Depressive Symptomatology In Patients Research Articles

Lipid parameters and depression in patients with chronic tinnitus: A cross-sectional observation

BackgroundPathophysiological theories assume importance of metabolic abnormalities in patients with major depression - and possibly chronic tinnitus. Although chronic tinnitus frequently correlates with depression, links between high-density lipoprotein (HDL) and depression are uninvestigated. MethodsTwo-hundred patients with chronic tinnitus (Mage = 55; 51% female) were examined. Serum levels of total cholesterol (TC), triglycerides (TGs), HDL, low-density lipoprotein cholesterol (LDL), non-HDL, as well as LDL/HDL and TC/HDL ratios were analysed. Questionnaires included depression subscales of the ICD-10 Symptom Rating, the Hospital Anxiety and Depression Scale (HADS_D), and the Berlin Mood Questionnaire (BSF). Multivariate analyses of covariance and linear regression models - which controlled age, tinnitus-related distress and perceived stress - investigated between-subgroup differences (p < 0.05) and linear associations between HDL indices and depression (p < 0.01). ResultsHDL levels did not differ for tinnitus-symptom durations, smoking and alcohol use levels, statin or antihypertensive drug use, and body-mass indices. Relative to non-to-mildly depressed patients with chronic tinnitus, patients with moderate-to-severe depression (n = 45; 23%) had significantly lower HDL levels (d = −0.35) and higher LDL/HDL (d = 0.39) and TC/HDL ratios (d = 0.40). Across participants, HDL-levels were negatively associated with depression as measured by the HADS_D and BSF_indifference scales. ConclusionsIn keeping with general depression research, low serum HDL levels correlate with depressive symptomatology in patients with chronic tinnitus. This association may be influenced by proximal (e.g. modulations of HPA-axis activity) or distal factors (e.g. maladaptive coping behaviours) – both of which should be conceptualized within psychological stimulus-processing frameworks.

The effects of JNJ-39393406 a positive allosteric nicotine modulator on mood and cognition in patients with unipolar depression: A double-blind, add-on, placebo-controlled trial

Nicotinic agonists have been shown to improve cognition and mood, but this improvement is inconsistent and short-lived, possibly due to receptor desensitization. Positive Allosteric Modulators (PAMs) of the nicotinic alpha-7 nicotinic-acetyl-choline receptor (a7nAChR) are hypothesized to change the configuration of the nicotinic receptor and delay desensitization, potentially increasing the duration of the activation of the receptor, and improving clinical efficacy. This was a randomized controlled trial (RCT) adding JNJ-39393406 9 (a PAM of the a7nAChR) (n=35) or placebo (n=36) to treatment as usual for two weeks in 71 patients with unipolar depression. Mixed models for repeated measures analyses were performed Primary outcome measures were the Brief Assessment of Cognition in Schizophrenia (BACS) composite and the Montgomery-Asperg Depression Rating Scale (MADRS) scores. The drug was well tolerated, however mixed models for repeated measures comparing JNJ-39393406 to placebo showed no significant difference for MADRS total score (p=0.78), BACS composite score (p=0.34), or any of the secondary outcome measures. There was no significant difference in adverse events between the study groups (p=0.44). In conclusion, this study's findings do not support the hypothesis that a positive nicotinic receptor modulator can improve cognitive or depressive symptomatology in patients with unipolar depression.

Psychometric Properties of the Chinese Version of the Bipolar Depression Rating Scale for Bipolar Disorder.

