Depression Module Research Articles

A multicenter, randomized, double-blind, placebo-controlled trial to test efficacy and safety of transcranial direct current stimulation to the motor cortex after stroke (NETS): study protocol

IntroductionThe WHO estimates that each year 5 million people are left permanently disabled after stroke. Adjuvant treatments to promote the effects of rehabilitation are urgently needed. Cortical excitability and neuroplasticity can be enhanced by non-invasive brain stimulation but evidence from sufficiently powered, randomized controlled multi-center clinical trials is absent.MethodsNeuroregeneration enhanced by transcranial direct current stimulation (tDCS) in stroke (NETS) tested efficacy and safety of anodal tDCS to the primary motor cortex of the lesioned hemisphere in the subacute phase (day 5–45) after cerebral ischemia. Stimulation was combined with standardized rehabilitative training and repeatedly applied in 10 sessions over a period of 2 weeks in a planned sample of 120 patients. Primary outcome parameter was upper-extremity function at the end of the 2-weeks intervention period of active treatment or placebo (1:1 randomization), measured by the upper-extremity Fugl-Meyer assessment. Sustainability of the treatment effect was evaluated by additional follow-up visits after 30 and 90 days. Further secondary endpoints included metrics of arm and hand function, stroke impact scale, and the depression module of the patient health questionnaire.PerspectiveNETS was aimed at providing evidence for an effective and safe adjuvant treatment for patients after stroke.Trial registration: ClinicalTrials.gov Identifier NCT00909714. Registered May 28, 2009.

Anxiety and depression in patients with breast cancer undergoing radiotherapy: the role of intelligence, life history, and social support\u2014preliminary results from a\xa0monocentric analysis

PurposeIt is known that the diagnosis of breast cancer often causes anxiety and depression. Radiotherapy of the breast as an obligatory part of a breast-conserving treatment concept can markedly increase these psychological symptoms in many, but not all patients. In this clinical observational study, we aimed at identifying cognitive, health-related and social factors that may either enhance or reduce the emergence of anxiety and depression.MethodsUsing a longitudinal study design with 25 women (mean age: 52.9 years; SD = 10.6; age range 29–70 years) with a first diagnosis of nonmetastatic breast cancer, measures of anxiety, depression, situational emotional states, intelligence, and aspects of social frameworks were assessed before, during, and after radiotherapy of the breast. At 4 time-points, standard and self-constructed questionnaires were used to assess the course of anxiety and depressive symptoms across the radiotherapy intervention.ResultsWe found that anxiety is highest immediately before the start of radiation therapy, while the anxiety level was lowest on the day that therapy was completed. Anxiety and depression were enhanced in women with a lifetime history of chronic diseases at all time points of measurement. Moreover, women with high intelligence and low social support had stronger symptoms of depression than women with low intelligence and a stable family background at some time points of measurement. The degree of anxiety was neither related to intelligence nor to social support.ConclusionFor the first time, we demonstrate empirical pilot data on cognitive and social modulators of anxiety and depression in women with breast cancer over the course of radiotherapy. Our results may help to optimize clinical procedures and thereby reduce symptoms of anxiety and depression in these patients.

Chronic Pain and Its Association with Depressive Symptoms and Renal Function in Hypertensive Patients.

Chronic pain is a common concern and is considered to be one of the major problems in patients with chronic physical disorders. We studied the effect of pain in patients with hypertension with or without chronic kidney disease (CKD) and the association between pain and symptoms of depression. The study involved 158 hypertensive individuals (59.5% male, mean age 55 years), of whom 47 (29.8%) had CKD (estimated glomerular filtration rate < 60 mL/min/1.73 m2). Pain was assessed with the pain/discomfort domain of the EuroQol-5 D, while depressive symptoms were assessed with the depression module of the Patient health questionnaire (PHQ-9). The prevalence of chronic pain in our sample was 44.3%. Women exhibited chronic pain more often compared to men (57.1% vs. 42.9%, p < 0.001). The presence of CKD was not significantly associated with a higher prevalence of chronic pain among hypertensive patients. Depressive symptoms were significantly associated with the presence of chronic pain. These findings were confirmed in the logistic regression analysis. Chronic pain is common in hypertensive individuals and the association with depression warrants further investigation and may have practical implications in managing these patients.

