Criteria For Depressive Disorder Research Articles

Behavioral anhedonia in Major Depressive Disorder (MDD)

Introduction: Depression is a major public health problem, with existing pharmacological and non-pharmacological treatments not equally effective in all patients. The complex etiology and pathogenesis of depression pose a challenge that requires different approach strategies to effectively alleviate this mental symptom. Anhedonia, or loss of interest and pleasure in commonly enjoyed activities, is one of the main diagnostic criteria for depressive disorders in the psychiatric diagnostic systems of the Diagnostic Statistical Manual (DSM) and International Statistical Classification of Diseases (ICD). Major depressive disorder indicates a depressive condition that does not solely rely on reports of sad mood but the presence of anhedonia behavior. The review of these studies aims to determine changes in anhedonia behavior in depressive disorders. Methods: This research review was prepared using the literature review method by collecting valid scientific literature, namely Google Scholar, PubMed and Scientific Direct. Discussion: Anhedonia behavior is related to several factors, including social interaction is the most complex and ambiguous human environment. Hence the existence of rules that are fraught with misunderstandings. It requires complex examination to determine exactly what the rewarding components of social interaction are.

Efficiency of Vortioxetine in Depressive Symptoms in Parkinson’s Disease

IntroductionParkinson’s disease (PD) is the most common serious movement disorder in the world, affecting about 1% of adults older than 60 years. The disease is attributed to selective loss of neurons in the substantia nigra, and its cause is enigmatic in most individuals. Patients with PD display both motor and non-motor symptoms. For some patients, the non-motor symptoms are more bothersome than the motor symptoms. One of the most common non-motor symptoms of PD is depression.ObjectivesTreatment of depression with antidepressant drugs is well established. In the last 20 years use of antidepressant has risen mainly due to the introduction of the selective serotonin reuptake inhibitors (SSRIs). Our primary aim was to demonstrate an improvement in depressive symptoms in patients who started treatment with vortioxetine. A secondary aim was to show those who was successfully treated with vortioxetine but was unresponsive to paroxetine and escitalopram without worsening the extrapyramidal symptoms of PD.MethodsIn collaboration with the Department of Neurology, we included patients who are being treated for Parkinson’s disease and who meet the criteria for depressive disorder after a psychiatric examination. We divided the patients into two groups: those who had not previously taken any antidepressant drugs and those who were already on therapy with paroxetine and escitalopram but without the expected therapeutic response. All patients were prescribed vortioxetine in their treatment, and the Hamilton Depression Rating Scale (HDRS) was determined during their first meeting with the psychiatrist, and then again after 6 weeks of taking the medication. Also, we used Mini mental state examination (MMSE) to measure cognitive impairment.Our primary outcome measure was the number of patients in each treatment group who responded to treatment. Response was defined as the proportion of patients who had a reduction of at least 50% from the baseline score on the Hamilton Depression Rating Scale (HDRS)ResultsOur primary outcome measure was the number of patients in each treatment group who responded to treatment. Response was defined as the proportion of patients who had a reduction of at least 50% from the baseline score on the Hamilton Depression Rating Scale (HDRS)ConclusionsIn our research, vortioxetine has proven to be effective in treating depressive symptoms without worsening Parkinson’s disease, unlike paroxetine and escitalopram, which resulted in partial effects.Disclosure of InterestNone Declared

Parental separation and death during childhood as predictors of adult psychopathology: An examination of racial differences.

Parental separation and parental death during childhood are common but understudied forms of adverse childhood events (ACEs), thus little is known about the impact on psychological functioning in adulthood. We examined whether parental death and parental separation during childhood was associated with risk of diagnostic criteria for depressive disorders, anxiety disorders, posttraumatic stress disorder (PTSD), or personality disorders during adulthood. Second, we compared parental separation and parental death and psychopathology across African Americans (N = 499) and Whites (N = 782). The sample consists of 1,211 participants (n = 669 females). Diagnostic interviews were administered by master's or doctorate-level degree holders in Clinical Psychology or Social Work. There was good to excellent interrater reliabilities (mean kappa of .84 ± .05; range: .79-.93) spanning anxiety, mood, anxiety, trauma, and personality disorders. White participants reporting parental separation during childhood were more likely to report depressive disorders (OR = 2.151, p < .001), PTSD (OR = 2.218, p < .01) and personality disorders (OR = 1.764, p < .001) during adulthood. African American endorsement of parental separation during childhood did not predict depressive disorders (OR = 1.21, p = .357), anxiety disorders (OR = 1.107, p = .659), PTSD (OR = 1.351, p = .425) or personality disorders (OR = 1.432, p = .098) during adulthood. Overall, participants who reported parental death did not have significantly higher rates of depressive disorders (OR = 1.100, p = .668), anxiety disorders (OR = 1.357, p = .207), PTSD (OR = 1.351, p = .425), and personality disorders (OR = 1.432, p = .098). Parental separation was a significant risk factor for adult psychopathology, but only for White participants. Parental death was not a risk factor for adult psychopathology no matter the person's race. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Psychological characteristics and emotional difficulties underlying school refusal in adolescents using functional near-infrared spectroscopy

