Change In Depression Scores Research Articles

The effects of a tailored cardiac rehabilitation program on depressive symptoms in women: A randomized clinical trial

Background Depression is known to co-occur with coronary heart disease (CHD). Depression may also inhibit the effectiveness of cardiac rehabilitation (CR) programs by decreasing adherence. Higher prevalence of depression in women may place them at increased risk for non-adherence. Objective To assess the impact of a modified, stage-of-change-matched, gender-tailored CR program for reducing depressive symptoms among women with CHD. Methods A two-group randomized clinical trial compared depressive symptoms of women in a traditional 12-week CR program to those completing a tailored program that included motivational interviewing guided by the Transtheoretical Model of behavior change. Women in the experimental group also participated in a gender-tailored exercise protocol that excluded men. The Center for Epidemiological Studies Depression (CES-D) Scale was administered to 225 women at baseline, post-intervention, and at 6-month follow-up. Analysis of Variance was used to compare changes in depression scores over time. Results Baseline CES-D scores were 17.3 and 16.5 for the tailored and traditional groups, respectively. Post-intervention mean scores were 11.0 and 14.3; 6-month follow-up scores were 13.0 and 15.2, respectively. A significant group by time interaction was found for CES-D scores ( F(2, 446) = 4.42, p = .013). Follow-up tests revealed that the CES-D scores for the traditional group did not differ over time ( F(2, 446) = 2.00, p = .137). By contrast, the tailored group showed significantly decreased CES-D scores from baseline to post-test ( F(1, 223) = 50.34, p < .001); despite the slight rise from post-test to 6-month follow-up, CES-D scores remained lower than baseline ( F(1, 223) = 19.25, p < .001). Conclusion This study demonstrated that a modified, gender-tailored CR program reduced depressive symptoms in women when compared to a traditional program. To the extent that depression hinders CR adherence, such tailored programs have potential to improve outcomes for women by maximizing adherence. Future studies should explore the mechanism by which such programs produce benefits.

Increased sensitivity for angry faces in depressive disorder following 2 weeks of 2-Hz repetitive transcranial magnetic stimulation to the right parietal cortex

According to the cognitive neuropsychological hypothesis of antidepressant action, the onset of subjectively experienced therapeutic effects to treatment is preceded by favourable changes in psychological functioning that can be measured by implicit methods. The aim of this study was to examine additional data to explore this hypothesis in an intention-to-treat repetitive transcranial magnetic stimulation (rTMS) study targeting the right parietal cortex. Changes in depression scores from baseline and the sensitivity for recognizing emotional facial expressions were studied in 28 patients with depressive disorder receiving ten sessions of real (n=14) or sham (n=14) rTMS treatments in a double-blind, sham-controlled design. In the patient group results showed significantly higher sensitivity for recognizing angry facial expressions in response to receiving real compared to receiving sham rTMS treatment. Overall mood improvement was similar across real and sham rTMS treatments. However, the sensitivity for recognizing angry facial expressions was correlated to the percentage decrease in depression scores. These results provide the first preliminary support for the cognitive neuropsychological hypothesis of antidepressant action in rTMS treatment.

Combined catecholamine and indoleamine depletion following response to ECT

The mechanism of action of electroconvulsive therapy (ECT) in treating major depression is unknown. We studied two candidate mechanisms through inhibiting simultaneously the synthesis of noradrenaline and serotonin in patients immediately after successful treatment with ECT using a randomised, placebo-controlled, double-blind crossover design. There were no significant changes in depression scores under any experimental conditions, or between the amine-depleted and placebo groups despite reductions of 61% in serum homovanillic acid, 47% in 3-methoxy-4-hydroxyenylethyleneglycol, and 89% in serum tryptophan. Catecholamine and serotonin availability may not be necessary for maintaining the initial antidepressant response to ECT.

