Introduction

Electroconvulsive therapy involves the induction of a seizure by applying an electrical stimulus through electrodes, usually on both sides of the scalp. It remains being one of the main treatments for severe and psychopharmacological treatment-resistant mental illnes.

Objectives

This case aims to show the evolution of a severe depressive episode after electroconvulsive therapy.

Methods

Case report.

Results

We present a case of a 75-year-old woman, with no previous history in Mental Health who consults in the emergency department for a psychomotor inhibition and negative for both water and food intakefor a month of evolution. The patient began presenting excessive fear of being alone and of performing activities, showing herself more and more clumsy, and finally becoming completely dependent on the basic activities of daily living. During hospitalization in Psychiatry, the patient repeatedly referred to the conviction of being dead and of not needing to eat or drink because of it. Inhibition episodes alternated with psychomotor restlessness, and olfactory and gustatorysensory perceptual changes appeared during hospitalization. Symptons did not improve after the introduction of antidepressant or antipsychotic treatment, being finally necessary the application of electroconvulsive therapy, presenting the patient clinical improvement progressively until the depressive symptomatology finally disappeared.

Conclusions

Serious depressive episodes, associated or not with psychotic symptoms, are an indication of electroconvulsive therapy. In this case, the rapid onset of the condition, the state of inhibition she presented and the short time of evolution were predictive factors of good evolution, objectifiable from the first sessions.

Introduction

Social networking sites (SNSs) addiction becomes prominent in daily life. Despite the growing body of literature regarding unfavorable effects of SNSs addiction on psychological well-being, the studies performed with the psychiatric population are still scarce.

Objectives

The objective of this research is to discover whether excessive utilization of SNSs affects symptom severity among patients diagnosed with depressive disorder.

Methods

One hundred and eleven patients diagnosed with depressive disorder and 100 healthy controls (HCs) were participated in our study. Montgomery-Asberg Depression Rating Scale (MADRS) and Bergen Social Media Addiction Scale (BSMAS) were administered by both depressive disorder and HC groups. Independent samples t-test and chi-square tests were executed to estimate the differences in the socio-demographic variables. MANCOVA analysis was used to identify specific group differences in BSMAS and MADRS when significant main effects were found in sociodemographic variables. In order to reveal the associations between SNSs use and depressive disorder Pearson correlations and linear regression analyses were performed.

Results

BSMAS total score and MADRS total score were significantly different between depressive disorder and HC groups. MADRS total score was found significantly associated with BSMAS total score in depressive disorder group.

Conclusions

The clinicians should consider SNSs addiction while managing the depressive symptoms of depressive disorder patients.

Introduction

A 45-year-old woman with a diagnosis of Major Depression since 2012. This diagnosis has not been well controlled given the multitude of adverse effects with different antidepressants, including SSRIs and duals. Following the incorporation of Vortioxetine, depressive and cognitive symptoms improved substantially, with no apparent adverse effects so far.

Objectives

Compare the effectiveness of vortioxetine with other antidepressants, and the low profile of adverse effects thereof, in addition to cognitive improvement.

Methods

Brief presentation of the clinical case, and systematic literature review in PubMed, with the terms: "Vortioxetine" "versus"

Results

Vortioxetine shows an effectiveness similar to other antidepressants, with fewer adverse effects, and in some studies cognitive improvement of patients

Conclusions

Think about Vortioxetine as an effective drug in the treatment of major depression, with a low profile of adverse effects and probable cognitive improvement

Rate it as a primary or secondary therapeutic option against depressive symptoms.

Introduction

Alexithymia and the theory of mind (ToM) are essential elements for a proper social life. Difficulties in identifying and describing someone’s emotions or feelings of others, have negative effects on social cognition and influences the evolution of depressive disorders.

Objectives

Assessment of alexithymia and the ToM in a group of subjects with recurrent depressive disorder.

Methods

The study included 42 patients diagnosed with recurrent depressive disorder (according to ICD-10), based on inclusion/exclusion criteria. The analyzed parameters were: the onset of the disorder, alexithymia (Toronto Alexithymia Scale-TAS20) and the ToM (Reading the Mind in the Eye Test). The lot was divided into three sublots depending on the length of the evolution: 1^st lot 1-4 years, 2^nd lot 5-10 years, 3^rd lot over 10 years. Data were statistically processed.

Results

Following the interpretation of the results, it was shown that alexithymia was present in all subjects, regardless of the onset of the disorder, with no significant differences between the three groups (P-value=0.37215). Regarding ToM, mean score of patients was a reduced one, without any statistically significant differences (P-value=0.920299). There is also a direct correlation between alexithymia and the ToM in the 1^st lot (r=-0.519124317).

Conclusions

Alexithymia and ToM are both impaired in patients with depressive disorder. In the first five years of evolution of the disorder, the more inability of expressing emotions is present, the more ToM capacity is reduced.

Introduction

Primary studies using resting-state functional magnetic resonance imaging (rsfMRI) have reported abnormal functional connectivity in the triple network model (i.e., central executive, default mode, and salience networks) in major depressive disorder (MDD). It has been proposed that the aberrant connectivity of these neurocognitive networks plays a significant role in the cognitive deficits, emotional dysfunction, and specific symptoms (e.g., anhedonia, rumination, loss of motivation, and psychomotor retardation) of MDD.

Objectives

The present study aims to advance our understanding of MDD by identifying abnormal patterns of functional connectivity in depressed patients and by examining the relations of these abnormalities to specific clinical symptoms, cognitive deficits, and emotional dysfunctions.

Methods

We conducted the first-ever meta-analysis of the triple network model of depression by quantitatively combining all existing fMRI studies that compared functional connectivity of the central executive, default mode, or salience networks in patients diagnosed with MDD to age-matched healthy controls.

Results

Patients with MDD showed statistically significant (α=0.05–0.0001; family-wise-error-rate controlled) patterns of aberrant functional connectivity, including a variety of hyperconnected and hypoconnected regions located within and between the default mode, central executive, and salience networks.

Conclusions

This study evaluates the triple network model of depression and suggests novel neural targets for treatment. We also propose ways to increase the efficacy of existing neurostimulation therapies (e.g., transcranial magnetic stimulation) and possible strategies to inform treatment selection and symptom-targeting for patients with MDD.

Introduction

Early life stress (ELS) is a major risk factor for many psychiatric disorders including major depressive disorder (MDD). Although our understanding of the etiology of depression has substantially improved over the last years, a clear cause and, thus, an effective therapy remain obscure.

Objectives

In the past decade miRNAs as epigenetic modifier have shown immense importance for development and progression of many psychiatric disorders including major depression. In this study, the role of miRNA and their associated changes in ELS pathology was tested by examining miRNA expression in hypothalamus of adult rats who were maternally separated in their early lives.

Methods

Male and female Sprague Dawley pups were maternally separated for 3 hours per day for the first two weeks of life, postnatal days (PND) 1-14. As adults (PND 90), the animals were tested for depressive behavior phenotypes and then sacrificed. miRNA expression in the hypothalamus was tested using qPCR method.

Results

Male ELS animals exhibited decreased swimming behavior in the forced swim test. Both males and female ELS animals consumed less sucrose in the sucrose preference test; these behaviors indicate increased depressive phenotype. In male animals, miR-124 and -29 expression was increased while miR-135 expression was decreased only in female animals.

Conclusions

Our results suggest that 124-3p and 135b-5p, and miR-29a-3p may contribute to the etiopathology of depression specifically after early stressful experiences. Also, miRNAs may be differentially regulated in depressed males and females.

Introduction

Finasteride, a competitive inhibitor of 5 alpha-reductase enzyme, is used for treatment of androgenetic alopecia in males. Several effects derived from finasteride administration can be related to the appearance of depressive symptoms as serum dihydrotestosterone level decrease or the inhibitory effect on androgen and steroid 5alpha-reduction in the brain.

Objectives

To present our clinical experience in the treatment of a depressive episode and propose the likely relation with finasteride treatment.

Methods

We selected one patient with previous treatment with finasteride who developed a depressive episode.

Results

29 years old male referred to our outpatient Mental Health Service with depressive symptoms for 2 years with an accentuation in recent months. No previous personal psychiatric history, no drug abuse or psychopharmacological treatment. In treatment with finasteride the three previous years. Refers sad mood, anxiety, irritability, inhibition, apathy, poor initiative to carry out activities, early awakening, low hedonic capacity, thoughts of death and failures in cognitive sphere. No refers previous trigger. We established diagnosis of moderate depressive episode without psychotic symptoms and initiated antidepressive treatment with vortioxetine 10 mg. We also encouraged to discontinue finasteride treatment to consider a probable relationship with the mood disorder. The patient experienced a positive evolution with ad integrum recovery in the 3 subsequent months.

Conclusions

Finasteride treatment might be related to depressive symptoms, so it should be discontinued in the presence of mood disorders. Further studies should be required in order to determine the need of antidepressant treatment once finasteride is discontinued.

Introduction

Dermatomyositis (DM) is a multisystem autoimmune inflammatory disease with skin manifestations, muscle weakness and systemic symptoms. These manifestations lead patients to suffer a low quality of life. While various inflammatory disorders and their association with depression are well documented, only few litterature is reporting cases of DM associated with major depressive disorder.

Objectives

We present a rare case of DM associated with depressive disorder and suicidal ideation in order to discuss the possible link relating these two entities.

Methods

We conducted a literature review on pubmed website, using these keywords: dermatomyositis, depressive disorder and suicidal ideation.

Results

A 31-year-old woman, with no prior personal neuropsychiatric history, was diagnosed with dermatomyositis and started on azathioprine and methylprednisolone. Two years later, she was referred to our psychiatric unit with complaints of depressed mood, reduced pleasure, fatigue, sleep disturbance, feelings of worthlessness and reduced self-esteem. She also reported suicidal thoughts with a specific plan. She met clinical criteria from diagnostic and statistical manual of mental disorders (DSM-5) for major depressive disorder, and was starded on sertraline 50mg orally per day for two weeks then titrated to 100mg per day. Clinical course showed improvement in depressive symptoms with no more suicidal ideation within two weeks. The temporal relationship between the onset of depressive symptomes and DM suggest that depression may have been induced either by the inflammatory disorder or anti-inflammatory treatments.

Conclusions

Patients suffering from inflammatory systemic disease should be screened for depressive disorders. Providing them appropriate mental health care seems crucial to improve patients prognosis and quality of life.

