Course Of Depression Research Articles

The Problem of Assessing the Extent of Somatic Comorbidity in Patients with Major Depressive Disorder and Bipolar Disorder: Metabolic Syndrome, Cardiovascular Diseases, and Type II Diabetes Mellitus

The deleterious impact of depression on the course and outcome of somatic illness is well understood, but the subject of how somatic diseases affect the clinical picture, course, and prognosis of depression has received little attention. There is a lack of awareness on the actual level of comorbidity of somatic diseases in patients with depression, as well as the relationship of comorbidity with clinical features of the disease, patient age, sex, and diagnostic variants of depression. Metabolic syndrome (MS), cardiovascular diseases (CVDs), and type II diabetes (T2D) are the most common comorbidities, causing significant impairment and contributing to mortality rates. All these diseases are closely related to depression through shared pathophysiologic mechanisms of neuro-immuno-metabolic and cardio-metabolic nature. Inflammatory processes and genetic risk factors play a crucial role in realization of these mechanisms. Objective: The aim of this study is to analyze the existent knowledge on prevalence of MS, CVDs, and T2D in patients with major depressive disorder (MDD) and bipolar disorder (BD) in comparative aspect, taking into account possible effects of sex and age. Additionally, we strive to highlight the specific clinical features of comorbid patients. Methods: We conducted a literature review on the topic of comorbidity of MDD and BD with MS, CVDs, and T2D. We mostly selected meta-analyses and prospective studies with large samples. Results: According to current research, MS affects an average of 30-35% of individuals with both BD and MDD, with a minor predominance of male patients. CVDs are detected in an average of 18-20% of patients with BD and 25-45% of patients with MDD, also with a slight predominance of male patients. T2D affects an average of 8-10% of people with both BD and MDD, with no gender differences. There are no consistent and identifiable clinical signs that distinguish comorbid patients from non-comorbid patients for either BD or MDD. Conclusion: More research into the comorbidity of depression and chronic somatic diseases is required, particularly given the scarcity of scientific data for the Russian population.

Social Anxiety and Depression in Portuguese and Spanish Adolescents: The Moderating Role of Emotional Intelligence.

Social anxiety (SA) and depressive disorder usually coexist. Emotional Intelligence (EI) is a protective factor against emotional disorders. The aim of this study is to examine the moderating role of EI in the relationship between SA and depression among Spanish and Portuguese adolescents. Information on these variables was collected through a cross-sectional study with 1456 students between 12 and 19years of age. The software PROCESS was used to perform the analysis of conditional processes (model 1). The moderation model was conducted, including the covariate country, and showed significant differences between countries in the relationship between SA and Depression. The summary model explained that 42% of the Depression. The statistical analysis was repeated separately for Portuguese and Spanish adolescents, with EI as the moderating variable. The effect of SA on depression was significant for individuals with low or moderate EI, while for adolescents with high EI there was no statistically significant effect. To prevent these outcomes, early interventions, including the enhancement of Trait EI, with adolescents with SA could reduce the risk of developing SA disorder, as well as subsequent depressive disorders in adolescence and early adulthood. This is especially important because research indicates that depression caused by SA is strongly associated with a worse course of depression.

Tracking the course of depressive and anxiety symptoms across adolescence (the CATS study): a population-based cohort study in Australia

