Domains Of Depressive Symptoms Research Articles

The association between insulin resistance and depressive symptoms – A national representative cross-sectional study

ObjectiveIncreasing evidence suggests a positive association between insulin resistance (IR) and depression. However, whether sex-or body mass index–specific differences exist remains controversial, and only few studies have analyzed specific symptom domains. Thus, the present study aimed to analyze the association between IR and depressive symptom domains and to clarify the effects of sex and body mass index. MethodsThe study sample comprised 4007 participants, aged 19–79, from the Korea National Health and Nutrition Examination Study 2020. Participants completed health interviews and examinations, providing data on circulating insulin and glucose levels, the Patient Health Questionnaire-9 (PHQ-9), and related covariates. IR was calculated using the homeostasis model assessment of insulin resistance. Associations between IR and PHQ-9 were analyzed using negative binomial regression with adjustments for the complex survey design. ResultsThe association between log-transformed IR and PHQ-9 total scores was statistically significant (incidence rate ratio [IRR] = 1.17, 95% confidence interval [CI] = 1.07–1.29, p = 0.001). Only body mass index specific differences were statistically significant, as the association was only significant in those without obesity (IRR = 1.21, 95% CI = 1.06–1.38, p = 0.005). IR was associated with cognitive/affective (IRR = 1.23, 95% CI = 1.08–1.41, p = 0.002) and somatic (IRR = 1.14, 95% CI = 1.04–1.25, p = 0.005) depressive symptom domains. Sensitivity analyses revealed similar results. ConclusionsIR was positively associated with cognitive/affective and somatic depressive symptoms in non-obese individuals.

Neuroanatomy of post-stroke depression: the association between symptom clusters and lesion location.

Post-stroke depression affects about 30% of stroke patients and often hampers functional recovery. The diagnosis of depression encompasses heterogeneous symptoms at emotional, motivational, cognitive, behavioural or somatic levels. Evidence indicates that depression is caused by disruption of bio-aminergic fibre tracts between prefrontal and limbic or striatal brain regions comprising different functional networks. Voxel-based lesion-symptom mapping studies reported discrepant findings regarding the association between infarct locations and depression. Inconsistencies may be due to the usage of sum scores, thereby mixing different symptoms of depression. In this cross-sectional study, we used multivariate support vector regression for lesion-symptom mapping to identify regions significantly involved in distinct depressive symptom domains and global depression. MRI lesion data were included from 200 patients with acute first-ever ischaemic stroke (mean 0.9 ± 1.5 days of post-stroke). The Montgomery-Åsberg Depression Rating interview assessed depression severity in five symptom domains encompassing motivational, emotional and cognitive symptoms deficits, anxiety and somatic symptoms and was examined 8.4 days of post-stroke (±4.3). We found that global depression severity, irrespective of individual symptom domains, was primarily linked to right hemispheric lesions in the dorsolateral prefrontal cortex and inferior frontal gyrus. In contrast, when considering distinct symptom domains individually, the analyses yielded much more sensitive results in regions where the correlations with the global depression score yielded no effects. Accordingly, motivational deficits were associated with lesions in orbitofrontal cortex, dorsolateral prefrontal cortex, pre- and post-central gyri and basal ganglia, including putamen and pallidum. Lesions affecting the dorsal thalamus, anterior insula and somatosensory cortex were significantly associated with emotional symptoms such as sadness. Damage to the dorsolateral prefrontal cortex was associated with concentration deficits, cognitive symptoms of guilt and self-reproach. Furthermore, somatic symptoms, including loss of appetite and sleep disturbances, were linked to the insula, parietal operculum and amygdala lesions. Likewise, anxiety was associated with lesions impacting the central operculum, insula and inferior frontal gyrus. Interestingly, symptoms of anxiety were exclusively left hemispheric, whereas the lesion-symptom associations of the other domains were lateralized to the right hemisphere. In conclusion, this large-scale study shows that in acute stroke patients, differential post-stroke depression symptom domains are associated with specific structural correlates. Our findings extend existing concepts on the neural underpinnings of depressive symptoms, indicating that differential lesion patterns lead to distinct depressive symptoms in the first weeks of post-stroke. These findings may facilitate the development of personalized treatments to improve post-stroke rehabilitation.