IntroductionUnlike unipolar depression, depressive episode of bipolar disorder is often associated with clinical characteristics, such as atypical and mixed symptoms. However, there are currently no valid and reliable specific tools available to assess the specific psychiatric symptomatology of depressive episode of bipolar disorder in China. Therefore, we aimed to evaluate the psychometric properties of the Chinese version of the Bipolar Depression Rating Scale (BDRS) in Chinese patients with bipolar disorder.MethodsThe sample of this study included 111 patients with bipolar disorder (30 male, 81 female). All participants were interviewed with the Chinese version of the BDRS (BDRS-C), the 17-item Hamilton Depression Rating Scale (HAMD-17), the Montgomery-Asberg Depression Rating Scale (MADRS) and the Young Mania Rating Scale (YMRS). A psychometric analysis of the BDRS was conducted.ResultsThe Cronbach’s alpha coefficient of the BDRS-C reached a value of 0.869. The BDRS-C score and scores for the HAMD-17 (r = 0.819, p < 0.01), the MADRS (r = 0.882, p < 0.01) and the YMRS (r = 0.355, p < 0.01) exhibited significant positive correlations. Close correlations were observed between the mixed subscale score of the BDRS-C and the YMRS score (r = 0.784, p < 0.01). Exploratory factor analysis resulted in three factors: a primary depressive symptoms cluster, a secondary depressive symptoms cluster, and a mixed symptoms cluster.ConclusionThe Chinese version of the BDRS has satisfactory psychometric properties. This is a valid and reliable instrument to assess depressive symptomatology in patients with bipolar disorder.

Dietary Glutamic Acid, Obesity, and Depressive Symptoms in Patients With Schizophrenia.

Introduction: Schizophrenia is a lifelong condition associated with several comorbid conditions such as physical illnesses like obesity, as well as co-occurring psychiatric symptoms such as depression. Research regarding susceptibility to some of these comorbidities has primary focused on genetic risks or neurotransmitters and very little work has been done to understand environmental factors such as diet. In particular, understanding the role of dietary glutamic acid consumption on co-morbidities in patients with schizophrenia is important, as evidence suggests that glutamic acid consumption may directly influence glutamatergic neurotransmission; a key neurotransmitter related to schizophrenia, its associated co-morbidities, and depression. Therefore, the aim of this study was to examine the potential relationship between dietary glutamic acid and depressive symptomatology in patients with schizophrenia, stratified by obesity status, due to its relationship with inflammation, antipsychotic use, and depressive symptoms.Methods: Subjects included in this analysis, were part of a parent cross-sectional study in which included three dietary recalls analyzed using protocols outlined as part of the National Health and Nutrition Examination Surveys (NHANES) standardized criteria. Additionally, body mass index (BMI), and Beck Depression Inventory were obtained at this visit. Subjects with a BMI ≥ 30 kg/m2 were included in the obesity group, and the relationship between glutamic acid consumption and BDI scores was analyzed after controlling for age, race, sex, antidepressant and antipsychotic use, and animal and vegetable protein intake which provide natural forms of dietary glutamic acid.Results: A total of 168 participants were included in this study, of which 42.5% were female and 52.9% were White. The mean BMI for the group as a whole was 33.5 ± 8.7 (kg/m2) and the mean BDI was 14.5 ± 10.2 (range 2–50). No differences were found between obesity groups, other than a greater hyperlipidemia, hypertension, and lower waist to hip ratio. Overall, no relationship was found between dietary glutamic acid and BDI scores, However, for non-obese participants, diets higher levels of glutamic acid were associated with greater depression symptomatology (p = 0.021).Conclusion: These preliminary results indicate a possible correlation between dietary glutamic acid a depressive symptoms in non-obese patients with schizophrenia, although further research is needed to specifically examine this relationship.

Course of depressive symptomatology and its association with serum uric acid in one-anastomosis gastric bypass patients

The changes in depressive symptomatology during the first year following one-anastomosis gastric bypass (OAGB) were evaluated and its association with uric acid (sUA). Fifty patients were included in this analysis. Beck Depression Inventory (BDI) for measuring depressive symptomatology, blood samples, and anthropometric measurements were assessed before (T0), at 6 (T6), and 12 months (T12) after surgery. There was a significant reduction in BDI total score at T6 (− 5.6 (95% CI − 2.1, − 9.1) points; p = 0.001) and at T12 (− 4.3 (95% CI − 0.9, − 7.9) points; p = 0.011). BMI loss was unrelated to depressive symptomatology. Patients with moderate to severe depressive symptomatology presented lower sUA levels than patients with none or minimal to mild (p = 0.028). ROC analysis revealed that sUA levels below 5.0 at T6 and 4.5 mg/dl at T12 had a prognostic accuracy for depression severity. Furthermore, delta sUA was significantly associated with delta BMI (β = 0.473; p = 0.012) and delta waist circumference (β = 0.531; p = 0.003). These findings support an improvement in depressive symptomatology in the first year postoperatively, however, without relation to BMI loss. Patients with moderate to severe depressive symptomatology presented with lower sUA levels over time. Therefore, sUA could be useful to predict moderate to severe depressive symptomatology in patients undergoing OAGB in clinical practice.