Adolescent mental health appears to be in crisis, yet few studies have comprehensively charted the course of common mental disorders (CMDs; depression and anxiety) across this key life stage. We aimed to describe the course of CMD symptoms in adolescence by summarising annual prevalence, cumulative incidence, and course for depression and anxiety, both separately and as comorbid CMDs, by sex assigned at birth in a contemporary Australian cohort. The Child to Adult Transition Study (CATS) was established in 2012 to form a representative cohort of adolescents in Melbourne, VIC, Australia. 43 schools were recruited using a stratified sampling approach, and all 2289 students aged 8-9 years were invited to participate. 1239 (54·1%) students obtained parental written informed consent and were followed up annually from 2012 to 2019 for a total of ten waves. Data from waves 3-10 (ages 10 to 18 years) were used for the current study and analysed to describe the course of symptoms of CMDs across adolescence. Primary measures of interest were clinically relevant depressive symptoms, clinically relevant anxiety symptoms, and any CMD (clinically relevant depressive or anxiety symptoms) at waves 3-10. A secondary measure of interest was comorbid CMDs (concurrent reporting of clinically significant anxiety and depressive symptoms) at waves 3-10. Depressive symptoms in the past 2 weeks were self-reported using the 13-item validated Short Mood and Feelings Questionnaire (SMFQ) at each wave, with a threshold score of 12 or more indicating clinically relevant symptoms. Anxiety symptoms in the past two weeks were self-reported using an 8-item shortened version of the Spence Children's Anxiety Scale (SCAS) at each wave, with a threshold score of 11 or higher indicating clinically relevant symptoms. The course of CMDs was described using annual prevalence, cumulative incidence for depression and anxiety, separately and combined. Missing data were handled via multiple imputation. An author with lived experience was involved in the research and writing process. Of the 1239 adolescents who participated in the study, 667 (53·8%) were female and 572 (46·2%) were male. 769 (62·1%) of 1239 were classified as socioeconomically advantaged, 675 (66·4%) of the 1016 with available data had a mother whose highest level of education was vocational or tertiary, and 579 (70·7%) of the 819 participants with ethnicity data identified as Anglo-Celtic or European. Overall, incidence of any clinically significant CMD symptoms during adolescence was 74% (95% CI 70-77; 84% [81-88] for females and 61% [55-66] for males). Independently, incidences of clinically significant depressive symptoms and anxiety symptoms were 65% (62-68) and 58% (55-62), respectively. Incidence of comorbid CMD was 48% (45-52). The estimated mean ages of first report in adolescence for both sexes were 14·1 years (95% CI 13·9-14·4) and 13·6 years (3·3-13·9) for depressive and anxiety symptoms, respectively. Of those who reached the threshold score for any CMD between ages 10 and 18 years, over half had a chronic (three or more waves) course (depression 54% [49-60]; anxiety 52% [47-58]), and a third met criteria for full remission at any subsequent wave (depression 30% [25-35]; anxiety 33% [27-39]). Females were consistently estimated to have a worse course of adolescent CMDs compared with males (eg, 64% [58-70] of females had a chronic course of depressive symptoms vs 37% [26-48] of males). In this contemporary multi-wave cohort study, almost three-quarters of adolescents reported CMD symptoms. The likelihood of chronicity of CMD symptoms (ie, recurrence) was high. Universal responses are urgently required to address this considerable public health problem. National Health and Medical Research Council of Australia and the Royal Children's Hospital Foundation.

Brain Activation Associated with Response to Psychotherapies for Late-life Depression: A Task-based fMRI Study

BackgroundThe course of late-life depression is associated with functioning of multiple brain networks. Understanding the brain mechanisms associated with response to psychotherapy can inform treatment development and a personalized treatment approach. This study examined how activation of key regions of the salience network, default mode network and reward systems is associated with response to psychotherapies for late-life depression. MethodsThirty-three older adults with major depressive disorder were randomized to 9 weeks of Engage or Problem-Solving Therapy for late-life depression. Participants completed a Probabilistic Reversal Learning task in the MRI at baseline and Week 6. We focused on focal activation in regions of interest selected a priori: the subgenual cingulate cortex (sgACC; DMN); the dorsal anterior cingulate cortex (dACC; salience network and reward system); and the nucleus accumbens (NAcc; reward system). We applied mixed-effects regression models to examine whether brain activation was associated with psychotherapy response. ResultsWe found that at baseline, low activation of the dACC and the sgACC was associated with lower depression severity over 6 weeks of psychotherapy. In addition, we observed significant time*activation interactions, such that after 6 weeks of psychotherapy, lower dACC activation and higher NAcc and sgACC activation were each associated with lower depression severity. Further, we found that baseline slower response to negative feedback and faster response to positive feedback was associated with lower depression severity over 6 weeks of psychotherapy. ConclusionsOur findings suggest that activation of reward, salience, and DMN regions may serve as markers of response during psychotherapy for late-life depression. Engagement of these networks may be linked to treatment outcome. Personalized psychotherapies can target individuals’ brain profiles to improve outcomes for older adults with major depression. Article SummaryThis study examined whether activation of regions of the reward, salience and default mode networks is associated with response to psychotherapies for late-life depression. We found that baseline low activation of the dACC and the sgACC was associated with lower depression severity during psychotherapy. We also found that at week 6, lower dACC activation and higher NAcc and sgACC activation were linked with lower depression severity. These regions may represent promising brain mechanisms for future personalized interventions.

Relationships between emotional state, sleep disturbance and health-related quality of life in patients with axial spondyloarthritis.