BackgroundThis study aims to explore the psychological characteristics, related emotional problems and potential NIR brain function mechanism of adolescents who refuse to attend school.MethodsThe study included 38 adolescents (12–18 years old) who were not attending school and 35 healthy controls (12–18 years old) who are attending school regularly. Participants completed (1) general demographics, (2) Eysenck Personality Questionnaire (EPQ), (3) Zung Self-Rating Depression Scale (SDS), (4) Zung Self-Rating Anxiety Scale (SAS), and (5) Symptom Checklist-90 (SCL-90). In addition to the clinical tests, participants completed functional near-infrared spectroscopy (fNIRS). Mental health, personality, and emotional state were evaluated in both groups to explore the differences and to understand the underlying mechanisms of school refusal during adolescence.ResultsAdolescents who did not attend school had higher neuroticism scores on the Eysenck Personality Questionnaire than healthy controls (p(FDR) < 0.001), introversion and concealment scores were lower than those of healthy controls (p(FDR) < 0.001), there was no significant difference in psychoticism scores between groups. SDS, SAS, SCL-90 scores and factor scores were higher than those of healthy control group (p(FDR) < 0.001), NIR functional brain imaging was different from healthy control group in the 12 and 27 channels (p(FDR) = 0.030, p(FDR) = 0.018), and no difference was found in the remaining channels (p(FDR) > 0.05). There were statistically significant differences in age and gender between the adolescents who refused school and the control group (p(FDR) < 0.001).ConclusionSchool refusal adolescents are relatively introverted and sensitive and need more attention in daily life. Although the adolescents’ emotional problems did not reach the diagnostic criteria of depressive disorder and anxiety disorder, their scores were still higher than those of the control group, suggesting that we should pay more attention to their emotional problems in order to better help them return to school. Using fNIRS, it was found that abnormalities in frontal lobe regions in adolescents with school refusal behaviors, which would contribute to early diagnosis and timely intervention of school refusal behaviors.

P132: Efficacy of Vortioxetine in Major Depression in Terminal Cancer. About a Case

Introduction:Major depression is one of the most widely recognized psychiatric disorders in cancer patients. In Spain,16.49% of cancer patients develop a Major Depressive Disorder. It arises as a reaction to a traumatic experience influenced by events and environmental conditions and develops as a consequence, of an adverse event, whether single or recurring. When depressive symptoms interfere with the proper functioning of cancer patients, antidepressants are the first line of treatment. We refer to Vortioxetine as the antidepressant of choice.Medical History:We present a 68-year-old patient diagnosed with Prostate Neoplasm (Gleason Grade 6 STAGE IV Adenocarcinoma) with Bone and Pulmonary Metastasis, who was referred, to the PADES Service of CSS Bernat Jaume, for poor pain control at the L5-L7 lumbar spine level. (VAS 9/10), immobility and depression after his prognostic information and short-term expectations.We want to assess the usefulness of Vortioxetine for depression in cancer terminal patients. The diagnostic criteria for depressive disorder were evaluated according to the DSM-V(6) risk factors for depression in palliative patients. The Visual Analogue Scale for the evaluation of the pain (0 no pain and 10, unbearable pain). Previously used medications for pain control, and depression were assessed. It was decided to start treatment with Vortioxetine and assess the response.Treatment:We started Vortioxetine 5 mg for a week and appetite improved, as well as VAS 5/10. After fifteen days, he was able to walk, and his insomnia and anxiety decreased. He remained stable with the prescribed medication until, due to complications secondary to his oncological pathology, he was admitted to The Palliative Care Unit to begin sedation.Conclusions:In terminal cancer patients with depression, it would be advisable to use Vortioxetine to improve their quality of life in situation of last days.

