Common Affective Disorder Research Articles

Therapeutic potential and mechanisms of stem cells in major depressive disorder: a comprehensive review.

Depression is a common affective disorder characterized by persistent low mood, diminished interest or pleasure in normally enjoyable activities, disturbances in sleep patterns, and suicidal ideation. Conventional treatments often yield unsatisfactory results and are associated with several adverse effects. However, emerging literature has highlighted the potential of stem cell (SC) transplantation as a promising avenue for treating depression owing to its favorable anti-inflammatory and neurotrophic properties. This review summarizes the therapeutic effects and underlying mechanisms associated with SC transplantation in depression, offering a conceptual framework for the future application of SCs in the clinical treatment of depression.

Follicle-stimulating hormone induces depression-like phenotype by affecting synaptic function.

Depression is one of the most common affective disorders in people's life. Women are susceptibility to depression during puberty, peripartum and menopause transition, when they are suffering from sex hormone fluctuation. A lot of studies have demonstrated the neuroprotective effect of estrogen on depression in women, however, the effect of FSH on depression is unclear. In this study, we investigated the role of FSH on depression in mice. Our study demonstrated that FSH induced depression-like behaviors in mice in a dose-dependent manner. This induction was associated with elevated levels of pro-inflammatory cytokines, including IL-1β, IL-6, and TNF-α in both serum and hippocampal tissues. Additionally, FSH treatment resulted in impaired synaptic plasticity and a reduction in the expression of key synaptic proteins. It is noteworthy that the depression-like behaviors, inflammatory cytokines expression and synaptic plasticity impairment induced by FSH could be alleviated by knocking down the expression of FSH receptor (FSHR) in the hippocampus of the mice. Therefore, our findings reveal that FSH may play an important role in the pathogenesis of depression and targeting FSH may be a potential therapeutic strategy for depression during hormone fluctuation in women.

SLEEPY MELODIES: Android-Based Application For Hypno Sleeping Process In Babies 0-6 Months

The postpartum period is the period of six weeks after delivery or 42 days from the birth of the baby until the reproductive organs return to their normal pre-pregnancy state. During the postpartum period, only some postpartum mothers managed to adjust to the post-natal psychological change phase, while others did not manage to adjust and experienced psychological disorders. According to Nasri (2017), one of the problems of postpartum mothers is psychological problems, the most common affective or mood disorders found in postpartum women are postpartum blues. According to Ibrahim (2012) many factors are suspected to be the trigger for the postpartum blues including hormonal factors, age, parity, experience in the process of pregnancy and childbirth, education, marital status, unwanted pregnancies, history of mental disorders, socioeconomic, and social support. . In addition, readiness in caring for babies is also a factor in the occurrence of post partum blues if the baby is fussy for a long time. One way for mothers who are affected by the postpartum blues due to difficulties in caring for babies, especially putting babies to sleep, is to use the hypno sleeping method with white noise media. According to the National Sleep Foundation, white noise can give babies a better sense of sleep, without being distracted by distracting high-pitched sounds.Along with the industrial revolution 4.0 which changed the way humans work from manual use to digitalization, the representation of applications that can be used in community service. The aim of this study was to produce an application Sleppy Melodies Android-based to help mothers make it easier for their children to sleep. This research design uses the model Research and Development. Sources of data for this study came from mothers with children aged 0-6 months, midwives, material experts, and media experts. There were 87% of mothers and 89% of midwives who responded very well to the application Sleepy Melodies Android-based. In this study it can be concluded that application Sleepy Melodies android-based declared eligible by 86% to be used by health workers and mothers in improving the quality of infant sleep.

Repetitive Transcranial Magnetic Stimulation Reduces Depressive-like Behaviors, Modifies Dendritic Plasticity, and Generates Global Epigenetic Changes in the Frontal Cortex and Hippocampus in a Rodent Model of Chronic Stress.

