Nondepressed Patients Research Articles

The Link between Major Depressive Disorder & Chronic Coronary Syndrome - A Literature Review

Depression is prevalent among patients with coronary artery disease and has significant consequences. Occurrence of depression after a new diagnosis of stable angina is common and affects nearly 1 in 5 individuals. There have been several biological mechanisms by which depression may be related to coronary artery disease. As compared with nondepressed patients, those with depression have increased catecholamine levels,elevated resting heart rate, and decreased heart rate variability. . Behavioral characteristics of patients with depression include poor medication adherence, lower exercise tolerance,physical inactivity, poor dietary habits,and tobacco use. Although depression and its impact have been well documented in post-MI patients, much less is known about its significance in patients with chronic coronary syndrome(CCS).Despite the fact that CCS is the most common manifestation of coronary artery disease,sothere is a huge gap in the field of knowledge correlating CCS and depression. University Heart Journal 2023; 19(1): 26-30

Early cortical atrophy is related to depression in patients with neuropathologically confirmed Parkinson's disease

ObjectiveDepression is a common comorbidity in Parkinson's disease (PD) and other synucleinopathies. In non-PD geriatric patients, cortical atrophy has previously been connected to depression. Here, we investigated cortical atrophy and vascular white matter hyperintensities (WMHs) in autopsy-confirmed parkinsonism patients with the focus on clinical depression. MethodsThe sample consisted of 50 patients with a postmortem confirmed neuropathological diagnosis (30 Parkinson's disease [PD], 10 progressive supranuclear palsy [PSP] and 10 multiple system atrophy [MSA]). Each patient had been scanned with brain computerized tomography (CT) antemortem (median motor symptom duration at scanning = 3.0 years), and 19 patients were scanned again after a mean interval of 2.7 years. Medial temporal atrophy (MTA), global cortical atrophy (GCA) and WMHs were evaluated computationally from CT scans using an image quantification tool based on convolutional neural networks. Depression and other clinical parameters were recorded from patient files. ResultsDepression was associated with increased MTA after controlling for diagnosis, age, symptom duration, and cognition (p = 0.006). A similar finding was observed with GCA (p = 0.017) but not with WMH (p = 0.47). In PD patients alone, the result was confirmed for MTA (p = 0.021) with the same covariates. In the longitudinal analysis, GCA change per year was more severe in depressed patients than in nondepressed patients (p = 0.029). ConclusionsEarly medial temporal and global cortical atrophy, as detected with automated analysis of CT-images using convolutional neural networks, is associated with clinical depression in parkinsonism patients. Global cortical atrophy seems to progress faster in depressed patients.

Autophagy markers, cognitive deficits and depressive symptoms in Parkinson's disease.

Depressive symptoms are common in Parkinson's disease (PD). The relationships between autophagy and PD or depression have been documented. However, no studies explored the role of autophagy markers associated with depressive symptoms in PD. Our study aimed to investigate the relationships between autophagy markers, cognitive impairments and depressive symptoms in PD patients.A total of 163 PD patients aged 50-80years were recruited. Plasma concentrations of autophagy markers (LC3-I, LC3-II and p62/SQSTM1) and glycolipid parameters were measured. Depressive symptoms, cognitive impairments, and motor function were assessed using the Hamilton Depression Rating Scale-17 (HAMD-17), the Montreal Cognitive Assessment (MoCA), and the Movement Disorders Society Unified Parkinson's Rating Scale Part III (MDS-UPDRS-III), respectively.There were no significant differences between depressed and non-depressed PD patients for LC3-I, LC3-II, LC3-II/LC3-I and p62/SQSTM1. After controlling confounding variables, LC3-II/LC3-I showed an independent relationship with depressive symptoms in PD patients (Beta = 10.082, t = 2.483, p = 0.014). Moreover, in depressive PD patients, p62/SQSTM1 was associated with MoCA score (Beta = -0.002, t = -2.380, p = 0.020); Further, p62/SQSTM1 was related to naming ability; in addition, p62/SQSTM1 was independently associated with delayed recall (Beta = -0.001, t = -2.452, p = 0.017).LC3-II/LC3-I was related to depressive symptoms in PD patients. In depressive PD patients, p62/SQSTM1 was associated with cognitive function, especially naming ability and delayed recall.

