Depression Status and Associated Factors in Chinese Occupational Truck Drivers.

Depression Status and Associated Factors in Chinese Occupational Truck Drivers.

Cell Biochem Biophys. 2013 May 28;
Shen S, Li Y, Zhou M, Zhang C, Jiang Y, Kang Y

The aim of this study was to assess the depression status and associated factors in occupational truck drivers. Four hundred and forty-one male occupational truck drivers were recruited from transport companies. The self-rating depression scale (SDS) and Eysenck Personality Questionnaire-R Short Scale were used to measure the depression status and factors associated with it for occupational truck drivers. The observed SDS of (mean ± SD) 52.91 ± 11.41 was significantly higher than the average national score (41.99 ± 10.57). There were 237 cases of depression, making the incidence of 53.74 %: 116 (26.30 %) patients had mild depression, 104 (23.58 %) moderate depression, and 17 (3.85 %) severe depression. Drivers with <1 year of experience had the highest SDS score; their score was significantly (p < 0.05) different from the one in more experienced drivers. Furthermore, the SDS score in drivers with high school education was significantly higher than in drivers with secondary education (53.41 ± 11.67 vs. 50.62 ± 11.77, respectively; p < 0.05). SDS scores positively correlated with extroversion and neuroticism, and negatively correlated with psychoticism. In conclusion, depression is present in professional drivers, especially those with <1 year of driving experience. The level of depression is associated with driving experience, education status and personality. Based on this study, we propose to establish psychological health profiles for each professional driver, and to provide psychological counseling to them, especially drivers with <1 year of experience. HubMed – depression


Evidence for the Benefits of Nonantipsychotic Pharmacological Augmentation in the Treatment of Depression.

CNS Drugs. 2013 May 28;
Chang CM, Sato S, Han C

Failure to achieve an adequate response after initial antidepressant treatment in patients with depression is common and remains a clinical challenge. In recent years, some atypical antipsychotic agents have been approved by the US Food and Drug Administration for use in an augmentation strategy for major depressive disorder, and other agents are already in common use in clinical practice. We conducted a search of MEDLINE for relevant studies of augmentation strategies using randomized controlled trials and meta-analyses, and we summarize and discuss the various agents other than atypical antipsychotics. Lithium and thyroid hormone augmentation may improve the response of tricyclic antidepressants but not that of selective serotonin reuptake inhibitors. The efficacy of augmentation with modafinil, buspirone, methylphenidate, folic acid, pindolol and lamotrigine is limited or equivocal. Most of the studies have not focused on treatment-resistant depression (TRD). More trials are needed to help develop evidence-based options for augmentation in TRD. HubMed – depression


Association between Sirtuin 2 gene rs10410544 polymorphism and depression in Alzheimer’s disease in two independent European samples.

J Neural Transm. 2013 May 28;
Porcelli S, Salfi R, Politis A, Atti AR, Albani D, Chierchia A, Polito L, Zisaki A, Piperi C, Liappas I, Alberti S, Balestri M, Marsano A, Stamouli E, Mailis A, Biella G, Forloni G, Bernabei V, Ferrari B, Lia L, Papadimitriou GN, De Ronchi D, Serretti A

Among the several genes associated with late-onset Alzheimer’s disease (LOAD), recently, Sirtuin genes have roused a growing interest because of their involvement in metabolic homeostasis and in brain aging. Particularly SIRT2 gene has been associated with Alzheimer’s disease (AD) as well as with mood disorders. The aim of this study is to investigate the possible associations between Sirtuin 2 gene (SIRT2) rs10410544 polymorphism and AD as well as depression in AD. In addition, we performed some exploratory analyses to investigate possible associations between the rs10410544 genotype and clinical features. We investigated these associations in two independent samples: the first one was composed of 275 Greek inhabitants and 117 patients; the second sample counted 181 Italian people and 43 patients. All patients were affected by LOAD. We failed to find any association between rs10410544 genotype and AD in the two samples. On the other hand, we found an association between the single nucleotide polymorphism (SNP) and depressive symptomatology (in the total sample p = 0.002), which was modulated by the tumor necrosis factor (TNF) values. Particularly, TT genotype seems to be protective versus depression. Finally, in the exploratory analyses, we found that the TT genotype was associated with earlier AD onset and a longer duration of the illness. In conclusion, we confirmed the association between SIRT2 gene and mood disturbances, although in AD patients. Further, we provided evidence that the TT genotype may be protective versus depressive symptoms, allowing an easier and thus earlier diagnosis of AD. This awareness may lead to a more detailed approach to these patients concerning diagnosis and therapy. HubMed – depression


Treatment resistant depression: strategies for primary care.

Curr Psychiatry Rep. 2013 Jul; 15(7): 370
Preston TC, Shelton RC

Depression is commonly diagnosed and treated in primary care. Recent evidence indicates that the majority of depressed patients will not fully recover with an initial antidepressant treatment. This paper reviews commonly used options for treatment after an inadequate initial antidepressant response. The alternatives range widely, and include escalating the dose of the initial antidepressant, switching to an alternative medication, combining two antidepressants with different mechanisms of action (e.g., bupropion + SSRI or mirtazapine + venlafaxine), adding other medications such as lithium or certain atypical antipsychotics (olanzapine, aripiprazole, or quetiapine) to the antidepressant, adding a natural product such as l-methylfolate or s-adenosylmethionine (SAMe), or adding cognitive behavioral psychotherapy. What agent to be used will depend on the comfort level of the primary care practitioner and the availability of Psychiatry referral. However, it is reasonable to take one or more additional steps to attempt to achieve remission. HubMed – depression


When do you Prescribe Antidepressants to Depressed Children?

Curr Psychiatry Rep. 2013 Jul; 15(7): 366
Soutullo C, Figueroa-Quintana A

Major depressive disorder (MDD) in children and adolescents is a public health problem that requires evidence-based management. Our objective is to review available studies, with a PubMed search, and briefly summarize safety and efficacy results of (mostly SSRI) antidepressants in children and adolescents with MDD. Fluoxetine and escitalopram are safe and effective in the treatment of MDD in children and adolescents both in reduction of symptoms, and in remission/response rates. However, response rates are lower than for non-OCD anxiety. Sertraline also had positive results in one study that pooled results from two studies. The number needed to treat (NNT) for MDD is 10, and the number needed to harm (NNH) for suicidality is 112. Methodological limitations in the studies include, mainly, high placebo response rates, associated with multiple study sites, younger patients, and lower MDD severity. Treatment should be maintained close to 1 year after remission, to prevent relapse. FDA-approved fluoxetine and escitalopram are safe and effective in the treatment of pediatric MDD. Sertraline also has some data supporting its efficacy and safety, but is not FDA-approved. The possible modest increase in suicidal ideation in some patients should be known by clinicians, but the risk/benefit ratio is 1 to 11.2 times favorable to using SSRIs in moderate to severe MDD. HubMed – depression