Criteria For Major Depression Research Articles

The role of lack of grandparental support in perinatal depression

BackgroundLow social support has been identified as a risk factor for perinatal mental health problems. However, previous studies mainly focused on partner support or general social support and neglected the roles of grandparents. Here, we examine whether a lack of grandparental support is related to increased risk of a diagnosis of perinatal depression. In addition, we examine whether poor grandparental support is related to more depressive symptoms in mothers with and without previously diagnosed perinatal depression and whether perceived grandparental support buffers against parenting difficulties in mothers with perinatal depression. MethodsThe sample was drawn from an Australian pregnancy cohort study and consisted of 725 women, including 230 women who met criteria for Major Depression. At 12 months postpartum, women reported on grandparental geographical proximity and hours of grandparental childcare support. Perceived grandparental support was assessed with the Postpartum Social Support Questionnaire and parenting difficulties and depressive symptoms with the Parenting Stress Index and the Edinburgh Postnatal Depression Scale. ResultsPerceived grandparental support was related to fewer depressive symptoms among mothers with perinatal depression. In addition, higher levels of perceived grandparental support were related to lower parenting stress in mothers with and without perinatal depression. LimitationsIntergenerational conflicts and quality of grandparenting were not assessed. ConclusionsOur findings indicate that supportive grandparents may prevent the development of more severe perinatal depression in mothers experiencing perinatal mental health problems. Future studies should examine whether involving grandparents in treatment may add to the effectiveness of existing perinatal mental health interventions.

Factors associated with antenatal depression among women attending antenatal care at Mubende Regional Referral Hospital: a cross-sectional study

IntroductionThis study aimed to investigate the prevalence, severity, and factors associated with antenatal depression among women receiving antenatal care at Mubende Regional Referral Hospital (MRRH) in Uganda. Antenatal depression is a critical concern for maternal and child well-being, as it is associated with adverse outcomes such as preterm birth, abortion, low birth weight, and impaired maternal-infant bonding. Despite several international guidelines recommending routine screening for antenatal depression, local Ugandan guidelines often overlook this essential aspect of maternal care.MethodsA cross-sectional study involving 353 pregnant women utilized the Patient Health Questionnaire 9 (PHQ-9) to assess antenatal depression. Participants were categorized as having antenatal depression if their total PHQ-9 score was ≥ 5 and met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for either major or minor depression. Psychosocial demographic and obstetric characteristics were recorded. Logistic regression analysis identified factors linked to antenatal depression.ResultsThe burden of antenatal depression was notably high, affecting 37.68% of the participants. Among those with antenatal depression, the majority exhibited mild symptoms 94 (70.68%). The significant factors associated with antenatal depression, revealed by multivariate analysis, included younger age (≤ 20 years), older age (≥ 35 years), history of domestic violence, alcohol use, gestational age, history of abortion, history of preeclampsia, and unplanned pregnancies.ConclusionThis study revealed a significantly high prevalence of antenatal depression, emphasizing its public health importance. Most cases were classified as mild, emphasizing the importance of timely interventions to prevent escalation. The identified risk factors included age, history of domestic violence, alcohol use, first-trimester pregnancy, abortion history, previous preeclampsia, and unplanned pregnancy.

The Role of State Versus Trait Anxiety on Cognition in Older Adults With Major Depressive Disorder

ObjectiveAnxiety superimposed on late life depression (LLD) results in greater changes to prefrontal and medial temporal brain regions compared to depression alone. Yet, the combined impact of anxiety and depression on cognition in LLD has not been thoroughly investigated. The current study investigated whether annual changes in state and trait anxiety were associated with cognitive changes in older adults with major depression. We hypothesized that the presence of anxiety among older depressed adults would be associated with worse cognitive performance in the domains of memory and executive functioning over time. DesignThree-year longitudinal observational study of older adults with LLD who were offered antidepressant treatment. SettingAcademic Health Center. MethodsParticipants included 124 adults aged 60+ who met criteria for major depression at baseline. The association between anxiety and cognition was examined with separate multilevel linear models that addressed both between-subject and within-person effects of state and trait anxiety on cognitive functioning tests. ResultsIndividuals who experienced annual increases in anxiety above his/her personal average also experienced cognitive decline. Increases in state anxiety were associated with declines in memory and global cognition. By contrast, increases in trait anxiety were associated with declines in mental flexibility and memory. These findings remained significant even when controlling for changes in depression over time. ConclusionIn LLD, individual increases in state and trait anxiety were associated with cognitive declines in different domains.

