Depressive Symptomatology Research Articles

Replication Study to Evaluate the Effects of Awe on Humility

This paper replicates Stellar and Colleagues’ 2018 study involving an experimental manipulation of awe using standardized video induction, as well as proposing and testing out an additional hypothesis. The previous study hypothesized that watching an awe-inducing video would lead participants to write fewer strengths before writing their weaknesses. In addition to the replication, we hypothesized that participants with higher scores of depressive symptomatology (DS) would list fewer strengths due to diminished self-concept and self-efficacy. Ninety-four undergraduate psychology students were recruited from McGill University ranging from 18 to 35 years of age. Participants were randomly assigned to either the awe-inducing or neutral video condition, and then filled out measures of humility, emotional reactions, and DS. In contradiction with the original study, participants in the awe condition and the neutral condition did not significantly differ in their ratio of disclosed strengths to weaknesses, therefore no significant correlations were found between awe and humility or humility and depression. Additionally, results indicated that participants with greater DS did not list fewer strengths compared to those scoring lower on the CES-D. We were unable to directly replicate the original study and thus rejected our alternate hypothesis. This study had various potential limitations, among which are the possibilities of self-report bias, issues regarding convenience sampling, and bias due to time constraints. The current study advances the literature by including depression relating to awe and humility. Further research is needed, to differentiate lab-induced awe from natural experiences of awe and identify possible moderating factors on humility.

Low Functional network integrity in cognitively unimpaired and MCI subjects with depressive symptoms: results from a multi-center fMRI study

Evidence suggests that depressive symptomatology is a consequence of network dysfunction rather than lesion pathology. We studied whole-brain functional connectivity using a Minimum Spanning Tree as a graph-theoretical approach. Furthermore, we examined functional connectivity in the Default Mode Network, the Frontolimbic Network (FLN), the Salience Network, and the Cognitive Control Network. All 183 elderly subjects underwent a comprehensive neuropsychological evaluation and a 3 Tesla brain MRI scan. To assess the potential presence of depressive symptoms, the 13-item version of the Beck Depression Inventory (BDI) or the Geriatric Depression Scale (GDS) was utilized. Participants were assigned into three groups based on their cognitive status: amnestic mild cognitive impairment (MCI), non-amnestic MCI, and healthy controls. Regarding affective symptoms, subjects were categorized into depressed and non-depressed groups. An increased mean eccentricity and network diameter were found in patients with depressive symptoms relative to non-depressed ones, and both measures showed correlations with depressive symptom severity. In patients with depressive symptoms, a functional hypoconnectivity was detected between the Anterior Cingulate Cortex (ACC) and the right amygdala in the FLN, which impairment correlated with depressive symptom severity. While no structural difference was found in subjects with depressive symptoms, the volume of the hippocampus and the thickness of the precuneus and the entorhinal cortex were decreased in subjects with MCI, especially in amnestic MCI. The increase in eccentricity and diameter indicates a more path-like functional network configuration that may lead to an impaired functional integration in depression, a possible cause of depressive symptomatology in the elderly.

Schizotypy, affective temperaments and anhedonia in bipolar depression.

"Schizotypy" is a term describing personality traits reflected in emotional, perceptual and cognitive styles. Affective temperaments are trait-like features which were observed to be stable in time and predispose to mood disorders. The purpose of this study was to examine relationship between schizotypal features, affective temperaments and anhedonia in patients with bipolar depression. 54 patients with bipolar depression were included in the study. Participant were administered the following psychometric tools: Dimensional Anhedonia Rating Scale (DARS), Snaith-Hamilton Pleasure Scale (SHAPS), Oxford-Liverpool Inventory of Feelings and Experiences (O-LIFE), Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A), and Quick Inventory of Depressive Symptomatology - Self-Report (QIDS-SR). Correlations between the variables were calculated and linear regression models were built. Only hyperthymia (affective temperament) and introvertive anhedonia (schizotypal domain) were statistically significantly correlated with anhedonia. In regression models, introvertive anhedonia predicted higher whereas hyperthymic features lower severity of anhedonia (measured by the SHAPS scale). Hyperthymic features are protective and introvertive anhedonia is a risk factor for consummatory anhedonia.

