linked to proximal mediators of outcome. These indirect effects have not been examined in adults with substance dependence and co-occurring psychiatric disorders. We examined mediators and moderators of the effects of neurocognitive impairment on substance use among adults in treatment for alcohol or drug dependence and major depression (MDD). Method Participants were veterans (N =197, mean age = 49.3 years, 90% male, 75% Caucasian) in a trial of two group interventions for alcohol/drug dependence and MDD. Measures examined here included intake neurocognitive assessments and percent days drinking (PDD), percent days using drugs (PDDRG), self-efficacy, 12-step affiliation, and depressive symptoms measured every 3 months from intake to the 18-month follow-up. Results Greater intake neurocognitive impairment predicted lower self-efficacy, lower 12-step affiliation, and greater depression severity, and these time-varying variables mediated the effects of impairment on future PDD and PDDRG. The prospective effects of 12-step affiliation on future PDD were greater for those with greater neurocognitive impairment. Impairment also interacted with depression to moderate the effects of 12-step affiliation and self-efficacy on PDD. Adults with greater impairment and currently severe depression had the strongest associations between 12-step affiliation/self-efficacy and future drinking. Conclusions Greater neurocognitive impairment may lead to poorer outcomes from group therapy for alcohol/drug dependence and MDD due to compromised change in therapeutic processes. Distal factors such as neurocognitive impairment can interact with dynamic risk factors to modulate the association between therapeutic processes and future drinking outcomes. PMID:24588403

Self-perceived personality characteristics in seasonal affective disorder and their implications for severity of depression

DEFF Research Database (Denmark)

Hjordt, Liv Vadskjær; Dam, Vibeke H; Ozenne, Brice

2018-01-01

The personality traits Neuroticism and Extraversion may be involved in the development of seasonal affective disorder (SAD). However, the impact of personality traits on SAD severity and whether such self-reported traits fluctuate with season is unknown. We investigated the association between...... Neuroticism, as acquired in a symptom-free phase and depression severity in individuals with SAD and seasonal changes in personality traits in individuals with SAD compared to healthy controls. Twenty-nine individuals diagnosed with SAD and thirty demographically matched controls completed the NEO Personality...... Inventory-Revised and the Major Depression Inventory twice: in summer when individuals with SAD were symptom-free, and in winter when they experienced SAD symptoms. In summer, the groups scored similarly on their personality traits, and the controls did not score any different in winter compared to summer...

Depression, anxiety and quality-of-life among relatives of patients with severe brain injury

DEFF Research Database (Denmark)

Norup, Anne; Welling, Karen-Lise; Qvist, Jesper

2012-01-01

Primary objective: To investigate the emotional well-being of relatives of patients with a severe brain injury in the acute setting, as well as risk factors associated with high anxiety and depression scores and impaired quality-of-life. Research design: Clinical convenience sample. Methods...

High prevalence of moderate and severe depressive and anxiety symptoms in polycystic ovary syndrome: a systematic review and meta-analysis.

Science.gov (United States)

Cooney, Laura G; Lee, Iris; Sammel, Mary D; Dokras, Anuja

2017-05-01

Do women with polycystic ovary syndrome (PCOS) have an increased prevalence of moderate and severe depressive and anxiety symptoms compared with control women, and do these symptoms correlate with age, BMI, testosterone, hirsutism or insulin resistance (IR)? Women with PCOS have significantly increased odds of moderate and severe depressive and anxiety symptoms, independent of obesity, and the symptoms are weakly associated with age, BMI, elevated testosterone, hirsutism and IR. Previous studies have reported that women with PCOS have an increased prevalence of mild depressive and anxiety symptoms or an increase in mean depression and anxiety scores, although these scores are usually within the normal range. Thus, it is therefore not clear whether these findings are clinically significant. The prevalence of moderate and severe depressive and anxiety symptoms, which require follow-up and would benefit from treatment, is not known in this population. A comprehensive systematic review (SR) was performed up to January 2016 and included 30 cross-sectional studies, representing 3050 subjects with PCOS and 3858 controls, from 10 different countries. The meta-analysis (MA) on depressive symptoms included 18 studies and the MA on anxiety symptoms included 9 studies. A separate SR identified 15 studies for the meta-regression examining the associations with PCOS-related symptoms or comorbidities. All studies included adult women with PCOS, defined by the National Institutes of Health or Rotterdam criteria, and a control group without PCOS. Ovid, Embase, PsychInfo and Cochrane were searched up to January 2016. Included studies used a validated screening tool to compare the prevalence or mean scores of depressive and/or anxiety symptoms. Random effects MA was used to estimate the pooled odds ratio (OR) of depressive and anxiety symptoms. Sensitivity analyses of methodological characteristics and a meta-regression of the pooled standardized mean difference (SMD) to evaluate

Evaluation of the DSM-5 Severity Indicator for Binge Eating Disorder in a Community Sample

Science.gov (United States)

Grilo, Carlos M.; Ivezaj, Valentina; White, Marney A.

2015-01-01

Research has examined various aspects of the diagnostic criteria for binge-eating disorder (BED) but has yet to evaluate the DSM-5 severity criterion. This study examined the DSM-5 severity criterion for BED based on binge-eating frequency and tested an alternative severity specifier based on overvaluation of shape/weight. 338 community volunteers categorized with DSM-5 BED completed a battery of self-report instruments. Participants were categorized first using DSM-5 severity levels and second by shape/weight overvaluation and were compared on clinical variables. 264 (78.1%) participants were categorized as mild, 67 (19.8%) as moderate, 6 (1.8%) as severe, and 1 (0.3%) as extreme. Analyses comparing mild and moderate severity groups revealed no significant differences in demographic variables or BMI; moderate severity group had greater eating-disorder psychopathology (small effect-sizes) but not depression than mild group. Participants with overvaluation (N=196; 60.1%) versus without (N=130; 39.9%) did not differ significantly in age, sex, BMI, or binge-eating frequency. Overvaluation group had significantly greater eating-disorder psychopathology and depression than non-overvaluation group. The greater eating-disorder and depression levels (medium-to-large effect-sizes) persisted after adjusting for ethnicity/race and binge-eating severity/frequency, without attenuation of effect-sizes. Findings from this non-clinical community sample provide support for overvaluation of shape/weight as a specifier for BED as it provides stronger information about severity than the DSM-5 rating based on binge-eating. Future research should include treatment-seeking patients with BED to test the utility of DSM-5 severity specifiers and include broader clinical validators. PMID:25701802

Experiencing reproductive concerns as a female cancer survivor is associated with depression

Science.gov (United States)

Gorman, Jessica R.; Su, H. Irene; Roberts, Samantha C.; Dominick, Sally A.; Malcarne, Vanessa L.

2014-01-01

Background Young adult female cancer survivors have unmet reproductive concerns and informational needs that are associated with poorer quality of life. The purpose of this study was to examine the association between current reproductive concerns and moderate to severe depression among young survivors. Methods This cross-sectional study includes 200 female cancer survivors between the ages of 18 and 35 years who completed a web-based survey measuring reproductive history, parenthood desires, reproductive concerns after cancer, and quality of life indicators. Results The mean age of participants was 28 years (SD = 4.4) and almost two-thirds were diagnosed within 5 years of completing the survey. Multivariable logistic regression analysis controlling for education, duration of survivorship, and social support revealed an association between experiencing reproductive concerns and moderate to severe depression (OR = 1.30, 95% CI = 1.06–1.60 for each 5 unit increase in RCAC score). Of those with moderate to severe depression, 23% had high RCAC scores as compared to 6% of those with minimal to mild depression (p < 0.001). Conclusion A higher level of reproductive concerns was associated with greater odds of experiencing moderate to severe depression. Almost a quarter of survivors in this sample reported moderate to severe depression, and addressing reproductive concerns represents one potential area of intervention to improve the psychosocial health of young survivors. PMID:25377593

Experiencing reproductive concerns as a female cancer survivor is associated with depression.

Science.gov (United States)

Gorman, Jessica R; Su, H Irene; Roberts, Samantha C; Dominick, Sally A; Malcarne, Vanessa L

2015-03-15

Young adult female cancer survivors have unmet reproductive concerns and informational needs that are associated with poorer quality of life. The purpose of this study was to examine the association between current reproductive concerns and moderate to severe depression among young survivors. This cross-sectional study included 200 female cancer survivors between the ages of 18 and 35 years who completed a Web-based survey measuring reproductive history, parenthood desires, reproductive concerns after cancer, and quality-of-life indicators. The mean age of the participants was 28 years (standard deviation, 4.4 years), and almost two-thirds were diagnosed within 5 years of survey completion. A multivariate logistic regression analysis controlling for education, duration of survivorship, and social support revealed an association between experiencing reproductive concerns and moderate to severe depression (odds ratio for each 5-unit increase in the Reproductive Concerns After Cancer [RCAC] score, 1.30; 95% confidence interval, 1.06-1.60). Among those with moderate to severe depression, 23% had high RCAC scores, whereas 6% of those with minimal to mild depression did (P reproductive concerns was associated with greater odds of experiencing moderate to severe depression. Almost a quarter of survivors in this sample reported moderate to severe depression, and addressing reproductive concerns represents one potential area of intervention for improving the psychosocial health of young survivors. © 2014 American Cancer Society.

Evaluation of the impact of severity of itching symptoms on the level of depression in patients with allergic contact eczema (preliminary study

Directory of Open Access Journals (Sweden)

Małgorzata Czarny-Działak

2014-06-01

Full Text Available Introduction : Allergic contact dermatitis is one of the most frequent skin disorders in the general population as well as among people who work professionally. Allergic contact allergens are simple chemical compounds. The most common are nickel and fragrance substances. Aim of the research : To estimate if and how the degree of itching in allergic contact dermatitis influences the development of depression. Material and methods: The treatment was conducted on a group of 17 people with allergic contact dermatitis. Each person was treated in order to estimate the level of depression using Becks scale and the level of itching. Next, it was estimated if the level of itching had any influence on the development of depression. Results: All skin diseases, including allergic contact eczema affect the biological and psychosocial functioning, and the quality of human. Five patients out of 17 showed features of depression: 3 mild (2 men and 1 woman, which is the most common state of transition, and 2 (women moderately-severe depressive symptoms. Both patients with moderately-severe depressive symptoms had a significant degree of severity of pruritus. Conclusions: It was stated that the level of itching has no influence on the development of depression.

Lower inhibitory control interacts with greater pain catastrophizing to predict greater pain intensity in women with migraine and overweight/obesity.

Science.gov (United States)

Galioto, Rachel; O'Leary, Kevin C; Thomas, J Graham; Demos, Kathryn; Lipton, Richard B; Gunstad, John; Pavlović, Jelena M; Roth, Julie; Rathier, Lucille; Bond, Dale S

2017-12-01

Pain catastrophizing (PC) is associated with more severe and disabling migraine attacks. However, factors that moderate this relationship are unknown. Failure of inhibitory control (IC), or the ability to suppress automatic or inappropriate responses, may be one such factor given previous research showing a relationship between higher PC and lower IC in non-migraine samples, and research showing reduced IC in migraine. Therefore, we examined whether lower IC interacts with increased PC to predict greater migraine severity as measured by pain intensity, attack frequency, and duration. Women (n = 105) aged 18-50 years old (M = 38.0 ± 1.2) with overweight/obesity and migraine who were seeking behavioral treatment for weight loss and migraine reduction completed a 28-day smartphone-based headache diary assessing migraine headache severity. Participants then completed a modified computerized Stroop task as a measure of IC and self-report measures of PC (Pain Catastrophizing Scale [PCS]), anxiety, and depression. Linear regression was used to examine independent and joint associations of PC and IC with indices of migraine severity after controlling for age, body mass index (BMI) depression, and anxiety. Participants on average had BMI of 35.1 ± 6.5 kg/m 2 and reported 5.3 ± 2.6 migraine attacks (8.3 ± 4.4 migraine days) over 28 days that produced moderate pain intensity (5.9 ± 1.4 out of 10) with duration of 20.0 ± 14.2 h. After adjusting for covariates, higher PCS total (β = .241, SE = .14, p = .03) and magnification subscale (β = .311, SE = .51, p migraine attacks. Future studies are needed to determine whether interventions to improve IC could lead to less painful migraine attacks via improvements in PC.

Depressed parents' attachment: effects on offspring suicidal behavior in a longitudinal, family study

Science.gov (United States)

MacGregor, Erica K.; Grunebaum, Michael F.; Galfalvy, Hanga C.; Melhem, Nadine; Burke, Ainsley K.; Brent, David A.; Oquendo, Maria A.; Mann, J. John

2015-01-01

Objective To investigate relationships of depressed parents' attachment style to offspring suicidal behavior. Method 244 parents diagnosed with a DSM-IV depressive episode completed the Adult Attachment Questionnaire at study entry. Baseline and yearly follow-up interviews of their 488 offspring tracked suicidal behavior and psychopathology. Survival analysis and marginal regression models with correlated errors for siblings investigated the relationship between parent insecure attachment traits and offspring characteristics. Data analyzed were collected 1992–2008 during a longitudinal family study completed January 31, 2014. Results Parent avoidant attachment predicted offspring suicide attempts at a trend level (p=0.083). Parent anxious attachment did not predict offspring attempts (p=0.961). In secondary analyses, anxious attachment in parents was associated with offspring impulsivity (p=0.034), and in offspring suicide attempters, was associated with greater intent (p=0.045) and lethality of attempts (p=0.003). Avoidant attachment in parents was associated with offspring impulsivity (p=0.025) and major depressive disorder (p=0.012). Parent avoidant attachment predicted a greater number of suicide attempts (p=0.048) and greater intent in offspring attempters (p=0.003). Results were comparable after adjusting for parent diagnosis of borderline personality disorder. Conclusion Insecure avoidant, but not anxious, attachment in depressed parents may predict offspring suicide attempt. Insecure parent attachment traits were associated with impulsivity and major depressive disorder in all offspring, and with more severe suicidal behavior in offspring attempters. Insecure parental attachment merits further study as a potential target to reduce risk of offspring psychopathology and more severe suicidal behavior. PMID:25098943

Depressed parents' attachment: effects on offspring suicidal behavior in a longitudinal family study.

Science.gov (United States)

MacGregor, Erica K; Grunebaum, Michael F; Galfalvy, Hanga C; Melhem, Nadine; Burke, Ainsley K; Brent, David A; Oquendo, Maria A; Mann, J John

2014-08-01

To investigate relationships of depressed parents' attachment style to offspring suicidal behavior. 244 parents diagnosed with a DSM-IV depressive episode completed the Adult Attachment Questionnaire at study entry. Baseline and yearly follow-up interviews of their 488 offspring tracked suicidal behavior and psychopathology. Survival analysis and marginal regression models with correlated errors for siblings investigated the relationship between parent insecure attachment traits and offspring characteristics. Data analyzed were collected 1992-2008 during a longitudinal family study completed January 31, 2014. Parental avoidant attachment predicted offspring suicide attempts at a trend level (P = .083). Parental anxious attachment did not predict offspring attempts (P = .961). In secondary analyses, anxious attachment in parents was associated with offspring impulsivity (P = .034) and, in offspring suicide attempters, was associated with greater intent (P = .045) and lethality of attempts (P = .003). Avoidant attachment in parents was associated with offspring impulsivity (P = .025) and major depressive disorder (P = .012). Parental avoidant attachment predicted a greater number of suicide attempts (P = .048) and greater intent in offspring attempters (P = .003). Results were comparable after adjusting for parent diagnosis of borderline personality disorder. Insecure avoidant, but not anxious, attachment in depressed parents may predict offspring suicide attempt. Insecure parental attachment traits were associated with impulsivity and major depressive disorder in all offspring and with more severe suicidal behavior in offspring attempters. Insecure parental attachment merits further study as a potential target to reduce risk of offspring psychopathology and more severe suicidal behavior. © Copyright 2014 Physicians Postgraduate Press, Inc.

Symptom severity, quality of sleep, and treatment adherence among patients suffering from schizophrenia and depression

NARCIS (Netherlands)

Bosch, M.P.C.; Waberg, J.; Noort, M.W.M.L. van den; Staudte, H.; Lim, S.; Egger, J.I.M.

2016-01-01

Aim: Treatment non-adherence is a common problem in patients suffering from schizophrenia and depression. This study investigated the possible relationships between symptom severity, quality of sleep, and treatment adherence. Methods: Thirty outpatients with schizophrenia and 58 outpatients with

Differences in depression severity and frequency of relapses in opiate addicts treated with methadone or opiate blocker after detoxification

OpenAIRE

Jovanović Tatjana; Lazarević Dušan; Nikolić Gordana

2012-01-01

Background/Aim. Relapse of opiate dependence is a common occurrence after detoxification and introduction of opiate addicts in abstinence from opiates. Clinical evaluation showed that over 90% of opiate addicts exhibit depressive manifestations during detoxification, or develop post-detoxification depression. The aim of this study was to determine differences in the frequency of relapses, severity and course of depression during a of 6-month period, and previous patterns of use of opioi...

A comparison of the major depression inventory (MDI) and the beck depression inventory (BDI) in severely depressed patients

DEFF Research Database (Denmark)

Konstantinidis, Anastasios; Martiny, Klaus; Bech, Per

2011-01-01

We set out to examine the psychometric properties of the MDI in comparison to the BDI in a mixed group of patients with primary depression.......We set out to examine the psychometric properties of the MDI in comparison to the BDI in a mixed group of patients with primary depression....

[Can I have some sunshine to cheer me up? vitamin D deficiency and depression in the elderly].

Science.gov (United States)

Stalpers-Konijnenburg, S C; Marijnissen, R M; Gaasbeek, A B; Oude Voshaar, R C

2011-01-01

Vitamin D deficiency is very common in the elderly, and the geriatric patient is probably at even greater risk. Vitamin D plays an important role in calcium homeostasis; recent studies point to a possible causal link between vitamin D deficiency and the development and severity of depression. In this article we focus on an 80-year-old patient with depression and severe vitamin D deficiency and give advice on the diagnosis and treatment of vitamin D deficiency. To supplement the current multidisciplinary guidelines on depression, we recommend routine testing of serum vitamin D level prior to confirming the diagnosis of depression in the elderly.

A Randomized Trial of Collaborative Care for Perinatal Depression in Socioeconomically Disadvantaged Women: The Impact of Comorbid Posttraumatic Stress Disorder.

Science.gov (United States)

Grote, Nancy K; Katon, Wayne J; Russo, Joan E; Lohr, Mary Jane; Curran, Mary; Galvin, Erin; Carson, Kathy

2016-11-01

The comorbidity of posttraumatic stress disorder (PTSD) with antenatal depression poses increased risks for postpartum depression and may delay or diminish response to evidence-based depression care. In a secondary analysis of an 18-month study of collaborative care for perinatal depression, the authors hypothesized that pregnant, depressed, socioeconomically disadvantaged women with comorbid PTSD would show more improvement in the MOMCare intervention providing Brief Interpersonal Psychotherapy and/or antidepressants, compared to intensive public health Maternity Support Services (MSS-Plus). A multisite randomized controlled trial with blinded outcome assessment was conducted in the Seattle-King County Public Health System, July 2009-January 2014. Pregnant women were recruited who met criteria for a probable diagnosis of major depressive disorder (MDD) on the Patient Health Questionnaire-9 and/or dysthymia on the MINI-International Neuropsychiatric Interview (5.0.0). The primary outcome was depression severity at 3-, 6-, 12-and 18-month follow-ups; secondary outcomes included functional improvement, PTSD severity, depression response and remission, and quality of depression care. Sixty-five percent of the sample of 164 met criteria for probable comorbid PTSD. The treatment effect was significantly associated with PTSD status in a group-by-PTSD severity interaction, controlling for baseline depression severity (Wald χ²₁ = 4.52, P = .03). Over the 18-month follow-up, those with comorbid PTSD in MOMCare (n = 48), versus MSS-Plus (n = 58), showed greater improvement in depression severity (Wald χ²₁ = 8.51, P depression response (Wald χ²₁ = 4.13, P depression care had a greater impact on perinatal depressive outcomes for socioeconomically disadvantaged women with comorbid PTSD than for those without PTSD. Findings suggest that a stepped care treatment model for high-risk pregnant women with both MDD and PTSD could be integrated into public health systems in

Antepartum depression severity is increased during seasonally longer nights: relationship to melatonin and cortisol timing and quantity.

Science.gov (United States)

Meliska, Charles J; Martínez, Luis F; López, Ana M; Sorenson, Diane L; Nowakowski, Sara; Kripke, Daniel F; Elliott, Jeffrey; Parry, Barbara L

2013-11-01

Current research suggests that mood varies from season to season in some individuals, in conjunction with light-modulated alterations in chronobiologic indices such as melatonin and cortisol. The primary aim of this study was to evaluate the effects of seasonal variations in darkness on mood in depressed antepartum women, and to determine the relationship of seasonal mood variations to contemporaneous blood melatonin and cortisol measures; a secondary aim was to evaluate the influence of seasonal factors on measures of melancholic versus atypical depressive symptoms. We obtained measures of mood and overnight concentrations of plasma melatonin and serum cortisol in 19 depressed patients (DP) and 12 healthy control (HC) antepartum women, during on-going seasonal variations in daylight/darkness, in a cross-sectional design. Analyses of variance showed that in DP, but not HC, Hamilton Depression Rating Scale (HRSD) scores were significantly higher in women tested during seasonally longer versus shorter nights. This exacerbation of depressive symptoms occurred when the dim light melatonin onset, the melatonin synthesis offset, and the time of maximum cortisol secretion (acrophase) were phase-advanced (temporally shifted earlier), and melatonin quantity was reduced, in DP but not HC. Serum cortisol increased across gestational weeks in both the HC and DP groups, which did not differ significantly in cortisol concentration. Nevertheless, serum cortisol concentration correlated positively with HRSD score in DP but not HC; notably, HC showed neither significant mood changes nor altered melatonin and cortisol timing or quantity in association with seasonal variations. These findings suggest that depression severity during pregnancy may become elevated in association with seasonally related phase advances in melatonin and cortisol timing and reduced melatonin quantity that occur in DP, but not HC. Thus, women who experience antepartum depression may be more susceptible than

Flotation separation of arsenopyrite from several sulphide minerals with organic depressants

Institute of Scientific and Technical Information of China (English)

Wang Fuliang; Wang Ligang; Sun Chuanyao

2008-01-01

In this paper,the separation of arsenopyrite from chalcopyrite,pyrite,galena with organic depressants (guergum and sodium humic)was discussed,and the functioning mechanism of those organic depressants was dis-cussed.The experimental results of monomineral flotation indicated that both guergum and sodium humic have depress-ing effect on arsenopyrite in the presence of ethyl xanthate.Guergum and sodium humic showed different depressing a-bility to pyrite,chalcopyrite and galena,and the higher the pH value in pulp,the stronger the depressing ability.Ultra-violet-Visible Spectrophotometric study showed that the adsorption layer of xanthate on surface of minerals had been de-sorbed by the two organic depressants,and the selective desorption of the collector layer was found from different miner-als.The xanthate cover on minerals surface was set free when dosage of the organic depressants was high enough.For artificially-mixed minerals,the separation of arsenopyrite from other sulphides was successfully realized by controlling dosage of the organic depressants.And sodium humic had been used successfully to decrease arsenic content in sulphide concentr ates in a commercial Lead-Zinc concentrator.

Early onset depression: the relevance of anxiety.

Science.gov (United States)

Parker, G; Wilhelm, K; Asghari, A

1997-01-01

The aim of this study was to determine risk factors that may differentiate early onset from late onset depression. A non-clinical cohort that had been assessed from 1978 to 1993 at 5 yearly intervals and that had a high prevalence rate of lifetime depression took part in the study. We established an appropriate age cut-off to distinguish early onset (i.e. before 26 years) of major and of minor depression, and examined the relevance of a number of possible determinants of early onset depression assessed over the life of the study. Despite several dimensional measures of depression, self-esteem and personality being considered, they generally failed (when assessed early in the study) to discriminate subsequent early onset depression, with the exception of low masculinity scores being a weak predictor of major and/or minor depression. Early onset depression was strongly predicted, however, by a lifetime episode of a major anxiety disorder, with generalised anxiety being a somewhat stronger and more consistent predictor than panic disorder, agoraphobia and minor anxiety disorders (ie social phobia, simple phobia). The possibility that anxiety may act as a key predispositional factor to early onset depression and to a greater number of depressive episodes is important in that clinical assessment and treatment of any existing anxiety disorder may be a more efficient and useful strategy than focussing primarily on the depressive disorder.