Effectiveness of Behavior Management Intervention in Migraine With a Focus on Comorbid Depressive

Background: Migraine negatively affects sufferers’ physical and mental health and social and economic status. Objectives: This study compared the effectiveness of behavior management therapy and pharmacotherapy in reducing migraine-related disabilities with and without focusing on comorbid depressive symptoms. Materials &amp; Methods: This quasi-experimental study has a pre-test-post-test design with a control group. The study was conducted on migrainous patients with comorbid depressive symptoms referred to neurology clinics in Rasht City, Iran, in 2021. A total of 18 female patients were selected using purposive sampling based on neurological diagnosis and the diagnostic and statistical manual of mental disorders (DSM-5) criteria for depressive disorder. The participants were randomly assigned to two groups after matching regarding age and severity of depression. Combined therapy (behavior management intervention [BM] and pharmacotherapy [P]) was performed in two groups during eight sessions, with (case group) and without (control group) focusing on comorbid depressive symptoms. The data were collected using the Beck depression inventory (BDI-II), the headache disability inventory (HDI) , and the headache diary (HD) and analyzed using multivariate analysis of covariance. Results: The first therapeutic approach was significantly superior to the second in reducing migraine-related disabilities (F(2, 13)=10.43, P&lt;0.05, Wilks Lambda=0.384, partial Ƞ2=0.616). Conclusion: Combined therapy (BM &amp; P) focusing on comorbid depressive symptoms can be an alternative or complementary therapeutic method to reduce various disabilities in migraine patients.

651-P: Sensitivity and Specificity of the PHQ-8 to Identify Depressive Disorder (DD) in Teens with Type 1 Diabetes (T1D)

Objective: A recent study identified that a cut-off score &amp;gt;5 on the Patient Health Questionnaire (PHQ-9) had greater sensitivity and specificity to detect DD in teens with T1D than the normative cut-off score. Still, limited provider training or capacity to intervene on a suicide screening item (item 9) leads some clinics to omit item 9. We examined the ideal cut-off score to detect DD in teens with T1D using the modified PHQ-8 screener, and if removing item 9 impacts sensitivity. Methods: Teens (N=100; Mean age = 15.0 ± 1.7; 60% Male; 87% White; Mean HbA1c = 8.88 ± 1.8%) completed the PHQ-8 electronically. We used the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS DSM-5) depression module to determine if the teen met criteria for DD. We compared teens’ PHQ-8 cut-off scores (PHQ-8 ≥ 10) to KSADS results. Results: Per KSADS, 15% of teens met criteria for current DD. The PHQ-8 demonstrated low sensitivity (.20) to detect DD using a normative cut-off score, but an adjusted cut-off score &amp;gt;5 increased sensitivity (.87) while maintaining good specificity (.80) (Table 1). Conclusions: Using a lower cut-off score of &amp;gt;5 on the PHQ-8 can more reliably identify DD in teens with T1D and matches previous PHQ-9 sensitivity and specificity metrics. This suggests removing item 9 does not negatively impact DD screening accuracy, although clinics should consider alternative methods to screen for suicide risk. Disclosure S.R.Patton: None. A.Marker: None. R.Mcdonough: None. M.A.Clements: Consultant; Glooko, Inc., Research Support; Dexcom, Inc., Abbott Diabetes.

Depression, anxiety and burden of care in caregivers of children with &amp;beta;-thalassemia major