Cognitive - Behavioural Coping Strategies as Predictor of Suicide Risk Severity

Background and aim: Cognitive behavioural coping strategies are closely correlated with depression and suicide risk. The aim of this study is to explore the particular features of cognitive-behavioural coping strategies and their impact on depression levels and suicidal ideation. Methods: The study included a total of 131 participants, of whom 65 had a clinical diagnosis of depression and 66 were controls. Psychometric tools were administered to both groups: Montgomery-Asberg Depression Scale (MADRS), Depression Anxiety Stress Scale (DASS21R), Strategic approach to coping scale (SACS), Columbia Suicide Severity Rating Scale (C-SSRS), in order to assess the differences between depressive and non-depressive individuals in relation to cognitive behavioural coping strategies. Results and conclusion: Results based on statistical analysis of scores obtained on various psychometric scales showed significant differences between depressed and non-depressed patients. Also, cognitive-behavioural strategies could represent predictors that can be used in the prevention of suicide risk.

ALCOHOL-DEPENDENT INPATIENTS IN NORTHERN VIETNAM: A PROSPECTIVE STUDY ON FACTORS RELATED TO RELAPSE

Alcohol-dependent patients face a risk of relapse after detoxification and alcohol dependence relapse is affected by many factors in different countries. The study aims to analyze some of the factors associated to the relapse in alcohol-dependent inpatients in northern Vietnam. Methods: A prospective study that monitored alcohol-dependent inpatient in northern Vietnam for six months. Results: Patients with education from high school and higher had a relapse rate of 0.65 times as compared to patients with education below high school (IRR=0.65; 95% CI: 0.43-0.99). Patients with four or more times of alcohol withdrawal had a relapse rate of 1.76 times compared with patients with less than four times of alcohol withdrawal (IRR=1.76; 95% CI: 1.09-2.84). Patients with severe and very severe depressive disorders on the Hamilton depression rating scale at one month after being discharge from hospital had a relapse rate of 4.27 times that of non-depressed patients. (IRR=4.27; 95% CI: 1.08-16.97). Conclusion: Alcohol-dependent patients had many previous alcohol withdrawal times, the co-occurrence of depressive disorder increased alcohol dependence relapse and relapse soon after recovering from alcohol dependence. In particular, higher education was a protective factor against relapse. These factors were depended on economic, medical, cultural and social characteristics in different countries. ASEAN Journal of Psychiatry, Vol. 24 (7) September, 2023; 1-8

How Does Anxiety and Depression Affect the Outcome after Periradicular Infiltration Therapy?-A Retrospective Analysis of Patients Undergoing CT-Guided Single-Level Nerve Root Infiltration Due to Chronic Monoradicular Pain.

The aim of this study was to research the influence of psychological confounders on patient-reported outcomes (PROs) after lumbar infiltration therapies of periradicular infiltrations (PRI). Patients who underwent PRI in a single center between June 2018 and December 2019 were included. PRI was performed in patients with predominantly unilateral lumbar radiculopathy which existed for at least 6 weeks based on single-level nerve root compression (caused by a herniated disc, stenosis of the lateral recess, or neuroforamen), confirmed by morphological imaging. The numeric pain rating scale (NRS) for back pain (BP) and leg pain (LP) and the Oswestry Disability Index (ODI) were assessed preinterventionally, on the first day (only NRS) and at 6 weeks, and then 3, 6, and 12 months postinterventionally. The minimally clinically important difference (MCID) served as the threshold for the therapeutic effectiveness evaluation. The health-related quality of life (SF-36) was recorded preinterventionally and after 12 months. Based on the Hospital Anxiety and Depression Scale, the patients were dichotomized into depressed or nondepressed and anxious or nonanxious. Categorical data were evaluated using Fisher's exact test, and continuous data were evaluated using Student's t test. Separate linear mixed models were built to estimate the effect of anxiety or depression on repeatedly measured PROs following PRI. Data were analyzed using SPSS software. The analysis included 102 patients. Most mean baseline PROs were significantly worse in anxious or depressed patients than in nonanxious or nondepressed patients: Anxiety NRS-BP (p = 0.007), ODI (p < 0.001); Depression NRS-BP (p = 0.026), NRS-LP (p < 0.001), ODI (p < 0.001). All patients showed a clinically meaningful reduction in pain and functional improvement over a 12-month follow-up. There was no significant difference in the estimated overall mean PRO between all patients (p > 0.05). In conclusion, anxiety and depression are associated with worse PROs before and after PRI. However, patients with underlying depression or anxiety can expect a similar gain in PRO compared to patients without depressive or anxious symptoms.

