Depression Treatment: Sexual Orientation and Disclosure in Relation to Psychiatric Symptoms, Diurnal Cortisol, and Allostatic Load.

Sexual Orientation and Disclosure in Relation to Psychiatric Symptoms, Diurnal Cortisol, and Allostatic Load.

Filed under: Depression Treatment

Psychosom Med. 2013 Jan 29;
Juster RP, Smith NG, Ouellet E, Sindi S, Lupien SJ

ObjectivesLesbian, gay, and bisexual (LGB) individuals-particularly those who have not disclosed their sexual orientation-are believed to experience increased chronic stress in comparison with heterosexuals. This interdisciplinary study assessed whether psychiatric symptoms (self-rated anxiety, depression, and burnout), stress hormone profiles (diurnal cortisol), and physiological dysregulations (allostatic load [AL]) would differ for a) LGBs versus heterosexuals and b) disclosed LGBs versus nondisclosed LGBs.MethodsThe study included 87 healthy participants (mean [SD] age = 24.6 [0.6] years; LGB n = 46, 43% women; and heterosexual n = 41, 49% women). Diurnal cortisol sampled at five time points was averaged for 2 days. AL indices were based on an algorithm incorporating 21 biomarkers representing neuroendocrine, immune/inflammatory, metabolic, and cardiovascular functioning. Psychological measures were assessed with well-validated questionnaires.ResultsBetween-group results revealed no significant differences in symptoms of anxiety and burnout, nor among diurnal cortisol levels between sexual orientations. By contrast, gay/bisexual men unexpectedly had lower depressive symptoms (p = .003) and AL levels (p = .043) compared with heterosexual men. Within-group results revealed that disclosed LGBs had fewer psychiatric symptoms (p values < 0.01) and lower cortisol levels +30 minutes upon awakening (p = .004) compared with nondisclosed LGBs. Disclosure was not significantly related to AL levels.ConclusionsLGBs did not manifest more stress-related problems than did heterosexuals. Life transitions like disclosing to one's family and friends may be protective against psychopathologies and hyperactive cortisol awakening responses. Our novel findings underline the roles disclosure processes have on positive health and well-being for sexual minorities. HubMed – depression


Bone Density Characteristics and Major Depressive Disorder in Adolescents.

Filed under: Depression Treatment

Psychosom Med. 2013 Jan 29;
Fazeli PK, Mendes N, Russell M, Herzog DB, Klibanski A, Misra M

ObjectiveMajor depressive disorder (MDD) is common during adolescence, a period characterized by rapid bone mineral accrual. MDD has recently been associated with lower bone mineral density (BMD) in adults. Our objective was to determine whether MDD is associated with BMD, bone turnover markers, vitamin D, and gonadal steroids in adolescents.MethodsSixty-five adolescents 12 to 18 years of age (32 boys: 16 with MDD and 16 controls; 33 girls: 17 with MDD and 16 controls) were included in a cross-sectional study. BMD and body composition were obtained by dual-energy x-ray absorptiometry. Estradiol, testosterone, 25-hydroxy vitamin D levels, N-terminal propeptide of Type 1 procollagen (a marker of bone formation), and Type I collagen C-telopeptide (a marker of bone resorption) were measured.ResultsBoys with MDD had a significantly lower BMD at the hip (mean [standard deviation] = 0.99 [0.17] g/cm(2) versus 1.04 [0.18] g/cm(2), body mass index [BMI] adjusted, p = .005) and femoral neck (0.92 [0.17] g/cm(2) versus 0.94 [0.17] g/cm(2); BMI adjusted, p = .024) compared with healthy controls after adjusting for BMI. This significant finding was maintained after also adjusting for lean mass and bone age (hip: p = .007; femoral neck: p = .020). In girls, there were no significant differences in BMD between the girls with MDD and the controls after adjusting for BMI (p >.17).ConclusionsMale adolescents with MDD have a significantly lower BMD as compared with healthy controls after adjusting for body mass and maturity. This association is not observed in girls.
HubMed – depression


Effects of Vitamin and Mineral Supplementation on Stress, Mild Psychiatric Symptoms, and Mood in Nonclinical Samples: A Meta-Analysis.

Filed under: Depression Treatment

Psychosom Med. 2013 Jan 29;
Long SJ, Benton D

ObjectiveBiochemical processes in the brain affect mood. Minor dietary inadequacies, which are responsible for a small decline in an enzyme’s efficiency, could cumulatively influence mood states. When diet does not provide an optimal intake of micronutrients, supplementation is expected to benefit mood. This meta-analysis evaluated the influence of diet supplementation on mood in nonclinical samples.MethodsDatabases were evaluated and studies were included if they considered aspects of stress, mild psychiatric symptoms, or mood in the general population; were randomized and placebo-controlled; evaluated the influence of multivitamin/mineral supplements for at least 28 days. Eight studies that met the inclusion criteria were integrated using meta-analysis.ResultsSupplementation reduced the levels of perceived stress (standard mean difference [SMD] = 0.35; 95% confidence interval [CI] = 0.47-0.22; p = .001), mild psychiatric symptoms (SMD = 0.30; 95% CI = 0.43-0.18; p = .001), and anxiety (SMD = 0.32; 95% CI = 0.48-0.16; p < .001), but not depression (SMD = 0.20; 95% CI = 0.42-0.030; p < .089). Fatigue (SMD = 0.27; 95% CI = 0.40-0.146; p < .001) and confusion (SMD = 0.225; 95% CI = 0.38-0.07; p < .003) were also reduced.ConclusionsMicronutrient supplementation has a beneficial effect on perceived stress, mild psychiatric symptoms, and aspects of everyday mood in apparently healthy individuals. Supplements containing high doses of B vitamins may be more effective in improving mood states. Questions about optimal levels of micronutrient intake, optimal doses, and active ingredients arise. HubMed – depression


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