Differential Diagnosis Of Depression Research Articles

How Can Near‐Infrared Spectroscopy (NIRS) Help Understanding of the Psychotherapy Process? A Scoping Review of Therapeutic Interactions

AbstractIn recent years, near‐infrared spectroscopy (NIRS) has garnered significant attention for its potential clinical applications as a non‐invasive and straightforward method for measuring brain functions. While NIRS has become useful in psychiatric contexts by aiding in the differential diagnosis of depression, its application in clinical psychology is still developing. Due to its ecological validity, which allows for measurements in natural settings, NIRS shows promise in revealing the dynamic elements of the psychotherapy process. In this study, we conducted a scoping literature review of the use of NIRS in psychotherapeutic interactions, exploring its potential to unveil the complexities of psychotherapy settings involving interpersonal interactions. Employing a scoping review approach, we systematically searched the PubMed, PsycINFO, and Web of Science databases for articles published through October 19, 2023 about studies using NIRS as a measurement instrument: This yielded various therapeutic interactions. Of the 155 retrieved results that remained after the initial screening, seven met the inclusion criteria. Of these, six studies examined the synchronization of brain functions through the simultaneous brain activity measurements (hyperscanning) of two participants. The review revealed that, despite the anticipated potential of NIRS, it has become evident there is a dearth of research focusing on interactions during psychotherapy. Furthermore, the few available studies have not explored changes in line with the progression of psychotherapeutic interactions. Consequently, future studies should address whether NIRS can effectively assess alterations in brain function resulting from micro‐level events, such as the therapeutic interaction between therapists and clients during psychotherapy.

Clinical picture and differential diagnosis of depression in old age

Depression in old age is often underdiagnosed, although it is the leading mental health problem at this age. The significance of assessment and adequate treatment of depression among elderly patients cannot be overstated, since it significantly impairs the quality of life, increases morbidity and mortality in many of the chronic disease groups. In addition, it is a primary risk factor in completed suicide, which occurs up to three times more often among elderly than in other age groups. In our non-systematic (narrative) summary study, we briefly review the clinical picture and differential diagnosis of depression in elderly patients, as well as the main aspects of screening and treatment. The clinical characteristics and the pathology of the disease at this age raise a number of methodological questions that could be the subject of further empirical studies. Orv Hetil. 2023; 164(39): 1537-1543.

The Leuven late life depression (L3D) study: PET-MRI biomarkers of pathological brain ageing in late-life depression: study protocol

BackgroundMajor depressive disorders rank in the top ten causes of ill health in all but four countries worldwide and are the leading cause of years lived with disability in Europe (WHO). Recent research suggests that neurodegenerative pathology may contribute to the development of late-life depression (LLD) in a sub-group of patients and represent a target for prevention and early diagnosis. In parallel, electroconvulsive therapy (ECT), which is the most effective treatment for severe LLD, has been associated with significant brain structural changes. In both LLD and ECT hippocampal volume change plays a central role; however, the neurobiological mechanism underlying it and its relevance for clinical outcomes remain unresolved.MethodsThis is a monocentric, clinical cohort study with a cross-sectional arm evaluating PET-MR imaging and behavioural measures in 64 patients with LLD compared to 64 healthy controls, and a longitudinal arm evaluating the same imaging and behavioural measures after 10 ECT sessions in 20 patients receiving ECT as part of their normal clinical management. Triple tracer PET-MRI data will be used to measure: hippocampal volume (high resolution MRI), synaptic density using [11C]UCB-J, which targets the Synaptic Vesicle Glycoprotein 2A receptor, tau pathology using [18F]MK-6240, and cerebral amyloid using [18F]-Flutemetamol, which targets beta-amyloid neuritic plaques in the brain. Additional MRI measures and ultrasound will assess cerebral vascular structure and brain connectivity. Formal clinical and neuropsychological assessments will be conducted alongside experience sampling and physiological monitoring to assess mood, stress, cognition and psychomotor function.DiscussionThe main aim of the study is to identify the origin and consequences of hippocampal volume differences in LLD by investigating how biomarkers of pathological ageing contribute to medial temporal lobe pathology. Studying how synaptic density, tau, amyloid and vascular pathology relate to neuropsychological, psychomotor function, stress and ECT, will increase our pathophysiological understanding of the in vivo molecular, structural and functional alterations occurring in depression and what effect this has on clinical outcome. It may also lead to improvements in the differential diagnosis of depression and dementia yielding earlier, more optimal, cost-effective clinical management. Finally, it will improve our understanding of the neurobiological mechanism of ECT.Trial registrationClinicalTrials.gov Identifier: NCT03849417, 21/2/2019.