Axial spondyloarthritis (ax-SpA) is an autoinflammatory disease affecting multiple organs. While emphasizing the treatment of chronic diseases, it has been found that the prevalence of mental disorders and insomnia in patients is also increasing. We investigated mood status, sleep quality and the health-related quality of life (HRQoL) in these patients. A total of 94 pairs ax-SpA patients and age- and sex-matched healthy controls were included in this cross-sectional study. Demographic and clinical data were collected. We assessed the disease activity by the Ankylosing Spondylitis Disease Activity Score, including C-reactive protein (ASDAS-CRP), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Functional Index (BASFI). The Hospital Anxiety and Depression Scale (HADS), the Pittsburgh Sleep Quality Index (PSQI) and the Medical Outcomes Survey Sheet Form-36 (SF-36) were used to evaluate mood status and quality of sleep and life, respectively. We evaluated the factors related to anxiety and depression scores, sleep disturbance scores and quality of life scores, and the predictors of anxiety, depression and sleep disturbance were analyzed. Forty-five active patients and forty-nine relieved patients were enrolled. We found that the median HADS anxiety (HADS-A), depression (HADS-D) subscale scores and PSQI score were significantly higher in active ax-SpA than in inactive patients, and were significantly higher than those in controls (HADS-A 9 vs. 5 vs. 3, p < 0.001; HADS-D 8 vs. 5 vs. 3, p < 0.001; PSQI 10 vs. 6 vs. 3, p < 0.001). Moreover, the HADS-A scores were positively correlated to positive HLA-B27 (p = 0.042), pain (p = 0.002) and the BASFI score (p = 0.012), HADS-D scores were positively correlate to disease course (p < 0.001) and PSQI scores were significantly positively correlated to the BASFI score (p = 0.009). Logistic regression analysis showed that BASFI was a risk factor for anxiety, age was a protective factor for depression and disease course was a risk factor for depression. The optimal cut-off value of BASFI in predicting anxiety was 1.55 with an area under the curve value of 0.8488 (p < 0.001), and the optimal cut-off value of age and the course of the disease in predicting depression was 50.5years old with an area under the curve value of 0.62 (p = 0.0482) and 54months with an area under the curve value of 0.7988 (p < 0.001). In addition, disease activity was negatively correlated with SF-36 dimensions, and anxiety, depression and sleep disturbance in ax-SpA patients also had significant negative effects on HRQoL (p < 0.05). Patients with active ax-SpA tend to be more anxious, depressed and sleep disturbed, and have worse HRQoL than patients in remission. Patients with ax-SpA are more likely to be anxious with worse spinal function, more likely to be depressed with younger age and longer course of disease. Therefore, the assessment of mental health, sleep and HRQoL should also be included in the long-term management of patients with ax-SpA. Key Points • Active ax-SpA patients tend to have more anxiety, depression, sleep disturbances and worse HRQoL compared with patients in remission • The optimal cut-off value of BASFI in predicting anxiety was 1.55, the age and the course of the disease in predicting depression was 50.5years old and 54months.

Longitudinal trajectories of symptom change during antidepressant treatment among managed care patients with depression and anxiety

Despite the high correlation between anxiety and depression, little remains known about the course of each condition when presenting concurrently. This study aimed to identify longitudinal patterns during antidepressant treatment in patients with depression and anxiety, and evaluate related factors associated with these patterns. By analyzing longitudinal self-report Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) scores that tracked courses of depression and anxiety over a three-month window among the 577 adult participants, six depression and six anxiety trajectory subgroups were computationally derived using group-based trajectory modeling. Three depression subgroups showed symptom improvement, while three showed nonresponses. Similar patterns were observed in the six anxiety subgroups. Multinomial regression was used to associate patient characteristics with trajectory subgroup membership. Compared to patients in the remission group, factors associated with depressive symptom nonresponse included older age and lower depression severity.

The Many Faces of Guilt: A Review Mapping Unique and Overlapping Expressions in OCD and Depression.

Guilt, a complex emotional experience pervading many lives, takes on an intricate form when intertwined with psychiatric conditions. As a multifaceted concept, guilt represents a key diagnostic feature in depression and is an integral part of obsessive compulsive disorder (OCD). This systematic review aimed to synthesize empirical research on the varied dimensions of guilt across these two mental illnesses, where guilt is emphasized as a pathognomonic factor. A systematic computer-based literature search was conducted, using a rigorous set of eligibility criteria and specific keyword combinations to ensure relevant and exhaustive coverage of the topic. Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, a comprehensive literature search spanning multiple databases identified 12 eligible studies on guilt in OCD and 8 in depression. The findings revealed 20 distinct guilt constructs measured across the two disorders. Notably, 5 unique guilt subtypes and 15 themes for OCD and 6 exclusively studied guilt for depression emerged, reflecting potential disorder-specific manifestations of guilt. Delineating such guilt profiles holds the potential to untangle the role of guilt in the onset, perpetuation, and clinical course of OCD and depression. This comprehensive mapping of guilt constructs provides an empirical foundation for elucidating disorder-specific pathways influenced by guilt, thereby informing the development of targeted psychological interventions tailored to the distinct guilt patterns underpinning these debilitating conditions.

