The Impact of Primary Biliary Cirrhosis on Perceived Quality of Life: The UK-PBC National Study.

The impact of primary biliary cirrhosis on perceived quality of life: The UK-PBC national study.

Hepatology. 2013 Mar 7;
Mells G, Pells G, Newton JL, Bathgate A, Burroughs A, Heneghan M, Neuberger J, Day D, Ducker SJ, , Sandford R, Alexander G, Jones DE

Primary biliary cirrhosis (PBC) has a complex clinical phenotype, with debate about the extent and specificity of frequently described systemic symptoms such as fatigue. The aim of this study was to use a national patient cohort of 2353 patients recruited from all clinical centres in the UK to explore the impact of disease on perceived life quality. Clinical data regarding diagnosis, therapy and biochemical status were collected and have been reported previously. Detailed symptom phenotyping using recognised and validated symptom assessment tools including the PBC-40 was also undertaken and is reported here. Perception of poor quality of life and impaired health status was common in PBC patients (35% and 46% respectively) and more common than in an age and sex matched community control group (6% and 15%, p<0.0001 for both). Fatigue and symptoms of social dysfunction were associated with impaired perceived quality of life using multi-variate analysis. Fatigue was the symptom with the greatest impact. Depression was a significant factor, but appeared to be a manifestation of complex symptom burden rather than a primary event. Fatigue had its greatest impact on perceived quality of life when accompanied by symptoms of social dysfunction, suggesting that maintenance of social networks is critical for minimising the impact of fatigue. Conclusion: The symptom burden in PBC, which is unrelated to disease severity or UDCA response, is significant and complex and results in significant quality of life deficit. The complexity of symptom burden, and its lack of relation to disease severity and treatment response, suggest that specific approaches to symptom management are warranted which address both symptom biology and social impact. (HEPATOLOGY 2013.). HubMed – depression


Suicidal ideation and reported suicide attempts in Greece during the economic crisis.

World Psychiatry. 2013 Feb; 12(1): 53-9
Economou M, Madianos M, Peppou LE, Theleritis C, Patelakis A, Stefanis C

The financial crisis in Greece is largely impinging on the health and mental health of the population, raising concerns about a potential rise in suicide rates. The aim of this study was to explore changes in suicidal ideation and reported suicide attempts between 2009 and 2011 in a representative sample of the population and in several population subgroups. The socio-economic predictors of suicidal ideation and suicide attempts in 2011 were also investigated. Two nationwide cross-sectional telephone surveys were conducted in 2009 and 2011 using the same methodology. A random and representative sample of 2192 and 2256 people, respectively, took part in the surveys. Between 2009 and 2011, there was a substantial increase in the prevalence of suicidal ideation and reported suicide attempts. People suffering from depression, men, married individuals, people experiencing financial strain, people with low interpersonal trust, and individuals with a history of suicide attempts were particularly vulnerable. HubMed – depression


When does depression become a disorder? Using recurrence rates to evaluate the validity of proposed changes in major depression diagnostic thresholds.

World Psychiatry. 2013 Feb; 12(1): 44-52
Wakefield JC, Schmitz MF

High community prevalence estimates of DSM-defined major depressive disorder (MDD) have led to proposals to raise MDD’s diagnostic threshold to more validly distinguish pathology from normal-range distress. However, such proposals lack empirical validation. We used MDD recurrence rates in the longitudinal 2-wave Epidemiologic Catchment Area Study to test the predictive validity of three proposals to narrow MDD diagnosis: a) excluding “uncomplicated” episodes (i.e., episodes that last no longer than 2 months and do not include suicidal ideation, psychotic ideation, psychomotor retardation, or feelings of worthlessness); b) excluding mild episodes (i.e., episodes with only five to six symptoms); and c) excluding nonmelancholic episodes. For each proposal, we used lifetime MDD diagnoses at wave 1 to distinguish the group proposed for exclusion, other MDD, and those with no MDD history. We then compared these groups’ 1-year MDD rates at wave 2. A proposal was considered strongly supported if at wave 2 the excluded group’s MDD rate was not only significantly lower than the rate for other MDD but also not significantly greater than the no-MDD-history group. Results indicated that all three excluded groups had significantly lower recurrence rates than other MDD (uncomplicated vs. complicated, 3.4% vs. 14.6%; mild vs. severe, 9.6% vs. 20.7%; nonmelancholic vs. melancholic, 10.6% vs. 19.2%, respectively). However, only uncomplicated MDD’s recurrence rate was also not significantly greater than the MDD occurrence rate for the no-MDD-history group (3.4% vs. 1.7%, respectively). This low recurrence rate resulted from an interaction between uncomplicated duration and symptom criteria. Multiple-episode uncomplicated MDD did not entail significantly elevated recurrence over single-episode cases (3.7% vs. 3.0%, respectively). Uncomplicated MDD’s general-distress symptoms, transient duration, and lack of elevated recurrence suggest it may generally represent nonpathologic intense sadness that should be addressed in treatment guidelines and considered for exclusion from MDD diagnosis to increase the validity of the MDD/normal sadness boundary. HubMed – depression


Re-cycling Paradigms: Cell Cycle Regulation in Adult Hippocampal Neurogenesis and Implications for Depression.

Mol Neurobiol. 2013 Mar 8;
Patrício P, Mateus-Pinheiro A, Sousa N, Pinto L

Since adult neurogenesis became a widely accepted phenomenon, much effort has been put in trying to understand the mechanisms involved in its regulation. In addition, the pathophysiology of several neuropsychiatric disorders, such as depression, has been associated with imbalances in adult hippocampal neurogenesis. These imbalances may ultimately reflect alterations at the cell cycle level, as a common mechanism through which intrinsic and extrinsic stimuli interact with the neurogenic niche properties. Thus, the comprehension of these regulatory mechanisms has become of major importance to disclose novel therapeutic targets. In this review, we first present a comprehensive view on the cell cycle components and mechanisms that were identified in the context of the homeostatic adult hippocampal neurogenic niche. Then, we focus on recent work regarding the cell cycle changes and signaling pathways that are responsible for the neurogenesis imbalances observed in neuropathological conditions, with a particular emphasis on depression. HubMed – depression


Correlates of depressive symptomatology in African-American breast cancer patients.

J Cancer Surviv. 2013 Mar 8;
Sheppard VB, Llanos AA, Hurtado-de-Mendoza A, Taylor TR, Adams-Campbell LL

PURPOSE: This study assessed the levels of depressive symptomatology in African-American women with breast cancer compared to those of women without breast cancer and examined demographic, psychosocial, and clinical factors correlated with depression. METHODS: A total of 152 African-American women were recruited from Washington, DC and surrounding suburbs. Breast cancer patients (n?=?76 cases) were recruited from a health care center and women without cancer were recruited from health fairs (n?=?76 comparison). We assessed depression, psychosocial variables (ego strength and social support), and sociodemographic factors from in-person interviews. Stage and clinical factors were abstracted from medical records. Independent sample t test, chi square test, analyses of variance, and multiple regression models were used to identify differences in depression and correlates of depression among the cases and comparison groups. RESULTS: Women with breast cancer reported significantly greater levels of depression (m?=?11.5, SD?=?5.0) than women without breast cancer (m?=?3.9, SD?=?3.8) (p?HubMed – depression