High-Order Functional Connectivity Network for Differential Diagnosis of Depression

Resting-state functional connectivity (FC) changes dynamically and major depressive disorder (MDD) has abnormality in functional connectivity networks (FCNs), but few existing resting-state fMRI study on MDD utilizes the dynamics, especially for identifying depressive individuals from healthy controls. In this paper, we propose a methodological procedure for differential diagnosis of depression, called HN3D, which is based on high-order functional connectivity networks (HFCN). Firstly, HN3D extracts time series by independent component analysis, and partitions them into overlapped short series by sliding time window. Secondly, it constructs a FCN for each time window and concatenates correlation matrices of all FCNs to generate correlation time series. Then, correlation time series are grouped into different clusters and high-order correlations for HFCN is calculated based on their means. Finally, graph based features of HFCNs are extracted and selected for a linear discriminative classifier. Tested on 21 healthy controls and 20 MDD patients, HN3D achieved its best 100% classification accuracy, which is much higher than results based on stationary FCNs. In addition, most discriminative components of HN3D locate in default mode network and visual network, which are consistent with existing stationary-based results on depression. Though HN3D needs to be studied further, it is helpful for the differential diagnosis of depression and might have potentiality in identifying relevant biomarkers.

Culture and mental disorders

ObjectivesShow with a case report how psychiatric pathology may face differential diagnosis problems when sociocultural aspects are involved.Methods and materialsSeventy-three year old man, born in Colombia. During the last two months, he had come many times to the emergency service due to behavioural changes. He does not have previous psychiatric history. His daughter refers that one of the patient's sisters has been diagnosed of “mystical madness”. The previous days he abandoned his medical treatment saying that he “gets in touch with his wife and that he wants to meet her”. Since his wife's dead, he had presented an excessively adapted behaviour, without grief symptoms. The first hospitalization day he said we wanted to get married with one of his daughters, with a sexual content speech, being able to get emotional when he spoke about his dead wife. Now the patient is under frequent reviews, and it is thought the differential diagnosis of depression with psychotic symptoms, due to the lack of symptoms remission.ConclusionWhenever we face different psychiatric diagnosis we don’t keep in mind some sociocultural factors, which could be masked and raise different doubts. It is important to keep in mind that each country or ethnical have their own cultural habits which are going to deeply influence patient's personality.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Spatio-Temporal EEG Markers for Recognition Auditory Images in Norm and Psychopathology

The psychophysiological mechanisms of cognitive processes dysfunctions remain poorly understood. The purpose of this study was to modeling spatial-temporal parameters of coherent EEG assessment during auditory recognition in normal conditions and psychopathology. 40 healthy subjects and 72 patients with homogeneous psychopathological states depressive nature (average age of 34 ± 3.4 years) using the standard and original research methods were investigated. Individual-psychological characteristics and the severity of cognitive defect was evaluated according to the clinical interview, research verbal memory, the traditional methods of evaluating situational and personal anxiety, the differential diagnosis of depression. The study was conducted in St Petersburg “Psycho-Neurological Clinic No 1”. We have used the original method of studying the perception of auditory images, audiometry, computer electroencephalography with multidimensional mathematical treatment and psychological analysis of higher mental functions in patients with paranoid schizophrenia and control normal subjects. Analysis of coherence alpha- and beta-EEG rhythms in solving cognitive tasks for recognition of auditory images revealed that the functional interaction of the cortical areas normally significantly increased compared to background EEG. The features of the topography of functional relationships of alpha- and beta-EEG rhythms in the perception of auditory information are confirmed. Focuses interactions are recorded in the frontal areas. It marked the integration of these frontal zones with front associative cortex and temporal areas of the left hemisphere, as well as parietal and occipital areas of both hemispheres. At psychopathology reducing the number of coherent communications, violation of the formation of foci of coherence was registered.

Quantitative Electroencephalography for Objective and Differential Diagnosis of Depression: A Comprehensive Review

<p>Quantitative electroencephalography (QEEG) has been dramatically developed during recent years in cognitive neurosciences. It has shown significant potential in the diagnosis of cognitive neurological disorders as well as in the evaluation of treatment outcomes and response. Early diagnosis of depression, differential diagnosis, and assessing the treatment outcomes and response are currently the main research fields of QEEG in depression. Identifying reliable disorder-specific EEG-based biomarkers that have strong correlations with the depression specific cognitive functions is one of the major challenges in these fields. Such biomarkers not only allow early and cost-effective diagnosis of depression, but also may have differential diagnostic and predictive values for treatment response of a variety of treatments. This paper aims at a comprehensive review on the main principles of QEEG in developing biomarkers for MDD. The databases of PubMed (1985-2015), Web of Sciences (1985-2015), and Google Scholar (1980-2015) were searched using the set terms. The obtained results were screened for the title and abstract by two authors and they came to consensus whether the studies are related to the review. The main advantages of QEEG for mood disorders are also reviewed. In addition, different QEEG-based measures for objective diagnosis of MDD as well as for distinguishing depressed patients from healthy subjects are discussed.</p>