Changes in Beck Depression Inventory scores in prostate cancer patients undergoing androgen deprivation therapy or prostatectomy.

ObjectivesAndrogen deprivation therapy (ADT) has seen increasing use as a prostate cancer treatment in recent years and has proven medically effective in numerous contexts. The treatment, however, is associated with a host of side effects including depression. Managing the psychological wellbeing of prostate cancer patients is important for maximizing their survival outcomes. Thus, this study aimed to evaluate depressive symptomatology in patients with androgen deprivation therapy (ADT) compared with that in patients who underwent prostatectomy and to explore the factors that affect depressive symptoms, which might occur during ADT.MethodsOne hundred and seven patients undergoing ADT (ADT group) and prostatectomy (Operation group) were enrolled. Adjustments were made for differences in characteristics between groups using a propensity score model with stabilized weights before treatment. Depressive symptoms between groups were compared using the Beck Depression Inventory (BDI) before treatment and six months after treatment initiation. To identify factors affecting depressive symptoms during ADT, multivariate regression analysis was performed on the mean change in BDI score, age, body mass index, testosterone level, prostate-specific antigen level, the international index of erectile function (IIEF), and the Gleason score.ResultsThe BDI score significantly increased in the ADT group compared to the operation group six months after treatment initiation (p < 0.001). Multivariate regression analysis revealed that before ADT, the BDI score was higher by 0.446 according to the IIEF. During ADT, the BDI score increased by 1.579 according to changes in BMI (p = 0.021) and decreased by 0.01 according to changes in testosterone levels (p = 0.034).ConclusionDepressive symptoms can be exacerbated in prostate cancer patients undergoing ADT. Efforts are needed to diagnose and treat depression appropriately, especially if depressive symptoms change in ADT patients with a high IIEF score before ADT, or reduced testosterone levels or increased BMI during ADT.

Il ruolo dell'infiammazione nella depressione: dalla patogenesi alla risposta al trattamento

In the last decades, research has demonstrated a higher activation of the immune system in patients affected by schizophrenia, bipolar disorder, major depression and anxiety. However, it is not clear whether these pathologies showed distinct inflammatory profiles and if these profiles could help to develop specially focused therapies. The efficacy of anti-inflammatory agents in the case of depression is inconsistent, and it shows evidence only in some subcategories of patients. In particular, anti-inflammatory drugs seem to significantly improve the depressive symptomatology in patients with high levels of plasma or serum inflammatory molecules. On the other hand, the efficacy of pharmacological therapies appears to correlate with a reduction in the level of inflammatory cytokines. Therefore, as shown by the Authors’ research group and by the GENDEP European project, specific inflammatory biomarkers could help to predict the efficacy of pharmacological therapies, identify whether patients will respond or not to the conventional treatment for depression and develop adjuvant therapies.

0733 Retrospective Pain Reports In OSA Patients: Roles Of Depressive Symptoms, Polysomnographic And Self-report Sleep Measures