Longitudinal assessment of social cognition in de novo Parkinson’s disease patients and its relationship with dopaminergic innervation

BackgroundSocial Cognition (SC) has been scarcely studied in Parkinson’s disease (PD), and findings in early disease are controversial. SC encompasses different capacities such as facial emotion recognition (FER); Theory of Mind (ToM), the ability to understand other people’s intentions (cognitive-ToM) and emotions (affective-ToM); and self-monitoring, the ability to regulate one’s own behavior in social contexts. A relationship between dopaminergic deficit and SC in PD has been suggested. ObjectivesTo prospectively assess, over a two-year period, SC in newly diagnosed drug-naïve, cognitively normal and non-depressed PD patients. Furthermore, we aimed to evaluate the relationship between SC and Fluorodopa (Positron Emission Tomography) Ki uptake, which is a marker of dopaminergic depletion. MethodsWe compared SC performance between 25 de novo PD patients and 20 healthy controls (HC), and within-patients at baseline and two-year follow-up. The SC assessment included FER, ToM, as well as self-monitoring measures. The relationship between SC and dopaminergic innervation was also assessed in patients. ResultsSC scores did not differ between PD and HC groups at baseline, nor between baseline and follow-up evaluation in PD. A significant positive correlation between self-monitoring and Fluorodopa Ki uptake in the left pallidum in PD patients was found at baseline. At follow-up, ToM (stories) positively correlated with Fluorodopa Ki uptake in the right thalamus and the left putamen. ConclusionSC appears to be preserved in de novo PD and remains stable in the short-term. Although more evidence is needed, our results support a relationship between dopamine innervation in subcortical regions and SC.

Depression and anxiety in acute ischemic stroke involving the anterior but not paramedian or inferolateral thalamus.

Emotional and cognitive deficits are prevalent in strokes involving the thalamus. In contrast to cognitive deficits, emotional deficits have not been studied prospectively in isolated thalamic stroke. In 37 ischemic thalamic stroke patients (57.0 [50.0; 69.5] years [median (Q1; Q3)], 21 males, 5 anterior, 12 paramedian, 20 inferolateral vascular territory), and 37 non-stroke control patients matched for age and sex, we prospectively examined depression, anxiety, activities of daily living, and quality of life at 1, 6, 12, and 24 months post-stroke using the Hospital-Anxiety-and-Depression Scale (HADS), Nürnberger-Alters-Alltagsaktivitäten scale (NAA), and Short Form-36 (SF36) questionnaire. Voxel-based lesion-symptom mapping (VLSM) and lesion-subtraction analyzes were performed to determine associations between questionnaire scores and thalamic stroke topography. At 1 month post-stroke, anterior thalamic stroke patients had higher depression scores [8.0 (7.5; 10.5)] than paramedian [4.5 (1.0; 5.8)] and inferolateral [4.0 (1.0; 7.0)] thalamic stroke patients. Furthermore, anterior thalamic stroke patients had higher anxiety scores [11.0 (8.0; 14.5)] than their matched controls [2.5 (2.0; 2.5)], paramedian [4.5 (1.0; 5.8)] and inferior [4.0 (1.0; 7.0)] thalamic stroke patients. Depression and anxiety scores in anterior thalamic stroke patients remained high across the follow-up [depression: 9.0 (3.5; 13,8); anxiety:10.05 (2.8, 14.5)].Physical health assessed by SF36 was intact in anterior [1 month post-stroke: T-score = 55.9 (37.0; 57.6)] but reduced in inferolateral [44.5(32.4; 53.1)] thalamic stroke, whereas mental health was reduced in anterior thalamic stroke [32.0 (29.8; 47.3)].VLSM confirmed that voxels in the anterior thalamus around Montreal Neurological Institute (MNI) coordinates X = -8, Y = -12, Z = 2 were more often affected by the stroke in depressed (HADS-score ≥ 8) than non-depressed (HADS-score < 8) patients and voxels around coordinates X = -10, Y = -12, Z = 2 were more often affected in anxious (HADS-score ≥ 8) than non-anxious (HADS-score < 8) patients. Anterior, but not paramedian or inferolateral thalamic stroke was associated with depression and anxiety. Even though our results are mostly significant in the left thalamus, this observation on stroke laterality might be confounded by the fact that the right hemisphere was underrepresented in our study.