Amygdala Activity During Autobiographical Memory Recall in Depressed and Vulnerable Individuals: Association With Symptom Severity and Autobiographical Overgenerality.

Science.gov (United States)

Young, Kymberly D; Siegle, Greg J; Bodurka, Jerzy; Drevets, Wayne C

2016-01-01

In healthy individuals, autobiographical memory recall is biased toward positive and away from negative events, while the opposite is found in depressed individuals. This study examined amygdala activity during autobiographical memory recall as a putative mechanism underlying biased memory recall and depressive symptoms in currently depressed adults and two vulnerable populations: individuals remitted from depression and otherwise healthy individuals at high familial risk of developing depression. Identification of such vulnerability factors could enable interception strategies that prevent depression onset. Sixty healthy control subjects, 45 unmedicated currently depressed individuals, 25 unmedicated remitted depressed individuals, and 30 individuals at high familial risk of developing depression underwent functional MRI while recalling autobiographical memories in response to emotionally valenced cue words. Amygdala reactivity and connectivity with anatomically defined amygdala regions were examined. During positive recall, depressed participants exhibited significantly decreased left amygdala activity and decreased connectivity with regions of the salience network compared with the other groups. During negative recall, control subjects had significantly decreased left amygdala activity compared with the other groups, while depressed participants exhibited increased amygdala connectivity with the salience network. In depressed participants, left amygdala activity during positive recall correlated significantly with depression severity (r values >-0.38) and percent of positive specific memories recalled (r values >0.59). The results suggest that left amygdala hyperactivity during negative autobiographical recall is a trait-like marker of depression, as both vulnerable groups showed activity similar to the depressed group, while amygdala hypoactivity during positive autobiographical recall is a state marker of depression manifesting in active disease. Treatments

A manual-based phenomenological art therapy for individuals diagnosed with moderate to severe depression (PATd): A randomized controlled study.

Science.gov (United States)

Blomdahl, Christina; Guregård, Suzanne; Rusner, Marie; Wijk, Helle

2018-05-14

This study investigated the effects of manual-based Phenomenological Art Therapy for individuals living with depression in addition to treatment as usual (PATd/TAU) compared with only treatment as usual (TAU) for individuals diagnosed with moderate to severe depression. 79 adults (men = 29.1%) were included in this randomized-controlled-trial (RCT), multicenter study in Sweden with an intention-to-treat design. Participants were randomized into either the PATd/TAU-group (n = 43) or TAU-group (n = 36). Data were collected at baseline and at end of treatment. The main outcomes were depression levels and self-esteem. Secondary outcomes were suicide ideation and sickness absence. The PATd/TAU-group showed a significant decrease of depression levels. The PATd/TAU-group returned to work to a higher degree than the TAU-group. Self-esteem significantly improved in both groups. Suicide ideation was unaffected. Manual-based PATd works as expected, being an effective treatment, and contributes to recovery for individuals with moderate to severe depression. This outcome needs to be confirmed and its long-term effects examined in further studies. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Association of Beck Depression Inventory score and Temperament and Character Inventory-125 in patients with eating disorders and severe malnutrition

OpenAIRE

Tanaka, Satoshi; Yoshida, Keizo; Katayama, Hiroto; Kohmura, Kunihiro; Kawano, Naoko; Imaeda, Miho; Kato, Saki; Ando, Masahiko; Aleksic, Branko; Nishioka, Kazuo; Ozaki, Norio

2015-01-01

The authors investigated the association between personality and physical/mental status in malnourished patients with eating disorders. A total of 45 patients with anorexia nervosa, avoidant/restrictive food intake disorder, and other specified feeding or eating disorders were included and compared with 39 healthy controls. Personality characteristics and severity of depression were assessed using the Temperament and Character Inventory-125 and Beck?s Depression Inventory. Depression correlat...

Increased risk of severe depression in male partners of women with breast cancer

DEFF Research Database (Denmark)

Nakaya, Naoki; Saito-Nakaya, Kumi; Bidstrup, Pernille Envold

2010-01-01

BACKGROUND:: A few small studies published to date have suggested that major psychosocial problems develop in the partners of cancer patients; however, to the authors' knowledge, no studies to date have addressed their risk for severe depression. In a retrospective cohort study, the risk for hosp......BACKGROUND:: A few small studies published to date have suggested that major psychosocial problems develop in the partners of cancer patients; however, to the authors' knowledge, no studies to date have addressed their risk for severe depression. In a retrospective cohort study, the risk...... for hospitalization with an affective disorder of the male partners of women with breast cancer was investigated, using unbiased, nationwide, population-based information. METHODS:: Followed were 1,162,596 men born between 1925 and 1973 who were aged ≥30 years at study entry, resided in Denmark between 1994 and 2006......-related indicators obtained from national administrative and disease registers. RESULTS:: During the 13 years of follow-up, breast cancer was diagnosed in the partners of 20,538 men. On multivariable analysis, men whose partner was diagnosed with breast cancer were found to be at an increased risk of being...

Frontal alpha asymmetry as a pathway to behavioural withdrawal in depression: Research findings and issues.

Science.gov (United States)

Jesulola, Emmanuel; Sharpley, Christopher F; Bitsika, Vicki; Agnew, Linda L; Wilson, Peter

2015-10-01

Depression has been described as a process of behavioural withdrawal from overwhelming aversive stressors, and which manifests itself in the diagnostic symptomatology for Major Depressive Disorder (MDD). The underlying neurobiological pathways to that behavioural withdrawal are suggested to include greater activation in the right vs the left frontal lobes, described as frontal EEG asymmetry. However, despite a previous meta-analysis that provided overall support for this EEG asymmetry hypothesis, inconsistencies and several methodological confounds exist. The current review examines the literature on this issue, identifies inconsistencies in findings and discusses several key research issues that require addressing for this field to move towards a defensible theoretical model of depression and EEG asymmetry. In particular, the position of EEG asymmetry in the brain, measurement of severity and symptoms profiles of depression, and the effects of gender are considered as potential avenues to more accurately define the specific nature of the depression-EEG asymmetry association. Copyright © 2015 Elsevier B.V. All rights reserved.

An investigation of two dimensions of impulsivity as predictors of loss-of-control eating severity and frequency.

Science.gov (United States)

Espel, Hallie M; Muratore, Alexandra F; Lowe, Michael R

2017-10-01

Loss-of-control (LOC) eating episodes represent one form of dysregulated eating common to full- and sub-threshold eating disorders. Extensive evidence suggests that impulsivity, particularly in the context of negative affect and/or depression, may play an important etiological role in the development and maintenance of LOC eating. However, most prior studies have considered LOC eating as a dichotomous rather than dimensional construct, and few studies have considered the interaction of multiple dimensions of impulsivity while also accounting for the role of depressive symptoms. The present study examined the independent and interacting effects of two facets of impulsivity-response inhibition and negative urgency-on LOC eating episode severity and frequency among college women (N = 102). Depressive symptom severity was included as a covariate. Results indicated that greater negative urgency was associated with greater LOC severity; this effect was moderated by response inhibition, such that the effect of urgency was particularly pronounced for individuals with higher response inhibition capacity. Negative urgency was the only significant predictor of LOC frequency. Depression had no significant effect on either LOC severity or frequency (ps ≥ 0.16). Results support the importance of considering multiple facets of impulsivity in predicting LOC eating behavior, and further indicate that factors influencing subjective severity and frequency of LOC may be distinct. Copyright © 2017 Elsevier Ltd. All rights reserved.

Efficacy of motivational interviewing and cognitive behavioral therapy for anxiety and depression symptoms following traumatic brain injury.

Science.gov (United States)

Ponsford, J; Lee, N K; Wong, D; McKay, A; Haines, K; Alway, Y; Downing, M; Furtado, C; O'Donnell, M L

2016-04-01

Anxiety and depression are common following traumatic brain injury (TBI), often co-occurring. This study evaluated the efficacy of a 9-week cognitive behavioral therapy (CBT) program in reducing anxiety and depression and whether a three-session motivational interviewing (MI) preparatory intervention increased treatment response. A randomized parallel three-group design was employed. Following diagnosis of anxiety and/or depression using the Structured Clinical Interview for DSM-IV, 75 participants with mild-severe TBI (mean age 42.2 years, mean post-traumatic amnesia 22 days) were randomly assigned to an Adapted CBT group: (1) MI + CBT (n = 26), or (2) non-directive counseling (NDC) + CBT (n = 26); or a (3) waitlist control (WC, n = 23) group. Groups did not differ in baseline demographics, injury severity, anxiety or depression. MI and CBT interventions were guided by manuals adapted for individuals with TBI. Three CBT booster sessions were provided at week 21 to intervention groups. Using intention-to-treat analyses, random-effects regressions controlling for baseline scores revealed that Adapted CBT groups (MI + CBT and NDC + CBT) showed significantly greater reduction in anxiety on the Hospital Anxiety and Depression Scale [95% confidence interval (CI) -2.07 to -0.06] and depression on the Depression Anxiety and Stress Scale (95% CI -5.61 to -0.12) (primary outcomes), and greater gains in psychosocial functioning on Sydney Psychosocial Reintegration Scale (95% CI 0.04-3.69) (secondary outcome) over 30 weeks post-baseline relative to WC. The group receiving MI + CBT did not show greater gains than the group receiving NDC + CBT. Findings suggest that modified CBT with booster sessions over extended periods may alleviate anxiety and depression following TBI.

Predicting Depression From Language-Based Emotion Dynamics: Longitudinal Analysis of Facebook and Twitter Status Updates.

Science.gov (United States)

Seabrook, Elizabeth M; Kern, Margaret L; Fulcher, Ben D; Rickard, Nikki S

2018-05-08

Frequent expression of negative emotion words on social media has been linked to depression. However, metrics have relied on average values, not dynamic measures of emotional volatility. The aim of this study was to report on the associations between depression severity and the variability (time-unstructured) and instability (time-structured) in emotion word expression on Facebook and Twitter across status updates. Status updates and depression severity ratings of 29 Facebook users and 49 Twitter users were collected through the app MoodPrism. The average proportion of positive and negative emotion words used, within-person variability, and instability were computed. Negative emotion word instability was a significant predictor of greater depression severity on Facebook (r s (29)=.44, P=.02, 95% CI 0.09-0.69), even after controlling for the average proportion of negative emotion words used (partial r s (26)=.51, P=.006) and within-person variability (partial r s (26)=.49, P=.009). A different pattern emerged on Twitter where greater negative emotion word variability indicated lower depression severity (r s (49)=-.34, P=.01, 95% CI -0.58 to 0.09). Differences between Facebook and Twitter users in their emotion word patterns and psychological characteristics were also explored. The findings suggest that negative emotion word instability may be a simple yet sensitive measure of time-structured variability, useful when screening for depression through social media, though its usefulness may depend on the social media platform. ©Elizabeth M Seabrook, Margaret L Kern, Ben D Fulcher, Nikki S Rickard. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 08.05.2018.

Maternal depressive symptoms in pediatric major depressive disorder: relationship to acute treatment outcome.

Science.gov (United States)

Kennard, Betsy D; Hughes, Jennifer L; Stewart, Sunita M; Mayes, Taryn; Nightingale-Teresi, Jeanne; Tao, Rongrong; Carmody, Thomas; Emslie, Graham J

2008-06-01

In the present study, we assess maternal depressive symptoms at the beginning and end of treatment to investigate the possible reciprocal relationship of maternal illness with the child's depressive illness and treatment. We present data on 146 children and their mothers who were participating in a pediatric acute treatment study of fluoxetine. Patients were assessed with the Children's Depression Rating Scale-Revised at baseline and at each treatment visit. Mothers completed the Quick Inventory of Depressive Symptomatology-Self Report at baseline and end of acute treatment. Thirty percent of mothers had moderate to severe levels of depressive symptoms at the child's baseline assessment. Overall, mothers reported improvement in maternal depressive symptoms at the end of their child's acute treatment, although maternal depression was not specifically targeted for intervention. Furthermore, mother's depressive symptoms appear to be associated with the child's depression severity both at the beginning and end of treatment. Mothers with higher levels of depressive symptoms had children with higher levels of depression severity at baseline and over the course of treatment. However, maternal depressive symptoms at baseline had no association with the rate of improvement of child depression severity. This study indicates a positive relationship between the depression severity of mothers and their children. These findings highlight potential areas of intervention in the acute treatment of childhood depression.

Effect of Mirtazapine Treatment on Serum Levels of Brain-Derived Neurotrophic Factor and Tumor Necrosis Factor-α in Patients of Major Depressive Disorder with Severe Depression.

Science.gov (United States)

Gupta, Rachna; Gupta, Keshav; Tripathi, A K; Bhatia, M S; Gupta, Lalit K

2016-01-01

This study evaluated the clinical efficacy of mirtazapine and its effect on serum brain-derived neurotrophic factor (BDNF) and tumor necrosis factor-α (TNF-α) levels in patients of major-depressive disorder (MDD) with severe depression. Patients (aged 18-60) with MDD diagnosed by DSM-IV criteria, and Hamilton Rating Scale for Depression (HAM-D) score ≥25 were included (n = 30). Mirtazapine was given in the doses of 30 mg/day. All patients were followed up for 12 weeks for the evaluation of clinical efficacy, safety along with serum BDNF and TNF-α levels. HAM-D score at the start of treatment was 30.1 ± 1.92, which significantly (p depressed patients and treatment response is associated with an increase in serum BDNF and a decrease in serum TNF-α levels. © 2016 S. Karger AG, Basel.

Major depressive disorder is associated with abnormal interoceptive activity and functional connectivity in the insula.

Science.gov (United States)

Avery, Jason A; Drevets, Wayne C; Moseman, Scott E; Bodurka, Jerzy; Barcalow, Joel C; Simmons, W Kyle

2014-08-01

Somatic complaints and altered interoceptive awareness are common features in the clinical presentation of major depressive disorder (MDD). Recently, neurobiological evidence has accumulated demonstrating that the insula is one of the primary cortical structures underlying interoceptive awareness. Abnormal interoceptive representation within the insula may thus contribute to the pathophysiology and symptomatology of MDD. We compared functional magnetic resonance imaging blood oxygenation level-dependent responses between 20 unmedicated adults with MDD and 20 healthy control participants during a task requiring attention to visceral interoceptive sensations and also assessed the relationship of this blood oxygenation level-dependent response to depression severity, as rated using the Hamilton Depression Rating Scale. Additionally, we examined between-group differences in insula resting-state functional connectivity and its relationship to Hamilton Depression Rating Scale ratings of depression severity. Relative to the healthy control subjects, unmedicated MDD subjects exhibited decreased activity bilaterally in the dorsal mid-insula cortex (dmIC) during interoception. Activity within the insula during the interoceptive attention task was negatively correlated with both depression severity and somatic symptom severity in depressed subjects. Major depressive disorder also was associated with greater resting-state functional connectivity between the dmIC and limbic brain regions implicated previously in MDD, including the amygdala, subgenual prefrontal cortex, and orbitofrontal cortex. Moreover, functional connectivity between these regions and the dmIC was positively correlated with depression severity. Major depressive disorder and the somatic symptoms of depression are associated with abnormal interoceptive representation within the insula. © 2013 Society of Biological Psychiatry Published by Society of Biological Psychiatry All rights reserved.

Mortality and life expectancy in persons with severe unipolar depression

DEFF Research Database (Denmark)

Laursen, Thomas Munk; Musliner, Katherine L; Benros, Michael E

2016-01-01

BACKGROUND: Depression is a common psychiatric disorder, with a lifetime prevalence of 10-15% in the Danish population. Although depression is associated with excess mortality, it is not yet understood how this affects life expectancy. Our aim was to examine mortality rates and life expectancy...... in patients with unipolar depression compared to the general population, and to assess the impact of comorbid somatic illness and substance abuse. METHODS: We followed a Danish population-based cohort from 1995-2013 (N=5,103,699). The cohort included all residents in Denmark during the study period. Mortality...... rate ratios (MRRs) and life expectancy in persons with unipolar depression were calculated using survival analysis techniques. RESULTS: The overall MRR was 2.07 (95% Confidence Interval (CI): 2.05-2.09) in people with a previous unipolar depression diagnosis compared to the general Danish population...

Depression, posttraumatic stress disorder, and grade point average among student servicemembers and veterans.

Science.gov (United States)

Bryan, Craig J; Bryan, AnnaBelle O; Hinkson, Kent; Bichrest, Michael; Ahern, D Aaron

2014-01-01

The current study examined relationships among self-reported depression severity, posttraumatic stress disorder (PTSD) symptom severity, and grade point average (GPA) among student servicemembers and veterans. We asked 422 student servicemembers and veterans (72% male, 86% Caucasian, mean age = 36.29 yr) to complete an anonymous online survey that assessed self-reported GPA, depression severity, PTSD severity, and frequency of academic problems (late assignments, low grades, failed exams, and skipped classes). Female respondents reported a slightly higher GPA than males (3.56 vs 3.41, respectively, p = 0.01). Depression symptoms (beta weight = -0.174, p = 0.03), male sex (beta weight = 0.160, p = 0.01), and younger age (beta weight = 0.155, p = 0.01) were associated with lower GPA but not PTSD symptoms (beta weight = -0.040, p = 0.62), although the interaction of depression and PTSD symptoms showed a nonsignificant inverse relationship with GPA (beta weight = -0.378, p = 0.08). More severe depression was associated with turning in assignments late (beta weight = 0.171, p = 0.03), failed exams (beta weight = 0.188, p = 0.02), and skipped classes (beta weight = 0.254, p = 0.01). The relationship of depression with self-reported GPA was mediated by frequency of failed examns. Results suggest that student servicemembers and veterans with greater emotional distress also report worse academic performance.

Social support and employment status modify the effect of intimate partner violence on depression symptom severity in women: results from the 2006 Behavioral Risk Factor Surveillance System Survey.

Science.gov (United States)

Dougé, Nathalie; Lehman, Erik B; McCall-Hosenfeld, Jennifer S

2014-01-01

Depression and intimate partner violence (IPV) are significant health issues for U.S. women. Interaction effects between IPV and other psychosocial factors on the severity of depressive symptoms have not been fully explored. This study assessed effect modification, that is, how IPV interacts with sociodemographics, psychosocial factors and health risk behaviors, on the severity of depressive symptoms in women. We utilized cross-sectional data from female respondents (n = 16,106) of the 2006 Behavioral Risk Factors Surveillance Survey. Sociodemographics, psychosocial variables, and health risk behaviors determined to be significantly associated with depression were tested for interaction effects with IPV. Weighted ordinal logistic regression and predicted probabilities illustrated the effect of IPV status on depressive symptom severity, stratified by interaction effects. Recent and lifetime IPV exposure were associated with more severe depressive symptoms compared with no IPV exposure. IPV history interacted with employment status and social support on the severity of depressive symptoms in women. Overall, any IPV exposure was associated with more severe depressive symptoms among women with low social support and unemployment, although the effect of recent (versus lifetime) IPV was most pronounced among women with high social support or employed women. Social support and employment status interact with IPV on the severity of depressive symptoms in women. Therefore, social support or workplace interventions designed to improve depressive symptoms should examine IPV history. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Prevalence and Severity of Depression among People Living with ...

African Journals Online (AJOL)

The validated Patient Health, Duke University of North Carolina functional social support questionnaires were used as interviewer-administered tools. The study revealed 14.4% prevalence of depression, with the mild category (9.5%) as the predominant subtype. Factors associated with the risk of developing depression ...

Measurement-based Treatment of Residual Symptoms Using Clinically Useful Depression Outcome Scale: Korean Validation Study

Science.gov (United States)

Jeon, Sang Won; Han, Changsu; Ko, Young-Hoon; Yoon, Seo Young; Pae, Chi-Un; Choi, Joonho; Park, Yong Chon; Kim, Jong-Woo; Yoon, Ho-Kyoung; Ko, Seung-Duk; Patkar, Ashwin A.; Zimmerman, Mark

2017-01-01

Objective This study was aimed at evaluating the diagnostic validity of the Korean version of the Clinically Useful Depression Outcome Scale (CUDOS) with varying follow-up in a typical clinical setting in multiple centers. Methods In total, 891 psychiatric outpatients were enrolled at the time of their intake appointment. Current diagnostic characteristics were examined using the Structured Clinical Interview for DSM-IV (41% major depressive disorder). The CUDOS was measured and compared with three clinician rating scales and four self-report scales. Results The CUDOS showed excellent results for internal consistency (Cronbach’s α, 0.91), test-retest reliability (patients at intake, r=0.81; depressed patients in ongoing treatment, r=0.89), and convergent and discriminant validity (measures of depression, r=0.80; measures of anxiety and somatization, r=0.42). The CUDOS had a high ability to discriminate between different levels of depression severity based on the rating of Clinical Global Impression for depression severity and the diagnostic classification of major depression, minor depression, and non-depression. The ability of the CUDOS to identify patients with major depression was high (area under the receiver operating characteristic curve=0.867). A score of 20 as the optimal cutoff point was suggested when screening for major depression using the CUDOS (sensitivity=89.9%, specificity=69.5%). The CUDOS was sensitive to change after antidepressant treatment: patients with greater improvement showed a greater decrease in CUDOS scores (p<0.001). Conclusion The results of this multi-site outpatient study found that the Korean version of the CUDOS is a very useful measurement for research and for clinical practice. PMID:28138107

Oxidative stress and depressive symptoms in older adults: A magnetic resonance spectroscopy study.

Science.gov (United States)

Duffy, Shantel L; Lagopoulos, Jim; Cockayne, Nicole; Hermens, Daniel F; Hickie, Ian B; Naismith, Sharon L

2015-07-15

Major depression is common in older adults and associated with greater health care utilisation and increased risk of poor health outcomes. Oxidative stress may be implicated in the pathophysiology of depression and can be measured via the neurometabolite glutathione using proton magnetic resonance spectroscopy ((1)H-MRS). This study aimed to examine the relationship between glutathione concentration and depressive symptom severity in older adults 'at-risk' of depression. In total, fifty-eight older adults considered 'at-risk' of depression (DEP) and 12 controls underwent (1)H-MRS, medical and neuropsychological assessments. Glutathione was measured in the anterior cingulate cortex (ACC), and calculated as a ratio to creatine. Depressive and anxiety symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS). Compared to controls, DEP patients had increased glutathione/creatine ratios in the ACC (t=2.7, p=0.012). In turn, these increased ratios were associated with greater depressive symptoms (r=0.28, p=0.038), and poorer performance on a verbal learning task (r=-0.28, p=0.040). In conclusion, depressive symptoms in older people are associated with increased glutathione in the ACC. Oxidative stress may be pathophysiologically linked to illness development and may represent an early compensatory response. Further research examining the utility of glutathione as a marker for depressive symptoms and cognitive decline is now required. Copyright © 2015 Elsevier B.V. All rights reserved.

Perceived life stress exposure modulates reward-related medial prefrontal cortex responses to acute stress in depression.

Science.gov (United States)

Kumar, Poornima; Slavich, George M; Berghorst, Lisa H; Treadway, Michael T; Brooks, Nancy H; Dutra, Sunny J; Greve, Douglas N; O'Donovan, Aoife; Bleil, Maria E; Maninger, Nicole; Pizzagalli, Diego A

2015-07-15

Major depressive disorder (MDD) is often precipitated by life stress and growing evidence suggests that stress-induced alterations in reward processing may contribute to such risk. However, no human imaging studies have examined how recent life stress exposure modulates the neural systems that underlie reward processing in depressed and healthy individuals. In this proof-of-concept study, 12 MDD and 10 psychiatrically healthy individuals were interviewed using the Life Events and Difficulties Schedule (LEDS) to assess their perceived levels of recent acute and chronic life stress exposure. Additionally, each participant performed a monetary incentive delay task under baseline (no-stress) and stress (social-evaluative) conditions during functional MRI. Across groups, medial prefrontal cortex (mPFC) activation to reward feedback was greater during acute stress versus no-stress conditions in individuals with greater perceived stressor severity. Under acute stress, depressed individuals showed a positive correlation between perceived stressor severity levels and reward-related mPFC activation (r=0.79, p=0.004), whereas no effect was found in healthy controls. Moreover, for depressed (but not healthy) individuals, the correlations between the stress (r=0.79) and no-stress (r=-0.48) conditions were significantly different. Finally, relative to controls, depressed participants showed significantly reduced mPFC gray matter, but functional findings remained robust while accounting for structural differences. Small sample size, which warrants replication. Depressed individuals experiencing greater recent life stress recruited the mPFC more under stress when processing rewards. Our results represent an initial step toward elucidating mechanisms underlying stress sensitization and recurrence in depression. Copyright © 2015 Elsevier B.V. All rights reserved.