Comparing psychological versus pharmacological treatment in emotional disorders: A network analysis.

Transdiagnostic group cognitive behavioural therapy (TD-GCBT) is more effective in improving symptoms and severity of emotional disorders (EDs) than treatment as usual (TAU; usually pharmacological treatment). However, there is little research that has examined the effects of these treatments on specific symptoms. This study used Network Intervention Analysis (NIA) to investigate the direct and differential effects of TD-GCBT + TAU and TAU on specific symptoms of anxiety and depression. Data are from a multicentre randomised clinical trial (N = 1061) comparing TD-GCBT + TAU versus TAU alone for EDs. The networks included items from the PHQ-9 (depression) and GAD-7 (anxiety) questionnaire and mixed graphical models were estimated at pre-treatment, post-treatment and 3-, 6- and 12-month follow-up. Results revealed that TD-GCBT + TAU was associated with direct effects, mainly on several anxiety symptoms and depressed mood after treatment. New direct effects on other depressive symptoms emerged during the follow-up period promoted by TD-GCBT compared to TAU. Our results suggest that the improvement of anxiety symptoms after treatment might precipitate a wave of changes that favour a decrease in depressive symptomatology. NIA is a methodology that can provide fine-grained insight into the likely pathways through which treatments exert their effects.

Association of Pregnant Women's Perinatal Depression with Sociodemographic, Anthropometric and Lifestyle Factors and Perinatal and Postnatal Outcomes: A Cross-Sectional Study.

Background: In recent decades, the incidence of depression has gradually increased in the general population globally. Depression is also common during gestation and could result in detrimental gestational complications for both the mother and the fetus. The survey presented aimed to evaluate whether pregnant women's perinatal depression could be associated with socio-demographic, anthropometry and lifestyle factors, and perinatal and postnatal outcomes. Methods: This is a cross-sectional survey conducted on 5314 pregnant women. Socio-demographic and lifestyle factors were recorded by relevant questionnaires via face-to-face interviews. Anthropometric parameters were measured by qualified personnel. Perinatal depressive symptomatology status was evaluated by Beck's Depression Inventory (BDI-II) questionnaire. Results: Depressive symptoms throughout gestation were found in 35.1% of the enrolled women. Perinatal depression was significantly associated with lower educational and economic level, pre-pregnancy regular smoking and reduced levels of Mediterranean diet adherence levels, a higher prevalence of gestational diabetes and preterm birth, as well as a higher incidence of delivering by caesarean section and abnormal childbirth weight. Perinatal depression was also significantly associated with a higher prevalence of maternal postpartum depression and lower prevalence of exclusive breastfeeding practices, as well as with a higher incidence of childhood asthma. Conclusions: Pregnant women's perinatal depression appears to be associated with various socio-demographic, anthropometry, and lifestyle characteristics and with a higher frequency of several adverse pregnancy complications. The present findings emphasize the importance of pregnant women's perinatal mental health, highlighting the need to develop and apply public strategies and policies for psychological counseling and support of future mothers to minimize probable risk factors that may trigger perinatal depression. Novel well-organized, follow-up surveys of enhanced validity are highly recommended to establish more definitive conclusions.

Sleepiness in retired male boxers: daytime sleepiness and its relationship with impulsiveness and depression symptomatology in retired professional male boxers

Background Boxing exposes fighters to head impacts and potential traumatic brain injury (TBI). Though research has explored the neuropsychiatric consequences of contact sports, there is limited research into Excessive Daytime Sleepiness (EDS) and its relationship to other outcomes, such as impulsiveness and depression. Therefore, this study aimed to describe EDS in retired boxers using the Epworth Sleepiness Scale (ESS) and to examine how boxing and sleepiness relate to impulsiveness and depression symptomatology. Methods 86 male retired professional boxers from the Professional Fighters Brain Health Study (PFBHS) met the inclusion criteria. Adjusted multivariable models analyzed relationships between professional boxing bouts, EDS (ESS), impulsiveness (Barratt Impulsiveness Scale Version 11 (BIS-11)), and/or depression (Patient Health Questionnaire-9 (PHQ-9)). A causal mediation analysis was performed to assess whether boxing bouts and ESS scores predicted BIS-11 and PHQ-9 scores. Results Mean age was ∼51 years, fighters averaged ∼36 professional bouts, and ESS mean(SD) was 7.5(5.3). ESS scores were significantly associated with raw BIS-11 (Beta = 1.26, 95%CI = 0.77–1.75, p < 0.001) and ordinal PHQ-9 (OR = 1.20, 95%CI = 1.11–1.31, p < 0.001) scores in adjusted models, and the significant relationship between boxing bouts and BIS-11/PHQ-9 was mediated by ESS. Conclusions EDS in retired male professional boxers may be strongly associated with other neuropsychiatric sequelae of TBI (impulsiveness and depression). Sleepiness; sleep; boxing; contact sports; impulsiveness; impulsivity; depression; Epworth sleepiness scale box

