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Dysthymia

Identifying predictors of a favourable outcome for outpatients with a persistent depressive disorder treated with Cognitive Behavioural Analysis System of Psychotherapy: A prospective cohort study
Dean JA, Eldering MJ, Schoevers RA and van Driel CMG
Cognitive Behavioural Analysis System of Psychotherapy (CBASP) is the first therapy specifically developed for persistent depressive disorder (PDD). This study aimed to identify predictors of favourable treatment outcome after group CBASP and assess change in depression severity over 24 weeks.
Greater vulnerability to cannabis dependence among heavy cannabis user French women
Guillem E and Baylé FJ
Between 1990 and the mid-2010s, France registered a sharp rise in the spread and consumption of cannabis. At the same time, there has been an increase in the concentration of Δ9-tetrahydrocannabinol contained in cannabis. The aims of our study are to measure addictive and psychiatric comorbidities in cannabis users in France, and to compare characteristics between women and men.
Evaluation of the internet-based intervention "Selfapy" in participants with unipolar depression and the impact on quality of life: a randomized, parallel group study
Schefft C, Krämer R, Haaf R, Jedeck D, Schumacher A and Köhler S
Depressive disorders cause a major burden of disease worldwide and often lead to a loss of social functioning. Patients suffering from depressive disorders report a lower quality of life (QOL) than people without a history of mental health issues. Internet-based interventions (IBIs) based on cognitive behavioral therapy (CBT) are effective in reducing symptom severity but data on their impact on quality of life in clinically depressed patients so far is scarce.
Dosage effects of psychodynamic and schema therapy in people with comorbid depression and personality disorder: four-arm pragmatic randomised controlled trial
Kool M, Van H, Arntz A, Bartak A, Peen J, Dil L, de Boer K and Dekker J
Higher intensity of psychotherapy might improve treatment outcome in depression, especially in those with comorbid personality disorder.
Baseline Characteristics From a New Longitudinal Cohort of Patients With Noncancer Pain and Chronic Opioid Use in the United States
Secrest S, Miller-Matero LR, Chrusciel T, Salas J, Sullivan MD, Zabel C, Lustman P, Ahmedani B, Carpenter RW and Scherrer JF
Retrospective cohort studies have consistently observed that long-term prescription opioid use is a risk factor for new major depressive episodes. However, prospective studies are needed to confirm these findings and establish evidence for causation. The Prescription Opioids and Depression Pathways cohort study is designed for this purpose. The present report describes the baseline sample and associations between participant characteristics and odds of daily versus nondaily opioid use. Second, we report associations between participant characteristics and odds of depression, dysthymia, anhedonia, and vital exhaustion. Patients with noncancer pain were eligible if they started a new period of prescription opioid use lasting 30 to 90 days. Participants were 54.8 (standard deviation ± 11.3) years of age, 57.3% female and 73% White race. Less than college education was more common among daily versus nondaily opioid users (32.4% vs 27.3%; P = .0008), as was back pain (64.2% vs 51.3%; P < .0001), any nonopioid substance use disorder (12.8% vs 4.8%; P < .0001), and current smoking (30.7% vs 18.4% P < .0001). High pain interference (50.9% vs 28.4%; P < .0001) was significantly associated with depression, as was having more pain sites (6.9 ± 3.6 vs 5.7 ± 3.6; P < .0001), and benzodiazepine comedication (38.2% vs 23.4%; P < .0001). High pain interference was significantly more common among those with anhedonia (46.8% vs 27.4%; P < .0001), and more pain sites (7.0 ± 3.7 vs 5.6 ± 3.6; P < .0001) were associated with anhedonia. Having more pain sites (7.9 ± 3.6 vs 5.5 ± 3.50; P < .0001) was associated with vital exhaustion, as was back pain (71.9% vs 56.8%; P = .0001) and benzodiazepine comedication (42.8% vs 22.8%; P < .0001). Patients using prescription opioids for noncancer pain have complex pain, psychiatric, and substance use disorder comorbidities. Longitudinal data will reveal whether long-term opioid therapy leads to depression or other mood disturbances such as anhedonia and vital exhaustion. PERSPECTIVE: This study reports baseline characteristics of a new prospective, noncancer pain cohort study. Risk factors for adverse opioid outcomes were most common in those with depression and vital exhaustion and less common in dysthymia and anhedonia. Baseline data highlight the complexity of patients receiving long-term opioid therapy for noncancer pain.
Towards a major methodological shift in depression research by assessing continuous scores of recurrence of illness, lifetime and current suicidal behaviors and phenome features
Maes M, Zhou B, Jirakran K, Vasupanrajit A, Boonchaya-Anant P, Tunvirachaisakul C, Tang X, Li J and Almulla AF
The binary major depressive disorder (MDD) diagnosis is inadequate and should never be used in research.
William Boven's 1915 thesis "Similarity and Mendelism in the heredity of dementia praecox and manic-depressive insanity"
Kendler KS and Justis V
Boven published, in 1915, his MD thesis at the University of Lausanne in which he examined 60 3- to 4-generation pedigrees ascertained from admitted patients with dementia praecox (DP) and manic-depressive insanity (MDI). He asked three questions: (i) were DP and MDI hereditary? (ii) were they the same or distinct conditions? and (iii) were they Mendelian disorders? Based on the rarity of environmental precipitants severe enough to cause disorder onset and the pattern of disorders in relatives, Boven concluded that both disorders were inherited. He found that MDI largely ran in families through direct transmission across generations while DP was only common in collateral relatives. Both pedigrees contained a substantial number of "psychopathic" (personality disordered) relatives in which DP and MDI pedigrees typically had, respectively, paranoid, and dysthymic/cyclothymic features. Boven concludes that their inheritance is largely distinct but not exclusive, as some pedigrees contained cases of both disorders. With assistance from Wilhelm Weinberg, Boven applied algebraic models with proband correction to rates of DP and MDI in sibships and found the results inconsistent with Mendelian transmission. His study represents among the first examinations, using "modern" methods, of the familial relationship between DP and MDI and the first published in French.
Epidemiologic and genetic associations of female reproductive disorders with depression or dysthymia: a Mendelian randomization study
Ling S, Dai Y, Weng R, Li Y, Wu W, Zhou Z, Zhong Z and Zheng Y
Observational studies have previously reported an association between depression and certain female reproductive disorders. However, the causal relationships between depression and different types of female reproductive disorders remain unclear in terms of direction and magnitude. We conducted a comprehensive investigation using a two-sample bi-directional Mendelian randomization analysis, incorporating publicly available GWAS summary statistics. Our aim was to establish a causal relationship between genetically predicted depression and the risk of various female reproductive pathological conditions, such as ovarian dysfunction, polycystic ovary syndrome(PCOS), ovarian cysts, abnormal uterine and vaginal bleeding(AUB), endometriosis, leiomyoma of the uterus, female infertility, spontaneous abortion, eclampsia, pregnancy hypertension, gestational diabetes, excessive vomiting in pregnancy, cervical cancer, and uterine/endometrial cancer. We analyzed a substantial sample size, ranging from 111,831 to 210,870 individuals, and employed robust statistical methods, including inverse variance weighted, MR-Egger, weighted median, and MR-PRESSO, to estimate causal effects. Sensitivity analyses, such as Cochran's Q test, MR-Egger intercept test, MR-PRESSO, leave-one-out analysis, and funnel plots, were also conducted to ensure the validity of our results. Furthermore, risk factor analyses were performed to investigate potential mediators associated with these observed relationships. Our results demonstrated that genetic predisposition to depression or dysthymia was associated with an increased risk of developing PCOS (OR = 1.43, 95% CI 1.28-1.59; P = 6.66 × 10), ovarian cysts (OR = 1.36, 95% CI 1.20-1.55; P = 1.57 × 10), AUB (OR = 1.41, 95% CI 1.20-1.66; P = 3.01 × 10), and endometriosis (OR = 1.43, 95% CI 1.27-1.70; P = 2.21 × 10) after Bonferroni correction, but no evidence for reverse causality. Our study did not find any evidence supporting a causal or reverse causal relationship between depression/dysthymia and other types of female reproductive disorders. In summary, our study provides evidence for a causal relationship between genetically predicted depression and specific types of female reproductive disorders. Our findings emphasize the importance of depression management in the prevention and treatment of female reproductive disorders, notably including PCOS, ovarian cysts, AUB, and endometriosis.
Induced erotomania by online romance fraud - a novel form of de Clérambault's syndrome
Alotti N, Osvath P, Tenyi T and Voros V
Although the impact of internet usage on mental health is extensively documented, there is a notable scarcity of reports in the literature concerning internet-induced erotomania. Erotomania is a rare and likely underdiagnosed delusional disorder. It is characterized by an irrational belief held by the affected persons that someone of higher socioeconomic status harbor romantic feelings toward them. Here, we describe the psychopathology of erotomanic delusion induced by online romantic fraud in a female patient. Employing this case as a focal point, we illuminate novel aspects of erotomania that warrant attention and examination.
Depression and Personality Traits Across Adolescence-Within-Person Analyses of a Birth Cohort
Morken IS, Wichstrøm L, Steinsbekk S and Viddal KR
Depressive symptoms and personality traits covary in adolescents, but our understanding of the nature of this relation is limited. Whereas a predisposition explanation posits that specific personality traits increase the vulnerability for developing depression, a scar explanation proposes that depression may alter premorbid personality. Attempts to test these explanatory models have relied on analyses that conflate within-person changes and between-person differences, which limits the implications that can be drawn. Moreover, research on the early adolescent years is lacking. The present study therefore examined within-person associations between depressive symptoms and Big Five personality traits across ages 10 to 16. Children (n = 817; 49.9% boys) and parents from two birth cohorts in Trondheim, Norway, were assessed biennially with clinical interviews capturing symptoms of major depressive disorder and dysthymia, and self-reported Big Five personality traits. Analyses were conducted using a random intercept cross-lagged panel model, which accounts for all unmeasured time-invariant confounding effects. Increased Neuroticism predicted an increased number of depressive symptoms-and increased depressive symptoms predicted increased Neuroticism-across ages 10 to 14. Moreover, increased depressive symptoms forecast reduced Extraversion across ages 10 to 16, and reduced Conscientiousness from ages 12 to 14. Increases in Neuroticism may contribute to the development of depressive symptoms-in line with the predisposition model. As regards the scar model, depression may have an even wider impact on personality traits: increasing Neuroticism and reducing Extraversion and Conscientiousness. These effects may already be present in the earliest adolescent years.
