Different Subtypes Of Depression Research Articles

The use of antidepressants is linked to bone loss: A systematic review and metanalysis.

Depression and antidepressants are among risk factors for osteoporosis. However, there are still inconsistencies in literature regarding bone consequences of antidepressant drugs and the role of age and the natural decline of bone health in patients with depression. To investigate the relationship between antidepressant and bone mineral density (BMD). We conducted a systematic review and metanalysis according to PRISMA guidelines searching on PubMed/Medline, Cochrane Database, and Scopus libraries and registered with PROSPERO (registration number CRD42021254006) using generic terms for antidepressants and BMD. Search was restricted to English language only and without time restriction from inception up to June 2021. Methodological quality was assessed with the Newcastle-Ottawa scale. Eighteen papers were included in the qualitative analysis and five in the quantitative analysis. A total of 42,656 participants affected by different subtypes of depression were identified. Among the included studies, 10 used serotonin reuptake inhibitors (SSRIs) only, 6 involved the use of SSRIs and tricyclic antidepressants, and 2 the combined use of more than two antidepressants. No significant studies meeting the inclusion criteria for other most recent categories of antidepressants, such as vortioxetine and esketamine. Overall, we observed a significant effect of SSRI on decrease of BMD with a mean effect of 0.28 (95% CI = 0.08, 0.39). Our data suggest that SSRIs are associated with a decrease of BMD. We aim to raise clinicians' awareness of the potential association between the use of antidepressants and bone fragility to increase monitoring of bone health.

TNF-α, IL-6 and hsCRP in patients with melancholic, atypical and anxious depression: an antibody array analysis related to somatic symptoms

BackgroundThe association between inflammation and major depressive disorder (MDD) remains poorly understood, given the heterogeneity of patients with MDD.AimsWe investigated inflammatory markers, such as interleukin (IL)-6, high-sensitivity C reactive protein...

Plasma circulating cell-free mitochondrial DNA in depressive disorders.

Plasma circulating cell-free mitochondrial DNA (ccf-mtDNA) is an immunogenic molecule and a novel biomarker of psychiatric disorders. Some previous studies reported increased levels of ccf-mtDNA in unmedicated depression and recent suicide attempters, while other studies found unchanged or decreased ccf-mtDNA levels in depression. Inconsistent findings across studies may be explained by small sample sizes and between-study variations in somatic and psychiatric co-morbidity or medication status. We measured plasma ccf-mtDNA in a cohort of 281 patients with depressive disorders and 49 healthy controls. Ninety-three percent of all patients were treated with one or several psychotropic medications. Thirty-six percent had a personality disorder, 13% bipolar disorder. All analyses involving ccf-mtDNA were a priori adjusted for age and sex. Mean levels in ccf-mtDNA were significantly different between patients with a current depressive episode (n = 236), remitted depressive episode (n = 45) and healthy controls (n = 49) (f = 8.3, p<0.001). Post-hoc tests revealed that both patients with current (p<0.001) and remitted (p = 0.002) depression had lower ccf-mtDNA compared to controls. Within the depressed group there was a positive correlation between ccf-mtDNA and "inflammatory depression symptoms" (r = 0.15, p = 0.02). We also found that treatment with mood stabilizers lamotrigine, valproic acid or lithium was associated with lower ccf-mtDNA (f = 8.1, p = 0.005). Decreased plasma ccf-mtDNA in difficult-to-treat depression may be partly explained by concurrent psychotropic medications and co-morbidity. Our findings suggest that ccf-mtDNA may be differentially regulated in different subtypes of depression, and this hypothesis should be pursued in future studies.

