History Of Major Depressive Disorder Research Articles

0635 Associations Between Ambient Light Exposure and Development of Depressive Symptoms in Women at Risk for Postpartum Depression

Abstract Introduction There is increasing recognition that ambient light exposure plays a critical role in daytime functioning, including mood regulation. In this analysis, we examined associations between 24-hour light exposure patterns and mood in women at risk of developing postpartum depression. Methods Perinatal women ages 18-40 with a history of major depressive disorder or bipolar disorder who did not meet criteria for depression at study enrollment during 3rd trimester wore wrist actigraphs that recorded ambient light levels for one week at 3rd trimester (~33 weeks’ gestation) and again during postpartum weeks 2, 6, and 16. Depressive symptoms were assessed with the Hamilton Depression Rating Scale (HAM-D-17) at the end of each recording week. To summarize the light data, we calculated the arithmetic mean of the log-light levels in twenty-four 60-minute bins across each day and then aggregated each hour across each recording week. We used nonlinear model fitting (cosinor) to calculate area under the curve (AUC) and compared 24-hour and morning (8:00 am to 12:00 pm) light exposure patterns between women with elevated depression symptoms at week 16 (HAM-D-17 > 7) and women with low depression symptoms at study entry and week 16 (HAM-D-17 <=7) using Mann-Whitney U-tests. Results Compared with women who did not become depressed (n=15), those who ultimately developed depression (n=8) had significantly lower morning light exposure at 3rd trimester and at postpartum week 6, but not at postpartum week 16. Effect sizes were moderate at 3rd trimester (eta-squared=0.30) and small at Week 6 (eta squared=0.24). There were no significant differences in the overall 24-hour AUC of light exposure between participants who developed significant depressive symptoms at postpartum week 16 and non-depressed women at any time point [3rd trimester: p=0.35; postpartum week 6: p=0.92; postpartum week 16: p=0.35]. Conclusion In this sample of perinatal women at risk for postpartum depression, new mothers who developed clinically-significant depressive symptoms at postpartum week 16 had lower levels of morning light exposure during 3rd trimester and at 6 weeks postpartum. Lower peripartum morning light exposure may predict the development of postpartum depression. Support (if any) MH086689 to KMS

Clinical characteristics and outcomes of patients with mental illnesses who attempted suicide by drug overdose: A retrospective analysis of 109 cases.

Individuals with mental illnesses are exposed to an increased risk of suicide. In this study, we aimed to investigate the clinical characteristics and outcome of psychiatric patients who attempted suicide by drug overdose and required emergency care. A retrospective study was carried out in the Department of Emergency, the First Affiliated Hospital, Zhejiang University School of Medicine. Electronic medical records of psychiatric patients who were hospitalized due to suicide attempts from March 2019 to February 2022, with a discharge diagnosis of drug overdose were reviewed. Suicide-related data of patients were collected, including suicide month, time from suicide to admission, type of drugs, the number of tablets taken, as well as demographic and clinical profiles (e.g., gender, age, marital status, profession, physical comorbidities, and diagnosis of mental illness). In the results, half of the patients were young people, female patients accounted for a higher proportion (72.5%), and the incidence of suicide was higher in winter than other seasons. Among the 109 psychiatric patients, 60 patients (55.0%) had a history of major depressive disorder, and 86 patients (78.9%) committed suicide with various psychotropic drugs, among which anxiolytics were the most commonly used drugs. Thirty-seven patients (33.9%) experienced severe physical complications caused by drug overdose, with lung infections being the most common. The clinical outcome of most patients was favorable following emergent treatment, while 2 patients (1.8%) older than 80 failed to survive. A better understanding of psychiatric patients referred to emergency care due to suicide by drug overdose helps to improve the clinical management and prognosis of patients.