Depression in dementia : Development and testing of a nursing guideline

NARCIS (Netherlands)

Verkaik, Renate

2009-01-01

It is widely acknowledged that depression in dementia is a burden for patients as well as for their caregivers. A pro-active attitude among caregivers is needed to recognize this severe health problem in demented residents and to respond to it. This thesis firstly provides greater insight into

Stressful life events and depression symptoms: the effect of childhood emotional abuse on stress reactivity.

Science.gov (United States)

Shapero, Benjamin G; Black, Shimrit K; Liu, Richard T; Klugman, Joshua; Bender, Rachel E; Abramson, Lyn Y; Alloy, Lauren B

2014-03-01

Stressful life events are associated with an increase in depressive symptoms and the onset of major depression. Importantly, research has shown that the role of stress changes over the course of depression. The present study extends the current literature by examining the effects of early life stress on emotional reactivity to current stressors. In a multiwave study (N = 281, mean age = 18.76; 68% female), we investigated the proximal changes that occur in depressive symptoms when individuals are faced with life stress and whether a history of childhood emotional abuse moderates this relationship. Results support the stress sensitivity hypothesis for early emotional abuse history. Individuals with greater childhood emotional abuse severity experienced greater increases in depressive symptoms when confronted with current dependent stressors, controlling for childhood physical and sexual abuse. This study highlights the importance of emotional abuse as an indicator for reactivity to stressful life events. © 2013 Wiley Periodicals, Inc.

Plasma Metabolites Predict Severity of Depression and Suicidal Ideation in Psychiatric Patients-A Multicenter Pilot Analysis.

Science.gov (United States)

Setoyama, Daiki; Kato, Takahiro A; Hashimoto, Ryota; Kunugi, Hiroshi; Hattori, Kotaro; Hayakawa, Kohei; Sato-Kasai, Mina; Shimokawa, Norihiro; Kaneko, Sachie; Yoshida, Sumiko; Goto, Yu-Ichi; Yasuda, Yuka; Yamamori, Hidenaga; Ohgidani, Masahiro; Sagata, Noriaki; Miura, Daisuke; Kang, Dongchon; Kanba, Shigenobu

2016-01-01

Evaluating the severity of depression (SOD), especially suicidal ideation (SI), is crucial in the treatment of not only patients with mood disorders but also psychiatric patients in general. SOD has been assessed on interviews such as the Hamilton Rating Scale for Depression (HAMD)-17, and/or self-administered questionnaires such as the Patient Health Questionnaire (PHQ)-9. However, these evaluation systems have relied on a person's subjective information, which sometimes lead to difficulties in clinical settings. To resolve this limitation, a more objective SOD evaluation system is needed. Herein, we collected clinical data including HAMD-17/PHQ-9 and blood plasma of psychiatric patients from three independent clinical centers. We performed metabolome analysis of blood plasma using liquid chromatography mass spectrometry (LC-MS), and 123 metabolites were detected. Interestingly, five plasma metabolites (3-hydroxybutyrate (3HB), betaine, citrate, creatinine, and gamma-aminobutyric acid (GABA)) are commonly associated with SOD in all three independent cohort sets regardless of the presence or absence of medication and diagnostic difference. In addition, we have shown several metabolites are independently associated with sub-symptoms of depression including SI. We successfully created a classification model to discriminate depressive patients with or without SI by machine learning technique. Finally, we produced a pilot algorithm to predict a grade of SI with citrate and kynurenine. The above metabolites may have strongly been associated with the underlying novel biological pathophysiology of SOD. We should explore the biological impact of these metabolites on depressive symptoms by utilizing a cross species study model with human and rodents. The present multicenter pilot study offers a potential utility for measuring blood metabolites as a novel objective tool for not only assessing SOD but also evaluating therapeutic efficacy in clinical practice. In addition

Plasma Metabolites Predict Severity of Depression and Suicidal Ideation in Psychiatric Patients-A Multicenter Pilot Analysis.

Directory of Open Access Journals (Sweden)

Daiki Setoyama

Full Text Available Evaluating the severity of depression (SOD, especially suicidal ideation (SI, is crucial in the treatment of not only patients with mood disorders but also psychiatric patients in general. SOD has been assessed on interviews such as the Hamilton Rating Scale for Depression (HAMD-17, and/or self-administered questionnaires such as the Patient Health Questionnaire (PHQ-9. However, these evaluation systems have relied on a person's subjective information, which sometimes lead to difficulties in clinical settings. To resolve this limitation, a more objective SOD evaluation system is needed. Herein, we collected clinical data including HAMD-17/PHQ-9 and blood plasma of psychiatric patients from three independent clinical centers. We performed metabolome analysis of blood plasma using liquid chromatography mass spectrometry (LC-MS, and 123 metabolites were detected. Interestingly, five plasma metabolites (3-hydroxybutyrate (3HB, betaine, citrate, creatinine, and gamma-aminobutyric acid (GABA are commonly associated with SOD in all three independent cohort sets regardless of the presence or absence of medication and diagnostic difference. In addition, we have shown several metabolites are independently associated with sub-symptoms of depression including SI. We successfully created a classification model to discriminate depressive patients with or without SI by machine learning technique. Finally, we produced a pilot algorithm to predict a grade of SI with citrate and kynurenine. The above metabolites may have strongly been associated with the underlying novel biological pathophysiology of SOD. We should explore the biological impact of these metabolites on depressive symptoms by utilizing a cross species study model with human and rodents. The present multicenter pilot study offers a potential utility for measuring blood metabolites as a novel objective tool for not only assessing SOD but also evaluating therapeutic efficacy in clinical practice. In

Effect of antidepressant medication use on emotional information processing in major depression.

Science.gov (United States)

Wells, Tony T; Clerkin, Elise M; Ellis, Alissa J; Beevers, Christopher G

2014-02-01

Acute administration of antidepressant medication increases emotional information processing for positive information in both depressed and healthy persons. This effect is likely relevant to the therapeutic actions of these medications, but it has not been studied in patients with major depressive disorder taking antidepressants as typically prescribed in the community. The authors used eye tracking to examine the effects of antidepressant medication on selective attention for emotional stimuli in a sample of 47 patients with major depressive disorder (21 medicated and 26 unmedicated) and 47 matched comparison subjects without depression. Participants completed a passive-viewing eye-tracking task assessing selective attention for positive, dysphoric, threatening, and neutral stimuli in addition to providing medication information and self-report measures of depression and anxiety severity. Depressed participants currently taking antidepressants and nondepressed comparison subjects demonstrated greater total gaze duration and more fixations for positive stimuli compared with unmedicated depressed participants. Depressed participants on medication also had fewer fixations for dysphoric stimuli compared with depressed participants not on medication. Antidepressants, as prescribed in the community to patients with depression, appear to modify emotional information processing in the absence of differences in depression severity. These results are consistent with previous work and indicate a robust effect for antidepressants on positive information processing. They also provide further evidence for modification of information processing as a potential mechanism of action for antidepressant medication.

Tonic immobility during sexual assault - a common reaction predicting post-traumatic stress disorder and severe depression.

Science.gov (United States)

Möller, Anna; Söndergaard, Hans Peter; Helström, Lotti

2017-08-01

Active resistance is considered to be the 'normal' reaction during rape. However, studies have indicated that similar to animals, humans exposed to extreme threat may react with a state of involuntary, temporary motor inhibition known as tonic immobility. The aim of the present study was to assess the occurrence of tonic immobility during rape and subsequent post-traumatic stress disorder and severe depression. Tonic immobility at the time of the assault was assessed using the Tonic Immobility Scale in 298 women who had visited the Emergency clinic for raped women within 1 month of a sexual assault. Information about the assault and the victim characteristics were taken from the structured clinical data files. After 6 months, 189 women were assessed regarding the development of post-traumatic stress disorder and depression. Of the 298 women, 70% reported significant tonic immobility and 48% reported extreme tonic immobility during the assault. Tonic immobility was associated with the development of post-traumatic stress disorder (OR 2.75; 95% CI 1.50-5.03, p = 0.001) and severe depression (OR 3.42; 95% CI 1.51-7.72, p = 0.003) at 6 months. Further, previous trauma history (OR 2.36; 95% CI 1.48-3.77, p stress disorder and severe depression. Knowledge of this reaction in sexual assault victims is important in legal matters and for healthcare follow up. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

Does depression influence symptom severity in irritable bowel syndrome? Case study of a patient with irritable bowel syndrome and bipolar disorder.

Science.gov (United States)

Crane, Catherine; Martin, Maryanne; Johnston, Derek; Goodwin, Guy M

2003-01-01

Irritable bowel syndrome (IBS) is frequently associated with mood disorder. However, it is typically difficult to distinguish between disturbed mood as a causal agent and disturbed mood as a consequence of the experience of IBS. This report considers the association between mood and symptom severity in a patient with diarrhea-predominant IBS and stable, rapid cycling bipolar disorder with a predominantly depressive course. Such a case provides an important opportunity to determine the direction of the relationship between mood and IBS symptom severity because the fluctuations of mood in bipolar disorder are assumed to be driven largely by biological, rather than psychosocial, processes. The study was carried out prospectively, with ratings of mood and IBS symptom severity made daily by the patient for a period of almost 12 months. The patient experienced regular and substantial changes in mood as well as fluctuations in the level of IBS symptoms during the study period. Contrary to expectation, the correlation between mood and IBS symptom severity on the same day suggested that the patient experienced less severe IBS symptoms during periods of more severe depression. However, time series analysis revealed no significant association between these two processes when serial dependence within each series was controlled for. The unusual co-occurrence of IBS with bipolar disorder provides direct evidence to indicate that depression does not necessarily lead to an increase in the reported severity of IBS, at least in the context of bipolar disorder, and may under certain circumstances actually be associated with a reduction in the severity of IBS symptoms. Factors that might moderate the relationship between depression and symptom severity are discussed.

Prevalence and Severity of Depression among Undergraduate ...

African Journals Online (AJOL)

Undergraduate Students in Karachi, Pakistan: A Cross. Sectional Study ... questionnaire to appraise the presence and extent of depression among the participants. Their socio- ..... and disability by cause 1990-2020: Global burden of disease ...

Psychosocial aspects of resistance in complex treatment of depressive disorder.

Science.gov (United States)

Sedlackova, Zuzana; Prasko, Jan; Latalova, Klara; Kamaradova, Dana; Ociskova, Marie; Grambal, Ales; Sigmundova, Zuzana; Kasalova, Petra; Cakirpaloglu, Snezana

2015-01-01

Treatment of major depressive disorder can be affected by a broad range of factors. In our study, we focused on the relationships of demographic, psychological, clinical and social factors to the course of treatment of depression. The study included 151 patients (finally 140 patients were evaluated) hospitalized for major depressive disorder. They were assessed for demographic characteristics, the rates of depression and anxiety, quality of life, the rates of dissociation and insomnia, and subjective and objective disease severity at different times during treatment. Patients were treated with standard doses of antidepressants or other psychiatric medication. They also completed a 6-week long daily cognitive-behavioural therapy. Data were statistically analyzed. There were significant decreases in the overall severity of the disorder, anxiety level and depression rate during treatment. Improvement measured by objective Clinical Global Impression (oCGI-I) at the end of treatment was not significantly correlated with any of the measured parameters (age of patient, onset of illness, duration of disease, doses of medication etc.). It only significantly positively correlated with the initial evaluation of the patient by oCGI. However, the improvement in subjective assessment (using sCGI-I) correlated with many parameters (increased age, later onset of the disease, greater disease severity at baseline in both overall and subjective evaluation of the severity, anxiety and depressive symptomatology). Furthermore, it was negatively correlated with most quality of life parameters, such as H (Home), F (Feelings), L (Leisure), Sr (Social relations) and G (General). The results suggest that individual variables, such as the degree of psychopathology, particularly depression and anxiety, most quality of life parameters, higher patient age and age of disorder onset may be associated with poorer subjective response to complex treatment of patients with major depressive disorder.

Last Suicide Attempt before Completed Suicide in Severe Depression: An Extended Suicidal Process May Be Found in Men Rather Than Women.

OpenAIRE

Brådvik, Louise

2013-01-01

The objective of this study was to compare the time from last suicide attempt to suicide in men and women with major depressive disorder with melancholic and/or psychotic features. The case records of 100 suicide victims with severe depression were evaluated. All suicide attempts during the course of depression were noted. The time from last suicide attempt to suicide was compared as well as the occurrence of suicide attempt during the last depressive episode, by gender. Male suicide attempte...

Acute and long-term treatment of late-life major depressive disorder: duloxetine versus placebo.

Science.gov (United States)

Robinson, Michael; Oakes, Tina Myers; Raskin, Joel; Liu, Peng; Shoemaker, Scarlett; Nelson, J Craig

2014-01-01

To compare the efficacy of duloxetine with placebo on depression in elderly patients with major depressive disorder. Multicenter, 24-week (12-week short-term and 12-week continuation), randomized, placebo-controlled, double-blind trial. United States, France, Mexico, Puerto Rico. Age 65 years or more with major depressive disorder diagnosis (one or more previous episode); Mini-Mental State Examination score ≥20; Montgomery-Asberg Depression Rating Scale total score ≥20. Duloxetine 60 or 120 mg/day or placebo; placebo rescue possible. Primary-Maier subscale of the 17-item Hamilton Depression Rating Scale (HAMD-17) at week 12. Secondary-Geriatric Depression Scale, HAMD-17 total score, cognitive measures, Brief Pain Inventory (BPI), Numeric Rating Scales (NRS) for pain, Clinical Global Impression-Severity scale, Patient Global Impression of Improvement in acute phase and acute plus continuation phase of treatment. Compared with placebo, duloxetine did not show significantly greater improvement from baseline on Maier subscale at 12 weeks, but did show significantly greater improvement at weeks 4, 8, 16, and 20. Similar patterns for Geriatric Depression Scale and Clinical Global Impression-Severity scale emerged, with significance also seen at week 24. There was a significant treatment effect for all BPI items and 4 of 6 NRS pain measures in the acute phase, most BPI items and half of the NRS measures in the continuation phase. More duloxetine-treated patients completed the study (63% versus 55%). A significantly higher percentage of duloxetine-treated patients versus placebo discontinued due to adverse event (15.3% versus 5.8%). Although the antidepressant efficacy of duloxetine was not confirmed by the primary outcome, several secondary measures at multiple time points suggested efficacy. Duloxetine had significant and meaningful beneficial effects on pain. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights

Screening for depression and assessing change in severity of depression. Is the Geriatric Depression Scale (30-.15- and 8- item versions) useful for both purposes in nursing home patients?

NARCIS (Netherlands)

Smalbrugge, M.; Jongenelis, L.; Pot, A.M.; Eefsting, J.A.; Beekman, A.T.F.

2008-01-01

The objectives of this study were to determine the ability of the 30-, 15- and 8-item versions of the GDS for screening and assessing change in severity of depression in nursing home patients. The GDS and the MADRS were administered to 350 elderly NH-patients by trained interviewers. The presence of

HPA-axis stress reactivity in youth depression: evidence of impaired regulatory processes in depressed boys.

Science.gov (United States)

Lopez-Duran, Nestor L; McGinnis, Ellen; Kuhlman, Kate; Geiss, Elisa; Vargas, Ivan; Mayer, Stefanie

2015-01-01

Given the link between youth depression and stress exposure, efforts to identify related biomarkers have involved examinations of stress regulation systems, including the hypothalamic-pituitary-adrenal (HPA) axis. Despite these vast efforts, the underlying mechanisms at play, as well as factors that may explain heterogeneity of past findings, are not well understood. In this study, we simultaneously examined separate components of the HPA-axis response (e.g. activation intensity, peak levels, recovery) to the Socially Evaluated Cold-Pressor Test in a targeted sample of 115 youth (age 9-16), recruited to overrepresent youth with elevated symptoms of depression. Among youth who displayed a cortisol response to the task, depression symptoms were associated with higher peak responses but not greater rate of activation or recovery in boys only. Among those who did not respond to the task, depression symptoms were associated with greater cortisol levels throughout the visit in boys and girls. Results suggest that depression symptoms are associated with a more prolonged activation of the axis and impaired recovery to psychosocial stressors primarily in boys. We discussed two potential mechanistic explanations of the link between depression symptoms and the duration of activation: (1) inhibitory shift (i.e. point at which the ratio of inhibitory and excitatory input into the axis shifts from greater excitatory to greater inhibitory input) or (2) inhibitory threshold (i.e. level of cortisol exposure required to activate the axis' feedback inhibition system).

Evaluation of the Psychometric Properties of the Asian Adolescent Depression Scale and Construction of a Short Form: An Item Response Theory Analysis.

Science.gov (United States)

Lo, Barbara Chuen Yee; Zhao, Yue; Kwok, Alice Wai Yee; Chan, Wai; Chan, Calais Kin Yuen

2017-07-01

The present study applied item response theory to examine the psychometric properties of the Asian Adolescent Depression Scale and to construct a short form among 1,084 teenagers recruited from secondary schools in Hong Kong. Findings suggested that some items of the full form reflected higher levels of severity and were more discriminating than others, and the Asian Adolescent Depression Scale was useful in measuring a broad range of depressive severity in community youths. Differential item functioning emerged in several items where females reported higher depressive severity than males. In the short form construction, preliminary validation suggested that, relative to the 20-item full form, our derived short form offered significantly greater diagnostic performance and stronger discriminatory ability in differentiating depressed and nondepressed groups, and simultaneously maintained adequate measurement precision with a reduced response burden in assessing depression in the Asian adolescents. Cultural variance in depressive symptomatology and clinical implications are discussed.

Central Adrenal Insufficiency and Diabetes Insipidus Misdiagnosed as Severe Depression

Directory of Open Access Journals (Sweden)

Naoki Hiroi

2010-01-01

Full Text Available A 68 year-old Japanese man, who had been suffering from immobilization and disuse syndrome, was admitted to our hospital for evaluation of polyuria with polyposia, hyponatremia and low blood pressure. His plasma osmolality was greater than that of his urine. His endocrinological examination revealed low levels of plasma adrenocorticotropic hormone (ACTH and cortisol, and a normal response of ACTH to the corticotrophin-releasing hormone (CRH challenge. Plasma ACTH did not increase with insulin loading. A low plasma vasopressin (AVP level and no response of AVP to a 5% saline administration were observed. We diagnosed central adrenal insufficiency with central diabetes insipidus. Six months after starting administration of hydrocortisone and 1-deamino-8D-arginine vasopressin, his psychological symptoms had improved, and 1.5 years after starting treatment, he was able to walk. In conclusion, it is not particularly rare for adrenal insufficiency to be misdiagnosed as depression. However, a correct early diagnosis is necessary, because, if adrenal insufficiency is not definitively diagnosed, the patient's quality of life diminishes markedly.

Dietary patterns, their covariates, and associations with severity of depressive symptoms among university students in Lebanon: a cross-sectional study.

Science.gov (United States)

Jaalouk, Doris; Matar Boumosleh, Jocelyne; Helou, Lea; Abou Jaoude, Maya

2018-01-19

The study aims to identify dietary patterns in university students in Lebanon, to determine their associations with socio-demographic, lifestyle, and stress factors, and to assess the link between identified dietary patterns and severity of depressive symptoms, controlling for multiple confounders. Four hundred and fifty-seven private university students were surveyed. Information about dietary intake, socio-demographic and lifestyle factors, physical activity, and depressive symptoms were collected by the 73-item food frequency questionnaire, background questionnaire, International Physical Activity Questionnaire-Short Form, and Patient Health Questionnaire (PHQ-9), respectively. Dietary patterns were identified by exploratory factor analysis. Multiple linear regression analyses were conducted to (1) identify covariates that were independently associated with dietary patterns and (2) examine the independent associations between each of the dietary patterns and severity of depressive symptoms. Five dietary patterns were identified: "traditional Lebanese", "Western fast food", "dairy", "Lebanese fast food" and "fruits". Higher scores of traditional Lebanese and fruits patterns were found to be associated with more meals per day, frequent breakfast consumption, and non-smoking. Higher Western fast food diet scores were shown to be associated with male gender, fewer meals per day, less frequent breakfast consumption, more frequent snacking, and alcohol consumption. Higher scores of the dairy pattern were found to be positively associated with hypertension, non-smoking, and frequency of alcohol consumption. Higher Lebanese fast food pattern scores were found to be associated with higher frequency of meal intake while watching TV and alcohol consumption. None of the five dietary patterns showed a significant association with severity of depressive symptoms after controlling for confounders. Severity of depressive symptoms showed no independent association with the

Differential response to right unilateral ECT in depressed patients: impact of comorbidity and severity of illness [ISRCTN39974945

Directory of Open Access Journals (Sweden)

Wahlbeck Kristian

2002-01-01

Full Text Available Abstract Background Recent electroconvulsive therapy (ECT efficacy studies of right unilateral (RUL ECT may not apply to real life clinics with a wide range of patients with major depressive episodes. Methods The study included two groups of patients. In addition to a homogeneous group of patients with major depression according to DSM-IV criteria with severity of the major depressive episode > 16 scores on 17-item Hamilton Rating Scale for Depression (HDRS (Group 1, n = 16, we included a heterogeneous group of patients with less severe major depressive episodes or with a variety of comorbid conditions (Group 2, n = 24. We randomly assigned the patients to an RUL ECT treatment dosed at 5 or 2.5 times seizure threshold with an intent-to-treat design. The outcomes measured blindly were HDRS, number of treatments, and Mini-Mental State Examination (MMSE. The patients were considered to have responded to treatment if the improvement in HDRS score was at least 60% and they had a total score of less than ten. Results The Group 2 patients responded poorer (8% vs. 63%, and had more often simultaneous worsening in their MMSE scores than Group 1 patients. The differences in the outcomes between the two different doses of RUL ECT treatment were not statistically significant. Conclusions ECT effectiveness seems to be lower in real-life heterogeneous patient groups than in homogeneous patient samples used in experimental efficacy trials.

Salience Network and Depressive Severities in Parkinson's Disease with Mild Cognitive Impairment: A Structural Covariance Network Analysis.

Science.gov (United States)

Chang, Ya-Ting; Lu, Cheng-Hsien; Wu, Ming-Kung; Hsu, Shih-Wei; Huang, Chi-Wei; Chang, Wen-Neng; Lien, Chia-Yi; Lee, Jun-Jun; Chang, Chiung-Chih

2017-01-01

Purpose: In Parkinson's disease with mild cognitive impairment (PD-MCI), we investigated the clinical significance of salience network (SN) in depression and cognitive performance. Methods: Seventy seven PD-MCI patients that fulfilled multi-domain and non-amnestic subtype were included. Gray matter structural covariance networks were constructed by 3D T1-magnetic resonance imaging and seed based analysis. The patients were divided into two groups by psychiatric interviews and screening of Geriatric Depression Scale (GDS): PD-MCI with depression (PD-MCI-D) or without depression (PD-MCI-ND). The seed or peak cluster volume, or the significant differences in the regression slopes in each seed-peak cluster correlation, were used to evaluate the significance with the neurobehavioral scores. Results: This study is the first to demonstrate that the PD-MCI-ND group presented a larger number of voxels of structural covariance in SN than the PD-MCI-D group. The right fronto-insular seed volumes and the peak cluster of left lingual gyrus showed significant inverse correlation with the Geriatric Depression Scale (GDS; r = -0.231, P = 0.046). Conclusions: This study is the first to validate the clinical significance of the SN in PD-MCI-D. The right insular seed value and the SN correlated with the severity of depression in PD-MCI.