Assessment of post-concussion emotional symptom load using PCSS and PROMIS instruments in pediatric patients

ABSTRACT Objectives The purpose of this study is to evaluate the utility of the Patient-Reported Outcomes Measurement Information System (PROMIS) anxiety and depressive symptom domains in conjunction with the Post-Concussion Symptom Scale (PCSS)for identifying pediatric patients with emotional symptoms following a concussion, and to identify predictors of higher emotional symptom loads. Methods We recruited English-speaking patients aged 8–17 years presenting to a tertiary-care concussion clinic from 2014 to 2018 (n = 458). Demographics and clinical data including PCSS, injury date, previous history of anxiety/depression, and Vestibular/Ocular-Motor Screen (VOMS) were collected from patients’ electronic medical records. Participants completed surveys in the PROMISTM Pediatric Item Bank v1.1-Anxiety and Depressive Symptoms domains at their initial clinic visit. Multivariable linear regression identified predictors of higher emotional symptom loads. Results Overall, 425 (92.8%) reported ≥1 emotional symptom on either PROMIS or PCSS. Predictors of higher emotional symptom loads were abnormal VOMS, female sex, history of anxiety or depression, and longer time since injury. Conclusion Our results suggest that adding PROMIS anxiety and depressive symptom surveys to pediatric concussion evaluations may identify more children with emotional symptoms, allowing clinicians to better direct post-concussion treatment and incorporate psychological support for patients if necessary. Future studies should examine whether earlier identification of emotional symptoms with these tools facilitates recovery and improves short- and/or long-term psychological outcomes in pediatric concussion.

Differential Associations Between Depressive Symptom-Domains With Anxiety, Loneliness, and Cognition in a Sample of Community Older Chinese Adults: A Multiple Indicators Multiple Causes Approach.

Depressive symptoms are common in older adults, and often co-occur with other mental health problems. However, knowledge about depressive symptom-domains and their associations with other conditions is limited. This study examined depressive symptom-domains and associations with anxiety, cognition, and loneliness. A sample of 3,795 participants aged 60 years and older were recruited from the community in Hong Kong. They were assessed for depressive symptoms (Patient Health Questionnaire-9 [PHQ-9]), anxiety (Generalized Anxiety Disorder 7-item), loneliness (UCLA 3-item), and cognition (Montreal Cognitive Assessment 5-Minute Protocol). Summary descriptive statistics were calculated, followed by confirmatory factor analysis of PHQ-9. Multiple Indicators Multiple Causes analysis was used to examine the associations between mental health conditions in the general sample and subgroups based on depressive symptom severity. A 4-factor model based on the Research Domain Criteria showed the best model fit of PHQ-9 (χ2/df = 10.63, Root-Mean-Square Error of Approximation = 0.05, Comparative Fit Index = 0.96, Tucker-Lewis Index = 0.93). After adjusting for demographics, 4 depressive symptom-domains were differentially associated with anxiety, loneliness, and cognition across different depression severity groups. The Negative Valance Systems and Internalizing domain (NVS-I; guilt and self-harm) were consistently associated with anxiety (β = 0.45, 0.44) and loneliness (β = 0.11, 0.27) regardless of depression severity (at risk/mild vs moderate and more severe, respectively, all p < .001). The consistent associations between the NVS-I domain of depression with anxiety and loneliness warrant attention. Simultaneous considerations of depressive symptom-domains and symptom severity are needed for designing more personalized care. NCT03593889.

