Depression Disturbance Research Articles

Antidepressants administration in rheumatoid arthritiswith comorbid depression

Objective. To study comorbid depression influence on course of rheumatoid arthritis (RA)and antidepressants efficacy in such pts. Material and methods. 70 pts with RA (all women) fulfilled the 1987 ACR criteria with comorbid depression disturbances were included. 30 from them received course of treatment with antidepressants (main group). 20 refused proposed therapy (main control group). 20 RA pts without depression were included in an additional control group which was also followed up. Hamilton scales of depression and anxiety were used. Results. Baseline clinical measures did not significantly differ between study groups. Antidepressants application in main group pts was accompanied by significant improvement of tender and swollen joint count, morning stiffness duration, pain intensity (score),functional disability index (FDI) after 3 months (<0,001,<0,001, <0,01, <0,001,<0,001). This improvement further increased to sixth month of follow up. Comparison of main and additional control groups showed better outcome in the absence of comorbid depression and its negative influence on results of treatment. Conclusion. Effective treatment of depression with modern antidepressants (selective inhibitors of reverse serotonin capture) in pts with RA improves clinical course of the disease, its prognosis and pts quality of life.

Does sleep disturbance mediate neuropsychological functioning in older people with depression?

Background Depression in older adults is associated with neuropsychological dysfunction, fronto-subcortical brain changes and sleep disturbance. Research suggests that adequate sleep is critical for many aspects of cognition including processing speed, verbal skills and memory. However, the association between sleep disturbance and neuropsychological functioning in depression has not been well evaluated. The current study therefore aimed to investigate these relationships. Methods Forty-eight people (mean age = 59.6, sd = 8.2) meeting DSM-IV criteria for unipolar major depression were included for analysis. Neuropsychological assessment included assessment of processing speed, learning and memory, verbal fluency and executive functions. Early and late insomnia were defined by scores on the Hamilton Depression Rating Scale. Results While early insomnia was related to depression severity and poorer global cognition, late insomnia was associated with later age of depression onset, depression severity, and poorer scores on tests of verbal fluency and memory. The associations between cognition and late insomnia were not accounted for by depression severity or age of onset of disorder. Limitations This study was retrospective in nature, and did not include objective measures of sleep. Conclusions This is the first known study to indicate that late insomnia in older people with major depression may be independently and aetiologically linked to neuropsychological performance, particularly verbal fluency and memory. It may also indicate underlying structural and neurochemical changes. Sleep and circadian disturbance may serve as a biomarker for ongoing cognitive decline and may be a potentially modifiable risk factor.

Relationship between body image disturbance and incidence of depression: the SUN prospective cohort.

BackgroundBody image disturbance is an increasing problem in Western societies and is associated with a number of mental health outcomes including anorexia, bulimia, body dysmorphia, and depression. The aim of this study was to assess the association between body image disturbance and the incidence of depression.MethodsThis study included 10,286 participants from a dynamic prospective cohort of Spanish university graduates, who were followed-up for a median period of 4.2 years (Seguimiento Universidad de Navarra – the SUN study). The key characteristic of the study is the permanently open recruitment that started in 1999. The baseline questionnaire included information about body mass index (BMI) and the nine figure schemes that were used to assess body size perception. These variables were grouped according to recommended classifications and the difference between BMI and body size perception was considered as a proxy of body image disturbance. A subject was classified as an incident case of depression if he/she was initially free of depression and reported a physician-made diagnosis of depression and/or the use of antidepressant medication in at least one of the follow-up questionnaires. The association between body image disturbance and the incidence of depression was estimated by calculating the multivariable adjusted Odds Ratio (OR) and its 95% Confidence Interval (95% CI), using logistic regression models.ResultsThe cumulative incidence of depression during follow-up in the cohort was 4.8%. Men who underestimated their body size had a high percentage of overweight and obesity (50.1% and 12.6%, respectively), whereas women who overestimated their body size had a high percentage of underweight (87.6%). The underestimation exhibited a negative association with the incidence of depression among women (OR: 0.72, 95% CI: 0.54 – 0.95), but this effect disappeared after adjusting for possible confounding variables. The proportion of participants who correctly perceived their body size was high (53.3%) and gross misperception was seldom found, with most cases selecting only one silhouette below (42.7%) or above (2.6%) their actual BMI.ConclusionWe found no association between body image disturbance and subsequent depression in a cohort of university graduates in Spain.