The dental management of patients with severe depression disorder (Literature review

Directory of Open Access Journals (Sweden)

Nanan Nur’aeny

2016-06-01

Full Text Available World Health Organization (WHO in the year 2000 have identified major depressive disorder ranks as the fourth leading cause of death in the world. WHO also estimates that in 2020, the disorder will increase to second only to ischemic heart disease. People at high risk of first occurrence of depression are those who have a family history. Depression can happen to anyone and at all ages, ranging in age from children, young adults up to old age. This paper will discuss the literature review of an overview of depression and itsmanagement in dentistry. Patients with major depressive disorder may have abnormalities in the oral cavity affected by lack of oral hygiene as well as a manifestation of mental disorder and its treatment. Dental and oral management conducted in accordance with procedures and have to be carried out carefully especially to patients with mental disorders such as depression. Tooth decayed, gingivitis, xerostomia, oral candidiasis, oral lesion, and TMJ disorder are clinical findings in depressed patient, so as dentists may cooperate with psychiatrists in providing comprehensive treatment to improve quality of life of the patients.

Quality of life and functioning of Hispanic patients with Major Depressive Disorder before and after treatment.

Science.gov (United States)

López, Enrique; Steiner, Alexander J; Manier, Karra; Shapiro, Bryan B; Vanle, Brigitte; Parisi, Thomas; Dang, Jonathan; Chang, Tiffany; Ganjian, Shaina; Mirocha, James; Danovitch, Itai; IsHak, Waguih William

2018-01-01

Similar rates of remission from Major Depressive Disorder (MDD) have been documented between ethnic groups in response to antidepressant treatment. However, ethnic differences in functional outcomes, including patient-reported quality of life (QOL) and functioning, have not been well-characterized. We compared symptomatic and functional outcomes of antidepressant treatment in Hispanic and non-Hispanic patients with MDD. We analyzed 2280 nonpsychotic treatment-seeking adults with MDD who received citalopram monotherapy in Level 1 of the Sequenced Treatment Alternatives to Relieve Depression study. All subjects (239 Hispanic, 2041 non-Hispanic) completed QOL, functioning, and depressive symptom severity measures at entry and exit. Hispanic participants had significantly worse QOL scores at entry and exit (p depressive symptom severity or functioning. Both groups had significant improvements in depressive symptom severity, QOL, and functioning from entry to exit (all p values depressive symptom severity, greater QOL, and better functioning at exit compared to patients without private insurance. This study was a retrospective data analysis, and the Hispanic group was relatively small compared to the non-Hispanic group. Hispanic and non-Hispanic participants with MDD had similar responses to antidepressant treatment as measured by depressive symptom severity scores, quality of life, and functioning. Nevertheless, Hispanic patients reported significantly worse quality of life at entry. Copyright © 2017 Elsevier B.V. All rights reserved.

Severe depressive symptoms as predictor of disability pension : a 10-year follow-up study in Denmark

NARCIS (Netherlands)

Bultmann, Ute; Christensen, Karl B.; Burr, Hermann; Lund, Thomas; Rugulies, Reiner

Are severe depressive symptoms prospectively associated with disability pension? To answer that question, we linked data from a representative sample of the Danish workforce with disability pension (DP) award data from the National Registry on Public Transfer Payments. Of the 5106 study

The Healthy Activity Program (HAP), a lay counsellor-delivered brief psychological treatment for severe depression, in primary care in India: a randomised controlled trial.

Science.gov (United States)

Patel, Vikram; Weobong, Benedict; Weiss, Helen A; Anand, Arpita; Bhat, Bhargav; Katti, Basavraj; Dimidjian, Sona; Araya, Ricardo; Hollon, Steve D; King, Michael; Vijayakumar, Lakshmi; Park, A-La; McDaid, David; Wilson, Terry; Velleman, Richard; Kirkwood, Betty R; Fairburn, Christopher G

2017-01-14

Although structured psychological treatments are recommended as first-line interventions for depression, only a small fraction of people globally receive these treatments because of poor access in routine primary care. We assessed the effectiveness and cost-effectiveness of a brief psychological treatment (Healthy Activity Program [HAP]) for delivery by lay counsellors to patients with moderately severe to severe depression in primary health-care settings. In this randomised controlled trial, we recruited participants aged 18-65 years scoring more than 14 on the Patient Health Questionnaire 9 (PHQ-9) indicating moderately severe to severe depression from ten primary health centres in Goa, India. Pregnant women or patients who needed urgent medical attention or were unable to communicate clearly were not eligible. Participants were randomly allocated (1:1) to enhanced usual care (EUC) alone or EUC combined with HAP in randomly sized blocks (block size four to six [two to four for men]), stratified by primary health centre and sex, and allocation was concealed with use of sequential numbered opaque envelopes. Physicians providing EUC were masked. Primary outcomes were depression symptom severity on the Beck Depression Inventory version II and remission from depression (PHQ-9 score of better results than did EUC alone for the secondary outcomes of disability (adjusted mean difference -2·73 [-4·39 to -1·06]; p=0·001), days out of work (-2·29 [-3·84 to -0·73]; p=0·004), intimate partner physical violence in women (0·53 [0·29-0·96]; p=0·04), behavioural activation (2·17 [1·34-3·00]; pbetter than EUC alone was for patients with moderately severe to severe depression in routine primary care in Goa, India. HAP was readily accepted by this previously untreated population and was cost-effective in this setting. HAP could be a key strategy to reduce the treatment gap for depressive disorders, the leading mental health disorder worldwide. Wellcome Trust

Electro convulsive therapy in a pre-pubertal child with severe depression.

Directory of Open Access Journals (Sweden)

Russell P

2002-10-01

Full Text Available Electro Convulsive Therapy (ECT in pre-pubertal children is a controversial and underreported treatment. Even though the effectiveness and side effects of ECT in adolescents are comparable with those in adults, there is a pervasive reluctance to use ECT in children and adolescents. We report the case of a pre-pubertal child in an episode of severe depression with catatonic features, where a protracted course of ECT proved life-saving in spite of prolonged duration of seizures and delayed response to treatment. The case illustrates the safety and efficacy of ECT in children. Relevant literature is also reviewed along with the case report.

Unmasking materialistic depression as a mental health problem: its effect on depression and materialism in an African-United States undergraduate sample.

Science.gov (United States)

Azibo, Daudi Ajani ya

2013-09-05

Misdiagnosis of African-U.S. persons is argued to be a built-in characteristic of Western-based assessment requiring augmentation with culture-focused input where possible. Regarding depression, materialistic depression is explained as an African-centered African-U.S. culture-focused construct of masked depression. Materialistic depression symptomatology is presented. Materialism orientation is postulated to necessarily be associated with materialistic depression. 144 undergraduates, 37 male (25.7%) and 107 female (74.3%), average age of 21 completed the Zung Self-rating Depression Scale, the depression subscale of the Symptom Checklist 90-R, the materialism subscale of the Cultural Misorientation Scale, and the Materialistic Depression Quiz. Contrasting high versus lower scoring MDQ groups on both depression scores produced reliable t-tests (pMaterialistic Depression Quiz, high scorers versus medium and low scorers had greater depression scores on two depression measures and greater materialism scores. Materialistic depression appears a masked form of depression not to be overlooked. Copyright © 2013 Elsevier B.V. All rights reserved.

Depression associated with dementia.

Science.gov (United States)

Gutzmann, H; Qazi, A

2015-06-01

Depression and cognitive disorders, including dementia and mild cognitive impairment, are common disorders in old age. Depression is frequent in dementia, causing distress, reducing the quality of life, exacerbating cognitive and functional impairment and increasing caregiver stress. Even mild levels of depression can significantly add to the functional impairment of dementia patients and the severity of psychopathological and neurological impairments increases with increasing severity of depression. Depressive symptoms may be both a risk factor for, as well as a prodrome of dementia. Major depressive syndrome of Alzheimer's disease may be among the most common mood disorders of older adults. Treating depression is therefore a key clinical priority to improve the quality of life both of people with dementia as well as their carergivers. Nonpharmacological approaches and watchful waiting should be attempted first in patients who present with mild to moderate depression and dementia. In cases of severe depression or depression not able to be managed through nonpharmacological means, antidepressant therapy should be considered.

Parental bonding and self-esteem as predictors of severe depressive symptoms: a 10-year follow-up study of Norwegian physicians.

Science.gov (United States)

Grotmol, Kjersti S; Ekeberg, Øivind; Finset, Arnstein; Gude, Tore; Moum, Torbjørn; Vaglum, Per; Tyssen, Reidar

2010-01-01

Elevated rates of suicide and depression among physicians have been reported. The associations between perceived parental bonding and depressive symptoms have yet to be studied longitudinally in this occupational group. In a nationwide cohort, we sought to study parental bonding as a predictor for severe depressive symptoms and to determine whether self-esteem mediates this relationship. After graduation (T1), medical students (N = 631) were followed-up after 1 (T2), 4 (T3), and 10 (T4) years. There were no gender differences in mean depressive scores. Female physicians reported higher levels of care from their mothers (p self-esteem for both sexes.

Stress-evoked opioid release inhibits pain in major depressive disorder.

Science.gov (United States)

Frew, Ashley K; Drummond, Peter D

2008-10-15

To determine whether stress-evoked release of endogenous opioids might account for hypoalgesia in major depressive disorder (MDD), the mu-opioid antagonist naltrexone (50mg) or placebo was administered double-blind to 24 participants with MDD and to 31 non-depressed controls. Eighty minutes later participants completed a painful foot cold pressor test and, after a 5-min interval, began a 25-min arithmetic task interspersed with painful electric shocks. Ten minutes later participants completed a second cold pressor test. Negative affect was greater in participants with MDD than in non-depressed controls throughout the experiment, and increased significantly in both groups during mental arithmetic. Before the math task, naltrexone unmasked direct linear relationships between severity of depression, negative affect while resting quietly, and cold-induced pain in participants with MDD. In contrast, facilitatory effects of naltrexone on cold- and shock-induced pain were greatest in controls with the lowest depression scores. Naltrexone strengthened the relationship between negative affect and shock-induced pain during the math task, particularly in the depressed group, and heightened anxiety in both groups toward the end of the task. Thus, mu-opioid activity apparently masked a positive association between negative affect and pain in the most distressed participants. These findings suggest that psychological distress inhibits pain via stress-evoked release of opioid peptides in severe cases of MDD. In addition, tonic endogenous opioid neurotransmission could inhibit depressive symptoms and pain in people with low depression scores.

The effects of trauma on perinatal depression: Examining trajectories of depression from pregnancy through 24 months postpartum in an at-risk population.

Science.gov (United States)

Grekin, Rebecca; Brock, Rebecca L; O'Hara, Michael W

2017-08-15

Research suggests that trauma exposure is associated with perinatal depression; however, little is known about the nature of the relation between trauma history and trajectory of depression, as well as the predictive power of trauma history beyond other risk factors. Additionally, more research is needed in at-risk samples that are likely to experience severe traumatic exposure. Secondary data analysis was conducted using demographic and depression data from the Healthy Start and Empowerment Family Support programs in Des Moines, Iowa. Hierarchical linear modeling was used to examine trajectories of perinatal depressive symptoms, from pregnancy to 24 months postpartum, and clarify whether trauma exposure, relationship status, and substance use uniquely contribute to trajectories of symptoms over time. On average, depressive symptoms decreased from pregnancy to 24 months postpartum; however, trajectories varied across women. Single relationship status, substance use, and trauma history were each predictors of higher depression levels at several points in time across the observed perinatal period. Single relationship status was also associated with decline in depressive symptoms followed by a rebound of symptoms at 22 months postpartum. These data were not collected for research purposes and thus did not undergo the rigorous data collection strategies typically implemented in an established research study. History of trauma, substance use and single relationship status represent unique risk factors for perinatal depression. For single women, depressive symptoms rebound late in the postpartum period. Single women are at greater risk for substance use and traumatic exposure and represent a sample with cumulative risk. Eliciting social support may be an important intervention for women presenting with these risk factors. Copyright © 2017 Elsevier B.V. All rights reserved.

The influence of depressive symptoms on alcohol use among HIV-infected Russian drinkers.

Science.gov (United States)

Palfai, T P; Cheng, D M; Coleman, S M; Bridden, C; Krupitsky, E; Samet, J H

2014-01-01

Depressive symptoms have been linked to HIV progression through a number of biobehavioral mechanisms including increased alcohol use. Although research supports an association between alcohol use and depressive symptoms among HIV patients, there have been few studies that have examined whether depressive symptoms predict subsequent drinking, especially among heavy drinking HIV-infected patients. Heavy drinking Russian HIV-infected patients (n=700) were recruited from addiction and HIV care settings for a randomized controlled trial of a risk reduction intervention [HERMITAGE]. GEE overdispersed Poisson regression analyses were conducted to assess the association between depressive symptoms and alcohol consumption 6-months later. In adjusted analyses, depressive symptom severity was significantly associated with drinks per day (global p=.02). Compared to the non-depressed category, mild depressive symptoms were significantly associated with more drinks per day [IRR=1.55, (95% CI: 1.14, 2.09)], while moderate [IRR=1.14, (95% CI: 0.83, 1.56)] and severe [IRR=1.48, (95% CI: 0.93, 2.34)] depressive symptoms were not. Associations between depressive symptom severity and heavy drinking days were not statistically significant (global p=.19). Secondary analyses using the BDI-II screening threshold (BDI-II>14) and the BDI-II cognitive subscale suggested an association between depressive symptoms and drinks per day over time but not heavy episodic drinking. Among heavy drinking HIV-infected patients, elevated depressive symptoms were associated with greater subsequent alcohol use. These findings suggest that depressive symptoms may be important to address in efforts to reduce alcohol-related risks among HIV-infected populations. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Memory biases in remitted depression: the role of negative cognitions at explicit and automatic processing levels.

Science.gov (United States)

Romero, Nuria; Sanchez, Alvaro; Vazquez, Carmelo

2014-03-01

Cognitive models propose that depression is caused by dysfunctional schemas that endure beyond the depressive episode, representing vulnerability factors for recurrence. However, research testing negative cognitions linked to dysfunctional schemas in formerly depressed individuals is still scarce. Furthermore, negative cognitions are presumed to be linked to biases in recalling negative self-referent information in formerly depressed individuals, but no studies have directly tested this association. In the present study, we evaluated differences between formerly and never-depressed individuals in several experimental indices of negative cognitions and their associations with the recall of emotional self-referent material. Formerly (n = 30) and never depressed individuals (n = 40) completed measures of explicit (i.e., scrambled sentence test) and automatic (i.e., lexical decision task) processing to evaluate negative cognitions. Furthermore participants completed a self-referent incidental recall task to evaluate memory biases. Formerly compared to never depressed individuals showed greater negative cognitions at both explicit and automatic levels of processing. Results also showed greater recall of negative self-referent information in formerly compared to never-depressed individuals. Finally, individual differences in negative cognitions at both explicit and automatic levels of processing predicted greater recall of negative self-referent material in formerly depressed individuals. Analyses of the relationship between explicit and automatic processing indices and memory biases were correlational and the majority of participants in both groups were women. Our findings provide evidence of negative cognitions in formerly depressed individuals at both automatic and explicit levels of processing that may confer a cognitive vulnerability to depression. Copyright © 2013 Elsevier Ltd. All rights reserved.

Low serum levels of High-Density Lipoprotein cholesterol (HDL-c) as an indicator for the development of severe postpartum depressive symptoms

Science.gov (United States)

Ramachandran Pillai, Raji; Wilson, Anand Babu; Premkumar, Nancy R.; Kattimani, Shivanand; Sagili, Haritha

2018-01-01

Postpartum depression (PPD) is a psychiatric complication of childbirth affecting 10–20% of new mothers and has negative impact on both mother and infant. Serum lipid levels have been related to depressive disorders, but very limited literatures are available regarding the lipid levels in women with postpartum depression. The present study is aimed to examine the association of serum lipids with the development of postpartum depressive symptoms. This is a cross sectional study conducted at a tertiary care hospital in South India. Women who came for postpartum check-up at 6th week post-delivery were screened for PPD (September 2014-October 2015). Women with depressive symptoms were assessed using EPDS (Edinburgh Postnatal Depression Scale). The study involved 186 cases and 250 controls matched for age and BMI. Serum levels of lipid parameters were estimated through spectrophotometry and the atherogenic indices were calculated in all the subjects. Low serum levels of Total Cholesterol (TC) and High Density Lipoprotein cholesterol (HDL-c) were significantly low in PPD women with severe depressive symptoms. The study recorded a significant negative correlation between HDL-c and the EPDS score in PPD women (r = -0.140, p = 0.05). Interestingly, the study also observed a significant negative correlation between Body Mass Index (BMI) and EPDS scores in case group (r = -0.146, p = 0.047), whereas a positive correlation between the same in controls (r = 0.187, p = 0.004). Our study demonstrated that low levels of serum HDL-c is correlated with the development of severe depressive symptoms in postpartum women. Study highlights the role of lipids in the development of postpartum depressive symptoms. PMID:29444162

Low serum levels of High-Density Lipoprotein cholesterol (HDL-c as an indicator for the development of severe postpartum depressive symptoms.

Directory of Open Access Journals (Sweden)

Raji Ramachandran Pillai

Full Text Available Postpartum depression (PPD is a psychiatric complication of childbirth affecting 10-20% of new mothers and has negative impact on both mother and infant. Serum lipid levels have been related to depressive disorders, but very limited literatures are available regarding the lipid levels in women with postpartum depression. The present study is aimed to examine the association of serum lipids with the development of postpartum depressive symptoms. This is a cross sectional study conducted at a tertiary care hospital in South India. Women who came for postpartum check-up at 6th week post-delivery were screened for PPD (September 2014-October 2015. Women with depressive symptoms were assessed using EPDS (Edinburgh Postnatal Depression Scale. The study involved 186 cases and 250 controls matched for age and BMI. Serum levels of lipid parameters were estimated through spectrophotometry and the atherogenic indices were calculated in all the subjects. Low serum levels of Total Cholesterol (TC and High Density Lipoprotein cholesterol (HDL-c were significantly low in PPD women with severe depressive symptoms. The study recorded a significant negative correlation between HDL-c and the EPDS score in PPD women (r = -0.140, p = 0.05. Interestingly, the study also observed a significant negative correlation between Body Mass Index (BMI and EPDS scores in case group (r = -0.146, p = 0.047, whereas a positive correlation between the same in controls (r = 0.187, p = 0.004. Our study demonstrated that low levels of serum HDL-c is correlated with the development of severe depressive symptoms in postpartum women. Study highlights the role of lipids in the development of postpartum depressive symptoms.

Evaluation of the DSM-5 severity indicator for binge eating disorder in a clinical sample

Science.gov (United States)

Grilo, Carlos M.; Ivezaj, Valentina; White, Marney A.

2015-01-01

Objective This study tested the new DSM-5 severity criterion for binge eating disorder (BED) based on frequency of binge-eating in a clinical sample. This study also tested overvaluation of shape/weight as an alternative severity specifier. Method Participants were 834 treatment-seeking adults diagnosed with DSM-5 BED using semistructured diagnostic and eating-disorder interviews. Participants sub-grouped based on DSM-5 severity levels and on overvaluation of shape/weight were compared on demographic and clinical variables. Results Based on DSM-5 severity definitions, 331 (39.7%) participants were categorized as mild, 395 (47.5%) as moderate, 83 (10.0%) as severe, and 25 (3.0%) as extreme. Analyses comparing three (mild, moderate, and severe/extreme) severity groups revealed no significant differences in demographic variables or body mass index (BMI). Analyses revealed significantly higher eating-disorder psychopathology in the severe/extreme than moderate and mild groups and higher depression in moderate and severe/extreme groups than the mild group; effect sizes were small. Participants characterized with overvaluation (N = 449; 54%) versus without overvaluation (N = 384; 46%) did not differ significantly in age, sex, BMI, or binge-eating frequency, but had significantly greater eating-disorder psychopathology and depression. The robustly greater eating-disorder psychopathology and depression levels (medium-to-large effect sizes) in the overvaluation group was observed without attenuation of effect sizes after adjusting for ethnicity/race and binge-eating severity/frequency. Conclusions Our findings provide support for overvaluation of shape/weight as a severity specifier for BED as it provides stronger information about the severity of homogeneous groupings of patients than the DSM-5 rating based on binge-eating. PMID:26114779

Prefrontal cortex activation is associated with a discrepancy between self- and observer-rated depression severities of major depressive disorder: a multichannel near-infrared spectroscopy study.

Science.gov (United States)

Akashi, Hiroyuki; Tsujii, Noa; Mikawa, Wakako; Adachi, Toru; Kirime, Eiji; Shirakawa, Osamu

2015-03-15

Studies on major depressive disorder (MDD) show that the degree of correlation between the Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HAMD) varies widely. We aimed to determine whether this discrepancy reflects specific functional abnormalities in the frontotemporal cortex. Mildly depressed or euthymic patients with MDD (n=52), including 21 patients with MDD with the discrepancy, i.e., those with low HAMD17 scores (≤13) but high BDI-II scores (>28), and 31 patients without the discrepancy, i.e., those with low HAMD17 scores and low BDI-II scores (≤28), participated in the study along with 48 control subjects. Regional changes of oxygenated hemoglobin (oxy-Hb) levels during a verbal fluency task (VFT) were monitored using a 52-channel near-infrared spectroscopy (NIRS) device. In the frontotemporal regions, mean oxy-Hb changes induced by the VFT were significantly smaller in patients with MDD than in control subjects. In 5 channels within frontal regions, the increase in mean oxy-Hb levels was significantly greater in MDD patients with the BDI-HAMD discrepancy than in those without the discrepancy. In 6 channels within the frontal region of the patients with MDD, significant positive correlations were observed between mean oxy-Hb changes and BDI total scores (ρ=0.38-0.59; Pdepressed patients, particularly those with melancholia. The distinct pattern of activation of the prefrontal cortex suggests that MDD with the BDI-HAMD discrepancy is pathophysiologically different from MDD without the discrepancy. Copyright © 2014 Elsevier B.V. All rights reserved.

[Depressive disorder and issues related to DiabetIMSS beneficiaries].

Science.gov (United States)

Fu-Espinosa, Mario; Trujillo-Olivera, Laura Elena

2013-01-01

Diabetes mellitus type 2 (DM2) is the leading cause of death in people from 15 to 64 years in Mexico, and other regions in the world. For the chronic nature of diabetes and complications caused by inadequate metabolic control, patients may have mood disorders such as depression. Several studies have demonstrated higher prevalence of depression in diabetic patients than in general population. Our objective: is to determine prevalence and factors associated with depressive disorder in patients with type 2 diabetes mellitus enrolled in DiabetIMSS during 2010. Analytical study with random probability sampling. The analysis included prevalence, odds ratios with 95% confidence intervals. The Center Epidemiological Studies Depression Instrument was used. Prevalence of depression was 32.7% at 95% CI = 26.4-38.9%), 67.3% for women, 32.7 % for men; good metabolic control was 51.9%, CI = 95% (45.13-58.66%). We found a higher prevalence of depressive disorders than in the general population, no statistical association with glycemic control, keeping a greater proportion of women as well as the main aspect of depression associated with the perception of emotional support. We discuss DiabetIMSS program effectiveness.

Autobiographical memory specificity in response to verbal and pictorial cues in clinical depression.

Science.gov (United States)

Ridout, Nathan; Dritschel, Barbara; Matthews, Keith; O'Carroll, Ronan

2016-06-01

Depressed individuals have been consistently shown to exhibit problems in accessing specific memories of events from their past and instead tend to retrieve categorical summaries of events. The majority of studies examining autobiographical memory changes associated with psychopathology have tended to use word cues, but only one study to date has used images (with PTSD patients). to determine if using images to cue autobiographical memories would reduce the memory specificity deficit exhibited by patients with depression in comparison to healthy controls. Twenty-five clinically depressed patients and twenty-five healthy controls were assessed on two versions of the autobiographical memory test; cued with emotional words and images. Depressed patients retrieved significantly fewer specific memories, and a greater number of categorical, than did the controls. Controls retrieved a greater proportion of specific memories to images compared to words, whereas depressed patients retrieved a similar proportion of specific memories to both images and words. no information about the presence and severity of past trauma was collected. results suggest that the overgeneral memory style in depression generalises from verbal to pictorial cues. This is important because retrieval to images may provide a more ecologically valid test of everyday memory experiences than word-cued retrieval.. Copyright © 2016 Elsevier Ltd. All rights reserved.