(201) Young Adult Males Report Reluctance in Disclosing Sexual Health Concerns to Physicians: A Cross-Sectional Study

Abstract Introduction The reported prevalence of sexual dysfunction in young adult males has recently increased, but estimates are highly variable, ranging from 1% to 30%. Sexual dysfunction can have organic, psychogenic, and multidimensional causes, and sexual concerns warrant medical assessment. However, both clinical management and epidemiologic research depend upon the willingness of patients to disclose symptoms. Despite this issue, there is limited research on the comfort level of young adult males in discussing sexual health or sexual dysfunction with physicians. Objective To assess the comfort level of young adult males in discussing their sexual health, including sexual side effects caused by medications, with doctors. Methods A cross-sectional, paid survey was designed in collaboration with our institution’s biostatistics core using Qualtrics XM. Biological males ages 18 to 35 were recruited using social media. The survey included demographic characteristics and contained several 5-point Likert scale questions to query perceptions of personal health. Additionally, respondents ranked the top three of seven subjects that they felt most difficult to talk about with their doctor (mental health, physical health, school/job achievement, maintaining body weight, ability to orgasm, libido, and erectile function). Participants also ranked the three items that were most important to them according to their current personal values. These ranked variables were subsequently transformed to calculate an “impact score” for analysis (3 points = ranked 1st; 2 points = ranked 2nd; 1 point = ranked 3rd; 0 points = unranked). Results 505 out of 665 electronically delivered surveys were returned (76% response rate), and 486 had complete and evaluable responses. Age was normally distributed with a mean of 27.4 years (SD: 3.6). Participants were 40% non-white, 21% LGBTQ+, and 89% sexually active. 37% reported a history of major depressive disorder (MDD) and 34% reported a history of generalized anxiety disorder (GAD). 51% of respondents agreed or strongly agreed with the statement, “I am embarrassed to talk about sexual problems with my doctor.” As illustrated by Figure 1A, respondents ranked all sexual health topics as uniformly and significantly more difficult to discuss with their physicians compared to all other aspects of personal health assessed (p=0.0000-0.02). As displayed in Figure 1B, respondents indicated that sexual health subjects were of lower importance relative to the other areas of personal health. Grossly, there were no significant correlations between impact scores and age. Conclusions Our results suggest that young adult males display high rates of embarrassment and reluctance in sharing sexual concerns with physicians. Though young adult males place less value on sexual health, it is closely interconnected with mental and physical well-being. Our findings reinforce the crucial need for physicians to actively combat stigma around sexual health conversations, normalize these discussions with their young adult male patients, and directly inquire about sexual concerns in patients with medical conditions or medications with known sexual side effects. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Dadi, Teleflex, Lina.

Suicidal Thoughts and Behaviors in Older U.S. Military Veterans: Results From the National Health and Resilience in Veterans Study

To identify the prevalence and correlates associated with suicidal thoughts and behaviors (STBs) in a nationally representative sample of older (55+) US military veterans. Data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study (N=3,356; mean age=70.6). Self-report measures of past-year suicidal ideation (SI), lifetime suicide plan, lifetime suicide attempt(s), and future suicide intent were examined in relation to sociodemographic, neuropsychiatric, trauma, physical health, and protective factors. A total of 6.6% (95% CI=5.7%-7.8%) of the sample endorsed past-year SI, 4.1% (CI=3.3%-5.1%) a lifetime suicide plan, 1.8% (CI=1.4%-2.3%) a lifetime suicide attempt, and 0.9% (CI=0.5%-1.3%) future suicide intent. Higher levels of loneliness and lower levels of purpose in life were most strongly associated with past-year SI; lifetime history of major depressive disorder with suicide plan and suicide attempt; and frequency of past-year SI and more negative expectations regarding emotional aging with future suicide intent. These findings provide the most up-to-date nationally representative prevalence estimates of STBs among older military veterans in the United States. Several modifiable vulnerability factors were found to be associated with suicide risk in older US military veterans, suggesting that these factors may be targets for intervention in this population.