Monocyte/macrophage mediates the impact of depression on Crohn’s disease

Background Depression increases the risk of Crohn’s disease (CD) and worsens its prognosis. Monocytes/macrophages, immune modulate cells, play vital roles in both depression and CD. Objectives We investigated whether monocyte/macrophage could mediate the impact of depression on CD through induction of CD4 + T lymphocyte differentiation and epithelial barrier dysfunction, in addition to the alteration of their own phagocytic ability and cytokines production. Methods Circulating monocytes and intestinal macrophages were isolated from eligible CD patients, divided into depressed and non-depressed groups. Phagocytosis was determined using flow cytometry while in vitro cytokine production was quantified using Luminex assay and qPCR. CD4 + T cells were cocultured with monocytes, then Type 1 Helper T Lymphocytes Th1/Type 2 Helper T Lymphocytes (Th2) /Type 17 Helper T Lymphocytes (Th17)/Treg subsets were analyzed using flow cytometry and qPCR. Caco-2 monolayers simulating epithelial barrier were cocultured with macrophages, and integrity and proliferation were evaluated. Tight junction protein expression was detected using immunofluorescence and western blot. Results Decreased monocyte/macrophage phagocytosis and enhanced production of pro-inflammatory cytokines including Tumor necrosis factor-α (TNF-α), Interleukin-6 (IL-6) and Interleukin-1β (IL-1β) were revealed in the depressed versus non-depressed CD groups. Higher proportions of Th1 and Th17 cells with a lower proportion of Treg cell were observed after cocultured with monocytes from the depressed versus non-depressed CD patients. So were the expressions of their corresponding transcription factors T-bet, Retinoic Acid Related Orphan Nuclear Receptor gamma T (RORγt) and Forkhead box protein P3 (FoxP3). Caco-2 cells cocultured with macrophages from depressed CD displayed lower Transepithelial electric resistance (TEER), reduced proliferation activity, and decreased tight junction protein expressions compared with their counterpart cocultured with macrophages from non-depressed CD. Conclusions Monocyte/macrophage may underlie the impact of depression upon CD via decreased phagocytosis, increased pro-inflammatory cytokine production, inducing CD4 + T cell differentiation toward Th1/Th17 cells rather than Treg cell, and impairing macrophage-enhanced epithelial barrier.

The effect of accompanying anxiety and depression on patients with different vestibular syndromes.