Introduction

Women undergo adaptive physical and psychological changes during pregnancy, which make them vulnerable to psychological disorders.

Objectives

Primary aim of the study was to validate the 16-item MBS Dutch version for use in our Italian puerperae population,
the secondary aim was to analyze the relationship between the MBS and its threefactor structure, negative affect, positive affect, and depression and the EPDS and its three subscales, anhedonia, anxiety, and depression in singleton, at term, and uncomplicated pregnancies.

Methods

This study used a prospective observational design and included concurrent validation analysis of the 16-item Maternity BluesScale (MBS) Dutch version to determine the direction and magnitude on the Edinburgh Postnatal Depression Scale (EPDS) symptoms, including three factors, anhedonia, anxiety, and depression in 320 puerperae early after childbirth.

Results

We found a statistically significant correlation between MBS and EPDS global scores (0.22, p < .001). Moreover, Negative affect was significantly correlated with the EPDS global score (0.23, p < .001), anhedonia (0.12, p < .05), and anxiety (0.25, p < .001); Positive affect with the EPDS global score (0.14, p < .05) and depression (0.13, p < .05); and Depression subscale with EPDS global score (0.15, p < .05), anhedonia (0.12, p < .05), and anxiety (0.12, p < .05), and depression (0.12, p < .05). In addition, the subgroup of women (n = 33, 10.3%) with EPDS > 12 presented significantly higher global MBS score (2.51 ± 0.38 versus 2.26 ± 0.38, p = .01), with negative affect (2.88 ± 0.67 versus 2.62 ± 0.38, p=.04), positive affect (2.52 ± 0.69 versus 2.32 ± 0.38, p = .04), and depression (2.09 ± 0.75 versus 1.82 ± 0.36, p = .02).

Conclusions

These findings together suggest that women with higher maternity blues scores may represent a distinct subgroup at increased risk of depression

Introduction

Cotard syndrome (CS) is a rare clinical condition characterized by negation and nihilistic delusions. It was first described in 1880 by Jules Cotard as negation delirium. It’s no longer classified as an independent disorder in the current classification systems (ICD-10, DSM-5). Cotard delusions were reported in patients across a relatively wide spectrum of neurological, psychiatric, and medical disorder.

Objectives

The goal of this study was to do a brief review about CS and describe the clinical features, demographic characteristics, therapeutic approaches and differential diagnosis.

Methods

Pub MED searches were conducted for relevant articles, published before 2019. Search terms used included Cotard delusion, nihilistic delusion, CS and major depressive disorder.

Results

Most of the published studies are limited to short series or isolated cases. The prevalence and incidence of this syndrome is unclear. Depression was reported in 89% of subjects; the most common nihilistic delusions concerned the body and existence. The treatment is focused mainly on the management of the underlying clinical condition, for example in patients with depressive disorders and psychotic symptoms it has been found that antidepressants are useful, combined with antipsychotics. Some authors propose the use of mood stabilizers. There are case reports in which the treatment with electroconvulsivotherapy was successful, becoming the treatment of choice.

Conclusions

CS occurs in current clinical practice infrequently, it appears as a nonspecific syndrome of heterogeneous etiology. We must consider CS as a serious condition because affective and delusional symptoms can lead to increased suicide risk and often require hospitalization.

Introduction

Many patients presenting in the primary health care for somatic symptoms also present mental health problems which are not always properly addressed

Objectives

To screen for depressive symptoms in the outpatient population over 50 years old

Methods

From 01.07.2019 to 31.08.2019, patients over 50 years old who received outpatient treatment in the primary health care were asked to be administered PHQ-9. 120 of them agreed and the data were analyzed with SPSS-22.

Results

From the 120 participants, 48% (N=58) were 50-64 years old, and 45% (N=54) were males. 66% (N=79) reported symptoms of severe depression, 26% (N=31) moderately severy, 6% (N=7) moderate depression and the other 3 participants had no symptoms of depression.
According to the data analysis, females in the age group 65-96 were more affected by depressive symptoms.

Conclusions

Depression remains an underdiagnozed condition in primary care, with many patients presenting for another health problem but when screened for depression score high on screening tools like PHQ-9. The most affected group is females from 65 to 96 years old.

Introduction

The term “sense of agency” (locus of control) refers to the perception that a person’s behavior is controlled by internal or external agencies and factors. On the axis of sense of agency, we can distinguish two poles: the internal and the external. It has become clear that patients with Mild Depressive Disorder tend to be more external in sense of agency orientation, compared to healthy individuals. Moreover, a number of studies discusses the relation between external pole of agency and low medication adherence finding that in depression, the sense of agency concerning the health control beliefs may be a crucial factor that interferes in treatment compliance.

Objectives

In the present study, our objective was to examine how sense of agency and depressive symptoms are related in general population with no psychiatric history so far and if this affects medicine adherence.

Methods

We used two self-report questionnaires (BLOC and BDI-II). We collected data from 56 adults (23 men), between 18 and 45 years old with no psychiatric or neurological disorder history until the date of assessment and we applied T-test, correlation and regression analyses with SPSS.

Results

By using linear regression on the BDI-II and the BLOC scores, we have found a positive correlation between depressive symptoms and external pole of sense of agency.

Conclusions

There was a strong relationship between the depressive symptoms and external sense of agency in subjects with no psychiatric background. The present study is the first that verifies this relation for the greek non-psychiatric population, as far as we know.

Introduction

Robust evidence points to bidirectional associations between late-life depression and physical disease development. Depression accompanied with loneliness may show worse prognosis and higher levels of symptom severity in old age. However, little is known about the role of loneliness in the relationship between depression and multimorbidity development.

Objectives

To study the influence of depression with loneliness on chronic disease development later in life.

Methods

Data from the Ageing Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) project were used. The sample comprised 2328 older adults (55.37% women; M = 61.16 years at baseline, SD = 6.52) from two European countries (UK and Czech Republic). Three groups were formed: control group (CG); depressive symptom episode group (DEP); a group with depression and loneliness (DEP+LONE). Number of multimorbid conditions (comprising 18 physical diseases) was predicted at a follow-up (arithmetic mode of follow-up = 4 years) considering a metabolic score and diseases at baseline, study group and other relevant sociodemographic and health-related factors. The analyses were conducted separately by men and women.

Results

DEP+LONE membership significantly predicted the multimorbidity in both sexes. Over 50% of women and 54% of men from the DEP+LONE group showed two or more physical conditions at follow-up. Additionally, DEP group membership predicted multimorbidity at follow-up in men (p < .01).

Conclusions

These results highlight the relevant contribution of loneliness in depression-related metabolic dysregulation in chronic condition development, probably by means of metabolic dysregulation boosting. This study claims for action to reduce the impact of loneliness in old age and to promote healthy ageing.

Introduction

In the structure of the mental disorders depression holds the leading position. In recent years, there has been an increase of publications showing the combination of depression and psychosocial maladaptation, which both acts as a derivative in the clinic of depressive disorders and as an independent phenomenon, having a distinct effect on their course.

Objectives

The purpose of the work is to study to study of relationships of structure and severity of manifestations of psychosocial maladaptation and anxiety-depressive symptoms in women with depressive disorders of different genesis.

Methods

252 women with a diagnosis of depressive disorder were examined: 94 people with depressive disorder of psychogenic genesis, 83 women with endogenous depression and 75 patients with depressive disorder of organic genesis. The patients were divided into groups depending on the genesis of the depressive disorder and the presence and severity of problems in psychosocial functioning. The study was conducted using clinical-psychopathological and psychodiagnostic methods.

Results

As a result of the study, it was found that genesis of depression has been found to have the greatest impact on depression in the absence of signs of maladaptation and its mild degree. As the severity of maladaptation increases, the impact of the genesis of depression decreases and is less severe in severe maladaptation. Anxiety is less dependent on the genesis of depression, and is more determined by the degree of maladaptation.

Conclusions

Thus, in determining the directions of psychotherapeutic and rehabilitation management of depressive disorders in women, it is mandatory to take these parameters into account.

Introduction

The prevalence of depression can rise as high as 20% among patients with cardiovascular disease. There is growing evidence about the association between both pathologies. In fact, depression is considered as a risk factor for the development of cardiovascular disease. Inflammation may be a common mechanism underpinning both disorders.

Objectives

To identify inflammation and oxidative and nitrosative stress biomarkers as predictors of the development of major depressive episodes in patients with heart failure.

Methods

This is a prospective, observational cohort study, with patients diagnosed with heart failure, who are admitted for the first time to a specialized general hospital outpatient unit. Patients will be evaluated at admission and followed up every 3 months for a total period of 12 months. Biochemical variables (pro-inflammatory interleukins, acute phase proteins, and markers of oxidative and nitrosative stress) will be evaluated. Outcome variables will be the development of a major depressive episode according to DSM-5 criteria and the intensity of depressive symptoms according to MADRS.

Results

We obtained a sample of 38 patients. The majority of them were male (68.4%) and Caucasian (100%). 34.2% of the patients suffered a depressive episode during the follow-up period. Factorial analysis showed significant association between the depressive symptoms and the inflammatory biomarkers (Figure 1).

Conclusions

The prevalence of depression among our sample of heart-failure patients reached 34.2%. Our study showed a positive association between the inflammatory biomarkers and the PHQ-9 score. Further research is needed in order to better understand the pathophysiology of this association.

Introduction

Tranylcypromine (TCP) is prescribed for treatment resistant depression (TRD). The irreversible monoamine oxidase-(MAO)-A/B inhibitor is often labeled as a treatment of “last resort”. This classification was established when the number of treatment options was limited.

Objectives

With 58% responders as the mean in TCP-treatment of TRD in controlled studies, the question arises which therapeutic options occur in non-responders of TCP (TCP-NR), and whether TCP is actually a “last resort”.

Methods

The therapy of TCP-NR was investigated in a comprehensive review of controlled and non-controlled clinical studies of TCP in depression as well as in case reports of medical-scientific literature.

Results

93 therapies of TCP-NR have been found (63 in the follow-up of clinical studies, 30 in case reports). Continuing TCP itself was included in 48 trials of TCP-NR (augmentation/combination of TCP). Discontinuation of TCP and switch to another antidepressant was applied in 45 TCP-NR. Response was achieved in 48 trials (51.6%), 36 in TCP-augmentation/combination (75%), and 12 after discontinuation of TCP (26.7%). The higher number of responders in augmentation/combination of TCP is explained by the selectivity of case reports. For lithium-augmentation (78.6% responders), however, data are considered as less selective because results of the follow-up of TCP-studies are also included.

