Depressive Symptoms and All-Cause Mortality in a Nationally Representative Longitudinal Study With Time-Varying Covariates.

Depressive Symptoms and All-Cause Mortality in a Nationally Representative Longitudinal Study With Time-Varying Covariates.

Psychosom Med. 2013 Mar 26;
Houle JN

ObjectiveThis study aimed to examine the relationship between depressive symptoms and all-cause mortality in a longitudinal study with a nationally representative sample. Research has shown that depressive symptoms increase mortality risk, but results have been inconclusive regarding the role of physical health conditions in the relationship. This study asks whether the association between depressive symptoms and mortality exists independent of contemporaneous physical health conditions, is spurious because of prior physical health conditions, or is mediated by later physical health conditions.MethodsData are drawn from the Americans’ Changing Lives Study, a nationally representative longitudinal sample of 3617 noninstitutionalized Americans aged 25 years or older. Respondents were interviewed in 1986, 1989, 1994, and 2002. Depressive symptoms (Center for Epidemiologic Studies Depression Scale), physical health, and confounders were measured at each wave. Mortality status was ascertained yearly through 2007. Discrete time hazard models with time-varying covariates were used to estimate the association between Center for Epidemiologic Studies Depression Scale scores and mortality.ResultsBetween 1986 and 2007, 1411 survey respondents died. Depressive symptoms were associated with mortality after adjusting for stress, coping characteristics, social support, and health behaviors (odds ratio [OR] = 1.23, 95% confidence interval [CI] = 1.11-1.36, p < .001). However, the association became nonsignificant after accounting for contemporaneous physical health conditions (OR = 1.06, 95% CI = 0.95-1.17, p = .31). Prior physical health conditions did not explain the association between depressive symptoms and mortality (OR = 1.24, 95% CI = 1.11-1.39, p < .001). The association between lagged depressive symptoms and mortality was mediated by later physical health conditions (p = .94).ConclusionsStudy findings support the mediation hypothesis. The effect of depressive symptoms on mortality is mediated by later physical health. HubMed – depression


Baseline thyroid indices and the subsequent response to citalopram treatment, a pilot study.

Brain Behav. 2013 Mar; 3(2): 89-94
Abulseoud OA, Gitlin M, Altshuler L, Frye MA

The lack of reliable outcome predictors and the delayed onset of therapeutic response to antidepressants are among the clinical challenges in the treatment of depression. Identifying clinical correlates associated with antidepressant response would reduce symptom severity and morbidity for patients with depression. Twenty-three subjects with major depression were treated with citalopram 20 mg/day in a 6-week open trial and were also simultaneously randomized to either adjunctive triiodothyronine (T3) 25 ?g BID (n = 7), pindolol 5 mg BID (n = 8), or placebo (n = 8). Baseline thyroid-stimulating hormone (TSH), FT4, FT3, and TT3 were measured for potential relationships to treatment response across groups. In males only, there was a significant inverse correlation between baseline free T4 and time to response (r = -0.7, P = 0.034). In both males and females across all treatment conditions, as measured by Kaplan-Meier (K-M) maintenance failure time, baseline TSH below the mean (1.5 ng/dL) was associated with a shorter time to response (50% reduction in Montgomery and Asberg Depression Rating Scale [MADRS] score) (?(2) = 4.53, df = 1, P = 0.03). Patients with baseline TSH above the mean were less likely to reach full remission (MADRS ? 7) (?(2) = 4.38, df = 1, P = 0.03). No significant differences between groups emerged in the mean response time. Baseline thyroid function, as measured by serum free T4 and TSH, may predict a patient’s response time to antidepressant treatment with citalopram. HubMed – depression



Depress Anxiety. 2013 Mar 26;
Bloch MH, Green C, Kichuk SA, Dombrowski PA, Wasylink S, Billingslea E, Landeros-Weisenberger A, Kelmendi B, Goodman WK, Leckman JF, Coric V, Pittenger C

