Early-onset Depression Research Articles

A Link between Parental Psychopathology and Preschool Depression: Take Care of Parents to Take Care of Children.

The first aim of this outcome research was to analyze the impact of parental support treatment in a sample of depressed preschool children divided into two groups of comparison (under-reactive and over-reactive) through evolution in the Clinical Global Impression (CGI). The second aim was to analyze the correlation between the presence of parental psychopathology and the severity of children's disorders. Our clinical sample consisted of 32 preschool-age children with a final diagnosis of MDD. The children's assessment included a psychiatric assessment to establish a diagnosis of MDD, confirmed by means of a semi-structured interview, which was administered again one month after the end of parental treatment. All the parents began a six-month parent training treatment conducted by experienced child psychiatrists, whereas children were not treated. During this period, the Clinical Global Impression Scale (CGI) was filled out monthly in order to observe the evolution of the children's disorders. Post-hoc tests showed a significant difference from before the treatment to after the treatment only in the over-reactive group (p = 0.00). Regarding parental psychiatric disorders, in the over-reactive group, only 3 children had no parents with psychopathology. In the under-reactive group, no child lacked a parent with psychopathology. Parent training treatment seems to be a valid intervention to improve preschool depression, especially in over-reactive groups, and to prevent dysfunctional parental styles connected to parental psychopathology.

A Standardized Protocol for Early-life Stress-induced Social Defeat in Mice.

Neuropsychiatric diseases, like depression, have a considerable and persistent impact on human health; however, little is known about their underlying pathogenesis. Social defeat is a model for stress-induced psychopathologies that could present with behaviors resembling those observed in humans with depression. However, previous animal models of social defeat mainly focus on adults. Here, we re-design the protocol of early-life stress-induced social defeat paradigm, which is based on a classic resident-intruder model. Briefly, each two-week-old experimental mouse of C57BL/6 strain is introduced into the home cage of an unfamiliar CD1 aggressor mouse for 30 min per day for 10 consecutive days. Later, all experimental mice are raised individually for another month. Finally, the mice are identified as defeated through social interaction and open field tests. This model has been shown to be etiological and predictive and provide high validity and could be a powerful tool to investigate the underlying pathogenesis of early onset depression. Graphical overview.

Association of homocysteine and polymorphism of methylenetetrahydrofolate reductase with early-onset post stroke depression.

Homocysteine (Hcy) has been indicated to be involved in pathophysiology of post stroke depression (PSD). There is a lack of research to study the relationship between Hcy metabolism genes and PSD. Our study aims to investigate the relationship among Hcy metabolism genes, Hcy, and early-onset PSD. We recruited 212 patients with stroke and collected their peripheral blood sample, clinical data, and laboratory test on admission. 12 single nucleotide polymorphisms (SNPs) in methylenetetrahydrofolate reductase (MTHFR), methionine synthase reductase (MTRR), and methionine synthase (MTR) genes were genotyped by high-resolution melt analysis. PSD was diagnosed by DSM-V at 2 weeks after stroke. Binary logistic regression and haplotype analysis were used to examine the association between Hcy metabolism genes and PSD. Mediation analysis was performed to clarify whether the SNPs exerted their effect on PSD by affecting the Hcy level. 81 patients were diagnosed with PSD, and the incidence rate was 38.2%. Hcy level in PSD group was significantly higher than it in non-PSD group (p = 0.019). MTHFR rs1801133 AA genotype an A allele were associated with an elevated risk of PSD after adjustment for some confounding factors (OR = 4.021, 95% CI: 1.459∼11.080, p = 0.007 for AA genotype; OR = 1.808, 95% CI: 1.172∼2.788, p = 0.007 for A allele). Furthermore, the effect of MTHFR rs1801133 AA genotype on PSD was mediated by Hcy (OR = 1.569, 95% CI: 0.013∼3.350, p < 0.05). MTHFR rs1801133 and Hcy were associated with PSD, and MTHFR rs1801133 may exert an effect on PSD via mediating Hcy level. This offers a new perspective for treating PSD and understanding the mechanism of PSD.