Maternal major depression during early pregnancy is associated with impaired child executive functioning at 4.5 years of age

BackgroundMaternal depression is a serious condition that effects up to 1 in 7 pregnancies. Despite evidence linking maternal depression to pregnancy complications and adverse fetal outcomes, there remain significant gaps in its identification and treatment. More work is needed to define the specific timing and severity of depression that most urgently requires intervention, where feasible, to protect maternal health and the developing fetus. ObjectiveTo examine whether the timing and severity of maternal depression and/or anxiety during pregnancy effects child executive functioning at age 4.5 years. Executive functioning in the pre-school years is a strong predictor of both school readiness and long term quality of life. Study DesignThis longitudinal observational pregnancy cohort study included a sample of 323 mother-child dyads taking part in the Ontario Birth Study, an open pregnancy cohort in Toronto, Ontario, Canada. Maternal symptoms of depression and anxiety were assessed at 12-16 and 28-32 weeks of pregnancy, and at the time of child testing at age 4.5 years, using the 4-item Patient Health Questionnaire. Child executive functioning was measured during a home visit using standardized computerized administration of the Flanker test (a measure of attention) and the Dimensional Change Card Sort (a measure of cognitive flexibility). Stepwise linear regressions, controlling for possible confounding variables, were used to assess the predictive value of continuous measures of maternal depression and/or anxiety symptoms at each assessment time on the Flanker and Dimensional Change Card Sort. Post-hoc general linear models assessed whether maternal depression severity categories (no symptoms, mild symptoms, probable major depressive disorder) were helpful in identifying children-at-risk. ResultsAcross all children, after controlling for potential confounds, greater maternal depressive symptoms at weeks 12-16 of pregnancy predicted worse performance on both the Flanker test (ΔR2=0.058, p < .001) and the Dimensional Change Card Sort (ΔR2 = 0.017, p = 0.018). Post-hoc general linear modelling further demonstrated that the children of mothers meeting screening criteria for major depression in early pregnancy scored 11.3 % lower on the Flanker test, and 9.8 % lower on the Dimensional Change Card Sort, than did children exposed to no maternal depressive symptoms in early pregnancy. Mild depressive symptoms had no significant effect on executive function scores. There was no significant effect of anxiety symptoms or maternal anti-depressant use in early pregnancy, nor of pandemic conditions or maternal symptoms in later pregnancy or at the time of child testing on either the Flanker or Dimensional Change Card Sort results. ConclusionThis is the first study to demonstrate that during weeks 12-16 of pregnancy, fetal exposure to maternal major depression, but not milder forms of depression, associates with impaired executive functioning in the pre-school years. Child executive functioning is critical for school readiness and predicts long-term quality of life. This emphasizes an urgent need to improve the recognition and treatment of maternal major depression, particularly in early pregnancy, to limit its negative effects on the patient and on child cognitive development.