Severity of Peripheral Neuropathy in Diabetic Patients

Introduction: Diabetes mellitus is a chronic degenerative disease that can significantly impact both life expectancy and quality of life among affected populations, primarily by disrupting metabolic control and exacerbating disease complications. Objective: To assess the severity of neuropathy across four domains (pain, loss of sensation, postural instability, and depression) in individuals with diabetes mellitus. Materials and Methods: This was a cross-sectional, descriptive-correlational, and qualitative study The study population comprised diabetic individuals attending outpatient clinics for diabetic foot care at Hospital de S. João - Unidade de Valongo and Centro Hospitalar do Alto Ave in Guimarães. Variables included gender, age, type and duration of diabetes, neuropathic characteristics, balance, dependency/independence, and depression. Results: Regarding neuropathy severity, most diabetic patients exhibited loss of sensation and moderate pain, with no apparent postural instability or depression. However, both instability and depression were observed when neuropathic signs were present. Conclusions: The presence of neuropathic signs was associated with increased postural instability, reduced functionality, and a higher prevalence of depressive symptoms. Furthermore, a positive relationship was observed between pain severity and depressive symptomatology.

Network analysis of anxiety and depressive symptoms during the COVID-19 pandemic in older adults in the United Kingdom

The health crisis caused by COVID-19 in the United Kingdom and the confinement measures that were subsequently implemented had unprecedented effects on the mental health of older adults, leading to the emergence and exacerbation of different comorbid symptoms including depression and anxiety. This study examined and compared depression and anxiety symptom networks in two specific quarantine periods (June–July and November–December) in the older adult population in the United Kingdom. We used the database of the English Longitudinal Study of Aging COVID-19 Substudy, consisting of 5797 participants in the first stage (54% women) and 6512 participants in the second stage (56% women), all over 50 years of age. The symptoms with the highest centrality in both times were: “Nervousness (A1)” and “Inability to relax (A4)” in expected influence and predictability, and “depressed mood (D1”; bridging expected influence). The latter measure along with "Irritability (A6)" overlapped in both depression and anxiety clusters in both networks. In addition, a the cross-lagged panel network model was examined in which a more significant influence on the direction of the symptom "Nervousness (A1)" by the depressive symptoms of "Anhedonia (D6)", "Hopelessness (D7)", and "Sleep problems (D3)" was observed; the latter measure has the highest predictive capability of the network. The results report which symptoms had a higher degree of centrality and transdiagnostic overlap in the cross-sectional networks (invariants) and the cross-lagged panel network model of anxious and depressive symptomatology.

Transcranial magnetic stimulation for obsessive-compulsive disorder - preliminary results of an observational study