Course of Depression and Anxiety among Refugees and Asylum Seekers: A Systematic Review and Meta-analysis of Longitudinal Studies

AbstractRefugees and asylum seekers are at a high risk of developing mental health disorders, especially depression and anxiety. The prevalence of these disorders in refugees and asylum seekers has been well-documented in cross-sectional studies, but it is impossible to track their course over time using this research design. Hence, this systematic review and meta-analysis used data from existing longitudinal studies to examine the course of depression and anxiety in refugees and asylum seekers in upper-middle and high-income countries. Longitudinal studies reporting depression and anxiety were systematically searched from seven databases (Ovid MEDLINE, Ovid EMBASE, Ovid CINAHL, Scopus, Web of Science, PsycINFO, and Google Scholar) and included studies that fulfilled the inclusion criteria and underwent Joanna Briggs Institute (JBI) quality assessment. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was used to report the findings. An estimated pooled prevalence of depression and anxiety across time points was reported using a random effect model with a 95% confidence interval. Cochran’s Q and I2 statistics were conducted to assess heterogeneity among included studies, while funnel plots and Eggers tests were used to assess publication bias. Twenty longitudinal studies for depression and eight longitudinal studies for anxiety were included in the final analysis. The pooled prevalence of depression and Anxiety at baseline was 23.14% (95% CI: 16.34, 29.94) and 25.33% (95% CI: 5.10, 45.57), respectively. After the baseline data collection, the pooled prevalence of depression and anxiety increased over time. Specifically, the prevalence of depression rose from 17.55% (95% CI: 6.66, 28.45) 1 year after baseline to 34.04% (95% CI: 15.45, 52.63) 3 years after baseline. Similarly, the pooled prevalence of anxiety increased from 14.96% (95% CI: 10.59, 29.33) at 1 year after baseline to 33.09% (95% CI: 26.96, 39.21) at 3 years after baseline. The prevalence of depression more than doubled over the course of 3 years, rising from 17.55% at the 1-year mark after baseline to 34.04% at the 3-year mark after baseline. Similarly, the prevalence of anxiety exhibited a significant increase from 14.96% at the 1-year mark after baseline to 33.09% at the 3-year follow-up. These findings underscore the importance of implementing early settlement interventions and designing targeted measures to mitigate the prevalence of anxiety and depression among refugees and asylum seekers.

Associations between white matter microstructure and cognitive decline in major depressive disorder versus controls in Germany: a prospective case-control cohort study

Cognitive deficits are a key source of disability in individuals with major depressive disorder (MDD) and worsen with disease progression. Despite their clinical relevance, the underlying mechanisms of cognitive deficits remain poorly elucidated, hampering effective treatment strategies. Emerging evidence suggests that alterations in white matter microstructure might contribute to cognitive dysfunction in MDD. We aimed to investigate the complex association between changes in white matter integrity, cognitive decline, and disease course in MDD in a comprehensive longitudinal dataset. In the naturalistic, observational, prospective, case-control Marburg-Münster Affective Disorders Cohort Study, individuals aged 18-65 years and of Caucasian ancestry were recruited from local psychiatric hospitals in Münster and Marburg, Germany, and newspaper advertisements. Individuals diagnosed with MDD and individuals without any history of psychiatric disorder (ie, healthy controls) were included in this subsample analysis. Participants had diffusion-weighted imaging, a battery of neuropsychological tests, and detailed clinical data collected at baseline and at 2 years of follow-up. We used linear mixed-effect models to compare changes in cognitive performance and white matter integrity between participants with MDD and healthy controls. Diffusion-weighted imaging analyses were conducted using tract-based spatial statistics. To correct for multiple comparisons, threshold free cluster enhancement (TFCE) was used to correct α-values at the family-wise error rate (FWE; ptfce-FWE). Effect sizes were estimated by conditional, partial R2 values (sr2) following the Nakagawa and Schielzeth method to quantify explained variance. The association between changes in cognitive performance and changes in white matter integrity was analysed. Finally, we examined whether the depressive disease course between assessments predicted cognitive performance at follow-up and whether white matter integrity mediated this association. People with lived experience were not involved in the research and writing process. 881 participants were selected for our study, of whom 418 (47%) had MDD (mean age 36·8 years [SD 13·4], 274 [66%] were female, and 144 [34%] were male) and 463 (53%) were healthy controls (mean age 35·6 years [13·5], 295 [64%] were female, and 168 [36%] were male). Baseline assessments were done between Sept 11, 2014, and June 3, 2019, and after a mean follow-up of 2·20 years (SD 0·19), follow-up assessments were done between Oct 6, 2016, and May 31, 2021. Participants with MDD had lower cognitive performance than did healthy controls (p<0·0001, sr2=0·056), regardless of timepoint. Analyses of diffusion-weighted imaging indicated a significant diagnosis × time interaction with a steeper decline in white matter integrity of the superior longitudinal fasciculus over time in participants with MDD than in healthy controls (ptfce-FWE=0·026, sr2=0·002). Furthermore, cognitive decline was robustly associated with the decline in white matter integrity over time across both groups (ptfce-FWE<0·0001, sr2=0·004). In participants with MDD, changes in white matter integrity (p=0·0040, β=0·071) and adverse depressive disease course (p=0·0022, β=-0·073) independently predicted lower cognitive performance at follow-up. Alterations of white matter integrity occurred over time to a greater extent in participants with MDD than in healthy controls, and decline in white matter integrity was associated with a decline in cognitive performance across groups. Our findings emphasise the crucial role of white matter microstructure and disease progression in depression-related cognitive dysfunction, making both priority targets for future treatment development. German Research Foundation (DFG).

