Maintenance Of Depressive Disorders Research Articles

Effects of Metabolic Syndrome and Sex on Stress Coping Strategies in Individuals with Depressive Disorder

Metabolic syndrome (MetS) is related to depression and contributes to reduced life expectancy in individuals with mental disorders. Stress coping strategies are important factors in the development and maintenance of depressive disorders and have been related to metabolic disturbances. The aim of this study was to determine whether there is a difference in the use of positive (re- and devaluation, distraction, and control) and negative stress coping strategies in relation to patients’ MetS. A sample of 363 individuals (n female = 204, n male = 159) with a diagnosis of depression was measured with the Stress Coping Style Questionnaire and the Beck Depression Inventory. In addition, we collected data on MetS (waist circumference, triglycerides, high-density lipoprotein, fasting glucose/diabetes, blood pressure/hypertonia) according to the International Diabetes Federation. A 2 × 2 design including Mets (with vs. without) and sex (female vs. male) was performed to test for differences in stress coping strategies. Individuals with depression and MetS scored higher on distraction strategies than depressed individuals without MetS (p < 0.01, corrected with false discovery rate). In addition, we found sex differences in stress coping strategies indicating that women with depression scored higher on distraction strategies (p < 0.001, FDR corrected), as well as negative strategies (p < 0.001, FDR corrected), than men. No significant interaction between MetS and sex was found regarding the higher value of stress coping strategies. Findings suggest that individuals with depression and MetS used distraction strategies to a higher amount to cope with stress, which could be stress eating in some cases, than those without MetS. Women with depressive disorders had higher values than men on other coping strategies in our sample of individuals with depression. A better understanding of MetS and sex-specific differences in stress coping strategies might help to plan more effective preventive strategies and personalized treatment options for depression.

Eye movement desensitization and reprocessing for adolescents with major depressive disorder: study protocol for a multi-site randomized controlled trial

BackgroundMajor depressive disorder (MDD) is one of the most common mental disorders in adolescence carrying a serious risk of adverse development later in life. Extant treatments are limited in effectiveness and have high drop-out and relapse rates. A body of literature has been published on the association between distressing/ traumatic experiences and development and maintenance of MDD, but the effectiveness of a trauma-focused treatment approach for MDD has hardly been studied. This study aims to determine the effectiveness of eye movement desensitization and reprocessing (EMDR) therapy as stand-alone intervention in adolescents diagnosed with MDD.MethodsThis study will be a randomized controlled trial with two conditions: (1) EMDR treatment (6 sessions) and (2) waiting list condition (WL: 6 weeks, followed by EMDR treatment). First, participants receive a baseline measure after which they will be randomized. Participants will be assessed post-intervention after which the WL participants will also receive six EMDR sessions. Follow-up assessments will be conducted at 3 and 6 months follow-up. Study population: In total, 64 adolescents (aged 12–18) diagnosed with a major depressive disorder (DSM-5) and identified memories of at least one distressing or traumatic event related to the depressive symptomatology will be included. Main study parameters/endpoints: Primary outcome variables will be the percentage of patients meeting criteria for MDD classification, and level of depressive symptoms. Secondary outcome measures include symptoms of PTSD, anxiety, and general social-emotional problems. At baseline, family functioning and having experienced emotional abuse or neglect will be assessed to explore whether these factors predict post-treatment outcome.DiscussionWith the present study, we aim to investigate whether EMDR as a trauma-focussed brief intervention may be effective for adolescents with a primary diagnosis of MDD. EMDR has been proven an effective treatment for traumatic memories in other disorders. It is hypothesized that traumatic memories play a role in the onset and maintenance of depressive disorders. Particularly in adolescence, early treatment of these traumatic memories is warranted to prevent a more chronic or recurrent course of the disorder.Trial registrationInternational Clinical Trial Registry Platform (ICTRP): NL9008 (30–10-2020).

Role of nutrition in depression and other mental illnesses

Nutrients, foods, and dietary components have a significant role in the development and maintenance of depressive disorders as well as the intensity of depression symptoms. Nutritional elements may alter the biomarkers linked to depression and may also influence the onset of depression, obesity, and diabetes. Recent research has identified novel mediators of mood fluctuations and energy balance that operate the gut-brain networks. In this context, a number of healthy foods including olive oil, fish, fruits, vegetables, nuts, legumes, poultry, dairy, and unprocessed meat, have been shown to have a negative correlation with the risk of depression and may even help with the symptoms of depression. The use of sweetened beverages, processed foods, fried foods, processed meat, refined grains, high-fat dairy products, biscuits, snacks, and pastries, on the other hand, has been linked in longitudinal studies to an elevated risk of depression. Nevertheless, it is usually challenging to draw a firm conclusion about a true prospective causal association from this primarily retrospective research since depressed people may also alter their eating habits incidentally as a result of their sadness. Additionally, it has been suggested that some dietary substances, including as calcium, chromium, folate, PUFAs, vitamin D, B12, zinc, magnesium, and D-serine, might be utilised as add-on treatments with antidepressants. In this situation, food and lifestyle changes may be a desired, practical, effective, and non-stigmatizing depression preventive and treatment option. In early randomized controlled clinical studies, a number of drugs that have historically been used to treat metabolic disorders—including pioglitazone, metformin, exenatide, atorvastatin, and gram-negative antibiotics showed some promise for treating depression.

