Mapping prodromal symptoms in patients with bipolar disorder: A network perspective

Bipolar disorder (BD) is a major mental disorder that significantly impairs behavior and social functioning. This study assessed the network structure of prodromal symptoms in patients with BD prior to their index mood episode. Semi-structured interviews were conducted with the Bipolar Prodrome Symptom Scale-Retrospective (BPSS-R) to examine patients' prodromal symptoms. Network analysis was conducted to elucidate inter-relations between prodromal symptoms. A total of 120 eligible patients participated in this study. Network analysis indicated that the observed model was stable. The edge Mania3-Depression9 ('Racing thoughts' - 'Thinking about suicide', edge weight = 14.919) showed the strongest positive connection in the model, followed by the edge Mania1-depression1 ('Extremely energetic/active' - 'Depressed mood', edge weight = 14.643). The only negative correlation in the model was for Mania7-depression2 ('Overly self-confident' - 'Tiredness or lack of energy', edge weight = -1.068). Nodes Mania3 ('Racing thoughts'), Depression9 ('Thinking about suicide'), Mania1 ('Extremely energetic/active'), and Depression1 ('Depressed mood') were the most central symptoms. Both depressive and manic or hypomanic symptoms appeared in the prodromal phase. Symptoms reflecting 'Racing thoughts', 'Thinking about suicide', 'Extremely energetic/active', and 'Depressed mood' should be thoroughly assessed and targeted as crucial prodromal symptoms in interventions to reduce the risk of BD episodes.

New curcumin-loaded nanocapsules as a therapeutic alternative in an amnesia model

This study aimed to investigate the action of two different formulations of curcumin (Cur)-loaded nanocapsules (Nc) (Eudragit [EUD] and poly (ɛ-caprolactone) [PCL]) in an amnesia mice model. We also investigated the formulations' effects on scopolamine-induced (SCO) depressive- and anxiety-like comorbidities, the cholinergic system, oxidative parameters, and inflammatory markers. Male Swiss mice were randomly divided into five groups (n = 8): group I (control), group II (Cur PCL Nc 10 mg/kg), group III (Cur EUD Nc 10 mg/kg), group IV (free Cur 10 mg/kg), and group V (SCO). Treatments with Nc or Cur (free) were performed daily or on alternate days. After 30 min of treatment, the animals received the SCO and were subjected to behavioral tests 30 min later (Barnes maze, open-field, object recognition, elevated plus maze, tail suspension tests, and step-down inhibitory avoidance tasks). The animals were then euthanized and tissue was removed for biochemical assays. Our results demonstrated that Cur treatment (Nc or free) protected against SCO-induced amnesia and depressive-like behavior. The ex vivo assays revealed lower acetylcholinesterase (AChE) and catalase (CAT) activity, reduced thiobarbituric species (TBARS), reactive species (RS), and non-protein thiols (NSPH) levels, and reduced interleukin-6 (IL-6) and tumor necrosis factor (TNF) expression. The treatments did not change hepatic markers in the plasma of mice. After treatments on alternate days, Cur Nc had a more significant effect than the free Cur protocol, implying that Cur may have prolonged action in Nc. This finding supports the concept that it is possible to achieve beneficial effects in nanoformulations, and treatment on alternate days differs from the free Cur protocol regarding anti-amnesic effects in mice.

Relationship between composite dietary antioxidant index and depression among overweight and obese adults

BACKGROUND

The use of specific dietary patterns to alleviate depressive symptoms has gained increasing recognition. The Composite Dietary Antioxidant Index (CDAI) is a crucial criterion for assessing antioxidant diets. We examined the relationship between CDAI and depression among overweight and obese adults through a cross-sectional study conducted in the United States.

METHODS

We used weighted multivariate logistic regression models with subgroup analysis to study the relationship between CDAI and depression. Generalized additive models were used to determine whether there was a nonlinear association between them. We developed a two-piece linear regression model to calculate the inflection point utilizing a recursive strategy.

RESULTS

After adjusting for confounding variables, the odds ratios (ORs; 95 % CI) for the correlation between CDAI and depression were 0.75 (0.67, 0.84). A saturation effect emerged for the overweight group, following which we calculated the inflection point for the overweight population, which displayed ORs (95 % CI) of 0.62 (0.47, 0.80) before the inflection point of 0.83 and the ORs (95 % CI) of 1.01 (0.77, 1.31) after 0.83. The interaction was statistically significant in the sex stratification of the obese population.

CONCLUSIONS

Our study highlighted a negative association between CDAI and depression among overweight and obese adults. Saturation effects and sex differences were observed in the overweight population.

Social determinants of health and gender differences in depression among adults: A cohort study

The role of social determinants of health (SDoH) in gender differences in depression remains unclear among Chinese adults. We aimed to explore the association between SDoH and depression and investigate their role in explaining gender differences in depression. This prospective longitudinal cohort study used four wave surveys (2012, 2016, 2018, and 2020) of the China Family Panel Study (CFPS). Fourteen SDoH variables were assessed, and depression was measured using the 8-item short version of the Center for Epidemiologic Studies Depression Scale. The Cox proportional hazards regression and multiple mediation analysis were performed to estimate the effect sizes. The longitudinal sample included 18,874 participants aged 18-92 years (51.4 % males and 48.6 % females). Women had higher risk of depression than men. Unfavorable SDoH were associated with higher risk of depression. After including multiple SDoH in mediation analysis, multiple SDoH mediated 15.7 % of the total effect of gender on depression. In sum, SDoH significantly influenced depression, and specific factors explained gender differences in depression. Supporting women in education, employment, and community involvement could help reduce gender differences in depression.

Lifestyle in bipolar disorder: A cross-sectional study

BACKGROUND

Modifiable lifestyle behaviors are important factors for improving mental health, yet there has been a lack of research studying lifestyle as a multidimensional construct in bipolar disorder (BD). The aim of this cross-sectional study was to compare the lifestyle patterns of individuals with BD in a current mood episode with healthy controls (HCs) using the Short Multidimensional Inventory Lifestyle Evaluation (SMILE).

MATERIALS AND METHODS

The sample consisted of 46 individuals with BD currently experiencing a depressive or manic episode and 50 HC, assessed using the MINI International Neuropsychiatric Interview, Montgomery-Åsberg Depression Rating Scale (MADRS), and the Young Mania Rating Scale (YMRS). The SMILE scale assesses lifestyle across seven domains: diet and nutrition, substance abuse, physical activity, stress management, restorative sleep, social support, and environmental exposures. Between-groups comparisons were performed based on the presence of a psychiatric diagnosis and the type of BD episode.

RESULTS

We found significant differences in the total SMILE score (r=0.75, p<0.001) and in scores from each domain of the scale between BD and HC (p<0.05), where individuals with BD in a depressive or manic episode with or without mixed features reported worse lifestyle across all domains. Differences between individuals with BD in different mood episodes across domains on the SMILE scale were non-significant.

CONCLUSION

Findings from this study highlight the presence of unhealthy lifestyle patterns in people with BD regardless of the polarity of their mood episode. Implementation of multidimensional lifestyle assessments is an essential step toward detecting the clustering of unhealthy lifestyle patterns in BD.

Identification of novel biomarkers linking depressive disorder and Alzheimer's disease based on an integrative bioinformatics analysis

BACKGROUND

Previous reports revealed that a history of major depressive disorder (MDD) increased the risk of Alzheimer's disease (AD). The immune disorder is associated with MDD and AD pathophysiology. We aimed to identify differentially expressed immune-related genes (DEIRGs) that are involved in the pathogenesis of MDD and AD.