NAPSAQ-1: National Patient Sleep Assessment Questionnaire in depression

Objectives. Sleep disturbance is a common feature of depression. Symptoms often persist after treatment of the depressive episode, representing a risk factor for relapse. There is a lack of data regarding the nature of sleep disturbance in depression in the UK. Methods. We surveyed patients’ views about their depressive symptoms and associated sleep difficulties. We received 513 responses via postal questionnaire. Results. A total of 97% reported sleep difficulties during depression: symptoms of insomnia were more frequently reported than hypersomnia. Ninety-nine percent of those with sleep problems also reported daytime symptoms including lack of concentration, exhaustion and lethargy, no energy and feeling sleepy; 40% admitted napping during the day; 59% indicated that poor sleep greatly affected their quality of life (QOL); 34% considered it to be “very distressing”; 69% of respondents were taking antidepressant medication at the time (44% said it improved their sleep, 56% said it had no effect or worsened their sleep); 69% had sought extra treatment for their sleep problems. Conclusions. Sleep disturbance in depression is a common and distressing problem that seems relatively unresolved by treatment. There is a need for more successful management in order to improve QOL in these patients and reduce a factor in depressive relapse.

Escitalopram in Treatment of Sleep Disturbances in Major Depressive Disorder

Major depressive disorder (MDD) is common and severe affective disorder with sleep disturbances and non-bizarre delusions which are organized in permanent and unshakeable delusional system. Neurobiological basis of MDD is still completely unknown, but significant role has serotoninergic and noradrenergic neuronal systems. Escitalopram is highly potent and highly selective serotonin re-uptake inhibitor.Purpose of this study was to estimate efficacy of the escitalopram in treatment of sleep disturbances in MDD.Methods:This prospective clinical study included 95 patients diagnosed by ICD-10 criteria for MDD, who are randomly divided into control (30 patients) and experimental group (65 patients). Patients were observed for 6 months in hospital and outpatients conditions, according to specially designed protocol, which included Hamilton Depression Rating Scale (HAMD) and Leeds Sleeping Evaluation Questionnaire (LSEQ). Control group was treated with maprotiline (75-150 mg/24h) and experimental group with escitalopram (10-20 mg/24h).Results:Escitalopram therapy influenced on HAMD score with high statistical significance vs. maprotiline, p=0.000. Escitalopram therapy improves LSEQ score after 6 months in comparison to maprotiline therapy with high statistical significance p=0.000. Percentage of adverse effects is significantly lower in escitalopram (10.76%) than in maprotiline (26.67%) group.Conclusion:Escitalopram has significantly better efficacy and lower adverse effects rate in treatment of depressive symptoms and sleep disturbances in MDD patients comparing to maprotiline.

Anxiety and depression disturbances in some chronic skin diseases

A Hospital Anxiety and Depression Scale (HADS) was applied to follow-up the degree of anxiety and depression of 61 patients with skin diseases, 32 males and 29 females aged between 21 and 68 years occasionally examined in the outpatient consulting room of the Clinic of dermatovenereology at the Medical University of Varna. The results vary within the limits of slight to moderate aberrations. They demonstrate, however, a high level of comorbidity between anxiety and depression. In this respect, anxiety disorders occupy a leading position. Scripta Scientifica Medica 2008; 40(2): 165-166.

Sleep disorders as core symptoms of depression

Links between sleep and depression are strong. About three quarters of depressed patients have insomnia symptoms, and hypersomnia is present in about 40% of young depressed adults and 10% of older patients, with a preponderance in females. The symptoms cause huge distress, have a major impact on quality of life, and are a strong risk factor for suicide. As well as the subjective experience of sleep symptoms, there are well-documented changes in objective sleep architecture in depression. Mechanisms of sleep regulation and how they might be disturbed in depression are discussed. The sleep symptoms are often unresolved by treatment, and confer a greater risk of relapse and recurrence. Epidemiological studies have pointed out that insomnia in nondepressed subjects is a risk factor for later development of depression. There is therefore a need for more successful management of sleep disturbance in depression, in order to improve quality of life in these patients and reduce an important factor in depressive relapse and recurrence.