Little evidence for a reduced late positive potential to unpleasant stimuli in major depressive disorder

BackgroundIndividuals with major depressive disorder (MDD) present with deficits in emotional reactivity. Conflicting models have been proposed to explain this effect. We sought to confirm reports of blunted reactivity to negatively-valanced emotional stimuli, in line with the emotional context insensitivity hypothesis of depression, in a preregistered study. MethodsForty-one depressed participants and 41 age- and gender-matched healthy controls were presented a series of unpleasant and neutrally-valanced pictures in a passive view paradigm while acquiring electroencephalography (EEG). The late positive potential (LPP), an EEG correlate of emotional reactivity, was compared between groups using mixed-effects repeated-measures models and exploratory cluster-based permutation tests. A sensitivity analysis was performed to assess the robustness of LPP findings by reanalysing the LPPs using 24 EEG pipelines from studies identified in the literature. ResultsWe found no difference in LPP amplitudes between MDD and healthy individuals using the preregistered analysis pipeline. The sensitivity analysis revealed that the magnitude and direction of LPP effect sizes were affected by the analysis pipeline. Exploratory permutation analysis revealed an electrode cluster that showed a significant reduction in the LPP for MDD participants while viewing unpleasant pictures. ConclusionsThese results do not provide evidence in support of the emotional context insensitivity hypothesis, except for the exploratory data-driven approach. Methodological differences, in particular in the analysis pipeline, contribute to the heterogeneity of LPP modulation in depression. A standardised approach to quantify EEG correlates of emotional reactivity is needed to evaluate alternative models of emotional reactivity in depression.

Potential Depression and Associated Factors Among Individuals Undergoing Dialysis: A Hospital-Based Cross-Sectional Survey in Central Kerala.

Potential Depression and Associated Factors Among Individuals Undergoing Dialysis: A Hospital-Based Cross-Sectional Survey in Central Kerala.

Compassion, communication, and the perception of control: a mixed methods study to investigate patients’ perspectives on clinical practices for alleviating distress and promoting empowerment during awake craniotomies

Purpose To inquire into clinical practices perceived to mitigate patients’ intraoperative distress during awake craniotomies. Methods This mixed-methods study involved administration of Amsterdam Preoperative Anxiety and Information Scale and PTSD Checklist prior to the awake craniotomy to evaluate anxiety and information-seeking related to the procedure and symptoms of PTSD. Generalized Anxiety Disorder Scale and Depression Module of the Patient Health Questionnaire were administered before and after the procedure to evaluate generalized anxiety and depression. Patient interviews were conducted 2-weeks postprocedure and included a novel set of patient experience scales to assess patients’ recollection of intraoperative pain, overall distress, anxiety, distress due to noise, perception of empowerment, perception of being well-prepared, overall satisfaction with anaesthesia management, and overall satisfaction with the procedure. Qualitative data were analysed using conventional content analysis. Results Participants (n = 14) had undergone an awake craniotomy for tissue resection due to primary brain tumours or medically-refractory focal epilepsy. Validated self-report questionnaires demonstrated reduced levels of generalized anxiety (pre mean = 8.66; SD = 6.41; post mean= 4.36; SD = 4.24) following the awake craniotomy. Postprocedure interviews revealed very high satisfaction with the awake craniotomy and anaesthesia management and minimal levels of intraoperative pain, anxiety, and distress. The most stressful aspects of the procedure included global recognition of medical diagnosis, anxiety provoked by unfamiliar sights, sounds, and sensations, a perception of a lack of information or misinformation, and long periods of immobility. Important factors in alleviating intraoperative distress included the medical team’s ability to promote patient perceptions of control, establish compassionate relationships, address unfamiliar intraoperative sensations, and deliver effective anaesthesia management. Conclusion Compassion, communication, and patient perception of control were critical in mitigating intraoperative distress. Clinical practice recommendations with implications for all clinicians involved in patient care during awake craniotomies are provided. Use of these interventions and strategies to reduce distress are important to holistic patient care and patient experiences of care and may improve the likelihood of optimal brain mapping procedures to improve clinical outcomes during awake craniotomies.