Association between depression and the likelihood of having children: a nationwide register study in Finland

Depression may be associated with a lower likelihood of having children, but the findings are inconsistent. Previous population-based studies on this topic are limited. We examined associations between depression and the likelihood of having children, the number of children, and the parental age at first birth. We also evaluated whether these associations differ for people with low, middle, and high educational levels. We conducted a nationwide register cohort study including all individuals born in Finland from 1960 to 1980 (n=1,408,951). Depression diagnoses were identified from the Care Register for Health Care (containing records of inpatient hospital episodes for the period 1969 to 2017 and of specialist outpatient visits for the period 1996 to 2017). The main outcomes-having biological children, the number of biological children, and the parental age at first birth-were identified from the Population Register of Statistics Finland and were defined either in the last year of the follow-up in 2017 or the last year alive or living in Finland. The association between depression and the likelihood of having children was examined using a logistic regression analysis; the association between depression and the number of children was evaluated using Poisson regression analyses, and the association between depression and the age at first birth was evaluated using a linear regression analysis. All analyses were conducted separately for men and women. For both men and women, secondary care-treated depression was associated with a lower likelihood of having children (odds ratio, 0.66; 95% confidence interval, 0.64-0.67 for men; odds ratio, 0.84; 95% confidence interval, 0.82-0.85 for women) and with having fewer children (incidence rate ratio, 0.86; 95% confidence interval, 0.86-0.87 for men; incidence rate ratio, 0.96; 95% confidence interval, 0.96-0.96 for women). Depression was associated with a slightly lower parental age at first birth (33.1 vs 34.0; P<.001 for men; 31.3 vs 32.1; P<.001 for women). Dose-response associations between the severity of depression and a decreased likelihood of having children, as well as having fewer children, were observed. Earlier onset of depression was related to a lower likelihood of having children and to having fewer children. Among men and women in middle- and high-level educational groups, depression was associated with a lower likelihood of having children and with having fewer children. Among men with a low level of education, no associations were observed. Among women with a low level of education, depression was associated with a higher likelihood of having children and with having more children. Both men and women with secondary care-treated depression have a lower likelihood of having children and have fewer children. Our findings suggest that depression may be one of the factors that contribute to the likelihood of having children, which should be addressed by policy makers.

Age of onset for major depressive disorder and its association with symptomatology

BackgroundThe age of onset (AOO) is a key factor for heterogeneity in major depressive disorder (MDD). Looking at the effect of AOO on symptomatology may improve clinical outcomes. This study aims to examine whether and how AOO affects symptomatology using a machine learning approach and latent profile analysis (LPA). MethodsThe study enrolled 915 participants diagnosed with MDD from eight hospitals across China. Depressive symptoms were assessed using the 17-item Hamilton Depression Rating Scale. The relationship between symptom profiles and AOO was explored using Random Forest. The effect of AOO on symptom clusters and subtypes was investigated using multiple linear regression and LPA. A continuous AOO indicator was used to conduct the analyses. ResultsBased on the Random Forest, symptom profiles were closely associated with AOO. The regression model showed that the severity of neurovegetative symptoms was positively associated with AOO (β = 0.18, p < 0.001), and the severity of cognitive-behavioral symptoms was negatively associated with AOO (β = −0.12, p < 0.001). LPA demonstrated that the subgroups characterized by suicide and guilt had earlier onset of depression. The subgroup with the lowest global severity of depression had the latest onset. LimitationsAOO was recalled retrospectively. The relative scarcity of participants with childhood and adolescence onset depression. ConclusionsAOO has an important impact on symptomatology. The findings may enhance clinical evaluations for MDD and assist clinicians in promoting earlier detection and individualized care in vulnerable individuals.

A new nomogram including total cerebral small vessel disease burden for individualized prediction of early-onset depression in patients with acute ischemic stroke.