Heart rate variability and depressed mood in physical education students: A longitudinal study

Autonomic nervous system (ANS) activity, and more specifically its parasympathetic component, has been reported to be associated with depression. The objective of this longitudinal study was to assess whether changes in heart rate variability (HRV) and in depressive moods were interrelated in healthy young subjects. Thirty students in physical education with a high physical load, were followed over the university year at 3 periods: October (P1), February (P2) and May (P3). Depressive mood was assessed by the score on the Depression subscale of the profile of mood state (POMS) questionnaire. HRV was assessed in supine and during an active orthostatic test with total power (TP ms²) as the sum of the very low (VLF), low (LF) and high frequency (HF) bands, LF/HF ratio representing sympathetic and HF ms² parasympathetic modulations. Results showed that changes in Depression scores between P1 and P2 were negatively and positively associated with changes in TP ms², LF ms², and HF ms² in supine position and during orthostatism respectively. Although Anger/Aggressivity, Fatigue, and Vigor scores of the POMS were also correlated with changes in some HRV indices, Depression was the only significant predictive factor of changes in TP ms² and HF ms² between P1 and P2 in supine position and during orthostatism. These results were not observed between P2 and P3. In conclusion, in a healthy young sample of population, changes in depressive moods are associated with changes in total rhythmical power of HRV and more specifically its parasympathetic component.

Commentary on King KM, Colella TJF, Faris P &amp; Thompson DR (2009) Using the cardiac depression scale in men recovering from coronary artery bypass surgery. Journal of Clinical Nursing 18, 1617–1624

Patients with coronary heart disease (CHD) who require coronary artery bypass graft (CABG) surgery are usually older and are more likely to have multiple comorbidities compared with those undergoing percutaneous coronary interventions (Niles et al. 2001). In addition to this increase in disease burden, the prevalence of depressive symptomatology among patients after CABG surgery has also been shown to be as high as 23% (Pirraglia et al. 1999). Depression and depressive symptoms are prevalent in people with CHD and are associated with adverse cardiovascular outcomes (Whooley et al. 2008). There is strong evidence that the detection and treatment of depression improves health outcomes (Somberg & Arora 2008), thus underscoring the importance of screening for depression in the cardiac care setting. As King et al. (2009) correctly highlight, the detection of even mild depression in patients following CABG surgery is important, and the cardiac depression scale (CDS), designed specifically to identify depression in patients with cardiac disease, has been shown to be sensitive in detecting a broad spectrum of depressive symptoms in patients with cardiac disease (Hare & Davis 1996). Although disease-specific health-related quality of life measures is expected to be more responsive to changes in clinical status (Sullivan et al. 2004), whether this is the case for the CDS in assessing depression in patients following CABG surgery is still to be determined. Most patients surveyed in this study by King et al. (2009) reported low scores on the Beck depression inventory (BDI) at all four points in time (mean : 4AE31–8AE08 from a possible range of 0–63), reducing the possibility of capturing any change in depression scores using the BDI is reduced. Despite the low BDI scores, it is surprising that both the BDI and the CDS had similar power in detecting change in depression scores over time. Although the focus of this article by King et al. was an examination of the utility and a validity of the CDS in patients following their first CABG surgery, further clarification about the study context and method was warranted. First, the study sample only included men. Although the authors explained that this was a sub-study of a clinical trial, no explanation was given as to why no women were included. Second, it would be useful for the readers to know why the authors selected a standardised health record audit as well as telephone contact as their method of data collection. One wonders why a self-administered questionnaire was not used, perhaps because of the written English language literacy of the study sample? Third, the authors made a perfunctory mention of the measurement of interrater reliability scores over the course of the study. The specifics of measurement were not stated. Was it only the standardised depression measures used in this study, or was it all data collected via telephone contact, and did they include data collected via the standardised health record audit? Further clarification of these interrater reliability measurements would have been worthwhile for the reader. Nevertheless, King et al. should be commended for assessing depression in their study sample using both the BDI and the CDS at four points in time over the 36-week study period;