Depression is the most common affective disorder worldwide, accounting for 4.4% of the global population, a figure that could increase in the coming decades. In depression, there exists a reduction in the availability of dendritic spines in the frontal cortex (FC) and hippocampus (Hp). In addition, histone modification and DNA methylation are also dysregulated epigenetic mechanisms in depression. Repetitive transcranial magnetic stimulation (rTMS) is a technique that is used to treat depression. However, the epigenetic mechanisms of its therapeutic effect are still not known. Therefore, in this study, we evaluated the antidepressant effect of 5 Hz rTMS and examined its effect on dendritic remodeling, immunoreactivity of synapse proteins, histone modification, and DNA methylation in the FC and Hp in a model of chronic mild stress. Our data indicated that stress generated depressive-like behaviors and that rTMS reverses this effect, romotes the formation of dendritic spines, and favors the presynaptic connection in the FC and DG (dentate gyrus), in addition to increasing histone H3 trimethylation and DNA methylation. These results suggest that the antidepressant effect of rTMS is associated with dendritic remodeling, which is probably regulated by epigenetic mechanisms. These data are a first approximation of the impact of rTMS at the epigenetic level in the context of depression. Therefore, it is necessary to analyze in future studies as to which genes are regulated by these mechanisms, and how they are associated with the neuroplastic modifications promoted by rTMS.

The Mechanisms Underlying the Pharmacological Effects of GuiPi Decoction on Major Depressive Disorder based on Network Pharmacology and Molecular Docking

Major Depressive Disorder (MDD) is a common affective disorder. GuiPi decoction (GPD) is used to treat depression in China, Japan, and Korea. However, its effective ingredients and antidepressant mechanisms remain unclear. We attempted to reveal the potential mechanisms of GPD in the treatment of MDD by network pharmacology and molecular docking. In addition, we conducted an enzymatic activity assay to validate the results of molecular docking. GPD-related compounds and targets, and MDD-related targets were retrieved from databases and literature. The herb-compound-target network was constructed by Cytoscape. The protein- protein interaction network was built using the STRING database to find key targets of GPD on MDD. Enrichment analysis of shared targets was analyzed by MetaCore database to obtain the potential pathway and biological process of GPD on MDD. The main active compounds treating MDD were screened by molecular docking. The PDE4s inhibitors were screened and verified by an enzyme activity assay. GPD contained 1222 ingredients and 190 potential targets for anti-MDD. Possible biological processes regulated by GPD were neurophysiological processes, blood vessel morphogenesis, Camp Responsive Element Modulator (CREM) pathway, and Androgen Receptor (AR) signaling crosstalk in MDD. Potential pathways in MDD associated with GPD include neurotransmission, cell differentiation, androgen signaling, and estrogen signaling. Fumarine, m-cresol, quercetin, betasitosterol, fumarine, taraxasterol, and lupeol in GPD may be the targets of SLC6A4, monoamine oxidase A (MAOA), DRD2, OPRM1, HTR3A, Albumin (ALB), and NTRK1, respectively. The IC50 values of trifolin targeting Phosphodiesterase (PDE) 4A and girinimbine targeting PDE4B1 were 73.79 μM and 31.86 μM, respectively. The IC50 values of girinimbine and benzo[a]carbazole on PDE4B2 were 51.62 μM and 94.61 μM, respectively. Different compounds in GPD may target the same protein, and the same component in GPD can target multiple targets. These results suggest that the effects of GPD on MDD are holistic and systematic, unlike the pattern of one drug-one target.

Development and validation of a nomogram based on lymphocyte subsets to distinguish bipolar depression from major depressive disorder.