Identification of novel biomarkers linking depressive disorder and Alzheimer’s disease based on an integrative bioinformatics analysis

BackgroundPrevious reports revealed that a history of major depressive disorder (MDD) increased the risk of Alzheimer’s disease (AD). The immune disorder is associated with MDD and AD pathophysiology. We aimed to identify differentially expressed immune-related genes (DEIRGs) that are involved in the pathogenesis of MDD and AD.MethodsWe downloaded mRNA expression profiles (GSE76826 and GSE5281) from the Gene Expression Omnibus (GEO) database. The R software was used to identify DEIRGs for the two diseases separately. Functional enrichment analysis and PPI network of DEIRGs were performed. Finally, the relationship between shared DEIRGs and immune infiltrates of AD and MDD were analyzed, respectively.ResultsA total of 121 DEIRGs linking AD and MDD were identified. These genes were significantly enriched in immune-related pathways, such as the JAK-STAT signaling pathway, regulation of chemotaxis, chemotaxis, cytokine-cytokine receptor interaction, and primary immunodeficiency. Furthermore, three shared DEIRGs (IL1R1, CHGB, and NRG1) were identified. Correlation analysis between DEIRGs and immune cells revealed that IL1R1 and NRG1 had a negative or positive correlation with some immune cells both in AD and MDD.ConclusionBoth DEIRGs and immune cell infiltrations play a vital role in the pathogenesis of AD and MDD. Our findings indicated that there are common genes and biological processes between MDD and AD, which provides a theoretical basis for the study of the comorbidity of MDD and AD.

Electrophysiological evidence of mal-adaptation to error in remitted depression

Identifying risk markers for major depressive disorder (MDD) that persist into remission is key to address MDD’s high rate of recurrence. Central to MDD recurrence are the disorder’s negative information processing biases, such as heightened responses to errors, which may subsequently impair abilities to monitor performance and adjust behaviors based on environmental demands. However, little is known regarding the neurophysiological correlates of post-error adaptation in depression. The current study investigated event-related potentials (ERPs) and behavioral performance following errors from a flanker task in 58 participants with remitted MDD (rMDD) and 118 healthy controls (HC). Specifically, using trial-level data, we tested: (a) the impact of errors on response-locked ERPs of the current and post-error trials (error-related negativity [ERN] and correct response negativity [CRN]) and (b) longer-term adaptation to errors (ERN/CRN) over the course of the task. Compared to HC, rMDD participants showed a larger ERN to the current trial and smaller habituation in ERN over time. On trials immediately following errors, rMDD participants showed slower reaction times that were predicted by the previous-trial ERN amplitude but comparable accuracy to HC, suggesting a deficient ability to disengage from errors and/or a compensatory effort to mitigate accuracy decrements. Critically, this pattern of responding: (a) was concurrently associated with greater levels of anhedonia symptoms, more severe MDD history, and interpersonal impairment (but lower impairment in life activities) and (b) predicted more anhedonia symptoms at one-year follow-up. Collectively, a hyperactive performance monitoring system may be a useful risk marker for future MDD recurrence.

Correlates of chronic depression in the general population: results from the CoLaus|PsyCoLaus study

PurposePrevious population-based studies have partially provided inconsistent results regarding the co-variates of chronic depression, which were likely to be attributable to methodological limitations. The present paper that compared people with chronic major depressive disorder (MDD), non-chronic MDD and no mood disorder in the community focused on specific atypical and melancholic depression symptoms and subtypes of MDD, family history (FH) of mood disorders, measured physical cardio-vascular risk factors (CVRF), personality traits, coping style and adverse life-events.MethodsData stemmed from a population-based cohort including 3618 participants (female 53%, n=1918; mean age 50.9 years, s.d. 8.8 years). Among them 563 had a lifetime history of chronic MDD, 1060 of non-chronic MDD and 1995 of no mood disorder. Diagnostic and FH information were elicited through semi-structured interviews, CVRF were assessed through physical investigations.ResultsThe major findings were that chronic MDD was associated with increase in appetite/weight and suicidal ideation/attempts during the most severe episode, higher exposure to life-events in adulthood, higher levels of neuroticism, lower levels of extraversion and lower levels of informal help-seeking behavior but less frequent FH of MDD compared to non-chronic MDD.ConclusionChronic MDD is associated with a series of potential modifiable risk factors which are accessible via psychotherapeutic approaches that may improve the course of chronic MDD.