The Association of Depressive Symptoms With Plasma C-Reactive Protein in Patients With Major Depressive Disorder Under Treatment

Objectives: This study evaluates the relationship between plasma high sensitive c-reactive protein (HSCRP) in patients with Major Depressive Disorder (MDD) under therapy. Methods: This cross-sectional study included 90 patients with MDD that had been diagnosed previously to confirm their matching «DSM-5 criteria for MDD version 7.0.2,» employing the «mini-international neuropsychiatric interview.» Also, they were on antidepressants prescriptions for at least 4 months. The criteria of MDD were based on the self-administered inquiry forms for evaluating depression severity, comprising the 9-item Patient Health Questionnaire (PHQ-9) depression module. A venous blood sample was collected from all participants for White Blood Cells (WBCs) counts and HSCRP assays. Besides their BMI calculations, SPSS v. 23, was used for all statistical tests. Results: HSCRP mean serum levels were within normal ranges among MDD patients. The Mean±SD age of the MDD patients was 39.5±0.9 years, and most of them were obese; their Mean±SD BMI was 32.9±15.8 kg/m2. The mean WBCs count of the participants was within the normal ranges. The ratio of male/female participants in this study was 1.64:1. There was a non-significant difference between the sexes in all study parameters: no significant variations in the distribution of HSCRP levels according to the scores of depression severity. There was no significant variation in the distribution of WBCs counts according to the severity of depressive thoughts. A receiver operating characteristic curve (when tested for the diagnostic ability of HSCRP) revealed poor predictability to distinguish those with severe MDD from those with no or mild depressive thoughts: area under the curve=0.484, sensitivity=0.52, specificity=0.46, and P&gt;0.05. Discussion: The outcomes of our study highlighted the importance of low-grade inflammation as a risk factor of the onset or even worsening of depression in patients with MDD. This finding is reflected by a significant difference in the mean levels of serum HSCRP between those having mild and severe PHQ-9 scores. However, the mean serum levels of HSCRP were not correlated with the severity of depressive symptoms.

Hippocampal neuropeptide Y2 receptor blockade improves spatial memory retrieval and modulates limbic brain metabolism

IntroductionThe neuropeptide Y (NPY) is broadly distributed in the central nervous system (CNS), and it has been related to neuroprotective functions. NPY seems to be an important component to counteract brain damage and cognitive impairment mediated by drugs of abuse and neurodegenerative diseases, and both NPY and its Y2 receptor (Y2R) are highly expressed in the hippocampus, critical for learning and memory. We have recently demonstrated its influence on cognitive functions; however, the specific mechanism and involved brain regions where NPY modulates spatial memory by acting on Y2R remain unclear. MethodsHere, we examined the involvement of the hippocampal NPY Y2R in spatial memory and associated changes in brain metabolism by bilateral administration of the selective antagonist BIIE0246 into the rat dorsal hippocampus. To further evaluate the relationship between memory functions and neuronal activity, we analysed the regional expression of the mitochondrial enzyme cytochrome c oxidase (CCO) as an index of oxidative metabolic capacity in limbic and non-limbic brain regions. ResultsThe acute blockade of NPY Y2R significantly improved spatial memory recall in rats trained in the Morris water maze that matched metabolic activity changes in spatial memory processing regions. Specifically, CCO activity changes were found in the dentate gyrus of the dorsal hippocampus and CA1 subfield of the ventral hippocampus, the infralimbic region of the PFC and the mammillary bodies. ConclusionsThese findings suggest that the NPY hippocampal system, through its Y2R receptor, influences spatial memory recall (retrieval) and exerts control over patterns of brain activation that are relevant for associative learning, probably mediated by Y2R modulation of long-term potentiation and long-term depression.