This study aims to investigate the situation of vertigo disorder combined with anxiety and depression in patients with different types of vestibular syndrome. A total of 330 patients with vertigo in otolaryngology outpatient department were selected, and clinical information such as age, gender, and scores of Dizziness handicap inventory (DHI), Generalized anxiety disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9) were collected. Analyzed the differences among acute vestibular syndrome (AVS), episodic vestibular syndrome (EVS) and chronic vestibular syndrome (CVS) in terms of age, gender, comorbid anxiety and depression, and the multivariate ordered logistic regression analysis was used to evaluate the relationship between the above factors and the degree of vertigo disorder. The three types of vestibular syndrome had no significant difference in age composition, sex composition, anxiety and depression. There was no significant difference in the probability of anxiety and depression among vertigo patients of different ages and genders. The total score of vertigo disorder and each sub-item score were higher in patients with anxiety and depression. Patients with anxiety mainly manifested in EVS and CVS, while patients with depression mainly manifested in EVS and AVS. The probability of increased vertigo in anxious patients was 4.65 times that of non-anxious patients, and the probability of increased vertigo in depressed patients was 3.49 times that of non-depressed patients. Age and gender had no statistically significant effect on the degree of vertigo. In patients with EVS, anxiety and depression had a significant effect on the degree of vertigo; in patients with CVS, anxiety had a significant effect on the degree of vertigo, but depression had no significant effect. Age and gender do not significantly affect the degree of vertigo disorder and mental state in various vestibular syndromes. Instead, anxiety and depression are the risk factors for aggravating the degree of vertigo disorder, and manifest differently in each type of vestibular syndrome. Therefore, it is necessary to use a quick scale tool to conduct a standardized screening of the psychological status of patients with vertigo.

The Role of Exercise on Fatigue Among Patients With Multiple Sclerosis in the King Fahad Hospital, Madinah, Saudi Arabia: An Analytical Cross-Sectional Study.

Background Multiple sclerosis (MS) is a chronic autoimmune disease caused by multiple factors. It can lead to many physical and mental symptoms. Fatigue is one of the most commonly mentioned complaints among MS patients that can affect their quality of life. Physical activityhas many benefits for the physical and mental health of patients with MS. Aim To assess the role of exercise on fatigue among patients with multiple sclerosis and identify the relationship between depression, sleep quality, sociodemographic variables, and fatigue. Methods This is an analytical cross-sectional study based on a sample size of 235patients recruited from the MS clinic at King Fahad Hospital (KFH) in Madinah. The outcome of the study was fatigue among MS patients. Data were collected through telephone calls from February to May 2022 using a structured questionnaire and scales, such as the Godin Leisure-Time Exercise Questionnaire (GLTEQ), Modified Fatigue Impact Scale (MFIS), Patient Health Questionnaire (PHQ2), and Pittsburgh Sleep Quality Index (PSQI). Data were analyzed through SPSS version 20 (IBM Corp., Armonk, NY, USA). The correlation coefficient (r), Chi-square tests, and simple and multiple logistic regression were used as found appropriate. Results Out of the total samples, 37.4% were male and 62.6% were female. The median age of patients was 36 years. The prevalence of fatigue was 37% among patients, with a reported median fatigue score of 26. It was found that 63% of the patients were physically inactive; 32.2% were overweight, 14.2% were obese; 63.8% of patients had poor sleep quality. The fatigue score was negatively correlated with the GLTEQ score, but the results were not significant (r=-0.066; P-value (level of significance)=0.335). Nonetheless, a moderately significant correlation was observed between the MFIS and PSQI and MFIS and PHQ2 (r=0.505, P=<0.001 and r=0.520, P=<0.001, respectively). The Chi-square test showed a significant association between fatigue and progressive types of MS, the primary progressive MS (PPMS), secondary progressive MS (SPMS), and relapsing-remitting MS (RRMS) (odds ratio (OR)=4.4; 95%confidence interval (CI): 2.1-8.9), P=<0.001). Depressed patients were 9.7 times more likely to develop fatigue compared to non-depressed patients (P=<0.001). Those with poor sleep quality were 4.6 times more likely to develop fatigue compared to those with good sleep quality (P=<0.001).Fifty-six percent of fatigue among MS patients were predicted by low income, progressive types, unemployment, obesity, depression, and poor sleep quality. Conclusion Fatigue is a major complaint among MS patients. Most of the patients were found to be physically inactive, depressed, and have poor sleep quality. This study found an association between physical inactivity and fatigue, but the results were not significant. There was a significant association between sociodemographic factors like low income and unemployment, poor sleep quality, obesity, progressive types of MS, depression, and fatigue. Encouraging exercise practice and implementing a regularexercise program are needed, along with weight management plans. Further studies and psychological support meetings are required, with the importance of a holistic approach to patient care.