The Mood-Muscle Meta Bridge (Brain Muscle Axis)
Kalra S, Arora S and Kapoor N
Psychological well-being is essential for the maintenance of good metabolic health. Modern management of most chronic metabolic disorders rightly focusses on improving the health-related quality of life of persons living with disease. In this brief communication we describe the bidirectional association between muscle function and mood (psychological health), explore the various pathways that link these aspects of health, and underscore their clinical implications. This paper emphasizes the importance of maintaining good mental health through exercise and vice a versa.
Global, regional, and national burdens of depressive disorders in adolescents and young adults aged 10-24 years from 1990 to 2019: A trend analysis based on the Global Burden of Disease Study 2019
Luo J, Tang L, Kong X and Li Y
Depressive disorders (DD) including dysthymia and major depressive disorder (MDD) are common among adolescents and young adults. However, global trends in DD burden remain unclear.
Trance and Possession Disorder With Underlying Dysthymia: A Case Report
Chadha Y, Patil R, Toshniwal S and Sinha N
Trance and possession disorder (TPD) is an intriguing and complex phenomenon in the realm of psychology and psychiatry. Trance is characterized by a state of temporary marked alteration in the state of consciousness without replacement by an alternate identity, with either a narrowing of awareness of immediate surroundings or behaviors that are beyond one's control. Possession is defined as an episode of alteration in the state of consciousness with the replacement of the customary sense of personal identity by a new identity, identified by the patient or his entourage as the spirit of an animal, a deceased individual, a deity, or a power. This often manifests culturally and contextually, varying in intensity and duration across different societies and belief systems, which could be due to an interplay of emotional stress and repressed emotions, domestic discord, or sociocultural issues. We report a case from Maharashtra, India, involving a patient diagnosed with TPD with underlying dysthymia. This case also highlights the complex interplay between these two psychiatric conditions and how managing one condition subsequently ceased the trance episodes.
Mental Illness Diagnoses May Not Cause All Mental Symptoms: A Simulation Study for Major Depressive Episodes, Dysthymic Disorder, and Manic Episodes
Chao YS, Wu CJ, Po JY, Huang SY, Wu HC, Hsu HT, Cheng YP, Lai YC and Chen WC
Objectives This study aims to understand the statistical significance of the associations between diagnoses and symptoms based on simulations that have been used to understand the interpretability of mental illness diagnoses. Methods The symptoms for the diagnosis of major depressive episodes, dysthymic disorder, and manic episodes were extracted from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR, American Psychiatric Association, Philadelphia, Pennsylvania). Without real-world symptom data, we simulated populations using various combinations of symptom prevalence and correlations. Assuming symptoms occurred with similar prevalence and correlations, for each combination of symptom prevalence (0.05, 0.1, 0.3, 0.5, and 0.7) and correlation (0, 0.1, 0.4, 0.7, and 0.9), 100 cohorts with 10,000 individuals were randomly created. Diagnoses were made according to the DSM-IV-TR criteria. The associations between the diagnoses and their input symptoms were quantified with odds ratios and correlation coefficients. P-values from 100 cohorts for each combination of symptom prevalence and correlation were summarized. Results Three mental illness diagnoses were not significantly correlated with their own symptoms in all simulations, particularly when symptoms were not correlated, except for the symptom in the major criteria of major depressive episodes or dysthymic disorder. The symptoms for the diagnosis of major depressive episodes and dysthymic disorder were significantly correlated with these two diagnoses in some simulations, assuming 0.1, 0.4, 0.7, or 0.9 symptom correlations, except for one symptom. The overlap in the input symptoms for the diagnosis of major depressive episodes and dysthymic disorder also leads to significant correlations between these two diagnoses, assuming 0.1, 0.4, 0.7, and 0.9 correlations between input symptoms. Manic episodes are not significantly associated with the input symptoms of major depressive episodes and dysthymic disorder. Conclusion There are challenges to establish the causation between psychiatric symptoms and mental illness diagnoses. There is insufficient prevalence and incidence data to show all psychiatric symptoms exist or can be observed in patients. The diagnostic accuracy of symptoms to detect a disease cause is far from perfect. Assuming the symptoms of three mood disorders may present in patients, three diagnoses are not significantly associated with all psychiatric symptoms used to diagnose them. The diagnostic criteria of the three diagnoses have not been designed to guarantee significant associations between symptoms and diagnoses. Because statistical associations are important for making causal inferences, there may be a lack of causation between diagnoses and symptoms. Previous research has identified factors that lead to insignificant associations between diagnoses and symptoms, including biases due to data processing and a lack of epidemiological evidence to support the design of mental illness diagnostic criteria.
Depressive Syndromes in Men with Hypogonadism in the TRAVERSE Trial: Response to Testosterone Replacement Therapy
Bhasin S, Seidman S, Travison TG, Pencina KM, Lincoff AM, Nissen SE, Miller MG, Flevaris P, Li X, Wannemuehler K and Pope HG
The effect of testosterone on depressive symptoms in men with hypogonadism remains incompletely understood.
Evaluation of catatonia in autism and severe depression revealing Phelan-McDermid syndrome and tetrahydrobiopterin deficiency
Boley G, Pierri J, Finegold D and Pan L
The authors describe a female in her late twenties, presenting with catatonia and diagnosed with epilepsy, autism spectrum disorder, mild intellectual disability, psychosis, dysthymia, anxiety and bipolar disorder, receiving weekly electroconvulsive therapy (ECT). After testing, findings indicated an interstitial deletion in the 22q13.33 region associated with Phelan-McDermid syndrome. In addition, the patient had low cerebral spinal fluid tetrahydrobiopterin (BH) levels, suggesting dysfunction in the pterin biosynthetic pathway. As a result, the patient started on sapropterin, a BH replacement small molecule. After sapropterin treatment, catatonia improved, and the need for ECT decreased. There was an improvement in her cognitive ability, attention and independence. However, there has been no improvement in seizure frequency.
Efficacy and moderators of metacognitive training for depression in older adults (MCT-Silver): A randomized controlled trial
Schneider BC, Veckenstedt R, Karamatskos E, Ahlf-Schumacher J, Gehlenborg J, Schultz J, Moritz S and Jelinek L
Up to 79 % of older adults with depression do not receive treatments commensurate with guideline recommendations. Metacognitive Training-Silver (MCT-Silver) is a low-intensity group training, which aims to reduce depressive symptoms by targeting (meta)cognitive beliefs.
Effectiveness of family-based therapy for depressive symptoms in children and adolescents: A systematic review and meta-analysis
van Aswegen T, Samartzi E, Morris L, van der Spek N, de Vries R, Seedat S and van Straten A
Early-onset depression contributes significantly to the global health burden and has long-term negative effects. This meta-analysis collates and examines the effectiveness of family-based interventions, where family members are involved in the treatment of depression in children and adolescents. A literature search was performed up to 8th March 2023. Randomised controlled trials of family-based interventions were included for participants aged 3-18 years with a diagnosis of major depressive disorder or dysthymia, according to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013) or with a score above a cut-off on a standardised self-report depression measure. The overall effect size for treatment versus active control was g = 0.22 (95% confidence interval [CI]: -0.05-0.50) (nine studies; 659 participants), and for treatment versus non-active control it was g = 0.46 (95% CI: -0.09-1.01) (four studies; 385 participants). Effect sizes were not statistically significant, and heterogeneity was high, ranging between I  = 64.3-81.1%. Subgroup analysis comparing attachment-based family therapy with family therapy using other theoretical frameworks did not yield a significant difference between the two. The effects of family-based therapies were larger than those in the comparison groups, but family-based therapy did not demonstrate a significant treatment benefit compared to the controls. More randomised controlled trials are warranted, considering that evidence for other psychotherapies for depression in children and adolescents, indicates modest effects. Family-based therapy may be an alternative for children and adolescents whose needs are not addressed by these treatments.
Suicides among American Indian/Alaska Native firefighters: Data from the National Violent Death Reporting System, 2003 - 2017
Pennington ML, Ylitalo KR, Thomas KL, Coe E, Humphries M and Gulliver SB
Suicide is a significant public health problem in the United States and disproportionally affects male American Indian/Alaska Natives (AI/AN). Suicide is particularly problematic among AI/AN firefighters who are more likely to report suicide ideation, planning, attempts, and risk compared to non-Hispanic white (NHW) firefighters. The aim of the current study was to compare non-Hispanic AI/AN firefighter and NHW firefighter suicide decedents by demographics and risk/precipitating factors using National Violent Death Reporting System data for 45 male non-Hispanic AI/AN firefighter and 588 male NHW firefighter decedents who died by suicide. Compared to NHW firefighter decedents, AI/AN firefighter decedents were significantly younger and had significantly higher odds of experiencing alcohol use problems and a recent death/suicide of a family member/friend. AI/AN firefighter decedents had significantly lower odds of documented mental health problems, documented diagnosis of depression/dysthymia, receipt of mental health treatment, or leaving a suicide note compared to NHW firefighter decedents. Results from this study may inform tailored suicide prevention and screening efforts among first responders with the goal of lowering suicide mortality among AI/AN firefighters and fire service as a whole.