Abstract Introduction Exploring the relationship between OSA and pain, some studies showed hyperalgesia, and others, hypoalgesia. It was proposed that apnea-related sleep fragmentation causes hyperalgesia, and hypoxemia, hypoalgesia. However, SpO2 nadir had opposite relationships with pain measures in different studies. A 2018 review of over 1000 studies reported lack of consistent relationship between OSA and pain variables. Further, OSA was shown to relate to depressed mood, which may alter pain perception. Presently, retrospective reports of pain are analyzed as a function of polysomnographic and self-report sleep variables and depressive symptomatology in patients evaluated for OSA. Methods A total of 1,166 patients (923 women, 1136 minorities, 18-97 y.o., age M=53.1±15.2, BMI M=34.4±8.7) undergoing an overnight PSG filled out the Center for Epidemiologic Studies Depression Scale-Revised (CESDR), ISI, PSQI, ESS, and Chronic Pain Grade Scale yielding pain intensity (PI) and functional effect (FE) scores. PI and FE were separately regressed onto age, sex and BMI, followed by PSG and self-report variables meeting p&amp;lt;0.1 criterion. AHI and SpO2nadir were forced into the models. Results Mean AHI=29.6±34.7, range 0-167/hr, 72.3% had AHI≥5. Higher PI related to higher AHI (p=0.005, R2&amp;lt;1%), lower total arousal index (TAI, p=0.006, R2&amp;lt;1%), higher total sleep time (TST, p=0.003, R2&amp;lt;1%), higher PSQI (p&amp;lt;0.001, R2=5%), and higher CESD (p=0.001, R2&amp;lt;1%), without interactions with sex. Higher FE related to higher AHI (p=0.004, R2&amp;lt;1%), lower TAI (p&amp;lt;0.001, R2=1%), higher PSQI (p&amp;lt;0.001, R2=3%, and higher CESD (p&amp;lt;0.001, R2=2%). Sex had a significant interaction only with AHI (p=0.032); the FE-AHI relationship was significant in women (p=0.012), but not in men. Conclusion On retrospective reports of pain in this large sample, higher AHI related to greater pain intensity in both sexes and to greater functional effect in women only. Unexpectedly, higher pain measures were also related to lower TAI and higher TST. Higher depressive symptomatology and subjective sleep disturbance on PSQI were related to greater pain intensity and its functional effect. Only a small portion of the variance in pain measures was accounted for by PSG and self-report variables. Support none

Depressive symptoms in Type 1 and Type 2 Diabetes Mellitus and its relationship with glycemic control

Objective: The current study assessed depressive symptoms in Type 1 Diabetes Mellitus (T1DM) and Type 2 Diabetes Mellitus (T2DM) patients and explored whether these symptoms were associated with glycemic control. Methods: A cross-sectional design was used. Patients attending diabetes consultations participated in the study (N = 347). Participants completed the Beck Depression Inventory (BDI), and glycemic control was based on A1C criteria. Results: The mean score on the BDI, for either T1DM or T2DM, was not clinically significant and was not associated with diagnosis duration. The association between depression and glycemic control was significant in both DM types. T2DM participants presenting more depressive symptoms were those with greater glycemic control. T1DM and T2DM differences regarding depressive symptoms were in somatic symptoms. Conclusions: In T2DM depressive symptoms may be confounded with DM physical consequences. There is also the possibility that negative mood plays a mediating role in mobilizing survival strategies that promote glycemic control. Furthermore, the assessment of depressive symptomatology in patients with diabetes could benefit from the availability of a disease-specific measure.

Association between serum lipid levels, osteoprotegerin and depressive symptomatology in psychotic disorders

Although the relationship between positive and negative symptoms of psychosis and dyslipidemia has been thoroughly investigated in recent studies, the potential link between depression and lipid status is still under-investigated. We here examined the association between lipid levels and depressive symptomatology in patients with psychotic disorders, in addition to their possible inflammatory associations. Participants (n = 652) with the following distribution: schizophrenia, schizophreniform and schizoaffective disorder (schizophrenia group, n = 344); bipolar I, II, NOS, and psychosis NOS (non-schizophrenia group, n = 308) were recruited consecutively from the Norwegian Thematically Organized Psychosis (TOP) Study. Clinical data were obtained by Positive and Negative Syndrome Scale (PANSS), and Calgary Depression Scale for Schizophrenia (CDSS). Blood samples were analyzed for total cholesterol (TC), low-density lipoprotein (LDL), triglyceride (TG), C-reactive protein (CRP), soluble tumor necrosis factor receptor 1(sTNF-R1), osteoprotegerin (OPG), and interleukin 1 receptor antagonist (IL-1Ra). After adjusting for age, gender, BMI, smoking, and dyslipidemia-inducing antipsychotics, TC and LDL scores showed significant associations with depression [β = 0.13, p = 0.007; β = 0.14, p = 0.007], and with two inflammatory markers: CRP [β = 0.14, p = 0.007; β = 0.16, p = 0.007] and OPG [β = 0.14, p = 0.007; β = 0.11, p = 0.007]. Total model variance was 17% for both analyses [F(12, 433) = 8.42, p < 0.001; F(12, 433) = 8.64, p < 0.001]. Current findings highlight a potential independent role of depression and inflammatory markers, CRP and OPG in specific, in the pathophysiology of dyslipidemia in psychotic disorders.