Depression and body image disturbances among females seeking treatment for obesity in Saudi Arabia

Hypothesis: Obesity is an increasingly prevalent disease around the world and is becoming one of the main public health problems in developed countries. The relationship between obesity and psychological distress continued to be debated by researchers and clinicians. This study aimed to assess depression and body image disturbances in obese patients seeking treatment for obesity. Method : A case-control design was adopted in the study. Total of (236) obese women, self-referred to a residential weight-loss facility for weight control, were invited to participate in this study. Obese women were compared with (296) of an age-matched control group. All participants completed the Beck Depression Inventory for depressive symptoms, Multidimensional Body-Self Relations Questionnaire for body-image satisfaction and The Body Image Avoidance Questionnaire. Results : revealed that obesity were more common among older than younger females, among married than single females, and among those with lower level of education than those with higher level. Obese women as compared with non-obese reported significantly more symptoms of depression and significantly more negative body image. Conclusions and significance: Our results indicate a high frequency of depressive symptoms, and concern with body image among obese patients. Therefore, obese women who seek treatment should be screened for depression and body image dissatisfaction.

Circadian rhythm disturbances in depression

The aim of this article is to review progress in understanding the mechanisms that underlie circadian and sleep rhythms, and their role in the pathogenesis and treatment of depression. Literature was selected principally by Medline searches, and additional reports were identified based on ongoing research activities in the authors' laboratory. Many physiological processes show circadian rhythms of activity. Sleep and waking are the most obvious circadian rhythms in mammals. There is considerable evidence that circadian and sleep disturbances are important in the pathophysiology of mood disorders. Depressed patients often show altered circadian rhythms, sleep disturbances, and diurnal mood variation. Chronotherapies, including bright light exposure, sleep deprivation, and social rhythm therapies, may be useful adjuncts in non-seasonal and seasonal depression. Antidepressant drugs have marked effects on circadian processes and sleep. Recent progress in understanding chronobiological and sleep regulation mechanisms may provide novel insights and avenues into the development of new pharmacological and behavioral treatment strategies for mood disorders.

Function biocontrol (FBC) method application in the course of depressive disturbance treatment

Cette contribution propose que les idées de Freud au sujet de l’agressivité sont à considérer comme pour le moins unilatérales autant que problématiques, et que le potentiel heuristique du mythe d’Œdipe à ce sujet est par conséquent limité. Elle montre comment le psychiatre hongrois Lipót Szondi essaie de remédier à cette lacune dans la psychanalyse freudienne en faisant appel au mythe de Caïn et Abel. L’analyse de ce mythe fraternel crée un espace pour une approche plus nuancée de l’agressivité humaine. Le regard différent jeté par Szondi sur l’agressivité humaine propose un nouvel apport à l’interprétation unilatérale de Freud qui est basée sur les destins du sadisme et/ou de la pulsion de mort. Cette contribution veut attirer l’attention sur l’amendement szondien de l’Œdipe freudien et veut montrer comment la psychanalyse pourrait bénéficier d’accueillir les « fils prodigues » mythiques, Caïn et Abel.This paper argues that Freud's insights into human aggression can at the very least be viewed as one-sided and problematic, and that the heuristic potential of the Œdipus myth, correspondingly, is limited. It considers how the Hungarian psychiatrist Lipót Szondi, tries to bridge this gap using the myth of Cain and Abel. The aim of this paper is to explore how Szondi's interpretation of this myth offers a much more subtle approach to human aggression. Szondi's alternative and distinctive look at aggressive phenomena offers an exciting and fruitful addition to Freud's interpretation as exclusively referring to sadism and/or the death instinct. This contribution wants to highlight Szondi's amendment to Freud's Œdipus and aims to show that psychoanalysis can benefit from taking into account the mythical figures of Cain and Abel as its “prodigal sons”.