ObjectiveBipolar depression (BD) and major depressive disorder (MDD) are both common affective disorders. The common depression episodes make it difficult to distinguish between them, even for experienced clinicians. Failure to properly diagnose them in a timely manner leads to inappropriate treatment strategies. Therefore, it is important to distinguish between BD and MDD. The aim of this study was to develop and validate a nomogram model that distinguishes BD from MDD based on the characteristics of lymphocyte subsets.Materials and methodsA prospective cross-sectional study was performed. Blood samples were obtained from participants who met the inclusion criteria. The least absolute shrinkage and selection operator (LASSO) regression model was used for factor selection. A differential diagnosis nomogram for BD and MDD was developed using multivariable logistic regression and the area under the curve (AUC) with 95% confidence interval (CI) was calculated, as well as the internal validation using a bootstrap algorithm with 1,000 repetitions. Calibration curve and decision curve analysis (DCA) were used to evaluate the calibration and clinical utility of the nomogram, respectively.ResultsA total of 166 participants who were diagnosed with BD (83 cases) or MDD (83 cases), as well as 101 healthy controls (HCs) between June 2018 and January 2022 were enrolled in this study. CD19+ B cells, CD3+ T cells, CD3–CD16/56+ NK cells, and total lymphocyte counts were strong predictors of the diagnosis of BD and MDD and were included in the differential diagnosis nomogram. The AUC of the nomogram and internal validation were 0.922 (95%; CI, 0.879–0.965), and 0.911 (95% CI, 0.838–0.844), respectively. The calibration curve used to discriminate BD from MDD showed optimal agreement between the nomogram and the actual diagnosis. The results of DCA showed that the net clinical benefit was significant.ConclusionThis is an easy-to-use, repeatable, and economical nomogram for differential diagnosis that can help clinicians in the individual diagnosis of BD and MDD patients, reduce the risk of misdiagnosis, facilitate the formulation of appropriate treatment strategies and intervention plans.

Affective disorders and сognitive impairment in the early stages of Parkinson’s disease

Background: Parkinson's disease (PD) is an age-related neurodegenerative disease in developed countries. The prevalence of PD ranges from 41 per 100,000 in the fourth decade of life to more than 1,900 per 100,000 in people over 80 years of age. Neurodegeneration associated with Parkinson's disease probably occurs several decades before the onset of motor symptoms. Affective and cognitive impairments are one of the most frequent non-motor manifestations of PD, which can lead to a number of adverse outcomes. Aim: to evaluate affective and cognitive impairments in patients at the early stages of PD. Methods: 61 patients with PD participated in the study. All the participants were divided into two groups depending on the presence or absence of a diagnosis of depression verified by psychiatrists: Group 1 was the main group (n=48), group 2 was the control group (n=13). The control group included patients without depression. The average age of the participants was 62.29.6 years. The analysis of the PD stages was carried out in both groups. In the main group, stage II PD was diagnosed in 75%, in the control group in 31% of patients. The average duration of the disease was 2.51.6 years. A clinical examination was carried out using the Beck depression questionnaire, apathy scale, Spielberger anxiety questionnaire and anxiety assessment scale in PD (to assess emotional disorders), cognitive function assessment scale in PD (SHOBP-Cog, Scopa-Cog), digital symbol replacement test (symbols-numbers test), Montreal assessment Scale cognitive functions (MoCA test), a test for connecting numbers and letters, and a Stroop test (for evaluating cognitive functions). Results: It was revealed that in the early stages of PD, the prevalence of depression, clinically significant apathy, personal and reactive anxiety was high. Significantly higher rates of depression severity, depression level, apathy level and personal anxiety were noted among the patients with stage II PD compared to the patients with stage I PD. There was a marked tendency to a decrease in cognitive functions at stage I of PD, aggravated at stage II of the disease, which was confirmed by the results of the tests: a low level of cognitive functions on the Montreal scale was detected in 52%; 70% of patients, regardless of the PD stage, showed a low rate of completion of the 1st and 2nd parts of the Stroop test for their age; the results of the digital character replacement test were below normal in 75% of cases. Conclusion: The most common affective disorders in the early stages of PD are depression and anxiety. Apathy and depression have a negative impact on the cognitive functions of patients, which worsen with the progression of the disease.

