Depressive Episodes In Patients Research Articles

Assessing the serum concentration levels of NT-4/5, GPX-1, TNF-α, and l-arginine as biomediators of depression severity in first depressive episode patients with and without posttraumatic stress disorder.

Neurotrophin-4/5 (NT-4/5) and glutathione peroxidase-1 (GPX-1) have been shown to play a major role in neuronal processes including depression and posttraumatic stress disorder (PTSD). They protect the body from oxidative damage by affecting neuronal growth, development and plasticity. The aim of the study was to evaluate the concentrations of NT-4/5, GPX-1, tumor necrosis factor-α (TNF-α), and l-arginine in patients suffering from varying levels of depression severity, PTSD, and depression comorbid with PTSD. The study involved 460 participants, 360 of whom were diagnosed with different types of depressive episodes. They included: 60 patients with mild depression (MD), 60 patients with moderate depression (MOD), 60 patients with severe depression (SeD), 60 patients with MD and PTSD (MD+PTSD), 60 patients with MOD and PTSD (MOD+PTSD), 60 patients with SeD and PTSD (SeD+PTSD), and 60 patients with PTSD alone. Each group of 60 subjects comprised 30 females and 30 males. The control group comprised 40 subjects. The 10th revision of the International Statistical Classification of Diseases and Related Health Problems was utilized to diagnose depression and PTSD. At 7a.m. blood samples were collected and serum NT-4/5, GPX-1, TNF-α and l-arginine concentrations were assessed using the ELISA method. Depressive episodes with and without PTSD and PTSD alone became more severe as the levels of TNF-α, l-arginine increased and the levels of NT-4/5, GPX-1 decreased. l-arginine, TNF-α, NT-4/5 and GPX-1 can be markers of depression severity in both males and females with first depressive episode with or without posttraumatic stress disorder.

Randomized controlled trial of repetitive transcranial magnetic stimulation combined with paroxetine for the treatment of patients with first-episode major depressive disorder

Repetitive transcranial magnetic stimulation (rTMS) has been introduced as a new and effective treatment option for major depression. This paper examined the effectiveness of rTMS on first episode depressed patients when combined with antidepressant drugs. A random sample of forty-three first-episode depressed patients received active or sham rTMS to the left dorsolateral prefrontal cortex, and concomitantly took paroxetine for 4 weeks, and paroxetine monotherapy for 4 weeks afterwards. Response was defined as a ≥50% decrease on the total Hamilton Depression Rating Scale (HDRS) from the baseline, and remission was defined as an HDRS total residual score <8. The dosage of paroxetine was the average dose per day in each week. Repeated-measures ANOVA revealed a significant improvement in the HDRS with active compared with sham rTMS from the end of the 1st week to the 4th week. At the end of the 4th week, response rate was 95.5% with active and 71.4% with sham rTMS, remission rate was 68.2% with active and 38.1% with sham rTMS, while these significant differences disappeared at the endpoint of the study. These findings indicate that rTMS at 10-Hz accelerated the onset of action and augmented the response to paroxetine for first-episode depressed patients.

Protective effect of regular physical activity on major depressive episodes in patients with early stages of chronic kidney disease

Previous studies have demonstrated an association between physical activity (PA) and depression in diverse population. The purpose of our study is to examine if PA within the recommended level over time is associated with major depressive episode (MDE) in patients with early stages of chronic kidney disease (CKD) in Mainland China. Patients with stages 2–5 CKD not receiving dialysis were enrolled from a nephrology outpatient clinic between May 2014 and February 2016. Based on the patterns of PA over time, all patients were divided into four groups: persistently active, from inactive to active, from active to inactive, and persistently inactive. An MDE was diagnosed by using the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition)-based the Mini International Neuropsychiatric Interview. Among 150 patients, 34 had a current MDE (22.7%) and 116 did not (77.3%). After multivariable adjustment, patients being persistently active had significantly lower odds of having an MDE (odds ratio 0.102, 95% confidence interval, 0.022–0.467, p = .003) compared with those who were persistently inactive. Additionally, patients with diabetes mellitus had significantly higher odds of having an MDE (odds ratio 4.287, 95% confidence interval, 1.473–12.483, p = .008) compared with those without diabetes mellitus. Our results suggest a protective effect of regular PA on MDE in patients with early stages of CKD in Mainland China.

Autobiographical memory and its meaning in selected mental disorders.