Depression, Anhedonia, and Psychomotor Symptoms:The Role of Dopaminergic Neurocircuitry

The heterogeneity of major depression suggests that multiple neurocircuits and neurochemicals are involved in its pathogenesis. Anhedonia and psychomotor symptoms are, however, particularly characteristic features of major depression and may provide insights into its underlying psychobiology. Importantly, these symptoms appear to be mediated by dopaminergic mesolimbic and mesostriatal projections, the function of which is, in turn, influenced by key gene variants and environment stressors. Indeed, there is growing evidence of the way in which the dopaminergic system is associated with cognitive-affective disturbances in depression, and provides a useful target for therapeutic interventions. At the same time, a range of other systems are likely to contribute to the psychobiology of this condition.

Psychosocial factors contributing to persistent depressive symptoms in type 2 diabetic patients: a Croatian survey from the European Depression in Diabetes Research Consortium

Objective The study was aimed at exploring a 1-year course of depression in persons with type 2 diabetes and analysing demographic, disease-related, and psychological variables that may predict persistent depressive symptoms. Patients and methods One hundred patients from a randomly selected sample of 470 outpatients were found to be suffering from severe depressive symptoms. They were followed and re-examined for depression after 1 year. Baseline depression was assessed by the Center for Epidemiologic Studies—Depression scale (CES-D) and a face-to-face diagnostic interview relying on the DSM-IV. Nonparametric tests for between-group differences were used to compare patients who recovered from depression with those who still suffered from severe depressive symptoms. Multiple logistic regression was used to determine predictors of depression persistence. Results Seventy-nine of 100 patients with baseline depression scores indicative of severe depression were reached at 1-year follow-up. Among them, 53% were shown to have improved depressive symptoms to CES-D <16, while 47% continued to suffer from severe depressive disturbances (CES-D ≥16). Logistic regression analysis indicated that psychosocial variables predicted persistently elevated depressive symptoms better than demographic and diabetes-related ones. Clinical depression at baseline (OR=3.8, CI 1.31–10.98, P=.01), diabetes-related distress (OR=3.3, CI 1.01–10.98, P=.05), and social and physical quality-of-life aspects (OR=0.92, CI 0.88–0.97, P=.0005 and OR=0.94, CI 0.90–0.98, P=.002, respectively) were shown to be independent predictors of 1-year depression outcomes. Conclusions Severity of baseline depression, a degree to which depression disrupted the patients' quality of life, and concomitant emotional problems related to diabetes were shown to be associated with persistently elevated depressive symptoms.

T09-P-18 Role of the affective pathology in formation of sexual dysfunctions at men

Study role of the affective pathology in formation of sexual dysfunctions at men. In research have been used clinical-psychopathological, clinical-sexological, the scale of Hamilton, Spielberg-Chanin's questionnaire, MFI-20 and statistical methods. Studying pathogenesis and development pathogenic the proved therapy of sexual dysfunctions at patients with mental disorder is one of priority problems (tasks) both scientific, and practical sexology. Complex studying with use of the statistical analysis (a method of multiple linear regression and correlations Spearman) 190 patients with the sexual dysfunctions caused by mental frustration nonpsychotic of a level (at 11.6% - disorder of adaptation, at 3.6% - dissociativ disorder of sensations, at 21.1% - a neurasthenia, at 10.0% - somatization disorder, at 6.3% - hypochondrical disorder, at 7.2% - decompencation specific frustration of the person, at 21.8% - schizotipical disorder and at 18.4% - other organic disorder of the person and behaviour) has allowed to establish interrelation between structure of a mental and sexual pathology. As a result of the lead (carried out) analysis it has been established, that libido disorder arose mainly at persons with the weak sexual constitution (beta=0.82-0,29; P <0.001-0,05) on a background of long and proof affective infringements with prevalence of asthenic and depressive disturbances of an easy and average degree of expressiveness (beta=0.60-0.28; P <0.001-0.05). Erectile disorder, arising on a background of affective infringements with prevalence subdepressive, easy asthenic, disturbing and somatovegetatic disturbances (beta=0.89-0.12; P <0.001-0.05) it was observed mainly at persons with the average sexual constitution (beta=0,45- 0,15; P <0,05). Ejaculation disorder as premature ejaculation observed mainly at patients with a neurasthenia and resudual-organic mental disorder arose on a background easy asthenic and somatovegetatic disturbances (beta=0.61-0.37; P <0.001-0.05). Thus, the analysis of the received data testifies to a key role of affective disturbances in formation of sexual dysfunctions at patients with mental disorder nonpsychotic a level. Therefore the choice psychopharmacotherapy and psychotherapy as basic methods in system of medical - rehabilitation actions is pathogenetic proved.