#5293 THE IMPACT OF SEVERE DEPRESSION ON THE SURVIVAL OF OLDER PATIENTS WITH END-STAGE KIDNEY DISEASE

Abstract Background and Aims Incidence of depression increases in patients with end-stage kidney disease (ESKD). We evaluated the association between depression and mortality among older patients with ESKD, which has not been studied previously. Method This nationwide prospective cohort study included 487 patients with ESKD aged &amp;gt; 65 years, who were categorized into minimal, mild-to-moderate, and severe depression groups based on their Beck Depression Inventory-II (BDI-II) scores. BDI-II scores were separated into three symptom domains: affective, cognitive, and somatic depressive symptoms. The association between the depression groups and survival were analyzed using multivariate Cox proportional hazard regression models. Predisposing factors for high BDI-II scores were evaluated using logistic regression analysis. The associations among the three depressive-symptom domains and survival were also analyzed. Results The severe depression group showed a higher modified Charlson comorbidity index value and lower serum albumin, phosphate, and uric acid levels than the other depression groups. The Kaplan–Meier curve revealed a significantly lower survival in the severe depression group than in the minimal and mild-to-moderate depression groups (P = 0.011). Multivariate Cox regression analysis confirmed that severe depression was an independent risk factor for mortality in the study cohort [hazard ratio (HR), 1.39; 95% confidence interval (CI), 1.01–1.91; P = 0.041). BDI-II scores were associated with modified Charlson comorbidity index (P = 0.009) and serum albumin level (P = 0.004) in multivariate linear regression. Among the three depressive symptoms, higher somatic symptom scores were associated with increased mortality (HR, 2.45; 95% CI, 1.25–4.79; P = 0.009). Conclusion Among older patients with ESKD, severe depression increases mortality compared with minimal or mild-to-moderate depression. And patients with concomitant somatic symptoms require careful management of their comorbidities and nutritional status.

Conceptualizing anxiety and depression in children and adolescents: a latent factor and network analysis

The objective of this study is to gain insight into the inherent structure of anxiety and depressive symptoms by combining the strengths of latent factor analysis and network analysis. The sample comprised 743 children and adolescents aged 4–18 years (M = 11.64, SD = 3.66, 61% males) who sought routine care outpatient psychotherapy. Parents or primary caregivers rated anxiety and depressive symptoms of their children on a DSM-5-/ICD-10-based symptom checklist. First, we analyzed the factor structure of the internalizing symptoms using exploratory factor analysis (EFA). Next, we conducted a network analysis and identified central and bridge symptoms that may explain comorbidity between anxiety disorders and depression. We then employed exploratory graph analysis (EGA) as an alternative tool within the framework of network psychometrics to estimate the number of dimensions (i.e., communities within a network). Finally, we tested a model based on these results using confirmatory factor analysis. The results demonstrate a complex interplay between anxiety and depressive symptom domains. Four factors/communities were identified by EFA and EGA, but the item-community allocation differed, and the interpretation of factors/communities was unclear. A clear distinction between these domains could not be supported. However, associations within a domain were stronger than associations between the two domains. We identified pain, suicidal, irritable, and afraid of adults as bridge items between the symptom domains. In conclusion, our findings further advance the general understanding of the frequently reported co-occurrence of anxiety and depressive symptoms and diagnoses in clinical practice. Identifying bridge symptoms may inform intervention practices by targeting specific symptoms that contribute to the maintenance of anxious and depressive behaviors.

Excess body weight and specific types of depressive symptoms: Is there a mediating role of systemic low-grade inflammation?

ObjectivesObesity is associated with an increased risk of depression. Systemic low-grade inflammation, a plausible consequence of obesity, has also been linked to depression. However, the potential mediating effects of systemic low-grade inflammation on the association between excess body weight and specific symptom domains of depression remain uncertain. This study examined whether systemic low-grade inflammation mediated the associations of excess body weight (overweight and obesity) with subsequent overall, cognitive-affective, and somatic depressive symptoms. DesignThis study used a prospective cohort design. MethodsThe final analytical sample included 4,942 adults aged ≥50 years drawn from the English Longitudinal Study of Ageing (ELSA). Body mass index (BMI) and covariates were ascertained at baseline (wave 4, 2008/09). Continuous BMI scores were divided into four categories: ‘normal weight’ (18.5 ≤ BMI <25 kg/m2); ‘overweight’ (25 ≤ BMI <30 kg/m2); ‘obesity’ (BMI ≥30 kg/m2); in addition to ‘excess body weight’ (‘overweight’ and ‘obesity’ combined). Covariates included sociodemographic variables, behavioural factors, and chronic physical conditions. Serum concentrations of CRP were measured at wave 6 (2012/13). Depressive symptoms were assessed at baseline and ten years later (wave 9, 2018/19), using the 8-item Centre for Epidemiological Studies Depression (CES-D) Scale. Two symptom domains were constructed, distinguishing between cognitive-affective (depressed mood, loneliness, sadness, enjoyment in life, and happiness) and somatic (sleep problems, low energy levels, and fatigue) symptoms. Mediation analyses were performed to examine whether CRP statistically mediated the associations between BMI categories and depressive symptoms. ResultsIn multivariable-adjusted analyses, excess body weight was associated with elevated somatic (OR = 1.231, 95% CI: 1.029, 1.473), but not cognitive-affective or overall depressive symptoms at follow-up. Higher CRP was associated with elevated somatic (OR = 1.156, 95% CI: 1.061, 1.259), but not cognitive-affective or overall depressive symptoms. CRP acted as a partial mediator (14.92%) of the association between excess body weight and elevated somatic, but not cognitive-affective, or overall depressive symptoms. ConclusionSystemic low-grade inflammation may partially explain the association of excess body weight with somatic depressive symptoms, but not the associations with cognitive-affective or overall depressive symptoms.