IntroductionObsessive-compulsive disorder (OCD) has a high prevalence and causes a significative reduction in functionality and quality of life.First and second line treatment is ineffective in a variable percentage of patients. In such cases transcranial magnetic stimulation (TMS) may be considered.ObjectivesThe goal of this study is to evaluate the impact of TMS treatment on obsessive-compulsive, anxious and depressive symptomatology in patients with OCD.MethodsA prospective observational study was conducted, including all patients diagnosed with OCD who underwent TMS in the Psychiatry department of Centro Hospitalar Universitário de São João since March 2023.Symptomatology was assessed using the Yale Brown Obsessive-Compulsive Scale (Y-BOCS), the Hamilton Anxiety Rating Scale (HAM-A) and the Hamilton Depression Rating Scale (HAM-D) before and after treatment.Statistical analysis was performed using the SPSS-Statistics program. A significance level of 0.05 was considered.ResultsAs of October 31, 2023, nine individuals with OCD completed treatment with TMS, 33% male and with a median age of 40 years (range 33-57).The median Y-BOCS score pre-TMS was 30 (range 20-33) and post-TMS 28 (range 16-34). The median difference was 2.5 (range -5-14) and was not statistically significant (p=0.128). The median score on the HAM-A pre-TMS was 21 (range 9-41) and post-TMS 18 (range 11-24). The median difference was 0 points (range -4-21) and was not statistically significant (p=0.345).The median HAM-D score pre-TMS was 26 (range 14-40) and post-TMS 19 (range 10-32). The median difference was 2.5 (range -3-20) and was not statistically significant (p=0.225).Conclusions Preliminary findings suggest that the impact of TMS on obsessive-compulsive, anxious, and depressive symptomatology in patients with OCD does not appear to be clinically or statistically significant.Further results are necessary to confirm this trend.Disclosure of InterestNone Declared

The impact of functional class and depressive symptomatology on rule-based insensitivity

Rule-governed behavior (RGB) is important for accounting for complex human behavior, as well as informing clinical practice. In line with Relational Frame Theory, RGB is divided into functional classes including pliance, which is rule-following under the control of apparent arbitrary social consequences, and tracking, which is rule-following under the control of apparent natural non-arbitrary consequences. In theory, pliance should produce lower levels of contingency sensitivity compared to tracking, but how this effect relates to nonclinical populations is unclear. This study (n = 134) tested the relationship between contingency sensitivity in pliance and tracking through a Matching-to-Sample task, while incorporating a measure of depressive symptomatology to test if a distinction in insensitivity would be seen in nondepressed participants. Results indicated that pliance was associated with lower levels of contingency sensitivity relative to tracking overall, and that depressive symptomatology did not influence this. Results are discussed in relation to prior inconsistencies in the experimental literature on RGB, and potential methods for operationalizing pliance in experimental settings.

Harmonizing and Contrasting Psychotherapy Approaches: Case Presentation

AbstractVarious psychotherapeutic approaches could be used for the assessment, formulation, and treatment of the same case. It is of great importance to include cultural evaluation and empathetic reformulation in psychotherapy applications. This case presentation illustrates a female patient in her thirties who was consulted at the psychiatric outpatient clinic with depressive symptomatology, which presented after a psychosocially stressful life event. Following a detailed clinical evaluation, psychotherapeutic treatment was planned with the diagnosis of major depressive disorder. In this case presentation and subsequent discussion, the case-specific advantages, along with standard and differing aspects of different psychotherapeutic methods and treatments, will be evaluated.Disclosure of InterestNone Declared

Major depressive episode in the elderly. Use of maintenance ECT: a case report.

IntroductionWe present the case of an elderly patient with a severe depressive episode who, in order to maintain psychopathological stabilisation, receives ECT on an outpatient basis.ObjectivesThe objective is to briefly review the use of ECT as a maintenance treatment for severe depression in the elderly.MethodsPatient aged 76 years, multipathological, with a history of hypertension, DM and LBP. Femoral head fracture, myelodysplastic syndrome, severe osteoporosis with vertebral crushing, requiring rescue treatment with tramadol, and renal failure.She came for consultation, reporting depressive symptoms of months’ duration, together with delusions of ruin and nihilism. Despite antidepressant and stabilising treatment with duloxetine at daily doses of 120mg, extended-release quetiapine 600mg, lorazepam 2.5mg and mirtazapine 45mg, the patient began to show negative behaviour towards accepting food, clinophilic behaviour and abandonment, which led to her being admitted to the short-term hospitalisation unit.ResultsDue to the severity of the depressive symptomatology, it was decided to start ECT, administering a total of 12 sessions, which were effective, and outpatient follow-up was resumed. However, after a week, the patient again began to show marked apathy and abulia, as well as complete anorexia lasting more than 24 hours, which led to a new admission. It was then that it was decided to maintain the ECT treatment, on an outpatient basis, as maintenance treatment, together with pharmacological treatment.ConclusionsECT is indicated in severe depression, with or without psychotic symptoms, with malnutrition and organic pathology. According to studies, it has a beneficial response of more than 60%. However, the rate of receiving depressive symptomatology in a severe episode is high, despite ECT, so studies and clinical practice recommend maintenance ECT. It is usual to start with weekly sessions, and progressively space them out to maintain the minimum that guarantees stability.Disclosure of InterestNone Declared

Understanding the role of mental pain in suicidal individuals: from clinical to neuroimaging perspective.