Gut feelings: the relations between depression, anxiety, psychotropic drugs and the gut microbiome
Brushett S, Gacesa R, Vich Vila A, Brandao Gois MF, Andreu-Sánchez S, Swarte JC, Klaassen MAY, Collij V, Sinha T, Bolte LA, Wu J, Swertz M, de Kroon MLA, Reijneveld SA, Wijmenga C, Weersma RK, Fu J, van Loo HM, Kurilshikov A and Zhernakova A
The gut microbiome is involved in the bi-directional relationship of the gut - brain axis. As most studies of this relationship are small and do not account for use of psychotropic drugs (PTDs), we explored the relations of the gut microbiome with several internalizing disorders, while adjusting for PTDs and other relevant medications, in 7,656 Lifelines participants from the Northern Netherlands (5,522 controls and 491 participants with at least one internalizing disorder). Disorders included dysthymia, major depressive disorder (MDD), any depressive disorder (AnyDep: dysthymia or MDD), generalized anxiety disorder (GAD) and any anxiety disorder (AnyAnx: GAD, social phobia and panic disorder). Compared to controls, 17 species were associated with depressive disorders and 3 were associated with anxiety disorders. Around 90% of these associations remained significant (FDR <0.05) after adjustment for PTD use, suggesting that the disorders, not PTD use, drove these associations. Negative associations were observed for the butyrate-producing bacteria in participants with AnyDep and for in AnyAnx participants, along with many others. Tryptophan and glutamate synthesis modules and the 3,4-Dihydroxyphenylacetic acid synthesis module (related to dopamine metabolism) were negatively associated with MDD and/or dysthymia. After additional adjustment for functional gastrointestinal disorders and irritable bowel syndrome, these relations remained either statistically (FDR <0.05) or nominally ( < 0.05) significant. Overall, multiple bacterial species and functional modules were associated with internalizing disorders, including gut - brain relevant components, while associations to PTD use were moderate. These findings suggest that internalizing disorders rather than PTDs are associated with gut microbiome differences relative to controls.
The Prevalence of Mood Disorders Among Health and Non-health Undergraduate Students in King Saud University, Riyadh, Saudi Arabia: A Cross-Sectional Study
Alhenaki BA, Alsubait AK, Abuhaimed M, Aljurayyad FO, Alsubaie MN and Agha S
Mood disorders (MDs) are among the most common of all mental health diagnoses, with increasing prevalence and a devastating impact on individuals, families, and the community. This study aimed to estimate the frequency of MDs among health and non-health profession students.
What Came First, Mania or Depression? Polarity at Onset in Bipolar I and II: Temperament and Clinical Course
Janiri D, Simonetti A, Moccia L, Hirsch D, Montanari S, Mazza M, Di Nicola M, Kotzalidis GD and Sani G
(1) Background: Bipolar disorder (BD) is divided into type I (BD-I) and type II (BD-II). Polarity at onset (PO) is a proposal to specify the clinical course of BD, based on the type of the first episode at disorder onset-depressive (D-PO) or manic (M-PO). At the same time, affective temperaments represent preexisting variants of the spectrum of affective disorders. Our objectives were to investigate the hypothesis that temperament may exert an influence on PO, and that this factor can serve as an indicator of the forthcoming course of the disorder, carrying significant therapeutic implications. (2) Methods: We included 191 patients with BD and examined clinical variables and temperament; the latter was assessed using the short version of the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Auto-questionnaire (TEMPS-A-39-SV). We tested the associations between these variables and PO using standard univariate/bivariate methods followed by multivariate logistic regression models. (3) Results: 52.9% of the sample had D-PO and 47.1% had M-PO. D-PO and M-PO patients scored higher for dysthymic and hyperthymic temperaments, respectively ( < 0.001). Also, they differed in BD subtypes, age at first affective episode, illness duration, number of depressive episodes, seasonality, suicide risk, substance use, lithium, and benzodiazepine use ( < 0.05). Only BD-II and age at first depressive episode were predictors of D-PO, whereas BD-I, age at first manic/hypomanic episode, and hyperthymic temperament were predictors of M-PO ( < 0.01). (4) Conclusions: Our findings point to the importance of carefully assessing temperament and PO in patients with BD, to better predict the clinical course and tailor therapeutic interventions to individual patients' needs.
Prevalence of mental disorders among older Australians: Contrasting evidence from the 2020-2021 National Study of Mental Health and Wellbeing among men and women and the Health In Men Data Linkage Study
Almeida OP, Hankey GJ, Yeap BB, Golledge J, Etherton-Beer C, Robinson S and Flicker L
To determine the prevalence of common mental disorders among older Australians included in the Health In Men Data Linkage Study and compare those with the results of the 2020-2021 National Study of Mental Health and Wellbeing (NSMHW).
The influence of psychological traits and prior experience on treatment expectations
Basedow LA, Fischer A, Benson S, Bingel U, Brassen S, Büchel C, Engler H, Mueller EM, Schedlowski M and Rief W
Placebo and nocebo responses are modulated by the treatment expectations of participants and patients. However, interindividual differences predicting treatment expectations and placebo responses are unclear. In this large-scale pooled analysis, we aim to investigate the influence of psychological traits and prior experiences on treatment expectations.
Comparison of childhood trauma between depressive disorders and personality disorders
Jayakody K and Gunadasa S
The relationship between childhood trauma with major depressive disorder (MDD) and personality disorders is complex. We explored the differences in the subjective reporting of childhood trauma to determine whether there were differences between those with a diagnosis of personality disorder and those with MDD. Adult patients with depressive symptoms were recruited from three adult psychiatry inpatient wards. Sixty inpatients fulfilled the study criteria and were requested to complete the childhood trauma questionnaire (CTQ). At discharge, diagnosis was determined and was allocated mainly to two groups: those with MDD and those with personality disorder. Those with MDD, dysthymia and subsyndromal depressive symptoms were included in the Depression Broad Definition (DBD) group (secondary analysis). Significantly higher subjective reporting of childhood trauma was observed in the personality disorder group compared with MDD in three CTQ domains. Similarly, significantly higher reporting of childhood trauma was observed in all five CTQ domains in those with a personality disorder compared with the DBD group. In conclusion, the presence of personality disorder was associated with greater subjective reporting of childhood trauma compared with those with MDD, and further research is required to explore the differences in objective experience of childhood trauma between the diagnoses using objective measures.
Secular trends in the incidence of major depressive disorder and dysthymia in China from 1990 to 2019
Li M, Gao W, Zhang Y, Luo Q, Xiang Y, Bao K and Zaki N
Depression is increasingly recognized as a worldwide serious, public health concern. A better understanding of depression is important for advancing its management and learning the difference between major depressive disorder (MDD) and dysthymia. Our aim is to conduct a concurrent analysis of the trends of both MDD and dysthymia in China.
Pharmacological update of mirtazapine: a narrative literature review
Hassanein EHM, Althagafy HS, Baraka MA, Abd-Alhameed EK and Ibrahim IM
Mirtazapine (MTZ) is an antidepressant drug with an exceptional pharmacological profile. It also has an excellent safety and tolerability profile. The present review provides a pharmacological update on MTZ and summarizes the research findings of MTZ's effects on different diseases. MTZ is hypothesized to have antidepressant effects because of the synergy between noradrenergic and serotonergic actions and is effective in treating major depressive disorder and depression associated with epilepsy, Alzheimer's disease, stroke, cardiovascular disease, and respiratory disease. In cancer patients, MTZ significantly reduced sadness, nausea, sleep disruption, and pain and improved quality of life. Also, it has promising effects on Parkinson's disease, schizophrenia, dysthymia, social anxiety disorder, alcohol dependency, posttraumatic stress disorder, panic disorder, pain syndromes, obsessive-compulsive disorder, and sleep disorders. Additionally, MTZ is potentially therapeutic in different situations associated with depression, such as liver, kidney, cardiovascular, respiratory, infertility, heavy metal-induced neurotoxicity, and pruritus. Potent antioxidative, anti-inflammatory, and anti-apoptotic bioactivities mediate these promising effects. These positive outcomes of the scientific investigations motivate more and more clinical trials for a golden exceptional antidepressant in different conditions.
Prevalence and correlates of DSM-5 opioid withdrawal syndrome in U.S. adults with non-medical use of prescription opioids: results from a national sample
Mannes ZL, Livne O, Knox J, Hasin DS and Kranzler HR
In the U.S. non-medical use of prescription opioids (NMOU) is prevalent and often accompanied by opioid withdrawal syndrome (OWS). OWS has not been studied using nationally representative data. We examined the prevalence and clinical correlates of OWS among U.S. adults with NMOU. We used data from 36,309 U.S. adult participants in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III, 1,527 of whom reported past 12-month NMOU. Adjusted linear and logistic regression models examined associations between OWS and its clinical correlates, including psychiatric disorders, opioid use disorder (OUD; excluding the withdrawal criterion), medical conditions, and healthcare utilization among people with regular (i.e. ≥3 days/week) NMOU ( = 534). Over half (50.4%) of the sample was male. Approximately 9% of people with NMOU met criteria for DSM-5 OWS, with greater prevalence of OWS (∼20%) among people with regular NMOU. Individuals with bipolar disorder, dysthymia, panic disorder, and borderline personality disorder had greater odds of OWS (aOR range = 2.71-4.63). People with OWS had lower mental health-related quality of life (β=-8.32,  < .001). Individuals with OUD also had greater odds of OWS (aOR range = 26.02-27.77), an association that increased with more severe OUD. People using substance use-related healthcare services also had greater odds of OWS (aOR range = 6.93-7.69). OWS was prevalent among people with OUD and some psychiatric disorders. These findings support screening for OWS in people with NMOU and suggest that providing medication- assisted treatments and behavioral interventions could help to reduce the burden of withdrawal in this patient population.
