Depressive Syndrome Research Articles

Elevated frequency and everyday functioning implications of vascular depression in persons with HIV disease

Depression and cardiovascular disease are common and associated with one another in HIV disease. This study aimed to determine the frequency and everyday functioning implications of the clinical syndrome of vascular depression among people living with HIV (PLWH). Participants in this cross-sectional study included 536 PLWH and 272 seronegative individuals who completed a biomedical and psychiatric research evaluation. Vascular depression was operationalized as the current presence of: 1) two or more vascular conditions; and 2) depression as determined by a normative elevation on the Depression/Dejection subscale of the Profile of Mood States or a diagnosis of Major Depressive Disorder per the Composite International Diagnostic Interview. Everyday functioning was measured by both self- and clinician-rated activities of daily living. A logistic regression model showed that HIV was associated with a three-fold increased risk of vascular depression, independent of potential confounding factors. A second logistic regression model within the PLWH sample showed that PLWH with vascular depression had significantly greater odds of dependence in everyday functioning as compared to PLWH with either vascular disease or depression alone. The elevated frequency of vascular depression in PLWH is consistent with the vascular depression hypothesis from the late-life depression literature. The high rate of functional dependence among PLWH with vascular depression highlights the clinical importance of prospective work on this syndrome in the context of HIV disease.

Effective Connectivity Between the Orbitofrontal Cortex and the Precuneus Differentiates Major Psychiatric Disorders: Results from a Transdiagnostic Spectral DCM Study.

We have previously identified aberrant connectivity of the left precuneus, ventrolateral prefrontal cortex, anterior cingulate cortex, and anterior insula in patients with either a paranoid (schizophrenia), or a depressive syndrome (both unipolar and bipolar). In the current study, we attempted to replicate and expand these findings by including a healthy control sample and separating the patients in a depressive episode into two groups: unipolar and bipolar depression. We hypothesized that the connections between those major nodes of the resting state networks would demonstrate different patterns in the three patient groups compared to the healthy subjects. Resting-state functional MRI was performed on a sample of 101 participants, of which 26 patients with schizophrenia (current psychotic episodes), 24 subjects with Bipolar Disorder (BD), 33 with Major Depressive Disorder (MDD) (both BD and MDD patients were in a current depressive episode), and 21 healthy controls. Spectral Dynamic Causal Modeling was used to calculate the coupling values between eight regions of interest, including the anterior precuneus (PRC), anterior hippocampus, anterior insula, angular gyrus, lateral Orbitofrontal Cortex (OFC), middle frontal gyrus, planum temporale, and anterior thalamus. We identified disturbed effective connectivity from the left lateral orbitofrontal cortex to the left anterior precuneus that differed significantly between unipolar depression, where the influence was inhibitory, and bipolar depression, where the effect was excitatory. A logistic regression analysis correctly classified 75% of patients with unipolar and bipolar depression based solely on the coupling values of this connection. In addition, patients with schizophrenia demonstrated negative effective connectivity from the anterior PRC to the lateral OFC, which distinguished them from healthy controls and patients with major depression. Future studies with unmedicated patients will be needed to establish the replicability of our findings.

Potential Drug-Drug Interactions among Patients with Schizophrenia Spectrum Disorders: Prevalence, Association with Risk Factors, and Replicate Analysis in 2021

Background and Objectives: Patients with schizophrenia are often exposed to polypharmacotherapy, which may lead to drug-drug interactions. The aim of the study was to investigate the prevalence of potential drug-drug interactions (pDDIs) in hospitalized patients with schizophrenia spectrum disorders and to identify factors associated with pDDIs and manifested symptoms and signs. Materials and Methods: This cross-sectional observational study included 311 inpatients admitted to a psychiatric hospital. The LexiComp drug interaction program was used to identify pDDIs in 2014. Factors associated with the prevalence of pDDIs and factors related to clinically observed symptoms and signs were assessed using multivariable regression. In addition, replicate analysis of pDDI was performed using 2021 program updates. Results: The prevalence of pDDIs was 88.7%. Our study showed that more than half of the patients received at least one drug combination that should be avoided. The most common pDDIs involved combinations of two antipsychotics or combinations of antipsychotics and benzodiazepines, which can lead to cardio-respiratory depression, sedation, arrhythmias, anticholinergic effects, and neuroleptic malignant syndrome. The number of prescribed drugs was a risk factor for pDDIs (OR 2.85; 95% CI 1.84-5.73). All groups of clinically observed symptoms and signs were associated with the number of drugs. In addition, symptoms and signs characteristic of the nervous system and psychiatric disorders were associated with antipsychotic dosage (IRR 1.33; 95% CI 1.12-1.58), which could contribute to the development of extrapyramidal syndrome, insomnia, anxiety, agitation, and bipolar mania. The 2021 version of the drug interaction program showed a shift in drug interactions toward a lower risk rating, implying less severe patient management and possibly less alert fatigue. Conclusions: Patients with schizophrenia spectrum disorders are at high risk of developing drug-drug interactions. Optimization of drug therapy, patient monitoring, and use of drug interaction programs could help to prevent pDDIs and subsequent adverse drug events.