β – thalassemia major is a chronic inherited blood disorder requiring lifelong treatment including blood transfusion, putting tremendous burden on caregivers of the affected children. Aims were to measure the burden of care, prevalence and severity of depression and anxiety, and their association with various socio-demographic and illness related factors in caregivers of children with β – thalassemia major. A cross-sectional study was conducted on 100 caregivers of children suffering from β – thalassemia major coming to the Paediatrics department of S.S.G. Hospital, Vadodara. Study tools used were Zarit Burden Interview, General Health Questionnaire-28, Diagnostic and Statistical Manual of mental disorders (fifth edition) diagnostic criteria for depressive disorders and generalised anxiety disorder, Hamilton Depression and Anxiety Rating Scales. Forty seven (47%) caregivers had moderate to severe burden of care. Fifty four (54%) caregivers screened positive for having psychiatric morbidity out of which thirty five (35%) had depressive disorders and fourteen (14%) had generalised anxiety disorder. 24 (68.6%) and 9 (64.3%) had moderate to severe depression and anxiety respectively. Burden of care and depression were significantly associated with lower income and those requiring blood transfusions every 2 weeks or less. Thalassemia has its impact not only on the patients but also on the mental health of their caregivers leading to high levels of depression, anxiety and burden of care in them. They should be routinely screened for depression and anxiety to provide adequate mental health care to these individuals.

“Asking for help, quite a challenge”. Time from onset of symptoms to consultation with a psychiatrist

IntroductionOne of the biggest challenges for primary care professionals is to know when it is appropriate to request a consultation with a psychiatrist. A complete medical history should be performed to detect anxious-depressive symptoms, as well as to determine the intensity, the trigger, time of evolution, and the functional repercussion (1). It is also important that the patient is able to express his or her symptoms and ask for help. The concept of “Alexitimia” refers to the difficulty of expressing feelings verbally, and is a frequent symptom in depressive patients (2).In mild cases and with little repercussion, the physician himself can initiate treatment and follow up (3). However, on other occasions, it will be advisable to request a consultation with psychiatry.ObjectivesThe main objective is to observe the time that elapses from the onset of symptoms until consultation with the Mental Health team is finally requested. Some preliminary results can already be obtained from this data collection.MethodsWe have decided to carry out a descriptive study, collecting different variables from patients attending a first Psychiatry consultation.Results In a total sample of 208 patients, the majority (67%) were between 31 and 60 years old. Following the DSM-V criteria (4), patients were classified into groups according to their disorder: Adaptive, depressive, or other. These data were cross-referenced (Figure 1).Subsequently, the time elapsed from the onset of symptoms (referred by the patients) was collected, until the referral to Psychiatry was processed. In order to make a comparison, average time (in days) was calculated for the different groups according to their age and diagnosis.Those patients under 30 years were referred to psychiatry later. A downward trend was seen as the age range increased. In the “younger than 30” and “between 31 and 60” groups, patients who met criteria for Depressive Disorder took longer to be referred, which was striking considering that they are usually considered as more severe patients (Figure 2). This can be attributed to a greater difficulty in expressing their emotions (alexithymia), as another depressive symptom. Disaggregating these data by gender, the patients who clearly took the longest to be referred were men under 30 years old with a final diagnosis of Depressive Disorder (Figure 3). This gender difference is consistent with the social impact of alexithymia according to some articles (5).Image:Image 2:Image 3:ConclusionsIt is important that primary care physicians know how to take a complete history in those patients with symptoms of anxiety and depression.In many cases, patients themselves have difficulties expressing their emotions and feelings (alexithymia), which may be another symptom of their discomfort.This may lead to a delay in the time until referral to a psychiatry is requested, and therefore a worsening of symptoms.Disclosure of InterestNone Declared

Clinical Research Updates.

Clinical Research Updates.

A Chinese adaptation of six items, self-report Hamilton Depression Scale: Factor structure and psychometric properties.

The objective of this research was to verify the psychometric characteristics of the Chinese Adaptation of self-report HAMD-6. Outpatients and inpatients who met the DSM-5 criterion for major depressive disorder (MDD) were evaluated by the Chinese self-report HAMD-6, seventeen items of Hamilton Depression Rating Scale (HAMD-17), Patient Health Questionnaire Depression Scale (PHQ-9) and Improved Clinical Global Impression Scale (iCGI-S). The internal consistency reliability, retest reliability, criterion validity and construct validity of the Chinese self-report HAMD-6 were tested. Pearson correlation coefficient was used to assess the correlativity between the total score and the item scores. By drawing the Receiver Operating Characteristics (ROC) curve, the best cut-off value, sensitivity and specificity of Chinese Adaptation self-report HAMD-6 were obtained. Cronbach's alpha coefficient of the Chinese self-report HAMD-6 was 0.91, and the intra-group correlation coefficient (ICC) of retest reliability was 0.81(P<0.01). The Spearman correlation coefficients of the Chinese self-report HAMD-6, Chinese clinician version of HAMD-6, PHQ-9 and HAMD-17 were 0.86, 0.81 and 0.86, respectively (all P<0.01). Results of the confirmatory factor analysis (CFA) supported a unidimensional construct. In addition, HAMD-17≤7 and iCGI-S=1 were taken as the remission criteria for depression disorder, and the ROC curves of the Chinese self-report HAMD-6 were plotted with a cut-off value of 3/4, the specificity and sensitivity were 0.85/0.92 and 0.96/0.93 respectively. These results suggested that the abbreviated Chinese self-report HAMD-6 has good reliability and validity among the Chinese population. This study suggested that the remission cut-off value of the scale is 3/4.