Is there evidence that emotional reasoning processing underlies emotional disorders in adults? A systematic review

The prevalence of emotional disorders has increased in recent times. Emotional Reasoning (ER), which is a transdiagnostic process, occurs when feelings, rather than objective evidence, are used as a source of information to make judgements about the valence of a situation. Differences in ER may explain the existence and maintenance of emotional disorders. The objective is to systematically review the role of ER in the occurrence and severity of emotional disorders. Following PRISMA guidelines, we searched through: PubMed, PsycInfo, Scopus and The Cochrane Library. Search terms were "Emotional Reasoning", "ex-consequentia reasoning", "Affect-as-information"; and "emotional disorders", "anxiety", "depression", "depressive". Nine articles were included. An association was demonstrated between ER and a greater degree of anxious symptomatological severity. In depressive symptomatology, no significant differences were found. One study reported the effect of Cognitive Behavioural Therapy on ER bias, finding no changes after the intervention. Finally, another study evaluated the efficacy of computerised experiential training in reducing ER bias, showing significant differences. There are few studies on ER and its evolution in research has not been uniform over time. Encouragingly, though, research to date suggests that ER is a transdiagnostic process involved in several anxiety disorders. More investigation is needed to dilucidate whether ER also underlies the onset and maintenance of depressive disorders.

Can't look Away: Attention control deficits predict Rumination, depression symptoms and depressive affect in daily Life

BackgroundRumination and a reduced capacity to disengage attention as appropriate to context (attention control deficits) have each been implicated in the etiology and maintenance of depressive disorders. However, it remains unclear whether rumination is a mechanism by which attention control deficits predict depression, and whether these relations are observed outside of laboratory settings. We tested whether rumination mediates the effects of attention control deficits marked by slow disengagement from negative-valenced stimuli (sad faces) and fast disengagement from positive-valenced stimuli (happy faces) on depression symptoms and depressive affects in the daily lives of adults with various depression histories. MethodForty-six participants (n = 23 with histories of Major Depressive Disorder) completed a clinical evaluation, an eye-tracking task that indexed attention control, and a 7-day Ecological Momentary Assessment (EMA) follow-up during which Negative (NA) and Positive Affect (PA) were measured at times of peak distress that occurred in the hour preceding each EMA prompt. ResultsDelayed disengagement from sad faces predicted elevated depression and NA levels, and low PA levels, independent of depression histories. Rumination mediated the effects of delayed disengagement from sad, and rapid disengagement from happy, faces on depression and NA levels. Effects of disengagement on rumination were maintained independent of depression levels. LimitationsOur sample size limited the detection of small statistical effects, and we could not clarify temporal relationships between attention control deficits and rumination. ConclusionOur findings suggest that attention inflexibility and rumination persist independent of depressive states and should be targets of clinical intervention.

A theoretical framework for treating perinatal depression using couple-based interventions.

Between 10% and 20% of women will experience depression in the perinatal period, which begins during pregnancy and extends into the first year after delivery. Perinatal depression (PD) is associated with significant emotional and social impairments that impact women, their children, and their partners. Although the majority of women with PD do not seek treatment, a considerable proportion of those who engage in treatment do not achieve remission. The couples and depression literature suggests that interpersonal processes are central in the development and maintenance of depressive disorders and thus, as researchers seek safe and effective treatments for perinatal populations, there may be therapeutic benefit in examining the role that partners play in women's recovery. The primary goal of this practice review is to highlight the utility of including partners in treatment for maternal PD and propose a model for practitioners to guide their work with couples within this domain. Specifically, this model involves three key components of treatment: psychoeducation, communication training, and behavioral activation. Each component addresses distinct risk factors for women and couples in the perinatal period in hopes of offering guidance to practitioners for how to address PD symptomology through a dyadic lens. (PsycINFO Database Record

Is Experiential Avoidance a Mediating, Moderating, Independent, Overlapping, or Proxy Risk Factor in the Onset, Relapse and Maintenance of Depressive Disorders?