Plasma IL-8 signature correlates with pain and depressive symptomatology in patients with burning mouth syndrome: Results from a pilot study.

Burning mouth syndrome (BMS) is a neuropathic orofacial pain condition of unknown aetiology that encompasses intra-oral burning pain without abnormal clinical findings. Psychological, neural and inflammatory processes are associated with BMS pathogenesis. Currently, studies characterising plasma cytokine/chemokine profiles with pain and depression in patients with BMS are lacking. Considering that inflammation is associated with the pathophysiology of BMS, and that inflammation is closely associated with pain and depression, we aimed to correlate depressive symptomatology and oral cavity pain with plasma cytokine/chemokine signatures in a cohort of patients with BMS. In this study, plasma protein levels of Th1 cytokines (IFN-γ, IL-2, IL-12p70, TNF-α), Th2 cytokines (IL-4, IL-10, IL-6, IL-13) and the chemokine IL-8 were assessed in patients with BMS (n = 10) and healthy volunteers (n = 10), using pro-inflammatory-10-plex assays. Clinical histories, alongside self-rated oral cavity pain intensities and depressive symptomatology were assessed using a visual analogue scale and the 16-item Quick Inventory of Depressive Symptomatology questionnaires, respectively. We present evidence that BMS is associated with increased depressive symptomatology and enhanced oral cavity pain. Plasma isolated from BMS patients display enhanced expression of the pro-inflammatory chemokine IL-8, when compared to plasma from healthy individuals. Plasma IL-8 signature correlates with pain and depressive symptomatology in the study cohort. Overall, these findings indicate that plasma IL-8 profiles are dysregulated in BMS and that modulation of IL-8 production in the disorder may be a tool in the management of BMS symptomatology.

Relationship Between HIV and Depressive Symptomatology in Patients From Northern Portugal: Analysis of Individual, Health, and Social Predictors

Depression is the most prevalent mental disorder in people living with HIV. Our study involved 371 participants in outpatient treatment for HIV in hospitals in northern Portugal. Participants were referred to the study by the attending physician/nurse, and data were collected through an individual interview at a single evaluation moment. Participants were mostly male (70%), with an average age of 46.63years (SD=11.77), and a known diagnosis of HIV for an average of 10.13years (SD=6.42). Severe depressive symptoms were identified in 18% of participants. We identified several significant predictors of depressive symptoms: being female, being in a situation of social exclusion, having adverse experiences throughout life, infection by sexual contact in a stable marital relationship, daily concerns regarding health, negative family relationships, and dissatisfaction with social support. Findings suggest the need to include regular mental health assessments and referral for specialized psychological support services.

Evaluation of psychosocial aspects in participants of cancer genetic counseling

BackgroundThe instrument called “Hospital Anxiety and Depression Scale” (HADS) is frequently used to evaluate anxious and depressive symptomatology in patients who receive Cancer Genetic Counseling (CGC). However, this instrument cannot identify all of the psychosocial factors, such as the antecedents of the patients’ emotional states or their concerns. The objective of the present research was to compare cases detected with psychosocial alterations by means of HADS and a Psychological Health Interview (PHI).MethodsA transversal analytical design was used. One hundred ten participants were included (97.3% females and 2.7% males). The average age was 45 years ±10 years.ResultsThe PHI identified twice the amount of participants with psychosocial alterations than did HADS, which only detected 43% of these participants.ConclusionsThe results of our study suggest that the PHI should be applied in addition to HADS to identify participants who would require psychological support due to recurrent concerns.