Disentangling the individual and contextual effects of math anxiety: A global perspective

Math anxiety is a common affective disorder in students that is characterized by intrusive thoughts that disrupt critical cognitive resources required for math problem-solving. Consistent associations between math anxiety and math achievement have been observed across countries and age groups, placing math anxiety among other important correlates of math achievement, such as socioeconomic status and magnitude representation ability. However, studies examining math anxiety's relation to achievement have largely focused on the effect of students' own math anxiety (individual effect), while little is known regarding the effect of math anxiety in students' educational context (contextual effect). Using three international studies of achievement (n = 1,175,515), we estimated both the individual and contextual effects of math anxiety across the globe. Results suggest that while there are consistent individual effects in virtually all countries examined, the contextual effects are varied, with only approximately half of the countries exhibiting a contextual effect. Additionally, we reveal that teacher confidence in teaching math is associated with a reduction of the individual effect, and country's level of uncertainty avoidance is related to a lessening of the contextual effect. Finally, we uncovered multiple predictors of math anxiety; notably, student perception of teacher competence was negative related with math anxiety, and parental homework involvement was positively related with math anxiety. Taken together, these results suggest that there are significant between-country differences in how math anxiety may be related with math achievement and suggest that education and cultural contexts as important considerations in understanding math anxiety's effects on achievement.

Speech depression recognition based on attentional residual network.

Depressive disorder is a common affective disorder, also known as depression, which is characterized by sadness, loss of interest, feelings of guilt or low self-worth and poor concentration. As speech is easy to obtain non-offensively with low-cost, many researchers explore the possibility of depression prediction through speech. Adopting speech signals to recognize depression has important practical significance. Aiming at the problem of the complex structure of the deep neural network method used in the recognition of speech depression and the traditional machine learning methods need to manually extract the features and the low recognition rate. This paper proposes a model that combines residual thinking and attention mechanism. First, depression corpus is designed based on the classic psychological experimental paradigm self-reference effect (SRE), and the speech dataset is labeled; then the attention module is introduced into the residual, and the channel attention is used to learn the features of the channel dimension, the spatial attention feedback the features of the spatial dimension, and the combination of the two to obtain the attention residual unit; finally the stacking unit constructs a speech depression recognition model based on the attention residual network. Experimental results show that compared with traditional machine learning methods, this model obtains better results in the recognition of depression, which can meet the need for actual recognition application of depression. In this study, we not only predict whether person is depressed, but also estimate the severity of depression. In the designed corpus, the depression binary classification of an individual is given based on the severity of depression which is measured using BDI-II scores. Experimental results show that spontaneous speech can obtain better results than automatic speech, and the classification of speech features corresponding to negative questions is better than other tasks under negative emotions. Besides, the recognition accuracy rate of both male and female subjects is higher than that under other emotions.

How do people with social anxiety disorder manage daily stressors? Deconstructing emotion regulation flexibility in daily life

Emotion regulation flexibility is a person's tendency to shift their use of emotion regulation strategies in response to contextual demands. A lack of flexibility is thought to underlie affective disorders, yet conceptualizations of “flexibility” vary widely, and few studies have empirically assessed flexibility. In this study, we outline methods for measuring emotion regulation flexibility and then examine evidence for inflexibility in people with a common affective disorder: social anxiety disorder (SAD). Participants were community adults diagnosed with SAD and a psychologically healthy control group who completed a 14-day experience-sampling study. Participants recorded their most anxiety-provoking event each day, how they evaluated contextual demands (i.e., perceived controllability, emotional intensity) of these events, and their use of seven emotion regulation strategies to manage anxiety. Hypotheses and analyses were preregistered with the Open Science Framework (https://osf.io/s7kqj/). Participants with SAD demonstrated some evidence of inflexibility. They used three disengagement strategies (rumination, thought suppression, expressive suppression) more often than controls and did so independently of contextual demands (specifically, perceived controllability). Nonetheless, participants with SAD largely demonstrated similar regulatory patterns as controls, most notably in their use of engagement strategies (acceptance, cognitive, reappraisal, problem-solving). We measured two of many possible contextual demands, did not compare to a mixed clinical group or other affective disorders (e.g., depression), and did not assess temporal sequences of strategy use. People with SAD demonstrate some inflexibility in their use of disengagement regulation strategies.