Sex- and age-specific prevalence and risk factors of depressive symptoms in Parkinson's disease.

Although depressive symptoms are common in PD, few studies investigated sex and age differences in depressive symptoms. Our study aimed to explore the sex and age differences in the clinical correlates of depressive symptoms in patients with PD. 210 PD patients aged 50-80 were recruited. Levels of glucose and lipid profiles were measured. The Hamilton Depression Rating Scale-17 (HAMD-17), the Montreal Cognitive Assessment (MoCA) and the Movement Disorder Society Unified Parkinson's Disease Rating Scale Part III (MDS-UPDRS-III) assessed depressive symptom, cognition and motor function, respectively. Male depressive PD participants had higher fasting plasma glucose (FPG) levels. Regarding the 50-59years group, depressive patients had higher TG levels. Moreover, there were sex and age differences in the factors associated with severity of depressive symptoms. In male PD patients, FPG was an independent contributor to HAMD-17 (Beta = 0.412, t = 4.118, p < 0.001), and UPDRS-III score was still associated with HAMD-17 in female patients after controlling for confounding factors (Beta = 0.304, t = 2.961, p = 0.004). Regarding the different age groups, UPDRS-III (Beta = 0.426, t = 2.986, p = 0.005) and TG (Beta = 0.366, t = 2.561, p = 0.015) were independent contributors to HAMD-17 in PD patients aged 50-59. Furthermore, non-depressive PD patients demonstrated better performance with respect to visuospatial/executive function among the 70-80years group. These findings suggest that sex and age are crucial non-specific factors to consider when assessing the relationship between glycolipid metabolism, PD-specific factors and depression.

Altered functional connectivity of the locus coeruleus in Alzheimer's disease patients with depression symptoms

Studies have shown that functional abnormalities in the locus coeruleus (LC) are strongly associated with depressive symptoms, but the pattern of LC functional connectivity in Alzheimer's disease patients with depressive symptoms (D-AD) remains unclear. The current study aimed to investigate the characteristics of LC functional connectivity (FC) in D-AD using resting-state functional magnetic resonance imaging (rsfMRI). We obtained rsfMRI data in 24 D-AD patients (aged 66–76 years), 14 non-depressive AD patients (nD-AD) (aged 69–79 years) and 20 normal controls (aged 67–74 years) using a 3 T scanner. We used the FC approach to investigate abnormalities in the LC brain network of D-AD patients. One-way ANCOVA and post-hoc two-sample t-tests were performed to compare the strength of functional connectivity from the LC among the three groups. Our results showed that, compared with normal controls, D-AD showed decreased left LC FC with the right caudate and left fusiform gyrus, whereas nD-AD showed decreased left LC FC with the right caudate, right middle frontal gyrus and left fusiform gyrus. Compared to nD-AD, D-AD showed increased left LC FC with right superior frontal gyrus and right precentral gyrus. These findings contribute to our understanding of the neural mechanisms of D-AD.

Association of depression with disease duration, quality of life and adherence in Parkinson's disease: A cross sectional study.