The correlation between adolescents psychical disorders and their difficulties of psychosocial adaptation

Objective:To study the correlation between adolescents' psychical disorders and their difficulties of psychosocial adaptation.Methods:There were 63 adolescents in our study (47 girls, 16 boys), who were hospitalised in the Department of Psychiatry of Clinics of Kaunas Medical University (Lithuania) during the period from September to December, 2005 year. 27 adolescents (19 girls and 8 boys) had suicidal and self-harming behaviour. Psychical disorders were diagnosed according to ICD-10 diagnostic criterions. We used Strengths and Difficulties Questionnaire SDQ-lit. adapted for Lithuania.Results:While comparing the means of scales of both sexes adolescents, with diagnoses of depressive, behavioural and adaptation disturbances, we found statistically dependent difference only in emotionally disturbance scale results (p=0,016). Analysing separately girls and boys groups, girls showed to be worse psychosocially adapted and had more emotional problems. Girls, who tried to commit suicide, had more emotional (p=0,006), psychosocial problems (p<0,001). Girls, who were diagnosed affective disorders, had more expressed emotional (p<0,001) and general adaptation (p =0,031) difficulties. Parents noted that, their daughters who committed a suicide and had behaviour disturbances, had more expressed emotional (p=0,007) and general adaptation (p=0,053) problems.Conclusions:1. Adolescent girls, who were diagnosed depressive illnesses, had more emotional and general adaptation problems, than girls, who were diagnosed behaviour or adaptation disorders. 2. Adolescent girls, who tried to commit suicide, had more expressed behaviour problems, emotional, general adaptation difficulties. 3. Most expressed emotional and general adaptation difficulties were typical to girls who were diagnosed depression and who tried to commit suicide.

Changes in Regional Cerebral Blood Flow After Repetitive Transcranial Magnetic Stimulation of the Left Dorsolateral Prefrontal Cortex in Treatment-Resistant Depression

Changes in Regional Cerebral Blood Flow After Repetitive Transcranial Magnetic Stimulation of the Left Dorsolateral Prefrontal Cortex in Treatment-Resistant Depression

Mind-body interface: the role of n-3 fatty acids in psychoneuroimmunology, somatic presentation, and medical illness comorbidity of depression.

With the unsatisfaction of monoamine-based pharmacotherapy and the high comorbidity of other medical illness in depression, the serotonin hypothesis seems to fail in approaching the aetiology of depression. Based upon the evidence from epidemiological data, case-control studies of phospholipid polyunsaturated fatty acids (PUFAs) levels in human tissues, and antidepressant effect in clinical trials, PUFAs have shed a light to discover the unsolved of depression and connect the mind and body. Briefly, the deficit of n-3 PUFAs has been reported to be associated with neurological, cardiovascular, cerebrovascular, autoimmune, metabolic diseases and cancers. Recent studies revealed that the deficit of n-3 PUFAs is also associated with depression. For example, societies that consume a small amount of omega-3 PUFAs appear to have a higher prevalence of major depressive disorder. In addition, depressive patients had showed a lower level of omega-3 PUFAs; and the antidepressant effect of PUFAs had been reported in a number of clinical trials. The PUFAs are classified into n-3 (or omega-3) and n-6 (or omega-6) groups. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), the major bioactive components of n-3 PUFAs, are not synthesized in human body and can only be obtained directly from the diet, particularly by consuming fish. DHA deficit is associated with dysfunctions of neuronal membrane stability and transmission of serotonin, norepinephrine and dopamine, which might connect to the aetiology of mood and cognitive dysfunction of depression. On the other hand, EPA is important in balancing the immune function and physical healthy by reducing arachidonic acid (AA, an n-6 PUFA) level on cell membrane and prostaglandin E2 (PGE2) synthesis. Interestingly, animals fed with high AA diet or treated with PGE2 were observed to present sickness behaviours of anorexia, low activity, change in sleep pattern and attention, which are similar to somatic symptoms of depression in human. Therefore, the deficit of EPA and DHA in depression might be associated with mood disturbance, cognitive dysfunction, medical comorbidity and somatic symptoms in depression. Indeed, the role of n-3 PUFAs in immunity and mood function supports the promising psychoneuroimmunologic hypothesis of depression and provides an excellent interface shared by body and mind.