History of major depressive disorder is associated with differences in implicit learning of emotional faces

Major depressive disorder is often associated with worsened reward learning, with blunted reward response persisting after remission. In this study, we developed a probabilistic learning task with social rewards as a learning signal. We examined the impacts of depression on social rewards (facial affect displays) as an implicit learning signal. Fifty-seven participants without a history of depression and sixty-two participants with a history of depression (current or remitted) completed a structured clinical interview and an implicit learning task with social reward. Participants underwent an open-ended interview to evaluate whether they knew the rule consciously. Linear mixed effects models revealed that participants without a history of depression learned faster and showed a stronger preference towards the positive than the negative stimulus when compared to the participants with a history of depression. In contrast, those with a history depression learned slower on average and displayed greater variability in stimulus preference. We did not detect any differences in learning between those with current and remitted depression. The results indicate that on a probabilistic social reward task, people with a history of depression exhibit slower reward learning and greater variability in their learning behavior. Improving our understanding of alterations in social reward learning and their associations with depression and anhedonia may help to develop translatable psychotherapeutic approaches for modification of maladaptive emotion regulation.

The Impact of COVID-19 Lockdown on Adults with Major Depressive Disorder from Catalonia: A Decentralized Longitudinal Study.

The present study analyzes the effects of each containment phase of the first COVID-19 wave on depression levels in a cohort of 121 adults with a history of major depressive disorder (MDD) from Catalonia recruited from 1 November 2019, to 16 October 2020. This analysis is part of the Remote Assessment of Disease and Relapse-MDD (RADAR-MDD) study. Depression was evaluated with the Patient Health Questionnaire-8 (PHQ-8), and anxiety was evaluated with the Generalized Anxiety Disorder-7 (GAD-7). Depression's levels were explored across the phases (pre-lockdown, lockdown, and four post-lockdown phases) according to the restrictions of Spanish/Catalan governments. Then, a mixed model was fitted to estimate how depression varied over the phases. A significant rise in depression severity was found during the lockdown and phase 0 (early post-lockdown), compared with the pre-lockdown. Those with low pre-lockdown depression experienced an increase in depression severity during the "new normality", while those with high pre-lockdown depression decreased compared with the pre-lockdown. These findings suggest that COVID-19 restrictions affected the depression level depending on their pre-lockdown depression severity. Individuals with low levels of depression are more reactive to external stimuli than those with more severe depression, so the lockdown may have worse detrimental effects on them.

Tensorial independent component analysis reveals social and reward networks associated with major depressive disorder.

Major depressive disorder (MDD) has been associated with changes in functional brain connectivity. Yet, typical analyses of functional connectivity, such as spatial independent components analysis (ICA) for resting-state data, often ignore sources of between-subject variability, which may be crucial for identifying functional connectivity patterns associated with MDD. Typically, methods like spatial ICA will identify a single component to represent a network like the default mode network (DMN), even if groups within the data show differential DMN coactivation. To address this gap, this project applies a tensorial extension of ICA (tensorial ICA)-which explicitly incorporates between-subject variability-to identify functionally connected networks using functional MRI data from the Human Connectome Project (HCP). Data from the HCP included individuals with a diagnosis of MDD, a family history of MDD, and healthy controls performing a gambling and social cognition task. Based on evidence associating MDD with blunted neural activation to rewards and social stimuli, we predicted that tensorial ICA would identify networks associated with reduced spatiotemporal coherence and blunted social and reward-based network activity in MDD. Across both tasks, tensorial ICA identified three networks showing decreased coherence in MDD. All three networks included ventromedial prefrontal cortex, striatum, and cerebellum and showed different activation across the conditions of their respective tasks. However, MDD was only associated with differences in task-based activation in one network from the social task. Additionally, these results suggest that tensorial ICA could be a valuable tool for understanding clinical differences in relation to network activation and connectivity.

