Depression Treatment: Sex Differences in White Matter Alterations Accompanying Obstructive Sleep Apnea.

Sex differences in white matter alterations accompanying obstructive sleep apnea.

Filed under: Depression Treatment

Sleep. 2012; 35(12): 1603-13
Macey PM, Kumar R, Yan-Go FL, Woo MA, Harper RM

Females with obstructive sleep apnea (OSA) show different psychological and physiological symptoms from males, which may be associated with sex-related variations in neural injury occurring with the disorder. To determine whether male- or female-specific brain injury is present in OSA, we assessed influences of sex on white matter changes in the condition.Two-group factorial.University medical center.80 subjects total, with newly diagnosed, untreated OSA groups of 10 female (age mean ± SE: 52.6 ± 2.4 years, AHI 22.5 ± 4.1 events/h) and 20 male (age 48.9 ± 1.7, AHI 25.5 ± 2.9) patients, and 20 female (age 50.3 ± 1.7) and 30 male (age 49.2 ± 1.4) healthy control subjects.None.Brain fiber integrity was assessed with fractional anisotropy (FA), a diffusion tensor imaging-derived measure. Sleep quality, daytime sleepiness, depression, and anxiety were assessed with questionnaires. We identified regions of differing injury in male versus female OSA patients by assessing brain regions with significant interaction effects of OSA and sex on FA. Areas of sex-specific, OSA-related FA reductions appeared in females relative to males, including in the bilateral cingulum bundle adjacent to the mid hippocampus, right stria terminalis near the amygdala, prefrontal and posterior-parietal white matter, corpus callosum, and left superior cerebellar peduncle. Females with OSA showed higher daytime sleepiness, anxiety and depression levels, and reduced sleep quality.Sex differences in white matter structural integrity appeared in OSA patients, with females more affected than males. These female-specific structural changes may contribute to or derive from neuropsychological and physiological symptom differences between sexes. CITATION: Macey PM; Kumar R; Yan-Go FL; Woo MA; Harper RM. Sex differences in white matter alterations accompanying obstructive sleep apnea. SLEEP 2012;35(12):1603-1613.
HubMed – depression


Boys born small for gestational age may be at an increased risk of symptoms of depression and anxiety during adolescence if exposed to chronic stress.

Filed under: Depression Treatment

Evid Based Ment Health. 2012 Nov 30;
Rawana J

HubMed – depression


The Validity of Medication Adherence Self-Reports in Adults With Type 2 Diabetes.

Filed under: Depression Treatment

Diabetes Care. 2012 Nov 30;
Gonzalez JS, Schneider HE, Wexler DJ, Psaros C, Delahanty LM, Cagliero E, Safren SA

OBJECTIVETo assess the validity of self-report measures of diabetes medication adherence and evaluate the effect of depression on the validity of these reports.RESEARCH DESIGN AND METHODSAdults with type 2 diabetes, treated with oral medications, completed a set of medication adherence self-reports that varied response scales and time frames, were administered structured clinical interviews for depression, and provided blood samples for HbA(1c) as part of a screening for an intervention study. A subsample of participants with HbA(1c) ?7.0% and clinically significant depression received Medication Event Monitoring System (MEMS) bottle caps to record adherence. Analyses examined relationships between adherence measures and HbA(1c) and, in the subsample, MEMS. Moderated linear regression evaluated whether depression severity modified relationships with HbA(1c).RESULTSParticipants’ (n = 170, 57% men, 81% white, mean HbA(1c) = 8.3% [SD, 1.7]) adherence self-reports were significantly (r = -0.18 to -0.28; P < 0.03) associated with lower HbA(1c). In the subsample (n = 88), all self-reports were significantly (r = 0.35 to 0.55; P ? 0.001) associated with MEMS-measured adherence. Depression significantly moderated the relationship between three of six self-reports and HbA(1c); at high levels of depression, associations with HbA(1c) became nonsignificant.CONCLUSIONSResults support the validity of easily administered self-reports for diabetes medication adherence. One-month, percentage-based ratings of adherence had the strongest associations with MEMS and HbA(1c); those requiring the report of missed doses had weaker associations. One-week self-ratings and measures that require respondents to record the number of missed doses appear to be vulnerable to bias from depression severity. HubMed – depression


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