This paper presents the general characteristics of the phenomenon of autobiographical memory (AM), the current knowledge of the subject and describes hitherto identified distortions of AM in mental disorders.AM is the part of memory concerning the personal past of an individual. It includes episodic and semantic memories associated with an identity. It affects an activity and structuring of goals, it is set in human experience and emotions and it helps in creating plans. The evolutionary sig-nificance of AM is probably to facilitate short-term goal-oriented behaviors by comparing them with the previous ones. People with AM disorders often have difficulties in social functioning.The disorders of emotional life and affect, which are present in most psychiatric disorders, deform AM. It was confirmed, inter alia, in post-traumatic stress disorder, depression, autism, schizophrenia, and alcohol dependence syndrome. Overgeneral memories (the inability to recall memories that are fully filled with details) being typical of depression, and flashbacks (the involuntary recall of memories which are highly filled with visual-sensory content) being characteristic of PTSD are considered one of the most studied deficiency of AM. The study of AM potentially carries many cognitive and clinical implications. It may facilitate the prediction of the onset of a depressive episode in patients at risk; it can also help to develop psychotherapeutic techniques which are helpful in its treatment, which has in part already taken place. Few studies relate to neurofunctional changes in AM and they need a follow-up.

PS70. Treatment outcome of the acute depressive episode in patients with bipolar disorders with suicide attempts

PS70. Treatment outcome of the acute depressive episode in patients with bipolar disorders with suicide attempts

Age at menarche is related to number of previous depressive episodes in patients with bipolar disorder

IntroductionOestrogen fluctuations may be an important factor in the etiology of bipolar disorder and age at menarche is associated with the clinical course of BD. Moreover, it is associated with traits related to mood.AimsThe aim of our study was to explore the differences in age at menarche between euthymic BD patients and healthy controls, as well as to explore the relationship between age at menarche and lifetime psychopathology within BD.MethodsThe study group consisted of 83 patients diagnosed with BD, compared to the healthy control group (n = 73) and matched according to age, gender, and body mass index (BMI). Lifetime psychopathology has been assessed according to predominant polarity as well as previous history of suicide attempts and psychotic episodes.ResultsAge at menarche in BD patients was similar to that in controls. After covarying for confounders, we observed that age at menarche is negatively related to number of previous depressive episodes in euthymic BD patients, but not other indicators of lifetime psychopathology.ConclusionsBD patients with earlier age at menarche are more likely to present with more depressive episodes in the course of illness. Systemic, longitudinal monitoring of the course of illness, and potential hormonal fluctuations within particular groups of patients are warranted.Disclosure of interestThe authors have not supplied their declaration of competing interest.

DEPRESSIVE EPISODE INCIDENCE IN PATIENTS WITH CHRONIC HEPATITIS C TREATED WITH PEGYLATED INTERFERON AND RIBAVIRIN.

The effectiveness of antiviral therapy with pegylated interferon and ribavirin for chronic hepatitis C is far from ideal and presents several adverse events. Among such events, there is the depressive episode that can even lead to treatment discontinuity. Analyze the incidence of depressive episodes in patients with chronic hepatitis C treated with pegylated interferon (IFN-PEG) and ribavirin, as well as the possible factors associated with its occurrence and its impact on patients' sustained virological response. People with chronic hepatitis C undergoing antiviral therapy were interviewed at the baseline, at the 4th, 12th, 24th and 48th treatment weeks and 4 weeks after the end of it, using the HADS scale for tracking the depressive episode. Patients with HADS ≥9 were subjected to Beck Depression Inventory (BDI-II) to grade the episode. Clinical, sociodemographic, laboratorial and histological variables were obtained to identify factors related to the onset of depression. The sustained virological response rate (negative HCV-RNA 6 months after end of therapy) was compared among patients with and without depressive symptoms. The study comprised 32 patients, most men (59%) with mean age of 54±11.13 years old. Genotype non-1 was prevalent (56%) and 81% of the patients were non-cirrhotic. The depressive episode was diagnosed in 25% of the patients and the peak incidence was found in the 12th treatment week. The depressive episode was moderate in 87% of the patients and only one patient abandoned the treatment. None of the analyzed factors was associated with depressive episode onset. A trend was observed in female patients ( P =0.08). The sustained virological response rate was of 75% and 67% in patients with and without depressive episode, respectively ( P =0.66). The incidence of depressive episodes in patients with chronic hepatitis C undergoing antiviral therapy was of 25% and the 12th treatment week was the most critical one. The presence of depressive episode did not affect the sustained virological response rate.