Using Staged Care to Provide “Right Care First Time” to People With Common Affective Disorders

Back to table of contents Previous article Next article LettersFull AccessUsing Staged Care to Provide “Right Care First Time” to People With Common Affective DisordersVilas Sawrikar, M.Psych., Ph.D., Ian B. Hickie, M.D., F.R.A.N.Z.C.P.Vilas SawrikarSearch for more papers by this author, M.Psych., Ph.D., Ian B. HickieSearch for more papers by this author, M.D., F.R.A.N.Z.C.P.Published Online:1 Dec 2021https://doi.org/10.1176/appi.ps.721205AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail IN REPLY: We welcome the opportunity to respond to Metz and Minkoff (1) in relation to our June article published in Psychiatric Services (2). Metz and Minkoff (1) raise important considerations about previous developments in service delivery for mental health. Specifically, they refer to the LOCUS family of multidimensional assessment tools for determining level of care utilization (3). They assert that these earlier instruments share important conceptual similarities with the staged-care models we described (2).We agree that there are several models that variously describe “stepped,” “staged,” and collaborative care (4). Each of these approaches seeks to promote the reach, effectiveness, and efficiency of mental health care utilization in the population. Models use a variety of multidimensional assessments to stratify individuals for hierarchically arranged service packages, which vary according to the intensity, duration, and mix of treatment options. Our presentation of staged care was presented with specific reference to stepped collaborative care to contextualize it within existing frameworks for the management of affective disorders. Consequently, it did not refer specifically to LOCUS (or other models) that do not target specific groups of mental illness (3).To further clarify the contribution of staged care for affective disorders, we outline here the key differences between this approach and other integrated health care models. Staged care is a tool of risk stratification, in that it seeks to assign individuals immediately to the right level of care. The type of risk measured by clinical staging relates to the likelihood of illness progression, assessed by illness trajectory, severity and chronicity, functional impairment, comorbidity, and neurocognitive functioning. It has utility in predicting treatment outcomes and prognosis (5). Therefore, staged care assimilates information regarding likely prognosis and treatment outcomes into initial treatment selection. It emphasizes that mental health care needs to be increasingly personalized and preemptive. Secondary prevention options are embedded within treatment packages, and access to specialist mental health services is increased at earlier stages of illness.Furthermore, we proposed clinical staging criteria for affective disorders emerging in childhood, adulthood, and older adulthood (2). Multidimensional assessments and algorithms for determining care levels support the integration of these criteria into staged care. The statement that the article represented the first attempt to stage childhood disorders was in relation to the application of clinical staging criteria across the lifespan. It is hoped that the distinct aspect of integrating staging criteria into service delivery will promote a new phase of development in integrated health care that embeds prevention within systems that reduce the burde of mental illness.

High Prevalence of Post-stroke Anxiety in Elderly Patients Following COVID-19 Outbreak.

Objective: Post-stroke anxiety (PSA) is a common affective disorder in patients with ischemic stroke. The elderly are more susceptible to mental health issues, however, few studies have so far focused on PSA in elderly patients, especially in the context of the COVID-19, causing psychological issues in the general population. The aim of the present study was to assess the prevalence and risk factors of PSA in elderly patients following COVID-19 outbreak.Methods: We retrospectively analyzed 206 elderly inpatients with newly diagnosed acute ischemic stroke in the First Affiliated Hospital, Sun Yat-sen University, from January 2020 to December 2020. Patients were categorized into the PSA group and the non-PSA group based on Hamilton Anxiety Scale scores at admission (within 1 week after stroke onset). Demographic and clinical data, mental state by Mini-Mental State Examination, depression by Hamilton Depression Scales (HAMD), and stroke severity and outcome by National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale were compared between the two groups. Univariate analysis and binary logistic regression analysis were used to analyze risk factors associated with PSA. We determined the cutoff scores for significant predictors of PSA using the area under the curve (AUC) and receiver operating characteristic.Results: Of the 206 stroke patients, 62 (30.1%) developed anxiety. Binary logistic regression analysis showed that female gender [adjusted odds ratio (aOR): 2.288, 95% confidence interval (CI):1.021–5.128, P = 0.044], high NIHSS scores [aOR: 1.264, 95% CI: 1.074–1.486, P = 0.005] and HAMD scores [aOR: 1.345, 95% CI: 1.215–1.490, P < 0.001] were independent risk factors for PSA. The cutoff threshold for the NIHSS scores was 3.5 points with an AUC of 0.64 and the cutoff threshold for HAMD scores was 5.5 points with an AUC of 0.89.Conclusion: Our results showed a high incidence of PSA in elderly patients after the COVID-19 outbreak. Female gender, high NIHSS and HAMD scores were the independent risk factors for PSA.