Implications of Cannabis sativa on serotonin receptors 1B (HTR1B) and 7 (HTR7) genes in modulation of aggression and depression

Implications of Cannabis sativa on serotonin receptors 1B (HTR1B) and 7 (HTR7) genes in modulation of aggression and depression

Predictors for successful psychotherapy: Does migration status matter?

BackgroundWe investigated, if migration status, and additional sociodemographic and clinical factors, are associated with somatization and depressiveness at admission and with remission after inpatient psychotherapy.MethodsMultiple linear and binary logistic regression analyses were used to identify predictors for severity of somatoform and depressive symptoms at admission of inpatient psychotherapy (T0), and for remission after inpatient psychotherapy (T1). We tested the association between symptoms concerning somatization (PHQ-15: Patient-Health-Questionnaire Somatization Module) and depression (PHQ-9: Patient-Health-Questionnaire Depression Module) and several sociodemographic and clinical factors in 263 patients at admission. For remission after treatment, we additionally included severity of symptoms at admission, number of diagnoses and duration of treatment in the regression models. Remission after treatment was defined as response plus a post value of less than 10 points in the respective questionnaire. Clinical relevance was interpreted using effect sizes (regression coefficients, Odds Ratio (OR)) and Confidence Intervals (CI).FindingsSignificant and clinically relevant predictors for high symptom severity at T0 were lower education (β = -0.13, p = 0.04), pretreatment(s) (β = 0.205, p = 0.002) and migration status (β = 0.139, p = 0.023) for somatization, and potential clinically relevant predictors (|β|>0.1) for depression were living alone (β = -0.116, p = 0.083), pretreatment(s) (β = 0.118, p = 0.071) and migration status (β = 0.113, p = 0.069). At T1 patients with pretreatment(s) (OR = 0.284 [95% CI: 0.144, 0.560], p<0.001) and multiple diagnoses (OR = 0.678 [95% CI: 0.472, 0.973], p = 0.035) were significantly and clinically relevant less likely to show a remission of depressive symptoms. In addition, a potentially clinically meaningful effect of migration status on remission of depressive symptoms (OR = 0.562 [95% CI: 0.264, 1.198], p = 0.136) cannot be ruled out. For somatoform symptoms pretreatment(s) (OR = 0.403, [95% CI: 0.156, 1.041], p = 0.061) and education (OR = 1.603, [95% CI: 0.670, 3.839], p = 0.289) may be regarded as clinically relevant predictors for remission.ConclusionThe results of our study suggest that migration status has a clinically relevant influence on severity of somatoform and depressive symptoms at admission. Clinical relevance of migration status can also be assumed regarding the remission of depression. Migration status and further factors affecting the effectiveness of the treatment should be analyzed in future research among larger samples with sufficient power to replicate these findings.

Effect of COVID-19 on mental health among the young population in Lebanon

BackgroundCOVID-19 is a global pandemic that has raised worldwide public health concerns. The wide spread of the virus has led to unprecedented disturbance to regular life for people around the globe and impacted their mental health. AimsThe aims of the current study were to investigate the prevalence of psychiatric symptoms related to insomnia, depression, and anxiety, and identify risk factors contributing to psychological stress in Lebanese young population during COVID-19 pandemic. MethodA cross-sectional study was done on the Lebanese young population. Participants were 4397 males and females aged 18 to 35 years who filled a self-administered online questionnaire. Three validated scales were used to measure the mental health status of the participants during the COVID-19 pandemic: 7-item Insomnia Severity Index for insomnia, the Patient Health Questionnaire 9-item depression module for depression, and the 7-item Generalized Anxiety Disorder scale for anxiety. ResultsThe median interquartile range scores for anxiety, insomnia, and depression, were 8 (4–13), 10 (5–14), and 9 (5–12) respectively. Higher anxiety scores were reported with female gender (P<0.001) and alcohol usage (P=0.04). Moderate to severe insomnia was associated with single (P=0.02) and divorced marital status (P=0.003), university education (P<0.001), consumption of caffeinated beverages (P=0.02) and energy drinks (P=0.03). Higher depression scores were associated with status of being the only person working at home (P=0.01), family income more than 500 USD (P=0.008), multiple insurance plans (P=0.01), and contact with a confirmed COVID-19 case (P=0.01). ConclusionsThe findings of this study demonstrate the considerable impact of COVID-19 pandemic and lockdown on Lebanese young population's mental status such as anxiety, depression and insomnia. Further follow-up studies are warranted to assess the long-term mental effects that can be imposed by the pandemic.