METHODS

We downloaded mRNA expression profiles (GSE76826 and GSE5281) from the Gene Expression Omnibus (GEO) database. The R software was used to identify DEIRGs for the two diseases separately. Functional enrichment analysis and PPI network of DEIRGs were performed. Finally, the relationship between shared DEIRGs and immune infiltrates of AD and MDD were analyzed, respectively.

RESULTS

A total of 121 DEIRGs linking AD and MDD were identified. These genes were significantly enriched in immune-related pathways, such as the JAK-STAT signaling pathway, regulation of chemotaxis, chemotaxis, cytokine-cytokine receptor interaction, and primary immunodeficiency. Furthermore, three shared DEIRGs (IL1R1, CHGB, and NRG1) were identified. Correlation analysis between DEIRGs and immune cells revealed that IL1R1 and NRG1 had a negative or positive correlation with some immune cells both in AD and MDD.

CONCLUSION

Both DEIRGs and immune cell infiltrations play a vital role in the pathogenesis of AD and MDD. Our findings indicated that there are common genes and biological processes between MDD and AD, which provides a theoretical basis for the study of the comorbidity of MDD and AD.

Altered gut bacterial-fungal interkingdom networks in children and adolescents with depression

BACKGROUND

Most studies of the gut-brain axis have focused on bacteria; little is known about commensal fungi. Children and adolescents with depression were reported to have gut bacterial microbiota dysbiosis, but the role of the mycobiota has not been evaluated.

METHODS

Faecal samples were obtained from 145 children and adolescents with depression and 110 age- and gender-matched healthy controls. We analysed the fungal microbiota, including in terms of their associations with the gut microbiota, and subjected the internal transcribed spacer 2 (ITS2) rRNA gene to mitochondrial sequencing.

RESULTS

Our findings revealed unaltered fungal diversity, but altered taxonomic composition, of the faecal fungal microbiota in the children and adolescents with depression. Key fungi such as Saccharomyces and Apiotrichum were enriched in the depressed patients, while Aspergillus and Xeromyces showed significantly decreased abundance. Interestingly, the bacterial-fungal interkingdom network was markedly altered in the children and adolescents with depression, and mycobiome profiles were associated with different bacterial microbiomes.

LIMITATION

The cross-sectional design precluded the establishment of a causal relationship between the gut mycobiota and the children and adolescents with depression.

CONCLUSIONS

The gut mycobiome is altered in the children and adolescents with depression. Our findings suggest that fungi play an important role in the balance of the gut microbiota and may help identify novel therapeutic targets for depression.

Blocking osteopontin expression attenuates neuroinflammation and mitigates LPS-induced depressive-like behavior in mice

INTRODUCTION

Neuroinflammation plays an important role in the development of major depressive disorder (MDD). Osteopontin (OPN) is one of the key molecules involved in neuroinflammation. We demonstrate here for the first time a key role of OPN in lipopolysaccharide (LPS)-induced depressive-like behavioral syndrome.

METHODS

Systemic administration of LPS (5 mg/kg) mimics distinct depressive-like behavior, which could significantly upregulate OPN expression in microglia/macrophage in the hippocampus. The neurobehavioral assessments, quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR), Western blot, immunofluorescent staining, flow cytometry cell staining and Golgi staining were performed.

RESULTS

Similar to fluoxetine treatment (the positive control), OPN knockdown with shRNA lentivirus markedly reversed LPS-induced depressive-like behavior. Moreover, knockdown of OPN suppressed LPS-induced proinflammatory cytokine expression, microglial activation, dendritic spines loss, as well as unregulated PSD-95 and BDNF in the hippocampus.

CONCLUSION

We demonstrated that targeting OPN expression in microglia/macrophage might help to rescue LPS-induced depressive-like behavior. The underlying mechanism may relate to the modulation of neuroinflammation, BDNF signaling and synaptic structural complexity.

Altered neural correlates of optimal decision-making in individuals with depressive status

Making optimal decisions by computing risk and benefit is necessary for humans. However, whether individuals with depressive status could utilize the optimal strategy to guide decision and its neural correlates remain unclear. The current study explored these issues by combining a decision task and high temporal-resolution electroencephalogram (EEG). The decision task involved an eight-box trial in which participants successively decided whether to open a box containing a potential reward or punishment, deciding to stop guaranteed they would retain the rewards already accumulated. Theoretically, the optimal strategy in the task was to stop at the fourth box, which had the largest expected value. We found that individuals with depressive status stopped fewer trials at the fourth box, relative to healthy controls, indicating their impaired optimal strategy during decision-making. Moreover, compared to healthy controls, individuals with depressive status showed weaker P2 amplitude and weaker beta-band oscillation at the frontocentral scalp when deciding whether to open the fourth box. Additionally, for healthy controls but not for individuals with depressive status, the P2 amplitude fully mediated the relationship between participants' degree of expected benefit (as reflected by the recreational risk-taking scale) and the frequency of trials stopped at the fourth box. Overall, this study revealed that the P2 amplitude and beta-band oscillation might explain the altered optimal decision-making in individuals with depressive status.

The course of psychiatric symptoms in older age bipolar disorder during the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic gives us the unique opportunity to study the course of psychiatric symptoms and resilience in older adults with bipolar disorder (OABD) whilst experiencing a collective long lasting stressor. The aim of this study was to investigate the course of depressive, manic and anxiety symptoms in OABD during the first six months of COVID-19 and how loneliness and mastery are associated with this course. Mastery is defined as the control one experiences over one's life and environment. Resilience is defined as adaptation to challenging life conditions encompassing several aspects of personal resources.

METHODS

In April 2020 (n = 81), June 2020 (n = 66) and September 2020 (n = 51), participants were included from the Dutch Older Bipolars (DOBi) cohort study.

RESULTS

Depressive, manic and anxiety symptoms increased over all timepoints. Participants with a higher sense of mastery experienced a greater increase in depressive and anxiety symptoms. Loneliness did not interact with the course of these symptoms.

CONCLUSIONS

OABD were resilient in the first months of COVID-19 outbreak, however depressive, manic and anxiety symptoms increased as the pandemic continued. Treatment strategies in coping with long lasting stressful events should include the focus on sense of mastery.

Gut microbiota is associated with weight gain in children treated with atypical antipsychotic: A pilot longitudinal study

We studied longitudinal changes in the microbiome with weight gain during atypical antipsychotics (APs) treatment. 43 inpatients naive to AP paediatric medication were included in the longitudinal microbiota study. The baseline composition of the gut microbiome in the case group was characterised by an increase in Parabacteroides and Eubacterium_hallii_group. During the follow-up, the relative abundances of Romboutsia and Klebsiella increased significantly after 3 months of AP treatment; however, no significant changes in these two gut bacteria were observed in the control group. The baseline composition of the gut microbiome contributed to the risk of AP-associated weight gain.

Six-year changes of posttraumatic stress symptoms and depressive symptoms among Chinese earthquake survivors: A network analysis

BACKGROUND

The risk factors of Posttraumatic Stress Symptoms (PTSS) and depressive symptoms have been well-established, but whether the network structure of their symptoms changes over time remains unclear. This study aims to examine the six-year changes of network structure of PTSS and depressive symptoms among Wenchuan earthquake adult survivors in China.

METHODS

In this pooled cross-sectional study, respondents were sampled from the same population at each of the five waves (N = 1343, 1205, 1177, 1376, and 1339). The network structure of them was investigated using network analyses.

RESULTS

The study shows network connections stable across waves were the positive connections between hyperarousal and intrusions, hyperarousal and somatic symptoms, and two dimensions of positive effects. Stable negative connections were those between depressed affects and positive effects, avoidance and depressed affects, avoidance with interpersonal symptoms and avoidance with somatic symptoms. Across waves, fearful emotion consistently was the strongest bridge symptom connecting with PTSS symptoms. However, for PTSS the strongest bridge symptom varied across time as it was avoidance in wave 1 but were hyperarousal in other four waves.