An initial investigation of the role of depressive and anxious syndromes in Problematic Internet Use in adolescence and young adults

Depressive and anxious syndromes have been proposed as risk factors and as consequences of Problematic Internet Use (PIU). There has been no study relating affective symptoms in subjects with Problematic Internet Use and those with major depressive and anxious syndromes. In this study, three samples were collected: two from ambulatory clinical settings of the North Lisbon Hospital Centre (1. Centre for PIU and 2. Out-patient psychiatry consultation for adolescents and young adults) and a control group from Faculdade de Medicina da Universidade de Lisboa. Internet use profile and affective psychopathology were assessed and socio-demographic characteristics were controlled. The results revealed that both the PIU group and the clinical group presented significantly higher depression and anxiety scores than the control group while there was no significant difference between them. Also, Problematic Internet Users, similarly to the clinical group, tend to live in less functional families. We speculate that the similitude between samples and yet such different clinical presentations could be explained if Internet acted as a buffer to affective psychopathology. These findings warrant exploring the possibility of PIU as new (and generation biased) psychopathology of depressive or anxious states.

Alice in Wonderland syndrome and bipolar depression.

Alice in Wonderland syndrome and bipolar depression.

Electrophysiological assessment of nutritional optic neuropathy: a case report

PurposeTo report an unexpectedly asymmetric, progressive nutritional optic neuropathy associated with vitamin A deficient optic canal hyperostosis in a 15-year-old female with a long history of a restricted diet.MethodsWe performed comprehensive ophthalmic assessments in a fifteen-year-old female with a long history of restricted eating who presented with suspected nutritional optic neuropathy, predominantly affecting the right eye vision.ResultsA review of computerised tomography and magnetic resonance imaging revealed bilateral optic canal hyperostosis likely associated with vitamin A deficiency. Electrodiagnostic tests and optical coherence tomography provided structure–function evidence of bilateral retinal ganglion cell dysfunction and notably revealed severe loss of temporal fibres in the left eye which showed cecocentral scotoma but normal visual acuity. Although selective damage of the papillomacular bundle has been well-documented in nutritional and toxic optic neuropathies, compressive optic canal hyperostosis secondary to nutritional deficiency has been rarely reported.ConclusionsNutritional deficiencies are increasing in high-income countries and may be linked to the rise of gastrointestinal disorders, strict vegan and vegetarian diets and avoidant restrictive food intake disorder (ARFID) associated with conditions such as depression and autism spectrum syndrome (ASD). Our findings highlight the value of electrodiagnostic testing alongside imaging in complex nutritional optic neuropathies to help monitor, guide treatment and preserve remaining sight in a child.

Metagenomic analysis of Tongxie Yaofang therapy for rat models of ulcerative colitis with liver depression and spleen deficiency syndrome

Tongxie Yaofang (TXYF) has therapeutic effect on the ulcerative colitis (UC) with liver depression and spleen deficiency syndrome. This study investigated the changes in the gut microbiota of UC rats treated with TXYF. Wistar rats were divided into three groups: Control, dinitrobenzene sulfonic acid (DNBS)-colitis, and DNBS + TXYF (n = 8 per group). UC model was constructed via intrarectally injection of DNBS (25 mg DNBS and 0.25 mL 50% ethanol); rats in DNBS + TXYF group were administered with TXYF (20.8 g/kg) for 21 days. Physiological parameters were measured. Five samples from each group were selected for metagenomic analysis. TXYF treatment significantly reduced disease activity index, colon mucosal damage index, and tumor necrosis factor-alpha level. TXYF treatment prevented DNBS-induced dysregulation of gut microbial communities. Compared with DNBS-colitis group, the abundance of Firmicutes increased significantly and that of Bacteroidetes and Proteobacteria decreased in DNBS + TXYF group. Pathways such as protein processing in the endoplasmic reticulum pathway was enriched in the DNBS-colitis group, whereas it was decreased in the DNBS + TXYF group. Thus, TXYF treatment could effectively restore the dysregulation of intestinal flora induced by UC.