IntroductionIn the attempt to shed light on the phenomenology of suicide, this contribution focuses on the role of mental pain as a main ingredient of suicide.ObjectivesPrevious studies have shown that mental pain, childhood negative experiences, and maltreatment are associated with suicide risk. Neuroimaging studies demonstrated that such emotional pain shares the same neuroanatomical circuit of somatic pain. Furthermore, concepts related to death, failure, or other unfortunate circumstances activate specific cerebral areas in a suicidal individual compared to a non-suicidal subject.MethodsThe author, through a multicenter investigation, conducted a sizeable clinical study on mental pain related to psychiatric disorders and suicide risk. With this aim, a dataset of more than 2200 psychiatric patients is explored to investigate suicide risk, mental pain, childhood trauma, and the role of depressive symptomatology. Implications emerging from neuroimaging studies are investigated.ResultsA framework emerges about the role of childhood traumatization in mediating between suicide risk and mental pain; furthermore, when individuals experience high mental pain and high depressive symptomatology, regardless of the diagnoses, they are exposed to higher suicide risk.ConclusionsSuch results are presented in light of neuroimaging studies’ role in identifying how mental pain and brain activation are detected in suicidal individuals. Therefore, this contribution aims to understand better mental pain’s role in clinical practice and research activities.Disclosure of InterestNone Declared

Secondary Trauma by Internet Content Moderation: a Case Report

Introduction In recent years, a global debate has emerged regarding the protection of Internet users from exposure to harmful content. Content moderation is defined as the organized practice of filtering user-generated content posted on internet, social networks, and media to determine the appropriateness of the content for a site, locality, or jurisdiction. The growing volume of this content along with the psychological impact of this activity have promoted the application of automated approaches based on artificial intelligence and machine-learning. However, the changing characteristics of content, as well as the cultural differences that influence its appropriateness, mean that human moderation of Internet content currently continues to exist. Psychological effects of this activity such as symptoms of post-traumatic stress disorder (PTSD) could represent an example of secondary trauma.Objectives Our aim is to describe a clinical case of post-traumatic stress disorder presenting with specific traumatic exposure idiosyncrasy that could lead to a better consequence characterization of a recent social phenomena such as internet content moderation.MethodsWe expose the clinical case of a woman with emotional distress who was reffered to our outpatient psychiatric unit in Barcelona in 2022 after five years working as an internet content moderator.ResultsWe describe the case of a 35-year-old woman without relevant medical, toxicologic or psychiatric record that presents to our out-patient psychiatric clinic with post-traumatic stress disorder after five years of working as an internet content moderator and being exposed to visual traumatic content such as sexual assault and paedophilia. The clinical presentation consisted with one year of recurrent daily panic attacks, intrusive images about the traumatic exposure, intrusive thoughts, insomnia, vivid nightmares, avoidance of exposure to her son, distrust of the environment and intense fear for her son security. The disorder interfered in her capacity to work. The patient received psychological treatment and ISRS (Sertraline) was prescribed, however only partial response was reached with persistence of the majority of symptoms.ConclusionsThe presented case suggests a temporal and symptom content relationship between the described work exposure and the appearance of emotional distress in a patient without PTSD history. Although previous evidence of secondary trauma in people exposed to indirect traumatic experiences has been reported, for example in healthcare professionals, the exposure to alien trauma through digital exposure as a workactivity is yet to be specifically examined. It is necessary to expand knowledge on the clinical expression of this phenomenon due to the observed recurrence of anxious and depressive symptomatology related to repeated exposure to traumatic content.Disclosure of InterestNone Declared

The Beck Depression Inventory-II in Community-Dwelling Middle-Aged and Older Greeks: Factor Structure and Demographic Associations