Add-on pramipexole for anhedonic depression: study protocol for a randomised controlled trial and open-label follow-up in Lund, Sweden
Lindahl J, Asp M, Ståhl D, Tjernberg J, Eklund M, Björkstrand J, van Westen D, Jensen J, Månsson K, Tornberg Å, Svensson M, Deierborg T, Ventorp F and Lindqvist D
Many depressed patients do not achieve remission with available treatments. Anhedonia is a common residual symptom associated with treatment resistance as well as low function and quality of life. There are currently no specific and effective treatments for anhedonia. Some trials have shown that dopamine agonist pramipexole is efficacious for treating depression, but more data is needed before it could become ready for clinical prime time. Given its mechanism of action, pramipexole might be a useful treatment for a depression subtype characterised by significant anhedonia and lack of motivation-symptoms associated with dopaminergic hypofunction. We recently showed, in an open-label pilot study, that add-on pramipexole is a feasible treatment for depression with significant anhedonia, and that pramipexole increases reward-related activity in the ventral striatum. We will now confirm or refute these preliminary results in a randomised controlled trial (RCT) and an open-label follow-up study.
Estimated Prevalence of Depressive Disorders in Children From 2004 to 2019: A Systematic Review and Meta-Analysis
Spoelma MJ, Sicouri GL, Francis DA, Songco AD, Daniel EK and Hudson JL
Depression during childhood (ie, age <13 years) poses a major health burden. Recent changes in environmental and lifestyle factors may increase children's risk of mental health problems. This has been reported for anxiety disorders, but it is unclear whether this occurs for depressive disorders.
Temporal priority of lifetime alcohol use disorders and comorbid psychiatric disorders in adults: Results from a population-based nationwide survey in Korea
Lee J, Kim BS, Hong JP, Cho SJ, Lee JY, Park JI, Jeon HJ and Chang SM
Despite the high prevalence of alcohol use disorders (AUDs) in Korea, few studies have been conducted on the temporal priority with comorbid mental disorders. We investigated the temporal priority of lifetime AUDs and comorbid mood and anxiety disorders among the general population of Korea.
Suicidal risk and protective factors in major affective disorders: A prospective cohort study of 4307 participants
Miola A, Tondo L, Pinna M, Contu M and Baldessarini RJ
Suicidal behavior is strongly associated with major affective disorders, but there is a need to quantify and compare specific risk and protective factors in bipolar disorder (BD) and major depressive disorder (MDD).
How valid are proxy assessment of mental health and sleep comorbidities of patients with epilepsy using standardized questionnaires?
Serrand C, Faucanié M, Jaussent A, Crespel A, Denuelle M, Bartolomei F, Vercueil L, Derambure P, Tyvaert L, Marchal C, Landre E, Szurhaj W, Mura T, Navarro V, Rheims S and Picot MC
The study aimed to determine the level of agreement between patients with epilepsy and their proxies when assessing psychiatric comorbidities, sleep disorders, and medication adherence using standardized questionnaires.
Longitudinal bidirectional associations between diabetic retinopathy and diagnosed depression: Results from a Danish nationwide registry-based cohort study
Pedersen FN, Stokholm L, Andersen N, Andresen J, Bek T, Hajari JN, Heegaard S, Højlund K, Kawasaki R, Möller S, Laugesen CS, Schielke KC, Thykjær AS, Peto T, Pouwer F and Grauslund J
Diabetic retinopathy (DR) is a feared complication and a leading course of visual impairment, but the connection between DR and depression including the direction has never been studied in a nationwide cohort. We aimed to assess, whether the associations between DR and diagnosed depression are bidirectional.
Associations between depression and cancer risk among patients with diabetes mellitus: A population-based cohort study
Shi-Heng W, Hsu LY, Lin MC and Wu CS
The co-occurrence of depression and diabetes mellitus has been linked to an increased risk of developing cancer. This study aimed to investigate whether depression further amplifies the risk of cancer among individuals with diabetes.
Population-attributable risk of psychiatric disorders for suicide among adolescents and young adults in Taiwan
Hung YA, Liao SC, Chang CM, Chang SS, Yang AC, Chien YL, Wu CS and Gau SS
Youth suicide rates have increased markedly in some countries. This study aimed to estimate the population-attributable risk of psychiatric disorders associated with suicide among Taiwanese youth aged 10-24 years.
[Psychopathological differences between female adolescent patients with and without suicide attempt]
Martínez-Medina MP, González-Forteza C and Padrós-Blázquez F
Traditionally, psychopathology has been related to suicide risk, furthermore if we bear in mind that the recent meta-analysis on the relationship between some mental disorders and the risk of suicide attempt are inconclusive, and have been performed with non-clinical samples.
Alcohol use disorder criteria exhibit different comorbidity patterns
Watts AL, Watson D, Heath AC and Sher KJ
Alcohol use disorder is comorbid with numerous other forms of psychopathology, including externalizing disorders (e.g. conduct disorder) and, to a lesser extent, internalizing conditions (e.g. depression, anxiety). Much of the time, overlap among alcohol use disorder and other conditions is explored at the disorder level, assuming that criteria are co-equal indicators of other psychopathology, even though alcohol use disorder criteria span numerous varied domains. Emerging evidence suggests that there are symptom clusters within the construct of alcohol use disorder that relate differentially with important external criteria, including psychopathology and allied personality traits (e.g. impulsivity, novelty-seeking). The present study mapped individual alcohol use disorder criteria onto internalizing and externalizing dimensions.
Neurodevelopmental risk and adaptation as a model for comorbidity among internalizing and externalizing disorders: genomics and cell-specific expression enriched morphometric study
Kuang N, Liu Z, Yu G, Wu X, Becker B, Fan H, Peng S, Zhang K, Zhao J, Kang J, Dong G, Zhao X, Sahakian BJ, Robbins TW, Cheng W, Feng J, Schumann G, Palaniyappan L and Zhang J
Comorbidity is the rule rather than the exception for childhood and adolescent onset mental disorders, but we cannot predict its occurrence and do not know the neural mechanisms underlying comorbidity. We investigate if the effects of comorbid internalizing and externalizing disorders on anatomical differences represent a simple aggregate of the effects on each disorder and if these comorbidity-associated cortical surface differences relate to a distinct genetic underpinning.
Research Progress of Central and Peripheral Corticotropin-Releasing Hormone in Irritable Bowel Syndrome with Comorbid Dysthymic Disorders
Liang YF, Chen XQ, Zhang MT, Tang HY and Shen GM
Irritable bowel syndrome (IBS) is considered a stress disorder characterized by psychological and gastrointestinal dysfunction. IBS patients not only suffer from intestinal symptoms such as abdominal pain, diarrhea, or constipation but also, experience dysthymic disorders such as anxiety and depression. Studies have found that corticotropin-releasing hormone plays a key role in IBS with comorbid dysthymic disorders. Next, we will summarize the effects of corticotropin-releasing hormone from the central nervous system and periphery on IBS with comorbid dysthymic disorders and relevant treatments based on published literatures in recent years.
Depression and Cost-Related Health Care Utilization Among Persons with Diabetes
McClintock HF, Edmonds SE and Bogner HR
The presence of depression among people with diabetes can substantially increase health care costs and reduce health care utilization. This study aimed at further elucidating the factors underlying the relationship between depressive disorders and health care utilization among people with diabetes. Data were obtained from the 2019 Behavioral Risk Factor Surveillance System, and the sample was limited to people with diabetes ( = 22,642). The independent variable was assessed by a lifetime diagnosis of depressive disorder, including depression, major depression, dysthymia, or minor depression. The dependent variable was cost-related health care utilization assessed as a response (yes/no) to whether participants had not seen a doctor due to costs in the past year. Logistic regression models examined the association between depressive disorders and health care utilization, adjusting for covariates incorporating weighting to account for study design. Overall, 25.2% of the people with diabetes reported having had a depressive disorder in their lifetime. People with diabetes who had ever been diagnosed with a depressive disorder were more likely to have reported not seeing a doctor due to costs in the past year (adjusted odds ratio: 1.82 [1.49, 2.28]). Findings from this study suggest a need for further research regarding the relationship between depression and cost-related health care utilization among people with diabetes.
Infra-Low-Frequency Neurofeedback Treatment in Dysthymia: A Case Study
Tschiesner R
Depression is one of the most common mental disorders worldwide. Dysthymia, a long-lasting form of depressive disorder that is also known as persistent depressive disorder (PDD) with pure dysthymic syndrome according to the (DSM-5), is characterised by being difficult to treat. The most prominent therapeutic approaches in treating dysthymia are pharmacotherapy and psychotherapy, but recent studies also demonstrate the success of neurofeedback in treating individuals with depressive disorders. However, infra-low-frequency (ILF) neurofeedback, the main new neurofeedback protocol, lacks empirical evidence, and there is no evidence that it can treat dysthymia. This case report investigates the ILF neurofeedback method in a male patient with dysthymia. After 45 sessions of ILF neurofeedback combined with ILF synchrony, a decrease in symptom severity was found on assessment after treatment, and these results remained consistent at a low level at a 6-month follow-up. Additionally, the patient reported benefits on interpersonal and cognitive levels and in daily life situations. This study should incentivise further investigations into using ILF neurofeedback to treat dysthymia and all variations of depressive disorders.