Depressive symptoms homophily among community-dwelling older adults in japan: A social networks analysis.

Late-life depression is one of the most common mental illnesses that cause serious consequences, but the majority do not reach out for mental health services and relapses are common. The present study investigated profiled similarity of older adults' social networks in terms of depressive symptoms. In 2017, we distributed questionnaires inquiring about confidants in the community, depressive symptoms based on the 15-item Geriatric Depression Scale (GDS-15), and demographic and functional characteristics to all the community-dwelling older adults under the national insurance system in Wakuya City (Miyagi prefecture, Japan). Applying the Exponential Random Graph Model, we estimated the likelihood of a confidant relational tie by the similarity of overall and specific depressive symptoms within 217,470 potential ties among 660 respondents eligible for analysis. The overall depressive symptom homophily was marginally significant (p < 0.10), indicating that the likelihood of a confidant relational tie between two community-dwelling older adults was decreased by 5%, with one point increase in their difference in the total number of depressive symptoms (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.90–1). Focusing on specific domains of depressive symptoms, we found significant apathy homophily (p < 0.05) but no significant suicidal ideation of homophily. The results indicated that there is a 19% decrease in the likelihood of a confidant relational tie between two community-dwelling older adults by one point increase in their difference in the total number of apathy symptoms (OR, 0.81; 95%CI, 0.67–0.98) but no change by increasing the difference in their total number of suicidal ideation symptoms (OR, 1; 95%CI, 0.87–1.14). These findings suggest depressive symptom homophily, particularly with respect to apathy domains, in confidant social networks of community-dwelling older adults, and the importance of network intervention in preventing late-life depression.

Short-term aerobic exercise for depression in acute geriatric psychiatry: study protocol for a randomized controlled trial

BackgroundMajor depression is one of the main mental illnesses in old age, with acute exacerbated episodes requiring treatment in geriatric psychiatry. A meta-analysis showed that aerobic exercise in moderate intensity has large effects in older adults with major depression, but there is no evidence of aerobic exercise in geriatric psychiatry. Therefore, this study aims to analyze the feasibility and effects of an ergometer-based aerobic exercise on depressive symptoms.MethodsA single-center randomized controlled trial will be conducted in an acute geriatric psychiatric hospital. Inpatients allocated to the intervention group will receive a 2-week aerobic ergometer program. The control group will receive seated flexibility exercise in addition to usual care. The overall effects on the patients’ depressive symptoms will be measured by clinical global impression of change (CGI) as the primary outcome. Changes in depressive symptom domains, physical (in)activity, and aerobic performance as well as the dosage of applied antidepressants will be examined as secondary outcomes.DiscussionThis short-term aerobic exercise program is expected to decrease depressive symptoms in acute exacerbated periods in older adults. The results may increase the evidence for implementing physical activity interventions in acute hospital settings. The disease-related motivation for exercise in acute exacerbated depressive periods will be the most challenging aspect. The treatment of depression requires new cost-effective approaches, especially in acute geriatric psychiatry with potential benefits for patients, family members, and clinicians.Trial registrationGerman Clinical Trial Register ID: DRKS00026117Trial statusProtocol Version 1.2 dated February 23, 2022. By February 23, 2022, the trial had recruited a total of 15 participants in two wards at the Department of Geriatric Psychiatry at the LVR-Hospital Cologne. Recruitment started on November 12, 2021. The recruitment is expected to continue for at least 12 months.