Review and Hypothesis: A Potential Common Link Between Glial Cells, Calcium Changes, Modulation of Synaptic Transmission, Spreading Depression, Migraine, and Epilepsy-H.

There is significant evidence to support the notion that glial cells can modulate the strength of synaptic connections between nerve cells, and it has further been suggested that alterations in intracellular calcium are likely to play a key role in this process. However, the molecular mechanism(s) by which glial cells modulate neuronal signaling remains contentiously debated. Recent experiments have suggested that alterations in extracellular H+ efflux initiated by extracellular ATP may play a key role in the modulation of synaptic strength by radial glial cells in the retina and astrocytes throughout the brain. ATP-elicited alterations in H+ flux from radial glial cells were first detected from Müller cells enzymatically dissociated from the retina of tiger salamander using self-referencing H+-selective microelectrodes. The ATP-elicited alteration in H+ efflux was further found to be highly evolutionarily conserved, extending to Müller cells isolated from species as diverse as lamprey, skate, rat, mouse, monkey and human. More recently, self-referencing H+-selective electrodes have been used to detect ATP-elicited alterations in H+ efflux around individual mammalian astrocytes from the cortex and hippocampus. Tied to increases in intracellular calcium, these ATP-induced extracellular acidifications are well-positioned to be key mediators of synaptic modulation. In this article, we examine the evidence supporting H+ as a key modulator of neurotransmission, review data showing that extracellular ATP elicits an increase in H+ efflux from glial cells, and describe the potential signal transduction pathways involved in glial cell—mediated H+ efflux. We then examine the potential role that extracellular H+ released by glia might play in regulating synaptic transmission within the vertebrate retina, and then expand the focus to discuss potential roles in spreading depression, migraine, epilepsy, and alterations in brain rhythms, and suggest that alterations in extracellular H+ may be a unifying feature linking these disparate phenomena.

Fear, worry and sadness: an exploratory study of psychological wellbeing in men caring for their partner with ovarian cancer.

Ovarian cancer is the leading cause of death from female cancers in Australia with the majority of women presenting with advanced disease. The burden of caregiving is largely borne by male carers; however, little research has examined the challenges male ovarian cancer caregivers (MOCC) experience. This study aimed to explore the psychosocial wellbeing and cancer-related challenges experienced by MOCC. A cross-sectional small-scale exploratory online survey study recruited 36 MOCC. The study questionnaire was comprised of the Generalised Anxiety Disorder Scale (GAD-7), Patient Health Questionnaire Depression Module (PHQ-9), Functional Assessment of Cancer Therapy Scale (FACT-G) Family Member, Fear of Cancer Recurrence Scale, Insomnia Severity Index (ISI), Functional Assessment of Chronic Illness Therapy Fatigue Scale (FACTIT-F) and Cancer-Related Challenges Scale (CRCS). The most common challenges ever experienced were worry about the future (91%), fear of metastasis (90%) and feeling worried or uncertain (88%). The most common current challenges were fear of cancer recurrence (75%), fear of metastasis (68%) and changes in sexual relationships (64%). Depression and anxiety were significantly correlated with all psychosocial variables highlighting the relationships between elements of wellbeing for MOCC. Clinical levels of fear of cancer recurrence were reported by 89% of MOCC. The challenges faced by MOCC are psychosocial in nature. There is a high correlation between anxiety and depression, and this coupled with the fear of disease recurrence indicates a greater need for screening of these issues, appropriate referral and development of support resources for this high-risk group of cancer carers.

Psychometric assessment of the Swedish version of the injustice experience questionnaire among patients with chronic pain.