Polish Adaptation of the Psychache Scale by Ronald Holden and Co-workers.

The conducted study was aimed at making a Polish adaptation of the Scale of Psychache by Ronald Holden and co-workers. The scale is a self-assessment method which comprises 13 statements and is designed to assess subjectively experienced psychological pain. 300 persons were examined - undergraduates and postgraduates of the University of Lodz and the Technical University of Lodz. The group of the study participants consisted of 185 women and 115 men. Moreover, there were examined 150 alcohol addicted men, 50 co-addicted women and 50 major depressive episode (MDE) patients. The Polish version of the Scale is a reliable and valid tool. The exploratory and confirmatory factor analysis has proved the existence of one factor. The internal consistency, assessed on the basis of Cronbach's alpha, equalled 0.93. The method displays positive and statistically significant relationships to levels of depression, hopelessness, anxiety, anhedonia and negative relations to levels of optimism, life satisfaction, and positive orientation. Alcohol addicted men with presently diagnosed suicidal thoughts were characterised by a significantly higher level of psychological pain as compared to alcoholics without such thoughts. A higher level of psychache was also reported in people with depression who have a history of attempted suicide compared with those who have not attempted suicide. The effect of the conducted adaptation works on the Psychache Scale speaks for recommending the method for scientific research and use in therapeutic practice.

ID 149 – Emotional modulation of CNV in unipolar vs bipolar depression during unconscious cue-picture association

Objectives We aimed at studying the differences in brain activity of patients with uni- and bipolar depression, recorded during the anticipation of negative emotional vs neutral visual stimuli. All patients were in the very beginning of their treatment because of the depressive episode. Methods 128-Channel EEG was recorded in 12 patients (6 female) with major depressive disorder (MDD) and 12 patients (5 female) with bipolar disorder (BD), while they performed categorization of images as humans or animals. Half of the photographs were neutral and half were showing angry/aggressive people or animals. A pattern (the cue) was presented 2 s prior to the picture; and its meaning was not explained. We analyzed the slow wave (CNV) recorded during the picture anticipation. Results Due to cue-picture association established in our contingency-unaware patients, there were alterations in CNV during angry vs neutral face anticipation – the emotional modulation (EM). MDD patients showed EM in the anterior area, while in BD patients EM had central distribution. Conclusions EM topography during the anticipation may reflect the neurophysiological differences of patients in depressive episode depending of their disorder (MDD vs BD). Key message Unconscious emotional modulation of CNV may be helpful in differentiating certain kinds of psychopathology.

ID 158 – Emotional modulation of EEG rhythms in unipolar vs bipolar depression during unconscious cue-picture association

Objectives We aimed at studying the differences in brain activity of patients with uni- and bipolar depression, recorded during the anticipation of negative emotional vs neutral visual stimuli. All patients were in the beginning of their treatment of depression. Methods 128-channel EEG was recorded in 12 patients (6 female) with major depressive disorder (MDD) and 12 patients (5 female) with bipolar disorder (BD), while they performed categorization of images as humans or animals. Half of the photographs were neutral and half were showing angry/aggressive people or animals. A pattern (the cue) was presented 2 s prior to the picture; and its meaning was not explained. We performed wavelet-analysis of EEG recorded during the picture anticipation. Results Due to cue-picture association established in our contingency-unaware patients, there were alterations in EEG during angry vs neutral face anticipation – the emotional modulation (EM). Compared to MDD in BD the number of spatio-temporal loci of differences was lower and close to the results of controls. Conclusions EM topography during the anticipation may reflect the neurophysiological differences of patients in depressive episode depending of their disorder (MDD vs. BD). Key message Unconscious emotional modulation of EEG may be helpful in differentiating certain kinds of psychopathology.

