Depression Treatment: Do Depression and Educational Attainment Mediate the Association Between Ethnicity and Dementia?.

Do Depression and Educational Attainment Mediate the Association between Ethnicity and Dementia?.

Filed under: Depression Treatment

Gerontology. 2012 Nov 8;
Momtaz YA, Hamid TA, Yusoff S, Ibrahim R

Introduction: Research shows marked differences in the prevalence of dementia among different ethnic groups. However, there is a relative dearth of studies focusing on how ethnicity may influence dementia. The main aim of the current study is to test potential mediating effects of depression and level of education on the association between ethnicity and dementia. Methods: The sample for this study, consisting of 2,796 community-dwelling elderly people aged 60 years and older, was drawn from a cross-sectional national survey entitled ‘Mental Health and Quality of Life of Older Malaysians’. The Malaysian adapted version of the Geriatric Mental State-Automated Geriatric Examination for Computer-Assisted Taxonomy was used to assess dementia and depression. Data analysis was conducted using IBM SPSS version 19. Results: As expected, the result of the ?(2) analysis revealed significant ethnic difference in the prevalence of dementia (?(2) = 58.05, p ? 0.001). The results of the mediational analyses revealed that depression (Z = 4.05, p ? 0.001) and education (Z = 2.78, p ? 0.01) significantly, but partially, mediate the association between ethnicity and dementia. This suggests that disparities of depressive symptoms and education contribute to ethnic difference in the prevalence of dementia. Conclusions: These findings provide more insight into how ethnicity may influence an individual’s vulnerability to dementia. The limitations of the study along with implications of the findings and needs for further study are discussed.
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CRHR1 genotypes, neural circuits and the diathesis for anxiety and depression.

Filed under: Depression Treatment

Mol Psychiatry. 2012 Nov 13;
Rogers J, Raveendran M, Fawcett GL, Fox AS, Shelton SE, Oler JA, Cheverud J, Muzny DM, Gibbs RA, Davidson RJ, Kalin NH

The corticotrophin-releasing hormone (CRH) system integrates the stress response and is associated with stress-related psychopathology. Previous reports have identified interactions between childhood trauma and sequence variation in the CRH receptor 1 gene (CRHR1) that increase risk for affective disorders. However, the underlying mechanisms that connect variation in CRHR1 to psychopathology are unknown. To explore potential mechanisms, we used a validated rhesus macaque model to investigate association between genetic variation in CRHR1, anxious temperament (AT) and brain metabolic activity. In young rhesus monkeys, AT is analogous to the childhood risk phenotype that predicts the development of human anxiety and depressive disorders. Regional brain metabolism was assessed with (18)F-labeled fluoro-2-deoxyglucose (FDG) positron emission tomography in 236 young, normally reared macaques that were also characterized for AT. We show that single nucleotide polymorphisms (SNPs) affecting exon 6 of CRHR1 influence both AT and metabolic activity in the anterior hippocampus and amygdala, components of the neural circuit underlying AT. We also find evidence for association between SNPs in CRHR1 and metabolism in the intraparietal sulcus and precuneus. These translational data suggest that genetic variation in CRHR1 affects the risk for affective disorders by influencing the function of the neural circuit underlying AT and that differences in gene expression or the protein sequence involving exon 6 may be important. These results suggest that variation in CRHR1 may influence brain function before any childhood adversity and may be a diathesis for the interaction between CRHR1 genotypes and childhood trauma reported to affect human psychopathology.Molecular Psychiatry advance online publication, 13 November 2012; doi:10.1038/mp.2012.152.
HubMed – depression

 

An integrated secondary prevention group programme reduces depression in cardiac patients.

Filed under: Depression Treatment

Eur J Prev Cardiol. 2012 Nov 12;
Turner A, Murphy BM, Higgins RO, Elliott PC, Le Grande MR, Goble AJ, Worcester MU

Objective: Depression is common following an acute cardiac event and can occur at a time when behaviour change is strongly recommended to reduce the risk of further cardiovascular events. The ‘Beating Heart Problems’ programme was designed to support cardiac patients in behaviour change and mood management.Methods: The programme was based on cognitive behaviour therapy and motivational interviewing. A randomized controlled trial (RCT) comparing the 8-week group programme with usual care was undertaken between 2007 and 2010. All patients attended a hospital-based clinic for assessment of physiological risk factors at baseline (6 weeks after their acute event), and at 4- and 12-month follow up. Psychological and behavioural indicators were assessed by self-report questionnaires. Of the 275 patients enrolled into the RCT, 42 (15%) had Beck Depression Inventory-II scores >13 at baseline. Treatment and control group comparisons were undertaken for this subgroup, using growth curve modelling and testing for group differences over time in psychological, physiological, health behaviour, and self-efficacy measures.Results: Significantly greater improvements (p < 0.01) in depression symptoms and self-rated health were reported for the intervention group, as well as significantly larger gains in confidence in managing depression (p < 0.05) and anger (p < 0.01). Trends (0.05 < p < 0.10) for larger treatment group improvements were also seen for anxiety symptoms and confidence in managing anxiety.Conclusion: A group secondary-prevention programme that integrates behavioural and mood management strategies leads to decreased depression, increased confidence, and improved health perceptions in depressed cardiac patients. HubMed – depression

 

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