LIMITATIONS

This study was based on a pooled cross-sectional survey, which inhibits conclusions regarding causal influences between symptoms at the individual patient level.

CONCLUSIONS

The network structure of PTSS and depressive symptoms was partly stable, yet also varied across survey waves. Core symptom clusters for PTSS and depressive symptoms were avoidance and depressed affect, respectively. The central role of these clusters in PTSS and depressive symptoms has important implications to future psychiatric programs.

Fecal microbiota in pediatric depression and its relation to bowel habits

Although gut microbiota dysbiosis has been observed in the fecal samples of depressive adult patients, the detailed structure and composition of microbiota in pediatric depression remain unclear. To enhance our understanding of gut microbiota structure in depressive children, as well as the relationship between gut microbiota and bowel habits, we performed 16S rRNA sequencing to evaluate the gut microbial population in a cohort of 171 children (101 depressive patients and 70 controls) aged 12-18 years. Further analysis consisting of 30 drug-naive patients and 23 controls was performed to validate the results. Compared to controls, we found markedly decreased microbial richness and diversity, a distinct metagenomic composition with reduced short-chain fatty acid-producing bacteria (associated with healthy status), and overgrowth of bacteria such as Escherichia-Shigella and Flavonifractor in pediatric depression. Further analyses limited to drug-naive patients found similar results. Notably, we also observed that several taxa may be involved in the pathogenesis of disordered bowel habits in pediatric depression. Our findings suggest could inform future pediatric depression interventions specifically targeting the bacteria associated with bowel movements.

Comparing Mentalizing Abilities in Older Adults with and without Common Mental Disorders

INTRODUCTION

The concept of mentalization is of central importance not only in modern psychotherapy but also in geriatric psychotherapy. In relation to older people, deficits in some aspects of the ability to mentalize, such as the theory of mind (ToM), affect perception, and metacognitive skills, are known. However, little is known about the mentalization ability of older people with mental disorders. The aim of the present study was to investigate the mentalizing abilities of older patients with depressive and anxious symptoms.

METHODS

In this study, the ability to mentalize using the Mentalization Questionnaire (MZQ), the HEALTH-49 questionnaire, Trail-Making Test (executive functions), and Reading-the-Mind-in-the-eyes-test (ToM) was studied in a clinical (n = 150) and a nonclinical comparison sample of people (n = 150) in different age groups (40-54, 55-69, ≥70). The evaluation of the data was conducted with different statistical methods, especially variance and regression analyses.

RESULTS

The clinical sample of all age groups showed significantly poorer mentalizing skills than the nonclinical samples. There were large correlations to health-related aspects. Additionally, in the regression analysis, only the setting variable (clinical vs. nonclinical) had an influence on the MZQ score and neither gender, education, executive functions nor ToM had a significant influence. Age also had no effect and did not correlate with MZQ scores but did correlate negatively with ToM.

CONCLUSIONS

The results show the importance of mentalization concepts for mental disorders in patients in the second half of life. There are indications of an imbalance of different aspects of mentalizing ability, especially between self- and other-related mentalizing abilities. Improving this balance could be a goal of therapeutic interventions.

Eating, sleeping and moving recommendations in clinical practice guidelines for paediatric depression: umbrella review

BACKGROUND

Current first-line treatments for paediatric depression demonstrate mild-to-moderate effectiveness. This has spurred a growing body of literature on lifestyle recommendations pertaining to nutrition, sleep and exercise for treating paediatric depression.

AIMS

Paediatric depression clinical practice guidelines (CPGs) were reviewed for quality and to catalogue recommendations on nutrition, sleep and exercise made by higher-quality CPGs.

METHOD

Searches were conducted in Medline, EMBASE, PsycINFO, Web of Science and CINAHL, and grey literature CPGs databases for relevant CPGs. Eligible CPGs with a minimum or high-quality level, as determined by the Appraisal of Guidelines for Research and Evaluation, Second Edition instrument, were included if they were (a) paediatric; (b) CPGs, practice parameter or consensus or expert committee recommendations; (c) for depression; (d) the latest version and (e) lifestyle recommendations for nutrition, sleep or exercise. Key information extracted included author(s), language, year of publication, country, the institutional body issuing the CPG, target disorder, age group, lifestyle recommendation and the methods used to determine CPG lifestyle recommendations.

RESULTS

Ten paediatric CPGs for depression with a minimum or high-quality level contained recommendations on nutrition, sleep or exercise. Lifestyle recommendations were predominately qualitative, with quantitative details only outlined in two CPGs for exercise. Most recommendations were brief general statements, with 50% lacking supporting evidence from the literature.

CONCLUSIONS

Interest in lifestyle interventions for treatment in child and youth depression is growing. However, current CPG lifestyle recommendations for nutrition, sleep or exercise are based on expert opinion rather than clinical trials.

Adult ADHD, executive function, depressive/anxiety symptoms, and quality of life: A serial two-mediator model

BACKGROUND

Adult attention-deficit/hyperactivity disorder (ADHD) is associated with impaired executive function (EF), depressive/anxiety symptoms, and poor quality of life (QoL). In this study, we aimed to investigate correlations among these variables and to build a simple or serial mediation model for exploring the mechanisms between adult ADHD and QoL.

METHODS

This was a cross-sectional study. The sample included 223 participants with ADHD and 54 healthy volunteers. Participants were required to complete the following scales: ADHD Rating Scale (ADHD-RS), Brief Version of the World Health Organization Quality of Life Scale (WHOQOL-BREF), Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A), Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS). Correlations among EF, depressive/anxiety symptoms and QoL were analyzed using Pearson correlation. The simple and serial mediation models were analyzed using PROCESS (version 3.3).

RESULTS

The correlations between EF and QoL, depressive/anxiety symptoms and QoL, and depressive/anxiety symptoms and EF were statistically significant. In ADHD adults with comorbidities, the correlation coefficients were between -0.19 and -0.47, -0.20 and -0.62, 0.28 and 0.50, respectively. In simple mediation models, EF and depressive/anxiety symptoms were significant mediators respectively between ADHD and QoL, respectively. In a serial two-mediator model, ADHD could affect QoL indirectly via EF and then via depressive/anxiety symptoms significantly.

LIMITATIONS

The average age was young, the degree of education was high, and only self-reported scales were relied on.

CONCLUSIONS

There is a mutual effect between EF and emotional symptoms. This was the first study to build a serial two-mediator model between ADHD and QoL, suggesting the importance of EF and depressive/anxiety symptoms.

Screening for depression in old age : A comparison of the geriatric depression scale and the depression in old age scale

OBJECTIVE

Since 1996, older patients have been treated in the Nuremberg Geriatric Day Hospital. The geriatric depression scale (GDS) is an obligatory part of the geriatric assessment at admission but its use in the clinical setting has revealed some problems. The aim of the study was to compare the GDS with the depression in old age scale (DIA-S) in terms of applicability and psychometric characteristics.

METHODS

As gold standard a semi-structured interview was used to record the depression criteria according to Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Using a sample of 375 patients, sensitivity and specificity as well as positive and negative predictive values were calculated for both screening tests.

RESULTS

No clear superiority of any screening method could be proven. The sensitivity of the DIA‑S in the overall sample was higher than that of the GDS, but the specificity was much lower. In terms of predictive values, there were slight advantages for the GDS. In the sub-samples, poorer values were found in both scales for cognitively impaired or dementia patients with slightly better values for GDS.

CONCLUSION

The DIA‑S can be used very easily in everyday clinical practice, but no advantages of this method compared to GDS could be demonstrated.