Targeting hippocampal phospholipid and tryptophan metabolism for antidepressant-like effects of albiflorin

BackgroundCurrent antidepressant therapy remains unsatisfactory due to its delayed clinical onset of action and the heterogeneity of depression. Targeting disturbed neurometabolic pathways could provide a novel therapeutic approach for the treatment of depression. Albiflorin is a phytomedicine isolated from the root of Peony (Paeonia albiflora Pall) with excellent clinical tolerance. Until now, the antidepressant-like activities of albiflorin in different subtypes of depression and its effects on neurometabolism are unknown. PurposeThe objective of this study was to investigate the rapid antidepressant-like effects of albiflorin in three common animal models of depression and elucidate the pharmaco-metabolic mechanisms of its action using a multi-omics approach. ResultsWe found that albiflorin produces rapid antidepressant-like effects in chronic unpredictable mild stress (CUMS), olfactory bulbectomy (OBX), and lipopolysaccharide (LPS)-induced murine models of depression. Using a system-wide approach combining metabolomics, lipidomics, and transcriptomics, we showed that the therapeutic effects of albiflorin are highly associated with the rapid restoration of a set of common metabolic abnormities in the hippocampus across all three depression models, including phospholipid and tryptophan metabolism. Further mechanistic analysis revealed that albiflorin normalized the metabolic dysregulation in phospholipid metabolism by suppressing hippocampal cytosolic phospholipases A2 (cPLA2). Additionally, inhibition of cPLA2 overexpression by albiflorin corrects abnormal kynurenine pathway of tryptophan metabolism via the cPLA2-protein kinase B (Akt1)-indoleamine 2,3-dioxygenase 1(IDO1) regulatory loop and directs tryptophan catabolism towards more hippocampal serotonin biosynthesis. ConclusionOur study contributed to a better understanding of the homogeneity in the metabolic mechanisms of depression and established a proof-of-concept for rapid treatment of depression through targeting dysregulated neurometabolic pathways.

Dietary Patterns are Differentially Associated with Atypical and Melancholic Subtypes of Depression.

Diet has been associated with the risk of depression, whereas different subtypes of depression have been linked with different cardiovascular risk factors (CVRFs). In this study, our aims were to (1) identify dietary patterns with exploratory factor analysis, (2) assess cross-sectional associations between dietary patterns and depression subtypes, and (3) examine the potentially mediating effect of dietary patterns in the associations between CVRFs and depression subtypes. In the first follow-up of the population-based CoLaus|PsyCoLaus study (2009–2013, 3554 participants, 45.6% men, mean age 57.5 years), a food frequency questionnaire assessed dietary intake and a semi-structured interview allowed to characterize major depressive disorder into current or remitted atypical, melancholic, and unspecified subtypes. Three dietary patterns were identified: Western, Mediterranean, and Sweet-Dairy. Western diet was positively associated with current atypical depression, but negatively associated with current and remitted melancholic depression. Sweet-Dairy was positively associated with current melancholic depression. However, these dietary patterns did not mediate the associations between CVRFs and depression subtypes. Hence, although we could show that people with different subtypes of depression make different choices regarding their diet, it is unlikely that these differential dietary choices account for the well-established associations between depression subtypes and CVRFs.

Depressive Symptom Profile Transitions From Midlife to Late Life in the Wisconsin Longitudinal Study

Late-life depression is a significant public health problem among the growing elderly population in the United States. Structural social capital has previously been associated with lowering depressive symptoms in later life, but these results have been inconsistent. However, few studies have investigated this association when investigating different subtypes of depression. The current study used data from the Wisconsin Longitudinal Study (WLS) of 3,197 respondents to examine how structural social capital influences baseline depression statuses and transitions in these depression statuses. Latent class and latent transition analysis (LCA/LTA) were used to identify latent statuses at two time points in the WLS – 1992 and 2011 – as well as transitions between those statuses. Four depression statuses were identified at both time points: Very Depressed, Depressed and Lonely, Agitated and Restless, and Not Depressed. Gender, self-rated health, total assets, structural social capital measures, and polygenic score for depression were all predictors of baseline depression statuses. Transitions between depression statuses were associated with two forms of structural social capital – social support and social involvement. These findings add to the increasing number of studies investigating subtypes of depression in older adults as well as to scholars examining the association between structural social capital and depressive symptoms. Results suggest possible social and behavioral factors policymakers can use to identify risk of depression in mid-life and areas of intervention to improve depressive symptoms for aging adults.