Online mindfulness as a promising method to improve exercise capacity in heart disease: 12-month follow-up of a randomized controlled trial.

There is increasing evidence that mindfulness can reduce stress, and thereby affect other psychological and physiological outcomes as well. Earlier, we reported the direct 3-month results of an online modified mindfulness-based stress reduction training in patients with heart disease, and now we evaluate the effect at 12-month follow-up. 324 patients (mean age 43.2 years, 53.7% male) were randomized in a 2:1 ratio to additional 3-month online mindfulness training or to usual care alone. The primary outcome was exercise capacity measured with the 6 minute walk test (6MWT). Secondary outcomes were blood pressure, heart rate, respiratory rate, NT-proBNP, cortisol levels (scalp hair sample), mental and physical functioning (SF-36), anxiety and depression (HADS), perceived stress (PSS), and social support (PSSS12). Differences between groups on the repeated outcome measures were analyzed with linear mixed models. At 12-months follow-up, participants showed a trend significant improvement exercise capacity (6MWT: 17.9 meters, p = 0.055) compared to UC. Cohen’s D showed significant but small improvement on exercise capacity (d = 0.22; 95%CI 0.05 to 0.39), systolic blood pressure (d = 0.19; 95%CI 0.03 to 0.36), mental functioning (d = 0.22; 95%CI 0.05 to 0.38) and depressive symptomatology (d = 0.18; 95%CI 0.02 to 0.35). All other outcome measures did not change statistically significantly. In the as-treated analysis, systolic blood pressure decreased significantly with 5.5 mmHg (p = 0.045; d = 0.23 (95%CI 0.05–0.41)). Online mindfulness training shows favorable albeit small long-term effects on exercise capacity, systolic blood pressure, mental functioning, and depressive symptomatology in patients with heart disease and might therefore be a beneficial addition to current clinical care.Trial registration: www.trialregister.nl NTR3453

0610 SUBJECTIVE SLEEP QUALITY RELATES TO DEPRESSIVE SYMPTOMATOLOGY IN OBSTRUCTIVE SLEEP APNEA PATIENTS

Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) are common tools to assess sleep disturbance in various patient populations. However, PSQI was shown to relate to psychological variables rather than objective sleep measures in non-clinical samples, and ISI was related to symptoms of depression in OSA patients. We related PSQI and ISI to PSG variables and depressive symptomatology in patients undergoing OSA evaluation. Forty-nine patients (18-59y.o., 24 women, 27 minorities, no neurological or endocrine conditions) completed PSQI (normal range PSQI<6), ISI (normal range: ISI<8), and Center for Epidemiologic Studies Depression Scale-Revised (normal range: CESD-R<16) on the evening of PSG. PSQI and ISI scores were regressed on sleep latency, sleep efficiency, awakenings, arousal index, N1%, N3%, REM%, REM latency, AHI, SpO2% nadir, time spent below SpO2 90%, desaturation index, and CESD-R. Age, sex and BMI were used as covariates wherever significant. Mean AHI=22.9 ± 32.5; mean PSQI=8.0 ± 3.3; mean ISI=10.9 ± 5.8; mean CESD-R=10.6 ± 9.1. Higher PSQI was related to higher REM% (p=0.02) and higher CESD-R (p=0.01). Higher ISI was related to higher CESD-R (p=0.01) and not to any PSG variables. In regressing CESD-R onto PSG measures, higher CESD-R related to longer REM latency (p=0.02), with no relationship to other variables. On average, OSA patients reported disturbed sleep on PSQI and ISI, while depressive symptomatology was within normal limits. However, self-reported poor sleep related to depressive symptoms rather than objective measures of sleep disturbance and sleep disordered breathing. Generally sub-clinical CESD-R scores and the direct relationship between CESD-R and REM latency in this sample argue against endogenous depression. To the extent present, depressive symptoms in OSA patients may represent a negative cognitive style, which bears on the patient’s subjective evaluation of their sleep. None.