Preliminary comparison of plasma notch-associated microRNA-34b and -34c levels in drug naive, first episode depressed patients and healthy controls

BackgroundMajor depressive disorder (MDD) is a common debilitating disease of unknown etiology. The expression of miRNA is closely related to depression and efficacy of antidepressant therapy. However, whether Notch-associated miRNAs expressions involved in first-episode of MDD are still unknown. MethodsIn this study, the expression levels of Notch1, Hes1 mRNA and 5 miRNAs (miR-369–3p, miR-34b–5p, miR-34c–5p, miR-381 and miR-107) in peripheral blood leukocytes of 32 MDD patients and 32 healthy controls were detected using qRT-PCR method. We also assessed the severity of depressive symptom, suicide risk level, negative life events and event-related potential P300. ResultsThe expression levels of miR-34b–5p (62.49 as the median of cases group and 38.62 as median of control group) and miR-34c–5p (7.17 as the median of cases group and 5.45 as median of control group) in MDD patients were significantly higher than these in control subjects. NOTCH1 gene were significantly lower in MDD patients (5.35 as the median of cases group and 6.80 as median of control group), and was negatively correlated with the expression miR-34c-5p and miR-34b-5p. The expression level of miR-34b–5p and miR-369–3p were significantly lower in patients with suicide idea. N1 latency of P300 were positive correlated with miR-34c–5p, miR-107 and miR-381, and P2 latency of P300 were positive correlated with miR-34c–5p, miR-107 and miR-381. LimitationsThe sample size was small and the role of candidate miRNAs in the regulation of Notch1 gene and cognitive function are still need to be further investigated. ConclusionsDifferentially Notch-associated miRNAs expressions in peripheral blood might be involved in MDD, and the miR-34b–5p and miR-34c–5p levels in peripheral blood leukocytes are closely related to MDD, suicide idea and cognitive function, further studies with large sample size are warranted to test the feasibility of these miRNAs serving as biomarkers for MDD.

The role of interleukin genes in the course of depression

BackgroundResearch studies conducted in recent years have confirmed that in the absence of medical illnesses, depressive disorders are associated with upregulation of many inflammatory cytokines such as tumor necrosis factor-aplha (TNF-α), interleukin-1 and 6 (IL-1,IL-6). The main objective of the study was to examine whether recurrent depressive disorders (rDD) are accompanied by more profound inflammatory disturbances than the first episode of depression (ED-I). The analysis included the expression of mRNA and protein levels of three interleukins namely. IL-1, IL-6 and IL-10.MethodsThe study was carried out in a cohort of 130 patients: ED-I group – 44 patients, rDD group – 86 patients respectively.ResultsOur results suggest that there was no significant statistical difference between the analyzed groups as regards the intensity of the depressive disorders. Furthermore, No differences in the expression of IL-1, IL-6 and IL-10 genes on the level of both mRNA and protein were observed among the groups. Additionally, there was no significant interrelation been documented between the number of depression episodes experienced v/s the expression of selected genes.ConclusionsThere is no significant difference in IL-1, IL-6 and IL-10 expression between patients with recurrent depressive disorders and those suffering from the first episode of depression. 2. There seems to be no difference in acute first episode depression vs. acute episode of depression in patients with a recurrent disorder. Further larger trials are needed.

Increased activities of both superoxide dismutase and catalase were indicators of acute depressive episodes in patients with major depressive disorder

Oxidative stress may play an important role in the pathophysiology of major depressive disorder (MDD). The aim of this study was to investigate the serum levels of oxidative stress biomarkers and S100B in patients with MDD in an acute phase, and evaluate the changes in superoxide dismutase (SOD), protein carbonyl content (PCC), glutathione peroxidase (GPX), 8-hydroxy 2'-deoxyguanosine after treatment (8-OHdG), catalase (CAT), thiobarbituric acid reactive substances (TBARS) and S100B. We consecutively enrolled 21 MDD inpatients in an acute phase and 40 healthy subjects. Serum oxidative stress markers were measured with assay kits. Serum SOD and CAT activities in MDD patients in an acute phase were significantly higher than those of healthy subjects, and serum PCC levels were significantly lower. The HAM-D scores had a significantly positive association with S100B levels. Eighteen depressed patients were followed up, and there was no significant difference among all of the markers after treatment. In conclusion, our results suggest that increased activities of both SOD and CAT might be indicators of acute depressive episodes in MDD patients.

Psychological therapies for preventing seasonal affective disorder.