The Home Environments of Infants of Mothers with Early, Remitted Clinical Depression and No Depression during the First Two Years Postpartum
Henry LM, Manian N, Esposito G and Bornstein MH
The current study examines stability, continuity, and group and gender differences in the home environments of infants of mothers with early, remitted clinical depression and no postpartum depression, overcoming methodological variations in the extant literature. Fifty-five mothers diagnosed with clinical depression (major or minor depression, dysthymia, or depressive disorder not otherwise specified) at 5 months and fully remitted by 15 and 24 months, and 132 mothers with no postpartum depression ( = 32.47; 69.7% European American) completed the Home Observation for Measurement of the Environment (HOME) Inventory Infant/Toddler version when their infants were 15 and 24 months old. No differences in stability estimates of the HOME scales were found between the groups. In terms of continuity, controlling for maternal education and infant birth order, HOME responsivity, involvement, and total score decreased, while HOME acceptance increased between 15 and 24 months in the full sample. There were no effects of group or gender. Results may point to the home environment as a key protective factor for infants of mothers with early, remitted clinical depression, or findings may suggest improved maternal parenting cognitions and practices following remission.
Effect of affective temperament on illness characteristics of subjects with bipolar disorder and major depressive disorder
Simonetti A, Luciano M, Sampogna G, Rocca BD, Mancuso E, De Fazio P, Di Nicola M, Di Lorenzo G, Pepe M, Sambataro F, Signorelli MS, Koukopoulos AE, Chiaie RD, Fiorillo A and Sani G
Affective temperaments represent the stable, biologically determined substrates of mood disorders. The relationship between affective temperaments and bipolar disorder (BD) or major depressive disorder (MDD) has been described. However, the strength of such relationship should be tested while considering other factors influencing the diagnosis of BD/MDD. Literature also lacks a comprehensive description of the interplay between affective temperament and characteristics of mood disorders. The aim of the present study is to address these issues.
Prenatal exposure to a natural disaster and early development of psychiatric disorders during the preschool years: stress in pregnancy study
Nomura Y, Newcorn JH, Ginalis C, Heitz C, Zaki J, Khan F, Nasrin M, Sie K, DeIngeniis D and Hurd YL
Growing evidence shows an association between in utero exposure to natural disasters and child behavioral problems, but we still know little about the development of specific psychopathology in preschool-aged children.
A Three-Year Longitudinal Study of Risk Factors for Suicidality in North Korean Defectors
Lee H, An JH, Chang H, Jun JY and Hong JP
This longitudinal study examined risk factors for future suicidality among North Korean defectors (NKDs) living in South Korea.
The global, national, and regional burden of dysthymia from 1990 to 2019: Insights from the Global Burden of Disease 2019 study
Peng H, Wu X, Wen Y, Zhang H, Lin J and Guan W
Explaining the Female Preponderance in Adolescent Depression-A Four-Wave Cohort Study
Morken IS, Viddal KR, von Soest T and Wichstrøm L
In the transition from childhood into adolescence, a female preponderance in depression emerges. Despite substantial empirical research to test theoretical propositions as to why this happens, our understanding is still limited. One explanation claims that girls become exposed to more stress (stress exposure model) whereas another proposes that girls become more vulnerable to the impact of stress (stress reactivity model) than boys when entering adolescence. Stressful life events (SLEs) and bullying victimization are established risk factors for adolescent depression. However, whether these factors contribute to the gender difference in depression is undetermined and thus investigated herein. Children (49.9% boys; n = 748) and parents from two birth cohorts in Trondheim, Norway, were followed biennially from ages 8 to 14 with clinical interviews about symptoms of depressive disorders and self-reports on SLEs. Teachers reported on bullying victimization. Prospective associations were investigated using an autoregressive latent trajectory model with structured residuals, examining within-person longitudinal associations while accounting for all time-invariant confounding effects. The number of depressive symptoms increased from ages 12 to 14 among girls. In the period before (ages 10 to 12), girls and boys were equally exposed to SLEs and bullying victimization. Increased stress (both SLEs and bullying victimization) at age 12 predicted increased depression at age 14 more strongly among girls than boys. Hence, increased impact-but not exposure-of SLEs and bullying victimization in girls may partly explain the emerging female preponderance in depression, in line with a stress reactivity model.
Prevalence of affective disorders in Chinese school-attending children and adolescents aged 6-16 based on a national survey by MINI-Kid
Deng H, Wen F, Xu H, Yang H, Yan J, Zheng Y, Cui Y and Li Y
Major depressive disorder (MDD), dysthymia disorder (DD) and bipolar disorder (BD) are the most prevalent affective disorders. A nationwide epidemiological investigation of MDD, DD and BP in school-attending children and adolescents was carried out, taking the effect of age, gender and comorbidity into consideration.
Antidepressants and quality of life in patients with major depressive disorder - Systematic review and meta-analysis of double-blind, placebo-controlled RCTs
Wiesinger T, Kremer S, Bschor T and Baethge C
Quality of Life (QoL) is an important outcome in mental disorders. We investigated whether antidepressant pharmacotherapy improved QoL vs. placebo among patients with MDD.
Meta-analytic prevalence of comorbid mental disorders in individuals at clinical high risk of psychosis: the case for transdiagnostic assessment
Solmi M, Soardo L, Kaur S, Azis M, Cabras A, Censori M, Fausti L, Besana F, Salazar de Pablo G and Fusar-Poli P
Comorbid mental disorders in subjects at clinical high risk for psychosis (CHR-P) may impact preventive care. We conducted a PRISMA/MOOSE-compliant systematic meta-analysis, searching PubMed/PsycInfo up to June 21st, 2021 for observational studies/randomized controlled trials reporting on comorbid DSM/ICD-mental disorders in CHR-P subjects ( protocol ). The primary and secondary outcomes were baseline and follow-up prevalence of comorbid mental disorders. We also explored the association of comorbid mental disorders compared with CHR-P versus psychotic/non-psychotic control groups, their impact on baseline functioning and transition to psychosis. We conducted random-effects meta-analyses, meta-regression, and assessed heterogeneity/publication bias/quality (Newcastle Ottawa Scale, NOS). We included 312 studies (largest meta-analyzed sample = 7834, any anxiety disorder, mean age = 19.98 (3.40), females = 43.88%, overall NOS > 6 in 77.6% of studies). The prevalence was 0.78 (95% CI = 0.73-0.82, k = 29) for any comorbid non-psychotic mental disorder, 0.60 (95% CI = 0.36-0.84, k = 3) for anxiety/mood disorders, 0.44 (95% CI = 0.39-0.49, k = 48) for any mood disorders, 0.38 (95% CI = 0.33-0.42, k = 50) for any depressive disorder/episode, 0.34 (95% CI = 0.30-0.38, k = 69) for any anxiety disorder, 0.30 (95% CI 0.25-0.35, k = 35) for major depressive disorders, 0.29 (95% CI, 0.08-0.51, k = 3) for any trauma-related disorder, 0.23 (95% CI = 0.17-0.28, k = 24) for any personality disorder, and <0.23 in other mental disorders (I > 50% in 71.01% estimates). The prevalence of any comorbid mental disorder decreased over time (0.51, 95% CI = 0.25-0.77 over 96 months), except any substance use which increased (0.19, 95% CI = 0.00-0.39, k = 2, >96 months). Compared with controls, the CHR-P status was associated with a higher prevalence of anxiety, schizotypal personality, panic, and alcohol use disorders (OR from 2.90 to 1.54 versus without psychosis), a higher prevalence of anxiety/mood disorders (OR = 9.30 to 2.02) and lower prevalence of any substance use disorder (OR = 0.41, versus psychosis). Higher baseline prevalence of alcohol use disorder/schizotypal personality disorder was negatively associated with baseline functioning (beta from -0.40 to -0.15), while dysthymic disorder/generalized anxiety disorder with higher functioning (beta 0.59 to 1.49). Higher baseline prevalence of any mood disorder/generalized anxiety disorder/agoraphobia (beta from -2.39 to -0.27) was negatively associated with transition to psychosis. In conclusion, over three-quarters of CHR-P subjects have comorbid mental disorders, which modulate baseline functionig and transition to psychosis. Transdiagnostic mental health assessment should be warranted in subjects at CHR-P.
The effect of two cognitive therapies on subjective wellbeing of individuals with depression: results from a randomised controlled trial
Medina JC, Paz C, Salla M, Aguilera M, Montesano A, Compañ V and Feixas G
Despite the burden associated to depression, current standards of care are still limited in scope and effectiveness. In addition, therapy outcomes have frequently focused solely on symptoms, leaving patients' wellbeing relatively unaddressed.
Amantadine in Treatment of Dysthymia-The Pilot Case Series Study
Krzystanek M, Martyniak E, Pałasz A, Skałacka K, Chwalba A and Wierzbiński P
Dysthymia is a common chronic mood disorder in which isolated symptoms of depression persist for at least 2 years. Despite the many medications recommended for the treatment of dysthymia, no recommendations have yet been made for the treatment of patients who fail to achieve clinical improvement. This justifies attempts to identify second-line drugs for the treatment of dysthymia. In an open and naturalistic case study, five patients diagnosed with dysthymia in whom at least one antidepressant treatment was ineffective were treated with amantadine. In the age- and gender-matched external control group, patients were treated with sertraline at 100 mg/day. Depressive symptoms were assessed using HDRS-17. Two men and three women were treated with 100 mg amantadine for 3 months with 3-5 months follow-up. After 1 month of treatment with amantadine, a significant reduction in the intensity of depressive symptoms was achieved in all patients, and the clinical improvement increased over the next 2 months of treatment. No deterioration in well-being was observed in any patient after discontinuation of amantadine. The effect of amantadine treatment was comparable to that of sertraline treatment in patients with dysthymia who improved with this drug. The present study indicates that amantadine is an effective and well-tolerated drug in the treatment of dysthymia. Amantadine may be associated with a quick improvement in symptoms in the treatment of dysthymia. Treatment with this drug seems to be associated with good tolerability and persistency of the therapeutic effect after the discontinuation of the treatment.