Role of Equatorial Wave Transitions in Tropical Cyclogenesis over the Western North Pacific

This study associates tropical cyclone (TC) activity over the western North Pacific (WNP) with the equatorial wave transition from an interannual viewpoint, revealing that the tropical cyclogenesis mean location may be modulated by a longitudinal shift in the transition of Mixed Rossby-gravity (MRG) waves to off-equatorial tropical depression (TD) disturbances from year to year. To a large extent, the wave transition is attributable to the monsoon trough in response to the thermal state of the warm pool (WP) over the WNP. During the cold state years in the WP, the basic flow confluence region associated with the monsoon trough penetrates eastward, leading to an eastward shift in the location of the wave transition. Such an environment, in which wave accumulation and energy conversion occur, is favorable for tropical cyclogenesis; as a result, the averaged cyclogenesis location moves eastward. The condition is reserved during the warm years in the WP, resulting in the prominent westward-retreating mean TC formation.

Physical and emotional disturbances in children with adenotonsillar hypertrophy

Enlarged tonsils and adenoids (part of Waldeyer's ring) are responsible for obstructive sleep disordered breathing. Obstructive sleep disordered breathing episodes lead to hypoxaemia, hypercapnia and a state of arousal, all of which affect normal development of the nervous system. In this study, two hypotheses were tested: (1) obstructive sleep disordered breathing is caused by adenotonsillar hypertrophy and is associated with hypoxia and brain dysfunction; and (2) children with obstructive sleep disordered breathing more commonly display emotional lability, depressive behaviour and anxiety. A total of 225 children were examined. The study group consisted of 121 children with adenotonsillar hypertrophy (87 aged six to nine years and 34 aged 10 to 13 years) and with obstructive sleep apnoeas and hypopnoeas confirmed by polysomnography. Patients were compared with 104 children with no obstructive sleep disordered breathing and no adenotonsillar hypertrophy (74 aged six to nine years and 30 aged 10 to 13 years). The following tests were used to measure the children's emotional disorders: the children's depression inventory; the state-trait anxiety inventory for children; and the emotional instability scale. The average values and standard deviations were calculated for all results. Student's t-test was used to compare differences in all groups of children. The minimum level of p < 0.05 was set as statistically significant. Children with adenotonsillar hypertrophy are more likely to experience poor brain development and sleep problems. They also have emotional disturbances. In the sick and healthy children aged six to nine years, mean results for the emotional instability scale were statistically significantly different in the two groups, being higher in children with adenotonsillar hypertrophy than in healthy children. Mean values for the children's depression inventory test were higher in children with adenotonsillar hypertrophy, but the differences were not statistically significant. In the state-trait anxiety inventory for children test, the mean T score was T = 1.760 and the level of significance was p = 0.08 for both groups. Since the standard level of significance was p < 0.05, the differences in mean values for the state-trait anxiety inventory for children test bordered on statistical significance. There were no differences between tests results in the older children (10 to 13 years). Recent studies have confirmed the negative emotional effect of adenotonsillar hypertrophy induced obstructive sleep disordered breathing in children aged six to nine years. The main problems are emotional lability, and anxiety and depressive disturbances. Such emotional problems subside in older children (aged 10 to 13 years).

P.2.a.015 Sleep disturbance in depression: results from a UK survey

P.2.a.015 Sleep disturbance in depression: results from a UK survey

Zivilisatosen

Psychosocial disorders and lifestyle trends have become more important in dermatology. Lifestyle diseases are a biopsychosocial phenomenon that can only be diagnosed and treated by paying attention to the quickly changing sociocultural aspects. The naming and popularization of the particular lifestyle diseases takes place by the media, but there is only an imprecise medical classification of these phenomena. This article gives an overview of the current situation and medical conditions of lifestyle diseases and try to assign them to an established psychosomatic diagnosis, based on the clinical symptomatic. Most often somatoform disorders, somatization disorders with a repeated presentation of physical symptoms which cannot be medically objectified or depressive disturbances are found.