Associations between screen time and internalizing disorder diagnoses among 9- to 10-year-olds

BackgroundChildren and adolescents spend an increasing amount of time with screen media. Identifying correlates of youth mental disorders has become more urgent with rates of depression, self-harm, suicide attempts, and suicide deaths rising sharply among U.S. children and adolescents after 2012. This study examined the relationship between screen time and internalizing disorders in preadolescent children between the ages of 9 and 10. MethodsParticipants were 9- and 10-year-old youth (n = 11,780) in the baseline of the multi-site Adolescent Brain and Cognitive Development Study (ABCD). Youth reported the number of hours a day they spent watching TV shows or movies, watching videos online, playing video games, texting, using social media, and video chatting. Youth responded to an abbreviated version of the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS-5), a semi-structured clinical interview measuring current and past symptoms of internalizing disorders using DSM-5 criteria. ResultsYouth spending 2 or more hours (vs. less than 2) a day with screen media were more likely to fit criteria for depressive disorders, self-harm, and suicidal ideation or attempts, even after adjustment for demographic covariates. For anxiety disorders, associations with digital media use (social media, texting, gaming, and online videos) were stronger than with screen time generally. LimitationsThis is a cross-sectional study utilizing retrospective screen time reports, which limits our ability to determine causality and the accuracy of the reports. ConclusionsPreadolescents who spend more time using screens, especially digital media, are more likely to fit DSM-5 criteria for internalizing disorders.

Prevalence of depressive disorders and associated demographic characteristics in Shandong: An epidemiological investigation

BackgroundDepression is characterized by debilitating symptoms and high recurrence rates, and there are relatively few large-scale epidemiological surveys of depressive disorders conducted in Shandong since 2005. Data from the largest Epidemiological Survey of Mental Disorders conducted in 2015 in Shandong were collected to investigate the prevalence of depressive disorders and associated demographic characteristics in general adult population. MethodsA multi-stage stratified cluster sampling method was adopted to select residents and a two-stage screening and assessment process was used to define the prevalence and characteristics of depressive disorders. Respondents were initially screened using the General Health Questionnaire followed by a structured clinical interview using the DSM-IV criteria. ResultsAmong 27,489 respondents who completed the survey, 1277 respondents met the diagnostic criteria for depressive disorders. The adjusted prevalence in the last month was 4.86%, among which the prevalence of major depressive disorder, dysthymia, and unspecified depressive disorder were 2.32%, 1.78%, and 0.75%, respectively. 40.35% of depression patients had moderate or severe functional impairment and only 10.65% of patients had visited a psychiatric service. Univariate and multivariate analyses revealed that age, gender, occupation, education, marital status, and urban/rural living were associated with the prevalence. LimitationsThe key limitation is that this is a cross-sectional survey therefore cannot draw any causal relationship between risk factors and disease progression. ConclusionsFindings from this largest epidemiological study reveal current prevalence of depressive disorders and associated demographic factors and offers opportunities for policy makers and health-care professionals to improve mental health provision in Shandong.

