Prefrontal cortex activities during verbal fluency and emotional words tasks in major depressive, adjustment, and bipolar disorders with depressive states

BACKGROUND

It can be difficult to differentiate psychiatric disorders from depressive states, with little knowledge on how to differentiate them. This study aimed to evaluate changes in brain activity during cognitive and emotional tasks in patients with depressive state to help with differential diagnoses.

METHODS

Sixty-two patients with depressive states [17 with adjustment disorder (AD), 27 with major depressive disorder (MDD), and 18 with bipolar disorder (BD)] and 34 healthy controls (HC) were recruited. We used a verbal fluency task (VFT) and emotional word tasks with happy and threat words. Functional near-infrared spectroscopy measured the relative change in oxygenated hemoglobin in the frontotemporal areas.

RESULTS

During the VFT, patients with AD or MDD showed significantly reduced activation in the bilateral frontotemporal region (all p < 0.01), whereas patients with BD demonstrated significantly reduced activation in the right frontotemporal areas compared to HC (p < 0.01). During the emotional words task with happy words, patients with MDD showed significantly increased activity in the frontopolar area compared to HC (p = 0.023). Binary logistic regression analysis showed that MDD or BD was significantly associated with brain activity during the happy word task. In distinguishing MDD or BD from HC, the happy words task performed equally well, with an area under the curve of 0.70.

LIMITATIONS

All study patients were taking psychotropic drugs.

CONCLUSIONS

Brain activation in response to a combination of cognitive or emotional stimuli could assist in distinguishing patients with depressive states from healthy controls.

Can sleep disturbance influence changes in mental health status? Longitudinal research evidence from ageing studies in England and Japan

BACKGROUND

Little is known about the role of sleep disturbance in relation to changes in depressive states. We used data obtained from the participants aged 65 and over in the English Longitudinal Study of Ageing (ELSA, waves four and five, N = 3108) and the Japan Gerontological Evaluation Study (JAGES, 2010 and 2013 sweeps, N = 7527) to examine whether sleep disturbance is longitudinally associated with older adults' patterns of depressive states.

METHODS

We created four patterns of depressive states (non-case, recovered, onset, repeatedly depressive) by combining responses to the measures (scoring four or more on seven items from the Center for Epidemiological Studies Depression Scale for the ELSA participants and scoring five or more for the Geriatric Depression Scale-15 for the JAGES participants) obtained at the baseline and follow-up. Sleep disturbance was assessed through responses to three questions on sleep problems. Age, sex, partnership status, household equivalised income, alcohol and cigarette use, and physical function were treated as confounders in this study. Additionally, information on sleep medication was available in JAGES and was included in the statistical models.

RESULTS

More ELSA participants were non-depressive cases and reported no sleep disturbances compared with the JAGES participants. Findings from multinomial logistic regression analysis showed that more sleep disturbance was associated with the onset group in ELSA (RRR = 2.37, 95% CI = 1.44-3.90) and JAGES (RRR = 2.41, 95% CI = 1.79-3.25) as well as the recovery (RRR = 3.42, 95% CI = 1.98-5.90, RRR = 2.71, 95% CI = 1.95-3.75) and repeatedly depressed group (RRR = 7.24, 95% CI = 3.91-13.40, RRR = 5.16, 95% CI = 3.82-6.98).

CONCLUSIONS

Findings suggest that the association between sleep disturbance and depression in older adults is complex.

Association of subsyndromal and depressive symptoms with inflammatory markers among different ethnic groups: the multi-ethnic study of atherosclerosis (MESA)

OBJECTIVE

Depressive symptoms are associated with inflammation yet the association between inflammation and different levels of depression remains unclear. Therefore, we studied the association of subsyndromal and depressive symptoms with inflammatory markers in a large multi-ethnic cohort.

METHODS

C-reactive protein (CRP) (n=6269), interleukin-6 (IL-6) (n=6135) and tumor necrosis factor-alpha (TNF-α) (n=1830) were measured in selected participants from the multi-ethnic study of atherosclerosis (MESA). Subsyndromal depressive symptoms were defined as a CES-D value from 8 to 15, depressive symptoms as a CES-D≥16 and normal as a CES-D≤7. Depressive states (subsyndromal and depressed) were entered into multivariable linear regression models incrementally adjusting for demographic, behavioral, biologic and comorbidities.

RESULTS

Among 6289 participants not taking antidepressants and free from CVD, the mean age was 62.2, while 52% were women, 36.4% were Caucasian, 28.9% African-American, 22.3% Hispanics and 12.4% Chinese-American. Of the total, 24.2% had subsyndromal depression and 11.8% had depressive symptoms. Compared to the non-depressed group and after controlling for demographics, there was no association between both subsyndromal and depressive symptoms with logCRP (β=-0.01, p=0.80 and β=-0.05, p=0.25 respectively), logIL-6 (β=0.01, p=0.71 and β=-0.04, p=0.07 respectively) and logTNF-α (β=-0.03, p=0.29 and β=0.06, p=0.18 respectively). Moreover, fully adjusted models showed no significant associations for logIL-6 and logTNF-α and the different depressive categories. However, with full adjustment, we found a significant inverse association between depressive symptoms and lnCRP (β=-0.10, p=0.01) that was not present for subsyndromal depression (β=-0.05, p=0.11).

CONCLUSION

Among participants not taking anti-depressants, subsyndromal depression is not associated with inflammation. However, depressive symptoms measured by CES-D≥16 are associated with a lower inflammation (CRP).