High-level of anxiety and depressive symptoms among patients with general medical conditions and community residents: a comparative study

BACKGROUND

The global burden of anxiety and depressive symptoms become increasing, specifically accounts for high burden of morbidity among patients with medical conditions in low-income countries. The aim was to compare the level of anxiety and depressive symptoms in participants with general medical conditions and community residents in northwest Ethiopia.

METHODS

Comparatively 2625 adults in the community and 1363 patients at health center in Mecha Demographic Surveillance and Field Research Center (MDSFRC) had interviewed. Level of anxiety and depressive symptoms was assessed by Hospital Anxiety and Depression Scale (HADS) and logistic regression analysis was employed with corresponding adjusted OR (AOR) and 95% confidence interval (CI) at p-value less than 0.05 declaration of significant.

RESULTS

A higher prevalence of high-level anxiety and depressive symptoms, 12.6% with 95% CI; 11.0%, 14.0% and 10.1%, 95% CI; 8.0%, 12% were found among participants at health center compared to community residents, 6.8%, 95% CI; 7.0%, 8.0% and 5.2%, 95% CI; 4.0%, 6.0% at (p value < .0001), respectively. Social support, loss of a parent before age of 18 years, physical/verbal abuse, and having general medical conditions were significantly associated with both high-level anxiety and depressive symptoms. However, factors such as advanced age, perceived relative wealth, living alone, and having a family history of mental illness were associated with high-level of anxiety symptoms, but not with depressive symptoms.

CONCLUSIONS

Proportion of high-level of anxiety and depressive symptoms were found a two-fold higher in patients with medical condition than healthy residents in the community. Patients with medical illnesses should be assess for anxiety and depressive symptoms at health center.

Depressive, anxiety, and burnout symptoms on health care personnel at a month after COVID-19 outbreak in Indonesia

BACKGROUND

Health care personnel (HCP) who demonstrated close contact with Corona virus disease (COVID-19) patients might experience a higher risk of infection and psychological problems. This study aims to explore depressive, anxiety, and burnout symptoms among HCP with a higher risk for psychological trauma.

METHODS

This study was a cross-sectional study using secondary data from an online assessment, which was conducted 1 month after the COVID-19 outbreak. A total of 544 respondents from 21 provinces in Indonesia were included. Data on depressive, anxiety, and burnout symptoms were transformed first using the Rasch model and then categorized. Data from HCP in the higher risk group and the lower risk group were analyzed.

RESULTS

A higher percentage of HCP experiencing depressive symptoms (22.8%), anxiety (28.1%), and burnout (26.8%) are found in the higher risk group. The chance for the higher risk group's HCP to present with moderate and severe depressive symptoms, anxiety, and burnout are: 5.28 (Confidence interval (CI): 2.01-13.89; p < 0.05), 1.36 (CI: 0.09-1.96; p >  0.05), and 3.92 (CI: 2.08-7.40; p < 0.05) times higher, respectively. The probability for patient-induced burnout is 2.13 (CI: 1.51-3.007; p < 0.05) times higher and highest among the other burn out dimensions. The depressive symptoms complained were similar between groups: loneliness, sleep disturbances, difficulty concentrating, and inability to initiate activities. Loneliness demonstrates the highest logit value among the symptoms.

CONCLUSIONS

HCP with direct contact and responsibility to treat COVID-19 patients exhibit a higher risk to experience depressive symptoms and burnout. Communication with peers and staying in contact with family needs to be encouraged. Psychological well-being should be considered for high-risk HCP. Incentive or insurance guaranteed by the government or institution is essential as a reward and compensation during this period.

Sharp increase in depression and anxiety among Brazilian adults during the COVID-19 pandemic: findings from the PAMPA cohort

Objectives

We aimed to compare the prevalence of depression and anxiety symptoms before and during the pandemic and identify factors associated with aggravated mental health symptoms.

Study design

Retrospective cohort study.

Methods

We identified the proportion of normal, mild, moderate, and severe symptoms of depression and anxiety before and during the social distancing restrictions in adults from southern Brazil. An online, self-administered questionnaire was delivered for residents within the state of Rio Grande do Sul. Depressive and anxiety symptoms were examined by the Hospital Anxiety and Depression Scale.

Results

Most of the participants (n = 2314) aged between 31 and 59 years (54.2%), were women (76.6%), White (90.6%) with a university degree (66.6%). Moderate-to-severe symptoms of depression and anxiety were reported in 3.9% and 4.5% of participants, respectively, before COVID-19. During the pandemic (June–July, 2020), these proportions increased to 29.1% (6.6-fold increase) and 37.8% (7.4-fold increase), respectively. Higher rates of depressive and anxiety symptoms were observed among women, those aged 18–30 years, diagnosed with chronic disease and participants who had their income negatively affected by social restrictions. Remaining active or becoming physically active during social distancing restrictions reduced the probability of aggravated mental health disorders.

Conclusions

Depressive and anxiety symptoms had a 6.6- and 7.4-fold increase since the COVID-19 pandemic. Public policies such as physical activity promotion and strategies to reduce the economic strain caused by this pandemic are urgently needed to mitigate the impact of the pandemic on mental health.

Comorbid depressive and anxiety symptoms and frailty among older adults: Findings from the West China health and aging trend study

BACKGROUND

Depression and anxiety are two common mental disorders in older people. Studies have reported that depression is strongly associate with frailty, but few studies focus on anxiety disorder and comorbid two mental disorders. In this study, we aimed to identify associations between comorbid depressive and anxiety symptoms with frailty in older adults.

METHODS

4,103 community-dwellings adults aged 60 and older from the baseline of the West China Health and Aging Trend (WCHAT) study were included. Frailty was measured by the Fried frailty phenotype criteria. The 15-item Geriatric Depression Scale (GDS-15) and 7-item Generalized Anxiety Disorder Scale (GAD-7) assessed for depressive and anxiety symptoms with a cut-off value of 5. Multinomial logistic regression was used to explore the association between different depressive and anxiety status and frailty.

RESULTS

8.7% of old adults suffered comorbid depressive and anxiety symptoms in the present study. The prevalence of pre-frailty and frailty was 47.0% and 6.7%, respectively. After adjusting for covariates, individuals with comorbid depressive and anxiety symptoms had higher odds of being pre-frail (OR=1.86, 95% CI=1.41, 2.45) and frail (OR=7.03, 95% CI=4.48, 11.05) compared to those without depressive and anxiety symptoms. In the comorbidity group, those with severe comorbid symptoms also had higher prevalence of pre-frailty and frailty.

LIMITATIONS

Depressive and anxiety symptom assessments were based on screening tools.

CONCLUSIONS

This study suggested comorbid depressive and anxiety symptoms were associated with frailty among Chinese older adults. Further efforts to screen and target depression and anxiety comorbidity may be warranted.

Metabolic profiling identifies TC and LDL as potential serum biomarkers for depressive symptoms in schizophrenia

This study aimed to explore the relationship between serum levels of cardiometabolic biomarkers and depressive symptoms in schizophrenia patients treated with atypical antipsychotics. A total of 210 patients with schizophrenia and 70 healthy controls were recruited in our present study. All patients were rated on the 17-item Hamilton Depression Rating Scale (HAMD-17) to measure depressive symptoms and the Positive and Negative Syndrome Scale (PANSS) for psychopathology. Serum cardiometabolic biomarkers (HDL, LDL, TC, TG, GLU) in all participants were measured. Our results showed that schizophrenia patients had higher levels of serum GLU, TG, TC, LDL and BMI, but lower levels of HDL than controls (all P < 0.05). Compared to patients without depressive symptoms, those with depressive symptoms showed higher PANSS total, general psychopathology, positive and negative symptom scores (all p < 0.05), as well as higher serum levels of LDL (p < 0.001) and TC (p = 0.011). In addition, our correlation analysis showed that serum LDL (P < 0.001) and TC (P = 0.045) levels were positively associated with HAMD total scores in schizophrenia patients after age, sex and education levels were controlled. Our results suggest the appearance of depression in schizophrenia patients may be associated with high levels of metabolic parameters, especially TC and LDL.