Conclusions

A definition of the MAO-inhibitor as a “last resort” in the treatment of depression seems to be misguiding today because of the manifold treatment options. There are good chances of response for TCP-NR in TRD with e.g. lithium augmentation of TCP, augmentation with second generation antipsychotic drugs or switch to other antidepressants.

Introduction

Little is known how depressive symptoms and suicidal ideations interfere with the perception of different tastes of food.

Objectives

To evaluate emotional responses to different tastes of food as possible markers of depressive symptoms and suicidal ideations.

Methods

In total, 74 adult patients aged up to 55 years (86.5% females) with diagnosis of Major Depressive disorder (MDD) were included. MDD was assessed using Mini-International Neuropsychiatric Interview (MINI) and Montgomery-Asberg Depression Rating Scale (MADRS); suicidal ideations were evaluated using MADRS item 10. The desire of different tastes of food was evaluated using a “Food Taste Questionnaire” and rated using Likert scale from 1 to 4 (highest to lowest). Emotional expressions to different food tastes were evaluated using the FaceReader software (Noldus).

Results

Of all patients, 60.8% (n=45) did not have suicidal ideations. The comparison of desire for different tastes of food before depression episode vs. depression episode revealed significant decrease of desire in three tastes: sour 3.34 ±0.8 vs. 3.57 ±0.66; p<0.000 respectively; salty 2.97 ±0.93 vs. 3.2 ±0.91; p<0.001 respectively; spicy 3.01 ±1.01 vs. 3.38 ±0.95; p<0.000 respectively, but not in sweet and neutral food tastes. Yet significantly lower intensity of emotional expressions was found in suicidal group to sweet (0.34 ±0.08 vs. 0.30 ±0.07, p=0.022, respectively) and neutral tastes of food (0.29 ±0.05 vs. 0.25 ±0.05, p=0.01, respectively).

Conclusions

The changes of desire in different food tastes and emotional expressions to different tastes of food could be used as markers in recognition of depressive symptoms and suicidal ideations.

Introduction

Depression is associated with worse diabetes self-care and worse diabetes outcomes.

Objectives

To test whether depressive symptoms at diagnosis of type 2 diabetes (T2D) was associated with delay in initiation of insulin therapy at 8 years follow up.

Methods

The South London Diabetes (SOUL-D) incident T2D cohort was prospectively followed-up to 8 years. At T2D diagnosis, depressive symptoms were measured using the Patient Health Questionnaire (PHQ-9). The date of insulin initiation was extracted from primary care records. The Kaplan-Meier method determined time to insulin initiation, and Cox regression controlled for baseline confounders: age, gender, ethnicity, BMI, diabetes distress, negative insulin beliefs, present microvascular and macrovascular complications and HbA1c.

Results

In this preliminary analysis of n=1003, the average age at baseline was 56.6 (SD=10.85) years, the proportion of females was 45.5%, and ethnicity status was 48.8% White and 47.3% African Caribbean/Asian/other. The prevalence of depressive symptoms (PHQ-9 ≥10) was 14.6% (n=146). The proportion who were depressed versus not depressed who were started on insulin therapy was n=34/146 and n=99/848 and the mean time to starting insulin was 83.3 (SD 23.98) and 86.3 (SD 20.88) months respectively. After adjusting for confounding variables, this was a small but significant association (hazard ratio=1.06, 95% confidence interval 1.02-1.10, p=0.005).

Conclusions

Depressive symptoms is associated with earlier initiation of insulin therapy suggesting that these patients may have a worse prognosis even at the time of diagnosis of T2D.

Introduction

Depression (D) is associated with an increased risk of developing a metabolic syndrome (MS) vascular disorders and dementia . Additionaly the endocannabinoid system is involved in the regulation of mood . The associations of MS with mild cognitive impierment (MCI) , and depression was examened.

Objectives

Association of anandamide (AEA) and 2-arachidonoylglycerol (2-AG), with mood changes were examened.

Methods

Methods and results: The data collected from 300 patients with MS according IDF criteria and vascular disorders (aged 30 – 60 years) have been analyzed. MCI was confirmed by psychodiagnostic interview according to the criteria of ICD-10 ant nuropsychological testing. Depression and mood disorders were confirmed by psychodiagnostic interview according to the criteria of ICD-10.

Endogenous cannabinoids level was determined by chromatography-mass spectrometry.

Results

As a result of research 300 subject were divided into 2 groups, group A – with D and/or MCI (221 subjects) and the group B -without mood disorders (49 subjects). Using the Mann-Whitney test significantly strong connection between high levels of total cholesterol (TC), cholesterol low density lipoprotein (LDL-C) and MCI in group A were obtained. Optional subjects with sings of MS and D had a high level of VLDL and LDL-C in comparison with subjects without D. Level of 2-AG significantly different in anxious patients with MS.

Conclusions

Conclusion: Our data support that there is link between MCI and components of MS, Increasing in the level of LDL and VLDL can provoke MCI in middleage subjects with MS. MS activates ECS that triggers the development of cognitive impairment and anxiety

Introduction

The ideal goal of antidepressant treatment for patients with major depressive disorder (MDD) is to achieve full recovery of individual, occupational, and psychosocial functions. However, lower remission/response rates and higher relapse rates have been consistently reported in real world treatment setting. In addition, some subpopulations of MDD including mixed or anxious features are known to present poor clinical outcomes than those without such subsymptoms.

Objectives

The present study aimed to observe potential benefit of aripiprazole augmentation in the treatment of major depressive disorder with mixed specifier (MDDM) in naturalistic treatment setting.

Methods

Data were collected from MDDM patients using a retrospective chart review for 8 weeks (week −8 and week 0) in routine practice. All patients were on current antidepressants upon starting of aripiprazole. Patients were treated without restriction of doses of aripiprazole. The primary endpoint was the mean change of Montgomery−Åsberg Depression Rating Scale (MADRS) total scores along with various secondary endpoint measures.

Results

In total 38 patients were analyzed. The changes of MADRS, Clinical Global Impression (CGI)-severity, Young Mania Rating Scale, Sheehan Disability Scale, and CGI-clinical benefit total scores from baseline to the endpoint were −7.1, −0.8, −4.9, −4.1, and −3.6, respectively (all p ＜ 0.0001). At the endpoint, the responder and remitter rates by MADRS score criteria were approximately 32% and 21%, respectively.

Conclusions

The present findings have clearly shown the effectiveness and tolerability of aripiprazole augmentation for MDDM patients in routine practice. The present study warrants subsequent, adequately-powered, well-controlled studies for generalizability near future

Introduction

About 30% of patients with major depression do not respond satisfactorily to treatment. These have lower productivity, higher medical comorbidity and more suicide attemps than patients with an adequate response.

Objectives

The aim of this study is to review the clinical management of treatment-resistant depression, basing on a real clinical case.

Methods

Clinical management of treatment-resistant depression was reviewed with regard to the case of a 52-year-old woman with a history of a major depression that did not respond to medication (including two antidepressants, lithium and lamotrigine). In the mental examination, she presented intrusive, recurrent and egodistonic ideas of guilt, which generated intense discomfort. Her mood was secondary to the onset of such ideas. Attending to the symptomatology and poor response to medication, the diagnosis was changed to an obsesive compulsive disorder with predominance of obsessive ideas, and the treatment was simplifyed and optimized with paroxetine at antiosbsessive doses. Currently, the patient has remained asymptomatic for the last ten months.

Results

Although there is no consensus, the term “treatment-resistant depression" generally referes to major depressive episodes that do not respond satisfactorily to two adequate antidepressant trials. This has been associated with different factors, including misdiagnose or concurrent psychiatric disorders, such as obsessive-compulsive disorders. Therefore, an exhaustive psychopathological evaluation and an adequate differential diagnosis it is essential in all cases.

Conclusions

Due to therapeutic and prognostic implications, in case of a major depression that does not respond adequately to treatment, the diagnosis must be verified and other psychiatric conditions must be ruled out.

Introduction

Recent studies suggest a close relationship between childhood trauma and major depressive disorder. The effect of childhood trauma on the recurrence of depressive episodes is still controversial.

Objectives

The aim of our study was to analyze the relationship between childhood trauma and the recurrence of depression in patients suffering from major depressive disorder.

Methods

We proceeded to a cross-sectional and retrospective study. We recruited 50 patients followed for major depressive disorder. Patients responded to the short form of Childhood Trauma Questionnaire Scale. Depressive symptoms were evaluated by the Hamilton Depression Rating Scale. Information about the recurrence of depression during the two first years following the first depressive episode were collected from the medical file.

Results

Patients with recurrent depressive episodes had a significantly higher physical abuse score (p=0.04) than those who did not have depression relapse during the first two years of follow-up. There was no significant difference in the frequencies of exposure to the different dimensions of childhood trauma between patients with depressive recurrence in the first two years of follow-up and those who did not.

Conclusions

This study emphasizes the existence of a significant association between physical abuse and the recurrence of depressive episode. Moreover, the retrospective design means that no cause-to-effect relationship can be attested.

Introduction

Studies suggested that the adjuvant therapy of docosahexaenoic acid (DHA) and Eicosapentaenoic acid (EPA) and antidepressant would be effective on the treatment of major depressive disorder, especially in patients with not optimal clinical response to antidepressant treatment in monotherapy

Objectives

The primary objective of this study was aimed to evaluate the efficacy of docosahexaenoic acid (DHA) and Eicosapentaenoic acid (EPA) in outpatients diagnosed with major depressive disorder and not optimal clinical response to antidepressant treatment.

Methods

total sample of 200 outpatients with major depressive episode (according to I.C.D. 10 criteria) and previous suboptimal response to antidepressant treatment were recruited.

DHA and EPA were added to the previous antidepressant treatment at flexible doses of 1 or 2 capsules per day. Each capsule contains 180 mg DHA and 460 mg EPA; Vitamin E 10 mg.

The following evaluations was undergone at baseline, and then every 2 weeks until endpoint (eight week of treatment): Montgomery- Asberg Depression Rating Scale (MADRS)

Optimal response was defined as a reduction of 50% in MADRS scores and remission was defined with ≤ 8 score in MADRS, both measured at endpoint.