Protocolo diagnóstico de depresión en ancianos

Depression in the elderly is a heterogeneous group of processes characterised by the presence of depressive symptoms. The reductionism of a single concept of depression needs to be overcome in the elderly, because these processes have a distinct pathophysiological and/or physiological origin. The presence of different aetiologies requires the implementation of various therapeutic strategies, depending on the type of depressive process presented by the patient. In this protocol, we describe the atypical clinical nature of depression in the elderly, a condition that is frequently underdiagnosed. We also provide the diagnostic steps that help in the differential diagnosis of depression in the elderly, showing a number of specificities in the most characteristic depressive processes. We focus on 2 still poorly understood circumstances: the presence of adaptive disorders in the elderly and the relationship between depression and dementia.

Differential diagnosis of depression and Alzheimer's disease with the Addenbrooke's Cognitive Examination-Revised (ACE-R).

BackgroundOne of the usual problems psychologists and clinicians face in clinical practice is differential diagnostics of Alzheimer’s disease and depression. It has been reported that the ACE and ACE-R could discriminate the cognitive dysfunctions due to depression from that due to dementia, although this is not uniform in all studies. The current study aimed to evaluate the utility of the ACE-R to differentiate late-life onset depression (with severe episode) from mild-moderate Alzheimer’s Disease (AD).MethodsThis study received approval from the Lithuanian Bioethics Committee. All participants were older than 50 years (mean age = 66.52 (±8.76) years). The study sample consisted of 295 individuals: 117 with severe depression, 85 with mild-moderate Alzheimer’s disease (AD), and 94 age, gender and education matched participants of control group.ResultsThe ACE-R had high sensitivity (100%) and specificity (81%) at detecting cognitive impairments related to AD. Patients with late-life onset depression (ACE-R mean 76.82, SD = 7.36) performed worse than controls (ACE-R mean 85.08, SD = 7.2), but better than the AD group (ACE-R mean 54.74, SD = 12.19). Participants with late-life onset depression were differentiated by mild impairment in the ACE-R total score with mild memory (13.79, SD = 6.29) and greater deficits in letter fluency (3.65, SD = 1.21) than in semantic fluency (4.68, SD = 1.23). Participants with AD were differentiated by severely impaired performance on attention and orientation (11.80, SD = 2.93), memory (8.25, SD = 3.47) and language subtests (17.21, SD = 4.04), and moderately impaired performance on verbal fluency (6.07, SD = 2.74).ConclusionsACE-R has diagnostic accuracy in detecting people with AD and can be used in differential diagnostics of late-life onset depression (severe episode) and AD. Diagnostic accuracy may be improved by analyzing the neuropsychological profiles and using lower cutoffs for different age groups.

Effectiveness of Electroconvulsive Therapy for Depression and Cotard’s Syndrome in a Patient with Frontotemporal Lobe Dementia

In the field of psychogeriatrics, the differential diagnosis of depression and dementia, as well as the treatment of depression and comorbid dementia, is an important issue. In this paper, the authors present the case of a 72-year-old woman with Cotard's syndrome and frontotemporal dementia (FTD) who was admitted to a psychiatric hospital with delusions of negation accompanied by depressive symptoms. Pharmacotherapy over a 2-year hospitalization was unsuccessful, and she was subsequently transferred to our university hospital. A total of 18 sessions of electroconvulsive therapy released her from psychomotor inhibition, appetite loss, and Cotard's delusions. The indication for electroconvulsive therapy in patients with dementia is discussed.

Sleep Pathologies in Depression and the Clinical Utility of Polysomnography

Abnormal sleep accompanies many psychiatric conditions, but has long been recognized as a particularly conspicuous feature of affective disorders. More than a mere epiphenomenon, the powerful link between sleep and mood regulation is most dramatically demonstrated by the high efficacy of sleep deprivation in alleviating depression. Indeed, the sleep abnormalities that accompany depression may be due to the same neuropathologies that are responsible for its mood and cognitive symptoms. This powerful link between sleep and mood regulation makes polysomnography (PSG) a useful window into the underlying pathophysiology of depression, yet it is underused, particularly in clinical diagnosis. Recent depression research has emphasized the importance of establishing biologically relevant subtypes of depression with treatment specificity and prognostic value. PSG measures, among other biological markers, may be of importance in establishing these subtypes. Two subtypes of depression that appear to have robust biological differences, the melancholic and atypical subtypes, have recently been shown to have different sleep profiles that can aid in differential diagnosis. Further, routine use of PSG in the workup of a depressed patient would minimize the chances of misdiagnosis in those suffering from primary sleep disorders such as sleep apnea, which can present secondary mood symptoms resembling depression. Increased use of PSG in clinical psychiatric practice would enlarge the body of data available for defining new depressive subtypes in the future. It would also serve an immediate purpose in the separation of atypical, compared with melancholic, depression, and the differential diagnosis of depression from primary sleep disorders.