Cultural variation in temporal associations among somatic complaints, anxiety, and depressive symptoms in adolescence

OBJECTIVE

Different domains of internalizing symptoms (somatic, anxiety, depressive) often occur concurrently, suggesting that they may share common etiology. In longitudinal analyses of internalizing among youth, anxiety is often found to precede depression. However, relatively few studies have also assessed how somatic problems, the third symptom domain, are involved in longitudinal patterns of internalizing. In addition, temporal relations among internalizing symptom domains may vary by cultural group as somatic symptoms are posited to be a more culturally-normative way of communicating or experiencing distress in non-Western, interdependent cultures. Thus, the present study examined longitudinal relations among these three internalizing symptom domains in three ethnocultural adolescent samples.

METHODS

304 European American, 420 Vietnamese American, and 717 Vietnamese adolescents' self-reported internalizing symptoms (somatic, anxiety, depressive) were assessed at three time points, spaced three months apart, using multigroup cross-lagged path analysis.

RESULTS

Anxiety symptoms consistently predicted increases in depressive symptoms in European American adolescents. In contrast, for Vietnamese and Vietnamese American adolescents, the most consistent relation was with somatic complaints predicting increases in anxiety. Anxiety and depressive symptoms bidirectionally predicted each other among the Vietnamese and Vietnamese American adolescents.

CONCLUSIONS

Cultural group differences were evident in the temporal course of internalizing symptoms. The pattern of results have implications for culturally relevant intervention targets, during a developmental period of risk for internalizing disorders.

Alzheimer and depressive cognitive-like behaviors in male and female rats: A new method for exposure to ambient air pollution

In the previous studies regarding the effects of exposure to ambient air pollution on biological markers and/or behavior of animals, the gaseous pollutants are not separated from the particulate matter (PM). Hence the synergetic effect of gaseous pollutants and PM was not considered. In this regard, current study was aimed to devolve a new method for separation of PM from gaseous pollutants. Also, the effect of exposure to fine particulate matter (PM_2.5) on the Alzheimer and depressive cognitive-like behaviors in rats after 3 and 6 months were investigated. Three chambers were designed including exposure group 1 (PM_2.5 plus gaseous pollutants alone), exposure group 2 (gaseous pollutants alone) and control group (clean air). Exposure time was 5 h per day (9.00 a.m.-2.00 p.m.) for 4 days per week. The concentration of PM_2.5 and gaseous pollutants (O₃, NO₂, and SO₂) were monitored in the exposure hours, continuously. Concentration of PM_2.5 by beta attenuation method and concentration of O₃, NO₂, and SO₂ by UV fluorescence was monitored. Also, the concentration of metals including Al, Cr, Mn, Pb, Cd, Ni, Fe, and Cu and 16-polycyclic aromatic hydrocarbons (PAHs) bound PM_2.5 by inductively coupled plasma mass spectrometry (ICP-MS) and gas chromatography-mass spectrometry (GC-MS) were analyzed, respectively. Cognitive-like behavior related to Alzheimer and depressive behaviors were determined by Y maze and Force swimming. The concentration of PM_2.5 in the 3 and 6 months exposure was higher than WHO guideline, significantly (p-value <0.05). The concentration of O₃, NO₂ and SO₂ in the 3 and 6 months exposure was lower than WHO guideline, significantly (p-value <0.05). The order of metals in the PM_2.5 according to mean concentration Al > Ca > Cu > Cd > Na > Fe > Cr > Ni > Mn > Pb. Also, the sum concentration of 16-PAHs in the PM_2.5 in the 3 and 6 months exposure was 45.7 ± 37.15 ng/m³ and 30.04 ± 25.27 ng/m³, respectively. Exposure to PM_2.5 cannot significantly increase Alzheimer and depressive cognitive-like behaviors in the rats. Also, a significant difference between male and female in Alzheimer and depressive cognitive-like behaviors not observed. •A new method for separation of PM_2.5 from other PM in the ambient air by ECO-PM sampler was presented.•A new method for separation of PM_2.5 from gaseous pollutants in the ambient air by HEPA filter and active carbon was presented.•Tow exposure groups including exposure 1: PM_2.5 plus gaseous pollutants and exposure 2: gaseous pollutants only were designed for increased accuracy of the in-vivo study.•Exposure to PM_2.5 cannot cause significant increased Alzheimer and depressive cognitive-like behaviors in the rats.

Adhering to a vegetarian diet may create a greater risk of depressive symptoms in the elderly male Chinese population

BACKGROUND

A vegetarian diet may be a risk factor for depression, but this relationship was unclear in the elderly Chinese population.

METHODS

Self-report data were gathered from 1051 elderly persons using the Cohort of Elderly Health and Environment Controllable Factors, which was created in West Anhui, China. The depressive symptoms were set as binary, ordinal, and continuous outcomes, respectively, whereas the dietary structures were computed as an ordinal variable and a dummy variable. Multiple logistic regression, ordinal regression, and linear regression were used to assess the relationship by adjusting the potential confounding variables with p-values of <0.1 in univariate analysis.

RESULTS

The elderly participants who had a vegetable-based diet had the highest GDS scores of 8.78 ± 6.894 (p = 0.001) and the highest rate of depression (32.9%, p = 0.003). After adjustment for the potential confounders, elderly men who had a vegetable-based diet had a higher rate of depression (OR[95%CI]: 1.62[1.07-2.46], 4.71[1.38-16.03]), more severe symptoms of depression (OR[95%CI]: 8.85[2.94-34.12]), and higher GDS scores (β[95%CI]: 1.46[0.70-2.22], 2.97[1.28-4.67]) than male participants who had a meat-based diet, but this was not the case in women.

LIMITATIONS

All data were self-reported. The study lacked quantitatively evaluated dietary intake. The duration of the current dietary structures and comorbidities were not reported. The cross-sectional study made the causal role uncertain.

CONCLUSIONS

Vegetarian diets may pose a greater risk of depressive symptoms among the elderly Chinese population, especially elderly men. Given the cross-sectional nature of this study, the causal role was uncertain. Further prospective studies, in particular among elderly women, are needed.

Related but different: distinguishing postpartum depression and fatigue among women seeking help for unsettled infant behaviours

BACKGROUND

A growing body of evidence in relatively healthy populations suggests that postpartum depression and fatigue are likely distinct but related experiences. However, differentiating depression and fatigue in clinical settings remains a challenge. This study aimed to assess if depression and fatigue are distinct constructs in women with relatively high fatigue and psychological distress symptoms attending a residential program that assists with unsettled infant behaviour.

METHODS

167 women (age: M = 34.26, SD = 4.23) attending a private residential early parenting program completed the Depression Anxiety Stress Scale (DASS21-D), Fatigue Severity Scale (FSS) and self-report sleep variables before program commencement. Confirmatory Factor Analysis examined the associations between depression and fatigue latent factors.

RESULTS

A two-factor model of separate but related depression and fatigue constructs provided a significantly better fit to the data than a one-factor model of combined depression and fatigue (p < .001). In the two-factor model, the depression and fatigue latent factors were moderately correlated (.41). Further predictive utility of this two-factor model was demonstrated as both depression and fatigue factors were independently predicted by worse self-reported sleep efficiency.