Results

We observed a significant decrease in the total score on the MADRS (Δ=12.51±4.27; p<0.01) At endpoint (8week) we observed response rates of 41% and remission rates of 32%.

Conclusions

In our Study, DHA and EPA added to the antidepressant treatment has found to be effective and safe in the treatment of patients diagnosed with major depressive disorder with not optimal response to antidepressant treatment

Introduction

Cognitive impairment has been reported in patients with Major Depressive Disorder (MDD) although not all patients have poor performance in formal neuropsychological assessments.

Objectives

This study aims to explore the demographic, clinical and health-related predictors of cognitive impairment in patients with MDD.

Methods

Demographic, clinical, health-related variables and cognitive scores measured with the Cambridge Neuropsychological Test Automated Battery (CANTAB) were compared between 74 patients with MDD and 68 healthy controls. Multivariate regression was performed to explore the factors that predicted cognitive impairment in MDD patients.

Results

Significant neuropsychological deficits were evident in MDD compared with healthy controls in the global cognitive index (F=5.01; gl=10, 131; p<0.001). Patients showed a worse performance in memory (Delayed Matching to Sample: F=23.78; p=<0.001), attention (Rapid Visual Information Process Test: F=7.10; p=0.009) and executive function (Spatial Working Memory: F=6.63; p=0.011; One Touch Stockings of Cambridge: F=7.44; p= 0.007) test.

In the regression analysis performed in MDD patients years of schooling (β=˗0.44; p=<0.001), physical exercise (β=˗0.29; p=0.005) and severity of depressive symptoms (β=0.22; p=0.035) predicted the cognitive impairment (F=10.74; p<0.001)

Conclusions

Patients with MDD have deficits in different cognitive domains. These deficits are predicted by the years of education, the severity of depressive symptoms and the performance of physical exercise. These results support the importance of the implementation of interventions targeting the cognitive reserve and lifestyle habits of MDD patients, in addition to the conventional therapeutical approach focused on symptoms control.

Introduction

There is a lack of data on the efficacy of physical exercise (PE) as a treatment method for depression in managing in-patients in the short-term treatment course.

Objectives

The aim of our study was to assess the efficacy of the physical exercise program as an adjuvant therapy for depression.

Methods

For our study we formed two groups of patients with major depression receiving medical care at the Republican Research and Practice Mental Health Center: (1) the ones who received PE in addition to their usual treatment (n=57, mean age 43.4 years, SD =12.5) and (2) those with only treatment as usual - the control group (n=49, mean age 43.04, SD =13.7). PE was conducted with the frequency of 3-5 times a week in a group under the supervision of a fitness instructor. The PE program included aerobic and muscle-strengthening exercises as well as elements of yoga and pilates. We used Beck Depression Inventory (BDI), Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HAM-A), the Positive and Negative Affect Schedule (PANAS), sleep and quality of life questionnaires.

Results

The mean number of sessions in the main group was 11 (7-14). There was a significant decrease of depressive and anxiety symptoms in both groups but the effect sizes were bigger in the main group on HDRS (Cohen’s d=3.38 versus 2,5 in controls) and HAM-A (Cohen’s d=3.7 versus 2,11 in controls).

Conclusions

Our results support the idea of the efficacy of short-term PE program as an adjuvant therapy for treating depression.

Introduction

Sarcoidosis is a disease caused by the growth of accumulations of inflammatory cells (granulomas) in any part of the body, above all lungs and lymph nodes. It is related with an intense fatigue, cronic pain and many cases of major depression. There is no a specific treatment for that idiopathic and systemic disease, but it must be multidisciplinary according to relieve symptoms.

Objectives

This case encourages us to extend the use of TCE in selected patients to reduce depression major symptoms and comorbidity produced by polymedication. It would improve therapy adherence with less drugs in prescription.

Methods

It is presented a clinical report and literature review of a patient treated in our hospital who takes around 20 different drugs (benzodiazepines, mood stabilizers, antiepileptics, antipsychotic drugs, analgesics, morphics…) and 7 of them were prescribed by a psychiatrist.

Results

After 8 sesions, the patient has a preserved reality judgement and no idea of death. The maintenance treatment passed to 3 different kind pills after the intervention (duloxetine, quetiapine and lormetazepam) with persistence of pain, insomnia and amnesia.

Conclusions

Treatment was effective with well-known side-effects. The persistence of pain and physical symptoms aims us to encourage the multidisciplinary treatment with Rheumatology and Internal Medicine.

Introduction

The chronic fatigue is formed under the influence of academic overload, everyday stress, sleep deficit and lack of rest.

Objectives

The purpose of this study was to identify the individual psychological factors for chronic fatigue in students.

Methods

321 volunteers, first-third year students from the Taras Shevchenko National University of Kyiv aged 17-23 years participated in this study. To determine the level of fatigue we used `The degree of chronic fatigue syndrome` test of A. Leonova.

Results

The inversions of chronic fatigue were established with the strength and mobility of nervous processes, extraversion, sincerity, and outward euphoric type of emotional reaction.A direct correlation is established with the following indicators of students' emotional sphere and states:Trait and State Anxiety,neuroticism,alexithymia, low-stress resistance, psychological distress, and emotional burnout. Inward refractory and outward dysphoric types of emotional reaction also contribute to the development of chronic fatigue. Regression analysis revealed that the most significant predictors of chronic fatigue are the level of neuroticism, exhaustion, anxiety as a state and personality trait, and students' experience of psychological distress.Positively assessing one's learning success reduces the level of chronic fatigue. Progression of chronic fatigue from first to the third year showed the role of education overload.Playing sports and dancing decrease the level of chronic fatigue, which indicates a significant effect of physical activity in the prevention of fatigue and exhaustion in students.

Conclusions

The development of chronic fatigue is determined by the features of the nervous system,personal properties, and the emotional state. Students' lifestyle, physical activities affect the formation of chronic fatigue.

Introduction

High levels of pro-inflammatory markers (e.g. TNF-alfa, IL-6, C-reactive protein) have been reported in patients diagnosed with major depressive disorder (MDD). Inflammation has been considered a potential factor that may worsen the MDD evolution, therefore drugs that interfere with inflammatory processes have been suggested as add-on to antidepressant therapy in partial or resistant cases.

Objectives

To evaluate the current data in favour of recommendation for anti-inflammatory drugs as augmentation agents in the treatment of MDD.

Methods

A literature review was conducted in the main electronic databases (PubMed, EMBASE, CINAHL, Cochrane Database of Systematic Reviews, Thomson Reuters/Web of Science) using the search paradigm “anti-inflammatory drugs” OR “immune modulators” AND “major depressive disorder”. All papers published between 1990 and 2019 were included in the primary analysis, than they were filtered by using pre-determined inclusion and exclusion criteria.

Results

Infliximab is an anti-TNFα chimeric monoclonal antibody that decreased depression severity in patients with an increased initial level of inflammation markers in clinical trials. Adalimumab is a monoclonal antibody with anti-TNFα properties that decreased the severity of depressive symptoms after 12 weeks in patients with psoriazis, while etanercept (also an anti-TNFα inhibitor) confirmed its efficacy over the affective symptoms during an 84 week-extension trial in patients with the same dermatological pathology. Tocilizumab and sirukumab are studied as add-on to antidepressant drugs, but the results are still inconclusive.

Conclusions

Although immune modulation therapy is a new type of intervention for MDD, it may be a promising intervention for MDD with partial response to antidepressants.

Introduction

Mood disorders are amongst the most common groups of mental disorders in young people (YP). Depression may affect 8-20% of all YP and may result in a cascade of negative developmental outcomes predicting long-term morbidity and poor functioning. In view of this, the COST action ‘European Network of Individualized Psychotherapy Treatment of Young People with Mental Disorders’ (TREATme) was set up to help improve mental health services in YP.

Objectives

One of the overarching aims of TREATme is to carry out a systematic review to assess for the effectiveness of psychotherapeutic interventions in YP. In this study, we present results from the systematic review of treatment effectiveness of youth interventions for mood disorders.

Methods

Following PRISMA guidelines, we systematically searched for clinical trials targeting mood symptoms in YP in PubMed and PsycINFO. The PICOS model was used to define inclusion and exclusion criteria. Included studies were selected by reaching consensus between six independent raters.

Results

The systematic search yielded 4181 papers. The title and abstract were reviewed and a consensus was reached to accept 608 papers for full-text review. As per inclusion criteria, a consensus was reached to include 91 papers into the review for effectiveness of psychotherapeutic interventions in mood disorders.

Conclusions

The results of this systematic review provides an overview of the current evidence base of youth psychotherapeutic interventions for mood disorders. Discussion of findings will emphasize the importance of personalizing psychotherapy treatment to target effectively mood disorders in YP.

Introduction

The extent of cognitive dysfunction of Major Depressive Disorder (MDD) is still not clear and one plausible explanation is the existence of different degrees of cognitive impairment among patients.

Objectives

To identify clusters of MDD patients using sociodemographic, clinical and cognitive measures as indicators of grouping. To explore the association between cognitive profiles and clinical, demographic and psychosocial characteristics.

Methods

174 participants with a current MDD episode (HDRS-17 >8) were recruited. To identify homogeneous subgroups of patients, a two-step clustering analysis was carried out using age, years of schooling, depressive symptomatology (HDRS-17), number of depressive episodes, stage of treatment-resistance and cognitive domains as factors. Demographic, clinical and functional variables were analysed between resulting clusters by means of one-way ANOVAs or chi-square when appropriate.

Results

The variable with the highest importance of clustering was treatment resistance, closely followed by cognitive performance. Three clusters were identified: Cluster 1 (C1, cognitively preserved, n=68, 39%). It was characterized by a sample of non-resistant patients with higher years of schooling; Cluster 2 (C2, selectively impaired, n=66 patients, 38%), where all patients were treatment resistant with selective cognitive deficits; Cluster 3 (C3, globally impaired patients, n=40, 23%) with significant deficits in all neurocognitive domains. In this cluster, patients were classified as resistant (n=23, 58%) and non-resistant (n=17, 42%) and showed more depressive symptoms. The globally impaired patients had significantly lesser education and lower IQ.

Conclusions

The findings support cognitive heterogeneity in patients with an active episode of MDD. These results might benefit future and more tailored treatment strategies targeting cognitive dysfunction.