Emotional response to sport concussion compared to ACL injury

Primary objectives: To ascertain and compare the nature of emotional response of athletes to concussion and to anterior cruciate ligament (ACL) injury.Research design: Pre-injury, post-injury and longitudinal emotional functioning of athletes with concussion (n = 16), athletes with ACL injuries (n = 7) and uninjured athletes (n = 28) were compared in a prospective repeated-measures design.Methods and procedures: Participants completed the short version of the Profile of Mood States (POMS). ANOVAs and trend analysis were used to examine between and within group differences across time on two sub-scales, Total Mood Disturbance and Depression.Main outcomes and results: Athletes with ACL injury reported higher levels of depression for a longer duration than athletes with concussion. Relative to un-injured controls, athletes with concussion reported significant changes in Total Mood Disturbance and Depression post-injury, whereas athletes with ACL injuries reported significant changes in Depression scores only. Different patterns of post-injury emotional disturbance for the injured groups were observed by trend analyses.Conclusions: Concussed athletes do not report as much emotional disturbance as athletes with ACL injuries. Differential patterns of emotional disturbance were detected between injured groups. The authors recommended that clinical protocols and educational programmes address emotional sequelae associated with sport concussion and ACL injury.

The role of childhood parent figure loss in the etiology of adult depression: findings from a prospective longitudinal study

The underlying question of this study is whether childhood parental loss between infancy and sixth grade is a predictor of adult depression at age 26 years when a rating of loss severity is used. The loss rating considered the length of the separation/loss, the familiarity of substitute caregivers, the primary or supporting role of the lost parent figure, and traumatic features of the loss. The study also investigated the role of gender, developmental timing of the loss, life stress, SES, prior parental care and attachment history, and follow-up family relationships in the pathways between loss and depression. Results are reported from a prospective longitudinal study of children (N = 164) born into poverty. Measures were collected prenatally through age 26 years and included multiple methods and multiple reporters. Results indicated that the most robust predictor of adult depression was loss history between 5 years old and grade 2. Earlier and later measures of loss were not related to adult depression. However, intervening loss experiences predicted change in depression scores from childhood to adulthood. Loss continued to predict adult depression after controlling for SES, maternal life stress, participant life stress, gender, early caregiving, and follow up family functioning. This study found no significant gender differences. These results suggest that loss is a risk factor for adult depression for both boys and girls and that the quality of early and later caregiving do not entirely buffer children from the effects of parental loss.

All you have to do is call; a pilot study to improve the outcomes of patients with coronary artery disease

Background Studies have identified prevalence rates of major depression in patients with cardiovascular disease to range from 16% to 23%, whereas 65% of patients report some symptoms after a myocardial event. Depression has been shown to be strongly related to overall poorer outcomes in patients with coronary artery disease. Purpose The purpose of this pilot study was to assess the potential benefit of providing follow-up information regarding mental health resources to patients who had undergone cardiac catheterization and had reported significant levels of depression symptoms. Two methods of providing this follow-up information (personal telephone interaction and mailed-out written information) were compared. Methods As part of the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease registry, patients completed baseline questionnaires, including the 10-item Center for Epidemiologic Studies Depression (CES-D) Scale. Patients reporting a score of 10 or higher were randomly assigned to one of three groups. Group A patients were contacted by mail, whereas Group B patients were contacted through a telephone follow-up call by a nurse. Both groups received information regarding community- and hospital-based mental health resources. Six weeks after the initial contact, patients in Groups A and B and those in a third control group (Group C) were called and asked to complete a repeat CES-D via telephone interview. Logistic regression modeling was used to determine the influence of the intervention on the change in depression scores from baseline to 6 weeks. Results Ninety-eight respondents had both baseline and 6-week CES-D scores. The mean age of the respondents was 64.9 years, and women constituted 27% of the sample. There was no statistically significant clinical difference between the three groups. Regression analysis demonstrated that patients who were contacted by either telephone or mail were significantly more likely to report improvement in the CES-D scores (odds ratio = 3.03, p = .03) as compared with the control group. Furthermore, respondents who were phoned reported the highest percentage of improved CES-D scores as compared with the mailed and control groups. Conclusions This pilot study demonstrated that early recognition strategies and referral protocols that address mental health needs are effective in decreasing the reported depressive symptomatology of this high-risk population. Proactively addressing mental health issues as an integral part of the overall treatment with patients with coronary artery disease could potentially improve the health outcomes in this population.