Effects of Satureja brevicalyx essential oil inhalation on coping premenstrual syndrome

Introduction: The aim of this research was to evaluate the effects of Satureja brevicalyx essential oil inhalation on premenstrual syndrome. Methods: The oils were extracted by hydro-distillation using a modified Clevenger-type apparatus and chemical composition was performed by Gas chromatography-mass spectrometry (GC–MS). Furthermore, a quasi-experimental study was conducted, where 61 participants were divided in two groups, comprising an experimental with essential oils and a control group with no treatment. Main psychological symptoms were assessed with the used of Zung Self-Rating Anxiety Scale (SAS) and Zung Self-Rating Depression Scale (SDS) as well as total score of premenstrual syndrome was evaluated with Premenstrual Syndrome Scale (PMSS). Results: chemical analysis showed that linalool (17.6%) was the main component. All variables showed a decrease in posttest study phase in comparison with pretest in experimental group (p<0.05). A large size effect was observed for anxiety (d = 1.25; Δ = 1.35). Besides, moderate changes were found for depression (d = 0.79; Δ= 0.81) and premenstrual syndrome total score (d = 0.62; Δ = 0.56). Conclusion: The essential oil of Satureja brevicalyx exerts a potencial use, especially for the treatment of psychological symptoms of premenstrual syndrome.

Species Differences in Blood Lymphocyte Responses After Spinal Cord Injury.

People with spinal cord injury (SCI) get recurrent infections, such as urinary tract infections (UTIs) and pneumonias, that cause mortality and worsen neurological recovery. Over the past decades, researchers have proposed that post-SCI lymphopenia and decreased lymphocyte function increase susceptibility to infections and worsen neurological outcome in humans, leading to a condition called SCI-induced immune depression syndrome (SCI-IDS). In this review, we explore how SCI affects blood lymphocyte homeostasis and function in humans and rodents. Understanding how SCI affects blood lymphocytes will help the management of recurrent infections in spinal cord injured people and shed light on the clinical translation of findings in animal models to humans.

Teraligen in the complex treatment of anxiety-phobic, behavioral and depressive syndromes in children and adolescents with schizotypal disorder

To determine the frequency of prescribing and the main therapeutic targets of Teraligen in the treatment of Schizotypal disorder (STD) in childhood and adolescence. The sample consisted of 151 patients aged 7 to 16 years with a diagnosis of STD (F 21), of which 31.1% (n=47) of female patients and 68.9% (n=104) of male patients who received inpatient or outpatient treatment at the FSBI NCPZ from 2008 to 2020. The study was conducted by clinical-psychopathological, clinical-catamnestic, and statistical methods. Teraligen was prescribed by psychiatrists to patients with STD in 74.2% of cases, of which in 46.4% of cases patients received Teraligen even before the diagnosis of STD in connection with complaints of neurotic disorders (anxiety, fears and sleep disorders) (n=30), as well as in connection with autistic-like behavior (n=22). At the time of follow-up, 55% (n=83) of patients received Teraligen, of which 63.9% (n=53) of patients were prescribed it for the first time. The applied schemes of prescribing Teraligen for the treatment of anxiety-phobic, depressive and behavioral syndromes within the framework of the STD in a relatively age-related aspect are presented. The high frequency of prescribing Teraligen by psychiatrists and neurologists to children and adolescents with STD at different stages of observation is shown, which reflects the confidence of specialists in this drug. Teraligen has demonstrated a multidimensional pharmacological effect, including a mild antipsychotic effect, providing reduction of a wide range of psychopathological symptoms, with good tolerability and drug interaction. The study of the possibilities of Teraligen, both for monotherapy and for augmentation of the treatment of mental pathology in childhood, remains relevant.