Introduction

Depression represents one of the leading causes of disability and poor quality of life among people worldwide. Associations between food and depression, such as lower fish consumption and increased risk of depression, have been documented. There is evidence that gut microbiota modulates brain function, playing a major role in the pathogenesis of depression.

Objectives

To review the literature and to summarize the current knowledge about gut microbiome and depression.

Methods

Non-systematic review of the literature on the topic available in scientific database pubmed, with the keywords: “depression” and “gastrointestinal microbiome”. Articles published between 2014/01/01 and present date in English, Spanish and Portuguese in a total of 80.

Results

Modification of gut microbiota composition may damage the intestinal barriers, allowing the inflow of bacterial metabolites from gut to lumen, which may lead to an increase in circulation of lipopolysaccharides. High-sugar diet or high-fat diet contribute to this gut composition modification. The study of the impact of gut microbiome on symptoms of depression resulted in the proposal of three mechanisms: inflammation directly, through the hypothalamus-hypophysis- axis and through interference with neurotransmitter signalling.

Conclusions

The direct relation between gut microbiota and depression remains unclear, but inflammation is implied. Identification of the signalling pathways between gut microbiome and brain is needed to increase the knowledge, to reinforce the need for dietary quality as a prevention measure and to promote the development of new therapeutic targets.

Introduction

Pathological Gambling (PG) has been associated with many psychiatric disorders.

Objectives

We aimed to analyse depressive level and determine their association to the gambling and to evaluate self-esteem amongst gamblers.

Methods

We conducted a cross-sectional study. Data was collected prospectively from a group of gamblers in Monastir, Tunisia. Data collection accurred between the months of february and march 2018. Only players of a locally popular stakes game were included. A questionnaire was answered anonymously, including: Socio-Demographic characteristics, the Rosenberg self esteem scale, the Beck depression inventory, the South Oaks Gambling score SOGS.

Results

This study included 134 male participants with a mean age of (24.2 ±5.3). The study population counted 69 Gamblers, 33.3% of whom were Pathological Gamblers. A statistically significant association between high self-esteem and Gambling was found (20.9% of Gamblers had high self-esteem vs. 8.3% of non Gamblers ; p= 0.048). Pathological Gambling was significantly associated to moderate to severe depression (63.6% of PG vs. 35.5% of non PG had moderate to severe depression;p= 0.03).

Conclusions

Pathological Gamblers had high self-esteem and a tendency for depression.

Introduction

30-60% of all depressive disorders show signs of resistance to treatment, which is an additional burden in the socio-economic aspect, significantly impairs the quality of life of patients, is the cause of disability and social maladaptation of depressed patients.

Objectives

To identified biological and psychosocial predictors of treatment resistant depressive disorder (TRD).

Methods

Based on comparative socio-demographic, clinical and patho-psychological, psycho-diagnostic, laboratory biochemical and neurophysiological analysis 187 patients with TRD were examined.

Results

Neurochemical studies have shown that in TRD marked imbalance for prooxidant and antioxidant systems with upward last one, also infringement mechanisms of active transport of Na into the extracellular environment, which is a marker of violation of the integrity of cells and their subsequent damage. Neuroimunological research in TRD showed significant disregulation systems, cellular and humoral immune deficiency with the appearance of activity. The predominance of rhythm changes in brain structures in the right hemisphere, expressed interhemispheric assymmetry that preferentially localized in the frontal and parietal lobe of the right hemisphere, reducing synchronization signals in the frontal, parietal and central temporal cortical areas with potentiation reduce integration in both hemispheres was identificated as neurophysiological predictors for TRD pathogenesis. Non-adaptive coping variants prevalent in patients with TRD, the result is a lack of medical compliance (48.3% of cases with TRD), which creates additional difficulties in treatment of such patients.

Conclusions

The principles and components of a complex treatment system for TRD were defined. The implemented system showed positive clinical dynamics, changes in social functioning and quality of life in patients with TDR

Introduction

There is growing interest in the role of calorie-restriction diets in a variety of health-related conditions. Particularly, fasting stands as a millennial practice, with multiple documented benefits, such as decreased cardiovascular and cancer risk and weight-loss. However, evidence on mental health benefits is still lacking.

Objectives

To shed light on the potential benefits of fasting in mood disorders, specifically depression.

Methods

A literature review on PubMed/MEDLINE was conducted, using the query “(fasting OR intermittent fasting) AND depression”.

Results

Growing evidence highlights the potential benefits of fasting for certain periods (intermittent-fasting or IF) in brain functioning. Antidepressant-like effects in mice had been previously described in a number of studies involving acute fasting. Among humans, a remission rate of 86% was observed in depressed individuals who fasted for ten days, with increased energy levels and anxiety relief. Also, a recent study found improved depressive symptoms in obese women who lost significant weight following IF. Furthermore, evidence shows IF might alleviate cognitive symptoms and the characteristic ‘brain fog’ in depressive disorders, improving mental clarity. These benefits may be due to an increase in brain-derived neurotrophic factor (BDNF), with amplified neurogenesis and resilience, as well as optimized serotonin metabolism. Also, overall reduced inflammation and influence on gut microbiome may be important.

Nevertheless, certain studies have not found significant mood differences associated with fasting, hence evidence is still inconclusive.

Conclusions

Fasting might stand as promising therapeutic adjuvant to treat depression. Further investigation and randomized controlled trials are needed to reach valid conclusions.

Introduction

The symptoms of the depression in high intellectual potential (HIP) children (IQ > 130) are little studied.

Objectives

The aim of the study is to understand depression versus no depression in a sample of gifted children, with a standardized and normative scale.

Methods

We assessed the depression with the Multiscore Depression Inventory for Children (MDI-C) in a national sample of 361 HIP children (primary school and college) requesting association of gifted children. This assessment is a self-report instrument administrered to 8 to 17 years old, enabling to measure multicomponent symptoms of depression represented in 8 subscales (Anxiety, Self-Esteem, Sad mood, Instrumental helplessness, Social introversion, Low energy, Pessimism, Defiance). All the parents answered to a questionnaire about academic learning of their child.

Results

IQ 130-139 versus >140 IQ are not significant with depression in primary school (p < .43) and college (p < .26). We found 47% of depression. All the symptoms are associated to the depression score (p < .001).

HIP children with depression have significantly (p < .001) difficulty at primary school in reading, 23 % (vs) 6 % without depression, respectively 7 % vs 2 % for written expression (p < 0,003) and 7 % vs 2 % for arithmetic (p < .003). At the college, there is an increase of learning disabilities.

Conclusions

IQ score is not in relationship with depression. However IQ > to 130 may mask school disabilities, so it appears necessary to examine the subtests of IQ which are significantly low, and assess neuropsychological and motor brain functions.

Introduction

Vasopressin is involved in the regulation of the HPA axis through vassopresin 1a (V1a) and 1b (V1b) receptors located in the limbic system, and this axis is a key structure in the regulation of social behaviors and response to stressful stimuli.

Objectives

To assess the level of evidence in favour of V1b receptor effects in clinical and preclinical models of psychiatric disorders.

Methods

A search of major electronic databases (Cochrane, PubMed, PsychInfo, EMBASE) was performed, using keywords “vasopressin type 1b receptor”, “major depression”, “anxiety disorders”, and “psychiatric disorders”. Also, the database clinicaltrials.gov was questioned using the same keywords.

Results

ABT-436 is a V1b receptor antagonist that was investigated for major depression and showed positive results, while the tolerability was good overall, main adverse events being nausea, decraesed systolic blood pressure, increased heart rate. HPA attenuation was observed during this trial with ABT-436 after 7 days. A single-dose interaction study with ABT-436 was conducted in moderate alcohol drinkers and no significant interaction was detected between the two substances. TASP0233278, TASP0390325, V1b-30N, and SSR149415 have exerted anxiolytic and antidepressant effects in several preclinic models of depression and anxiety. Also, V1b receptors antagonists have been explored for the treatment of aggressive behaviors and stress-related disorders in preclinical models.

Conclusions

Antagonism of the V1b receptors is a promising therapy for affective, anxiety, stress-related and substance-related disorders, but most data are derived from preclinical trials and more research is needed before considering it a clinically valid option.

Introduction

Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage. Primary care settings in Asia, Africa, Europe, and in the Americas had patients reporting persistent pain prevalence of 10 to 25%.

Objectives

To see the prevalence of depressive symptoms amongst patients with chronic pain disorder attending specialized pain clinics in Oman and to examine the factors that contributed to depression in patient with chronic pain

Methods

It is a cross sectional study and included patients aged more than 18 years attending the pain clinic between April 2019 to November 2019. Estimated Sample size will be about 300 participants. And,all participants asked to complete Patient Health Questionnaire (PHQ-9) and Demographics survey. Descriptive statistics computed for socio-demographic characteristics and items of the PHQ-9. Comparison between groups conducted using two-tailed Student’s t-test.

Results

A total of 322 chronic pain patients(205 females [64%]) participated in the study. The prevalence of depression was 71% (95% CI: 64.7–77.3) based on the PHQ-9 diagnostic criteria using a cutoff point of >5. Among those patients who were depressed, 15 (4.6%) had severe depression as compared to 50 (15.5%), 66 (20.5%), and 98 (30.5%) who had moderately severe, moderate, and mild depression, respectively. Previous figures was significantly associated with age,financial status, medical history of depression,and pain severity.

Conclusions

Depression is common among chronic pain patients with several risk factors aggravating its presentation. Due to their increased risk of depression,psychiatric counselling should be prioritized and made available as a multidisciplinary approach for the treatment of chronic pain patients.

Introduction

The link between depression and acute coronary syndrome (ACS) was well established. Depression that occurs the first time after a coronary event appears to be a separate entity.

Objectives

The objectives were to evaluate the incidence of depression following a first episode of ACS and to identify the risk factors associated with this entity.

Methods

We conducted a prospective, multi-center study in four cardiology departments in Tunisia, during the period from June to December 2018. We included patients hospitalized for a first episode of ACS. We used the Hospital anxiety depression scale (HADS) to assess depression.

Results

A total of 110 subjects were included. The average age of the study population was 57±8,1 years. Sex ratio (Male/Female) was 3,78. Prevalence of depression among this population was 19,1%. Univariate analysis revealed three factors associated with the incidence of depressive symptomatology after ACS; namely alcohol consumption (p = 0.019), overweight (p = 0.035) and anxiety (p <0.001).