Changes in Severity of Allergy and Anxiety Symptoms Are Positively Correlated in Patients with Recurrent Mood Disorders Who Are Exposed to Seasonal Peaks of Aeroallergens

RATIONALE: Considering clinical and animal evidence suggesting a relationship between allergy and anxiety, we hypothesized that, from low to high aeroallergen exposure, changes in anxiety symptom scores in patients with primary mood disorders will correlate with changes in allergy symptom scores. We also anticipated that sensitization to tree pollen, as determined by allergen specific IgE antibodies, will predict a greater worsening of anxiety during exposure to tree pollen.METHODS: 51 patients with unipolar or bipolar disorder (age: 19-63 years, 65% female) were recruited. Tree- pollen IgE positive subjects (12) were included as the experimental group and patients negative to a multi-allergen serological test (39) were included in the control group. Self reports of anxiety and allergy symptoms were obtained once during the peak airborne pollen counts and once during the period of low airborne pollen counts, as reported by two local pollen counting stations.RESULTS: Using linear regression models, we found a significant positive association between allergy scores and anxiety scores (p < 0.04); however, the IgE specific tree pollen positivity was not significantly associated with changes in anxiety scores.CONCLUSIONS: Because changes in anxiety scores relate to changes in depression scores, the relationship between allergy and anxiety likely involves states rather than only traits. Future research is necessary to further our understanding of the potential reciprocal relationship between anxiety and allergy. RATIONALE: Considering clinical and animal evidence suggesting a relationship between allergy and anxiety, we hypothesized that, from low to high aeroallergen exposure, changes in anxiety symptom scores in patients with primary mood disorders will correlate with changes in allergy symptom scores. We also anticipated that sensitization to tree pollen, as determined by allergen specific IgE antibodies, will predict a greater worsening of anxiety during exposure to tree pollen. METHODS: 51 patients with unipolar or bipolar disorder (age: 19-63 years, 65% female) were recruited. Tree- pollen IgE positive subjects (12) were included as the experimental group and patients negative to a multi-allergen serological test (39) were included in the control group. Self reports of anxiety and allergy symptoms were obtained once during the peak airborne pollen counts and once during the period of low airborne pollen counts, as reported by two local pollen counting stations. RESULTS: Using linear regression models, we found a significant positive association between allergy scores and anxiety scores (p < 0.04); however, the IgE specific tree pollen positivity was not significantly associated with changes in anxiety scores. CONCLUSIONS: Because changes in anxiety scores relate to changes in depression scores, the relationship between allergy and anxiety likely involves states rather than only traits. Future research is necessary to further our understanding of the potential reciprocal relationship between anxiety and allergy.

The Nothing that is Something: Core Dysphoria as the Central Feature of Borderline Personality Disorder. Implications for Treatment

People with borderline personality disorder (BPD) often describe a longstanding depression or dysphoria central to the disorder. The dimension of chronic inner dysphoria is reflected in the DSM criterion of "emptiness" and is demonstrated on self-report measures of depression. In this paper, we report on outcomes for patients with BPD treated with outpatient psychodynamic psychotherapy based on the Conversational Model. Data were collected using the Zung depression scale and the Westmead severity scale at 1 year and at 2 years from two groups of patients. One group had 1 year in psychotherapy, the other had 2 years in therapy. While general symptom scores improved steadily over time in the two-year group, gains for the one-year group tapered off in the second year. Change in depression scores continued at an unchanged rate in the second year for the two-year group compared to a leveling out of gains in the group treated for one year. Gains in general symptom scores were more substantial, suggesting that change in affect occurs more slowly than other symptomatic changes. Drawing upon our findings and those of others in the field, it appears that this slowness of affective change may reflect that patients with BPD have an inner world where predominant negative affectivity became established early in life in the context of disturbances of relatedness. This has implications for the appropriate duration of psychotherapeutic engagement with this group. We argue for more prolonged psychotherapy in this group, which is consistent with current understanding of processes of attachment and development.