Evaluating depressive symptomatology in older adults is important for monitoring and treatment. However, few studies have examined the association of the Beck Depression Inventory-II (BDI-II) to demographic characteristics in middle-aged and older adults or have tested its factor structure using confirmatory factor analysis (CFA). Participants were 542 middle-aged and older Greek community-dwellers of a wide education range. The BDI-II score was correlated with age and education and one-way analysis of variance compared mean score in men and women, controlling for differences in education. In addition to the unidimensional model, eight models were tested using CFA: four two-factor models, a three-factor model, two bifactor models, and a hierarchical model with three first order factors and a second order factor. Age was marginally associated with BDI-II score; education was inversely associated with it in this sample of a wide range of education. Women scored higher than men, although controlling for education attenuated the differences. Internal consistency was similar to that of other studies. Of the nine models tested using CFA eight showed good fit but the bifactor models yielded anomalous factor loadings. The hierarchical model of Byrne, Stewart, Kennard, and Lee showed the best fit in terms of all the indices. The results indicate the presence of a second-order general depression factor that influences highly correlated first-order factors and extend the applicability of the hierarchical model to older community dwellers.

Impulsivity, suicide risk and cannabis consumption

IntroductionCannabis is the most widely consumed illegal drug in the world and one of the easiest to access. This drug provides a feeling of well-being and euphoria. However, frequent consumption is associated with several complications including increased impulsivity and an increased risk of suicidal behaviour.ObjectivesOur objective was to study the link between cannabis consumption, impulsivity and suicide intentionality.MethodsWe conducted a cross-sectional study, during the period from September 2020 to October 2021, among cannabis users consulting the Sfax Detoxification Center in Tunisia. Impulsivity was studied using the Barrat Impulsivity Scale (BIS 15) and suicide intentionality was assessed using the Suicide intent scale Beck; Pierce (SIS) in subjects with history of a suicide attempt.ResultsWe included 38 consumers. The average age is 26 years old and the sex ratio was 8.5 with an over-representation of men. The average BIS15 score was 38.2 ranging between 19 and 45. We have demonstrated that the higher the level of cannabis dependence, the higher the level of impulsivity. A high level of impulsivity was found in younger subjects (p=0,04) and with a low socio-economic level and unemployment (p =0,021). Suicidal intentionality, assessed in 10 patients with a history of suicide attempt, was low and intermediate in 40% and 60% of users respectively, which means a low to intermediate risk of subsequent completed suicide.Conclusions Impulsivity is associated with aggressive behaviour, various accidents including motor vehicle accidents, more self-mutilation and a much greater risk of dying by suicide than the general population. Frequent cannabis use is also associated with increased risk of developing all types of suicidal behaviours independently of the existence of depressive symptomatology. Overall, it is important to take into account the issues of impulsivity and substance abuse in daily clinical work as they influence the level of dangerousness.Disclosure of InterestNone Declared

Prevalence and predictive factors of depressive and anxious symptoms among healthcare professionals at Farhat Hached University Hospital in Sousse during COVID-19

IntroductionThe COVID-19 pandemic was originally of a magnitude exceeding that of previous epidemics, placing a heavy burden on healthcare systems in general and healthcare professionals in particular.ObjectivesTo assess the prevalence of depressive and anxiety symptoms among healthcare professionals at Farhat Hached Hospital in Sousse during the COVID-19 pandemic and to identify associated risk factors.MethodsThis is a descriptive cross-sectional study conducted among healthcare professionals practicing in the Farhat Hached Hospital of Sousse, which took place during the period extending between August and November 2021. The 9-item Patient Health Questionnaire (PHQ-9), the 7-item Generalized Anxiety Disorder (GAD-7), were used to assess depression and anxiety respectively.ResultsOur study included 326 healthcare professionals from the Farhat Hached University Hospital. The mean age of our population was 36.38 ±10.19 years, with a clear female predominance of 81.3%. The prevalences of depression and anxiety were 46% and 35.3% respectively. Female gender and being a paramedical staff were risk factors for depressive and anxiety symptoms. On the other hand, professional seniority of over 5 years was statistically significantly associated with anxiety. Sporting activity was inversely associated with depressive and anxiety symptoms.The multi-variate analytical study revealed that the practice of leisure activities other than sport was a protective factor against the occurrence of depressive symptomatology in healthcare professionals, while current smoking and the practice of a sporting activity were inversely associated with the occurrence of anxious symptomatology.ConclusionsThese findings underline the need for specific prevention strategies to reduce these symptoms and help healthcare professionals maintain their mental health. This will help to guarantee the quality and efficiency of work in the medical environment, to better control the pandemic.Disclosure of InterestNone Declared