Seasonal affective disorder (SAD) is a seasonal pattern of recurrent major depressive episodes that most commonly occurs during autumn or winter and remits in spring. The prevalence of SAD ranges from 1.5% to 9%, depending on latitude. The predictable seasonal aspect of SAD provides a promising opportunity for prevention. This is one of four reviews on the efficacy and safety of interventions to prevent SAD; we focus on psychological therapies as preventive interventions. To assess the efficacy and safety of psychological therapies (in comparison with no treatment, other types of psychological therapy, second-generation antidepressants (SGAs), light therapy, melatonin or agomelatine or lifestyle interventions) in preventing SAD and improving patient-centred outcomes among adults with a history of SAD. We conducted a search of the Cochrane Depression, Anxiety and Neurosis Review Group Specialised Register (CCDANCTR) to 11 August 2015. The CCDANCTR contains reports of relevant randomised controlled trials from EMBASE (1974 to date), MEDLINE (1950 to date), PsycINFO (1967 to date) and the Cochrane Central Register of Controlled Trials (CENTRAL). Furthermore, we searched the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Knowledge, The Cochrane Library and the Allied and Complementary Medicine Database (AMED) (to 26 May 2014). We conducted a grey literature search (e.g. in clinical trial registries) and handsearched the reference lists of all included studies and pertinent review articles. To examine efficacy, we planned to include randomised controlled trials on adults with a history of winter-type SAD who were free of symptoms at the beginning of the study. To examine adverse events, we intended to include non-randomised studies. We planned to include studies that compared psychological therapy versus any other type of psychological therapy, placebo, light therapy, SGAs, melatonin, agomelatine or lifestyle changes. We also intended to compare psychological therapy in combination with any of the comparator interventions listed above versus the same comparator intervention as monotherapy. Two review authors screened abstracts and full-text publications against the inclusion criteria. Two review authors planned to independently extract data and assess risk of bias. We planned to pool data for meta-analysis when participant groups were similar and when studies assessed the same treatments versus the same comparator and provided similar definitions of outcome measures over a similar duration of treatment; however, we included no studies. We identified 2986 citations through electronic searches and reviews of reference lists after de-duplication of search results. We excluded 2895 records during title and abstract review and assessed 91 articles at full-text review for eligibility. We found no controlled studies on use of psychological therapy to prevent SAD and improve patient-centred outcomes in adults with a history of SAD. Presently, there is no methodologically sound evidence available to indicate whether psychological therapy is or is not an effective intervention for prevention of SAD and improvement of patient-centred outcomes among adults with a history of SAD. Randomised controlled trials are needed to compare different types of psychological therapies and to compare psychological therapies versus placebo, light therapy, SGAs, melatonin, agomelatine or lifestyle changes for prevention of new depressive episodes in patients with a history of winter-type SAD.

Second-generation antidepressants for preventing seasonal affective disorder in adults.