Exercise Fails to Improve Neurocognition in Depressed Middle-Aged and Older Adults

Although cross-sectional studies have demonstrated an association between higher levels of aerobic fitness and improved neurocognitive function, there have been relatively few interventional studies investigating this relationship, and results have been inconsistent. We assessed the effects of aerobic exercise on neurocognitive function in a randomized controlled trial of patients with major depressive disorder (MDD). Two-hundred and two sedentary men (n = 49) and women (n = 153), aged 40 yr and over and who met diagnostic criteria for MDD, were randomly assigned to the following: a) supervised exercise, b) home-based exercise, c) sertraline, or d) placebo pill. Before and after 4 months of treatment, participants completed measures of: Executive Function (Trail Making Test B-A difference score, Stroop Color-Word, Ruff 2 & 7 Test, Digit Symbol), Verbal Memory (Logical Memory, Verbal Paired Associates), and Verbal Fluency/Working Memory (Animal Naming, Controlled Oral Word Association Test, Digit Span). Multivariate analyses of covariance were performed to test the effects of treatment on posttreatment neuropsychological test scores, with baseline neuropsychological test scores, age, education, and change in depression scores entered as covariates. The performance of exercise participants was no better than participants receiving placebo across all neuropsychological tests. Exercise participants performed better than participants receiving sertraline on tests of executive function but not on tests of verbal memory or verbal fluency/working memory. We found little evidence to support the benefits of an aerobic exercise intervention on neurocognitive performance in patients with MDD.

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Chronic VNS for the Treatment of Morbid Obesity

Eight patients with treatment-resistant depression (TRD) underwent adjunctive chronic VNS for periods up to 14months. Although the patients denied dieting or change in activity level, there was a slow and highly significant loss of weight accompanied by decreased metabolism in the ventromedial prefrontal cortex, a cortical area involved in interoception with dense connections to the hypothalamus. The loss of weight was proportional to the initial weight. Weight loss was not related to change in depression scores. Neuromodulation through VNS may offer a novel approach to weight regulation.

Antidepressant efficacy of high-frequency transcranial magnetic stimulation over the left dorsolateral prefrontal cortex in double-blind sham-controlled designs: a meta-analysis

For more than a decade high-frequency repetitive transcranial magnetic stimulation (rTMS) has been applied to the left dorsolateral prefrontal cortex (DLPFC) in search of an alternative treatment for depression. The aim of this study was to provide an update on its clinical efficacy by performing a meta-analysis involving double-blind sham-controlled studies. A literature search was conducted in the databases PubMed and Web of Science in the period between January 1980 and November 2007 with the search terms 'depression' and 'transcranial magnetic stimulation'. Thirty double-blind sham-controlled parallel studies with 1164 patients comparing the percentage change in depression scores from baseline to endpoint of active versus sham treatment were included. A random effects meta-analysis was performed to investigate the clinical efficacy of fast-frequency rTMS over the left DLPFC in depression. The test for heterogeneity was not significant (QT=30.46, p=0.39). A significant overall weighted mean effect size, d=0.39 [95% confidence interval (CI) 0.25-0.54], for active treatment was observed (z=6.52, p<0.0001). Medication resistance and intensity of rTMS did not play a role in the effect size. These findings show that high-frequency rTMS over the left DLPFC is superior to sham in the treatment of depression. The effect size is robust and comparable to at least a subset of commercially available antidepressant drug agents. Current limitations and future prospects are discussed.