Treatment-naïve first episode depression classification based on high-order brain functional network

BackgroundRecent functional connectivity (FC) studies have proved the potential value of resting-state functional magnetic resonance imaging (rs-fMRI) in the study of major depressive disorder (MDD); yet, the rs-fMRI-based individualized diagnosis of MDD is still challenging. MethodsWe enrolled 82 treatment-naïve first episode depression (FED) adults and 72 matched normal control (NC). A computer-aided diagnosis framework was utilized to classify the FEDs from the NCs based on the features extracted from not only traditional “low-order” FC networks (LON) based on temporal synchronization of original rs-fMRI signals, but also “high-order” FC networks (HON) that characterize more complex functional interactions via correlation of the dynamic (time-varying) FCs. We contrasted a classifier using HON feature (CHON) and compared its performance with using LON only (CLON). Finally, an integrated classification model with both features was proposed to further enhance FED classification. ResultsThe CHON had significantly improved diagnostic accuracy compared to the CLON (82.47% vs. 67.53%). Joint classification further improved the performance (83.77%). The brain regions with potential diagnostic values mainly encompass the high-order cognitive function-related networks. Importantly, we found previously less-reported potential imaging biomarkers that involve the vermis and the crus II in the cerebellum. LimitationsWe only used one imaging modality and did not examine data from different subtypes of depression. ConclusionsDepression classification could be significantly improved by using HON features that better capture the higher-level brain functional interactions. The findings suggest the importance of higher-level cerebro-cerebellar interactions in the pathophysiology of MDD.

Differences in Neurobiology of Different Syndrome of Melancholia in the Viewpoint of TCM

To some extent, melancholia in different Traditional Chinese Medicine (TCM) Syndromes represents different subtypes of depression. Whether bipolar depression or general depression, whether accompanied with or without psychotic symptoms, or with or without cognitive impairment, there are clinical and possible biological differences in these depressions, which indicates that different subtypes of depression represented by different TCM syndromes not only are different clinical syndromes, but also imply that there may be some biomarkers. The melancholia with liver depression and stagnation is different from melancholia with deficiency of both heart and spleen in clinical symptoms, which may indicate that there are differences in some potential biological biomarkers. For example, central nervous transmitters, trace elements, electrophysiology, neuroendocrinology, brain imaging, and even genomics may differ among different TCM syndrome types of depression, which not only serves for the modernization of TCM, but also finds biological differences for different TCM syndrome types of depression.

Striving for a Fuller Characterization of the Cellular Neuropathology of Depression Subtypes

Background: The diagnosis of depression is not only highly prevalent but also remarkable heterogeneous symptomatically. Only a few symptoms are considered common to most presentations of depression, while others form various combinations to define subtypes of depressive disorder. Most antemortem neuroimaging studies and postmortem neurochemical and cellular research have demonstrated significant structural, functional and cellular alterations shared by a majority of subjects with depression. However, it seems very likely that identifying relevant etiological factors and cellular mechanisms associated with the specific neuropathology of depression subtypes may help to focus or individualize depression treatments. Objective: The main aim of this review article is to point to the need of studying those differential cellular mechanisms characterizing different subtypes of depression as they relate to relevant neural circuits. Method: The review is based on a literature search using mainly PubMed and Google Scholar databases. Articles were considered relevant if they contained studies relating depression subtypes (or distinct symptom clusters) to neuroimaging or neuropathological parameters. Results and Conclusions: Antemortem quantification in psychiatric diagnostic scales and neuroimaging studies, with their larger number of subjects, have started to identify functional differences that discriminate depression subtypes. However, characterization of cellular and neurochemical pathology in neurons and glial cells has yet to be directed to uncover molecular and cellular mechanisms in relevant brain centers and circuits differentially affected in depression subtypes. Identifying these mechanisms will depend on our ability to first sort out cellular alterations by combining postmortem and animal model studies of depression subtypes. Keywords: Depression, pathology, neuroimaging, neuroanatomy, subtypes, glia.