59 The Impact of Anxiety on Memory Performance in Older Adults with Depression

Objective:Late life depression (LLD) refers to a diagnosis of major depressive disorder in people older than 60, and has been linked to significant cognitive impairment and increased risk of Alzheimer's disease. Although anxiety and depression are highly comorbid, the impact of anxiety on cognition in LLD is far less researched. This is important given that over 20% of middle aged and older adults endorse clinically significant chronic worry. Generalized anxiety disorder in older adults with major depression is associated with poorer cognition and worse treatment outcomes compared with those without anxiety. Therefore, the purpose of the study is to examine the role of anxiety on memory in LLD. We hypothesized that presence of anxiety among older depressed adults would be associated with worse cognitive performance over time.Participants and Methods:Participants included 124 individuals (69.4% female, 90.3% Caucasian) aged 60 or above (M = 71.5, SD = 7.4) who met criteria for major depression, single episode or recurrent. They completed the State Trait Anxiety Inventory, Montgomery Asberg Depression Rating Scale, and a measure of verbal episodic memory (WMS-IV Logical Memory) as part of a larger neuropsychological battery. Data were collected from baseline to three years as part of a larger NIMH-supported longitudinal study. Two-level linear mixed-effect models were fitted to predict memory. State and trait anxiety were used as time-varying predictors. The between-person (level 2) and within-person (level 1) effects of anxiety on memory were assessed controlling for the time trend, age, education, gender, race, and change in depression over time.Results:Plot trajectories across variables revealed a negative correlation such that as anxiety decreased, memory improved over time. Hierarchical linear mixed-effect models revealed that average state anxiety was a marginally significant between-person (level2) predictor for memory [B=-0.041, t(128)=-1.8, p=0.083]. Individuals with greater average state anxiety were more likely to experience memory decline compared to those with lower average state anxiety. In addition, the within-person effect (level 1) of state anxiety was significant [B=-0.096, t(253)=-2.7, p=0.007]. As an individual's anxiety increased over time, their memory declined. Trait anxiety showed a significant within-person effect on memory [B=-0.087, t(254)=-2.0, p=0.048], but a non-significant between-person effect [B=-0.005, t(124)=-0.06, p=0.95].Conclusions:Anxiety appears to increase the risk of memory decline in older adults with major depression, a cohort who are already at risk of cognitive decline. Changes in anxiety increased risk of memory decline even when accounting for changes in depression over time. Although the causal link between anxiety and cognitive impairment remains unclear, it is possible that anxiety and worry may compete for cognitive resources necessary for demanding tasks and situations, detracting from abilities, such as attention and working memory. Older adults with depression may also have difficulty coping adaptively with anxiety, which may negatively affect cognition. Finally, presence of anxiety may represent a form of mild behavioral impairment, a prodrome of cognitive decline leading to dementia. Overall, the present study highlights the negative impact of anxiety on memory performance, indicating that treatment interventions targeting anxiety in older adults are essential to help prevent cognitive decline.

Are depressive and other mood disorders best conceptualized as disorders of energy, and related motor activity, rather than mood?

The most basic distinction between depressive (and other mood) disorders and other major mental disorders is the notion that they are primarily mood or affective disorders and not fundamentally perturbations of other cognitive, perceptual, motor, communication, impulse, sleep−wake, fear-response, arousal, developmental or personality functions. The primacy of mood or affective state is captured in the ‘core’ criteria for major depression (depressed mood or loss of pleasure) and the other major mood disorders (e.g., for dysthymia – prolonged depressed mood) (American Psychiatric Association, 2013). For bipolar disorder, while the presence of manic features (with increased motor activity) (Scott et al., 2017) is the core element, the depressive phase is described in similar terms, with the emphasis on the same shared features of major depression (i.e., depressed mood or loss of pleasure).