Association between multiple sclerosis and depression

IntroductionMultiple Sclerosis (MS) is considered an autoimmune inflammatory disease and it is the most common demyelinating disease of the central nervous system. Although its aetiology remains unknown, it has been considered to be multifactorial. MS tends to be more commonly diagnosed in young Caucasian women. It has been described four clinical courses: relapsing-remitting MS, primary progressive MS, secondary progressive MS and progressive remitting MS based on the temporal sequence in which the symptoms arise. Clinic is also very different because it depends on the sites where the lesions occur. The most frequent signs and symptoms are motor and visual deficits, paraesthesia, gait ataxia, diplopia, dizziness and bladder dysfunction. Depressive symptomatology is also among the most common symptoms of MS.ObjectivesShow the importance of depressive symptomatology in patients with MS.AimsEvaluation the connection between MS and depression.MethodsSearch for articles concerning MS and depression on Pubmed and Scielo databases from July 2014 through October 2016.ResultsPsychiatric manifestations, and especially depressive symptoms, affect almost 40% of MS patients in remission, and about 90% of those in a flare-up. This may be due to the diagnosis itself, with its large amount of symptoms and its variable progression, but also due to side effects of therapy. It gives a major contribute to suicidality (7.5%) when compared to the general population.ConclusionA combined approach and treatment is in order to diminish the incapacity caused by both these illnesses in every single patient.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Effects of extended cannabis abstinence on clinical symptoms in cannabis dependent schizophrenia patients versus non-psychiatric controls

BackgroundRates of cannabis use among patients with schizophrenia are high, however little is understood about clinical effects of continued cannabis use and cessation after illness onset. Therefore, we investigated the effects of 28-days of cannabis abstinence on psychotic and depressive symptomatology in cannabis dependent patients with schizophrenia. MethodMales with cannabis dependence and co-morbid schizophrenia (n=19) and non-psychiatric controls (n=20) underwent 28-days of monitored cannabis abstinence. Clinical symptoms were assessed at baseline and then weekly. Abstinence was encouraged using weekly therapy sessions and contingency reinforcement, confirmed by twice-weekly urine assays. ResultsForty-two percent (8/19) of patients and 55% (11/20) of controls achieved 28-days of sustained cannabis abstinence. In patients, PANSS subscores did not change over time irrespective of abstinence status. In contrast, patient abstainers demonstrated a more pronounced reduction in depression scores compared to non-abstainers, however, the Abstinence Status x Time interaction was non-significant. DiscussionShort-term (28-days) cannabis abstinence is not associated with improvement in psychotic symptoms, but may be associated with improvement in depressive symptomatology in patients with schizophrenia. Future studies employing larger samples as well as a continuous cannabis-using group may help to better characterize the causal effects of cannabis on symptom outcomes in this disorder.

The research of social and clinico-dynamic factors of predisposition to development of depressive symptoms in patients with paranoid schizophrenia

Background. The raise of the quality of diagnostics of depressive symptomatology in patients with paranoid schizophrenia by revelation of the factors of predisposition to its development.Materials and methods. 82 хворих patients (studied group) were examined for paranoid schizophrenia with depressive syndrome and 47 – without the syndrome of depression (group of comparison). For this aim the clinical-anamnestic, socio-demographic, clinico-psychopathological and pathopsychological methods of research were used. The scales PANSS, CDSS, HARS, HDRS, questionnaire for the assessment of social functioning and the life quality of psychic patients were also used. On the base of received results the prognostic importance of the separate factors of predisposition to the development of depressive symptomatology in patients with paranoid schizophrenia was assessed.Results of research. Social predisposing factors: absence of own family; inability to use the existent educational and professional potential; absence of work and short employment history. The age and gender belonging had not essential influence on the development of depressive symptomatology. The clinico-dynamic factors of predisposition were determined as: depressive-paranoid syndrome in the period of exacerbation; duration of exacerbation period more than 40 days; development of depressive symptomatology at the beginning of disease and its further conservation; raise of the frequency of rehospitalizations with the course of disease; short dose of supporting therapy and short-term remissions without rehabilitation support; continuous-progredient course of disease with development of apathetic-abulic defect.Conclusions. Depressive symptomatology can develop at any stage of schizophrenia disease. Being associated with depressive symptomatology, disease fast acquires the unfavorable, malignant course with reduction of the quality and duration of emissions and raise of rehospitalization level already in first 5 years of disease. It is proved by the low level of compliance, development of hospitalism, decrease of social functioning and level of life quality. The revealed social and clinico-dynamic predisposition factors will allow raise the level of diagnostics of depressive symptomatology in patients with paranoid schizophrenia. Elaboration of the complex socio-medical rehabilitation of patients with depressive symptomatology at paranoid schizophrenia that takes into account the revealed factors of predisposition will favor the increase of the level of social functioning and life quality of this contingent of patients