Neonatal Withdrawal Syndrome: A Diagnosis to Keep in Mind

During pregnancy, women are put through many challenges, sometimes facilitating the appearance of depression and anxiety symptoms, leading to the use of psychotropic drugs like benzodiazepines. We present the case of a male new born who presented breathing distress signs during the first hour of life, needing supplemental oxygen. His mother was diagnosed with depressive syndrome and anxiety and was medicated with escitalopram until six months of pregnancy and diazepam as needed until the end of gestation. He was admitted to the Neonatal Intensive Care Unit. In the first 12 hours of admission, he started with irritability, difficulty calming, and exaggerated Moro reflex. Blood tests, lumbar puncture, and cultures were performed, and antibiotics were started. During the first five days of admission, while on antibiotics, he also presented poor sucking reflexes, altered stools, hyper alert look, hyperreflexia, and jitteriness episodes, with low blood inflammatory markers. Withdrawal syndrome was considered after blood and cerebrospinal fluid cultures were negative, and no improvement of the neurological status with antibiotics. He was monitored with Finnegan’s score and improved with containment and comfort measures. This case pretends to emphasize the importance of adequate psychiatric follow-up during pregnancy and of awareness among neonatologists and pediatricians regarding the medicines that can be related to withdrawal syndrome.

Life-threatening Hypercalcaemic Crisis Due to Benign Primary Hyperparathyroidism, a Case Report

Primary Hyperparathyroidism (PHPT) is a frequent cause of hypercalcaemia and parathyroid adenoma is the most frequent aetiology. Most patients are now diagnosed incidentally or with slightly symptomatic disease, however PHPT can cause extremely elevated calcium levels leading to hypercalcaemic crisis, a life-threatening clinical scenario associated with calcium-related organ failure. We present a case of a woman with long-lasting neuropsychiatric symptoms caused by PHPT, misdiagnosed as a depressive syndrome, which ultimately develops hypercalcaemic crisis. After parathyroidectomy, patient fully recovered organ failure and previous depressive symptoms within six months. Early diagnosis, adequate resuscitation and organ support associated with parathyroidectomy can lead to a better prognosis in comparison with the elevated mortality reported in the past.

Thoughts about dropping out of studies as warning sign for suicidal ideation and mental health problems in male university students

Despite increasing rates for suicidal ideation in university students, male students remain reluctant in reporting such thoughts. It is thus paramount to establish more easily detectable risk factors for male students. The present study examines study dropout thoughts as potential low-treshold risk factor as well as gender-differences in established risk patterns. A total of N = 4894 German university students (24.6% men) completed a cross-sectional online survey on their mental health at the University of Cologne. In addition to sociodemographic and questions related to university studies (e.g., dropping out of studies), the Patient Health Questionnaire D (PHQ-D) was used to assess psychological syndromes (any psychological syndrome, depressive syndrome, alcohol syndrome), life stressors and suicidal ideation. Study dropout thoughts were more prevalent among male students, while being associated with increased suicidal ideation for both genders assessed. For all outcomes, significant gender-differences were observed with financial stress and a recent bad experience being risk factors for suicidal ideation in men but not women. Relationship problems, problems at work and current psychotherapy use were positively associated with suicidal ideation in women but not in men. Thus, study dropout thoughts were associated with suicidal ideation in university students and there were male-specific risk patterns for suicidal ideation and associated mental health problems. Consequently, male university students reporting study dropout thoughts or financial stress should be screened for suicidality and mental health problems. Future prevention measures in the University context should consider study dropout thoughts and male-specific risk-patterns to increase the chances to detect male student’s suicidality and to improve the effectiveness of suicide prevention programs for men.

Efficacy of potassium N-acetylaminosuccinate (Cogitum) in the treatment of asthenic syndrome: results of double-blind placebo-controlled trial

Study of the effectiveness of monotherapy with potassium N-acetylaminosuccinate (Cogitum) for asthenic syndrome (fatigue) in individuals, uncharacteristic somatic, neurological diseases, anxiety disorders, depression and other diseases that may interfere with asthenia. Patients with fatigue scores of 22 or more on the Fatigue Assessment Scale (FAS) were randomly divided into the main group (MG) - 37 people, mean age 22 years [21; 24] and the control group (CG) - 34 people, mean age 21 years [19; 23]. The Trail Making Test (TMT-A and TMT-B), the assessment of general well-being on a visual analogue scale (VAS), where 0 is the worst state of health, 10 is the state of absolute well-being, was assessed. MG patients received a solution of potassium N-acetylaminosuccinate (Cogitum) 750 mg per day in a sterile container, CG patients received sterile water with banana flavor in a sterile container. The duration of the study was 21 days. Prior to the start of the study, there were no statistically significant differences in FAS, TMT, and VAS between MG and CG. After 21 days, the FAS score in the MG decreased (p=0.00001), the time of TMT-A (p=0.000012) and TMT-B (p=0.000033) decreased, the VAS score increased (p=0.00024). There were no statistically significant changes in the CG. Placebo effect was noted in 10 patients of the CG (29.4%). Potassium aminosuccinate (Cogitum) at a daily dose of 750 mg and a duration of treatment of 21 days effectively eliminates the symptoms of asthenic syndrome (fatigue), while accompanied by an improvement in complex cognitive functions. The results of our study suggest that fatigue (asthenic syndrome) and cognitive impairment may have a common pathogenetic mechanism - a deficiency of systems in which mediators are N-acetylaspartate and N-acetylaspartylglutamate. Cogitum had no side effects and was well tolerated. Cogitum is superior to placebo in the treatment of fatigue (asthenic syndrome).

