First-episode Depressive Disorder Research Articles

Relationship between thyroid hormone and sex hormone levels and non-suicidal self-injury in male adolescents with depression.

Non-suicidal self-injury (NSSI) is the intentional and repeated direct injury to one's bodily tissues or organs without the intent to die, which is not socially sanctioned and does not result in death. This study will be the first to explore the relationship between NSSI behavior and thyroid hormone and sex hormone levels in male adolescents with depression. Among the inpatients in the children's ward of Shandong Mental Health Center, eighty male patients with first-episode depressive disorder were randomly selected. Forty male adolescent depressed patients with NSSI behaviors were set as the NSSI group, and forty male adolescent depressed patients without NSSI behaviors were set as the No-NSSI group. Their thyroid hormones (free triiodothyronine, free thyroxine, and thyroid stimulating hormone) and sex hormones (estradiol, progesterone, and testosterone) were measured, and the severity of self-injury in the NSSI group was assessed using the Adolescent Self-Injury Questionnaire. The NSSI group was tested again after 6 weeks of sertraline treatment for biological indicators and assessed by the Self-Injury Questionnaire to compare the hormonal differences between the NSSI group and the No-NSSI group and compare the differences of each index before and after treatment in the NSSI group. T3/T4 (p = 0.001) and FT3 (p = 0.023), TSH levels (p < 0.001) were lower in the NSSI group than in the No-NSSI group before treatment, and FT4 (p = 0.036) and T (p < 0.001) levels were higher than in the No-NSSI group. T3/T4 levels were higher in the NSSI group after treatment (p < 0.001). FT4 (p < 0.001) and T (p = 0.001) levels and self-injury questionnaire scores (p < 0.001) decreased after treatment in the NSSI group. In the NSSI group at baseline, FT4 levels were negatively correlated with self-injury questionnaire scores (r = -0.459, p = 0.003) and testosterone levels were positively correlated with self-injury questionnaire scores (r = 0.383, p = 0.015), and in the NSSI group after treatment, FT4 difference was negatively correlated with self-injury questionnaire score reduction rate (r = -0.037, p = 0.019), and testosterone difference was positively correlated with self-injury questionnaire score reduction rate (r = 0.424, p = 0.006). Logistic regression analysis showed that low TSH and high testosterone levels were independent risk factors for the development of non-suicidal self-harming behaviors in male adolescent depressed patients. Changes in thyroid hormone and sex hormone levels may be associated with non-suicidal self-injurious behavior in male adolescent depressed patients.

Associations between Autoimmunity and Depression: Serum IL-6 and IL-17 Have Directly Impact on the HAMD Scores in Patients with First-Episode Depressive Disorder.

Objective The study is aimed at evaluating the immune-activation state before and after treatment in patients with first-episode depressive disorder (FDD) with evaluating the ILs and CRP levels and further clarifying the association between autoimmunity and the etiology and pathogenesis of FDD. Methods We designed a case-control study. FDD patients and healthy subjects were enrolled in the FDD group and control group. Serum IL-6, IL-17, and CRP were measured before and after selective serotonin reuptake inhibitor (SSRI) therapy, as well as Hamilton rating scale for depression (HAMD) and life event scale (LES) scores. The correlations between IL-6 and IL-17 and HAMD and LES scores were analysed, and multiple linear regression analysis was performed for HAMD score. Results 40 FDD patients and 40 healthy subjects were included in the FDD and control group from October 2009 to September 2012. Before treatment, the IL-6 (28.99 ± 5.51, P < 0.001) and IL-17 (41.15 ± 4.80, P < 0.001) in the FDD group were significantly higher than the control group (16.84 ± 3.78 and 21.68 ± 3.72, respectively). The C-reactive protein (CRP) level in two groups was comparable (P = 0.879). After treatment, the IL-6 (18.69 ± 5.07, P < 0.001) and IL-17 (30.67 ± 3.47, P < 0.001) levels and HAMD scores (6.73 ± 4.15) in the FDD group were significantly decreased than before treatment (P < 0.001, respectively). CRP level was slightly increased after treatment without statistically significant (P = 0.239). The HAMD score correlated with IL-6 (r = 0.638, P < 0.001) and IL-17 (r = 0.927, P < 0.001); the total LES and negative LES also correlated with IL-6 (r = 0.226, P < 0.05) (r = 0.366, P <0.001) and IL-17 (r = 0.348, P < 0.001) (r = 0.493, P < 0.001). Multiple linear regression analysis showed that both of the IL-6 and IL-17 had direct impact on HAMD score. Conclusion The autoimmunity status was overactivated in FDD patients, and serum IL-6 and IL-17 levels had direct impact on the HAMD score. Patients who experienced more negative life events had higher activation level of autoimmunity status and HAMD scores, and serum IL-6 and IL-17 levels can be decreased by SSRI treatment.