Depressive symptoms anticipate behavioral and emotional factors among older adults: A prospective cross-lagged panel design.

This study examined the temporal relationship among depression, anxiety, insomnia, perceived stress, and physical activity in adults aged 60+ years with a history of major depressive disorder. We conducted a longitudinal study with 12 weeks of follow-up. Assessments consisted of phone or video interviews and included questionnaires evaluating depression, anxiety, insomnia, perceived stress, and physical activity. Our analytic approach consisted of a depression-focused cross-lagged panel model (CLPM) to examine week-to-week correlations among the five measures. The depression-focused CLPM identified statistically significant week-to-week self-predictive effects for each of the five measures. Higher depressive symptom burden was a strong predictor of increased stress, greater insomnia, and less physical activity the following week. No other cross-measure predictions were statistically significant. Our analytical approach clarifies the directional relationship among variables that typically co-occur with depression showing that higher depression symptom burden predisposes older adults to poor sleep, a reduced level of daytime activity, and a greater sense of stress. These findings support the need for longitudinal assessments and targeted interventions for reducing symptoms of depression in older adults.

Acute Suicidal Ideation in the Context of Esketamine Maintenance Therapy

Acute Suicidal Ideation in the Context of Esketamine Maintenance Therapy

MALIGNANT CATATONIA IN MEDICAL WARDS: A BROAD DIFFERENTIAL DIAGNOSIS

IntroductionCatatonia is an uncommon and heterogeneous psychomotor syndrome. It can be not only the manifestation of a psychiatric disorder but also a wide range of medical conditions. The malignant catatonia is a subtype of catatonia which includes dysautonomic signs such as hyperthermia or hemodynamic instability, and because most of the affected patients are taking antipsychotics or antidepressants previously, it can be confounded with medical conditions such as neuroleptic or serotonin syndrome.ObjectivesTo present a case of malignant catatonia admitted in a medical wardMethodsThe present study is a case report of a patient admitted with initial diagnosis of serotonin syndrome in a medical ward of our hospital and referred to the consultation and liaison psychiatry (CLP) unit. We also searched previously case reports, series and systematic reviews about catatonia secondary to medical conditions and hyperthermia catatonia.ResultsMs. TN is a 71-year-old woman, with prior history of major depressive disorder. One month ago she was admitted in a psychiatric ward of another hospital for a depressive episode with psychotics features, and was treated with escitalopram 10mg/day, vortioxetine 10mg/day, mirtazapine 15mg/day, trazodone 50mg/day, quetiapine 700mg/day and haloperidol 5mg/day. She had a worsening of depressive symptoms with suicidal thoughts, negativism and psychomotor retardation, and subsequently hyperthermia, rigidity, mydriasis, tachicardia and increased bowel sound. She was tranfered to our medical ward, and diagnosed of serotonin syndrome. She was stopped all the psychiatric drugs and was treated with dantrolene and support measures. After 10 days without antidepressants or antipsychotics she maintened the same symptomatology and was referred to our CLP unit. The psychopathological evaluation showed stupor, mutism, waxy flexibility and negativism, and she responded to a challenge test with intravenous clonazepam 0,5mg. She was diagnosed of malignant catatonia and was started oral clonazepam 2mg/day. Although there was a partial response, she did not tolerate higher doses because of sedation and finally was treated with electroconvulsive therapy (ECT). She dad a remission of catatonic symptoms after only two sessions of ECT.ConclusionsMalignant catatonia can be confounded with other medical conditions such as serotonin or neuroleptic syndromes. All of them can have catatonic signs, and it is important to recognize them (a challenge test with a benzodiacepine can be helpful). The key to distingish malignant catatonia from them is that some of the catatonic signs (negativism and psychomotor retardation) happened before the dysautonomic signs. Also, it is uncommon that a serotonin syndrome persisted more than 3-5 days after the suspension of antidepressants. Consultation and liaison psychiatrists can help for the differential diagnosis and management of patients with suspected catatonia in medical wards.Disclosure of InterestNone Declared

Transactional Relations Between Peer Victimization and Depressive Symptoms Among Youth at Risk of Developing Depression: Evidence for Gender Differences.