The use of the Injustice Experience Questionnaire (IEQ) in psychological assessment of individuals with chronic pain is supported by research. The psychometric properties of the Swedish version, the IEQ-S, has not yet been evaluated. Hence, the aim was to investigate structural validity, and concurrent criterion validity of the IEQ-S against the Work Ability Index (WAI), the Pain Catastrophizing Scale (PCS-SW), the Patient Health Questionnaire 9-item depression module (PHQ-9), and the Generalized anxiety disorder 7-item scale (GAD-7). Internal consistency and test-retest reliability were also studied. Sixty-five participants, referred to a University hospital, with a pain duration over three months were consecutively sampled. They completed the IEQ-S at admission and again within six weeks. A confirmatory factor analysis was performed for the study of structural validity. Concurrent criterion validity was evaluated using Spearman's correlation coefficient. Internal consistency reliability for the full IEQ-S was calculated using the Cronbach's alpha. Test-retest reliability was calculated using an Intraclass Correlation Coefficient (ICC). The median total score (0-48, where high scores indicate high levels of injustice) at admission (test 1) was 27.0 (n=64), 25th percentile=15.3, 75th percentile=37.8, range=3-48 points. A one-factor model was supported with item-loadings between 0.67-0.92. Spearman's correlation coefficient between the IEQ-S and the WAI (n=56) was rS =-0.46; the PCS-SW (n=63) was rS =0.68, the PHQ-9 (n=64) was rS =0.50 and the GAD-7 (n=64) was rS =0.57, p<0.01. Cronbach's alpha was 0.94 (n=64). The ICC was 0.80 (n=55), with a 95% confidence interval, ranging between 0.69-0.88. Our study supported structural validity and concurrent criterion validity of the IEQ-S against other measures of psychological constructs and work ability. It also supported the internal consistency reliability of the IEQ-S and the test-retest reliability with a retest interval up to six weeks, was good. These findings support the use of the IEQ-S as an adjunct tool to assess appraisals of injustice in patients with chronic pain who are referred to tertiary care in Sweden. The added value might be identification of those who are at risk for slow or no improvement in their pain condition over time, and sick-leave, but this has to be confirmed in future studies. EPN Uppsala D-No 2016-376.

Trajectories and risk factors for anxiety and depression in children and adolescents with cancer: A 1-year follow-up.

BACKGROUNDThere is limited data on the longitudinal trajectories of psychiatric disorders in children with cancer and risk factors for their persistence. The current study aimed to longitudinally assess the trajectories and risk factors for anxiety and depressive symptoms and disorders in children and adolescents with cancer.METHODSChildren and adolescents with cancer and their parents completed the Patient‐Reported Outcomes Measurement Information System (PROMIS) Depression and Anxiety Module and were interviewed by the semi‐structured Affective and Anxiety Modules of the Kiddie Schedule for Affective Disorders and Schizophrenia for School‐Age Children (K‐SADS), at 4 time points, 1, 4, 7, and 12 months following the diagnosis of cancer.RESULTSOf the 99 patients enrolled, 48% met criteria for anxiety and/or depressive disorders at least once during the follow‐up period. There was a significant decrease in PROMIS pediatric and parent anxiety and depression scores (all p's < 0.01) and in the rate of depressive disorders over time (p = 0.02), while rates of anxiety disorders remained stable. Anxiety PROMIS pediatric and parent scores at baseline, having brain tumors and being in the acute treatment phase significantly predicted the presences of anxiety disorders at endpoint.CONCLUSIONSOur results highlight the importance of screening for anxiety and disorders in children with cancer, especially among those with brain tumors and at the acute phase of treatment.

Isoginkgetin treatment attenuated lipopolysaccharide-induced monoamine neurotransmitter deficiency and depression-like behaviors through downregulating p38/NF-κB signaling pathway and suppressing microglia-induced apoptosis.