Linking Digital Traits from Facial Expression, Voice, and Head Motion to Montgomery–Åsberg Depression Rating Scale Subscales

IntroductionThe 10-item Montgomery–Åsberg Depression Rating Scale (MADRS) measures different dimensions of depression symptomatology. Digital traits may generate deeper understanding of the MADRS subscales and provide insights about depression symptomatology.ObjectivesTo identify digital traits that predict specific MADRS subscales and ascertain which digital traits are important for which MADRS subscales.Methods During a Phase II decentralised clinical trial in major depressive disorder (MDD), patients completed the MADRS and used AiCure (LLC, New York, NY, USA), a smartphone application, to complete image description tasks at baseline. Digital measurements identified from the literature as relevant to MDD symptomatology were conducted using audio and video data derived from the image description tasks. Digital measurements included speech (rate, sentiment and first-person singular pronouns), vocal acoustics (intensity, pause fraction and fundamental frequency), facial expressivity (regional facial movement) and head pose (Euclidean and angular head movement). Digital traits analysis involved data pre-processing followed by machine learning (ML) using Elastic Net, Decision Tree, and Random Forest models; model performance was evaluated using 5-fold cross-validation and mean absolute error (MAE). Important digital traits were calculated by percentage change in MAE after permuting a specific variable. Important digital traits for the MADRS Apparent Sadness subscale score were mapped to defined, interpretable domains.ResultsThe ML model predictions varied for different MADRS subscales (Table). Overall, Elastic Net and Random Forest models outperformed Decision Tree across all subscales scores other than suicidal thoughts. Half of the literature-based digital traits contributed to the prediction of ≥1 MADRS sadness sub-scale score. The important digital traits for the Apparent Sadness subscale score could be mapped to 4 domains (Figure); this aligned with findings from the literature.Image:Image 2:ConclusionsDigital traits collected from patients with MDD were able to predict certain MADRS subscales better than others.FundingBoehringer Ingelheim.Disclosure of InterestZ. Zhu Employee of: Boehringer Ingelheim Pharmaceuticals, Inc., Y. Wu Employee of: Boehringer Ingelheim Pharmaceuticals, Inc., J. Seidel Employee of: Boehringer Ingelheim International GmbH, D. Roy Employee of: Boehringer Ingelheim Pharmaceuticals, Inc., E. Salzmann Employee of: Boehringer Ingelheim International GmbH

Identifying Depression Subtypes and Investigating their Consistency and Transitions in a 1-Year Cohort Analysis