Biological research on burnout-depression overlap: Long-standing limitations and on-going reflections

In this commentary, we discuss seldom-noticed methodological problems affecting biological research on burnout and depression and make recommendations to overcome the limitations of past studies conducted in this area. First, we suggest that identified subtypes of depression (e.g., depression with melancholic features and depression with atypical features) should be taken into account in future biological research on burnout and depression, given that different subtypes of depression have been associated with distinct autonomic and neuroendocrine profiles. Second, we underline that research on burnout-depression overlap is made difficult by the absence of a consensual conceptualization and operationalization of burnout. In order to resolve this problem, we draw researchers’ attention to the urgency of establishing a commonly shared, clinically valid diagnosis for burnout. Finally, we question the possibility of identifying a biological signature for burnout in light of global research on burnout-depression overlap.

Psychometric properties from a Spanish validation of Depressive Experiences Questionnaire (DEQ)

Introduction: This study assessed the psychometric prop­erties of the Spanish translation of the Depressive Expe­riences Questionnaire (DEQ). This questionnaire measures two different personality dimensions vulnera­ble to two different subtypes of depression, anaclitic de­pression and introjective depression, respectively. Ob­jectives: The aims of this study are to assess the psy­chometric properties of Spanish translation of Depres­sive Experiences Questionnaire and its relationship with at­tachment styles. Method: The sample (N = 416) con­sisted of undergraduate students with a mean of 27.63 (ST = 10.98) years old. The administration was collec­tive and taken under the supervision of the researcher. Results: The results showed good internal consistency, similar to that of other studies. The findings showed sig­nificant re­lationships with other instruments measuring depressive symptomatology and confirmed the hypothe­sis of a rela­tionship between the DEQ and attachment style. Conclu­sion: The Spanish version of the DEQ could be an in­strument for distinguishing the types of personality vul­nerability to different expressions of de­pression in the Spanish population.

Gender differences in subtypes of depression by first incidence and age of onset: a follow-up of the Lundby population

The Lundby Study is a prospective mental health survey in a community population (N = 3563), in which data were collected in 4 waves of field-work between 1947 and 1997. We investigated gender differences during the follow-up in overall first incidence rates, ages of onset, and incidence by age of onset patterns, in different subtypes of depression. The overall incidence rate in females was higher than males for most subtypes of depression. However, for depression with melancholic and/or psychotic features, the overall first incidence rate did not differ significantly between the genders. The mean age of onset did not differ significantly between females and males in any of the depressive subtypes. Nevertheless, females and males had different first incidence rates by age of onset patterns for unipolar non-melancholic DSM-IV mood disorder and major depressive disorder (MDD), with a consistent gender incidence gap across all ages, but with the most conspicuous gender gap in middle age. The first incidence rates by age of onset patterns for DSM-IV MDD with melancholic and/or psychotic features did not differ significantly between the genders. The findings support that females are more prone than males to develop depression with medium severity, but no gender differences were found in melancholic and/or psychotic depression. The findings may support that unipolar non-melancholic depression and melancholic and/or psychotic depression represents different disorders. Tentative explanations for this are discussed.

The Role of Neuropeptide Y mRNA Expression Level in Distinguishing Different Types of Depression.