Younger women are more susceptible to inflammation: A longitudinal examination of the role of aging in inflammation and depressive symptoms

BackgroundThe degree to which effects of inflammation on mood and behavior vary across the lifespan remains relatively unexplored despite well-established, age-related alterations in both the immune and central nervous systems. Further, the implications of this developmental process within different symptom domains warrants careful consideration. MethodsWomen diagnosed with breast cancer (n = 188; ages 27–89) provided blood samples and reported depressive symptoms prior to adjuvant treatment, at the end of adjuvant treatment, and 6-, 12-, and 18-months after completing adjuvant treatment via the CES-D. Blood was assayed for C-reactive Protein (CRP) and interleukin (IL)-6. We used mixed linear effect models to estimate within- and between-person effects of CRP or IL-6 on 4 domains of depressive symptoms: depressed affect, low positive affect, somatic complaints, and interpersonal problems. ResultsHigh average inflammation was associated with elevated somatic complaints (CRP p = .009, IL-6: p = .05), interpersonal problems (CRP p = .002, IL-6 p < .001), and positive affect (IL-6 p = .03), but only among the youngest women in the sample (age 50 or younger). Younger women also reported more depressed affect at assessments when inflammation was higher (CRP p = .045, IL-6 p = .09). ConclusionsThe association between inflammation and specific depressive symptoms is dynamic and varies across the lifespan, which may help clarify apparent inconsistencies in the extant literature as well as inform more precise interventions targeting this pathway.

Simultaneous employment and depressive symptom trajectories around retirement age in Chile

Objectives: Over the last decade, an increasing number of empirical studies have examined long-term patterns of depression among adults around retirement age and identified employment status as a crucial determinant. However, most research has examined associations between cross-sectional measures of employment and prospective depression patterns, overlooking the changing nature of employment statuses, particularly close to retirement age. Furthermore, most knowledge in this field comes from studies conducted in developed countries in Western Europe and North America. To address these gaps, this study examined simultaneous trajectories in the employment and depressive symptom domains among two age groups of Chileans before and after the standard retirement age. Method: Using population-representative data and longitudinal statistical methods, we identified different trajectory types among two age groups (one aged 56–65 and another aged 66–75, at baseline) and characterized them according to social and health characteristics. Results: We found that trajectories defined by permanent employment were accompanied by lower depressive symptoms than trajectories indicating either retirement or inactivity. However, trajectories combining employment and the absence of depressive symptoms were primarily followed by individuals with advantaged health and social statuses at the baseline. Conclusion: Public policies aimed at promoting the mental health of older adults through their labor market integration risk forcing individuals who have accumulated social and health disadvantages across the life course to work longer.

Aging as a Context for the Role of Inflammation in Depressive Symptoms.

Inflammation has been implicated in the pathogenesis and maintenance of depressive symptoms. The role of inflammation in depressive symptomatology may be complex, varying within endophenotypes and across the lifespan. Aging is associated with myriad changes in the structure and function of the brain. Yet, little attention has been given to the role of inflammation in depressive symptoms within a lifespan developmental framework. In this study, we examined whether the association between inflammation and depressive symptom domains varied by age. Participants were a community sample of individuals (N = 2,077, Range = 30–84) who participated in the Biomarker projects of the MIDUS2, MIDUS Refresher, or the MIDJA study. Inflammation was indexed by two inflammatory markers consistently implicated in depressed individuals, interleukin 6 (IL-6) and C-reactive protein (CRP), measured in blood. Depressive symptom domains, including depressed affect, anhedonia, somatic complaints, and interpersonal problems, were reported via the Center for Epidemiologic Studies—Depression Scale (CES-D). Inflammatory markers were associated with more somatic complaints, more interpersonal problems, and less anhedonia. Age moderated the relationship between inflammatory markers and two depressive symptom subscales. Specifically, the positive association between inflammation and somatic complaints and the negative association between inflammation and anhedonia increased with age. These observations offer preliminary evidence from a large community sample that aging may be an important context for the role of inflammatory signaling in different aspects of psychological and behavioral well-being.

