Predictors of Cognitive/Affective and Somatic Depression in Heart Failure Patients.

Predictors of Cognitive/Affective and Somatic Depression in Heart Failure Patients.

Filed under: Depression Treatment

Clin Nurs Res. 2013 Jan 30;
Seo Y, Yates B, Dizona P, Laframboise L, Norman J

The effects of depression on patients with heart failure (HF) are substantial, yet the predictors remain unclear. The predictors of cognitive/affective and somatic depression in stable HF patients were studied. Using a cross-sectional design, 150 HF outpatients were recruited at two mid-Western HF clinics. Predictors included dyspnea with activities of daily living, family and friend social support, and loneliness; age and gender were control variables. All constructs were measured using standardized instruments. Structural equation modeling (SEM) showed that cognitive/affective depression was predicted by greater dyspnea and loneliness, whereas somatic depression was predicted by more dyspnea and friend support. Also, greater dyspnea was related to more loneliness and less friend support; less friend support was related to loneliness. Women reported more dyspnea and loneliness. Since cognitive/affective and somatic depression have different predictors, further study is warranted to identify HF patients at risk for depression and to establish interventions targeted at improving depression.
HubMed – depression


Potential Mechanisms of Action of Lithium in Bipolar Disorder : Current Understanding.

Filed under: Depression Treatment

CNS Drugs. 2013 Feb 1;
Malhi GS, Tanious M, Das P, Coulston CM, Berk M

Lithium has been used for over half a century for the treatment of bipolar disorder as the archetypal mood stabilizer, and has a wealth of empirical evidence supporting its efficacy in this role. Despite this, the specific mechanisms by which lithium exerts its mood-stabilizing effects are not well understood. Given the inherently complex nature of the pathophysiology of bipolar disorder, this paper aims to capture what is known about the actions of lithium ranging from macroscopic changes in mood, cognition and brain structure, to its effects at the microscopic level on neurotransmission and intracellular and molecular pathways. A comprehensive literature search of databases including MEDLINE, EMBASE and PsycINFO was conducted using relevant keywords and the findings from the literature were then reviewed and synthesized. Numerous studies report that lithium is effective in the treatment of acute mania and for the long-term maintenance of mood and prophylaxis; in comparison, evidence for its efficacy in depression is modest. However, lithium possesses unique anti-suicidal properties that set it apart from other agents. With respect to cognition, studies suggest that lithium may reduce cognitive decline in patients; however, these findings require further investigation using both neuropsychological and functional neuroimaging probes. Interestingly, lithium appears to preserve or increase the volume of brain structures involved in emotional regulation such as the prefrontal cortex, hippocampus and amygdala, possibly reflecting its neuroprotective effects. At a neuronal level, lithium reduces excitatory (dopamine and glutamate) but increases inhibitory (GABA) neurotransmission; however, these broad effects are underpinned by complex neurotransmitter systems that strive to achieve homeostasis by way of compensatory changes. For example, at an intracellular and molecular level, lithium targets second-messenger systems that further modulate neurotransmission. For instance, the effects of lithium on the adenyl cyclase and phospho-inositide pathways, as well as protein kinase C, may serve to dampen excessive excitatory neurotransmission. In addition to these many putative mechanisms, it has also been proposed that the neuroprotective effects of lithium are key to its therapeutic actions. In this regard, lithium has been shown to reduce the oxidative stress that occurs with multiple episodes of mania and depression. Further, it increases protective proteins such as brain-derived neurotrophic factor and B-cell lymphoma 2, and reduces apoptotic processes through inhibition of glycogen synthase kinase 3 and autophagy. Overall, it is clear that the processes which underpin the therapeutic actions of lithium are sophisticated and most likely inter-related.
HubMed – depression


Prospective Relations Between Parental Depression, Negative Expressiveness, Emotional Insecurity, and Children’s Internalizing Symptoms.

Filed under: Depression Treatment

Child Psychiatry Hum Dev. 2013 Feb 1;
Cummings EM, Cheung RY, Davies PT

Building on the conceptual framework of emotional security theory (Davies and Cummings in Psychol Bull 116:387-411, 1994), this study longitudinally examined multiple factors linking parental depressive symptoms and child internalizing symptoms. Participants were 235 children (106 boys, 129 girls) and their cohabiting parents. Assessments included mothers’ and fathers’ depressive symptoms when children were in kindergarten, parents’ negative expressiveness when children were in first grade, children’s emotional insecurity 1 year later, and children’s internalizing symptoms in kindergarten and second grade. Findings revealed both mothers’ and fathers’ depressive symptoms were related to changes in children’s internalizing symptoms as a function of parents’ negative emotional expressiveness and children’s emotional insecurity. In addition to these similar pathways, distinctive pathways as a function of parental gender were identified. Contributions are considered for understanding relations between parental depressive symptoms and children’s development.
HubMed – depression


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