Long-term courses of major depressive disorder : Characteristics, risk factors and the definitional challenge of treatment response

The definition of long-term courses of depression is heterogeneous. Chronic and treatment-resistant courses, in particular, represent ahigh-cost factor and greatly reduce the quality of life. Based on the pharmacotherapeutic treatment-resistant depression (TRD), more and more systemic approaches are becoming important. This narrative review provides an overview of the long-term course of depressive disorders, including various definitions and influencing factors. In addition, an overview of biomarker research on treatment response with afocus on neuroimaging is presented. Aselective literature search was conducted in PubMed and Google Scholar for anarrative review. Particular attention was given to larger cohort studies, systematic reviews, meta-analyses and studies on the prediction of treatment response. Chronic and treatment-resistant courses mean arelevant reduction in the quality of life and increased health risks. The assessment of treatment response is adefinitional challenge: An alternative to TRD is the systemically oriented difficult to treat depression (DTD). The focus is thus moving away from symptom reduction towards controlling the level of functioning. Biomarker research for treatment response offers potential but currently mainly serves to gain theoretical knowledge. Recording the long-term course of depressive illnesses is important, but also complex. Clinical interventions should therefore include acontinuous monitoring and the focus on maintaining the quality of life.

Study of the Relationship between Insulin Resistance and Risk of Developing Depression and Anxiety Disorders

Abstract Background Studies have suggested that diabetes increases the risk of incident depression and anxiety. Also, it can contribute to a more severe course of depression and anxiety with different mechanisms. Moreover, Insulin resistance is an essential component in development of diabetes in diabetic patients. Yet, no sufficient studies revealed the relationship between insulin resistance and depression and anxiety. Hence, this is important to prevent, early detect, treat, and identify factors affecting their incidence, as this affects prognosis and insulin resistant individuals’ quality of life. Aim of the Work To study the relationship between insulin resistance and risk of developing depression and anxiety disorders. Patients and Methods This is a case control study conducted on patients from diabetes and Internal medicine clinics and department of Ain Shams University Hospitals. This present study aimed at analyzing the data of 60 participants divided into 3 groups. Group 1has 20 Insulin resistant diabetic patients. Group 2 has 20 Insulin resistant non diabetic patients. Group 3 has 20 Non insulin resistant non diabetic normal subjects, over two months period from December 2022 to March 2023. They were subjected to clinical examination and laboratory work up including (HbA1c, HOMA IR, lipid profile), then they were screened by PHQ and GAD. Results A total of 60 participants who are composed of 56.6% females, 70% non workers, 78% married, 30% smokers and 62% with BMI more than 25. As regards psychiatric assessment, PHQ assessment shows a total of 34 participants having depression representing (56.67%), while GAD assessment shows 28 subjects having anxiety disorder (46.67%). As regard the comparison between the 3 groups the HOMA IR values are higher in group 1 and 2, while, HbA1c values are more in group 1 which show a statistical significance with p value &amp;lt;0.001 each. As regards, psychiatric assessment of the participants, 75% of group 1, 60% of group 2 and only 35% of group 3 suffer from depression scored by PHQ. This shows a statistically significant correlation between DM, IR and depression (p value = 0.036) Furthermore, 65% of group 1, 55% of group 2 and only 20% of group 3 suffer from scored by GAD. This shows a statistically significant correlation between DM, IR and anxiety (p value = 0.011) Conclusion Depression shows significant correlation with HbA1c value and Anxiety shows significant correlation with HOMA IR value. Hence, psychiatric evaluation can’t be ignored in any case with insulin resistance or diabetes. Detecting factors which affect the prevalence of such complications will help in preventing them in the future. So, further research to establish management protocols to reduce these complications is needed.

Predictors of response to accelerated rTMS in the treatment of treatment-resistant depression.