A pilot study on effect of adjunctive transcranial direct current stimulation on symptom domains of depression in patients with depressive disorder.

Background:Depression is a highly prevalent condition and includes clusters of symptoms, namely, depressive cognition, anxiety, and visceral symptoms. Depressive symptoms often respond sub-optimally to pharmacotherapy. Adjunctive transcranial direct current stimulation (tDCS), a noninvasive brain stimulation modality, may improve depressive symptomatology.Aim:The aim of this study was to study the effect of tDCS as an augmentation strategy in depression and its various symptom domains.Materials and Methods:It is a prospective interventional study. Patients diagnosed with depressive disorder (based on International Classification of Disease- 10 criteria, diagnosed by treating psychiatrist), aged 18-70 years, who showed inadequate improvement on antidepressant selective serotonin reuptake inhibitors, were recruited after informed consent. Each participant was administered 20 sessions of tDCS over 2 weeks, each session of 20 min, with anode placement at left dorsolateral prefrontal cortex and cathode at right supraorbital region. Hamilton Rating Scale for Depression (HAM-D) was administered pre- and post-intervention to assess the change in symptoms.Results:Of a total of 35 participants, the mean score on HAM-D prior to and postintervention was 19.97 (standard deviation [SD] = 3.519) and 13.17 (SD = 3.365), respectively. The difference was statistically highly significant (P = 0.000) on paired t-test. All symptom domains of HAM-D, identified using the Cole and Motivala model (Cole et al., 2004), also showed significant reduction from pre-tDCS to post-tDCS scores (P = 0.000).Conclusion:Positive effect of tDCS on depressive symptoms, its tolerability and safety profile, and affordability makes it an effective therapeutic strategy in augmenting antidepressants in patients with depression. However, longer period studies with larger sample size may yield more generalizable results.

Serum Vitamin D Concentrations Are Associated With Depressive Symptoms in Men: The Sixth Korea National Health and Nutrition Examination Survey 2014.

ObjectiveThere is increasing evidence of an inverse association between serum vitamin D concentrations and depression, but whether there are sex-specific differences remains controversial. Thus, the aim of this study was to investigate the association between serum vitamin D concentrations and specific domains of depressive symptoms by each sex in the Korean general population.MethodsThe study sample comprised 820 men and 916 women, aged from 19 to 76, who participated in the Korea National Health and Nutrition Examination Survey 2014. Participants completed health interviews and health examinations providing data of serum 25-hydroxyvitamin [25(OH)D] concentrations, the Patient Health Questionnaire-9 (PHQ-9), and certain covariates. Associations were analyzed using negative binomial regression.ResultsAfter adjusting for various covariates, the association between log-transformed serum 25(OH)D concentrations and total PHQ-9 scores was statistically significant {incidence rate ratio [IRR] = 0.74 [95% confidence interval (CI) = 0.59–0.93]} only in men. Additionally, the association between log-transformed serum 25(OH)D concentrations and the PHQ-9 cognitive/affective subscore was statistically significant [IRR = 0.56 (95% CI = 0.40–0.80)] only in men. There was no association for the somatic subscore.ConclusionsSerum vitamin D levels were inversely associated with cognitive/affective depressive symptoms only in men.

The network structure of core depressive symptom-domains in major depressive disorder following antidepressant treatment: a randomized clinical trial.