Modification of depression by COMT val158met polymorphism in children exposed to early severe psychosocial deprivation

Science.gov (United States)

Drury, Stacy S; Theall, Katherine P; Smyke, Anna T; Keats, Bronya JB; Egger, Helen L; Nelson, Charles A; Fox, Nathan A; Marshall, Peter J; Zeanah, Charles H

2014-01-01

Objective To examine the impact of the Catechol-O-Methyltransferase (COMT) val158met allele on depressive symptoms in young children exposed to early severe social deprivation as a result of being raised in institutions. Methods 136 children from the Bucharest Early Intervention Project (BEIP) were randomized before 31 months of age to either care as usual (CAU) in institutions or placement in newly created foster care (FCG). At 54 months of age, a psychiatric assessment using the Preschool Age Psychiatric Assessment (PAPA) was completed. DNA was collected and genotyped for the COMT val158met polymorphism. Multivariate analysis examined the relationship between COMT alleles and depressive symptoms. Results Mean level of depressive symptoms was lower among participants with the met allele compared to those with two copies of the val allele (p <0.05). Controlling for group and gender, the rate of depressive symptoms was significantly lower among participants with the met/met or the met/val genotype (adjusted relative risk (aRR) = 0.67, 95% CI = 0.45, 0.99) compared to participants with the val/val genotype, indicating an intermediate impact for heterozygotes consistent with the biological impact of this polymorphism. The impact of genotype within groups differed significantly. There was a significant protective effect of the met allele on depressive symptoms within the CAU group, however there was no relationship seen within the FCG group. Conclusions This is the first study, to our knowledge, to find evidence of a gene × environment interaction in the setting of early social deprivation. These results support the hypothesis that individual genetic differences may explain some of the variability in recovery amongst children exposed to early severe social deprivation. PMID:20403637

Relationship Between Adenosine - Induced ST Segment Depression During 99mTc-MIBI Scintigraphy and The Severity of Coronary Artery Disease

International Nuclear Information System (INIS)

Cho, Jung Ah; Choi, Jung Il; Kwak, Dong Suk

1994-01-01

Pharmacologic coronary vasodilation in conjunction with myocardial perfusion scintigraphy has become an alternative to dynamic exercise test for the diagnosis and risk stratification of coronary artery disease, especially in patients who are unable to perform adequate exercise. Dipyridamole and adenosine have been used for pharmacologic stress testing with myocardial perfusion imaging. Adenosine is a potent, coronary vasodilator with rapid onset of action, short half life, near maximal coronary vasodilation and less serious side effects. ST segment depression has been reported in about 7-15% of patients with coronary artery disease receiving dipyridamole in conjunction with myocardial perfusion imaging. The exact cause and clinical significance are not known. In order to evaluate the relationship between adenosine-induced ST segment depression during 99m Tc-MIBI myocardial perfusion scintigraphy and the severity of coronary artery disease, we performed 99m -MIBI imaging after intravenous infusion of adenosine in 120 patients with suspected coronary artery disease. Of the 120 patients, 28 also performed coronary angiography. There were 24 patients with ST segment depression during 99m Tc-MIIBI scintigraphy and 96 patients without ST segment depression. Adenosine was infused intravenously at a dose of 0.14 mg/kg per minute for 6 minutes and 99 MmTc-MIB1 was injected at 3 minute. We then compared the hemodynamic changes, side effects, scintigraphic and angiographic findings. Heart rate increased 90 ± 19 beats/minute in the group with ST depression compared with 80 ±16 beats/minute in the group without ST depression(p 9m Tc-MIBI images were abnormal in 23(96%) patients with ST segment depression and 66(69%) patients without ST segment depression(p 99m Tc-MIBI myocardial perfusion scintigraphy with intravenous adenosine is related to the severity of coronary artery disease.

The Relationship between PTSD and Chronic Pain: Mediating Role of Coping Strategies and Depression

Science.gov (United States)

Morasco, Benjamin J.; Lovejoy, Travis I.; Lu, Mary; Turk, Dennis C.; Lewis, Lynsey; Dobscha, Steven K.

2013-01-01

People with chronic pain and comorbid posttraumatic stress disorder (PTSD) report more severe pain and poorer quality of life than those with chronic pain alone. This study evaluated the extent to which associations between PTSD and chronic pain interference and severity are mediated by pain-related coping strategies and depressive symptoms. Veterans with chronic pain were divided into two groups, those with (n=65) and those without (n=136) concurrent PTSD. All participants completed measures of pain severity, interference, emotional functioning, and coping strategies. Those with current PTSD reported significantly greater pain severity and pain interference, had more symptoms of depression, and were more likely to meet diagnostic criteria for a current alcohol or substance use disorder (all p-values ≤ 0.01). Participants with PTSD reported more use of several coping strategies, including guarding, resting, relaxation, exercise/stretching, and coping self-statements. Illness-focused pain coping (i.e., guarding, resting, and asking for assistance) and depressive symptoms jointly mediated the relationship between PTSD and both pain interference (total indirect effect = 0.194, p pain severity (total indirect effect = 0.153, p = 0.004). Illness-focused pain coping also evidenced specific mediating effects, independent of depression. In summary, specific pain coping strategies and depressive symptoms partially mediated the relationship between PTSD and both pain interference and severity. Future research should examine whether changes in types of coping strategies following targeted treatments predict improvements in pain-related function for chronic pain patients with concurrent PTSD. PMID:23398939

The association between food insecurity and depressive symptoms severity among pregnant women differs by social support category: a cross-sectional study.

Science.gov (United States)

Natamba, Barnabas K; Mehta, Saurabh; Achan, Jane; Stoltzfus, Rebecca J; Griffiths, Jeffrey K; Young, Sera L

2017-07-01

Common mental disorders, such as depression and anxiety, affect approximately 16% of pregnant women in low- and middle-income countries. Food insecurity (FI) has been shown to be associated with depressive symptoms. It has also been suggested that the association between FI and depressive symptoms is moderated by social support (SS); however, there is limited evidence of these associations among pregnant women living in low-income and middle-income countries. We studied the association between FI and depressive symptoms severity and assessed whether such an association varied among Ugandan pregnant women with low vs. high SS. Cross-sectional data were collected among 403 pregnant women in northern Uganda. SS was assessed using an eight-item version of the Duke-UNC functional SS scale. FI and depressive symptoms were assessed by, respectively, the individually focused FI scale and the Center for Epidemiologic Studies-Depression scale. Women were categorized into two SS groups, based on scoring category (adjusted beta (95%CI): 0.91 (0.55; 1.27)) than for women belonging to the high SS group (0.53 (0.28; 0.78)) (adjusted p value for interaction = 0.026). There is need for longitudinal or interventional studies among pregnant women living in northern Uganda or similar contexts to examine the temporal sequence of the associations among food insecurity, depressive symptoms severity and social support. © 2016 John Wiley & Sons Ltd. © 2016 John Wiley & Sons Ltd.

Lifetime eating disorder comorbidity associated with delayed depressive recovery in bipolar disorder.

Science.gov (United States)

Balzafiore, Danielle R; Rasgon, Natalie L; Yuen, Laura D; Shah, Saloni; Kim, Hyun; Goffin, Kathryn C; Miller, Shefali; Wang, Po W; Ketter, Terence A

2017-12-01

Although eating disorders (EDs) are common in bipolar disorder (BD), little is known regarding their longitudinal consequences. We assessed prevalence, clinical correlates, and longitudinal depressive severity in BD patients with vs. without EDs. Outpatients referred to Stanford University BD Clinic during 2000-2011 were assessed with the Systematic Treatment Enhancement Program for BD (STEP-BD) affective disorders evaluation, and while receiving naturalistic treatment for up to 2 years, were monitored with the STEP-BD clinical monitoring form. Patients with vs. without lifetime EDs were compared with respect to prevalence, demographic and unfavorable illness characteristics/current mood symptoms and psychotropic use, and longitudinal depressive severity. Among 503 BD outpatients, 76 (15.1%) had lifetime EDs, which were associated with female gender, and higher rates of lifetime comorbid anxiety, alcohol/substance use, and personality disorders, childhood BD onset, episode accumulation (≥10 prior mood episodes), prior suicide attempt, current syndromal/subsyndromal depression, sadness, anxiety, and antidepressant use, and earlier BD onset age, and greater current overall BD severity. Among currently depressed patients, 29 with compared to 124 without lifetime EDs had significantly delayed depressive recovery. In contrast, among currently recovered (euthymic ≥8 weeks) patients, 10 with compared to 95 without lifetime EDs had only non-significantly hastened depressive recurrence. Primarily Caucasian, insured, suburban, American specialty clinic-referred sample limits generalizability. Small number of recovered patients with EDs limited statistical power to detect relationships between EDs and depressive recurrence. Further studies are warranted to explore the degree to which EDs impact longitudinal depressive illness burden in BD.

Depressive disorders and the menopause transition.

Science.gov (United States)

Llaneza, Plácido; García-Portilla, María P; Llaneza-Suárez, David; Armott, Begoña; Pérez-López, Faustino R

2012-02-01

Depressive disorders and symptoms are common among middle-aged women. The effects of hormones on depression remain unclear. This review aims to clarify the nature of depressive disorders during the menopause transition as well as their links with climacteric syndrome, sexuality, cardiovascular risk and cognitive function. The recent literature on depressive disorders and menopause is reviewed. Women are more vulnerable than men to depressive disorders. Endocrine influences have been postulated but differences in, for example, coping style and response to stress may also contribute to the gender difference in the prevalence of depressive disorders. Gender differences in socialization may lead to higher rates of depression in women. There are data top suggest that menopause and depression are associated, although there is not a common clear causative factor. Women with climacteric symptoms (hot flushes, night sweats, vaginal dryness and dyspareunia) are more likely to report anxiety and/or depressive symptoms. Bothersome vasomotor symptoms could be associated with sleep disturbances, which in turn can increase reports of anxiety and depressive symptoms. Biopsychosocial and partner factors have a significant influence on middle-aged women's sexuality and depressive disorders, and most antidepressants can have a negative effect on sexual response. Lastly, studies have consistently shown that women with high levels of depressive symptoms are at greater cardiovascular risk and have poorer cognitive function than non-depressed women. At present, a direct relationship between psychiatric symptoms and hormonal changes such as estrogen decrease has not been clearly found. Stress, educational level, ethnicity, socioeconomic factors and partner status may influence the prevalence and clinical course of both menopause symptoms and depressive disorders. Since in many cases depression is a lifelong condition, and is associated with severe comorbid conditions, further studies are

Evidence for Broadening Criteria for Atypical Depression Which May Define a Reactive Depressive Disorder.

Science.gov (United States)

Silverstein, Brett; Angst, Jules

2015-01-01

Objective. Arguing that additional symptoms should be added to the criteria for atypical depression. Method. Published research articles on atypical depression are reviewed. Results. (1) The original studies upon which the criteria for atypical depression were based cited fatigue, insomnia, pain, and loss of weight as characteristic symptoms. (2) Several studies of DSM depressive criteria found patients with atypical depression to exhibit high levels of insomnia, fatigue, and loss of appetite/weight. (3) Several studies have found atypical depression to be comorbid with headaches, bulimia, and body image issues. (4) Most probands who report atypical depression meet criteria for "somatic depression," defined as depression associated with several of disordered eating, poor body image, headaches, fatigue, and insomnia. The gender difference in prevalence of atypical depression results from its overlap with somatic depression. Somatic depression is associated with psychosocial measures related to gender, linking it with the descriptions of atypical depression as "reactive" appearing in the studies upon which the original criteria for atypical depression were based. Conclusion. Insomnia, disordered eating, poor body image, and aches/pains should be added as criteria for atypical depression matching criteria for somatic depression defining a reactive depressive disorder possibly distinct from endogenous melancholic depression.

Evidence for Broadening Criteria for Atypical Depression Which May Define a Reactive Depressive Disorder

Directory of Open Access Journals (Sweden)

Brett Silverstein

2015-01-01

Full Text Available Objective. Arguing that additional symptoms should be added to the criteria for atypical depression. Method. Published research articles on atypical depression are reviewed. Results. (1 The original studies upon which the criteria for atypical depression were based cited fatigue, insomnia, pain, and loss of weight as characteristic symptoms. (2 Several studies of DSM depressive criteria found patients with atypical depression to exhibit high levels of insomnia, fatigue, and loss of appetite/weight. (3 Several studies have found atypical depression to be comorbid with headaches, bulimia, and body image issues. (4 Most probands who report atypical depression meet criteria for “somatic depression,” defined as depression associated with several of disordered eating, poor body image, headaches, fatigue, and insomnia. The gender difference in prevalence of atypical depression results from its overlap with somatic depression. Somatic depression is associated with psychosocial measures related to gender, linking it with the descriptions of atypical depression as “reactive” appearing in the studies upon which the original criteria for atypical depression were based. Conclusion. Insomnia, disordered eating, poor body image, and aches/pains should be added as criteria for atypical depression matching criteria for somatic depression defining a reactive depressive disorder possibly distinct from endogenous melancholic depression.

Moderators of fluoxetine treatment response for children and adolescents with comorbid depression and substance use disorders.

Science.gov (United States)

Hirschtritt, Matthew E; Pagano, Maria E; Christian, Kelly M; McNamara, Nora K; Stansbrey, Robert J; Lingler, Jacqui; Faber, Jon E; Demeter, Christine A; Bedoya, Denise; Findling, Robert L

2012-06-01

Our recent 8-week, randomized, placebo-controlled trial of fluoxetine in adolescents (ages 12-17 years) with comorbid depression and substance use disorder (SUD) did not detect a significant antidepressant treatment effect. The purpose of this secondary analysis was to explore moderators of the effect of fluoxetine in this sample. Static moderators measured at baseline were depression chronicity and hopelessness severity; time-varying moderators measured at baseline and weekly during the 8-week trial period were alcohol and marijuana use severity. Treatment effects on depression outcomes were examined among moderating subgroups in random effects regression models. Subjects assigned to fluoxetine treatment with chronic depression at baseline (p = .04) or no more than moderate alcohol use during the trial (p = .04) showed significantly greater decline in depression symptoms in comparison to placebo-assigned subgroups. The current analysis suggests that youth with chronic depression and no more than moderate alcohol consumption are likely to respond better to treatment with fluoxetine compared with placebo than youth with transient depression and heavy alcohol use. Copyright © 2012 Elsevier Inc. All rights reserved.

The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories.

Science.gov (United States)

Lovibond, P F; Lovibond, S H

1995-03-01

The psychometric properties of the Depression Anxiety Stress Scales (DASS) were evaluated in a normal sample of N = 717 who were also administered the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). The DASS was shown to possess satisfactory psychometric properties, and the factor structure was substantiated both by exploratory and confirmatory factor analysis. In comparison to the BDI and BAI, the DASS scales showed greater separation in factor loadings. The DASS Anxiety scale correlated 0.81 with the BAI, and the DASS Depression scale correlated 0.74 with the BDI. Factor analyses suggested that the BDI differs from the DASS Depression scale primarily in that the BDI includes items such as weight loss, insomnia, somatic preoccupation and irritability, which fail to discriminate between depression and other affective states. The factor structure of the combined BDI and BAI items was virtually identical to that reported by Beck for a sample of diagnosed depressed and anxious patients, supporting the view that these clinical states are more severe expressions of the same states that may be discerned in normals. Implications of the results for the conceptualisation of depression, anxiety and tension/stress are considered, and the utility of the DASS scales in discriminating between these constructs is discussed.

The Relationship between the Broader Autism Phenotype, Child Severity, and Stress and Depression in Parents of Children with Autism Spectrum Disorders

Science.gov (United States)

Ingersoll, Brooke; Hambrick, David Z.

2011-01-01

This study examined the relationship between child symptom severity, parent broader autism phenotype (BAP), and stress and depression in parents of children with ASD. One hundred and forty-nine parents of children with ASD completed a survey of parenting stress, depression, broader autism phenotype, coping styles, perceived social support, and…

The relationship of Internet addiction severity with Attention Deficit Hyperactivity Disorder symptoms in Turkish University students; impact of personality traits, depression and anxiety.

Science.gov (United States)

Dalbudak, Ercan; Evren, Cuneyt

2014-04-01

The aim of this study was to investigate the relationship of Internet addiction (IA) with Attention Deficit Hyperactivity Disorder (ADHD) symptoms while controlling the effect of personality traits, depression and anxiety symptoms in Turkish university students. A total of 271 university students participated in the present study. The students were assessed through the Internet Addiction Scale (IAS), the Wender Utah Rating Short Scale (WURS-25), the Turkish version of the Adult ADHD Self-Report Scale (ASRS), the Eysenck Personality Questionnaire Revised Abbreviated Form (EPQR-A), the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). According to IAS, participants were separated into three groups, namely, moderate/high, mild and without IA groups. The rates of groups were 19.9% (n=54), 38.7% (n=105) and 41.3% (n=112), respectively. Correlation analyses revealed that the severity of IAS is positively correlated with WURS-25, ASRS (total, inattention and hyperactivity/impulsivity subscales), neuroticism personality trait, depression and anxiety scores, whereas it is negatively correlated with extraversion personality trait. Hierarchical regression analysis indicated that depression and anxiety symptoms, introversion and neuroticism personality traits and the severity of ADHD symptoms (particularly hyperactivity/impulsivity symptoms) are the predictors for IAS score, respectively. The severity of ADHD symptoms has predicted the severity of IA even after controlling the effect of personality traits, depression and anxiety symptoms among Turkish university students. University students with severe ADHD symptoms, particularly hyperactivity/impulsivity symptoms may be considered as a risk group for IA. Copyright © 2014 Elsevier Inc. All rights reserved.

Prediction of Response to Medication and Cognitive Therapy in the Treatment of Moderate to Severe Depression

Science.gov (United States)

Fournier, Jay C.; DeRubeis, Robert J.; Shelton, Richard C.; Hollon, Steven D.; Amsterdam, Jay D.; Gallop, Robert

2009-01-01

A recent randomized controlled trial found nearly equivalent response rates for antidepressant medications and cognitive therapy in a sample of moderate to severely depressed outpatients. In this article, the authors seek to identify the variables that were associated with response across both treatments as well as variables that predicted…

Association of different levels of depressive symptoms with symptomatology, overall disease severity, and quality of life in women with fibromyalgia

DEFF Research Database (Denmark)

Soriano-Maldonado, Alberto; Amris, Kirstine; Ortega, Francisco B

2015-01-01

PURPOSE: This study examined the associations of different levels of depression with pain, sleep quality, fatigue, functional exercise capacity, overall fibromyalgia (FM) severity, and health-related quality of life (HRQoL) in women with FM. METHODS: A total of 451 women with FM participated.......4-23.7), as well as poorer sleep quality (3.2-units; 95 % CI 1.7-4.7) and mental component of HRQoL (-17.0-units; 95 % CI -21.0 to -12.9) than participants with minimal signs of depression. There was no association of signs of depression with pain sensitivity, exercise capacity, or the physical component of HRQo...... in this cross-sectional study. Depressive symptoms (Beck Depression Inventory; BDI-II), pain intensity (numerical rating scale; NRS), pain sensitivity (algometry), sleep quality (Pittsburgh Sleep Quality Index), fatigue (Multidimensional Fatigue Inventory), functional exercise capacity (6-min walk test), FM...

Depression and Risk of Developing Dementia

OpenAIRE

Byers, Amy L.; Yaffe, Kristine

2011-01-01

Depression is highly common throughout the life course and dementia is common in late life. The literature suggests an association between depression and dementia, and growing evidence implies that timing of depression may be important to defining the nature of the association. In particular, earlier-life depression or depressive symptoms consistently have been shown to be associated with a 2-fold or greater increase in risk of dementia. In contrast, studies of late-life depression have been ...

Depression, anxiety and obsessive-compulsive symptoms in relation to nutritional status and outcome in severe anorexia nervosa.

Science.gov (United States)

Mattar, Lama; Thiébaud, Marie-Raphaele; Huas, Caroline; Cebula, Christelle; Godart, Nathalie

2012-12-30

Depression, anxiety and obsessive-compulsive disorder are frequently reported to co-occur with anorexia nervosa (AN). There is clinical consensus that depressive symptoms and anxiety may in part be sequelae of malnutrition in AN. However, evidence-based data are still very rare. The present study among severe AN patients investigates links between these psychological variants and nutritional status at admission and subsequent to nutritional rehabilitation. Twenty-four women with AN diagnosed according to the Diagnostic and Statistical Manual IV (DSM-IV) were included prospectively and consecutively at hospitalisation. Nutritional status was assessed by body mass index (BMI). Several psychological aspects were assessed using various scales for depression, anxiety, social phobia, obsessive and eating behaviour symptoms. Follow-up weights and heights at 4-12 years after hospital discharge were measured in 18 patients. BMI and all the scores except the Yale-Brown obsessive-compulsive scale (Y-BOCS) showed significant improvement between admission and discharge. This study highlights the fact that some of the depressive and anxiety symptoms at least partially decrease with nutrition rehabilitation. The improvement in the scores on the psychometric scales between admission and discharge was not correlated with BMI improvement. Psychometric scores at admission and at discharge were not correlated with BMI at follow-up. BMI at follow-up was correlated with minimum lifetime BMI (r=0.486, P=0.04). Future studies should use a better indicator for nutritional status than BMI alone, and should also consider the initial degree of weight loss and the rate at which weight was lost. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Enhancing Hispanic participation in mental health clinical research: development of a Spanish-speaking depression research site.

Science.gov (United States)

Aponte-Rivera, Vivianne; Dunlop, Boadie W; Ramirez, Cynthia; Kelley, Mary E; Schneider, Rebecca; Blastos, Beatriz; Larson, Jacqueline; Mercado, Flavia; Mayberg, Helen; Craighead, W Edward

2014-03-01

Hispanics, particularly those with limited English proficiency, are underrepresented in psychiatric clinical research studies. We developed a bilingual and bicultural research clinic dedicated to the recruitment and treatment of Spanish-speaking subjects in the Predictors of Remission in Depression to Individual and Combined Treatments (PReDICT) study, a large clinical trial of treatment-naïve subjects with major depressive disorder (MDD). Demographic and clinical data derived from screening evaluations of the first 1,174 subjects presenting for participation were compared between the Spanish-speaking site (N = 275) and the primary English-speaking site (N = 899). Reasons for ineligibility (N = 888) for the PReDICT study were tallied for each site. Compared to English speakers, Spanish speakers had a lower level of education and were more likely to be female, uninsured, and have uncontrolled medical conditions. Clinically, Spanish speakers demonstrated greater depression severity, with higher mean symptom severity scores, and a greater number of previous suicide attempts. Among the subjects who were not randomized into the PReDICT study, Spanish-speaking subjects were more likely to have an uncontrolled medical condition or refuse participation, whereas English-speaking subjects were more likely to have bipolar disorder or a non-MDD depressive disorder. Recruitment of Hispanic subjects with MDD is feasible and may enhance efforts at signal detection, given the higher severity of depression among Spanish-speaking participants presenting for clinical trials. Specific approaches for the recruitment and retention of Spanish-speaking participants are required. © 2013 Wiley Periodicals, Inc.

Major depressive disorder and depressive symptoms in intermittent explosive disorder.

Science.gov (United States)

Medeiros, Gustavo C; Seger, Liliana; Grant, Jon E; Tavares, Hermano

2018-04-01

It is estimated that between 1.7 and 2.6 million people have had intermittent explosive disorder (IED) during their life in the United States alone. Co-occurring psychiatric disorders are very common in IED, being major depressive disorder arguably the most common. The objective of this study was to examine the clinical correlates of IED and depressive manifestations in 74 treatment-seeking subjects. After controlling for confounders, there were associations between major depressive disorder and severity of depressive symptoms, and (a) higher assault scores, (b) more severe hostile behavior and (c) worse social adjustment. Management of depressive symptoms may be an important for IED treatment. Copyright © 2018 Elsevier B.V. All rights reserved.

Self-harming in depressed patients: pattern analysis.