CONCLUSIONS

This study provides empirical evidence that for women attending a clinical service with relatively high fatigue and psychological distress, postpartum depression and fatigue remain separate but related experiences. These findings suggest that in women seeking clinical support in the postpartum period, both depression and fatigue need to be carefully assessed to ensure accurate diagnoses, and (b) whilst depression intervention may improve fatigue, targeted fatigue intervention may also be warranted.

Association of Inflammatory Bowel Disease (IBD) with Depressive Symptoms in the United States Population and Independent Predictors of Depressive Symptoms in an IBD Population: A NHANES Study

Background/Aims

There is a paucity of population-based studies on the association between inflammatory bowel disease (IBD) and depression in the U.S. population. We sought to study this association using the National Health and Nutrition Examination Survey (NHANES) database.

Methods

We used NHANES data from 2009 to 2010. Our study included 190,269,933 U.S. adults without IBD and 2,325,226 with IBD. We sought to determine whether IBD is an independent risk factor for depressive symptoms (DS) in the U.S. population and studied the independent predictors of DS in IBD population.

Results

DS was present in 49% of the IBD population versus 23% of the non-IBD population (p<0.001). During the multivariate analysis, we found that IBD was independently associated with DS in the U.S. population (p=0.002). The independent predictors of DS in the IBD population were older age (p=0.048) and divorced/separated/widowed status (p=0.005). There was nonsignificant increase in suicidal risk in IBD population with DS versus that in non-IBD population with DS (27% vs 12%, respectively, p=0.080). Only 36% of IBD individuals with DS visited mental health professional or psychiatrist within the past year.

Conclusions

IBD is independently associated with DS in the U.S. population. Further research is warranted on risk stratification, screening and management of those with IBD who are at risk of depression.

Amygdala functional connectivity in female patients with major depressive disorder with and without suicidal ideation

BACKGROUND

Major depressive disorder (MDD) is a known major risk factor for suicide and is one of the most common mental disorders. Meanwhile, gender differences in suicidal behavior have long been recognized including the finding that women have higher rates of suicidal ideation and/or suicidal behavior than men. The mechanism underlying suicide ideation in female patients with MDD remains poorly understood. The aim of the present study was to examine possible suicidal behavior-related neural circuitry in female MDD.

METHODS

In this study, 15 female participants with the first-episode MDD with suicidal ideation and 24 participants with the first-episode MDD without suicidal ideation as well as 39 female participants in a healthy control (HC) group, ranging in age from 18 to 50 years, underwent resting-state functional magnetic resonance imaging. The whole-brain amygdala resting-state functional connectivity (rsFC) was compared among these three groups.

RESULTS

Compared with female participants with the first-episode MDD without suicidal ideation and those in the HC group, female participants with the first-episode MDD with suicidal ideation showed a significant difference in rsFC between the amygdala and precuneus/cuneus (p < 0.05, corrected). No significant difference in amygdala-precuneus/cuneus rsFC was observed between female patients with the first-episode MDD without suicidal ideation and the HC group (p < 0.05, corrected).

CONCLUSIONS

Our findings suggest that suicidal ideation in female patients with the first-episode MDD may be related to an abnormality in amygdala neural circuitry. The abnormality in amygdala-precuneus/cuneus functional connectivity might present the trait feature for suicide in women with the first-episode MDD. The precuneus/cuneus may be an important region related to suicide and require future study.

Mapping the relationship between anxiety, anhedonia, and depression

INTRODUCTION

Anxiety and depression are often comorbid conditions, but there is uncertainty as to how this comorbidity develops. Thus, in three studies, we attempted to discern whether anhedonia may be a key linking factor between anxiety and depression.

METHODS

Three studies asked participants about their symptoms of anxiety and depression: in Study 1, 109 participants completed measures of anxiety, depression, activity avoidance, and perceived enjoyability and importance of avoided activities; in Study 2, 747 participants completed measures of anhedonia, anxiety, depression, and defensiveness; in Study 3, 216 participants completed measures assessing the same constructs as in Study 2 at four time-points (ranging 11 months in span).

RESULTS

In Study 1, symptoms of anxiety and depression were positively related only in individuals who relinquished potential enjoyment due to their anxiety-related avoidance; in Study 2, the indirect effect of anhedonia helped explained how anxiety symptoms imparted risk onto depressive symptoms; and in Study 3, anxiety led to anhedonia and then depression over time and anhedonia led to anxiety and then depression at both 5 and 11 months.

LIMITATIONS

The manuscript is limited by the use of a student sample in study 2, cross-sectional methods in studies 1 and 2, and reliance on self-ratings.

CONCLUSIONS

Anxiety may devolve into depression through anhedonia, such that anxious individuals begin to lose pleasure in anxiety-provoking activities, which results in the development of other depressive symptoms.

Seasonal affective disorder and alcohol abuse disorder in a population-based study

Seasonal affective disorder (SAD) is a recurrent major depressive disorder with a seasonal pattern, which is characterized by sad mood, low energy, longer sleep duration and carbohydrate craving. Furthermore, seasonal changes in mood and behavior may be closely related to alcohol use disorder (AUD). Nevertheless, there is scarce research on the study of cognitive impairments in SAD and AUD. We aimed to examine the relationship between the prevalence between SAD and AUD patients, and how cognitive functioning might be related to these variables. To do this, a sample of 8135 Finnish subjects was invited to take part in the population-based Health 2011 Survey, of whom 5903 did participate and 4554 were interviewed for mental health status with the Munich version of Composite International Diagnostic Interview. They also completed the modified Seasonal Pattern Assessment Questionnaire, the Mini-Mental State Examination, the category (animals) verbal fluency test, and the Rey Auditory Verbal Learning Test. Our results reveal the existence of a strong link between SAD and AUD in a large sample of Finnish population, as well as association between SAD and short-term memory problems.

Maintenance therapy with second generation antipsychotics for bipolar disorder - A systematic review and meta-analysis

BACKGROUND

Second generations antipsychotics (SGA) are frequently used for maintenance treatment in bipolar disorder. We systematically reviewed the efficacy and long-term effects of treatment with SGA, regardless of treatment strategy (SGA administered either as monotherapy or as adjunctive therapy), in comparison to placebo, lithium or valproate. Primary outcomes were relapses (mood episode recurrence) and discontinuation.

METHOD

Clinical studies were identified through database searching in PubMed, Embase, PsychInfo and Cochrane Library and critically appraised based on the Cochrane Handbook. Full data extraction of raw data was performed and analyzed with meta-analyses, and level of evidence graded using GRADE. Only randomized controlled studies (RCT) and observational studies were included, with a minimum follow-up of 6 months. Comparators used were restricted to placebo, lithium, valproate or other anti-epileptic drugs.

RESULTS

We identified 15 RCTs on SGA in bipolar disorder with follow-up-time of 6 months up to 2 years, and one observational study reporting long-term effects of up to 4 years. A total of 6142 patients were included in the randomized trials. No long-term RCTs beyond 2 years follow-up was identified. All RCTs except for one included patients with bipolar disorder type I only. All RCTs except for two included patients pre-stabilized on the drug under investigation prior to randomization (enrichment design). For SGA as adjunctive therapy to lithium or valproate, meta-analyses showed that treatment with either aripiprazole (RR: 0.65, 95% CI 0.50-0.85), quetiapine (RR: 0.38, 95% CI 0.32-0.46) or ziprasidone (RR: 0.62, 95% CI 0.40-0.96) reduced the overall risk of relapses in patients that had responded during the stabilization phase. Adjunctive therapy with quetiapine was the only drug that reduced both manic and depressive episodes. For SGA as monotherapy, only quetiapine was shown to be better than lithium/ valproate for both manic and depressive relapses, but only for patients stabilized on quetiapine during the acute phase. As monotherapy, olanzapine, quetiapine and risperidone were shown to be superior to placebo in reducing the overall risk of relapses.