Sex differences in depressive symptomatology in patients with chronic hepatitis C during pegylated interferon alpha therapy: A 72-week prospective study

IntroductionTreatment with pegylated interferon alpha (PEG-IFN-α) is associated with depression more frequently in chronic hepatitis C (CHC) patients than with other inflammatory diseases.ObjectivesTo prospectively asses sex differences in the prevalence of depression in CHC patients during the PEG-IFN-α, as well as in the CHC group with no therapy.MethodsSample consisted of 103 subjects with CHC on the PEG-IFN-α and 103 subjects with CHC without interferon therapy. The diagnosis of depressive disorder was established by using Structured Clinical Interview and Criteria of International Classification Disorder. The severity of depression was assessed by using Hamilton Depression Rating Scale (HAMD ≥ 8) prior to PEG-IFN-α (baseline) and at the follow-up visits (4th, 12th, 24th, 48th, 72nd week).ResultsDuring the course of PEG-IFN-α, 49.5% of subjects showed depressive symptomatology (HAMD ≥ 8). Except at baseline and in the 72nd week, on the all other follow-up visits the prevalence of depression was significantly higher in female subjects (*all Ps &lt; 0.05). The strongest difference was observed in the 12th week: of all the subjects with HAMD ≥ 8, 68.8% were female and 32.7% were male (P &lt; 0.001). The multivariate logistic regression model showed that female sex is a very strong predictor for the development of depression during the interferon treatment [Exp (B) = 6.729]. There were no significant sex differences in the prevalence of depression in the control group.ConclusionsOur study (the longest study in this area) indicate that the prevalence of depression is significantly higher in female subjects with CHC during antiviral treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Quinolinic Acid Responses during Interferon-α-Induced Depressive Symptomatology in Patients with Chronic Hepatitis C Infection - A Novel Aspect for Depression and Inflammatory Hypothesis.

BackgroundThe aim of this exploratory study is to gain for the first time a more comprehensive picture of the impact of changes of quinolinic acid concentrations on depressive symptomatology during and after IFN-α therapy.MethodsThe quinolinic acid concentrations of 35 HCV patients are examined in a prospective survey over the entire period of IFN-α treatment as well as three months later at six different times (baseline, one, three, six and nine months after the beginning of IFN-α treatment, and after the end of treatment).ResultsDuring IFN-α treatment Hamilton Depression Rating Scale scores rise significantly. At the same time there is greater activity of indoleamine 2,3-dioxygenase, with a resulting increase in plasma kynurenine concentrations. Compared to baseline values quinolinic acid concentrations increase significantly during therapy, reflecting an increased neurotoxic challenge. In addition, patients with higher scores in the Hamilton Depression Rating Scale at six and nine months after starting therapy show significantly higher levels of quinolinic acid concentration.ConclusionsThe increase of quinolinic acid during IFN-α therapy might contribute to depressive symptomatology through the neurotoxic challenge caused by quinolinic acid. Subsequently, our exploratory study results support the inflammatory hypothesis of depression. The awareness of relevant risk factors of IFN-α treatment-induced depression is essential to develop preventative treatment strategies.