Seasonal affective disorder (SAD) is a seasonal pattern of recurrent major depressive episodes that most commonly occurs during autumn or winter and remits in spring. The prevalence of SAD ranges from 1.5% to 9%, depending on latitude. The predictable seasonal aspect of SAD provides a promising opportunity for prevention. This review - one of four reviews on efficacy and safety of interventions to prevent SAD - focuses on second-generation antidepressants (SGAs). To assess the efficacy and safety of second-generation antidepressants (in comparison with other SGAs, placebo, light therapy, melatonin or agomelatine, psychological therapies or lifestyle interventions) in preventing SAD and improving patient-centred outcomes among adults with a history of SAD. A search of the Specialised Register of the Cochrane Depression, Anxiety and Neuorosis Review Group (CCDANCTR) included all years to 11 August 2015. The CCDANCTR contains reports of randomised controlled trials derived from EMBASE (1974 to date), MEDLINE (1950 to date), PsycINFO (1967 to date) and the Cochrane Central Register of Controlled Trials (CENTRAL). Furthermore, we searched the Cumulative Index to Nursing and Allied Health Literature, Web of Knowledge, The Cochrane Library and the Allied and Complementary Medicine Database (to 26 May 2014). We also conducted a grey literature search and handsearched the reference lists of included studies and pertinent review articles. For efficacy, we included randomised controlled trials on adults with a history of winter-type SAD who were free of symptoms at the beginning of the study. For adverse events, we planned to include non-randomised studies. Eligible studies compared an SGA versus another SGA, placebo, light therapy, psychological therapy, melatonin, agomelatine or lifestyle changes. We also intended to compare SGAs in combination with any of the comparator interventions versus the same comparator intervention as monotherapy. Two review authors screened abstracts and full-text publications and assigned risk of bias ratings based on the Cochrane 'Risk of bias' tool. We resolved disagreements by consensus or by consultation with a third party. Two review authors independently extracted data and assessed risk of bias of included studies. When data were sufficient, we conducted random-effects (Mantel-Haenszel) meta-analyses. We assessed statistical heterogeneity by calculating the Chi(2) statistic and the Cochran Q. We used the I(2) statistic to estimate the magnitude of heterogeneity and examined potential sources of heterogeneity using sensitivity analysis or analysis of subgroups. We assessed publication bias by using funnel plots. However, given the small number of component studies in our meta-analyses, these tests have low sensitivity to detect publication bias. We rated the strength of the evidence using the system developed by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) Working Group. We identified 2986 citations after de-duplication of search results and excluded 2895 records during title and abstract reviews. We assessed 91 full-text papers for inclusion in the review, of which four publications (on three RCTs) providing data from 1100 people met eligibility criteria for this review. All three RCTs had methodological limitations due to high attrition rates.Overall moderate-quality evidence indicates that bupropion XL is an efficacious intervention for prevention of recurrence of depressive episodes in patients with a history of SAD (risk ratio (RR) 0.56, 95% confidence interval (CI) 0.44 to 0.72; three RCTs, 1100 participants). However, bupropion XL leads to greater risk of headaches (moderate-quality evidence), insomnia and nausea (both low-quality evidence) when compared with placebo. Numbers needed to treat for additional beneficial outcomes (NNTBs) vary by baseline risks. For a population with a yearly recurrence rate of 30%, the NNTB is 8 (95% CI 6 to 12). For populations with yearly recurrence rates of 40% and 50%, NNTBs are 6 (95% CI 5 to 9) and 5 (95% CI 4 to 7), respectively.We could find no studies on other SGAs and no studies comparing SGAs with other interventions of interest such as light therapy, psychological therapies, melatonin or agomelatine. Available evidence indicates that bupropion XL is an effective intervention for prevention of recurrence of SAD. Nevertheless, even in a high-risk population, four of five patients will not benefit from preventive treatment with bupropion XL and will be at risk for harm. Clinicians need to discuss with patients advantages and disadvantages of preventive SGA treatment and might want to consider offering other potentially efficacious interventions, which might confer lower risk of adverse events. Given the lack of comparative evidence, the decision for or against initiating preventive treatment of SAD and the treatment selected should be strongly based on patient preferences.Future researchers need to assess the effectiveness and risk of harms of SGAs other than bupropion for prevention of SAD. Investigators also need to compare benefits and harms of pharmacological and non-pharmacological interventions.

Decreased serum zinc concentration during depressive episode in patients with bipolar disorder

ObjectivesZinc may be involved in the pathophysiology and treatment of depressive disorder. However, data on this issue in bipolar disorder (BD) are limited. The aim of the study was to assess zinc concentrations in the blood serum of patients at various phases and stages of bipolar disorder. MethodsThe study included 129 patients with a diagnosis of bipolar disorder type I (n=69) or type II (n=60). Fifty-eight were in a depressive episode, 23 in a manic episode and 48 in remission. Fifty healthy volunteers made a control group. Zinc concentration was measured using flame atomic absorption spectrometry. ResultsSerum zinc level in patients diagnosed with BD type I in the depressive phase was significantly reduced as compared with mania, remission and healthy subjects. In the BD type II, serum zinc level in hypomania, depression or remission phase was not significantly different from the control group. In the whole group, lower level of zinc in depression compared to remission and control subjects was found during late stage of the illness but not in the early stage. Zinc concentration was not dependent on the severity of manic or depressive symptoms and subtype of depression but correlated positively with the number of manic/hypomanic relapses in the past year. LimitationsLack of prospective model, heterogeneity of pharmacological treatment, small number of subgroups presenting specified clinical features. ConclusionsDecreased serum zinc concentration occurs in depression in BD type I and probably in depression in the late stage of BD.