Co-occurrence of Aggression and Suicide Attempt Among Young People and Related Factors: Findings from Iranian Youth Cohort Study in Ravansar
Khazaie H, Hamzeh B, Najafi F, Chehri A, Rahimi-Movaghar A, Amin-Esmaeili M, Moradinazar M, Zakiei A and Pasdar Y
Aggression and suicide attempt are behaviors that affect public health. To better understand the nature of these behaviors, the present study was conducted to investigate the concurrence of suicide attempt and aggression in young people. This study sought to identify those factors which contribute to the co-occurrence of suicide attempt and aggression in young people.
Repurposing the antipsychotic drug amisulpride for targeting synovial fibroblast activation in arthritis
Papadopoulou D, Roumelioti F, Tzaferis C, Chouvardas P, Pedersen AK, Charalampous F, Christodoulou-Vafeiadou E, Ntari L, Karagianni N, Denis MC, Olsen JV, Matralis AN and Kollias G
Synovial fibroblasts (SFs) are key pathogenic drivers in rheumatoid arthritis (RA). Their in vivo activation by TNF is sufficient to orchestrate full arthritic pathogenesis in animal models, and TNF blockade proved efficacious for a high percentage of patients with RA albeit coinducing rare but serious side effects. Aiming to find new potent therapeutics, we applied the L1000CDS2 search engine, to repurpose drugs that could reverse the pathogenic expression signature of arthritogenic human TNF-transgenic (hTNFtg) SFs. We identified a neuroleptic drug, namely amisulpride, which reduced SFs' inflammatory potential while decreasing the clinical score of hTNFtg polyarthritis. Notably, we found that amisulpride function was neither through its known targets dopamine receptors D2 and D3 and serotonin receptor 7 nor through TNF-TNF receptor I binding inhibition. Through a click chemistry approach, potentially novel targets of amisulpride were identified, which were further validated to repress hTNFtg SFs' inflammatory potential ex vivo (Ascc3 and Sec62), while phosphoproteomics analysis revealed that treatment altered important fibroblast activation pathways, such as adhesion. Thus, amisulpride could prove beneficial to patients experiencing RA and the often-accompanying comorbid dysthymia, reducing SF pathogenicity along with its antidepressive activity, serving further as a "lead" compound for the development of novel therapeutics against fibroblast activation.
Rethinking ketamine and esketamine action: Are they antidepressants with mood-stabilizing properties?
d'Andrea G, Pettorruso M, Lorenzo GD, Mancusi G, McIntyre RS and Martinotti G
Ketamine and esketamine, the S-enantiomer of the racemic mixture, have recently generated considerable interest as potential therapeutic agents for Treatment-Resistant Depression (TRD), a complex disorder that includes various psychopathological dimensions and distinct clinical profiles (e.g., comorbid personality disorder, bipolar spectrum, dysthymic disorder). This perspective article provides a comprehensive overview of the action of ketamine/esketamine from a dimensional point of view, taking into account the high prevalence of bipolarity in TRD and the evidence of the efficacy of these substances on mixed features, anxiety, dysphoric mood, and, generally, bipolar traits. Additionally, the article underscores the complexity of the pharmacodynamic mechanisms of action of ketamine/esketamine, which goes beyond the non-competitive antagonism of NMDA-R. The need for further research and evidence is highlighted, mainly to evaluate the efficacy of esketamine nasal spray in bipolar depression, the presence of bipolar elements as a predictor of response, and the potential role of these substances as mood stabilizers. The article implies that, in the future, ketamine/esketamine could be used with fewer limitations, not only as antidepressants for the most severe form of depression but also as valuable tools to stabilize subjects with mixed symptoms or bipolar spectrum.
Prevalence of depression in visually impaired children and adolescents: A systematic review and meta-analysis
Bakhla AK, Pallavi P, Kisku RR, Goyal N, Kumar A and Prasad K
The prevalence of depression among visually impaired or blind children and adolescents has not been systematically reviewed. This study aims to provide the prevalence of depression among visually impaired or blind children and adolescents. This systematic review and meta-analysis were conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines (PRISMA) (2020) and Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. A systematic search of various online databases was done to identify and include studies reporting the prevalence of depression among visually impaired or blind children and adolescents (aged up to 20 years). A random-effects meta-analysis was used to estimate the pooled prevalence of depression. Heterogeneity was assessed using I to explain heterogeneity meta-regressive analysis and subgroup analyses were done. With the finally selected 13 studies consisting of 822 participants, the overall pooled prevalence of depression or dysthymia among visually impaired children or adolescents was 14% (137/822 individuals, 95% CI = 9% to 20%), with high heterogeneity between studies (I = 80.11%; < 0.001). Five studies that expressed gender distribution showed a cumulative prevalence of diagnosed depressive disorders was 6.85% and 18.96%, respectively, for male (n = 219, I = 47.52) and female (n = 116, I = 60.6%) participants. In this systematic review and meta-analysis, we selected and analyzed 13 studies and estimated pooled prevalence of depression was 14% (95% CI = 9% to 20%), among visually impaired or blind children and adolescents.
Diet and depression: A systematic review of whole dietary interventions as treatment in patients with depression
Swainson J, Reeson M, Malik U, Stefanuk I, Cummins M and Sivapalan S
Depression is a common mental illness that afflicts over 300 million individuals worldwide. Despite a variety of therapeutic options available, a significant number of depressed patients fail to respond to treatment. Current guidelines for treating depression suggest that supplementation of essential nutrients may be an appropriate adjunctive to treatment, but research investigating full dietary interventions for depressed patients is scarce.
Course of subthreshold manic symptoms and related risk factors in the general population: A three-year follow-up study
Beekman RAL, Ten Have M, de Graaf R, Kupka RW and Regeer EJ
Subthreshold manic symptoms (subM) are a risk factor for the onset and recurrence of bipolar disorder (BD). Individuals with subM may benefit from preventive interventions, however, their development is hampered by a lack of knowledge on subM prevalence and subsequent course. This study examines subM characteristics, course, and risk factors for an unfavourable course.
Post-therapy plasma concentrations of quetiapine in Taiwanese patients
Huang CY, Lin YF, Chen CR and Lin SK
Quetiapine is widely used to treat psychiatric disorders such as major depression, generalized anxiety disorder, dysthymic disorder, and insomnia other than schizophrenia and bipolar disorder. This study investigated the diagnostic distribution of quetiapine use in patients in a psychiatric hospital, the doses of quetiapine prescribed, and the plasma concentrations (Cps) of quetiapine and active metabolites.
The effects of weather on depressive symptoms in patients after cardiac surgery
Vencloviene J, Beresnevaite M, Cerkauskaite S, Lopatiene K, Grizas V and Benetis R
Patients with cardiovascular disease have depression more often than the general population does. The aim of the study was to detect the associations between the psychological state and weather variables in patients who underwent coronary artery bypass grafting or valve surgery. The prospective study was performed during 2008-2012 in Kaunas, Lithuania. The psychological state of 233 patients was assessed by using the Symptom Checklist-90-Revised instrument. The assessment was carried out at 1.5 months, 1 year, and 2 years after the surgery. A sample of 531 measurements of psychological states was used. To investigate the relationships between psychological scores and daily weather variables, a mixed linear model was used adjusting for sex, the type of surgery, age, the marital status, the presence of arterial hypertension, diabetes, major depressive disorders, dysthymic disorders, agoraphobia, smoking before surgery, and myocardial infarction in the anamnesis. The mean somatisation score and air temperature on the second day prior to the survey were found to have a negative correlation in the multivariate model. Lower mean scores of anxiety and depression were linked to hotter days (air temperature >16.25°C on the second day) that did not occur in July or August. During colder days (air temperature <0.35°C), a higher mean score of anxiety and phobic anxiety was observed. A higher mean score of somatizations, depression, and anxiety was seen on the second day after the day with wind speed ≤2.85 kt and on the day after the day with relative humidity <66%. Both a decrease and an increase in daily atmospheric pressure were associated with a higher depression score. Our results confirm that among patients after open heart surgery, psychosomatic complaints are related to some weather changes. The obtained results can help to determine the complexity of weather patterns linked to poorer psychological health.
Antidepressants for the treatment of depression in people with cancer
Vita G, Compri B, Matcham F, Barbui C and Ostuzzi G
Major depression and other depressive conditions are common in people with cancer. These conditions are not easily detectable in clinical practice, due to the overlap between medical and psychiatric symptoms, as described by diagnostic manuals such as the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD). Moreover, it is particularly challenging to distinguish between pathological and normal reactions to such a severe illness. Depressive symptoms, even in subthreshold manifestations, have a negative impact in terms of quality of life, compliance with anticancer treatment, suicide risk and possibly the mortality rate for the cancer itself. Randomised controlled trials (RCTs) on the efficacy, tolerability and acceptability of antidepressants in this population are few and often report conflicting results.
Pre-existing Mental Health Diagnoses Are Associated With Higher Rates of Postoperative Complications, Readmissions, and Reoperations Following Arthroscopic Rotator Cuff Repair
Freshman RD, Oeding JF, Anigwe C, Zhang AL, Feeley BT, Ma CB and Lansdown DA
To investigate the association between preoperative mental health disorders and postoperative complications, readmissions, and ipsilateral revision procedures among patients undergoing arthroscopic rotator cuff repair (RCR).
Associations between Sleep, Depression, and Cognitive Performance in Adolescence
Quevedo-Blasco R, Díaz-Román A and Quevedo-Blasco VJ
The relevance of cognitive performance during adolescence requires further studies that analyze potential associated factors. This study aimed to analyze inductive reasoning, reading comprehension, and mathematical thinking (problem-solving and number and calculation) in relation to sleep and depression in 244 students aged 12-17 years (47.6% boys and 52.4% girls). Daytime sleepiness, sleep quality, dysthymia, and euthymia (state and trait) were assessed by self-reported questionnaires. Moreover, correlations between these variables and cognitive performance, and differences depending on sociodemographic variables (sex, age, or academic year) were analyzed using non-parametric tests. Robust regression models were also conducted to evaluate the predictive role of significant variables on cognitive performance. The results showed significant bidirectional relationships between sleep- and depression-related variables, and between the latter ones and cognitive performance. Depression-trait was more related to cognitive performance than depression-state, and euthymia more than dysthymia, but neither daytime sleepiness nor sleep quality significantly correlated with it. As for sociodemographic variables, girls reported worse sleep and more depressive symptoms than boys did, and younger students reported better sleep but performed worse than the older ones. Although these findings should be further explored in forthcoming studies adding other promising variables, they highlight the importance of promoting euthymia to improve cognitive performance in adolescents.