Background:Microglia activation-induced neuroinflammation may contribute to the etiology of depression. Podocarpus nagi containing high concentration of isoginkgetin could effectively treat mental diseases in ancient times. However, the therapeutic role, peculiarly in the brain–immune modulation in depression is still unclear. This study aimed to determine effects of isoginkgetin on lipopolysaccharide (LPS)-induced depression-like changes. Furthermore, its modulation on the p38/nuclear factor-kappa B (NF-κB) pathway in LPS-activated microglia was evaluated.Methods:Adult Kunming mice were intraperitoneally injected vehicle or isoginkgetin (4 mg/kg) daily for 14 days before saline or LPS (0.83 mg/kg) administration. Depression-like behavior, neurotransmitter levels, and markers of neuroinflammation were determined. Isoginkgetin effect on LPS-induced microglial activation was then assessed in BV2 cells. Finally, conditioned medium (CM) derived from isoginkgetin-treated BV2 cells was co-cultured with SH-SY5Y cells for 24 h. Cell viability and apoptosis were evaluated.Results:LPS significantly induced helplessness and anxiety, which were associated with decreased 5-HT, noradrenaline, and dopamine concentrations. Meanwhile, LPS increased microglia M1 hallmark Iba1 expression and serum interleukin (IL)-1β concentration. These changes were attenuated by isoginkgetin treatment. In vitro, isoginkgetin markedly suppressed the production of IL-1β, IL-6, tumor necrosis factor-alpha, cyclooxygenase-2, inducible nitric oxide, and reactive oxygen species, which are released from LPS-stimulated BV2 cells. More interestingly, CM from isoginkgetin-treated BV2 cells significantly alleviated SH-SY5Y cell apoptosis and restored cell viability compared to LPS-treated group through the inhibition of p38/NF-κB signaling pathway.Conclusion:These data demonstrate that isoginkgetin is an effective therapeutic agent for depression-like behaviors and neuropathological changes via potent anti-inflammatory property.

Pain and Depression among Adult Outpatients with Osteoarthritis in Nigeria

Introduction: Arthritis is a degenerative joint disease with many forms, but osteoarthritis is most common resulting from trauma or infection to the joint or aging. Depressive disorders often go undiagnosed especially in chronic physical illnesses like osteoarthritis. Osteoarthritic pain is associated with a high risk of depressive illness. This study evaluated the prevalence of major depression and its relationship with physical pain among patients with osteoarthritis. Methods: This was a cross-sectional study involving 134 adult outpatients, with osteoarthritis at the University of Benin Teaching Hospital. The demographic profile, subjective pain intensity, and diagnosis of major depression were obtained with a sociodemographic questionnaire, Visual Analog Pain Scale, and depressive module of Composite International Diagnostic Interview, respectively. Results: Thirty-seven (27.61%) and 40 (29.85%) participants had current and 12-month depressive disorder, respectively. A unit (year) increase in the illness duration was associated with a 68% increase in the likelihood of having depression (adjusted odds ratio [aOR] 1.68,P= 0.044), while the presence of comorbidity was the only independent correlate of 12-month depression among the participants (aOR 0.11,P= 0.031). Subjective pain severity had no independent correlation with depressive disorder. Conclusion: Major depression is prevalent among patients with osteoarthritis. Clinicians should have a high index of suspicion of depressive disorder, especially in the presence of medical comorbidities and longer duration of illness.

Angiotensin-(1-7) and Mas receptor in the brain

The renin-angiotensin system (RAS) is a key regulator of blood pressure and electrolyte homeostasis. Besides its importance as regulator of the cardiovascular function, the RAS has also been associated to the modulation of higher brain functions, including cognition, memory, depression and anxiety. For many years, angiotensin II (Ang II) has been considered the major bioactive component of the RAS. However, the existence of many other biologically active RAS components has currently been recognized, with similar, opposite, or distinct effects to those exerted by Ang II. Today, it is considered that the RAS is primarily constituted by two opposite arms. The pressor arm is composed by Ang II and the Ang II type 1 (AT1) receptor (AT1R), which mediates the vasoconstrictor, proliferative, hypertensive, oxidative and pro-inflammatory effects of the RAS. The depressor arm is mainly composed by Ang-(1-7), its Mas receptor (MasR) which mediates the depressor, vasodilatory, antiproliferative, antioxidant and anti-inflammatory effects of Ang-(1-7) and the AT2 receptor (AT2R), which opposes to the effects mediated by AT1R activation. Central Ang-(1-7) is implicated in the control of the cardiovascular function, thus participating in the regulation of blood pressure. Ang-(1-7) also exerts neuroprotective actions through MasR activation by opposing to the harmful effects of the Ang II/AT1R axis. This review is focused on the expression and regulation of the Ang-(1-7)/MasR axis in the brain, its main neuroprotective effects and the evidence regarding its involvement in the pathophysiology of several diseases at cardiovascular and neurological level.