ObjectivesThe present study was designed to evaluate the effects of total cerebral small vessel disease (CSVD) on early-onset depression after acute ischemic stroke (AIS), and to develop a new nomogram including total CSVD burden to predict early-onset post-stroke depression (PSD).MethodsWe continuously enrolled patients with AIS who were hospitalized at the First Affiliated Hospital of Soochow University between October 2017 and June 2019. All patients were assessed for depressive symptoms using the 17-item Hamilton Depression Scale (HAMD-17) at 14 ± 2 days after the onset of AIS. The diagnosis for depression was made according to the American Diagnostic and Statistical Manual of Mental Disorders Version 5 (DSM-5). The demographic and clinical data were collected including total CSVD burden. On the basis of a multivariate logistic model, the independent factors of early-onset PSD were identified and the predictive nomogram was generated. The performance of the nomogram was evaluated by Harrell's concordance index (C-index) and calibration plot.ResultsA total of 346 patients were enrolled. When contrasted to a 0 score of total CSVD burden, the score ≥2 (moderate to severe total CSVD burden) was an independent risk factor for early-onset PSD. Besides, gender, cognitive impairments, baseline Barthel Index (BI), and plasma fibrinogen were independently associated with early-onset PSD. The nomogram based on all these five independent risk factors was developed and validated with an Area Under Curve (AUC) of 0.780. In addition, the calibration plot revealed an adequate fit of the nomogram in predicting the risk of early-onset depression in patients with AIS.ConclusionsOur study found the total CSVD burden score of 2–4 points was an independent risk factor of early-onset PSD. The proposed nomogram based on total CSVD burden, gender, cognitive impairments, baseline BI, and plasma fibrinogen concentration gave rise to a more accurate and more comprehensive prediction for early-onset PSD.

The potential risk factors of early-onset post-stroke depression from immuno-inflammatory perspective.

BackgroundMounting evidence strongly uncovered that peripheral immuno-inflammatory response induced by acute stroke is associated with the appearance of post-stroke depression (PSD), but the mechanism remains unclear.Methods103 stroke patients were assessed at 2 weeks after onset using Diagnostic and Statistical Manual of Mental Disorders, 5th edition and then divided into PSD and non-PSD groups. Polymorphisms of inflammatory molecules (interleukin [IL]-1β, IL-6, IL-10, IL-18, tumor necrosis factor-α [TNF-α], interferon-γ [IFN-γ] and C-reactive protein [CRP]), complete blood count parameters, splenic attenuation (SA) and splenic volume (SV) on unenhanced chest computed tomography, demographic and other clinical characteristics were obtained. Binary logistic regression model was used to analyze the associations between inflammation-related factors and the occurrence of PSD at 2 weeks after stroke.Results49 patients were diagnosed with PSD at 2 weeks after onset (early-onset PSD). The C/T genotypes of CRP rs2794520 and rs1205 were less in PSD group than non-PSD group (both adjusted odds ratio = 3.364; 95%CI: 1.039-10.898; p = 0.043). For CRP rs3091244, the frequency of G allele was higher (80.61% vs. 13.89%) while the frequency of A allele was lower (6.12% vs. 71.30%) in PSD patients than non-PSD patients (χ2 = 104.380; p<0.001). SA of PSD patients was lower than that of non-PSD patients in the presence of CRP rs2794520 C/T genotype and rs1205 C/T genotype (both t = 2.122; p = 0.039). Peripheral monocyte count was less in PSD group than non-PSD group (adjusted odds ratio = 0.057; 95%CI: 0.005-0.686; p = 0.024).ConclusionsCRP polymorphisms, SA based on CRP genotype, and peripheral monocytes are associated with the risk of early-onset PSD, suggesting peripheral immuno-inflammatory activities elicited by stroke in its aetiology.

Mental Health Benefits of Breastfeeding: A Literature Review.

Pregnancy is typically viewed as a time of emotional well-being for prospective mothers, but for some, this period can negatively impact mental health. However, the relationship between postpartum mental health and breastfeeding is not clearly understood. Considering that many health authorities recommend breastfeeding, clearly defining this relationship is important. This review aims to illustrate the effects that breastfeeding has on the mental health of postpartum mothers. An extensive computerized search was performed through databases of PubMed, CINAHL, and Medline. All studies conducted to determine the effects of breastfeeding on mental health were screened and included in this review. Search terms related to breastfeeding, postpartum, and mental health were used. This review on breastfeeding and postpartum depression (PPD) begins by discussing the correlation between lactation and the maternal stress response. Another component discussed is the duration of breastfeeding and its importance in limiting PPD symptoms. The review then shifts to focus more on the psychological aspects of breastfeeding, notably on changes to the sleep-wake cycle and mother-infant interactions. The final part of the review emphasizes the danger that early breastfeeding cessation imposes on a mother’s mental health, portraying how prenatal and early-onset postpartum depression may lead to early breastfeeding cessation. This composite collection of studies clarifies the importance of breastfeeding in reducing the incidence and severity of maternal postpartum depression.

Do early episodes of depression and anxiety make homelessness more likely?