Science.gov (United States)

Parker, G; Malhi, Gin; Mitchell, Philip; Kotze, Beth; Wilhelm, Kay; Parker, Kay

2005-10-01

As deliberate self-harm (DSH) is a common concomitant of depressive disorders, we undertook a study examining the relevance of possible determinants and correlates of DSH. Three separate samples of depressed outpatients were studied to determine consistency of identified factors across samples, with principal analyses involving gender, age and diagnosis-matched DSH and non-DSH subjects. Across the samples, some 20% of subjects admitted to episodes of DSH. Women reported higher rates and there was a consistent trend for higher rates in bipolar patients. Univariate analyses examined the relevance of several sociodemographic variables, illicit drug and alcohol use, past deprivational and abusive experiences, past suicidal attempts and disordered personality functioning. Multivariate analyses consistently identified previous suicide attempts and high 'acting out' behaviours across the three samples, suggesting the relevance of an externalizing response to stress and poor impulse control. Results assist the identification and management of depressed patients who are at greater risk of DSH behaviours.

Standardization of depression measurement

DEFF Research Database (Denmark)

Wahl, Inka; Löwe, Bernd; Bjørner, Jakob

2014-01-01

OBJECTIVES: To provide a standardized metric for the assessment of depression severity to enable comparability among results of established depression measures. STUDY DESIGN AND SETTING: A common metric for 11 depression questionnaires was developed applying item response theory (IRT) methods. Data...... of 33,844 adults were used for secondary analysis including routine assessments of 23,817 in- and outpatients with mental and/or medical conditions (46% with depressive disorders) and a general population sample of 10,027 randomly selected participants from three representative German household surveys....... RESULTS: A standardized metric for depression severity was defined by 143 items, and scores were normed to a general population mean of 50 (standard deviation = 10) for easy interpretability. It covers the entire range of depression severity assessed by established instruments. The metric allows...

Fish Consumption Moderates Depressive Symptomatology in Elderly Men and Women from the IKARIA Study

Directory of Open Access Journals (Sweden)

Christina Chrysohoou

2011-01-01

Full Text Available Background. The aim was to examine the association of depressive symptoms with fish eating habits, in elderly individuals. Methods. From June to October of 2009, we studied 330 men and 343 women, aged 65 to 100 years, permanent inhabitants of Ikaria Island. Among several characteristics, depression was assessed with the Geriatric Depression scale (GDS range 0–15, while dietary habits through a valid semiquantitative food frequency questionnaire. Results. Women had significantly higher values of the GDS compared to men (4.8±3.5 versus 3.3±3.1, =.001. Participants in the upper tertile of depression scale ate less frequent fish and consumed higher quantities of alcohol, compared to those in the lowest tertile (all 3 times/week versus never/rare was inversely associated with the odds of having GDS greater the median value (i.e., 4 (oddsratio=0.34, 95% CI: 0.19, 0.61, after controlling for several cofounders. Conclusion. Frequent fish consumption in elderly seems to moderate depression mood.

Adjunctive low-dose docosahexaenoic acid (DHA) for major depression: An open-label pilot trial.

Science.gov (United States)

Smith, Deidre J; Sarris, Jerome; Dowling, Nathan; O'Connor, Manjula; Ng, Chee H

2018-04-01

Whilst the majority of evidence supports the adjunctive use of eicosapentaenoic acid (EPA) in improving mood, to date no study exists using low-dose docosahexaenoic acid (DHA) alone as an adjunctive treatment in patients with mild to moderate major depressive disorder (MDD). A naturalistic 8-week open-label pilot trial of low-dose DHA, (260 mg or 520 mg/day) in 28 patients with MDD who were non-responsive to medication or psychotherapy, with a Hamilton Depression Rating Scale (HAM-D) score of greater than 17, was conducted. Primary outcomes of depression, clinical severity, and daytime sleepiness were measured. After 8 weeks, 54% of patients had a ≥50% reduction on the HAM-D, and 45% were in remission (HAM-D ≤ 7). The eta-squared statistic (0.59) indicated a large effect size for the reduction of depression (equivalent to Cohen's d of 2.4). However confidence in this effect size is tempered due to the lack of a placebo. The mean score for the Clinical Global Impression Severity Scale was significantly improved by 1.28 points (P depression.

The Major Depressive Disorder Hierarchy: Rasch Analysis of 6 items of the Hamilton Depression Scale Covering the Continuum of Depressive Syndrome.

Directory of Open Access Journals (Sweden)

Lucas Primo de Carvalho Alves

Full Text Available Melancholic features of depression (MFD seem to be a unidimensional group of signs and symptoms. However, little importance has been given to the evaluation of what features are related to a more severe disorder. That is, what are the MFD that appear only in the most depressed patients. We aim to demonstrate how each MFD is related to the severity of the major depressive disorder.We evaluated both the Hamilton depression rating scale (HDRS-17 and its 6-item melancholic subscale (HAM-D6 in 291 depressed inpatients using Rasch analysis, which computes the severity of each MFD. Overall measures of model fit were mean (±SD of items and persons residual = 0 (±1; low χ2 value; p>0.01.For the HDRS-17 model fit, mean (±SD of item residuals = 0.35 (±1.4; mean (±SD of person residuals = -0.15 (±1.09; χ2 = 309.74; p<0.00001. For the HAM-D6 model fit, mean (±SD of item residuals = 0.5 (±0.86; mean (±SD of person residuals = 0.15 (±0.91; χ2 = 56.13; p = 0.196. MFD ordered by crescent severity were depressed mood, work and activities, somatic symptoms, psychic anxiety, guilt feelings, and psychomotor retardation.Depressed mood is less severe, while guilt feelings and psychomotor retardation are more severe MFD in a psychiatric hospitalization. Understanding depression as a continuum of symptoms can improve the understanding of the disorder and may improve its perspective of treatment.

Prognostic value of myocardial perfusion SPECT versus exercise electrocardiography in patients with ST-segment depression on resting electrocardiography.

Science.gov (United States)

De Lorenzo, Andrea; Hachamovitch, Rory; Kang, Xingping; Gransar, Heidi; Sciammarella, Maria G; Hayes, Sean W; Friedman, John D; Cohen, Ishac; Germano, Guido; Berman, Daniel S

2005-01-01

The value of exercise-induced ST-segment depression for the prognostic evaluation of patients with 1 mm of ST depression or greater on the resting electrocardiogram is controversial. Patients who underwent exercise myocardial perfusion single photon emission computed tomography (MPS) and had resting ST depression of 1 mm or greater with a nondiagnostic exercise electrocardiographic response (n = 1122) were followed up for 3.4 +/- 2.3 years. Those with paced rhythm, pre-excitation, left bundle branch block, or myocardial revascularization within the first 60 days after MPS were excluded. Additional exercise-induced ST-segment depression was considered significant if > or = 2 mm MPS was scored semiquantitatively by use of a 20-segment model of the left ventricle; the percentage of myocardium involved with stress defects (% myo) was derived by normalizing to the maximal possible score of 80. Hard events were defined as nonfatal myocardial infarction or cardiac death. A Cox analysis was used to determine independent predictors of hard events among clinical, exercise, and nuclear variables. Hard event rates increased as a function of % myo for either patients with exercise-induced ST depression (1.4%/y for normal MPS vs 4.1%/y for % myo >10%, P 10%, P = .0001). Age, diabetes mellitus, shortness of breath as the presenting symptom, and % myo were independent predictors of hard events. Exercise-induced ST depression was predictive of hard events only when it was 3 mm or greater. The presence and extent of perfusion defects, reflected in the % myo, had incremental prognostic value over clinical variables and also over all degrees of exercise-induced ST depression. Although MPS effectively risk-stratifies patients with resting ST depression of 1 mm or greater, the prognostic value of exercise-induced ST depression is limited in these patients, with a small added risk when severe (> or = 3 mm).

An experimental investigation of emotional reasoning processes in depression.

Science.gov (United States)

Berle, David; Moulds, Michelle L

2013-09-01

Cognitive models of depression emphasize how distorted thoughts and interpretations contribute to low mood. Emotional reasoning is considered to be one such interpretative style. We used an experimental procedure to determine whether elevated levels of emotional reasoning characterize depression. Participants who were currently experiencing a major depressive episode (n = 27) were compared with those who were non-depressed (n = 25 who had never been depressed and n = 26 previously but not currently depressed) on an emotional reasoning task. Although there were some trends for depressed participants to show greater levels of emotional reasoning relative to non-depressed participants, none of these differences attained significance. Interestingly, previously depressed participants engaged in more non-self-referent emotional reasoning than never-depressed participants. Emotional reasoning does not appear to characterize mild to moderate levels of depression. The lack of significant differences in emotional reasoning between currently depressed and non-depressed participants may have been a consequence of the fact that participants in our currently depressed group were, for the most part, only mildly depressed. Non-self-referent emotional reasoning may nevertheless be a risk factor for subsequent depressive episodes, or else serve as a 'cognitive scar' from previous episodes. In contrast with the predictions of cognitive models of depression, emotional reasoning tendencies may not be especially prominent in currently depressed individuals. Depressed individuals vary greatly in the degree to which they engage in emotional reasoning. Individuals with remitted depression may show elevated of levels non-self-referent emotional reasoning compared with those who have never had a depressive episode, that is, rely on their emotions when forming interpretations about situations. Our findings require replication using alternative indices of emotional reasoning. Our currently

Motivational deficits in major depressive disorder: Cross-sectional and longitudinal relationships with functional impairment and subjective well-being.

Science.gov (United States)

Fervaha, Gagan; Foussias, George; Takeuchi, Hiroyoshi; Agid, Ofer; Remington, Gary

2016-04-01

Many individuals with major depressive disorder present with prominent motivational deficits; however, the effect of these symptoms on functional outcomes in the illness remains unclear. Individuals with major depression who participated in the Sequenced Treatment Alternatives to Relieve Depression study were included in the present investigation (N=1563). Motivational deficits were evaluated using a derived measure from the Hamilton Depression Rating Scale, while functioning was assessed using the Work and Social Adjustment Scale. Subjective outcomes were also evaluated using the Quality of Life Enjoyment and Satisfaction Questionnaire. After treatment with citalopram, over 70% of participants continued to experience some degree of motivational deficits. These deficits were significantly associated with greater functional impairments both globally and in each domain of functioning evaluated. These symptoms were also linked to worse subjective outcomes such as overall life satisfaction and quality of life. Change in the severity of motivational deficits over time was significantly linked with changes in outcome. Motivational deficits continued to demonstrate a significant association with outcomes, even after controlling for potentially confounding variables such as duration of depressive episode and severity of other depressive symptoms. Motivational deficits are significantly linked to the functional impairment present in many people with major depression, just as they are in other psychiatric illnesses such as schizophrenia. A greater understanding of the underlying mechanisms of these motivational deficits in particular, beyond other depressive symptoms, is critical to the development of strategies aimed at enhancing functional recovery and improved subjective well-being. Copyright © 2015 Elsevier Inc. All rights reserved.

Improving depression and enhancing resilience in family dementia caregivers: a pilot randomized placebo-controlled trial of escitalopram.

Science.gov (United States)

Lavretsky, Helen; Siddarth, Prabha; Irwin, Michael R

2010-02-01

This study examined the potential of an antidepressant drug, escitalopram, to improve depression, resilience to stress, and quality of life in family dementia caregivers in a randomized placebo-controlled double-blinded trial. Forty family caregivers (43-91 years of age, 25 children and 15 spouses; 26 women) who were taking care of their relatives with Alzheimer disease were randomized to receive either escitalopram 10 mg/day or placebo for 12 weeks. Severity of depression, resilience, burden, distress, quality of life, and severity of care-recipient's cognitive and behavioral disturbances were assessed at baseline and over the course of the study. The Hamilton Depression Rating Scale scores at baseline ranged between 10 and 28. The groups were stratified by the diagnosis of major and minor depression. Most outcomes favored escitalopram over placebo. The severity of depression improved, and the remission rate was greater with the drug compared with placebo. Measures of anxiety, resilience, burden, and distress improved on escitalopram compared with placebo. Among caregivers, this small randomized controlled trial found that escitalopram use resulted in improvement in depression, resilience, burden and distress, and quality of life. Our results need to be confirmed in a larger sample.

Maternal posttraumatic stress disorder and depression in pediatric primary care: association with child maltreatment and frequency of child exposure to traumatic events.

Science.gov (United States)

Chemtob, Claude M; Gudiño, Omar G; Laraque, Danielle

2013-11-01

Maternal posttraumatic stress disorder (PTSD) may be associated with increased risk for child maltreatment and child exposure to traumatic events. Exposure to multiple traumatic events is associated with a wide range of adverse health and social outcomes in children. To examine the association of probable maternal depression, PTSD, and comorbid PTSD and depression with the risk for child maltreatment and parenting stress and with the number of traumatic events to which preschool children are exposed. Cross-sectional observational design. We used analysis of variance to determine whether probable maternal psychopathology groups differed on child maltreatment, parenting stress, and children's exposure to traumatic events. Hierarchical regression analyses were used to examine the unique and interactive effects of depression and PTSD severity scores on these outcomes. Urban pediatric primary care outpatient clinic. Ninety-seven mothers of children aged 3 to 5 years. Pediatric primary care visit. Probable maternal depression and/or PTSD, parenting stress, child exposure to traumatic events, and child maltreatment. Mothers with probable comorbid PTSD and depression reported greater child-directed psychological aggression and physical assault and greater parenting stress. The children of mothers with PTSD (mean number of events the child was exposed to, 5.0) or with comorbid PTSD and depression (3.5 events) experienced more traumatic events than those of mothers with depression (1.2 events) or neither disorder (1.4 events). Severity of depressive symptoms uniquely predicted physical assault and neglect. Symptom scores for PTSD and depression interacted to predict psychological aggression and child exposure to traumatic events. When PTSD symptom severity scores were high, psychological aggression and the number of traumatic events children experienced rose. Depressive symptom severity scores predicted the risk for psychological aggression and exposure to traumatic events

Depressed gut? The microbiota-diet-inflammation trialogue in depression.

Science.gov (United States)

Koopman, Margreet; El Aidy, Sahar

2017-09-01

According to the WHO reports, around 350 million people worldwide suffer from depression. Despite its high prevalence, the complex interaction of multiple mechanisms underlying depression still needs to be elucidated. Over the course of the last few years, several neurobiological alterations have been linked to the development and maintenance of depression. One basic process that seems to link many of these findings is inflammation. Chronic inflammation has been associated with both biological factors such as excessive neurotransmitter concentrations as well as psychological processes such as adult stress reactivity and a history of childhood trauma. As a balanced microbial community, modulated by diet, is a key regulator of the host physiology, it seems likely that gut microbiota plays a role in depression. The review summarizes the existent literature on this emerging research field and provides a comprehensive overview of the multifaceted links between the microbiota, diet, and depression. Several pathways linking early life trauma, pharmacological treatment effects, and nutrition to the microbiome in depression are described aiming to foster the psychotherapeutic treatment of depressed patients by interventions targeting the microbiota.

Cognitive conflicts in major depression: Between desired change and personal coherence

Science.gov (United States)

Feixas, Guillem; Montesano, Adrián; Compañ, Victoria; Salla, Marta; Dada, Gloria; Pucurull, Olga; Trujillo, Adriana; Paz, Clara; Muñoz, Dámaris; Gasol, Miquel; Saúl, Luis Ángel; Lana, Fernando; Bros, Ignasi; Ribeiro, Eugenia; Winter, David; Carrera-Fernández, María Jesús; Guàrdia, Joan

2014-01-01

Objectives The notion of intrapsychic conflict has been present in psychopathology for more than a century within different theoretical orientations. However, internal conflicts have not received enough empirical attention, nor has their importance in depression been fully elaborated. This study is based on the notion of cognitive conflict, understood as implicative dilemma (ID), and on a new way of identifying these conflicts by means of the Repertory Grid Technique. Our aim was to explore the relevance of cognitive conflicts among depressive patients. Design Comparison between persons with a diagnosis of major depressive disorder and community controls. Methods A total of 161 patients with major depression and 110 non-depressed participants were assessed for presence of IDs and level of symptom severity. The content of these cognitive conflicts was also analysed. Results Repertory grid analysis indicated conflict (presence of ID/s) in a greater proportion of depressive patients than in controls. Taking only those grids with conflict, the average number of IDs per person was higher in the depression group. In addition, participants with cognitive conflicts displayed higher symptom severity. Within the clinical sample, patients with IDs presented lower levels of global functioning and a more frequent history of suicide attempts. Conclusions Cognitive conflicts were more prevalent in depressive patients and were associated with clinical severity. Conflict assessment at pre-therapy could aid in treatment planning to fit patient characteristics. Practitioner points Internal conflicts have been postulated in clinical psychology for a long time but there is little evidence about its relevance due to the lack of methods to measure them. We developed a method for identifying conflicts using the Repertory Grid Technique. Depressive patients have higher presence and number of conflicts than controls. Conflicts (implicative dilemmas) can be a new target for intervention in

Direct and indirect influences of childhood abuse on depression symptoms in patients with major depressive disorder.

Science.gov (United States)

Hayashi, Yumi; Okamoto, Yasumasa; Takagaki, Koki; Okada, Go; Toki, Shigeru; Inoue, Takeshi; Tanabe, Hajime; Kobayakawa, Makoto; Yamawaki, Shigeto

2015-10-14

It is known that the onset, progression, and prognosis of major depressive disorder are affected by interactions between a number of factors. This study investigated how childhood abuse, personality, and stress of life events were associated with symptoms of depression in depressed people. Patients with major depressive disorder (N = 113, 58 women and 55 men) completed the Beck Depression Inventory-II (BDI-II), the Neuroticism Extroversion Openness Five Factor Inventory (NEO-FFI), the Child Abuse and Trauma Scale (CATS), and the Life Experiences Survey (LES), which are self-report scales. Results were analyzed with correlation analysis and structural equation modeling (SEM), by using SPSS AMOS 21.0. Childhood abuse directly predicted the severity of depression and indirectly predicted the severity of depression through the mediation of personality. Negative life change score of the LES was affected by childhood abuse, however it did not predict the severity of depression. This study is the first to report a relationship between childhood abuse, personality, adulthood life stresses and the severity of depression in depressed patients. Childhood abuse directly and indirectly predicted the severity of depression. These results suggest the need for clinicians to be receptive to the possibility of childhood abuse in patients suffering from depression. SEM is a procedure used for hypothesis modeling and not for causal modeling. Therefore, the possibility of developing more appropriate models that include other variables cannot be excluded.

Nocturnal Wakefulness is Associated with Next-Day Suicidal Ideation in Major Depression and Bipolar Disorder

Science.gov (United States)

Ballard, Elizabeth D.; Vande Voort, Jennifer L.; Bernert, Rebecca A.; Luckenbaugh, David A.; Richards, Erica M.; Niciu, Mark J.; Furey, Maura L.; Duncan, Wallace C.; Zarate, Carlos A.

2016-01-01

Objective Self-reported sleep disturbances may confer elevated risk for suicidal ideation, suicide attempts, and death. However, limited research has evaluated polysomnography (PSG)-determined sleep disturbance as an acute physiological risk factor for suicidal thoughts. This study sought to investigate the relationship between nocturnal wakefulness in association with next-day suicidal ideation using overnight PSG assessment from data collected between 2006 and 2013. Method Participants with DSM-IV-diagnosed major depressive disorder (MDD) or bipolar depression underwent overnight PSG monitoring in a sleep laboratory. The Hamilton Depression Rating Scale (HAM-D) was administered the morning after PSG recording to assess next-day suicidal ideation, severity of depressive symptoms, and subjective sleep disturbances. Results Using a generalized linear mixed model, a significant time-by-ideation interaction was found indicating greater nocturnal wakefulness at 4:00 AM among participants with suicidal ideation (F(4,136) = 3.65, p = .007). Increased time awake during the 4:00 AM hour (4:00 to 4:59) was significantly associated with elevated suicidal thoughts the next day (standardized β = .31, p = .008). This relationship persisted after controlling for age, gender, diagnosis, and severity of depressive symptoms. Conclusion Greater nocturnal wakefulness, particularly in the early morning hours, was significantly associated with next-day suicidal thoughts. PSG-documented sleep disruption at specific times of night may represent an acute risk factor of suicidal ideation that warrants additional research. Clinical Trials Identifier NCT00024635 PMID:27337418

Has the symptom severity inclusion requirement narrowed the definition of major depressive disorder in antidepressant efficacy trials?

Science.gov (United States)

Zimmerman, Mark; Walsh, Emily; Chelminski, Iwona; Dalrymple, Kristy

2017-03-15

The inclusion criteria of all placebo-controlled studies of antidepressants have required a minimum level of severity on standardized measures of symptoms of depression. In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project we examined the association between scores on the Hamilton Depression Rating Scale (HAMD) and the number of criteria met for MDD, as well as the impact of different HAMD cutoff scores on the distribution of the number of DSM-IV criteria met. We speculated that the use of a minimum symptom severity score (MSSS) for inclusion in an antidepressant efficacy trial (AETs) disproportionately excludes patients who are at or just above the diagnostic threshold for MDD, whereas patients who are well above the diagnostic threshold are not excluded. Seven hundred forty outpatients with current MDD were evaluated with a semi-structured diagnostic interview. We compared the distribution of DSM-IV MDD criteria scores in patients who scored at or above or below the 3 cutoff scores on the HAMD most commonly used for inclusion in an AET. The distribution of the number of DSM-IV MDD symptom criteria met was significantly associated with HAMD scores. Compared to patients scoring below 18 on the HAMD the patients scoring 18 and above were less likely to report 5 MDD criteria (13.9% vs. 43.7%, χ 2 =82.2, pconducted in a single outpatient practice in which the majority of patients were white, female, and had health insurance. Although the study was limited to a single site, a strength of the recruitment procedure was that the sample was not selected for participation in a treatment study, and exclusion and inclusion criteria did not reduce the representativeness of the patient groups. While there is not a perfect relationship between the HAMD score and the number of DSM MDD criteria present, the results of the current study suggest that HAMD scores can be thought of as a proxy for the number of DSM

Food insecurity, social networks and symptoms of depression among men and women in rural Uganda: a cross-sectional, population-based study.

Science.gov (United States)

Perkins, Jessica M; Nyakato, Viola N; Kakuhikire, Bernard; Tsai, Alexander C; Subramanian, S V; Bangsberg, David R; Christakis, Nicholas A

2018-04-01

To assess the association between food insecurity and depression symptom severity stratified by sex, and test for evidence of effect modification by social network characteristics. A population-based cross-sectional study. The nine-item Household Food Insecurity Access Scale captured food insecurity. Five name generator questions elicited network ties. A sixteen-item version of the Hopkins Symptom Checklist for Depression captured depression symptom severity. Linear regression was used to estimate the association between food insecurity and depression symptom severity while adjusting for potential confounders and to test for potential network moderators. In-home survey interviews in south-western Uganda. All adult residents across eight rural villages; 96 % response rate (n 1669). Severe food insecurity was associated with greater depression symptom severity (b=0·4, 95 % CI 0·3, 0·5, Pinsecurity and depression symptoms was stronger than for men on the periphery of their village social network, and for men with many poor personal network contacts, respectively. In this population-based study from rural Uganda, food insecurity was associated with mental health for both men and women. Future research is needed on networks and food insecurity-related shame in relation to depression symptoms among food-insecure men.

Promoting homework adherence in cognitive-behavioral therapy for adolescent depression.

Science.gov (United States)

Jungbluth, Nathaniel J; Shirk, Stephen R

2013-01-01

This study used prospective, observational methods to evaluate six features of therapist behavior as predictors of homework adherence in cognitive-behavioral therapy for adolescent depression, with the goal of identifying therapist strategies with the potential to improve adolescent adherence. Therapist behaviors were expected to interact with initial levels of client resistance or adherence to predict subsequent homework completion. Participants were 50 referred adolescents (33 female, 54% ethnic minority) ages 14 to 18 (M = 15.9) meeting diagnostic criteria for a depressive disorder, and without comorbid psychotic disorder, bipolar disorder, autism spectrum disorder, intellectual disability, or concurrent treatments. Therapist homework-related behaviors were coded from audiotapes of Sessions 1 and 2 and used to predict adolescents' homework adherence, coded from audiotapes of Sessions 2 and 3. Several therapist behaviors were predictive of subsequent homework adherence, particularly for initially resistant or nonadherent adolescents. Stronger homework rationale and greater time allocated to explaining homework in Session 1 predicted greater adherence at Session 2, particularly for initially resistant adolescents. Stronger rationale and eliciting reactions/troubleshooting obstacles in Session 2 predicted greater adherence at Session 3, particularly for adolescents who were less adherent to prior homework. Strategies such as providing a strong rationale, allocating more time to assigning homework, and eliciting reactions/troubleshooting obstacles may be effective ways to bolster homework adherence among initially less engaged, depressed teens.