Accelerated repetitive transcranial magnetic stimulation (rTMS) is a promising treatment for treatment-resistant depression (TRD). We aimed to investigate the existence of clinical predictive factors in response to accelerated rTMS in the treatment of TRD. In total, 119 TRD patients who received accelerated rTMS were included in this study. The stimulation protocol was 15Hz stimulation over the the left dorsolateral prefrontal cortex. The protocol consisted of 25 sessions, each session lasting 30min for a total of 3000 pulses. Five sessions were applied per day for 5 consecutive days. At baseline (T0), day 5 (immediately after treatment) (T1), 4 weeks after treatment (T2), depression severity was evaluated using the 17-item Hamilton Depression Rating Scale (HAMD-17), cognitive function was evaluated using Wisconsin Card Sorting Test (WCST), the intensity of suicidal ideation was evaluated using the Columbia-Suicide Severity Rating Scale (C-SSRS). Systemic immune-inflammation index (SII) was calculated at T0 and T2. The HAMD-17 scores, WCST performance, the C-SSRS scores at T1 and T2 were improved from T0 (P < 0.01). The SII at T2 was lower than at T0 (P < 0.01). The response rates at T1 and T2 were 57.98% (69/119) and 48.74% (58/119), respectively. The results of binary logistic analysis showed that shorter course of depression, two failed antidepressant trials, no history of ECT treatment, and lower levels of SII were predictive factors for accelerated rTMS treatment response at T1 and T2 (P < 0.05), while not having a history of hospitalization was a predictive factor for response at T2 (P < 0.05) but not at T1 (P > 0.05). Based on ROC curve analysis, the optimal cut-off values of SII for discriminating responders from non-responders at T1 and T2 were < 478.56 and < 485.03, respectively. The AUC of SII at T0 predicting response for T1 and T2 were 0.729 and 0.797. We found several clinical predictors of better responses to the accelerated rTMS. Identifying clinical predictors of response is relevant to personalize and adapt rTMS protocols in TRD patients.

Prospects for the Use of Thymoquinone (a Component of Nigella sativa) in the Prevention and Therapy of Neuropathologies

Black cumin and its component thymoquinone (TQ) are known as drugs with a wide range of pharmacological activities: immunomodulating, anti-inflammatory, antimicrobial, antiviral, antineoplastic properties. These drugs also have neuroprotective properties in neurodegenerative diseases (Alzheimer's, Parkinson's), ischaemia, epilepsy, encephalomyelitis, traumatic brain injury. The main mechanisms of action are antioxidant activity increased expression of neuroprotective genes and proteins with decreased activity of pro-inflammatory cytokines and the NF-кB pathway, which plays a key role in neuroinflammation. A separate section is devoted to the effects of black cumin and TQ on the course of depression, a common and socially significant illness. Reduced signs of depression and increased levels of a neuroprotective factor belonging to the neutrophin family (BDNF), a characteristic marker of depression, were described in 54 depressed patients. The review discusses the prospects for prevention and therapy with these drugs in central nervous system pathology.

Personality traits and change in depression status at 18 months: Findings from a British Psychiatric Morbidity Survey

BackgroundDepression is a common mental disorder, yet it shows low remission rates. The available evidence on personality traits as factors associated with the course of depression has common methodological limitations. Identifying personality traits linked with depression can improve understanding of the course of illness. Therefore, we aimed to investigate personality traits that are associated with the course of depression over 18 months. Methodslongitudinal data of 2366 Adult Psychiatric Morbidity Survey respondents were analysed. Assessments were applied at two-time points (baseline) and follow-up (about 18 months later). We assessed the total score on the screening questionnaire from the Structured Clinical Interview (SCID-II) for the dependent, obsessive-compulsive, and borderline personalities. Depression was measured using the revised Clinical Interview Schedule (CIS-R) version. ResultsAn increase of one score on the borderline personality scale at baseline increased the odds of experiencing persistent depression by 1.50 times (OR = 1.50, 95 % CI [1.22–1.86]), depression onset by 1.30 times (OR = 1.30, 95 % CI [1.14–1.50]), and recovery by 1.52 times (OR = 1.52, 95 % CI [1.35–1.70]), comparing to no depression group. Elevated scores of dependent personality traits significantly predicted depression persistence (OR = 1.95, 95 % CI [1.52–2.49]). An increase of one score on the obsessive-compulsive personality scale increases the odds of depression onset by 1.21 times (OR = 1.21, 95 % CI [1.04–1.39]). LimitationsThe APMS survey defined depression statuses in a limited sense, which may affect the generalisability of these results. ConclusionThe present study confirms previous findings and contributes evidence suggesting that personality dysfunctions worsen depression outcomes.

The course of children's mental health symptoms during and beyond the COVID-19 pandemic.