Our study aim was to investigate how experiential avoidance ‘works together’ with bordering psychological constructs (i.e., rumination, worry and neuroticism) in predicting the onset, relapse and maintenance of depressive disorders. We performed a longitudinal cohort study with repeated assessments after 2 and 4 years in a sample of 737 persons with a 6-month recency dysthymic and/or major depressive disorder, a sample of 1150 remitted persons with a history of previous depressive disorders; and a sample of 626 persons with no 6-month recency depressive or anxiety disorders and no previous depressive disorders. Experiential avoidance predicted onset, relapse as well as maintenance of depressive disorders during the 4-year follow-up period. However, after controlling for rumination, worry and neuroticism, experiential avoidance no longer significantly predicted onset, relapse or maintenance of depressive disorders in contrast to repetitive thinking in the form of rumination or worry. Experiential avoidance also did not mediate or moderate the effect of rumination, worry and neuroticism.

Cognitive Distortions in Depressed Women: Trait, or State Dependent?

Objective: According to the cognitive theory developed by Beck, cognitive distortions are important mediators for the onset and maintenance of depressive disorders. It has not been researched if these cognitive distortions are more frequently encountered during the depressive episode, or if they are trait-like features. This study aims to investigate this. The hypothesis of the study is that cognitive distortions are state dependent. Method: Three groups of outpatients (n=178 patients in acute major depressive episode, n=168 depressive patients in remission, n=177 healthy controls) presenting to the psychiatry clinics of three different state hospitals were recruited for the study. The participants were diagnostically interviewed by the MINI according to the DSM-IV criteria. The participants were asked to complete the Cognitive Distortions Scale and the severity of their depression was measured by the Inventory for Depressive Symptomatology. Results: According to the cognitive distortion subscales, except for the self-blame subscale, the acute depressive group scored the highest. Also it was found that the cognitive distortions of the depressive populations, except for the self-blame related ones, statistically differed from the healthy controls’. Self-blame related distortions were mood state dependent. Conclusion: The results have revealed that self-criticism, helplessness, hopelessness and preoccupation with danger related distortions had trait-like features, whereas self-blame related distortions were state dependent. This has clinical implications for the psychotherapeutic treatment of cognitive distortions in depression. Specifically, self-criticism related distortions should be managed during cognitive therapy for depression since the other subscales seem rather problematic.

EPA-1730 – Cognitive distortions in depressed women: trait or mood state dependent

Introduction & Aims Cognitive distortions play an important role in the onset and maintenance of depressive disorders. It has not been investigated whether these distortions have trait like properties or are dependent on mood states. This study aims to find out this aspect. Our hypothesis is that as depression remits, the frequency of cognitive distortions will lessen. Methods For this study female outpatients (178 acutely depressed & 168 in remission) and their healthy female relatives (177 controls) presenting to the psychiatry clinics of three hospitals in Turkey were recruited. The participants were diagnosed according to DSM criteria by MINI. The participants were evaluated by IDS-C, and they filled out the Cognitive Distortions Questionnaire. The groups were compared with each other on these scales by appropriate statistical methods. Results Except for the self-blame subscale scores, the highest scores were found in the acutely depressed patients, and the lowest scores in the healthy controls. The same subscales also managed to differentiate the patients in remission from the controls. Self-blame scores were found to be mood state dependent. Conclusion These results suggest that cognitive distortions, except for the self-blame subscale, remain activated even after depression remits. Therefore, cognitive distortions related to self-criticism, helplessness, hopelessness and preoccupation with danger should be continuously monitored, and targeted for therapeutic interventions, even after remission is achieved. Yet, the content analysis of these distortions highlight the fact that the most important depressive distortions may be related to self-criticism, which is a component of the classical cognitive triad.

Child and adolescent depression in the family.

There are numerous individual, familial, and environmental factors that impact the onset of depressive disorders in youth. This article presents an overview of these factors and describes our own research evaluating a possible model of how disturbances in family functioning could lead to the development of depression in youth. Given that families are often implicated in the development and maintenance of depressive disorders in youth, it has been argued that maximally effective treatments for youth should include families. Thus, a review of empirically evaluated treatments that involve parental/familial participation for youth with depression is presented. These treatments vary widely in number of meetings, format, and content. Finally, it is proposed that the greatest benefit to including a parent or family component is improving the maintenance of treatment effects. To support this hypothesis, data from one of our own investigations is presented.