LIMITATIONS

There were considerable limitations to the evidence base of maintenance treatment with SGA in bipolar disorder. Most studies used stabilized patients, i.e. enrichment design (selection bias), had considerable dropout levels (attrition bias), and variable degree of reporting bias. No long-term RCT data on efficacy is available beyond 2 years, and almost all studies are on bipolar disorder type I patients only. Despite these limitations, we elucidate quantitative findings from meta-analyses conducted on the randomized trials published on the topic.

Amygdala-prefrontal cortex resting-state functional connectivity varies with first depressive or manic episode in bipolar disorder

BACKGROUND

Bipolar disorder (BD) is one of the most complex mental illnesses, characterized by interactive depressive and manic states that are 2 contrary symptoms of disease states. The bilateral amygdala and prefrontal cortex (PFC) appear to play critical roles in BD; however, abnormalities seem to manifest differently in the 2 states and may provide further insight into underlying mechanisms.

METHODS

Sixteen participants with first-episode depressive and 13 participants with first-episode manic states of bipolar disorder as well as 30 healthy control (HC) participants underwent resting-state functional magnetic resonance imaging (fMRI). Resting-state functional connectivity (rsFC) between the bilateral amygdala and PFC was compared among the 3 groups.

RESULTS

Compared with depressive state participants of the BD group, manic state participants of the BD group showed a significant decrease in rsFC between the amygdala and right orbital frontal cortex (p<0.05, corrected). In addition, rsFC between the amygdala and left middle frontal cortex was significantly decreased in depressive and manic state participants of the BD group when compared with the HC group (p<0.05, corrected).

CONCLUSIONS

Our findings suggest that mood state during the first episodes of BD may be related to abnormality in hemispheric lateralization. The abnormalities in amygdala- left PFC functional connectivity might present the trait feature for BD, while deficits in amygdala- right PFC functional connectivity might be specific to manic episode, compared to depressive episode.

Seasonal variations in mood and behavior associate with common chronic diseases and symptoms in a population-based study

The purpose of this study was to assess how seasonality is associated with some of the most common non-communicable diseases (NCDs) in the general Finnish population. The global seasonality score (GSS) was used to measure the magnitude of seasonality in 4689 participants, in addition to which they reported the extent to which the seasonal variations in mood and behavior were experienced as a problem. Regression models and the odds ratios were adopted to analyze the associations adjusted for a range of covariates. Seventy percent of the participants had seasonal variations in sleep duration, social activity, mood, or energy level, and forty percent those in weight and appetite. Angina pectoris and depression were significantly associated with seasonality throughout the analysis. Hypertension, high cholesterol levels, diabetes, other (than rheumatoid) joint diseases and other (than depressive) psychological illnesses were significantly associated with experiencing a problem due to the seasonal variations, with an increase in the GSS, and with seasonal affective disorder and its subsyndromal form. The co-occurrence of the seasonal variations in mood and behavior with certain common NCDs warrants future research to have insights into the etiology and potentially shared pathways and mechanisms of action.

Omega-3/omega-6 fatty acid ratios in different phospholipid classes and depressive symptoms in coronary artery disease patients

Depressive symptoms are highly incident among coronary artery disease (CAD) patients and increase mortality. Reduced ratios of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) (omega-3 fatty acids) to arachidonic acid (AA, omega-6 fatty acid) concentrations have been linked with depressive symptoms in CAD. It remains unclear whether depressive symptoms are differentially associated with that ratio in different phospholipid classes, and this may have mechanistic implications. This study investigated associations between depressive symptoms in CAD patients and the EPA+DHA to AA ratio in the major phospholipid classes. This was a cross-sectional study of stable CAD patients. Sociodemographic, medical, medication, and cardiopulmonary fitness data were collected from each patient. Each patient was assessed for depressive symptoms using the 17-item Hamilton Depression Rating Scale (HAM-D). The percentage of EPA, DHA, and AA in each erythrocyte phospholipid class was determined using gas chromatography from fasting blood. Relationships between EPA+DHA to AA ratios and depressive symptoms were assessed using linear regression and were corrected for multiple comparisons. Seventy-six CAD patients were included (age=61.9 ± 8.5, 74% male, HAM-D=7.2 ± 5.9). In a backward elimination linear regression model, lower EPA+DHA to AA in erythrocyte phosphatidylinositol (B=-12.71, β=-0.33, p<.01) and sphingomyelin (B=-2.52, β=-0.37, p<.01) was associated with greater depressive symptom severity, independently of other known predictors. Other phospholipid classes were not associated with depressive symptoms. In conclusion, the relationship between EPA+DHA to AA ratios and depressive symptoms in CAD may not be consistent across phospholipid classes. Continued investigation of these potentially differential relationships may clarify underlying disease mechanisms.

Differences of biased recall memory for emotional information among children and adolescents of mothers with MDD, children and adolescents with MDD, and normal controls

This study examines explicit memory bias for emotional information in children and adolescents with major depressive disorder (MDD). Participants were a convenient sample of 28 children and adolescents of mothers with MDD, 28 children and adolescents with MDD, and 29 healthy controls. Their age range was 11-17 years old. The groups were matched for gender ratio, mean age, and the years of educational level. They were assessed by the Recall Task. Emotional stimuli consisted of three sets of words namely sad, happy, and neutral words. Children and adolescents of mothers with MDD similar to children and adolescents with MDD recalled more sadness stimuli in comparison with the controls. In other words, they showed an explicit memory bias towards sad stimuli. Also, healthy children significantly recalled more happy words than the other two groups. There was no significant difference among the three groups for the recall of neutral stimuli. Current findings support that there is a recall memory bias for emotional information in children with MDD. These children more than healthy children recall sad words. Moreover, healthy children recall happy words more than children with MDD.

Alteration of spontaneous neuronal activity in young adults with non-clinical depressive symptoms

Non-clinical depressive symptoms (nCDSs) are highly prevalent in young adults and may be associated with the risk of developing full-fledged depressive disorders. However, the neural basis underlying nCDSs remains unknown. To explore the alteration of spontaneous brain activity in individuals with nCDSs compared with healthy controls (HCs), we investigated resting-state brain activity using the amplitude of low-frequency fluctuations (ALFF) in subjects with nCDSs (n=17) and HCs (n=20). All subjects were drawn from a sample of 1105 college students participating in a survey assessing depressive symptoms. We determined that nCDSs can lead to reduced ALFF in the right ventral lateral prefrontal cortex (VLPFC) and right dorsolateral prefrontal cortex (DLPFC) and to increased ALFF in the left fusiform, left posterior cerebellum, right cuneus, left inferior parietal lobule, right supramarginal gyrus and bilateral precuneus. In addition, with respect to Beck Depression Inventory (BDI) scores and ALFF values in subjects with nCDSs, a positive correlation was discovered in the right DLPFC, while a negative correlation was identified in left posterior cerebellum and bilateral precuneus after correction. These results indicate that nCDSs are characterized by altered spontaneous activity in several important functional regions. We suggest that altered ALFFs in the right DLPFC, left posterior cerebellum and bilateral precuneus may be biomarkers that are related to the pathophysiology of nCDSs in young adults.