Commentary on Sawrikar etal.: Using Staged Care to Provide "Right Care First Time" to People With Common Affective Disorders.

Commentary on Sawrikar etal.: Using Staged Care to Provide "Right Care First Time" to People With Common Affective Disorders.

Using Staged Care to Provide “Right Care First Time” to People With Common Affective Disorders

An ongoing need exists for innovation in service delivery to ensure that mental health services deliver high-quality treatment and prevention in the population. This Special Article proposes the adoption of "staged care" as a population health-oriented service delivery model for packages of specialized services delivered largely in ambulatory care settings for individuals with common affective disorders. Staged care integrates measures of clinical need alongside clinical stage and personal choice to select hierarchically arranged service packages for individuals. Packages then vary according to the intensity, duration, and mix of treatment options. This Special Article describes five levels of care in staged care: self- or family-directed monitoring and management, low-intensity services, moderate-intensity services, high-intensity services, and acute and specialist community mental health services. The care environment, treatment team, and length of treatment are also described, and provisional criteria are specified for assigning individuals to different care levels on the basis of current clinical need and clinical stage. Staged care is presented as a model that guides treatment selection and health service delivery to ensure that the high-quality care aims of "right care first time" and prevention are achieved and optimal use of available resources is considered.

Aberrant amplitude low-frequency fluctuation (ALFF) and regional homogeneity (ReHo) in generalized anxiety disorder (GAD) and their roles in predicting treatment remission.

BackgroundGeneralized anxiety disorder (GAD) is a common affective disorder characterized by comprehensive anxiety with dysregulation of brain activity which can be reflected by functional magnetic resonance imaging (f-MRI). We aimed to examine abnormal aberrant amplitude low-frequency fluctuation (ALFF) and regional homogeneity (ReHo) in GAD and evaluate their ability to predict treatment remission.MethodsUsing resting-state fMRI (Rs-fMRI), we examined ALFF and ReHo in 30 GAD patients and 30 healthy control (HC) participants. Using on DEPASF4.3 Advanced Edition, voxel-based two-sample t-test analysis was performed on the ALFF and ReHo maps to compare GAD to HC groups, and to compare remitters (n=9) and non-remitters (n=21). Pearson’s correlation analysis was used to explore the relationship between baseline Hamilton Anxiety Rating Scale (HAM-A) scores/illness duration and mean ALFF/ReHo values. The severity of GAD symptoms was rated with HAM-A. Remission was defined as HAM-A ≤7 by week 8.ResultsCompared to the HC group, GAD patients showed lower ALFF in the right postcentral and right precentral gyrus; lower ReHo in the right precentral, right postcentral, and left precentral gyrus; and higher ReHo in the left posterior cingulate cortex. ALFF values for left postcentral gyrus was negatively correlated with baseline HAM-A, while that of the middle frontal gyrus was positively correlated with baseline HAM-A scores. ReHo value of the left postcentral gyrus was negatively correlated with baseline HAM-A, while that of the right middle frontal gyrus was positively correlated with baseline HAM-A scores. ALFF of the right frontal_superior_orbital and right frontal-medial-orbital cortex was positively correlated with illness duration. ReHo of the left supplementary motor area cortex was negatively correlated with illness duration. Remitters showed higher ALFF in the left hippocampus and higher ReHo value in the right postcentral cortex compared to nonremitters.ConclusionsThese results suggest that altered regional brain activity and local synchronization may be related to the pathophysiology of GAD and have certain value in predicting remission in treatment.