Depression in Children with Epilepsy in a Teaching Hospital South/South Nigeria

Background: Epilepsy affects over 50 million in the world with a life time prevalence of 7.6%. It is the commonest paediatric neurological disorder and about 80% of these children live in the developing countries. Depression is the most common psychiatric comorbid condition in children with epilepsy.&#x0D; Objective: To investigate the prevalence of depression among children aged 9-18yr with epilepsy and evaluate factors associated with depression.&#x0D; Methods: 380 children with epilepsy were interviewed using researcher designed questionnaire, the clinical version of DICA-IV in a 2nd stage design, after having been screened with CES-DC. The study was descriptive with psychometric evaluation. Data obtained were analysed using SPSS version 22.0. p-values&lt;0.05 were statistically significant.&#x0D; Results: Using the CES-DC with a cut- off point of 15 and above, 117 (30.8%) of the respondents had significant scores for depression. All the 117 who were interviewed with DICA-IV met the DSM-IV criteria for major depression with 40 (10.5%) of them currently very depressed requiring urgent attention. Sociodemographic factors of; sex revealed that males were more depressed than females p=0.000, OR: 0.86, Age showed 9-11yr with a strong association p=0.001, OR:1.91. Marital status- Divorced or separated parents showed a higher association p=0.01 OR:2.233. Children with longer duration of illness had a strong association p=0,025, OR:1.203 and the more frequent the seizures, the stronger the association p=0.001, OR:1,411.&#x0D; Conclusion: There is relativelhjy high prevalence of depression in children with epilepsy in Port Harcourt. More health education is needed to provide a comprehensive care.

A population-based twin study of the symptomatic diagnostic criteria for major depression that occur within versus outside of major depressive episodes.

Are genetic risk factors for current depressive symptoms good proxies for genetic risk factors for syndromal major depression (MD)? In over 9000 twins from the population-based Virginia Adult Twin Study of Psychiatric and Substance Use Disorders, the occurrence of all nine DSM symptomatic criteria for MD in the last year was assessed at personal interview and then grouped by their temporal co-occurrence. The DSM criteria which occurred outside (OUT) v. inside of (IN) MD episodes were then separated. We calculated tetrachoric correlations for OUT and IN depressive criteria in monozygotic (MZ) and dizygotic (DZ) pairs and fitted univariate and bivariate ACE twin models using OpenMx. The mean twin correlations (±95% CIs) for IN depressive criteria were substantially higher than for OUT depressive criteria in both MZ [+0.35 (0.32-0.38) v. 0.20 (0.17-0.24)] and DZ pairs [0.20 (0.17-0.24) v. 0.10 (0.04-0.16]. The mean IN-OUT cross-correlation in MZ and DZ pairs was modest [+0.15 (0.07-0.24) and +0.07 (0.03-0.12)]. The mean heritability estimates for the nine In v. Out depressive criteria was 0.31 (0.22-0.41) and 0.15 (0.08-0.21), in MZ and DZ pairs, respectively. The mean genetic correlation between the nine IN and OUT depressive criteria was +0.07 (-0.07 to 0.21). Depressive criteria occurring outside depressive episodes are less heritable than those occurring within. These two ways criteria can manifest are not closely genetically related. Current depressive symptoms - most of which are occurring outside of depressive episodes - are not, for genetic studies, good proxies for MD.

Maternal attachment state of mind and perinatal emotional wellbeing: Findings from a pregnancy cohort study

ObjectivesMaternal attachment state of mind is an important potential predictor of risk and resilience to perinatal emotional wellbeing and early parenting. To explore maternal attachment in relation to perinatal depression and emotional wellbeing. MethodsThis study drew on data collected within an ongoing cohort from 170 women recruited in early pregnancy, including 67 who met criteria for Major Depression. Maternal attachment state of mind was assessed with the Adult Attachment Interview (AAI) in pregnancy. Additional measures included the Structured Clinical Interview for the DSM (SCID), at 12 months the Strange Situation Procedure (SSP), Child Trauma Questionnaire (CTQ), Parenting Stress Index, and antenatal maternal hair cortisol concentrations (HCC). LimitationsSample size to be able to undertake all analyses using the 4 way classifications, cortisol measurement is limited to hair only and there is no prospectively collected measure of childhood trauma in mothers. ConclusionsThis study found that maternal attachment, specifically the Non-Autonomous states of mind, adjusted for clinical depression, was associated with higher cortisol in pregnancy and higher depressive symptoms across pregnancy and the postpartum. Furthermore, separately those with depression and Non-Autonomous states of mind also had higher postpartum parenting stress. There was no significant intergenerational concordance between AAI and SSP attachment classifications. Our findings support future research exploring the role of maternal attachment state of mind in understanding perinatal depression and emotional wellbeing.