Higher Burden of Depression Among Older Women

The prevalence of depression is disproportionately higher in older women than men, yet the reasons for this sex difference are not clear. To determine whether the higher burden of depression among older women than men might be attributable to sex differences in the onset (ie, first or recurrent episodes) or persistence of depression and/or to differential mortality among those who are depressed. Prospective cohort study. General community in greater New Haven, Connecticut, from March 23, 1998, to August 31, 2005. A total of 754 persons, 70 years or older, who were evaluated at 18-month intervals for 72 months. The 3 outcome states were depressed, nondepressed, and death, with scores of 20 or more and less than 20 on the Center for Epidemiological Studies Depression Scale denoting depressed and nondepressed, respectively. The association between sex and the likelihood of 6 possible transitions (namely, from nondepressed or depressed to nondepressed, depressed, or death) was evaluated over time. The prevalence of depression was substantially higher among women than men at each of the 5 time points (P < .001). In most cases, transitions between the nondepressed and depressed states were characterized by moderate to large absolute changes in depression scores (ie, > or = 10 points). Adjusting for other demographic characteristics, women had a higher likelihood of transitioning from nondepressed to depressed (odds ratio, 2.02; 95% confidence interval, 1.39-2.94) and a lower likelihood of transitioning from depressed to nondepressed (odds ratio, 0.27; 95% confidence interval, 0.13-0.56) or death (odds ratio, 0.24; 95% confidence interval, 0.09-0.60). Among older persons, the higher burden of depression in women than men seems to be attributable to a greater susceptibility to depression and, once depressed, to more persistent depression and a lower probability of death.

Omega-3 Fatty Acids as a Treatment for Perinatal Depression: Randomized Double-Blind Placebo-Controlled Trial

Epidemiological, biological marker and treatment studies, as well as neuroscientific theories, indicate a possible link between omega-3 fatty acids and perinatal depression (PND). Hence the aim of the present study was to assess whether omega-3 fatty acid treatment is superior to placebo in the treatment of PND. A double-blind randomized placebo-controlled trial was undertaken. Women with major depression during the perinatal period received either fish oil or placebo for six weeks. Changes in depression scores were recorded weekly. A total of 26 subjects were recruited and there was no significant difference in depression scores between those receiving fish oil and those receiving the placebo. This is formally a negative study, suggesting that there is no benefit for omega-3 fatty acids over placebo in treating PND. The reason could be that the study was underpowered due to recruitment difficulties and therefore we suggest that it may be unwise to interpret this result as conclusive. Omega-3 is a natural product that is a safe and well-tolerated treatment. Further research is therefore needed in this area to establish whether omega-3 fatty acids are an effective treatment for PND.

Relations of Mood with Body Mass Index Changes in Severely Obese Women Enrolled in a Supported Physical Activity Treatment

Background/Aims: It has been suggested that physical activity may affect weight reduction outcomes through associated improvements in mood. Relations of physical activity, mood, and weight change are not well understood in persons classified as severely obese (BMI ≧40 kg/m²), however. This research tested these relationships in women with severe obesity. Methods: 57 women with a mean BMI of 43.8 kg/m² were enrolled in a cognitivebehavioral exercise support treatment with group-based nutrition information. Measurement of depression, tension, overall mood, and BMI was taken at baseline and month 6, and exercise session attendance was recorded. Results: The treatment was associated with significant improvements in depression, tension and total mood disturbance scores as well as in BMI over 6 months. Changes in mood scores that were more positive were correlated with a greater reduction in BMI. Mean attendance in the prescribed 3 session/week exercise regimen was 46.0%, and attendance was significantly correlated with changes in tension and total mood disturbance scores, and approached significance with changes in depression scores. Conclusion: Findings suggested significant relations of mood and weight changeas well as of physical activity and mood in severely obese women associated with a treatment of moderate physical activity. With extensions of this research, weight loss theory and treatment may benefit.

The ICD Shock and Stress Management Program: A Randomized Trial of Psychosocial Treatment to Optimize Quality of Life in ICD Patients