Network analysis (NA) conceptualizes psychiatric disorders as complex dynamic systems of mutually interacting symptoms. Major depressive disorder (MDD) is a heterogeneous clinical condition, and very few studies to date have assessed putative changes in its psychopathological network structure in response to antidepressant (AD) treatment. In this randomized trial with adult depressed outpatients (n = 151), we estimated Gaussian graphical models among nine core MDD symptom-domains before and after 8 weeks of treatment with either escitalopram or desvenlafaxine. Networks were examined with the measures of cross-sectional and longitudinal structure and connectivity, centrality and predictability as well as stability and accuracy. At baseline, the most connected MDD symptom-domains were fatigue-cognitive disturbance, whereas at week 8 they were depressed mood-suicidality. Overall, the most central MDD symptom-domains at baseline and week 8 were, respectively, fatigue and depressed mood; in contrast, the most peripheral symptom-domain across both timepoints was appetite/weight disturbance. Furthermore, the psychopathological network at week 8 was significantly more interconnected than at baseline, and they were also structurally dissimilar. Our findings highlight the utility of focusing on the dynamic interaction between depressive symptoms to better understand how the treatment with ADs unfolds over time. In addition, depressed mood, fatigue, and cognitive/psychomotor disturbance seem to be central MDD symptoms that may be viable targets for novel, focused therapeutic interventions.

Clinical correlation of vitamin D in depression

Background: Literature has substantially advanced our understanding of the action of vitamin D in depression, much is still unknown concerning how vitamin D relates to dimensions of depression. Hence, authors aimed to examine the relationship of vitamin D in patients of depression, its correlation with the severity of depression and different symptom domains of depression.Methods: This Hospital based case control study included 75 patients with depression and 50 controls who were age and gender matched. Beck’s Depression Inventory II was used to assess the severity and symptom domains of depression. Vitamin D levels was assessed using Enhanced Chemiluminescence Technique.Results: Vitamin D deficiency was found significantly (&lt;0.001*) among cases than controls. Significant (0.003*) inverse correlation was observed between severity of depression and vitamin D level.In cognitive symptoms, pessimism, punishment feeling, self-criticism, suicidal thoughts and worthlessness were found significantly higher among vitamin D deficient patients. However, in somatic-affective symptoms, crying, indecisiveness, loss of energy, irritability, concentration difficulty and being tired were the significant by prominent symptoms in vitamin D deficient patients.Conclusions: Vitamin D (&lt;50 nmol/L) was found to be significantly associated with depressive symptoms with cognitive and somatic-affective symptoms being affected by vitamin D deficiency.

Concurrent benzodiazepines undermine the antidepressant effect of ketamine

Fatigue and depression are closely associated. The purpose of this secondary analysis was to understand the relationships between depression and improvements in specific depression domains on the anti-fatigue effects of ketamine, which we previously reported.This secondary analysis re-evaluated data collected longitudinally from 39 patients with treatment-resistant Major Depressive Disorder (MDD) enrolled in a double-blind, randomized, placebo-controlled, crossover trial using a single intravenous infusion of ketamine hydrochloride (0.5 mg/kg over 40 minutes) or placebo. A mediation model assessed the effect of depression on the anti-fatigue effects of a single dose of intravenous ketamine versus placebo at Day 1 post-infusion. Fatigue was measured using the National Institutes of Health–Brief Fatigue Inventory (NIH-BFI), and depression was assessed by the Montgomery–Ǻsberg Depression Rating Scale (MADRS).Compared to placebo, ketamine significantly improved fatigue (p = .0003) as measured by the NIH-BFI, but the anti-fatigue effects of ketamine disappeared (p = .47) when controlling for depression as measured by MADRS total score. In this study sample, the anti-fatigue effects of ketamine were mostly accounted for by the changes in amotivation and depressed mood scores.In this study, ketamine did not have a unique effect on fatigue outside of its general antidepressant effects in patients with treatment-resistant depression. Specifically, the anti-fatigue effects of ketamine observed in this study seem to be explained by the effects of ketamine on two symptom domains of depression: amotivation and depressed mood. The study findings suggest that the anti-fatigue effects of ketamine should be assessed by fatigue-specific measures other than the NIH-BFI or future studies should enroll fatigued patients without depression.