Parkinson's disease (PD) is a progressive motor disorder often accompanied by non-motor symptoms such as depression. The objective was to estimate the prevalence of depression in PD patients, and assess its association with disease duration, quality of life and adherence to treatment. This cross-sectional study was conducted in a tertiary care centre for patients diagnosed with PD. Depression was diagnosed using Hamilton Depression Rating Scale. The Chi-square test was used to assess the difference in proportions of depression in various types and severity of PD. Depression was also correlated with disease duration, quality of life (QOL) and adherence to treatment using the Pearson correlation test. A P value of <0.05 was considered statistically significant. Among 51 patients, 20 (39.22%) patients were found to have depression. The mean duration of disease in depressed patients was significantly longer compared to that in non-depressed patients (7.99 ± 4.53 vs. 3.62 ± 2.23, P < 0.001), respectively. The non-depressed patients were better adherent to treatment (1.71 ± 1.5 vs. 0.56 ± 0.91). The quality of life of patients was significantly low for depressed patients (21.90 ± 6.91 vs. 13.16 ± 6.93, P < 0.001). Depression in Parkinson's patients was positively correlated with the duration of the disease (P-value <0.001); disease staging (P-value <0.001). Quality of life (QOL) had a strong correlation with depression (P-value <0.001) and Hoehn and Yahr (HY) staging (P-value <0.05). Depression was found in 39.22% of PD patients and was more significantly associated with disease duration, non-adherence to treatment and decreased quality of life.

The contribution of the cingulate cortex: treating depressive symptoms in first-episode drug naïve schizophrenia.

Our previous study has shown the cingulate cortex abnormalities in first-episode drug naïve (FEDN) schizophrenia patients with comorbid depressive symptoms. However, it remains largely unknown whether antipsychotics may induce morphometric change in cingulate cortex and its relationship with depressive symptoms. The purpose of this study was to further clarify the important role of cingulate cortex in the treatment on depressive symptoms in FEDN schizophrenia patients. In this study, 42 FEDN schizophrenia patients were assigned into depressed patients group (DP, n=24) and non-depressed patients group (NDP, n=18) measured by the 24-item Hamilton Depression Rating Scale (HAMD). Clinical assessments and anatomical images were obtained from all patients before and after 12-week treatment with risperidone. Although risperidone alleviated psychotic symptoms in all patients, depressive symptoms were decreased only in DP. Significant group by time interaction effects were found in the right rostral anterior cingulate cortex (rACC) and other subcortical regions in the left hemisphere. After risperidone treatment, the right rACC were increased in DP. Further, the increasing volume of right rACC was negatively associated with improvement in depressive symptoms. These findings suggested that the abnormality of the rACC is the typical characteristics in schizophrenia with depressive symptoms. It's likely key region contributing to the neural mechanisms underlying the effects of risperidone treatment on depressive symptoms in schizophrenia.

Neurocognitive Impairment in Patients with HIV and Depression in Nigeria

HIV has been associated with neurocognitive impairment which may be due to the direct effect of the virus, indirect effect or due to medications side effects or due to a combination of factors. HIV and depression have been shown separately to have neurocognitive deficits.&#x0D; Aim: Determine the prevalence of NCI and factors associated with it among depressed and non-depressed patients with HIV on combined antiretroviral treatment (cART).&#x0D; Methodology. A descriptive comparative cross-sectional study was conducted among People living with HIV (PLHIV) at Aminu Kano Teaching Hospital in Kano State, northern Nigeria. Participants were grouped into HIV with depression and HIV without depression groups based on current diagnosis using the depression module of the MINI International Neuropsychiatric Interview (MINI)-7th edition. A multi-domain neuropsychological battery (MDNPT) of 5 tests (assessed 5 cognitive domains) was used to diagnose Neurocognitive impairment.&#x0D; Results: Fifty-seven percent of the study sample were females, and the mean age of the participants was 37.54 (±10.04) years with an age range of 18-65 years.&#x0D; The prevalence of NCI was 74% among the depressed 68.3% among the non-depressed group (p=0.484). Years of education and IHDS score were significantly associated with NCI in the depressed group (p &lt; 0.05 respectively). While among the non-depressed group, Years of education, average monthly income and IHDS score were significantly associated with NCI (p &lt; 0.05 respectively).&#x0D; Conclusion: Neurocognitive impairment occurs in HIV-positive patients but is worsened by a depressive disorder. There is a need to adequately assess and treat HIV patients with depression. Treatment may improve neurocognitive impairment in depressed HIV patients.