Depression, Perceived Risk of COVID-19, Loneliness, and Perceived Social Support from Friends Among University Students in Poland, UK, and India.

The study examines the prevalence of depression among university students in Poland, the UK and India in the face of the second pandemic wave of COVID-19. The paper also examines the protective role of perceived social support, the hypothesis being that social support from friends would reduce depression. The data from university students (N=732) in Poland (N=335), UK (N= 198), and India (N=199) were collected online during of the fall/winter 2021. Participants completed measures of depression (CES-D), COVID-19 risk perception index, loneliness (DJGLS), and perceived social support (MSPSS). Almost 52% of all participants (58.5% in Poland, 62.6% in the UK, and 29.1% in India) met the criteria for major depression. The higher levels of depression symptoms were associated with a higher perceived risk of COVID-19, greater loneliness, female gender, younger students' age, and the lower levels of perceived social support. The greater family support predicted lower levels of depression symptoms in the Polish and Indian samples. Structural equation analyses (SEM) revealed the indirect effect of perceived social support from friends on the association between social loneliness and depression and between age and depression. This result shows that the support from friends significantly reduced depression, regardless of age, the level of social loneliness, and the perceived risk of COVID-19. Our conclusions link to university specialists' enhancement of psychological help for students with depression. We also recommend information campaigns on depression and treatment options.

Influences on Stress Load in Young Girls with Major Depression

Based on former empirical studies and theoretical models the present study investigated, whether stress symptoms, stress coping, and activity of HPA axis are different in girls with major depression compared to non-depressed controls. 148 girls with a mean age of 15 years were studied twice with 6 months between the two assessments. 74 fulfilled DSM IV criteria for major depression at first assessment. Stress symptoms and stress coping were measured with validated German questionnaires. The cortisol awakening response was analyzed by collecting saliva samples. Depressed girls showed a greater stress load, which was significantly influenced by stress coping strategies. HPA axis activity was heightened in depressed girls, but does not seem to have an influence on stress load.

The Serum Brain-Derived Neurotrophic Factor Increases in Serotonin Reuptake Inhibitor Responders Patients with First-Episode, Drug-Naïve Major Depression

Brain-derived neurotrophic factor (BDNF) is a growth factor synthesized in the cell bodies of neurons and glia, which affects neuronal maturation, the survival of nervous system, and synaptic plasticity. BDNF play an important role in the pathophysiology of major depression (MD). The serum BDNF levels changed over time, or with the improvement in depressive symptoms. However, the change of serum BDNF during pharmacotherapy remains obscure in MDD. In particular, the changes in serum BDNF associated with pharmacotherapy have not yet been fully elucidated. The present study aimed to compare the changes in serum BDNF concentrations in first-episode, drug-naive patients with MD treated with antidepressants between treatment-response and treatment-nonresponse groups. The study included 35 inpatients and outpatients composed of 15 males and 20 females aged 36.7 ± 6.8 years at the Department of Psychiatry of our University Hospital. All patients met the DSM-5 diagnostic criteria for MD. The antidepressants administered included paroxetine, duloxetine, and escitalopram. Severity of depressive state was assessed using the 17-item HAMD before and 8 weeks after drug administration. Responders were defined as those whose total HAMD scores at 8 weeks had decreased by 50% or more compared to those before drug administration, while non-responders were those whose total HAMD scores had decreased by less than 50%. Here we showed that serum BDNF levels were not significantly different at any point between the two groups. The responder group, but not the non-responder group, showed statistically significant changes in serum BDNF 0 and serum BDNF 8. The results suggest that the changes of serum BDNF might differ between the two groups. The measurement of serum BDNF has the potential to be a useful predictor of pharmacotherapy in patients with first-episode, drug-naïve MD.