YSFC01-06 - Perspectives of using neuroimaging methods in differential diagnosis of depression

IntroductionDepression is one of the most common mental health problem and it grows greater every year around the world.AimsThe main aims were to analyze the possibility of using functional and structural neuroimaging methods in diagnosis of different depression types and to find the predictors of pharmacological resistance.Materials & methods46 patients with depression syndrome were distributed into 3 groups: 1) Neurotic Depression (Diagnosis: Adjustment disorders) - ND group; 2) Endogenous Depression (Diagnosis: Recurrent Depression, Bipolar Affective Disorder - current depressive episode, Schizoaffective disorder, depressive type) - PD group, 3) Depression due to organic pathology (Diagnosis: Organic depressive disorder, Organic mixed affective disorder) - OD group. Controls were 18 years old- and gender-matched healthy participants. We used several methods of functional (positron-emission tomography, functional magnetic resonance imaging) and structural (voxel-based morphometry, diffusion-tensor imaging) neuroimaging.ResultsWe found several functional and structural abnormalities in limbic structures within all three groups. Some of them were the same, some were different. Also we found several functional and structural predictors of pharmacological resistance.ConclusionsWe found several functional and structural abnormalities in all three depressive groups. Almost all of them were parts of so-called frontal-subcortical circuits, dysfunction of which, according to the present knowledge, could play crucial role in depression pathogenesis.Summarizing our own results and analyzing the data of our colleagues, we complement a theory of depression pathogenesis and propose an original point of view for neurobiological basis of different types of depressive disorders and its pharmacological resistance.

Adults With Down Syndrome

Adults With Down Syndrome

A 71-year-old Woman with Cognitive Deficits and Social Withdrawal

<p>Mrs. R is a 71-year-old woman who is retired and lives with her 75-year-old husband. She is a mother of two daughters and grandmother of five grandchildren. Mrs. R is of Irish descent and immigrated to the United States with her parents and younger brother in her late teenage years. She was a student with great ability at school and graduated college. She worked as an English teacher and fulfilled her interest in music. She was married at age 26, and she maintained good social and occupational life. </p> <h4>ABOUT THE AUTHORS</h4> <p>Nahla Mahgoub, MD, is Instructor in Psychiatry and Assistant Attending Psychiatrist, and Nabil Kotbi, MD, is Assistant Professor of Psychiatry and Assistant Attending Psychiatrist, Weill Medical College of Cornell University, New York, NY.</p> <p>Address correspondence to: Nahla Mahgoub, MD, 21 Bloomingdale Rd, White Plains, NY, 10605; or e-mail <a href="mailto:namd06@aol.com">namd06@aol.com</a>, <a href="mailto:nam2024@med.cornell.edu">nam2024@med.cornell.edu</a>. </p> <p>Dr. Mahgoub has disclosed no relevant financial relationships.</p> <h4>EDUCATIONAL OBJECTIVES</h4> <ol><li> Review the manifestations and differential diagnosis of depression in Alzheimer's disease. </li> <li>Discuss the risk factors of depression in Alzheimer's disease.</li> <li>Summarize the recommendations and guidelines for treatment of depression in Alzheimer's disease. </li> </ol>

Textbook of Clinical Neuropsychiatry

Textbook of Clinical Neuropsychiatry

Differential diagnosis of depression in adolescence challenging

![Figure][1] Dr. Hagman Editor’s note: Differential diagnosis of depression in adolescence is a challenging task. For this issue of “Consultant’s Corner,” the editors of Adolescent Health Update asked Jennifer Hagman, M.D., associate professor of psychiatry at the University of

Depression in Cancer Patients

Depression is seen in many cancer patients. It is an especially important issue in palliative care, as depression can be more common in patients who are at the end of life. Accurate assessment and treatment can have a powerful impact on improving a patient's quality of life. This article reviews the definition and the differential diagnosis of depression in cancer patients. It then focuses on some of the treatment options available, including pharmacotherapy and psychotherapy.

Differential diagnosis of depression and dementia: A case study

Differential diagnosis of depression and dementia: A case study

Differential diagnosis of depression and dementia in geriatric patients by quantitative magnetic resonance imaging

Differential diagnosis of depression and dementia in geriatric patients by quantitative magnetic resonance imaging

Differential diagnosis of depression and dementia: A case study

Differential diagnosis of depression and dementia: A case study