Psychological and Behavioral Factors Involved in Temporomandibular Myalgia and Migraine: Common but Differentiated Profiles
Viñals Narváez AC, Sánchez-Sánchez T, García-González M, Ardizone García I, Cid-Verdejo R, Sánchez Romero EA and Jiménez-Ortega L
Many studies have revealed high comorbidity and a clear association between temporomandibular disorders (TMD) and migraine. Furthermore, evidence points out that common psychological and behavioral factors might be related to the observed TMD and migraine association. However, this association and the underlying psychological factors are poorly understood.
Differences in gray matter volumes of subcortical nuclei between major depressive disorder with and without persistent depressive disorder
Hung CI, Wu CT and Chao YP
This study aimed to compare the differences in gray matter volumes (GMVs) of subcortical nuclei between major depressive disorder (MDD) patients with and without persistent depressive disorder (PDD) at long-term follow-up.
How can the DSM-5 alternative model of personality disorders advance understanding of depression?
Vittengl JR, Jarrett RB, Ro E and Clark LA
The DSM-5 introduced an alternative model of personality disorder (AMPD) that includes personality dysfunction plus maladaptive-range traits. This study clarifies relations of depression diagnoses and symptoms with AMPD personality pathology.
Treatment of major depressive disorder (MDD) or dysthymic disorder (DD) in spinal cord injury (SCI) patients: a protocol for a systematic review and network meta-analysis
Han JM, Choi WS, Choi H, Jang BH, Kim HJ, Son CH, Park JY, Kim YS, Jang HJ and Kim JH
Although various treatments exist for depression in patients with spinal cord injury (SCI), the comparative effects and relationships between these treatments have not been clearly presented. This study aims to present comprehensive evidence for the treatment of major depressive disorder or dysthymic disorder in patients with SCI by comparing the therapeutic and adverse effects of pharmacological and non-pharmacological treatments through a systematic review and network meta-analysis.
The impact of early-life environment on absence epilepsy and neuropsychiatric comorbidities
Sarkisova K and van Luijtelaar G
This review discusses the long-term effects of early-life environment on epileptogenesis, epilepsy, and neuropsychiatric comorbidities with an emphasis on the absence epilepsy. The WAG/Rij rat strain is a well-validated genetic model of absence epilepsy with mild depression-like (dysthymia) comorbidity. Although pathologic phenotype in WAG/Rij rats is genetically determined, convincing evidence presented in this review suggests that the absence epilepsy and depression-like comorbidity in WAG/Rij rats may be governed by early-life events, such as prenatal drug exposure, early-life stress, neonatal maternal separation, neonatal handling, maternal care, environmental enrichment, neonatal sensory impairments, neonatal tactile stimulation, and maternal diet. The data, as presented here, indicate that some early environmental events can promote and accelerate the development of absence seizures and their neuropsychiatric comorbidities, while others may exert anti-epileptogenic and disease-modifying effects. The early environment can lead to phenotypic alterations in offspring due to epigenetic modifications of gene expression, which may have maladaptive consequences or represent a therapeutic value. Targeting DNA methylation with a maternal methyl-enriched diet during the perinatal period appears to be a new preventive epigenetic anti-absence therapy. A number of caveats related to the maternal methyl-enriched diet and prospects for future research are discussed.
Sleep Complaints Among Adults With Major Depressive Episode Are Associated With Increased Risk of Incident Psychiatric Disorders: Results From a Population-Based 3-Year Prospective Study
Barbotin B, Hoertel N, Olfson M, Blanco C, Sanchez-Rico M, Lejoyeux M, Limosin F and Geoffroy PA
Sleep alterations have been suggested as a cause and consequence of psychiatric disorders. In this context, we evaluated the incidence of psychiatric disorders following sleep complaints in adults with major depressive episode (MDE). In a large, nationally representative 3-year prospective survey, the National Epidemiologic Survey on Alcohol and Related Conditions conducted in 2001-2002 (Wave 1) and 2004-2005 (Wave 2), we used structural equation modeling to examine shared and specific effects of trouble falling asleep, early morning awakening, and hypersomnia on incidence of common comorbid disorders among patients with MDE. The analyses adjusted for sociodemographic and clinical characteristics, including sedative or tranquilizer use. Among participants with MDE at Wave 1, 3-year incidence rates were dysthymia = 2.9%, general anxiety disorder = 8.2%, panic disorder = 3.4%, social anxiety disorder = 4.0%, specific phobia = 3.0%, alcohol use disorder = 8.1%, nicotine dependence = 6.2%, cannabis use disorder = 2.7%, and other drug use disorder = 4.9%. Participants with 3-year incident psychiatric disorders commonly had trouble falling asleep (67.6% for cannabis use disorder to 76.4% for panic disorder), early morning awakening (43.3% for cannabis use disorder to 55.6% for dysthymia), and hypersomnia (51.3% for nicotine use disorder to 72.1% for social anxiety disorder). The effects of the incident general psychopathology factor, representing mechanisms related to incidence of all psychiatric disorders, were exerted almost exclusively through a factor representing shared effect across all sleep complaints. Sleep complaints were associated with increased risk of incident psychiatric disorders, independent of sociodemographic and clinical characteristics. These findings suggest that sleep complaints should be clinically assessed in all psychiatric disorders, as these prodromal symptoms might constitute transdiagnostic biomarkers and therapeutic targets for prevention.
Neuropsychiatric Symptoms after Liver Transplantation in a 65-Year-Old Male Patient
Bugallo-Carrera C, Facal D, Domínguez-Lenogue C, Álvarez-Vidal V, Gandoy-Crego M and Caamaño-Ponte J
The development of immunosuppressants has been key for the advancement of solid organ transplant surgery. Specifically, cyclosporine, tacrolimus, or everolimus have significantly increased the survival rate of patients by reducing the risk of a rejection of the transplanted organ and limiting graft-versus-host disease. We report the case of a 65-year-old man who, after undergoing a liver transplantation and receiving an immunosuppressive treatment with cyclosporine and everolimus, presented severe obsessive, psychotic, and behavioral symptoms over the past three years, and describe the pharmacological and non-pharmacological interventions implemented against these symptoms. In this case, the immunosuppressants used have been cyclosporine and, preferably, everolimus. On the other hand, potential adverse reactions to the treatment have been observed, including neuropsychiatric symptoms such as tremor, anxiety, dysthymia, psychosis, and behavioral disorders, which make it necessary to use corrective psychoactive drugs such as benzodiazepines, antidepressants, and antipsychotics, combined with non-pharmacological interventions. A transversal approach, from the medical and psychosocial disciplines, facilitates success in managing neuropsychiatric symptoms after soft organ transplants.
Young adults with psychosis: Intentions for cannabis reduction and cessation based on theory of planned behavior
Petros R, Walker DD, Davis A and Monroe-DeVita M
Young adults experiencing a first episode of psychosis (FEP) have high rates of cannabis use and cannabis use disorder (CUD). No evidence-based practice effectively treats CUD for people with FEP, and little is known about factors that influence intentions to reduce or stop using. A critical inquiry was conducted to identify salient factors contributing to intentions of young adults with FEP to reduce or discontinue cannabis use, guided by theory of planned behavior (TPB).
Demographic factors, psychiatric and physical comorbidities associated with starting preexposure prophylaxis in a nationally distributed cohort
Drallmeier T, Garrett EK, Meyr A, Salas J and Scherrer JF
Due to a large number of small studies and limited control for confounding, existing evidence regarding patient characteristics associated with PrEP initiation is inconsistent. We used a large electronic health record cohort to determine which demographic, physical morbidity and psychiatric conditions are associated with PrEP initiation. Eligible adult (≥18 years) patients were selected from the Optum® de-identified Electronic Health Record dataset (2010-2018). Non-HIV sexually transmitted diseases and high risk sexual behavior was used to identify patients eligible for PrEP. A fully adjusted Poisson regression model estimated the association between age, gender, race, insurance status, comorbidity index, depression, anxiety, dysthymia, severe mental illness, substance use disorder and nicotine dependence/smoking and rate of PrEP initiation. The cohort (n = 30,909) was mostly under 40 years of age (64.3%), 67.6% were female and 58.2% were White. The cumulative incidence of PrEP initiation was 1.3% (n = 408). Patients ≥60 years of age, compared to 18-29 year olds and Black compared to White patients had significantly lower rates of PrEP initiation. Anxiety disorder was significantly associated with higher rate of PrEP initiation (RR = 1.67; 95%CI:1.20-2.33) and nicotine dependence/smoking with a lower rate (RR = 0.73; 95%CI:0.54-0.97). PrEP is underutilized, and a race disparity exists in PrEP initiation. In the context of existing research, nicotine dependence/smoking is the patient characteristic most consistently associated lower rates of starting PrEP. Given the high prevalence of smoking in PrEP eligible patients, physicians may want to integrate discussions of smoking cessation in patient-provider decisions to start PrEP.
Long-term disability in common mental disorders in Chinese community: evidence from a five-year follow-up study
Zhang Y, Li M, Yin H, Ma C, Huang Z, Yan Y, Kou C, Hu M, Wen J, Chen S, Jia C, Yan J, Ding H, Li Q, Yang L, Huang Y, Liu Z and Xu G
Common mental disorders are general term for mental disorders with high disability rates and significant social burden. The purpose of this study was to determine the degree of long-term disability associated with common mental disorders and to interpret the relationship between common mental disorders and long-term disability.