This paper studies the relationship between early mental health episodes and early homelessness, focusing on depression and anxiety amongst disadvantaged Australians. Using data from the Australian Journeys Home survey, we investigate whether the early onset of mental health conditions make a first transition into homelessness more likely. Similarly, we analyze whether early experiences of homelessness increase the likelihood of early onset of depression or anxiety. We perform our analysis separately for men and women since there are gender differences in rates of both mental health diagnosis and homelessness. After accounting for the effects of joint observed and unobserved determinants, we find that a person's first episode of depression makes a transition to homelessness more likely for both men and women. In contrast, anxiety disorders have no effect on the likelihood of experiencing homelessness. In addition, people's first experience of homelessness has no effect on the likelihood of developing depression, but does increase the likelihood of anxiety disorders for men only.

Early versus late onset depression: sociodemographic and clinical characteristics

BackgroundLate-onset depression is different from early-onset depression in its sociodemographic and clinical characteristics and risk factors. This study aimed to demonstrate the differences in sociodemographic characteristics as well as clinical presentation between late-onset depression (after the age of 60 years) and early-onset depression (before the age of 45 years) and to determine the sociodemographic risk factors for late onset depression. Fifty-five patients between 18 and 45 years of age (group 1) and 55 patients aged 60 years and above (group 2) diagnosed for the first time with major depressive disorder were compared regarding sociodemographic and clinical characteristics. They were recruited from the psychiatric clinic at Sohag University Hospital. All participants were subjected to a Structured Clinical Interview for DSM-IV (SCID-IV), sociodemographic data form, Beck Depression Inventory-Second Edition (BDI-II), and Apathy Evaluation Scale (AES).ResultsThe patients in group 2 were more commonly single (29%), employed (74.54%), living in rural areas (56.36%), and had high school education (41.81%). While the patients in group 2 were more commonly widows (18.18%), unemployed (61.81%), had less than high school education (47.27%), and had chronic diseases (78.81%). Significant risk factors for late onset depression are being widow, unemployed, having low socioeconomic status, and having a chronic medical disease. Patients with late-onset depression were more commonly presented with apathy, cognitive impairment, and somatic symptoms, as well as sleep disturbance (mean±SD 57±6, 70.9%, 61.81%, and 81.81%, respectively) than early-onset depression (mean±SD 49± 4, 47.27%, 36.36%, and 70.9%, respectively).ConclusionsCases with late onset depression are featured by being unemployed, widow, having low socioeconomic status and low educational level, suffering from a chronic medical condition and living in an urban area. In late onset depression, somatic symptoms, apathy, sleep disturbances, as well as cognitive impairment are prevalent presenting symptoms.

Factors Associated Depression In Secondary Schools Adolescents In Gombe, North-eastern, Nigeria

Background: Depression is a mood disorder characterised by loss of interest and enjoyment (anhedonia), and reduced energy leading to increased fatigability and diminished activity. Depression is a major contributor to the overall global burden of disease. It has a profound effect on adolescents because those who experience depression at an early age often struggle with depression throughout their lives, and in many cases, early onset of depression predicts more severe depression during adulthood. Objectives: This study aimed to determine the prevalence of depression and associated factors among secondary school adolescents in Gombe, Nigeria. Methodology: Three hundred and ninety-five adolescents aged 13- 18 years were selected using a multistage sampling method. The Beck Depression Inventory-II (BDI-II) was used to assess depression and a structured questionnaire was used to obtain the sociodemographic characteristics of the subjects. Results: The mean age of subjects was 16.2±1.4 years. The prevalence of depression was 37.7% (142/377). Subjects from low socio-economic class (χ2= 30.601, p&lt; 0.001). Subjects with non-parental caregivers were 4.8 times more likely to be depressed than those that had parental caregivers (OR 4.760, CI 1.882-12.04). Depression was significantly higher among subjects from public schools (χ2= 22.698, p&lt; 0.001). Also, the majority of the subjects who failed the exams preceding the study had depression as compared to those that passed the exams (χ2=5.389, p= 0.030). Conclusion: The burden of depression is high among adolescent secondary school students in Gombe. Psychosocial stressors such as low social class, non-parental care, parental divorce and poor academic performance are significant determinants of depression among adolescents. Early detection of depression is recommended as it has a strong relationship with suicidal ideation among adolescents.

