Abnormal Fatty Acid Composition in the Frontopolar Cortex of Patients With Affective Disorders.

Abnormal fatty acid composition in the frontopolar cortex of patients with affective disorders.

Filed under: Depression Treatment

Transl Psychiatry. 2012; 2: e204
Tatebayashi Y, Nihonmatsu-Kikuchi N, Hayashi Y, Yu X, Soma M, Ikeda K

Bipolar and major depressive disorders are essentially relapsing and remitting disorders of affect with nearly full recovery between episodes. Although the underlying molecular mechanisms remain unclear, myelin-related abnormalities have long been suspected. Here, using novel statistical analysis, we show that subtle but significant abnormalities exist in the composition of fatty acids (FAs), including docosapentaenoic acid (22:5n-3), one of the omega-3 polyunsaturated FAs, found in the post-mortem frontopolar cortex (FPC) of subjects with bipolar or major depressive disorders, although not in those with schizophrenia. These abnormalities were all aggravated in a myelin level-dependent manner, suggesting their close relationship with myelination. Animal studies have further revealed that chronic antidepressant treatment induces robust changes in brain FA metabolism, but contributes only part of the abnormalities found in the affective disorder brains. These findings indicate that the pathophysiology of affective disorders involves an unknown type of perturbed myelination in the FPC that may serve as a novel diagnostic and therapeutic target.
HubMed – depression

Nausea and Vomiting of Pregnancy: Prevalence, Severity and Relation to Psychosocial Health.

Filed under: Depression Treatment

MCN Am J Matern Child Nurs. 2013 Jan; 38(1): 21-27
Kramer J, Bowen A, Stewart N, Muhajarine N

PURPOSE:: Symptoms of nausea and vomiting are commonly experienced during early pregnancy (nausea and vomiting of pregnancy or NVP) and have been associated with stress, anxiety, and depression in pregnancy. However, nausea and vomiting in late pregnancy is a little-studied phenomenon. The purpose of our study was to examine the prevalence, severity, and psychosocial determinants of NVP during early and late pregnancy. STUDY DESIGN AND METHODS:: Data were originally from a longitudinal and epidemiological study of depression in pregnancy and postpartum in a cohort of 648 Canadian women conducted from 2005 to 2008. Measures included the Nausea and Vomiting in Pregnancy Instrument (NVPI), the Cambridge Worry Scale (CWS), and the Edinburgh Postnatal Depression Scale (EPDS). Demographic, maternal/obstetrical, psychological, and behavioral variables related to NVP were also examined. Odds ratios and 95% confidence intervals were calculated for all risk factors investigated using multiple logistic regression, controlling for potential confounders. RESULTS:: The prevalence of NVP was 63.3% (n = 551) at Time 1 (early pregnancy) and 45.4% (n = 575) at Time 2 (late pregnancy). Severity of symptoms was associated with earlier gestation, antiemetic medication use, employment status, and symptoms of major depression. Maternal smoking and having the support of three or more persons were protective for NVP. CLINICAL IMPLICATIONS:: This study suggests that screening for NVP should be ongoing throughout pregnancy and measures that address NVP, poor social support, and depression are warranted. Further research is needed in regard to effective management of this very common and distressing condition.
HubMed – depression

Suggested early onset of true action of antidepressant drugs may be artefactual: a heuristic study.

Filed under: Depression Treatment

Int Clin Psychopharmacol. 2013 Jan; 28(1): 29-32
Parker G, Paterson A, Blanch B

In recent decades, there have been many studies reporting that antidepressants have a rapid onset of action, with improvement occurring in the first week. The current pilot study questions whether such findings reflect an artefact emerging from high rates of ‘nonspecific’ improvement and evaluates the phenomenon in a small sample of melancholic patients seemingly lacking nonspecific improvement propensities. Twenty-nine patients with a well-defined melancholic depression completed a 12-week treatment study comparing drug therapy versus cognitive behaviour therapy. The primary outcome measure was the Hamilton Rating Scale for Depression, and a self-report measure of depressed mood severity (the Daily Rating Scale) was completed daily. Analyses seeking time till onset of action were limited to those receiving drug therapies. The lack of improvement in the first 4 weeks for those receiving cognitive behaviour therapy argued for the melancholic patients lacking the capacity for a nonspecific response to therapy. Formal 12-week responder status in those receiving the antidepressant could not be predicted from improvement status until day 12 of the study, and not in the first week as reported in most previous studies of those with major depression. This pilot study argues for any study seeking to quantify the specific interval for onset of action of antidepressant drugs focusing on only those with well-defined melancholia.
HubMed – depression

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