Childhood Maltreatment, Stressful Life Events, Cognitive Emotion Regulation Strategies, and Non-suicidal Self-Injury in Adolescents and Young Adults With First-Episode Depressive Disorder: Direct and Indirect Pathways.

IntroductionChildhood maltreatment (CM), stressful life events (SLE), and cognitive emotion regulation strategies (CERS) have been considered crucial in the development of non-suicidal self-injury (NSSI) and major depressive disorder (MDD), but the pathways of this association are not clear. We aim to identify direct effects of CM and SLE on NSSI and depression severity and its indirect effects via CERS in adolescents and young adults with a diagnosis of MDD.MethodsA total of 114 patients (aged 14–24 years) with first episode MDD were included and further divided into the NSSI group (n = 56) and non-NSSI group (n = 58) according to the DSM-5 criteria. Diagnostic interviews and self-report measures were conducted to assess CM, SLE, CERS, and diagnose NSSI. Severity of depressive symptoms was measured using the Hamilton Rating Scale (HAMD). The structural equation model was used to assess the pathways.ResultsMDD patients with NSSI had more frequent family history of mental illness, more experience of CM and SLE, more serious depression, less use of adaptive CERS, and more use of maladaptive CERS. In the final structural equation model (χ2 = 4.82, df = 6, p = 0.57, CFI = 1.0, TLI = 1.10, and RMSEA = 0), the experience of CM and SLE showed a significant indirect effect on NSSI through adaptive CERS. CM and SLE only had direct effects on depression severity.ConclusionsNSSI are prevalent in adolescents and young adults with MDD and highly intertwined with CM, SLE, and CERS. Adaptive CERS, not maladaptive CERS may be a possible mechanism relating CM and SLE to NSSI in MDD patients.

Reaction time and attention bias characteristics of patients with first-episode depressive disorder

Objective To explore the reaction time and attention bias characteristics of patients with first-episode depressive disorder. Methods Totally 32 patients with first-episode depressive disorder (MD group) and 24 non-depression control participants(NC group) matched with MD group on age, gender and education level were enrolled in the study.The clinical symptoms were assessed by Beck Depression Inventory(BDI). All participants completed a dot-probe task to assess attentional preference for facial stimuli with varying valence (happy, sad and neutral facial expressions). Results The reaction times(RTs) of MD group was longer than that of NC group in the dot-probe task ((468.6±87.7)ms, (451.7±82.5)ms, P<0.01). The four-way ANOVA revealed a significant main effect of prime duration, indicating overall shorter RTs on primes with longer duration ((476.9±88.4)ms vs ( 456.2±82.7)ms vs (447.7±83.9)ms, P<0.01). Compared with NC group, the scores of attention bias for sad faces were decreased in MD group ((7.43±26.4)ms vs (-4.97±19.5)ms, P<0.05). With the longer duration of presentation, the score of attention maintenance of emotional facies for MD group were increased (happy faces: (-11.0±4.8)ms, (2.2±6.9)ms, (6.1±8.5)ms; angry faces: (-1.6±7.5)ms, (6.5±8.6)ms, (14.9±6.7)ms). The adherence score of attention to happy faces were decreased ((1.8±5.6)ms, (-8.2±6.7)ms, (-8.7±7.1)ms), while the score of adherence score towards sad faces were increased ((-7.6±7.2)ms, (-2.6±8.5)ms, (1.5±6.2)ms) with increasing prime duration. Conclusion Patients with first-episode depressive disorder have slower response to emotional faces and associated with attentional bias for sad faces. With the increasing prime duration, it is more and more obvious to attentional bias in the two aspects of allocation and adherence. Key words: First-episode; Depression; Emotional facies; Attentional biases