Value of Heart Rate Variability, Neutrophil-Lymphocyte Ratio and Quality of Life of Patients with Depressive Symptoms in Acute Myocardial Infarction

Introduction. Major depression criteria can be found in more than 20% of coronary heart patients and more than 30% acute coronary syndrome patients have significant depressive symptoms. Several studies have shown that reduction of hearth rate variability (HRV) and enhancement of neutrophil lymphocyte ratio (NLR) can cause enhancement of morbidity and mortality in myocardial infarction patients. On the other hand, depression can cause reduction of HRV, enhancement of NLR and reduction of quality of life. This study aimed to determine differences in HRV, NLR and quality of life between acute myocardial infarction (AMI) patients with depressive symptoms and AMI patients without depressive symptoms. Methods. A cross-sectional study was conducted among AMI patients who were treated during the period of March to July 2021 at the Intensive Cardiac Care Unit (ICCU) Cipto Mangunkusumo Hospital Jakarta. Samples were taken consecutively until the amount of sample is met. Data were analyzed using unp aired T test. Results. There was a total of 46 subjects AMI patients in this study, ten subjects with depressive symptoms and 36 subjects without depressive symptoms. From the analysis, it was found that AMI patients with depressive symptoms had lower standard deviation normal to normal (SDNN) average (p=0.447), lower low frequency/high frequency (LF/HF) (p=0.323), and higher NLR average (p=0.438) than AMI patients without depressive symptom, although it was not statistically significant. Analysis showed that the mean value of SF36 total scores (p<0.001), physical function domain scores (p<0.001), energy domain scores (p<0.001), mental health domain scores (p<0.001), social function domain scores (p=0.028), bodily pain domain scores (p=0.002), and general health domain scores (p=0.002) were lower in AMI patients with depressive symptoms. Conclusion. AMI patients with depressive symptoms had lower SDNN, lower LF/HF, and higher NLR than AMI patients without depressive symptoms, although it was not statistically significant. AMI patients with depressive symptoms significantly have lower quality of life than AMI patients without depressive symptoms.

Associations Between Mild Behavioral Impairment (MBI‐C) Affective Domains and Alzheimer’s Disease Neuroimaging Biomarkers in Older Adults

AbstractBackgroundPrevious work has shown that neuropsychiatric symptoms (NPS) such as depression in older adults are associated with cognitive decline and brain pathology related to Alzheimer’s disease (AD), but the constellation of NPS driving these associations is unclear. Traditionally, depressive symptoms have been assessed with the Geriatric Depression Scale (GDS), but newer NPS assessments, such as the Mild Behavioral Impairment‐Checklist (MBI‐C), have shown promise for identification of specific early features of symptomology. Here we examined the two affective domains of the MBI‐C in cognitively unimpaired older adults with moderate‐to‐severe depressive symptoms and non‐depressed older adults, and the association between these domains and neuroimaging biomarkers of AD.Method21 clinically normal (CN) older adults who met DSM5 criteria for major depression (MDD) (73.0±4.3 y.o., 62% female) and 25 non‐depressed older adults from related observational studies at our site (70.8±3.7 y.o., 64% female) underwent a clinical battery that included the GDS and MBI‐C self‐report domains focused on decreased interest‐motivation‐drive and increased dysphoria‐anhedonia‐anxiety (Range for each domain: 0–18). Participants completed neuroimaging consisting of MRI, amyloid‐(C11‐PiB)‐PET, and tau‐(F18‐FTP)‐PET. We focused analyses on neocortical amyloid and regional tau and atrophy in the amygdala and hippocampus. A Pearson correlation was used to assess the association between GDS total score and MBI‐C component scores. Linear regressions adjusted for age were used to investigate relationships between MBI‐C domains and ATN biomarkers.ResultGDS total score was correlated with both MBI‐C domains across all participants (Fig.1, p&lt;0.01). In participants with MDD, the MBI‐C decreased interest‐motivation‐drive domain was associated with elevated FTP in the amygdala and hippocampus, while the increased dysphoria‐anhedonia‐anxiety domain was not significantly related to PET signal (Table 2, Fig.2). MBI‐C domains were not related to PET signal or atrophy in non‐depressed control participants.ConclusionPreliminary findings with the MBI‐C suggest that the decreased interest‐motivation‐drive domain may be associated with tau pathology in older adults with moderate‐to‐severe depression. Additional work needs to be done in a larger depressed cohort to further understand the associations between specific depressive phenotypes and AD pathology.