Comparison of Effects of Early Onset Depression and Late-Life Depression on Human Body

Late-life depression is considered as one of the features of older age instead of a treatable disease. This under recognition of this major disorder leads to multiple visits of patients to different medical consultants with different clinical presentations. This research aimed to find out the relevance of age of onset of depression with its serious life-threatening output like brain hemorrhage, suicide etc. Methods: Then if divide it according to its classifications, there will be two types of depression, first one is early-onset depression that happens before 60 years of age and second one is late-life depression that occurs in elderly 60 years of age or above. Age of onset matters alot while making diagnosis or treating depression because of the differences in treatment response and complications. Depression is directly linked with brain and start effecting whole body including. As the day’s passes, it effects more our brain and body as compared to previous day. 196 patients are taken as sample and divide them into different groups according to early and late life depression. Results: After the research, according to the results that are generated as patients with late life depression show more harmful effects and leads to brain hemorrhage as compared to those who was diagnosed during early-onset of depression. Conclusion: It is concluded that these hemorrhage and nervous disorder does not occur with early onset of depression but with late onset depression.

Clinical and biological subtypes of late-life depression

BackgroundLate-life depression (LDD) results from multiple psychosocial and neurobiological changes occurring in later life. The current study investigated how patterns of clinical symptoms and brain structural features are classified into LDD subtypes. MethodSelf-report scale of depression, behavioral rating of affective symptoms, and brain structural imaging of white matter change and cortical thickness were assessed in 541 older adults with no cognitive impairment or mild cognitive impairment. Latent profile analysis was used to identify distinct subtypes of depression. ResultsThe latent profile analysis identified four classes with mild to severe depressive symptoms and two classes with minimal symptoms. While the classes primarily differed in the overall severity, the combinatory patterns of clinical symptoms and neuropathological signature distinguished the classes with similar severity. The classes were distinguished in terms of whether or not neurodegenerative risk accompanied the corresponding depressive symptoms. The presence of the negative self-scheme and cortical thinning pattern notably characterized the subtypes of LDD. LimitationsThe underlying etiologies of the biological subtypes are still speculative, and the current study lacks clinical history that differentiates late- and early-onset depression. ConclusionsOur finding provides insight in identifying heterogeneities of depressive disorder in later life and suggests that self-report and behavioral symptom profile in combination with white matter lesion and cortical thickness effectively characterizes distinct subtypes of LDD.

Early-Onset Depression Is Associated With Specific Neurovegetative Symptoms

IntroductionThe age at onset of depression is not only an important clinical predictor of the further disease course, but also a robust marker, reflecting the genetic impact on depression risk.ObjectivesThis study aimed to find whether early-onset depression had an association with specific clinical symptoms, comorbid psychiatric disorders and family history of mood disorders.MethodsThis pilot cross-sectional, multicenter study was performed under the supervision of the Russian National Consortium for Psychiatric Genetics. Early-onset depression was defined as the first depressive episode before the median age of onset in the sample (Me=29 years). Logistic regression models were used to determine the independent association of early-onset depression, after adjusting for the effects of sex and age, with binary characteristics.ResultsA total of 172 patients with depression were enrolled in the study (64.5% women; age - 40.9 (15.9) years). Early-onset depression was associated with psychomotor retardation (p=0,025; OR=2,3; 95%CI [1,1 - 4,9]), decreased libido (p=0,014; OR=2,8; 95%CI [1,2 - 6,2]), and lower prevalence of weight loss/decreased appetite (p=0,011; OR=0,4; 95%CI [0,2 - 0,8]). No associations were found with the history of comorbid psychiatric disorders and the family history of mood disorders.ConclusionsEarly-onset depression is associated with specific neurovegetative symptoms. Further clinical and genetic studies are needed to evaluate the specific effects of age at onset of depression on its clinical course.DisclosureResearch is supported by an RSF grant №20-15-00132.