In binary logistic regression, alcohol consumption was the independent predictor of the incidence of depression after ACS with an odds ratio of 4.680 and a 95% confidence interval [1.449; 15,107]; p = 0.01.

Conclusions

Our results higlight that alcohol consumption, overweight and anxiety are risk factors for developing an "incident depression" among patients admitted for a first episode of ACS. Our data suggest that practitioners should consider these variables in patients admitted for the first episode of ACS to screen for depressive symptomatology.

Introduction

The management of neuropathic pain (NP) remains complex, generally because of the psychiatric comorbidity that is often under diagnosed.

Objectives

The aim of our study was to determine the link between depression and the characteristics of NP regardless of etiology.

Methods

Methods: A cross-sectional study was conducted at the pain treatment center, Tunis, Tunisia and the Physiological Investigations department, Habib Bourguiba University Hospital, Sfax, Tunisia. We used DN4 Assessment tool to assess NP and an analogue visual scale to assess the NP severity. We used the Arabic version of Hospital anxiety depression scale (HADS) to assess depression.

Results

A total of 61 NP subjects were included. The average age of the study population was 52.71 ±14.29 years. Sex ratio (Male/Female) was 0.52. Depression prevalence was 65.6%. Patients with high DN4 score were significantly more depressed (p= 0.025). Positive and significant associations were found between the depression score and NP severity (p= 0.001, r = 0.41) and depression score and treatment duration (p= 0.013, r = 0.31). Depressed NP patients had significantly greater impairment than the non-depressed (p= 0.007, p=0).

Conclusions

Our results highlighted the high prevalence of depression among NP patients, especially those with severe NP and long duration treatment. Thus, screening of depression should be part of the basic NP assessment among these subjects.

Introduction

Psychopharmacoepidemiological surveys indicate a continuous increase of administering add-on treatment strategies in the pharmacotherapy of major depressive disorder (MDD) over the last decades.

Objectives

This naturalistic European multicenter, cross-sectional study aimed to determine socio-demographic and clinical variables associated with the prescription of add-on treatment strategies in patients with MDD.

Methods

Adult patients with MDD (DSM criteria) were recruited in 10 sites across 8 European countries. Their socio-demographic, medication, clinical, and treatment variables were obtained and depressive symptom severity was measured by the Montgomery and Åsberg Depression Rating Scale (MADRS). The patients` characteristics were compared between MDD patients medicated with and without add-on medication using descriptive statistics and analyses of covariance. Binary logistic regressions were performed to examine the association between explanatory variables and teatment with add-on medications.

Results

60.6% of 1409 included participants received add-on treatment (mean number of concurrently prescribed psychiatric drugs: 2.18 ± 1.22). 33.9% received benzodiazepines, 29.5% antidepressant combination treatment, 26.1% antipsychotics, 11.3% mood stabilizers, and 7.6% pregabalin. Male gender, older age, Caucasian origin, higher weight, low educational status, absence of occupation, psychotic symptoms, melancholic and atypical features, suicide risk, inpatient treatment, some psychiatric comorbidities (panic disorder, agoraphobia, obsessive-compulsive disorder, bulimia nervosa), comorbid somatic comorbidity in general and concurrent hypertension, thyroid dysfunction, diabetes, and heart disease in particular, higher MADRS total scores, treatment resistance, and higher antidepressant dosing were significantly associated with add-on pharmacological treatment.

Conclusions

Our findings suggest a association between receiving add-on treatments and treatment-resistant/difficult-to-treat MDD conditions characterized by severe symptomatology and a high amount of psychiatric and somatic comorbidities.

Introduction

Depression is a common disease that reduces the quality of life and limits seriously psychosocial functioning.

Objectives

The aim of this study is to investigate the role of hope and resilience in the outcome of depressive disease and in suicidality.

Methods

Seven scales (BPRS-HAMD-MADRS-HADS-SNYDERCDRISC10-SSI) have been administered to subjects with the following features: diagnosis of unipolar depressive disorder, bipolar disease and schizoaffective disorder with a major recent depressive episode according to DSM V criteria, age between 18 and 75 years, no history of drug addiction, of psychiatric disease caused by a medical condition and of mental delay.

Results

The sample is made of 75 patients: 28 males and 47 females. The average age is 48 years. The majority was single, followed by married and divorced. Most of the patients were occupied with a depressive episode. An inverse relation was found between higher levels of hope and resilience and lower severity of depression (p <0.0001) and between higher levels of resilience and lower levels of suicidality (p 0,037). Furthermore an inverse relation between age and resilience (p 0,020) and a direct relation between age and years of disease (p <0.0001) and between resilience and hope levels (p <0.0001) were found. In women there was a higher length of disease (p 0,033) and higher levels of depression (p 0,040).

Conclusions

It would be interesting to investigate which factors determine a major length of depressive disease in women versus men and a major length of disease and an older age in depressed occupied respect to depressed unemployed.

Introduction

Depression and obesity are two conditions with great impact over global health. This is mainly due to their high frequency and the morbidity and mortality associated to both.

Objectives

The main aim of the present systematic review is to study the association between obesity and depression and the prognostic implications derived from it.

Methods

A literature review was performed in the PUBMED and EMBASE databases with an inclusion deadline of December 31, 2017.

Results

18 articles were found (9 cross-sectional studies, 6 longitudinal studies and 3 clinical trials), which were reviewed by critical reading by the two main authors. These selected articles confirmed that there is indeed a link between depression and obesity, although there are doubts as to the significance of this relation.

Conclusions

Although literature shows a link between depression and obesity, more studies are necessary to determine the sign of this association. Indeed, certain variables such as the atypical depressive subtype, female sex or African-American ethnicity were important when studying this association. The methodological variability of the studies was high, which could have influenced the results. It is recommended that in the future criteria should be unified and also to resort to follow-up studies.

Introduction

Depression is recognized as a major public health problem that has a considerable impact on individuals and society. For treating depression, antidepressants are the most popular choices. However, their undesirable side effects and delayed onset of therapeutic action are still raising concerns. The number of studies investigating the effectiveness and adverse effects of acupuncture in treating depression has increased gradually in the past decades. However, as most clinical studies or reports were published in Chinese-language journals, various acupuncture methods and their effects remain unknown for the western world.

Objectives

This article aims to provide a brief review of acupuncture and its application in the treatment of depression in China.

Methods

This research selected and reviewed some representative studies towards acupuncture appliaction in the treatment of depression in China.

Results

Many systems of acupuncture including manual acupuncture, electroacupuncture, moxibustion, could be used to treat depression and proved to have achieved good clinical results. Electroacupuncture had an advantage in improving some factors score than manual acupuncture. Combining acupuncture and antidepressant for the treatment of depression could have a better effect than antidepressants alone and reduce side effects produced by antidepressants. Acupuncture could also reduce the recurrence rate of depression. Auricular，abdominal, and scalp acupuncture combined with body acupuncture was more effective than each of these methods alone for treating depression.

Conclusions

We believe more advanced clinical studies with reliable experimental design and rigorous data analysis methods are needed to further evaluate the effectiveness and adverse effects of acupuncture for the treatment of depression.

Introduction

Perinatal depression refers typically to women as to the most recent episode of major depression if the onset of moods symptoms occurs during pregnancy or in the 4 weeks following delivery, according to the DSM-5:F32.9; and, as a syndrome associated with pregnancy or the puerperium (commencing within about 6 weeks after delivery) that involves significant mental and behavioral features, following CIE11:6E20.0. However, what happens with new fathers?

Objectives

Expose justification and possible diagnostic criteria for paternal postnatal depression.

Methods

Systematic search and literature review.

Results

Depression in fathers in the postnatal period is associated with later psychiatric disorders in their children, independently of maternal postnatal depression. Strikingly, the transition to parenthood is associated with a marked deterioration in marital quality. Besides, the correlation between paternal and maternal depression was positive and moderate, which, often harms the parental-infant relationship. Depression in new fathers occurs most frequently between 3 to 6 months after birth and the meta-estimate is up to 26 % in that period. Some depressive symptoms are similar between mothers and fathers, nevertheless, men feel less able to cry and manifest vulnerability norms, and instead express externalizing depressive symptoms like anger and irritability, in contrast to the internalizing symptoms more common among women. Furthermore, there are some specific features of “the paternal brain”.

Conclusions

The recognition of paternal postnatal depression will allow suffering fathers to be visible both clinically and socially, which will allow the implementation of specific prevention and treatment strategies for the benefit not only of them but of the whole family.

Introduction

Depression and alcohol use disorders (AUD) have a negative impact on health-related quality of life (HRQOL) in general population. However, research on the association of comorbid AUD and HRQOL among clinically depressed patients is scarce.

Objectives

The aim of this study was to explore the change in HRQOL among specialized mental health care depressive patients who typically have various concurrent psychiatric disorders. The focus was in the impact of comorbid AUD on improvement of HRQOL in this sample.

Methods

The study population (n=242) scored at least 17 points in Beck Depression Inventory at baseline and did not suffer from psychotic disorders. Those with baseline Alcohol Use Disorders Identification Test (AUDIT) > 10 were categorized as AUD group (n=99, 40.9%). Treatment intervention comprised behavioural activation for all and additional motivational interviewing for those with AUD. HRQOL was assessed regularly during 24-months follow-up by 15D questionnaire. AUD and non-AUD patients were compared and the factors explaining 15D score were analyzed.

Results

15D score improved in the whole study population during the first year of follow-up (improvement 0 - 6 months, p<0.001; 6 - 12 months, p=0.001). A difference between AUD groups was found only at 24-months follow-up point when mean 15D score in non-AUD group was better (p=0.002). In linear mixed model for 15D the changes were better explained with other factors than comorbid AUD.

Conclusions

The treatment intervention was successful in terms of improvement in HRQOL regardless of the comorbid AUD.

Introduction

Depressive disorder is a common psychiatric illness in medical students. The high risk of depressive disorders in the medical students may result from various factors. Since the depression could lead to low academic achievement, low quality of life and suicidality in the medical students, identification of risk factors for depression is beneficial.

Objectives

This study aims to determine the prevalence and associated factors of depressive disorder in the preclinical medical students of Chiang Mai University, Thailand.

Methods

This cross-sectional study was conducted in the preclinical medical students of Chiang Mai University in October 2018. Basic characteristic data and potential risk factors of depression were gathered. Additionally, depressive disorder was evaluated by using the 9-items-patient health questionnaire. Analysis of multivariable ordinal logistic regression was used to identify the independent association of variables with depression.