Offspring of mothers with a history of major depressive disorder (MDD) are at high risk of developing the disorder themselves, yet specific mechanisms of risk remain unclear. One hypothesized mechanism is interpersonal stress, which has been shown to be elevated in offspring of mothers with a history of MDD. The goal of this study was to examine the role of a specific form of interpersonal stress, peer victimization (overt and relational). In doing so, we not only examined the impact of peer victimization on changes in youth depression, but also youth depression on changes in peer victimization, consistent with stress generation models. Participants were 251 mothers with (n = 129) or without (n = 122) a history of MDD and their child (aged 8-14 years at baseline) who were assessed every six months for two years. Using random intercepts cross-lagged panel models (RI-CLPM), we were able to separate between-subject effects (mother MDD group differences in average levels of peer victimization and offspring depressive symptoms) and within-subject effects (transactional influences between within-subject fluctuations in peer victimization and depressive symptoms among offspring over time). Overall, these effects were stronger for relational victimization than for overt victimization and stronger for girls than boys. These results support the role of peer victimization, particularly relational victimization, as a risk factor among offspring of mothers with MDD, particularly girls, and highlight transactional relations between relational victimization and depressive symptoms in girls over time, which may create a vicious cycle of risk.

QTC-4-MeOBnE Ameliorated Depressive-Like Behavior and Memory Impairment in 3xTg Mice.

Growing evidence has associated major depressive disorder (MDD) as a risk factor or prodromal syndrome for the occurrence of Alzheimer's disease (AD). Although this dilemma remains open, it is widely shown that a lifetime history of MDD is correlated with faster progression of AD pathology. Therefore, antidepressant drugs with neuroprotective effects could be an interesting therapeutic conception to target this issue simultaneously. In this sense, 1-(7-chloroquinolin-4-yl)-N-(4-methoxybenzyl)-5-methyl-1H-1,2,3-triazole-4- carboxamide (QTC-4-MeOBnE) was initially conceived as a multi-target ligand with affinity to β-secretase (BACE), glycogen synthase kinase 3β (GSK3β), and acetylcholinesterase but has also shown secondary effects on pathways involved in neuroinflammation and neurogenesis in preclinical models of AD. Herein, we investigated the effect of QTC-4-MeOBnE (1mg/kg) administration for 45days on depressive-like behavior and memory impairment in 3xTg mice, before the pathology is completely established. The treatment with QTC-4-MeOBnE prevented memory impairment and depressive-like behavior assessed by the Y-Maze task and forced swimming test. This effect was associated with the modulation of plural pathways involved in the onset and progression of AD, in cerebral structures of the cortex and hippocampus. Among them, the reduction of amyloid beta (Aβ) production mediated by changes in amyloid precursor protein metabolism and hippocampal tau phosphorylation through the inhibition of kinases. Additionally, QTC-4-MeOBnE also exerted beneficial effects on neuroinflammation and synaptic integrity. Overall, our studies suggest that QTC-4-MeOBnE has a moderate effect in a transgenic model of AD, indicating that perhaps studies regarding the neuropsychiatric effects as a neuroprotective molecule are more prone to be feasible.