Disentangling the association of depression on the anti-fatigue effects of ketamine

BackgroundFatigue and depression are closely associated. The purpose of this secondary analysis was to understand the relationships between depression and improvements in specific depression domains on the anti-fatigue effects of ketamine, which we previously reported. MethodsThis secondary analysis re-evaluated data collected longitudinally from 39 patients with treatment-resistant Major Depressive Disorder (MDD) enrolled in a double-blind, randomized, placebo-controlled, crossover trial using a single intravenous infusion of ketamine hydrochloride (0.5 mg/kg over 40 minutes) or placebo. A mediation model assessed the effect of depression on the anti-fatigue effects of a single dose of intravenous ketamine versus placebo at Day 1 post-infusion. Fatigue was measured using the National Institutes of Health–Brief Fatigue Inventory (NIH-BFI), and depression was assessed by the Montgomery–Ǻsberg Depression Rating Scale (MADRS). ResultsCompared to placebo, ketamine significantly improved fatigue (p = .0003) as measured by the NIH-BFI, but the anti-fatigue effects of ketamine disappeared (p = .47) when controlling for depression as measured by MADRS total score. In this study sample, the anti-fatigue effects of ketamine were mostly accounted for by the changes in amotivation and depressed mood scores. ConclusionsIn this study, ketamine did not have a unique effect on fatigue outside of its general antidepressant effects in patients with treatment-resistant depression. Specifically, the anti-fatigue effects of ketamine observed in this study seem to be explained by the effects of ketamine on two symptom domains of depression: amotivation and depressed mood. The study findings suggest that the anti-fatigue effects of ketamine should be assessed by fatigue-specific measures other than the NIH-BFI or future studies should enroll fatigued patients without depression.

Positive Affect as a Predictor of Smoking Cessation and Relapse: Does It Offer Unique Predictive Value among Depressive Symptom Domains?

ABSTRACTBackground: Prior studies have suggested that, among the domains of depressive symptoms, low positive affect (PA) may have a distinct relationship with smoking cessation and relapse. However, the empirical basis for PA-focused interventions cessation is limited, with some mixed findings. Objectives: Using a large, diverse sample of treatment-seeking smokers, this study tested the hypothesis that PA adds unique predictive value beyond the effects of the other symptom domains in models of cessation and relapse. Methods: Adult smokers participating in a smoking cessation trial (n = 450) were included in this post hoc analysis. Cessation outcomes included smoking abstinence at end of treatment and at 6-month follow-up. Relapse was defined as recurrence of smoking at 6-month follow-up among the end-of-treatment abstainers. Depressive symptoms were assessed at baseline using the Center for Epidemiologic Studies-Depression (CES-D) scale. Results: With the exception of PA, all of the CES-D domains predicted reduced likelihood of smoking abstinence at end of treatment and cotinine-confirmed (but not self-reported) abstinence at 6 months, as did total CES-D score (all p-values < .05). None of the symptom domains predicted relapse. Conclusions/Importance: Our results provide further evidence that current depressive symptoms predict worse cessation outcomes, but they fail to support recent work suggesting that low PA has incremental predictive value for cessation or relapse beyond the other depressive symptom domains. To improve quit rates for smokers with depressive symptoms, evidence-based mood management interventions should be included in treatment planning.

Depressive symptom domains and alcohol use severity among Hispanic emerging adults: Examining moderating effects of gender

ObjectiveA limited amount of research has examined the effects of unique depressive symptom domains on alcohol use behavior among Hispanics of any developmental stage. This study aimed to (a) examine the respective associations between depressive symptom domains (e.g., negative affect, anhedonia, interpersonal problems, and somatic complaints) and alcohol use severity among Hispanic emerging adults, and (b) examine if gender moderates each respective association. Method181 Hispanic emerging adults (ages 18–25) completed an anonymous cross-sectional online survey. Participants completed a demographic questionnaire, the Alcohol Use Disorder Identification Test, and the Center Epidemiological Studies Depression Scale. Hierarchical multiple regression was used to estimate respective associations of negative affect, anhedonia, interpersonal problems, and somatic complaints in relation to alcohol use severity. Moderation tests were also conducted to examine if gender functioned as an effect modifier between respective depressive symptom domains and alcohol use severity. ResultsFindings indicated higher levels of anhedonia were associated with higher alcohol use severity (β=0.20, p=0.02). Moderation analyses indicated that somatic complaints (β=−0.41, p=0.02) and interpersonal problems were associated with greater alcohol use severity among men (β=−0.60, p<0.001), but not women. ConclusionsFindings underscore the need to examine the relationship between specific depressive symptom domains and alcohol use; and the importance of accounting for potential gender differences in these associations.