The Impact of Ruminative Processing on the Development of Intrusive Memories

AbstractDespite substantial evidence of the detrimental effects of ruminative self-focus, paradoxically (as noted and reviewed by Watkins, 2004) there are clear suggestions that under some circumstances self-focused attention can actually promote well-being and confer benefits. We sought to replicate the findings of Watkins (2004) that adopting an abstract/analytical mode of processing following a negative event results in increased spontaneous intrusions of the event; that is, results in poor emotional processing. In the current study 57 low (BDI-II ≤ 7) and 59 high (BDI-II ≥ 12) dysphoric undergraduate participants viewed a four minute emotion-eliciting video, were randomly assigned to an analytical, experiential, or distraction processing condition, then monitored the frequency of video-related intrusions. Results indicated the effectiveness of the video in inducing moderately distressing intrusions, and suggest that the hypothesised effects of ruminative self-focus on intrusion severity may be dependent upon the self-referential nature of the material to be processed. Results did support previous findings (Williams & Moulds, 2007) that intrusion-related distress is not merely a function of intrusion frequency. Directions for future investigations of the cognitive processes that are important in the maintenance of depressive disorders are discussed.

Depression-Like Behavior and Stressor-Induced Neuroendocrine Activation in Female Prairie Voles Exposed to Chronic Social Isolation

To assess whether the responses of prairie voles to social stressors play a mechanistic role in the behavioral and physiological changes associated with affective disorders such as depression, as suggested in previous studies. Prairie voles (Microtus ochrogaster) are socially monogamous rodents that share features of social behavior with humans; therefore, they may serve as useful models for examining social behavioral regulations and physiological responses related to depression. In this study, we hypothesized that social isolation in female prairie voles would induce depression-relevant behaviors and alter their neuroendocrine responses to an acute social stressor. Twenty adult female prairie voles were exposed to either 60 days of social isolation or paired (control) housing. They were tested and observed for a depression-like behavior (anhedonia). The levels of corticotropin-releasing factor- and oxytocin-immunoreactive cells in the paraventricular nucleus of the hypothalamus and circulating levels of hormones and peptide were measured in response to an acute social stressor (resident-intruder test). Chronic social isolation produced anhedonia, measured by reduced sucrose intake and sucrose preference relative to the control animals. Compared with the paired animals, the isolated prairie voles displayed increased plasma hormone and peptide levels (oxytocin, arginine vasopressin, and corticosterone) after a 5-minute resident-intruder test, mirrored by an increased number of oxytocin- and corticotropin-releasing factor-immunoreactive cells in the hypothalamic paraventricular nucleus. These findings suggest that isolation in a socially monogamous rodent model induces both behavioral and neuroendocrine changes that are relevant to depression. These results may provide insight into the mechanisms that underlie the development and/or maintenance of depressive disorders in humans.

In vitro effects of the dicyclohexylammonium salt of hyperforin on interleukin-6 release in different experimental models.

Cytokine hypersecretion might be involved in the onset and maintenance of depressive disorders and it has been suggested that St. John's wort extracts (Hypericum perforatum, SJW) might exert their antidepressant-like effects by affecting peripheral interleukin-6 (IL6) expression. We found that hyperforin, one putative active principle of SJW, and its dicyclohexylammonium salt (hyperforin-DCHA), inhibited the substance P (SP)-induced [L6 release inhuman astrocytoma cells (U373MG) with an Cs50 of 1.6 pM, indicating that hyperforin is likely to account for the inhibitory effect previously found in the same experimental model with SJW ex-tracts. [3H]SP binding experiments in parallel on the same intact cells indicate that hyperforin-DCHA does not interact with neuro-kinin-I receptors but very likely interacts with some intracellular steps leading to the synthesis and/or release of IL6. Hyperforin-DCHA also inhibited, with a similar IC50, the IL6 release induced in U373MG cells by two other classic proinflammatory stimuli,ILl and lipopolysaccharide (LPS), as well as the LPS-induced IL6 release in whole rat blood. Hyperforin-DCHA was less active in whole human blood. The concentrations required in vitro to inhibit LPS-induced IL6 release from rat and human whole blood are about one order of magnitude higher than the hyperforin levels measured in the plasma of rats or humans treated with pharmaco-logically active doses of SJW or hyperforin-DCHA.

An assessment of social skills deficiencies in depression

Lewinsohn's model of depression assigns to social skills deficiencies a major role in the development and maintenance of depressive disorders. In the present report, the social skills of depressives (under psychiatric care), social skills trainees (nonpsychiatric), and normal controls were assessed using the Social Situations Questionnaire (SSQ). Depressed patients and nondepressed social skills trainees reported a similar degree of difficulty in their social functioning and both differed significantly from normal controls. Further classification of the SSQ items into the categories of basic functions, social encounters, entertainment, interactive skills, and closeness of relationships revealed parallel trends for depressives and social skills trainees, thus also suggesting qualitative similarities between these groups. The finding that depressed patients and nondepressed social skills trainees exhibited similar difficulties suggests that social skills deficiencies may not be etiologically linked to depression but rather increase vulnerability to depressive disorders.