Genetic predisposition to major depressive disorder differentially impacts alcohol consumption and high-risk drinking situations in men and women with alcohol use disorder

Lifetime history of major depressive disorder (MDD) has a sex-specific association with pretreatment alcohol consumption in patients with alcohol dependence. Here, we investigated the association of genetic load for MDD estimated using a polygenic risk score (PRS) with pretreatment alcohol consumption assessed with Timeline Follow Back in a sample of 287 men and 156 women meeting DSM-IV-TR criteria for alcohol dependence. Preferred drinking situations were assessed using the Inventory of Drug Taking Situations (IDTS). Linear models were used to test for association of normalized alcohol consumption measures with the MDD-PRS, adjusting for ancestry, age, sex, and number of days sober at baseline. We fit models both with and without adjustment for MDD history and alcohol-use-related PRSs as covariates. Higher MDD-PRS was associated with lower 90-day total alcohol consumption in men (β = −0.16, p = 0.0012) but not in women (β = 0.11, p = 0.18). The association of MDD-PRS with IDTS measures was also sex-specific: higher MDD-PRS was associated with higher propensity to drink in temptation-related situations in women, while the opposite (negative association)was found in men. MDD-PRS was not associated with lifetime MDD history in our sample, and adjustment for lifetime MDD and alcohol-related PRSs did not impact the results. Our results suggest that genetic load for MDD impacts pretreatment alcohol consumption in a sex-specific manner, which is similar to, but independent from, the effect of history of MDD. The clinical implications of these findings and contributing biological and psychological factors should be investigated in future studies.

Attentional biases for sad faces in offspring of mothers with a history of major depression: trajectories of change from childhood to adolescence.

Theorists have proposed that the way children process social-emotional information may serve as a mechanism of risk for the intergenerational transmission of depression. There is growing evidence that infants and children of mothers with a history of major depressive disorder (MDD) during the child's life exhibit attentional avoidance of sad faces, which has been proposed as an early emerging emotion regulation strategy. In contrast, there is clear evidence that at-risk and depressed adolescents and adults exhibit difficulty disengaging attention from sad faces. Seeking to link these two literatures, the current U.S.-based study used eye tracking within the context of an accelerated longitudinal design to assess attentional biases in 8-14-year-old offspring of mothers with a history MDD during the child's life (n=123) or no history of MDD (n=119) every six months for two years, allowing us to map trajectories of attention from age 8 to 16. Mother MDD history moderated age-based changes in children's gaze duration to sad (t[240]=2.44, p=.02), but not happy (t[240]=0.11, p=.91) or angry (t[240]=0.67, p=.50), faces. Consistent our hypotheses, offspring of mothers with MDD exhibited significantly less attention to sad faces than offspring of never depressed mothers before age 8.5 but significantly more attention to sad faces after age 14.5, which was due to an increase in gaze duration to sad faces from childhood to adolescence among offspring of mothers with MDD (t[122]=5.44, p < .001) but not among offspring of never depressed mothers (t[118]=1.49, p=.14). It appears that the form, and perhaps function, of attentional bias may shift across development in at-risk youth. To the extent that this is true, it has significant implications not only for theories of the intergenerational transmission of depression risk but also for prevention and early intervention efforts designed to reduce this risk.

Flourishing despite Chronic Obstructive Pulmonary Disease (COPD): Findings from a Nationally Representative Survey of Canadians Aged 50 and Older.

Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of mortality and is often associated with serious disability and depression. Little is known about the characteristics of those who are in complete mental health (CMH) despite having COPD. This study’s objectives are to: (1) estimate the prevalence and odds of absence of psychiatric disorders (APD) and CMH among older adults that reported having COPD, compared to their peers that did not; (2) identify factors associated with APD and with CMH. Bivariate and logistic regression analyses were conducted using the nationally representative Canadian Community Health Survey—Mental Health. The results indicate that there was a significantly (p < 0.001) lower prevalence of APD (86.7% vs. 95.0%) and CMH (66.7% vs. 77.0%) among older adults aged 50+ with COPD (n = 703) compared to those without COPD (n = 10,189). Half of the sample was female (50.5%) and the majority of whom were under age 70 (62.5%). Factors significantly (p < 0.05) associated with higher odds of APD and of CMH among older adults with COPD include being married, having a confidant, being physically active, and having no lifetime history of major depressive disorder or generalized anxiety disorder. For every additional adverse childhood experience, the odds of APD declined by 31%. The majority of those with COPD are mentally flourishing despite having this disabling and life-threatening disorder. These findings underline the importance of targeted interventions and outreach to those most vulnerable to poorer mental health outcomes including the socially isolated.