Previous studies demonstrate that the protein of neuropeptide Y (NPY) is abnormal in depression patients, but the changes of NPY in different types of depression are unclear. This study was aimed to examine protein and mRNA expression levels of NPY in 159 cases with four groups including post-stroke depression (PSD) group, stroke without depression (Non-PSD) group, major depressive disorder (MDD) group and normal control (NC) group. The protein and gene expression analysis were performed by enzyme-linked immunosorbent assay (ELISA) and quantitative polymerase chain reaction-based methods. One way analysis of variance (ANOVA), chi-square tests and nonparametric test were used to evaluate general characteristics, clinical and biological materials. In order to explore the role of NPY in different types of depression, the partial correlations, binary logistic regression analysis and receiver operating characteristic (ROC) curve were calculated for PSD and MDD groups. There are significant differences of NPY protein (Fdf(3) = 5.167, P = 0.002) and mRNA expression levels ( = 20.541, P < 0.001) among four groups. Bonferroni multiple comparisons found that the NPY protein was significantly decreased in PSD (FBonferroni = −7.133, P = 0.002) and Non-PSD group (FBonferroni = −5.612, P = 0.018) compared with NC group. However, contrasted with MDD group, the mRNA expression was increased in PSD and Non-PSD group by nonparametric test (all P < 0.05). In binary logistic analyses, NPY mRNA expression was independent predictors of PSD (odds ratio: 1.452, 95% CI, 1.081–1.951, P = 0.013). The ROC curve showed NPY mRNA had a general prognostic accuracy (area under the curve: 0.766, 95% CI, 0.656–0.876, P < 0.001). This is the first study to explore the distinguishing function of NPY in different types of depression. It will provide help in the identification of different subtypes of depression.

Efficacy of an adjunctive brief psychodynamic psychotherapy to usual inpatient treatment of depression: Results of a randomized controlled trial

BackgroundFor severe and chronic depression, inpatient treatment may be necessary. Current guidelines recommend combined psychological and pharmacological treatments for moderate to severe depression. Results for positive effects of combined treatment for depressed inpatients are still ambiguous. MethodsThis randomised controlled trial examined the efficacy of adding an intensive and brief psychodynamic psychotherapy (IBPP) to treatment-as-usual (TAU) for inpatients with DSM-IV major depressive episode. The primary outcomes were reduction in depression severity, and response and remission rates at post-treatment, 3-month and 12-month follow-up points. ResultsA linear mixed model analysis (N=149) showed a higher reduction in the observer-rated severity of depressive symptoms at each follow-up point for the IBPP condition compared with the TAU condition (post-treatment ES=0.39, 95%CI 0.06–0.71; 3-month ES=0.46, 95%CI 0.14–0.78; 12-month ES=0.32, 95%CI 0.01–0.64). Response rate was superior in the IBPP group compared with the TAU group at all follow-up points (post-treatment OR =2.69, 95%CI 1.18–6.11; 3-month OR=3.47, 95%CI 1.47–8.25; 12-month OR=2.26, 95%CI 1.02–4.97). IBPP patients were more likely to be remitted 3 months (OR=2.82, 95%CI 1.12–7.10) and 12 months (OR=2.93, 95%CI 1.12–7.68) after discharge than TAU patients. LimitationsHeterogeneous sample with different subtypes of depression and comorbidity. ConclusionsIBPP decreased observer-rated depression severity up to 12 months after the end of treatment. IBPP demonstrated immediate and distant treatment responses as well as substantial remissions at follow-up. IBPP appears to be a valuable adjunct in the treatment of depressed inpatients.