Salience Network and Depressive Severities in Parkinson’s Disease with Mild Cognitive Impairment: A Structural Covariance Network Analysis

Directory of Open Access Journals (Sweden)

Ya-Ting Chang

2018-01-01

Full Text Available Purpose: In Parkinson’s disease with mild cognitive impairment (PD-MCI, we investigated the clinical significance of salience network (SN in depression and cognitive performance.Methods: Seventy seven PD-MCI patients that fulfilled multi-domain and non-amnestic subtype were included. Gray matter structural covariance networks were constructed by 3D T1-magnetic resonance imaging and seed based analysis. The patients were divided into two groups by psychiatric interviews and screening of Geriatric Depression Scale (GDS: PD-MCI with depression (PD-MCI-D or without depression (PD-MCI-ND. The seed or peak cluster volume, or the significant differences in the regression slopes in each seed-peak cluster correlation, were used to evaluate the significance with the neurobehavioral scores.Results: This study is the first to demonstrate that the PD-MCI-ND group presented a larger number of voxels of structural covariance in SN than the PD-MCI-D group. The right fronto-insular seed volumes and the peak cluster of left lingual gyrus showed significant inverse correlation with the Geriatric Depression Scale (GDS; r = -0.231, P = 0.046.Conclusions: This study is the first to validate the clinical significance of the SN in PD-MCI-D. The right insular seed value and the SN correlated with the severity of depression in PD-MCI.

Salience Network and Depressive Severities in Parkinson’s Disease with Mild Cognitive Impairment: A Structural Covariance Network Analysis

Science.gov (United States)

Chang, Ya-Ting; Lu, Cheng-Hsien; Wu, Ming-Kung; Hsu, Shih-Wei; Huang, Chi-Wei; Chang, Wen-Neng; Lien, Chia-Yi; Lee, Jun-Jun; Chang, Chiung-Chih

2018-01-01

Purpose: In Parkinson’s disease with mild cognitive impairment (PD-MCI), we investigated the clinical significance of salience network (SN) in depression and cognitive performance. Methods: Seventy seven PD-MCI patients that fulfilled multi-domain and non-amnestic subtype were included. Gray matter structural covariance networks were constructed by 3D T1-magnetic resonance imaging and seed based analysis. The patients were divided into two groups by psychiatric interviews and screening of Geriatric Depression Scale (GDS): PD-MCI with depression (PD-MCI-D) or without depression (PD-MCI-ND). The seed or peak cluster volume, or the significant differences in the regression slopes in each seed-peak cluster correlation, were used to evaluate the significance with the neurobehavioral scores. Results: This study is the first to demonstrate that the PD-MCI-ND group presented a larger number of voxels of structural covariance in SN than the PD-MCI-D group. The right fronto-insular seed volumes and the peak cluster of left lingual gyrus showed significant inverse correlation with the Geriatric Depression Scale (GDS; r = -0.231, P = 0.046). Conclusions: This study is the first to validate the clinical significance of the SN in PD-MCI-D. The right insular seed value and the SN correlated with the severity of depression in PD-MCI. PMID:29375361

Relationship of Smartphone Use Severity with Sleep Quality, Depression, and Anxiety in University Students

OpenAIRE

Demi?rci?, Kadi?r; Akg?n?l, Mehmet; Akpinar, Abdullah

2015-01-01

Background and Aims The usage of smartphones has increased rapidly in recent years, and this has brought about addiction. The aim of the current study was to investigate the relationship between smartphone use severity and sleep quality, depression, and anxiety in university students. Methods In total, 319 university students (203 females and 116 males; mean age = 20.5 ? 2.45) were included in the study. Participants were divided into the following three groups: a smartphone non-user group (n...

Depression in Coronary Artery Disease

Directory of Open Access Journals (Sweden)

Nasser Safaie

2012-09-01

Full Text Available Introduction: Depression is one of the Common psychological disorders. From the cognitive point of view, the unhealthy attitudes increase the severity of the depression. The aim of this study was to investigate depression and unhealthy attitudes in coronary patients hospitalized at Tabriz Shahid Madani Heart Center. Methods: One hundred twenty eight hospitalized patients having myocardial Infarctions were studied regarding unhealthy attitudes, severity of depression and demographic data. Results: The study showed a significant relation between unhealthy attitudes, BDI (Beck Depression Inventory and severe depression. Moreover, a significant relation existed between gender and depression (P=0.0001. In addition, the level of education increased the intensity of unhealthy attitudes (P=0.0001. Several researches in both outside and inside Iran support the idea. Conclusion: Based on present study and more other investigations, it can be suggested to provide the necessary elements and parameters such as antidepressant medication, psychologists, complementary treatment for coping with negative mood and its unwanted consequences.

Stressful life events, perceived stress, and 12-month course of geriatric depression: direct effects and moderation by the 5-HTTLPR and COMT Val158Met polymorphisms.

Science.gov (United States)

Zannas, Anthony S; McQuoid, Douglas R; Steffens, David C; Chrousos, George P; Taylor, Warren D

2012-07-01

Although the relation between stressful life events (SLEs) and risk of major depressive disorder is well established, important questions remain about the effects of stress on the course of geriatric depression. Our objectives were (1) to examine how baseline stress and change in stress is associated with course of geriatric depression and (2) to test whether polymorphisms of serotonin transporter (5-HTTLPR) and catechol-O-methyltransferase (COMT Val158Met) genes moderate this relation. Two-hundred and sixteen depressed subjects aged 60 years or older were categorized by remission status (Montgomery-Asberg depression rating scale≤6) at 6 and 12 months. At 6 months, greater baseline numbers of self-reported negative and total SLEs and greater baseline perceived stress severity were associated with lower odds of remission. At 12 months, only baseline perceived stress predicted remission. When we examined change in stress, 12-month decrease in negative SLEs and level of perceived stress were associated with improved odds of 12-month remission. When genotype data were included, COMT Val158Met genotype did not influence these relations. However, when compared with 5-HTTLPR L/L homozygotes, S allele carriers with greater baseline numbers of negative SLEs and with greater decrease in negative SLEs were more likely to remit at 12 months. This study demonstrates that baseline SLEs and perceived stress severity may influence the 12-month course of geriatric depression. Moreover, changes in these stress measures over time correlate with depression outcomes. 5-HTTLPR S carriers appear to be more susceptible to both the effects of enduring stress and the benefit of interval stress reduction.

Older Adults and Depression

Science.gov (United States)

... find more information? Reprints Share Older Adults and Depression Download PDF Download ePub Order a free hardcopy ... depression need treatment to feel better. Types of Depression There are several types of depression. The most ...

Prevalence of restless legs symptoms according to depressive symptoms and depression type: a cross-sectional study.

Science.gov (United States)

Auvinen, Piritta; Mäntyselkä, Pekka; Koponen, Hannu; Kautiainen, Hannu; Korniloff, Katariina; Ahonen, Tiina; Vanhala, Mauno

2018-01-01

Restless legs syndrome is a sensorimotor disorder and it is associated with several other diseases especially mental illnesses. To analyze the relationship between the symptoms of restless legs syndrome and the severity of depressive symptoms and the prevalence of restless legs symptoms in depression subtypes. A cross-sectional study of primary care patients in the Central Finland Hospital District. The prevalence of restless legs symptoms was studied in 706 patients with increased depressive symptoms and 426 controls without a psychiatric diagnosis by using a structured questionnaire. The depressive symptoms were evaluated with the Beck Depression Inventory (BDI) and the psychiatric diagnosis was confirmed by means of a diagnostic interview (Mini-International Neuropsychiatric Interview). The subjects with increased depressive symptoms were divided into three groups (subjects with depressive symptoms without a depression diagnosis, melancholic depression and non-melancholic depression). In the whole study population, the prevalence of restless legs symptoms increased with the severity of depressive symptoms. The prevalence of restless legs symptoms was highest in the melancholic and non-melancholic depressive patients (52 and 46%, respectively) and then in subjects with depressive symptoms without a depression diagnosis (43.4%), but the prevalence was also substantial (24.6%) in subjects without a psychiatric diagnosis. Restless legs symptoms are very common in primary care among subjects with depression, regardless of the depression type. The prevalence of restless legs symptoms increased with increasing severity of depressive symptoms, regardless of the diagnosis. These findings should be considered in clinical evaluation and treatment of patients visiting their physician due to restless legs or depressive symptoms.

Do continued antidepressants protect against dementia in patients with severe depressive disorder?

DEFF Research Database (Denmark)

Kessing, Lars Vedel; Forman, Julie Lyng; Andersen, Per Kragh

2011-01-01

may decrease the risk of developing dementia in patients with depression. We investigated whether continued treatment with antidepressants is associated with a decreased rate of dementia in a population of patients discharged from psychiatric healthcare service with a diagnosis of depression. We used...... register data on all prescribed antidepressants in all patients discharged from psychiatric healthcare service with a diagnosis of depression and with subsequent diagnoses of dementia in Denmark from 1995 to 2005. A total of 37 658 patients with a diagnosis of depression at their first psychiatric contact......Studies on humans show that depressive disorder is associated with an increased risk of developing cognitive dysfunction, and animal studies suggest that antidepressants may have neuroprotective abilities. On the basis of these observations, it was hypothesized that treatment with antidepressants...

Self-reported perinatal depressive symptoms and postnatal symptom severity after treatment with antidepressants in pregnancy: a cross-sectional study across 12 European countries using the Edinburgh Postnatal Depression Scale

Directory of Open Access Journals (Sweden)

Lupattelli A

2018-06-01

postnatal depressive symptoms by severity across multiple countries and the association between antidepressant treatment in pregnancy and postnatal symptom severity. Materials and methods: This was a multinational web-based study conducted across 12 European countries (n=8069. Uniform data collection was ensured via an electronic questionnaire. Pregnant women at any gestational week and mothers of children with <1 year of age could participate. We used the Edinburgh Postnatal Depression Scale (EPDS to measure the prevalence of antenatal and postnatal depressive symptoms according to severity, which were corrected by survey weight adjustment (descriptive analysis. Within mothers with a psychiatric disorder (n=173, we estimated the association between antidepressant treatment in pregnancy and postnatal depressive symptom severity, as standardized EPDS mean scores, via the inverse probability of treatment weight (association analysis. Results: In the descriptive analysis (n=8069, the period prevalence of moderate-to-very severe depressive symptoms was higher in the western and eastern regions relative to the northern region, both in the antenatal period (6.8%–7.5% vs 4.3% and in the postnatal period (7.6% vs 4.7%. One in two mothers with psychiatric disorders used an antidepressant in pregnancy (86 of 173. In the association analysis, women medicated at any time during pregnancy (adjusted β=−0.34, 95% confidence interval [CI] =−0.66, −0.02 had a significant postnatal symptom severity reduction compared with the nonmedicated counterpart. This effect was larger (β=−0.74, 95% CI =−1.24, −0.24 when the analysis was restricted to mothers within 6 months after childbirth. Conclusion: The prevalence of self-reported antenatal and postnatal depressive symptoms differs across European countries. Among women with psychiatric disorders, those who had been on treatment with antidepressants during pregnancy were less likely to report postnatal depressive symptoms

Competence of depressed patients for consent to research.

Science.gov (United States)

Appelbaum, P S; Grisso, T; Frank, E; O'Donnell, S; Kupfer, D J

1999-09-01

The capacities of depressed patients to consent to research have been questioned by commentators who fear that the cognitive effects of a disorder may impair subjects' abilities to protect their interests. This study used a new instrument for assessing depressed patients' capacities to consent to research and examined their performance, including the relation between severity of depression and extent of impairment. Twenty-six female outpatients with major depression (assessed with the Schedule of Affective Disorders and Schizophrenia-Lifetime Version) enrolled in a study of maintenance psychotherapy were recruited for this project. Consent-related abilities were measured with the MacArthur Competence Assessment Tool-Clinical Research (MacCAT-CR) 1 week after intake and again 8-10 weeks later. Depressive symptoms were measured by the Hamilton Depression Rating Scale. Almost all subjects performed quite well on the capacity measures and maintained that level of performance over time. There was no correlation between performance and degree of depressive symptoms and little relation to prior research experience. Some subjects appeared confused about the extent to which decisions about assignment to treatment groups would be made on the basis of their clinical condition rather than randomly. This outpatient group with major depression showed few impairments in their decision-making capacities related to research. As in other studies, some concerns were raised about subjects' appreciation that treatment assignments would not be individualized for their needs. Examination of hospitalized patients and those with psychotic depression would help to determine whether they show greater degrees of impairment. The MacCAT-CR was easily adapted for use with this depressed group.

Economic Hardship and Depression Among Women in Latino Farmworker Families.

Science.gov (United States)

Pulgar, Camila A; Trejo, Grisel; Suerken, Cynthia; Ip, Edward H; Arcury, Thomas A; Quandt, Sara A

2016-06-01

Farmworker family members risk poor mental health due to stressors including poverty, relocation, and documentation status. This paper explores the relationship between farm-work related stressors and depressive symptoms in women of Latino farmworker families. 248 mothers of young children completed fixed-response interviews in Spanish. Measures included the Center for Epidemiologic Studies-Depression Scale, Migrant Farmworker Stress Inventory, and USDA Household Food Security Survey Module. Bivariate analyses indicated greater depressive symptoms with more economic hardship, more farm work-related stressors, greater age, and being unmarried. In multivariable logistic regression, economic hardship remained the only factor associated with depressive symptoms. Greater economic hardship, but not general farm work-related stress, is a main factor associated with depression in women of Latino farmworker families. Maternal depression can have consequences for both mothers and families. Mental health services for women in farmworker families should be targeted to those with the greatest economic challenges.

Nutritional Aspects of Depression

Directory of Open Access Journals (Sweden)

Undine E. Lang

2015-09-01

Full Text Available Several nutrition, food and dietary compounds have been suggested to be involved in the onset and maintenance of depressive disorders and in the severity of depressive symptoms. Nutritional compounds might modulate depression associated biomarkers and parallel the development of depression, obesity and diabetes. In this context, recent studies revealed new mediators of both energy homeostasis and mood changes (i.e. IGF-1, NPY, BDNF, ghrelin, leptin, CCK, GLP-1, AGE, glucose metabolism and microbiota acting in gut brain circuits. In this context several healthy foods such as olive oil, fish, fruits, vegetables, nuts, legumes, poultry, dairy and unprocessed meat have been inversely associated with depression risk and even have been postulated to improve depressive symptoms. In contrast, unhealthy western dietary patterns including the consumption of sweetened beverage, refined food, fried food, processed meat, refined grain, and high fat diary, biscuits, snacking and pastries have been shown to be associated with an increased risk of depression in longitudinal studies. However, it is always difficult to conclude a real prospective causal relationship from these mostly retrospective studies as depressed individuals might also change their eating habits secondarily to their depression. Additionally specific selected nutritional compounds, e.g. calcium, chromium, folate, PUFAs, vitamin D, B12, zinc, magnesium and D-serine have been postulated to be used as ad-on strategies in antidepressant treatment. In this context, dietary and lifestyle interventions may be a desirable, effective, pragmatical and non-stigmatizing prevention and treatment strategy for depression. At last, several medications (pioglitazone, metformin, exenatide, atorvastatin, gram-negative antibiotics, which have traditionally been used to treat metabolic disorders showed a certain potential to treat depression in first randomized controlled clinical trials.

Antidepressant Therapy in Severe Depression May Have Different Effects on Ego-Dystonic and Ego-Syntonic Suicidal Ideation

Directory of Open Access Journals (Sweden)

Louise Brådvik

2011-01-01

Full Text Available The objective of the present study was to investigate whether ego-dystonic and ego-syntonic suicidal ideation occurred at different frequencies during antidepressant therapy. A blind evaluation has been performed on records of 100 suicides with a primary severe depression and 100 matched controls, admitted to the Department of Psychiatry, Lund, Sweden. Ego-dystonic suicidal ideation was more commonly reported during adequate treatment as compared to ego-syntonic ideation (P=.004. Men who committed suicide during adequate antidepressant therapy more often reported ego-dystonic suicidal ideation earlier in their lives compared with those who were not treated (P=.0377. This may indicate that treatment failure for ego-dystonic ideation was a precursor of their suicides. Consequently, ego-dystonic ideation seems to show a poorer response to antidepressant therapy as compared to ego-syntonic ideation, which may be more directly related to depression. Ego-dystonic ideation is proposed to be related to depressive psychosis.

Stigma in Male Depression and Suicide: A Canadian Sex Comparison Study.

Science.gov (United States)

Oliffe, John L; Ogrodniczuk, John S; Gordon, Susan J; Creighton, Genevieve; Kelly, Mary T; Black, Nick; Mackenzie, Corey

2016-04-01

Stigma in men's depression and suicide can restrict help-seeking, reduce treatment compliance and deter individuals from confiding in friends and family. In this article we report sex comparison findings from a national survey of English-speaking adult Canadians about stigmatized beliefs concerning male depression and suicide. Among respondents without direct experience of depression or suicide (n = 541) more than a third endorsed the view that men with depression are unpredictable. Overall, a greater proportion of males endorsed stigmatizing views about male depression compared to female respondents. A greater proportion of female respondents endorsed items indicating that men who suicide are disconnected, lost and lonely. Male and female respondents with direct personal experience of depression or suicide (n = 360) strongly endorsed stigmatizing attitudes toward themselves and a greater proportion of male respondents indicated that they would be embarrassed about seeking help for depression.

Nocturnal Wakefulness Is Associated With Next-Day Suicidal Ideation in Major Depressive Disorder and Bipolar Disorder.

Science.gov (United States)

Ballard, Elizabeth D; Vande Voort, Jennifer L; Bernert, Rebecca A; Luckenbaugh, David A; Richards, Erica M; Niciu, Mark J; Furey, Maura L; Duncan, Wallace C; Zarate, Carlos A

2016-06-01

Self-reported sleep disturbances may confer elevated risk for suicidal ideation, suicide attempts, and death. However, limited research has evaluated polysomnographically determined sleep disturbance as an acute physiologic risk factor for suicidal thoughts. This study sought to investigate the relationship between nocturnal wakefulness in association with next-day suicidal ideation using overnight polysomnography assessment from data collected between 2006 and 2013. Sixty-five participants with DSM-IV-diagnosed major depressive disorder or bipolar depression underwent overnight polysomnography monitoring in a sleep laboratory. The Hamilton Depression Rating Scale (HDRS) was administered the morning after polysomnography recording to assess next-day suicidal ideation, severity of depressive symptoms, and subjective sleep disturbances. Using a generalized linear mixed model, a significant time-by-ideation interaction was found indicating greater nocturnal wakefulness at 4:00 am among participants with suicidal ideation (F4,136 = 3.65, P = .007). Increased time awake during the 4:00 am hour (4:00 to 4:59) was significantly associated with elevated suicidal thoughts the next day (standardized β = 0.31, P = .008). This relationship persisted after controlling for age, gender, diagnosis, and severity of depressive symptoms. Greater nocturnal wakefulness, particularly in the early morning hours, was significantly associated with next-day suicidal thoughts. Polysomnographically documented sleep disruption at specific times of night may represent an acute risk factor of suicidal ideation that warrants additional research. ClinicalTrials.gov identifier: NCT00024635. © Copyright 2016 Physicians Postgraduate Press, Inc.

Cue reactivity is associated with duration and severity of alcohol dependence: an FMRI study.

Directory of Open Access Journals (Sweden)

Zsuzsika Sjoerds

Full Text Available INTRODUCTION: With the progression of substance dependence, drug cue-related brain activation is thought to shift from motivational towards habit pathways. However, a direct association between cue-induced brain activation and dependence duration has not yet been shown. We therefore examined the relationship between alcohol cue-reactivity in the brain, cue-induced subjective craving and alcohol dependence duration and severity. Since alcohol dependence is highly comorbid with depression/anxiety, which may modulate brain responses to alcohol cues, we also examined the relation between comorbid depression/anxiety and cue-reactivity. METHODS: We compared 30 alcohol dependent patients with 15 healthy controls and 15 depression/anxiety patients during a visual alcohol cue-reactivity task using functional magnetic resonance imaging blood oxygenated level-dependent responses and subjective craving as outcomes. Within the alcohol dependent group we correlated cue-reactivity with alcohol dependence severity and duration, with cue-induced craving and with depression/anxiety levels. RESULTS: Alcohol dependent patients showed greater cue-reactivity in motivational brain pathways and stronger subjective craving than depression/anxiety patients and healthy controls. Depression/anxiety was not associated with cue-reactivity, but depression severity in alcohol dependent patients was positively associated with craving. Within alcohol dependence, longer duration of alcohol dependence was associated with stronger cue-related activation of the posterior putamen, a structure involved in habits, whereas higher alcohol dependence severity was associated with lower cue-reactivity in the anterior putamen, an area implicated in goal-directed behavior preceding habit formation. CONCLUSION: Cue-reactivity in alcohol dependence is not modulated by comorbid depression or anxiety. More importantly, the current data confirm the hypothesis of a ventral to dorsal striatal shift

Differences in depression severity and frequency of relapses in opiate addicts treated with methadone or opiate blocker after detoxification

Directory of Open Access Journals (Sweden)

Jovanović Tatjana

2012-01-01

Full Text Available Background/Aim. Relapse of opiate dependence is a common occurrence after detoxification and introduction of opiate addicts in abstinence from opiates. Clinical evaluation showed that over 90% of opiate addicts exhibit depressive manifestations during detoxification, or develop post-detoxification depression. The aim of this study was to determine differences in the frequency of relapses, severity and course of depression during a of 6-month period, and previous patterns of use of opioids in the two groups of opiate addicts treated by two different therapeutic modalities. Methods. The results of the two groups of opiate addicts were compared: the patients on substitution methadone treatment (M and the patients treated with opiate blocker naltrexone (B. In all the patients, clinical and instrumental evaluations confirmed depressive syndrome. Opioid relapses were diagnosed by the panel test for rapid detection of metabolites of opiates in urine. Then they were brought in connection with scores of depression and addiction variables. The Hamilton Depression Scale (HAMD and Zunge Depression Scale were the applied instruments for measuring the level of depression. All the subjects completed a questionnaire Pompidou (short version. Psychological measurements were carried out during a 6-month follow-up on three occasions. The presence of opiate metabolites in urine was controlled every two weeks. Results. Both groups of patients (M and B had high scores on HAMD during the study. The group on methadone had a strong depression in all three measurements. There was a drop in the level of depression in both experimental groups over time, which was accompanied by a decrease in the incidence of recurrence. In both tested groups the frequency of relapses was positively correlated with earlier addiction variables - intravenous application of opioids, the experience of overdose, the absence of immunization against hepatitis C and hepatitis C virus carriers

[Differences in depression severity and frequency of relapses in opiate addicts treated with methadone or opiate blocker after detoxification].

Science.gov (United States)

Jovanović, Tatjana; Lazarević, Dusan; Nikolić, Gordana

2012-04-01

Relapse of opiate dependence is a common occurrence after detoxification and introduction of opiate addicts in abstinence from opiates. Clinical evaluation showed that over 90% of opiate addicts exhibit depressive manifestations during detoxification, or develop post-detoxification depression. The aim of this study was to determine differences in the frequency of relapses, severity and course of depression during a of 6-month period, and previous patterns of use of opioids in the two groups of opiate addicts treated by two different therapeutic modalities. The results of the two groups of opiate addicts were compared: the patients on substitution methadone treatment (M) and the patients treated with opiate blocker naltrexone (B). In all the patients, clinical and instrumental evaluations confirmed depressive syndrome. Opioid relapses were diagnosed by the panel test for rapid detection of metabolites of opiates in urine. Then they were brought in connection with scores of depression and addiction variables. The Hamilton Depression Scale (HAMD) and Zunge Depression Scale were the applied instruments for measuring the level of depression. All the subjects completed a questionnaire Pompidou (short version). Psychological measurements were carried out during a 6-month follow-up on three occasions. The presence of opiate metabolites in urine was controlled every two weeks. Both groups of patients (M and B) had high scores on HAMD during the study. The group on methadone had a strong depression in all three measurements. There was a drop in the level of depression in both experimental groups over time, which was accompanied by a decrease in the incidence of recurrence. In both tested groups the frequency of relapses was positively correlated with earlier addiction variables - intravenous application of opioids, the experience of overdose, the absence of immunization against hepatitis C and hepatitis C virus carriers. The opioid relapse behavior is associated with a

A novel form of spontaneous tool use displayed by several captive greater vasa parrots (Coracopsis vasa).