Comparison of Sleep Disturbance, Physical Activity, and Health-Related Quality of Life According to Depressive Symptoms in Patients with Metabolic Syndrome: A Secondary Analysis from the Korea National Health and Nutrition Examination Survey Using a Propensity Score Matching Analysis.

Metabolic syndrome has become a global epidemic, and the age of its onset is decreasing. However, its prevalence can be reduced by lifestyle modifications. This study examined the differences in sleep disturbance, physical activity, and health-related quality of life associated with depressive symptoms in patients with metabolic syndrome aged ≥ 40 years. This cross-sectional secondary analysis of data from the 2016 and 2018 Korean National Health and Nutrition Examination Surveys. Of 1404 patients with metabolic syndrome aged ≥ 40 years, depressed and non-depressed patients (103 vs. 103) were matched 1:1 on demographic characteristics using propensity score matching. The outcome variables were then compared between the two groups. We investigated health status, including metabolic syndrome indices, health behaviors, such as sleep disturbances and physical activity, and health-related quality of life. After propensity score matching, health-related quality of life was the only variable that differed significantly between the groups; it was significantly lower in patients with depression (0.77) than in those without depression (0.88) (p = 0.001). Our results suggest that depression with metabolic syndrome is likely to cause a decrease in patients' quality of life; therefore, development of management systems and programs for early intervention to tackle at-risk groups is necessary.

A personalized intervention to prevent depression in primary care based on risk predictive algorithms and decision support systems: protocol of the e-predictD study.

ClinicalTrials.gov, identifier: NCT03990792.

New Perspectives on Treatment of Depression in Coronary Heart Disease.

It has been 35 years since we published a study in Psychosomatic Medicine showing that patients with coronary heart disease (CHD) and major depression were at twice the risk of having a cardiac event as were nondepressed patients (Carney et al. Psychosom Med. 1988;50:627-33). This small study was followed a few years later by a larger, more convincing report from Frasure-Smith et al. (JAMA. 1993;270:1819-25) showing that depression increased the rate of mortality in patients with a recent acute myocardial infarction. Since the 1990s, there have been many more studies of depression as a risk factor for cardiac events and cardiac-related mortality from all over the world, and many clinical trials designed to determine whether treating depression improves medical outcomes in these patients. Unfortunately, the effects of depression treatment in patients with CHD remain unclear. This article considers why it has been difficult to determine whether treatment of depression improves survival in these patients. It also proposes several lines of research to address this question, with the goal of definitively establishing whether treating depression can extend cardiac event-free survival and enhance quality of life in patients with CHD.

Depression circuit adaptation in post-stroke depression

BackgroundLesion locations of post-stroke depression (PSD) mapped to a depression circuit which centered by the left dorsolateral prefrontal cortex (DLPFC). However, it remains unknown whether the compensatory adaptations that may occur in this depression circuit due to the lesions in PSD. MethodsRs-fMRI data were collected from 82 non-depressed stroke patients (Stroke), 39 PSD patients and 74 healthy controls (HC). We tested the existence of depression circuit, examined PSD-related alterations of DLPFC-seeded connectivity and their associations with depression severity, and analyzed the connectivity between each repetitive transcranial magnetic stimulation (rTMS) target and DLPFC to find the best treatment target for PSD. ResultsWe found that: 1) the left DLPFC showed significantly stronger connectivity to lesions of PSD than Stroke group; 2) in comparison to both Stroke and HC groups, PSD exhibited increased connectivity with DLPFC in bilateral lingual gyrus, contralesional superior frontal gyrus, precuneus, and middle frontal gyrus (MFG); 3) the connectivity between DLPFC and the contralesional lingual gyrus positively correlated with depression severity; 4) the rTMS target in center of MFG showed largest between-group difference in connectivity with DLPFC, and also reported the highest predicted clinical efficacy. LimitationsLongitudinal studies are required to explore the alterations of depression circuit in PSD as the disease progress. ConclusionPSD underwent specific alterations in depression circuit, which may help to establish objective imaging markers for early diagnosis and interventions of the disease.