Research progress in combination applications of antidepressant drugs

Depression is a common affective disorder. The application of antidepressants can significantly alleviate the symptoms of depression, which is the most important way to treat depression in clinical practice. Due to the complex etiology, wide variety, as well as diversity and severity of serious concomitant symptoms, rational addition of other drugs into antidepressants can significantly improve the cure rates of depression, reduce adverse reactions, and improve patient compliances. Therefore, the combined applications of differential drugs have been commonly used in clinic. In this paper, more than 600 literatures about depression from 2010 to 2019 were collected based on the key words of antidepressant, depression, combined medication, synergism and increase efficiency. Based on this, by summarizing and classifying the existing combinations of antidepressant drugs, this paper systematically expounds the current combined applications of antidepressant drugs in three categories, i.e. western medicines combined with western medicines, western medicines combined with traditional Chinese medicines, and traditional Chinese medicines combined with traditional Chinese medicines, in the expectation of providing the direction and basis for the selection of rational combinations of antidepressant drugs in clinic.

Neural Responsiveness To Reward And Cognitive Control Following An Eight-week Aerobic Exercise Trial For Depression

Major Depressive Disorder (MDD) is a common affective disorder that affects nearly 20% of adults and is a leading cause of global disability and disease. Despite demonstrated efficacy of aerobic exercise for depression, there is a poor understanding of clinical and neurobiological mechanisms. Two candidate mechanisms of depression that may be modifiable through aerobic exercise are reward processing and cognitive control deficits. PURPOSE: The primary aim was to examine the effects of an 8-week aerobic exercise (AE) program on event-related potential (ERP) indices of reward processing (RewP) and cognitive control (ERN), and symptoms of depression among individuals with MDD. Secondary aims were to determine whether changes in reward (RewP) or cognitive control (ERN) were related to changes in depressive symptoms and whether baseline RewP or ERN could predict the likelihood of an antidepressant response. METHODS: Individuals with MDD (N = 51; 75% female) were stratified by depressive symptoms and randomized to either moderate-intensity AE (n = 26) or light-intensity stretching (n = 25) that was completed 3 times per week for 45 min. Depressive symptoms, aerobic fitness, and ERPs were assessed pre and post intervention. RESULTS: Compared to stretching, the AE condition resulted in pre-to-post reductions in depressive symptoms (p < .01; η2p = 0.17), while both conditions experienced pre-to-post increases in aerobic fitness (p < .01, η2p = 0.14). Although no mean-level treatment changes in RewP or ERN were observed, there was a relationship between pre-to-post change in ERN and change in depressive symptoms (r = -0.41, p < .01), indicating a decrease in ERN was related to larger pre-to-post reductions in depressive symptoms. At baseline, a larger ERN was predictive of greater pre-to-post change in depressive symptoms, (p < .05, OR = 1.27), while there was a trend for baseline RewP as a predictor of treatment response (p = .07, OR = 1.24). CONCLUSION: These findings provide support for the antidepressant effects of AE and highlight ERN as a potential neurobiological marker that predicts and tracks the antidepressant response. Future research incorporating predictors of response and examining neurobiological mechanisms may help advance understanding of the effects of exercise as a treatment for depression.

A Brain Signaling Framework for Stress-Induced Depression and Ketamine Treatment Elucidated by Phosphoproteomics.