Science.gov (United States)

Lambert, Megan L; Seed, Amanda M; Slocombe, Katie E

2015-12-01

Parrots are frequently cited for their sophisticated problem-solving abilities, but cases of habitual tool use among psittacines are scarce. We report the first evidence, to our knowledge, of tool use by greater vasa parrots (Coracopsis vasa). Several members of a captive population spontaneously adopted a novel tool-using technique by using pebbles and date pits either (i) to scrape on the inner surface of seashells, subsequently licking the resulting calcium powder from the tool, or (ii) as a wedge to break off smaller pieces of the shell for ingestion. Tool use occurred most frequently just prior to the breeding season, during which time numerous instances of tool transfer were also documented. These observations provide new insights into the tool-using capabilities of parrots and highlight the greater vasa parrot as a species of interest for studies of physical cognition. © 2015 The Author(s).

Postpartum Depression

Science.gov (United States)

... 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 ...

Telephone-based physical activity counseling for major depression in people with multiple sclerosis.

Science.gov (United States)

Bombardier, Charles H; Ehde, Dawn M; Gibbons, Laura E; Wadhwani, Roini; Sullivan, Mark D; Rosenberg, Dori E; Kraft, George H

2013-02-01

Physical activity represents a promising treatment for major depressive disorder (MDD) in people with multiple sclerosis (MS). We conducted a single-blind, two-arm randomized controlled trial comparing a 12-week physical activity counseling intervention delivered primarily by telephone (n = 44) to a wait-list control group (N = 48). Ninety-two adults with MS and MDD or dysthymia (M(age) = 48 years; 86% female, 92% White) completed an in-person baseline assessment and were randomized to wait-list control or an intervention involving motivational-interviewing-based promotion of physical activity. The treatment group received an initial in-person session; 7 telephone counseling sessions (Weeks 1, 2, 3, 4, 6, 8, and 10), and an in-person session at Week 12. The primary outcome, treatment response, was defined as those with 50% or greater reduction in the Hamilton Depression Rating Scale (HAM-D) score. Our primary hypothesis, that the proportion of responders in the treatment group would be significantly greater than in the control group, was not confirmed. However, compared with the control group, those in the treatment group evidenced significantly lower depression severity on the HAM-D, on self-reported depression, and on a measure of potential side effects and at 12 weeks were less likely to meet the criteria for MDD as set forth in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Physical activity increased significantly more in the treatment condition, though it did not mediate improvement in depression severity. Telephone-based physical activity promotion represents a promising approach to treating MDD in MS. Further research is warranted on ways to bolster the impact of the intervention and on mediators of the treatment effect.

Early Maladaptive Schemas in Depressed Women and Its Relationship with Depression

Directory of Open Access Journals (Sweden)

Hacer Bolat KONUKÇU

2013-07-01

Full Text Available Objective: Objective: Schemas are deep enduring cognitive structures that are the source of dysfunctional cognitions, emotions and behaviors, activate after critical incidents in depression. A subset of schemas called Early Maladaptive Schemas (EMS which are hyphotised to arise from early traumatic and adverse life events are also claimed to be related with not only personality disorders but also mood disorders. In this study we aimed to investigate the relationship between early maladaptive schemas and depression and relationship between schema scores and depression severity in depressed women and compare it with non-depressed controls.Methods: 40 women attending to an outpatient psychiatry clinic and 30 healthy controls participated. All participants were assessed with SCID-1. Data were obtained by using a Sociodemographic Questionnaires, Young Schema Questionnaire-Short Form 3 (YSQ and Beck Depression Inventory (BDI.Results: All except one (enmeshment/undeveloped self maladaptive schema scores of depressed women were higher than controls. BDI was correlated to some schema and schema domain scores in both depressed and control groups but the correlations were stronger in control group. Mean emotional deprivation, negativism, abandonment and instability, failure EMS scores showed the highest difference between two groups. The schema domains most related to depression symptom severity were disconnection and rejection, impaired autonomy and performance.Conclusions: Almost all early maladaptive schemas are related to depression, and some schemas are related to depression symptom severity but these correlations are weaker in control group. This may mean that EMS are stable and mood independent structures. Although other schemas are related to depression, mostly related EMS in women might be emotional deprivation schema. These schemas may also overlap with Beck’s unlovability core belief or sociotropy dimension

The comparison of severity and prevalence of major depressive disorder, general anxiety disorder and eating disorders before and after bariatric surgery.

Science.gov (United States)

Matini, Diana; Ghanbari Jolfaei, Atefeh; Pazouki, Abdolreza; Pishgahroudsari, Mohadeseh; Ehtesham, Mehdi

2014-01-01

Severe obesity is highly co-morbid with psychiatric disorders and may have effect on the quality of life. This study aimed to compare severity and prevalence rate of depression, anxiety and eating disorders and quality of life in severe obese patients before and 6 months after the gastric bypass surgery. This was a prospective observational study which conducted at Hazarat Rasool-Akram Hospital in Tehran, 2012. Questionnaires included demographic questions, eating disorder Inventory (EDI), The Short Form Health Survey (SF-36) for quality of life, Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I) and Hamilton Rating Scale for Depression (HRSD) and anxiety (HRSA). Participants were interviewed two times, before surgery and six months after, to determine changes of the disorders. Patients with the history of bariatric surgery, individuals younger than 18 year old and those who disagreed to join the study were excluded. In assessing the eating disorder inventory-3rd version (EDI-3), Significant reduction in drive for thinness (DT) (p= 0.010), bulimia (B) (pdepression in HRSD (p= 0.311), prevalence of depression (p= 0.189) and prevalence of general anxiety disorder according to SCID (p=0.167) did not differ significantly, at this period. Although weight loss after bariatric surgery improved the physical component of quality of life, this improvement did not affect the mental aspect of life, depression and anxiety and it seems that these psychopathologies need attention and treatment in addition to weight loss treatments in patients with obesity.

Regional brain volumes, diffusivity, and metabolite changes after electroconvulsive therapy for severe depression

DEFF Research Database (Denmark)

Jørgensen, A.; Magnusson, P.; Hanson, Lars G.

2016-01-01

, and metabolite changes in 19 patients receiving ECT for severe depression. Other regions of interest included the amygdala, dorsolateral prefrontal cortex (DLPFC), orbitofrontal cortex, and hypothalamus. Patients received a 3T MR scan before ECT (TP1), 1 week (TP2), and 4 weeks (TP3) after ECT. Results......: Hippocampal and amygdala volume increased significantly at TP2 and continued to be increased at TP3. DLPFC exhibited a transient volume reduction at TP2. DTI revealed a reduced anisotropy and diffusivity of the hippocampus at TP2. We found no significant post-ECT changes in brain metabolite concentrations...

One year follow-up of post-partum-onset depression: the role of depressive symptom severity and personality disorders.

Science.gov (United States)

Uguz, Faruk; Akman, Cemal; Sahingoz, Mine; Kaya, Nazmiye; Kucur, Rahim

2009-06-01

Long-term follow-up and risk factors of persistent post-partum depression (PPD) are fairly unknown compared with its prevalence in the developing countries. In this study, we did a follow-up measure of PPD and examined the factors, which were associated with PPD 1-year post-partum. Our sample comprised of 34 women. Depressive symptoms were assessed by the Edinburgh post-natal depression scale (EPDS) 6 weeks post-partum, and women with scores >12 on this scale was categorised as depressed. Personality disorders were determined at the same occasion by means of the Structured Clinical Interview for DSM-III-R personality disorders (SCID-II). One year post-partum EPDS was completed. The rate of PPD 1-year post-partum was 32.4%, and it was unrelated to age at assessment, primiparity, number of children, employment status, economical status and educational level. Women depressed 1-year post-partum had significantly higher basal scores of EPDS and more often also a diagnosis of any axis II disorder; and specifically dependent and obsessive-compulsive personality disorders. In our sample, the predictors of 1-year post-partum PPD were having higher basal score of EPDS and the existence of a personality disorder. This study suggests that women with PPD, scoring high in the EPDS scale 6 weeks post-partum and having a personality disorder, run a higher risk for depression at 1-year follow-up.

Nutritional aspects of depression.

Science.gov (United States)

Lang, Undine E; Beglinger, Christoph; Schweinfurth, Nina; Walter, Marc; Borgwardt, Stefan

2015-01-01

Several nutrition, food and dietary compounds have been suggested to be involved in the onset and maintenance of depressive disorders and in the severity of depressive symptoms. Nutritional compounds might modulate depression associated biomarkers and parallel the development of depression, obesity and diabetes. In this context, recent studies revealed new mediators of both energy homeostasis and mood changes (i.e. IGF-1, NPY, BDNF, ghrelin, leptin, CCK, GLP-1, AGE, glucose metabolism and microbiota) acting in gut brain circuits. In this context several healthy foods such as olive oil, fish, fruits, vegetables, nuts, legumes, poultry, dairy and unprocessed meat have been inversely associated with depression risk and even have been postulated to improve depressive symptoms. In contrast, unhealthy western dietary patterns including the consumption of sweetened beverage, refined food, fried food, processed meat, refined grain, and high fat diary, biscuits, snacking and pastries have been shown to be associated with an increased risk of depression in longitudinal studies. However, it is always difficult to conclude a real prospective causal relationship from these mostly retrospective studies as depressed individuals might also change their eating habits secondarily to their depression. Additionally specific selected nutritional compounds, e.g. calcium, chromium, folate, PUFAs, vitamin D, B12, zinc, magnesium and D-serine have been postulated to be used as ad-on strategies in antidepressant treatment. In this context, dietary and lifestyle interventions may be a desirable, effective, pragmatical and non-stigmatizing prevention and treatment strategy for depression. At last, several medications (pioglitazone, metformin, exenatide, atorvastatin, gram-negative antibiotics), which have traditionally been used to treat metabolic disorders showed a certain potential to treat depression in first randomized controlled clinical trials. © 2015 The Author(s) Published by S

Evaluation of depressive symptoms and sleep alterations in college students.

Science.gov (United States)

Moo-Estrella, Jesús; Pérez-Benítez, Hugo; Solís-Rodríguez, Francisco; Arankowsky-Sandoval, Gloria

2005-01-01

Increasing evidence suggests that sleep alterations could favor subsequent depression development. In order to identify the simultaneous occurrence of these parameters in young people, in this work we evaluated the prevalence of depressive symptoms, sleep habits, and possible sleep disturbances in college students. Beck Depression Inventory (BDI), Epworth Sleepiness Scale (ESS), and a Sleep Habits Questionnaire were applied to students registered at the Autonomous University of Yucatan, Merida (mean age 20.2 +/- 2.6 years). The final sample was composed of 340 (53%) women and 298 (47%) men. Reliability of the BDI and ESS was assessed by Cronbach's alpha method. Taking 10 as ESS cut-off point, it was found that 31.6% of the students had a high level of sleepiness. Students with depressive symptoms had a greater number of days with somnolence during class (p students without symptoms. In comparison to subjects without depressive symptoms, students with those symptoms rated their sleep quality as poor (p sleep after going to bed (p sleep alterations in a large proportion of the studied subjects, which were more severe in those who showed depressive symptoms. Educating students for appropriate sleep hygiene and encouraging them to seek professional advice to treat sleep disturbances may be useful to prevent depression.

A Subgroup Analysis of the Impact of Vortioxetine on Functional Capacity, as Measured by UPSA, in Patients with Major Depressive Disorder and Subjective Cognitive Dysfunction.

Science.gov (United States)

Keefe, Richard S E; Nomikos, George; Zhong, Wei; Christensen, Michael Cronquist; Jacobson, William

2018-05-01

We evaluated vortioxetine's effects on functional capacity in demographic and clinical subgroups of patients with major depressive disorder. This was an exploratory analysis of the CONNECT study (NCT01564862) that evaluated changes in functional capacity using University of California San Diego Performance-based Skills Assessment data, categorized by sex, age, education, employment status, and baseline disease severity (Montgomery-Åsberg Depression Rating Scale, Clinical Global Impressions-Severity of Illness). Greater changes in University of California San Diego Performance-based Skills Assessment composite scores were observed with vortioxetine vs placebo in specific subgroups: males (∆+3.2), females (∆+2.9), 45-54 or ≥55 years (∆+5.6, ∆+3.4), working (∆+2.8), high school or greater education (∆+2.7, ∆+2.8), disease severity (Montgomery-Åsberg Depression Rating Scale, 4, ∆+3.0), major depressive episodes (≤2, >2 [∆+2.7,+3.3]), and episode duration (≤22, >22 weeks [∆+3.7,+2.4]). Our findings support the need for additional studies to assess whether vortioxetine improves functional capacity within specific patient subgroups. clinicaltrials.gov: NCT01564862.

Depression, women, and the workplace.

Science.gov (United States)

Wollersheim, J P

1993-01-01

Depression is a highly prevalent disorder that causes much personal distress and difficulties in functioning at home and in the workplace. In the workplace, as elsewhere, depression can manifest as a variation in normal mood, as a symptom, as a disorder, or as a disease. Occupational health professionals are more concerned with clinical depression, a term used to signify any type of depression that causes significant personal distress and/or problems in functioning. Clinical depression is manifest in the workplace and adversely affects the employee's work satisfaction and performance. For most types of depression, women are at a higher risk than men. A number of events and variables related to women and depression were reviewed. Although the effects of some of these events, such as menopause, can be manifest in the workplace, they are not associated with an increased incidence of clinical depression. Other events, such as victimization (e.g., childhood sexual abuse or battering by an intimate partner), are associated with higher risks of depression in women. Women derive substantial satisfaction from interpersonal relationships but also are at greater risk for depression when strains and conflicts in these relationships occur. In the workplace women who have no difficulty in arranging for child care and whose spouses share in the care of children show lower rates of depression. When marriages are unhappy, women are three times as likely as men to be depressed. These findings speak to the importance of relationships to women. In the workplace, when women are depressed, problems with relationships are likely to be involved. Clinically depressed women are not difficult to identify in work settings. Dejected mood and loss of interest in usual activities are noticeable, along with numerous other symptoms that accompany depression. The effective treatment of depression depends on careful diagnosis and assessment. Both drug therapy and the more structured psychotherapies

Depressive symptoms and hazardous/harmful alcohol use are prevalent and correlate with stigma among TB-HIV patients in Lesotho.

Science.gov (United States)

Hayes-Larson, E; Hirsch-Moverman, Y; Saito, S; Frederix, K; Pitt, B; Maama-Maime, L; Howard, A A

2017-11-01

Limited data exist on the prevalence and correlates, including stigma, of mental health conditions, including depressive symptoms and alcohol use, among patients co-infected with tuberculosis (TB) and the human immunodeficiency virus (HIV) in sub-Saharan Africa, despite their negative impact on health outcomes. To assess the prevalence and correlates of depressive symptoms and hazardous/harmful alcohol use among TB-HIV patients in the Start TB patients on ART and Retain on Treatment (START) study. START, a mixed-methods cluster-randomized trial, evaluated a combination intervention package vs. standard of care (SOC) to improve treatment outcomes in TB-HIV co-infected patients in Lesotho. Moderate/severe depressive symptoms and hazardous/harmful alcohol use were measured using baseline questionnaire data collected from April 2013 to March 2015. Demographic, psychosocial, and TB- and HIV-related knowledge and attitudes, including stigma, were assessed for association with both conditions using generalized linear mixed models. Among 371 participants, 29.8% reported moderate/severe depressive symptoms, and 24.7% reported hazardous/harmful alcohol use; 7% reported both. Depressive symptoms were significantly associated with less education, more difficulty understanding written medical information, non-disclosure of TB, greater TB stigma, and the SOC study arm. Hazardous/harmful alcohol use was significantly associated with male sex, as well as greater TB and external HIV stigma. Prevalence of depressive symptoms and hazardous/harmful alcohol use were high, suggesting a need for routine screening for, and treatment of, mental health disorders in TB-HIV patients.

Associations Between Pain, Current Tobacco Smoking, Depression, and Fibromyalgia Status Among Treatment-Seeking Chronic Pain Patients.

Science.gov (United States)

Goesling, Jenna; Brummett, Chad M; Meraj, Taha S; Moser, Stephanie E; Hassett, Afton L; Ditre, Joseph W

2015-07-01

As smoking impacts physiological pathways in the central nervous system, it is important to consider the association between smoking and fibromyalgia, a pain condition caused predominantly by central nervous system dysfunction. The objectives were to assess the prevalence of current smoking among treatment-seeking chronic pain patients with (FM+) and without (FM-) a fibromyalgia-like phenotype; test the individual and combined influence of smoking and fibromyalgia on pain severity and interference; and examine depression as a mediator of these processes. Questionnaire data from 1566 patients evaluated for a range of conditions at an outpatient pain clinic were used. The 2011 Survey Criteria for Fibromyalgia were used to assess the presence of symptoms associated with fibromyalgia. Current smoking was reported by 38.7% of FM+ patients compared to 24.7% of FM- patients. FM+ smokers reported higher pain and greater interference compared to FM+ nonsmokers, FM- smokers, and FM- nonsmokers. There was no interaction between smoking and fibromyalgia. Significant indirect effects of fibromyalgia and smoking via greater depression were observed for pain severity and interference. Current smoking and positive fibromyalgia status were associated with greater pain and impairment among chronic pain patients, possibly as a function of depression. Although FM+ smokers report the most negative clinical symptomatology (i.e., high pain, greater interference) smoking does not appear to have a unique association with pain or functioning in FM+ patients, rather the effect is additive. The 38.7% smoking rate in FM+ patients is high, suggesting FM+ smokers present a significant clinical challenge. © 2015 American Academy of Pain Medicine.

Postpartum depression, suicidality, and mother-infant interactions.

Science.gov (United States)

Paris, Ruth; Bolton, Rendelle E; Weinberg, M Katherine

2009-10-01

To date, few studies have examined suicidality in women with postpartum depression. Reports of suicidal ideation in postpartum women have varied (Lindahl et al. Arch Womens Ment Health 8:77-87, 2005), and no known studies have examined the relationship between suicidality and mother-infant interactions. This study utilizes baseline data from a multi-method evaluation of a home-based psychotherapy for women with postpartum depression and their infants to examine the phenomenon of suicidality and its relationship to maternal mood, perceptions, and mother-infant interactions. Overall, women in this clinical sample (n = 32) had wide ranging levels of suicidal thinking. When divided into low and high groups, the mothers with high suicidality experienced greater mood disturbances, cognitive distortions, and severity of postpartum symptomotology. They also had lower maternal self-esteem, more negative perceptions of the mother-infant relationship, and greater parenting stress. During observer-rated mother-infant interactions, women with high suicidality were less sensitive and responsive to their infants' cues, and their infants demonstrated less positive affect and involvement with their mothers. Implications for clinical practice and future research directions are discussed.

Is the beck anxiety inventory a good tool to assess the severity of anxiety? A primary care study in The Netherlands study of depression and anxiety (NESDA

Directory of Open Access Journals (Sweden)

van der Feltz-Cornelis Christina M

2011-07-01

Full Text Available Abstract Background Appropriate management of anxiety disorders in primary care requires clinical assessment and monitoring of the severity of the anxiety. This study focuses on the Beck Anxiety Inventory (BAI as a severity indicator for anxiety in primary care patients with different anxiety disorders (social phobia, panic disorder with or without agoraphobia, agoraphobia or generalized anxiety disorder, depressive disorders or no disorder (controls. Methods Participants were 1601 primary care patients participating in the Netherlands Study of Depression and Anxiety (NESDA. Regression analyses were used to compare the mean BAI scores of the different diagnostic groups and to correct for age and gender. Results Patients with any anxiety disorder had a significantly higher mean score than the controls. A significantly higher score was found for patients with panic disorder and agoraphobia compared to patients with agoraphobia only or social phobia only. BAI scores in patients with an anxiety disorder with a co-morbid anxiety disorder and in patients with an anxiety disorder with a co-morbid depressive disorder were significantly higher than BAI scores in patients with an anxiety disorder alone or patients with a depressive disorder alone. Depressed and anxious patients did not differ significantly in their mean scores. Conclusions The results suggest that the BAI may be used as a severity indicator of anxiety in primary care patients with different anxiety disorders. However, because the instrument seems to reflect the severity of depression as well, it is not a suitable instrument to discriminate between anxiety and depression in a primary care population.

Psychiatric Comorbidity in Depressed HIV-infected Individuals: Common and Clinically Consequential

Science.gov (United States)

Gaynes, Bradley N.; O'Donnell, Julie; Nelson, Elise; Heine, Amy; Zinski, Anne; Edwards, Malaika; McGuinness, Teena; Riddhi, Modi A.; Montgomery, Charita; Pence, Brian W

2015-01-01

Objective To report on the prevalence of psychiatric comorbidity and its association with illness severity in depressed HIV patients. Methods As part of a multi-site randomized controlled trial of depression treatment for HIV patients, 304 participants meeting criteria for current Major Depressive Disorder (MDD) were assessed for other mood, anxiety and substance use disorders with the Mini-International Neuropsychiatric Interview, a structured psychiatric diagnostic interview. We also assessed baseline adherence, risk, and health measures. Results Complicated depressive illness was common. Only 18% of participants experienced MDD with no comorbid psychiatric diagnoses; 49% had comorbid dysthymia, 62% had ≥1 comorbid anxiety disorder, and 28% had a comorbid substance use disorder. Self-reported antiretroviral adherence did not differ by the presence of psychiatric comorbidity. However, psychiatric comorbidity was associated with worse physical health and functioning: compared to those with MDD alone, individuals with ≥1 comorbidity reported more HIV symptoms (5.1 vs. 4.1, p-value=0.01), and worse mental health-related quality of life on the SF-12 (29 vs. 35, p<0.01). Conclusion For HIV patients with MDD, chronic depression and psychiatric comorbidity are strikingly common, and this complexity is associated with greater HIV disease severity and worse quality of life. Appreciating this comorbidity can help clinicians better target those at risk of harder-to-treat HIV disease, and underscores the challenge of treating depression in this population. PMID:25892152

One-day behavioral intervention in depressed migraine patients: effects on headache.

Science.gov (United States)

Dindo, Lilian; Recober, Ana; Marchman, James; O'Hara, Michael W; Turvey, Carolyn

2014-03-01

To determine whether a 1-day behavioral intervention, aimed at enhancing psychological flexibility, improves headache outcomes of migraine patients with comorbid depression. Migraine is often comorbid with depression, with each disorder increasing the risk for onset and exacerbation of the other. Managing psychological triggers, such as stress and depression, may result in greater success of headache management. Sixty patients with comorbid migraine and depression were assigned to a 1-day Acceptance and Commitment Training plus Migraine Education workshop (ACT-ED; N = 38) or to treatment as usual (TAU; N = 22). Patients completed a daily headache diary prior to, and for 3 months following, the intervention. Clinical variables examined included headache frequency/severity, medication use, disability, and visit to a health care professional. Comparisons were made between baseline findings and findings at the 3-month follow up. Participants assigned to the ACT-ED condition exhibited significant improvements in headache frequency, headache severity, medication use, and headache-related disability. In contrast, the TAU group did not exhibit improvements. The difference in headache outcomes between ACT-ED and TAU was not statistically significant over time (ie, the treatment by time interaction was nonsignificant). These results complement those of a previous report showing effects of ACT-ED vs TAU on depression and disability. A 1-day ACT-ED workshop targeting psychological flexibility may convey benefit for patients with comorbid migraine and depression.These pilot study findings merit further investigation using a more rigorously designed large-scale trial.