Association of adolescent and young adult depression and anxiety with perinatal mental health in fathers: Findings from an Australian longitudinal study

The current study examined associations between preconception diagnoses of major depressive disorder (MDD) and anxiety disorders in adolescence and young adulthood and perinatal depression and anxiety symptoms in early fatherhood. In an Australian community cohort study of health and development, earlier history of MDD and anxiety disorders (extending back to adolescence) were assessed retrospectively in the third trimester of pregnancy via the Composite International Diagnostic Interview. Paternal perinatal depression and anxiety were then assessed prospectively over three timepoints (third trimester of pregnancy, 8 weeks and 12 months postpartum), using established cut-points on the Edinburgh Postnatal Depression Scale and the Depression Anxiety Stress Scales (anxiety subscale). Mixed-effects regression models examined risk associations between preconception diagnoses of MDD and anxiety disorders, and perinatal depression and anxiety symptoms at each timepoint, adjusting for socio-demographic factors and concurrent maternal mental health difficulties. The odds of clinically concerning levels of paternal perinatal depression and anxiety were 6-fold and 4-fold higher, respectively, in men with a preconception history of MDD. The odds of perinatal depression were 3-fold higher in men with a preconception history of an anxiety disorder. Less evidence was found for an association between preconception diagnoses of an anxiety disorder and perinatal anxiety in fathers. Interventions aimed at improving mental health in men during adolescence and young adulthood may promote continued psychological health in men during early fatherhood.

S3382 Budesonide in Treating a Patient With Microscopic Enteritis

Introduction: Microscopic enteritis is an inflammatory condition in the small bowel that causes chronic diarrhea and bloating. It is associated with gluten intolerance, allergies, drug therapy, inflammatory bowel disease, and autoimmune conditions. Despite the prevalence of risk factors for microscopic enteritis, the understanding of the disease remains limited. Case Description/Methods: A 33-year-old man with past medical history of major depressive disorder presented with chronic diarrhea. Seven months ago, he started to have 2-5 loose bowel movements daily, with Bristol stool consistency ranging from 4-7. The diarrhea did not improve with fasting and was not nocturnal, but heavy meals worsen his symptoms. The patient denied having abdominal pain, bright red blood per rectum, incontinence, weight loss, fever, or chills. The patient attempted to take pancrelipase, loperamide, probiotics, increased fiber intake, with no improvement in his symptoms. Workup was negative for tissue transglutaminase and stool culture for gastrointestinal pathogens, but significant for fecal calprotectin >200 mcg/g. Colonoscopy showed non-bleeding internal hemorrhoids, normal entire colon and terminal ileum (Figure). Pathology of the biopsy taken from the terminal ileum showed small intestinal mucosa with mild intraepithelial lymphocytes suggesting a diagnosis of inflammatory bowel disease vs microscopic enteritis. The patient was started on budesonide 9 mg by mouth daily for 2 months, which led to diarrhea resolving and remaining asymptomatic off the medication. Discussion: Microscopic enteritis is an inflammatory condition that affects the small bowel. It can be caused by infection, gluten intolerance, medications, or autoimmune diseases. Workup for microscopic enteritis involves testing for endomysial antibodies, anti-tissue transglutaminase, HLA typing and immunoglobulin titers. To avoid missing this diagnosis in a patient with chronic diarrhea, in addition to the common practice of random colonic biopsies to rule out microscopic colitis, intubation of the terminal ileum along with biopsies should be performed. Histologically, the epithelium in microscopic enteritis is infiltrated with lymphocytes, and lamina propria has increased eosinophils and plasma cells. Given the known response of microscopic colitis to budesonide, a trial of budesonide was started and was sufficient to resolve the patient’s symptoms and lead to complete clinical remission.Figure 1.: A. descending colon; B. ascending colon; C. ileo-cecal valve; D. terminal ileum.