Depressive symptoms are associated with poor outcome for lumbar spine surgery

Background and aimsThe symptoms of pain and depression often present concomitantly, but little is known as to how the different subtypes of depression affect surgical outcome. The aim of this study was to determine whether there is a difference in outcome after lumbar spine surgery between non-depressed patients and patients with different subtypes of depressive symptoms: non-melancholic (NmDS) and melancholic depression (MDS). MethodsThis was a cross-sectional postal survey. A self-made questionnaire, the Beck Depression Inventory (BDI) and the Oswestery Low Back Disability Questionnaire (ODI) were sent to patients who had undergone lumbar spine surgery in the Oulu University Hospital between June, 2005 and May, 2008. BDI≥10 were further classified into NmDS or MDS. ResultsA total of 537 patients (66%) completed the survey. Of these, 361 (67%) underwent disc surgery, 85 (16%) stabilizing surgery and 91 (17%) decompression. Participants were divided into three groups: BDI<10 N=324 (60%), NmDS N=153 (29%) and MDS N=60 (11%). The mean ODI (SD) in the BDI<10 group was 16 (15), in the NmDS group 36 (15), and in the MDS group 41 (18) (p<0.001). The ODI profiles were different between the groups (p<0.001). Pain was more frequent in depressive patients (88% of MDS, 81% in NmDS and 40% in BDI<10 patients experienced pain, p<0.001). The intensity of pain and pain-related disability was lowest among the patients in the BDI<10 group and highest among the MDS patients. Regular pain medication was used by 87% of patients in the MDS group, 93% of patients in the NmDS group, and 71% of patients in the BDI<10 group (p<0.001). Response to pain medication with NRS (0–10) was 5.6 among MDS, 5.8 among NmDS and 6.5 among BDI<10 patients (p<0.001). ConclusionDifferent types of depressive symptoms are associated with poor outcome after lumbar spine surgery. The outcome was worst in patients suffering from the MDS subtype. This was observed in pain intensity, functional disability and response to pain medication. ImplicationIt would be important to evaluate depression pre- and postoperatively. Offering a tailored rehabilitation programme to MDS patients should be considered.

L’orage émotionnel : du off thymique du patient parkinsonien à l’hyperréactivité de la bipolarité

Emotional dysregulation is an essential dimension that may occur in several psychiatric and neurologic disorders. We focused on clinical characteristics of emotional state variations in bipolar disorder and in Parkinson's disease. In both pathologies, the emotional intensity variability involves important diagnostic and therapeutic issues. It is difficult to identify a major depressive episode in Parkinson's disease because of the overlap of specific symptoms of Parkinson's disease with depressive symptoms, and especially concerning emotional symptoms. Neurologists will have to choose their drug therapy between dopaminergic agonists to improve symptoms like apathy and emotional numbness and/or more classical antidepressants like selective serotoninergic inhibitors to improve thymic symptoms with negative valence. Likewise, emotional reactivity in bipolar depression, measured with a dimensional scale named as “Multidimensional Assessment of Thymic state Scale”, allowed showing two subtypes of depression. One with emotional hyporeactivity, similar to the depression in Parkinson's patients with apathy, would better respond to dopaminergic agonists, whereas the one with emotional hyperreactivity would better respond to atypical antipsychotics. These two different subtypes of depression could involve two different monoaminergic circuits, and that would be the dopaminergic system for the hyporeactive depression while the serotoninergic system would be for the hyperreactive one. Emotional reactivity appears to be a relevant clinical characteristic to distinguish two subtypes of depression, besides the diagnostic, and to bring to light physiopathology's mechanisms that will help to improve the therapeutic choices.

Geriatric depression and its relation with cognitive impairment and dementia

Different subtypes of depressive syndromes exist in late life; many of them have cognitive impairment and sometimes it is difficult to differentiate them from dementia. This research aimed to investigate subtypes of geriatric depression associated with cognitive impairment, searched for differential variables and tried to propose a study model. A hundred and eighteen depressive patients and forty normal subjects matched by age and educational level were evaluated with an extensive neuropsychological battery, scales to evaluate neuropsychiatric symptoms and daily life activities (DLA). Depressive patients were classified in groups by SCAN 2.1: Major Depression Disorder (MDD) (n: 31), Dysthymia Disorder (DD) (n: 31), Subsyndromal Depression Disorder (SSD) (n: 29), Depression due to Dementia (n: 27) (DdD). Neuropsychological significant differences (p<0.05) were observed between depressive groups, demonstrating distinctive cognitive profiles. Moreover, significant differences (p<0.05) were found in DLA between DdD vs all groups and MDD vs controls and vs SSD. Age of onset varied in the different subtypes of depression. Beck Depression Inventory (BDI) and Mini Mental State Examination (MMSE) were significant variables that helped to differentiate depressive groups. Significant correlations between BDI and Neuropsychological tests were found in MDD and DD groups. Depressive symptoms and its relation with neuropsychological variables, MMSE, cognitive profiles, DLA and age of onset of depression should be taken into consideration for the study of subtypes of geriatric depression.