Risk Factors of Suicidal Behaviour in old age

Several observational studies investigated risk factors for suicide attempts/completed suicides in older age with contrasting evidence from ongoing population-based research. The risk factors most associated to suicide attempts than other variables were: depressive disorders, methods employed to self-harm (particularly poisoning), and psychotropic drug utilization followed by psychological factors and disability. Moreover, male sex, violent methods to self-harm, any psychiatric disorder (depression, anxiety and bipolar disorders), a poor medical condition, stressors/bereavement, and living alone appeared to be more significant for predicting completed suicides in late life. There is growing evidence of a role of environmental exposures in the pathogenesis and epigenetics of suicidal behavior in older age. Little is known about the possible relationship between suicidal ideation in older age and its biopsychosocial predictors, although psychiatric disorders (among which late-life depression, LLD), play a fundamental role. LLD, distinguished as late-onset depression (LOD) and early-onset depression (EOD). Suicidal ideators accounted for 2.32% of subjects, were female, smokers and obese affected by multimorbidity. After adjusting for age, gender, education and social dysfunction, suicidal ideation was associated to LLD (EOD&gt;LOD:OR:21.71, 95% CI:9.22-51.14). In the full random forest model, asthma was the most important contributor to suicidal ideation. Among biomarkers, interleukin (IL)-6 followed by tumor necrosis factor (TNF)-a, Apolipoprotein E e4 allele-carriers, C-reactive protein contributed most to suicidal ideation. Although EOD is a strong determinant of suicidal ideation, other non-psychiatric factors, i.e., serum inflammation biomarkers, APOE e4 allele, and multimorbidity, should be taken into account when evaluating a suicidal ideation phenotype in older age.DisclosureNo significant relationships.

Determinants and consequences of polypharmacy in patients with a depressive disorder in later life.

ObjectivesPolypharmacy and late‐life depression often congregate in the geriatric population. The primary objective is to identify determinants of polypharmacy in patients with depression, and second to examine polypharmacy in relation to various clinical phenotypes of depression and its course.MethodsA longitudinal observational study using data of the Netherlands Study of Depression in Older persons (NESDO) including 375 patients with depression ≥ 60 years and 132 non‐depressed comparisons. Linear and logistic regression were used to analyze both polypharmacy (dichotomous: ≥5 medications) and number of prescribed drugs (continuous) in relation to depression, various clinical phenotypes, and depression course.ResultsPolypharmacy was more prevalent among patients with depression (46.9%) versus non‐depressed comparisons (19.7%). A lower level of education, lower cognitive functioning, and more chronic diseases were independently associated with polypharmacy. Adjusted for these determinants, polypharmacy was associated with a higher level of motivational problems, anxiety, pain, and an earlier age of onset. A higher number of drugs was associated with a worse course of late‐life depression (OR = 1.24 [95% CI: 1.03–1.49], p = 0.022).ConclusionOlder patients with depression have a huge risk of polypharmacy, in particular among those with an early onset depression. As an independent risk factor for chronic depression, polypharmacy needs to be identified and managed appropriately. Findings suggest that depression moderates polypharmacy through shared risk factors, including motivational problems, anxiety, and pain. The complex interaction with somatic health burden requires physicians to prescribe medications with care.

P714. Pilot Study of Early-Onset Major Depression and Exosomal MicroRNA Cargo Enriched for Neuronal Cell Origin

Major depression (MD) is highly prevalent, ranking second in the global burden of disease, with an overall lifetime risk estimated to be 16.2% in the general population. This pilot study addresses the molecular genetics of early life depression by characterizing the composition of extracellular vesicle (ECV) microRNA cargo in a phenotypically rich, extant twin sample (Parent R01 MH101518; Ntotal=860 twins; ages 15-22; 57% female). We will target both bulk and neuronal-enriched ECVs and analyze the microRNA (miRNA) cargo to investigate potential biomarkers of differential biological pathway regulation based on multiple definitions and markers of MD in young people.

A Comparative Study of Regional Homogeneity of Resting-State fMRI Between the Early-Onset and Late-Onset Recurrent Depression in Adults.