Clock genes in human alcohol abuse and comorbid conditions

Alcohol-use disorders are often comorbid conditions with mood and anxiety disorders. Clinical studies have demonstrated that there are abnormalities in circadian rhythms and clocks in patients with alcohol-use disorders. Circadian clock gene variants are therefore a fruitful target of interest. Concerning alcohol use, the current findings give support, but are preliminary to, the associations of ARNTL (BMAL1) rs6486120 with alcohol consumption, ARNTL2 rs7958822 and ARNTL2 rs4964057 with alcohol abuse, and PER1 rs3027172 and PER2 rs56013859 with alcohol dependence. Furthermore, it is of interest that CLOCK rs2412646 and CLOCK rs11240 associate with alcohol-use disorders only if comorbid with depressive disorders. The mechanistic basis of these associations and the intracellular actions for the encoded proteins in question remain to be elucidated in order to have the first insight of the potential small-molecule options for treatment of alcohol-use disorders.

A blunted sympathetic and accentuated parasympathetic response to postural change in subjects with depressive disorders

BACKGROUND

In recent years, the bi-directional relationship between depression and ANS dysfunction has received considerable attention, but findings remain inconclusive. In this study, we aimed to examine the spectral HRV response to postural change in subjects with depressive disorders and in healthy controls, in order to gain insight into the characteristics of autonomic nervous system (ANS) response to postural change in subjects with depressive disorders.

METHODS

We compared HRV response to postural change between subjects with depressive disorders and healthy controls aged 20-37 years. Depression severity was assessed by the self-reported Beck Depression Inventory-II (BDI-II). Spectral HRV was analyzed at two moments: 10 min seated rest and 10 min at standing position, with spontaneous breathing.

RESULTS

No significant differences existed in the resting spectral HRV indices between subjects with depressive disorders and controls, however, following postural change, the increasing level of LF and LF/HF was lower and the decreasing level of HF power was higher, in the individuals with depression than that in healthy subjects. The differences in the LF power, HF power and the LF/HF ratio between seated rest before standing up and after postural change were found negatively correlated with depression severity.

CONCLUSION

We found a blunted sympathetic and accentuated parasympathetic response to postural change in subjects with depressive disorder, suggesting that the autonomic impairment and early ANS dysfunction may exist among depressed individuals. These findings indicated that spectral analysis of HRV associated with postural change may be a more sensitive method than resting HRV analysis for detecting ANS dysfunction in depressive disorders.

LIMITATIONS

Further studies are needed to expand the sample size and to clarify the mechanisms responsible for the autonomic dysfunction observed in individuals with depressive disorders.

Increased interhemispheric functional connectivity in college students with non-clinical depressive symptoms in resting state

The underlying neural basis of non-clinical depressive symptoms (nCDSs) remains unclear. Interhemispheric functional connectivity has been suggested as one of the most robust characteristics of brain's intrinsic functional architecture. Here, we investigated the functional connectivity between homotopic points in the brain using the voxel-mirrored homotopic connectivity (VMHC) approach. We performed VMHC analysis on resting-state functional magnetic resonance imaging (rs-fMRI) data from 17 individuals with nCDSs and 20 healthy controls (HCs) who were enrolled from a sample of 1105 college students. We found increased VMHCs in the bilateral posterior cerebellum and fusiform gyrus in nCDSs subjects compared with HCs. Furthermore, receiver operating characteristic (ROC) curves indicated that VMHC values in the posterior cerebellum lobes could use to differente nCDSs from HCs [area under the curve (AUC), 0.756; p<0.01]. We suggest increased VMHCs indicate a possible compensatory mechanism involved in the pathophysiology of nCDSs. VMHC values of the posterior cerebellum lobes might serve as a reliable biomarker for identifying nCDSs.

Avoidance mediates the relationship between anxiety and depression over a decade later

Anxiety and depression are often highly correlated with each other. To explain this connection, the present study examined the longitudinal relationship between earlier anxiety and later depression, using avoidance as a mediator and trauma as a moderator. Participants (N=6504 adolescents) completed baseline measures of anxiety and depression, a measure of avoidance one year later, a measure of trauma six to eight years later, and a measure of depression 12-14 years later. Analyzed with structural equation models, the results showed that anxiety predicted later depression, and this relationship was partially mediated by avoidance. The relationship between avoidance and depression was not moderated by trauma. Together, these findings suggest that anxiety may influence later depression through avoidance, and this relationship remains unaffected by experiencing a traumatic experience.

CRP, IL-6 and depression: a systematic review and meta-analysis of longitudinal studies

BACKGROUND

Inflammatory markers are raised in cross-sectional studies of depressed patients and may represent an important mediating factor for behaviour, neural plasticity and brain structure.

METHODS

We undertook a systematic review of longitudinal studies, investigating whether raised inflammatory markers indicate an increased risk of subsequent depressive symptoms. We searched three databases (1970-2012) for longitudinal studies with repeat data on CRP or IL-6 levels and subsequent depressive symptoms. We calculated effect sizes using a mixed-effects model, with separate meta-analyses for inflammatory markers and age groups.

RESULTS

We identified eight papers for CRP (14,832 participants) and three for IL-6 (3695 participants). There was a significant association between increased CRP and depressive symptoms (weighted-mean effect size 'unadjusted r'=0.069, p<0.0005; 'adjusted r'=0.046, p<0.0005), with moderate heterogeneity between studies (Q=11.21, p=0.08, I(2)=46.5). For IL-6 the weighted-mean effect size was smaller ('unadjusted r'=0.045, p-value=0.007; 'adjusted r'=0.097, p-value=0.06).

LIMITATIONS

The meta-analysis was based on a relatively small number of studies (particularly for IL-6) and only two inflammatory markers. There was moderate heterogeneity between studies and some evidence of publication bias.

CONCLUSIONS

Raised inflammatory markers have a small but significant association with the subsequent development of depressive symptoms. This is a robust effect which remains significant after adjustment for age and a wide range of factors associated with risk for depression. Our results support the hypothesis that there is a causal pathway from inflammation to depression.

The 5HTT and MAO-A polymorphisms associate with depressive mood and climacteric symptoms in postmenopausal women

OBJECTIVE

The aim of this study was to assess the influence of the 44-bp polymorphism in the 5HTTLPR (SLC 6A4) (serotonin-transporter-linked polymorphic region, solute carrier family 6 member 4) promoter region and the 30-bpVNTR (variable number of tandem repeats) polymorphism in the MAO-A (monoamine oxidase A) promoter region on the prevalence of depressive mood and the severity of climacteric symptoms in postmenopausal women.

MATERIAL AND METHODS

The study involved 630 women from northern Poland who had their last menstrual period at least one year before the study. The women did not abuse alcohol or cigarettes, had not been diagnosed as having endocrinological, cancerous or mental diseases, and had not received psychiatric treatment by the time. This survey-based study was performed using the following research instruments: the Beck Depression Inventory (BDI), to evaluate depressive symptoms, and the Blatt-Kupperman Menopausal Index, to measure the severity of climacteric symptoms.

RESULTS

The average age of the women was 57.5 ± 6.4 years. Depressive symptoms of different severity according to the BDI were diagnosed in 29.2% of the women (minor-18.6%, moderate-7.1%, severe-3.5%) and according to the Blatt-Kupperman Menopausal Index were diagnosed in 42% of the women (minor-24.1%, moderate-9.2%, severe-8.7%). Allele 'l' was significantly more common in the women without climacteric symptoms than those with minor, moderate or severe climacteric complaints (p ≤ 0.05). There was a significant correlation between the severity of climacteric and depressive symptoms (p ≤ 0.05). The women who had severe climacteric symptoms also had more severe depressive symptoms.

CONCLUSIONS

1. The 5HTTLPR gene polymorphism contributes to climacteric symptoms in postmenopausal women. 2. The Blatt-Kupperman Menopausal Index is an instrument which can not only be used for the measurement of the severity of climacteric symptoms but also the early detection of perimenopausal women at the risk of developing depressive symptoms.