The predictive power of subgroups: An empirical approach to identify depressive symptom patterns that predict response to treatment

BackgroundDepression research has been trying to improve the response rates to treatments by identifying a valid set of differential predictor variables. Potential candidates have been proposed, one of which were different subtypes of depression. However, the results on the predictive quality of subtypes on treatment are conflicting. MethodsThe analyzed data consisted of Hamilton Depression Rating Scales (HAM-D17) of 879 depressive inpatients, which were recruited in a naturalistic multicenter study. Mean length of stay was 9.9 weeks. In a first step, a Latent Class Analysis (LCA) was conducted to classify the patients into smaller groups. In a second step, the class variable was included in a Linear Mixed Effects model to predict the same patients’ response to treatment. ResultsFive classes were obtained from LCA, showing substantially different symptom profiles. One of the classes, with a symptom profile similar to melancholic depression, showed substantially slower response to treatment (i.e. estimated time to remission; 11.3 weeks) than the remaining classes in the study (6.6–8.6 weeks). LimitationsThe applied measurement instrument, the HAM-D17, did not include items for two additional, frequently found subtypes of depression: psychotic and atypical depression. Thus, these subtypes could not emerge in the LCA. Furthermore, there was no systematic variation of treatment in the data. Thus, a differential effect of the classes on treatment could not be measured. ConclusionsThe classification of patients according to their symptom profiles seems to be a potent predictor for treatment response. However, the obtained symptom patterns are not completely congruent with the theoretically proposed subgroups. Against the background of the results, dividing melancholic depression in a rather cognitive and vegetative subtype may be promising.

The incidence and causes of different subtypes of depression in prostate cancer patients: implications for cancer care

Although depression occurs in prostate cancer patients at a higher incidence than in age-matched non-cancer peers, little is known about the relative incidence of subtypes of depression among these patients. To examine this issue, 507 prostate cancer patients completed a survey questionnaire of background factors, depression symptoms, and common prostate cancer-related stressors. Five common subtypes of depression were defined from the wider literature, and patients' depressive symptomatology was used to determine their scores on each of the five depression subtypes. Nearly half of the patients had scores which could be classified as clinically significant for at least one of the five depression subtypes, with some patients showing clinically significant scores for multiple depression subtypes. Different depression subtypes were predicted by different prostate-cancer-related stressors. Because each of the five depressive subtypes examined here has different symptomatologies and treatment recommendations, these data suggest that treatment goals for prostate cancer patients might vary according to the type of depression a patient presents.

Electroretinographic assessment in major depressed patients receiving duloxetine: Might differences between responders and non-responders indicate a differential biological background?

Despite intense research efforts, still too little is known about the biological determinants of depression, thus soliciting diverse study approaches. Among others, the electroretinography (ERG) has been proposed even as a putative proxy (retinal) measurement of central dopaminergic activity for Major Depressive Disorder (MDD) both in drug-naïve patients and subjects receiving antidepressant treatments. Nonetheless, current evidences are merely preliminary, essentially considering just older classes of antidepressants, thus requiring confirmation studies even with newer agents as duloxetine. Twenty MDD subjects and 20 matched controls received duloxetine 60 mg/day for 12 weeks, being monitored both by standard ERG recording and by administration of the Hamilton scales for Depression and Anxiety and the Young Mania Rating Scale at baseline and week 12 (end of the study). ERG mean rod b-wave amplitude significantly reduced from baseline to week 12 in those depressed subjects achieving final response (p=.024), decreasing from the highest rank values to the ones, substantially unmodified, seen among non-responders and controls. Small sample size and lack of multiple assessments. At least some MDD patients responding to duloxetine might exhibit a peculiar ERG pattern, hypothetically indicating a specific biological background. If confirmed by larger-sampled studies, these results might shed further light in the understanding of the biological determinants of different subtypes of depression, ideally showing alternative patterns of response upon different treatment interventions.