BackgroundNeurobiological mechanisms underlying the recurrence of major depressive disorder (MDD) at different ages are unclear, and this study used the regional homogeneity (ReHo) index to compare whether there are differences between early onset recurrent depression (EORD) and late onset recurrent depression (LORD).MethodsEighteen EORD patients, 18 LORD patients, 18 young healthy controls (HCs), and 18 older HCs were included in the rs-fMRI scans. ReHo observational metrics were used for image analysis and further correlation of differential brain regions with clinical symptoms was analyzed.ResultsANOVA analysis revealed significant differences between the four groups in ReHo values in the prefrontal, parietal, temporal lobes, and insula. Compared with EORD, the LORD had higher ReHo in the right fusiform gyrus/right middle temporal gyrus, left middle temporal gyrus/left angular gyrus, and right middle temporal gyrus/right angular gyrus, and lower ReHo in the right inferior frontal gyrus/right insula and left superior temporal gyrus/left insula. Compared with young HCs, the EORD had higher ReHo in the right inferior frontal gyrus/right insula, left superior temporal gyrus/left insula, and left rolandic operculum gyrus/left superior temporal gyrus, and lower ReHo in the left inferior parietal lobule, right inferior parietal lobule, and left middle temporal gyrus/left angular gyrus. Compared with old HCs, the LORD had higher ReHo in the right fusiform gyrus/right middle temporal gyrus, right middle temporal gyrus/right angular gyrus, and left rolandic operculum gyrus/left superior temporal gyrus, and lower ReHo in the right inferior frontal gyrus/right insula. ReHo in the right inferior frontal gyrus/right insula of patients with LORD was negatively correlated with the severity of 17-item Hamilton Rating Scale for Depression (HAMD-17) scores (r = −0.5778, p = 0.0120).ConclusionAdult EORD and LORD patients of different ages have abnormal neuronal functional activity in some brain regions, with differences closely related to the default mode network (DMN) and the salience network (SN), and patients of each age group exhibit ReHo abnormalities relative to matched HCs.Clinical Trial Registration[http://www.chictr.org.cn/], [ChiCTR1800014277].

Symptomatic plaque enhancement is associated with early-onset post-stroke depression

BackgroundThe association between imaging features closely associated with symptomatic intracranial atherosclerotic plaques and early-onset post-stroke depression (PSD) is currently unclear. Materials and methods76 ischemic stroke patients who underwent high-resolution vessel wall magnetic resonance imaging (HR-VWI) were divided into PSD and non-PSD groups according to their DSM-V diagnoses and HAMD-17 scores at 14 days after onset. Clinical data and the imaging features associated with symptomatic plaques (including the enhancement index (EI), remodeling index, and plaque surface irregularity) were compared between groups. Multifactorial logistic regression analysis was used to find independent predictors of early-onset PSD. Spearman rank correlation analysis explores the association between clinical data, symptomatic plaque imaging features, and HAMD-17 in patients. ResultsThe sample comprised 36 patients with early-onset PSD. The symptomatic plaque EI and infarct volume were significantly higher in depressed patients than in patients without depression (P < 0.05). Multivariate logistic regression showed that symptomatic plaque EI could be used as an independent predictor of early-onset PSD after correcting for the confounding factor of infarct volume (OR = 1.034, 95% CI:1.014–1.055, P = 0.001). In the total sample, symptomatic plaque EI, infarct volume, and HAMD-17 had a significant positive correlation with each other (P < 0.05). LimitationsThis study focused only on the patients' symptomatic plaques and did not monitor patients' systemic inflammation levels at the time of HR-VWI. ConclusionsThe degree of symptomatic plaque enhancement is an independent predictive imaging marker of early-onset PSD and can be used the early diagnosis of early-onset PSD.

Impacts of intervals between sequential development of depression and dementia in older adults: A nationwide population-based study

BackgroundDepression has been reported as a risk factor for dementia, as well as the continuation of dementia development. This study aimed to stratify older people with dementia (PwD) into three groups (no depression, early depression and recent depression) to compare their inpatient health care utilization and to explore related clinical impacts. MethodsOverall, 11,612 PwD were identified from Taiwan's National Health Insurance Research Database and were further divided into 9,257 PwD without depression, 1,179 PwD with recent depression (< 2 years from dementia diagnosis), and 1,176 PwD with early depression (> 2 years from dementia diagnosis). Three matched cohort pairs (Cohort 1: no depression versus recent depression, Cohort 2: no depression versus early depression, and Cohort 3: recent depression versus early depression) were constructed to compare inpatient health care utilization three years after dementia onset. ResultsThe incidence of hospitalization related to mental illness among PwD with a recent or early depression onset were significantly higher than their matched cohort without depression. The recent depression group had a greater rate ratio (RR) with a longer length of stay due to depression (RR: 8.29, 95% CI: 2.74-25.12) compared to the no depression group, and the early depression group had 4.24 times (95% CI: 1.56-11.59) and 6.40 times (95% CI: 2.18-18.82) longer length of stay than the no depression group due to depression, and mood disorders. ConclusionsDepression significantly increased inpatient health care utilization of depression and mood disorder among older PwD with early depression.