Depressive Disorders and Virologic Failure in Adolescents with Perinatally Acquired HIV in Northeast Thailand

Background: Children with perinatally acquired HIV, growing into adolescence, go through a period of change during which adherence to antiretroviral therapy can decrease, and mental health disorders are most often diagnosed for the first time. Objective: To investigate the prevalence of depressive disorders and factors associated with virologic failure in adolescents with perinatally acquired HIV under care at a tertiary hospital in Northeast Thailand. Materials and Methods: The present study was a cross-sectional study conducted between June 2017 and October 2018 at Srinagarind Hospital, Faculty of Medicine, Khon Kaen University. Participants with perinatally acquired HIV aged 12 to 24 years old who disclosed their HIV status and had been taking antiretroviral therapy for at least one year were interviewed by the psychiatrist, using DSM-5 criteria of depressive disorders. The diagnosis was made concurrently with psychiatric interventions in those who met indications for treatment. Virologic failure was defined as plasma HIV-1 RNA greater than 1,000 copies/mL. Factors associated with virologic failure were evaluated by univariable and multivariable analyses. Results: Seventy-nine participants were enrolled. Their median age was 17.5 years old, with an interquartile range of 14.9 to 18.9, and 57% were female. Nine had virologic failure and 14 (17.7%) were diagnosed with depressive disorders. On multivariable analysis, depressive disorders were associated with virologic failure (adjusted odds ratio 7.55, 95% CI 1.65 to 34.65). Conclusion: The prevalence of depressive disorders in adolescents with perinatally acquired HIV was 17.7%. Depressive disorders were found to be one of the factors associated with virologic failure. Keywords: Depressive disorders; Adolescents; Perinatally acquired HIV; Virologic failure

Computerized cognitive training in people with depression: a protocol for a systematic review and meta-analysis

BackgroundPeople with depression often present with concurrent cognitive impairment. Computerized cognitive training (CCT) is a safe and efficacious strategy to maintain or enhance cognitive performance in a range of clinical populations. However, its efficacy in people with depression and how it varies across populations and design factors are currently unclear.MethodsWe searched MEDLINE, EMBASE, and PsycINFO from inception to 13 July 2021 for randomised controlled trials examining the efficacy of CCT vs any control condition on cognitive, mood, psychiatric symptoms, psychosocial, and daily functioning in adults with depression. Eligible samples include studies specifically targeting people with major depressive disorder as well as those with other diagnoses where at least 50% of the sample meets the clinical criteria for depression, with the exception of major psychiatric disorders or dementia. The primary outcome is change in the overall cognitive performance. Multivariate analyses will be used to examine the effect sizes on each outcome category as well as possible effect modifiers and correlations between categories. The risk of bias will be assessed using the Cochrane risk of bias tool version 2.DiscussionTo the best of our knowledge, this will be the first systematic review and meta-analysis of narrowly defined CCT across clinical populations with depression. We aim to investigate not only whether CCT is efficacious for cognition, but also how such effects vary across design factors, what other clinically relevant outcomes might respond to CCT, and the extent to which they differ across populations.Systematic review registrationPROSPERO CRD42020204209

Depression among young adults - risks and protective factors in the COVID-19 pandemic.

The present study aimed to assess the depression symptoms and predictors of depression in Polish young adults during online learning in the COVID-19 pandemic. The online questionnaire, including the Kutcher Adolescent Depression Scale, was distributed to young Poles through school principals. The final sample consisted of 1,500 students between the ages of 18 and 23 attending secondary schools. Multivariable logistic regression assessed the relationships between sociodemographic factors, pandemic stressors, coping behaviours and depressive symptoms. 56% of young Polish adults are experiencing significant depressive symptoms (95% CI: 1.82-13.96). Social isolation was recognized as the main stressor. Many significant predictors of depression were captured. Being female, living in the countryside, talking to parents, and participating in sports and hobbies are found to be protective factors. The following sociodemographic factors are important predictors of depression in young adults: being male, attending a secondary school, living in a large city. Experiencing stress due to pandemic and online learning is one of the risk factors for depression. The majority of young Poles met the criteria for depressive disorders. The initial findings of the presented study not only highlight the need to address mental health consequences for young people during online learning, but also provide the grounds for the development of post-pandemic interventions.

Understandings of depression among community members and primary healthcare attendees in rural Ethiopia: A qualitative study.