Ribosomal DNA transcription in dorsal raphe nucleus neurons is increased in residual schizophrenia compared to depressed patients with affective disorders

The central serotonergic system is implicated differentially in the pathogenesis of depression and schizophrenia. The dorsal raphe nucleus (DRN) is the main source of serotonergic innervation of forebrain limbic structures disturbed in both disorders. The study was carried out on paraffin-embedded brains from 27 depressed (15 major depressive disorder, MDD and 12 bipolar disorder, BD) and 17 schizophrenia (9 residual and 8 paranoid) patients and 28 matched controls without mental disorders. The transcriptional activity of ribosomal DNA (rDNA) in DRN neurons was evaluated by the AgNOR silver staining method. A significant effect of diagnosis on rDNA activity was found in the cumulative analysis of all DRN subnuclei. Further analysis revealed an increase in this activity in residual (but not paranoid) schizophrenia compared to depressed (both MDD and BD) patients. The effect was most probably neither confounded by suicide nor related to antidepressant and antipsychotic medication. Our findings suggest that increased activity of rDNA in DRN neurons is a distinct phenomenon in residual schizophrenia, related presumably to differentially disturbed inputs to the DRN and/or their local transformation compared with depressive episodes in patients with affective disorders.

Comparison of plasma MicroRNA levels in drug naive, first episode depressed patients and healthy controls

Major depression is the most common psychiatric disorder. The diagnosis of depression depends on a patient's subjective complaints, and the nature of the heterogeneous disorder. Thus, there is no known biomarker for depression to date. Previous research has indicated that microRNAs are dysregulated in bipolar disorder and schizophrenia. We aimed to investigate microRNA dysregulation in plasma samples of patients with major depression. Venous blood samples of 50 depressed patients and 41 healthy controls were collected and the quantification of microRNAs was established using qRT-PCR. We found miR-320a significantly downregulated and miR-451a significantly upregulated in depressed patients. We also found miR-17-5p and miR-223-3p upregulated, but not as significantly as miR-451a. Merging our results with previous published data shows that the blood miR-320 family may be a potential microRNA family dysregulated in major depression. Research should be performed on miR-320-related pathways and their relationship to depression. Additionally, miR-451a could serve as a candidate biomarker for depression based on the acting mechanism of ketamine. Studies targeting miR-451a levels before and after treatment could be helpful.

Relationships between mixed features and borderline personality disorder in 2811 patients with major depressive episode.

The study focused on the relationship between mixed depression and borderline personality disorder (BPD). The sample comprised 2811 patients with a major depressive episode (MDE). Clinical characteristics were compared in patients with (BPD+) and without (BPD-) comorbid BPD and in BPD+ with (MXS+) and without (MXS-) mixed features according to DSM-5 criteria. A total of 187 patients (6.7%) met the criteria for BPD. A DSM-IV-TR diagnosis of bipolar disorder (BD) was significantly more frequent in patients with BPD+ than in patients with BPD. Patients with BPD+ were significantly younger and reported lower age at onset than BPD-. Patients with BPD+ also showed more hypomania/mania in first-degree relatives in comparison with patients with BPD-, as well as more psychiatric comorbidity, mixed features, atypical features, suicide attempts, prior mood episodes and antidepressant-induced hypo/manic switches. Mixed features according to DSM-5 criteria were observed in 52 (27.8%) BPD+. In comparison with MXS-, MXS+ were significantly younger at age of onset and at prior mood episode and had experienced more mood episodes and hypo/manic switches with antidepressant treatments. Major depressive episode patients with comorbid BPD reported a high prevalence of mixed features and BD. The presence of DSM-5 mixed features in MDE patients with BPD may be associated with complex course and reduced treatment response.

Stressful life events preceding the onset of depression in Asian patients with major depressive disorder.

Previous studies have identified the significant role of stressful life events in the onset of depressive episodes. However, there is a paucity of cross-national studies on stressful life events that precede depression. We aimed to compare types of stressful life events associated with the onset of depressive episodes in patients with major depressive disorder (MDD) in five Asian countries. A total of 507 outpatients with MDD were recruited in China (n = 114), South Korea (n = 101), Malaysia (n = 90), Thailand (n = 103) and Taiwan (n = 99). All patients were assessed with the Mini-International Neuropsychiatric Interview and the List of Threatening Experiences. The prevalence of each type of stressful life events was calculated and compared between each country. The type of stressful life event that preceded the onset of a depressive episode differed between patients in China and Taiwan and those in South Korea, Malaysia and Thailand. Patients in China and Taiwan were less likely to report interpersonal relationship problems and occupational/financial problems than patients in South Korea, Malaysia and Thailand. Understanding the nature and basis of culturally determined susceptibilities to specific stressful life events is critical for establishing a policy of depression prevention and providing effective counseling services for depressed patients.