Relationship satisfaction and psychological wellbeing in men having participated in the MindTheHeart® psychoeducation intervention after an acute coronary syndrome.

This study investigated the associations of relationship satisfaction, depression, and anxiety post-acute coronary syndrome in a sample of men having completed an early, couple-focused, and men-tailored psychoeducation intervention. A baseline sample of 50 male patients were followed over a 12-month period and completed the Couples Satisfaction Index and the Depression, Anxiety and Stress Scale. Results revealed a significant improvement in depression symptoms from T0 to T1, during which all participants completed the MindTheHeart® psychoeducation intervention. In addition, a hierarchical regression analysis showed that relationship satisfaction is an important predictor of this improvement in depression symptoms. Our preliminary findings point to the consideration of life partners in post-ACS interventions and encourage the exploration of this clinical approach in future research.

Microbiome and gut-brain axis affecting stress behavior

In context to the neurological system, the function and evolution of host physiology as influenced by intestinal microbiota are of great interest. It has long been understood how crucial the gut-brain axis is in controlling reactions to stress. More recently, the microbiota has become a crucial component in this gut-brain regulation, particularly under stressful circumstances brought on by actual or perceived homeostatic strain. The gut microbiota seems to have an impact on the growth of emotional behavior, stress- and pain-modulation systems, and brain neurotransmitter systems, according to studies employing mice raised in a germ-free environment. Current evidence suggests that multiple mechanisms, including neural pathways and immune signaling, may be involved in gut microbiota–to–brain signaling and that the brain can in turn alter microbial composition and behavior via the autonomic nervous system. The gut microbiota has been implicated in a variety of stress-related conditions including anxiety, depression, and irritable bowel syndrome, although this is largely based on animal studies or correlative analysis in patient populations. Additional research in humans is sorely needed to reveal the relative impact and causal contribution of the microbiome to stress-related disorders. We will briefly explore the crucial aspect of this axis in this review, as well as the methodological issues that have been raised in previous attempts to define normal microbiota and chronicle its temporal development.

Predominant affective temperaments in modern-type depression and hikikomori syndrome

Predominant affective temperaments in modern-type depression and hikikomori syndrome

Association between diet, depression, anxiety and metabolic syndrome: a systematic literature review and meta-analysis

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Challenges in Mental Health: Anxiety, Depression and Burnout Syndrome during the COVID-19 Pandemic in Mexico

Results of an observational, cross-sectional and prospective study of students from two medical schools, (ESM and ESMH) from Instituto Politecnico Nacional (IPN) Mexico, are presented, 653 respondents to assess depression, anxiety, alcohol and substance use. Physicians who recently graduated doctors and medical students close to graduating were specifically evaluated. Variables (anxiety, depression, suicidal ideation and substance use) were evaluated. Results: 301 students of the total population attended with symptoms of mild level anxiety while 131 presented severe anxiety; Regarding levels of depression in general, 65.8% coursed with some depression, the ESM reported 27.8% with moderate depression and the ESMH with 24.2 in the same type of depression. The incidence of substance use in both schools was 15.2%. The male sex registered a consumption of 7.4% and the female sex 9.7%. Regarding the results of risk of suicidal ideation, the ESM registered 27% and the ENMH registered a risk of 35.5%. The pressures received due to work overload, the COVID-19 pandemic, the lack of supplies and medical equipment.

Verbal and Spatial Working Memory Impairment in Mild Cognitive Impairment Patients with Liver-Qi Depression Syndrome: An Event-Related Potential Study

Verbal and Spatial Working Memory Impairment in Mild Cognitive Impairment Patients with Liver-Qi Depression Syndrome: An Event-Related Potential Study