Implantable cardioverter defibrillator (ICD) patients potentially face significant psychological distress because of their risk for life-threatening arrhythmias and the occurrence of ICD shock. The purpose of this study was to test an ICD stress and shock management program delivered in either a six-week format or a one-day workshop format. This intervention was aimed at reducing psychological (anxiety) and physiological (salivary cortisol) markers of distress in ICD patients. Secondary endpoints included measures of quality of life (QOL) and patient acceptance of device therapy, as well as biological mediators of inflammation (TNFalpha and IL-6). The ICD stress and shock management program resulted in the reduction of anxiety (P < 0.05) and cortisol levels (P < 0.05) in both the six weekly sessions format and the one-day workshop. Measures of anxiety decreased more rapidly with weekly intervention (P = 0.05). Both formats also resulted in a significant increase in patient acceptance of the ICD (P < 0.01). Follow-up assessment from posttreatment (T2) to four-month follow-up (T4) indicated no significant change in depression scores from posttreatment for all groups taken together, but there was a significant group by time effect, such that the workshop group displayed an increase in depression scores from T2 (M = 8.71, SD = 4.39) to T4 (M = 13.57, SD = 11.90), P < 0.05. These results suggest that structured interventions for shocked ICD patients involving ICD education and cognitive-behavioral strategies can reduce psychological distress and improve quality of life, regardless of format.

Change in quality of life in Chinese women with breast cancer: changes in psychological distress as a predictor

The effect of fluctuating psychological distress on quality of life (QoL) scores is not well delineated. We examined how changes in psychological distress affected change in QoL over time in 259 Chinese women recovering from breast cancer (BC). Women were interviewed during their first postoperative outpatient visit for chemotherapy (Baseline), at 3 months (FU1), and at 6 months after Baseline (FU2). Respondents completed the Chinese version of the FACT-G version-3 scale [FACT-G (Ch)]. Psychological distress was assessed using three categorical measures of depression, mood, and boredom. Linear mixed effects (LME) models examined whether changes in psychological distress predicted subsequent changes in QoL. Respondents' mood improved significantly over time from baseline to FU2 (Baseline/FU2: standardized beta = -0.266, p < 0.005; FU1/FU2: standardized beta = -0.243, p < 0.005). Changes in depression scores consistently predicted subsequent changes in overall (standardized beta = 4.96; 95% CI, 3.749, 6.171, p < 0.001), physical (standardized beta = 1.752; 95% CI, 1.209, 2.294, p < 0.001), and functional (standardized beta = 0.872; 95% CI, 0.308, 1.436, p < 0.001) QoL scores. The magnitude of change in psychological distress significantly impacted physical and functional, but not social QoL in Chinese BC patients. These data highlight the need to address psychological and physical distress as part of the drive to improve physical and functional QoL for women with BC.

Changes in Allergy Symptoms and Depression Scores Are Positively Correlated In Patients With Recurrent Mood Disorders Exposed to Seasonal Peaks in Aeroallergens

Although growing evidence supports an association between allergy, allergens and depression, it remains unknown if this relationship is between “states” (possible triggers) or “traits” (possible vulnerabilities). We hypothesized that patients with recurrent mood disorders who are sensitized to tree pollen (as determined by allergen specific IgE antibodies), in comparison to those who are not sensitized, would report larger negative changes in mood during exposure to tree pollen in spring. We also hypothesized that differences between high and low tree pollen periods in self reported allergy symptoms would correlate positively with differences in self reported depression scores. We present 1-year preliminary data on the first 51 patients with unipolar or bipolar disorder (age: 19-63 years, 65% female, twelve patients were tree-pollen IgE positive). Ratings of mood and allergic disease status were performed once during the peak airborne pollen counts and once during the period of low airborne pollen counts, as reported by two local pollen counting stations. Linear regression models were developed to examine associations of changes in depression scores (dependent variable) with tree pollen sensitization, changes in the allergy symptom severity score, adjusted for gender and order of testing. We did not confirm the hypothesized relationship between a specific tree pollen sensitization and changes in mood during tree pollen exposure. We did confirm the hypothesized positive relationship between the changes in allergy symptoms and changes in subjects' depression scores (adjusted p<0.05). This result is consistent with previous epidemiological evidence connecting allergy with depression, as well as our recent reports of increased expression of cytokines in the prefrontal cortex in victims of suicide and in experimental animals sensitized and exposed to tree pollen. A relationship between changes in allergy symptom scores and changes in depression scores supports a state-level rather than only trait-level relationship, and thus lends optimism to future causality-testing interventional studies, which might then lead to novel preventative environmental interventions in mood disorders.