The COVID-19 pandemic is associated with increases in child mental health problems, but the persistence of these changes in the post-pandemic era remains uncertain. Additionally, it is unclear whether changes in mental health problems during the pandemic exceed the anticipated increases as children age. This study controls for the linear effect of age in 1399 children, investigating the course of child-reported anxiety, depression, hyperactivity, and inattention symptoms during and after the pandemic, and identifies risk and protective factors that predict these mental health trajectories. Children (51% male; ages 9-11 at the first timepoint) provided mental health ratings at three pandemic timepoints (July-August 2020; March-April 2021; November 2021-January 2022) and one post-pandemic timepoint (January-July 2023). Mothers reported pre-pandemic mental health (2017-2019) and socio-demographic factors. Children reported socio-demographic factors, risk (e.g. screen time, sleep), and resilience (e.g. optimism) factors during the first timepoint. Average mental health symptoms increased over time, with more children exceeding clinical cut-offs for poor mental health at each subsequent pandemic timepoint. Growth curve modeling, adjusting for age-related effects, revealed a curvilinear course of mental health symptoms across all domains. Examination of risk and protective factors revealed that pre-existing mental health symptoms and optimism were associated with the course of symptoms. After considering age effects, children's mental health follows a curvilinear pattern over time, suggesting an initial decline followed by a rising trend in symptoms post-COVID. These findings underscore the continued need for additional resources and timely, evidence-based mental health prevention and intervention for children.

Analysis of Depression Levels in Type 2 Diabetes Mellitus Patients at 'Aisyiyah General Hospital Ponorogo

Diabetes mellitus type 2 is a common health problem in Indonesia. Depressive symptoms are common among adults with diabetes. Clinically significant depression is present in one of every four people with type 2 diabetes mellitus. A diagnosis of type 2 diabetes mellitus increases the risk of incident depression and can contribute to a more severe course of depression. The aim of the study was to estimate the prevalence of depression in the population diagnosed with diabetes type 2. Respondens were patient with type 2 diabetes mellitus in Kardinah Hospital. This research is quantitative descriptive. The sampling technique using accident sampling with 60 individuals with type 2 diabetes mellitus. The data was taken by instrument using PH9. Data was analyzed by univariate test. The result of the analysis 82,3% no symptom of depression and 17,7% have a depression. Depression at all levels in DM sufferers cannot be ignored, intervention must be obtained. Because depression makes health problems worse.

Cross-sectional survey to determine fatigue in patients with systemic lupus erythematosus.

Fatigue is a prevalent symptom among individuals with active systemic lupus erythematosus (SLE). We aimed to investigate the status quo and influencing factors of fatigue in patients with SLE, to provide insights to the clinical SLE treatment and care. We conducted a longitudinal survey on the fatigue of active SLE patients from June 2022 to November 2023 in our hospital. Fatigue severity scale (FSS), Self-rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) were used for data collection. Pearson correlation and multiple stepwise regression analysis were conducted to analyze the relevant factors affecting the fatigue level of patients with SLE. A total of 212 active SLE patients were included, the incidence of fatigue in active SLE patients was 55.66%. There were statistical differences in the fatigue score between SLE patients with different age and course of SLE (all p < 0.05). Fatigue was positively correlated with anxiety (r = 0.559) and depression (r = 0.591) in patients with SLE (all p < 0.05). Multiple stepwise regression analysis indicated that age, course of SLE, anxiety and depression were the influencing factors of fatigue in SLE patients (all p < 0.05). Patients with SLE exhibit a significant degree of fatigue, which varies with respect to age, disease duration, and the presence of comorbid anxiety and depression. It is imperative that healthcare providers closely monitor the fatigue levels in this patient population and implement targeted interventions to mitigate the impact of fatigue on the quality of life and overall well-being of individuals with SLE.