Neuronal basis for pain-like and anxiety-like behaviors in the central nucleus of the amygdala.

Chronic pain is often accompanied by anxiety and depression disorders. Amygdala nuclei play important roles in emotional responses, fear, depression, anxiety, and pain modulation. The exact mechanism of how amygdala neurons are involved in pain and anxiety is not completely understood. The central nucleus of the amygdala contains 2 major subpopulations of GABAergic neurons that express somatostatin (SOM+) or protein kinase Cδ (PKCδ+). In this study, we found about 70% of phosphorylated ERK-positive neurons colocalized with PKCδ+ neurons in the formalin-induced pain model in mice. Optogenetic activation of PKCδ+ neurons was sufficient to induce mechanical hyperalgesia without changing anxiety-like behavior in naïve mice. Conversely, chemogenetic inhibition of PKCδ+ neurons significantly reduced the mechanical hyperalgesia in the pain model. By contrast, optogenetic inhibition of SOM+ neurons induced mechanical hyperalgesia in naïve mice and increased phosphorylated ERK-positive neurons mainly in PKCδ+ neurons. Optogenetic activation of SOM+ neurons slightly reduced the mechanical hyperalgesia in the pain model but did not change the mechanical sensitivity in naïve mice. Instead, it induced anxiety-like behavior. Our results suggest that the PKCδ+ and SOM+ neurons in the central amygdala exert different functions in regulating pain-like and anxiety-like behaviors in mice.

Prevalence and correlates of depression and quality of life among primary caregivers of patients with schizophrenia attending a Nigerian Tertiary Hospital

AimsTo determine the prevalence and correlates of depression and quality of life and their relationship among primary caregivers of patients with schizophrenia in a psychiatry specialist hospital.MethodA total of 138 caregivers of patients diagnosed with schizophrenia attending the outpatient clinic of the Neuropsychiatric Hospital Aro, Abeokuta were recruited. Sociodemographic questionnaire, Mini International Neuropsychiatric Interview (MINI-PLUS) (depressive module) and World Health Organization Quality of Life-Bref (WHOQOL-Bref) were administered on the caregivers while Brief Psychiatric Rating Scale (BPRS) was used to measure symptoms severity in the patients.ResultThe mean (±SD) age of respondents was 48.3 years (±14.7), 53.6% were females and 33.3% were without partners. The prevalence of depression among the caregivers who participated in the study was 13.8%. Female gender (χ2 = 5.68, df = 1, p = 0.02), hailing from a minority tribe (χ2 = 9.78 df = 1, p &lt; 0.01), and Previous treatment for mental illness (χ2 = 8.24 df = 1, p &lt; 0.01) were associated with depression. Female gender (ß = 1.35, OR = 3.86, p = 0.03), minority tribe (ß = 1.95, OR = 7.03, p &lt; 0.01), and previous treatment for mental illness (ß = 3.19, OR = 24.21, p = 0.01) were independently predictive of depression in the caregivers.Independent predictors of lower quality of life (QOL) were: Parents/siblings relationship for social relationship domain (ß = −7.076, p = 0.037) and spending more than 35 hours per week for Environmental domain (ß = −5.622, p = 0.028).Finally, a significant correlation was also found between Depression and Psychological Domain of QOL (t = 3.048, p &lt; 0.01) and Social Domain of QOL (t = 2.154, p = 0.03).ConclusionThis study shows that primary caregivers of patients with schizophrenia have high prevalence of depression and poor quality of life. There is need to pay attention to the psychological wellbeing and quality of life of caregivers who come in contact with psychiatric services, and not just the patients they accompany.