Depression is a common affective disorder characterized by significant and persistent low mood. Ketamine, an N-methyl-D-aspartate receptor (NMDAR) antagonist, is reported to have a rapid and durable antidepressant effect, but the mechanisms are unclear. Protein phosphorylation is a post-translational modification that plays a crucial role in cell signaling. Thus, we present a phosphoproteomics approach to investigate the mechanisms underlying stress-induced depression and the rapid antidepressant effect of ketamine in mice. We analyzed the phosphoprotein changes induced by chronic unpredictable mild stress (CUMS) and ketamine treatment in two known mood control centers, the medial prefrontal cortex (mPFC) and the nucleus accumbens (NAc). We initially obtained >8,000 phosphorylation sites. Quantitation revealed 3,988 sites from the mPFC and 3,196 sites from the NAc. Further analysis revealed that changes in synaptic transmission-related signaling are a common feature. Notably, CUMS-induced changes were reversed by ketamine treatment, as shown by the analysis of commonly altered sites. Ketamine also induced specific changes, such as alterations in synapse organization, synaptic transmission, and enzyme binding. Collectively, our findings establish a signaling framework for stress-induced depression and the rapid antidepressant effect of ketamine.

The effects of intramuscular administration of scopolamine augmentation in moderate to severe major depressive disorder: a randomized, double-blind, placebo-controlled trial.

Introduction:Major depressive disorder (MDD) is a common affective disorder. Currently established pharmacotherapies lack rapid clinical response, thereby limiting their ability to bring instant relief to patients. A series of clinical trials has demonstrated the antidepressant effects of scopolamine, yet few have studied the effects of add-on scopolamine to currently available antidepressants. It is not known whether conventional antidepressant treatment with a 3-day scopolamine injection could speed up oral antidepressant efficacy. The main focus of this study is to detect the capacity of the rapid-onset efficacy of such a treatment option.Methods and analysis:This study consisted of a single-centre, double-blind, three-arm randomized trial with a 4-week follow-up period. Sixty-six participants meeting entry criteria were randomly allocated to three treatment groups: a high-dose group, a low-dose group and a placebo control group. Psychiatric rating scales were administered at baseline and seven viewing points following the administration of intramuscular injections. The primary outcome measure was length of time from randomization (baseline) to early improvement.Results:Both primary and secondary outcome measures consistently showed no differences among the three groups. The cumulative response rate and the remission rate were 72.7% (48/66) and 47.0% (31/66). Intramuscular scopolamine treatment was relatively well tolerated. Two subjects with high-dose injections dropped out because of a drug-related side effect.Conclusion:Contrary to our prediction, we found that, compared to placebo (0.9% saline i.m.), scopolamine was not associated with a significantly faster antidepressant response rate.Trial registration:ClinicalTrials.gov, NCT03131050. Registered on 18 April 2017.

Prevalence and predictors of postpartum depression among mothers in the rural areas of Udupi Taluk, Karnataka, India: A cross-sectional study

ContextPostpartum depression (PPD) is a common affective disorder and is considered as an important public health problem as most of the time it remains unrecognized and affects the health of not only the mother but also the interpersonal relationships, mother-infant bonding as well as emotional and cognitive development of the baby. ObjectiveTo estimate the prevalence and analyze the factors associated with PPD. Settings and designA community based cross-sectional study was conducted in rural areas of Udupi Taluk, Karnataka over a period of six months. Methods and materialFour hundred ten (410) postnatal women within six months of their deliveries were interviewed using a semi-structured questionnaire, and were screened using Edinburgh Postnatal Depression Scale (EPDS). Statistical analysisDescriptive analysis was done on socio-demographic variables, obstetric, neonatal and postnatal and psychosocial factors. Logistic regression was carried to analyze the factors associated with PPD. ResultsPrevalence of PPD was 21.5%. Higher level of maternal and paternal educational status, labour complications, more than two children, history of an abortion and sleeping difficulty of the mothers were found to be statistically significant for PPD. ConclusionEarly identification of symptoms and timely referral to appropriate health care provider can prevent major depression in the postnatal period. Key messagesHigher level of educational status of mothers was found to be a risk factor whereas educated fathers were protective for PPD.