BACKGROUND: Obsessive-compulsive disorder (OCD) is a chronic condition that often produces lifelong morbidity, but few studies have examined long-term outcome (greater than 5 years) in adult patients. Available studies suggest that 32-74% of adult OCD patients will experience clinical improvement over the long term. However, these studies were conducted before validated OCD rating scales were established and the development of evidence-based treatments for OCD. METHODS: We investigated the 10-20 year outcome of 83 of 165 eligible subjects previously enrolled after participation in placebo-controlled trials of serotonin reuptake inhibitor (SRI) medications for OCD. We examined the association between clinical characteristics at initial assessment and OCD symptom severity at follow-up. We hypothesized that primary OCD symptom dimension and initial response to pharmacotherapy with serotonin reuptake inhibitors would be associated with later symptom severity. RESULTS: Only 20% (17 of 83) of subjects had experienced a remission of their OCD symptoms at follow-up (Y-BOCS ? 8). Forty-nine percent (41 of 83) of subjects were still experiencing clinically significant OCD symptoms. Response to initial SRI pharmacotherapy was significantly associated with long-term outcome: 31% (13 of 42) of subjects who responded (CGI < 3) to initial SRI pharmacotherapy were remitted at follow-up, compared to 12% (3 of 25) of partial responders and none of the 16 subjects who had no response to initial SRI pharmacotherapy. We did not find a significant association between long-term clinical outcome and any of the OCD symptom dimensions. CONCLUSION: Despite the introduction and dissemination of several evidence-based treatments for OCD, most adult OCD patients do not achieve remission. Initial response to pharmacotherapy was strongly associated with long-term outcome. Depression and Anxiety, 2013. © 2013 Wiley Periodicals, Inc. HubMed – depression



Depress Anxiety. 2013 Mar 26;
Potvin O, Bergua V, Swendsen J, Meillon C, Tzourio C, Ritchie K, Dartigues JF, Amieva H

BACKGROUND: Anxiety has been shown to often precede depression in children and young adults. Only a small number of investigations have examined this form of comorbidity in older adults and the temporal relationship of these syndromes remains unclear. The objective was to verify whether trait anxiety predicts incident/recurrent depressive symptomatology in older adults independently of variables susceptible to explain this relationship in this population, such as cognitive complaints, subjective health, and baseline depressive symptoms. METHODS: A random sample of 4,649 individuals aged 65 years or older from the Three-City Study, a prospective longitudinal study with a 10-year follow-up, was used. Incident and recurrent depressive symptomatology were determined by Center for Epidemiological Studies Depression Scale cutoff scores. Anxiety was measured using the trait scale of the State-Trait Anxiety Inventory. Cox proportional hazards models were used to determine the independent risk of depressive symptomatology for baseline anxiety, cognitive complaints, subjective health, and depressive symptoms, adjusting for sociodemographic, mental health, and physical health covariates. RESULTS: Incident depressive symptomatology was independently predicted by baseline anxiety, depressive symptoms, cognitive complaints, and subjective health. Recurrent depressive symptomatology was independently predicted by baseline anxiety and depressive symptoms, but not by cognitive complaints and subjective health. Anxiety was associated with a higher risk of incident depressive symptomatology only in participants without a history of a major depressive episode, and with a higher risk of recurrent depressive symptomatology in men than in women. CONCLUSIONS: Trait anxiety constitutes an important independent risk factor for subsequent depressive symptomatology in older adults. Depression and Anxiety, 2013. © 2013 Wiley Periodicals, Inc. HubMed – depression


Existential behavioural therapy for informal caregivers of palliative patients: a randomised controlled trial.

Psychooncology. 2013 Mar 27;
Fegg MJ, Brandstätter M, Kögler M, Hauke G, Rechenberg-Winter P, Fensterer V, Küchenhoff H, Hentrich M, Belka C, Borasio GD

BACKGROUND: Existential behavioural therapy (EBT) was developed to support informal caregivers of palliative patients in the last stage of life and during bereavement as a manualised group psychotherapy comprising six sessions. We tested the effectiveness of EBT on mental stress and quality of life (QOL). METHODS: Informal caregivers were randomly assigned (1:1) to EBT or a treatment-as-usual control group using computer-generated numbers in blocks of 10. Primary outcomes were assessed with the Brief Symptom Inventory (subscales somatisation, anxiety and depression), the Satisfaction with Life Scale (SWLS), the WHOQOL-BREF and a numeric rating scale for QOL (QOL-NRS, range 0-10). Data were collected at baseline, pre-treatment, post-treatment and follow-ups after 3 and 12?months. Treatment effects were assessed with a multivariate analysis of covariance. RESULTS: Out of 160 relatives, 81 were assigned to EBT and 79 to the control group. Participants were 54.5?±?13.2?years old; 69.9% were female. The multivariate model was significant for the pre-/post-comparison (p?=?0.005) and the pre-/12-month comparison (p?=?0.05) but not for the pre-/3-month comparison. Medium to large effects on anxiety and QOL (SWLS, WHOQOL-BREF, QOL-NRS) were found at post-treatment; medium effects on depression and QOL (QOL-NRS) emerged in the 12-month follow-up. No adverse effects of the intervention were observed. CONCLUSION: Existential behavioural therapy appears to exert beneficial effects on distress and QOL of informal caregivers of palliative patients. Further longitudinal evidence is needed to confirm these findings. Copyright © 2013 John Wiley & Sons, Ltd. HubMed – depression



View !! — diet for depression treatment – visit diet for depression treatment — With My Proven, Simple 3-Step Natural Formula YOU’LL: •Sleep better and wake up feeling re…