Results

The study found that the prevalence of depressive disorder in preclinical students was high (19.9%). The factors that significantly associated with depressive disorder among those medical students consisted of performing activity alone or not attending any activity; having underlying medical illness; high self evaluation on stress; stressors resulted from family members; and solving the problem by running away, aggressive behavior, and nightlife outing. However, playing sport in leisure time could reduce risk of depressive disorder.

Conclusions

According to these findings, prevalence rate of depressive disorders among preclinical medical students is high. Consequently, identification of the risk or protective factors may be beneficial in those medical students. However, further well-designed study may warrant these outcomes.

Introduction

According to the latest data, the prevalence of depression in the systemic lupus erythematosus is 11.5-47%.

Objectives

to determine the degree of depression in systemic lupus erythematosus and to use medico-psychological support to address them.

Methods

The study was conducted in 50 women patients receiving rheumatology. Of these, 35 patients were used in the main group (psychotherapy and psychopharmacotherapy) and 15 patients in the control group (psychopharmacotherapy was applied). The mean age of the controls was 25 ± 6.3. Patients used HADS to detect depression. For psychopharmacotherapy selected antidepressant, Geshtalt therapy for psychotherapy.

Results

According to the HADS, norm (4 ± 2.5) was found in 3 patients (8.6%) in the main group and 2 (13.3%) in the control group; subclinical manifestation depression (9 ± 1.5) in 16 (45.7%) in the main group and 7 (46.7%) patients in the control group; clinical manifestation depression (14 ± 3.5) was found in 16 patients (45.7%) in the main group and 6 (40%) in the control group. These patients were re-examined by HADS using antidepressant and psychotherapy. Norm (4 ± 2.5) in 14 patients (40%) in the main group and 3 (20%) patients in the control group; subclinical depression (9 ± 1.5) in 17 (48.6%) in the main group and 8 patients (53.3%) in the control group; clinically significant depression (14 ± 3.5) was found in 4 (11.4%) in the main group and 4 patients (26.7%) in the control group (ᵖ ≥0.01)..

Conclusions

The use of psychopharmacotherapy and psychotherapy to correct depressive disorders has had a positive effect.

Introduction

In the field of diet and depression, researchers come to firm conclusions about the benefits of a healthy diet on depression although most evidence comes from observational studies and robust findings are rare.

Objectives

We aim to assess whether research methods that allow for more researcher bias are more likely to overstate the benefits of a healthy diet on depression than research methods that allow for less researcher bias.

Methods

We systematically searched the databases PUBMED and Web of Science for narrative reviews, systematic reviews, and meta-analyses on the effects of diet on depression published before September 3^rd, 2019, and independently rated their conclusions as strong, moderate, or weak. Methodological quality of the included studies was assessed with the AMSTAR tool and the strength of the evidence by means of the GRADE approach.

Results

We found 19 narrative reviews, 10 systematic reviews, and 12 meta-analyses on this topic. Narrative reviews were 7.90 (95% CI: 2.04, 30.57) times more likely to report stronger conclusions than systematic reviews and meta-analyses. Authors with allegiance bias were more likely to report stronger conclusions. Systematic reviews and meta-analyses were of critically low quality, and the certainty of evidence was low.

Conclusions

Research methods that allow for researcher bias overstate the benefits of a healthy diet on depression. This may be due to the selective citation and potential conflicts of interest. Journal editors and reviewers should be aware of this bias and protect researchers, clinicians, and policy makers against opinions sold as data-driven conclusions.

Introduction

Family studies suggest that individuals with recurrent depressive disorder have a higher genetic liability for depression than individuals with a single depressive episode. However, no study has examined the direct effects of genetic liability on the relative and absolute risks for recurrence among individuals with depression.

Objectives

To estimate the effects of polygenic liabilities for major depression (PRS-MD), bipolar disorder (PRS-BD) and schizophrenia (PRS-SZ) on relative and absolute risk for recurrence among first-onset, hospital treated depression patients in Denmark.

Methods

We identified 14,812 individuals from the iPSYCH2012 sample (69% female, ages 10-30 at first depression diagnosis) diagnosed with depression between 1994-2011. Patients were followed from their first depression diagnosis until their first recurrence, death, emigration or December 31, 2016, whichever came first. PRS variables were trained using the most recent results from the Psychiatric Genomics Consortium and 23andMe. Relative and absolute hazards were estimated using cox regression.

Results

Patients were followed for up to 21 years (Median=6.4 years, IQR=4.6). 27.5% of the sample experienced at least one recurrent episode. There was a small but statistically significant association between PRS-MD and risk of recurrence: for each 1 SD increase in PRS-MD, risk of recurrence increased by 5% (HR=1.05, 95% CI=1.02-1.08, p=.0005). Absolute risk for recurrence increased by around 1% for each quartile of PRS-MD (Figure 1). PRS-BD or PRS-SZ were not associated with recurrence.

Conclusions

Higher polygenic liability for major depression is associated with increased risk for recurrence among first-onset depression patients, however the impact on absolute risk is modest.

Introduction

Brain-Derived Neurotrophic Factor (BDNF) is one of the most commonly studied neurotrophins. The lack of BDNF signalling in the emotion regulation regions in the brain is hypothesized to be a cause of mood disorders. A massive evidence has been generated showing that blood BDNF measures are related to depression state. Blood has been called a window to the brain. However, the amount of methodological studies on which such statement is grounded is limited. This talk will focus on Why we measure BDNF in depression, How we shoud measure it, and What exactly do we measure in each biological liquid.

Objectives

The objective of the talk is to comprehensively review the series of basic and methodological studies, and through the their light to reassess the clinical meaning of peripheral BDNF measurements.

Methods

A review of methodological studies, along with results of original work will be presented

Results

Conclusions

Introduction

Introduction

The Screen for Cognitive Impairment in Psychiatry (SCIP; Purdon, 2005) was developed to provide a quick assessment of cognitive deficits present in psychoses and affective pathologies. This instrument has three alternative forms that allow new measurements to be made in repeated evaluations. The duration of the administration for each of the forms is about 10-15 minutes. The SCIP includes subtests of verbal learning (immediate and delayed), working memory, verbal fluency, and psychomotor speed.

Objectives

Purpose

The aim of this study is to assess the psychometric properties of the Persian version of the SCIP (SCIP-P) for the detection of cognitive deficits in major depressive disorder (MDD).

Methods

Methods

A sample of 108) persons diagnosed with MDD and 108 healthy controls persons were assessed with the three alternate forms of the Persian translations of the SCIP.

Results

Results

The analysis of the dimensionality revealed a one-factor structure accounting for 53.1% of the variance, with loadings ranging from 0.66 for the processing speed subtest to 0.80 for the verbal learning-immediate recall subtest. Internal consistency, assessed by the Cronbach’s alpha, was α = 0.75. Test-retest reliability reached an intraclass correlation coefficient of 0.72. Persons with MDD scored lower than healthy controls in all the SCIP-P subtests.

Conclusions

Conclusions

This study contributes to the limited knowledge of the reliability and validity of the SCIP-P scores in affective disorders. The SCIP-P has proven to be a brief, reliable and valid instrument to assess cognitive impairment in MDD.

Introduction

Major depressive disorder (MDD) as one of the most prevalent mental disorders is still lacking therapeutic treatment methods with a short onset of action. Ketamine exhibits a rapid antidepressive effect, which is most pronounced 24h after a single infusion. Working memory (WM) impairments that play a major role in MDD appear to be positively influenced by ketamine. Neuroimaging studies have demonstrated that cognition-emotion interaction-related fronto-cingulate structures are often dysregulated in depressive patients during cognitive engagement.

Objectives

To our knowledge, the influence of ketamine on WM-related brain activity in severely depressed patients has not been investigated yet.

Methods

In order to shed light on the underlying mechanisms we investigated brain activity levels pre and post a single ketamine infusion in a sample of 16 severely depressed patients during an emotional WM task.

Results

Our results indicate that baseline activity levels in the lateral and medial prefrontal cortex and in the anterior cingulate cortex predict symptom improvement 24 hours after ketamine. Additionally, activity changes after ketamine in the left DLPFC were linked to reduction in depressive symptoms.

Conclusions

Interestingly, these effects were most pronounced regarding the improvement of cognitive symptoms. As the ACC and prefrontal cortex are both thought to be crucially involved in the regulation of cognition-emotion interaction and MDD mechanisms, the observed interaction might be directly linked to the neurobiological processes underlying the antidepressive effect of ketamine.

Introduction

Previous studies suggest that one of the possible depression pathophysiological pathways is autoimmune inflammation increasing inflammatory mediators’ levels and thus affecting mood.

Objectives

To compare depression and anxiety symptoms among inflammatory bowel disease patients receiving TNF-α inhibitors and those receiving treatment as usual (TAU).

Methods

Instruments: Ulcerative colitis activity index, Crohn's disease activity index, the subscale of neurovegetative symptoms of the Beck depression inventory, Hospital anxiety and depression scale. Active ulcerative colitis or Chron‘s disease patients not using antidepressants were included in the study and divided into an experimental group (receiving TNF-α inhibitors) and control group (receiving TAU).

Results

46 patients' data were analyzed. Between the experimental group and the control group, the disease activity index was not significantly different (Chron‘s disease 3.54 ±4.20; ulcerative colitis 5.70 ±5.00; p > 0.05) as well as the mean scores of the neurovegetative depression symptoms subscale of the Beck depression inventory (2.52 experimental ±3.91 control; p > 0.05). The mean score of the hospital anxiety and depression scale were significantly different between both groups (5.22 ±8.13; p < 0.05). The mean anxiety subscale scores' p=0,06, which shows trend for significance. The mean depressive subscale score was significantly different in the control group (1.43 ±2.65; p < 0.05).

Conclusions

Patients treated with biological therapy experienced fewer depression symptoms than patients showing similar disease activity but receiving TAU.

Introduction

Electroconvulsive therapy (ECT) is the most effective treatment for severe depression. Compared to a wealth of evidence about ECT-induced hippocampal volume increase, little is known about the effect of ECT on hippocampal functional connectivity (FC) and its association with clinical effect of ECT.

Objectives

To test whether the hippocampal FC changes induced by ECT were associated with clinical improvement.