Available evidence in Africa suggests that the prevalence of depression in primary care settings is high but it often goes unrecognized. In this study, we explored how depression is conceptualized and communicated among community members and primary care attendees diagnosed with depression in rural Ethiopia with the view to informing the development of interventions to improve detection. We conducted individual interviews with purposively selected primary care attendees with depression (n = 28; 16 females and 12 males) and focus group discussions (FGDs) with males, females, and priests (n = 21) selected based on their knowledge of their community. Data were analyzed using thematic analysis. None of the community members identified depression as a mental illness. They considered depressive symptoms presented in a vignette as part of a normal reaction to the stresses of life. They considered medical intervention only when the woman's condition in the vignette deteriorated and "affected her mind." In contrast, participants with depression talked about their condition as illness. Symptoms spontaneously reported by these participants only partially matched symptoms listed in the current diagnostic criteria for depressive disorders. In all participants' accounts, spiritual explanations and traditional healing were prominent. The severity of symptoms mediates the decision to seek medical help. Improved detection may require an understanding of local conceptualizations in order to negotiate an intervention that is acceptable to affected people.

Multiple Chronic Condition Combinations, Affect, and Memory Among Black and White Older Adults

Research demonstrates the adverse effects of coexisting multiple chronic conditions (MCCs) on older adults’ health and wellbeing. While most research relies on total counts of chronic conditions, little work explores how specific MCC combinations may have compounding effects on depression and memory. Furthermore, no published research explores differences in the prevalence and correlates of MCC combinations between Black and White older adults. The current study assesses within- and between-group heterogeneity in the prevalence and correlates of MCC combinations to advance health equity research. We utilize a sample of 16,757 Black and White older adults drawn from the 2014 wave of the Health and Retirement Study. Respondents were categorized into one of 32 MCC combination groups. Depressive symptoms and self-rated memory were calculated separately for Black and White respondents across each of the 32 groups. Chi-square tests, t-tests, and ANCOVAs were used to compare differences. Black and White respondents differed significantly in the prevalence of 14 out of 32 MCC combinations. Within-group differences were found such that 45% of Black respondents experiencing only Lung Disease met criteria for clinical depression; this rate is similar to Black respondents experiencing Diabetes + Heart Condition + Hypertension + Lung Disease (44.5%). Between-group differences revealed that Black respondents experiencing Arthritis + Diabetes + Hypertension had worse self-rated memory than White counterparts (MB = 3.24, MW = 3.13; two sample t[1139]= -2.04, p < .05; Cohen’s d = 0.13). Additional findings are presented, and theoretical and practical implications for this work are discussed.

Bacterial Metabolites of Human Gut Microbiota Correlating with Depression.

Depression is a global threat to mental health that affects around 264 million people worldwide. Despite the considerable evolution in our understanding of the pathophysiology of depression, no reliable biomarkers that have contributed to objective diagnoses and clinical therapy currently exist. The discovery of the microbiota-gut-brain axis induced scientists to study the role of gut microbiota (GM) in the pathogenesis of depression. Over the last decade, many of studies were conducted in this field. The productions of metabolites and compounds with neuroactive and immunomodulatory properties among mechanisms such as the mediating effects of the GM on the brain, have been identified. This comprehensive review was focused on low molecular weight compounds implicated in depression as potential products of the GM. The other possible mechanisms of GM involvement in depression were presented, as well as changes in the composition of the microbiota of patients with depression. In conclusion, the therapeutic potential of functional foods and psychobiotics in relieving depression were considered. The described biomarkers associated with GM could potentially enhance the diagnostic criteria for depressive disorders in clinical practice and represent a potential future diagnostic tool based on metagenomic technologies for assessing the development of depressive disorders.

Questionable Agreement: The Experience of Depression and DSM-5 Major Depressive Disorder Criteria.

Immediately before the release of DSM-5, a group of psychiatric thought leaders published the results of field tests of DSM-5 diagnostic criteria. They characterized the interrater reliability for diagnosing major depressive disorder by two trained mental health practitioners as of "questionable agreement." These field tests confirmed an open secret among psychiatrists that our current diagnostic criteria for diagnosing major depressive disorder are unreliable and neglect essential experiences of persons in depressive episodes. Alternative diagnostic criteria exist, but psychiatrists rarely encounter them, forestalling the discipline's epistemological crisis. In Alsadair MacIntyre's classic essay, such crises occur in science when a person encounters a rival schemata that is incompatible with their current schemata and subsequently constructs a narrative that allows them to reconstruct their own tradition. In search of rival schemata that are in conversation with their own tradition, psychiatric practitioners can utilize alternative diagnostic criteria like the Cultural Formulation Interview, embrace an epistemologically humble psychiatry, and attend to the narrative experience of a person experiencing a depressive episode.