Depression among higher secondary students of science stream of private schools of Rajkot
Chauhan D, Patel U, Rahul K and Patel M
Depression with the magnitude of 8 - 20% emerged as major mental health morbidity among adolescents due to its devastating consequences of suicidal tendencies, academic failure, poor social relationships, and substance abuse. The current study was carried out to estimate the magnitude of depression among the students of private higher secondary schools of science stream in Rajkot city, Gujarat.
"We want to be heard": Perspectives on mental health care among patients at a federally qualified health center
So M and Carlson K
Depression is a debilitating condition associated with significant medical, social, and economic costs for individuals and communities. Despite its widespread prevalence, depression is typically under-identified and under-treated, particularly for people of color and lower socioeconomic status. Primary care settings such as federally qualified health centers (FQHCs) offer an ideal opportunity to rectify this gap for underserved communities.
[Mental disorders in blepharospasm]
Tolmacheva VA, Parfenov VA, Ostroumova TM, Saloukhina NI, Nodel MR and Romanov DV
To analyze mental disorders in blepharospasm (BS) before and after botulinum therapy (BT).
Teenage Blues: Predictors of depression among adolescents in Nigeria
DadeMatthews A, Nzeakah C, Onofa L, DadeMatthews O and Ogundare T
Depressive disorders, with a prevalence of 15-21%, are among the most common disorders in children and adolescents, and increases the risk of suicide, the second leading cause of death in children aged 10 to 19.
The impact of bipolar spectrum disorders on professional functioning: A systematic review
Dominiak M, Jażdżyk P, Antosik-Wójcińska AZ, Konopko M, Bieńkowski P, Świȩcicki Ł and Sienkiewicz-Jarosz H
The impact of bipolar spectrum (BS) disorders on professional functioning has not been systematically reviewed yet. Since even subsyndromal symptoms may disturb functioning, the determination of the prognostic value of the spectrum of bipolarity for employment seems extremely relevant. The aim of this study was to assess the impact of BS disorders on professional functioning.
Worse prognosis in females with new onset of depression after oral cancer diagnosis: a retrospective case-control study
Hofmann E, Doll C, Rogge A, Preissner R, Heiland M, Preissner S and Koerdt S
Sex-related discrepancies in the prognosis of oral cancer patients have not been clarified. This study aimed to assess survival outcomes and potential prognostic factors in female and male patients with oral cancer.
An update on the pharmacotherapeutic strategies for the treatment of dysthymic disorder: a systematic review
Quagliato LA, Primavera D, Fornaro M, Preti A, Carta MG and Nardi AE
Longer treatment times, more comorbidity, more severe impairments in social, psychological, and emotional functioning, increased healthcare use, and more hospitalizations are all factors that are related to dysthymia. Given the significant prevalence of dysthymia (including persistent depressive disorder) worldwide, its comorbidity with several mental disorders, and the detrimental effects of these comorbidities, it is important to conduct a systematic review to compare the effects of pharmacological acute and maintenance treatments for dysthymia with placebo and standard care in the last 10 years, based on the publication of DSM5.
Factitious disorder comorbid with borderline personality disorder and dysthymia: from medically unexplained physical symptoms to functional neurological disorder
Lazzari C, Shoka A and Rabottini M
In this study, we introduce the concept of comorbidity between factitious disorder (FD), borderline personality disorder (BPD), dysthymia (DY), medically unexplained physical symptoms (MUPS) and functional neurological disorder (FND) characterising patients who may tend to exaggerate physical or psychiatric symptoms of presentation to a general or psychiatric hospital with a constellation of signs that do not receive confirmation from further clinical and instrumental assessments. The similarities between these syndromes and the constant presence of borderline personality in the psychopathology make it the possible link between all these syndromes.
The effects of adverse childhood experiences on depression and suicidal behaviors are partially mediated by neuroticism: A subclinical manifestation of major depression
Jirakran K, Vasupanrajit A, Tunvirachaisakul C and Maes M
Neuroticism, a personality trait, can predict major depressive disorder (MDD). The current study aims to determine whether a) neuroticism is a feature of the acute state of MDD, including suicidal behaviors (SB); and b) adverse childhood experiences (ACEs) are associated with neuroticism in MDD.
Clinical Characterization of Demoralization
Fava GA and Guidi J
[Inflammatory markers in organic nonpsychotic disorders]
Androsova LV, Vetlugina TP, Nikitina VB, Zozulya SA, Otman IN, Belokrylova MF and Klyushnik TP
To determine the indicators of systemic inflammation in peripheral blood samples of patients with organic non-psychotic disorders.
Workplace mental health characteristics of the Indigenous workforce in Canada: A descriptive study
Nowrouzi-Kia B, Gohar B, Sithamparanathan G, Sun RY and Casole J
The Indigenous workforce in Canada is challenged by a history of Euro-Canadian colonialism that has presented deleterious health outcomes, including those in the workplace.
Home-based transcranial direct current stimulation in dual active treatments for symptoms of depression and anxiety: A case series
Sobral M, Guiomar R, Martins V and Ganho-Ávila A
Transcranial direct current stimulation (tDCS) is a potential treatment strategy across some psychiatric conditions. However, there is high heterogeneity in tDCS efficacy as a stand-alone treatment. To increase its therapeutic potential, researchers have begun to explore the efficacy of combining tDCS with psychological and pharmacological interventions. The current case series details the effect of 6-10 weeks of self-administered tDCS paired with a behavioral therapy smartphone app (Flow™), on depressive and anxiety symptoms, in seven patients (26-51 years old; four female) presenting distinctive psychiatric disorders (major depression, dysthymia, illness anxiety disorder, obsessive-compulsive disorder, and anxiety disorders). tDCS protocol consisted of an acute phase of daily 30 min sessions, across 10 workdays (2 weeks Monday-to-Friday; Protocol 1) or 15 workdays (3 weeks Monday-to-Friday; Protocol 2). A maintenance phase followed, with twice-weekly sessions for 4 or 3 weeks, corresponding to 18 or 21 sessions in total (Protocol 1 or 2, respectively). The Flow tDCS device uses a 2 mA current intensity, targeting the bilateral dorsolateral prefrontal cortex. The Flow app offers virtually guided behavioral therapy courses to be completed during stimulation. We assessed depressive symptoms using MADRS-S and BDI-II, anxious symptoms using STAI-Trait, acceptability using ACCEPT-tDCS, and side effects using the Adverse Effects Questionnaire, at baseline and week 6 of treatment. Six patients underwent simultaneous cognitive-behavioral psychotherapy and two were on antidepressants and benzodiazepines. According to the Reliable Change Index (RCI), for depressive symptoms, we found clinically reliable improvement in five patients using MADRS-S (out of seven; RCI: -1.45, 80% CI; RCI: -2.17 to -4.82, 95% CI; percentage change: 37.9-66.7%) and in four patients using BDI-II (out of five; RCI: -3.61 to -6.70, 95% CI; percentage change: 57.1-100%). For anxiety symptoms, clinically reliable improvement was observed in five patients (out of six; RCI: -1.79, 90% CI; RCI: -2.55 to -8.64, 95% CI; percentage change: 12.3-46.4%). Stimulation was well-tolerated and accepted, with mild tingling sensation and scalp discomfort being the most common side effects. This case series highlights the applicability, acceptability, and promising results when combining home-based tDCS with psychotherapy and pharmacotherapy to manage depression and anxiety symptoms in clinical practice.
Mimicry and affective disorders
Salazar Kämpf M and Kanske P
Mimicry, the spontaneous imitation of an interaction partner, is an important part of everyday communication, as it has been shown to foster relationships and increase closeness. People with affective disorders often have problems in their interpersonal lives. In this review, we pursue the question if these problems are linked to differences in mimicry behavior. First, we summarize existing evidence on mimicry, depression and mood. Then, based on five theories differing in their core assumptions regarding mechanisms and functionality of mimicry, we derive suggestions on how mimicry might affect people suffering from bipolar disorders, dysthymia or depression. Depending on each theory, a different understanding of affective disorders and mimicry arises, and we show how the evidence fit in with the suggested theories. Previous studies on affective disorders have focused on mimicry behavior of participants watching photos, computer-generated images, or short video sequences. This review sheds light on the fact that evidence on mimicry needs to be broadened systematically for people with affective disorders in interactional settings. Mimicry represents a novel and important yet underestimated source for diagnostic, intervention and evaluation processes in affective disorders.
Testosterone Replacement Therapy in the Treatment of Depression
Anderson DJ, Vazirnia P, Loehr C, Sternfels W, Hasoon J, Viswanath O, Kaye AD and Urits I
Depression is a common disorder that affects millions globally and is linked to reduced quality of life and mortality. Its pathophysiology is complex and there are several forms of treatment proposed in the literature with differing side effect profiles. Many patients do not respond to treatment which warrants augmentation with other treatments and the investigation of novel treatments. One of these treatments includes testosterone therapy which evidence suggests might improve depressed mood in older patients with low levels of testosterone and helps restore physical impairments caused by age-related hormonal changes.
Relation of Depression and Anxiety Disorders in Choosing Obesity Management in Obese Patients
Abouzed M, Elsherbiny AM, Kamel A, Salama B, Elag KA, Abou Elzahab NF, Abdelkader HR and Altuhayni AS
Obesity is a chronic medical illness with a higher risk of physical and mental cascade. People who seek obesity treatment were reported to have some psychiatric disorders affecting their disease and selection of management.
Psychiatric morbidity in family members of alcohol dependence patients
Singh R, Goyal E, Chaudhury S, Puria A, Kumar S and Kumar A
There is a paucity of Indian studies assessing psychiatric morbidity among family members of subjects with alcohol use disorder.
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