Treatment Resistance in Severe Unipolar Depression: No Association With Psychotic or Melancholic Features.

Treatment resistance in severe unipolar depression: No association with psychotic or melancholic features.

Ann Clin Psychiatry. 2013 May; 25(2): 97-106
Zaninotto L, Souery D, Calati R, Sentissi O, Kasper S, Akimova E, Zohar J, Montgomery S, Mendlewicz J, Serretti A

Depressive subtypes generally have been neglected in research on treatment efficacy. We studied a sample of 699 severe unipolar depressed patients to detect any association between depressive features and treatment resistance.Participants were divided into psychotic (PSY, n = 90), melancholic (MEL, n = 430) and non-melancholic (n = 179) subjects according to clinical features. Formal diagnostic criteria (Mini International Neuropsychiatric Interview items), and items from 17-item Hamilton Rating Scale for Depression (HRSD17) were compared across groups. Non-responders were defined by a HRSD17 cut-off score of ?17 after the last adequate antidepressant treatment. Treatment-resistant depression (TRD) was defined as the failure to respond to ?2 adequate antidepressant trials. Non-linear regression models were designed to detect associations between depressive subtypes and TRD.PSY and MEL patients appeared to be more severely affected and to share some “core” melancholic symptoms. Both PSY and MEL patients reported a higher rate of seasonality. However, we found no clinical or illness course variable associated with TRD.Our results indicate that psychotic and melancholic depression share some “core” melancholia symptoms, while no distinguishing psychopathological feature appears to be associated with TRD in severely depressed patients. HubMed – depression


Modifiable risk factors for depressed mood among farmers.

Ann Clin Psychiatry. 2013 May; 25(2): 83-90
Onwuameze OE, Paradiso S, Peek-Asa C, Donham KJ, Rautiainen RH

Risk for depression among farmers is not fully understood. DSM-IV considers sadness or depressed mood a critical symptom of depression. The aim of this study was to examine risk factors for depressed mood among farmers using a longitudinal study design.Participants were principal farm operators in the Iowa Certified Safe Farm study. We identified risk factors for depressed mood by calculating relative risks (RR) using the generalized estimating equations method.In the multivariate model, pesticide exposure (RR = 1.26; 95% CI: 1.04 to 1.53), having an additional job off the farm (RR = 1.32; 95% CI: 1.08 to 1.62), stress (RR = 3.09; 95% CI: 2.55 to 3.75), and previous injury (RR = 1.41; 95% CI: 1.05 to 1.89) prospectively increased the risk of depressed mood.Consistent with earlier non-longitudinal studies, the results of this study suggest that reducing pesticide exposure, stress, and injury may reduce the risk of depression in the farm setting. HubMed – depression


Pattern classification of brain activation during emotional processing in subclinical depression: psychosis proneness as potential confounding factor.

Peerj. 2013; 1: e42
Modinos G, Mechelli A, Pettersson-Yeo W, Allen P, McGuire P, Aleman A

We used Support Vector Machine (SVM) to perform multivariate pattern classification based on brain activation during emotional processing in healthy participants with subclinical depressive symptoms. Six-hundred undergraduate students completed the Beck Depression Inventory II (BDI-II). Two groups were subsequently formed: (i) subclinical (mild) mood disturbance (n = 17) and (ii) no mood disturbance (n = 17). Participants also completed a self-report questionnaire on subclinical psychotic symptoms, the Community Assessment of Psychic Experiences Questionnaire (CAPE) positive subscale. The functional magnetic resonance imaging (fMRI) paradigm entailed passive viewing of negative emotional and neutral scenes. The pattern of brain activity during emotional processing allowed correct group classification with an overall accuracy of 77% (p = 0.002), within a network of regions including the amygdala, insula, anterior cingulate cortex and medial prefrontal cortex. However, further analysis suggested that the classification accuracy could also be explained by subclinical psychotic symptom scores (correlation with SVM weights r = 0.459, p = 0.006). Psychosis proneness may thus be a confounding factor for neuroimaging studies in subclinical depression. HubMed – depression


Personality change after Internet-delivered cognitive behavior therapy for depression.

Peerj. 2013; 1: e39
Johansson R, Lyssarides C, Andersson G, Rousseau A

Background. The Temperament and Character Inventory (TCI) by Cloninger is a widely used instrument to measure personality dimensions. Two dimensions of the TCI, Harm avoidance (HA) and Self-Directedness (SD), are known to be influenced by depressed mood. This study investigated changes in HA and SD after 10 weeks of Internet-delivered cognitive behavior therapy (ICBT) in a sample of clinically depressed subjects (N = 108). Differences in personality changes among treatment responders and non-responders were also investigated. Exploratory investigations on changes for other TCI dimensions, were also conducted. Methods. Depressed subjects were randomized either to ICBT or to a moderated online discussion group, which served as an active control group. The interventions lasted for 10 weeks. TCI was measured at baseline and after treatment. Depressive symptoms were assessed using the Beck Depression Inventory-II. Results. There were significant changes on HA and SD after ICBT. However, when comparing post-treatment HA and SD to the control, no differences were found. Among responders, larger changes compared to non-responders were found in HA and in SD, as well as in Cooperativeness. Conclusions. The study showed that HA and SD changed after ICBT. The changes in personality seem related to improvement in depression rather than a direct effect of ICBT. HubMed – depression


Targeted Rejection Triggers Differential Pro- and Anti-Inflammatory Gene Expression in Adolescents as a Function of Social Status.

Clin Psychol Sci. 2013 Jan; 1(1): 30-40
Murphy ML, Slavich GM, Rohleder N, Miller GE

Social difficulties during adolescence influence life-span health. To elucidate underlying mechanisms, we examined whether a noxious social event, targeted rejection (TR), influences the signaling pathways that regulate inflammation, which is implicated in a number of health problems. For this study, 147 adolescent women at risk for developing a first episode of major depression were interviewed every 6 months for 2.5 years to assess recent TR exposure, and blood was drawn to quantify leukocyte messenger RNA (mRNA) for nuclear factor-?B (NF-?B) and inhibitor of ?B (I-?B) and the inflammatory biomarkers C-reactive protein and interleukin-6. Participants had more NF-?B and I-?B mRNA at visits when TR had occurred. These shifts in inflammatory signaling were most pronounced for adolescents high in perceived social status. These findings demonstrate that social rejection upregulates inflammatory gene expression in youth at risk for depression, particularly for those high in status. If sustained, this heightened inflammatory signaling could have implications for life-span health. HubMed – depression