Introduction Major Depressive Disorder (MDD) is a complex mental health condition characterized by a wide spectrum of symptoms. According to the Diagnostic Statistical Manual 5 (DSM-5) criteria, patients can present with up to 1,497 different symptom combinations, yet all receive the same MDD diagnosis. This diversity in symptom presentation poses a significant challenge to understanding the disorder in the wider population. Subtyping offers a way to unpick this phenotypic diversity and enable improved characterization of the disorder. According to reviews, MDD subtyping work to date has lacked consistency in results due to inadequate statistics, non-transparent reporting, or inappropriate sample choice. By addressing these limitations, the current study aims to extend past phenotypic subtyping studies in MDD.Objectives(1) To investigate phenotypic subtypes at baseline in a sample of people with MDD;(2) To determine if subtypes are consistent between baseline 6- and 12-month follow-ups; and(3) To examine how participants move between subtypes over time.Methods This was a secondary analysis of a one-year longitudinal observational cohort study. We collected data from individuals with a history of recurrent MDD in the United Kingdom, the Netherlands and Spain (N=619). The presence or absence of symptoms was tracked at three-month intervals through the Inventory of Depressive Symptomatology: Self-Report (IDS-SR) assessment. We used latent class and three-step latent transition analysis to identify subtypes at baseline, determined their consistency at 6- and 12-month follow-ups, and examined participants’ transitions over time.ResultsWe identified a 4-class solution based on model fit and interpretability, including (Class 1) severe with appetite increase, (Class 2), severe with appetite decrease, (Class 3) moderate, and (Class 4) low severity. The classes mainly differed in terms of severity (the varying likelihood of symptom endorsement) and, for the two more severe classes, the type of neurovegetative symptoms reported (Figure 1). The four classes were stable over time (measurement invariant) and participants tended to remain in the same class over baseline and follow-up (Figure 2).Image:Image 2:Conclusions We identified four stable subtypes of depression, with individuals most likely to remain in their same class over 1-year follow-up. This suggests a chronic nature of depression, with (for example) individuals in severe classes more likely to remain in the same class throughout follow-up. Despite the vast heterogeneous symptom combinations possible in MDD, our results emphasize differences across severity rather than symptom type. This raises questions about the meaningfulness of these subtypes beyond established measures of depression severity. Implications of these findings and recommendations for future research are made.Disclosure of Interest C. Oetzmann Grant / Research support from: C.O. is supported by the UK Medical Research Council (MR/N013700/1) and King’s College London member of the MRC Doctoral Training Partnership in Biomedical Sciences., N. Cummins: None Declared, F. Lamers: None Declared, F. Matcham: None Declared, K. White: None Declared, J. Haro: None Declared, S. Siddi: None Declared, S. Vairavan Employee of: S.V is an employee of Janssen Research &amp; Development, LLC and hold company stocks/stock options., B. Penninx : None Declared, V. Narayan: None Declared, M. Hotopf Grant / Research support from: M.H. is the principal investigator of the RADAR-CNS programme, a precompetitive public–private partnership funded by the Innovative Medicines Initiative and the European Federation of Pharmaceutical Industries and Associations. The programme received support from Janssen, Biogen, MSD, UCB and Lundbeck., E. Carr: None Declared

Alexithymia in population with depressive disorders and suicidal ideation: results of an observational study

IntroductionIn clinical practice, significant delays in requesting help are observed in patients with depressive symptoms and suicidal ideation.ObjectivesThe objective of this study was to determine factors associated with the time of untreated illness in a population with depressive disorder attending mental health for the first time in the area of Hospital Clínico Universitario de Valladolid (HCUV).Methods Methods: This is an observational study including adult patients of both sexes, referred to their first mental health consultation from their Primary Care Physician, with a picture of depressive symptomatology associated with an identifiable stressor. Informed consent was obtained from the patients and authorized by the Ethics Committee of the HCUV. R Studio ® statistical analysis.The degree of emotional confusion was quantified with item 1 (“I am often confused about the emotions I feel”) of the Toronto Alexithymia Scale (TAS). This item is scored ( 1-5 )from most severe (1) to least (5). On the other hand, the time in weeks between symptom onset to referral, age and symptom severity according to the Montgomery Scale (MADRS) were recorded.ResultsResults: We present data collected in an initial sample of 278 treated patients, with a female predominance (68%), a MADRS severity score (18.05 ± 5.01) and a calculated time without treatment of 59.66 ± 62.26 weeks (Tables 1,2,3).A subsample of 72 patients with death ideation was studied, with a female predominance (75%) compared to the overall sample (X2 =1.99, p = 0.1585) (Table 4).It was also observed that death ideation was higher in younger patients (t = 3.18, p = 0.001907) and with a severe MADRS depression score (t = -7.92, p &lt; 0.0001), however they took a similar length of time to receive mental health treatment (T student t = -1.6605, p = 0.099); (Table 5). There is no previous published evidence that considers the timing of untreated symptoms. According to test statistics, there are differences in untreated symptom time considering gender and TAS score (Table 6).Conclusions Death ideation is a current health problem that deserves attention. In multivariate analysis models, an association with clinical and demographic factors has been found; however, there is up to 20% of the variation in prevalence that is not explained by the aforementioned factors. The factors that determine the time delay in seeking help (treatment delays) have not been studied so far. In this study we observe how a single variable doesn’t explain the delay in the first visit. The interaction between age, gender, alexithymia and hypoprosexia explains the delay in seeking help, although symptom severity doesn’t seem to be related. These data suggest that unexplained causality in multivariate studies may be related to the interaction between clinical and neuropsychological factors.Disclosure of InterestNone Declared