Methods

Resting-state functional MRI (rs-fMRI) was acquired before and after bilateral ECT in depressed individuals. A priori hippocampal seed-based FC analysis was conducted to investigate FC changes associated with clinical improvement. Depressive symptoms were evaluated using the 17-item Hamilton Depression Rating Scale (HAM-D). The analysis was conducted in the CONN toolbox, including seed-to-voxel maps as seeds, time as between-conditions contrast, and percentage change in HAM-D as between-subjects contrast. Age, sex, and baseline HAM-D scores were included as nuisance covariates. The statistical threshold was set at cluster-level false discovery rate (FDR)-corrected p <0.05 with a voxel height of p <0.001.

Results

Twenty-seven depressed individuals (67.5 ± 8.1 years old; 19 female) participated in the study. Connectivity changes between the right hippocampus and one cluster located in the ventromedial prefrontal cortex (vmPFC) showed positive correlation with HAM-D changes. Connectivity changes of the left hippocampal seed did not show any correlations with HAM-D changes.

Conclusions

Depressive symptom improvement after ECT was associated with right hippocampus-vmPFC connectivity changes. Given previous studies investigating other antidepressant treatments, modulation of the right frontolimbic connectivity may be critical for recovery from depression regardless of treatment modality.

Introduction

Ciliary neurotrophic factor (CNTF) is a 22-kDa cytokine belonging to interleukin-6 family and is mainly expressed in glial cells. CNTF is neurotrophin acting as neuroprotective agent. Physiological relevance of circulating CNTF still needs to establish..

Objectives

There are no reports in literature regarding serum concentration of CNTF in depression.

Methods

There were investigated 27 patients with MD at admission and after 30 days of antidepressant therapy (venlafaxine – 75-150 mg/day) and 11 healthy volunteers. Patient’s state was defined as depressive episode in frame of bipolar depressive disorder (type 2) (F32) and in structure of recurrent depressive disorder (F33).

CNTF concentration in serum was assessed by ELISA method. Statistical analysis was performed using Wilcoxon-Mann-Whitney u-test. Difference was considered as significant at p=0.05.

Results

At admission CNTF concentration in serum of MD patients was 679.11 pg/ml of serum. It was significantly for 71.7 % higher in comparison with healthy subjects (405.96 pg/ml of serum, p=0.01). It is shown the first time in literature that depression is followed by increased CNTF level in blood serum.

After 30 days of venlafaxine therapy there were found no changes of CNTF concentration in blood serum; it was on the level characteristic for patients at admission.

Conclusions

CNTF cannot reveal its neuroprotective functions in brain because of immediate leakage through damaged blood-brain barrier in blood stream.

Introduction

Several lines of evidence implicate dopamine is involved in the psychomotor retardation (PMR) in major depressive disorder (MDD). Abnormal cerebral blood flow (CBF) associated with PMR was found mainly in the cortico-basal ganglia-thalamo-cortical (CBTC) circuitry. The dopaminergic polymorphisms might influence the CBF of the CBTC circuitry, which is remained poorly understood to date.

Objectives

To investigate the association of the polymorphisms throughout the dopaminergic pathway with the CBF of PMR in MDD.

Methods

107 MDD patients were divided into PMR group and NPMR group according to the Salpetriere Retardation Rating Scale (SRRS) score and underwent resting-state Arterial spin labeling magnetic resonance imaging (ASL-MRI). The blood sample of 63 patients were collected for genotyping the dopaminergic polymorphisms. After quality controlling, 15 SNPs in 8 candidate genes were entered into the mass univariate modeling analysis.

Results

Genotype-by-PMR associations with the CBF differences were identified for 7 SNPs with the lowest significant P values. The brain regions predominately distributed in bilateral prefrontal cortex (PFC), temporal cortex, and striatum, the left thalamus, the right primary motor cortex, insular cortex, fusiform gyri, and lingual gyri. There were significant negative correlation between the CBF of the PFC and the PMR severity. However, the CBF of the striatum and the thalamus were positively correlated with the PMR severity.

Conclusions

The polymorphisms of dopaminergic pathway are associated with not only CSTC circuitry, but also some other brain regions involving in cognition and emotion controlling. While the increased CBF of PFC might suppress PMR, the increased CBF of striatum and thalamus adversely aggravate PMR.

Introduction

We present a clinical case whose biographical data and psychic symptoms make us propose diagnostic doubts. A good clinical history became essential to optimize the psychopharmacological treatment and achieve stabilization of the case.

Objectives

Describing differential diagnosis of mixed affective symptoms

Methods

68-year-old male patient with no history of mental health. His sister was probably diagnosed as a bipolar disorder. He starts a depressive episode consisting in clinofilia, apathy, insomnia, anorexia, weight loss along with delirious ideas of ruin leading to the cessation of his work activity and a hospital admission. His premorbid personality fits with cluster personality traits

Results

Adjusting treatment with venlafaxine up to a dose of 225mg /day the patient presents a clinical profile consisting on frank hyperthymia, verbiage, elevated self-esteem, disinhibition and hyperactivity that rapidly improves with the suppression of antidepressants and the introduction of quetiapine 200mg/day.

Conclusions

We present the case as a differential diagnosis among "bipolar disorder mixed affective episode" and "major depressive disorder with psychotic symptoms". Given the data of family history, age of onset, symptoms of debut, personality traits, evolution of the picture and response to psychotropic drugs.

Introduction

In 2018, Ahmad and co-workers reported that an RDoC-inspired anxious depression (AD) subtype derived from the Hamilton Depression Rating Scale (HDRS) significantly predicted remission in antidepressant treated subjects participating in non-placebo-controlled studies in major depression.

Objectives

To investigate (1) whether the association replicated in antidepressant-treated patients participating in placebo-controlled studies, and (2) if it would be present also in placebo-treated patients

Methods

We conducted a pooled, post-hoc analysis of 4832 patients who had completed six weeks of treatment with a selective serotonin reuptake inhibitor or placebo. AD was defined according to the criteria proposed by Ahmad and colleagues. Logistic regression was used to assess the three outcomes treatment failure, response and remission. All outcomes were assessed by both the full 17 item HDRS and the unidimensional HDRS-6 subscale. We first assessed whether there was an interaction between treatment and AD for any outcome parameter on either outcome measure. If there was no interaction, we conducted follow-up analyses stratified by treatment.

Results

There were no interactions between treatment and AD for any outcome on either outcome measure. The AD subtype did not significantly predict any outcome on either outcome measure in the stratified analyses.

Conclusions

The association between HDRS-defined AD and remission reported by Ahmad and co-workers was not replicated. This could be due to differences in trial design, e.g., placebo-controlled vs non-placebo-controlled, 6 week vs 8 week trial duration, etc. Nonetheless, in this population, the AD subtype was not a useful predictor of treatment outcomes.

Introduction

The morbidity of major depressive disorders (MDD) is not related only to affective changes but has many social and functional aspects and the indicators of their evolution are expressed in terms of quality of life (QOL).

Objectives

Our objectives were to evaluate the QOL of euthymic patients with MDD compared to healthy controls (HC) and to identify factors associated with its impairment.

Methods

This is a comparative and analytical study, conducted over 3 months, involving 30 euthymic patients with MDD, who were followed up in the outpatient psychiatry department of Hedi Chaker University Hospital in Sfax (Tunisia). They were compared to 34 HC.

General, clinical and therapeutic data were collected using a pre-established questionnaire. QOL was assessed with the «36 item Short-Form Health Survey» (SF-36).

Results

Relative to HC, patients with MDD had decreased overall SF-36 scores (50.88 vs 73.78; p<10-3) and decreased physical and psychological subdomain scores (p <10-3; p <10-3).

The study of the dimensional average scores of QOL via SF-36 and different variables revealed correlations between; impaired physical functioning and advanced age (p=0.026), impaired vitality and hospitalization frequency in psychiatry (p=0.047), physical health problems and psychotropic association (p=0.05), emotional health problems and poor adherence to treatment (p<10-3), and impaired global QOL and widowhood and divorce (p = 0.03).

Conclusions

QOL in the MDD is impaired even in the remission phase. This result encourages us to conceive the patient in his entire life not only from the angle of the disease alone.

Introduction

Introduction::depression, anxiety and somatization are closely related to each other and are a serious public health problem..

Objectives

Objectives: to study various somatic complaints of cardiological inpatients (CIP) to assess their severity in major depressive disorder (MDD) to assess the relationship between somatization and anxiety.

Methods

Methods: A cross-sectional study was conducted on 127 inpatients of the cardiology department also underwent HADS, SHAPS, and VAS to assess depression, anxiety, and pain. We compared the frequencies of standardized somatic complaints in inpatients without D (n = 58) and with MDD (n = 27).

Results

Results: a marked increase in standardized symptoms with MDD (Tabl.). It’s probably not somatic conditions.

Tabl.

Conclusions

Conclusion: in patients with cardiovascular disease MDD is combined with dificult somatization and anxiety.

Introduction

Unipolar depressive disorders (UDD) are associated with increased impulsivity during episodes of illness. However, there is little information about impulsivity during euthymic periods.

Objectives

Assessing impulsivity in euthymic patients with UDD compared to healthy controls (HC).

Studying the relation between impulsivity and clinical factors.

Methods

This was a comparative and analytical study, conducted in the outpatient psychiatry department of Hedi Chaker University Hospital in Sfax (Tunisia), from July to September 2019, among 30 euthymic patients with UDD compared to 34 HC. Data were collected on a pre-established questionnaire. Impulsivity was assessed with the Barratt Impulsiveness Scale (BIS-11).

Results

Mean ages of UDD patients and HC were 50.56 and 40.1 years, respectively. The sex ratio was 1 in UDD patients and 0.9 in HC groups. Among UDD patients 26.7% had a history of suicide attempt.

Impulsivity scores of the UDD patients were higher than HC on total (64.83 vs 53.52) and three subscales measures; motor (20.93 vs 16.14), attentional (15.6 vs 13.5) and non planning impulsivity (28.3 vs 23.7). High degree of impulsivity was noted in 26.7% of UDD patients. UDD patients scored significantly higher than the HC on total, motor, and non planning impulsivity scores (p = 0.000; p = 0.001; p=0.000, respectively). Total and motor impulsivity scores were correlated to history of suicide attempt (p= 0.014; p=0.041, respectively).

Conclusions

Patients with UDD had a high degree of impulsivity outside the critical period. Would this impulsivity be a marker of vulnerability to the risk of relapse of this disorder?