The prognostic role of fatigue, depression and anxiety on postoperative outcomes after pancreatectomy for pancreatic cancer. A prospective observational study (FAT-PRO study)

ObjectivesThis study aims to assess the prevalence of preoperative fatigue, depression and anxiety among patients undergoing pancreatic surgery for pancreatic cancer (PC), and possible relationship with postoperative outcomes. MethodsProspective data from 162 consecutive patients undergoing pancreatectomy for PC at a third-level referral centers for pancreatic surgery were collected. All patients preoperatively completed four questionnaires assessing depression (PHQ-9), anxiety (STAI-Y2), chronic illness fatigue (FACIT-F) and cancer therapy fatigue (FACT-G). ResultsForty patients (25%) where in the first quartile for chronic illness (FACIT-F ≤34) and/or cancer therapy (FACT-G ≤78) fatigue, 26 patients (16%) met the criteria for major depression (PHQ-9 ≥10) and 34 patients (21%) had anxiety symptoms (STAI-Y2 ≥40). Cancer therapy fatigue was significantly associated with higher rates of morbidity (70% vs 49%), major morbidity (Clavien-Dindo ≥3) (28% vs 11%), post-pancreatectomy hemorrhage (18% vs 4%), pulmonary complications (20% vs 9%) and mortality (8% vs null) (all P ≤ 0.01). Major depression was associated with higher rates of post-pancreatectomy hemorrhage and readmission (23% vs 5%). Multivariable logistic regression analysis of preoperative factors confirmed diabetes (OR 2.71, 95%CI 1.01–7.20; P = 0.04), ASA score ≥3 (OR 4.12, 95%CI 1.52–11.21; P < 0.01) and cancer therapy fatigue (OR 2.95, 95%CI 1.01–8.74; P = 0.04) to be independent predictors of major morbidity. ConclusionsHigher levels of fatigue (in particular cancer therapy fatigue) strongly correlates with worse postoperative outcomes.

No interaction between plasma IL-6 and MHPG in major depression treated with paroxetine

We investigated the plasma levels of MHPG, a metabolite of noradrenaline or IL-6, and the clinical response to paroxetine in major depression (MD). Twenty-eight patients who met the MD criteria as per DSM-5 were enrolled in this study (age 42 ​± ​8 years; male/female 15/13; single-/repeated-episode 12/16). The plasma levels of MHPG were not altered before or four weeks after paroxetine treatment. Plasma levels of IL-6 were significantly decreased 4 weeks after paroxetine treatment. The HAMD scores significantly decreased after paroxetine treatment. No correlation was found between changes in plasma MHPG and changes in HAMD scores before and 4 weeks after paroxetine treatment. No interaction was observed between plasma MGPH and plasma IL-6 in patients with MD treated with paroxetine. • Plasma levels of IL-6 were significantly decreased 4 weeks after paroxetine treatment. The HAMD scores significantly decreased after paroxetine treatment. • No correlation was found between changes in plasma MHPG or IL-6 and changes in the HAMD scores before and 4 weeks after paroxetine treatment. • No interaction was observed between plasma MGPH and plasma IL-6 in patients with MD treated with paroxetine.