Characteristics of depression treatment in men with testosterone deficiency

BACKGROUND: Treatment of depression in men with testosterone deficiency is particularly challenging because of the overlap between the symptoms of depression itself and those associated with testosterone deficiency, which requires the development of additional diagnostic and therapeutic approaches. AIM: To enhance the effectiveness of comprehensive treatment of depression in men with testosterone deficiency. MATERIALS AND METHODS: The study involved 140 male participants (aged 18–65 years) diagnosed with depressive episodes and recurrent depressive disorder according to the International Classification of Diseases, 10th revision. Patients were divided into the main group (testosterone levels below 12.1 nmol/l) and the control group (normal testosterone levels). The main group (n=90) was further divided into three therapeutic subgroups of 30 patients each: receiving sertraline monotherapy, testosterone monotherapy, and combined sertraline and testosterone treatment. The control group included men with depression and normal testosterone levels (n=50), who received sertraline only. RESULTS: Depression in men in the context of testosterone deficiency has distinct clinical features, both phenomenologically and syndromally. The severity of the depressive syndrome in men with testosterone deficiency is lower (17.0 [16.0; 18.75] points on the HDRS scale) than in patients with normal testosterone levels (19.0 [18.0; 22.0] points on the HDRS scale), and the depressive episode tends to occur later in life (47.0 [42.0; 55.0] years) compared to those with normal levels of testosterone (29.5 [24.25; 40.0] years) and is less likely to be recurrent than in those with normal testosterone levels (29.5 [24.25; 40.0] years). The study of the efficacy and safety of depression therapy in the context of testosterone deficiency shows that a combined approach to the treatment of depression in men with testosterone deficiency has both advantages (considering the specifics of patients by normalizing testosterone levels and erectile function) and disadvantages (relatively higher risk of adverse events) compared to sertraline monotherapy. CONCLUSION: The identified characteristics of the course and treatment of depression in the context of reduced testosterone levels allowed for the development of a more effective therapeutic and diagnostic algorithm.

Elevated Specific Pro-Inflammatory Cytokines in Peripheral Circulation Indicate an Increased Risk of Anxiety and Depression in Rosacea.

Pro-inflammatory cytokines mediate the course of rosacea, anxiety, and depression through various means such as immunity and inflammation. This study aims to further explore the relationship between rosacea, anxiety, and depression through changes in the levels of pro-inflammatory cytokines. 280 rosacea patients were included in the rosacea group, divided into: rosacea without mental disorders, rosacea with anxiety, rosacea with depression, and rosacea with combined anxiety and depression. The mental control group included 210 anxiety and depression patients, divided into: anxiety, depression, and combined anxiety and depression. The healthy control group consisted of 70 healthy individuals. Serum specimens were collected and ELISA was used to detect major pro-inflammatory cytokines. CEA, IGA, GFSS, RosaQoL, HAMA, and HAMD-24 were used for the diagnosis and severity assessment of rosacea and anxiety and depression. This study primarily used the Chi-Square test, Kruskal-Wallis H-test, generalized linear model, and binary logistic regression to evaluate the data. IL-1β, IL-17, and IL-8 levels in rosacea patients and anxiety/depression patients were higher than those in the healthy population (P<0.001), and TNF-α levels in rosacea patients were higher than those in the healthy population (P<0.001). There was an interaction between rosacea, anxiety, and depression in terms of IL-1β, IL-17, and IL-8 levels (P<0.001). Elevated levels of IL-1β, IL-17, and IL-8 are positively correlated with anxiety and depression in rosacea (all P<=0.05). It was confirmed that the elevated levels of IL-1β, IL-17, and IL-8 are positively correlated with the onset of anxiety and depression in rosacea. The interaction of the above inflammatory factors suggests a possible common inflammatory mechanism in the coexistence of rosacea and mental disorders. TNF-α only increased in patients with rosacea, combined with the skin-to-mental irreversible phenomenon, indicating that this cytokine may be a key and potential therapeutic target for the onset of rosacea.

Capgras Syndrome with Non-Violent Behaviour Presenting in Postpartum Period: Case Study with Literature Review

Background: Capgras syndrome (CS) is one of the delusional misidentification syndromes (DMS) characterized by the belief by the patient that the close person, usually a close relative or family member is replaced by an imposter who looks physically the same. Since the first case of Capgras syndrome was described in 1923, the published literature is confined to a small number of case reports and a single case series. Capgras syndrome rarely occurs in postpartum period; there are few references in the literature to any of the delusions of misidentification occurring in a post partum period. Moreover, some authors described Capgras syndrome as frequently involving hostility, violence and risk of neglect towards an object of delusional misidentification. Their reports based on single cases report or small case series that may be subject to significant reporting bias. This case outlined here on a female patient affected by Capgras syndrome in post partum period with brief review of the literature. Case presentation: A 32-year-old woman presented to the psychiatric clinic for a delusional belief that newborn had been replaced by another one. Capgras delusion was developed after caesarean section on her 12th postpartum day. The patient was healthy individual whose Capgras syndrome was not linked to any psychiatric or neurological states in the past. Anxiety and depressive symptoms followed progressively without postpartum psychosis. Though she has a fixed belief, which is that her baby was replaced by another one, she did not show any psychotic features or aggression behaviour. Conclusion: In this case report, Capgras syndrome is typically a monothematic delusion (delusion about the baby may have an altered identity or replaced by another one) and is not accompanied by other delusions. Also, it displays the course of anxiety and depression in the period of postpartum period that accompanied with Capgras syndrome. The patient has no postpartum psychosis, only a delusion about the baby replaced by another one. Though her ambivalent emotions toward the baby, the patient did not show any hostility, aggression behaviour or violence and denied thoughts of harming baby.