The Significance of Somatic Complaints for Maintenance of Depression in Young Girls

Based on former empirical studies and theoretical models the present study investigated, whether stress symptoms, stress coping and somatic complaints are different between depressed girls and healthy controls. 148 girls with a mean age of 15 years were studied twice with 6 months between the two assessments. 74 fulfilled DSM IV criteria for major depression at first assessment. Stress symptoms, stress coping and somatic complaints were measured with validated German questionnaires. Depressed girls showed more stress symptoms and a higher stress vulnerability. On the other hand in stress coping depressed girls preferred destructive strategies and had a lack of useful behaviors such as problem solving or search for social support. Somatic complaints had a significant influence on severity of depression six months later. The results were interpreted with respect to the cognitive model of Beck.

Post-awakening salivary alpha-amylase as modulator of treatment response in patients with burnout and major depression

Around 50% of patients with major depression do not respond to standard first-line treatments, such as psychotherapy and pharmacotherapy. At the same time, a subgroup exhibits altered functioning of stress-responsive bodily systems, such as the central locus coeruleus/sympathetic nervous system and the hypothalamic-pituitary-adrenal (HPA) axis. Given that these systems impact arousal and cognition, it is possible that this subgroup contributes to the high rates of non-responders. Our aim was to investigate whether sympathetic and HPA axis activity modulate treatment outcomes in patients with stress-related major depression. A total of N = 74 inpatients (median age: 50, 62% male) with signs of burnout who fulfilled diagnostic criteria for major depression were recruited. Saliva samples were collected at awakening as well as 30 and 45 min later. Alpha-amylase activity and cortisol concentrations were determined before patients underwent evidence-based multimodal treatment. Non-responders were defined as patients exhibiting a <50% decrease in depression on the Beck Depression Inventory. Non-responders had significantly higher post-awakening alpha-amylase activity than responders (p = .025). In addition, alpha-amylase activity increased significantly over the course of treatment (p = .004), irrespective of responder status. Post-awakening cortisol was neither a predictor nor an indicator of treatment response. If future research confirms alpha-amylase activity as a modulator of treatment response, this may indicate a subgroup of patients with major depression which may benefit from augmentative treatments, such as heart rate variability biofeedback and/or cognitive interventions targeting high arousal.

Housing instability and mental health among renters in the michigan recession and recovery study

ObjectiveTo examine whether housing instability—inclusive of eviction, homelessness, moving in with others, moving for cost reasons, or frequent moves—is associated with mental health among renters in the aftermath of the Great Recession of 2007–09. Study designA panel survey study. MethodsWe used data from the Michigan Recession and Recovery Study (2009–10, 2011 and 2013), a population-representative sample of working-aged adults, and logistic regression with propensity score weights to examine the association between housing instability over a year and a half and anxiety attack or depression symptoms at follow-up. ResultsRespondents with any housing instability were 14 percentage points more likely to have had a recent anxiety attack, and those who had moved for cost reasons were 16 percentage points more likely. Respondents who experienced eviction were significantly more likely to meet criteria for major or minor depression at follow-up, by 13 percentage points. ConclusionsPrior evidence of an association between housing instability and mental health is supported by these findings, which are robust to potential confounders, including financial and life shocks, housing quality, and neighborhood poverty concentration.

Determinants of Stress Coping in Young Girls with Major Depression

Based on former empirical studies and theoretical considerations the present study investigated differences in stress load and stress coping between adolescent girls with major depression and controls. In addition a biological indicator of chronic stress (the cortisol awakening response) was measured. 148 girls with a mean age of 15 years were studied and assessed twice with a time interval of six months in between. 74 fulfilled DSM IV criteria for major depression at first assessment. Stress symptoms and stress coping was measured with SSKJ 3-8 and SVFKJ, which are validated German questionnaires. Linear multiple regression was used to identify the variables which influence stress coping. Depressed girls reported a significantly higher stress load and significantly more destructive stress coping. The best prediction was found for a resignative coping strategy with initial degree of depression as best predictor. When using a lack of positive self instruction as dependent variable the cortisol awakening response also contributed significantly to the amount of explained variance. Because initial degree of depression seemed to determine the later inadequate coping strategies prevention programs for depression in adolescents are recommended.